“Unmerited divine assistance given humans for their regeneration or sanctification.” –Miriam-Webster’s fist definition of GRACE

“Man is born broken. He lives by mending. The grace of God is glue.” –Eugene O’Neil

Learning to manage pain

This is part of the story of how I am learning to manage pain.  At first, I thought of this as  a  “war story.” After all, I am a 68 year-old paraplegic. I live in an independent residence for 100 disabled and elderly residents. It is commonplace for us to sit in the bingo parlor across from my apartment and talk about our complaints. “It hurts here. It hurts there.”

Then I sought to describe the physical therapy life has imposed on me. It was with a catalog of exercises in mind that I mistakenly began this posting in January. Yes, there are exercises here–exercises to be  performed  daily.

Today is March first.  Yet I have not obtained mastery of movement as I continue to revise. Slowly, I am learning how gentle continual movement is key to transforming pain. I have been impatient to describe truths that seem all-encompassing. Now I realize the most  difficult truth is  how to narrow my  focus  to the achievable while recognizing there are limits to limitation.

No longer do I think of this post as a personal filing cabinet, a tool for organizing handouts from physical and occupational therapists–the consequence of physicians issuing prescriptions to conform to tedious Medicare regulations. Now I realize what I truly require:

•  Grace
•  Joy
•  Doing the tango from a wheelchair
• Fred Astaire wearing spats dancing with Ginger Rogers who reveals a lot of leg.

Sadly, this or a similar frequently used scale for measuring pain does  not solve the problem. Defining the "problem" of pain and providing a solution is the central focus of this essay. I recognize that what works for me might not work for you. I do hope that my efforts may provide comfort to my fellow chronic pain sufferers.

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My pain pain comes from four sources

• Spinal
• Previously dislocated right shoulder
• Arthritic neck and upper back
• Inflamed feet and lower legs

In October, 2014, the pain in my deteriorating spine became crippling. Crippling it has remained. Daily the pain level is 7. 5 on a scale of one to 10. This is a frequently used scale, one with faces, shown in emergency rooms, hospitals, doctors offices. Anything over 5 is serious. If you reach 7, you are entitled to morphine–initially quick acting and wonderful. Yet 45 minutes of 4 mg is wonderful once. After the initial for 4 mg you want 6; I want 6; 8 mg 45 mg 45 minutes later. You can’t always get what you want.

Music helps

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The safer bet is Oxycodene or Percocet, another flavor of the same drug. Herein the Commonwealth of Pennsylvania, Oxycodone–vanilla or chocolate–is the favorite illegal drug, more popular than heroin. My friend Ben said he read in the Atlantic or Harper’s that religious fanatics who worship snakes have been too high to bother.

Dancing helps even when it seems impossible

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For me the alternative is New York City where Memorial Sloan Kettering Cancer Center referred me to Columbia Medical Center at 168th Street for a spinal stimulator. This technology has been available since the Sixties. Soon spinal stimulator inserted with the remarkable skill of Dr. Christopher J. Winfree will be available. Soon is not now. Despite medication and steroid injections, there are days when I roll up in a ball, clutching my legs–an infant of 68 rolling on the floor in a fetal position. Yet, even then there is hope. One source is technology.

“Courage is grace under pressure,” Hemingway said famously and incorrectly.

What I am writing here has nothing to do with courage. Yes, it is difficult to write about pain without mentioning pain hurts. As with so many limitations of post-Tower-of-Babel language, the lexicon requires revision. I am not being brave. I am solving a problem. Here with discussion of pain rating charts that tell me I am experiencing “great pain,” the information has limited utility. When the nurse asks for a rating (how bad is the pain?), the answer helps her because if  I say “seven” she administers medication; “two”  no  medication. For me the question is more complicated. What am I doing here?  Isn’t my presence in an emergency room a riddle I have yet to figure out. Clearly,  I require reform. Yes, I will write about the spiritual aspect of pain.

Seven months ago the intensity of the pain was so great,  I called 911, an ambulance arrived, and I was wheeled on a gurney to the Emergency Room at Mount Nittany Medical Center.

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Going to the Emergency Room for pain, even State College’s pleasant and well run ER is a mistake for a variety of reasons.

Most significantly an ER is a mistake because pain medication is temporary. What is required is a different mind set–a perspective to managing pain that incorporates movement, joyous continuous movement.

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• Spinal pain

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The spinal pain is the worst. It is a consequence of the massive radiation which cured me of Hodgkin’s disease, cancer of the lymphatic system,  preventing me from dying at  age 30 .

To relieve spinal pain.Alicia J. Spence, physical therapist extraordinary, Phoenix Rehab recommends my ing basic stretches to relieve tight, tense shoulders due to bad posture, slouching or sitting for long periods of time.

This Yoga video is also helpful.

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Previously dislocated right shoulder

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Arthritic neck and upper back

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Inflamed feet and lower legs:

https://www.mayoclinic.org/symptom-checker/foot-swelling-or-leg-swelling-in-adults-adult/related-factors/itt-20009075

Why am I am writing this?

I believe the disabled and elderly should be encouraged to develop their talents, overcome obstacles, and be productive. In the 21 years since I became a paraplegic, I have been beset by health problems. I have close to death so often  Joanna, my elder daughter tells me, “Nothing  can kill you, Dad.” Yet a lot can slow  me down.

Sigmand Freud may not be your flavor of the month. Yet, he expressed this truth: “Love and work… work and love, that’s all there is.” Despite having survived cancer three times, I could live another thirty years, In April I will be a grandfather. In August Amelia Altalena, my younger daughter marries. There are friends and loved ones who surround me. I publish regularly. I have dreams I would like to build into communities.

The time to think of the disabled and elderly as a drain on resources is over. The Baby Boomers, smart, educated, firm believers that “if I am not for myself who is for me. Together, my landsmen and I will change our world for  the better. First, however,  I have to learn to manage my pain. To  move continually with joy. To reform including making a healthy sleep  schedule (asleep by 11 pm; greating the morning at 6 a reality and not merely a resolution. Think of me as a a guinea pig–your gunia pig.
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Hilman’s Stretches for Back Pain Relief, How to Stretch Routine, Beginners Home Yoga”

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Jen Hilman says about her stretches for back pain, “Incredibly relaxing and stress melting, this yoga for flexibility will be your favorite video yet. Feel some back pain relief after following along to this stretch routine.”http://www.JenHilman.com

To manage the intensity of pain so I can exercise:

I must use pain medication such as Oxycodone and  steroid injections.

Each medication may have dangerous long term consequences. Instead, at the suggestion of State College pain specialist Dr. Todd B. Cousins, he suggested I can eliminate medication by going to a specialist in NYC to insert a spinal stimulator, [5]

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Dislocating my right shoulder is a story I told on WPSU radio.

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Maimonides says the highest form of charity is to give a gift, loan, or partnership that will result in the recipient supporting himself instead of living upon others.

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Inflamed feet

When I broke my left ankle in August, my feet and legs became painfully inflamed.

To prevent an ugly condition called “pitting” Phoenix Rehab’s Alicia prescribed:

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1. Elevating my feet above my heart to reduce intimation to my lower extremities.

3. Applying cold compresses.

Example A. Stationary cycling.

4. Using motion to increase circulation.

 
From: FLASHDANCE
http://youtu.be/8NjbGr2nk2c

Example B: Motion for reducing swelling. Here, I am leaning against a large pillow on the wall adjacent to my bed. My legs are stretched across the bed so they reach the scooter. The scooter is locked so the seat will not rotate. I push the bottom of my feet against the rigid scooter chair. Focusing on reaching the pressure point, I push out hard.

https://www.youtube.com/watch?v=W8wEORnZxdg

Arthritis

When I went to the emergency room for spinal pain considerably higher than 8 on a scale where 10 is highest, I was x-rayed. Arthritis in the neck and shoulders.

There are useful head rotation exercises I will tell you about.

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 Previously dislocated shoulder

Twenty years ago when I became unable to walk, I fell over my toes, hit the sofa and dislocated my shoulder. Several times my shoulder dislocated again not healing properly. Now stretching not only alleviates pain, stretching preserves my ability to dress myself. The following link to WPSU-FM tells the story. http://legacy.wpsu.org/radio/single_entry/LL-1756/

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My son-in-law former Marine Jade Phillips installed this pulley which I had purchased from Phoenix Rehab.

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Crawling as exercise

Therapists

1. Allicia J. Spence, Phoenix Rehab, State College, PA
2.  The physical and occupational therapists at HealthSouth, Pleasant Gap, PA.

October 27, 2015 HealthSouth Physical Rehabilitation Hospital, Pleasant Gap, PA. Occupational Therapist Megan Brown considers the problems involved with driving my mobility device into the bathroom.

Meanwhile:

Dancing helps

Isadora Duncan, co-founder [with Martha Graham] of the modern dance movement, demonstrates her belief that human beings should move freely and without restriction (such as ballet slippers.

You should see me dancing while sitting in my power operated scooter.

 —30–

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Footnotes

1. Joy of Motion [1] is essential for managing my pain
3. I am writing this because I believe the disabled and elderly should be encouraged to develop their talents, overcome obstacles, and be productive.
4. When I was born, Hodgkin’s, a cancer of the lymphatic system, was regarded as universally fatal. The linear accelerator which cured me in 1976 is regarded today as primitive. The radiologist who treated me was killed by exposure to his own machine.
5. For twenty years I have been a paraplegic as a consequence of radiation burning a hole in my spinal cord. Now the radiation caused devastation to my spine has produced pain beyond description–eclipsing the other sources of pain which are part of my daily life.
7. A nurse took a photograph of my back immediately after surgery. So skillfully did Dr. Winfree insert the test stimulator that on December 22nd upon examining my back, Geisginger internist Sepana Menali could find no surgical scar.

References

1. http://www.drugs.com/oxycodone.html
2. McGonigal, Phd. Yoga for Pain Relief [2009]. Oakland, CA. New Harbinger Publications, Inc.
3. Log onto
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This post copyright © 2016  by Joel Solkoff. All rights reserved.

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"I love  every movement/ There's nothing I would change/ She doesn't need improvement/ She's much to nice to re-arrange/"