Why I left my tech job to work on chronic pain

Can you tell us how you recovered?

Great to hear you are feeling better now!

That being said, how sure are you it wasn't a you problem, since the rest of the company seemed to be fine with the way they operated?

Stress is so damaging to our bodies. Glad you got relief!

So you went back into software development after 5 years? Maybe you had a burnout and just needed to rest

What do you do for a living post-escaping the IT career?

"You should never, ever get back surgery" sounds like that easily could be wrong. It's annoying to have to always caveat but talking to a (good) doctor is important when making such decisions and not relying on tech forum advice necessarily. I know someone who said they went in for back surgery and walked out feeling permanently cured from the specific problem they had and the pain was completely gone. Details matter. Always consult experts when possible.

Along those lines is this excellent website: https://www.painscience.com/

> used me to change my routine and avoid certain activities which only exacerbated the issues, which led to more avoidance. Eventually I couldn’t walk.

Anecdotally, I had a phase where pretty much the same thing happened to me with the Achilles (+ calf/ankle) flare-ups I was having (during this part of my chronic journey). Eventually got through it by doing small walks around my home, then outside but keeping the frequency high each day (i.e. instead of 1 "long" walk, doing 3-4 short ones). I.e. Desensitisation / daily movement

> Minor post surgery issues

My wife has had two surgeries and each time she had a minor post surgery issue. One of them was an area that was tender to touch; another was chronic pain. Neither was mentioned as a possible side effect of the surgery by the surgeon. The main takeaway even if a bit extreme here is avoid all surgeries unless absolutely necessary.

I learned this the hard way, got achilles/ankle tendon issues trying to rest from a joint problem instead of ramping up activity which would've made me more resilient.

Pain is a legitimate diagnosis, though.

Hi Dan, I wanted to share a few links to articles on pain and circadian rhythms that I wrote during my PhD. Would love to connect if you have any questions.

[0] Circadian rhythms and pain: https://www.sciencedirect.com/science/article/abs/pii/S01497...

[1] The disruptive relationship among circadian rhythms, pain, and opioids: https://www.frontiersin.org/journals/neuroscience/articles/1...

[2] Circadian rhythm disruption exacerbates pain behavior in male mice: https://www.sciencedirect.com/science/article/abs/pii/S03064...

Hi, thanks for the thread, what are the websites you follow the most to read about this topic ?

Sometimes I wish there was a medHN

Awesome!I had two tumours in my hip and I lost around 90% of a few muscles. Pain is my friend since I started this journey, and I need to say, that learn how to deal with that should be the first treatment!

I'll read this blog with love!

Thanks

https://pmc.ncbi.nlm.nih.gov/articles/PMC9550520/

This exercise fixed it for me. I was diagnosed with GERD last year, I already had it for 2-3 years before that, but it got worse last year. I got ppis for a couple of months and when I finished all of them it came back worse. Fortunately I found this article, and I started doing the exercise daily morning after I woke up(and still do it). I can now eat tomatoes, food with mint, spicy food etc etc :) I have shared my experience with others and it helped them too

Edit - Changed the link, had posted something else by mistake

> In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse.

Chronic reflux as a symptom is almost always initially treated by PPIs because the cause among white collar workers is assumed to be chronic stress[1]. Since doctors can't "treat stress" only its symptoms, they will just tell you to try and manage stressors in your life yourself. Maybe suggest counseling but in general they are limited in what they can do. What they can do, if you are persistent in the complaint, is to just run through all the other less likely causes of it.

I was lucky omeprazole worked for me the first time. I knew exactly what was stressing me out 24/7 and the acid reflux and frequent belching combined with the "pit in my stomach" feeling was all too common and connected around my main stressor. In my case, it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly. I would feel physical angst parking at work every morning trying to remind myself of all the web of political infighting "what our team is hiding from this other team", "who we can discuss what with", "how that other team is actively undermining us and their other downstream partners, but how we are circumventing that" how to 4d chess maneuver yourself in the most counterproductive ways possible. It was illuminating on where a lot of those special "business requirements" come from sometimes, but it just wasn't for me. Cutting that out was a massive relief

[1]: Stress and glucocorticoids have well documented effects on the digestive system. I recommend the "Why Zebras Don't Get Ulcers" book chapter on stress and the digestive system.

> I think it kinda pisses them off not know, tbh

Oh definitely. Some doctors are physically incapable of uttering the words “I/We don’t know.” I know a few doctors, and have asked a couple of them about this. In private, they’re very frank about the limits of modern medicine. But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine. I can definitely understand their perspective, but it does sometimes make them come across as arrogant know-it-alls.

Hey, I just wanted to let you know that I have the _exact_ same issue as you since 2 years. It was much worse than what you described 2 years ago. Now it's just very annoying.

The diagnosis I got from my therapist is PTSD from my chikdhood due to the strong connection between stress and body.

The only thing I found that alleviates my symptoms short term is lots of Buddhist meditation (1-2 hours per day).

I wish you all the best and thank you so much for sharing.

The link between the gut and brain (especially in the case of dietary intolerances) is an interesting one! Keen to see if others have come across good research in the space

For me, the two big things that help are losing weight and reduced anxiety. When either are high the problem is noticeable when both are low it’s gone.

Foods make it worse, but it’s rarely an issue if I’m in decent shape and not stressed.

Just a sidenote: GERD can lead to Barrett's Esophagus (precancerous changes in tissue), and erosive damage to the esophagus can accumulate over time and abruptly become life threatening. After decades of terrible GERD, my father nearly died from exactly such an undetected gastric bleed, losing 11/12 of his blood (which doctors replaced as it coursed out) before an emergency-medicine team finally found and sealed the rupture.

He almost certainly suffered minor brain damage during this episode, and later, after about a decade of taking anti-protonic medications for reflux, developed exactly the abnormally rapidly growing abdominal cancer that patients who take anti-protonics apparently develop at a higher rate than similar GERD patients who don't.

I don't mean to give medical advice. I can only describe what happened in my family (which has a heritable deformation in the esophagus, leading to severe GERD). Take it with a grain of salt (and an antacid) as what it is: an anecdote from some anonymous nonexpert on the internet.

Anyhow, good luck. I'm glad to know you're working actively on the problem, not ignoring it as my father did, and I hope you find some long-term relief and peace.

All of my reflux went away last year when I started tirzepatide via my Zepbound prescription. I was having horrible heartburn daily and it’s just completely gone. I used to take tums and omeprazole literally daily, now it’s basically never.

> Don’t let yourself be gaslit that it’s all mental.

I agree, though this is a very difficult subject. Often, the people who would benefit the most from psychosomatic interventions are often the most resistant to accepting those explanations. Meanwhile, many of the physical chronic pain sufferers I know have desperately tried various mind-body programs (without success) because they will try anything that might help.

If people match the description of the author of this post and blog, where the pains are widespread, vague, and popping up around different parts of the body without explanation then you really should explore psychosomatic explanations like this author did.

However, I’m growing weary of the trend of people who fit this description starting newsletters they want you to subscribe to (like this one), writing apps they want you to download/buy, and making comments implying that they know better than doctors about chronic pain (while putting an obligatory “not a doctor” disclaimer juxtaposed to their comments complaining that doctors don’t know what they know). I think it’s great when people share their experience, but it’s getting tiresome to see it productized and generalized as a more universal explanation.

EDIT: Another trend in this space is to productize by building an audience (please subscribe to my Substack) and then introduce the monetization plan later: A subscription app, an e-book, a partnership with some product. It’s possible this person organically decided to quit their job, sell their house, and focus on writing a no strings attached Substack blog series to share information. However, I’ve seen this play out across enough health influencers that I recommend everyone stay cautious about people who claim to hold some information that will change your life but they need you to subscribe first. Be careful.

Thanks for sharing this.

Very much agree it's critical to get an accurate assessment, ideally from a doctor who understands pain science to rule out a structural cause. In saying this, I recognise many practitioners are not fully across this so I'm hoping this series will help increase awareness.

This first blog is meant as a quick intro to the series - blog post #2 will break down the different categories of chronic pain (i.e. broadly including tissue, nerve damage and pain due to brain plasticity - what the series is primarily focused on).

Would you mind sharing a little detail about what the physical malady turned out to be, and why it took so long to diagnose?

Sounds like an interesting medical mystery.

Technically it is an experience that is internal to the nervous system... but a doctor telling someone that it's imagined because they can't identify the root cause is criminal!! If we have to make something up about it we're literally better off calling it a demon.

Amazing, I'll take a look at it.

Thanks!

I think most people underestimate how much of their immune system depends on their sleep. Sleep quality, amount (hours) of sleep, time in bed, all of it -- they matter.

In stressful periods, it's likely not stress crushing the immune system, it's the indirect relationship that stress causes bad quality sleep and low amount of sleep, that in turn crushes the immune system.

If, even if under stress, you manage to work out a system/habit that allows you to get proper sleep, you'd likely be ok.

Did your friend leave IB after this diagnosis, or did he tough it out?

To me that's the real question. I think either option is defensible, depending on what one values in life. I've known certain people who pulled 80 hour work weeks for years only to give away double-digit percentages of their salaries to charity, because that was what was important to them, and I don't think they were wrong for doing that, just making choices at a margin I would find intolerable far earlier.