Co-written by Amy Nora Chronic Pain... is just that. It’s chronic, meaning it’s something we live with ALL the time. It is not the same as stubbing a toe or knocking your knee on the corner of the table. There is no cursing or exclamation of words and a few minutes later life is perfectly normal and you are moving on. Nor is it like breaking a bone, wearing a cast and being done with the pain and annoyance 6 months later. Chronic pain forces you to live differently. Life becomes methodical, more deliberate in the actions we take, and how we live our lives. This includes the simple things like getting out of bed, going out with friends, cleaning, or trying to cook a meal. You live you life in pain; therefore, you come to accept various levels of pain as normal. This does not mean that you would constantly rate your pain a 10/10, you may rate your pain as a 2/10. However, you had to stand and make a sandwich so now that has spiked to a 7/10. This is a fight fought daily by millions of Americans with degenerative diseases or chronic medical conditions.
I wanted to give you all a look into a day in life of living with chronic pain. But I decided to go about it a little differently. My friend and frequent contributor Amy Nora and I will both be sharing our views of what like living with chronic pain is like. As living with chronic pain can look very different for different people.
I feel that there is so much negativity in news about pain and pain medication these days with all the issues with the changes in the rules and regulations with narcotic prescriptions. There are people killing themselves because they can no longer receive their meds. Others are being fired from their Pain Management Doctors because they don't take their pain meds frequently enough. We have all heard the stories. But I don't want to focus on THAT today. I want to bring light to what a real day of someone with chronic pain is like. I want to talk about what a day with multiple conditions that cause chronic pain can be like. I think many people have a stigma in their mind that people with chronic pain take their pain meds and may have some pain everyday, but most of their day is spent doing what they want with no big issues. Just so we are all on the same page here's a point of reference: besides taking pain medication I also use a combination of heat, hot showers, massage, muscle rub and yoga to treat my pain. I do suffer from multiple chronic illnesses that cause chronic pain, I live daily with Lupus, Fibromyalgia, Debilitating Migraines, Endometriosis, Interstitial Cystitis as well as undiagnosed chronic back, hip and sciatic pain.
For most people when the alarm goes off or they wake up, they probably start going through the day ahead in their mind. As far as what they have planned, what's scheduled, what they are making for dinner etc. For me and those with chronic pain the first thing I do when I wake up is lay in bed for about 15 minutes let my body wake up so I can assess my pain. I have to lay there for a little while to let my body connect to my brain so I can really take account of how I am feeling. I generally start at my head and work down. This morning for example, I started with my head, and the pain was like a 2/10. Continued down to my throat, neck and glands because I have been fighting a cold/sinus infection, that was like a 2/10. Then down to my shoulders, elbows and hands. Left elbow was a 4/10, still not sure what that was about, but it has been happening a lot lately. My hands, about a 4/10 as well. So I start doing some stretches to see if they are just stiff or if they are going to hurt all day. They seem to be stiff and the pain seems to ease with stretching, so that is a relief. Down to my belly, cramps are like a 6/10 as endometriosis causes MEGA cramps when its time for your cycle. My bladder is probably an 8/10, because I didn't wake up all night and it feels like it is ready to explode. My low back is a 6/10 as is my left hip, and for the first time this week I didn't wake up with any sciatic pain or pain in my left calf. Which has been very painful everyday this week. Overall, I would say my pain would be about a 6/10 this morning. So now that I have assessed the pain that I woke up with, now I have to decide what I want to do about. Do I go ahead and take something before getting out of bed, or do I wait and see how things go as the morning progresses? That is sadly the question I address each and every morning after I wake up.
Generally, my rule of thumb in the morning is that if my overall pain is over a 5/10, I go ahead and take something for the pain. I have learned that if I don't the day is NOT going to get better. And I will most likely not be able to get the things on my to-do list done. Or at least not until later in the day. So this morning that is exactly what I did, I took something for pain got out of bed and did my morning stretches that allow me to be able to move in the morning. Without those stretches, thanks to the fibromyalgia I would not be able to move first thing in the morning. I won't bore you with the exact play by play of my day. But at each step of the way I have to decide if I can complete this task or if I should wait and attempt it later. This morning after getting dressed and having breakfast, my first task on my to-do list was cleaning my bathroom, I knew I didn't feel like it but it can only be put off for so long. For most able-bodied people they could probably go in and get it done all in one fail swoop. For me however, it takes several steps. Due to my pain and fatigue, any multi-step project will almost always require several breaks. Just to clean my small bathroom this morning I had to stop and rest FOUR TIMES!!!! And it took me over FORTY FIVE MINUTES. Even with the breaks, I still had to lay down with my heating pad on my back and abdomen for about 30 minutes before I could go on to my next task.
I continued on with my day the same way as above. I vacuumed and then had to rest and use the heating pad. Then I did some laundry and had to rest. After eating lunch the pain has escalated again to about a 7/10 so I had to quit what I was doing and lay down. Completing simple tasks is no longer simple. It has to be well thought out and planned. That is generally how it goes for most people with chronic pain/chronic conditions. I can no longer just complete a task without resting or taking several breaks. Things that used to be simple and easy are no longer so easy. Everything that is done has to be well thought out.
I miss my time out with friends and family. But a night out or even time at home with friends or family for dinner and a movie requires major planning. Over the years I have learned that if I want to spend a day out of the house no matter what I am doing I better prepare. I need to make sure I rest all day the day before, and maybe two days before. And I know that I will most likely be in bed and doing nothing for several days after. For what seems like a normal day out of the house shopping or an evening out to dinner and a movie to an able bodied person is much different to someone with chronic pain. For example, last week, my little sister played in her last competitive softball tournament. And I just simply wasn't going to miss it. Sadly, I knew I was going to pay for it because I didn't feel good going in and it was 95 that day. (People with lupus simply do not do well in the sun.) So I planned ahead and took it easy the day before, and stayed in bed till the last possible minute the morning of, got dressed, and got in the car for the 45 minute trip. I was already hurting (at about an 7/10) by the time we got out of the car, and at that point we still had about 15 minutes to go before the 75 minute game would start. I had taken my pain medication before I had left the house but it wasn't doing much to relieve the pain. I made it through the game, a quick lunch after the game with the family and the 45 min drive home. After my shower, a COLD shower, I crashed. And I certainly paid for it the next couple of days. Everything you can imagine hurt, my back and hip from sitting, my head from the heat. And just about every joint you can name. I really was hardly able to get out of bed the next day because the pain was so severe. That being said I wouldn't have changed it for the world. I got to see my sister play one last time. I would have done it 100 times over just to be there especially knowing how happy it made her that I was there to see her play.
If my pain is tolerable and I actually get out of the house like I talked about above when I attended my sisters game. Usually as soon as I get out of the house I am counting down the time until I can get back home to my bed and my heating pad. Generally I can’t focus on whatever I am doing because my pain is such a point of focus. I do enjoy getting out of the house but I can’t help but think about how much I am going to pay for leaving the house. So sometimes we have to pay for the good things in life. It shouldn’t be that way but it just is. We shouldn’t have to deal with all we do, but we do and we learn how to deal with the hand we were given.
I had my first experience being treated as a drug seeker this week, which I will tell you about in just a second. But I first want to give you a little backstory. Only a few months ago my family moved to a new state leaving behind the doctors who had treated me for many years. Knowing there has been so many issues with pain and pain medication, on my first visit I brought all of my medical records with me. In the state I moved from, the doctor treating the source of your pain would be the one that prescribed your pain meds. I discovered that my new Rheumatologist does not write pain meds. I take a rather mild medication; however, he preferred that my PCP write for anything related to pain. I use a combination of physical therapies, yoga, tai chi, breathing exercises, rest, heat, massage, and tears to handle and tolerate pain. Meds were a last resort for me. In fact, this was a decision that was not taken lightly, and very seriously discussed with my previous doctor. When I went to my new PCP to get the medication, I was promptly given a long lecture on how doctors are monitored and restricted, and how they are not allowed to write too many of these prescriptions. They did not look at the scanned records that are in their system, they did not call my rheumatologist. I was lectured. I was informed that I had to go to a second doctor to get pain medication, because that practice encouraged doctor shopping. Something the medical system here should know and discourage; however, this was their policy so I was being forced into this practice not by my choice but by their policy. A prescription was finally sent to the pharmacy which I picked up the next day; only I discovered the prescription was for THREE DAYS of the medication. I do not take the max prescribed, I do the best I can because there are no therapies left on the market for us to try. We are at the end of the proverbial rope. Asking for help once in awhile should not result in being treated like someone with a contagion that will cause deadly harm. I feel like physicians are pushing patients into medical marijuana (legal in my state) and can see why patients feel forced to seek illegal options. When you deal with chronic pain, you learn quickly what things will exacerbate it, what things you do that will make you pay a little bit of a higher price, and things you can do to help here or there. I have Lupus, Rheumatoid Arthritis, Sjogren's Syndrome, debilitating Migraines, Epilepsy, and Fibro.
If I am lucky, I wake up and think that my eyes might open properly the first time. My dog is a service dog and has been trained to help gently wake me. Part of this is because of pain, but also if I am jarred awake it is a promise of a day with a horrible migraine. I begin taking stock of what is alive or asleep or wishing it were dead on my body. One thing with RA is morning stiffness, so often you don't allow you initial impression of the day define you. I roll out of bed and hope I don't actually fall. The first 15 minutes of the day moving is generally agony; an 8/10 because your muscles and joints have no idea if they even want to move. This does not include all of the other fun stuff like cognitive dysfunction (you can't think clearly) or your eyes don't actually focus (thank you Sjogren's). After 15 minutes, sometimes 30 minutes, you have an idea of where you are going to hurt the worst for the day and what you will be dealing with. Normally, I know that my knees, hips, and lower back will always be a 5/10 and that is just what it is. If I having a migraine, I automatically medicate for that, and if the rest of my joints are above of 6/10 I will take medication to help with that. This is when two things hit me simultaneously. My need for coffee or tea and also what will I be able to do today? Is it a stuck in bed day? Maybe I can do a couple things, but I will have to depend on my cane? Oh, it is a good day. I can walk around and get two or three things done and just rest in between and after.
I had one day recently when I got really ambitious. I wanted to get sheets, blankets, and clothes washed and dried in the same day. That morning my pain started at around a 5.5/10. My energy was pretty decent, I had a plan of action in place and life was good. You become a bit of a master planner with chronic pain and any chronic illness. I have learned that I can have the best plan, and it will go straight down the toilet. I started with the regular clothes. Just the act of getting them moved from the washer to the dryer, using my laundry aid, escalated pain to an 8 and delayed me getting to my next load for an hour because my legs and back gave out and I was unable to tolerate the simplest actions required to put a load of laundry in. Sadly, this was with pain medication on board. My goal was three loads of laundry for the day. To an able bodied person, that may seem like nothing, for me to complete that in one day would have made me feel like I had just climbed Mt. Kilimanjaro. When you have a chronic illness that no longer is how life happens.
For me, time with friends is one of the most beautiful and precious things. It also is the one thing you lose that people don't understand about you. When first diagnosed I thought that I could just power through, now I have learned the price I pay. Last week I went to the movies with my sister and niece. I wanted to see Mamma Mia 2, they did too quite frankly. It was girls night. I had to rest 2 days prior. The night I went I almost collapsed going into the theatre, and I did collapse coming out. I started the night fatigued and about a 5/10; before we left I had a slight moment where I wanted to sit down and sleep for a month but I was not missing. By the time I got home I was about a 9/10. I have been flaring, which in our world means additional pain, swollen and stiff joints, and fatigue since. I would not trade that fun night though. There is a price you pay for all of your time. I know with this post, I am not asking for sympathy. But before you make a judgement, pause and maybe try and step into another's shoes for just a moment.
Even our families and closest friends don’t always understand. Chronic pain is hard for anyone to understand because it can’t be seen. When you look at us we don’t look any different from the next women. Unless you you see us limping, walking with a cane or rubbing a sore spot you wouldn’t know we were hurting. They try to understand, and at first they do really well. But even the closest of friends or family start to get frustrated after repeated cancellations. They think back to the time they sprained their ankle or tweaked their knee, and the pain was gone in a couple weeks and they don’t understand why “a little pain makes life so hard!”
What Amy and I shared above is simply a small glimpse into the life of someone who has chronic pain. Someone who has to carefully plan each and every task they do on a daily basis. No on will never be able to explain to what it feels like to feel like your body is no longer your own. Your head and heart want to do one thing but your body says NO. No one will ever be able to explain to you how hard it is when you have to turn down your best friend for the 9th time, simply because the pain is to unbearable. No one can ever explain what it feels like to be told by the people who you are closest to to "Just take some Tylenol, and a nap, and you will be fine!" No one will ever be able to tell you what it feels like EVERY SINGLE TIME you go to a doctors office and they see that you take pain medication, and you can see their thoughts about you change for the worse. No one will ever be able to tell you how it feels to have someone tell you to "Just exercise and lose some weight, and you will feel better!" All that being said, until you have lived and walked in our shoes please try to keep your judgments about us until you meet us, and really get to know us. Yes, my pain impacts almost all of my daily life, but it DOES NOT make me who I am.
Amber & Amy