chronic pain, Mental health

Ugly Truth 61: Pain Management

“Surrender is an incredibly difficult topic in light of chronic illness, because loss is often continued and sustained.”
-Cindee Snider Re, Finding Purpose: Rediscovering Meaning in a Life with Chronic Illness

Dear Readers,

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Sometimes I surrender to the process. Other times I demand more of myself and those who love me. Chronic pain is a tricky thing, and the truth is I am starting to lose heart.

Earlier this month I had an MRI that revealed an L5/S1 disc herniation and spinal stenosis. Still, these did not explain my pain levels, so my chiropractor referred me for pain management. Initially, he had spinal steroid injections on his mind. However, with a more conservative approach my Wife and I went for a second opinion. Ultimately, we located our own pain management physician who is also a spinal specialist. After my first exam he asked to view my MRI images himself, started me on Gabapentin, and referred me for a complete Nerve Conduction Study/EMG to asses my nerve damage before moving forward with epidural spinal injections. Today was that day, and let me just say if you have never experienced one of these, count yourself blessed because it’s some kind of monster.

Upon arrival my neurodiagnostic tech greeted my Wife and I. Even though he was awesome, knowledgeable, and forthcoming about the level of discomfort I would experience, nothing could have prepared me for this.

He explained that there would be three phases to the procedure. First, he would adhere leads to my lower extremities and use electrical stimulation to measure my nerve response. He would begin on a low setting and increase accordingly along my lower back, legs, and feet. Next, he would adhere leads to my forehead and feet to measure my brain’s response time to S1 nerve stimulation, an area thought to be damaged in my case. Finally, he would insert small needles into my legs, feet, and back to measure my nerve response in a flexed position versus a relaxed state. He stated treatment routes can range anywhere from nerve surgeons to physical therapy based in the results. He informed me the procedure would last thirty to forty five minutes, and we began.

I took a deep breath and did my best to relax even though I was anxious and cold. I tolerated the first round fairly well being that I have experience with a TENS unit at home. It felt very similar along my legs and feet, however, as he increased intensity so too did my discomfort. It was interesting to detect abnormalities in my response to stimulation on my left and right side. The right side of my body seems to be notably problematic due to spinal stenosis (a narrowing of the spine) and the subsequent nerve damage. My Wife sat across the room observing my limbs jumping on the table as the tech wound up his tools and administered increasing shocks to various parts of my body. I took comfort knowing she was there, and I was able to relax into a state of meditation. The tech asked if I was okay, and we had a good laugh about good patients and bad patients. He confided in me that some people scream and cry, and it isn’t unusual for them to walk out altogether. It didn’t take long before my meditation broke and I was overcome by wincing pain. Suddenly, I could understand why.

Next, the tech applied electrode gel and medical adhesive to my forehead right where your third eye might be, as well as on the top of my head. This was relatively painless, a gentle respite from what was to come. He explained this was used to measure brain activity in relation to sensation in the S1 nerve specifically. And so I sat, for two important minutes in complete silence, careful not to move.

Next came the needles, and even though I kept my humor about me to aid in my composure, I knew the next part would require I call the warrior in me to the surface. The tech explained he would insert small needles into three locations on each leg, and four on either side of my spine for a total of ten. The insertion of each needle was tolerable, but then he added intense electrical stimulation and asked me to flex and hold various positions. During the time of the recording, a loud crackling sound could be heard emitting from the computer speakers. As if the excruciating pain some may equate with torture wasn’t enough, I felt as though I could be scooped up by space creatures at any second. I began to groan and hum a bit, noticing some parts of me were significantly weaker and more pain producing than the rest. Lastly, he asked me to turn onto my tummy where he would repeat the same procedure on my lower back. Surprisingly, this wasn’t as painful as the others, likely due to the fact that I was already defeated and there’s more tissue to absorb the shock and pinch.

Finally, my Wife tied up a few loose insurance ends and my shoes were returned to me. The tech informed me he would forward his findings to a neurologist and we would have the results at my follow up appointment with my pain management doctor in three weeks. I thanked him and wished him a safe drive home. He handed us his business card and wished us well before I stumbled out the door.

The first thing I did was crawl into the car and light a cigarette. I felt all of my medical trauma adding up. I knew the tears would come, but not yet. First we had errands to run and children to mother. I felt as though I left my body more than once and nothing really mattered outside the dissociative cloud I had moved into. I just wanted to collapse into my Wife who I am so grateful for and shut the world out. I just wanted to take a moment to validate my suffering. I just wanted to fall apart and not worry about anything else. Soon the demand became too great, my boundaries crumbled in my vulnerability, and I moved into a state of overwhelm. Even though my loving well intentioned Wife was going on about practical things, I couldn’t hold it anymore and my eyes welled up with tears. Naturally she was concerned, but I reassured her it had nothing to do with the groceries. I’ve worked hard to push my processing delay forward with the wisdom that it’s okay and perfectly healthy to cry. I have been a brilliant suppressor who constantly seeks to release that part of herself.

Finally, we returned home and the night ensued with challenging parenting, wine, reflection, and warm water.

I could sit here and tell you ten clever Deskraven ways to cope with chronic pain, but the truth is I haven’t uncovered anything yet that has truly provided meaningful relief. Like psychology, it seems to be nothing more than symptom management and breakthrough pain despite your best efforts. There are good days and there are hard days. Today was most definitely a hard day.

So, here I lay in a tepid puddle measuring my mental health against physical defeat, sharing all of this with you for the sake of the one person who needs to read it. Please do not despair. You are not alone. Tomorrow will be mostly bed ridden sleep, and hard prayer for the answers I know are coming. When they do, I promise to share them with you, too.

Discuss: How has chronic pain impacted your life? How do you cope?

**If you’re a mental health survivor or mental health provider and want to tell your story – please email me at contact@deskraven.com!**

For more excellent insight and entertainment through a collaborative approach to all things mental health, including a guest post from yours truly, visit the Blunt Therapy Blog by Randy Withers, LPC! For additional perspectives on suicide prevention from master level mental health providers visit, 20 Professional Therapists Share Their Thoughts on Suicide!

In collaboration with Luis Posso, an Outreach Specialist from DrugRehab.com, Deskraven is now offering guides on depression and suicide prevention to its readers. For more information on understanding the perils of addiction visit, Substance Abuse and Suicide: A Guide to Understanding the Connection and Reducing Risk! In addition, for a comprehensive depression resource guide from their sister project at Columbus Recovery Center visit, Dealing with Depression!