A few words on Pain -

For most of you, "pain" is merely a word, and representative of something to be avoided. At most, "pain" is a temporary condition to be muddled through and then move on from.

Pain does have its uses - after all, it's a signal from the body to tell you that there is something wrong. It's also a useful evolutionary mechanism for learning - pain motivates you from doing something wrong to doing something right. That's what makes corporal punishment effective - when used properly. After all, didn't I just say that pain was something to be avoided?

However, there are those of us out here who suffer from chronic pain - for various reasons. It may be due to an illness, an old injury (or several!) a chemical imbalance in the body - and we don't even know all of the potential causes for chronic pain (for instance, there is a condition called "fibromyalgia." We don't know what causes it, we're only just figuring out how to manage it, but we aren't anywhere near finding a cure for it. My wife has it - so I've been learning a great deal.)

For me, the pain is due to old injuries - primarily fractures. Over the years I've accumulated quite a few fractures and deep scars, and all have left their marks on me. After a while, they became a source of CONSTANT pain.

For you, pain is probably something that can be avoided. For me (and my wife, and quite a few others,) pain is a constant companion throughout the day. Surgery can't fix it, medication can only dull it - it hurts from when we wake up to when we finally fall asleep, and then it starts all over again when we wake up the next day. Some days it's worse, some days it's better.

In my case, it ranges from good days of "merely annoying and mildly distracting" to bad days of "would somebody please kill me?" (I'm only mildly joking there - but even death, to date, has been a temporary inconvenience for me. I'm not sure it would work, but there are days where it hurts just to get out of bed and go take a leak...)

Headaches? Yeah, I can understand those - I've had a headache since NOV2007. Yes, I'm being medicated for it. Yes, I'm seeing a neurologist. Yes, she's just as in the dark about what's causing it as I am - and we've both looked at MRIs of my head (I can probably sketch the anatomy of my head from memory by now...) and we've been through a series of medications for it (and I'll probably be trying something new next time I go see her. The current med is losing effectiveness.)

Your boss probably talks about "having a headache and coming to work anyway" - I've got to deal with it all day, every day, without a break. Again, it varies in intensity from "distracting" to "disorienting" - I have days where my head hurts bad enough that I can't even see straight.

Recall I mentioned fractures? Most people think there's nothing to the "myth" that a drop in barometric pressure makes old fractures hurt - I'm here to tell you, it's no myth. I'm a reasonably accurate barometer, just going from the pain I'm feeling. Even if TSA weren't being an compleat and utter useless pain in the ass, I still wouldn't be able to fly - airliner cabins are only pressurised to 8000' MSL, and that's well below my "pain threshhold" for barometric pressure. I'd need a dose of morphine and fentanyl before I could spend any signficant time at altitude - I travel by train or car.

Considering the LOCATIONS of the fractures I've had - I've broken my neck in two places and shattered my face, among others - and you can see how it can rapidly get to be incapacitating. The barometer gets below 29.70" Hg, and my pain level spikes rather sharply. The barometer drops below 29.40" Hg, and I can't concentrate. If/when it manages to get below 29.00" Hg, I can't even get out of bed. Not /won't/ - CAN'T. It literally hurts too much to move.

And through all of this, I have people telling me I should at least get a part-time job. I can't do that. No-one is willing to accept someone - no matter how good he is! - working "if and when" and needing to be able to take time off rather suddenly, even in the middle of a shift.

I've managed to find something I can do most of the time - that's why I'm writing my books. Maybe they'll take off and I can get something useful done with my writing - but it's something I can work on in my own time, and if I need to take time off from doing it, I can. I can set my own schedule (primarily nocturnal,) I can stop doing it or take time off from it with little to no notice, I don't have to deal with a boss telling me to "just tough it out" (I swear, the next man who tells me that is going to be used for a battering ram on the nearest masonry wall. That's why I'm writing this - TO HELP PEOPLE UNDERSTAND. I hurt, and I can't move fast, but I'm far from weak.)

For exercise, about the most I can manage is to walk around the block once or twice a day - it's all I can do. Sometimes, I get around once and can't walk anymore - and whether I'm trying to go around once or twice, I take a cane so I can unload my knees if one of them should start playing up on me. I try to carry it rather than use it, but it's better to have it available.

I won't get into the other medical side effects I've been experiencing from major CNS trauma (I've got a few - and about a dozen MDs on my consultation list...) as this post is supposed to be about PAIN.

However, it's the PAIN aspect of it all that I most want people to try to understand. The problem with pain is that it can't be seen from the outside, and we usually manage to minimise the display of it (for instance, I ALWAYS limp. However, most of the time, the limping can really only be seen by someone who is either trained to notice it - an orthopaedist, osteopath, physical therapist, or similar; or by someone who is a keen observer. Most people can't see it.) Most sufferers of chronic pain can understand me when I say, "I wasn't born - the stoic brought me." Stoicism is equally a part of daily life - just as much as pain is.

We do odd things - some positions relieve the pain we're in.
We often eat odd things - I've found that spicy food (which I enjoy anyhow!) helps to mitigate pain. I've found that's due to the OC that makes hot peppers hot. Fine by me - I've got a decent collection of hot sauces anyhow...
When we say that we can't do something - it's because the pain either prevents us or interferes so badly that it's more difficult than you can imagine. Listen to us when we say it, and try to help us if you can - it's easier all around.
We don't usually talk about how much pain we're in - suffice it to say that, if a sufferer of chronic pain is actually vocally complaining about it, it's probably enough that it would overload you and render you unconscious. We don't have a phenomenal tolerance for pain because we WANT it, believe me! We have it because that's the only way we can really function in any capacity.

For fellow sufferers, a few things I've found out:

- Typical over-the-counter painkillers rapidly lose effectiveness. I can take Tylenol, Advil, or aspirin by the handful and it don't do nothing - therefore, I quit years ago.
- If you can handle it, eating spicy foods can and do help. I love going to Mongolian BBQ - both because I like spicy food anyhow, and because I feel better when I leave. I also have an extensive collection of hot sauces in the fridge - I like variety. Even something relatively mild (Bufalo Chipotle sauce - pleasant smoky flavour and a good pepper bite) can help you - chew on the idea.
- Getting drunk helps, but reserve that for when you want to totally take a break. Most of the time, you REALLY pay for it the next morning (I've heard that hangovers are bad - but I don't get them. However, having all of the pain come rushing back is NOT fun.)
- Pick a physical therapist's brain. You'll probably get some exercises or movements that you can do to help mitigate your pain - and you should be able to do most of them in your chair at work (if you're working) or at your desk at home (if you're not.) You might also pick up how to make something small that will help you, or can buy something relatively cheap that you'll get a good deal of use out of.
- Study anatomy. Learn how joints work - particularly if you have joints affected by pain. You can learn to do movements and exercises on your own that will help you, or what motions to avoid to make the pain worse.
- Medical care is a two-way street. The thing I've noted in common with most people who complain about "quality of care" is that the place TOTAL faith in the white coat. Ask questions. Question what you're told, just a bit. Make notes to refer to in between appointments, and keep in touch with your doctors. If you put some more INTO your appointments, you'll get a Hell of a lot more OUT of them! I make it a point to learn something new every time I go to see a doctor, and that has helped me considerably. Bear in mind that your MD doesn't have all the answers, even if he won't admit to it (the good ones do.) And, there's probably going to be a difference between the answer you get if you don't tell them anything and the answer you'll get if you inform them - and the informed answer you'll get from them will be much more effective.
- If you live with someone, ask their opinion of what they see you doing every now and again. When you're in pain, you're too close to the problem, and you may not notice something useful. My wife and I (both sufferers) keep an eye on each other, and let each other know if we see something different. Comes in handy - because each of us has indeed noticed something in the other that we didn't notice ourselves (does that make sense?)

If you're IN pain, I hope that the tips help, and I hope that reading something by a kindred spirit helps you as well.

If you're NOT in pain, I hope this helps you understand what those of us who ARE in pain go through - every day. It's far from everything that could be said on the subject, but it's probably a good deal more than you knew already - and that was what I was trying to do when I wrote this.

Good luck, everyone!