chronic pain

Living with Uncertainty

For a good portion of my life, I blithely went along thinking I could plan my day, my week, my next summer vacation, with certainty. And in the course of one hour, that assumption was blown away when my husband was diagnosed with a life-threatening illness.

At some level, we all know that substantive disruptions in our lives are possible in every moment, but I was certainly unprepared for mine. During the 8 months my husband was alive after that diagnosis, my planning horizon and my certainty about what the next moment might bring got really short. Sometimes I could plan the next hour; sometimes not. It felt like a wild and slightly crazy dance where I could rarely get my balance.

Barely three years later I faced my own life-threatening illness, and the crazy unbalanced dance began again. My life today is more stable than when I was diagnosed and going through treatment, but I still find myself wanting to recapture that old feeling – that my life can be orderly and predictable.

I have spent a good portion of the past 16 years learning to do the dance of uncertainty with light feet and with a regular warning to myself – sometimes successful, sometimes not – that the dance floor could tilt at any moment. I have found the techniques of mind-body medicine and yoga incredibly useful at reminding me to embrace what is here now, rather than wanting something else for tomorrow. Anything that connects me with my breath usually helps. Still, I notice how easy it is for me to forget and to assume that my life is stable and change is somewhere in the future.

In the past few weeks I have been reminded a number of times that change is more the norm than I would like to think. Why is this lesson so hard to learn? I feel the seduction of wanting stability, of deluding myself during times when my health seems predictable. I would not have chosen the circumstances of my husband's illness nor my own. But I often think that these challenges have been – and continue to be – my greatest teacher.

What I have is now.

Here.

This breath.

This moment.

 

More about yoga for chronic pain

My last blog post generated questions about the chronic pain video that was attached. What kind of yoga did Linda do? How much did she practice? Here is some context for her remarkable story.

Linda has been a yoga student in one of my weekly classes for quite a number of years. As she describes in the video, she arrived in pain and usually felt better when she left – the pain was eased physically and she was also more relaxed. The benefit, however, was not sustained, and she was plagued by chronic pain in multiple joints as well as neck and spine pain. This led her to be concerned about her condition as well as fatigued from managing her life with pain as a constant companion.

In the summer of 2012, I challenged the students in one of my classes to start a brief (and I really mean brief) daily home practice. I created what we affectionately called the "10-Minute Practice" because I assured them they could do it in 10 minutes or less. I created a stick-figure diagram with breathing instructions so they would have a guide to practice with at home and we reviewed it in class. It has 3 postures! A video version is below.

A number of students began to practice it daily and Linda was among them. She noticed that it helped diminish her morning stiffness and it also helped her feel centered to start her day. Interestingly, within a couple of months Linda decided to go on a diet, something she had not been considering previously. Over the next 20 weeks, she lost 25 pounds and she has kept them off ever since! The combination of daily yoga practice and weight loss seems to have markedly changed Linda's pain.

As Linda and I were talking about this blog, we both wondered if it was her daily yoga practice that created the right environment for her to embark on her diet. Her successful discipline in doing this 10-Minute Practice helped build her will and remind her that she could take on and follow through with new activities for self-care!

Living with Pain: Lessons Learned the Hard Way

Pain has been my regular companion for most of the past 12 years and for the past few days it has been pretty noisy. It continues to require both my energy and focus to establish and re-establish a sense of well-being as pain makes me tired and worn out and distracts both my thoughts and emotions. Perhaps you know the feeling.

There are a number of things that I know to be true for me:
-- First, there is the source of pain (the particulars in my body).
-- Second, there is my reaction to the pain.

The source of the pain might be known -- an injury, a surgical incision, a mouth sore (my current issue) -- or it might not be. As part of the normal physical response to pain, other parts of the body are activated -- muscles tense to guard and protect against further aggravation, complex nerve signals are triggered from the brain.

Sometimes I am able to change the pain -- either diminishing it or completely eliminating it. At other times, I cannot do anything about the pain. I should add that there is definitely a role for drugs in pain management. The worse the pain gets, the harder it is to manage it. So I have learned when it is time for me to haul out the pharmaceuticals. I know where that threshold is for me. Do you know where yours is?

Even if I cannot change the pain itself, I can almost always change my reaction to it. That reaction is characterized by fear (How long is this going to last? What does it mean?), anxiety (Will I be able to sleep? Can I work today? Is it time for drugs?), self-pity (This is not going away. Poor me!), and a deep sense of denial/rejection -- not wanting this pain in my body, wanting things to be different. When I change how I respond, I can often relieve the secondary physical symptoms and almost always ease both my emotional and mental state.

There are many techniques for managing your reaction to your pain. My impulse is mostly to reject it, ignore it, or want the pain to be different. For me, the place to start is to look straight at what is happening now -- the physical sensation, the emotions, and the things I am saying to myself. What helps me most is practicing -- really practicing! -- wanting what is present in any moment. That trains me not to direct my energy at rejecting the current reality, and it also prepares me to face the more challenging difficulties in my life. This kind of practice can and should occur even when there is no pain present, and we can all benefit. There is no way to avoid pain in this life.

Below is one woman's story of how yoga helped her with chronic, debilitating pain.

In addition to yoga, I have also found mindfulness-based meditation, systematic body scans, and guided imagery extremely helpful. If the pain is severe and compelling, I have a small library of MP3 files I can call upon: When it is just too hard to wade up thru the haze of pain and to focus, another voice can really help.

What techniques have you tried? What didn't work? What does? What have you learned?