Monthly Archives: November 2021

Pain

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I realized with a shock that I haven’t been using my Refresh eye drops for over three weeks now. Normally, my eyes are so dry upon waking that they burn like fire and it hurts to open them, and it hurts to blink.

Every morning, I would reach out my arm so my hand could dive into the drawer of my bedside table where it would search for a single-dose plastic vial. I would instill the drops in both eyes for sweet relief. I could blink, I could open them, I could read, my morning ritual.

But lately, I’ve had no need to go hunting for the eye drops. My eyes were closed so little. They didn’t have the chance to develop dryness. In a way that was good. But in another, that was bad.

Pain was the culprit. Stress the other. Causes for my sleeplessness.

When I first went to my PCP for my leg pain, the nurse walked me to the scale. “Wait until it says zero zero,” she said.

I heard the words clearly, but the message did not compute. I stepped onto the scale while it was still recalibrating.

“You did too soon!” she said.

I stepped off, the message having been delivered, and then I did it right.

“Pain distorts everything,” I said.

And it does.
It distorts your blood pressure.
It distorts your pulse rate.
It distorts your breathing.
It distorts your motion.
It distorts your awareness.
Its distorts your sleep.
It distorts your life.

Everything becomes about controlling the pain. Everything revolves around that goal. Those of us with RA pain, or other chronic pain, know this intimately. The invisible pain that we sometimes, or always, live with.

I am lucky. I rarely have RA pain nowadays, strictly speaking. And when I do, when something flares up, I zap it with a few days’ worth of Prednisone. My rheumatologist has me keep it on hand. “You know what to do,” he says, relying on my years of nursing experience. He lets me be my own nurse. I am, in essence, my only patient now.

But this nerve pain thumbs its nose at steroids. I did two Medrol Dosepaks in two consecutive weeks. Each a six-day course. With not much noticeable improvement at the time, but now two weeks after that, I am much better. Before on a scale of one to ten, I rated my pain at twenty. Now it hovers at two to three. For short, blissful periods it drops to zero. And at others it can climb to five or six, so yes, much better.

The problem is the lull fools me. I do stuff. I cook dinner. I have the audacity to change the bed, seeking help for that fourth corner. That tug that I know I shouldn’t do. I do laundry, picking up nothing heavier than a single item at a time. I wash dishes by hand, always a therapeutic exercise for me. The only minus I perceive is the stooping and bending to load the dishwasher.

Though bending in itself relieves the pressure. In the morning, when the pain is at its apogee, I bend and grab my ankles. I drop my hands to the floor and hold the pose. I rinse, lather, and repeat. The best relief is when I do it in a hot shower, ahhhh, hydrotherapy.

But if I do too much, the next morning when I take those first few excruciating steps of the day, I’d say about twenty, I should count them next time, distract myself from the pain, it is so much worse. But once I get those first steps out of the way, the pain starts to ebb. The tide recedes little by little. And I can walk unaided for the rest of the day.

Yesterday, a friend compared me to Sisyphus, but I disagree. His boulder didn’t get smaller.

Today, I awoke at seven, when normally the pain wakes me by five. And the pain registers at about one. I could walk unaided from the moment I left my bed. It could be improvement, or it could be that I did nothing yesterday. Either way, I am eternally grateful.

I am definitely sleeping for longer and longer periods at night. So, I’m thinking I should restock my bedside drawer with more Refresh eyedrops. Whoever thought I would be looking forward to artificial tears when I’ve shed plenty of real ones these past few weeks.

I have found ways to cope, and music is my crutch. Without it , I don’t think I could cope with anything. I finally set up an iTunes account and have been giving my credit card a workout, setting up a playlist to help me start my day. And sometimes end my day.

This song, with a Texas bent, of course, I dedicate to the relationship between my body and me. Yes, stand by me.

Sigh-Atica Part 2

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My pretty IV. Never had one that’s pink and purple before.

just like I never had sciatica land me in the hospital before.

it’s been a wild two weeks. I had faith that my doctor’s conservative treatment of steroids and nerve pain medication at bedtime would do the trick.

just like I had faith in him. For the past twenty years or more.

Exactly one week later on Monday, I returned to his office, after making it clear to his staff that it was either his office or urgent care.

Can you be here within the hour? they said. I could and I did. He suggested that we increase the nightly nerve pain medication dose and that I start a narcotic to treat the pain that had settled like hot daggers in my calf. Plus Motrin 600 mg every 8 hours for pain as well. And he would order an MRI.

I said, what about the inflammation? He said since the steroids didn’t work, why repeat them? He said that the Motrin would help with that too. Now, he knows who he is talking to. I gave him a look and all he said to me then was, “OK, Irma?”

Since this wasn’t McDonald’s, I couldn’t change my order at will. I took my prescriptions and limped to my car where my husband waited. I scheduled the MRI, the soonest was Thursday, while in the car waiting for prescriptions to be filled.

The pain was doing me in. Especially in the mornings. I don’t cry easily, but I did a lot of crying Tuesday, Wednesday, and Thursday morning. Bent over whatever countertop I could get to, I bawled with the pain, a walker at my side. We ended up with two of them from when my husband had an MI five years ago, and boy, did they come in handy now.

I ended up taking one Motrin 600 mg. It tore my stomach up. I took it with trepidation, but I was desperate so I took the plunge. I lived to regret it. The narcotic he put me on was like taking water for the pain I had. I sought relief from hot showers, letting the water soothe my leg. And from my trusty heating pad, half expecting to incur 3rd-degree burns before it was all over. Sleep? What was that?

I made it to the MRI on Thursday evening. I was glad it was an evening appointment because that was when my pain was near tolerable, but still, lying in that constricting tube with my eyes tightly shut, my ears plugged with soft foam plugs, and covered with heavy headphones that were supposed to provide music, music that was overpowered by the loud clicking and clanging noises of the machine, all I could think of was that my leg was hurting me. I had to lie flat on my back, and that position was not the most forgiving. And I had to lie still, 30 minutes the tech said. I couldn’t move, even if I’d been able to, wedged in as I was.

That night I made an effort to sleep, but by 4 a.m., when I’d struggled to the bathroom, I lay in bed and cried. I knew the gig was up. It was time for the ER. I took one of my fake pain pills, and gave it an hour. Meanwhile, my husband was up and ready to go. Don’t push me, I said.

We got to the ER at 7 a.m. and it was blissfully empty. Not a soul except the staff. That was a bonus in this covid age. I was in the back getting an IV started within 10 minutes. My nurse was this cute little guy that could have been my son. He pushed Dilaudid and Decadron into my vein and smoothly removed those boiling, hot daggers from my leg. I almost cried again with relief. They’d been in there for over a week.

I had a barrage of doctors come by. They all agreed on the treatment, steroids to reduce the inflammation around the nerve, potent narcotics for pain, a strong muscle relaxer, double the administration of the nerve pain medication, among other meds, and admission until pain controlled sufficiently to go home.

A neurosurgeon had been called and he was the first to arrive. I saw the MRI, he said. You have a slipped disc which is causing pressure on the nerve. It’s a slight protrusion he said, but you have degenerative changes and I would not want to go in there to fix it. Thanks, RA! was my first thought. But I didn’t want him to go in there to fix it, either.

An injection into the nerve was also suggested, but I decided to make that plan B. We would go with the meds, body mechanics, exercises, and physical therapy first.

Last night, I had another great nurse. We spent half the night talking. When the day nurse had asked me what I wanted to share about myself on the info board in my room, I said I have RA, thinking clinically. And she said no, something personal, so I blurted out what I like to do best, reading and writing. He noted that and the conversation started from there and went on most of the night.

He held my hand on the way to the bathroom and back. This was an observation unit where the rooms do not have their own bathrooms. It wasn’t far from my room, but it might as well have been miles away. And once on the way back, which was the most painful part as my nerve was now awakened to the fact that I was upright and moving, I said the bad word that rhymes with truck.

I immediately said sorry, but he started laughing. By this time we felt we knew each other, and he said, I never thought I would hear that word from you. And then I started to laugh, in-between gasps of pain.

I fell asleep between 3 and 6 a.m., when he woke me up for my meds. And later, when I managed to get to the bathroom alone as the day nurse didn’t respond to my call, I discovered that half my pain was gone! It only hurt from the knee down and that was cut in half as well. It was hallelujah time, and time to arrange for going home. The meds had made progress in less than a day.

The board in my room.