Archives for posts with tag: pain management

This morning I woke in pain; my arthritis has flared up after many days of not bothering me much at all. The hot dry days offer relief…but…it’s still hot. It’s still dry. I am in pain. I slowly rose, patient with the stiffness of my spine. This is a morning for music and dance, cool breezes be damned. I peer through the patio blinds and notice with some surprise that already the days are shortening and dawn is coming later…did I wake ahead of the alarm? I double-check. It went off. It woke me. I no longer remember hearing it. Pain is a distraction.

I start the day with Usher, and coffee. Facebook tells me my computer is infected with malware. I glare at the page with skepticism and irritation. Why is Facebook telling me what to do? I log out with a promise to myself to let my traveling partner know; I trust him, and his skills, more than any app or browser warning. Hell – the warning probably is the malware, requesting permission to get started. For the moment I find myself in contemplation of all that is unclean and vile about the internet, and my head aches with the weight of the suspicion, and distrust. The pain, again, is a distraction.

I reach for my coffee, and burn my tongue, then spill it in my lap for the added delight of hot coffee held to tender flesh by coffee soaked jeans. Seriously? Who the hell ordered this day? I snarl at myself, managing to knock over my chair as I get up, too quickly, to change clothes. The chair falls on my foot. Great. The top I wanted to wear doesn’t go with the pair of jeans I just put on. The top I’d wear instead is in the laundry. I break a nail reaching for an acceptable alternative. Are you fucking kidding me? What is up with today?

Pain is no joke. The unexpected return of significant arthritis pain this morning easily throws me off, which would be, perhaps, just a little amusing in the face of words like ‘chronic’ and ‘long-term’ – if I were in any mood whatever to laugh about it. Right now I just hurt. I hurt and I’m sort of mad at the day right now. Don’t say it. I know what works. There are practices to practice and it’s time for that. I get it. Pardon me while I take a few minutes to take care of me.

Yes, yes. I know.

Yes, yes. I know.

1. I took my medication on time, and it’ll take another 30-40 minutes to be fully effective. It only addresses the symptom: pain. There is more to do to put the day back on track.

2. Medical cannabis helps by potentiating the Rx pain reliever – and it will take the edge off my quickly deteriorating mood, and wipe the snarl off my face promptly…and make yoga easier.

3. Putting the rest of the morning aside, yoga is next, and I take my time with a long sequence of postures that lengthen and gently flex my spine, easing the pain where the pain lives. The headache begins to diminish.

4. Then, meditation – this is an Rx that goes straight to the brain, literally, and is a first/last/always step for me these days…although, sometimes, like a child resisting bedtime I fight the necessity irritably for no good reason.

5. Coffee. I take my time making a really first-rate cup of coffee for myself, and sit down to enjoy it, feeling very much that the morning has been ‘reset’.

It is once again a morning filled with music and I am smiling and sipping my coffee as contentedly as if I woke up on an entirely different morning. Choices, verbs, patience and self-compassion, and the willingness to accept that the potential to improve a poor experience exists…and practicing practices for the win. 🙂

Enjoying other moments.

Enjoying other moments.

The morning moves on, time passes, I sit quietly enjoying pictures of a walk with the wanderer after work, yesterday. If I spend more time thinking about the rough start to the morning, lingering on uncomfortable sensations, unpleasant emotions, or the difficulties themselves, than I do savoring the delights of other moments with similar depth and clarity, over time my negative bias will increase, and my ‘background experience’ will become more negative as well. I take this understanding very seriously, and commit to enjoying my coffee and thinking about the evening behind me. I linger over the recollection of finally taking a photograph of a dragonfly.

He's there, really. (I have no idea why I like dragonflies so very much, but I do.)

He’s there, really. (I have no idea why I like dragonflies so very much, but I do.)

I think, too, about the later conversation with my traveling partner, and the feeling of connection and warmth in spite of the physical distance. That takes my thoughts all sorts of lovely places, thinking about love, Love, and loving. At this point there is no hint of the morning’s challenges remaining in my experience of the moment, and I find myself ready to move on with the day.

Am I achieving emotional self-sufficiency? Do I need to ask this question now? Living the experience is, perhaps, enough.

Beautiful.

Beautiful.

Today is a good day for practicing practices, using verbs, and having my own experience – if it’s mine, I can change it. 🙂

I woke with a nasty headache this morning. It rises from locked up muscles alongside my arthritic vertebrae, like parallel columns of pain, becoming one just at the base of my neck and feeling rather ‘braided’ with tension up my neck, cradling my skull with an embrace of even more pain that wraps the lower back portion of my head. It is not acute nor pulsating, it is a more dull steady presence with more than necessary intensity. I have this headache relatively often. Generally, expressed in words, it sounds like this “I have a headache”. Other headaches sound more like this “I have a headache”. It isn’t possible to tell from words how severe someone else’s pain is. Pain doesn’t show much; by the time pain can be easily seen on my face, I am in so much more pain than can be easily managed that it’s not likely sympathy can do much more than offer a few kind words. I cherish the kindness.

Much of the time, because pain is not easily visible, my experience is one of being haplessly mistreated by well-meaning people, even people who know me well, and profess deep affection for me; they don’t know I am in pain, moment to moment. Simple requests sometimes sound quite ludicrous to me… “Can you just go ahead and…”. I have not yet learned to say “No, actually, I can’t ‘just’… I’m in too much pain to do that.” The amount of pain I am in this morning is well beyond the day-to-day pain I know so well. It’s hard to consider other things and look past the pain…and when I succeed in turning my attention elsewhere, I quickly find that whatever I am thinking over becomes tainted by the pain; my negative bias increases, I feel discontent, angry, frustrated, emotional, resentful… and it so easily changes from an experience of physical pain, to an experience of emotional pain. The result is often that I find myself blaming some circumstance for my feelings. My subjective emotional experience becomes the focus of my attention, distracting me from the pain but leading me down a rabbit hole of mis-information, negativity, doubt, insecurity, and fearful speculation not tied to my actual experience of events. Pain is a mind-altering drug, and it’s always a bad trip.

I woke early today. I woke because of the pain. This headache is that bad. I meditated quietly until the alarm went off; two hours passed pretty quickly. I feel reasonably calm, content, and balanced; I know that the pain has the potential to mess with my mind, and destroy my fragile lovely moment. Mindfulness, self-compassion, kind treatment of this mortal vessel I inhabit, and patient attentiveness to self-care basics will be incredibly important while this headache lingers. I know what to expect when I speak up about the headache, too. “Well, have you…?” and “When I have a headache, I…” or “What have you done for it?” People tend to be pretty well-meaning about headaches. It’s frustrating to wade through the helpful suggestions; I’ve been doing this awhile, and at 52 there’s not much in the way of new stuff to try for this headache. I work on staying calm and focused, and not crying over small bullshit simply because I hurt too much to handle real life well. It’s the best favor I can do the world on a morning like this one.

Choose your adventure. Choose your perspective. Choose your experience.

Choose your adventure. Choose your perspective. Choose your experience.

Oddly, this isn’t really a post about pain; it’s about the very subjective nature of perspective. Pain is a metaphor, but I’m finding it challenging to move on from the pain itself, this morning. Tedious.

I recently read some writing an associate did regarding a shared experience. The subjective nature of perspective being what it is, I reacted to the words before I remember to take a few breaths and approach the words mindfully and aware that the unique perspective presented has nothing whatever to do with my experience of those same events. It took some time to move past my initial reaction of irritation at the ‘obvious’ dishonesty, the ‘irresponsible minimization’, and [to me] clear use of the opportunity for image management; my perspective is also subjective. I managed to set that baggage down pretty easily, and reconsider the words as nothing more than personal narrative, subjective and likely well-intended, without judging the words as ‘truthful’ or ‘honest’. Regardless of any of that, they are the words this associate chose to describe the experiences we shared. While it does say something about my associate’s experience – and my associate – those words have nothing to do with my experience, at all. If I react, buy in, become angry and express my anger with demands that my associate change their perspective of the shared experience we had, I give up my own experience to own theirs as the valid reflection of events. It was a pretty joyful moment when that hit me; all I have to do to enjoy my experience from my own perspective when someone else’s perspective causes me discomfort, alarm, distress, or anger, is to go ahead and continue to have my own experience, from my own perspective! I validate my own experience fully by simply having it. Wow. Simple and powerful.

Every one of us has our own perspective. Being able to comfortably listen and hear another person’s perspective improves my ability to be compassionate, to be kind, to be wise… and it also eases me into a lovely place with myself, too; more able to treat myself well, by honoring my own experience as real and true, and mine. It isn’t about who is ‘right’ – ‘right’ doesn’t enter into my subjective perspective of my own experience – nor does it feature heavily in yours. Arguing about a subjective perception of events isn’t helpful – because we choose our experience, and have no obligation to choose what someone else has chosen. Facts are facts – and I have learned caution, even there; very little of what we share with each other has anything at all to do with ‘facts’. Thoughts are not facts. Emotions are not facts. Values are not facts. Narratives of experiences are not facts. Memories are not facts. Each of those things are entirely subjective, and mostly pretty made up. We are attached to our own, sometimes to the point of being completely irrational about holding on to the ‘rightness’ of them without regard to the pain we cause others.

One beautiful moment, so many ways to enjoy it.

One beautiful moment, so many ways to enjoy it.

Today is a lovely morning, from my perspective, in spite of pain. Today is a good day to live my experience awake, aware, and mindfully. Today is a good day to show the world kindness – because I can, and it’s simply a better way to enjoy my experience. Today is a good day to brush off the things that distract me from love, with an understanding smile; we are each so very human. Today is a good day to be the change.

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.

I’ve gotten some decent sleep this weekend, even ‘slept in’ two days in row. This morning I slept until nearly 9:00 am. I woke abruptly, some noise most likely, but truly I was well-rested and returning to sleep was neither likely, nor would it be a healthy choice; the day had begun. I woke in considerable physical pain, and moments into the morning it was clear that I was not yet sufficiently able to maintain emotional balance to be casually interacting with people – I was genuinely hurt by the initial interaction with one member of the household, this morning, and it was not worth all that; it was a just moment of insensitivity and callousness common to people before they are completely awake, first thing in the morning, and I myself was also just waking up and prone to taking things excessively personally. It wasn’t personal, but I was – and perhaps still am – unprepared to deal with it appropriately, although I think I did okay with it. Pain management is a very big deal for good emotional resilience; if my pain is not well-managed I tend to take things more personally, and also struggle with being very emotionally needy. I chose a wiser path, and took my coffee with me into a quieter space, to take time for meditation, then catch up on email…and now, here I am.

Choose your experience; we're live and unscripted.

Choose your experience; we’re live and unscripted.

Good sleep. Appropriate pain management. Taking medication on time. Taking time to meditate. Recognizing and distinguishing between internal and external stressors. Calories. Exercise. There are a lot of pieces to the self-care puzzle, and they all matter. The challenge is practicing good self-care even when I am in a crappy mood, in pain, feeling ill, or distressed with PTSD symptoms. Today shouldn’t be that difficult…the major challenge today is ‘merely’ physical pain. I hurt, but I hurt pretty much all winter long, every year, and have for many years. I’m not bitching; other people hurt more often, and hurt worse than I do. I have a lot to be grateful for, and I don’t take those things for granted these days; they really matter, and taking care to appreciate the good things, and be grateful for what I have, and what works, and what feels good is a practice that is tending to ‘adjust’ my implicit memory, and my ‘default settings’ regarding how I experience my life in a more positive direction. I’ve made a lot of progress down this path – I both enjoy a better experience, generally, than I used to most days – and I can tell that my experience is improved, too.  (It’s not much help when things get objectively better, but do so in the absence of being able to recognize that improvement!)

It’s an interesting puzzle that what I want in life, the things I yearn for most fervently, can so easily sap me of my emotional resilience and self-sufficiency, and undermine a good experience I have by drawing my attention away from what is good right now, and putting the focus on some moment of discontent – that in some cases actually only exists in my thinking, without any anchor in some element of my experience in life.

Discontent joins the emotions on the short list of ’emotions I just don’t enjoy or find value in’…worry, guilt, jealousy, disappointment, and discontent amount to a lot of dark days for a lot of human primates. I don’t put anger or fear on that list – they both serve obvious purposes ‘used in moderation’; they are legitimate warning klaxons to improve my chances of survival. Moving away from what frightens me may mean my surviving some dangerous moment in the world. Being moved to anger tends to keep my awareness aligned to my values, but for now I can’t do much more to describe anger’s potentially helpful qualities; it’s an area of weakness for me, and I struggle with it to this day. The thing about those other emotions? They are all pinned to expectations and expectations are so often the ruin of a good time. I love to plan, and I like the comfort and security of having done so…but becoming attached to an expectation is a different thing. Clear and explicit expectation-setting has its place in day-to-day life, absolutely true. It’s the implicit, unverified, un-validated, unconfirmed, “I thought we…” sorts of expectations that fuck us all up. It occurred to me this morning, sipping coffee that is unexpectedly ‘bitter’…if I could entirely let go of implicit expectations, I would likely also be letting go of worry, guilt, jealousy, disappointment, discontent…and possibly other subtle negative emotions that can potentially mess with another otherwise great day. It’s a practical thing, and probably worth the effort involved. I won’t miss even a moment of discontent, worry, guilt, disappointment, or jealousy if I never feel those emotions ever again.

Today? Yes, I’m contemplating expectations and discontent, because I woke first with one, and then trending toward developing the other. I happened to take notice of the trajectory of my emotions, and put myself on pause to give it some thought. Had I allowed the moment to overwhelm me, and gotten caught up in ruminating about the drivers of my discontent, and begun wallowing in my disappointment that ‘my expectations’ failed me, I’d be in a very different place right now. I think the constant practicing of better practices proved itself this morning; I found perspective over my unexpectedly bitter coffee, and a tiny bit of unexpectedly positive news.

Today is unscripted. Ideally, I hold no expectations that I haven’t set explicitly, and even then I understand that change is. Today is a good day to live life engaged in the moment, present in my interactions, and open to the possibilities I hadn’t considered exploring. Today is a good day to change my experience of the world.

It’s a very purposeful and to-the-point title, is it not? 🙂

I spent last evening out, on a rainy night, and there was rather a lot of walking involved. I went out with my camera, and thoughts of taking some very interesting pictures at a time of day I am rarely downtown. It rained, and it rained pretty continuously. It rained too much to have my phone out all the time; my phone is my primary camera, these days. (Unpaid endorsement: camera on the HTC One M8 phone is amazing!) The time wasn’t wasted; I walked, considered things, observed things, and remained present and engaged in my experience as a practical exercise in ‘free-range mindfulness’.

Very busy primates, building things and chasing away the starry night sky.

Very busy primates, building things and chasing away the starry night sky.

I reached a point, during the evening, when I suddenly felt disenfranchised, alone, disappointed in life, discontent, and cross with myself in a vague way that had me looking for causes. My brain immediately started pointing out all the small things in life that aren’t ideal, and highlighting any moment of doubt, or insecurity. This seemed, at the time, headed for a familiar outcome. I could feel a future fight or argument sort of percolating within my consciousness, although moments before I had been enthusiastic about my evening, content, eager to walk on and see the night… why the change?

Differences in the way my evening began really had me off to a good start, so I took a step back and did some ‘taking in the good’ exercises, and almost out of  habit I made a point of giving myself my full attention; how did my body feel right now, rather than just noticing the content of my thoughts and the flow of my emotions? I was warm and dry, because I had remembered to wear weather-appropriate clothing, and had even zipped my raincoat before I left the building. I had worn comfortable, waterproof hiking boots, because I knew I’d be walking a lot. I had taken care to manage my calories well over the course of the day…and realized I was hungry, and that it was dinner time – was my blood sugar low? That would explain some measure of irritability, easily. My ankle was aching from all the walking, even with my cane, but I had also been attentive to pain management all day long…oh. It was past time for my medication – that’s not good for my level of pain, which can drive a lot of unhappiness, discontent, and discomfort, but it also affects my mood when I don’t take it on time (one of the consequences of yielding to the need for an Rx pain reliever). So…hungry…hurting…and late with both calories and medication. Yep. That definitely stirs up some random emotional bullshit and discontent.

I took time for dinner, and enjoyed it without rushing. I made a point of carefully choosing for nutritional content, and appropriate calories (which in this case, meant eating somewhat less than half the portion served, the remainder I very neatly boxed up and gave to a homeless guy at the transit center rather than have it go to waste, he made interesting conversation and appreciated the hearty meal). Getting off my feet for a few minutes helped reduce my pain. I took my pain medication, and reminded myself with a glance at the time that it would be about 70 minutes before it was fully effective. Warm and dry, well-fed and nourished, rested and medicated, I walked on about an hour later. The wait staff at the restaurant was very kind; it was just past dinner rush, and I made a point of letting the hostess know I would want to linger for about an hour because of the pain I was in. She seated me such that I could, without inconveniencing business, in a small booth for two somewhat out-of-the-way. My waiter must have been tipped off, the service was both exceptional and very supportive. Communication for the win!

I made my way here and there, and eventually headed for home, earlier than I’d planned. The rainy weather wasn’t a good fit for the notion I’d had for the evening. Once home, I had a warming hot shower, and made a mug of chamomile tea, and connected with my partner, who was surprised to see me home, and welcomed me eagerly, and with love. It was all quite lovely, and sweet, and warm.

How we care for ourselves is actually a really big deal. I still have to make a point of acknowledging it very specifically when it comes up, because I am very prone to taking the emotions that come up due to poor self-care and making them ‘about’ other things entirely. This morning, too. I slept poorly last night, not falling asleep until sometime past one, and not managing uninterrupted sleep at all, waking every 90 minutes or so. I made myself get up, at one point, when I woke near to the time I usually get up for work, and took my morning medication, had a big drink of water, and went back to sleep for another little while. Self-care: the timing on some medications matters a lot. Taking this step ensures that I am at less risk of mid-morning nastiness from taking my meds off schedule. That’s an easy one.

Making my way home on a rainy evening, smiling, and content with the night.

Making my way home on a rainy evening, smiling, and content with the night.

I woke up, at last, fairly grumpy, and very nearly stumbled over the self-care issue in spite of the evening considering it; I was somewhat terse with my partner – who was making me a latte (surprise!). I’m pleased that I quickly recognized that this was another self-care related incident; sleep matters that much for our emotional balance, resilience, and good cognition. We exchanged loving words, and I went on to write this post and sip on this tasty tasty latte. (My traveling partner is not a barista, however he makes a very good espresso beverage, and most particularly his lattes and mochas are quite smooth and wonderful.)

The practical details matter. Are you having a shitty day? Have you checked in with yourself?

  • Did you get adequate good quality rest?
  • Are you in pain? Have you taken appropriate steps to manage that?
  • Do you take emotion/cognition altering medication? Did you take them on time?
  • Are you in good health? If you may be ill, are you taking symptom relieving medication?
  • Is your symptom relieving medication potentially emotion/cognition altering? (many are)
  • Have your nutritional needs been met, including quantity of calories appropriate to your needs, and food choices appropriate to your health?
  • Are your clothes uncomfortable? (no kidding, it matters)

So often when I am on course for a bad mood, or a bad day, if I attend to the practical basics of self-care I can turn it all around*. It’s the details that matter, and not attending to my own needs quickly results in all sorts of crappy negative emotions that aren’t really about anything, but can quickly become so. I’m learning to refuse my own attempts to make events out of fleeting emotions. It’s a nice change.

Today is a good day to take care of this fragile vessel. Today is a good day to heed the only warning system it has to alert me of needs – feelings. Today is a good day to support myself, and make choices that meet my needs over time. Today is a good day to change how I take care of me. Today is a good day to be mindful that each of us faces these same needs. Today is a good day to change my perspective on the world.

*There’s still a ton of verbs involved, and no matter how good the ideas, practical self-care requires actual practice, and actual action. There was some irony in that the morning following writing this post took a turn for the worse, although not in a permanent way, and did so because I allowed myself to be distracted from my awareness of time, and timing, and wound up not taking care of morning calories, and afternoon medication in a timely fashion. I don’t write because I have answers; I write because sharing the questions has value for me, all on its own. 🙂