Sympathy for Chronic Pain

(An actual migraine-related post!) 

I don’t know if there’s a generally accepted definition of “chronic pain.”  However, even when my migraines were at their worst and most frequent, I personally would not have described my pain as “chronic.”  I had six migraines a month, and each knocked me out for a day to a day and a half.  I would call that “frequent, acute pain,” rather than chronic pain.

This weekend, I had an experience that helped me understand what chronic pain must be like.  As I mentioned yesterday, my husband and I took a gondola ride up to the top of a ski trail, then hiked back down the switchback.  (How hard can down be? we thought.)  The switchback was uncommonly steep and made of very loose gravel that was made even looser by the rain the day before.  It was difficult.  I have lost 10 pounds, but I’m still roughly 30 pounds overweight, and I worried about my knees.  By the time I was halfway down, I could feel the strain in my obliques, quadriceps, hip abductors, and glutei.  At the bottom, we were tired and floating on a massive endorphin high.

By evening, when the endorphins were long gone, I was getting rather stiff.  By the next day, getting into and out of the car was difficult for me.  Standing up from a seated position, or sitting down from a standing position, was difficult.  Getting started walking was tough, though once I got going, I could move, though stiffly and more slowly than usual.  Basically, anything that changed the shape of any of the muscles (bending an extended muscle, or extending a bent one) from the waist down was difficult.

By the second day, I was considering calling in sick.  I could barely manage the stairs in my house.  I had to decide between getting off at an elevated T station where I would have to take the stairs down (no down escalator! shame on the MBTA) and walk a half mile, or getting off at an underground T station that has no escalators at all and no elevators, and climbing two flights of stairs before walking a block.  Neither appealed; I did the former.

By dinnertime, I thought I’d like nothing better than to sit still, preferably in a hot bath, but it was my turn to cook dinner, so I soldiered on.  After dinner, I started unpacking a few boxes (we’re still settling into our new house), and putting things away involved using the stairs, so I calculated very carefully so that any time I went up or down a staircase, I carried as much stuff as possible so as to make fewer trips.

Let’s just say, I really overdid it up on Mount Moriah.

Today I am much better, only about as sore as I would expect to be after a slightly strenuous workout.

All day Monday, and all day yesterday, I kept thinking, This is what chronic pain must be like.

• Normal body movements are restricted – depending on where the pain is, a chronic pain sufferer may have trouble dressing, walking, doing ordinary chores, getting to work, or even just sitting down or standing up.
• There’s a constant balance between taking care of your body and taking care of your life.  Should I go to work, or call in sick? I thought.  Should I make dinner, since it’s my turn, or try to get my husband to do it?
• Everything takes longer when you’re in pain.  It took longer to get into and out of the car.  It took longer to walk a half mile.  It took longer even to make dinner.
• Carrying on daily activities is important, even if it’s hard.  And it is hard, physically and psychologically.  But I took my usual walks, albeit slower, and I made dinner and did chores.  It was good for my mind, and I think it was good for my sore muscles.  However, with true chronic pain, it’s always a question whether normal physical activity (whatever “normal” might mean to someone in pain) will help the pain or make it worse.
• You can’t just be spontaneous, you have to plan around your pain.  Ordinarily, if I were unpacking a box that had contents destined for all three floors of my house, I’d make several trips up and down the stairs without thinking.  Yesterday, I thought, Well, let’s see, the linens go on the second floor, and the CDs go in the CD rack, which is currently on the second floor but belongs on the first floor.  So I’ll take an armful of linens upstairs and bring the CD rack down.  And then I need to sweep, but the broom is in the kitchen, which is in the basement – but does anything on the first or second floors need to be moved to the basement?  I’m not saying I don’t think like that normally, but it was much more pronounced with pain, and it’s much more annoying to find yourself back on the first floor and remember that you left the most important thing you wanted upstairs.
• Public accommodations are important.  It has always baffled me why the MBTA spent so much time and money renovating the Charles Street T station – and only put in an Up escalator.  Where’s the Down escalator?  I’ve been surprised that the ADA (Americans With Disabilities Act, not American Diabetes Association) people let them get away with this.  But with my temporary mobility problem yesterday, my bafflement turned to anger.

Sufferers from migraine and other chronic head pain disorders will experience the details differently – after all, it’s our heads, not our legs, that are killing us - but the general principles are the same.  It’s difficult to live normally when something hurts all the time!