Thank you for all the kind and supportive comments yesterday.
Do you think you can make it through one more, very important, serious post on this topic?
In yesterday's post, I wrote about my experience with varying pain levels since my car accident. I also attempted to explain why people should not be so quick to judge and/or blame chronic pain sufferers.
I also might have called a few people assholes, in an inadvertent sort of way.
It's sad people are so quick to make up their minds about things they don't fully understand, but they are. I guess people like to feel superior and being judgmental gives them a boost. (And no, I'm not directing that comment at any ONE person.)
Today, I want to write about aspects of chronic pain I haven't really addressed here before.
For instance, did you know scientists have documented numerous physical changes which occur in patients experiencing pain over a long period of time? Yes, pain actually causes physical changes in a person's body.
In fact, the more frequently a nerve "fires" pain signals, the more efficient it gets – to the point of being hyperactive/hypersensitive and creating even MORE pain. Pain also "rewrites" or alters a person's central nervous system.
And not in a good way.
People with high pain levels also tend to have high blood pressure and lower life expectancies. I've also recently been told I'm severely lacking in Vitamin D, in spite of my outdoor lifestyle in the California sunshine.
It turns out low levels of Vitamin D are tied to high pain levels.
Who would have thought?
I could go on and on and on with a list of all the physical changes chronic pain causes.
The list would be extensive.
Several brain chemicals, including the much talked about serotonin, decrease in patients with high pain levels also.
As if ongoing pain isn't depressing enough, it screws with your brain chemistry at the same time.
Serotonin is believed to help STOP the movement of pain signals in the brain. Obviously, if you're experiencing a lot of pain, having MORE serotonin would be beneficial. Decreasing it (as pain does) only exacerbates the situation.
I was fortunate to have a doctor put me on a low dose antidepressant right before surgery #3. He explained my serotonin levels would be dropping in conjunction with yet another surgery and he wanted me to stay on it until I got through my recovery. He thought it would help with pain management.
Was I clinically depressed at the time?
Would I have become clinically depressed if he didn't put me on something?
Who can say?
Did it help with my pain?
I don't think so.
At the time, I told myself the pain would probably be worse without it but I also wondered how it could possibly be worse than it was. (Surgeries #3 – #5 were the worst time period in my post accident years.)
Later, Dr. Painless informed me the dose I had been given was too low to be effective as a pain management tool. He also informed me the antidepressant the doctor had chosen wasn't the best choice for pain treatment. (The doctor's intentions had been good, but he wasn't a pain specialist.) However, having some extra seratonin in my body was probably better than not having it.
Dr. Painless changed my medication to Cymbalta which is the only drug in its class having received FDA approval specifically as a treatment for pain. (It increases serotonin and norepinephrine – both decrease pain signals in the brain.)
I didn't really want to go on it (I'm very anti-drug), but the pain I was in was terrible and I was desperate enough to try anything.
Has it worked for me?
Well, this is what I know …
I'm now doing more than I ever have since the accident. I'm living my life more fully in spite of my pain/injuries/disability. Part of that is the result of the bionics in my arm. Part of it is due to the muscle relaxers I take every night to control the horrible spasming I get in the muscles surrounding my arm/shoulder/neck. (Dr. Painless put me on those too after taking one look at my continually spasming muscles.) Part of it is probably Cymbalta calming down the pain signals in my brain.
Am I anywhere near "normal?"
Am I better than I was a year ago?
(Remember yesterday when I mentioned I now live in the 6 – 8 zone on the pain chart most of the time now, vs. the 9 or 10 zone? And yes, I still experience bad pain flare ups but they occur less often.)
Before I close, I want to bring up one more very important topic.
Did you know very few chronic pain patients ever become addicted to pain narcotics?
The media would have us believe MOST chronic pain patients are addicts and complaining of continuing pain just to receive narcotics. In reality, pain patients without prior addiction problems have an extremely low level of addiction (0.19%).
My biggest regret in my first three years post car accident is not having taken MORE pain meds. Everyone I knew, doctors included, scared me to death at the thought of taking them. I was so afraid of becoming addicted, I would discontinue the use of meds as soon as possible after each surgery.
The pain I was in during that time period was brutal.
I told myself toughing it out was the RIGHT thing to do, because omigod I don't want to become a drug addict.
I've only learned in the last year, the chances of my becoming addicted were extremely remote and it would have been so much better for me, in every sense of the word, if I'd taken more pain meds.
All the "don't take drugs, tough it out" advice I got (and still get) was well intentioned, but incorrect.
Pain takes a horrible physical toll on a person.
Managing pain as much as possible, usually with a multi-faceted approach, is the most important thing a chronic pain patient can do to lessen that physical impact.
You can find Part I of this post by clicking here.
© Twenty Four At Heart