Thursday, July 26, 2012

How do you define work and the ability to work?

One thing I've always  been weak on and continue to try to improve upon is keeping things concise.  In my writing, especially, I tend to try to include all types of information into a post that should be, if going by the advice of all of the experts, limited to your topic and support for that topic.

I've been practicing, and I'll do my best tonight, up until the point that it feels unnatural.

How do you define work?  Here's Webster's definition, and it is one I will not argue with:
work: activity in which one exerts strength or faculties to do or perform something: a : sustained physical or mental effort to overcome obstacles and achieve an objective or result b : the labor, task, or duty that is one's accustomed means of livelihood c : a specific task, duty, function, or assignment often being a part or phase of some larger activity.
There is a select group of people that tend to define work strictly as follows, to the best of my reckoning: work: when somebody leaves the house everyday for 8-12 hours and makes money for the activities they performed during those hours.

Next we'll define disability:
a : the condition of being disabled b : inability to pursue an occupation because of a physical or mental impairment
Finally, we'll use the CDC's and WebMD's definitions and descriptions to have a look at moderate-to-severe arthritis (which I have in the right knee and spine; both areas have had two surgeries each) and degenerative disc disease, as well as fibromyalgia which my doctor insists that I have but I deny) (also, because there will be my commentary in with quoted commentary from these official websites, I'll highlight my words in yellow, until my summary): 
CDC definition for osteoarthritis in knee and effects, found here:
 Osteoarthritis is a disease characterized by degeneration of cartilage and its underlying bone within a joint as well as bony overgrowth. The breakdown of these tissues eventually leads to pain and joint stiffness. The joints most commonly affected are the knees, hips, and those in the hands and spine. The specific causes of osteoarthritis are unknown, but are believed to be a result of both mechanical and molecular events in the affected joint. Disease onset is gradual and usually begins after the age of 40. There is currently no cure for OA. Treatment for OA focuses on relieving symptoms and improving function, and can include a combination of patient education, physical therapy, weight control, and use of medications.

VIII. Impact on health-related quality of life (HRQOL) [AAOS Fact Sheet; NHANES III data]

  • OA of the knee is 1 of 5 leading causes of disability among non-institutionalized adults. (19)
  • About 80% of patients with OA have some degree of movement limitation
    • and 25% cannot perform major activities of daily living (ADL’s), 11% of adults with knee OA need help with personal care and 14% require help with routine needs.
  • About 40% of adults with knee OA reported their health “poor” or “fair”.
  • In 1999, adults with knee OA reported more than 13 days of lost work due to health problems.
  • Hip/knee OA ranked high in disability adjusted life years (DALYs) (20) and years lived with disability (YLDs). (20)

IX. Unique characteristics

  • Disease in weight bearing joints has greater clinical impact.
  • About 20–35% of knee OA and ~50% of hip and hand OA may be genetically determined. (21, 22)
  • Established modifiable and nonmodifiable risk factors: (4, 21, 22, 23)
    • Modifiable
      • Excess body mass (especially knee OA).
      • Joint injury (sports, work, trauma).
      • Occupation (due to excessive mechanical stress: hard labor, heavy lifting, knee bending, repetitive motion).
        • Men — Often due work that includes construction/mechanics, agriculture, blue collar laborers, and engineers.
        • Women — Often due work that includes cleaning, construction, agriculture, and small business/retail.
    • Structural malalignment, muscle weakness.
    • Non-modifiable.
      • Gender (women higher risk).
      • Age (increases with age and levels around age 75).
      • Race (some Asian populations have lower risk).
      • Genetic predisposition.
NOTE: Current smoking has been shown to be protective for osteoarthritis although it is unknown if this is due to the physiological effects of smoking on collagen, bone and cartilage tissue or if it is due to some unmeasured surrogate factor.
  • Other possible risk factors:
    • Estrogen deficiency (ERT may reduce risk of knee/hip OA).
    • Osteoporosis (inversely related to OA).
    • Vitamins C, E and D – equivocal reports.
    • C-reactive protein (increased risk with higher levels).

Next, we'll take a look at spinal arthritis and degenerative disc disease from WebMD since CDC didn't have adequate descriptions of them (I have been diagnosed with moderate-to-severe arthritis in my spine and degenerative disc disease, along with the mild-to-moderate arthritis in my right knee and the resulting deformation of the knee from injury):

What Is Osteoarthritis of the Spine?

Osteoarthritis of the spine is a breakdown of the cartilage of the joints and discs in the neck and lower back.
Sometimes, osteoarthritis produces spurs that put pressure on the nerves leaving the spinal column. This can cause weakness and pain in the arms or legs.

Who Gets Osteoarthritis of the Spine?

In general, osteoarthritis happens as people age. Younger people may get it from one of several different causes:
  • injury or trauma to a joint
  • a genetic defect involving cartilage
  • a condition that makes the joint lose its proper formation 
For people younger than 45 years old, osteoarthritis is more common among men. After age 45, osteoarthritis is more common among women. Osteoarthritis occurs more often among people who are overweight. It also occurs more frequently in those who have jobs or hobbies that put repetitive stress on certain joints.

What Are the Symptoms of Osteoarthritis of the Spine?

Osteoarthritis of the spine may cause stiffness or pain in the neck or back. It may also cause weakness or numbness in the legs or arms. Usually, the back discomfort is relieved when the person is lying down.
Some people experience little interference with the activities of their lives. Others become more severely disabled.
In addition to the physical effects, a person with osteoarthritis might also experience social and emotional problems. For instance, a person with osteoarthritis that hinders daily activities and job performance might feel depressed or helpless.

Degenerative Disc Disease (WebMD, cont.)

What is degenerative disc disease?

Degenerative disc disease is not really a disease but a term used to describe the normal changes in your spinal discs as you age. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).
See a picture of the spine camera and the discs in your spine camera.
The changes in the discs can result in back or neck pain and/or:
These conditions may put pressure on the spinal cord and nerves, leading to pain and possibly affecting nerve function.

What causes degenerative disc disease?

As we age, our spinal discs break down, or degenerate, which may result in degenerative disc disease in some people. These age-related changes include:
  • The loss of fluid in your discs. This reduces the ability of the discs to act as shock absorbers and makes them less flexible. Loss of fluid also makes the disc thinner and narrows the distance between the vertebrae.
  • Tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material inside the disc (nucleus) may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.
These changes are more likely to occur in people who smoke cigarettes and those who do heavy physical work (such as repeated heavy lifting). People who are obese are also more likely to have symptoms of degenerative disc disease.
A sudden (acute) injury leading to a herniated disc (such as a fall) may also begin the degeneration process.
As the space between the vertebrae gets smaller, there is less padding between them, and the spine becomes less stable. The body reacts to this by constructing bony growths called bone spurs (osteophytes). Bone spurs can put pressure on the spinal nerve roots or spinal cord, resulting in pain and affecting nerve function.

What are the symptoms?

Degenerative disc disease may result in back or neck pain, but this varies from person to person. Many people have no pain, while others with the same amount of disc damage have severe pain that limits their activities. Where the pain occurs depends on the location of the affected disc. An affected disc in the neck area may result in neck or arm pain, while an affected disc in the lower back may result in pain in the back, buttock, or leg. The pain often gets worse with movements such as bending over, reaching up, or twisting.
Next is fibromyalgia:

What is fibromyalgia?

Fibromyalgia is widespread pain in the muscles and soft tissues above and below the waist and on both sides of the body. People with fibromyalgia feel pain, tenderness, or both even when there is no injury or inflammation.
Fibromyalgia can cause long-lasting (chronic) pain. It has no cure. But with treatment, most people with fibromyalgia are able to work and do their regular activities. When it is not controlled, you may not have any energy. Or you may feel depressed or have trouble sleeping. But there are many things you can do to help manage your symptoms.

What causes fibromyalgia?

No one knows for sure what causes fibromyalgia. But experts have some ideas, such as:
  • Nerve cells may be too sensitive.
  • Chemicals in the brain (neurotransmitters) may be out of balance.
  • The deep phase of sleep may be disrupted and affect the amount of hormones that your body releases.

What are the symptoms?

The main symptoms of fibromyalgia are:
  • Deep or burning pain in your trunk, neck, low back, hips, and shoulders.
  • Tender points camera (or trigger points) on the body that hurt when pressed.
People with fibromyalgia may have other problems, such as:
Symptoms tend to come and go. You may have times when you hurt more, followed by times when symptoms happen less often, hurt less, or are absent (remissions). Some people find that their symptoms are worse in cold and damp weather, during times of stress, or when they try to do too much.

How is fibromyalgia diagnosed?

Doctors diagnose fibromyalgia based on two things:
  • Widespread pain on both sides of your body above and below the waist
  • Tenderness in at least 11 of 18 points when they are pressed
Before the diagnosis, your doctor will make sure that you don't have other conditions that cause pain. These include rheumatoid arthritis, polymyalgia rheumatica, lupus, and other autoimmune diseases.

So, for those that really need to see this, here it is.  I qualify for Social Security Disability because of my injuries (one service-connected, two not).  This isn't just to people in my personal circles who need to have a MUCH BETTER understanding of medical conditions before passing judgment, but the fact that I've written and published four novels in the last 18 months with a fifth due out in November and I've managed to repair a couple of hundred computers during that time (remember the definitions of work?  I meet and exceed them), work that was done in an environment that allows me to bend over or lay down when neccessary to relieve severe pain--work that let's me moan out loud when I have to without scaring co-workers (this type of behavior is something I mask very well in public for short periods of time, which may be a precursor to people asking, "Why doesn't he have a 9-5?) --work that permits me to take breaks when I need them or work late into the night as spacing my breaks out requires.  This is not just that closer circle of people who think they know what it's like to be me; it's for anybody in general who judges somebody that they don't see leaving their home from 9-5 while have zero understanding of their medical conditions and zero understanding of the work they manage to do at home in spite of those medical conditions.

The bottom line is this: I think most of my friends and people in today's world who are up with the times and are open-minded understand that they shouldn't be judging anyone for anything until they know all the facts (which you never will regarding any one individual because, at least, all facts are never disclosed), but to those who insist on judging by using their narrow-minded views on what work or disability means, you need to educate yourselves.  If you don't educate yourselves on the conditions and personal lives of people you judge, which is virtually impossible in some cases because people do not all choose to disclose all of their personal information to you so they can get a favorable judgment from you, then you don't know.  If you won't hear that reasoning and insist on judging anyway, or if you use some form of jealousy or negativity in general to try to jump on somebody in this situation, you are on a very low plane of intelligence and understanding.  Extremely low.  It's ghetto.  It's barbaric in some ways.

I've found that the people on this low plane rarely choose to rise up and learn--to figure it out and stop judging--so to them, I shake my head and say goodbye to thier chance for understanding and happiness, because you cannot have happiness until you have understanding, and the negativity resulting from judging while not understanding combined with the unwillingness to learn and understand is a circle that takes a person straight downward on an intelligence and happiness scale.

For those that judge me, I can't stop you, but I'll bet I could terrify you if I walked up to you with a mirror that said "Judge this person" on it while showing it directly to you.... oh how blind the judgmental ones are when the hot light of inspection is turned upon them.  For those who get it--who understand that I do fight this fight every single day and I still produce when an average man might quit altogether--you people are the ones I admire.  I truly have deep respect for you and whatever you have done to reach understanding.  There are plenty of people out in the world today falsely claiming to be disabled or not working the 9-5 for other reasons; I swear on my daughter's life that I am not one of them.  So, if you have read all that and you still insist on judging, this is my permanent middle finger aimed your way until you are enlightened.  For those that have chosen to learn what is necessary to understand, or at least to realize that you don't know enough to judge, you are always a friend to me and I'll do anything I can for you.

Enough is enough.


  1. Wow, that's a lot of information. But I guess some people need the cold hard facts to get the bigger picture or see something in another way. Kudos! Eric.

  2. And what's funny is the group of people I had to target this to was a group that I had already SHOWN that medical blog to, Eric (you remember that one? I know they read it), with the mri, xray, and actual doctor's reports. I'm so sick of people thinking they know something when they don't even bother to read the effin facts. Ugh.