Solving undiagnosible rectal (butt) pain

Why You (almost) Never hear a Dog Fart

And how understanding that helped me solve my pain-in-the-butt problem!       © Russ Lanoie

Apparently many of us humans suffer from problems with our “sitting apparatus,” and some of these problems are a whole lot more complicated to understand and treat than others.  As dogs never seem to have much trouble sitting and we share a common evolution as vertebrates, I’ve discovered that they provide a helpful way to explain one of the possible causes of this phenomenon.

My own problem started years ago, as I recall having to check off the HEMMORHOIDS box on countless military induction medical forms.  Twenty something years later I had an operation to remove those dangling things in hopes of curing what had become a nagging discomfort.  When the surgeon checked his work shortly after the operation, I remember him complementing himself on a fine job. I, however, complained that the sensation that I now characterized as near constant itch was still there.  So he took a sample of the skin in that area and sent it off to some lab only to receive a report that everything appeared normal.

So I tried on my own to solve the problem, experimenting with several salves and creams to stop the persistent itch.  I finally hit upon an over the counter ointment that has cortisone in it.  While this seemed to counter the itch it eventually created a larger problem.  Now, although the itch was gone, the itch turned into a genuine pain.  I have many memories of not being able to sit on any soft chair or car seat without aggravating the pain.  This complicated my life as I spend my days operating a tractor.  At one point, in order to relieve the pain and keep my tractor operating I rigged up a harness that allowed me to stand while driving, in a stance much like the old milk truck drivers of years past or the charioteers of even longer ago.  Hence I called my rigging my “Ben Hur-ting” outfit.  While it helped me keep working, it did little to solve the problem.

My first trip to an MD resulted in a diagnosis, as it typically does, of prostatitis. The first order of business was to try an antibiotic to fight off the infection.  I quickly found that a side effect was to also kill off the friendly bacteria that keep the gut working smoothly.  I recall that, just after Easter Sunday during this treatment, because I ate too much candy (an old habit of a Lenten observer) I was standing at a lecture with one hand trying to comfort my sore butt while the other hand was trying to sooth my belly that was fighting back from my ill-advised indulgence.  The other part of the treatment was to “keep the prostate drained.”  Though this was a generally pleasurable treatment, it did nothing to eliminate the butt pain.

So I started to see specialists, spending much of the time with my patient wife driving while I laid down in the back seat.  We saw a:

  • Neurologist who, I believe, said the pain was in my head;
  • Urologist who probed up into my front plumbing but found nothing wrong,
  • Gastroenterologist who found nothing wrong with my gas,
  • Proctologist, who probed around my butt to see if there was something wrong with some vestigial glands left over from when we still walked on all fours similar to the dogs who eventually helped me understand  my problem. (Think of dogs dragging their butt on the carpet)

And finally a pain clinic where I received a shot of something that would have made the pain go away if the pain had been a result of “natural causes.” I asked the doctor administering the shot if I’d be able to teach in our local school kids ski program that afternoon and he assured me I would.  What he didn’t warn me was that I wouldn’t be able to pee until mid-afternoon when I was in charge of a half dozen third graders riding up the chair lift at our local ski area. The shot didn’t help

Someone recommended acupuncture which was conveniently available at a local clinic so I went for a few sessions.  When they didn’t seem to be helping, the acupuncturist suggested that I come sometime after the clinic was closed and he would light the end of long, slender, soft fabric covered stick of something with Asian symbols on it that I would hold over my head while it slowly burned.  He wanted the clinic empty because he said the burning substance smelled a lot like pot!  He gave me the stick to take home with me and I have not tried it or gone back to the clinic!

At some point in all this, my daughter who is a nurse, suggested that my problem might be the continued use of the cortisone for that persistent itch. While curing the itch, its extended use may have been damaging the skin in an area that tends to be tender anyway, especially for an equipment operator who often pounds around on a tractor seat for hours. She suggested, with reinforcement from a local osteopath, that I simply stop the cortisone and the other local anesthetics that I’d come to use and try using corn starch to keep the area dry.  Eureka, it worked!

Though it did make the itch go away, and I still use it today to prevent that itch from recurring, it did not cure what had become the nagging pain that I can only describe as feeling like I was sitting on a golf ball size rock that was pushing up into my “bung hole” as LBJ colorfully described that part of human anatomy.

[Because my daughter had also diagnosed a pilonidal cyst on the bottom of the spine of another family member, and by now had also become a mental health counselor, I offered to make her a sign that read “J L: Odds and Ends”!]

Just about the time I was ready to see a geologist to find out what kind of rock it was that was causing the pain, I happened to remember meeting someone who would shortly bring resolution to this uncomfortable episode.  Several years before, when visiting my brother-in-law on the West coast, he took us up into the hills north of San Francisco to meet a friend of his.  I remembered that his friend, Dr. David Wise had just written a book called “A Headache in the Pelvis.”  Thinking that his book might hold the key to a cure I procured a copy ASAP.

Dr. Wise explained, in great detail, why this problem could and should not be treated by an MD, but rather a PHYSICAL THERAPIST.  What luck, as I personally know the leading local physical therapist who I promptly e-mailed to see what she knew about treatment for this malady. By another stroke of luck, she e-mailed back and said that, not only was she familiar with the treatment, but at that very moment was heading to the West coast for a seminar by Dr. Wise. Another eureka moment!

ENTER THE FARTING DOG

I point to man’s best friend to help make the cause of the problem as simple to understand as possible.  We all know how a dog reacts to certain things.  When it’s happy, a dog wags its tail, but when it’s nervous or uncomfortable, it often puts its tail between its legs.  It turns out that we humans have this in common with the dogs.  Though we can’t show our cheerfulness by wagging our tails, or react to stress by putting our tail between our legs, we can do a similar thing when we are “up tight.”  We tighten many of our muscles, including our butts in an automatic response to stress or perhaps to discomfort such as a nagging itch.  We also are taught to control our butt muscles at a very early age to lessen the need for diapers.  And, in order to be appropriate in polite company, we often have to restrain our urge to let out the aromatic and often audible offending product of digestion.

So how does this relate to dogs?  To me it’s simple.  Dogs are generally less up tight than their masters, so when they feel the urge to pass gas, it just flows freely through an unrestricted portal, making little or no sound.   Humans, on the other hand, try to let the gas out slowly in order to be discreet.  The gas passing through a tense orifice often makes a satisfying sound if no one else is around or creates embarrassment if in certain company.

So how this relates to us humans, and particularly my pain, is that, by continually tightening the butt muscles in response to gas or, particularly in my case, that continued itch for many years, the muscles simply go into spasm.  Because it is a muscle issue and not any internal medical issue, it is a physical therapist who should do the treatment.

So turning to my friend and her recent training, I started a series of treatments that provide relief to the offending muscles. This was done by “digital manipulation” which probably does not require much imagination to picture, but does require surgical gloves for the provider.  Sure enough, she could tell which muscles were tight and pressured them until they released their death grip.

After several treatments the pain was all but completely gone and has stayed gone for years.  But her admonition, I’m sure backed by Dr Wise’ advice, is to relax those muscles whenever I notice them beginning to tighten up.  I follow this advice religiously, often catching myself tightening up for no good reason.

So a regimen of corn starch to keep the itch from returning and remembering to keep my sitting apparatus as relaxed as does my dog laying on the family couch  has provided more relief than all the “ologists” who should read Dr Wise’ book.

Thank you David Wise.

Note that my brother-in-law, Erik Peper, Ph.D, professor and director of the Institute of Holistic Healing Studies at California State University, San Francisco wrote the endorsement for ­A Headache in the Pelvis and introduced me to the book and to Dr. David Wise.

 Thanks Erik

Making hot water systems in the age of Solar Electricity

 

For many years the best way to capture the energy of the sun, other than simply by inviting it through south facing windows, was to use it to heat domestic hot water. It was only about ten years ago that the Plymouth Area Renewable Energy Initiative (PAREI) sparked Solar Raisers such as this one organized by the Tin Mountain Conservation Center where 40 people helped install an evacuated tube system on a home in Madison, NH.

The advantage to solar hot water is that it does not require very sophisticated technology to capture the energy of the sun and transfer it into water for either residential or commercial use.  Indeed, there are lots of do-it-yourself schemes such as bread box heaters that involve almost no technology by simply placing a black painted water tank inside of an insulated box glazed with any of several available transparent or translucent glazings, sometimes as simple as old storm windows.  This writer had a hose connected to an old water tank with no glazing but just fully exposed to the sun for use as an outside shower for summertime.  Sometimes the water would almost reach scalding temperatures on warm sunny days.

On the other end of the scale are hot water systems that are used for space heating with storage tanks connected to pumps and controls that circulate hot water through pipes embedded in a floor or other distribution system as in the Tin Mountain rooftop system that heats the building along with a wood fired backup boiler.  These are generally engineered systems requiring a lot of technology and hardware.

The most common application has been for residential hot water  using evacuated tube systems or simple “flat plate” collectors that consisted of glass or other type of glazing covering an insulated box with an “absorber plate” generally made of copper with a series of pipes running through it that connected to a storage tank much like a conventional water heater. I will explain the system that has successfully served my own home since I installed it in 1978.

As my wife and I operated a business we called Alternative Systems in the mid ‘70’s, we built a house that incorporated much of the technology we sold at the time.  A Fisher woodstove, still in use, a composting toilet that served for many years, a story in itself for another time, Window Quilts, and a Daystar solar hot water system.  Daystar, located in Burlington, MA, made very high efficiency flat plate collectors. Curiously, Daystar was actually owned by Exxon, hinting that the oil companies maybe actually have realized that fossil fuel’s days were numbered.

The Daystar system came as a complete package and I sold several of them, some to DIY folks who set them up themselves, and other to customers who had plumbers do the installation.  A few were roof mounted but several were mounted closer to the ground, generally at a 45 degree angle to optimize their ability to capture the sun year round.  An engineer friend mounted his so that they could be tilted with the seasons to gain even more sun, and, I add from my own experience having had to use a very long handled snow rake on my own collectors, to simplify removing snow that crusted over with ice on a very few occasions.

My own system was the subject of a federal monitoring program that consisted of metering hot water and backup electricity and a run time meter on the circulator pump.  A researcher visited my house periodically to take readings that showed that our system provided 85% of our hot water even with two little ones in reusable cloth  diapers!  To optimize the system we even had a switch that would allow us to turn off the back-up electric power on mornings where the sky was clear to the West, indicating that the day’s washing would be in sun-heated hot water.

The system did require some maintenance, however, as the water from our municipal system tends to rot out water heaters very quickly, so our biggest expense has been to replace the stone line tank a couple of times until we finally installed a “lifetime” high performance stainless steel tank.  One replacement control module and one or two circulator pumps were the other plumbing components replaced in over forty years of service, while the original collectors still gather the energy from the sun every times it comes out.  The bigger issue is replacing the roof shingles on the south side of our roof, because the collectors will have to be removed and, hopefully replaced with a couple of spare collectors that I have from the old Alternative Systems days.  I’ve been able to get by with the original shingles by painting them with aluminum paint every few years that has been surprisingly successful but has finally run its course.  Note that hot water collectors are MUCH heavier than the solar electric PV panels that are beginning to take their place which has been much of the reason for my procrastination.

It is not so much that today’s solar electric Photovoltaic or PV panels are so much lighter than solar hot water collectors as it is that their cost has plummeted and their efficiency increased while the cost of electricity is constantly climbing.  These are the reasons that our Solar Water Raisers of ten years ago have given way to a greatly increased interest in solar electricity. There are many advantages to PV’s over solar hot water systems, not the least is that there are no mechanical components to wear out or a heat transfer fluid to leak or need changing.  PV’s can be installed almost anywhere within reasonable reach of wiring, either from the roof down or underground from a ground mount system.

PV’s however are not generally a DIY installation unless you are like my engineer friend who installed his solar hot water system and also his own PV system years later so he could follow the sun with them.  PV installations usually will at least need the services of a licensed electrician to make the proper connection into the structure’s wiring system in conjunction with the local utility’s requirements, at least in grid-tied systems (not off-grid with battery backup).

Heat pump water heaters

A new twist with heating domestic hot water is electric water heaters with heat pump technology built in. This means that the heater uses electricity to take heat from its immediate environment and transfer it into the water rather than only use a built in electric heating element as do most electric water heaters. As with other heat pump systems, this make the system two to three times more efficient than a traditional electric water heater by using one unit of energy to produce two or three units. It uses the same technology that is popping up everywhere in the form of “mini-split” heat pump systems with most of the mechanical part of the system, the compressor, outside the house, and one or more “heads” that transfer the heat or cooling remotely inside.

During periods of high demand the water heater can be set to rely on a standard electrical coil built in to the tank whereas mini-splits heating a building might have to rely on fossil fuel backup heating. However, when a mini-split heat pump is working in an extremely cold outside environment it drops back to performing like any other electrical resistance heating unit with one unit of energy in and one unit out. Because water heaters are not usually operating in sub-freezing temps, there should never be a time that a heat pump water heater should never lose an effective level of efficiency.

There are several advantages to this type of water heater besides its increased efficiency including that it can help cool the inside of a building in summer by taking the heat from the room where it is located and transferring it into the water, and also that it can utilize electricity from a building’s PV system resulting in another way of using the sun to heat water.  In addition, several states and utilities provide rebates for heat pump water heaters.

A disadvantage of a heat pump water heater is the fact that it is taking heat from its environment which might be fine if it is in a room with a wood stove or furnace, but not if it is stealing heat that is generated by an expensive non-renewable energy source. I’ve also heard that these systems they can actually chill an already cold basement to the point that pipes can freeze!

As for the future of stand-alone solar hot water systems, the complexity and expense of a system appears to make little economic sense when compared to a PV powered heat-pump system.  On the other hand, keeping an existing solar hot water system operational makes abundant sense so long as major components do not need replacing.  Unfortunately there are existing solar hot water systems that are not functioning simply because of the failure of a minor component that a subsequent homeowner or an unfamiliar plumber does not have the wherewithal to troubleshoot.

We’ve found that Solar Raisers from years ago served to take away the mystery of solar hot water for the several plumbers who took part as they came to realized that solar hot water systems are little more than any other domestic hot water system except that the source of the heat was the sun beaming on solar collectors instead of some kind of gas or oil fired system or some wires hooked to the grid.

 

Drying out a Wet Basement

Wet basement, why it happens, how to solve

Keeping Your Home's Feet Dry

Many homes in our part of New Hampshire are built into hillsides that have ground water close to the surface, especially in the spring and after heavy rainstorms. Because they are on a slope, the dewatering system for these homes and businesses can simply use gravity to carry groundwater safely away. The system that is used to gather the water is often called a “french drain,” a footing drain, or a perimeter drain because it usually is installed around the perimeter of the footing of the foundation. Ideally such a drain carries the water down slope to “daylight.” Properly installed and maintained, such a system can be very effective at its job. However, many systems are poorly installed and even more are not at all maintained and often totally forgotten until water backs up into the basement or living space.

Since gravity basement drainage systems are seldom examined by home inspectors unless there is or has been a problem, and new homeowners have too many other things to fill their minds, foundation drains are too often overlooked. So how can a diligent home owner tell if the building has a drainage system or not? Sump pump systems are obvious, but gravity perimeter drains usually are not. One easy way to tell on newer homes is to look at a copy of the septic system plan that should be available and kept with important documents such as the deed. If the house is on a hillside and the septic system occupies a mound in the yard usually downhill from the house indicating that the area has a high water table, there should be a sketch on the plan showing a drain outlet at least 35 feet from the corner of the leach field., 75 feet for older systems.

For years I’ve helped home and business owners locate, troubleshoot and repair these drainage systems, sometimes with as little as a couple of scoops with a shovel to uncover the end of a forgotten drain outlet and other times with the major undertaking of excavating around the foundation to reinstall a proper drainage system. After having written several articles about basement drainage over the years I’ve put them all together in an on-line publication called KEEPING YOUR HOME’S FEET DRY.  This document covers sump pumps and gravity perimeter drains in great detail, with photos and descriptions from personal experience.  It is available free at www.RuralHomeTech.com /wet-basements/