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.
