Basic Pain Management

Recently, I read that there comes a time in any learning process you pursue long and hard enough where the only way to continue learning is to teach the subject to others. This came from a book of fiction but it is not fictional. In a line from his book series "The Dresden Files," Jim Butcher actually explains why this is true. I'm an oddball because I never seem to be able to believe in or remember something until I understand why it is true. Butcher wrote that teaching relative novices in a field where one has a lot of experience forces one to go back to the basics and look at them with the benefit of experience.

Pain management has some very basic rules to it. Society actually seems geared to make us forget them even though some were taught to us as children. The first rule I'd like to go over usually requires someone saying it aloud before it makes such sense that it's almost embarrassing. "If it hurts, don't do it." My brain can only take so much concentration and/or stress before it gives me a bad headache. I used to be a second chance debt collector for a credit card company. My coworkers and I specialized in accounts that were more than 90 days past due. If you get behind by 90 days or more, you have a good reason for it or you think you do.  That meant nearly every call I made at work got a hostile reaction which led to disabling pain.

My first brain surgeon certified me as temporarily disabled (unable to work my current job) based on that fact. If it hurts, don't do it. I know some people will talk about slogans like "no pain, no gain" but we're not talking about the same thing. On a very good day, I am in the degree of discomfort that slogan is meant to describe. When you exercise, you can expect to have a certain degree of soreness/burning based on the specific exercise. That soreness is not intolerable and goes away with a dose of what healthy people call painkillers. Those of us suffering from chronic pain experience worse than that getting out of bed in the morning.

Real pain makes it almost impossible to continue what you did to trigger it or to do a good job of it anyway. Society tells us to soldier on and go back to work despite the pain that saps our concentration at best. My mother-in-law, Judy, is a bus monitor. Her job requires her to assist handicapped children on the school bus. She needs to be able to move around, assist and, on some rare occasions, restrain children just enough to keep them safe. She needs her full concentration, judgment and physical strength available to do her job in the event of a crisis. Normally, she is more than just capable of doing so. She's a real pro.

Unfortunately, she sustained an injury. I won't go into specifics to keep her privacy intact but the pain is significant. It has deprived her of sleep even while not working. (She was on vacation at the time.) She was instructed to do a number of things that also fall under her business but one of those instructions was to rest. Moving around normally is painful enough without lifting children. The obvious question she might ask me is what could she do without her job. I hate to say it but losing her job is not the worst case scenario here. I don't have intimate knowledge of her job which she has said is less physical this year but what if she dropped someone's child? Pain is a warning sign and the warning is to take some damned time off and heal before someone gets hurt. If she tries to ignore the warning, the best case scenario is that someone very important to me gets hurt...her.

As a writer who experiences pain associated with concentration, I am all too aware of how frustrating this is. At some point (likely soon), my normal background pain which already requires narcotics to be tolerable will flare up and force me to notice it. At that point, it will be time to stop writing. If I stop while the pain is comparatively mild, I might not be forced to take my breakthrough meds. I might even be able to return to my writing project in a few hours. One of my problems is that I am stubborn. Yes, I am stubborn. I know that writing can lead to instances of extreme pain but I write anyway. That's a reasonable amount of stubbornness. Forcing myself to keep working through the pain until I cannot write another word is stupid.

On my unreasonable days, I will act unreasonably. There are days when I shouldn't try to write a single word. (I do many other things but I'm trying to keep it simple.) There are days when I will keep going until I need my breakthrough meds because of writing, wait for them to take effect and then start again. Guess what? The pain always comes back and I will have already taken my dose of breakthrough meds for that allotted time period so I have to admit defeat and suffer for hours on end. I will find myself in my broken chair kicking myself metaphorically only because I can't do it physically. Hindsight is usually pretty accurate and I will agitate myself into more pain because I'm blaming myself.

Blaming yourself is the next lesson. I've reached that point where I need to stop or suffer the consequences. Let me just conclude by reminding everyone including my dear mother-in-law that most of the pain we chronic sufferers feel just happens. It isn't because of something we did. Knowing when to stop helps a lot around the margins and might be the difference in whether your pain meds take full effect or not. Don't blame yourself. Even the worst self inflicted pain is a mistake and mistakes happen.