Sunday, February 25, 2007

Knowledge is Power

Knowledge is power.

Chronic pain is usually something which is causing you far more discomfort than it is any threat to your person. Acute pain usually (but not always) means something pretty major is happening, that either your life or part of your body is in some danger or else something extraordinary is happening, such as that another, somewhat smaller, human being is emerging from your insides. Acute pain is actually quite useful. More useful when you know that it will soon end, when you have the opportunity to escape the cause of pain or seek medical intervention, of course.

Chronic pain isn’t very useful. In some cases, it can prevent you causing further damage to a part of you which is already damaged or otherwise struggling to function, but only in so far that it stops you moving about in a certain way. Chronic pain is of no use to you at all when you are at rest and yet prevented from getting any peace from it.

But knowledge is power.

Unfortunately, neat explanations for chronic pain are often lacking. Where doctors know exactly what is going on and why, they can often do something about it. Most chronic pain conditions are just a little bit mysterious. Some are completely baffling.

At first, it is very frightening not knowing what is happening to your body. You imagine all the things that might be happening or might be going to happen. You consider the most sinister possibilities. You even consider impossibilities; you fear that you might explode, break in half or shatter or else some part of you might spontaneously fall off.

It is also very frightening not knowing when or indeed if this is ever going to stop.

Because knowledge is power. Lack of knowedge is powerlessness.

In time, you learn things. You learn that since nothing dramatic has happened so far, nothing dramatic is likely to happen. You learn that you’re not dying. Or even if you are, it isn’t happening very quickly. You learn the patterns. You learn about the worst that can happen.

You learn the tricks the brain plays when it comes to discomfort. You have been learning this all your life. As a child, you remember trying to be brave. You remember managing not to cry at any injury until you saw the blood, and then not being able to help it. The sight of blood somehow made it hurt more. You remember sustaining black eyes without shedding a tear because you didn’t want to seem like a Girl. And it didn’t hurt, not nearly as much as it would look like it ought to have hurt a day or two later.

You learnt the intense pain your particular organs endured in order to menstruate (the sight of blood somehow made you throw up) and how much easier it became, once in perspective. You saw your womb on a screen, just a tiny wee pocket at the bottom of your tummy, with two rosebuds growing out of it on curling stalks. You were amazed at how pretty it was, but it also made you realise that the pain which was felt throughout your entire abdomen was an illusion. The problem was only in that one little place, congested with blood. And all you needed to do is to draw the blood, or the consumption of your thoughts, away from that place.

Chronic pain is often an illusion. Not something you dreamed up yourself, but a trick of the nervous system. If it was real, a real problem that hurt that much for this long, then you would explode, break in half or shatter, or else some part of your body would spontaneously fall off. Something in your body is telling a lie.

Knowledge of this is your power.

Not that there is any malice in these lies; it is just a technical error, perhaps, quite literally, an electrical fault. There is no force of darkness you get to battle against and overcome.

You learn that God was a cowboy electrician. Much better at plumbing, and miles better at aesthetic design; landscaping, sculpture, that kind of thing. Not a very technical mind, you see. The margins of His physics books are filled with doodles of flowers, trees and birds.

You learn that there are things you can do to distract yourself from that erroneous message, to disconnect parts of your mind from that circuit and occasionally, to place yourself in a state where the message becomes a quiet whimper on the edge of your consciousness. You learn how to do these things when the pain is stable.

Because it’s all just a lot of tiny neurons, a lot of buzzing wires.

And knowing that’s all it is, makes it much less painful.


fluttertongue said...

Knowledge is indeed comforting although it can be distressing when you are hurting and everyone tells you that there is nothing wrong. I'm just not that trusting of their knowledge. Some of those close to me assume that I must be used to the pain by now. But it hurts as much as it did the first time - that is the nature of pain, it is there to be noticed. When I am busy, stable pain is less noticable, but slowly it becomes unbearable and there is no promise that it will ever end. It still makes me cry - people assume I have emotional instability, but surely it is normal to cry when it hurts. It keeps happening. I'm not used to it.

The Goldfish said...

I'm sorry, Fluttertongue, that you're in the place you are just now.

It is normal to cry when it hurts. It is also normal to be made far more emotionally volatile by being tired and in pain, such that the tears come easily whatever brought them on.

Anonymous said...

chronic pain is so damn debilitating.

The brain is wired up to take notice of pain signals above all other stimuli, in case there's anything you should be doing about them. So you have to fight twice as hard to concentrate on what else you are doing, or what people or circumstances are trying to tell you.

And that's tiring.

Chronic pain is so damned irritating.

Is there any sufferer who has never been inspired to shout at their own body to Shut the fuck up when the painkillers just won't work.

Chronic pain is so damned isolating.

Most people can empathize with acute pain, even if they've never suffered anything worse than a tetanus vaccination. The idea that pain goes on and on, maybe with no visible spur, and yes, you have taken the tablets, is just incomprehensible and eventually boring.

Chronic pain just is, that's the trouble with it.

Mary said...

It would be nice if certain people could accept that chronic pain exists and indeed prevents people from doing things even when there is no visible injury.

My nervous system may be lying to me about the pain, but I am not lying to you about what I am experiencing.

Of course the reverse of that is people who see you obviously in pain and having trouble doing things, and can't accept that this is part of daily life, and that a pack of frozen peas/a hot water bottle/a GP appointment/a trip to A&E is Really Not Necessary.

seahorse said...

I will come back to this when my concentration has improved. I can tell it will be of enormous help to me.

Zan said...

There is a certain degree of comfort in knowing that, no, there's nothing deadly going on. That's true. However, it doesn't really matter much to me that my pain is just my brain misreading signals or overreacting to stimuli or whatever the hell it is that it's doing. When I'm in the moment, I just don't care. It hurts. It hurts and I can't sleep and the pills won't work and people look at me and say "But you don't look sick" and I want to stab them in the eyes and say "Oh, but you don't LOOK blind" to see how that makes them feel...

When I'm not having a flare up, when it's just the normal amount of pain, sure. I can deal. I can parcel up that bit of pain and just....well, it's there, but it's not everything.

I still can't get over this fear that this pain means I'm going to be alone forever. That I'm going to be endlessly in this cycle of feeling wonderful and being happy and then BAM, I'm back in the pit.

Wheelchair Dancer said...

ohhhh. yes. damn good post.


IrrationalPoint said...

Excellent post.

The Goldfish said...

Thanks everyone.

Sally said...

Oh yes, yes yes.
I often say, to those who question: "If I was fit and well and working and all, and then one day I woke up feeling like this (pain, profound fatigue, brain wiped, you know, the usual) I would be very afraid, I would go back to bed, call the doctor, and stay there until s/he did something and I recovered. But after three months I had to get up again ..."
Thanks Goldfish and commenters.

matt said...

Yes chronic pain destroys, it destroyed me. But thinking about it for me just made it worse.