Wednesday, May 4, 2016

Thankfully Embarrassing

Yesterday was one of those times when I was able to step back and really appreciate things. It wasn't necessarily the standard way to start that train of thought, but it was very honestly felt, and was also something that I'd spent many years trying to learn how to feel.

After breakfast, Mom and I were walking our 15 month old goldendoodle, Gilbert, around the block before the day really started. Gilbert's astonishingly large for his breed, at just under 100 lbs, but he's the biggest teddy bear ever know to dogdom. Well, We were about 3/4 of the way around the block when he decided to take off back in the direction we'd just been, I think to go check out and grab a pine cone. Unfortunately, goldendoodles don't come with turn signals, and he can move quickly when he wants. He yanked me back around, with my arm flying in the lead, and I ended up just shy of falling on the ground. Color me less than impressed. Having been yanked hard, 180* from where I'd been holding the leash, my shoulder and arm were very...aware, I guess would be a good word(?) and the entire right side of my body felt slightly numb from shock.

Mom immediately had me check the range of motion of my shoulder, to make sure that I hadn't done any damage to the joint, and, since I could move it even if it hurt like all bajeezis, we continued the walk home, this time with her holding the leash. Once we got home, I did ice the arm for 20 minutes, but then not completely keep it immobile afterwards, as I didn't want the arm to freeze and end up making it worse in the long run.

Well -  fast forward a little over an hour later, and I was still really hurting in my upper arm, just below the bicep, actually, and then down into my lower arm it was feeling tingly, and then my fingers were cold and numbish. Not a great way to be feeling, especially since I had caved and taken two ibuprofen despite the fact that I get rebounds from it. I ended up calling the nurse hotline, and was recommended, after trying to answer the questions, to go to Emergency, rather than UC, because they were concerned that there might have been something vascular that was the problem. Vascular is something not to be messed around with, I agree.

I hit the ER at the perfect time, it seemed, as I was able to walk right in to triage, with about six people coming in after me in the following 10 minutes while I was being processed.

This was the part where things started to get somewhat embarrassing for me. 

Every time I talked to a new tech or nurse, and finally the attending himself, I was asked the completely commonplace question of what number I would rate my pain at. I hate this question, and felt completely ridiculous. The only time I've ever really been to the ER was when my migraines had gotten so bad that I was either losing consciousness, unable to stop crying, or else some other kind of horrific pain level. And I'd still never call a 10, because I knew it could be worse.  And now I was in the same place with a pain I'd probably have given a 7 at the absolute highest when they were pressing and stabbing my arm to look for injuries.

Wimpy me, right?
Only, no - and I really kept a grip on that.

Chronic pain is a completely different type of sensation than an acute injury. One I've had nigh on 15 years to get used to, at some level. The other showed up two hours prior. Very different, and I need t remember to treat them differently. Acute pain is something that my body's showing as a way to let my brain know that something actually is going wrong and I need to pay attention. When an acute injury happens, it's not something to automatically just shrug and struggle to ignore because that is what I'm supposed top do with the chronic pain. Acute pain needs to be tended to.

Acute pain is allowed painkillers too. And that's something.

I haven't had any painkillers for my migraines in around three years, I think. Before that it was only very occasionally that I would allow myself to take what my neurologist had given me, because I knew that I have a tendency to habituate to medications. I couldn't afford to lose the effectiveness of that Rx.

There's also another reason
Many years ago, back in middle school when the migraines were first settling into the status migrainous, I was, it turns out, abusing Excedrin Migraine at school, trying to deal with the pain and keep going at school. I always stuck to what the bottle said as the doses, yes, but I would be taking the max doses every day, sometimes for several weeks at a time, trying to be able to function and go to school when I could. When my neurologist found out exactly how frequently I was taking the Excedrin, I almost thought he'd blow a blood vessel.

I was informed in no uncertain terms that taking that much pain medication was unacceptable, and was actually doing my body more harm than good. I didn't want to believe him, of course, but Dr B explained that my body was now associating the ingredients in the pills with pain, and would actually go and create more whenever it saw those chemicals.
Rebound headaches.
It took a phenomenal about of willpower and tears to stop taking the Excedrin, and my attendance did plummet (although my grades didn't) but I eventually stopped getting that type of headache so frequently.

Now I practically never take any OTC painkiller. Aspirin, ibuprofen, and acetaminophen all induce rebounds, and I use naproxen very sparingly for physical pain, as I know it could easily lose effectiveness.

But cutting back to yesterday and my arm - The attending MD decided that I had just strained the nerves in my arm, as well as the muscles when Gilbert yanked me so suddenly, but that there was no lasting actual damage. He recommended icing it and taking 600 mg of ibuprofen as needed to help with the pain and any swelling that might be happening.

Ibuprofen  -  Great.

Well, I did take the ibuprofen, as instructed. I'm a good little patient, and do as my doctors say. But today, yes, I'm still dealing with the rebound headache that I started about noon yesterday when I took the first full 600mg. It's incredibly frustrating, in a way, my having/getting to deal with the headache even though I was taking the painkiller for something completely unrelated, something acute. Accepting pain as an exchange for relief of pain might not make the most sense to some people, but I guess it's logical for me. I know that the rebound headache is just that, and I'd rather wait it out than end up creating a worse situation with my arm.

It's interesting, this morning. The headache woke me up around 4:15 maybe, although I fought to fall asleep for about 20 minutes. I'm not used to the rebound headache feeling anymore. The pain feels different, presents and focuses differently than my normal migraine, and frankly? I'm out of practice. Each different type of headache or migraine that I get has a different way to tolerate, and I haven't had to do so with a rebound in ages.

I'm proud of that.
I'm also proud of the fact that I allowed myself to feel the acute pain in my arm. There was a time when I would have refused, or even maybe been unable, I'm not sure, to acknowledge that something was wrong. I didn't feel my body, I existed only in my head.
So feeling physical, acute pain in my body, where it was a simple injury, being able to pay attention, give it a pain number of its own, and get it checked out when I was concerned with what I was feeling, and then also being able to be caught out of practice with my painkiller induced rebound headaches are all things I'm glad I had happen.

I'm successfully and more attentively living in my body, no matter what the migraines be.

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