The UPS and DOWNS of chronic pain

I just came from the doctor, and he and I agreed that things are going splendidly following my shoulder replacement twelve days ago. This could mean that I’m one surgery away from being relatively pain free. Why, then, do I feel sadder than I’ve felt in a long time. To try to understand, I wrote “The UPS and DOWNS of chronic pain.”

THE UP: People will give you a lot of sympathy. THE DOWN: Sympathy has the shelf-life of bananas.

THE UP: You find out who your friends are. THE DOWN: You discover that you don’t have many.

THE UP: You will find friends among other people who suffer. THE DOWN: You wonder if you will still be friends if one or both of you stops suffering.

THE UP: You’re excused from making a lot of the difficult decisions about life that normal people make. THE DOWN: You don’t get the rewards that come from those decisions.

THE UP: You get to take a lot of drugs that have the power to make you feel pretty good at times. THE DOWN: If you’re in a lot of pain, you can hardly tell you took them, and in no time at all, you will have to take enough drugs to kill a normal person in order to feel even a little high.

THE UP: You always have something to talk about. THE DOWN: People don’t want to hear it.

THE UP: Pain is a school that teaches you that you’re tougher than you ever imagined. THE DOWN: The tuition is outrageous.

THE UP: You don’t have the energy or the desire to create a social face. THE DOWN: Your newfound honesty will often look like irascibility to everyone else.

THE UP: You accumulate an impressive store of medical knowledge about obscure conditions and treatments. THE DOWN: No one gives a damn.

THE UP: Against all odds, you are buoyed along by hope for a brighter tomorrow. THE DOWN: Like a sandcastle on the beach, your hope has to be rebuilt twice a day.

THE UP: No one can tell by looking at you how much pain you’re in. THE DOWN: Even when you try your best to describe it, no words are adequate.

THE UP: Your family will insist that you’re not a burden. THE DOWN: You know they’re lying.

THE UP: If nothing else stops the pain, there’s always death—if not now, then someday. THE DOWN: A life spent looking forward to death isn’t much of a life.

THE UP: Someday, you really might get past the pain, and then you will enter into a land “in which all things are made new.” THE DOWN: You will discover that this new land comes with a whole set of new problems.

In summary, even if I escape this pain, I know from within my own body how vulnerable I am, and how hard—if not impossible—it is to fix some things. How, then, can I ever live without fear, and how can I ever live without guilt that I don’t suffer when so many others do? My first real peer support was from Michelle at http://thesmallgodsshallbemyjudge.blogspot.com and Twinkle at http://elysianreveries.blogspot.com. Michelle will probably always hurt and has been near death a few times, and Twinkle is now in so much pain that she seldom writes anymore. For me to feel good when they cannot is to betray them.

Today, I heard on the news about the street fighting in Syria. Those who are wounded are afraid to go to the hospital because the police can pick them up there and murder them. They are therefore taken to private homes where they lie in agony in a city without water or electricity. Then there are the women in Africa who are shunned because of pregnancy-related incontinence; there are the abandoned pets that whimper in cages at the pound; there are the beasts of the forest that face starvation when they grow old; there are the women who are sold into sexual slavery; and there are the children who are forced to grow up in violent homes and on violent streets. So much suffering! So much suffering!

Please don’t think for a moment that I imagine myself to have risen to some exalted position from which I KNOW pain because ALL I can ever say is that I know what I have experienced, and whether by some imaginary measuring stick, it has been a little or a lot, it has been sufficient to change me, and, at this moment anyway, I just wish I could go back to the way my life used to be, because I don’t feel refined, and I don’t feel enlightened; I just feel broken, and I don’t think I will ever feel whole again.

On surviving yet again

Miscellaneous experiences and reflections

Three shoulder surgeries in 25 months. If you don’t think that sounds like fun, you really ought to try it sometime. This was my first joint replacement though, and recovery should be easier because less soft tissue was involved, and it’s soft tissue that takes forever to heal.

I remember getting a nerve block just before they rolled me into the O.R. at 7:30 Friday morning, but the O.R. anesthesiologist must have cold-cocked me the minute I arrived because I don’t remember anything after my gurney hit the swinging doors. I don’t even remember waking up in recovery or being rolled upstairs to my room.

Because I’ve lived on narcotics for so long, they no longer work well, so my first night in the hospital was hell. I had a PCA (Patient Controlled Anesthesia) pump that injected a xylocaine-like drug into my neck, but when the main block wore off in the middle of the night, the PCA didn’t touch my pain, so I was given intravenous morphine, Dilaudid, and oxycodone, all within ninety minutes and all without effect. Nurse Jen then called Mark (my surgeon) and he told her to double the Dilaudid, but even that didn’t help.

Jen then said “I don’t mind waking doctors up in the middle of the night, so if you think of something else that might help your pain, you tell me.” It soon hit me that I needed Neurontin along with the Dilaudid, so Nurse Jen woke Mark up a second time and got me a prescription for 900 mgs of Neurontin, and the two drugs together enabled me to sleep three hours for a two night total of seven hours. (Mark hates the drug, and he knows that I know this, so I laughed about him being awakened in the middle of the night to prescribe it.) As you might imagine, Saturday sucked, yet if I hadn’t suggested the Neurontin, no one else would have thought of it, and I wouldn’t have gotten any sleep.

Thirty-six hours after surgery, I could barely walk 200 feet, and I needed Peggy’s assistance to go that far. Twenty hours later, I came home and walked 2,000 feet all by myself. Today—three days post-op, I walked a mile.

I won’t take a medicine unless I know what it’s for, and this meant that I sometimes turned down medicines while I was in the hospital. If I asked a nurse what XXX was for, and she said, “I don’t know, but it’s on your schedule, so you need to take it,” I didn’t take it.

After I was put into a room, I was surrounded by seven machines of one kind or another, and I was hooked up to four of them around the clock. I literally couldn’t stand up to use my urinal without a lot of wires and tubes becoming entangled. Also, some of these machines had alarms that kept going off for no good reason. I finally insisted that the worst offender be disconnected, and after three hours of serious bitching on my part, it was.

My main physical therapist was an Aussie guy who didn't want to talk about anything but his diabetes and his desire to move back to Australia for the government run healthcare. I kept thinking: “I wish you were there now, dude; I wish you were there now.” If I had it to do over I would have asked for another therapist, but all it takes is a moment of weakness, and some selfish bastard will steamroll you every time. I’ll still complain about him, but doing so after the fact will be less satisfying.

I think that most nurses and doctors respect a patient more—and treat him better—when he’s not mindlessly compliant. As for the ones who are bothered by it, I assume they’re on a power trip, or else they’re so lazy that they resent being forced to actually think for a change.

I had my yearly physical just before my surgery, and, just for the hell of it, I called my internist “Doctor Kirk” (Kirk is his first name). I hadn’t called him by his title since I started going to him 21 years ago, and he looked flabbergasted. I interpret an insistence on being addressed by a title as indicative of a need to have people brown-nose you, so I guess it’s just as well that I’ll never meet the queen.

The anesthesiologist who performed my nerve block was so concerned because I’m “not narcotic naïve” (meaning that I take a lot of narcotics) that he came by twice on his days off to check on my pain level. I wanted to leap out of bed and kiss him. Doctors like that are to die for.

I’m pretty sure that a nurse stole some of my Dilaudid, but I believe you should be 99% sure before you formally complain about such a thing, and I was only at 98.5% (although I did mention my suspicions to her).

I’m sure that some of you wonder if I’m ever tempted to pray given that I’m in chronic pain and have had numerous surgeries. No, I’m not. When someone tells me that their oncologist had “given up” on their Aunt Matilda, but that god dropped by and healed her cancer, I think about how much more impressed I would be had god re-grown her missing leg, or eye—or even her missing toenail. Funny how religious people only pray for things that might happen anyway. Why is this, religious people? Why not ask god to raise the dead or at least re-grow teeth? I mean, jeez, how difficult could a bicuspid be?

Finally—and for the hundredth time—allow me to warn you against ever allowing yourself to be intimidated by a lot of diplomas and certificates, or by a bigger than life personality. I promise you, you will occasionally have an idea that is so brilliant yet so seemingly obvious that you will be appalled that the experts overlooked it. Yet, they did because even the most brilliant, caring, and educated people suffer from the all too human tendency of falling into a rut.

150 years ago today, the war started

Three months later, a soldier who was about to go into battle wrote the following letter to his wife.

July the 14th, 1861
Washington D.C.

My very dear Sarah:

The indications are very strong that we shall move in a few days - perhaps tomorrow. And lest I should not be able to write you again I feel impelled to write a few lines that may fall under your eye when I am no more.

I have no misgivings about, or lack of confidence in the cause in which I am engaged, and my courage does not halt or falter. I know how American Civilization now leans upon the triumph of the government and how great a debt we owe to those who went before us through the blood and suffering of the Revolution. And I am willing - perfectly willing - to lay down all my joys in this life, to help maintain this government, and to pay that debt.

Sarah, my love for you is deathless, it seems to bind me with mighty cables that nothing but omnipotence can break; and yet my love of Country comes over me like a strong wind and bears me irresistibly with all those chains to the battlefield. The memory of all the blissful moments I have enjoyed with you come crowding over me, and I feel most deeply grateful to God and you, that I have enjoyed them for so long. And how hard it is for me to give them up and burn to ashes the hopes and future years, when, God willing, we might still have lived and loved together, and see our boys grown up to honorable manhood around us.

If I do not return, my dear Sarah, never forget how much I loved you, nor that when my last breath escapes me on the battle field, it will whisper your name...

Forgive my many faults, and the many pains I have caused you. How thoughtless, how foolish I have sometimes been!...

But, O Sarah, if the dead can come back to this earth and flit unseen around those they love, I shall always be with you, in the brightest day and in the darkest night... always, always. And when the soft breeze fans your cheek, it shall be my breath, or the cool air your throbbing temple, it shall be my spirit passing by.

Sarah do not mourn me dead; think I am gone and wait for me, for we shall meet again...

Sullivan


A solid shot from a Confederate cannon tore off Sullivan Ballou’s right leg a few days after he wrote the above letter, and he died a week later. Soon afterwards, rebel soldiers exhumed and mutilated his body, which was never recovered. Sarah didn’t receive the letter until a year later when the governor of his state traveled to Virginia to bring home the remains of Rhode Islanders who died in battle.

Tell me, when you consider the history of warfare, which wars would you have been willing to die for? I wish I could look at what my nation has become and consider the 620,000 lives we lost in the Civil War alone to have been worthwhile, but I can’t. On one level, I envy the love that people like Ballou hold for this country, but on another, deeper level, I just consider them to have been suckers, well-meaning and heroic suckers to be sure, but suckers nonetheless. We don’t deserve what they gave. We never did.

America’s new IQ test

Test directions:

This is a pass-or-fail multiple-choice test that can be completed during a single TV commercial unless you’re a slow reader in which case it might take two.

So that you can get a higher score, most of the answers are correct, but where only one answer is correct, it’s so screamingly obvious that you’ll know it right away if you’re not a godless atheist, a bleeding-heart Democrat, or a smart-alecky foreigner.

There are eleven questions. That way you can throw one of them out if America's Most Eligible Bachelor comes back on before you’ve completed the test.

If you’ve ever voted for a president named Bush, you’ve already passed.

If you need to see the answers to know how you did, it means you failed.


Where are you most Sunday mornings at 10:00 a.m.?

1) Trying to find the door so I can leave the party.
2) Reading the Communist Manifesto.
3) Attending services at Calvary Baptist Church.
4) Having sex with my neighbor’s wife while he attends services at Calvary Baptist Church.
5) Listening to a preacher on the radio while driving to the Monster Truck Rally.

Which country do you hate most?

1) All of the ones that have a lot of ragheads.
2) France because the men talk like queers.
3) England. See France.
4) Canada because they think they’re better than us even though they waste their money on education and health care instead of investing it in nukes.
5) Australia because they have all those neat critters that can kill you, and all we have are a few candy-assed rattlesnakes and a half-dozen grizzly bears.

Which size should a patriotic American order no matter what the product?

1) Small
2) Medium
3) Large
4) Larger
5) As big as it gets

How many material possessions are enough?

1) No amount
2) An environmentally responsible amount
3) Twice as much as my stupid brother-in-law
4) One of every kind of gun, a two-ton Dodge Ram 4x4 with women on the mud flaps, and a lifetime supply of Coca Cola and Jack Daniels
5) Hugh Hefner’s house and broads

Which candidate would Jesus vote for?

1) Faggoty-ass Commie
2) America-hating Democrat.
3) God-fearing patriotic Republican
4) Green Puke Party slimeball
5) That Nader S.O.B.

Which of the following countries would Jesus nuke?

1) Monaco
2) Africa
3) France
4) Canada
5) All of the above because they don’t love him like America loves him

Which of the following might fit into a Glock?

1) M80
2) 9cm
3) 12 gauge 00 buck
4) .45 ACP
5) F-150

Who died for your sins to pacify a seriously pissed-off deity?

1) Oprah Winfrey
2) That heathen Arabb guy what the sand-niggers worship.
3) Jesus Christ, my Lord and Savior and the Only Begotten Son of God
4) Nobody
5) All of the above

What do you love most about nature?

1) Having a place to dump old refrigerators for free
2) Shooting Bambi
3) Hugging trees
4) Driving my ATV over endangered wildflowers
5) Having a place to party where the neighbors won’t call the cops and where I don’t have to pick up the empty cans, bottles, and Kentucky Fried Chicken boxes

Where will you be when Jesus comes again?

1) Rising to meet him in the air
2) Sleeping in
3) Smoking dope while pouring beer over my Fruit Loops
4) Looking at Internet porn
5) Worshipping that heathen Arabb guy

What good is an education?

1) It helps you to find the word Republican on the voters’ ballot.
2) It’s a lot harder to read your Bible if you don’t know how to read.
3) Having an education means that you can make out the story that goes with the pictures.
4) Being educated is bad because atheists and evolutionists wouldn’t be that way if they hadn’t gone to college.
5) If you can’t read the menu, how are you going to get a job at Mc Donald’s?