Living In Chronic Pain

• anesthesiologist
• family physician
• psychiatrist or psychologist
• physiologist
• nurse practitioner
• massage therapist
• chiropractor
• personal trainer
• acupuncturist
• pharmacist
• occupational or physical therapist

Chronic pain has many faces. It is becoming more prevalent in today’s society and is a major problem for most medical professionals. There is still quite a stigma to treating constant pain especially for women ( often seen as the weaker sex) .Pain is real and can seriously damage a person's quality of life with loss of work, causing more stigma, loss of friendships, mainly due to an inability to get out and see people and fatigue, and probably most importantly loss of family life. When pain hits a a young mother of small children. The children are often left to their own devices in finding quality play, help with homework and sometimes even meals. Spouses are left to pick up the pieces and although marriage should include for better or worse there is often a bitterness of underlying resentment for the time the spouse is left to do extra work giving him or her little time for any personal outlet of their own.

I was diagnosed with Lupus at the age of 32 with three young children and although I did have a supportive spouse and did not have to work myself he was traveling quite a bit leaving me with little means to deal with my pain. If I had known what I do today it could have made a huge difference in the quality of my life and that of my family's. I remember not being able to get up long enough to do more than make a quick meal and drive the children to wherever they needed to be. I could not even grasp the steering wheel of the car to drive and had to use the palms of my hands to turn the wheel. My inability to keep up with my friendships left me with little help such as carpooling, etc. I know now how much people need and want to help others and I should have just made some phone calls. There is something about pain that draws you inward and leaves you so exhausted that even making a call can be difficult. For those reading who don't have an illness or have good days, reach out to your sick friends without them asking and do something you know might be helpful, like bringing over a casserole to put in the freezer, carrying up the mail, asking to bring children home from school and maybe even let them come to your house for a little play time.

Just recently I have started acupuncture for pain. I will do an update on that later. It is very relaxing. Also Magnesium is good for inflammation. Another recommended supplement tis Calcium.

I am now on an anti-inflammatory diet which I plan to write about. It includes lots of fruits and raw or lightly cooked vegetables, salmon and other non-fatty meats, whole grains, green tea, red wine, if you like, and a small amount dark chocolate.

I take fish oil, CQ10, vit E,D3, and vit C daily.

I tend to carry a lot of neck tension and pain especially when working on the computer. Give a heating pad or electronic massager a try. Some can move with you while you work. Heat does wonders for my neck as well as massaging healing cream into the areas that hurt.

There are many options for men and women to deal with their pain today. It does take some mental work and planning to be more effective with pain management.

Pain clinics have opened up all over the country with anesthesiologists that know all the medications needed. They have strict monitoring programs to help their patients to deal with pain without abusing narcotics,etc. Along with medication, pain clinics often offer physical therapy, massage acupuncture, biofeedback and psychological counseling. As it is often said it sometimes takes a village to effectively lessen pain and increase a persons quality of life.

As a pain clinic patient myself I was first evaluated by a psychiatrist who helped me to recognize where and when my pain was worse and what my triggers are. We also discussed using biofeedback, massage, and keeping a journal to find my triggers. He started me on an anti-epileptic drug used to lessen the anxiety caused by the pain itself and keep it in and of itself from becoming a major trigger. I had already learned in my work as an RN that it much easier to stop pain by taking measures before it gets out of hand. Many people think they are being strong by waiting for hours to take their medication or stop and rest to the point that the pain is totally out of control and getting comfort can be almost impossible at that time

Next I see my primary pain physician, or anesthesiologist. He examined my trigger points and where my pain was worse. Together we came of with a plan of medication use to control my pain.

I still see my rheumatologist regularly because even though I had a plan for pain control I still have a disease process going on that needed constant monitoring. My liver enzymes must be tested to make sure the anti-inflammatory medication I have to take is not causing problems and I often need small doses of prednisone to calm down a severe inflammatory attack.

Today some doctors believe a chronic pain disease called fibromyalgia is caused by overactive pain receptors. A very useful drug named Lyrica is now being used to treat this pain.

Another belief about pain is that people that are (neurotic) have pain caused from within from self-induced stress. It is now believed the opposite is true and that the pain causes the stress leading to pain and then neurosis. People in chronic pain are often depressed and fatigued. Sleep is difficult and all the above becomes a vicious cycle that can be difficult to control.

We invested in a Hot tub which helps to bring blood to my hurting muscles and decrease inflammation.

The difficult social part about chronic pain is it is not visible. People can't see pain so they do no understand when you are not well enough to participate in activities. Unfortunately I have found that once i miss 2 or more activities I am no longer invited even though the next time I may be feeling fine and long for time with friends. It is a lonely illness.

• Get plenty of sleep. Establish a regular bedtime, slowly resetting your biological clock if necessary. This can be difficult especially if you feel best in the evening and want to accomplish too many things. Remember your goal is to get your pain under control so your days can be more productive. Take a warm bath, read a peaceful book, pray, and/or have a light snack with protein to help keep you asleep. Be sure your room is cool and totally darkened. Even the light from a clock can distract your sleep. Find a way to lessen outside noise by using white noise. A fan is an economical form of white noise, wear earplugs if necessary. Routine is key.
• Lower blue lights such as computer screens and fluorescent lights after 9 pm. These lights can prevent your body from activating sleep inducing melatonin. I still have to take 3 mg of melatonin nightly to get a good nights sleep.

• Take a warm to hot shower if you wake up very stiff. This can help to loosen tense muscles and get you moving, if you will. Many people, myself included will find the rainy, cold days are the worse with swollen joints, especially in the hands. Your body tends to become a human barometer.
• Try varying cold and hot compresses to painful areas. There are some very good heat patches available at your pharmacy. I like a prescription lidocaine patch for my shoulder and back pain.
• Sex can take a back seat when you are in pain. Try to be more spontaneous and use those times when your pain is low. You can try taken your medication and a warm bath prior to sex and remember intimacy takes on many forms and a marathon is not necessary. An understanding spouse will know you have limitations and be sensitive to them. Music is also calming and can be used any time for sex and relaxation. Music has away of awakening our senses like nothing else.
• Speaking of music, studies have found that calm music actually lifts our mood more than fast although if I feel good enough to clean fast music helps me move along more quickly and get done faster.
• Use your good days to cook and always make a little extra for leftovers later in the week or you can freeze food in small portion size containers so it does not seem like a leftover at all.

• Eat a nutritious breakfast. This is especially important when on pain medication. A warm bowl of Irish oatmeal with fruit, cinnamon (a very good antioxidant) and a little honey (another antioxidant) can be a good choice. You can add a little fiber to your breakfast if needed for constipation caused by your medications. Benefiber or one of it’s cousins is a good choice. Drink a glass of healthy juice or even a mixture to add more vitamins and minerals, although whole fruit is more beneficial.
• Drink plenty of water during the day. Lack of hydration can be a cause of headaches and more pain. Try adding some fresh fruit or cucumbers to a pitcher of water and add awesome flavor to your water. I like basil and cucumber in my water. Green tea is an excellent anti-oxidant.
• Get out and get some sunshine early in the day to help you increase your vitamin D needs. I find the fresh air and sunlight makes me actually feel better. This can be a great time to take a brisk walk. I enjoy playing in my garden for moderate exercise in the summer.
• A puppy or kitten can be a tremendous help with pain. Be sure to get a quiet puppy that does not require a lot of extra walking and playing. I play often with my grown children’s puppies and find it to be very calming and relaxing. A puppy adds the benefit of forcing me to go outdoors even when I don’t particularly feel energetic.
• Try to set up a time for a massage either weekly or twice monthly. This helps your muscles and blood flow and human touch goes a long way in decreasing pain.
• Vitamins can be important to your health. I take antioxidants such as vitamin C and fish oil as well as giving myself a twice monthly B12 injection. This is difficult vitamin to absorb thus the injection is the best form to use. The B vitamins help with nerve functioning and give us energy. I also take extra vitamin D for a deficiency I have which is often found in women with autoimmune conditions, Cq10 is a good antioxidant for your heart and vitamin e and cod liver oil also help with energy. Also take a good fish oil supplement.
• Cook or have someone cook meals with a variety of healthy fruits and vegetables and try to eat some protein with each meal especially if you are trying to lose some extra weight. I like to keep nitrate free lunch meat and soft boiled eggs in my refrigerator. Fish is a good choice for dinner at least twice a week. This will add the fish oil needed by your heart. Eat frequent small meals throughout the day to keep from putting undo stress on your intestinal tract and to keep your energy up. Many people with extreme fatigue actually have hypoglycemia and often let their blood sugar get too low. Be aware of your body's needs. Green tea in the afternoon can be a great pick me up.
• Take a daily nap for at least one to one and a half hours a day. Darken and make your room as quiet as possible. The hour is needed for restoring REM sleep to take effect.Don’t sleep much longer than that or you may not sleep at night.
• Be sure to take your medications on schedule and take your pain medications at the first hint of pain.
• Keep a journal of how you feel each day. What are your activities and the food you eat. What are your rest periods and how long do you rest. This will help you find your triggers.
• Ask your family for help with the housework and cooking when you are too sick or hire someone if possible. When you are able to get up pace yourself and try not to do so much you are worn out. Take frequent rest breaks and assess your pain and energy levels.
• When you have an upcoming event try to rest and save some energy for that day.
• It is important to enjoy life. Try to get out and do something you enjoy at least once or twice a week even if it something as small as visiting a special friend or going to a movie.
• New research has shown that B vitamins can be helpful for energy. Also it has been found that most of us have too little Vit D even with the supplements of milk ,cereal, etc. Have yourself and your family checked at least once as this is an important supplement in the fight against breast cancer, colon cancer and many other disease processes.
• Finally don't allow guilt to make things even worse. You probably did nothing to cause your problem and guilt will only cause you to feel bad emotionally and physically. It can become a vicious cycle. I had to let go of a lot of guilt for the year or two when I was sickest. Your children may say things that they don't know will trigger your guilt. Remember they are children and they recover quickly especially when they know they are loved and mine did.
• Be sure you get up and walk around and stretch often especially when writing or working on a computer.
• Try to be organized so you never get stressed.
• If you are like me you often get the comment " You look wonderful" Try to say no anyway. No quilt here . Your family and yourself comes first.
• DHEA has been used successfully on some lupus patients.

Some studies have shown Aleve is actually good for your heart. You can take to tablets at the start of your pain and another after 6 to 8 hours not taking more than 3 in 24 hours.

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