Friday, November 28, 2008

Pain Expectations

I've heard this line in a number of movies where somebody is going through trauma or tragedy. "Life isn't supposed to be this hard." Or "Love isn't supposed to hurt this much."

That would make me think, "What's the point of saying that?" You're just telling her she should feel lousy about what she's going through and how she's feeling about it. Wouldn't it be easier to think that actually, everyone has a tough life and everyone feels the pain? That's just how life is and there's nothing special about you. You don't have to feel like the universe has targeted you. You don't have to feel like a victim or martyr because that's not going to improve your situation anyway.

I feel the same about my cancer pains - the physical pain, I mean. It hurts a bit. Except I don't know if this would be considered "a bit" or "a lot". Is it supposed to hurt this much? If yes, then I'll just shut up and take it. If not, I might complain about it. If I do the former, I keep my pain to myself and don't become a nuisance to people around me with my whining and complaining. If I do the latter, I don't lessen the pain; I just increase the annoyance factor for anyone within hearing range.

If I think it's supposed to feel like this, then I get on with it instead of dwelling on it. Everyone with cancer has pain. I have cancer; I have pain. Of course, I take the pain medication and that helps a lot, but it doesn't get rid of all pain. At least it's not disabling or crippling pain.

I used to think I had a high tolerance for pain. Then I had babies. For the most part, I managed pretty well but we had to call in the epidural in the end for other reasons. But the timing of the epidural was off and I felt the contractions anyway. Now that's pain!

No woman giving birth does the "Woe is me, I'm suffering so much pain, you just can't understand what I'm going through" sob story because she's not special. Every woman who gives birth feels this pain. It's universal. There's no sympathy from the galleries. We don't tell them, "Giving birth isn't supposed to be this hard; it's not supposed to hurt this much." We tell them, "Pushing out a baby hurts like hell so expect it, prepare for it, and don't expect a prize for going through it because you're just like millions of other women who do the same thing every year." Have you ever heard anybody say to a woman who's just given birth, "Oh, poor you. That must have really hurt!"

So maybe it's the same with cancer. Expect the pain. Prepare for it. Don't expect any prizes. Suck it up and maybe it'll seem normal and less painful. And if that doesn't work... pass the morphine!

23 comments:

Ronnie Ng said...

Shin,

i'm reminded of the "Kubler-Ross model", which you covered in one of your previous posts...

when someone says, "Life isn't supposed to be this hard" or "Love isn't supposed to hurt this much", it's a form of denial & anger, which then leads to bargaining, depression and finally, acceptance...

In pretty much the same way you dealt with the reality of cancer, you decided to get on with this thing about pain, & jump straight into the stage of "acceptance" :)

Stay strong. ^^

<*ANGEL*> said...

Well, I used to think I had very low tolerance for pain... until I had children.

I went into labour for 12 hours and my cervix only expanded by 3 cm. My son's head was too big and so the doctor had to cut me up to help him out.

For me, childbirth is passing out and waking only to see the beautiful baby. No pain of pushing baby out at all.

And then the few days after, there was this uncomfortable feeling in my stomach. My doctor said most people need painkillers but I did not take them. My confinement lady told me most C-section mothers stay in bed due to the pain, but I was walking all over the place by day two.

In Chinese history, there is a story of how a general was hurt and had to undergo a "surgery". But as he was concentrating on his game of chess, he felt no pain at all.

The pain is, of course, real, especially when it is physical. But I guess the extent to which we feel it is proportional to the extent we focus on it.

Anonymous said...

Hi Shin,

Have you ever read
http://www.prayfordavid.blogspot.com/

He is David Ong and the author of "Talking The Walk".

He was diagnosed with Stage 3A multiple myeloma. (Salmon Durie Staging)

Shin, you're always in my mind.

Shin said...

Anonymous,

I had a quick look at David Ong's site. If you have read past posts on my blog, you'll see that I'm not religious.

Type in "god" or "religion" in the SEARCH field at the top of my blog page if you're interested in my views on religion.

Natalie said...

Dear Shin,

Do the pain medications help to lessen the pain? Are there any side effects like constipation and nausea?

Are you able to sleep and eat well?

And is the pain chronic or acute?

I hope you have a nice day. : )

Natalie
12 years old

Shin said...

Natalie,

The pain medications DO help lessen the pain but they don't completely eliminate it.

I have had some mild nausea and constipation in the past, but I don't know if it was due to the drugs or something else. I've managed to manage these symptoms with natural remedies.

I've been eating fairly well, but I seem to be losing weight again. I'm not sure why.

As for sleep... I think that's my biggest problem. I get an average five hours' sleep a night and my sleep is often interrupted by the kids waking me up. I'm working on a solution to that.

I have both chronic and acute pain. The chronic pain is in my back and chest areas, while the acute pain is in my left rib each time I cough - a sharp, stabbing pain.

I'm curious... why does a 12-year-old have so many questions about the details of my physical condition? I hope you're not a cancer patient yourself and wanting to compare notes.

Natalie said...

Dear Shin,

My late aunt had cancer. She passed on about ten years ago.

I never had the chance to ask her and she never told me. : (

I might be 12 years old but I am in the gifted programme and I am a member of MENSA. One day I hope to find a cure for cancer. : )

Natalie Delko (12 years old)

Shin said...

Natalie,

You seem to have the two main ingredients to success: intelligence and passion. If any 12-year-old is going to find a cure for cancer someday, it will be you.

I have faith in you.

Natalie said...

Dear Shin,

I believe somewhere within the pain receptor cells lies a switch-off mechanism that will lessen or eradicate the pain altogether. Pain could be both good and bad and if science could trigger a switch-off mode without harming any parts of the body or organ, a breakthrough would be possible.

I intend to pursue this theory by observing intensely how our nervous system works.

Natalie
12 years old

Shin said...

Natalie,

You show astounding maturity and intelligence for a person your age.

I hope you find that switch-off mode soon. I could use a break from this pain!

Natalie said...

Dear Shin,

Most painkillers could be addictive and that is why there is dire need to find a viable alternative. Within those pain receptors, there is a switch-off mode and it's not a myth.

The Chinese touched the tip of the iceberg by numbing the senses through acupuncture but there is a need to take it a step further. Somewhere within the nervous system lies the biological key to switch on and off unbearable pain without bringing harm to the body.

Pain itself is not a bad thing but to be able to control it just like a volume switch on your hi-fi system - that would be wonderful!

I am convinced within this decade, we will be able to find the biological code to control intense pain and manage it without addictive side effects.

Natalie
12 years old

Anonymous said...

Dear Shin,

Whatever experience we go through, we may ponder, ascribe meaning and purpose to it.
While some go through pain or difficulty, they endure the pain or difficulty by focusing on the fulfilment of the goal they seek.

Jamie said...

Natalie,
I do not believe you are twelve years old – but I hope you are and I hope you take my skepticism as a compliment.

Shin,
I often find myself thinking that a noisy person in pain is overdoing it and should “just suck it up and deal with it.” But I don’t really know what they are going through and I often feel guilty about thinking that way. I accept that just a we all have to deal with pain because that is part of life, we all have to deal with people who are dealing with pain because that is part of life. People in pain make noise. People with colds make noise. People with a peg leg and a hardwood floor make noise. I’m not mad or annoyed with any of them.

Also, if someone is in pain, I want to help. I think most of us feel the same way (and this is why the opportunistic and self centered will overstate what they are experiencing). If it causes you great pain to go up a flight of steps, then someone who feels no pain should go up those steps for you and you should not hesitate or feel guilty about accepting this help. Less net pain in this world is one of the things we should all be striving for, so if honestly showing your pain makes the process a little more transparent, then that’s okay. Pain is a bad thing. More pain is more of a bad thing. Showing that you are in great pain and allowing others to help is not a bad thing.

After saying this, I have to admit my view loses a bit of traction when a person starts experiencing pain where there is nothing anyone can do, physically, to help. Should we be expected to “just suck it up and deal with it” because no good can come out of making a big deal of it? For the little things, I think yes. For the big things, I don’t know. I have no idea how I would react in that situation and since I would never expect anyone else to behave in a way I can not confidently expect of myself, I can’t say what I think is the right or wrong way to react. However, I can say with great confidence that if or when I have to deal with one of the big things, I will be proud if I can handle it nearly as well as you.

Love,
Jamie

Anonymous said...

I don't think Natalie is a 12-year-old kid. Amazing you've the patience to reply to all comments & take their word (or identity or real intentions) for it.

Shin said...

Natalie,

People seem to doubt you're twelve because of your maturity and intelligence. I'd take that as a compliment.

I, for one, DO believe you're twelve because I used to teach kids your age and because I know a 12-year-old (a friend's daughter) who is a bit like you.

Ronnie Ng said...

Natalie,

I'm impressed from your prose that at your age, you're confident enough to apply affirmative phrases like "I believe", "I intend", "I'm convinced", & "we will be able to"...

I don't recall being as resolute as you when I was your age... ^^

Ronnie (Recycled 12-year-old)

Anonymous said...

Dear Shin,

As a reader of your blog, I have to evaluate how genuine are the identities and comments of the writers. This is by no means easy. The principle still remains: examine everything carefully and not be taken in by outward appearance of things.

Ronnie Ng said...

Anonymous,

In the evaluation of a writer's identity and his comments, I usually tell myself that "the map is NOT the territory" (a famous remark by philosopher Alfred Korzybski). In the online world, we cannot experience one another directly, but only through our own abstraction/perception... Our perception of or reaction to a comment is not toward the writer himself.

As for me, I usually look at someone with an attitude of "I don't know him/her actually. Let's see." I hold such an attitude towards a stranger, an acquaintance, and sometimes even my own friend. Paradoxically, this attitude can help me understand that person better, to help me discover the real him/her.

Sometimes it's better not to make an evaluation at all. I don't stand to gain anything if Natalie is really who she portrays herself to be. Neither do I lose an arm or a leg, if Natalie turns out to be a fraud. If I'm not required to make a wager, I'd rather just sit on the fence.

Natalie said...

Dear Aunty Shin,

All of them who doubt that I am twelve are all correct! I am not twelve cuz I will be thirteen come the first week of December. : )

I guess it's true to say most gifted children are misfits cuz the evidence shown here is so plain for all to see. : (

The world expects children to behave like children, talk like children and when they utter something intelligent or profound, the masses freak out!

We box ourselves in and by doing so, restrict the creative flow that is innate within ourselves.

We trap ourselves to define what we accept to be the norm and disregard everything else. And sad to say, that is how we stop thinking and learning and on a broader perspective, we are stunted in our growth to explore things that are different and new.

Natalie
Still 12 but next week 13 : )

Natalie said...

Replying to Uncle Ronnie...

I must admit that you have written one of the best pieces of advice.

Presumptions and assumptions stifle true learning and discovery. We assume what we think we know and we presume that it is true.

We categorize people by their age, their race and compartmentalize them in our own order, and by doing so create imaginary borders and barriers.

We assume that children are not supposed to think deep thoughts. We assume that termimal patients will eventually die. We display the lack of courage to think otherwise and more often by doing so, we deprive ourselves of seeing miracles from happening that defies the odds.

Give life a chance and give ourselves a chance by embracing what might not be the norm or the mundane, and should one day if you see any of your children compose an original piece of music or solve complex mathematical formulas, don't hit the roof.

Cuz life has indeed found a way to express itself. : )

Natalie
Still 12 : )

Well Wisher said...

I like this Natalie mystery topic. Some of us might turn out mysterious too.

But Shin is real.

lisacc said...

I know from someone working in palliative care that taking painkillers preventatively is actually more effective, you can also take smaller doses if you avoid waiting until the pain is peaking.

But when you're trying to keep to low dose morphine, and avoid the side effects - tiredness, acute and chronic nausea in my mother's case - it's understandable you might not take it earlier.

I am sure your doctors already have you on all the latest stuff, but have you tried the slow release patches or even the morphine pen thing that you can turn up and down? It's working much better for my mother, her pain is currently very well under control from being terrible just over a month ago.

Shin said...

Lisacc,

I agree - the goal is to take the painkillers before the pain comes. My problem is that I keep messing up with the timing. I have so many pills to take scattered throughout the day, it's a full-time job just to keep track of it all. I just have to be more vigilant about that.

We haven't considered the morphine patches or pen yet. My doctor recently prescribed another pain killer (Ultracet) in addition to the codeine and Panadol, but it didn't seem to be working. It's also very expensive, so I'm thinking of doing without it.

My latest problem is nausea - nothing serious. Just a low-grade constant queasiness that's preventing me from eating much (lost another kilo). Now that you mention it, the nausea might be a side-effect of the pain medication, rather than the chemo. I'll talk to my doctor about that.

Thanks for the great tips. I'm glad to hear your mother's got her pain under control. It makes a HUGE difference in a patient's outlook.