Читать книгу Taming Chronic Pain - Amy Orr - Страница 16

A small note about pain as it relates to some basic aspects of you: firstly, age. It is a well-known fact that, as we age, our bodies deteriorate, and once-simple tasks may become painful or even unachievable. That is a normal and expected part of life. However, the rate at which we deteriorate can vary widely, and, for those of us who have chronic health problems from a young age, the process starts earlier and can proceed more swiftly than average.

While many aspects of pain management apply to the expected symptoms of aging—such as arthritis—there is an aspect of pain management that the young have to perform, that the elderly do not. The fetishism of youth (a.k.a. health) makes it much, much harder for younger sufferers of chronic pain to live openly managing their pain. There is an awful phrase that I’m sure many, many of you have heard: “Well, you look fine.” Ah, of course. I look fine, therefore I must be fine. I am only twenty, or thirty, or forty, so by your standards there really can’t be anything much wrong with me. I must be exaggerating. I must be lazy, or a hypochondriac. There are no physical symptoms like a cast on my leg, and I am not eighty and therefore immune from your judgment about my health, ergo everything is well. This is, sadly, an opinion that even some doctors profess—if they can’t find anything wrong with you on first examination, then there is nothing wrong. Pull yourself together. Only the elderly experience physical deterioration.

Sadly, younger sufferers of pain do not experience camaraderie with others—friends in a similar physical state—or shared understanding of the world at large. It would be patently wrong to hurry along an elderly person in front of you on the sidewalk, but doing this to a younger person is socially acceptable. And complaining about a sore hip may be normal for a seventy-year-old, but being twenty and doing this makes you a whiner. No, it’s not fair.

It’s easy to look at those attitudes in the abstract and know they are wrong, know that those judgmental people don’t know you, don’t know that you are doing the best you can. But knowing that and feeling that way in the face of bemused stares and probing questions are two very different things. We will talk later about shoulding and its negative effects. There is a very difficult, specific part of shoulding that happens only to the young, and it is all-encompassing: you should be healthy. The fundamental belief that ill-health only comes with age is a pernicious and dangerous one and leads many people to ignore or try to tough their way through pain, without ever understanding the cause or becoming able to make it better. Again, knowing that someone is doing this to you is a very different thing from being able to say so, or being able to recognize it in the moment. More often than not, even for the most rational and self-assured people out there, the exclamation “You look fine!” will make you want to prove it, to live up to that, to agree and minimize and stop putting your pain management first. There is no amount of life experience that can stop this from happening, but you can stop it from affecting how you manage your health. Shame is a natural result of someone trying to shame you, but don’t let it change the way you have decided, rationally and calmly and with your doctor, to act. Someone else’s judgment is not more important than your need to manage yourself.

A similar point exists for gender and pain. Socially, there is an understanding that “men are tougher,” “real men don’t cry,” and other similarly asinine expectations that can make living in pain, openly, very difficult for men. Why don’t you just man up? Tough your way through it? Real men don’t let pain stop them. This is such obvious nonsense in the abstract that it’s hard to even write down, but it’s a very real aspect of many chronic pain sufferers’ lives that can make seeking treatment, accepting help, or even discussing their bodies with loved ones much harder. And, as with age, there is not really a way to stop this happening, to prevent society at large from putting these expectations on you. All you can do is make sure you are taking thoughtful care of yourself, follow your doctor’s advice, speak up when you feel able to challenge the nonsense, and ignore it when you don’t. Remember, your body is more important than other people’s expectations.

A Note on Exhaustion

A hidden but significant aspect of living with pain is exhaustion. This comes in several forms, the simplest of which is the basic feeling of being physically and mentally tired from just existing. Getting through each day takes a toll, being in pain is hard, and many people are understandably dog at the end of it. Your overall energy is lower when you experience pain, and this is true for everyone, regardless of age or gender.

Sleep is a separate but also very important issue for chronic pain sufferers. Getting quality sleep is much harder when in pain, when battling the side effects of medications, and when anxious about health. The normal consequences of living with pain lead to lack of sleep, and this massively contributes to physical and mental exhaustion. Many pain sufferers even suffer from chronic insomnia. The ability to rest effectively is crucial to allowing the body and brain time to recover, and, without this, pain is compounded. This is a perfect example of a vicious circle: in pain, can’t sleep, more pain (because you’re tired), can’t sleep.

Even the youngest or toughest person can quickly become fatigued when living with pain, and this presents many challenges to going about your daily life. Unfortunately, the solution is simple yet difficult: you have to put your rest first. First, no exceptions. No excuses. If what you need to rest effectively is to take a nap every afternoon, then that’s what you have to do. I don’t care if you’re twenty-five or seventy-five. You need sleep and rest, whatever this looks like for you, whatever anyone else thinks. Rest is one of the single most important tools in pain management. If it means a special soft bed, then great. If it means sleeping with a prop, go for it. If it means going to bed at eight o’clock and not getting to bar-hop with friends, then this is the decision you have to make. If you do not prioritize your body’s need to rest, you are not prioritizing your health. Fatigue is potentially deadly, so be proactive and don’t let it get on top of you.