Dealing With Our Chronic Pain Through Art

Y’all might not know this, but I have another blog, The Black Hole Tango, over on Tumblr, where I publish poetry and little creative bits and snippets, my own and others’ work as well.  Mostly my own. It’s just a little free space for sharing my work, which was my big goal in 2010, and yes, it’s taken me until the end of October to start actually fulfilling that goal. Hey,  better late, etc.

So, I just posted a poem over there that I wrote some time ago, and when I started to format it for the blog, it hit me:

This is my only poem about pain. Ever.

OK, I found that odd. I’ve been writing poems ever since my chubby hands could hold those big fat stubby pencils they gave us in first grade with the lined paper (although I’ve never shared them–except once on Father’s Day with my ex-husband). And I’m a big believer in using art to transform pain and other so-called negative life experiences.

So why did it take me that long to write a poem about my own chronic pain? And why haven’t I written any others?

I honestly don’t know. I suspect–I fear, that is–that it has something to do with that queasy feeling we all get when we write or think about sharing our physical pain with others. (Or, OK, maybe that’s just me. I shouldn’t assume.) And that’s no good for a poet. Or for anyone alive, really.

But in any event, there it is. It’s called “Legacy,” and you’re welcome to repost it anywhere, just please attribute it properly and if you’d be so kind as to give me a link back to that site (the Black Hole Tango) I’d be grateful, ’cause it’s brand spanking new and a little lonely out there in blogland.

And what I want to know is this: What do you do to process your pain through art? Do you dance it out? Paint the pain? Share your story with me, please!

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Halloween, Candy, and the Chronically Pained: Coping Tips for Parents

Oh, it’s my favorite time of year.

No, I’m really not kidding. I truly do love Halloween. I love the spooky vibe, the crisp chill in the air, the feeling that anything can happen, if you just look closely enough …

And, unfortunately, I’m also being sarcastic. Yeah, I just love Halloween. Walking around for four hours on end, hauling bags of candy which turn my child into a raging tornado of “GIMME!” and trash my house and … oh, yeah, did I mention the WALKING?! Halloween HURTS, people.

Well, fortunately, this year it seems my kid has decided to forego the usual trek around the neighborhood in favor of more centrally-located festivities. (Phew.) But for those of you with younger kids out there, Halloween truly presents some challenges.

Here’s how I handled it in years gone by:

Abdicate Early and Often

I totally let the kiddo’s dad take over the walking duties. In turn, I stayed home, passed out candy, and baked cookies. Yes, more sugar to give the Gimme Monster. It got me out of walking. Your point?

Rest Up/Dose Up

Ah, the old stand by trick of the chronically pained. Take a good long nap before any activities requiring lots of effort, and make sure you take your meds half an hour before starting up.

Have a Plan

I negotiated ahead of time with the kiddo to specify which houses we’d be going to, and in what order, and what would happen when Mommy cried “Uncle.” It didn’t eliminate the disappointment but it went a long way towards reducing the fallout.

What do you do to deal with Halloween? Do any of you eschew the holiday altogether — just turn the lights off and watch old episodes of Dexter? Do you give out stuff other than candy — you know, like, maybe that nutritious stuff instead? (I can’t fathom, but I hear some people . . .)  Give us your best coping tips in the comments!

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Check Me Out, On the Radio And All! Euston Arch Goes Media-Savvy…

What are you guys doing tonight at 8 PM Eastern? Nothing, you say? Nothing, that is, but washing the cat and alphabetizing your medicine cabinet?

Aw, then, come on over and listen to two fabulous women sitting in very different cities and talking about chronic pain! Yeah, that’s the ticket!

No, actually, it really is the ticket.  I’ll be a guest on Trudy Thomas’s “Living with RSD” internet radio show tonight at 8 PM. And, from what Trudy tells me, you should be able to check out the archives later, if you like and aren’t able to listen in live.

But if you can, join us — we’re going to chat about all kinds of fun stuff, like Halloween, and cotton candy and … oh, actually that’s just the stuff I want to talk about. Trudy’s really running the show so I bet it’s going to be even more spectaculariffic than that. One thing I definitely wanna chat about: just what the heck Google and ISPs have against my site, ferpetessake! Intrigued? You’ll have to tune in to find out more!

When Your Pain Level is “Too Serious For Numbers” – A Funny For You

No, seriously. It’s FUNNY. Pain can be FUNNY.

Exhibit A, ladies and gentlemen of the jury: Hyperbole and a Half‘s “Boyfriend Doesn’t Have Ebola. Probably.”

This came to my attention from a friend in response to a Facebook message I posted about how the recent trip really did a number on me and my average daily pain levels. (It was the graphic with the “Too Serious for Numbers” caption.)

And now I have a new online pharmacy for my daily dose of FUNNY pills!

The Chronic Pain/Prescription Drug Bad News Tsunami

Picture of Large Ocean Wave Breaking Near Shore

There’s a retrenchment going on in the war on chronic Pain (CP). I’ve noticed it with some dismay over the last several months or so, and this week it finally hit me: folks, we’ve got a full-blown insurgency on our hands. Or counter-insurgency. Whichever? I guess it depends on your perspective, as does so much these days. Are we — the ones calling for more assertive treatment of CP, including better access to pain medications — the insurgents? (Personally, I’ve always been fond of “partisans.” Or “Resistance.” I look good in a beret.)

Well, whichever, indeed, because labels don’t mean a damn thing when we’re getting hit by the mass media tsunami. And how could you have missed it, really? Don’t you know? Prescription pain drugs are evil!

Sigh.

Am I overreacting? Consider the items that popped across my Google alerts just this past week:

  • Pain Medicine News: Study: PCPs Often Underestimate Opioid Abuse Risk — free log-in required, and it’s worth it, honestly. (I’m kind of in awe of this one. Despite numerous studies and statistics to the contrary, we’re going to conclude that MOST — that is, a majority! — of CP patients are at moderate risk of addiction to opioids if prescribed them. Uh-huh.)
  • News & Observer: (NC) Sheriffs want lists of patients using painkillers (Oh, yes. That’s a brilliant idea. Yep, no need to worry about local government overreaching or privacy implications with this plan. At all. And like the study in the item above, it comes from my home state of North Carolina. Whiskey-tango-foxtrot, Tarheels?)
  • London Free Press: Police-doctor crackdown eyed in fight against Oxycontin scourge (Great. Now it’s a “scourge.” Hyperbole much, LFP?)
  • And, drumroll please — my favorite, from something called “the Salem News” (Oregon/Pacific NW): “Pain classified as a disease? Please, give us a break.” A lovely little op-ed full of sunshine and roses for the CP’d population from a self-described “Activist for Victims of OxyContin” named Marianne Skolek (inappropriate capitalization is hers, not mine). She’s also a nurse and a paralegal. (Not sure how that works.)

It’s enough to make a sane CP blogger/activist (note the lack of capitalization, Marianne?) get a little depressed. Excuse me – a little more depressed, since everyone knows we’re already, all of us, bawling buckets of messiness, right?

LORD. I’ve been rolling my eyes all week, so hard that I’ve got a perpetual headache. And – what’s this, Marianne? A CP patient experiencing pain who doesn’t run to the nearest pharmacological stewpot?  Yeah, that’s right. Guess what. I’m not alone. Guess what else? It’s MOST of us who don’t overmedicate.

Except people like Marianne and the sensationalist authors of the above pieces and the scowling big-daddy sheriffs of North Carolina don’t want to see that. They want to see the scourge, the tsunami. Sure, they’ll wrap it all up in soft, caring words but underneath it all is the sense of disdain and superiority over anyone weak enough to want to take a pill to alleviate their CP.

And at the heart of that, ladies and gentlemen, is the blessing of never having had to deal with it yourself. Once you cross over into this great land of All Pain, All the Time? You are changed. Perpetually and inexorably and profoundly changed.

I wouldn’t wish it on anyone. Not even Marianne or the sheriffs. Now, it seems as though Marianne had a daughter who died from an Oxycontin overdose. That’s tragic, and incredibly sad. It should not have happened.

Oxycontin is a drug. It’s a potent one, to be sure, but it’s not the devil. Nor are the people who make it, nor are the people who take it.

You want a devil? Look around at the them vs us world you’ve created, every time you urge the public to believe that prescription pain medication will absolutely, definitively kill them, no doubt.

Look long and hard at the prosecutions of good and caring doctors who – horrors! – use the medications as they’re supposed to be used: to relieve their patients’ pain.

Hell, just look at the criminalization of drug use — not dealing, mind you but merely use! We’re going to put people whose only crime was using a drug in jail. No, that makes no sense to me. You know who belongs in jail? Murderers. Rapists. Thieves. Politicians who steal or take kickbacks. Dealers. You know who doesn’t? Drug users or abusers. That? Is a sickness. Want to know how I know? Because a lot of really smart people got together and SAID SO.

Yeah, that’s what our overcrowded prisons need: throw a bunch of mentally ill people in GenPop because they’re mentally ill.

But. All right. The people have apparently spoken. (Though I’m not giving up on that yet.) Let’s just put that aside for a bit. What’s going on here, in this tidal wave of Crisis! Prescription Medication Abuse (can’t you just see the blazing CNN graphic and hear the specially-composed Intro of Doom now?), is something I’d thought reasonable people had put to bed awhile back:

We are not required to live our lives in pain. We’re just not.

But if this scare-mongering continues, then – well, as much as I hate the role of Cassandra, mark my words, folks: We will none of us have access to the prescriptions that can save our lives.

So, it’s Pain Awareness Month, you may have heard. Isn’t it time we all spoke up? Shouldn’t there be someone saying this stuff in a more public forum? I wrote to a contact at APF to share that Marianne op-ed this week. The response I got indicated that they just don’t even respond to her anymore. I can’t say I blame them. She’s obviously a little self-important and if the best platform she can manage is the “Salem News” website, then – well, whatever.

But shouldn’t the din of voices clamoring about “Pharmageddon” and “sheeple being led astray” (Oh, God, can I just make a new rule right now? No more made up words. And if you do make up a word, it has to at least be clever. “Pharmageddon” and “sheeple”? Do not qualify) — shouldn’t there be at least an equivalent counter-chorus? Somewhere?

It’s enough to give a CP girl a headache.

And note: I’m not even reaching for the Tylenol(tm).

Want to swim in the tsunami? Here you go, courtesy of Zemanta:

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How To Improve Your Sleep & Help Heal Your Chronic Pain With Yoga and Ayurveda

Insomnia and Watching the Clock

Sleep Hygiene and You

One of my favorite little bits of science-speak or expert lingo in the CP (chronic pain) arena is sleep hygiene.

Bwaa!

As if. As if it’s just a question of you getting clean enough. Like, “take a bath! you’ll sleep just fine.” And yes, I know that’s not what they’re really talking about when they use the word “hygiene” in this context. They mean the practices and procedures and routines you adopt around sleep.

Still. Bwaa, I say. Like it’s my fault I can’t sleep more than four hours straight.  Like it’s something I did wrong when I hurt so badly that I can’t even get to sleep in the first damned place. Like it’s as easy as brushing your teeth or using the proper wiping technique after going number two. Whatever, experts.

The way I see it, we’ve got three options, basically, when the sleep has left the building . . .

Door Number One …

Suffer. Lie there and suffer. Not appealing.

Door Number Two …

Ambien. Hey, been there, swallowed that. Still do, from time to time, when it’s really bad or when I have a major event the next day and just have to get a good night’s sleep. Still, I try to keep this one as a last-ditch effort. It is a controlled substance, so people look at me funny at the pharmacy when I go pick it up on my third refill. (You know the look I’m talking about.)

(By the way, I tried that other one – Lunesta – about five years ago. It was awesome — until I realized that the horrid taste in my mouth was not something I’d accidentally gotten a lick of but the Lunesta itself and it lasted all. Damned. Day. Nothing would make it stop.)

Door Number Three …

Alternative therapies. And here’s one aspect of CP management where I’m a huge believer in the alternative stuff. (Long-time readers know I’m extremely skeptical and at times highly critical of all the hype and puffery surrounding alt-therapies for CP conditions. But that’s another post. Or four.)

But when it comes to sleep? Alternative rocks. (Hee. I made a pun.) Especially bangin’: yoga and ayurveda, the twin components of Indian health management that have been around for centuries.

Yoga Your Way to Dreamland

The kind of yoga I’d recommend for sleep improvement is not the “Steve Ross on Oxygen”/fast-paced flow routine you might associate with a lot of Western approaches to yoga. Rather, this kind of yoga is gentle, restorative and way easier on the joints.

As with any yoga, however (well, heck, really this applies to any exercise at all but especially with yoga) you’ll want to check with your doc first, if you’ve never done it before, and you really want to start any kind of yoga program under the guidance of a trained teacher. If you can’t manage a live person in the same room with you, correcting your form, and keeping you from hurting yourself — yes, it is possible —  then at the very least, a competently-made DVD or video where such a person demonstrates proper form is highly recommended.

That said, a few poses that I find really helpful are “Legs Up the Wall” and a little number I like to call “Reclining Bound Angle With a Boatload of Props.”

Legs Up the Wall

Just exactly what it sounds like. Getting into position can be tricky, so scout around your house for the best location. Personally, I like to do this on one side of a doorway or open archway. You’ll need a sturdy wall and enough space in front of the wall to accommodate your upper body in a prone position.

Sit on the floor, and scoot your butt right next to the wall. Very gently, lie down on your side, and curl your legs up to your chest as you roll over on your back — nice and easy. Then as much as you can without straining (that part is important), straighten your legs up the wall. Lie there and breathe for a few minutes.  To come out, reverse the roll: bring your knees to your chest, roll to your side, and gently push yourself up.

The doorway variation I like to use: I angle my butt so it’s right against the right side of the door jamb and put my right leg up the wall, and the left leg I extend straight through the doorway. That adds a nice stretch to the front of the left hip and thigh. To work the other side, shift to the left side of the doorway (or the other side of the door, if that’s easier — either one works).

Now, a few notes. This is not a contest to see how straight you can make your legs. It’s about taking the pressure off your hips and lower extremities, and gently stretching out your back, the sacroiliac area, and the hamstrings.

You can also use a bolster to support your back as shown in the photo on this page.

Reclining Bound Angle With Boatload of Props

This one you can do anywhere you’ve got a patch of floor big enough to lie down on. I recommend a soft padded surface, so if you’ve got a mat, carpet, thick rug, comforter you don’t mind throwing on the floor, whatever – use it. Spread it out. You’ll also need the following (OK, perhaps “need” is a tad strong – you don’t actually need these things, but, boy howdy do they help):

  • Lightweight sandbag for eyes
  • Bolster (or thick blanket or large towel folded in half, then rolled up into cylindrical shape)
  • Two thick pillows – preferably foam
  • Another warm, soft blanket (this one to drape over yourself)

Rather than talk you into this one myself, I figure you’d appreciate the experts’ take on it. Get step-by-step instructions here from Yoga Journal, then add the bolster (lean back against it, resting vertically along your spine), the sandbag on your eyes, and the blanket over your body.

Ayurveda for Better Sleep

Yoga Journal has a pretty decent introductory article on Ayurveda and sleep disturbance here. I wouldn’t personally go for the clarified butter massage but you can achieve a much less messy result with any kind of warmed-up massage oil.

It might seem like an odd approach — different treatments for waking up before or after 2 AM? Vata? Pitta? What? — but our philosophy here at the Diaries is “try it all, keep what works.” Honestly, this stuff? Works. It’s a keeper, in my book. As always, your mileage may vary. Obviously, check with your doctor if you have any sensitivities or food allergies before trying ingesting or rubbing any new substance on your body.

Read On!

And if you’re in the mood to read more on this subject, check out my earlier Diaries posts, “To Sleep, Perchance to Lose Weight? Awesome” and More on Sleep and Chronic Pain” (the latter has links to posts at other sites about the relationship between sleep and CP).

Also, check out the cool Zemanta round-up of related articles below:

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American Pain Foundation Hosts Virtual March on Washington, Launches 10,000 Voices Campaign

Many Lit Taper Candles in the Night
In recognition of September’s designation as Pain Awareness Month, the American Pain Foundation (APF) announced yesterday the start of an online Virtual March on Washington which will include the launch of the 10,000 Voices campaign.

Designed to highlight the need for access to timely, appropriate pain management and medical care for the more than 76.5 million Americans who deal with chronic pain, the Virtual March and 10,000 Voices campaign aim to provide the resources and tools for people to raise awareness of pain issues and pain management, advocate for continued improvements in pain policy, and provide a gathering place for people to share their personal stories on pain.

“Although provisions of the National Pain Care Policy Act of 2009 were signed into law last March, we still have a long way to go to bring pain to the forefront in every community throughout the country,” said Will Rowe, chief executive officer of APF.  “We must seize this opportunity to come together and join the movement—people in pain, family members, caregivers and members of the medical community; build on the momentum of the bill; dismantle the barriers preventing better pain management; and conquer pain together.”

The Virtual March

The Virtual March runs from September 1 through September 30, 2010, and will feature:

  • the launch of the 10,000 Voices campaign—an online opportunity for people in pain, their caregivers and health care professionals to record and share their individual stories;
  • a letter-writing campaign with examples of letters on individual topics to send to lawmakers and other key officials;
  • condition-specific videos examining the challenges of life with chronic pain;
  • the Advocacy Toolkit, to help plan local awareness activities and local media outreach projects; and
  • an online guide to effective use of social media tools (Facebook, Twitter, blogs) in chronic pain advocacy and public education efforts.

“The Virtual March offers the tools to unite, empower and rally those who care about people living with pain and encourages them to be part of a movement that is making a difference in pain policy and pain management in a way that is accessible from your home or office. People can choose to participate in one activity or all,” said Rowe.

To learn more about the Virtual March and to find or post an activity that is happening in your area, visit www.APFActionNetwork.org.

American Pain Foundation Resources

APF also encourages people in pain and their caregivers to read and consult the following free publications available at the APF website:

  • “Access Matters: Making Sense of Health Coverage” provides an overview of health insurance and how to maximize your coverage;
  • “Pain Resource Guide: Getting the Help You Need” helps chronic pain patients empower themselves to create an assertive treatment plan;
  • “Treatment Options: A Guide for People Living with Pain” explains medications, psychosocial interventions, complementary approaches, rehabilitation therapies, surgical interventions and more;
  • “Target Chronic Pain” provides easy-to-use practical tools for pain assessment, management and communication.
  • “Pain Monitor,” a monthly e-newsletter, highlights news, legislative updates, research and resources for people living with pain.
  • “Exit Wounds: A Survival Guide to Pain Management for Returning Veterans and Their Families” offers veterans and their families vital information for their pain journey.

PainAid — An Online Support Community

PainAid is APF’s online support community featuring regularly-scheduled live chats each week, 100+ message boards, and “Ask-the-Expert” sessions moderated by licensed health care professionals. Membership in the online forum is free for chronic pain patients and their caregivers and loved ones. Topics range from illness-specific pain, traditional and complementary treatments, to depression and family matters, as well as financial/legal issues such as disability and workers compensation.

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Good Doc, Bad Doc, and One Mother of a Labor (Another Euston Arch’ Guide Excerpt)

What is this?

Every so often, interspersed with the “how to” tips and advice on handling chronic pain and the posts where I shamelessly try to feed my kid via affiliate marketing (and for the love of God, please, people, go buy something, will ya? In case you hadn’t heard, I’m basically homeless, people), I’ll share an excerpt from my work-in-progress titled, shockingly enough, The Tramadol Diaries.

Unless specifically stated otherwise, I advocate trying NOTHING in these posts as a means of dealing with your own chronic pain (especially without talking to your doctor first). Except the humor. That works. Also? Use what you got. Eighteen months pregnant? You have power, sister. Nobody wants to see you get angry, trust …


The Bad Docs

So, there I was. Six months pregnant, suffering from sciatica, diligently going to physical therapy session after physical therapy session and getting zero relief (although the ice massage was a fresh kind of hell that made me marvel at the medical profession’s capacity for sadism). I couldn’t sit for more than 20 minutes; I couldn’t stand for more than 10. I could walk for five minutes, but every step was pure torture.

And to top it all off, I had apparently signed on with Satan’s own OB-GYN practice. For six months, they shrugged off my weight gain about which I was worried. I’d been 20 pounds overweight to start, and given the complete lack of morning sickness, coupled with the inability to exercise and the severe pain from the sciatica, I’d been medicating the only way I could: Tylenol and food. Every appointment, I asked if I should be concerned about my weight; every appointment, they’d say “Nah.”

Then, at the sixth month appointment (which was actually almost at the end of the sixth month), the doctor came in and began — you got it — lecturing me about my weight. Because of my condition, I’d had another appointment the week before. Now the same scale was telling me I’d gained six pounds in one week.

I stared at her, dumbfounded, for a few minutes, then asked my ex (who wasn’t “ex” at the time, of course) to leave the room. His eyes widened, and he glanced a little fearfully from me to her. Subtext: “Please don’t kill the doctor, honey. I don’t think we can afford the bail.” But he left, dutifully, and I turned what I hoped was my steeliest gaze to the doctor.

“For six months,” I began slowly, struggling to maintain control of my rage, “I have asked every single damned one of you people whether I should be concerned about my weight. For six months, every single damned one of you have told me ‘No.’ Now, when I gain six pounds in one week, you come in here lecturing me about biscuits for breakfast?! Are you crazy or just stupid?”

She pulled her skinny self up to her full stature of 5’2″ and stared down her nose at me, the red-faced whale in her exam room. “Well, I’m sorry, but I don’t think I can accept responsibility for your feelings.”

I nodded slowly. “Then I don’t think I can accept responsibility for your outrageously padded bills.”

I waddled out as gracefully as I could manage and paused only at the office manager’s desk to ask for my records to be copied and mailed to me as my new OBGYNs would need them. The woman stared at me wide-eyed, and then stammered, “Yeah, yes, of course, sure.”

A week later, she called to tell me the records were ready and asked if I’d mind picking them up in person because she wanted to find out more about why I was leaving. I obliged her with a full recounting. She leaned forward in her chair and said, “What if I could guarantee you that you wouldn’t have to see that doctor again? You’re far enough along that I can …”

I shook my head. “Sorry, but you have a systemic problem here. On my second visit, I told another doctor – your senior partner here, if I’m not mistaken – about my sciatica. He laughed it off, then told me to use a heating pad. When I told him that I’d read in several books that heat could damage the baby, he scowled and replied, ‘Who are you going to trust? Some book or me?’ There have been other incidents, too, that I’d normally overlook. But that last visit? Last straw. I’m gone.”

I took my file and I drove down the street to my new doctors — three women who saved my baby.

The Good Docs

These women were amazing, as I found out during my first exam with them. The first woman I saw was a beautiful German woman who still spoke with a slight accent. She listened – at first, wearing the typical professional mask of emotionless attention – but as I continued to explain what had happened, her eyes grew wider and the mask slipped. By the time I got to the doctor’s “can’t take responsibility for your feelings” line, her mouth had actually dropped open a bit. After I recounted the whole speech to the office manager, she actually said, “You go, girl!” In a German accent.

It was awesome. I knew I was home. (She also ran some bloodwork to rule out insidious causes of the weight gain; ultimately, it was chalked up to a borderline hypertension and water retention, something I should have known about a lot sooner, and would have, had the first doctor actually paid attention to the problem, instead of focusing on her attempts to shame me.)

My next appointment was with a short woman my age who was eight months pregnant with twins herself. She could barely reach my stomach when I lay down on the exam table. That was funny.

Then the next visit, they increased my appointments to every other week, and I met Doc #3 – a tall, gorgeous African-American woman who could as easily have been a model. She had me howling with laughter from tales of her own labor and delivery of three kids.

And then, finally, my beautiful doctors told me that we had to consider induction. My princess was growing well — a little too well, in fact — and they were concerned about my ability to push her out if she got any bigger.

Labor, Aptly Named

I checked into the hospital on a Thursday morning — ironically enough, my best friend’s birthday (even more ironic because she, too, was pregnant and would end up giving birth to a baby girl two weeks later – on my birthday). Within half an hour, I was hooked up to a pitocin drip and had a long strip of hormone-cream-soaked gauze shoved up my vagina. (Sorry, guys.)

And we waited.

And waited.

And waited.

Twenty-four hours passed. Then thirty-six.

Then the fun really began. The contractions were coming every minute or so. I was well and truly laboring. And mother of God, it hurt. Not so much the contractions, but the back pain that followed the contractions by thirty to forty-five seconds. I kept insisting something was wrong, and everyone – including my otherwise-awesome mother – basically patted me on the head and told me to tough it out.

“You people suck,” I moaned. (I consider it a huge source of personal pride that this was the worst thing I said during the entire ordeal.)

They tried Stadol. I hallucinated. They gave me epidurals. I enjoyed a brief respite — really brief, like thirty minutes, and then it just stopped working. Twice.

At four in the morning on Saturday (forty hours after the pitocin drip had been started), my German doctor came in to talk to us.

“Your baby’s head is pushed right against the cervix, and as fast as you can dilate, it’s bruising and swelling the cervix shut. You haven’t progressed one centimeter in four hours – you’re still at seven, and you need to be at ten. Now, I can let you go another hour, if you want, but …”

“Cut me open now,” I hissed.

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A Warning About Your Pain Meds

Danger Sign in Front of Sea

At first glance, you might wonder why I’m linking to a news article from Des Moines, Iowa, about a man accused of rape who decided at the last minute pre-trial to fire himself as his own lawyer. What the heck does the right to represent oneself have to do with chronic pain?

I’ll show you. It has to do with his victim. And if you skimmed the article, as most of us do, you’d easily miss it:

Friday’s events provided another twist in the case, which has been unusual in almost every aspect. Hays is accused of entering the home of his friend [Victim’s Husband] and climbing into bed with [Victim]. Prosecutors alleged Hays raped [Victim] for more than three hours on Sept. 29, 2009. Hays maintains his innocence, but has not said what happened that night.
. . .
Meanwhile, both [Victim and Victim’s Husband] died before the case went to trial. [Victim] suffered from fibromyalgia, a chronic muscle and connective tissue disorder that causes sufferers intense pain, sleep disturbance and other symptoms. She died of an accidental pain medication overdose on Feb. 1. [Victim’s Husband] committed suicide three weeks later.

(I’m leaving out their names because she was a sexual assault victim, even though the linked-to article contains their full names. I’m assuming the names have been public for awhile; I just don’t feel comfortable using them, as a rape survivor myself.)

Accidental pain medication overdoses have been in the news a lot lately. Seems I can’t open a news site lately without seeing at least one headline about the rise in accidental overdose cases in U.S. emergency rooms. Now, I need to be clear: I am NOT convinced that the problem is as widespread and critical as the media has reported it to be. It’s pretty much conclusive that most major outlets confuse addiction with dependence, and it’s the least-well-kept secret in this country that the press sensationalizes statistics in order to sell copy (or adspace).

But clearly something’s going on here, and it needs to be talked about honestly.

I’ve never made a secret of how I feel about prescription pain medication. In case you missed it, though, let me reiterate: I’m all for it, when it’s appropriately prescribed and taken.  It’s saved my life, and that’s not hyperbole.

But it’s a good idea to remind ourselves of the facts. Pain medication can kill, when it’s not taken correctly. It can interact with any number of other substances — including benign crap like vitamins and herbal supplements. It can react with alcohol — even a little bit of alcohol. It can be over-taken, as when you forget that you already had that evening dose because the kids were screaming and your husband was ranting about work or whatever.

We tend to think of overdoses as happening to … you know, not to be impolite, but “those other people.” The ones who look/act/live nothing like us.

But as the news article above reminds us painfully: it does, in fact, happen to “us.” All the time? No. Inevitably? Of course not. Way too often for any compassionate person to accept? Oh, yeah.

Taking Time to Take Care of Yourself? E! Thinks You’re Self-Indulgent

One of my deep down dirty shameful secrets (besides the ever-colorful live-action Penthouse Forum that has been my dream life here lately, but that’s an entirely separate blog post) is that I crave celebrity gossip. I could defend this embarrassing addiction on the grounds that I’m really being ironic in my perusal of the paparazzi-provided snaps and accompanying blurbs but, really, why bother? I just dig reading about those crazy stars and their crazy, crazy ways.

But every so often something snaps me out of my glazed-over high while I’m devouring the scandalous details of Robsten or, y’know, whoever — something that reminds me it’s actually the real world in which I live, and that world bears absolutely zero resemblance to the one in which movie stars move and gossip rags and sites blab about said movements. (Heh. I said “movements.” Yes, I’m an 8-year-old boy, apparently.)

One such virtual two-by-four upside the head just slapped me silly. It was on the E! Online website, in the infuriatingly-titled piece “Is Julia Roberts the New Kristen Stewart?“:

Box office prestidigitators fully expect Eat Pray Love to dominate theaters this weekend, or, at the very least, contend for the top one or two spots. They largely credit the source material—Elizabeth Gilbert’s wildly successful and profoundly self-indulgent memoir by the same name.

(emphasis revised by Annie.)

Now, to understand fully the depth of my rage at the bolded accusation, you must know something about the book being referenced. In case you’ve been spending copious amounts of time underground lately, you’ll probably be aware that there is a book called Eat, Pray, Love; that it’s by Elizabeth Gilbert, a wonderful writer who (among many other things) wrote the terrific first-person nonfiction narrative which ultimately turned into the not-so-terrific movie Coyote Ugly; that it’s a memoir (i.e., it’s nonfiction and recounts the author’s personal experiences); that the focus of the book is on the year-long period in which Gilbert, recovering from a messy divorce and even messier love affair, traveled in turn to Italy, India, and Bali, in search of some self-awareness and ultimately peace.

What you might not know:

  • Gilbert arranged the trip and financed it through an advance from her publisher; the goal all along was to write the book about her experiences, and in this vein, the trip was both the experience itself and the research for the book about the experience. (Nonfiction authors, by the way, do this routinely. Unlike selling a novel, say, where the book gets written first, the nonfiction author will basically presell the book on the basis of a proposal; the publisher buys it and gives the author an advance against royalties; the author goes off and writes the book. That’s just the way it rolls.)
  • During her time in each country, she focused her attention on her relationship with food  and her body (Italy – “Eat”), herself and her spirituality (India – “Pray”), and others (Bali – “Love”).
  • Oprah loved her so much she had her on the show twice.
  • The book was then adapted into a movie starring Julia Roberts and Javier Bardem.

Then, in the midst of all this public adoration — Oprah! The New York Times bestseller list! A movie deal and Julia Roberts playing the author! — comes the perhaps-inevitable backlash. It became chic and de rigeur to mock Gilbert, to chastise her and her book, to rail against the audacity of a woman like Gilbert (whatever that means) advocating taking a year off and traveling all over the world to “find yourself” – as if real women (whatever that means) anywhere could afford to do such a thing.

It seemed to me that the backlash became ugly when it started focusing on her gender. That gender bias was expressed in comments on book-review sites across the web such as these gems:

  • It borders absurd that this story could be glorified to the degree of being considered a personal “triumph.” I would love to see how her story would have turned out minus the huge bank account that allowed her to take the vacation of her life. There is no depth of soul here…she had nothing to overcome and only herself to think about and all the money in the world to do it.
  • I found it hard to relate to a woman and her struggles when she is so fortunate to be able to travel and live freely for a year with the money she got from her book deal!!
  • I didn’t enjoy the book at all due to EG’s self-indulgence. In fact, I found several, “book chucking” moments where I almost threw the book across the room. . . . I honestly think the reason this book is so popular is shear vicariousness. Who wouldn’t want to spend an all-expense paid year of eating, self-reflecting, and falling in love?
  • WHY? I cringe to think why so many women want to feel that this was a true spiritual journey. It was a pre-paid journey.
  • It took me nearly a year to finish it. I was so disgusted by the writer’s apparent lack of awareness of her own privilege, her trite observations, and the unbelievably shallow way in which she represents a journey initiated by grief, that I initially couldn’t bear to read beyond Italy.
  • Liz decides to undertake a “spiritual journey” as well as a geographical one, all the while planning and being paid to write this book about it. She’d been able to take this journey of hers because of the advance she’d acquired in preparation for this book. Sound fishy already?
  • Lastly, it’s very disheartening that a book ostensibly about a spiritual journey to the self begins with details about her Manhattan real estate holdings and ends with… her landing herself a man. Well, congratulations on all fronts. How spiritually evolved.
  • I just kept thinking wahhhhhh the whole time. Poor woman wants out of her marriage so she leaves…. wahhhh. Poor woman is depressed so she whines wahhhhh. Life is so unfair for the poor woman wahhhh.
What’s perfectly horrifying to me: some of those comments were (putatively) made by other women.

So, never mind that almost all traditionally-published nonfiction books started out the same way. Never mind that this is Gilbert’s JOB. Never mind that her prose is masterful, or that she’s repeatedly protested that EPL is NOT some recipe she’s advocating for enlightenment, to be applied across the board, step by step, by any and every woman on earth — that, in fact, she’s repeatedly made it clear she’s only telling her story, and to the extent she’s advocating anything, it’s solely for women to give themselves the time and space they need to become self-aware, whatever that means for them individually.

No, never mind all that. Gilbert is to be vilified and excoriated personally because … she didn’t spend her year working in an orphanage in Mumbai? I don’t know. I confess I don’t quite understand it all myself.

Which brings me full circle to E!’s snarky dig: “profoundly self-indulgent.” Not just “self-indulgent” mind you but it’s profoundly so. Why? Because Gilbert, a female writer, had the audacity to come up with a creative way to give herself some much-needed personal time and then (the gall of her!) shared it with other uppity women? Because she actually focused on herself instead of others for a period of time? (Quelle horreur.) Because she got paid for doing her job?

What does any of this have to do with chronic pain? Plenty. Chronic pain turns your life upside down and inside out, to the point it resembles nothing like your life B.P. (before pain). It takes a profound amount of time, energy, and attention to even get diagnosed properly.  Then you have to come up with a suitable treatment plan, and then actually follow said plan. It’s exhausting, and it requires the reallocation of personal resources (i.e., time, energy, attention). Spend more time taking care of yourself  = spend less time taking care of others. It’s just simple math.

And it’s apparently an equation with which some women are still, after all these years, highly uncomfortable, to the point that they excoriate other women for doing just that.

Yet, here’s the thing: self-attention does not equal self-absorption or self-indulgence. It simply means attention to self.  That’s it. When it’s approached with open-mindedness, humor, and just the right amount of irreverent playfulness, as it is in Gilbert’s writings, attention paid to self (whether it’s your physical life, your spiritual essence, or your inner monologue) can be a profound act of grace both given and received.

To those women who think I’m self-indulgent for taking care of myself, then, I can only say: Eat (Pray Love) me.