Tuesday, 4 March 2008

Some Notes on Pain

I have had a mushed disc in my spine since I was 21, the result of a badly executed layout dive from an untested diving board. I have a cartilage tear in my left knee, the result of playing basketball and consistently stopping on my left foot, swiveling on my left foot, etc. Both these injuries are now the sites of osteoarthritis, as are other less abused joints, and I hurt a little bit, most of the time. Usually I don't notice it; it's just background noise. Climbing stairs carrying a load (Little Stuff, who is not so little any more), too much hiking on uneven ground, wearing even a two inch heel, sleeping on too hard a surface, all these things bring the soreness to my attention. I love hot tubs; once in water, I don't hurt at all.

This kind of thing does not translate into 'pain' for me; pain is what happens when you put the iron down on your hand, stub your toe against a wood block and break it, or have to get your system restarted after having a baby. Pain is what motivated JG to go and get his knee joint replaced; pain that was severe enough at times that he could not walk around Canadian Tire, pain that would cause the knee to buckle on him at unexpected moments. Pain is what he has now, with the newly repaired joint. Pain when he tries to turn over in bed, more and greater pain when he does the exercises to flex the joint, even greater pain when he has to navigate stairs. We are assured that this pain will go away, after a while. But my heart aches for him as he works through it.

The pain and his determination remind me of our elder daughter. She was a gymnast in high school and in University, competing in the inter University League. She loved gymnastics. She did very well indeed. She loved the competition, also. In her last year as a University competitor she fractured a bone in her foot a short time before the Canada wide finals. There was no question of her dropping out; the foot was taped, her coach monitored it for further injury, and she went ahead. I still remember how she looked as she did her 'flying' dismount from the high bar, a dismount that has to be landed on both feet, firmly. A 'solid' landing, they call it. She knew that the landing would be agony but down she went, solidly, onto the injured foot. For herself, for her team, she just accepted the pain and mastered it, her face a serene mask.

In hospital, they ask you to rate pain on a one to ten scale. I find that a very difficult task. In relation to what? I suppose they intend that 0 is no pain, but what is ten? Do you include duration? Area? Is ten the point where your will gives way and you start to scream? I have a clear memory of telling a nurse, 24 hours or so into giving birth to the ED, that I did not know how much more of it I could take. But of course, labour is not something you can opt out of. I finally got an epidural, about eight hours after the comment. The whole experience did not amuse me. When I got pregnant again, I found (this was 1966) a book written about the Lamaze method of breathing in labour. I memorized large chunks and managed the YD's birth with no pain blocks. The book was called 'Thank you, Doctor Lamaze', a sentiment that I echo. But to put it on a one to ten scale? I have no idea.

That's physical pain -- the ordinary kind, not chronic, severe pain which I suspect is debilitating in a different way. Mental pain, I believe, is different. It can fill your mind and your world, sap your will, destroy your capacity for joy. Mental pain and fatigue are a lethal combination. When my mother was dying, I remember losing control of how I behaved -- having the world 'grey out' is the only way I can describe it. I was angry with my family, who were trying their best to help me, I was angry with the well meaning staff of the hospital who were advising me to pull back and give myself a rest, I was most of all angry with myself for not coping, not being competent, not being able to fix things. It took me a long time to come back from that grey world, a long time and a lot of help.

Given a choice, I would take labour and childbirth over mental pain, anytime.


  1. wow. pain is a crazy sort of concept when you think of it. it is so relative. . .

    great post.

    Running on empty

  2. And yet, we are always aware of when we are experiencing physical pain. With many forms of mental pain we don't realize it's there until it stops.

  3. I know what pain on a scale of 10 is like. The final moments of giving birth to my son, who was born in the amniotic sac; I went from being 2cm dilated to 10cm in about an hour -- I was screaming and didn't know it, I bit my husband's hand and didn't know it. I felt like my heart was exploding out of my body. I was so afraid to give birth a second time, but lo, it was hardly anything in comparison... So I know what you mean about the pain scale. If I'd had her first, would I have said it was a 7? But in comparison it was just a 5?

    I hope your husband's knee heals quickly.