The Face of Chronic Pain...

Quote for the Day:

“In the depths of winter, I finally learned there was in me an invincible summer.” 

— Albert Camus

About a year ago I started to have back pain that became more and more severe.  I went to my chiropractor and massage therapist, but without relief...even after several visits.  After about 6 weeks of suffering and the pain getting worse and worse, I finally went to my medical doctor.  After x-rays and an MRI, I was diagnosed with 2 "small" disc herniations and arthritis in my back.  I was started on physical therapy, NSAIDS (non-steroidal anti-inflammatory drugs), pain medicine, a round of steroids, and was taken off of work for what ended up being 5 weeks.

With rest and PT, the pain got "better", but never totally disappeared, probably because of the arthritis.  I finally got to a point where things had "leveled off"...and we decided that PT had done all it could for me at the time.  By this time, I had returned to my job and, for the most part, unless I overdid it, my pain was fairly well under control.  It was during this time that I learned what I could and could not do without causing pain.  I learned that leaning forward causes great pain, so when transporting a patient, I had to take the foot end of the gurney and "steer" rather than push the gurney.  I learned to "lunge" with the left leg when reaching into the fridge for the milk on the bottom shelf, etc.

In other words, many routine things in my life needed to be relearned or not done at all.

I have still been seeing my medical doctor for follow-ups every 2 months, as well as continuing to go to the chiropractor and massage therapist.  Over the course of the last 8 months or so, the pain has started to worsen again to the point where I am in pain.  Everyday.  Pretty much all day long.  And now the pain frequently radiates down my left leg to behind the knee.  Sitting and laying down hurt the most, but even standing can hurt, too.

I am still on high doses of NSAIDS and use pain meds when the pain gets "unbearable".  I have issues with pain meds, including most of them make me nauseated...the only one that doesn't make me nauseated has been taken off the market since my back injury.  Fortunately, I still have some left from when they were ordered for me last October, and I guard them carefully...taking them only when absolutely necessary.  Since I am dealing with a chronic issue (arthritis) that will presumably only get worse in the future, I am also afraid of raising my tolerance to pain meds by taking too many now.  Though I've never had an addiction to drugs or alcohol, my fear of developing a dependence on pain meds and raising my tolerance to pain meds keeps me from taking them until the pain is severe and unbearable, often with me ending up in tears while I wait for the meds to take effect.

I have only missed one day of work due to my back pain since returning to work last November, and I rarely mention that I am in pain because I know that people tune you out after a while.  So even though I may be doing my usual duties or laughing and joking and carrying on as normal, I am still in pain.  All. The. Time.

Pain makes sleep difficult.  Pain makes work difficult.  Pain makes "life" difficult.

As a nurse, how do you extend comfort and caring to patients when they tell you they are in pain when you are in pain, too...possibly as much or more than the patient?  It's a challenge, to say the least.

I have an appointment with my medical doctor next week, and since things have gotten significantly worse since the last visit, I'm going to sit down with her and thoroughly discuss options and see what plan of care we can come up with, since the current one isn't working anymore.   Maybe I need another MRI since the pain has started going down my leg?  Epidural Injections?  Another round of steroids?  

I don't know...but I hope we can come up with something that won't require additional pain meds.  I wish there was a way to "fix" the problem rather than just treating the pain with medications.

Most people around me, including those close to me, don't know what I am dealing with right now and how severe the pain is much of the time.  But the chronic pain, and how it is affecting my life, is starting to wear on me.

The "take-away" from all of this?  I guess it is that we need to be mindful that each of us is fighting some kind of battle...whether it is apparent externally, or not.


Loretta