Trigger Warning: Discussion of pain management, addiction, and trauma.
As a youngster, and into adulthood, my addiction to drugs and alcohol brought me to many places that were physically challenging. That is to say, I got drunk and had my share of fights, falls, and scrapes. I ended up doing some damage to my body that is with me to this day.
Additionally, I was spending what little sober moments I had at swimming pools. I worked as a lifeguard, instructor, supervisor, and coach for 40-50 hours a week. The overwhelming majority of that time, I went barefoot on pool decks made of tile and concrete.
I remember older gentlemen cautioning me as they gingerly made their way to the slower lap lanes about going barefoot all the time. They would tell me of their arch, ankle, knee, hip, and lower back issues. These men would warn me of the damage, over time, from walking on cement with no shoes.
"Thank you sir." I would say. But these rare veterans of bare-footing didn't look like me. After all, I was in my early twenties, and I was never going to look like them. They had bellies . . . And man boobs! That was never going to be me!
Thirty years later, I am the one cautioning young guards about the dangers of walking around without footwear on pool decks. "Thank you sir." they say, with the same look of bewilderment and wonder at how a person can let themselves go to such an extent. Oh! To be young! Thin! And pretty again!
Uh . . . No thanks. I'd much rather have this wonderful, old body that I take swimming, walking, and to the occasional workout at a local gym. I can also do without the madness that encircled my livelihood during those younger years. At 30, I had too much energy, and too little insight. I'll take wisdom, insight, and serenity over youth and a svelte physique any day. Even if the trade-off includes the occasional aches, pains, and discomfort of entering my senior years.
I also remember being thirty-five and weighing 172 lbs. I'm about 5'll" and I was just convinced that, if I could lose another 5 lbs, I could make "Him!" love me. I never want to return to that space again either.
I also remember being thirty-five and weighing 172 lbs. I'm about 5'll" and I was just convinced that, if I could lose another 5 lbs, I could make "Him!" love me. I never want to return to that space again either.
Apologies to those that are young, healthy, and devoid of any issues disclosed previously in this blog. ;-)
Today, I'm a recovering alcoholic/addict. My sobriety date is October 31st, 1989. Because of past physical history mentioned above, I suffer with occasional aches and pains that vary from light, to moderate, to almost debilitating on rare occasions.
While there has been a new focus on pain management and the slippery slope to addiction (Both locally, and nationally), I've been (luckily) cognizant of the need to maintain my sobriety while addressing pain management issues for a very long time. There have been numerous instances where I've seen clean and sober people with excellent recovery skills, cross the line from treatment to relapse in what appeared to be microseconds.
So I've developed a routine that I keep in my mind for the rare occasion that pain management becomes an issue.
As I discuss my own, personal routine, I feel it is important to say that this is what works for me. I cannot speak for everyone as to how they should (or should not) treat their addiction during pain management moments. I've been blessed with muscle-skeletal issues that do not aggravate my life on a daily basis. My stuff comes and goes based on the factors listed previously. And I can do much with rest, stretching, water immersion, anti-inflammatory medications. and some mindful meditation that usually negates the need for anything stronger; albeit non-narcotic. Even anti-inflammatory meds are consumed sparingly and for a targeted time by yours truly.
But for me, non-narcotic does not give me free license to take prescription meds without the care and guidance of a support system. As a friend of mine in recovery says, "My as-needed button is broken."
There is another aspect to pain management for me. My trauma history is triggered by these discomforts as well. I can feel incredibly vulnerable and unable to protect myself when I'm in pain. My fear increases, and I begin to worry about my immediate safety, and that of my Husband. I'm not a grand physical specimen, and nobody in the UFC need worry about my abilities. But, when limited, I become keenly aware of how easy of a mark I have become. It's scary to be saddled with a history of trauma and bullying, and be in a condition where I can barely get around.
And there is the added stressor of having digestive discomfort when my back pain is at it's worst. I have occasional trouble with IBS (Not uncommon among sexual abuse survivors), and lower back and hip problems can exacerbate any issues with regularity. Being hyper-aware of the problems in my digestive tract can cause additional stress beyond the difficulty of dealing with pain. Specific moments of being violated are recalled, along with the present day discomfort in my bowel. This in turn reminds me of my trauma history in ways that are hard, and sometimes, horrible to deal with.
At moments like these, emotional self-care becomes tantamount; even in the face of physical pain. I make sure to be vulnerable with trusted friends about my trauma history in these terrifying moments. And I give over safety to them. They are such blessed people in my life, and they point me back to safety.
So there's a lot of stuff that I bring into any pain management decisions. I treat the whole thing like a triangle where one side is the addiction piece (Chemical), another side is the injury (Structural), and the final side is self care where trauma (Emotional) is concerned.
I find that treating the addiction piece is something I do automatically. This is due to practicing recovery on a daily basis. Gary McKenney was the Clinical Director when I lived at Serenity House in the winter of 1990. He used to say, "I work my program (of recovery) on a daily basis. So that when I have to, I don't have to." I thought he was freakin' Yogi Berra! But the lessons I've learned in that house at 30 Mellen Street are ongoing, right up through today.
If I'm in a space where I need to use something other than ibuprofen, then I prepare to have a series of conversations with other clean and sober people in recovery. I know that narcotics are not an option for me, and I don't want them for this issue. But discussions around non-narcotic, muscle relaxants are crucial to have going into the process. There are some that are effective. And others that, while effective, will leave me with a level of personal despondency, that I feel as if I've relapsed.
So I get on the phone, and I talk with folks. Then I make a doctor's appointment. I might even make the appointment, then have conversations with recovering people prior to the appointment. But I believe that one necessitates the other.
In my personal experience, I try to avoid quick-care or emergency room care. There are a few reasons for this. For one thing, these two medical venues are common places where people involved with active addiction will try and gain access to prescriptions that aid and ease the profound stages of withdrawal. Many times, I've seen folks in recovery receive treatment loaded with suspicion, and downright shaming messages, simply for trying to treat pain. But I've also witnessed folks in their cups with addiction being as charming, or nasty as the situation required, just to feed their addiction.
I want to work on my pain management in an environment where folks are familiar with me, and during regular business hours. This is part of the transparency that keeps my recovery safe as I enter into treating my occasional pain.
So the conversations have happened, the appointment (sometimes, same-day) has been made, and I bring someone with me to the facility, and into the examination room. This time, it was my Husband.
After my vitals are taken, I inform the providers of my addiction history and recovery. I insist that I will not be taking narcotics to treat the current pain and list the previous non-narcotic medications I have had both good and bad experiences with. I explain that my Husband is there with me for transparency and support during this endeavor . . . Have I mentioned the importance of transparency? Nothing can skewer recovery quicker than a secret.
Then I listen to the provider. I do not interrupt. I just take it all in. This can be hard, as professionals are making value judgments on my addiction. But if I want to be successful (i.e. Stay clean and sober), I must make room for any and all feedback. I have already had discussions with folks in recovery, and they have reminded me that what the provider says is a reflection of how they perceive addiction. Not a value-judgment on who I am.
So we come up with a new med that all agree on. I have discussed medication options with recovering folks before the appointment, and this med is in the realm of what was suggested. The Nurse Practitioner gives me a script that avoids any as needed instructions, reminds me to utilize my clean and sober support system, call the office with any questions/concerns. Then she turns to my Husband and reiterates the instructions to him. "Just so we're clear." she says. I like her instantly.
We stop at the local pharmacy and pick up the script. I take the medication as prescribed. About an hour later, I feel the pain and discomfort leave my body. One would think that is a good thing. Right?
Except that I feel guilty as hell! So I call a clean and sober friend to discuss pain management and the need for this med (Did I mention that my hip keeps dislocating?), and how important it is to treat the muscle spasms, so I can work the hip back in during Physical Therapy.
Over the next five days, I take the medication as prescribed. Then something strange happens. I stop feeling pain when it's time to take the next dose.
I'm someone who defaults to the side of not needing medication. Given my addiction history, I'm glad that is the case. I've seen the horrific results of folks who default in the other direction. There are both famous people and personal friends who have dosed once too many, and ended up careening into relapse. These situations become ugly in a most speedy fashion. Some of them end up with fatal results.
So if I had my druthers, I'd take the erring on the side of less meds are better. But that can lead to some difficulties as well. Mainly, needless suffering under the guise of having a staunch attitude about my recovery. This too can cause misery for myself and those that love me.
So I remain ever faithful to my clean and sober friends and the concept of transparency. I involve my providers in my ongoing care, touch base with recovering people morning, noon, and night, and inform my Husband of my pain levels.
Still, this makes for the second week of pain management a tightrope walk. I'm no longer in a place where I need as much as is prescribed, yet I need to manage my pain and muscle spasms so my body is open to treatment.
I need to ask myself (out loud) with the help of recovering people.
1. Am I in pain, or am I having muscle stiffness?
2. Should I be working?
3. What about light duty?
4. Will my back brace help?
5. If I'm wearing my back brace, I need to remember to only bound my abdomen for an hour at a time. Things in my intestines and other organs need freedom to move.
6. Am I talking with folks about my thoughts around pain? Hanging out with recovering people on a regular basis? Avoiding isolation?
7. Am I utilizing meditation?
8. Am I taking time to rest/relax?
9. Will swimming help? Or hurt?
10. When is the last time I called or spoke to someone in recovery?
11. Am I discussing my pain level with any and all professionals I am working with?
12. Does that pain level match what I am telling my friends in recovery?
It sounds like a lot, I know. But in order to maintain emotional and physical sobriety while dealing with pain management, is not something I take lightly. My end goal is to come out of this ready to function physically, medically, and spiritually. And to maintain my clean and sober status at all phases of my treatment.
Last Saturday, I found no need to take the medication. Physical therapy was helping me keep my hip in, and the additional exercises prescribed, swimming, and ibuprofen were enough to keep any discomfort at bay. I also had several discussions with recovering people about stiffness vs. soreness and/or pain. I had boatloads of stiffness and soreness, but no pain.
The physical therapy continues. When this all started, my hip hadn't been that bad in almost ten years. We are using stretching, resistance, and movement to realign the hip, and train the surrounding muscles to hold it in place.
It seems that I got away from some of the original exercises prescribed during a previous PT visit to keep the hip in alignment. I can hear Gary McKenney and his Yogi-isms again.
"I work my program on a daily basis. So when I have to, I don't have to."
OK. OK. I'll keep doing these exercises two to three times a week! Honest! . . .
Now where are my arch supports and stretchy bands?
M
Today, I'm a recovering alcoholic/addict. My sobriety date is October 31st, 1989. Because of past physical history mentioned above, I suffer with occasional aches and pains that vary from light, to moderate, to almost debilitating on rare occasions.
While there has been a new focus on pain management and the slippery slope to addiction (Both locally, and nationally), I've been (luckily) cognizant of the need to maintain my sobriety while addressing pain management issues for a very long time. There have been numerous instances where I've seen clean and sober people with excellent recovery skills, cross the line from treatment to relapse in what appeared to be microseconds.
So I've developed a routine that I keep in my mind for the rare occasion that pain management becomes an issue.
As I discuss my own, personal routine, I feel it is important to say that this is what works for me. I cannot speak for everyone as to how they should (or should not) treat their addiction during pain management moments. I've been blessed with muscle-skeletal issues that do not aggravate my life on a daily basis. My stuff comes and goes based on the factors listed previously. And I can do much with rest, stretching, water immersion, anti-inflammatory medications. and some mindful meditation that usually negates the need for anything stronger; albeit non-narcotic. Even anti-inflammatory meds are consumed sparingly and for a targeted time by yours truly.
But for me, non-narcotic does not give me free license to take prescription meds without the care and guidance of a support system. As a friend of mine in recovery says, "My as-needed button is broken."
There is another aspect to pain management for me. My trauma history is triggered by these discomforts as well. I can feel incredibly vulnerable and unable to protect myself when I'm in pain. My fear increases, and I begin to worry about my immediate safety, and that of my Husband. I'm not a grand physical specimen, and nobody in the UFC need worry about my abilities. But, when limited, I become keenly aware of how easy of a mark I have become. It's scary to be saddled with a history of trauma and bullying, and be in a condition where I can barely get around.
And there is the added stressor of having digestive discomfort when my back pain is at it's worst. I have occasional trouble with IBS (Not uncommon among sexual abuse survivors), and lower back and hip problems can exacerbate any issues with regularity. Being hyper-aware of the problems in my digestive tract can cause additional stress beyond the difficulty of dealing with pain. Specific moments of being violated are recalled, along with the present day discomfort in my bowel. This in turn reminds me of my trauma history in ways that are hard, and sometimes, horrible to deal with.
At moments like these, emotional self-care becomes tantamount; even in the face of physical pain. I make sure to be vulnerable with trusted friends about my trauma history in these terrifying moments. And I give over safety to them. They are such blessed people in my life, and they point me back to safety.
So there's a lot of stuff that I bring into any pain management decisions. I treat the whole thing like a triangle where one side is the addiction piece (Chemical), another side is the injury (Structural), and the final side is self care where trauma (Emotional) is concerned.
Not My Image
If I'm in a space where I need to use something other than ibuprofen, then I prepare to have a series of conversations with other clean and sober people in recovery. I know that narcotics are not an option for me, and I don't want them for this issue. But discussions around non-narcotic, muscle relaxants are crucial to have going into the process. There are some that are effective. And others that, while effective, will leave me with a level of personal despondency, that I feel as if I've relapsed.
So I get on the phone, and I talk with folks. Then I make a doctor's appointment. I might even make the appointment, then have conversations with recovering people prior to the appointment. But I believe that one necessitates the other.
In my personal experience, I try to avoid quick-care or emergency room care. There are a few reasons for this. For one thing, these two medical venues are common places where people involved with active addiction will try and gain access to prescriptions that aid and ease the profound stages of withdrawal. Many times, I've seen folks in recovery receive treatment loaded with suspicion, and downright shaming messages, simply for trying to treat pain. But I've also witnessed folks in their cups with addiction being as charming, or nasty as the situation required, just to feed their addiction.
I want to work on my pain management in an environment where folks are familiar with me, and during regular business hours. This is part of the transparency that keeps my recovery safe as I enter into treating my occasional pain.
So the conversations have happened, the appointment (sometimes, same-day) has been made, and I bring someone with me to the facility, and into the examination room. This time, it was my Husband.
After my vitals are taken, I inform the providers of my addiction history and recovery. I insist that I will not be taking narcotics to treat the current pain and list the previous non-narcotic medications I have had both good and bad experiences with. I explain that my Husband is there with me for transparency and support during this endeavor . . . Have I mentioned the importance of transparency? Nothing can skewer recovery quicker than a secret.
Then I listen to the provider. I do not interrupt. I just take it all in. This can be hard, as professionals are making value judgments on my addiction. But if I want to be successful (i.e. Stay clean and sober), I must make room for any and all feedback. I have already had discussions with folks in recovery, and they have reminded me that what the provider says is a reflection of how they perceive addiction. Not a value-judgment on who I am.
So we come up with a new med that all agree on. I have discussed medication options with recovering folks before the appointment, and this med is in the realm of what was suggested. The Nurse Practitioner gives me a script that avoids any as needed instructions, reminds me to utilize my clean and sober support system, call the office with any questions/concerns. Then she turns to my Husband and reiterates the instructions to him. "Just so we're clear." she says. I like her instantly.
We stop at the local pharmacy and pick up the script. I take the medication as prescribed. About an hour later, I feel the pain and discomfort leave my body. One would think that is a good thing. Right?
Except that I feel guilty as hell! So I call a clean and sober friend to discuss pain management and the need for this med (Did I mention that my hip keeps dislocating?), and how important it is to treat the muscle spasms, so I can work the hip back in during Physical Therapy.
Over the next five days, I take the medication as prescribed. Then something strange happens. I stop feeling pain when it's time to take the next dose.
I'm someone who defaults to the side of not needing medication. Given my addiction history, I'm glad that is the case. I've seen the horrific results of folks who default in the other direction. There are both famous people and personal friends who have dosed once too many, and ended up careening into relapse. These situations become ugly in a most speedy fashion. Some of them end up with fatal results.
So if I had my druthers, I'd take the erring on the side of less meds are better. But that can lead to some difficulties as well. Mainly, needless suffering under the guise of having a staunch attitude about my recovery. This too can cause misery for myself and those that love me.
So I remain ever faithful to my clean and sober friends and the concept of transparency. I involve my providers in my ongoing care, touch base with recovering people morning, noon, and night, and inform my Husband of my pain levels.
Still, this makes for the second week of pain management a tightrope walk. I'm no longer in a place where I need as much as is prescribed, yet I need to manage my pain and muscle spasms so my body is open to treatment.
I need to ask myself (out loud) with the help of recovering people.
1. Am I in pain, or am I having muscle stiffness?
2. Should I be working?
3. What about light duty?
4. Will my back brace help?
5. If I'm wearing my back brace, I need to remember to only bound my abdomen for an hour at a time. Things in my intestines and other organs need freedom to move.
6. Am I talking with folks about my thoughts around pain? Hanging out with recovering people on a regular basis? Avoiding isolation?
7. Am I utilizing meditation?
8. Am I taking time to rest/relax?
9. Will swimming help? Or hurt?
10. When is the last time I called or spoke to someone in recovery?
11. Am I discussing my pain level with any and all professionals I am working with?
12. Does that pain level match what I am telling my friends in recovery?
It sounds like a lot, I know. But in order to maintain emotional and physical sobriety while dealing with pain management, is not something I take lightly. My end goal is to come out of this ready to function physically, medically, and spiritually. And to maintain my clean and sober status at all phases of my treatment.
Last Saturday, I found no need to take the medication. Physical therapy was helping me keep my hip in, and the additional exercises prescribed, swimming, and ibuprofen were enough to keep any discomfort at bay. I also had several discussions with recovering people about stiffness vs. soreness and/or pain. I had boatloads of stiffness and soreness, but no pain.
The physical therapy continues. When this all started, my hip hadn't been that bad in almost ten years. We are using stretching, resistance, and movement to realign the hip, and train the surrounding muscles to hold it in place.
It seems that I got away from some of the original exercises prescribed during a previous PT visit to keep the hip in alignment. I can hear Gary McKenney and his Yogi-isms again.
"I work my program on a daily basis. So when I have to, I don't have to."
OK. OK. I'll keep doing these exercises two to three times a week! Honest! . . .
Now where are my arch supports and stretchy bands?
M