Picture a situation where you think you’re having a heart attack. You do the responsible thing and get yourself to the emergency room, where you undergo a battery of cardiac tests – and learn that your heart is in fine shape.A reason to celebrate, you would say.But imagine, then, that your unpleasant and disruptive symptoms recur... and persist, playing havoc with your quality of life – and that the doctors can come up with no satisfactory explanation for them.Imagine this continuing painfully for a year.THIS is what happened to a friend of mine starting in the spring of 2009.“It was a Friday between Purim and Pessah,” he recalled. “I had just done the Shabbat shopping and carried the heavy bags up three flights of stairs. I suddenly felt very weak, with chest pains and pain in my arms.“I knew I was in the target area for heart attack,” he went on. “I was 49, seriously overweight, and a medium to heavy smoker. So I went to Terem (emergency care center).”These were the tests my friend underwent then, or subsequently at Hadassah Hospital Ein Kerem: chest Xray, heart ultrasound, ECG, a neurological test called EEG, heart catheterization, and a cardiogram, which involved wearing a heart monitor for 24 hours. All of them eliminated both cardiological and neurological reasons for my friend’s malaise.“I found out later that they had even tested me for hard drugs,” he said.The doctors also ruled out Parkinson’s disease, multiple sclerosis (MS) and rheumatic fever.All very reassuring; but they were no nearer to diagnosing what ailed my friend.“At that point,” he continued, “things sort of petered out, since they had run out of things to test me for.”‘FOR the next year,” my friend continued, “I lived with exhaustion; continual pain attacks over my whole body, as if a heavy weight were pressing down on me; stiffness in my arms and legs, problems concentrating, heartburn and a heightened sensitivity to noise.“There’s a man who cleans the garden downstairs with a blower,” he said. “The noise causes me actual physical pain.“And for some reason,” he reflected, “supermarkets bring on these symptoms. Perhaps it’s the lights and the noise, or the crowding.”He uses the supermarket trolley as a Zimmer frame, he added.FINALLY, this past summer, a rheumatologist did some blood tests, questioned my friend about his pain, poked him in various places and found a number of tender points, including top of the shoulders, front sides of the neck, and upper chest.“If you’d come to me 100 years ago with the same symptoms,” the rheumatologist told him, “I’d have said you were suffering from rheumatism, the classic ‘wastepaper-basket’ diagnosis when everything else has been ruled out.”But what you have,” the doctor told him, “is a condition called fibromyalgia.”In the 1970s, researchers in sleep labs discovered a link between the kind of rheumatic pain my friend was experiencing and people who weren’t getting a certain kind of deep and restorative sleep called “slow-wave” – which does explain those recurring feelings of exhaustion.Amid medical controversy and charges of confusing cause and effect, a start had been made in describing an elusive condition, not life-threatening but made more debilitating by the frustration of frequent misdiagnosis.Fibromyalgia can be triggered by physical or emotional trauma, or by illness. Increased brain sensitivity to pain signals has been suggested. Family history may play a part, and the disorder occurs more often in women than in men.WHAT made me decide to tell my friend’s story in such detail? It was partly the hope that doing so might point similarly affected and bewildered readers toward a quicker and more accurate diagnosis.More than that, however, I saw his story as a warning to all of us because of a factor that has been implicated in this disorder: stress.Modern Western living inevitably comes with a large dollop of stress, whether it arises from people’s aspiration for more and greater achievements or more material goods or gain; or from the struggle to merely keep afloat in a world where many of the old rules no longer seem to apply.And in today’s world of work – which is fast changing almost beyond recognition – people are being subjected to possibly unprecedented levels of stress that pose a real threat to their internal balance.“Telecommuting” – a term that describes working from home – sounds trendy, but what it means is a blurring of the line between home and office, and consequently between work and leisure. And that can spell danger for those who – like my friend – carry a lot of responsibility, aren’t good at prioritizing, and spread themselves too thin doing things for other people at the expense of crucial private time.“When you work from home,” my friend said, “it puts you in a situation where you are virtually always on call.Working in an office, you may occasionally have an urgent project needing overtime to finish; but all other things being equal, there is a point where you leave and go home. Even if you then sit at the computer all evening, you’re using it to have fun, chat with friends, listen to music, pursue hobbies, and so on.“But when your home computer is also your work computer – especially if your clients are in a different time zone“ (my friend’s are in the US) – “you can be getting emails at 10 p.m. And you can still be working on a project at 2 or 3 in the morning.”It goes the other way as well.“In an office, you’re concerned only with work; but at home, you have domestic responsibilities on you as well – hanging out the washing, paying the bills, dealing with family problems. There is almost no time off.”NOW that he has been diagnosed, my friend faces the challenge of returning to his former active and pain-free self. His doctor told him that in 60 percent of cases, fibromyalgia sufferers can pull out of the condition.My friend consulted a dietician, changed his eating habits sensibly and has lost about 20 kilograms over six months, which he aims to keep off. He says it has greatly improved his general health.His smoking is more problematic: “’Denial’ isn’t just the name of a river in Egypt,” he responded quizzically when I asked if he was planning to give it up.walk for half an hour a day, sans cell phone. He has found that a “huge help.”MY friend said he is “cautiously optimistic” about the future.“The doctor suggested that I make a point of doing the things I like, such as playing the piano – and maybe take up bridge. I’m hoping that the tactic of making time for myself will play a decisive part in my recovery.”And, significantly, he wants to recreate a situation where he has leisure hours separate from his work hours.“I have thought about turning the clock back – about renting an office and going to work there, moving from ‘telecommute’ back to ‘telecenter,’” he said.“Not all progress is good,” he concluded wryly, looking tired.THE effective elimination of the office as a place to which you go to work and its replacement by telecommuting may be the unavoidable face of the future. It has undoubted benefits, the saving of time and money spent on traveling being one of them.But there are serious potential problems too – social isolation, a lack of casual brainstorming and information-sharing, and the risk of merging two milieus, home and office, into an unhealthy, stress-inducing hybrid.As I said, the trend may be inevitable – but we need to go into it with our eyes open.
In my Own Write: All work and no play
“When you work from home, it puts you in a situation where you are virtually always on call."
Picture a situation where you think you’re having a heart attack. You do the responsible thing and get yourself to the emergency room, where you undergo a battery of cardiac tests – and learn that your heart is in fine shape.A reason to celebrate, you would say.But imagine, then, that your unpleasant and disruptive symptoms recur... and persist, playing havoc with your quality of life – and that the doctors can come up with no satisfactory explanation for them.Imagine this continuing painfully for a year.THIS is what happened to a friend of mine starting in the spring of 2009.“It was a Friday between Purim and Pessah,” he recalled. “I had just done the Shabbat shopping and carried the heavy bags up three flights of stairs. I suddenly felt very weak, with chest pains and pain in my arms.“I knew I was in the target area for heart attack,” he went on. “I was 49, seriously overweight, and a medium to heavy smoker. So I went to Terem (emergency care center).”These were the tests my friend underwent then, or subsequently at Hadassah Hospital Ein Kerem: chest Xray, heart ultrasound, ECG, a neurological test called EEG, heart catheterization, and a cardiogram, which involved wearing a heart monitor for 24 hours. All of them eliminated both cardiological and neurological reasons for my friend’s malaise.“I found out later that they had even tested me for hard drugs,” he said.The doctors also ruled out Parkinson’s disease, multiple sclerosis (MS) and rheumatic fever.All very reassuring; but they were no nearer to diagnosing what ailed my friend.“At that point,” he continued, “things sort of petered out, since they had run out of things to test me for.”‘FOR the next year,” my friend continued, “I lived with exhaustion; continual pain attacks over my whole body, as if a heavy weight were pressing down on me; stiffness in my arms and legs, problems concentrating, heartburn and a heightened sensitivity to noise.“There’s a man who cleans the garden downstairs with a blower,” he said. “The noise causes me actual physical pain.“And for some reason,” he reflected, “supermarkets bring on these symptoms. Perhaps it’s the lights and the noise, or the crowding.”He uses the supermarket trolley as a Zimmer frame, he added.FINALLY, this past summer, a rheumatologist did some blood tests, questioned my friend about his pain, poked him in various places and found a number of tender points, including top of the shoulders, front sides of the neck, and upper chest.“If you’d come to me 100 years ago with the same symptoms,” the rheumatologist told him, “I’d have said you were suffering from rheumatism, the classic ‘wastepaper-basket’ diagnosis when everything else has been ruled out.”But what you have,” the doctor told him, “is a condition called fibromyalgia.”In the 1970s, researchers in sleep labs discovered a link between the kind of rheumatic pain my friend was experiencing and people who weren’t getting a certain kind of deep and restorative sleep called “slow-wave” – which does explain those recurring feelings of exhaustion.Amid medical controversy and charges of confusing cause and effect, a start had been made in describing an elusive condition, not life-threatening but made more debilitating by the frustration of frequent misdiagnosis.Fibromyalgia can be triggered by physical or emotional trauma, or by illness. Increased brain sensitivity to pain signals has been suggested. Family history may play a part, and the disorder occurs more often in women than in men.WHAT made me decide to tell my friend’s story in such detail? It was partly the hope that doing so might point similarly affected and bewildered readers toward a quicker and more accurate diagnosis.More than that, however, I saw his story as a warning to all of us because of a factor that has been implicated in this disorder: stress.Modern Western living inevitably comes with a large dollop of stress, whether it arises from people’s aspiration for more and greater achievements or more material goods or gain; or from the struggle to merely keep afloat in a world where many of the old rules no longer seem to apply.And in today’s world of work – which is fast changing almost beyond recognition – people are being subjected to possibly unprecedented levels of stress that pose a real threat to their internal balance.“Telecommuting” – a term that describes working from home – sounds trendy, but what it means is a blurring of the line between home and office, and consequently between work and leisure. And that can spell danger for those who – like my friend – carry a lot of responsibility, aren’t good at prioritizing, and spread themselves too thin doing things for other people at the expense of crucial private time.“When you work from home,” my friend said, “it puts you in a situation where you are virtually always on call.Working in an office, you may occasionally have an urgent project needing overtime to finish; but all other things being equal, there is a point where you leave and go home. Even if you then sit at the computer all evening, you’re using it to have fun, chat with friends, listen to music, pursue hobbies, and so on.“But when your home computer is also your work computer – especially if your clients are in a different time zone“ (my friend’s are in the US) – “you can be getting emails at 10 p.m. And you can still be working on a project at 2 or 3 in the morning.”It goes the other way as well.“In an office, you’re concerned only with work; but at home, you have domestic responsibilities on you as well – hanging out the washing, paying the bills, dealing with family problems. There is almost no time off.”NOW that he has been diagnosed, my friend faces the challenge of returning to his former active and pain-free self. His doctor told him that in 60 percent of cases, fibromyalgia sufferers can pull out of the condition.My friend consulted a dietician, changed his eating habits sensibly and has lost about 20 kilograms over six months, which he aims to keep off. He says it has greatly improved his general health.His smoking is more problematic: “’Denial’ isn’t just the name of a river in Egypt,” he responded quizzically when I asked if he was planning to give it up.walk for half an hour a day, sans cell phone. He has found that a “huge help.”MY friend said he is “cautiously optimistic” about the future.“The doctor suggested that I make a point of doing the things I like, such as playing the piano – and maybe take up bridge. I’m hoping that the tactic of making time for myself will play a decisive part in my recovery.”And, significantly, he wants to recreate a situation where he has leisure hours separate from his work hours.“I have thought about turning the clock back – about renting an office and going to work there, moving from ‘telecommute’ back to ‘telecenter,’” he said.“Not all progress is good,” he concluded wryly, looking tired.THE effective elimination of the office as a place to which you go to work and its replacement by telecommuting may be the unavoidable face of the future. It has undoubted benefits, the saving of time and money spent on traveling being one of them.But there are serious potential problems too – social isolation, a lack of casual brainstorming and information-sharing, and the risk of merging two milieus, home and office, into an unhealthy, stress-inducing hybrid.As I said, the trend may be inevitable – but we need to go into it with our eyes open.