

How chronic pain has made me happier - robheaton
http://robertheaton.com/2013/03/19/how-chronic-pain-has-made-me-happier/

======
jcr
Rob, there are many different forms of chronic pain, many different
severities, and many different causes. The most common instances of chronic
pain occur after some form of trauma (damage), but others occur without any
known trauma. From your description, you seem to be in the "post trauma"
category (from cycling), and the pain is limited to your legs.

Since you're still able to walk, and surprisingly, rollerblade and run, you
should to count yourself as very lucky.

I mean this sincerely. I won't compare pains in public, but I'll just say, I
still appreciate my good fortune and I always count my blessings. Whenever you
have moments when you're unable to do the things you want, try to remember the
things you can still do. It helps. Even if the only things you can manage to
do today is get yourself out of bed into a chair and try to concentrate well
enough to read, those are still accomplishments and you are lucky to be able
to do them.

You managed to use a computer for awhile or maybe even did a bit of typing
today? -- FUCK YEAH! Major Win!

Celebrate the wins. Appreciate the little things. Until a person is no longer
able to do the little things, those little things are taken for granted.

The supposed little things seem so pathetic by comparison, but comparison is
the real problem. If you compare yourself with others, there are only two
possible outcomes and both are harmful; either you'll become vain, or you'll
become insecure.

The best answer is to just do your best. At times, your best will be truly
bad, by comparison, but this is true for absolutely everyone. When you learn
to accept your abilities and appreciate your best, you've got the positive
momentum to keep striving for better. Everyone endures setbacks, and everyone
is enduring some rate of deterioration -- for example, think of some skill you
had but are now a bit rusty due to lack of practice (like SYS/360 or VAX
assembly code?). Only by continually trying to do your best can you stave off
the eventual decline a little longer, but more importantly, doing our best is
where we find happiness.

The rogues gallery of interaction on the Internet is always there, and every
day it seems to become more of a competition and conflict of harmful
comparisons. Whether it's the effigy of yourself on some "social" site being
compared with others, or your best work being compared with alternatives; the
comparisons are always there. The only thing you should ever take with you
from a comparison is new ideas to improve your best.

Laugh! It helps. Make jokes so others can laugh with you. (Yes, even here on
HN)

If you, or others, in our situation would like to contact me privately through
email, I have a good collection of information that can help people living
with chronic pain. My email is in my profile.

------
velniukas
I've struggled with chronic pain for almost 20 years after military and
ultramarathons in my 20's. Many knee operations, 100's of doctors around the
world without any success. Crawl up the wall in pain at night times.

Very recently however, I've found a doctor who prescribed extremely low doses
of medicines normally related to depression; and the effect has been almost
instantaneous in turning off the 24hr pain. I followed up the medical
literature and this seems to be a niche but evolving area - worth checking out
with your physician. I'm hoping that I'll be able to drop taking these daily
in the near future and get back to what normal people feel like. My
productivity has gone through the roof as well as being able to concentrate
better on work and not on the constant pain.

Now to start making the journey back to fit again :)

~~~
artmageddon
I'm not in the military, but I've done a number of ultramarathons and hope to
continue to do so for a little while at least before really settling down and
starting a family(I'll be 31 in May). Any advice?

(Edit: I'm glad that you've found a way to overcome the pain!)

~~~
velniukas
Best advice I got too late: Never run with a backpack. However walking with
weight is great exercise. I spent years habitually carrying a weighted pack or
divers weight-belt to 'acclimatize' my body, never took the escalator or lift
and ran every moment I could - in boots mostly. Sports medicine and knowledge
has improved enough now that these common mistakes can be avoided.

~~~
artmageddon
Interesting thoughts... typically I don't, but the last couple races I did
required it. I'm doing Marathon des Sables in a few weeks, which requires me
to carry a ~20lb bag for the 6 days I'll be out there, and I ran a 50mi race
this past October with a 5lb bag(water, light snacks). Of course, there was
the time spent training for it that required me to get ready to do these
races. My preference is without the bag, of course :) and I always do my runs
with running shoes, never in boots.

I'll try to do more of my runs after this one without the extra weight though
- thank you for your input! What ultras have you done?

~~~
velniukas
here is an interesting bit of advice on rucking that I found today.
[http://www.itstactical.com/centcom/interviews/still-
rucking-...](http://www.itstactical.com/centcom/interviews/still-rucking-
at-63-an-interview-with-former-delta-force-operator-ed-bugarin/) for myself -
never did anything formal - one of my mentors trained me according to a real
life combat situation he was in: run/walk 3 days/nights carrying 60kg (his
team was chased by vehicles). That was what I always trained for, so
definitely outside the norm. Good luck with MdS - would love to do that one
day.

------
andrewcooke
a bit late, but this thought only crystallized as i was out walking...

this post follows a common template (motif? i'm searching for the right word).
something along the lines of "i was an idiot then [random bad thing] happened
and things turned out for the better".

that's fine.

but. but. but what people seem to draw from this is that [random bad thing]
means life will be good. that's missing the important part. the important part
was _i was an idiot_. that is why things got better - they stopped being an
idiot.

and this is important, because when [random bad thing] happens people trot out
this kind of story as platitude. which REALLY DOES NOT HELP.

look at it this way. at best, you're assuming that before [random bad thing] i
was living an unreflective, impulsive, poorly thought out life. and now i will
be forced to re-evaluate my stance.

but maybe i already had a good life? maybe i already was cool? maybe i already
was happy?

[random bad thing] is defined by _bad_. so stopping using dumb stories to
"cheer up" people who are affected (well, if you do; sorry, got a bit carried
away there).

thanks. this was a public announcement on behalf of someone who was recently
diagnosed with [random bad thing] and really doesn't appreciate being told how
this opens up so many options. is that all _you_ are waiting for, to be
awesome? being a cripple?

~~~
hmbg
Agreed, bad things are bad. I was in pain for 3-4 years in my early twenties
due to Bechterew's disease, and it was a thoroughly bad experience. Though
still mild compared to what the author describes, it really messed me up,
making me angry and depressed. I had a good life before I got sick, and I have
a good life now that I have a proper diagnosis and working drugs.

It's fantastic that the author found peace with his pain, but I wouldn't wish
chronic pain on my worst enemy, and I definitely wouldn't expect people with
chronic pain to view it as a new opportunity.

I really hope your [random bad thing] works out to something not quite as bad.
Modern medicine is pretty awesome.

~~~
Myrcurial
I read this and laughed. There's two people on the planet that I've wished my
struggle upon. Of course, I might have only meant it figuratively... or maybe
not ;)

------
sincrlyurs
Whoever is suffering with chronic pain should check their Vitamin D level..
Check out the book "Power of Vitamin D" by Dr. Sarfraz Zaidi. He is MD, FACP,
FACE is an Assistant Clinical Professor of Medicine at UCLA. Dr. Zaidi, a
leading expert on Vitamin D, is also director of the Jamila Diabetes and
Endocrine Medical Center in Thousand Oaks, California. The book has been an
eye-opener for me. I suffer from skin rashes and have gone through various
tests/biopsies with positive results. No dermatologist could diagnose the
issue. But my PCP did a Vitamin D test, and found my level to be too low. I
have been taking Vitamin D suplement for the past 3 months, and I see a great
progress. Hope this helps you too..

~~~
nessus42
I was having mysterious chronic pain in my legs, and it mostly went away after
starting Vitamin D supplements. (Blood work had shown my Vitamin D levels to
be low.)

I've been suffering from chronic dizziness the past few years, and it sucks.
Doctors are not much use. This happened to me a decade ago for two years and
then it suddenly cured itself. But now it's back.

I can't imagine ever asserting that chronic dizziness makes me happier. On the
other hand, I trudge on and have been happy despite this very frustrating
affliction.

------
trashaway1553
Late to comment, but I read this post a few days ago and I wanted to comment
under a throw-away account. I can share some feeling with the author, but
there's _no way_ I agree that you can be _happier_ with chronic pain.

I've been also suffering from chronic pain since I was ~20. I remember it
started with mild focusing problem: I would feel unable to concentrate, and
every ~60 seconds or so I would have a sensation of disorientation that would
break my train of thought. Sounds innocent. I also thought that too, until it
started to get worse and I had to start looking for medical advice.

I carried on, even though you can imagine that even though there was actually
no pain, it's incredibly debilitating. At some point it got so bad, I remember
I had occasions where I would feel "lost" in the middle of a room, I would try
to remember what I was doing but as I was doing that I would re-start from 0,
and ask myself: what was..? Fortunately it wouldn't last for very long (maybe
a couple of minutes),and I actually never lost the "memory", I would just be
unable to think.

I still believe this was the onset of everything that followed. This feeling
got less and less frequent over the months. After 3 years I didn't have any of
those "lost in a room" moments. But as this feeling disappeared, I started to
have tingling pain in the fingers, that later extended to the whole arms. I
later (after _years_ , medical examinations, etc) discovered that what was
actually happening was muscle stiffness in the forearms, then neck, and then
the whole body, which created varying levels of suboptimal blood circulation,
and subsequently increased stiffness resulting in a negative feedback loop.

At various times, I had rippling muscles, like this:
<http://youtu.be/vKgFtIbCzcg>

Some other times I could strike any muscle with a finger with minimal force,
without pain at all, and it would form an isolated contraction, so small I
could actually _draw_ shapes on the biceps, which is something I would have
always fun doing to show doctors.

But the biggest problem became very soon to be pain. Everywhere. Due to
stiffness, fatigue, or whatever. I was doing piano lessons since a couple of
years, but I couldn't take it anymore. After a session I would feel stiffer, I
couldn't articulate the fingers smoothly as I could at the beginning of the
lesson itself. It was something that I loved, and the more I tried the more I
would feel powerless. Very, very slowly I stopped doing any piano entirely,
because I would only feel enraged, bad, and depressed.

I had to slow down work. A lot. Typing became a serious issue. I switched
countless keyboards. I would before "think while typing" and correct/fix the
code along the way. I now "think before doing anything".

One of the things that I always liked was hiking. I hiked a lot, 3-12 hours,
any elevation gain, any distance, no problem. I could hike slowly and think,
or I could just as well hike to stop thinking, which is also incredibly
effective. It's the perfect stress/pain valve, until last year I started
having the same issue in the legs too. Again, very slowly. Sometimes I would
just feel tired, and recover quickly. But over time the recovery took longer
and longer, until now it seems that I cannot properly recover even from mild
activity.

The biggest "a-ha" moment for me was two years ago, when I stopped doing
piano. The author of the post says it's "happiness" and enjoying the small
things. I don't think so. For me it was the moment I gave up. I tried _fucking
hard_ doing everything I could to fix the issue. I spent literally everything
I had on medical doctors, visits, etc. I tried alternative medicine. I
explored every detail I could, and failed. At this point you just let go, and
accept the problem as it is. I'm basically forced to care for the issue,
otherwise I wouldn't work at all, but does this make me happy?

I'm sorry, but no. I'd give you _anything_ so I don't have to suffer
continuously, so that I could do piano again, or hike without having to worry
about pain later, or even sit at the computer without feeling pain.

The way I work now is very different. When I want to work on a problem, or do
any activity, I have to focus hard, "zone out" completely if you will, to the
point that anything beyond the problem at hand has any space. It's hard to do.
But you can become good at it, like everything else. And it's not a method for
stress relief, because the moment you "let go" the pain is brought back too.

Maybe I'm missing the enlightenment the poster had. But chronic pain is
incredibly debilitating. I have moments were I really feel handicapped, even
though I can literally do everything. Chronic pain is bad guys, there is no
"good" that I can think of :(.

------
afreak
I've suffered with chronic pain since my car accident a few years ago. It
amazes me how I have gone from wanting to pop pills to deal with the damage
done to my back to just saying "fuck it" and letting the pain exist while I
move around. Pain medication is far worse than the pain itself due to how it
affects my appetite and digestive system.

Rob's article is definitely something that makes me feel a bit better about
wanting to challenge my body a bit more. I've taken up dancing and cycling
since my collision and I think that it can only get better.

------
jhartmann
This is so f'ing true. I have ankylosing spondylitis, and I'm in pain all the
time. My attitude towards the pain is what makes this bearable. While I'm
lucky that anti inflammatories and pain medicine are helpful, they aren't
something that even gets close to taking the pain completely away. Your
attitude towards pain, and the will to live a full and rich life besides the
demons that you face are what makes all the difference. The way I look at it
is that I have a demon, well most everyone out there has one or maybe several.
I can still walk, I'm able to pick up my son most of the time with some
effort, and I still live a mostly normal life. The lesson here is that our
demons only have the power we let them have, attitude is everything.

------
slothphull
I am not sure where to start: I was diagnosed 3 yrs ago with multiple
congenital cervical spine disorders. Inoperable & impacting 6 of my cervical
discs & compressing multiple nerve roots. Also herniated L5/S1 with nerve root
compression. Add to that severe depression, numerous neuropathic issues
resulted in being prescribed multiple heavy duty opiods & neuropathic pain
fixer-upperers :-)!! Then developed more medical conditions with more severe
disabling pain in back & legs followed by osteomyelitis. Needless to say I
know what severe excruciating chronic pain is & more to the point, it's impact
on my life. The latest issue resulted in losing 95% of use & feeling in my
right hand & fingers. Am on various antidepressants but recently reduced the
doses as I had had enough of the various other side effects. So, how do I
exist - I have retained & enhanced my sense of humour & I immerse myself in
education regarding my favourite subjects which are IT Security & IT Knowledge
in general. I read voraciously, and find that if I can immerse myself in
learning new things every day I can push aside the pain so it sits in the
background.. it is always there but when I am immersed I can function ( sort
of :-) )... sleep suffers; tend to sleep more at my keyboard than in bed!!
Cant walk without a walking stick anymore & occassionally lose the plot and
get very teary but am now able to side track both the depression & the
constant pain on demand... its not easy but it is do-able... it is possible to
live with chronic excruciating pain and I believe that it is very much an
individual thing but everyone can find a way to do it if they try hard enough
& are stubborn enough. Honestly, fighting it is way better than letting it
beat you!! Good Luck to you all.

~~~
Myrcurial
We should start the "I hurt all the time and also do IT Security" club. You'd
be surprised at the membership. :)

------
LemonParty
Rob -- good article. I've shared it with a couple of people I'm close with in
an attempt to help them understand what my life has been like for the past few
years. I've been suffering from chronic pain for a little while now, mostly in
pretty much every area of my back. I've been through the medial wringer, much
like yourself... more doctor's visits (everything from osteopaths to
rheumatologists to spinal surgeons, etc.), MRIs, and x-rays than I can count,
usually without much luck. I've been on all sort of medications: anti-
inflammatory, anti-seizure, opioid, biologic, etc. Nothing even made a dent.
I've always worked on getting better, but only very recently did I decide to
make it my #1 priority. Since then, I've probably read a dozen books on pain,
some of them enlightening and some of them just pure garbage. That included
everything from Dr. John Sarno to medical textbooks on the spine to hokey new
age books that advocated crystal patches. When I started reading about trigger
point therapy and postural recovery, everything clicked for me. Since then,
I've been extremely vigilant in taking care of my own trigger points as well
as making big strides in my sitting, standing, and walking posture...
addressing structural issues. Since then, I've been able to reduce my pain
from an average of 6 to a probably a 1-2. I've also reduced my medications to
one Tramadol a day as well as some light supplementation (Magnesium). I've
made such fantastic progress that I've considered changing my field to one
where I can help people in similar situations. I understand you've come to
embrace your pain, but it's never too late to cure yourself.

~~~
davidshq
@LemonParty - Do you have any recommendations for beginner reading on trigger
point therapy? I'd be interested in reading up on it a bit.

------
pyre
(A little off-topic but) if you are in such chronic pain all of the time,
wouldn't that be similar to the case of not feeling pain at all? Would it be
possible to hurt yourself and not even know it, or would the pain still
increase beyond a certain threshold when you _actually_ hurt yourself?

E.g. Maybe if you broke your leg, you would notice, but what about a
sprain/strain? Would it be possible to not even know, and further injure
yourself because your didn't modify your behaviour?

~~~
X-Istence
I am speaking from a different perspective, I have gout and have had it worsen
over the past couple of months while losing massive amounts of weight.

I now have pain in my feet that takes a couple of days to a week to go away
with meds. I bite through the pain, but I can also feel when I hurt some other
part of my body while working out. The pain is different, has a different
intensity and just in general is nothing like the pain from the gout.

One thing it does do is numb pain in general, even with different pain in
different parts of my body I have a higher pain tolerance in general, and I
feel the pain differently.

~~~
robheaton
I know what you mean about the pain feeling different. It's really hard to
describe, I imagine it's different for everyone. How are you approaching
working out?

~~~
X-Istence
I'm just going for it. I figure the sooner I lose the weight, the sooner the
gout will go away too.

------
anvandare
>You cultivate stoicism, although you aren't quite sure what it means.

Out of interest: have you read any Stoic (or similar 'acceptance'
philosophies, e.g. Epicureanism, Buddhism, Taoism) literature? If so, have you
found any of it helpful?

~~~
tomsthumb
I think they can be pretty helpful, not that they're going to eliminate your
pain or anything, but a little good perspective can go a long way. After a
bunch of reading and thinking and doing (ie practice) it seems much easier to
deal with pain and discomfort. They are both still there, but if it's 20
degrees to cold for my clothing it's not that big a deal and awkward
situations are actually pretty funny now, even in the moment.

So, the Taoist stuff deals mostly with the nature of reality. Buddhism tends
to run the gamut but has a lot to do with your experience, and Epicureanism is
sorta like Buddhism, but with more heavy language and serious attempts to
remove any hint of internal conflict and paradoxical teaching (those can both
be handy teaching tools).

All of them, to varying degrees, teach that you can alleviate suffering
through proper response, though it might be more accurate to say you can
refrain from creating more suffering. The mind is like the body. When you get
cut you clean it and bandage it and leave the thing alone. Anything else
directly messing with it is just hindering the process, however, you can help
yourself by doing things like making sure you have a good diet and get plenty
of rest. The above three teach you about diet and rest and so on, but for your
person.

------
robaato
Worth reading Tim Park's book:

Teach Us to Sit Still: A Sceptic's Search for Health and Healing

[http://www.amazon.co.uk/Teach-Us-Sit-Still-
Sceptics/dp/00995...](http://www.amazon.co.uk/Teach-Us-Sit-Still-
Sceptics/dp/0099548887)

An accurate review comment:

this autobiographical account of his journey from a life dominated by acute
pain to one where a reasonable equilibrium between body and soul enables him
to live in relative comfort and healthy productivity.

------
oxycontent
7 years of misery. Started taking and now abusing oxycodone but better a short
while in bliss than pure misery. It's all down hill from here but I don't care
as I feel good.

------
Karebear
This was so on point I started crying while reading it. This sentence hit home
'At first your only real emotion is rage.' It feels like rage is just under
surface for me at all times. I hurt all the time. It is just a matter of how
much. If the pain goes over a certain number, I become a mess. I always think
'oh no! Is this my NEW norm???' Thank you for writing the article. My husband
shared it with me.

------
midpan
10 years of chronic neuropathic pain following surgery have lead me down much
the same roller coaster of life. I also try to prioritize balance and
calmness, and while occasionally I feel like I'm losing my mind I feel like at
least recover faster and get through the next few minutes of pain, and repeat
the process all day every day. Good luck to all those who have had to face
chronic pain, its a daily battle.

------
Myrcurial
I'm a little surprised that no one has brought up Gabor Mate's work --
specifically When The Body Says No
(<http://drgabormate.com/writings/books/when-the-body-says-no/>) -- it's a
good walk through what is and isn't possible with the weird little
pharmacopeia you've got stashed in your head.

------
joeb2283
I just had a similar epiphany, at 45, my chronic pain was a signal I needed to
take better care of myself. As such, I think I'm in a good spot to help my
other friends and family deal as their bodies start falling apart. As
difficult as it is, you need to get your mind right. And you will regress, but
you'll be back, a different kind of cycle for you ;)

------
tangaroa11
I appreciate the resolve. I have the same affliction (unresolved, unidentified
neuropathy), but mine exists in my right cheek and orbital. Sometimes when I'm
lying down in the middle of the afternoon with stabbing pains things seem
unbearable; but, I persist.

------
jebblue
Wow I wasn't sure what to expect, amazing writing Rob, gripping, you should
write books not code, brilliant. In addition to the wonderful insights you
share, this was my favorite part: "You cultivate stoicism, although you aren't
quite sure what it means." :)

------
Myrcurial
After 15 years of something similar (if not exactly the same thing -- we
should talk) I'd suggest that you're in a valley of happiness now, please
enjoy it as I can guarantee that it won't last. You're going to cycle back to
the other states.

~~~
hartmanrc
I registered an account just so I could reply and confirm your statement.
While there are studies to suggest that 'Mindfulness' type approaches like the
OP describes helps, there is nothing to suggest it lasts.

Unfortunately it's not a sine wave, it's more like a downhill slope. As you
age, it only gets worse. I hate to appear like a dark cloud over the OP's
sunny article, but I'm 27 years in. For the first 10 years or so, I too
believed it made me stronger, tougher etc. Now I'm just happy to make it stop
- whatever it takes.

~~~
jhartmann
I don't know if I agree. I've had chronic pain since I was 18 (sure it was
worse later) so I'm 20 years in. I think attitude has a huge impact. I know I
was taking craploads more medicine with less results when I didn't put it in
the right perspective. We really can beat our pain if we put our head in the
demon's mouth as Jerry Colonna likes to say. There are obviously things that
are much worse, I know that sort of thinking really helps me. Google around a
little and see how people in wheelchairs are doing marathons or something
similar. Makes my pain seem tame by comparison.

~~~
hartmanrc
I agree that attitude certainly helps, I just think it is naive to believe it
alone will always be sufficient, and hubris to suggest it can work for
everyone.

Having said that - I'm glad it's working for you as well.

~~~
jhartmann
Definitely, I totally agree with that assessment. I know everyone's pain is
different, and chronic pain is never a walk in the park. This isn't going to
work for everyone as a magick cure all, but it definitely helps to stay
positive.

------
msandford
I am impressed that you managed to cycle hard enough that such a thing could
happen. My best month on the bike was 1000 miles; I can't imagine what you
must have done to 'earn' such a 'reward.'

~~~
Myrcurial
My neurogenic pain was caused by a broken wrist. Now it's everywhere.

~~~
msandford
Yikes! That's terrible. I am thankful that I only hurt when I exert myself for
long periods or too aggressively. Hitting the pavement does it too but I've
been fortunate not to do anything like that recently.

I find the concept that the brain could cause pain to exist where there is no
"real" (like sliced/torn nerve endings) fascinating and terrifying at the same
time. I didn't even realize that was a thing that could happen 'til I read
this article.

------
frogpelt
It's not the circumstances that determine who you're gonna be, but how you
deal with these problems and pains that come your way...

------
rawland
A healthy man has thousands of problems. A sick man only one.

Thank you, for sharing.

------
largesse
In the article, he hints at it with his discussion of acceptance, but more
directly there have been reports of people dealing better with chronic pain
through meditation.

Apparently, it comes down to the same thing: your attitude and emotional
response to pain are extremely important.

