Pain

I’m learning more about pain. Without going into detail I nursed a pain in my side that began in the fall, got worse in the winter, and became chronic this spring. I am just now coming out of it.

Nursed may not be the right word. Avoided, denied, ignored, feared the worst about, suffered might apply equally well. I did it fairly privately, sharing details mainly with my wife. She chided me for not acting in some way to address it, fix it, do something to actively change things around. Instead I did less and less.

Friends sometimes make good observations I don’t acknowledge. My friend Bill, who knew something of what I was going through, made this astute observation.

“The trouble with pain like that is the nagging fear that this might be the one that never goes away.”

That my pain was physical this winter is inconsequential. It just as well could have been emotional pain. The two are hardly distinguishable. Every conversation about one applies to the other.

I tried hard to ignore it, but that proved impossible. Had I known where it came from it may have been easier to deal with but there were any number of things that could have caused it and kept it alive. It was there, consistently, like one of those age spots that appear on your skin or a scar. A thing that became part of me, that was what this pain became. It was my constant companion.

At times it made me nauseous, stopped me from walking, from talking, drove all other thoughts from my mind. It was at its worst in the morning, when I was most likely to be alone. Maybe it was best I was alone. When pain takes over it is impossible to be a good friend even to those you love. Pain demands attention, and robs us of the ability to focus on anything else. Pain is a bully. It makes you do things you don’t want to do.

I have a new perspective on cranky old people, curmudgeons, and young people as well who appear stuck in an awful view of the world, all those who look around them and perceive the world at its worst. I think they are in pain and I think pain overwhelms them. I think they can feel little else, maybe nothing else.

After refusing to see a doctor for way too long I had a shitload of tests, costing thousands of dollars, which in the end were inconclusive. Rather than identifying the source of my pain they confirmed what was not causing it. That’s a futile exercise I think, ruling out what is not causing pain. How large is that universe, that set of things which do not cause us problems? What I wanted was a simple answer. I was especially hopeful when they suspected my gall bladder. I could imagine the conversation. It would no doubt have taken place over the phone, if not via e mail or text.

“Mr. McClure, your test results are in and they show a large number of stones in your gall bladder. It is enlarged and inflamed. The best course of action, we believe, is to remove it.”

“That’s great,” I would have replied. “What’s the earliest we can schedule the surgery?” Gall bladder removal these days is a breeze. Three small holes, probes like tiny blenders (I think of milk shake machines) which mush up the tissue, tubes that suck it out, and it’s over.

“How about Wednesday?”

“Wednesday is great.”

It would have been so sweet. The culprit, source of the pain, identified, the offending organ (not vital in any way) removed. Pain gone. Life returns to normal. Episode forgotten. It didn’t happen. The pain persisted and no one could explain why. I was starting to think they didn’t believe me.
One of the tests, by one of the additional doctors I sought out, did reveal a problem in my back. That was no surprise. My back has caused me pain off and on for years but nothing like this. A trip to a good chiropractor usually fixed me up for months, years even. The doctor in charge of this aspect of pouring over my body theorized that the pain in my side was being caused by this problem in my back, somehow connected, and if he numbed that area in my back it would go away.

“Have you done a good deal of physical labor in your life?”

“I baled hay and shelled corn for years when I was young.”

“Any incidents involving heavy lifting that you can remember which caused you particular back pain?”

“I picked up the front of my riding mower and put it on a concrete block to change a tire. Not my smartest move. I hitchhiked a lot in my mid-twenties. When cars or trucks stopped to pick me up I would run after them wearing a fifty pound backpack. I always thought that was harder on my knees than my back.” I have a bad right knee, an ankle messed up by a skiing accident, one leg shorter than the other, a build up on one shoe. All those things paled in comparison to the pain in my side. Funny how one concern drives away others.

“Well you are over sixty. It’s not unusual for men your age to experience spinal compression and accompanying problems.”

I had injections, something like a woman giving birth receives, an epidural. The pain in my back persisted. Theory dashed, he referred me to physical therapy. It was ironic I think, that the least expensive and most natural service came last.

At physical therapy I was lucky to meet Becky, a young physical therapist, extremely fit, who sized me up in a simple way; by what I could do. Lying on my back, she told me keep my knee straight, pick each leg up until I felt pain in my hamstring, and hold it. I did that, and my leg didn’t go up very far.

“Bend over and touch your toes.”

My fingertips went somewhere between my knees and my ankles, closer to my knees I’d say.

“Without bending forward or backward reach sideways down your leg as far as you can with your fingertips extended.”

That didn’t go very well. I could bend sideways farther on my right side than my left. The pain in my side lit up like a flare.

“Let’s try something simple. Stand up by the bar here. I’m going to put this band around your ankles. With your back straight and your knee locked I want you to pull the band forward, then to the side, then back. Keep your back straight.”

I could barely pull the band back at all without pain. Either leg.

“How am I doing?”

“You’re pretty tight and you’re not moving very well. Your hamstrings, your hip flexors especially. We’re going to have to do a lot of work on your core. Any idea how you got this way?”

“You mean how this happened? I retired, golfed more than usual, had some back pain. I’m not sure my chiropractor didn’t aggravate it some way.”

“No, I don’t mean that specifically. The particular event doesn’t really matter much now. I mean how did you get so tight? I bet at one time you had better muscle tone helping you support that back and rib cage. What have you been doing for exercise?”

“Nothing. It hurts to exercise. I’ve been writing all winter. I sit most all the time. It hurts when I stand. Hell, it hurts most when I lay flat.”

“Well, you’ve got to change that. We’ll help you.”

I went twice a week to therapy. Each time they started with a heat treatment, then massage, then various stretching and strengthening exercises. The staff were all very positive. Though simple and on the surface easy, each session wore me out. The first two weeks I would go home and immediately sleep. They increased the exercises, put me on a stationary bike and an arm bike. My therapist kept talking to me. I learned something at every session.

“Let’s talk about what else you’re doing, or have stopped doing.”

“I used to swim laps, but the rolling to one side, doing the crawl, extending my right arm and pulling against the water hurt my side. I got out of the habit.”

“Swimming could be major. Please try it again. Anything else you’ve stopped doing?”

“I haven’t played golf since last September. I can’t imagine putting that twist on my back.”

“It’s July. You’ve lost half the season. I think you could golf. You’ve got to suck that gut in. Your muscles, your abdominals, protect your bones and ligaments. Try a small bucket of balls, swing easy, see what happens. Who knows? Swinging easy could help your game. What else?”

“Well, in another life I used to do yoga. I’ve thought it could help. My wife swears by it and insists it would help me.”

”I think she’s right. You could do yoga too. Just don’t try to be a hero. Bail out of a pose when it hurts. You may not be ready for ‘plank’ for example. But there’s no reason you couldn’t do yoga. The truth is, you need to do more, move more, get more exercise. And as you age, you need to establish and keep those habits. I’m going to give you elastic bands to use at home for the exercises you do here. You’d be smart to get an exercise ball. In fact, you might sit on a ball when you write. Maybe not all day, but part of it.”

“I used to sit on a ball at work.”

“Sounds like you’ve changed your daily habits quite a bit. You may have to work through this pain. I think your pain may be totally or at least in large part a result of you being out of shape. Whatever eventually happens, you will only be helped by strengthening your body and getting in better physical condition.”

Why is it that when people with special knowledge and standing tell you things it means more than when those close to you say the same thing? I’d even told myself that. And who is closer to us than ourselves?

And so I began to confront my pain. I went back to the YMCA pool where the lifeguard said “Where you been? We missed you.”

I also signed up for gentle yoga at the Y. They offer it twice a week, on Tuesday and Thursday, opposite my physical therapy sessions on Monday and Wednesday. Soon after I happened to be at a dinner table opposite my oldest brother and brother in law, telling them I was taking yoga. They both, as if they’d practiced it, yet one looking out the corner of his eye at the other, like young kids in dance routine checking to see if they’re making the right move, closed their eyes, gazed upward, put their forefingers on their thumbs, and hummed. No one can tease you like family.

“Yeah, you guys think it’s funny,” I said, “but I’d like to see either of you do an hour of yoga with me. Yoga, even this gentle yoga I’m doing, would kick your butts.”

We talked about it some. Like many they don’t recognize yoga as true exercise because they equate workouts with being out of breath, only valid if they are aerobic. In yoga you move slowly and hold poses and stretches for prolonged periods of time. The idea is to breathe. If you can’t breathe during a Yoga pose you should stop. Yoga works out muscles, some you don’t know are there, and is ultimately very relaxing. It can be addicting. It has helped me a lot.

So here’s the concept that ended up working for me. You escape pain by getting help, confronting it, getting close to it, working on the edges of it, understanding it rather than fearing it. By admitting and confronting pain you have a chance at overcoming it. It’s starting to happen for me. Pain takes over my thoughts, displacing the good ones, much less, and much less often, than before. I’m able to do more. I’ve golfed twice without causing calamity in my body. I’m back to 5/8ths of a mile in the pool twice a week. And I’m doing both the exercises prescribed by my physical therapist and yoga. I’m getting better, starting to return to normal, or as close to normal as my 63 year old life worn body allows.

I got there with help. My wife primarily, but also the doctors, the physical therapist who was key, the YMCA, my patient yoga instructor. I think that’s how most people escape pain, with help from others. Emotional pain is much the same. We typically recognize emotional pain, addictions, or mental illness only when they result in big events-hospitalization, senseless crime, death, or suicide. Mental health, like our physical health, is rarely accomplished by us alone. I think there are times when each of us needs outside help achieve mental health. I can easily write 2,000 words on physical pain, where it is, what might be causing it, possible remedies, eventual cures. But emotional pain? Still fairly unacceptable to discuss. We suffer emotional pain, addiction, and mental illness privately and silently, fearing exposure of ourselves as weak. As you read this column did you blame me for my bad back and sore ribs? No. It was something that happened. So too with mental illness, but we have miles to go to make such parity a reality.

Of all the many opinions voiced and written about Robin Williams and his death one stood out for me. A Face Book post, connected hazily to conservative Christianity some days later, sought to remind us that in the end Robin Williams made a choice. It asserted his death was willful. As if he needed only to have a stronger faith. As if he was morally flawed.

I would say that Robin William’s choice was something like the choice made by a person atop a burning skyscraper. We witnessed that phenomenon when the World Trade Center was on fire and near collapse. People threw themselves to certain death off the roof and out the windows of the twin towers rather than being consumed by fire. It’s a choice, if you wish to call it one, between two horrible alternatives. Robin Williams died from withering emotional pain. I would no sooner place blame for his death on him than I would suggest an ALS victim was personally responsible for their death. He had received help but needed more. He died alone. Had he surrounded himself with others he may have lived. But he couldn’t stand the pain.

There are lessons to be learned from pain, but it’s a harsh teacher. One of the lessons is this; don’t go through pain by yourself. Seek advice and take it. Get help.