Pain Clinic #11: When A Treatment Complicates Chronic Illness


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.




Tropical Test Trip

Last winter, I took a two-weeklong trip to a tropical island with beautiful sandy beaches where I bathed in saltwater and sun the entire time. That’s exactly where I’d prefer to be now when the weather forecast is -1 C (30 F) and the temperature is expected to drop further; and it’s snowing today.

My destination was a tropical island because my dad built a retirement home and permanently moved there about three years ago. None of my family was thrilled about him making the move, but it was something he had dreamt of for a long time and, besides, it’s not bad knowing you have a place to stay if you feel the need to spend some relaxed time in the sun and blue-green waters of beautiful beaches. That was my intention after my abdominal surgery three years ago. Unfortunately, my pain and the intense fear of being so far away from my doctors and a hospital Emergency Room where my medical history is easily accessible if I need help to cope with an unexpected pain flare up, kept me grounded within the walls of my small home.

Last year, in spite of the pain, I felt determined to take my first trip out of the country since becoming ill. I call it my “test trip” because I was getting on a plane for the first time in four years and leaving the country for an extended period. It took the better part of two weeks to get organized and get everything I needed to take with me into a single suitcase. Whether it was the stress of taking the trip or trying to figure out all I needed to pack – or not – to take on the trip, I felt overwhelmed, anxious and frazzled until the moment I was sitting in my seat on the airplane.

I was anxious and worried about everything. I worried about how I would walk the long distance from the check-in desk to the gate to board my plane. I worried that once the plane took off that its vibrations, much like the vibrations as I travel in other vehicles, would cause my pain to increase while I traveled the thousands of miles to and from my destination. I worried that the cabin pressure might have unpredictable effects on my nervous system and overstimulate my nerves. I worried about how I would cope, if any or all of these things affected me, causing me to have a pain flare up so far away from home and from my doctors.

Thankfully, all of that worry and anxiety was for naught. After I booked my flight, I called the airline to ask about possible accommodations for anyone with needs similar to mine. Because I made that call, when I arrived at the airport check-in desk, they ordered a wheelchair for me so I didn’t have to walk the long distance to the departure gate. My friend I traveled with didn’t even have to wheel me to the gate, that was done by airline and airport staff to make sure I got there without any issues. When it was time to board the plane the airline staff pushed the wheelchair down the ramp to the door of the plane. When I found my seat, I buckled myself in and nervously waited for take-off because even when I was healthy feeling the pressure of the plane’s take-off was always the worst part for me.

The 4.5-hour flight was uneventful. I didn’t experience any unusual spikes in my pain and I even dozed off a few times as we flew above the clouds somewhere between 9,144 m and 12,192 m (30,000 ft. and 40,000 ft.). Shortly after the plane landed then stopped at the gate at the airport in our tropical destination and the other passengers deplaned, there was someone waiting to wheel me from the plane’s door. She wheeled me through Customs then to the baggage carousel, and finally to the Arrivals’ Exit where my dad – who now lives in that tropical paradise – would pick us up. That’s when my nerves finally calmed enough for me to connect with the reality that taking a trip didn’t have to be a frightening experience for me because of my illness.

Thus began a glorious two-week vacation. Actually, by no stretch of the imagination was that enough time to benefit from the warmth and the relaxing pace at which life moves there. Even on the days when we had rain it was better than being in the midst of this cold, gloomy concrete city. During those mornings, lying in bed hearing large raindrops hitting the windows and roof was calming and soothing; and even though it meant delaying plans on those days, when the sun came out from behind the heavy dark clouds it was as if it had never rained.

We didn’t do lots of sightseeing because I knew my body couldn’t handle it and I wanted to enjoy my time away as much as possible. However, we went on a few daytrips with my dad, which gave us a chance to see more of the island. On other days, we spent hours on the local beaches not too far from my dad’s home – one of which was within walking distance. We swam in waves of saltwater and felt soft sand between our toes as we stood on those beaches looking at blue as far as our eyes could see. We ate fresh-caught fish and locally grown fruits and vegetables; and I tried not to let my pain cloud the experience as the warm temperatures and sunlight enveloped my body.

My “test trip” was a success. I made it out of the country on my first attempt. Although, getting out took great effort, caused a great deal of stress, and some added pain. When it was time for me to return home, I was sad. I knew I’d see my dad within a few months when he traveled to our city for a short visit, but I was already missing him and the island. I was already missing the distance the trip had put between me and daily life that is so highly focused on coping with pain. I was already missing the carefree feeling that being thousands of miles away from home brings.

Yet, even with that sadness, I felt something else. I felt a sense of accomplishment. Because of that trip, I discovered that in spite of my illness I can still do one of the things I loved doing so much of in the past. I now know that even with this constant pain, I can still travel and I can find enjoyment in it.


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.