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Pain: A Primer


Apparently, in the subjective landscape which is pain perception, I have a very high tolerance (and threshold). To wit:
  • When I broke my foot 4 years ago, a fracture which presented with tissue damage, I managed on an occasional Advil. Moreover, I walked around on it till they confirmed (with secondary scans) that the foot was actually broken.
  • When, at work, I sustained a sizable third-degree burn on my hand (microwave soup accident, people), which my doctor friend Hilary saw afterwards and responded to with horror, instead of going to the hospital (recommended by peers, I should confess), I attended a briefing with a bag of frozen peas to take down the swelling.
  • When I had a baby with no medication, at home, and there were unforeseen complications, I was one of the 2 per cent of midwifery patients to require an episiotomy. Following this, my midwife reached inside my body (while paramedics were on the way to my house to take me to the hospital) and unwrapped the cord around my baby's neck (it was wrapped 3 times) while pulling her out fast. I needed 36 stitches and it's only by dint of my midwife's long-standing in the community that they didn't take me to the hospital to do this. (Note: They did freeze the area before stitching, which I found hilarious given that I'd basically just had surgery without medication.)
The interesting thing about these three examples (and I have a few others, but those are the flashy ones), is that they chronicle a pain response to immediate trauma. Effectively, my body responded to nocioceptive pain (that of injury to skin, tissue and bone) in a reasonably sanguine fashion.

Did I feel the pain? Oh, yes. But, more to the point, was I able to distinguish it from the trauma I was experiencing? Yeah.

That quality is probably what's saving my ass right now as I experience an extreme instance of chronic neuropathic pain. This is the kind of pain that comes from a seemingly endless, fucked up conversation between your brain and your body. It's not in response to trauma, but it can produce the symptoms of it.

To wit, apparently, the current degree of scar tissue in my upper back (left side) is consistent with that produced in a serious car accident or a fall from a high height. It wasn't there 3 years ago (before my pain began in earnest). I can only imagine how badly off I'd be at this point if I didn't do yoga all the fucking time.

The latest practitioner to look at what's happening, asked me what narcotic I was taking to manage the pain. When I told her I was subsisting on the occasional Advil gel-cap, yoga and another natural treatment I won't discuss here, she was shocked.

Technically, I think we can consider this the outcome of myofascial pain syndrome, though I've resisted definition for a long time. I know that the only thing my allopathic doc can do is offer me some drugs that I'll acclimate to, all too quickly. I also know what's been going on from the vantage point of the person who lives in my body. I've told y'all for years that this is about hyper-tension of muscles and spasm. What I didn't realize is that I've likely been dealing with peripheral nerve excitability (something concerning that I don't feel like linking to), a condition that requires me to exert effort to prevent my body from twitching in a weird rhythmic fashion.

That's what I've got to deal with first and foremost because it's the sign of damage and, unchecked, it will continue to contribute to it. Note: I intend to fix this with body-work, not drugs.

For those of you interested in myofascial pain - and I urge you not to be - I'm like the poster child. It usually arises out of the comorbid experience of TMJD, migraines, tension headaches, anxiety, noise and light sensitivity and mitral valve prolapse. Stress doesn't help. I experience all of these in force.

I'm telling you this by way of connecting with the broader universe - those who are pain sufferers and those of you who have known me for some time.

This is not an easy moment. The last 4 years have not been an easy moment but occasionally things seem very hard and this is one of those times.

I can't type easily right now. It takes a toll and I need to be judicious. Work is getting the bulk of my energy because it pays me. I will write when I can though, for reasons of life insanity and, well, pain management, I won't be writing as regularly for the next while. My body and mind are, frankly, exhausted.

Mind you, with silly definitions out of the way, next time we chat I can tell you about how I'm managing things. I can assure you that this pain isn't me, which is likely why I'm managing at all.

But in the meanwhile, I'd so love to hear from you. What's your experience of pain? Is it chronic? Are you oblivious to it? Do you have a terrific story of recovery? Can you provide advice - pain-havers and regular peeps alike. Let's talk!
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