Some thoughts on pain, and coping.
Jan. 28th, 2003 01:41 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
rivkaThe knee I scraped last Thursday still hurts. I tried uncovering over the weekend, but found that taking off the bandage increased the pain considerably. At one point, when I was complaining about it, I joked to ![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
curiousangel, "Sometimes it must be hard to believe that I've had major surgery." "Sometimes," he agreed.
Here's the thing, though: I think that it's actually easier for me to cope with serious, expectable pain than to cope with minor, unexpected pain.
When I had my hip replacement surgery, I had no anticipatory fear. None. I slept well the night before, without the benefit of a sleeping pill. I was perfectly calm and good-humored in the morning, going through the admitting process. My pulse and blood pressure weren't elevated. The nurses kept trying to reassure me, but I didn't feel at all frightened - after all, I knew exactly what would happen. I would be rendered unconscious, and when I woke up I would be in serious pain. If something went drastically wrong, I wouldn't ever know. If everything went right, there would be a long period of pain and weakness and rehabilitation. It was all very... expectable.
A couple of months later, I went to my doctor because of an ingrown toenail. He decided that, because the surgery meant I couldn't bend forward to take care of my feet, it would be best to cut the ingrown part of my toenail off. It would be done right away, under a local anesthetic, and it would provide instant pain relief. I nearly panicked. He promised me that he would use enough anesthetic to ensure that I didn't feel anything, and he did, but it didn't help me calm down. It took all my nerve not to refuse the procedure and go home. I coped marginally well - I didn't scream, or struggle, or cry - but I was clingy and difficult and shaky and very very scared.
These two procedures are a good contrast example because they happened so close together, but I've always been more brave and stoic about the big pains than the small ones. I remember being six years old and making jokes with the operating room staff as I was wheeled into surgery. ("Hi! My name is Mary Smith and I just ate breakfast." It had been carefully explained to me that if I ate anything before surgery they'd have to cancel the procedure.) At the same age, I was bitten by a dog and was subsequently afraid of dogs for years. Later on, as I developed arthritis, my joint pain often depressed and exhausted me - but I rarely complained, and I pushed on through with whatever had to be done. Menstrual cramps still sent me to bed for the day, though.
A part of this has to do with whether the pain is expectable. If I know what has to be endured, I can endure it. Unexpected pain is harder because I don't know what will happen, and because I'm not braced for it. Major painful events and ongoing chronic conditions lead me to consciously marshal my defenses. I don't have any prepared defense against a scraped knee. It's not... reliable.
It still scares me more to think of walking down an icy sidewalk than it does to think of the fact that someday I'll need another hip replacement. That's just not a practical way of organizing my responses to pain.
curiousangel, "Sometimes it must be hard to believe that I've had major surgery." "Sometimes," he agreed.Here's the thing, though: I think that it's actually easier for me to cope with serious, expectable pain than to cope with minor, unexpected pain.
When I had my hip replacement surgery, I had no anticipatory fear. None. I slept well the night before, without the benefit of a sleeping pill. I was perfectly calm and good-humored in the morning, going through the admitting process. My pulse and blood pressure weren't elevated. The nurses kept trying to reassure me, but I didn't feel at all frightened - after all, I knew exactly what would happen. I would be rendered unconscious, and when I woke up I would be in serious pain. If something went drastically wrong, I wouldn't ever know. If everything went right, there would be a long period of pain and weakness and rehabilitation. It was all very... expectable.
A couple of months later, I went to my doctor because of an ingrown toenail. He decided that, because the surgery meant I couldn't bend forward to take care of my feet, it would be best to cut the ingrown part of my toenail off. It would be done right away, under a local anesthetic, and it would provide instant pain relief. I nearly panicked. He promised me that he would use enough anesthetic to ensure that I didn't feel anything, and he did, but it didn't help me calm down. It took all my nerve not to refuse the procedure and go home. I coped marginally well - I didn't scream, or struggle, or cry - but I was clingy and difficult and shaky and very very scared.
These two procedures are a good contrast example because they happened so close together, but I've always been more brave and stoic about the big pains than the small ones. I remember being six years old and making jokes with the operating room staff as I was wheeled into surgery. ("Hi! My name is Mary Smith and I just ate breakfast." It had been carefully explained to me that if I ate anything before surgery they'd have to cancel the procedure.) At the same age, I was bitten by a dog and was subsequently afraid of dogs for years. Later on, as I developed arthritis, my joint pain often depressed and exhausted me - but I rarely complained, and I pushed on through with whatever had to be done. Menstrual cramps still sent me to bed for the day, though.
A part of this has to do with whether the pain is expectable. If I know what has to be endured, I can endure it. Unexpected pain is harder because I don't know what will happen, and because I'm not braced for it. Major painful events and ongoing chronic conditions lead me to consciously marshal my defenses. I don't have any prepared defense against a scraped knee. It's not... reliable.
It still scares me more to think of walking down an icy sidewalk than it does to think of the fact that someday I'll need another hip replacement. That's just not a practical way of organizing my responses to pain.
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no subject
Date: 2003-01-28 11:26 am (UTC)(i hardly ever get people who are actually *that* dumb. but once in a while...)
i've never had major surgery, but thinking about what you posted here, when i had hand surgery about ten years ago, i recall being relatively calm about it. last spring when i had a cyst removed (which she offered to do in the office, but i said noooo, i wanted the operating room), i was pretty substantially freaked out about it. (the fine fine nurses let me have my security nathan there with me up until they wheeled me off, fortunately, or else i'd have been in worse shape.)
no subject
Date: 2003-01-28 11:53 am (UTC)Ellen DeGeneres did a bit about it (I think it was her) a long time ago...something about masochists who stub their toes and get off on it. It really bugged me back then, although it's been so long since I saw it that I can't remember all the specifics.
I've actually wondered about the connection between chronic pain and bdsm activity; I know many people with both chronic pain and bdsm interests, and I sometimes wonder if in an odd and roundabout sort of way, doing BDSM is part of pain management or if it helps coping skills or something. Like being in some control of that pain from BDSM helps to balance the normal, every day sort of pain for some people.
Someday when I'm grown up maybe I'll be able to formulate a research question and get funded to study it more.
no subject
Date: 2003-01-28 12:20 pm (UTC)heh. let me know if you want research subjects!
as far as coping skills go, i think that some of the same coping skills apply in both cases. i mean, it's not like bdsm pain doesn't hurt, it's just that i like it sometimes. so there's learning how to breathe so that you can deal with the pain better, for example, which applies in both cases. also, endorphins from bdsm play probably help the rest of it hurt less for a while.
(now i miss my ex who i used to play with all the time. foo!)
no subject
Date: 2003-01-28 11:46 am (UTC)I have a... fear reaction (for want of a better word) schema with regard to heights. Being up in planes or tall buildings doesn't bother me in the least, but being on a stepladder gets my pulse quickening. I think the latter because I'm the one in control of things, whereas the building or the plane are somebody else's responsibility.
Whole lotta *seebling* going on
Date: 2003-01-28 03:04 pm (UTC)I'm more than OK with flying, hot-air ballooning and riding ski lifts or gondolas high up mountainsides - I actively love those things. Yet I get vertigo when standing more than a foot or so off the ground, and damned near have a panic attack if I have to walk up stairways I can see through (as in fire escapes, etc.)
And ditto to Rivka's expected pain-versus-sudden pain response. I hardly even notice the pretty much constant pain of sciatica any more, but but the sudden jolt of a stubbed toe or whacked elbow will almost make me puke.
(As for BDSM pain, my play partner recently observed that, once in a while, zie'll accidentally hurt zirself and find zirself wondering, "why don't I *like* this?" I figure it's all in the mental associations...)
no subject
Date: 2003-01-28 07:08 pm (UTC)MKK
no subject
Date: 2003-01-28 11:37 pm (UTC)no subject
Date: 2003-01-31 06:24 pm (UTC)I have a feeling that if you were able to distill part of a person's pain into 'the biggest hurts', it'd be such tiny things that no one would really believe it. But the biggest things always seem to be easier, maybe because they're so much more *there*.
I don't have any support for this other than my own feelings and experiences, and not too many of those experiences dealt with anything really *BIG*, but it's always seemed like one of those things that "well, doesn't everyone know that?"
Chuckle; meaning it's probably wrong. Anything that "everyone knows" is always wrong, right? :-)