On Overcoming Pain
bunniestudios.com
bunniestudios.com
1) "the realization that my life has changed for the worse in irreversible ways" - This is a dangerous perspective. Yes, life has changed, but if you focus on 'for the worse', you step onto a path that leads to depression in 90% of chronic pain patients. I instead focus on what I still can do. I might never be an athlete again, but I can walk. I can take short hikes in the mountains. I've changed my hobbies from an active collection of martial arts, biking, and hiking, into more sedate things like painting and woodworking. I celebrate staying active for half a day instead of dwelling on the fact that I used to be able to move all day. Much of your ability to adapt to chronic pain is mental, not physical, and this is exactly why CBT is recommended as a therapy - to help you to frame your life in positive, productive behaviors that keep you going in the right direction.
2) Everyone's pain is different. There is no single answer for how people deal with it (or fail to deal with it). This post sounded to me less like someone trying to communicate with their audience, and more like someone thinking it through for themselves. So while I had mixed reactions to the details of it all, I think the act of having put it together is likely a healthy move, so I appreciate the effort to have done so.
Experiment. Try different things, though try and varying them one at a time, so you can know what has an impact.
I never think about the fact that I can't run or ski or whatever.
I'm so very glad you ignored your doctor, but I wonder how many people out there didn't and never even tried to walk again after complex knee surgery.
We put so much trust in doctors, so I agree, who knows how many people he's harmed with that attitude.
Then, I herniated a disc in my lower back. I think it was from playing basketball (not really extreme heh). The pain was literally the worst thing I have ever felt. My back didn't hurt, but my leg from the hip to the foot felt like it was on fire or the skin was being pealed off. I couldn't sleep, walk, get in/out of a car, stand upright, lay flat, etc... Luckily a back injection got the inflammation and pain under control. But, my life going forward has forever changed. No more basketball. No more heavy deadlifts (I was deadlifting in the 500#s, now I stay 225# or less). No more heavy squatting. No more running (afraid of the impact). I do what I can and work from there, happy that modern medicine gave me a chance.
In the beginning, physiotherapy got it to a stage where I was able to ride again and function normally (albeit with pain and stiffness) and painkillers helped in this phase.
After 5 or so years, I went to a doctor because the remaining pain (especially the occasional "hard pinch" of a nerve would almost take my legs out from under me) was getting to me. He advice was to me that surgery is pretty much always a worse option in cases like mine because scar tissue does eventually fade (as it does elsewhere on your body) and it probably takes a good 10 years for that to happen.
I did the injury at the end of 2010 and, it seems the doctor was spot on as in the last year or so my pain had almost entirely faded away.
Just my little piece of anecdata.
I’m fine with tingling forever as long as I can avoid that pain. It’s hard to describe nerve pain to people who haven’t had it. My ACL surgery was relatively painless compared to my sciatic leg pain.
I feel healthy now and can walk, run, have excellent mobility. No more sciatic pain, some tightness in the lumbar if I'm careless.
I don't squat or deadlift at all anymore and focus more on calisthenics (pullups, pushups). I do a lot of running and it doesn't bother me.
But for those three years, things were dark. I brooded almost every day on my injury.
I do a ton of calisthenics, and thought about stopping squats and dead’s completely. The reason I didn’t is that they enforce good posture and the proper way to pick things up. They also strengthen all the muscles that will help keep me from being hurt again. With that said, I worked incredibly slowly back to where I am. From no weight to now. And, if I’m not feeling it that day, I have no problem just doing calisthenics or riding the bike. Ego be damned.
Yes, the chronic pain perhaps?
Imagine that, they won't prescribe long term pain killers in case you might get addicted and take them for too long. It's insanity. I hope things work out for!
The whole experience somewhat ironically turned me sharply against drugs in general. In my case the doctor should have forcibly cut me off much earlier. He tried, I protested, he relented -- that was a major mistake on his part. These drugs change your perception of normalcy and make you lose context. And it seems like it's every other week there's yet some new discovery of a negative effect of drugs we thought (and many still think) to be relatively harmless such as paracetamol/acetaminophen/tylenol [1]. That link is just a google scholar search for paracetamol since 2014. Worth perusing if you'd like a reason to avoid that bottle or blister pack next time you have some sort of ache or pain.
[1] - https://scholar.google.com/scholar?q=paracetamol&as_ylo=2014
Our bodies are annoying creatures in that many things that make us feel good or even feel 'right' are in reality absolutely terrible for us. Add a profit motive into making us feel good, let alone paired with some rather less than ethical players, and it becomes a very twisted system.
Turns out, chronic pain, when the prospects seem bad, drains your motivation away (even more so with functional neural problems, which simply make you feel like crap 100% of the time). Now, if you happen to be of procrastinating type before that, you're left with zero motivation. Your mind is kinda hazy in the mornings, so you have to rely on your habits to carry you through. Every movement requires effort now. For a lot of illnesses, physical therapy is the right answer—and meanwhile, the instinct says to stay in the chair with a big breakfast and marathon BoJack Horseman.* Maybe later the mind will clear up a bit or the pain will ease up, and you'll swing dumbbells around or go outside. Oh what do you know, it's evening already.
This regime made my physique problematic in the first place! Why don't I have an instinct that would tell me to move around and exercise?
And this is cumulative, of course—I should be making some better habits for tomorrow, but instead I'm dropping everything that seems of no immediate importance, which is like all that makes life healthy and interesting.
So, I once believed that conscious effort would carry me through life—but if you look into pretty basic psychology, the ape brain is way more firm at making day-to-day decisions. It's better to have habits that will work for you in hard times. The sentimental books about how you need to ‘overcome yourself’ were right, only they were distant and nonspecific.
* Note that marathoning BoJack Horseman is definitely recommended in different circumstances.
I thought 40 was just my inevitable peak and it all sucks from here. Life took on a real grey hue.
Well. My wife made us go on some “anti inflammatory” diet. No gluten. No dairy. No sugar. No alcohol. Low carb. No snacking. I moaned about it for days.
After 5 days my body was dramatically better. All the joint pain disappeared. The fluid in my ears is either gone or drastically more manageable right now.
I’m still on a similar diet today but not as strict. And I remain feeling really good. I can’t believe I was living with all this chronic pain this long and could have just changed up my diet.
So I drop this story here because I bet there’s some other folks out there that could see some impact in their life just being a bit more aware of their diet.
For me I have no idea what the real cause is. Sugar? Alcohol? Dairy? I’ve heard from others they have a sensitivity to a food and had similar symptoms. I took a food sensitivity test at everlywell.com which mentions a high sensitivity to brewers yeast. So maybe it’s that. Maybe my body just needed a detox to reboot. Who knows. But I feel great.
(The diet I went on was in an ebook from a healthy heart Facebook group https://m.facebook.com/groups/thehappyheartproject/) but it isn’t magical or mysterious. You can just figure it out yourself by staying away from the things I mentioned above for 5 days.
For anyone that likes complex problem solving and wants to start down the low carb road, I cannot recommend Ivor Cummins'[1] and Dr. Jeff Gerber's[2] work on diabetes and cholesterol enough.
Fortunately my issues to date seem to be controlled with heavy vitamin D3 supplementation, so I don't have to do a hard restriction on anything.
The most profound dilemma to me from my own outcome of pain is how "people who haven't lived the specific pain" are calling the shots. How illnesses resulting in physical & psychological pain are handled by treatments tailored by people who haven't experienced the pain. Similar with the allocation of finances and the perception of how one should adapt their outlook on life; based on how outsiders of the experience looking in will decide on what's best. It's comparable to how a victim is so easily coerced & manipulated in a lesser state and when having faith in persons with the status of attempting to help. Personally, I would trade my life in a heart beat for without daily pain and never the experience. Psychologically I can understand why people look to feel grateful for insight or to make people educated about pain. Sadly, I think it's just an irrational attempt in making one try to accept the unfortunate circumstances from the cruel will of the universe.
I take prescription NSAIDs and other drugs for a long time. Also a lot of acetaminophen per day. (Which I carefully monitor.) I also take, occasionally, narcotic pain killers (hydrocodone). Next January (2019) will be ten years since I added hydrocodone to the drugs I use for this.
But it is a tool. Nothing more. I take it only when I need it. I don't have any predictable usage pattern. It is for occasional use only. I have a very healthy fear of taking it at all, but if I'm in enough pain, I'll overcome that and take some. I have a good life and don't want to screw it up with narcotic pain killers. I have never had any resistance when asking for a refill. Neither my primary doctor nor arthritis specialist are worried that I'm taking too much.
If anything, I've noticed that in the last couple years, I've slowed down my usage a little bit. (Measured by time between refills.)
I think in pain management, the first thing is "learn to live with it", and then, "there are good drugs for days when it is really bad". (just IMO) I'm always looking for the lowest dose I can take that will be effective for any particular episode. I don't want to build up a tolerance. And I suppose I must not have built up a tolerance in ten years of occasional use.
I haven't become addicted. But I also don't drink alcohol. Or smoke. Or use very much caffeine. Maybe that is related, or maybe not.
I would say that hydrocodone has improved my quality of life. I get out and do things I sometimes wouldn't otherwise do.
Last year I was in Colorado and tried some, .... uh, ... products. First, I thought they were pretty pricey compared to hydrocodone, which costs me only $5 for a bottle of 30. Second, while they did help some, I didn't think they were nearly as effective. The hydrocodone is more like a nuclear weapon for pain.
I go to sleep with pain, and on many days wake up with pain. I have to hold down a job and take care of family, so I put on a wincing face and deal with it. I like to think I can mask the pain well, but my family tells me otherwise. I've tried medicines, injections, and countless remedies over the years and spent a bunch of money on doctors. But there is no reliable cure for me so far. I do all the usual things that people do at my stage in life, I laugh, I play, I go to work and do well ... but I don't think anyone really understands how much I have to kill of myself (my desires, my wish to be in a dark room with no noise and isolated, my wish to sit around and do nothing and just pass out with pain) to get thru each day. That has left me lonely, and a bit distrustful perhaps of people - though I try not to act on that thought.
A few years ago, I tried cannabis. Living in a state where it is illegal was a problem - both legally and with my job. I got a few different strains and experimented with it over the course of a few weeks. When I found the strain that worked, I cried. I cried so much. I was pain free in a way that I hadn't known in nearly 2 decades. I didn't even realize how much and where I was hurting. Apart from my head, every muscle in my body was hurting due to the constant strain of dealing with pain. And it was all gone. Gone. I felt like I was born again for a few days. And then it was over. I couldn't continue with it due to it being illegal. It was then I really understood how immoral having at a minimum cannabis not being allowed for medical purposes is. I don't know if it is a long term solution as I didn't have an opportunity to gather enough data and observations - but surely there is potential. I also didn't have any side effects, with the exception of "the munchies" - which is very real :).
Some random observations:
Meditation can help. My pain was more connected with my emotional state than I expected (much worse when stressed and much better when distracted by an enjoyable experience). Pain and negative emotions reinforce each other. Narcotics often break the concentration that makes meditation reduce pain. Nevertheless sometimes you gotta load up on narcotics so you can attempt to get the sleep your body needs to heal.
In my case I went through about 40 percacet the first week. But took 5-6 weeks for the next 40, and then I was off the heavy stuff and stuck to ibuprofin.
My shoulder still hurts.
I tore ligaments in my knee several years ago. The paragraph about the accident was extremely hard to read and caused me actual physical discomfort!
On reading certain passages, my afflicted leg (and only that leg) got tingles and goosebumps and the rest of me just... cringed... in horrified empathy. I feel ill just thinking about OP’s pain, and knowing, as OP does, that this is nothing compared to the pain of certain other maladies makes me wonder how anyone can bear it.
Please do yourself a favor and read that book, I hope it helps (it did help a very skeptical me one year ago).
It seems to me that this is the function of pain.
If one could voluntarily embrace this process, would this make opioids less necessary and/or desirable?
It certainly would, but "embracing" the process of pain is an enormous mental and physical challenge.
Entire religions, for example, are devoted to separating the mind from the experience of the body. But this takes years of conscious effort.