Tuesday, September 25, 2012

What is your pain level right now?

As a chronic pain sufferer, I am used to answering the following question from medical providers on a regular basis:
On a scale of 1 to 10, what is your pain level right now?
Days like today present a quandary.   It depends on the absolute definition of the word "pain".  (No, no, not "is" or "sex" or "It!") 

Nineteen months ago I slipped on a patch of ice in front of my house and severely damaged the soft tissue in my left shoulder.  Scans showed that there were no tears to any ligaments, tendons, or other mappable structures.  After six months of physical therapy we decided that it was as 'back' as it was going to get.  Unfortunately, this did not leave me with a healthy shoulder.

Part of my chronic health issue over the last seven years has been chronic inflammation.  If I sustain any sort of injury, it seems that I will be plagued by that injury on some level until my dying day.  The left shoulder is a prime example of this scenario.  Every day it at least aches to a certain degree.  Some days it straight out hurts.  Even so, in comparison to other pains that I have struggled with, the chronic shoulder pain rarely merits more than a 7.  However, the shoulder situation is about more than just "pain". 

Usually there is more of a sense of discomfort.  The joint feels swollen in some way.  It can feel better to hold my arm straight up, especially if I bend at the elbow and rest the weight of the arm on my head (nice image, right?  I've gotten some seriously odd stares at the office over this.)  There must be some swelling involved since, at its worse, my left hand feels a bit 'off' and my bicep may feel achy as well.  However, it's not all inflammation since my prescription NSAID only dampens the discomfort a little.  And, it's not strictly pain either, since taking the max dose of my non-opiate prescription pain relievers barely warrants a footnote when the shoulder is really acting up.  Usually both drugs together can  tune the discomfort down a notch or two so that I can get through the day.

USUALLY.  Today is not one of those days. 

If I were to step back and analyze "the pain" in my shoulder right now, it probably would warrant a six.  Right there, in the front of the shoulder.  SIX.  Six isn't that bad, right?

Except it's not just that spot where it definitely "hurts".  It's about all the discomfort in the surrounding tissue, into my bicep, and down to my hand.  THEN, there's the fact that my pelvic girdle is a bit achy today, as is my low back.  On top of that I know that when I get up from this chair, both thighs are going demand my attention with their multiple maddening small to midsized complaints.

It's all additive.  I logically know that all of it together is not as distracting and intolerable as the worse pain that I've ever experienced (tie between gallbladder attack and labor).  Still, when the dozens of bits conspire together you want to be able to quantify the sense that you can barely catch your breath from moment to moment for want of screaming.  Mostly, it's just below that or I wouldn't have been able to write all of this.  Though I did have to stop and refocus myself too many times to count.  Each time I take several deep breaths and try to dispel the cacophony of all those co-conspirators bouncing around in my head.

This is just one example of what it's like to live with chronic pain.  I am so glad that every day is not quite this bad.  Today is one of those days where I contemplate taking up prayer to a deity that I cannot believe in.  Oh, how I wish I could.  If I could pray, I would pray that the Lyme diagnosis and treatment will at least keep the discomfort from reaching this volume  ever again.  I would like to believe that I could make all (or at least most) of the pain go away.  But my skeptical wiring won't even let me hope for something that seems too much like a fairytale.

If you see me and I seem in good spirits, do not assume that it means that I am not in pain.  Also, if I am not showing it, do not ask me about my pain.  When I look fine, I'm doing my best not to think about it.  So please, please, don't remind me.  If I look miserable or distracted, feel free to ask me how I am doing.  Or if I need to talk about it and I trust you enough, I will bring it up. 

The last thing I want is to have my pain define my relationship with others.  Days like today it is hard for even me to remember this, but I am more than this pain that I live with.  Every day.  Every hour.  And sometimes, every minute ... to minute ... to minute.

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