
On Overcoming Pain - bigiain
https://www.bunniestudios.com/blog/?p=5429
======
codingdave
Suffering from chronic pain myself, I had two main thoughts when reading this:

1) "the realization that my life has changed for the worse in irreversible
ways" \- This is a dangerous perspective. Yes, life has changed, but if you
focus on 'for the worse', you step onto a path that leads to depression in 90%
of chronic pain patients. I instead focus on what I still can do. I might
never be an athlete again, but I can walk. I can take short hikes in the
mountains. I've changed my hobbies from an active collection of martial arts,
biking, and hiking, into more sedate things like painting and woodworking. I
celebrate staying active for half a day instead of dwelling on the fact that I
used to be able to move all day. Much of your ability to adapt to chronic pain
is mental, not physical, and this is exactly why CBT is recommended as a
therapy - to help you to frame your life in positive, productive behaviors
that keep you going in the right direction.

2) Everyone's pain is different. There is no single answer for how people deal
with it (or fail to deal with it). This post sounded to me less like someone
trying to communicate with their audience, and more like someone thinking it
through for themselves. So while I had mixed reactions to the details of it
all, I think the act of having put it together is likely a healthy move, so I
appreciate the effort to have done so.

~~~
matwood
This is a great attitude. You do what you can. In my younger days I felt I was
indestructible. Other than a torn ACL from wake boarding, I never got hurt
doing all sorts of sports from the mundane to the extreme. Even my ACL healed
100%.

Then, I herniated a disc in my lower back. I think it was from playing
basketball (not really extreme heh). The pain was literally the worst thing I
have ever felt. My back didn't hurt, but my leg from the hip to the foot felt
like it was on fire or the skin was being pealed off. I couldn't sleep, walk,
get in/out of a car, stand upright, lay flat, etc... Luckily a back injection
got the inflammation and pain under control. But, my life going forward has
forever changed. No more basketball. No more heavy deadlifts (I was
deadlifting in the 500#s, now I stay 225# or less). No more heavy squatting.
No more running (afraid of the impact). I do what I can and work from there,
happy that modern medicine gave me a chance.

~~~
sinker
Similar I ruptured a lumbar disk climbing when I was 25/26\. I was also
squatting and deadlifting heavy at the time. I went from the strongest time of
my life to the weakest where I couldn't even tie my shoes without extreme
pain. That lasted about three years where I gradually got better over time.

I feel healthy now and can walk, run, have excellent mobility. No more sciatic
pain, some tightness in the lumbar if I'm careless.

I don't squat or deadlift at all anymore and focus more on calisthenics
(pullups, pushups). I do a lot of running and it doesn't bother me.

But for those three years, things were dark. I brooded almost every day on my
injury.

~~~
matwood
I couldn’t imagine how hard 3 years must have been. I dealt with mine for
about 5 weeks before I got an injection. It was slowly getting better on its
own, but going for years would have been tough. I’m glad you made it through.

I do a ton of calisthenics, and thought about stopping squats and dead’s
completely. The reason I didn’t is that they enforce good posture and the
proper way to pick things up. They also strengthen all the muscles that will
help keep me from being hurt again. With that said, I worked incredibly slowly
back to where I am. From no weight to now. And, if I’m not feeling it that
day, I have no problem just doing calisthenics or riding the bike. Ego be
damned.

------
painstakingly
I suffer from chronic pain that is not curable. The doctors won't prescribe me
any pain killers out of fear I could get addicted. Only alternative is a CBT
therapy which can keep you stay relatively sane in that insane situation.
Every day is a battle between should I just end it now or should I keep on
surviving? I find it extremely depressing that medication that could
potentially be helpful is illegal here and people seem to have no empathy
whilst idea of popping heroin in hospital is totally fine. You probably know
where I am getting at... I have tried cannabis but I never could get
consistent quality or the same strain so 9 out of 10 times it didn't work and
also made me feel impaired. On top of that at least 5 times I got sold spice
(hemp flower sprayed with synthetic cannabinoids) and one time I got robbed at
a knife point by a "dealer". I cannot understand why person who suffers like
me has to go through that? What keeps me alive is Kratom which is also illegal
but I can source it from a country where it is legal so the quality is
consistent and good. I am saving money to move to a country where I can live
as pain free as I can get but every day apart from the struggle I fear I'll
become a criminal just because I want to live today. The system is fucked up
and nobody cares.

~~~
coleifer
When your decision of where you live is based on availability of drugs, I
think there might be a serious problem lurking, which you may not even be
consciously aware of. Good luck nonetheless.

~~~
tasuki
> I think there might be a serious problem lurking

Yes, the chronic pain perhaps?

------
aasasd
One thing that was rather news to me is how the body falls back into default
behaviors of questionable merit. When I was younger, I thought that, afflicted
with some pain, I would learn to ignore it and soldier on. Hoo boy.

Turns out, chronic pain, when the prospects seem bad, drains your motivation
away (even more so with _functional_ neural problems, which simply make you
feel like crap 100% of the time). Now, if you happen to be of procrastinating
type before that, you're left with zero motivation. Your mind is kinda hazy in
the mornings, so you have to rely on your habits to carry you through. Every
movement requires effort now. For a lot of illnesses, physical therapy is the
right answer—and meanwhile, the instinct says to stay in the chair with a big
breakfast and marathon BoJack Horseman.* Maybe later the mind will clear up a
bit or the pain will ease up, and you'll swing dumbbells around or go outside.
Oh what do you know, it's evening already.

This regime made my physique problematic in the first place! Why don't I have
an instinct that would tell me to move around and exercise?

And this is cumulative, of course—I should be making some better habits for
tomorrow, but instead I'm dropping everything that seems of no immediate
importance, which is like all that makes life healthy and interesting.

So, I once believed that conscious effort would carry me through life—but if
you look into pretty basic psychology, the ape brain is way more firm at
making day-to-day decisions. It's better to have habits that will work for you
in hard times. The sentimental books about how you need to ‘overcome yourself’
were right, only they were distant and nonspecific.

* Note that marathoning BoJack Horseman is definitely recommended in different circumstances.

~~~
bitexploder
The conscious mind is weak and will power alone is a laughable force, because
it is an illusion. You have to use both logic and emotion. Logic when emotion
is weak and emotion when logic fails. For me, it is about tricking your mind
into being completely convinced there is no stopping the coming suffering
(exercise, pain, whatever). You can call that habits (it is) but how you form
and think of the habit is different if you are a procrastinator. I have broken
bones and dealt with suffering like Bunnies (not as acutely extreme). There is
a peculiar thing analytical people do with suffering and pain and it can be
counterproductive. The overanalysis of it and trying to logic it all out. To
cope through total understanding. Some of the time it is just easier to use
and manipulate your own emotion, this can have a profound effect on
reprogramming the brain back to a more normal state compared to trying to
reason it all out from a mental perspective on recovery.

------
nate
This has been a rough couple years personally and professionally for me. My
dad almost died last March from multiple pulmonary embolisms. My mom had
breast cancer for the second time. The Highrise drama. But the real weird
underlying thing has been this constant chronic pain and other symptoms. I
could barely move my left shoulder without a ton of pain. I stopped pushing
doors open with my left arm for example to deal with it. I also couldn’t walk
up stairs without pain. My knees were awful. I chalked it all up to either
stress or just mid life getting old. Then I started getting a ton of fluid in
my ears. I thought it was some allergy that I just couldn’t fully combat with
antihistamines. It made me feel like I head a head cold. Cloudy. A little
dizzy. And this just went on for a couple years.

I thought 40 was just my inevitable peak and it all sucks from here. Life took
on a real grey hue.

Well. My wife made us go on some “anti inflammatory” diet. No gluten. No
dairy. No sugar. No alcohol. Low carb. No snacking. I moaned about it for
days.

After 5 days my body was dramatically better. All the joint pain disappeared.
The fluid in my ears is either gone or drastically more manageable right now.

I’m still on a similar diet today but not as strict. And I remain feeling
really good. I can’t believe I was living with all this chronic pain this long
and could have just changed up my diet.

So I drop this story here because I bet there’s some other folks out there
that could see some impact in their life just being a bit more aware of their
diet.

For me I have no idea what the real cause is. Sugar? Alcohol? Dairy? I’ve
heard from others they have a sensitivity to a food and had similar symptoms.
I took a food sensitivity test at everlywell.com which mentions a high
sensitivity to brewers yeast. So maybe it’s that. Maybe my body just needed a
detox to reboot. Who knows. But I feel great.

(The diet I went on was in an ebook from a healthy heart Facebook group
[https://m.facebook.com/groups/thehappyheartproject/](https://m.facebook.com/groups/thehappyheartproject/))
but it isn’t magical or mysterious. You can just figure it out yourself by
staying away from the things I mentioned above for 5 days.

~~~
jcousins
I'm always glad to read of another person getting multiple benefits from
low/ish carb eating. I live with chronic pain from a spinal infection and also
happen to have disordered eating issues. Low carb was _an_ answer to both of
those problems. It's not magic, I won't hail it as the one solution to myriad
problems but my inflammatory markers, blood sugar markers (reversed t2d),
weight (lost 200lbs) and ability to live with a modicum of normality (was bed
bound) don't lie.

For anyone that likes complex problem solving and wants to start down the low
carb road, I cannot recommend Ivor Cummins'[1] and Dr. Jeff Gerber's[2] work
on diabetes and cholesterol enough.

[1] [https://twitter.com/FatEmperor](https://twitter.com/FatEmperor)

[2] [https://twitter.com/JeffryGerberMD](https://twitter.com/JeffryGerberMD)

------
intralizee
This blog post is beautifully written.

The most profound dilemma to me from my own outcome of pain is how "people who
haven't lived the specific pain" are calling the shots. How illnesses
resulting in physical & psychological pain are handled by treatments tailored
by people who haven't experienced the pain. Similar with the allocation of
finances and the perception of how one should adapt their outlook on life;
based on how outsiders of the experience looking in will decide on what's
best. It's comparable to how a victim is so easily coerced & manipulated in a
lesser state and when having faith in persons with the status of attempting to
help. Personally, I would trade my life in a heart beat for without daily pain
and never the experience. Psychologically I can understand why people look to
feel grateful for insight or to make people educated about pain. Sadly, I
think it's just an irrational attempt in making one try to accept the
unfortunate circumstances from the cruel will of the universe.

------
DannyB2
I live with chronic pain. (ankylosing spondylitis)

I take prescription NSAIDs and other drugs for a long time. Also a lot of
acetaminophen per day. (Which I carefully monitor.) I also take, occasionally,
narcotic pain killers (hydrocodone). Next January (2019) will be ten years
since I added hydrocodone to the drugs I use for this.

But it is a tool. Nothing more. I take it only when I need it. I don't have
any predictable usage pattern. It is for occasional use only. I have a very
healthy fear of taking it at all, but if I'm in enough pain, I'll overcome
that and take some. I have a good life and don't want to screw it up with
narcotic pain killers. I have never had any resistance when asking for a
refill. Neither my primary doctor nor arthritis specialist are worried that
I'm taking too much.

If anything, I've noticed that in the last couple years, I've slowed down my
usage a little bit. (Measured by time between refills.)

I think in pain management, the first thing is "learn to live with it", and
then, "there are good drugs for days when it is really bad". (just IMO) I'm
always looking for the lowest dose I can take that will be effective for any
particular episode. I don't want to build up a tolerance. And I suppose I must
not have built up a tolerance in ten years of occasional use.

I haven't become addicted. But I also don't drink alcohol. Or smoke. Or use
very much caffeine. Maybe that is related, or maybe not.

I would say that hydrocodone has improved my quality of life. I get out and do
things I sometimes wouldn't otherwise do.

Last year I was in Colorado and tried some, .... uh, ... products. First, I
thought they were pretty pricey compared to hydrocodone, which costs me only
$5 for a bottle of 30. Second, while they did help some, I didn't think they
were nearly as effective. The hydrocodone is more like a nuclear weapon for
pain.

------
throwaway99874
I'm in my mid 30s and have had migraine headaches for well over a decade now.
The pain is so intense and overwhelming at times tears flow, and I moan in the
dark with the only hope that time will pass and it will eventually get better
at some point. The headaches occur as frequently as multiple times a week, and
can last for a whole day or days on end (the more severe ones are shorter
lived).

I go to sleep with pain, and on many days wake up with pain. I have to hold
down a job and take care of family, so I put on a wincing face and deal with
it. I like to think I can mask the pain well, but my family tells me
otherwise. I've tried medicines, injections, and countless remedies over the
years and spent a bunch of money on doctors. But there is no reliable cure for
me so far. I do all the usual things that people do at my stage in life, I
laugh, I play, I go to work and do well ... but I don't think anyone really
understands how much I have to kill of myself (my desires, my wish to be in a
dark room with no noise and isolated, my wish to sit around and do nothing and
just pass out with pain) to get thru each day. That has left me lonely, and a
bit distrustful perhaps of people - though I try not to act on that thought.

A few years ago, I tried cannabis. Living in a state where it is illegal was a
problem - both legally and with my job. I got a few different strains and
experimented with it over the course of a few weeks. When I found the strain
that worked, I cried. I cried so much. I was pain free in a way that I hadn't
known in nearly 2 decades. I didn't even realize how much and where I was
hurting. Apart from my head, every muscle in my body was hurting due to the
constant strain of dealing with pain. And it was all gone. Gone. I felt like I
was born again for a few days. And then it was over. I couldn't continue with
it due to it being illegal. It was then I really understood how immoral having
at a minimum cannabis not being allowed for medical purposes is. I don't know
if it is a long term solution as I didn't have an opportunity to gather enough
data and observations - but surely there is potential. I also didn't have any
side effects, with the exception of "the munchies" \- which is very real :).

------
anonacct37
I had a shoulder surgery last year. I definitely learned about constant pain
and some tips for dealing with it (with and without drugs).

Some random observations:

Meditation can help. My pain was more connected with my emotional state than I
expected (much worse when stressed and much better when distracted by an
enjoyable experience). Pain and negative emotions reinforce each other.
Narcotics often break the concentration that makes meditation reduce pain.
Nevertheless sometimes you gotta load up on narcotics so you can attempt to
get the sleep your body needs to heal.

In my case I went through about 40 percacet the first week. But took 5-6 weeks
for the next 40, and then I was off the heavy stuff and stuck to ibuprofin.

My shoulder still hurts.

------
titzer
I managed to injure the epithilium on both eyes and developed corneal lesions
after a particularly bad bout of dry eye. I spent more than two weeks at home,
hunkering in the dark due to photosensitivity, without any pain medications.
The pain was intense enough that it felt like needles going directly into my
eyes, with radiating pain that wrapped all the way around my head. With
antibiotic eyedrops and therapeutic contact lenses, my eyes were able to heal,
but for a time I was at risk of blindness. I sympathize with anyone who has
chronic pain, especially the psychological aspect of facing a life severely
diminished.

------
cdiamand
"It’s well documented that trauma imprints itself vividly onto the brain"

I tore ligaments in my knee several years ago. The paragraph about the
accident was extremely hard to read and caused me actual physical discomfort!

~~~
defined
I’m currently 1 week into recovery from a painful shredded (the surgeon’s
words) patellar tendon and repair.

On reading certain passages, my afflicted leg (and only that leg) got tingles
and goosebumps and the rest of me just... cringed... in horrified empathy. I
feel ill just thinking about OP’s pain, and knowing, as OP does, that this is
nothing compared to the pain of certain other maladies makes me wonder how
anyone can bear it.

------
dlhavema
I have near constant neck pain and have done every route I can think to
mitigate,manage,cure or deal with it. The strangest part is it switched sides
randomly. I've tracked/logged it multiple times and can make no sense of why
it switches. I think I need to track more things I'm doing to see what's
related to it... neck surgery, stim, acupuncture, multiple types of therapies,
heart, cold, massage, etc.. all give negligible results.

~~~
mil0x
I'm sorry to hear you have constant pain. I deal with constant neck pain, and
I can tell you two things that really, really helped (after trying pretty much
everything and even considering surgery). The first one is reading "Healing
Back Pain" by John Sarno. As an engineer the prospect of reading a book to
manage pain sounded quite dumb, but I can assure you it removed 90% of the
pain. The other thing that worked was taking 0.5mg Clonazepam whenever the
pain got worse. I got the prescription from a doctor saying that it works for
some patients with chronic pain.

Please do yourself a favor and read that book, I hope it helps (it did help a
very skeptical me one year ago).

------
amelius
I'm surprised the author was able to determine (and remember) the names of all
the drugs they were getting during this perceptional rollercoaster ride.

~~~
xobs
They provided an itemized, timestamped receipt. (Source: Bunnie is a colleague
of mine.)

~~~
agumonkey
Can I bet his memory is always quite good ? even though he was numbed at the
time.

------
winchling
_> if you find yourself in an unfortunate situation, my main advice is to pay
attention and learn as much as you can from it._

It seems to me that this is the _function_ of pain.

If one could voluntarily embrace this process, would this make opioids less
necessary and/or desirable?

~~~
magic_beans
> If one could voluntarily embrace this process, would this make opioids less
> necessary and/or desirable?

It certainly would, but "embracing" the process of pain is an enormous mental
and physical challenge.

Entire religions, for example, are devoted to separating the mind from the
experience of the body. But this takes _years_ of conscious effort.

~~~
winchling
I've noticed that when I stub my toe the suffering is considerably reduced if
I focus on the pain.

~~~
Omnius
By focus you mean jumping around and screaming/cursing at the furniture.
Agreed this helps me as well.

~~~
winchling
Those are the standard tools of distraction which I employed in earlier years.
I actually mean standing quietly still and shifting as much 'internal
attention' as possible to the injured toe.

