Pain

Pain comes in many different forms.  At the root level though (no pun intended for those in the medical field), pain is either emotional or physical.  Sometimes one creates, and then perpetuates the other.  For example, sometimes physical pain prevents us from being able to sleep, which in turn not only hurts our bodies further, causing everything from obesity, to problems with our immune systems, but the lack of sleep also interferes with our judgment and reason skills, causing us sometimes to be short tempered, depressed, or anxious.

On the other hand, emotional pain causes stress, or anxiety, or depression, which can take a toll physically on our body.  Causing insomnia, heart problems, digestive problems, cancer.

Sometimes, when dealing with chronic pain, people who are not doctors, or therapists like to think that they are.  To the pain problem they would say, “I take Aleve, and that takes care of all of my pain.  I do acupuncture.  I exercise.  I lost 40 lbs and my pain went away.  I go to a physical therapist.  I go to a chiropractor.  I get a massage every week.”

The advice for the emotional pain may be, everything from, “I use St John’s Wart.” to “Just let it go.  Get over it.  Why are you holding on to this?”

The only fault I can find in this type of advice is that what worked for them may not work for you or for me, and maybe the advice should instead be, I’d see a doctor about that.  It seems to me that the family physician I have today is perfectly capable of assessing my situation and determining whether or not he can help me.  If he can’t help me he will refer me to a specialst, like a chiropractor, or an acupuncturist, or a physical therapist, or a massage therapist, or a personal trainer or a dietician.  In my case though, it was a pain specialst.

The people in our lives offering advice are probably just trying to help though, so don’t be too upset with them.  In my case though, I’m glad I went to the doctor, and I’m glad he referred me to a pain specialist.  For the past 1 1/2 years I’ve had moderate success with my physical pain.  But let’s go back through my history for a moment so that I can illustrate the events leading up to today.  Not so much so you can understand me better, or sympathize with me, but so that maybe you can relate.  Maybe there are others out there who will read this and feel comforted that there is someone out there who knows what they are going through and struggling with, and maybe can relate.  If you are one of those people I’d love to hear your story.

I was born with a rare congenital deformity of my right shoulder.  My parents searched far and wide for a solution, to hear everything from, “It’s just a broken collar bone and will heal on it’s own.” to “There’s nothing we can do.  He’s just going to be deformed, have little use of his right arm.”

But then they found a doctor only 30 miles away at John’s Hopkins hospital in Baltimore, MD.  He knew exactly what the condition was, and was confident he could help.  So at 22 months old I was under the knife for the first time in my short life.

The surgery was as successful as one would have hoped, but I was not out of the woods yet.  Although I looked more normal, and had more motion in my right arm than I would have, I still had a great deal of challenges to face.

I grew up with horrible asthma, most likely unrelated, but still it took a deep emotional toll having to be rushed to the hospital for epinephrine shots, and constantly being on medication.  At 12 years old I was diagnosed with scoliosis, and cifosis.  I was supposed to wear a full body brace 22 hours a day.  Although I wore it to sleep, and when I was at home, I refused to wear it outside of the house and my parents didn’t force me.  Because of this I probably deal with a lot more physical pain than I would have if I had followed directions.  Plus, my body would look more normal.  Not that it’s bad, but it is different.

When kids were old enough to know how to be cruel, they were.  I was made fun of, called “No Neck”, bullied by many.  I started taking Marshall arts, and when I started to fight back, the bullying stopped, at least at the physical level.

At 13 I had to have surgery for a hiatal hernia along with acid reflux.  This was likely related to the deformity.  Over a week in the hospital, and weeks away from school.  You have to remember this was 1980.  More physical and emotional pain, although it was meant to relieve other chronic pain, which it did, for about 7 years.  Now I have a big scar, and I take prescription strength Prilosec chronically.

At 25 I was the passenger in a car which hit a tree.  The seat belt grabbed me so hard that my sternum snapped in two.  I’d never felt such pain, and I never would again, until I was at the pain doctor’s office the other day and he was injecting me with a steroid to try to get the swelling down in my lower back.  More about that later.  I was taken to the hospital by ambulance, admitted of course, and I spent several days there.  Even with the pain medication they were giving me, it hurt to move, and it hurt not to move.  Even breathing hurt.  Staying in one position for too long hurt.  Changing positions hurt.  There was no way to get rid of that pain for the first few days, except for sleep which came rarely.  Even then, I’d dream about it.

Around the end of the ’90s through the early half of the 2000s,  I started experiencing severe abdominal pain, particularly in the lower left.  The diagnosis this time was diverticulosis.  Flare ups of diverticulitis, meant trips to the doctor’s office and antibiotics.  The pain would go away for a time, but would return eventually.   The flare ups became more and more frequent, to the point where the last one was nearly deadly.  The infection had caused a perforation in my large intestine, and it was in my blood stream.  I was at a wedding in Cleveland when it got really bad.  I was up all night with intense pain, a mid grade fever, and vomitting.  When my Dad was ready to take me to the airport, I told him to take me to the hospital instead.  Good decision.  They did a CAT scan and immediately admitted me.  I spent 4 days in the hospital in Cleveland, over 500 miles from home, on a high dose of antibiotics, while they told me that if they couldn’t get the infection under control I would wind up with a colostomy bag, and I’d have to have a second surgery to put my broken lower digestive tract back together.  Luckily they did get it under control, and I went home, scheduled the surgery, and although this was yet another physical and emotional toll, that problem was fixed.

I had to give up a trip to Kenya because of this last incident.  It was paid in full.  This would have been my first major trip in years.  Instead, I had to spend months contacting the airlines, and hotels, and excursion managers to try to convince them to give me at least some of my money back, which of course caused further stress.  Ultimately I got a full refund from the airlines, but not much else.  This was about a third of the total amount I had already spent for the trip.  But that was Ok.  You wouldn’t believe the amount of help I received from family and friends.  The love they showed, not through words, but through actions, made it so much easier to accept the situation as it was, rather than to complain about what it could have been.

All this time, I was still dealing with skeletal pain.  This was not creating the emotional pain I was feeling, but it was certainly contributing to it.  Still, I had almost accepted it as just something that would be a part of my life.  It was always something there in the background which was just the result of getting older.  After all, I had tried the chiropractor,  the physical therapist, the exercise,  losing weight, the massage, and even the NSAIDs, and occasionally the narcotics, but ultimately these things either didn’t help at all, or helped so little that it wasn’t worth the effort.

All this time I was still dealing with emotional pain.  Perhaps a lot of this was my inability to shake the habits, and reactions to the world that I learned as a child.  Even though my actions are my responsibility,  sometimes my reactions are more than what is called for, and then the actions that come from those overractions, are far too swift and far too judgemental than what is appropriate.  I have dealt with the result of these overractions to the world in many different ways in the past, mostly in ways that cause further self-destruction.  Lately though, I try to deal with them by seeing a therapist, and by being with people who like me, are trying to overcome a lifetime of adversity.

When I was 23, my mother died.  My relationship with here at the time was rocky at best.  Then again, my mother’s relationship wth everyone towards the end was rocky.  She had pushed everyone out of her life.  She was on unusually high doses of pain medications,  muscle relaxants,  mood stabilizers, and anxiety reducers. She was depressed and angry all the time.  Sometimes her behavior was quite frankly, psychotic.  She had quite a rough childhood, and although this was not an excuse for the way she viewed and reacted to the world, when I look back, and relate her life experiences to my own, I can understand why she had become the person that she was, and how I could use her as an example of where I could go should I not make the right choices.  At the age of 48, she just didn’t wake up one morning.   The coroner said she had not taken any of her medications at a dose that was more than prescribed,  but that the dosages she was taking, and the combinations of medications she was taking most likely caused her heart to fail.  There is another factor which the coroners never take into account, which is that the drugs of sadness and loneliness, or more specifically the chemical reactions they cause and the damage they physically cause to our bodies, were also a contributing factor.

My mother’s death was hard to take, and I still cry about it every time I think about it because the last time we spoke we were having an argument about why I didn’t tell her I was back from vacation.   My last words to her were, “I’m afraid to talk to you!”.  I had stopped talking to her many times in that last year, sometimes for months.  Too much pain to talk to her, and so much pain not to.  But I was not alone.  There weren’t a lot of people left in my mother’s life who were able to tolerate her.  Today though, I have forgiven her, and I even thank her.  My experience with her has taught me much about myself, and especially about how I react to the world.  Most importantly,  she has shown me an extreme of where I could go if I don’t stay in touch with people with whom I have a healthy relationship, and do whatever is within my power to keep that relationship healthy.

So what is this leading up to?  As I have been somewhat successfully dealing with the emotional pain I have been through in life, I must also deal with the physical pain with just as much enthusiasm.   The people in my life, who can help me with physical pain are doctors.  The pain doctor has tried multiple different methods to help me with the pain in my lower back.  That’s right.  The deformity is in my right shoulder, but a lifetime of compensation has caused the joints in my spine on the lower left side to weaken, form arthritis,  pinch nerves, and cause me so much pain that I can’t sleep.  Sorry helpful advice givers, warm milk is not going to help here.

The doctor has tried a variety of methods, not just for this area of my back, but for other areas which are difficult for me.  Some have succeeded and the pain is gone.  Yet, some like this lower back pain have failed.  The doctor ordered an MRI.  I’ve had them for other parts of my back, but not here.  Unfortunately the results did not look promising.   The doctor read the report, and showed, me the pretty pictures, and showed me just how much of the pictures that weren’t so pretty.  He told me that he could give an epidural injection which would be directed at the main nerve which was causing the problem in the back.  He wasn’t sure how effective it would be, or how long it would last, and reminded me, that it was only treating one of my issues, and only the symptoms caused by that issue.  He then asked me if I had spoken to a surgeon.  Folks, when you are going to a pain doctor who’s motto is “Non-surgical solutions for pain”, and he is asking you if you have spoken to a surgeon, it’s time to make a difficult decision.

I asked him if there were exercises or physical therapy or any other less invasive methods.  His answer was, as he was shaking his head, I’m not going to tell you not to exercise.  I agreed to have the shot, and I couldn’t walk after he was finished.  The broken sternum was a long time ago,  but I can’t remember feeling the amount of pain I was feeling when that needle went in, for that extended a period of time, ever. It was only a minute.  60 seconds.  Holy shit!  But maybe it would be successful.  Maybe I could avoid surgery.  Maybe it was worth it.

Afterwards, the doctor and I were talking and I said, “Maybe I will just have to accept the fact that I’m going to have some amount of physical pain for the rest of my life.”  His answer was, “From what I saw in the MRI, not as much as you have been experiencing lately.  What you need to accept is that you are going to have to make a choice between chronic pain medication or surgery.”

I contemplated this for less than half a second.  Pain medication treats the symptom.  Ultimately you have to take more and more of it to have the same effect.  Finally, even on dangerously high doses, it no longer works, and then you are back to the choice of surgery if you don’t die first.  At that point though, you may want to die.  You may have pushed everyone in your life away because you have become dependant on the pain medication,  and that changes you.  You become self-righteous, self-absorbed, and self-serving.  Your thoughts become focused on your next dose, and everything else in your life backs off, fades away, and becomes unimportant and unecessary.  Your body suffers, your loved ones suffer, your mind suffers, and both your body and mind begin to die.  If it sounds like I’m speaking from experience, it’s because I am.  I’m not just talking about my mother either.  Thank God that this is not my life today.

This next part I have not experienced, but what do people in this situation do when they finally do have surgery?  I would expect they suffer.   If they have built up a high tolerance to pain medication, then how much will they need to handle post surgical pain?

I made the decision to wait.  If the injection didn’t work, I would get a second opinion,  and if the second doctor agreed, I would begin looking for a surgeon.  Unfortunately, although the injection worked for a couple of days, the pain is back today with a vengeance.   I will give it a couple more days, and then call the doctor back.  Did anyone see the puns in those last two sentences?

There are things from my past that I must let go of, but I can’t erase the memories.  I can only accept them, and hopefully learn from them, perhaps discovering that forgiveness is the best way to let go of the pain those memories cause me.

There are things in my life that I must accept, but sometimes I need the help of others to figure out what I need to accept, and what I can change.

Sometimes I have to listen to my friends and loved ones, and to experts, and combine that with my own experience to make the best decision possible for myself.

Then, once the decision is made, even if there are still doubts, I must take a leap of faith and let God handle it from there.  But I must not hesitate.  A decision to do something is not actually doing anything.

This past 3 years, I’ve decided I wanted to take some of those major trips I was discussing earlier.  It took me a while to build the courage back up to make such a financial commitment after what happened with Kenya.  In 2012 I went to Italy.  In 2013 I went on a tall ship cruise from Italy to Montenegro, to Croatia, to Slovenia, and back to Italy.

This year I decided I wanted to do something different, and at the end of October, I am going to Kenya.  I am only going though, if I take this leap of faith, and I do so in enough time to allow myself to heal.  So the time is now.

For now I have chosen to not accept the pain, and to make a decision that has the most likely chance of long term success.  If I was not living such a wonderful life today, with such wonderful people in it, I might have made a different decision.  Thank you to everyone who has been in my life, and who currently is for helping me to see clearly, and today get through painful times, whether they be emotional or physical.   I hope I can be there for you some day too.

3 thoughts on “Pain”

  1. I got a lot of help from your “Pain” blog. It helped me appreciate the gratitude that I must pay attention to, it let me know I am not the only one nearby who suffers from emotional pain and it helped me to understand you better. I believe that you also received relief from putting your thoughts down in writing. Thank you for helping me.

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