Category Archives for Pain Clinic

Pain Clinic #11: When A Treatment Complicates Chronic Illness

TRIGGER WARNING

Anyone who has survived a traumatic experience may be familiar with the feeling of separating from one’s body. This naturally occurring physiological process in the body helps a person withstand something terrifying or harmful. It also works to minimize potential psychological damage or outright losing one’s mind. I characterize it as the traveling of one’s mind, or what some might call the consciousness, into another space until it’s safe to return to the body. For someone who has never experienced this, it might sound hokey, but if you have lived through something traumatic, you know exactly what I’m describing.

It’s the moment when a person can see everything around them, but her/his body freezes making it impossible to interact with any of what’s happening. Whether it’s another car slamming into yours as it drives the wrong way down a one-way street, the moment a dog twice your weight pounces on you sinking its teeth into your body; or feeling another person physically overpower and violently assault you; you know the feeling to which I’m referring.

The medical name for this physiological process is dissociation. “In psychology, dissociation is any of a wide array of experiences from mild detachment from immediate surroundings to more severe detachment from physical and emotional experience. The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a loss of reality as in psychosis.”

The medical definition further states that dissociation is usually measured on a continuum from mild to severe. In a mild, non-pathological case, it’s seen as a coping or defense mechanism in cases of extreme stress or conflict; and in its mildest state it’s more commonly called daydreaming. While in severe or pathological cases of dissociation, the experience(s) can include: “a sense that self or the world is unreal; a loss of memory (amnesia); forgetting identity or assuming a new self (fugue); and fragmentation of identity or self into separate streams of consciousness (dissociative identity disorder, formerly termed multiple personality disorder) and complex post-traumatic stress disorder (PTSD).”

As I’ve already mentioned, dissociative disorders are sometimes triggered by trauma. Yet, in many cases, stress, whether unexpected or prolonged, is the trigger. The situation in which I found myself wasn’t unexpected, but it was stressful, and when I realized what I had experienced it scared me.

One of the recent treatments I’ve undergone – in yet another attempt to reduce and ultimately eliminate my chronic pain – deliberately puts the patient in a dissociative state. The idea is to use specific medication(s) to trick the nervous system into feeling (believing?) the pain no longer exists. I haven’t posted details about the treatment or my experience with it yet because I’m still in the midst of sorting through my feelings, researching and writing about all of it. The medication(s) used are meant to make the patient feel a definite separation between body and consciousness, which I strongly felt for about 20 minutes and had no way of stopping without ending the treatment and possibly losing all its potential benefits.

Mindf_ck-During – March 2018 – 1
Mindf_ck-During – March 2018 – 2

Since this treatment, the problem I’m having is whether I should undergo it for a second time considering the minimal relief it delivered vs. the major psychological effect(s) it’s still having on me. Effects I hadn’t connected with, or begun to understand, until I had a panic attack while thinking about the next scheduled treatment. I don’t know if I can withstand feeling separated from my body while watching – witnessing really – everything around me but feeling as though I’ve given up all conscious control.

Because the first treatment only delivered about five days of low pain levels, I’ve had to weigh whether the mindf@ck I have to withstand during the treatment and process after is worth a week of relief. Although, I’ve been told that an increased dose of the medication(s) could, possibly, last longer: anywhere from a few extra days to weeks or in the ultimate best-case scenario months. Is that enough to justify forcing my mind into a prolonged dissociative state?

All the contemplation I’ve been doing tells me it’s not enough. The likelihood that more treatments with this method, even with higher doses of the medication(s), will be more successful than the first is slim. However, it’s a known fact that the dissociative side-effects will happen with each treatment and may even intensify. Therefore, my Pain Specialists’ search for a long-lasting treatment must continue; and until they find one, I have to keep finding ways to cope with this unceasing pain every minute of every day.

Mindf_ck-After – March 2018 – 1
Mindf_ck-After – March 2018 – 2
Mindf_ck-After – March 2018 -4

 

 

Pain Clinic #10: The Hope of Bluebells

I had to be up and out of the house early in the morning for an appointment at the hospital yesterday. I had to check in to the Day Surgery Department at the hospital where I am seen by my Pain Specialists by 7:45 AM so they could prep me for yet another pain treatment. I haven’t been writing about my Pain Clinic visits much in past months because they are so frequent and usually consist of just a check in to see how I’m coping and what might be the next course of action. I’ve also been doing research about the procedures and medications they propose so I can better advocate for myself and not allow anxiety, due to lack of knowledge or understanding of what is being done to my body, to potentially create a mental block or resistance so my body can fully benefit from what I’m undergoing.

Yesterday’s pain treatment was particularly tough to handle mentally. However, on my way home from the hospital afterwards, I saw bluebells in a flowerbox outside a restaurant. I took some photos of them because, to me, they have always symbolized the beginning of Spring and the resurgence of life after the deepest cold of winter. It made me so happy when I saw them. I’m hoping they are a sign that what I went through yesterday in the treatment clinic, is the start of something better in my life…

 

The Hope of Bluebells 1 – May 2017
The Hope of Bluebells 2 – May 2017

 

Pain Clinic #9: Acupuncture Agony

I survived my first acupuncture treatment. I know that sounds dramatic, but I did have to sign a consent form and waive my right to sue the hospital and all staff if I had any negative reactions before my pain specialist started the treatment. Besides, once I outline what happened, that I characterize the outcome as survival might not sound far-fetched. After I signed the consent form, my pain specialist and the assisting nurse outlined all the possible known negative reactions I could experience during and after the treatment. The intention was to place ten acupuncture needles in my lower back close to my tailbone radiating outward to my hips, and more needles in other areas of my body. Because I can no longer lie comfortably on my stomach, we had to figure out the best position for me to lie down on the table to prevent me from moving during the treatment. The best position turned out to be lying on my left side with my right leg bent at the knee and supported by a pillow. I had another pillow placed under my head and both arms stretched in front of me – reading that back it sounds more complicated than it was. In anticipation of the bright lights of the treatment room, I brought a sleep mask with me that I put on to create a more relaxing mood.

With me lying steadily in place on the table, my pain specialist moved my clothes aside to get access to the bare skin of my lower back. She spoke to me as she started to insert the needles asking if they were causing too much pain as she placed them. Unfortunately, even though she didn’t insert them too deeply, the pain of each needle she put under the skin close to my tailbone was unbearable. After she inserted the fifth needle in the flesh close to my right hip, she decided not to put anymore into my back. I’m glad she stopped because I’m not sure I could have handled the pain of five more needles. My pain specialist placed the sixth and seventh needles on the backs of each of my hands in the soft pad between my thumbs and index fingers. The nurse set a timer for ten minutes, and then it was lights out.

During the first ten minutes, as I was lying on the table in the semi-darkness, I could feel an intense, tingling sensation radiating from each needle in my back and hands. It was uncomfortable and not at all like past soothing acupuncture treatments. When the timer went off the nurse came back to the treatment room to adjust, or as she said “twizzle” each needle. She set the timer for another ten minutes and left me alone in the dimmed room once more. The discomfort from the needles continued to grow. The familiar feeling I get at the beginning of a pain flare up started building in my legs, but there was still time left on the timer. While I waited for the time to run out, I hoped that the removal of the needles would ease the discomfort.

At the end of the twenty-minute treatment, my pain specialist returned to remove the needles. She delicately plucked each fine, silver sliver of metal from under my skin, and the nurse used cotton pads to dab blood away from some of the insertion points. My pain specialist told me to sit up slowly. As I sat up, a wave of nausea hit my stomach. I wanted to vomit. I sat still for a moment then tried to stand up. I felt dizzy. I had to sit back on the table. The nurse and my pain specialist were very concerned and made me lie back down for about 30 minutes. When I finally felt steady enough to stand up, the nurse said she could tell that I felt better because the colour had returned to my face. However, there was still concern that I might need more medical attention. She told me that if the nausea and dizziness continued or worsened that I should go to the emergency room.

As the day progressed, the nausea and dizziness started to fade slowly, but the pain flare up that followed was as unbelievable as it was unexpected. For the first week following that treatment, I had soreness in the areas where my doctor placed the needles; tingling in my hands and the soles of my feet; that tingling turned into fiery pain from the soles of both my feet all the way up to my pelvis and lower back, and I felt exhausted. I couldn’t sit comfortably and standing or moving around made the pain worse. I tried massaging the arches of my feet, my ankles and thighs but the added friction made the burning pain worse. Even my hands tingled, although I only had a single needle placed in each one. By the time I went back to the pain clinic for the second treatment a week later, I was so sore and stiff that my pain specialist decided against more acupuncture and had to increase the doses of my pain medications to help me cope with the pain. She also expressed surprise that I returned for another treatment and told me she hadn’t expected me to make it to the appointment because of the shape I was in after the first session, and how much pain I was still in while meeting with her. Even though I was still in so much pain, it never occurred to me to cancel the treatment.

It’s been a month since I had that acupuncture treatment and my pain is just getting back to a level where I can cope, even with the higher doses of pain medications. Because I had positive experiences with acupuncture in the past, this outcome came as a real shock to me. I knew that it was possible to feel some nausea and dizziness afterwards, but I wasn’t prepared for the intensity of what I experienced. Since going through this I found AcuTake, an online publication that provides information about acupuncture. According to an article on the site, “7 Acupuncture Side Effects That Are Normal”, one of the potential side effects is “worse symptoms” or what “is sometimes referred to as a healing crisis” because acupuncture “awakens your self-healing capabilities” and “can cause not only an exacerbation of current symptoms but also the recurrence of previous ailments that had been dormant.” The article further states, “The good news about this side effect is that it’s a sign that things are moving. In the case of acupuncture, this means that the primary objective is being met. That is, you are starting to transition on multiple levels from stuck to unstuck.”

I don’t know how true it is that I have to feel worse before I get better, but I have a follow-up appointment scheduled with my pain specialist in about two weeks and we’ll definitely have a conversation about whether the agony that comes with acupuncture will benefit me in the long run.

 

Stevie Wonder – Ordinary Pain