I've been living with chronic pain (due to osteoarthris and gout) for some 15 years now, and in that time I've learned all sorts of interesting things about it. One of the chief things being that there's only so much one can do to stave off chronic pain. You can be an absolute whiz with self-care, meds, supplements, home remedies, exercise, nutrition, alternative therapies, etc. etc. etc. ... and have some really fine days of minimal pain. But sometimes despite all your best efforts, you'll get a flareup anyway.
For instance, I'm one of those people whose joints will start aching in advance of the barometer dropping--and since I'm not planning to move to a weather-free bubble any time soon, I see no way of avoiding that. I'm also an expert at winding up in some awkward position in my sleep that torques out my knee. It doesn't matter how careful I am with placing pillows all around the cranky joint; I have been an active sleeper my entire life and there's no talking my subconscious out of it.
The corollary to the lesson of flareups happening even despite one's best efforts is that, beyond a certain point, there's little to be gained in microscopically examining what might have caused any particular flareup. Certainly if there's something hugely obvious that's in your power to change, then that's worth examining. But go too far down along the road of "why did this flareup happen?" and you get into "what did I do wrong this time?" ... and self-blame does no good in living with a long-term condition.
For example: I have at this point proved to myself over and over that my gout meds do a much more efficient job at keeping my uric acid levels at bay if I drink copious amounts of fluids--like at least that proverbial 8 glasses a day, and one or two over that even better. (Yes, I know some medical pundit comes along every now and then and declares the 8 glasses a day a myth. That may or may not be the case for the general population, but for anyone on allopurinol it is most definitely NOT a myth, and that's not just from some health pundits but from the NIH database on pharmaceuticals.) So--yes, those 8 glasses of fluids, preferably water, daily. I know this. Can I manage it every day? Sometimes ... it just doesn't quite happen. It's a lot of freakin' liquids to get down one's hatch, and I find I have to start working on it first thing in the morning and keep a count, or by bedtime I still have a glass or two to go amid prospects of staggering to the bathroom multiple times in the night.
Now I could beat myself up over being less than perfect with something I know will make me feel better if I just do it--but why do that to myself, when the borderline-gout-attack joint crankies will already be beating up on me? Plus--no. Just no. Done with beating up on myself for lack of perfection, or anything. It's just a nasty thing to do to oneself, and doesn't solve a thing.
Likewise, there's a thousand other things one could conceivably do to affect one's pain condition for better or worse, that often just wind up getting randomized the way life can do. Like the flareup I woke up to this morning: not only had I been a tad skimpy with my water intake the past couple of days, but yesterday I chose to go out wearing flipflops instead of more supportive shoes, just because I wanted to wear my flipflops, dammit. And I wound up driving around a whole lot looking for stuff, and apparently my car seat has decided it doesn't like my back anymore. Fine--I wore much more supportive shoes today, and tried to sit in the evil car seat for less time, and I still freakin' hurt. Like I said, no point in self-flagellation. Besides, the barometer did drop today, so for all I know my bod was hurting because of that.
The point is, I did go out again today anyway--and that brings me to my third big learning: there is no perfect way to decide whether you're overdoing it or underdoing it. The advice on whether to keep moving despite the pain or stop moving because the pain is a sign you are overdoing it I find contradictory and confusing. Again, obviously, if I suddenly feel like my leg is being clawed by rabid honey badgers and realize that the person swearing at the top of her lungs is me, well, yes, I can bloody well tell that's "danger Will Robinson" stop-everything pain. And I'm damn glad I've only experienced that a blessedly few times. But most of my pain is much less identifiable than that, various health pundits' assurances to the contrary. Frankly, it all hurts, and all hurting sucks.Even the pain one is meant to push through because it will feel better once you move, that pain sucks a whole lot more than the pundits give it credit for.
I got proof of this right after my hysterectomy. When I woke up in the hospital, the docs told me the best thing I could do for my recovery was to try and get up and walk around the ward, despite the pain. And so I did it, white-knuckling through it on a walker--and the nurses on my ward were amazed. Apparently almost nobody actually took them up on the walking-around-after abdominal-surgery thing, despite the doctors' encouragement, because the pain was too great for most patients. It was in that moment that I realized that all my years of pushing through daily arthritis pain had so trained up my ability to tough it through pain, that toughing out the post-abdominal surgery pain was not that much of a stretch for me. And in that next moment, I realized "ahah! So this daily pain I'm supposed to shrug off is really right up there with healing from having your innards surgically rearranged."
So--to push through, or not to push through: only the person with the pain can decide for sure. I seriously considered staying at home today. And I would have given myself permission to do so, and not felt like a wimp for doing so. What decided me on going out anyway was sheer determination to get one more day out in the fresh air on my remaining day off, before I start my work week and hole up with the computer. And yes, there was a desire to push myself at least a little more too--I have long-term health goals that require I be at least a little pushy. But it was my choice. And whichever way I decided would have been okay, because ultimately there is no perfect way to do this freakin' chronic pain thing, there's just doing whatever seems to be the thing you need to do in that moment, and not exacerbating the pain by getting painful with yourself.
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