Tuesday, October 18, 2011

Some Good Advice Deserves to Be Repeated Twice

Keep the Doctor Away by elvinstar
Yesterday I told you about my rough time last week.  In my eagerness to tell the whole story, I included a bit of advice that, in retrospect, might have gotten buried amidst all the other details.  I'm going to rectify that right now by repeating this good advice.

Words of Wisdom

Several years ago, I met with a pain specialist who came highly recommended.  While under his care, I got injured.  My rusting shower bench broke while I was sitting on it and I fell in the shower.  I just so happened to have a follow-up appointment with him the next day, and at that appointment he made a point of closely examining me to make sure that a) I hadn't hurt myself and b) those new injuries weren't being masked by my pre-existing chronic pain.

During that visit, he told me, "You have to be careful when you injure yourself, because your chronic pain can mask trauma from injuries."

For the moment, let's focus on that advice and not on the fact that that doctor eventually decided to stop seeing me because he came to believe he didn't have any treatments to offer me.

Pain Isn't All That Straightforward

The truth is that the perception of pain is not all that straightforward.  Sometimes when we get physically hurt, we don't feel anything.  Sometimes when we aren't physically hurt, we feel tremendous amounts of pain.  To read more about this phenomenon, I suggest checking out the Seven Things You Should Know About Pain Science.

My best guess is that when I hit my head last week, I did a couple of things that made my brain think my new head injury pain wasn't such a big deal:
  1. I rubbed my head where I hit it in an attempt to make the pain "go away", which it did after a few minutes.
  2. I resumed decorating the house, which was definitely quite a workout for me.
  3. By resuming the decorating process, I distracted myself from my head injury pain.
I can't say with 100% certainty that these actions led to my brain downgrading my head injury pain, but I believe they all played a role in my brain delaying the development of a significant pain response.

Let me also say that this isn't the first time something like this has happened to me since I started living with chronic pain.

What Hurts Isn't Always Where the Problem Is

A few years back I fell stepping down out of the storage room behind our garage.  Immediately afterwards, I was in a tremendous amount of pain around my left ankle and had to have Robert help me back into the house.  I tried icing my foot and ankle to see if the pain was from a sprain.  After about an hour, when the pain had not reduced significantly, I headed to the Emergency Room (ER).

I told the doctor that my ankle hurt.  He examined it and ordered an x-ray of my ankle.  When he didn't see an ankle fracture, he was ready to release me in an ankle brace.  Thank goodness a radiologist also reviewed the x-ray film, because he is the one that found the fracture in my foot, which lead to the doctor completely changing his discharge plan.

Sometimes It Doesn't Hurt At All

My final example is my recent urinary tract infection (UTI) at the end of September.

If you have ever had a UTI, you know how painful they can be.  Only this last one I had caused me no pain whatsoever.  It came to my attention when I had a day of sky-rocketing and then plummeting blood sugar readings that left me feeling sick, nauseous, dizzy and completely wiped out.

This story also involves yet another trip to the ER, where the doctor ordered a urinalysis and then IV antibiotics to start treating the infection right away.  I was both amazed and puzzled when during the infusion my nausea and dizziness disappeared and was replaced with the characteristic urinary pain that is the hallmark of a UTI.  That left me wondering why my body hadn't alerted me to the infection until that moment.

In hindsight, my only guess is that the UTI developed while I was taking 10 days of antibiotics to treat an infection in one of my stitches from my carpal tunnel surgery.  Somehow being on antibiotics convinced my brain that this additional infection was being taken care of.

What This Means For You

So back to the good advice from that pain expert I saw (you know, the one who decided that he couldn't help me...)

You have to be careful when you live with chronic pain, because chronic pain can mask symptoms of other health problems.

Which means:
  1. You'll need to remember this when you hurt yourself or something unusual happens.
  2. You'll need to educate your doctors about this fact, as they probably will be aware of it themselves.
  3. You'll need to learn to be a detective in order to decipher the mixed messages your body will give you from time to time.
  4. You'll need to be a strong advocate for yourself when faced with medical practitioners who discount your symptoms when they can't figure out what is wrong with you.
  5. You'll need to be more proactive about taking preventative measures so that you don't injure yourself or get frequent infections on top of your chronic pain.

The informational content of this article is intended
to convey general educational information
and should not be relied upon as a substitute
for professional healthcare advice.

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1 comment

Felicia Fibro said...

This post is a great reminder for all of us living with pain. Like you, I've ended up in the hospital before, only to find out what I thought was fibromyalgia pain was actually a newer issue.

When you said, "What Hurts Isn't Always Where the Problem Is" it reminded me of my last rheumatology appointment. I've been having pain in my lower back and upper leg and my rheumatologist was poking around, learning more he never touched my leg. Just to make sure we were communicating clearly I repeated where I was feeling the pain. He had heard me correctly, but said to him the pain there is a hip issue, not a leg issue.