Category: Other

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In Commemoration and Appreciation

9.11.flag
It is hard to believe that yesterday marked fifteen years since the horrific attack against our country on September 11, 2001.  Much has been said and written about the victims of the tragedy as well as the volunteers who risked their lives to help at the scene.  The stories of bravery and heroism that abounded following the attack helped restore our faith in humanity and bolster our pride as Americans. I would like to deviate somewhat from my typical blog to share one such story (with a medical twist) with you.

Samuel Benson is a good friend and community member who I had the pleasure of meeting several years ago. After the 9/11 attack, Sam played an integral role in the rescue efforts, and he has kindly offered to be interviewed about his experiences for today’s blog.  Sam’s actions and selflessness were not isolated to that tragic day fifteen years ago. Unfortunately, the ramifications of Sam’s involvement affect him medically to this day. As a medical care provider, I would like to focus this blog on his experiences in order to promote sensitivity and deepen our appreciation to him and the many others who share similar stories.

  • What was your role in responding to the 9/11 terrorist attack?

I worked at the Mayor’s Office of Emergency Management (OEM) at the time. In the 9/11 response, I was the Branch Director for Health & Medical Operations. In the role I coordinated the casualty management, fatality management, and the environmental health and safety functions.

  • What details do you recall from your involvement? What stood out to you most from that day?

It’s hard to pick out any one thing—a few thoughts come to mind. I remember walking out of the ruble and both the silence and then the calls for help. However, I had to leave the scene—it wasn’t my job as a paramedic to treat individuals, it was my job as an Emergency Manager to work the bigger issues.  I had to establish contact with EMS, the hospitals, the City and State Departments of Health, and the federal Public Health Service (PHS) for national medical assets. 

I also remember trying very hard to maintain balance. I had colleagues who were oh so proud of working 80 hours without sleep. I told them they were out of their mind: no one can effectively work like that—your decision making is so impaired, as well as a lack of self-awareness, that you might as well be drunk. I got home every single day. I may have only slept for 2 or 3 hours, but I got a physical and mental break. I remember getting healthcare workers removed from the scene who were so exhausted and stressed that they were breaking down in front of me.

  • Were you able to return to work immediately afterward? If not, how many weeks were you out of commission?

I was at work every day. My first day off was a few weeks later on Yom Kippur (The Day of Atonement).
I worked every single day including Shabbos (Sabbath), and Rosh HaShana (The Jewish New Year).
When the Anthrax Attack came, I was back to7 days a week. However, my daughter’s birthday fell out on Succot (Tabernacles). I made arrangements to take a break for 2 hours so I could run home, have lunch with her on her birthday, and then go back.

  • What medical challenges have you faced in the past 15 years due to your involvement with the 9/11 rescue mission?

In the months after 9/11, I developed the “World Trade Center Cough” which required treatment for a few years. Two years ago I was diagnosed with Chronic Leukemia and that has been officially attributed to 9/11. Last year I was diagnosed with an auto-immune disorder called Polymyalgia rheumatica (PMR). While it has not been officially linked, I know that an increasing number of responders have developed auto-immune problems and I expect that it will also be listed as a 9/11-related illness.

  • What one (or several) pearls of wisdom can you share with us about what you learned through your 9/11 experiences?

Know your role and what you need to do.

Understand your mission and objectives.

The larger the job, the more important to work it one-step-at-a-time.

 

Sam, we are very grateful to you for sharing your story and perspective.  We hope and pray that medical advancements will offer appropriate treatment for the aforementioned conditions you discussed.  Although you may view your role in the events that transpired as routine par for the course, we recognize you for the true hero that you are.

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A Tailbone of Two Injuries

 

The Coccyx (Tailbone)

The coccyx, colloquially referred to as the tailbone, is a small, often overlooked anatomical landmark that sits below the lumbar spine and sacrum.  Despite it’s tiny size, it is extremely clinically significant.  Think of it as the Grand Central Station of your pelvic floor, so to speak.  The coccyx serves as the attachment site of the gluteus maximus and levator ani muscles (which include the coccygeus, iliococcygeus, and pubococcygeus muscles) and ligaments (including the anterior, posterior, and lateral sacrococcygeal, sacrotuberous, and sacrospinous ligaments).  Injury to the coccyx can affect the aforementioned muscles and/or ligaments.  Conversely, injury to the muscles and/or ligaments can affect coccyx alignment.  Symptoms of coccyx dysfunction include coccyx pain (referred to as coccydynia), pain with defecation, pain with intercourse, pain with prolonged sitting, pain with transitional movements (such as sit to stand), coccyx pain, low back pain, and even neck pain.

As per the title of this blog, the tailbone is often injured in one of two ways.  It can either involve a traumatic onset, which involves a sudden and easily identifiable injury (ex. a sharp or painful fall), or an insidious onset, which is harder to pin point and often due to cumulative repetitive trauma.  These traumas may include a history of chronic pelvic floor muscle tightness which can pull the coccyx out of alignment, or it may be related to a history of multiple minor falls or sports injuries (even during childhood) which seemingly “healed on their own over time.”  As I often tell my patients, our musculoskeletal systems have a better memory than our brains, and what seemed at the time to be insignificant may in fact have a large impact down years later.  My goal in stating this is NOT to produce fear or nervousness over waking up tomorrow with symptoms of tailbone pain due to unresolved previous injuries.  Rather, my goal in sharing this information is to raise awareness and broaden your thinking; if you already DO experience any of the aforementioned symptoms, please consider that it may be due to the often overlooked coccyx.

Now that we have identified the importance of the coccyx and how it can become injured, let’s move onto the fun part…the part where physical therapists enter the scene…treatment and fixing the pain.  The most common direction of coccyx injury is a “flexed” coccyx, or the coccyx becoming stuck in an anterior/forward position.  Treatment of the coccyx involves external and internal mobilization of the coccyx to move it back into the proper position.  Internal work can be accomplished through vaginal or rectal approach, depending on the patient’s comfort level and preferences.  If the coccyx is deviated to either the right or left (in addition to or instead of a flexed coccyx), appropriate directional mobilizations are also indicated.  In addition, the therapist may choose to tape the coccyx into the newly corrected position after treatment to help maintain the correction.  Furthermore, as mentioned previously, the coccyx is attached to other structures, and therefore should not be treated in isolation.  Any muscle or ligament tightness needs to be addressed in order to maintain the improved alignment.  The final component of treatment is patient education about proper sitting posture, appropriate rest breaks to avoid prolonged sitting, and possible use of a donut or a different cushion initially for decreased pain.

If you or someone you know may benefit from pelvic floor physical therapy to treat an injured coccyx, please contact Revitalize Physical Therapy.  I would love to have the opportunity to help you along your healing journey!