Chronic: Pain We Don’t See, Chapter 3

Chapter 3: It Began Early 

Sunday: March 8, 2020 

Experts say there is a link between pain and depression. Sometimes it is hard to determine which came first. Just as there are different types of pain and causes for it, there are different types of depression and their causes can also vary. Not only is it important to identify the type of pain and depression you suffer from, it is just as important to understand the triggers for both. I am beginning to understand this better and the past week has been a good example. 

On the pain front, I know I have always felt physical pain in the form of an overall achiness since I was a child. As I got older, the best way to describe it was as if I had a headache-like feeling all over my body. Everything just ached. I’d feel it most in my back, hips and legs which much later I would attribute to carrying tension from either anxiety or trying to hide being depressed. It was exhausting. I always hurt most at the end of the day and do not recall waking the next morning with it. With sleep came relief. 

I loved sports and any chance I got to play was medicine for my brain. If no one was around to play a game, my active imagination allowed me to play by myself in my backyard. I found more ways to play football, baseball, basketball, soccer, and hockey by myself than you can imagine. Despite my often aching body, I’d drive my older brother, Chuck, who I shared a bedroom with, crazy at night playing an imaginary game of football on my bed. I’d run back and forth until I used up all my energy before calling it a day. 

By the time I was in second grade, I was playing little league baseball. I also played organized basketball. There were always neighborhood football games in the fall, but the sport I took to the most was soccer. I would continue playing it up through my first year of college. 

I also had a knack for injuries and over the years I accrued my share of them. When an ankle injury ended my soccer playing, I turned to running. 

Running allowed me the best of everything. It brought me peace of mind and cleared my head as I chalked up mile after mile training by myself. It released the feel good chemicals I desperately needed to help ward off bouts of depression and it gave me a much desired outlet for competition. I became an excellent runner and am proud of the PR’s (Personal Records) I worked tirelessly to achieve. Not many know just how great it feels to be running in a road race with a motorcycle escort leading the way as traffic is stopped for you while you lead a pack of runners and win a race. 

While my 20’s were spent chasing PR’s, my 30’s were spent trying to balance marriage, fatherhood, and work with my failed attempts at more PR’s. My 40’s ended with me nearly dead from a bicycle accident and unable to run as a result. It would take me ten years before I was able to find a way to run again. In between, I tried to get my fix from long bike rides, but in my mind, a day never passed without me thinking about going for a run. 

Since turning 30, I have had one ankle surgery, both knees scoped once, four shoulder surgeries (both twice), and one low back surgery. With these surgeries comes a degree of arthritis that is to be expected and I have learned to distinguish between an aching joint or joints and the overall achiness I felt as a child. 

I have also been fortunate enough to survive a bicycle accident that normally would have killed most people or left them confined to a wheelchair. At least this is what doctors and physical therapists told me. With survival came an entirely different sort of pain that comes from the numerous injuries suffered. Today, I have, among other things, bilateral herniated disks in each of my seven neck vertebrae (14), and one more internal herniation that pinches on my spinal cord from time to time. I also have severe stenosis in the spine as well as at all the points my nerves exit the neck and run down my arms. 

My strength in my arms has disappeared the last three years while a new type of pain has set in. At its worst, there are days my arms feel as if they are being ripped out of my shoulders and elbows, the nerves are on fire, and I feel as if I am being stabbed by little knives. Vicodin and muscle relaxants become a necessity, but too often, they do little for my pain. There also are the headaches in the back of my head that last for months at a time, the ringing in my ears that wakes me at night, and the extreme fatigue that comes from the energy expended from combating all this day after day. 

Then there is the depression. For me, the worst is the chemical imbalance I have lacked since day one. I have gotten better at combating situational depression and Seasonal Affect Disorder over the last few years, but I have relied on an antidepressant since 2014 to keep my head cleared of the constant fog I used to live with. Unfortunately, the Cymbalta that has worked so well since 2014 is no longer cutting it. 

In January, I began seeing a new therapist to see if talk therapy would do the trick, but even she seems to feel my current depression is due to a chemical imbalance. This is what has led me to try TMS, Transcranial Magnetic Stimulation. It is not easy finding an antidepressant that works. I have tried three others without much luck and it scares the shit out of me to think of what might happen if I can’t find a new one. As the psychiatrist explained last week, TMS will improve how well my antidepressant works. It may even result in not needing it any more and can also help with reducing my level of pain. 

Until yesterday, I enjoyed five days of pain free life. It is amazing how quick you can get back to enjoying day to day activities when pain is not interfering with life. My fatigue levels lightened, I slept through the night, and for a short time, I felt what I thought my life would feel like at my age. 

Since returning to running, I have been frustrated over just how difficult it is for me to enjoy two runs a week in the park down the street. Last month, I began an experiment and started running on an old treadmill my neighbor gave me. I found I not only can run on it every day, I can do it at a level I have not enjoyed since my pre surgical days. In just four weeks, I have gone from two struggling runs a week on grass or dirt to daily runs ranging from 40 to 80 minutes in length. My knees ache less. My hips no longer hurt. My pelvis remains aligned. Best of all, when I finish a run, I feel more at peace, much like I did when as a kid, I would ask my teacher if I could go run laps. 

Despite the terrible pain I felt yesterday, I woke this morning with a sense of hope. I am able to read my body better than ever. I can distinguish between moods and aches, recognize their triggers, and manage them in ways that work more often than they fail. Life is a constant learning experience. Yesterday’s lesson is over and a new one awaits me today. It’s always nice to look forward to what it is. 

Wednesday: March 11, 2020 

I gave up on sleeping tonight and am getting an early start to day six of my latest flare up. I am miserable. There is no distracting me from my pain and when I try to sleep, I cannot get into any position that brings me comfort. The throbbing in the back of my skull mixed with the stabbing pain down my spine made it impossible for me to support my head while watching TV last night. Laying on either side causes my shoulders to irritate the nerves that run through them. If I try to lie on my back then my arms begin to burn with nerve pain while my fingers become stiff to the point bending or straightening them is a painful task. 

I thought I found relief yesterday when I got a massage, but it was just temporary. By the time dinner rolled around, I was on my second dose of doubling up on Vicodin chased with a muscle relaxant. This is where people get into dangerous territory and I do not want to become one of the many we read about. I knew if I had a glass or two of the wine in our fridge, I’d fall into another world. However, like doubling up in Vicodin, it will only provide a temporary respite from the pain and lead to greater abuse. 

I am pinning my hopes that my chiropractor can give me some relief today and if he can’t, then I have to pray my acupuncture session on Friday does the trick. Until then, I have to ride out this storm of misery and remind myself of the progress I have made. However, if I don’t get a break from this pain soon, my progress will have been nothing more than a mirage. 

Tuesday: March 17, 2020 

In the past week, the focus of everyone, myself included, has been on the severity of Coronavirus, or COVID-19. Our lives have come to a halt. People have resorted to hoarding food and toilet paper while pretty much everything has shut down with the hope of slowing the rate of spreading the virus. Strangely, my life has changed very little. 

Since I have basically been home bound since late November, I am not feeling the impact of isolation others feel. My life has not changed much from what was already a pretty boring existence. I rise early, often because of my pain. I make sure I head out to the garage and get in a workout, most of which involves running on my new treadmill. I do chores, go on line, and hang out with my five dogs. 

This virus has limited how often I go out in public. I shopped for groceries in a nearly empty store on Sunday and that was it. My acupuncturist has informed me this Friday will be my last session with her until things blow over. She is almost four months pregnant and can’t put herself at risk of exposure. I expect my therapist will be contacting me soon to tell me she will not be meeting face to face with clients for the time being. I also won’t be surprised if I hear the same from my chiropractor. 

However, one thing that is still a go is my starting TMS treatment tomorrow. I am surprised it is still on and as I write this I know it could be cancelled tomorrow morning. When I spoke with the clinic last Friday, I was told it should not be a problem. However, with the speed in which this virus is spreading, the last thing I want is to begin the five week treatment program and have to halt it part way through. 

Thirty-eight co-pays at $35.00 a session is a big expense and I do not want to get part way through it only to have to start all over again because the clinic gets shut down or I test positive and have to be quarantined. There are more important things right now than me beginning TMS.