41. Chronic Neuropathic Pain (2): “You just learn to Ignore it”

[Numbers in square brackets refer to posts listed on the right and at the Home/Archives page.]

In 2004, after that fateful ‘simple’ biopsy operation on my spinal cord tumour, I spent three months in a rehab-geriatrist ward to learn to be a wheelchair user. There was another ‘long stay’ patient in the surgery ward: a young woman, who had a young daughter, was lying on her stomach on a special self-propelled bench/bed with wheels for her to wheel herself around — a kind of ‘stretched’ wheelchair, like a stretched limousine. She was waiting for an open wound in one of her buttocks to heal. She frequently came into the exercise clinic to receive heat and other treatment to relieve the tense muscles around her neck and shoulders. We gradually got to talk to each other and visited each other in our respective room. One day we had the following conversation.

‘How long have you been in a wheelchair?’
‘Fourteen years.’
‘Do you have pain’
‘Yes, of course.’
‘What’s it like?’
‘Exploding, burning, stabbing, electric shock, and more.’
‘That’s what I have too! Will it ever go away?’
‘No, never! It is chronic! From spinal cord injury.’
‘How do you cope with such constant, excruciating pain?’
‘You just learn to ignore it.’
‘How is it possible at all? The pain is always there!’
‘Yes, it is possible, given the time.’
‘But how?’
‘You will learn to do that.’ .

 

 

 

 

.

It was totally beyond my belief, understanding, and imagination! How is it possible at all to ignore such constantly present, often excruciating, strange sensations in the legs I can no longer move, in the thighs and buttocks that are always in contact with a seat cushion or a mattress, and in the feet that are always firmly placed on the footplate of the wheelchair? There is no practical way to free the painful parts from those contact surfaces unless I could fly up to float weightlessly in a vacuum. [32]

How is it possible at all not to feel all the soundless and invisible crackling, crunching, stabbing, pricking, drilling, pulsating, burning, freezing sensations that are constantly going on from my lower chest wall down to my toes! [03]  How is it possible not to feel the hypersensitive pain in my right leg when it is touched even most gently? [03]

The pain is there all the time, in whatever position and posture I am in, whether sitting up or lying down in bed, lying on the side or on my back. It is present in whatever I do: eating, showering, talking on the phone, talking to visitors or nurses or the doctor, and repeating the same monotonous arm exercises.

To ignore chronic pain is to ‘intentionally disregard it, that is, to consciously pay no attention to it, not admitting it, not acknowledging its presence or existence. Such a conscious effort may involve denying it, resisting it, fighting against it. My past experience with migraine attacks for nearly 35 years has taught me that the harder I tried to ignore it, to resist it, to fight against it, or to try to stop it, the more intense and debilitating the pain would become, often turning me into a highly stressed, totally helpless, and temporarily incapacitated being!

I didn’t think I could ever manage to intentionally, consciously ignore the ever-present pain. I am always aware of its persistent physical presence and can always feel it. Most of the time, I simply just continue doing whatever I am doing or have to do, amid the pain, despite the pain. It is likely that I simply just take it as background noises like the background music in the shopping centre or sounds and noises outside the house. Sometimes, I am so involved and engrossed in the activity that I temporarily forget about it, not feeling it for a while. However, as soon as my concentration goes, I can feel the pain again straight away. Sometimes, the pain is so acute that I simply can’t do anything at all!

The activity I get myself involved in usually serves to distract myself from pain temporarily, such as solving the seemingly endless pain- and disability-related problems, managing my irreversibly changed life, doing simple housework like laundry and simple cooking, conversing with someone on the phone, reading and answering e-mail, learning something new, doing something creative, searching and researching on-line, reading a book, writing about my experience, listening to music, attending a public talk or a play or an opera or a concert, watching television, listening to the radio, looking at the garden, listening to the birds, listening to the wind or the falling rain, watching the clouds in the sky, watching sunrise in front of my east-facing house, exercising, practicing deep breathing, meditating, reciting mantras.

Perhaps, what actually happens is that, over time, I have progressively got used to my chronic pain lurking in the background, and often continued to work through it, if it is not too severe. Consequently, I must have developed a greater tolerance to the persistent pain.

My overall approach is to have the attitude of facing the pain upfront, embracing it, focusing on it, sinking into it, analysing it, understanding it, knowing it, describing it in detail, metaphorising it [36], so as to identify, differentiate, categorise the types of pain in terms of their locations, patterns, frequency, intensity; and working out the triggers so as to prevent further flare-ups.

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NEXT POST: REACTIONS TO PAINKILLERS, DEC 16, 2018
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Abstract Photography 14, by Mostafameraji, own work, 2016. This file is licensed under the Creative Commons Attribution-Share Alike 4.0 International license. At https://commons.wikimedia.org/wiki/File:Abstract_photography_%D8%B9%DA%A9%D8%A7%D8%B3%DB%8C_%D8%A7%D9%86%D8%AA%D8%B2%D8%A7%D8%B9%DB%8C_14.jpg

Abstract Photography 06, by Mostafameraji, own work, 2016. This file is licensed under the Creative Commons Attribution-Share Alike 4.0 International license. At https://commons.wikimedia.org/wiki/File:Abstract_photography_%D8%B9%DA%A9%D8%A7%D8%B3%DB%8C_%D8%A7%D9%86%D8%AA%D8%B2%D8%A7%D8%B9%DB%8C_06.jpg

Infrared of the Galaxy Sky. 2003. By 2MASS/T. H. Jarrett, J. Carpenter, & R. Hurt.  http://www.ipac.caltech.edu/2mass/gallery/showcase/allsky_gal_col/index.html.
Copyright notice: http://www.ipac.caltech.edu/2mass/gallery/showcase/copyright.html
This file is in the public domain in the United States because it was solely created by NASA. NASA copyright policy states that “NASA material is not protected by copyright unless noted“. At https://commons.wikimedia.org/wiki/File:Galaxies_of_the_Infrared_Sky_.jpg

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40. Chronic Neuropathic Pain (1): Sudden Onset

[Numbers in square brackets refer to posts listed on the right at the Home/Archives page.]

On that fateful summer day in 2004, many hours after the biopsy operation on my spinal cord tumour [01], I first woke from anaesthetics in the evening but only briefly; still sleepy. Vaguely, I noticed my younger sister and my two friends standing at the end of the bed but I could hardly breathe or talk. In my half asleep state, I felt tightness around my lower chest wall, especially on the left, as if someone had wrapped it around with a heavy metal band.

            A Tight Band Around Lower Chest Wall

     Ouch…..!  Ouch….!
     Where has this broad metal band come from —
     Wrapping tightly around my lower chest wall, tying me to the bed?                 
     Who has put it there? Why?                             
     To stop me moving?
     To stop me breathing?
     To stop me speaking?
     Please remove it!
     Please let me breathe!
     Please let me sleep!

I fell asleep after speaking to my sister and two friends, with difficulty and only briefly. As I was falling asleep, I felt my legs becoming heavier and heavier. I was later woken by a nurse (M) who apparently had been turning me every hour or so while I slept. Later in the night, I told him that I could not move my legs; I could not feel my left leg; but my right leg was very painful. He told me that he would report it to the neurosurgeon. Later, another nurse (senior) came in to give me, or to increase the dosage of the intravenous desthemetisone (an anti-swelling steroid), and she told me about it. I asked for the time; it was about 10 p.m. I continued to sleep and felt being turned over a few times throughout the night.

When I finally woke up fully, it must be morning: there was bright sunlight outside the window and I heard trolleys being pushed along the corridor.  I found myself in a single room (in a surgical ward), facing a blank wall with no clock. I still felt a tight painful grip around my lower chest wall.  When I tried to turn to lie on my left to relieve the acute pain in the right buttock, I noticed my lower body did not move! I still could not move my legs!  When I touched my left leg, I could not feel anything! In sharp contrast, when I touched my right leg, I felt such  excruciating pain!  All my right side, from both the lower chest wall and lower back down to the toes was extremely hypersensitive to touch! 

          My Legs: Identical Twins No More [03]

     Drastically, overnight,
     my two legs have stopped being identical twins.
     They have stopped talking to each other.
     Right leg extremely hypersensitive to touch:
          millions of sharp needles
          pricking at my sensitive nerves.
     Left leg completely numb to touch.

In addition,I felt severe pains and strange sensations in my whole lower body that I had never experienced before: there were ‘constant activities’ inside both legs and buttocks: 

      Soundless and Invisible Fire Crackers  [07]

     Many long strings of fire crackers
     bursting and burning
     rapidly but incessantly
     up and down, inside my legs,
     from toes to buttocks,
     making crackling sounds
          I cannot hear;
     giving out hot bright sparks
          I cannot see.

I treated these completely unusual pains and symptoms as post-operative and believed that they were only temporary. I remembered back in 1989, a right-knee arthroscopy left me with temporary discomfort in my right leg for about a week, especially my calf: stiff, heavy, as if I had been standing on my feet from morning to night without resting, which were relieved by gliding the knee up and down while in lying or sitting position. However, these pains and sensations I was experiencing now were completely different.

I would never have imagined that these conditions would be permanent, and that I would become a permanent wheelchair user and a permanent sufferer of chronic, acute neuropathic pain for the rest of my life, as a result of a ‘simple’ biopsy operation on my spinal cord tumour [01], performed by an eager neurosurgeon. 

     Sudden Onset of Chronic Neuropathic Pain
                    (posted on Jan 7, 2015 [03])

    Many long hours after the biopsy surgery,
I wake from anaesthetics—
my entire body wrapped in strange new pain:        

    A tight broad metal band
corsets my lower chest wall—
I can hardly breathe;

    My lower body crackles, crunches
and bursts with sensation—
if only I could stop them.

    My two legs have stopped being identical twins:
right leg is hypersensitive to the gentlest touch;
the left is completely numb.
.

 

 

 

 

.
.

A sudden onset of permanent disability [02] and chronic neuropathic pain [03], and an irreversibly changed life style imposed on me [38], putting an abrupt end to my academic career [39]. Such multiple destruction and suffering for nearly 15 years now after a ‘simple’ biopsy operation! What happened in the operation?  Hopefully, it has never happened and will never happen to anyone else.
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NEXT  POST:  CHRONIC NEUROPATHIC PAIN (2),  NOV 30, 2018
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Jacek_Malczewski_-_Rekonwalescentka.jpg ‎(800 × 600 pixels, file size: 162 KB, MIME type: image/jpeg) (Jacek Malczewski – Convalescent Woman (1882)), posted by Ablakok, 2017. This file is licensed under the Creative Commons Attribution-Share Alike 4.0 International license. At  https://commons.wikimedia.org/wiki/File:Jacek_Malczewski_-_Rekonwalescentka.jpg

An example of a person in Pinel restraints, by James Heilman, MD, 2017.This file is licensed under the Creative Commons Attribution-Share Alike 4.0 International license. At https://commons.wikimedia.org/wiki/File:PinelRestaint.jpg

Firecrackers in action in Chinese New Year celebration. Photo by Dr. LEE Sao Bing, who is the Medical Director and Principal Surgeon of Shinagawa LASIK & Eye Centre, Singapore. Photo taken from his personal blog at:  https://drleesb.wordpress.com/2012/01/24/firecrackers-new-year/

Bonfire. Photo from English Wikipedia, 8 September 2004 by Fir0002. This file is liscensed under CC AS-A 3.0Unported License.  At http://commons.wikimedia.org/wiki/File:Bonfire4.jpg

Feux d’artifices rouges, 2008.  Author unknown.  Source:  http://www.photos-libres-de-droits-gratuites.com/photos/Artifices/feux-artifices-pldg007.jpg .  This file is licensed under the Creative Commons Attribution-Share Alike 2.0 France license. At  https://commons.wikimedia.org/wiki/File:Feux-artifices.jpg

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35. Pain is Physical; Suffering is Mental.


Reproduced from Prologue, first posted on Jan. 3, 2015.


 

Pain

.

Photo by Daphne Zaras http://en.wikipedia.org/wiki/Tornado#mediaviewer/File:Dszpics1.jpg

.

 

 

 

CSIRO_ScienceImage_10413_Project_Vesta_fire
.
Like tornadoes, earthquakes, tsunamis,
acute pain can devastate in an instant.
Like the reign of a cyclone or volcanic eruption,
pain is unbearable in its duration.
.

Chronic pain persists like a bushfire,
blizzard, flood, drought or heat wave:
excruciating, depleting, extensive,
destructive.
.

Chronic neuropathic pain, with its multiple symptoms,
is complex megadisaster: earthquake, tsunami, and nuclear blast;
or supercell thunderstorm with hail, lightning, cyclonic wind, and flood;
or volcanic eruption, with fire, lava flow and permanent damage.
.

However widespread the disaster,
we overcome and recover.
Pain is physical; suffering is mental.
Suffering is just the sky’s dry argument.
We do not let pain become suffering:
we triumph.
.
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CSIRO_ScienceImage_10409_Eucalypt_regrowth_after_Black_Saturday_bushfires

Eucalypt Regrowth after Black Saturday Bushfires



Tornado, Photo by Daphne zaras, in public domain. http://en.wikipedia.org/wiki/Tornado#mediaviewer/File:Dszpics1.jpg.
http://en.wikipedia.org/wiki/File:Dszpics1.jpg

Bush Fire. By CSIRO Australia.  CCA 3.0 Unported license.
http://commons.wikimedia.org/wiki/File:CSIRO_ScienceImage_10413_Project_Vesta_fire.jpg

Eucalypt Regrowth After Black Saturday Bushfires.
Photo by Robert Kerton, CSIRO, Australia.  CC0 AS-A 3.0 Unported License.     http://commons.wikimedia.org/wiki/File:CSIRO_ScienceImage_10409_Eucalypt_regrowth_after_Black_Saturday_bushfires.jpg