O Bendy Gymster: The Problem with pain tolerance

I always feel weird when I mention my high pain tolerance/threshold, as though I am making some glorious announcement of stoic macho toughness; hinting that everyone should fear my badass berserker attack, or poke me with needles and watch me grin evilly (I’m not sure where I’m getting this. I’m on painkillers).

Saying I have high pain tolerance feels like a brag, but it absolutely is not. When I say I’m not feeling pain properly, I’m not saying I’m being stoic and tough. Not feeling pain doesn’t indicate stoicism to me (double negative). Stoicism (applied colloquially, rather than referring to the philosophy of the Stoics) refers to a lack of reaction to pain. Pain is still felt. It is still experienced. It is simply not expressed. Toughness, on the other hand, might be interpreted as the ability to work through experienced pain when necessary.

But pain is important. Pain is information. If we absolutely must work through pain, then we must, because sometimes shit happens, but generally speaking, it’s not a good idea.

I end up working through pain – sort of, because it’s pain that I don’t experience fully – not due to necessity or toughness, but due to simply not knowing about it.

My high pain tolerance and threshold make life complicated sometimes. While I absolutely feel pain (there’s a lot of ouch in my uncoordinated life), I don’t usually process it in the way that people expect, unless it is very severe (and even then it is, apparently, bumped back a notch – or so I am told from my behaviour). This means that when a doctor is poking and prodding at an injury, asking “Does this hurt? How about this? And this?” I end up staring at them in confusion, because I don’t know if “slightly tingly” or “a bit fuzzy” or “I guess it’s sort of tender” or “I don’t feel a goddamn thing” is going to be useful.

I am worried that I won’t feel pain where and how I am supposed to, and will miss out on a correct diagnosis. This means that I have some very odd emotional reactions to blood test results, X-rays and the like.

Here’s the most recent example.

Yesterday, I went for a couple of shore dives. The water – this being Melbourne, and now being winter – was a chilly 12 degrees celsius, which is the sort of temperature I wouldn’t normally go near without a dry suit. Recently, I sold my dry suit, because I hadn’t used it in well over two years (I hadn’t even attached the inflator hose to my newest first stage regulator).

My (now sold) drysuit had boots attached, so when I dived in it, I was normally pretty warm, from neck to toe. My scuba booties were reserved for summer diving, for which they were perfectly adequate, even though they were a paltry 3mm.

I forgot how thin my booties were, and yesterday, when I went diving in cold water, wearing a 7mm neoprene suit and a Lavacore thermal undergarment, my feet went numb in under ten minutes.

Now, as a bendy person, I already don’t get quite as much proprioceptive feedback from my body as I need to maintain physical co-ordination. It’s why I have a tendency to trip over things, and bump into things, and fall on my arse on a regular basis (and probably why in the past 12 months I’ve broken a finger, pulled a calf muscle, injured my shoulder, and sprained my wrist). While you can train proprioception, at this point all my training is focusing on getting feedback from my core muscles and glutes. Working on kinetic awareness of my wider range of motion in arms and feet is probably going to be further down the line.

So after the dive, as I sauntered off to the toilet block with my clothes to get changed, I was walking with numb feet. I’ve done this before. I know the risk of falling over or spraining something is high. Feet are not just flat lumps you throw at the ground – you need to place them carefully, which you can’t easily do when you can’t feel them.

I was being super careful about how I placed my feet. I was paying solid attention.

And I still stubbed my toe on the gutter.

Given that my feet were still mostly numb – the pain penetrated but it was a dim, fuzzy thing – I simply said “Ow, that really hurt!”, frowned in surprise, and moved on.

My feet didn’t warm up until I’d been in the car for a while, on my way back to the dive shop to return the tanks, and the toe didn’t really start to hurt until I got home.

“Huh,” I thought. “Must have hit it hard. Oh well.” Since I was now coming down with a cold in earnest and feeling like crap, that was distracting me from anything else. Also, Husband was away, and I was grumpy about it.

It wasn’t until I woke up the next morning (this morning, at time of writing), that I realised the throbbing, spreading pain was actually constant and inescapable and had started to overwhelm the pain from nasal congestion.

I had two conflicting thought processes:

  • “If it’s broken, you’ll know about it. Stop sooking.” That would be the attitude I was raised with, and to a certain extent that’s fair enough given that I fell over every day as a kid, and it’s probably exhausting for a parent to have to comfort a child that falls over and hurts themselves all the time. So I always thought that broken bones would be really quite obviously agonisingly painful and that if I could actually function it couldn’t possibly be broken, and if I went to emergency to get it checked out I would just be wasting everyone’s time and being a big attention seeking git. This is reinforced by the fact that when my finger fractured last year, I felt it snap, and it obviously twisted.
  • “People can walk around on fractures and not know about it.” In high school, a friend of mine broke her ankle and walked on it for a week before someone insisted that the limp wasn’t improving and maybe it should be looked at. I’ve since had friends who had similar stories involve stress fractures and the like. It turns out that fractures to bone don’t actually come with gigantic neon signs.

I eventually decided that embarrassment was less problematic than walking around on a broken toe, so I got into the car and I drove down the mountain. I got some cold and flu meds from the pharmacy, stocked up on breakfast nuts (we were running low), and took myself to the local Emergency department (this gets stressful, as Husband is away this weekend. Taking oneself to emergency is never ideal).

I got the X-ray. I chatted to the doctor before he’d seen the X-ray. I had the familiar experience of him poking and prodding the toe and it not hurting, and me panicking because I’d just taken Codral, and what if I wasn’t feeling the right sore spot because I had codeine in my system, in addition to my usual inability to work this stuff out?

I couldn’t even point to where the pain was. That’s how bad I am at this.

However, when I thought “Okay, what would I do if I wanted to make it hurt more?”, suddenly I could process it, and I pressed at the outside of the first knuckle on my big toe and bang, ta-da, choirs of really mean angels singing, PAIN. Muted, codeine-soaked pain, but definitely the close cousin of the pain I’d been feeling all morning.

“There,” I said triumphantly. “It’s there.”

So when I saw the X-ray at last, my eyes arrowed into the side of the joint and there it was.

A little splinter of bone detached, pulled off by the tendon (avulsion fracture!).

And my first reaction was not “Oh shit, I’ve broken it, I’m fucking injured again, I’m so freaking sick of this…” No, that was actually my second reaction.

My first reaction was, “Thank god. There’s a cause for my pain. It’s visible. It’s provable. I’m feeling pain in the place where the injury is and one thing correlates to another thing and it makes sense and no-one is going to tell me I’m making it up.”

And that is all sorts of messed up.

And now I have a space boot.

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2 thoughts on “O Bendy Gymster: The Problem with pain tolerance

  1. […] I don’t talk about publicly very much, my pain processing is… wonky. I wrote about that here, but in a quick summary: I have both a high pain tolerance and a high pain threshold, and often I […]

  2. […] basically nothing for me. If the pain is of the level and type that will be helped by paracetamol, I won’t feel it. I am not kidding. The only reasons for me to take paracetamol are (1) to amplify the effect of […]

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