I had always felt pretty strong, for a woman at least. When furniture needed moving in my Austin workplace, I was there lifting and shoving. That’s why the aftermath of one single cough came as such a shock. It happened two years after I moved to Terlingua to work for a rafting outfitter. Rafting involves moving lots of heavy things – boats, frames, oars – and I had often pitched in when I was on the river instead of in the office where I normally worked. Hey, I can pull my weight here, I thought.

It was just a cough as I leaned over the sink brushing my teeth – and suddenly I was on the bathroom floor, with my back in such pain that I could hardly move. When I stood up, the best I could do was a forward tilt like a bowler who has just released the ball. Straight up was out of the question. I had no idea what had happened to me. That was 20 years ago—20 years of on-again, off-again pain, incapacity, and discouragement. It’s almost hard to remember those times, now that I am finally pain free.

In the first few weeks after the cough, the pain would get better until I unthinkingly did something to aggravate it. My job required sitting at a desk—also something I was no longer able to do. I could not stand or sit or drive without considerable pain, so I finally rolled out a pad on the office floor and set the phone beside it. It was a ludicrous situation, but the company was patient and understanding.

Finally someone suggested a chiropractor. I had never been to one and the closest was Dr. Cordero in Fort Stockton, but I was willing to try anything. A friend agreed to drive, with me lying in the back seat, the only way I could travel. Dr. Cordero’s diagnosis was that I had a slight congenital spinal problem and had been doing too much. After an X-ray and adjustment, I could finally stand upright, and without too much pain, for awhile. It was an incredible transformation. But the pain soon came back, though not as bad.

I drove to Alpine to consult an orthopedist, whose opinion was succinct: stand it as long as you can, then have surgery. Next patient! Desperate, I called my former boss, Mike Levy, publisher of Texas Monthly, who used to have back problems. He insisted that I see his neurologist in Austin, and made me stay on the line while he called to get me an appointment, which he insisted I keep. He is not a man you can easily say no to. A few days later, after breaking the 500-mile trip into three days, I left the neurologist’s office with a custom-fitted back brace with steel stays and a prescription for industrial strength ibuprofen.

A new job in Big Bend National Park seemed to help, too. I worked in the bookstore and was lifting and moving books all day, which strengthened my back and I was blessed with several years of only occasional pain. When it did strike, a trip or two to Audie Coggins, an Alpine chiropractor, would always put me right again. His sessions, which are similar to other chiropractors whom I have used elsewhere, consist of different methods of relaxing the muscles of the back so that the spine can be coaxed back into line. Usually with just a look at me walking or by feeling where my hip bones were, chiropractors can tell where I am out of alignment. Depending on how bad the pain is, and how long it has gone on, the first step in relaxation is lying prone on a padded table with electrodes attached in X patterns on my back—usually two sets. They send out short bursts of stimulation to the muscles which tighten, then relax. Then a heated, heavy blanket is placed over that and you are left to listen to soothing music for ten minutes or so.

If that was still insufficient I might be placed recumbent on a different table fitted with rollers that move up and down the spine. There remained only the adjustment, which in my case involves the chiropractor twisting my upper body as I am lying down, with just the right about of pressure in just the right places, usually from both sides. I, like just about everyone I saw there, left with a smile.

Moving books is one thing, but my next endeavor was something else again. I started up my family’s food processing business that had closed down in the early 1970s. One of the new products, which I was making, packaging, and selling, was a sweet pickle. Now sugar is very heavy, and so was just about everything else associated with my fledgling business. In a few short months my back was as bad as it had ever been. I was unable, finally, to lift anything weighing more than five pounds. Nothing at all seemed to help but bed rest and time, two things I couldn’t afford.

Again Coggins Chiropractic came to the rescue with a personal-sized electrical stimulation, or TENS, machine which I could use at home or in the car. A chiropractor I consulted when away from home suggested a new set of X-rays. They showed two compressed discs in my lower back. He diagnosed this as degenerative disc disorder, also known as an old back. He said what I really needed was IDD – intervertebral disc decompression. Unfortunately he did not have this contraption, but he suggested I find one.

I hunted one up in Odessa in the office of Dr. Thomas Meek. My treatment involved being strapped into something like a parachutist’s harness so that my upper torso was held in place while a padded girdle around my hips pulled down. The trick of these particular treatments is that the pressure is not constant, which would make the muscles contract in opposition and stay that way. This thing pulls strongly, then gradually relaxes every couple of minutes. I lay on my back, though some other designs have you lying on your stomach and holding on with you hands above your head. I haven’t tried it, but it didn’t look very relaxing. Although I was sore after the first treatment, I did feel as though it had done some good.

The recommended therapy is to go several days in a row, gradually decreasing the frequency over a multi-week period. For someone living in Terlingua, that was a problem. So I just got treatments when I could, in Odessa and in New Orleans when I visited my father. Getting an appointment was not difficult since the clinic there had lost so many of its regular patients after Katrina.

But the pain continued, despite my arranging to have someone else produce the weighty pickles, using the TENS unit, and doing plenty of stretching exercises. I decided that, whatever it took, I was going to have to have the full course of IDD treatments. I was sure I could get it done in Austin, where I still have friends who might put up with me for the two weeks I allowed, one session per day.

It turned out to be a difficult search, but I finally tracked down a clinic with a decompression machine. These are expensive pieces of equipment, costing in the neighborhood of $100,000 and this particular model had some extra bells and whistles: it registered how much pull I got each time the harness tightened up. The more pull, the more good, but if I were talking and not completely relaxed, the results were not as good. So I lay there with the lights low, listening to the machine work and watching the graph, trying to do a little bio feedback.

The first week went well, and I was feeling pretty good. Of course, I wasn’t doing any of the lifting and heaving I would have been doing at home. I was basically hanging out, taking long walks on Austin’s Hike and Bike Trails, and getting stretched. During the weekend break in treatments, though, my back re-asserted itself. I was changing sheets on my bed and felt that oh-so-familiar twang of muscle spasm.

At my Monday session I confessed that, pleasant as the treatments were, they obviously weren’t working. The doctor, Bradley Hubbard, knew my background with this affliction, having taken my complete history, and knew everything I had tried over all the years to get relief. He said there was another option: radiofrequency facet denervation, which his partner in the decompression machine, Dr. David Harris, practiced down the road at a fancy facility called Spine Austin. Bradley somehow arranged for me to see Dr. Harris a couple of days later.

I showed up with the required fresh set of X-rays which showed no herniation, fortunately, just two discs in the lower back mashed flat as tortillas. The Spine Austin staff decided that I could be a candidate for the procedure which, simply put, kills the facet joint nerves where my narrowed vertebrae were pressing on them, causing pain and muscle contractions, pulling my entire back out of alignment.

The prospect of this new treatment was both tempting, and more than a little frightening. It would involve inserting needles right into the offending nerves, then cauterizing them with high frequency radio waves. Up until recently it was only performed as a last resort, on people for whom even surgery had been unsuccessful.

First, though, there was a trial run. In order to make sure that the procedure would work, doctors Harris and Hubbard injected the nerves with a strong pain killer and steroid that would mimic the effect of the cauterizing procedure for a few days. This was on a Wednesday, late in the afternoon, and would be over in less than an hour. The only catch was that, except for some surface skin numbing, the facet joint nerves needed to be awake and aware so that the targeting would be as accurate.

I didn’t even have to strip, just drop my drawers a bit and lie face down on an imaging table. To say that it was very painful would be to belabor the obvious. They kindly provided a rubber ball to grip and a box of tissues within easy reach. They even gave me a souvenir print of the image of the needles doing their work in my nerves. That was a two-martini night!

Three days later--days of amazing absence of pain (after the numbness wore off), no matter what I did--I returned for the full treatment, almost a duplicate of the trial run. Except that, after I was already on the table they informed me that the $12,000-dollar cauterizing needle, after a long and busy life, had at that moment decided to die and a new one had to be sterilized and attached. It wasn’t a wait I relished, but it was short.

After the procedure was complete, after they had killed eight nerves that were being abused by the facet joints and I had made liberal use of both the squeezing ball and the tissues, I sat for awhile in the contoured recovery chairs, then went home.

It has now been almost two years since the procedure. For a while I had a lot of soreness, but that was because my back muscles had hardly been used in a couple of decades and objected to being set back to work. Beyond that, I have been pain free and able to lift a suitcase or a bag of dog food, or anything else within reason.

And I would do it again, even monthly, to stay that way.