Breakthrough Pain

I missed the Creative Non-Fiction seminar yesterday due to breakthrough pain. This is pain that somehow gets through all the training, all the routines, all the distraction and all the painkillers. For anyone suffering Chronic Pain it is a frustrating phenomenon that has to be accepted and dealt with to make sure it is kept to the minimum. If the breakthrough pain is not brought under control you find yourself falling back into permanent, uncontrolled pain.

That control is not easy to reassert.

In my case it means swallowing my pride, reaching for the more powerful opioids and making sure that all the relaxation, meditation and transference exercises are brought to the fore. Whilst some rest is really useful to let the worst of the pain die down and the analgesics take effect, over the course of the day resting becomes both exhausting and ineffective: exhausting because I have to focus on the exercises all the time; ineffective because that focus is impossible to keep up for very long.

So what to do?

In my case – and it may not be the same for everyone – it means distraction. Like most Chronic Pain sufferers, I have probably got the relaxation exercises worked out fairly well as it is a vital tool for controlling secondary tension and subsequent aches and soreness. Meditation and transference – essentially focusing on a different topic other than pain – are useful secondary tools but, like simple rest, become difficult to continue for hours on end. Distraction, in contrast, takes less mental effort for me and achieves the same end.

Distraction can be combined with relaxation, too, in that a walk in the countryside around here is so beautiful it is phenomenally distracting and relaxing at the same time. I also get exercise, which is another plank of Pain Management. The trouble is that I cannot always make it out for a walk as the act of walking can be too painful; I suspect the same problem exists for many other pain sufferers.  Whilst reading a good book can also be distracting and relaxing, I often find that I cannot focus on reading whilst in breakthrough pain.

So I have to find other forms of distraction. Writing is out, as it needs to much cohesive thought, as is research for the same reason. Similarly, there is only so much trawling around on the web or Facebook you can do before becoming bored (and the distraction failing!). I used to do loads of modelling, 3D designing and miniature’s painting but this is really difficult when I cannot control my hands. And if I could operate the PC, there are still only so many games you can play before being fed up losing because you can’t concentrate.

So, how else to distract? Trying to do something round the house is useful, whether it is a simple piece of DIY or a bit of painting; I can try and design games or game rules; I can plan out stories; I might even blog. The downside here is that on the hallucinogenic opioids I cannot trust myself to carry out even simple or creative tasks correctly.  I can listen to some decent music or watch DVDs (I try and avoid daytime TV unless Time Team is on), until that becomes ineffective, or I can try and hobble round to visit someone. Whatever I do, however, I have to ensure that I use the other major plank of Pain Management, pacing, because if I don’t I’m back to square one.

So, it seems that even distraction has its problems for me.

However, I have so many options that I can almost cyclically distract myself without being bored. The limit is what I can do at any one time during the period of recovery from breakthrough pain. It is only during the worst times, when I have to focus on breathing, relaxation, meditation and transference anyway, that the distraction will not work.

I am lucky, I guess in having such an eclectic fascination.

May your breakthrough pain be managed effectively, too.