Tuesday, September 2, 2008

On Pain

Inspired by Elizabeth's upcoming radio show on pain and a difficult day yesterday, here's a pain control technique I wish doctors would try.

In Pam England's Birthing from Within book and childbirth classes, she has patients practice pain control by holding or putting their hands in ice. If it doesn't sound painful, try it. The first few seconds, it's just cold, but as you hold the ice longer (not enough to cause frost damage!), the cold intensifies and turns into pain. You want to put it down, but you can't because it's not time yet. So your mind tries to adjust itself, looking for an out. When it realizes there is no out, that your hand's going to stubbornly hold that ice, you quickly develop coping techniques for it. If you hold that the length of a contraction, a minute or even up to a minute and a half, your hand just hurts. After you put that ice down, the pain gradually begins to fade away but doesn't disappear immediately. You begin to look forward to putting the ice down, for those breaks between "contractions" and with a Zen mind begin to realize the temporary nature of the pain and to either sink into it or focus on other senses.

Imagine picking up that ice yourself for a minute. Or better yet, do so, unless you have circulation/skin problems. It feels good to put the ice down.

But with most intense acute or chronic pain, you can't put the "ice" down. As pain patients, we'd like to put the ice down at any time and relax into that blissful fading of pain. You have to hold the ice longer--try 3 minutes even. The longer you hold the ice, the more difficult it is to control the pain with mental power, though you begin to adjust. But you don't have that break between contractions and there is no baby to look forward to at the end, and you don't know if the pain will end or how long it will take to diminish. If you've had acute pain frequently, you develop some trust that it will fade, that eventually you'll feel better. In the meantime, though, your life goes on hold.

If you do too much one day, or perhaps without doing anything out of the ordinary at all, you can't brush your teeth, get dressed, compel your body to move. So you postpone going to the bathroom because you're going to have to carry a 20-pound bag of ice with you. It's strapped to your neck and back and settles in your low spine and hip. Some of it melts and shifts, migrating down your back, down one leg. It's in your shoulder and knee, and impedes movement as well as creates pain. You have your wheels, but getting to them or transferring is painful too. You can't sit down on the toilet, so though female, you stand to pee. You can't make it out of the house. People wonder where you are. They think you have problems. You do have problems. But they've never carried more than a 5-pound bag of ice with them. They think they understand since they've carried around 5-pounds of pain packed in their lower back or around their knee or on their head for a while, but they can't.

Update: in-laws have had a lot of rain from the outer bands of Hanna in Jamaica but are doing well. And going on a cruise later today.

Update to update: Tell me the in-laws aren't on a boat in the middle of the hurricane. Somehow I know that they are unless the boat company cancelled because they're just that optimistic. Someone's got to worry around here.


Elizabeth McClung said...

Thanks for the analogy, it is a good one becuase I do regualarly have to be iced and yeah it hurts but they are supposedly doing it to "save me" but still!

Yes, also nothing quite so frustrating as someone who "Relates" to your problem. "YEah, I one had a back sprain from playing in the weekend tennis tournament so I know EXACTLY what you are feeling!" - oddly makes me want an ice pick near by and scream, "Want to know what I am feeling!?!" and start stabbing......but that's just the pain talking right..right?

FridaWrites said...

LOL! Just don't go icing your hands or anything--you're exempt from exercise since you already get pain.

I've had back sprains too, doesn't compare, does it?

FridaWrites said...

Oh, and people should just try sleeping next to a 20-lb. back of ice.

yanub said...

Right now, I'm sitting here at work, on an abnormally un-busy day, with my toes feeling like they are about to freeze and fall off. Even sitting on my feet doesn't help--it just makes my butt cold. It's no colder in here than it was last week, and I'm not dressed remarkably differently, so I know it's just me. I would be so happy right now to get the blasted ice out of my shoes. This doesn't rise to the level of pain, but at the moment, it is more annoying. So, your description of the ice exercise? Arrrgghhhhhh! Way too good.

FridaWrites said...

Hoping for warmer days ahead. I wish I could give this analogy to the moms at Girl Scouts who thought I could be cookie coordinator this year. Umm, how would I sort all the boxes and get them in and out of the van for booth sales, much less staff the booth sales? With the comments that are being dropped, I know they don't get it. Headdesk... or lapdesk anyway.

Liz said...

Oh I so know what you mean.

I find that feeling you describe -- of putting off having to pee -- particularly humiliating somehow.

People don't understand about pain, they think either your body works or it doesn't. So odd.

FridaWrites said...

I'm glad to know I'm not the only one who postpones pee. My husband will stop by the couch and pat my leg, and I'll say, "Don't touch me! Overload, overload!"

I hear you there--somehow the Girl Scout moms thought I could be cookie coordinator this year and since this troop sells thousands of boxes, I'm thinking ????. How'd I manage sorting that or staffing the booths?

Unknown said...

Thank you for being able to articulare things I cannot when I think about magical it would be to be pain free even momentarily. Often the full weight of the 'ice bag' doesn't hit me until very late at night, when I lie down, hoping to be drowsy and relaxed for bed. Unfortunately, the pain comes down on me all at once and I spend sometime a full hour bawling and pleading to be given one pain free day. Everything groans and becomes inflamed with pain and all can do is wait for it to calm down to a tolerable level.Every night I put off going to bed until I am passing out with exhaustion..the fear of the pain keeps me awake.
Thank you again. It helps to identify with others.

FridaWrites said...

You're welcome--I am sorry you have such pain. I'm postponing bed myself for the same reason. I hope you find some relief so you can sleep better--restful sleep makes it easier to deal with chronic pain.