Friday, January 23, 2015

Will accurately portraying life with chronic pain be a piece of Cake?

Lemon Cake Inspired By Thiebaut by DarisArt

My friends living with chronic pain and fibromyalgia are all a buzz about a new film called Cake.

According to Variety.com, the movie tells the story of Claire Simmons (played by Jennifer Aniston) who struggles with both chronic pain and a painkiller addiction.  It addresses the issues of suicide, grief and separation with a "darkly amusing" combination of humor and drama.

The story begins with the suicide of Nina, a member of the chronic pain support group that Claire attends.  After her death, Claire gets obsessed with Nina and starts an affair with Nina's husband (Sam Worthington.)  The story features Claire's support group leader (Felicity Huffman), housekeeper and physical therapist, as well as her husband.

Another article at Variety.com focuses on the fact that Jennifer Aniston doesn't wear make-up for this role.   According to the film's director Daniel Barnz, this is to show that Claire doesn't take care of herself.

A lot of my friends are sure are excited about someone with chronic pain being the main character of a movie.  The hope is that this character will somehow validate all our pain experiences to the doubters and disbelievers in our lives. I haven't seen this movie yet.  Neither have any of my chronic friends.  But we'll get our chance when the movie opens wide today in the USA (after a limited release in December 2014.) 

I do have some thoughts about all the press this movie is getting and all of the comments it has generated over on the Variety.com website.

First, I am concerned that Variety review says this movie is "...falling back on one of the hoariest and most overused of movie cliches..." and "...this manipulatively layered “Cake” probably won’t rise to the occasion..."  Ouch!

Second, while I guess being an actress and forgoing make-up for a role is some kind of Hollywood accomplishment, I think the explanation for why Claire doesn't wear make-up -- because she doesn't take care of herself -- is a little one-dimensional.  After all, I live with chronic pain and don't wear make-up, not because I don't take care of myself, but because I choose to forgo makeup and use my energy for other things I think are more important, like cooking or going to a doctor's appointment.  Which begs the question: does this movie really explain what it is like to live with chronic pain or does it just stereotype this condition?

Third, I am really concerned about how the story paints the picture of  Claire, the painkiller addicted chronic pain patient, because the fact is addiction is not common among chronic pain patients.  According to an evidence-based review of all available prior studies published in the medical journal Pain Medicine in 2008:
"...chronic opioid analgesic therapy exposure will lead to abuse/addiction in a small percentage of chronic pain patients..."  

Specifically, the risk for abuse and/or addiction was found to be on average about 3.27%.  They found that the greatest predictor of pain medication abuse or addiction was a current or past history of alcohol and/or illicit drug use, abuse or addiction.  Their recommendation? Pre-screening patients for these problems before prescribing opioid analgesic therapy.

Given all the changes that happened in 2014 with tightening access to narcotic pain medications, I'm afraid Cake is just going to be a visual aid for the public, feeding misconceptions about painkiller abuse.

Even healthcare professional have misconceptions about the proper use of narcotic pain medications to treat chronic pain.  Just this week, a prominent doctor in the field of fibromyalgia and chronic fatigue proclaimed, "You'll be pain free, because you'll be dead. Taking opioids for chronic, non-cancer pain increases your risk of death by 72%, according to a recent study in the journal Pain..."

I read a summary of that journal article and found it full of contradictory information.  For example, some researchers think that it's only the patients who obtain their narcotic pain medications from "nonmedical sources," like Claire in Cake, that overdose and wind up in the ER.  Then there is this quote (which I edited just a tiny bit for clarity):
"Safe and effective treatment of opioid-sensitive pain is possible... It requires deep pharmacological knowledge, experience, resources, considerable patience, and mental energy from a group of helpers who are able to take care of the whole bio-psycho-social conundrum of the chronic pain patient."  

That sounds exactly like what happens in my pain management doctor's office.  Hmm, too bad Claire didn't come and see my doctor.

But then again, someone treating their chronic pain appropriately with narcotic pain medications probably isn't the most interesting or provocative subject for a major motion picture, is it?  Hollywood loves misfits, even chronically ill ones.

Watch the trailer for Cake.


My most heartfelt advice for those who live with chronic pain and decide to go see Cake?  Don't get your hopes up thinking it will appropriately portray or advocate for the needs of people living with chronic pain.  Oh, and take it with a whole shaker of salt!

Until next time...


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Thursday, October 23, 2014

More Pain Means Less Everything Else

I've been living with more chronic pain lately and it's starting to show.

My mother-in-law called the other day and asked my hubby, "Why hasn't Selena posted on her blog lately?  Is she OK?"  She wanted to talk to me, but I was in the middle of a task, so I asked if I could call her back.

That gave me time to really ponder her question.

The truth is, I've been in a fibro flare-up for over 18 months now.  I know how it started -- being involved in a car accident last year.  Because getting into any kind of accident when you have chronic pain is probably one of THE worst things that can happen to you.

But then I realized the chain of events that has kept my flare-up going since then.  Things like:

  • ongoing dental work, in the form of crowns and root canals, that is causing me more pain. It seems like every 6 months I need another dental procedure! Next up...another root canal.
  • an increase in doctor's appointments, which are using up a lot of my available energy. But I feel the visits are an important part of my "get better" plan.
  • participating physical therapy, which unfortunately is increasing my pain and fatigue in the short run.  I am hoping that if I stick with it, it will be helpful to me in the long run. *fingers-crossed*

And let me not forget my post-accident anxiety about being in a car.  I am really paying attention to how other people are driving now and it is downright scary sometimes. I'm working on being less hyper-vigilant, but in the meantime, a ride in the car can be quite draining.

Here are some of the other things that a severe pain flare-up can do to us:

1) Any increase in severe pain mean you have less of everything else: less energy -- physical, mental and emotional, fewer good days, a decreased ability to leave the house, run errands and go places, and a diminished capability to get things done. 

2) Any time you have an increase in severe pain, you are forced to cut back on all your activities -- physical, mental and emotional.  The longer the duration of your increased pain, the more you cut back.

3) Deconditioning can be the result of a prolonged reduction in physical activity due to an increase in severe pain. Deconditioning is defined as:
...the loss of muscle tone and endurance due to chronic disease, immobility, or loss of function.
Deconditioning becomes another challenge to overcome on your path to recovery from a severe flare-up.

4) Ongoing pain flare-ups increase the other symptoms associated with your particular chronic pain disorder.  For me, this means more fibro fog, more painsomnia (pain-related insomnia), more fatigue and more numbness and tingling in my arms and hands.

So why haven't I been blogging more lately? 

Clearly my increased pain, fatigue and fibro fog all play a significant role.

But it is also my conscious choice to spend more of the energy I do have on the things that have the potential to help me get better in the long run, like treating my dental pain, seeing my pain management doctor and doing my best to participate in a gentle and graded physical therapy program. Because I want to get back to my baseline, to be a 30 out of of 100 again.  I've been more of a 20 for the last 18+ months and frankly, I'm not happy here.  (See the scale I am referring to here. )

I want to get back to container gardening, crafting, gaming and doing more of the things I used to be able to do a regular basis.  That includes achieving my goal to consistently blog and write too.

So while most normal, healthy people might recover from a car accident in 6 to 8 weeks, the simple fact is, for someone like me living with fibromyalgia, it takes more like 60 to 80+ weeks to recover.  It's the proverbial situation of "adding insult to injury."  When you live a life with chronic pain and/or chronic illness, it just takes more time to bounce back from any added severe stress, injury or trauma.

But I will get there, I promise you and I promise myself.  It is just going to take more time, energy and patience. What keeps me motivated?  Looking forward to less pain meaning more living my life.


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