Pain Management

Lately, my blog has become an active diary of my daily life, thoughts, and experiences. I don’t have a set agenda now nor when I started writing, so I’m unemotional about this. It’s neither “good” nor “bad;” it’s just an observation. Anyway, in keeping with that trend today (because why not?), it’s worth mentioning that yesterday was an especially tough day.

Here is what I wrote during lunch:

I don’t feel well today. My ankle is swollen into a stiff, achy, barely usable mess. The majority of the rest of my joints are sore as well, though not as eye-wateringly painful as the ankle. I’m nauseous and hungry at the same time, and I have vertigo.

I felt so poorly yesterday that I wasn’t able to keep my normal work schedule. Fortunately, my job is usually quite flexible, and yesterday was one of the days where I exercised this luxury. Although when I feel really sick or off in some way, it’s beneficial to not have to work (and generally necessary because I have to be in sharp mental acuity to handle my job assignments), not working frees my schedule and anxious mind to wander aimlessly and spiral into negative places.

Because it is so natural for me to feel depressed when I am sick, the fact that I can’t be productive further digs this groove in deeper like a well-worn trail. My mental health is boosted by many things, but perhaps none as powerful as accomplishment, success, and productivity. If I’m not up to working or can’t fulfill or complete my other responsibilities, interests, or routine activities, I seem nearly guaranteed to feel upset, antsy, and frustrated. In the interest of trying to steer my controllable emotional responses to a more positive and productive place, I’ve identified that this is a situation that definitely warrants effort. My “achievement” in this realm was pitiful yesterday; to be fair, it was the typical despondency this very circumstance tends to drag out. I felt depressed, aimless, lonely, and even sicker than my actual symptoms would technically register in the absence of any sort of emotional reaction or influence. This is the exact situation I want to avoid.

For me at least, it’s become evident over time that my mood, outlook, or psychological position can positively or negatively affect my illness experience. I have chronic diseases, so essentially, I’m always “unwell.” However, there are flare ups and remissions of sorts within this context. For example, right now, I’m in a disease flare up, so I’m significantly sicker than I may be in a couple weeks. By the very nature of being chronic, my autoimmune disorders are so frequently problematic that I’ve easily amassed many data points or evidence that clearly demonstrates to me that my mind can absolutely influence my perception of my real physical symptoms.

For example, a fever of 102 is always uncomfortable, but it can feel agonizing to the point of tears if I’m already upset or in a bad headspace, or it can feel simply tiring and like my body’s signal to rest. There’s no condition that better exemplifies this perception disparity than pain itself. The severity of my brain’s interpretation of pain is almost always modifiable by my attitude and management of my mood. Unfortunately, the dominant hand is sometimes held by the pain itself rather than my brain, such that the pain is too severe for me to control my mood or perception of it; it strong-arms my willpower into submission and dictates my mood. Thankfully, these times are more of an exception, and I truly believe that if I’m honest with myself, in most cases, my conscious willpower can take command of the pain signals.

I want to focus my efforts on improving my manipulation of the pain experience in these modifiable cases. I’m in appreciable physical pain 90% or more of the time in one way or another. The magnitude of this pain can really escalate quickly, especially when I start to feel hopeless and forlorn about its never-ending fate. If I actually objectively consider my typical pain characteristic of the past year or so, the average (save for some rare exceptions) discomfort is less severe than the most intense pains I’ve been in, like during my attack or other severe acute injuries. I survived those times (albeit barely, I confess), but on the barometer of pain I’ve experienced, the daily pains and flare ups don’t hit the very top of my register; therefore, I can get through it. Knowing that I have this headroom left between what I know I can endure and where the pain is probably registering gives me reason to believe that I should be able to capitalize on this space saved by the lower intensity to try and exercise my mental toughness to surf it with more poise and positivity. I should use this space to let my willpower dominate the pain perception.

Admittedly, I failed at this yesterday. I was overcome by discomfort from multiple body systems and structures. I couldn’t move without pain, eat without pain, or even lie down without pain. I paced around my house feeling anxious, bored, and useless. I certainly wasn’t cognitively sharp enough to work, I wasn’t up to sitting up to fiddle with a jigsaw puzzle, I was only able to write a short paragraph (full of complaints!), and nothing on TV could hold my attention. The time was crawling as I lay on my couch freezing and lonely. The void in my mind created by the absence of productive work or intellectually-demanding tasks left me vulnerable to perseverate on negative, unproductive thoughts (i.e., why can’t I be normal? Why do I have so few friends? My body is ugly and feels out of shape. Why did I have to be attacked? Why am I so weird?). I felt mentally weak and unable to lift my mood into a better place and shift my attitude to a more admirable one.

But I’m not going to beat myself up over this. I wasn’t feeling well at all and I wallowed in it. I missed the opportunity to practice rising above the discomfort and controlling my experience of the situation. This is the baseline condition though. It’s ok to be starting from here. There will be plenty of sick days to practice exemplifying the behavior I’m striving for. Some of these times I’ll probably fail and perform on par with what I consider this deplorable baseline state. However, other times, I am confident that I’ll use my tenacity and sheer determination to be as strong and impressive as I can be to wrangle my chronically depressed brain to be positive and keep my spirits up despite the challenging situation. I’m already impressively modeling this resolve today; my flare up is just as intense but I am moderating my experience with more command and poise. I’m staying as optimistic and phlegmatic as I would be on a “well” day. If that’s not an impressive feat, I don’t know what is. I’ll try to tackle the rest of the day with this same fortitude and keep the hope alive that the flare up will subside soon. At least then, it’s easier to win the depression war! Until then, I’ll plow forward and try to seek and amplify the good stuff. It’s always there; sometimes I just need a good magnifying glass.

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