Pain Fog: Living in spite of Chronic Pain
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Day 49. Tomorrow is Day 50!!

4/12/2015

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Tomorrow marks day fifty of my blog. My intention when I started the blog was it would be daily until the surgery date then weekly thereafter. We thought it would be about thirty daily posts, before I switched to weekly. Since my surgery isn't going to happen in April it has meant I continued. I will see where it goes from here, however I want to tell my readers a little bit about who else is reading.

To my surprise there are people reading from forty six different countries! Forty six! That has really kept me writing. Hello to China, Russia, Egypt, United States, Japan, Italy and to the other forty countries, I appreciate you being a part of my journey, and I sincerely hope you stay along for the ride.

Most of my blog visitors have come to me from those of you who have shared my link on Facebook. So thank you for doing that. You may not be in pain yourself but you never know who around you will benefit from the blog. So I am humbly asking if you would share this link today. Remember not all disabilities are visible so there maybe someone reading you page who could benefit.

We are very close to the one thousand reader mark and we thought it would be fun to try to reach it this week. We currently have 952 readers on a regular basis. She this week, share, share, share and let's see if we can reach one thousand. (Click on the Facebook or Twitter icon below to share).
With the physical limitations I have it is fun to be able to reach out to all of you through writing. Knowing I have all those people curious about what I have to say adds interest and responsibility to my day.
I want to thank those of you who have taken the time to leave comments, either privately or on the blog. Knowing you enjoy what I am writing and can learn from some of my experiences makes it very worthwhile.

Finally a positive attitude is more than just glossing everything over, we know that. Together we will stay positive while being real. I look forward to moving forward with all of you and hopefully some of your friends.
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Day 48. You gotta know when to walk away and know when to run‏.

4/11/2015

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I will start today with the most important things I look for in any practitioner. First I look for references from others, who have received effective treatment. What I consider to be another very important part of the relationship is the rapport between us. If I go to a practitioner and I do not feel comfortable or I feel as though they're rushing me or they're not listening to what I have to say, there is no second visit.One thing I know for sure after 20 years is that I'm in charge of my own health, and I look for a practitioner who feels the same way. The next thing I look for is someone with a very upbeat,positive approach. I don't go in there with s long face, whoa is me attitude, humor is a big bonus for me. Consequently, I have a physio and athletic therapist who make me laugh all the time. It's not that we can't have a serious conversation about my health, but it gets to be a bit of a drag dwelling on what's wrong all of the time. Dark humor has kept me going.

One of the things that I have used and continue to use as part of my treatment plan is chiropractic care. Somebody with a spinal cord injury, is generally not a good fit for chiropractic care. What I have learned, is chiropractors these days is various methods of treatment other than manual adjustments. Therefore I have gone to a chiropractor to receive ultrasound, electric muscle stimulation, cold Laser treatment and various other forms of chiropractic care.

Reiki and reflexology, I have found to be very relaxing, and almost meditative for me. While I like both of these treatments I have not found them to make a significant difference. To pain control. I would recommend trying them as they are certainly effective for some.

I feel like over the years I've probably taken every supplement and vitamin known to mankind, I'm not sure if any of that helped me, in any great way but I don't think it hurt me at all. What I would say about taking supplements and vitamins is to do so in the mindful way. I recommend trying one thing at a time and chart progress if you feel there is any.

Another form of treatment that fits both alternative treatment and the medical field is injections for pain. I have used both steroid Injections and natural injections to help with pain. I would have to say that I have found both to be very successful. I have had Cortisone shots in my shoulder, foot, hip and knee. While the injections are quite painful at the time of injection and shortly afterward, they are quite effective. They seem to last about six months.

A natural injection I have used for knee pain is called orthovisc, it can also go under the name of monovisc and synvisc. Here is what the companies who make the product say about it ;

"Orthovisc is one of the hyaluronates used in viscosupplementation. Orthovisc is injected directly into the knee joint to restore the cushioning and lubricating properties of normal joint fluid."

"Synvisc-one replaces the worn out synovial fluid to relieve the pain and improve the knee joint’s ability to act as a natural shock absorber."

This treatment has been excellent for me and I receive an injection as needed which is usually every six to eight months. I have to be inactive for about forty eight hours afterward because it is a little stiff and needs to be iced. I would say it is one of the easiest treatments I have, that has the longest affect.

That's the bulk of the methods I have used for pain control, with the exception of the olive oil detoxes and blue green algae treatments and things like that which I have tried but feel that part of my life was a phase when I didn't realize the importance of dissertation while looking for help.

I know there are many other forms of treatment out there that others have found successful, other than the ones I have spoken about in my six sessions on pain control. If you're reading for the first time you can find the others here.

Controlling pain is complicated. Different types of pain, require different methods of treatment, and everybody is different. There's much to be learned by other people, especially people who have been dealing with chronic pain for a long time. There is also a lot of different treatments today. What I would ask is that you go into this with an open mind, but don't leave your common sense out of the equation.

Desperation can make us try many different things with a hope of finding a successful treatment or cure. Once again I caution you to use your own good judgment and trust your instincts; if you feel something is working for you, and you truly feel better, but if you know that it isn't working,you need to let that go. If you try treatments and they don't work for you, don't beat your self up about it chalk it up to experience.

Finally, if a treatment doesn't work, especially after a practitioner has promised you it would, please don't let it affect your attitude toward your condition. Just because someone can't help you with the method they have tried, doesn't mean you can't be helped. It is easy to let their failure to help create despair. Remember, not all treatments help all people, give things a chance but know when to walk away.
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Day 47. Failure Before Success.

4/10/2015

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I will give brief descriptions here of some of the other treatments I have used, or continue to use. It is not a one size fits all kind of solution, when you have ongoing pain. What works for your friend or family member may not work for you. It may be that you need a different solution. You may also find that what works for you very well for a while, may not be as effective as time goes on. Being open to trying new things and not be too discouraged when they don't work are important factors.

Chronic pain and illness, takes a lot of trial and error. It can be exhausting and frustrating to find the right practitioner at the right time. What I ask is that you bring an open mind but also practice caution, if it is not working for you move on. In moving on, remember that although that method didn't work for you this time it may for somebody else, or for you in the future.

One of the simplest pieces of advice I received was to take magnesium. I remember at the time I was having pretty severe muscle cramping, mostly at night, and my physiotherapist recommended magnesium. I remember thinking magnesium is not going to work for me, she has no idea how bad these leg cramps are. During one of my visits to the rehab hospital, the doctor also suggested I take magnesium. He gave me the scientific proof that magnesium has been studied for muscle cramping and in some cases actually help you sleep better. It was what he said next that was my real motivator for taking the magnesium. He said if the magnesium didn't work that our next step would be injections of Botox into my legs on a regular basis. Suddenly the idea of taking magnesium sounded a whole lot better to me. I started taking it and it worked. Is not a perfect solution and it doesn't take the pain away but it does help relax the muscles. It is a lot easier and less invasive then injections of Botox.

That's just one example of how a closed mind can hurt you in cases where you're not willing to try something. I have to say I'm much more open-minded now. I'm willing to try just about anything. I'm a lot more intelligent and intuitive at finding out what is a good fit for me and what is not.

I feel frustrated by practitioners who won't be clear and honest with the patient. Most are so committed to their own way of doing things that they are not willing to see they can't help everyone with everything.

I went to many doctors before I found out I had a spinal cord injury. I was looking for a solution to the pain and its cause. Almost all of them were quite confident that they had the solution.

I remember one particularly disappointing encounter I had with a naturopath. At first he thought that I had an overgrowth of yeast and I went on the commonly used diet and took quite a number of supplements. With so much eliminated from my diet I did lose weight, therefore I felt better. But the only thing that changed about my pain was it actually had gotten worse. I went back for a follow up appointment and instead of saying I'm not sure what's happening here he proceeded to offer more supplements. He was so convinced that he would be able to cure me that I felt convinced. Moving along to a couple of months later none of the supplements made any difference at all to me and my pain was at an all-time high. The naturopath was clearly frustrated that there was no change in me. So the next line of attack was to ask me to go on another elimination diet. Thankfully shortly thereafter, the medical doctors found that there was a structural problem. I was diagnosed as an incomplete paraplegic with a spinal cord injury. There wasn't anything any doctor could give me to cure that situation. I did, however, go back to the naturopath because I felt it was important for him to know the outcome. I had followed all of his suggestions in the past, I thought I would get a much different response than I did. I was told that there wasn't anything further that he could do to help me and perhaps since I was in the

medical situation that they could help me. I certainly felt disillusioned, but it was an excellent lesson for me to learn; that is trust your gut. What I continue to know for sure is food was not the cause of my pain and I can eliminate anything I want to my diet and it was going to change the amount of pain I have. That's why I feel so frustrated when people connect serious medical situation to what people are eating. I eat a healthy, balanced diet and careful not to jump on any bandwagon with that latest food craze. If my pain was digestive I'm sure I would feel differently about it.

I do want to say here that I'm not speaking generally about naturopathic medicine, because I believe in it. I am speaking more specifically to my situation with this particular naturopath and that time. I have been to naturopaths, and they have been excellent. Let me just say though that I make it perfectly clear that when I am being treated for a condition by naturopath, or any other type of natural practitioner, that is a two way conversation. I will not go on indefinitely while they experiment with many different things. I'm willing to give it an honest effort if it makes sense to me.

Let me tell you a very different story about an naturopath. I met Diana about nine years ago. I went into see her and told her my condition. I was honest about my reservations about naturopaths. I'm not quite sure what she thought about me on her first visit together. I made it clear that I would not be giving up flour, sugar, salt, yeast etc. just to see how it affects me. I asked her to tell me what how she felt she could help me.We had the usual first consultation, and then set an appointment for the next visit. I was very surprised at our next visit that the very first solution she came up with was something I agreed with totally; Chinese acupuncture.

I had had experience with acupuncture in the past. Many of the physiotherapists had used it as part of their treatment with me. I told her that I found it somewhat helpful but it didn't last. She explained the difference between acupuncture used in Physio and acupuncture as used in Chinese medicine. I was going to give it a try. With an open mind, and a caution for knowing when to stop if it wasn't working. That day was the beginning of a very long term relationship. After my first visit, I was a little leery, but in my mind I had committed to at least four treatments before I made a decision. I continued once a week having acupuncture and began to like it more each time. Not only did I feel some pain relief, I felt a sense of well-being that I didn't experience with any other treatment. I'm not really sure when the meditative part of the acupuncture started but it certainly became a big part of my treatment. Diana inserted the needles, dimmed the lights and made sure I was comfortable. When she came back 20 to 25 minutes later she would find me in a complete relaxed state. Many times I went into her office not knowing that I was feeling high strung or stressed and I walked out of there relaxed and able to face the rehabilitation that I was going through.

My relationship with this naturopath is about 10 years right now. I continued with the acupuncture treatments for almost 9 years. She is a very skilled acupuncturist, as I have tried others and have never gotten the same result.

Obviously, we have developed relationship of trust and mutual respect. Over the years I've asked for her treatment for many things. Most of them have been very successful. I'm happy to say that while we discussed dietary options, she never suggested that I do any form of elimination diet.

There have been times over the years when a medical doctor has not been able to solve a problem but my naturopath has. I'll give you one example, my daughter had a tremendous rash it was all over her chest and was creeping up her neck, about to reach her face. We went to our

family doctor and he knew exactly what it was but there was no cure for it. I brought her to the naturopath and with a series of treatments it was completely clear in a week. We were told by our medical doctor the previous week that the rash could last up to three months. She was in grade 3 at the time, you can imagine her embarrassment . She was eternally grateful for the treatment she received and so was I. So I'm not saying medical doctors know everythIng; I am saying I like the term complementary medicine. I feel it's very important to look at all aspects of the self when you're treating a condition. I always talk to my doctor about any other form of treatment. He doesn't always agree but we have intelligent conversation about it. He has seen the benefit of acupuncture through my experience and we learn from each other.

This is a tough subject. I think it's unfair for anybody to say that they can categorically cure somebody if there is no cure for the diagnosis. Number one is buyer beware, even if it's your insurance money be careful that you're not being taken advantage of. We must take full responsibility for our health, and that usually means educating yourself about your disease or condition, without obsessing about it. Choose your practitioners carefully, go in with an open mind, but always remember that trust and respect must be mutual.

So let's talk about some of the other crazy stuff I've tried along the way in my next post.
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Day 46. Athletic Therapy for Non-athletes.

4/9/2015

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Today I am going for one of my newest and most successful forms of treatment. It is called Athletic Therapy. I started this about two years ago, quite by accident. Our local yoga studio offers many forms of care and several professionals have their practice there. I had been seeing a massage therapist there for some time. She recently moved her practice and I saw someone else had taken her place at the studio. I made an appointment and off I went for an assessment and "massage."

I was surprised to find a very new practice to me. James, is in fact a massage therapist, but he is also an Athletic Therapist who is also currently learning Osteopathy as well. After our assessment he felt I could most benefit from Athletic Therapy at that time. I must admit, at first I was a little disappointed. I was expecting soft music aroma therapy and a relaxing massage.....now I was having a treatment!

I need not have been disappointed. The therapy I experienced, having spent years in physio, was nothing like I expected. It is a gentle treatment done while you are fully clothed and it is very effective.

The reason I was seeing him that day was nerve pain down my arm with pins and needles into my hand. I had awoken two days in a row with no feeling in my right hand. I couldn't raise my arm over my head and my shoulder and neck were hurting nonstop. When I left that day, I wasn't pain free but the nerve pain and numbness were completely gone. It took about four treatments and the issue had settled once again. James uses ultrasound and EMS machine as well.

If you are interested in knowing more about EMS(electric muscle stimulation) and TENS (Transcutaneous electrical nerve stimulation) this is an excellent site to explain the differences and what they are used for.

Generally TENS is to relieve pain and a TENS machine can be purchased easily now, as it has become more mainstream and therefore can be used at home. EMS is more of a rehabilitation tool and mostly used by professionals, but with instruction, can also be used at home. I have both and have been taught to use them at home.

Ultrasound uses sound waves to generate heat in the area being treated. That heat then loosens the muscle tissue making it more pliable for stretching and treatment. It also helps create blood flow and lesson swelling and inflammation. I have found it to be helpful in many cases, including foot, shoulder and knees.

I have since seen him for my arthritic foot and knee. James knows my overall condition and we have dabbled in pain management for my back as well.

The Canadian Athlete Association describes the therapy like this: "Certified Athletic Therapists specialize in treating acute and chronic injuries to muscles, bones, and joints.

Best known for providing immediate on-field emergency care of professional and elite athletes, Athletic Therapists are skilled in returning athletes to competition and maximizing their performance potential as fast as possible after an injury. Those same skills and techniques also make them very effective in treating the injuries sustained by everyday active Canadians, including:
  • Common injuries from falls, daily activities and sports
  • Chronic and recurring conditions, pre-surgery and post-surgery
  • Emergencies at sporting events such as concussion, fractures, and spinal injuries
  • Workplace and motor vehicle accidents
Athletic Therapists rehabilitate injuries using the Sports Medicine Model, resulting in a faster recovery, a decreased chance of further injury, and fewer visits to a healthcare professional.
Certified Athletic Therapists are recognized by the credential CAT(C)."

In a word I describe it as relief, and relief without the usual pain. James has never hurt me during a treatment. When I can, I generally come home, have an epson salts bath and lie down for a short time afterward. I try to incorporate this aftercare into any treatment I have whether it is physio, acupuncture or massage. It seems to increase the effectiveness of the treatment. That is what I find most effective but it is possible to go about your day or even back to work if needed.
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Day 45. Alternative Pain Control. 

4/8/2015

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Today I want to talk about alternative treatments to pain management. In a previous post I discussed pain management under a doctor's care. 

In the last twenty years I have tried just about everything, at least once. When you are first experiencing pain there is a period of time when you want to try absolutely everything that is out there.  I think most people go through this phase. If you are lucky, you won't go broke trying it all out, and you may even find something that works.

I will caution you. If you see a practitioner of any kind, who says they can 100% "fix" you, I would walk away. Chronic pain has been around a long time and if they had the absolute cure for it we would all know about it. When you're desperate you will try anything, so perhaps talk it over with a trusted friend or family member, for that sober second thought.

Here are some of the treatments and products I have used.

I have talked about pain control through mindfulness and meditation in previous posts as well as pain control through medication.

I will break this next section down into three parts. Today I am suggesting most of the "at home" hands on approaches to chronic pain.

(1) Heat and Ice
The first thing to try when you are dealing with pain of any kind is the most simple cost free approach of heat and ice. Generally what is recommended is fifteen minutes of ice then fifteen minutes of heat. There are occasions when heat and ice are not appropriate for pain relief, you must know what you are treating so check with a physio, doctor or pharmacist first. I have used hot water bottles for the heat source but now that there are auto-shut-off heating pads, thats usually what I use. I do however have the microwave magic bags that are flexible and work great on the neck and upper back. These types of bags are also great for the freezer. For ice, I use ice packs or bags of frozen peas. Never put it directly on the skin because it can cause skin damage.

(2) Creams, Rubs and Patches
Creams, rubs and patches are still my go to approach when I want some immediate relief. They come in many different names and there are several different formulas.  

The active ingredients in over-the-counter topical pain medications may include: Counterirritants, Substances such as menthol and camphor produce a sensation of hot or cold that may temporarily override your ability to feel your arthritis pain. Examples include Icy Hot and Biofreeze.

Capsaicin causes the burning sensation you associate with chili peppers. Capsaicin creams deplete your nerve cells of a chemical that's important for sending pain messages. Examples include Capzasin and Zostrix.

Salicylates, contain the pain-relieving substance found in aspirin. Examples include Aspercreme and Bengay.

Voltarin gel belongs to the class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). It works by reducing pain, swelling, and inflammation.

Natural pain relieving creams I have tried are Arnica, trameel and LivReleif.

I have tried them all extensively and I have found relief with most, however the most effective has been Voltatin for joint and muscle pain and Zostrix for nerve pain. I would ask you to talk to your doctor and or pharmacist before using any of these because it may not be the best solution for you.

(3) Epson Salt Baths
Epson salt baths are another standard practice for me. The heat of the water is soothing and helps with joint pain. According tho the Espon salt council, here is how it works: "Magnesium is a primary component of Epsom salt. It is a mineral that the body needs and, unlike other minerals, is absorbed through the skin as you soak in the bath. The mineral helps relax skeletal muscles by flushing lactic acid buildup in the muscles, which may occur during physical exertion, such as a vigorous workout. Magnesium also plays an important role in the absorption of vitamins in the body. It also helps regulate muscle and nerve function. All of these effects significantly influence muscle soreness, which also affects muscle stiffness."

I use heat and ice to help on a regular basis and bathe daily in an Epson salt bath. I always have voltarin and Zostrix cream nearby and use it frequently. It is important not to rely on one method of pain relief because it seems as though there is not one thing that works one hundred percent of the time. These are tools I use in addition to medication, meditation and so much more. I will discuss other methods in tomorrow's post.
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Day 44. Rain Must Fall.

4/7/2015

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When spring arrives the sun seems hotter, the snow seems dirtier and the pavement seems sandier. That is until the rain comes. The harder the rain, the faster the real beauty of spring can peek through. It is only then we can see the colours of new growth, budding flowers and bright blue skies replace the dullness.

That's how I look at the process of chronic pain. You live in the drudgery of it for so long, then there's a diagnoses which gives a glimmer of light. That light can't be fully exposed until the rains come. The rain is the surgery, procedure or treatment followed by the hard work of recovery. At the end of all of that is the reward, but you have to deal with the dirt, mud and everything in between to get there.

Summer is on its way, literally and figuratively in my life. I'm not looking forward to the rainy part but I know it is necessary.

"Into each life some rain must fall." - H.W. Longfellow.

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Day 31. The Unknown.

3/25/2015

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It has been a month since I saw my neurosurgeon and was given the news that another spinal surgery was necessary. I wasn't surprised that something serious was wrong, I had been down this path before. I was shocked however by the extent at which they would have to go to fix the problem.

This wasn't a planned surgery so I am being fit into an already full schedule. That is where the unknown comes from. I have to wait until it all works out to know when the surgery will be. It has made it very difficult to plan. It's been hard enough getting used to the idea of another surgery but the unknown has made it worse.

Another unknown is how long the recovery will be. It is said to be three to six months for this type of surgery, however with a pre-existing spinal cord injury it is not easy to judge. The spinal cord loses resiliency we are told, the more times there is surgery on those of us with injury. It doesn't mean it will not recover, it means there is no clear path.

I was told to prepare for rehabilitation in an inpatient centre in Toronto. It is not a definite, and once again there is no way to tell for how long. We are also uncertain about the areas of the body that will be affected. Will it include the legs, back, bowel, bladder? We are unsure.

To add to the mix of uncertainty we are unsure of where our girls will be when this happens. Meghan, having finished her university year, has applied to jobs in her field in Guelph, Toronto and here. Jerri is applying for graduate schools and jobs in Toronto and abroad.

Given some timelines, Barry may be able to work in Toronto while I recover, but without dates, he's at a loss.

What we do know is very little and much is out of our control. It is a lesson in life, we think we control a lot, but in fact very little is in our control.

I'm very happy I have started meditation and mindfulness because it has helped with the lack of control, and impatience I'm feeling.

What I know for sure is I have a great doctor, in a great hospital and if I need rehab it will be in a first class rehab centre. But I still wish I knew more.
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    Maureen Clout

    I'm going in for a 4th neurosurgery; this time it's a repair to my lumbar fusion. Here, I will post my daily updates on dealing with diagnosis, surgery and recovery. Join me on my journey.

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