A recent article in Timemagazine addresses The Mystery of Pain. (Of course, we’re talking physical pain here, although, I believe, emotional and psychic wounds can lead to just as much distress as physical ailments do.) This piece was of interest to me because physical pain has been an ongoing nemesis in my life…for almost all my life. For the timespan of most of my twenties (about seven and a half years), for example, I experienced daily, often-times debilitating, headaches. And, it was during these years that I began to cope with periodic lower-back pain as well. I ultimately interpreted both of these physical conditions as reactions to the overwhelming stress in my life at the time, namely finding myself in a marriage that was the completely wrong place for me to be. When I left that relationship at about age 30, I was able to turn around the crippling nature of these physical conditions, get myself off the medication (Valium) I was using to cope, and make some progress in the areas of physical health and emotional growth. (The obvious smack-in-the-face exception is the fact that I moved directly from being addicted to Valium to a lifestyle of alcohol use and abuse, and that subsequently took a few more years to overcome.)
There have been some small portions of my life where I have lived relatively head- and back-ache free, but those times seem rather a dim memory. I continue to cope, the best I can, with daily pains in these parts of my body, and succeed pretty well most of the time. They have become, simply, conditions I have learned to live with.
But, I have aged. And I’ve not acquired the ability to get rid of chronic conditions, but, rather, seem to be an unwilling “collector.” I am not one of the people identified in the Time article who has a deteriorating body and is asymptomatic. Nope. When something is “off” with my system, I feel it, often times, it seems, with a higher degree of intensity when compared to others. I have recently written, for example, about my diagnosis of Chronic Myofascial Pain. This is a condition that dominates my awareness in terms of the feelings (or lack thereof) in my lower extremities all-day, every-day. I’ve apparently not yet made significant-enough progress in my learning curve about this condition, given that my attempts at self-treatment have yielded virtually no change. The bottom line is: I live with these chronic pain conditions everyday AND try to be as functional a human being I possibly can at the same time. I find this pretty challenging.
The writer for Timeasks “why does the same problem hurt one person and not the next?” Good question! I often wonder this myself. He suggests that we consider three factors: the “pain-inflammation connection;” “neural blockades;” & “depression and hormones.” Although I’m sure that the inflammation connection is a large part of my physical stuff, the relationship of depression to pain, of course, intrigues me. That has to be part of my dynamic as well, given my propensity to perpetually struggle with my emotional health. I’m convinced, in fact, that if I could find the right something (drug? herb? sleep potion?) to help me with chronic depression, then these other ailments would not loom as large for me as they currently do.
The article concludes with the statement that “today pain remains a tantalizing mystery.” (Duh. You think?) For now, we are advised to “cheer up, pop an Advil, keep working, go to the gym, eat something and buy your spouse a present.”
Ohmygod. I certainly feel reassured about handling my pain now. Thanks, Time.
I was educated as a chemist (a lot of my formal education is in that discipline, anyway), and I remember thinking a long time ago that chemistry is life. Well, that orientation has changed; biology is life is more where my head is at now.
I spend so much time these days paying attention to my body (primarily its limitations), that it’s practically laughable. And, here I am trying to learn all I can, as fast as I can, frustrated a lot by mostly having to teach myself.
Of course, I speak of the incredible learning curve I’m experiencing right now regarding myofascial pain. I have an entire new discipline to master as I try to learn all about myofascial trigger points, referred pain, self-massage, and living with a chronic pain condition. The Trigger Point Therapy Workbook is rapidly becoming my bible, from which I do daily readings, guiding my daily practice for health-seeking.
Here is another definition of a trigger point (see also “Survival”): “a highly irritable localized spot of exquisite tenderness in a nodule in a palpable taut band of muscle tissue” (Davies & Davies, p. 19)…which they elaborate on by saying “a trigger point hurts like the devil when you push on it.” There are apparently several methods available for relieving trigger points (and the pain that can subsequently be referred to other parts of the body), some of which require the services of a professional (a savvy doctor or physical therapist, for example); there are other methods one can pursue independently. I have a doctor, of course, who diagnosed this condition for me, but in the time I have before my next appointment, I’ve been studying up and attempting to start a regimen of self-care that includes locating and massaging the trigger points responsible for my pain. This is requiring a lot of time with the trigger-point reference manual, trying to identify muscle groups with which I have limited familiarity, probing my body, and struggling to locate my trigger points so that I may massage them. (This is turning out to be a non-trivial task!)
At any rate, I have intensely steep learning curves both at my new job and in the health area of my life. This is incredibly tiring, but I guess it’s merely playing out the hand I’ve been dealt right now.
I know that the entry a few days ago, entitled “Hope,” likely sounded, well, hopeful. And, at the time I wrote it, I was in that kind of space. However, I’ve actually found myself on an emotional roller-coaster since the Chronic Myofascial Pain diagnosis. One moment I’m feeling grateful for more information and for finding a doctor who believes he can help; the next I’m feeling anxious and depressed and overwhelmingly fatigued trying to cope with not only my physical stuff, but with trying to absorb a new way of interpreting the signals my body is sending.
I’ve been doing some web-surfing on the topic of chronic pain; I’ve been reading Fibromyalgia & Chronic Myofascial Pain: A Survival Manual; and I am trying to decipher some meaning from this. After all, this is not a trivial kind of development. I’ve received a verdict, even if it’s still somewhat tentative, of a chronic disease.
Ugh!
So, let’s talk about: how do you pronounce the name of this condition? What is it? How did I get it? What do I do now?
In case you’re wondering, the proper pronunciation of myofascia is my-oh-fash΄-a (so that fascia is pronounced similar to “fashion”).
I’ve been learning that this is not exactly an easy condition to explain. And, there seems to be quite a lot of information out there that is not consistent with what the Survival Manual says. For example, both my doctor and several websites call this affliction Myofascial Pain Syndrome – that is, by its former name. When this condition was given “disease status” it became known as Chronic Myofascial Pain about six years ago. It’s a little disconcerting that my doctor is using outdated terminology.
I’m trying to come up with simple language, with information derived from my reading, to try and describe what it is we’re talking about – but even Starlanyl & Copeland (2001) struggle with this task. They say, “one of the problems in discussing myofascia is that there is no familiar metaphor to help…visualize what and where it is.” (p. 17) They then indicate, however, that myofascia can be described “as the thin and almost translucent film that wraps around muscle tissue (think about the sticky white film you see covering some of the chicken parts you buy at the butcher shop).” But, really, it’s much more, given that myofascia can be visualized as a gauze- or web-like network permeating the entire body. Further, they indicate that “malfunctions due to trauma…can bind down the fascia. Restrictions…can create pain of malfunction throughout the body, sometimes with bizarre side effects and seemingly unrelated symptoms.” (p. 19) Myofascial pain is caused by “trigger points,” which are “extremely sore points that can occur in the myofascia in taught, ropy bands… or as painful lumps or nodules.” In essence, “a myofascial trigger point is a hyperirritable area of skeletal muscle.” (p. 23)
OK, OK! I know, enough already. Yes, my eyes glaze over when I try and understand this too…
You might be getting a little bit of the picture, anyway. I have tight, taught muscle tissue that is causing chronic pain (primarily in my left leg and foot, but also in my other extremities to a lesser degree). I’m theorizing that this inflammation of muscle tissue is pressing nerve against bone in my left leg, leading to the tingling and numbness in my left foot, especially the toes.
Here’s the short story of how I believe I got myself into this state…
In the few months following the episode I described in the last post (the winter of 2004-05), the stress at work was monumental. While still in the process of learning my job and becoming acclimated to the campus and a new working environment, I was directed to eliminate three of the programs in my division, requiring me to inform people that their programs and their jobs were going away. Additionally, after months of frustration, I let go the administrative assistant I had inherited. I also dismissed an instructor who was behaving badly and had likely gone off his medications. In sum, I dealt with multiple personnel and student-complaint problems, one after the other, all the while attempting to perform the myriad other responsibilities of an academic dean. And, many days during this time, I nearly froze to death in my office – a space that, on the surface, looked nice, but that had large windows which allowed the brutal east wind from the Columbia Gorge to permeate my working environment. If you will: imagine a tense, stressed-out guy, huddled and shivering in his office all day every day, and you can sort of get the picture: my working conditions were absurdly sub-optimal. One morning in May 2005, days after an intense episode of tortuous verbal abuse directed my way from the big guy, I awoke with incredible tingling and burning sensations in my left foot.
And, now, here I am. I went in to have blood drawn today so that we can rule out other possible explanations for my symptoms. I am gradually taking myself off the anti-anxiety medication I was using as a sleep aid every night (with the warning and the knowledge that my sleep and anxiety issues may worsen for a time). And what I’m doing now is trying to learn as much as I can about this disease before my next doctor appointment, which will happen at the end of September. I’m hoping that I can find enough energy and mental focus to be able to digest a lot of this information and be a fully-informed participant in my treatment plan.
Soundtrack Suggestion
At first I was afraid I was petrified Kept thinkin’ I could never live without you by my side; But then I spent so many nights Thinkin’ how you did me wrong And I grew strong…
Did I crumble Did you think I’d lay down and die? Oh no, not.I. I will survive Oh as long as I know how to love I know I’ll stay alive; I’ve got all my life to live, I’ve got all my love to give and I’ll survive, I will survive. Hey hey…
I have been posting entries here for nine months now. When I put together the first little note, last Thanksgiving Day, I wasn’t at all sure where I was going with this. I still don’t know that I’ve ever really defined a direction, but at this point, when I’m away for as much as five days now (the length of time since my last entry), I start getting a little antsy…thinking it’s about time to write something more. Besides: when that many days of living go by, a lot can happen. And, many things have happened in my life lately.
Some of the issues I talk about here come under the heading of random expressions of joy and angst. And, let’s be honest, in my writings I know I’ve focused more on angst than joy. But three days ago was my birthday, and though I was experiencing the usual self-reflection and anxiety about where I am at with my life (angst), there was some measure of joy as well. One of the best things to happen, mostly because it was so unexpected, was to receive a singing (“happy birthday to you”) phone call from friends in Portland. Although the day itself turned in to be one of my longest work days in a while, it was great to be remembered that morning.
I took the occasion of having a birthday, in tandem with working four-day weeks at the moment, to make an appointment with a doctor here for a check-up. I’ve written previously about the physical symptoms I’ve struggled with in recent months, speculating about such conditions as peripheral neuropathy and post-traumatic stress disorder. I know there’s a bunch of stuff going on with me physically that is not good. The stress I’ve endured the last two and a half years has taken a toll that I am aware of every single moment of every single day. And, the approaches I have used so far to address my symptoms have yielded only modest progress toward health. Through my chiropractor, I have used deep-tissue massage, ultra-sound, and chiropractic adjustment. I saw an acupuncturist for months, enduring the needles and moxibustion. I have continued on with the moxibustion approach myself, as well as frequent self-massaging of my legs. I take hot baths, and try to calm myself psychoacoustically. I read Pema Chödrön books and other spiritually-oriented tomes. And, I’ve just started reading Why Zebras Don’t Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping. With this last book, I’m attempting to get a handle on all the psycho-neuro-biological dimensions of the human experience and how stress has led to the physical symptoms I’m experiencing. The physician I was seeing in Portland was of no help in addressing my condition, although he agreed with my personal assessment of how I got to this point and provided some medication to help with my anxiety.
The first week I was at work here, I asked around for suggestions for local doctors. The second week I decided to make some calls. The first doctor had not taken new patients in five years, I was told. However, the receptionist for the second doctor took down some basic information and consulted with him. Yes, I was told, the doctor would see me.
My appointment was two days ago, the day after my birthday, at the end of my third week of work. I was nervous about pursuing this, but, at the same time, very pleased with myself that I was following through on my commitment to focus on getting healthy. This physician seemed to be quite perceptive about my condition, had a name for it, and expressed some confidence that we could find an appropriate treatment. This was incredible news! It’s his view that I am suffering from Chronic Myofascial Pain, which explains the ongoing weirdness happening in my extremities, especially my left leg and foot. Although I’ve got blood work ordered to rule out other possible causes, what I’ve learned about this condition so far is indeed a fit with the symptoms I’ve been dealing with. I’ve already purchased a “survival manual” for suffers of this condition.
After all the hopelessness I’ve felt having endured this condition for over 15 months, I’m now hopeful that I can actually, eventually, heal myself. Hope, especially around the time of my birthday, is quite-unexpected. (But wonderful: don't get me wrong!)
To round out this report of recent developments, I’ll mention that I attended the University of Oregonsummer commencement ceremony yesterday morning, as Beccalynn (Katrina’s daughter and Bryan and Tamson’s sister) is within a few credits of finishing her degree and decided to participate in graduation at this point. It was a beautiful day and I was delighted to be on hand for another rite-of-passage occasion. I’ve known Beccalynn since her late adolescence, and to see her now, married, the mother-of-two, and a college graduate, is another sign of hope for the future.
Last time, I talked a bit about cell-phone users and the annoying way their toys are used. I guess I’m still on the same rant today. The soundtrack of our lives in recent times, it seems, is no longer provided by the likes of Mozart or The Beatles or Death Cab for Cutie. Rather, the ambient, background sounds we all live with in the present day are dominated by the buzz of all-too-loud voices speaking gibberish into pocket-size electronic devices.
I honest-to-god believe this.
Then, combine all those cell-phone voices and ringtones with the noise pollution of cars, airplanes, jackhammers, blowers and mowers, and we’ve got ourselves a real problem.
Global-warming, terrorism, and wars in the Middle East aside, I conclude that we’re increasingly unhealthy and at-risk because of the noise pollution in our lives.
On the same day I wrote that last entry on “noise,” I rediscovered, in my music collection, a two-CD set by Dr. Andrew Weil called “sound body, sound mind: music for healing.” The message provided there coincides with my opinion on the effect of sound. Says Weil:
“Sound is an especially powerful influence on the human nervous system. It can harm and it can heal.”
I think that the noises we are subjected to in the course of a typical day heavily contribute to the amount of stress we experience. I know for certain that that’s true for me, anyway.
It has occurred to me recently that I may be afflicted with a condition called post-traumatic stress disorder (PTSD) as a result of the conditions of my life over the last two-plus years. If that’s true (I have no “diagnosis,” just suspicion), then perhaps I’m just flailing about and over-reacting here: I’m simply hypersensitive as a result of the state of my being right now.
But here’s the deal: I would hope that we humans could find a way to exist without being on sensory overload most of our waking hours.
I suspect that I’m not the only one who experiences their existence this way and wishes that things were different.
In the last couple days, I have started to use the psychoacoustic approach provided on the Weil CD set in an attempt to address my unacceptably high anxiety levels. I’m hoping that I can get some results with this method and that I can energize and heal my body and soul.
