Pain Management, Logic and the Mild High

In spite of the bummer of a title (and I can’t make it chipper and perky without employing some rather extreme suspension of disbelief), this is not supposed to be a complete downer of a post. It’s more about trying to find a way to be systematic and logical while working within a fairly chaotic system.

I have quite a few friends with chronic pain issues; by comparison, I’m fairly new to this (or am I? more on that in a minute).

My “magical wizard steroids” aren’t working so well any more, and the pain is back, although not as bad as it was pre-steroid.

There are different types of pain involved, and I actually have a little private glossary with terms for different pain, and a habit of trying to pinpoint which part of my internal abdominal cavity is affected. I’m using iPeriod as a pain diary (I mean, I also use it to track periods, but there are note sections, and ways to rate pain, so I’m all about that off-label use).

I have pretty good pain tolerance, too; and humans don’t remember pain well; this is why I started keeping a pain diary (which is every bit as gloomy as it sounds, but not nearly as Marquis de Sade as it could be. I’m sure there’s some delighted S&M author writing marvellous erotica for the kinky folks and calling it “The Pain Diaries”, but forgive me if I don’t google it). I don’t trust my memories of pain.

I have one parent with a substance abuse problem, so I question every decision to take painkillers – because the only painkillers I can take are narcotics. Paracetamol does literally nothing for my intestinal pain and NSAIDS (non-steroidal anti-inflammatories: naproxen, ibuprofen, diclofenac/Voltaren) are verboten when you are suspected of having inflammatory bowel disease.

I take the painkillers; they really help (they’re not perfect; with severe pain, they get rid of… some… of it); and they do make me slightly high. They used to make me really high, and I’ll be honest: that was fun, and felt like a consolation prize – but then I started to develop a tolerance.

I am writing in this roundabout way to put off describing the problem, but let me lay it out as analytically as I can.

  • I don’t want to take painkillers because they make me fuzzy and they are addictive and also I run out; which means I have to go back to the GP for a prescription; which means admitting that the treatment isn’t working; which makes me feel like a failure; which also makes me scared that the GP will think I have a substance problem (which she doesn’t, she is patient and constantly assures me that this is not something I should be worrying about right now. She is a fucking gem, I’m not even kidding). Also, they have side effects. Codeine slows down peristalsis and guys, I have a bowel problem. This isn’t great.

 

  • To deal with the fact that I don’t want to take the painkillers, I start inventing weird rules like “I will wait at least an hour to see if the pain goes away on its own” – and sometimes this actually works. The pain isn’t constant, really. Or at least, if it doesn’t go away completely, it wanes.

 

  • I also think a lot about “how bad is this pain? Can I work through it and tolerate it? Because if I can, I should.” This is not in a moral sense, but mostly because of (1) above. I can’t live on codeine. So I try to assess and analyse the rusty stabbing under my ribcage and the burning fiery cramps behind my navel. I try to put numbers on this. It doesn’t really work.

This system is, as you can see, a bit of a mind-fuck. I’ll run on this system for a while, and then I’ll start yearning to take painkillers – not because I’m desirous of the very mild high (although it is nice with the world the way it is running at the moment to briefly not care and not be terrified), but because I’m just tired of being in pain. I’m tired of trying to block it out and work through it, even though I can actually get away with it for a wild. I just want a fucking break from it, even though I don’t desperately need the painkillers at that point.

Here is the flipside:

  • a more scientific approach to pain management is to take effective painkillers at the onset of pain, as soon as possible. This is a hell of a lot more effective than waiting until it gets bad. This is what you’re supposed to be doing, at least for short-term pain. I’m not sure what the advice is for long term pain (as a side note, when I got sent home from the hospital recently after surgery on my hand, the doctor – who doesn’t know me – wrote “take two tablets every 8 hours” on the panadeine forte prescription and I LAUGHED AND LAUGHED AND LAUGHED because my running time is “every 4-6 hours, don’t hit max dose”. Every eight hours. HAHAHAHA nope).

 

  • Actually being in pain all the time, even when it’s just in the background, is an honest to god, bona fide mental health issue. It makes me I get bad tempered. I get frustrated. I get depressed. My creative juices dry up, my intellectual fascination shrinks to a pinpoint. I only get by focusing on the next thing and the next thing and I can’t look at the big picture or I just start crying. Also, I am not much fun to be around. I try to have a fairly tight, iron control on my temper and behaviour so I don’t make life unpleasant for the people around me, from co-workers to friends to Husband – and it’s exhausting. I sometimes just want to sit down and rant and say that it fucking sucks and I’m done with the whole mess, but I also want to stay positive… (not in a “toxic positivity culture” way, but in a “don’t give up” way).

 

  • I actually need to take the painkillers before I work out. As a person with hypermobility syndrome, I need to do a lot of core work, and also I run. Running is known to fuck with gut function, even for people with sensible and healthy and functioning digestive tracts. Running keeps me healthy in other ways, though, and I desperately want to keep doing it. Yesterday, I forgot to take drugs before I went for my run and I basically collapsed in a heap from pain in my last running interval. I pushed through until that point, and then I just… couldn’t.

 

So this is where I sit. I sit stuck between “I need to tough this out” and “I need to function” and I go back and forth. Some people don’t understand why I don’t take painkillers all the freaking time; and some people don’t understand why I take them at all. I don’t know how to find normal here, or what the benchmark is. I suppose I’m writing this to try and get it all out, and hope with fingers crossed that someone else with chronic pain issues will chime in and tell their own story and how they manage it, because I don’t get it. I feel like I’m living a half-life while I get this shit sorted out, and it’s just… balls.

Hmm.

My apologies, gentle reader, that was a bummer of a post. I’ll write about something else next time.

 

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Burn This Homily* To The Ground: The Moral Virtue of Silence

  (*for homily, read “platitude” “trope” “so-called wisdom” or “widespread bullshit”)

There isn’t any.

NEXT.

Oh, wait, that was hardly the excessively worded deconstruction that I usually enjoying inflicting on my hapless readers. I suppose I should go into more detail.

Those who read my blog but haven’t met me might not be surprised to learn that I am frequently just as verbose in person as I am online. Those who know me on Facebook, but not really in person, will be aware that I post a good deal of banal bullshit on my own life (updates on pets, how much sleep I’ve had, how good coffee is, why adulting is so hard, all the exercise I’m doing, the fact that I’ve actually done laundry and now have clean knickers, why I’m having surgery yet again and yet somehow surgery can’t cure being a clueless git who gets herself injured all the time) in addition to the sharing of various political articles (the next person who says “echo chamber” to me is going to get… look, I want to say throat punch but let’s be honest: a violent temper in my case doesn’t equal actual violence and the worst I’m going to do is get enraged and glare at you, so let’s just imagine I am way more badass than I actually am, alright? NOW QUAKE IN TERROR YOU FOOL)… holy crap, where was I?

The coffee just kicked in. I am bouncy and alive and, given that I had surgery on my hand just over a week ago, involving a general anaethestic which generally drops me on my butt with overwhelming fatigue and literal chemically-triggered depression for 2-3 weeks, this is a miracle.

I like to talk.

I have a lot to say.

I don’t have much of a sense of privacy, except in a few key areas which will surprise no-one. I’m usually quite willing to discuss things that do surprise people – the only thing that gives me pause is making them uncomfortable (as some discussions do leave people thinking “Holy fuck, how do I respond to this? Was this a grave confessional?” and I wish I could just tell them, no, dude, seriously, I talk about shit, I talk about everything, I don’t really give a fuck as long as it’s not making you uncomfortable and unhappy). If things butt up against my “oh wow suddenly I don’t want to talk about this, that is such a weird feeling for me…” line, then generally I will say so (being a bit of a people-pleaser – yes, really – I’ll start out trying to soft-pedal a change of subject in the hopes of not having to shut down a particular line of inquiry).

People like to critique other people for sharing boring shit on social media. Here’s my response to that [link], but to TL;DR: filter and scroll on, my friend, this is an amazing superpower you have. I’ve had people admit to me that they’ve filtered me because I just post so much and then I look at their feed and realise that they’re incredibly selective about what they post; I often feel a brief moment of envy and wistful admiration that they can do that. I am just not built that way. I never have been.

I have, in the past, felt ashamed of being so open. It makes me vulnerable. I’m an easy person to hurt. It used to make me feel foolish, when other people invoked their right to privacy and managed to deal with their problems and their lives without turning it all into a GIGANTIC BREATHTAKING HILARIOUS TERRIFYING NARRATIVE that could be shared with all and sundry.

Because we do have a trope that very talkative people are foolish, or shallow. We have a strange sort of societal notion that really valuable people are quiet and thoughtful (as though those things have to go together, honestly). There’s a lot of “well, who needs to hear about that when there are more important things?” (scroll, my friend. Scroll like the motherfucking wind)

There’s a lot of “No-one needs to know everything about your life” memes. Well, no. But I also don’t see a lot of romance in shutting up, either.

There’s a lot of “Empty vessels make the most sound.”

Spare me. The fact that I’m caught up in my giant breathtaking narrative in no way makes me superficial. It just means I like communicating. I like telling stories. I like reflecting – aloud, for an audience. It’s how I roll. If it’s not your thing, that’s fine; I don’t get to tell people what they should listen to or receive. I was shocked when I realised that I’m not alone, that there are a tonne of other people out there who live inside this constant stream of consciousness, that it’s not a completely abnormal way to exist. What a huge relief that was! We are numerous. We are vocal.

We are storytellers.

I read a lot of romance novels, either of the standard present day drama setting or the science-fantasy/paranormal settings. I’m a big marshmallow when it comes to those sorts of things and I enjoy them greatly (when well written, at least. And plotted. And charactered. I am quite picky these days).

The romantic male protagonist (because they tend to be quite heteronormative, but I do read a few that aren’t) tends to be silent and brooding. The heroine (see previous parentheses) tends to have to guess at his feelings and desires. Even in well written ones, the heroes aren’t overly communicative. There’s an element of toxic masculine tropery in that, but it doesn’t just apply to the guy: it applies to the women as well. They tend to be relatively quiet. Often, the bouncy, babbly, talkative women are sidekicks, or immature teenage sisters, or best friends who are tragically marked for death (Scream springs to mind). And the bouncy, babbly, lovable talkative guy rarely gets to have his own triumphant story.

That’s not true of all genres, but there is a running pattern.

I want a talkative hero. I want a romantic sexy hero who never shuts up. Maybe he babbles and gets embarrassed, maybe he’s just bouncy and a storyteller, but he’s not brooding, he’s not uncommunicative, he’s not living in a silent well of sexy broody tragedy, he’s just – well – a talker. There are probably things he doesn’t talk about, maybe that’s where the hook is, but who knows?

We have this idea that people who talk, people who communicate well, hell, even people like me who communicate more or less constantly… aren’t interesting. They’re superficial. They have no rich inner life. I’m not sure why. Maybe there’s less for the reader/viewer to figure out (hey, babble is a defense in many cases; you know we’ve got plenty of mystery of our own, hmm?). Maybe it runs up against that vicious “show, don’t tell” rule which means a main character probably shouldn’t be too self aware.

I did in fact get told this would be lazy writing if a character understood themselves well enough to realise some of their own flaws and try to actively work to correct them.

What, characters can’t get therapy?

A lot of which is – by the way – about talking, and about giving yourself permission to talk, and to feel, and to be open in a safe space about a whole bunch of shit that previously you thought you shouldn’t bother anyone with or that you were overreacting about and honestly, in therapy, it doesn’t matter whether you’re overreacting or not – what matters is that you’re reacting, and that’s interesting, and why, and what does it mean, and does it help and what do we do with it now?

This post is about talking. It’s about telling stories. It’s about, yes, run-on sentences and poor grammar and firing off ideas as they march through my talkative, talkative brain.

And it’s about telling you, that if you’re one of those people who, like me, has so much to say, even about the little things, all the little things, and you’re tired of people implying that you’re shallow or stupid or boring because you have so much to say – it’s okay. It’s really okay. Seriously? The only thing we have to worry about is making sure we let other people get words in edgewise. It can be hard to learn to listen when you have so much to say all the time, and if that’s a problem you have, I promise, you can learn and work on it and it gets better. It doesn’t mean you have to shut up all the time, just pick your moments.

It’s okay to talk. Honest.

 

 

Dog Quest: Rehoming

We have a bit of a sad announcement to make. Some friends already know, but as I’ve been struggling to come to terms with it, and haven’t been prepared for any pushback to come my way, I haven’t put it on Facebook, so here it is.

We’re going to try to re-home Abby.

There are a few reasons for this, but before I go into it: this decision was not made lightly. This decision is heartbreaking. I question it every day when I look at her adorable little face; when her oddly truncated tail goes “thump-thump-thump” on the floor when she see us; when she cuddles into my lap; when she brings me the tug rope and shoves it into my hand because IT IS PLAY TIME NOW.

It all came to a head when Lestat died. Lestat died because Abby, while she didn’t get to do physical harm to him, literally scared him to death. He was too old and his poor ticker couldn’t take it. She got through the door while I was carrying something. She doesn’t do this to Michael, but I’m unsteady on my feet, and it’s obvious. After what happened with Jabba, there was a lot of self-recrimination. I was being careful. I was about to close the door behind me. She literally bowled me over to get to our old man cat.

We talked it over after the attack on Jabba, but we couldn’t bring ourselves to do it.

Here’s the thing: Abby is a lovely dog in many ways. She is 100% a safe dog with people. As far as I’ve seen, she’s gentle with kids (very limited exposure though). She is very clever. She is trainable, learns readily, is eager to please, very playful and an enormously fun, loving dog.

But she has a very high prey drive; and she is very anxious and reactive. These are not easy things to deal with, especially in combination. She has attacked another dog. She has attacked cats. She is a gun dog in a Rottweiler body (with the possible exception that I don’t think she would have good retriever instincts – as a side note,  she would probably train that well. It’s very easy to take stuff away from her).

These don’t make her a bad dog. They don’t make her a dog that wouldn’t make someone a wonderful companion – but that someone needs to have no other pets.

We’re rehoming her for Ridcully’s sake; that doesn’t require explanation. As far as Abby is concerned, he is a fluffy edible toy. Amos does not have this cat-eating impulse.

We’re rehoming her for Amos’s sake; that does require explanation. While he loves to play with her, she bullies him. We’ve been told this is “normal dog hierarchy”, but this is by people who haven’t witnessed it. I have seen normal dog hierarchy: pushing and shoving and wrestling and jealousy. There is a level of antagonistic interaction that is perfectly normal. This is not that. Amos sometimes hides behind me when Abby comes close. He won’t play tug rope if she also wants to play. Some days he plays with her happily. Some days he actively avoids her. She causes him high levels of stress. When she gets frustrated or anxious, she basically starts fights with him, which end with him throwing her off, snarling, and running away. Actual fights, not playing. Sometimes these require intervention. I have stepped between snarling, furious dogs more often than I’d like. Professionals in the field have watched Abby’s interactions with other dogs very closely and have admitted that they can’t figure out her triggers. She is fine with them. She is happy. She is playing. Then she is not fine, is freaking out, and needs to be removed.

Yes, Amos will mourn when she goes. Yes, he will need a higher level of interaction from us to compensate. We get that. We still think, long term, he will be better off.

We’re rehoming her for our sake. We have tried a great many things to deal with her anxiety – exposure therapy, medication, carefully managed “working distance” – but it is beyond our skill level and available time. I could probably manage Abby’s issues quite well if I did literally nothing else with my life. I take my responsibilities to my dogs very seriously and the constant stress and guilt of trying to manage Abby and make sure she is feeling happy and safe is exhausting; it’s making me miserable. The constant stress of getting her away from the door that keeps Ridcully safe is exhausting. Distract her so she stops barking. Redirect her stress into play. Put stinky goop on her paws so that her anxious licking doesn’t give her yet another fungal or bacterial infection. It is constant. When we want to take Amos for a walk (Abby does not like walks; it took us a long time to work out that the extra stimulus freaked her out and she was always eager to get back in the car and go home), we always have to think about what we will do for Abby. Leave her in the yard? Risk of over-stress and abandonment panic. Put her in her crate? She will feel safe, at least, but that means we can’t stay out longer than a couple of hours (I refuse to leave her in there longer than that, unless it’s overnight for some reason).

Ultimately, we’re rehoming her for her sake. This is not rationalisation. This is just fact. Abby needs to be an only pet – no other dogs, no small fluffies. She needs someone who can make sure she gets lots of playing and interaction every day (i.e., someone who is home a lot, like me, but who is not dealing with the dramatically fluctuating energy levels of chronic illness. She’ll bring me the tug rope and I will be prostrate on the couch and… sigh). Maybe a family with teenagers who will romp with her. She needs a dog-experienced owner. She needs a yard that has opaque fencing so that she can’t see into the other yards and get stressed about it (this is actually an important tactic for anxious dogs).

Living in our house – where she is in competition with Amos for attention, where she can’t get the stimulating interaction she needs as a dog with a high prey drive and energy level, where we have post-and-wire fences that mean she gets worked up by anything that happens in the neighbours’ yards, where she is constantly aware of prey items she can’t get to – it’s not good for her. It might actually be making her condition worse.

There is a family or owner out there that will be delighted with Abby. She has an extremely sweet, loving nature. She is a fun, playful, snuggly dog.

She is just not right for us.

In terms of pushback: please don’t suggest we are “giving up” or doing this lightly. We fucking adore this dog and have had her for three years. Please don’t suggest we haven’t “really tried” – you have no idea I swear to god. Please don’t suggest that the Amos-Abby antagonism is normal dog interaction – you haven’t seen it (a couple of friends have), and you may not have a benchmark. Please don’t say we’re abandoning her or betraying her – I already feel like that is the case, and we have gone through this mental space so many times. Keeping a dog out of guilt isn’t going to make for a happy home either.

I wish things could be different. I deeply regret this, and the necessity of it, but when I picture her in a home with an experienced owner, as an only dog, happily playing tug and bouncing around in a yard that is all her own, I feel an overwhelming sense of happiness and relief. It will be hard to find the perfect home for her, but I’m sure it’s out there.