I Can’t Deal With This Pain

Every now and then a doctor (other than my rheumatologist) will ask me if something hurts. When I say no, they look often look surprised and ask my if I’m sure, because I should be able to feel pain associated with whatever it is that is being discussed. It’s at this point when I usually realize that I need to provide a more explanatory answers, and if often sounds something like this:

All of my body hurts all of the time, due to my rheumatoid arthritis. Chances are that what you are referring to is actually causing pain, but it’s just not registering.

It’s sort of interesting/fascinating/odd/whatever when you realize that the pain of RA often prevents you from feeling–or even noticing–other pains in your body. Once during physical therapy, I wasn’t able to tell that the skin around my wrists was being burnt by overly-hot heat packs. It wasn’t until we unwrapped the bandages and saw the red burns that both my physical therapist and I thought “uh-oh.”

There have also been multiple times when I don’t feel a thing from the currents coming from a professional TENS machine. One physical therapist (different from the one mentioned above) assumed the machine was not working or that the electrodes were not plugged in correctly, as it was turned up to its maximum setting and I couldn’t feel a thing. (Not only that, but all of the surrounding muscles were completely still.) Upon touching both contact points, she immediately got “shocked” and reeled backwards.

And I sat there, somewhat in disbelief. My physical therapist could not even touch the electrodes that were applied to my knees because of the strong electrical current, while I could not even feel a thing.

My relationship with pain has changed quite a bit over the past decade, and I have no doubt that it will continue to change in the future. The more I get to know it, though, the more I continue to learn seemingly contradictory things, such as the fact that my pain does have a protective element.

I’m not referring to the actual pain signals that are being sent to the brain, which is one of the classic explanations for pain.

I’m talking about the numbing aspect of pain; of the idea that the pain can get so bad that I can simultaneously feel and not feel the pain (as odd as this may sound). As much as chronic pain hurts, at a certain point is has become my new normal. It is my new baseline.

And while what I have written up to now is based upon my physical pain, I am no way trying to deny the corresponding emotional pain that is always present. From this perspective, the pain if just as–if not more–numbing…and this is the true challenge: constantly working not only against the physical aspects of pain, but the emotional aspects too.

For too long, I often felt like I was being dragged along by my rheumatoid arthritis. If only I could get one day or one hour off, I thought, then I could rest and recuperate, and be better prepared to deal with this continual challenge. But these rest breaks never came, and my entire self became more exasperated.

“I can’t deal with this pain,” I have often thought to myself. Indeed, I (as well as millions of other who live with chronic pain) have reached levels of pain that are beyond what the human body or mind are supposed to deal with…and if you haven’t been there yourself, no words or explanations will ever be able to truly describe exactly what it feels like.

But if ever there were a “can’t” that should *immediately* be eliminated, it has to be this one…because no matter how bad the pain can get at times, I really have no other choice than to deal with it, as best I can.

I’ll admit, there are still times when “I can’t deal with this pain” starts to slip back into my thoughts. As soon as I recognize it, though, I immediately replace it with:

I can deal with this pain.

Whenever I affirm this to myself, I sometimes find myself chuckling lightly, laughing at (but not taunting) the idea that I could possibly not be in control of how I decide to react to the pain. Once I assert that I can indeed deal with the pain no matter how severe it is, I realize that, I–and not my pain–am in control. I am reminded that it is I who controls my thoughts and my actions.

My chronic pain will never stop trying to control my life. (This is its nature, after all.) I let it take control in the past, and suffered miserably. I can now honestly say that I will never let it take control again, no matter how challenging it gets.

Never underestimate the power of eliminating one “not.”

Stay tuned…for the next adventure of Rheumatoid Arthritis Guy!

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Knock Me Down, Pick Me Up

After a couple of relatively symptom-free weeks, my rhuematoid arthritis is once again knocking me down. Today I didn’t get out of bed until around 1:00 p.m. Even then, I did’t much get past first gear…although I am proud to say that even as my day passed by in slow-motion, I was able to make it into the kitchen to cook dinner.

I find it interesting how nowadays, whenenever my RA starts to get the upperhand, I don’t have many of the thoughts that used to be have for so many years. No telling myself that I need to be doing something other than resting (or sleeping) in bed. No sadness about the fact that I live with the pain and disability on a daily basis. No fear about what might happen if things continue to get “worse.” Most importantly, no self-blame and no doubt; no wondering what I might have done to “cause” this flare. (I’ve gotten really good with the pacing and with not pushing myself too hard.)

This disease is hard enough, without my being hard on myself emotionally. So when my RA knocks me down, without so much as a second thought I start doing what I need to do in order to pick myself back up…and even though some people may find sadness (I know I used to) in the repetitive nature of what can often seem to be a “two steps forward one step back” type of life (or “one step forward two steps back,” when things are really critical), I’ve learned to appreciate even the beauty of these moments. First, because I’ve done it before and I know I can do it again. Second, because even though it may seem to be the same routine, each time around I make it a point to learn something new.

When I am stuck in bed, unable to even roll over, I no longer think about how much of my day I have “lost.” Even in this situation, whether I am sleeping or lost in my thoughts as my body deals with its temporary paralysis, I am not losing out on life…because this is my life.

Even though I will often say that I am having a good” day, I rarely ever try to tell myself that I am having a bad day. Now this isn’t to say that on more days than not, as was the case this morning, I awake to a body that is not working (in the traditional sense)…but I’ve learned that if, during these early hours of the day, I label it as a bad”day, then it will, well, stay bad all day long.

Because when I label my day as being bad, doing so leaves me feeling powerless in so many way. It will be just another bad day, and I will indeed feel like I am losing out on life.

But if I say that it is a challenging or a rough day, then I feel capable of doing something to change–as much as possible–the situation that I find myself in at any given moment. This allows me to accomplish what I pledged here on my blog when I first started writing so many years ago, which was that I would try to make my emotional well-being less dependent upon the absence or presence of pain in my body. (And which, I am proud to say, I have been quite successful in accomplishing, even as my rheumatoid arthritis continues to progress.)

When it comes to living with chronic pain, if I wait until the pain goes away before I permit myself to have a “good” day, then I might be waiting forever.

Which is why, no matter how much pain I’m in, no matter how much I am unable to move my body–without denying in any way, physically or emotionally, what is going on–I remind myself of two things:

1. This is my life.
2. Today is a good day.

Yes, I continue to get knocked down…I have no doubt though, of my ability to continue to pick myself back up.

Stay tuned…for the next adventure of Rheumatoid Arthritis Guy!

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Cheers To Quality Of Life!

“Quality of Life (QoL) is a phrase used to refer to an individual’s total wellbeing. This includes all emotional, social, and physical aspects of the individual’s life. However, when the phrase is used in reference to medicine and healthcare as Health Related Quality of Life (HRQoL), it refers to how the individual’s wellbeing may be impacted over time by a disease, a disability, or a disorder.” http://en.wikipedia.org/wiki/Quality_of_life_(healthcare)

I think some people who have been reading my blog for a while, and who have gotten a sense of my personality, know that I am the type of person who marches to the beat of my own drum. In my opinion, life is way too short to continually be worrying about “what other people might think”.. even more so as a disabled gay Latino guy. Trust me, I’ve heard *everything* when it comes to how I should or should not be living my life. Ultimately, though, the final decision comes down to me.

This is the same attitude that I apply towards my healthcare treatment options: it’s my life, my body, and I am going to decide what treatments options I use at any given time. Sometimes I use medicines (and start hearing here on my blog and on my Facebook page that I am “poisoning” myself), other times I don’t use medicines (and start receiving comments that I am “irresponsible” and “anti-med.”) While I don’t necessarily put too much weight in these types of opinions that I receive (see above), apparently neither does my rheumatologist, as he has always completely supported whatever decisions I make regarding my treatment plans. I do find, however, that such a linear approach to discussing this topic is not only overly-simplistic, but it also is not very helpful.

I don’t look at different threads individually, whether they be medicine, diet, exercise, emotional health, etc. I think of the whole; I think of my quality of life…because how I treat my rheumatoid arthritis is not something that I only have to figure out in the short-term for the next few weeks or months. It is something that I have to figure out for ever.

It is something that I have to figure out for life.

During my most recent flare that lasted more than a month, I quickly not only increased the dosage of my meds, but I also added Prednisone and multiple anti-inflammatory and steroid injections. I did notice some immediate temporary relief, but no lasting relief. As my symptoms continued to spin out of control, even my doctor struggled with what we should increase, being that my liver still has not gotten the all-clear from it’s most recent elevated enzyme scare. At a certain point two weeks ago, however, I told myself that I had had enough meds (as in I would continue with what I was on, but I would not add any more.)

I made this decision because my quality of life is much more than just the amount of disease activity that I might be experiencing. It’s also about how my body feels, and what my mind thinks. It’s about whether I am running to the bathroom every few minutes because my stomach is taking a beating from the meds. It’s about no longer feeling that I know my body…not because of the pain and disability, but because all of the different medicines that are streaming through its systems.

It’s about wanting to drink a margarita. (There, I said it, and I’m not the least bit ashamed!) It’s about wanting to drink more than one margarita, without having to calculate which day of the week is furthest from Methotrexate day. It’s about having gone almost all of 2012 alcohol free, and wanting to add a dash of Kahlua or Bailey’s to my coffee every now and then.

Quality of life is accepting that my rheumatoid arthritis is not only present, but it’s also progressive. And while the goal of many treatment plans is to slow the progression of this disease (which in the end what does this really mean?), or even to reach the Holy Grail of remission, one (or at least, I) must ask: at what cost?

The answer to this question is as individual as we are different people who are living with this disease. We all make different decision, and we darn well should be doing. Some of us focus on the medicine aspect of treatment. Others focus on the diet aspect. Yet others focus only on alternative treatments. Some try a combination of treatments. Some go a decade without making a change to their treatment plan, while others like to mix things up every few months.

Who is to say what is the one right way to treat rheumatoid arthritis?

No one. Because no one right way exists.

What exists are lots of different ways that work for lots of different people.

Here’s hoping that everyone who lives with rheumatoid arthritis and other types if inflammatory arthritis are successful in finding what works for them. Here’s further hoping that people are able to talk about what they are learning and discovering, without judging others and without being judged themselves.

Here’s hoping that we *all* have the best quality of life possible, no matter what approach we use to get there.

Stay tuned…for the next adventure of Rheumatoid Arthritis Guy!

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