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Pain, Depression, and the Online Form

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I have spent the last six weeks in chronic pain. It’s very hard to describe what that is like unless you have experienced it yourself, and if you have, well, you don’t need me to explain it to you, do you?

I have also spent the whole of my adult life battling with depression. For years I didn’t know what it was. I just thought it was normal, and that everybody probably felt the same way. Then came the realisation that actually, something was very wrong here, and I shouldn’t feel this way. But, being a man, I just lived with it. One miserable day to the next.

Chronic pain is very similar to depression. It is constant, it never goes away, and there is no respite from it, not even when you sleep, because it is always there, keeping you awake. Any sleep you do get is just exhausted slumber. Depression keeps you awake at night in the same way. Your mind constantly whirring. “What’s the point? Why do I feel this way? I’m worthless, my life is pointless. How do I make the pain go away?” At the end of the day, just like depression, all you want is for the pain to go away.

There is one more thing the two have in common, and I didn’t expect it. Both of them wear you down on their own, but the fight to get help for them can wear you down just as much.

My depression is something I learned to cope with. Initially I ignored it, let it eat away at me, and suffered the consequences of breakdowns because of it. Then, as I got older, I sorted it out. I visited a doctor, I was diagnosed with Bipolar Disorder, and I was given medication to make it better. And it worked. The depression never went away, it’s always there. The difference with the pills is that it is held in abeyance, bubbling below the surface, but controlled enough that it doesn’t boil over. It’s still hard keeping it under control. You have to concentrate on it, keep an eye on it, hide it and push it back down when it tries to bubble over, but the drugs make it easier.

Chronic pain is different. For me, anyway. It started simply enough. I put my back out. Something I have done before, and after a bout of painkillers and a few weeks of physio, it fixes itself.

Not this time.

This time I felt it creeping on, recognised what was happening and sought immediate help from my GP. I was going away at the weekend to a festival with the family at Silverstone, a trip that had been planned and paid for over nearly a year, and I knew I was going to need help getting through it. So I filled in the online form for my GP, the only way you can actually contact them these days, and within a few hours I was prescribed some painkillers. Excellent, I thought. That is just what I need to get me through the weekend.

Silly me, I thought I was having a sciatica flare-up. I wasn’t.

On the first day at Silverstone, my watch told me I had walked over 28,000 steps. That’s a lot, especially with a bad back. Those steps were taken over uneven ground, and by the end of the day I was in agony. I toughed it out with very little complaining (although I’m sure my family will tell you ohterwise), and by the end of the weekend I had done just under 70,000 steps. I then had to drive the hired camper van home. A four-hour journey. I had been battling through the constant, chronic pain all weekend, and by the time we got home I was in utter agony.

The first thing I did was call my GP. Several times. Each and every time, the phone would cut off after the opening spiel of the auto-attendant. Lines too busy, apparently. The auto-attendant advised me to fill in the form on the surgery website. I did. It took the best part of thirty minutes. Five minutes after I had submitted it, I received an email stating that online requests for that day had already been filled, and my submission had been deleted. Please try again in the morning.

That is frustrating at the best of times. For someone in chronic pain, with the only painkillers they had been prescribed having little effect, it was something else. I moaned and groaned my way through the night and filled the form in at 8am the following morning. Another thirty-minute job, but at least this time it didn’t get rejected.

I heard nothing. The form said I might not receive a reply for up to 72 hours. After 36, I tried calling the surgery. The same as before: a long listen to the auto-attendant, only to be cut off at the end of the message. Lines too busy.

Seven days later, after I had given up and was trying to survive on paracetamol, I received a text saying an appointment had been scheduled with the doctor. In seven days’ time. I called the surgery again. You guessed it: the same message, the same cut-off.

The following day I called again, and this time, after waiting patiently on the phone for nearly 50 minutes to speak to someone, I was told, “The doctor will call when the doctor calls you. We are very busy. Goodbye.” And that was that. I was hung up on.

In the meantime, I had been to the physio a couple of times. It turned out my issue wasn’t a simple sciatica flare-up. That had been established on my first visit and relayed to the GP. I very likely had a herniated disc in my lower lumbar region, pressing constantly on a nerve in my spine and causing the chronic, debilitating pain.

I’ve already said how hard it is to explain what chronic pain is like. Now I’m going to try to explain what it does to you. If I sat for too long, often no more than a couple of minutes, if I twisted suddenly, stood up too quickly, or sometimes just tried to take a step, the pain would completely floor me. That is how intense it is. I’d be upright, or nearly upright, and less than a second later I would be in a pile on the floor, screaming in agony. Then I’d have to relive the whole experience as I tried to get up again.

By the time of the promised GP appointment, I had been suffering for nearly three weeks. When the GP called, she spoke so fast I couldn’t really keep up with what she was saying. I tried to explain again how bad the pain was and that I needed something that would work now, but I could tell she wasn’t listening to me. I was told there would be a prescription waiting for me at the surgery. Relieved to hear this, I thanked her profusely, and my wife was dispatched to collect the long-awaited relief. She returned empty-handed. Apparently the medication couldn’t be issued without a second sign-off from another GP.

When I finally received the medication several hours later, it was the kind used for epilepsy, which is also used to treat nerve pain. On paper, fair enough. But it can take up to two weeks to take effect, and it has to be built up slowly. I had been in agony for three weeks already, and I had told the surgery three times now. I NEEDED PAIN RELIEF, AND I NEEDED IT NOW.

Another call to the surgery, another five minutes listening to the auto-attendant, only to be cut off again, having been advised once more to fill in the online form. I did. It was rejected and deleted again. The following morning, I filled in the form again and tried calling again. Nothing.

In desperation I booked an appointment with a private consultant, overjoyed that I had managed to get one in two days’ time. Only to discover the following day that the actual appointment was not for another three weeks. Desperation kicked in again and I booked a private GP appointment, only to discover when I got there that they couldn’t prescribe anything for me.

Just to note, part of the problem with getting an effective painkiller prescribed was my anti-depressant medication and a history of stomach ulcers. The only other pain relief available was anti-inflammatories, and those couldn’t be prescribed because of the health risks.

After another round of form filling and phone calls, I was eventually contacted by text message by a different GP. This one prescribed me the very same anti-inflammatories I supposedly shouldn’t take. With a caveat: I could only take two a day, not the usual two every four hours. At this point I was four weeks into living with the chronic pain. I knew, as you do, that there are other, more effective pain relief options available, but for some reason there was no way I was going to get them. Even though I’d had them before when I had put my back “out”.

I’m now five weeks in. I’ve been forced to take extended time away from work, and I am still in constant, chronic pain, with only a small amount of relief at my allotted anti-inflammatory time.

I’m still over a week away from my consultant appointment. Still in chronic pain. Pain that, when no one is about, reduces me to tears, much the same as my depression used to before it was sorted out. It makes me snap at my family when they don’t deserve it. It’s not their fault I’m frustrated with living like this, and it is very hard for them to understand. That brings its own emotional pain, on top of the physical pain.

I didn’t set out to write about how broken the NHS is. Some would say the post-COVID GP system gives surgeries something to hide behind, and that “we’re very busy” has become the answer to everything. I know they’re overworked. I know the staff are under huge pressure. But knowing that doesn’t relieve my pain, in much the same way my GP surgery hasn’t.

So, back to the point. Chronic pain is much like depression. It’s always there, constantly wearing you down, making you feel worthless, and the only respite is the right medication while you navigate the system, hoping for treatment.

Newton’s Laws: The Three Rules That Keep the World Moving

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Another delay in posting, so apologies again, but at least I’m only a day late this time. Anyway, here it is, and this week I’m going to delve into the Laws of Sir Isaac Newton.

Whether you’re kicking a football, driving a car, or watching a rocket launch into space, you’re seeing Isaac Newton’s laws of motion in action. Just take a moment, and imagine you’re sitting on a bus, and the driver, without warning, suddenly slams on the brakes, and your body lurches forward. Why does that happen?

Or imagine a football soaring across the pitch after a powerful kick from Harry Kane has sent the ball screaming into the back of the net from 30 yards out. What is it that makes it speed up, slow down, and eventually stop?

And how does a rocket, weighing hundreds of tonnes, actually manage to leave Earth and get into space?

The answer to all of these questions, and many more, can be traced all the way back to three ideas developed by Sir Isaac Newton more than 300 years ago. Published in 1687, Newton’s laws of motion became the de-facto foundation of classical physics and at the same time transformed our understanding of how the universe actually works.

It is remarkable that these laws are simple enough to explain everyday events while being so powerful they can help send spacecraft into orbit.

Now my faithful few, it’s time to dive in and take a closer look.

Let’s start with the First Law and look at why things don’t like to change.

Newton’s First Law is often called the Law of Inertia, which in simple terms, says that things tend to keep doing whatever they’re already doing. An object sitting still wants to stay sitting still, and an object moving along, minding its own business as it travels in a straight line wants to keep moving along, minding its own business, travelling in that same direction at the same speed. It will only change speed or direction if some force acts upon it causing it to do so.

As obvious as this may sound now, at the time it was a revolutionary idea.

Before Newton came along, most folk believed that motion required a constant force, which, if you think about it, in everyday life seems true. Roll a ball across the floor and it eventually stops. Newton, however, realised the ball doesn’t stop because moving objects naturally come to rest. It stops because forces such as friction and air resistance are working against it and if you were to remove those forces the ball would keep rolling indefinitely, and that tendency to resist changes in motion is called inertia.

You experience inertia every day. It’s why passengers lean forward when they are traveling in a bus and the driver brakes suddenly. All their bodies are simply trying to do is continue moving at the speed they were already travelling.

Newton’s Second Law applies to what happens when you push things. We all know that objects don’t always trundle along, moving in the same way. They can speed up, they can slow down, and they tend to change direction all the time. This is where Newton’s Second Law comes in.

It explains the relationship between force, mass, and acceleration, and in its formulaic state it is usually written as F = ma. In other words, force equals mass multiplied by acceleration. The idea is straight forward enough, the harder you push something, the greater its acceleration is. But the heavier the object, the more force you’ll need to produce the same effect.

Imagine you are pushing an empty shopping trolley along the isles of your favourite supermarket. It moves easily (unless you’ve got the one with the dodgy wheel). Now fill it with your weekly shop and suddenly it takes much more effort to get it moving. The force you’re applying might be the same, but the mass has increased.

This beautiful law is one of the most useful tools in science and engineering as it helps designers calculate everything from the power of a car engine to the thrust needed for a rocket launch.

That takes us nicely onto Newton’s Third Law. And that is, every force has a partner in crime.

By now, you might be wondering how movement starts in the first place, and the third law explains this. And this is the famous saying you have heard many, many times before, as Newton said, “For every action, there is an equal and opposite reaction.” Put simply, this means that whenever one object pushes on another, the second object pushes back with exactly the same force in the opposite direction.

Let’s take something as simple as walking down the street as an example. Most of us simply assume that, when walking, they move forward because their legs push them ahead. But, this isn’t the case as what actually happens is way more interesting. As your foot pushes backward against the ground, the ground pushes forward against your foot, and that reaction force propels you forward. Exactly the same principle explains swimming. As you push water backward, the water pushes you forward. It also explains rocket launches. As engines expel hot gases downward, those gases push back on the rocket, which sends it upward, soaring into the sky and beyond.

Without Newton’s Third Law, space travel wouldn’t be possible.

If you’re looking for proof that Newton’s laws aren’t just dusty ideas from a physics textbook, look no further than Apollo 13.

In the 1995 film, Tom Hanks portrays astronaut Jim Lovell, commander of the ill-fated lunar mission that suffered a catastrophic explosion on its way to the Moon. At one point, with the spacecraft’s systems being shut down to conserve precious power, Lovell turns to his crew and says:

“We just put Sir Isaac Newton in the driver’s seat.”

It’s a great Hollywood line, but it’s memorable because of its roots in reality.

The real Apollo 13 mission faced a daunting physics problem. After the explosion, the crew had to nurse a crippled spacecraft home from hundreds of thousands of miles away, with power limited and most of the systems switched off, so they could no longer rely on their computers in the normal way. Instead, they had to trust in the laws of motion and gravity, Newton’s laws, to carry them around the Moon and safely back to Earth. Even seemingly harmless actions could become a problem. The crew were warned by Mission Control not to vent any waste from the spacecraft  into space as this might create a small thrust, tiny enough that it could nudge them off course. In the vacuum of space, where there is no air resistance to slow things down, even tiny forces matter, and that is what Jim Lovell meant by “putting Newton in the driver’s seat.” The astronauts were placing their faith in the very laws Newton had described nearly three hundred years earlier.

The First Law kept the spacecraft moving along its path once it was set in motion, and the Second Law explained how small, carefully planned engine burns would alter their path when course corrections were needed. The Third Law explained why those engine burns worked at all, as gases expelled in one direction pushed the spacecraft in the opposite direction.

It’s one of those rare moments where science, history and popular culture intersect perfectly. At the height of the Space Age, surrounded by cutting-edge technology, three astronauts ultimately trusted one of the oldest and most fundamental ideas in physics. When everything else seemed uncertain, Sir Isaac Newton was still safely at the wheel.

As individually simple as Newton’s laws are, they produce a powerful picture.

The first tells us that motion doesn’t change without a force. The second tells us how much motion changes when a force is applied. The third explains where many of those forces come from in the first place.

Together, the three laws create a complete picture of how objects move, interact, and respond to the world around them. From bicycles and footballs to aircraft and planets, these three principles describe an astonishing range of motion.

More than three centuries after Newton wrote them down, they remain among the most important ideas in all of science.

So, the next time you’re on a bus and the driver brakes suddenly, or you’re at the footy and a screamer hits the back of the net, or you‘re watching Apollo 13 and Tom Hanks utters that famous line, you’ll be witnessing those three elegant laws at work.

Although the technology may change, the universe is still playing by Newton’s rules.