The Pain Drain
Not long ago I was editing a photo I’d taken of one of my drawings, preparing to post it to Twitter and my new art/portfolio blog, Wren Makes Art. Suddenly, an involuntary, sharp, frowning “uuuh!” came out of me. I lifted my fingers off the keyboard, tipped my head back, and closed my eyes.
Then I took a new breath, opened my eyes, and started to work again, like I always do. But this time, I noticed what I’d just done. I stopped to think about it. And I wondered: what just happened here? Because at first, I didn’t know.
Trying to understand pain
OK, I thought, I’m tired. Fine. So what’s new? I quieted myself and waited. In the moments that followed, I realized that my metacarpal joints (the knuckles closest to the palm) on my left hand were aching dully, throbbing along with my heartbeat. Two of them were actually pinging with a small, sharp, repeating pain. And moments after that, I realized that the knuckles on my right hand ached, too.
Understanding dawned. That sudden, unexpected, frustrated sigh was, I think, an involuntary and unconscious effort to expel my pain; to blow it out; maybe to blow it away. My subconscious mind was trying to cope with that pain even as the rest of it edited the photo.
And what was that “I’m tired” thing all about? It was 10:30 a.m.! OK, I’d been up since dawn, but I’d slept fairly well during the night and the morning had been a gentle one: coffee, toast, armchair email, and headline-reading. So why was I “tired?” What was “tired?”
Perhaps, because at that particular moment my defenses were down, it was an honest acknowledgement of what the pain in my hands was doing to me. More, it was a near-subconscious acknowledgement that this pain would probably accompany everything I did for the rest of the day. No, it wasn’t terrible pain. It hadn’t--and wouldn’t--keep me from doing the things I needed or wanted to do. But it was still always there in the background, sucking tenaciously away at my energy reserves. It wasn’t even noon yet, but I was already feeling the loss.
This was a small revelation for me. I’ve always known that pain is tiring, but that knowledge always came framed around the word PAIN in capital letters. You know--real pain. “Moderate-to-severe” pain, as described in the medical texts. I’d never really considered that mild pain might be just the same, except more sneaky.
But it is. Whether it’s big or small, pain eats away at our ability to cope and carry on with our lives. I believe that we manage to ignore mild, and even moderate, pain some or even most of the time. We do it because we can’t put life on hold just because we hurt. If we keep on keeping on, we distract ourselves from our pain and force it down into our subconscious mind.
And there it continues to exist, nibbling hungrily at our energy reserves. At some point during the day, though, we notice the energy loss.
For me, it’s a sort of odd, drained feeling that seems to have no identifiable cause. It makes me feel weak and wimpy--or worse, like it’s not real. Why should I be tired? Look at everyone bustling around. They aren’t tired out already! Obviously, my fatigue is imaginary. It’s all in my head.
It’s not, though. Pain--even the mild type--simply tires us out as we strive to ignore it and get on with our lives. That fatigue can be hard to push through. It’s like walking through knee-deep mud.
I’ve learned a few techniques to help me cope better with pain-related fatigue. First, I take time to treat the pain itself, once I identify it. Sometimes an over-the-counter pain reliever will be enough to knock back mild pain and allow me to renew my reserves. If the pain is more intense or insistent, I might take a stronger, prescription-only type. An important note: If you’re in frequent pain, as many of us who live with RD are, it’s a good idea to take pain meds on their recommended or prescribed schedule whether you hurt a lot or not. The idea is to stay ahead of the pain, rather than attempt to treat it after it’s become bad enough to distract, impair, and overwhelm you.
I also try to take frequent breaks during the day to give my mind, my body, and my hands, which are by far the most affected by my RD these days, a rest. These aren’t long breaks--just five or ten minutes every hour or so.
While I rest, I might use an ice or heat pack on my hands. Sometimes, that’s enough to temporarily ease my pain.
Since I work at home, I also try to take a nap. Like most people, I tend to get drowsy around mid-afternoon. This has nothing to do with whether I got a good night’s sleep; it happens to me and to everyone because our instinctual circadian rhythm tells us it’s time to take a rest. And man, it’s hard to say no to Mother Nature. So, instead of fighting it like I did when I worked at an office for an employer, I indulge the instinct. Not for long, mind you. Most days, a 20-minute nap is enough to refresh and renew me. When my pain levels are higher, I might nap for longer, but I’ve found that if I nap for more than an hour, I wake up foggy and disoriented. For me, shorter naps work better.
Napping isn’t laziness. Instead, it acknowledges that I live with a chronic disease that causes frequent pain and saps my energy. I’m more efficient overall when I allow myself to rest as I’ve described above--and I’ve noticed that when I stick to it--make it a habit--I not only have fewer flares, I can cope better with those I do.
I finished editing my photo that day after forcing myself to stop and rest for a while. My hands still ached, but like a cell phone charged for 10 minutes, I’d added to my ebbing reserves. It just makes sense, doesn’t it?
On a scale of 1(low) to 5(high), how difficult is it for you to talk about having RA?