How do you handle pain in your life? I handle it with a bit of Ibuprofen, a bit of Tylenol, an occasional Norco and a lot of acceptance. On long hikes, I handle it with distraction. (Hiking naked is a great distraction. Gets the endorphins to really flow. YMMV.) There is so much to see, I don’t have time for the pain. I curse a lot when pulling weeds and lift heavy objects with care.

I still do things that hurt (in moderation). I have to. If you stop, starting up again is difficult. Cardiovascular fitness is lost, muscular strength declines. Stop long enough and you can’t start up again. You ossify in place. I may just look into yoga to stay flexible.

I have a weird version of collagen. A couple of decades ago a rheumatologist told me that because of this I would have serious osteoarthritis later in life. Well, now I’m in the early sixties and all those life goals I had of hiking long trails are in the trash along with much of my upper body strength, any kind of running, climbing or even unscrewing bottle caps. Makes working on the car or in the yard a genuine pain.

human-collagen-molecule

Still, I do what I can. There is a part of me that says, “My knees hurt and are badly swollen. And the base of my thumb is making that loud grinding sound. My back wants to spasm. The g-damn hip is acting up again. Oh well. Do what I can to mitigate and make the rest just background noise.”

This kind of pain is not unusual for the elderly. I don’t consider myself to be elderly. It does tear me up a bit to see people much older than myself trekking up and down mountains with greater ease than I walk on the level with. However, it is what it is and if I were to dwell in the past there would be no purpose to the present.

Painkiller Guidelines

FILE – This Feb. 19, 2013, file photo, shows OxyContin pills arranged for a photo at a pharmacy in Montpelier, Vt. Prescription painkillers should not be a first-choice for treating common ailments like back pain and arthritis, according to new federal guidelines designed to reshape how doctors prescribe drugs like OxyContin and Vicodin. Amid an epidemic of addiction and abuse tied to these powerful opioids drugs, the CDC is urging general doctors to try physical therapy, exercise and over-the-counter pain medications before turning to painkillers for chronic pain. (AP Photo/Toby Talbot, File)

There appear to be a lot of people who cannot accept significant pain. Something hurts and they want relief NOW. I believe this is part of the opioid “epidemic”, people getting prescription drugs without first going thru pain management. Something similar happens with psychological pain, so one in eight people is on some kind of antidepressant medication.

Is physical and psychological pain really that much more common than even ten years ago? Or have patients and doctors just taken the easy way out? I feel quite certain that if I whined enough I could get much more potent drugs. In the past, I’ve had codeine and Tylenol 3 in my medicine chest without even asking.

I suppose that, eventually, I’ll have the knees replaced. There are a couple of surgical ways to fix the thumb. Not bad enough to replace the hip – yet – but someday it will be there. But I know there will always be some pain in the joints that are not replaced. One needs to learn how to manage pain regardless of what other drugs and therapies are available.

The same principle applies to psychological pain. The point should be to attack the environmental factors so as to minimize the pain. Cognitive behavioral therapy and environmental modification should be the front line treatments, not psychopharmacology. Ah, but the drugs are quick and easy for both doctor and patient. Modern mass-produced, industrialized, and digitized “society” (whatever that is) insists on driving round pegs into square holes with drugs.  Having round holes for them to occupy would be inefficient.

I’ve been on Prozac for about 20 years now. When I started, I was literally a zombie. I feltprozac more energy and less pain but it did nothing to clear up the toxic environment. I know that just by asking I can get the doctor to up the dose. Instead, I plan to taper off.  I know I am probably more subject to depression than the average person due to genes but it took a bad environment to make depression a full-time occupation   The conditions that exacerbated the depression are now gone and I have developed both the knowledge and a philosophy to fight the Devil. (Only took six decades to get there.)

For that matter, suppose your child has a behavioral problem in class. Many psychiatrists give the kid pills as the first line of treatment. Didn’t try out behavioral approaches, didn’t suggest modifying the school environment. Maybe not even any therapy. And thereby create addiction and a ready on-campus black market in Ritalin and other amphetamines. Then, should you do research 51sxF+nJxbL._SX329_BO1,204,203,200_and discover schools are required by law to assist your child’s special needs, the school will resist you. You must say the magic words “Individualized Education Program” to the correct person or you’ll get no help. It is much cheaper for them to have your shrink hand out pills.

I understand that crippling pain requires serious painkillers.  Medicine should encourage us to deal with chronic pain psychologically in addition to handing out the opioids. The correct dosage of any drug is the minimum needed to restore functionality, not so much you can forget that you have damage. Go beyond that and you risk addiction. Go beyond that and you risk doing things to make it worse.

I give a bye to those with a terminal illness or extraordinary pain. People with extensive burn damage can be pumped full of morphine until it nearly kills them and it still doesn’t stop the pain. A simple dental procedure could be a trip to hell without anesthetics. A full blast migraine can shut you down completely.

There are people who have real problems. My knees hurt? Some people are missing their legs. Thumbs hurt? There are people who have lost the use of their thumbs.  There are people who have lost their hands entirely. Or their arms. How do they still enjoy life while others in far better shape let a bit of pain drive them crazy?

Maybe we have gotten too affluent for our own good. Perhaps we need to spend some time thinking about life without all the comforts and blessings of security and modernity.

The Art of Stoicism

2 thoughts on “Pain

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