Archives for category: pain

Yeah…this is not about ‘management’ as in ‘leadership’, and it’s not about improving one’s resume for a better paying job with keys to the executive washroom. Nope. It’s another sort of ‘executive’ ‘management’ altogether. The ‘executive functions‘ of the brain manage cognitive processes, such as (and likely not limited to) working memory, reasoning, task flexibility, problem solving, planning, impulse control, and in specific areas like the ‘orbitofrontal cortex’, things like evaluating subjective emotional experiences (and so much more). All very interesting, no doubt, but for me it’s a little more personal, and relevant…my TBI is a frontal lobe injury. The lingering impairments are mostly executive function sorts of things, and as with so many other people, and other TBIs, very interestingly individual – the brain is fancy, and the outcome of any given injury is equally individual. A whole new world of potential to heal and move on opened up when I started learning more about how these injuries work (don’t work?), and why, and how it changes my experience… and in so many moments, the experience of those who make their lives (or work) with me.

It is what it is, at least the piece where I look in the mirror every morning and I am… me. It’s not all bad. It’s better, actually, than it once was. I’ve learned a lot. I’ve grown. I’ve become more skillful at caring for this broken vessel, and at sorting out some of the chaos and damage that lingers.  It is, sometimes, a shit experience and I struggle. Very human.

How about this one for a great practical joke on one human primate by the universe… one of my ‘favorites’… my PTSD causes serious sleep disturbances, nightmares, sometimes insomnia, and diminishes the hours of restful deep sleep I can get; I’m easily awakened by the littlest noises, or novelty, in my nighttime surroundings… (waaaait for it…) and my executive function impairments are much more pronounced – to the point of being quite obvious – if I don’t get good rest, reliably, pretty nearly every night. So… yeah. A night or two of poor sleep, for whatever reason, and I start… declining. My temper is often the first obvious sign that ‘things are not right’ – I become irritable, and easily angered, and feel less positive, generally, when my sleep is of poor quality. Next up, I start struggling with emotional balance, and lose ’emotional regulation’ characteristics in my day-to-day experience most adults don’t even realize they have going on in the background; I feel them most particularly when they slip away unexpectedly.  The more tired I become, the more fatigued over time, the more prone to real tantrums, crying jags, and irrational mood swings I become – and (waaaait for it…) less able to sleep; my brain won’t shut down. When I do find sleep, I sometimes dream that I’m awake in such detail I wake exhausted to the point of tears. Yep. Pretty god damned funny. (Not)

Most of the time, these days, I still manage decently well overall…enough to pass as a grown up most of the time. There’s no real way to share what the subjective experience is like (you sort of have to be there). Every one of the many calming practices I’ve learned matters a great deal. Every choice counts. Every effort is meaningful. Every success – however fleeting, however limited the benefit, however difficult it is to recognize in the moment – every success builds the foundation for successes to come. My hope is that over time, that foundation grows substantial enough to bear the burden of the entirety of the chaos and damage…strong enough to hoist me above the pain, long enough to really see the view from a radically different perspective somehow ‘above it’… I would very much like to keep working at life and love to find that I have transcended what has hurt me most and become that woman – or more – that I might have been without the chaos and damage.

Please don’t tell me that’s wishful thinking. Tonight I couldn’t bear to lose the crutch of some shred of positivity to lean on. I’m tired. I know I am. My brain is buzzing like it’s noon on a sunny summer day; I’m not sleepy…but if I can practice good practices (meditation, and yoga are both very calming), and avoid becoming negative, or caught up in some random moment of weirdness, or a sneak attack by my own brain, I might sleep – or at least rest. Rest is okay. Rest is enough.

Enough is okay with me. Hell, I’m not even having to ‘do it alone’, really; my traveling partner checks in now and again. I welcome the closeness, the touches, the tenderness. The reassurance that love is, helps me find my way in the darkest darkness.

Wrapping this one up on a positive note; perspective matters, too.

Wrapping this one up on a positive note; perspective matters, too.

I love fairy tales, and stories with a strong heroine, who faces a challenge, learns a lesson, and grows to become someone wonderful. I like a happy ending. I read a lot of ‘happily ever after’ endings over the years, and at some point ‘happily ever after’ became an implicit goal. That’s especially maddening because that is basically the least attainable goal ever imagined. I enjoy feeling happy. I find ‘joy’, ‘delight’, and all manner of pleasant happiness-related, happiness-producing quite wonderful and worth experiencing. I didn’t have much success making the whole point of existence getting to some difficult to define ‘happily ever after’ place. Quite the contrary, I think making ‘happily ever after’ something to chase resulted in a lot of personal unhappiness.

I don’t actually understand why happiness seems so much more common now that I’m not chasing it…but it does tend to be the experience I am having.

Unfolding like spring flowers.

The loveliness of simply being.

I am okay right now. It wasn’t my best evening. I enjoyed the day in relative physical comfort. By the time I arrived home, after a chilly drizzly commute, I was in pain and irritable. If I could fold time, I would put this moment, here, adjacent to my arrival, and perhaps enjoy myself and my family more, being in a better mood, and less pain. I’m not complaining, and I don’t recall being unpleasant, just in pain and perhaps too tired to be more considerate with my phrasing; I know it takes a lot to hurt my traveling partner’s feelings, and I know I succeeded. I will make amends in the morning, learn from the experience and move on. It’s okay to treat myself with great care, even though I feel badly about the evening going a bit sideways, and I have spent the evening gently, managing my pain, watching South Park, and writing. It was my intention to do these things when I arrived home hurting so much, and it’s pretty satisfying to find that good self-care has indeed helped a lot, although I am still in too much pain to be able to sleep just yet; yoga will help with that a lot, and meditation afterward is a nice way to finish the day.

Every time something works out just a bit better, I take time to really appreciate it, notice it, and hold onto the experience for some minutes. I ‘let it soak in’. I make a point of continuing those practices, and even investing more time in those that are regularly part of some new moment of personal success. In the most difficult moments, I am sometimes very briefly so bitter and hurt that I am unsure these things really matter, or that I am actually making progress day-to-day. The doubts are incredibly painful, and I am very relieved each time I get past that moment, to this place when ‘I am okay right now’, and able to enjoy the moment of progress, or resilience, or emotional safety – successes, all.

Stormy sky, quiet evening.

Stormy sky, quiet evening.

I feel more vulnerable sharing successes, than I do ‘failures’, or learning experiences. Vulnerable is okay, too. It’s a nice evening.

Pain sucks. A lot of people (me included) live with some measure of physical pain, moment-to-moment, day-to-day, or occasionally. It doesn’t matter at all how common pain is; it still sucks to experience it, generally. Pain is largely unavoidable, even when it is treatable, manageable, or resolvable. We feel pain, because we feel, and some stuff hurts.

Outrage is a different sort of feeling, although it generally falls into the set of ‘feelings beside pain that also suck’. Outrage is that peculiar mix of anger, despair, frustration, annoyance – and pain – that we experience when confronted with something that ‘just isn’t right at all’ and nothing seems to be getting done about it. More or less. (Your results may vary) Outrage is the stuff movements and causes are made of. Outrage sells newspapers, and advertising spots. Outrage gets us to show up and take a stand. Outrage is painful, and floods us with a cascade of negative emotions, as well as increasing our level of arousal – readying us to fight, to take action. Outrage is motivating… but it’s probably not really ‘healthy’ to linger in that state. I know, for me, outrage builds over time to slowly become fused with an ancient feeling of ‘learned helplessness’ that eventually develops into a sense of futility. Despair and frustration become dominant in that experience, as the urge to take action generates no positive outcome (generally); often we are being stoked into a sense of outrage for marketing purposes. There is no intent to drive change at all; we’re being used.

Outrage, delightfully enough, is not unavoidable. It’s totally avoidable. Outrage, generally, is optional. Quite optional. This is a new thought for me, or at least I think so right now.

Where is your outrage getting you these days? If it is solving problems, and moving you through your difficulties, and finding you in an improved place with your fellow human being – and finding them in an improved place, themselves, you are having some success with outrage. If your outrage changes one thing – any one thing – for the better, truly, then your outrage is effective. I’ve got nothing but gratitude for people who can endure outrage long enough to drive positive change. I’m even impressed.

Outrage generally just upsets me, resulting in agitation, frustration, arousal and leading to my PTSD symptoms flaring up, and my disinhibiting TBI definitely gets in the way of managing outrage appropriately. Over time, outrage takes me over, colors my experience, and renders the world a seeming palette of horrors, and despair without end. It’s unpleasant. It’s also totally avoidable.

I changed how I consume media, day-to-day, and in general it alleviates my experience of chronic outrage. There is plenty in the world to be outraged about, and certainly there’s enough for every human being to take a strong stand on an important issue and change the world…but…there’s actually so much potentially ‘wrong’ in the world, it could certainly ruin any one person’s day entirely to embrace all of it as a personal cause. I still care. I am learning not to allow myself to be dragged into chronic outrage. It’s not easy. I often catch myself getting pulled back into an issue through a link shared by a friend; it matters to me a great deal what matters to my friends and loved ones, and before I quite know how, I’m caught up in measles at Disneyland, or gun safety concerns, or police brutality, or any number of feminist issues that are of direct and immediate concern to me personally, as a woman. It happens fast.

Good self-care sometimes means putting down the device. Scrolling past the news article. Refraining from commenting. Taking a few deep breaths and letting it go. Why does it matter so much to manage chronic outrage? Emotional experience is tied to our physical experience pretty directly; emotions are chemical. Pain is physical – and emotional. Chronic outrage seems (in my own experience) to correlate to an experience of pain feeling more intense, less endurable, and less responsive to treatment. Hmmmm… give up chronic outrage and hurt less, or… don’t. Yeah. That’s an easy one.

Relax. Have a coffee. Think about something pleasant for a moment. Enjoy this moment, right here; it's the only one quite like it.

Relax. Have a coffee. Think about something pleasant for a moment. Enjoy this moment, right here; it’s the only one quite like it.

Today is a good day to be aware of media manipulation. Today is a good day to enjoy each positive moment with at least as much attention, passion, and engagement as I might bring to any cause or concern. Today is a good day to let small stuff go, and to choose my battles. Today is a good day to change the world.

This morning my pain woke me. Twice. Once around 2:00 am, and again at 5:30 am.

The first time was a classic moment; I got up sleepily, went to the kitchen and got a drink of water. It was in many respects identical to all such ‘drink of water’ moments in the wee hours. Squinting through the harshness of artificial lighting, going through the physical motions of getting a glass, filling it, drinking, and finally setting the glass on the counter rather randomly and returning to bed; it’s the same process however young or old I have been since I’ve been old enough to do it without help, and so habitual after all this time that there are likely uncountable such moments that leave no recollection at all.

The second time, I got up feeling a bit relieved that it was finally an hour at which I could take my Rx pain relief, my morning medication, but not late enough to be off on my timing. I tried to return to sleep, but this morning my pain got the better of any such desired outcome. I got up, and began the day in a distracted and disorderly fashion; I wasn’t really quite awake at all, but in too much pain to take things slowly first thing. When I realized my pain was driving haste, I stopped, sat down, and meditated for a few unmeasured minutes and started over.

I remind myself that these are all self-care practices, because they do require practice (otherwise they’d be ‘self-care thoughts’).

It’s quite a lovely morning. The fact that I hurt doesn’t really detract from that, it just made starting the day a tad challenging. Enjoying the morning solo, there was no one potentially between my pain and my coffee, or my not-quite-awake volatility and meditation. As early in the morning as it was, I put on favorite dance tracks (think The Crystal Method, Nicki Minaj, and Jesse J) and took advantage of the solo morning to dance; it sometimes really helps with my arthritis pain (which is in my spine) to move. That is certainly the case this morning, and I’m grateful to have a solo morning on a morning when I need that so much. (Not everyone wants to start their morning with Lil’ Jon at 6:00 am!)

Later today, the house will fill with family once again, gentler music of shared tastes. It’s been an excellent solo weekend; I am far more ready for a homecoming than I am for the weekend to end. I’m grateful things will happen in that order. 🙂

"Each time for the first time, each moment the only moment." Jon Kabat-Zinn

“Each time for the first time, each moment the only moment.” Jon Kabat-Zinn

Today is a good day for music, dance, and joy, to embrace simple delights, and take things slow.

I’ve got a solo weekend. I slept well, and comfortably, and even slept a couple more hours after waking at the usual time, taking my morning Rx, and returning to bed. It isn’t always  possible to return to sleep, and this morning it was lovely to wake slowly, much later, and enjoy the slow unfolding of body and mind as my consciousness booted up for the day. My coffee is delicious – a medium Americano, at 203 degrees, no sugar, no milk – just hot, smooth, and rich. No headache this morning. Rain pouring just beyond the partially open window; I love listening to the falling rain and smelling the freshness of the air outside. It is a very nice Saturday morning so far.

Oregon winter, stormy, and mild.

Oregon winter, stormy, and mild.

I am alone this weekend. This is not significant, it simply is. I enjoy solitude, generally, and I am feeling content and satisfied with my solitary state.

I am in a lot of pain. This is significant, not because it is unusual, but because it is an element of my experience that is pretty typical, day-to-day, varying in intensity far more often than ever really going away. This morning, I am in enough pain that at other points in my life the entirety of the first paragraph could not have existed side-by-side with the pain, itself. I’ve learned a lot more about taking care of me, and over time I am building self-care practices that even stand up to the departures from routine that sometimes result from things like … having a weekend alone. Oh yeah. It wasn’t so long ago that having a solo weekend would result in over-indulging on favorite treats, not sleeping well due to staying up late to read, watch movies, or wander, overlooking timing on timing-sensitive medications… just generally completely letting myself down with regard to actually taking good care of myself. Wallowing in self-indulgence is not self-care. That’s a pretty important understanding.

I love, for example, gummy sweets. I don’t much care if they are bears, drops, fish, worms, fruits, or healthy… I love gummy candy. They are now what they must be (for me) – a rare treat, in very very small portions. I don’t respond well to quantities of refined sugar. (Your results may vary.) I also tend to overdo it on gummy sweets – I know that first hand. I also know that even casual use of refined white sugar, cane sugar, beet sugar, or any similar sugars quickly increases my emotional volatility, sometimes correlates to unexpected tantrums, moodiness, and a basic feeling of not being ‘well’.  Good self-care means I continue to avoid gummy sweets when I am enjoying time on my own, just as I would en famille – accountability can’t be the sole driver of self-care (at least for me; it just doesn’t work.) That was a hard lesson to learn.

I practice good practices, even when I am enjoying a solo weekend, these days; I am capable of learning from my mistakes. Last night, feeling restless on a mild night, I walked 5 miles in the evening air rather than walking the aisles of the nearby grocery store looking for exotic treats for an evening nosh. Instead of indulging in a rich meal of favorite treats that do me no good, I enjoyed the healthy simple fare I generally do these days. I meditated. I did some yoga. I did more of the good things that care for my body and spirit, rather than fewer. Isn’t that really the thing? Investing in my own needs when I have more time to do so is an effort best spent on what really nurtures me – rather than childishly revolting against the sensible limits and restrictions I have chosen to place on myself to meet my needs over time, simply because ‘no one is watching’.

I wish I were so perfectly perfect that I didn’t need reminders, or could simply rest gently on what I have learned, confident my good practices would never fail me… I am not so perfect. I start fresh each morning, and do my best each day. I acknowledge missteps along the way, dust myself off when I stumble and keep on walking. I got here, because I make progress over time – and the journey isn’t finished. I invest will and study in gaining perspective, finding balance, and learning good self-care practices that nurture and heal me, over time. There are verbs involved. There is no ‘easy’. There is no ‘finish line’. There is no ‘win’ that amounts of finality and acknowledgement. Those aren’t criticisms, or something to be blue about; they are my endless opportunity for change, and for improving on what is, to become the woman I most want to be, and to find wellness and meaning along the way. Choices are right there to be chosen…choosing well, and following through on intention with will, and action… well… sometimes that requires a sticky note, or an alarm, or a calendar reminder, or something planned with a favorite friend. That’s okay too; this weekend, I am practicing my best practices for taking care of me.

Brunch with a friend; a very nice way to stick to a self-care routine. :-)

Brunch with a friend; a very nice way to stick to a self-care routine. 🙂