Pain Clinic #11: When A Treatment Complicates Chronic Illness

TRIGGER WARNING

Anyone who has survived a traumatic experience may be familiar with the feeling of separating from one’s body. This naturally occurring physiological process in the body helps a person withstand something terrifying or harmful. It also works to minimize potential psychological damage or outright losing one’s mind. I characterize it as the traveling of one’s mind, or what some might call the consciousness, into another space until it’s safe to return to the body. For someone who has never experienced this, it might sound hokey, but if you have lived through something traumatic, you know exactly what I’m describing.

It’s the moment when a person can see everything around them, but her/his body freezes making it impossible to interact with any of what’s happening. Whether it’s another car slamming into yours as it drives the wrong way down a one-way street, the moment a dog twice your weight pounces on you sinking its teeth into your body; or feeling another person physically overpower and violently assault you; you know the feeling to which I’m referring.

The medical name for this physiological process is dissociation. “In psychology, dissociation is any of a wide array of experiences from mild detachment from immediate surroundings to more severe detachment from physical and emotional experience. The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a loss of reality as in psychosis.”

The medical definition further states that dissociation is usually measured on a continuum from mild to severe. In a mild, non-pathological case, it’s seen as a coping or defense mechanism in cases of extreme stress or conflict; and in its mildest state it’s more commonly called daydreaming. While in severe or pathological cases of dissociation, the experience(s) can include: “a sense that self or the world is unreal; a loss of memory (amnesia); forgetting identity or assuming a new self (fugue); and fragmentation of identity or self into separate streams of consciousness (dissociative identity disorder, formerly termed multiple personality disorder) and complex post-traumatic stress disorder (PTSD).”

As I’ve already mentioned, dissociative disorders are sometimes triggered by trauma. Yet, in many cases, stress, whether unexpected or prolonged, is the trigger. The situation in which I found myself wasn’t unexpected, but it was stressful, and when I realized what I had experienced it scared me.

One of the recent treatments I’ve undergone – in yet another attempt to reduce and ultimately eliminate my chronic pain – deliberately puts the patient in a dissociative state. The idea is to use specific medication(s) to trick the nervous system into feeling (believing?) the pain no longer exists. I haven’t posted details about the treatment or my experience with it yet because I’m still in the midst of sorting through my feelings, researching and writing about all of it. The medication(s) used are meant to make the patient feel a definite separation between body and consciousness, which I strongly felt for about 20 minutes and had no way of stopping without ending the treatment and possibly losing all its potential benefits.

Since this treatment, the problem I’m having is whether I should undergo it for a second time considering the minimal relief it delivered vs. the major psychological effect(s) it’s still having on me. Effects I hadn’t connected with, or begun to understand, until I had a panic attack while thinking about the next scheduled treatment. I don’t know if I can withstand feeling separated from my body while watching – witnessing really – everything around me but feeling as though I’ve given up all conscious control.

Because the first treatment only delivered about five days of low pain levels, I’ve had to weigh whether the mindf@ck I have to withstand during the treatment and process after is worth a week of relief. Although, I’ve been told that an increased dose of the medication(s) could, possibly, last longer: anywhere from a few extra days to weeks or in the ultimate best-case scenario months. Is that enough to justify forcing my mind into a prolonged dissociative state?

All the contemplation I’ve been doing tells me it’s not enough. The likelihood that more treatments with this method, even with higher doses of the medication(s), will be more successful than the first is slim. However, it’s a known fact that the dissociative side-effects will happen with each treatment and may even intensify. Therefore, my Pain Specialists’ search for a long-lasting treatment must continue; and until they find one, I have to keep finding ways to cope with this unceasing pain every minute of every day.

 

 

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Because It’s Pi Day

Happy Pi Day!

For the second day of InkTober last year, I drew a pie to match the prompt for that day, which was the word ‘divided’. I didn’t like the way my drawing turned out. I can’t remember why but I rushed to draw and post my entry for that day – imagine that, only the second day of the challenge and I was anxious about possibly falling behind. I was unhappy with the result because although I’m not at the level of artistic accomplishment I’d like to be yet, I knew I could have done a better job. So, of course, I redrew the picture.

I like the second attempt better. The interesting thing is that it didn’t take much more time to finish it than I had invested in the first drawing. I’m guessing that because I was much calmer when I tried drawing it the second time, I was thinking more clearly, which translated into using the skills I’m learning more effectively.

I think today is the perfect day to share this. I may have mentioned at some point that I’m a geek  🤓

 

Mammogram: An Ounce of Prevention

When living with a chronic illness, it’s easy to lose sight of the many things that are normally done to maintain overall good health or to make sure there aren’t any new health issues. Recently, for the first time in ages, I did something preventive instead of focussing only on treating existing illness(es). I had a mammogram. My GP (general practitioner/family doctor) ordered it at the beginning of the new year. Because, in her words, I was “overdue” to have one done.

I know she was right. Nevertheless, I still wasn’t eager to have all feeling squashed out of my breasts. The last time I had a mammogram seemed like centuries ago, but I can still remember the pressure of the hard plastic trays that flatten a woman’s breasts so a detailed image of her breast tissue is clearly captured. It hurt. Because of that memory, I wasn’t looking forward to experiencing that extreme discomfort again.

I was able to get the mammogram appointment scheduled at the same Breast Clinic as the previous one. The Breast Clinic is in the same hospital as the Pain Clinic where I’m treated, which isn’t too far from my home, so I walked to my appointment. I’ve been walking to my appointments as much as possible in recent months, even though it takes days – and sometimes as much as a week or longer – to recover because it’s a chance to get some fresh air and much-needed exercise. Although it was quite cold outside, walking there in the crisp winter air was a chance to steel my nerves as I anticipated the added pain to come.

After registering at the Breast Clinic’s reception desk, I didn’t wait long to hear my name called. Along with another patient, I received instructions to undress in an area with small, curtained cubicles and to put on blue hospital gowns, making sure they opened in the front. Because it was freezing cold outside, I had dressed in multiple layers of warm clothes, so it took ages for me to undress, which being in a small confined space didn’t help. Of course, I also had a hard time tying the hospital gown closed. It wasn’t that I couldn’t tie the belt. It was that the oversized gown kept falling open. I finally gave up and walked into the sitting area clutching the collar closed.

As soon as I entered the sitting area, the Mammography Technician came to get me. She was cheerful in a way that put me on edge. I suppose that when you do work – no matter how well-intentioned – that causes another person to feel pain, being overly cheerful is one way to attempt to make them feel at ease while making yourself feel better. I followed her cheerfulness down the hall to the examination room where she told me to stand in front of the Mammography machine.

She fiddled with some dials on the control panel then walked over to position my body for the first scan. I was so anxious about the imminent flattening of my breasts that I started to sweat. That made me self-conscious because the hospital gown had to be pulled off my shoulders so the Mammography Technician could grab hold of each of my now sweaty breasts to place them, one at a time, on the shelf of the Mammography machine. After which she would lower the plastic tray above each breast until it squashed it; and while being squashed, enough x-rays to capture good images would shoot through each breast. Just thinking about this made me sweat more. Thankfully, the Mammography Technician didn’t seem to notice my sweat.

Even so, I fully expected my breasts to pop out from between the shelf and tray before an image could be captured. But no… regardless of how slippery my skin or the size of my breasts the Mammography Technician’s training was not going to fail her. She pinched and squeezed until every bit of each breast was first flattened vertically like too many books forced on a too small shelf; then horizontally like a sandwich in a Panini press. Then, just as I was bracing myself for more discomfort, it was over.

My memory, it seemed, had exaggerated the length of time I had previously spent having my flesh contorted. Although, I suspect, it might have more to do with the skill of the Mammography Technician. She didn’t spend a lot of time repositioning me (my body or my breasts) to settle me in the right angles to capture the necessary images. All it took was fours scans – each breast from two different positions – for her to get it right. In hindsight, maybe that’s why she’s so cheerful: she gets each patient in and out of the Mammography machine so fast they have nothing to complain about. At least I had nothing to complain about; she even let me take pictures of the Mammography machine so I wouldn’t have to look for stock photos online.

I left the exam room and I got dressed in the many layers of clothing I’d put on to keep me warm on my walk to and from the hospital, faster than I had undressed. As I took the elevator to the main floor and walked out into the frigid gray afternoon, I had a smile on my face because the thing that I – and millions of women all over the world – dreaded doing that afternoon, turned out not to be so bad. Thanks to that Mammography Technician, I left the Breast Clinic in a better mood than when I went in. And because of this positive experience, I’ll be reminding all the women I care about to go have mammograms.

Even better, that positive experience was the inspiration to create something colourful that I’ve titled: Decorated Drops.