Ignoring the pain

Recently an old friend came for morning tea and a chat. We talked about how it is possible to rise above pain if a person becomes engaged with something meaningful or creative. For some, a relationship lifts their thoughts above the pain, for others a connection with nature will surpass their awareness of pain in the body, while others are able to enter a world of creativity that blankets the world of pain. On a TV program I saw how scientists were interested in providing patients (suffering pain) with headsets and screens which enabled the patients to enter a digital fantasy world pursuing a goal through a series of challenges. The patients became so focused, so intent on the quest that they were able to forget the pain for a period of time.

I suppose the chief method for ignoring pain that I have employed over the years is reading. I love to immerse myself in a well-written true story which can temporarily give my mind rest from the insistent pain. Actually I have developed lots of techniques over the years – playing sudoku, listening to music, going for a walk, planning a speech, preparing an English lesson  – and you could probably compile a different list of your own favourite methods.

If I feel absolutely hemmed in with no ideas on how to ignore the pain I often go back to a phrase – ‘this too will pass.’ Time and again I have experienced the passing away of pain so this phrase is a very powerful reminder to me. I can tell myself to be calm as sooner or later I will find a way to lower the pain I am experiencing in a particular part of my body. It may take me months to achieve but I have had this happen in the past and I can find the way to make it happen again. For instance I remember a specific time when I was at my wit’s end:

  • In 1997 I had to stop writing as the pain in my writing hand was too intense. It was so bad that when it was absolutely necessary to sign my name I didn’t use my first name in full but reduced it to an initial plus the surname. I  found it difficult to sleep at night with the ache in my arm and so I developed a position of keeping that arm extended over my head and pillow all night which seemed to lessen the painful sensations. I decided I would keep writing with the other hand. I was never overly proficient with the other arm and gradually I felt that my right arm was also beginning to get a bad feeling so I stopped altogether. I could no longer play the piano. I still have diaries to remind me of that period of time – maybe 5 years all up. I found I needed to continue to make large arm movements (and overarm swimming was perfect) but I couldn’t hold my arms still, such as driving for long distances with both arms on the driving wheel, or lying flat on my back holding a book above my eyes to read. I could lift shopping bags but I couldn’t hold my arms still and carry the bags to the car  without aggravating the pain.
  • Eventually by paying attention to what worked and what didn’t and by not writing at all I managed to tone down the pain and these days I can write and play the piano but I only do these for short periods because I have a sense that within my arms there is a latent capacity for pain that could be re-activated if I do too much. When I feel tingles down the arm or a tightness or ache in individual fingers it is a reminder for me to pull back from whatever activity  is stirring up the sensation. It’s as if the body has a memory of pain in a certain place and it’s necessary to help the body forget the pain in order to recover.
irregular writing from holiday diary

irregular writing in a holiday diary

Ignoring the pain is different to thinking that if we (those of us who suffer chronic pain) take our attention away from the pain that the pain will actually improve. Our state of mind may improve if we ignore the pain but the pain runs its own course. I was dismayed when a doctor applauded me for going back to study as he felt that would take my mind off the pain and might even take the pain away!

We can deliberately ignore the pain for a certain period if we need to but there can come a time when the pain is too strong to be able to ignore. This is a time when it’s stupid to ignore the pain because it will increase if we don’t attend to it. My contention is that the sooner we register low levels of pain the better we will be able to redress it and stop it developing into a major episode. For example, the longer I am engrossed with designing something on the computer the more pain I will suffer in the shoulder/ neck/ head area the following day or longer – and not because I haven’t made all the ergonomic adjustments for working at the computer. But sometimes I choose to do this as I think something is very satisfying and worth the pain. Another example is the enjoyment I get from gardening – gardening sustains me more than it drains me and I find it hard to stop. Sometimes I misjudge whether it will only result in short term painful consequences or whether I have really stirred up extremely difficult shoulder pain again. Then I really regret that I didn’t stop the weeding earlier!

There are some people who might accuse us by saying,’You just need to relax!’ They imply that we have caused the chronic nature of the pain by being a very stressed, tense or anxious person. I think to myself, ‘I’d like to see you stay relaxed if you had this level of long-term pain. I too was a carefree person once!’ But it is true that becoming mentally tense can increase muscle tension which exacerbates the pain in the body – and that’s why we need to find out the kind of things that keep our own minds peaceful. The thing that can really tax my mind is that I go back over the day’s events trying to isolate what may have triggered more pain than I was expecting. Some days there just doesn’t seem to be any good reason.

So let’s ignore the simplistic advice about how better posture, a certain vitamin, a particular manual therapy, a new type of exercise etc. etc. will be the answer to our problem. Some people can even imply that we haven’t tried hard enough. I bite my tongue when really I feel like answering,  ‘Don’t you think I’ve tried all of that and more. If it was just that simple I would have recovered years ago!’

one way to soothe my shattered equilibrium

one way to soothe my shattered equilibrium

When I have done everything I know to keep the pain as low as I can and I still end up in a mess then I ignore thoughts of despair. I remind myself that I am still actually handling the pain, that it hasn’t overwhelmed me yet. I keep alive the thought that I will find a way to reduce that pain again. I calm myself with a nice cup of tea and I let myself switch off by reading a book. Or I allow myself to think of one step I can take next, one thing I can do to to feel I have re-gained control of what is happening – such as  ‘I’ll go swimming tomorrow’ or ‘I’ll switch the electrodes to another site.’ This way I manage to ignore fear and to keep hopeful that however bad it is at the moment another day will come when I will be so glad to be alive. And those days will be many.

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Microcurrent units

If you have discovered that Painmasters deliver the pain relief you need you might like to consider a more permanent form of microcurrent therapy. Here are 4 units I have some experience with: Micro 300, Micro 400, Micro 850 and MicroPlus.

different microcurrent units

different microcurrent units

In 2004 I went back studying after a very long break. I had no means of pain relief other than exercise and low-level medication. The few years in Auckland when I was able to purchase a continual supply of Painmasters had long faded away. I realised that attempting the course might bring about a nightmare of pain (mostly from the need to sit at computers) and so I went to the internet and typed in ‘micro current’ in the wild hope that there might be something out there that mimicked a Painmaster.

I was thrilled to discover on http://www.medcareservice.com a device called a Micro 300. This website no longer leads to the page on the Micro 300  device but the same unit can be seen at

http://www.3dhealthstore.com/micro-current-300.html

It was going to cost me more than $100 as well as postage from the U.S. It was a big event 10 years ago to order something online and arrange payment for it while living a whole ocean away from the source. I don’t know how many times I read and reread all the information on the site before I took the plunge – a plausible explanation was given on the website as to how microcurrent could address pain. When the case arrived I was nervous all over again in considering how to adjust the settings to achieve something similar to the Painmaster device. After reading the Micro 300 booklet I chose some settings and switched it on. After only a couple of days of experimenting I found the optimal settings and I was in business! All the different seats in lecture halls, tutorial rooms, library and cafeteria as well as computer chairs no longer seemed an insurmountable problem.

trying to make sense of technical specifications

wondering which technical specifications would match a Painmaster

When you remove the settings cover there are a number of choices to make. I can recommend the following selection however you could track some different settings to come to the optimal solution for your own pain condition. Just note that the MicroPlus has a second dial on the outer surface which I generally set in the range of 0.5 to 1.3 ( the lower end of the spectrum).

different settings to suit chronic pain

examples of settings that suit chronic pain

The Micro 300 model has now been replaced by the Micro 400 model. However Medcare Service no longer sells those models or posts to Australia. This forced me to search again and I found Llhasa OMS, a company which has always provided a very good service and you can arrange by email to have the unit posted to Australia. The units themselves come in hard black cases and mostly seem to be made in Taiwan even though they are sold globally. The case also comes with a battery and lead wires  as well as electrodes – I have not found these electrodes to be very durable. All the units have a small flashing light to show the battery is working.

The one which has become my main backstop is the Biomedical Life Systems Micro Plus which I have ordered from Allegro Medical – https://www.allegromedical.com– in the electrotherapy menu. I emailed them and they arranged to post it economically to Australia using DHL.

Lhasa OMS offers the Micro 850 (http://www.lhasaoms.com/Microcurrent-Units.html) at a very reasonable price. In many years of ordering I have only hit one snag  because there are 2 different models of the Micro 850, one offering a 10, 20, 40 minute length of current, another one providing a C(Continuous) 20, 40. The timer needs to be Continuous to address chronic pain so check this out when you email your order.

chronic pain requires the C (Continuous) setting on the Timer

chronic pain requires the C (Continuous) setting on the Timer

Of course whichever microcurrent unit you purchase there are still going to be occasional dramas and costs. You will regularly need to purchase new electrodes and lead wires as well as 9V batteries. You can try buying a recharger for a rechargeable 9V battery but I found that they never lasted more than 12 hours which was too troublesome. Eventually any microcurrent unit will expire after a few years of continuous use. The hard plastic cover for the settings and battery may also fall off.  Not to mention dropping the whole unit onto concrete floors! As a woman, I found I needed to dress in skirts or pants which ideally had a pocket so that the unit could rest in the pocket while the lead wires were threaded under the clothing. Although a microcurrent unit is a health device I always feel it is better to remove it before passing though airport screening and then reapply it before boarding. I just don’t want to make public explanations as to why I’m wearing something that looks like I’m wired to explode.

Purchasing the accessories can be time-consuming but here are a few tips for electrodes and leads if you don’t want to order them from overseas.

Alpha First Aid – in booths at Westfield shopping centres – sell the most common lead wire which fits into the Micro 400 and Micro 850

http://physioworks.com.au/online-store – under TENS Machines – sells electrodes.

http://whiteleyallcare.com.au sell PALS Valutrode Electrodes as well as less expensive AllCare Electrodes as well as the Lead for Allcare TENS (Product Code: ACTENLEADMK5) which is compatible with the Micro 400 and the Micro 850. The way to order to order these products is via www.myphysioshop.com.au.

By searching for a good price I have most recently ordered replacement electrodes from OPTOMO at https://www.optomo.com.au/category/tens-machines/

At the moment I have put the units into a cupboard and am enjoying the freedom of using Painmasters after a gap of 15 years (See  Mastering pain (part 1). No longer do I need to fiddle with settings, check the battery, purchase accessories online or deal with long wires bunched up underneath clothing. I can wear dresses! I can travel! I have proven to myself over and over that the level of microcurrent in a Painmaster – the original model provided up to 20μA (microAmps) and the latest model says 2.7 vDC @ 49μA  –  is a perfect match for removing the sensation of pain. I am so convinced about this Painmaster MCT patch that if I am not experiencing freedom from pain then I only need to move the patch to a slightly different place on my body. Maybe if I have strong pain occurring in a number of places – my shoulder as well as my buttocks – or if I cannot afford to use more than 2 Painmasters at a time, I will get out one of the above microcurrent units and use it in conjunction with a Painmaster.

Buying one Painmaster is a simple investment in finding out whether your pain responds to microcurrent. If it does then you can consider buying one of the microcurrent devices I have described.( Disclaimer) If it doesn’t work then you may not have the same kind of chronic pain as myself. But you have not wasted your money as it doubles as a device for sports injuries, for tennis elbow, for lower backs that ache from lots of lifting or for necks that ache from working at the computer…

Some doctors are sceptical that such a small current could make any noticeable improvement.

I am not saying that it cures chronic pain.

But I am saying that as long as I am wearing the patch in the correct site then it will render the pain negligible.

Doctors may want you to increase the settings on a microcurrent unit to milliamps in the belief it will give you a better outcome

BUT

 the use of a microcurrent for reducing pain is a surprising and wonderful example of how

less is MORE!

Exercise works

Exercise may be the last thing you feel like contemplating when your body is in pain. So let me tell you I would be one of the last people on earth to recommend exercise UNLESS I had found that it really reduced pain. Exercise on its own will never be enough but it can make significant inroads into your pain levels.

Strangely enough I can now remember the different types of exercise I have tried according to places I have lived. In Whyalla, South Australia I began with walking. I would get up before the children were awake and walk a number of blocks. My husband persuaded me to go to circuit classes at a local gym and there I found that the cool-down stretches made a big difference to the pain I was experiencing. This was followed by freestyle swimming at the Whyalla Recreation Centre. I would pay a babysitter to come at dinnertime and off I would go to swim a number of laps. By the time I got home the children were in bed, I would eat dinner and take some Mersyndol (Codeine plus antihistamine) – otherwise I would develop excruciating headaches in the night. I kept up with the swimming regime because it really reduced the pain in the lower half of my body. Much later I learned to swim with a snorkel and mask because this stopped the need to turn my head which brought on the headaches.

Some memorable backdrops to exercising have been

  • Mt Victoria in Devonport, Auckland, NZ.  Walking the dog on the circuit of this mount with panoramic views of Hauraki gulf and the green-blue waters of the harbour.
  • A small secluded beach near Whyalla. Watching multitudes of rainbows fragmenting in the sea around me.
  • A heated olympic outdoor pool in winter in Perth, W.A.. Getting there early to watch the rising mist as the pool covers were removed, breathing in the clean crisp air.
  • The bush pathways around Claremont, Perth.
  • The pathways around the New Farm Park, Brisbane which connect to paths along the Brisbane River.
local landscape whilst walking

enjoying the local landscape whilst walking

Somehow these surroundings have the added dimension of improving my mental state which can be overloaded with pain management.

Altogether, as well as walking, swimming and going to the gym, I have tried PUMP™, Pilates, Yoga, Jogging, Power Walking and Denise Austin aerobic videos – now replaced by other exercise DVD’s such as Increase Your Flexibility with Hun Yuan Tai Chi Chan Si Gong Foundation Exercises (see http://www.taichiacademy.com.au/products.php). Lately I have improved my backstroke swimming and I am currently learning more about Walkactive™.  (Learn about Joanna Hall’s method at walkactive.com)

I have found out for myself that Pilates and Yoga are too difficult for my body and instead of getting a nice deep stretch I can easily strain the muscles resulting in  a long episode of pain. Likewise jogging is too jarring for my body and can leave me with terrible headaches. Conversely ordinary gardening and housework are insufficient to bring about pain relief.

Another important tip I have learnt regarding myofascial pain is to stretch my muscles after the exercise not before. If you want to walk or jog or swim just start off at a slow to moderate pace and gradually build up speed and intensity. Then your body will be ready for deeper stretching at the end of your session.

Let me give you an example regarding the benefits of exercise. Twenty years ago I was attending a *fibromyalgia support group which a rheumatologist had recommended. A speaker talked about the idea of helping this condition by resting. It sounded quite attractive so I put it into practice.  I was running a household with 5 children, and my husband and I were preparing to go away for his long service leave. A few weeks had passed without exercise and I now felt I needed to clean the house  for my mother who was coming to mind the children. After a couple of very intensive cleaning days (barely sitting down) the bottom of one of my feet started to burn. Whenever I put my foot to the floor I experienced significant pain to the extent that I got myself some crutches. I was now forced to spend quite a bit of time resting on the bed. A couple of good friends came and helped with the chores til my Mum arrived. But the more time I spent lying down the worse my whole leg became – sometimes feeling a bit cold or heavy.

I realised that I needed to do something or I would not be able to go on this trip of a lifetime. So I began swimming in a heated pool at Takapuna (I hope those damp change rooms have been upgraded!). This was the best strategy – not to keep staying on my feet as that only made the pain in my foot worse but to keep the leg moving and active in another way. I kept this up for a few days more when my Mum arrived and thankfully I was able to get on that plane. [Years later I learned that the foot pain was stemming from the buttock/pelvis area and the swimming had mobilised that area.]

Obviously the lesson I learned from this was to KEEP on exercising, forget resting – and now if a certain part of my body gets stirred up I still need to keep it in motion but not with the activity that caused the area to malfunction. For instance I currently need to do gentle exercising of my shoulder but I mustn’t keep pulling out weeds as this caused the shoulder to flare up – admittedly we live on a large property and I have been pulling out thousands of weeds so that the land will return to native bush. I have also had to switch the arm I use for the computer mouse as that also fires up my shoulder even through it wasn’t the original cause.

Another lesson I have learned is to take medication with breakfast and wait an hour or so for it to take effect before I start exercising. And I exercise most days of the week.

Over the years I have settled into moderate exercise with many repetitions of the same movement for a number of different muscle groups, while maintaining a good posture. I suppose this is best described as exercises that tone and stretch. I am grateful in particular for  a DVD that provides 10 minute workouts to shape and strengthen the abdominals, the thighs, the buttocks and the arms & shoulders. I find that most exercises therapists recommend for me after treatment are already embedded in routines on this DVD.

Cindy Whitmarsh will be forever young to me. XXX

Cindy Whitmarsh will be forever young to me. XXX

All exercise DVD’s come with a disclaimer and I stress that I am passing on what works for me but you need to work out for yourself what type of exercising suits you best (Disclaimer). You need to find ways of exercising that you actually enjoy and that suit your own temperament or else you won’t be motivated to keep exercising. So don’t be afraid to gradually build up an exercise regime – it will give you pain relief and also stamina to cope with the condition. You may as well have the benefit of looking fit!

* Other doctors have since dismissed the diagnosis of fibromyalgia.

Chill out!

If ever I get into a dreadful episode where one part of my body will not stop ‘burning’ then I can switch off the pain for a while by applying an ice pack.

Ice can be used if you twist an ankle, if you get a bee sting, after chiropractic treatment and after some operations. Many health professionals recommend alternating ice and heat for inflammation and only applying them for short periods e.g.http://thephysiostudio.com.au/health-tips/ice-and-heat-application/ . 

An eHow article identifies whether heat or ice or both are suitable for different types of medical conditions – and quotes orthopedic surgeon Dr. Stephen H. Hochschuler that ‘ice should… not be used for patients who have rheumatoid arthritis, Raynaud’s Syndrome, cold allergic conditions, paralysis, or areas of impaired sensation’. This article also says that heat is most often used for chronic pain conditions such as arthritis. So be warned by my Disclaimer as I want to explain what has been an effective tool in reducing my pain but it is outside the above medical advice. 

It started when I did not have access to any of the electrotherapy devices I will describe in other posts. I could sit in my own special chair (which I dragged from home to many social occasions) and in my own special seating in the car to keep my pain levels low. But holidays posed excruciating problems with seating on plane flights (I would stand up when possible), in motels, restaurants and hire cars. Sitting in these would set up an unremitting burning sensation in one buttock and leg. When we decided to fly to Queensland for a family holiday I became absolutely desperate. How could I manage the pain so that I wouldn’t spoil the holiday? The thought came to me to use an ice pack so that I could numb the pain. In this way a campaign began to freeze my butt off!

The ice treatment worked so well that when I returned home I started carrying a small esky wherever I went. The esky contained several icepacks and an ice brick with a tea towel or two for wrapping up the icepack. The tea towel meant that the ice pack didn’t directly touch the skin (or else you can get an ice-pack burn!). And the more I did this, the less I experienced pain – which lines up with the one principle for reducing pain : the more pain relief you can provide the more the nervous system is damped down and the pain levels are lowered. It felt like I was helping the entire buttock area go to sleep and forget the pain. 

old styrofoam esky complete with ice pack covers

old styrofoam drink cooler complete with ice packs & covers

Ice is never going to be a complete remedy. Sometimes the pain in my butt has been too strong for the ice to control. But it is a good way to help stabilise the area and to use in conjunction with other tools. I had already noticed years ago when swimming in the surf and diving under the waves that the chilly water soothed my headache. Sometimes I will tuck an ice pack up under the base of the skull on one side or drape it round the back of  my neck and shoulders and this can mitigate a few headaches. If you’d like to try a safe alternative you could consider rubbing something such as Mentholated Ice Gel (widely available in supermarkets and pharmacies) around your neck and shoulder tops. Of course if you wake up one day and your neck is stiff and you can’t turn your head then draping a hotpack around the back of your neck is best. Don’t use ice in that situation.

As a matter of fact, heat is one of the worst things that can really ramp up the level of pain I am experiencing – such as working out in the garden for a couple of hours in high heat and humidity. I can almost guarantee that I will activate high-level pain when I have a spa (buttock-ache) or sauna (headache). One musculoskeletal specialist said that this reaction to heat is just another indication of how my myofascial pain is intertwined with my nervous system.

You probably don’t have this sensitivity to heat but you can still trial this ice treatment – but only do it for 20 mins – and track whether cold (or heat) alleviates your pain. I know that my first instinct years ago was to reach for a hot wheat pack so I wanted to mention this basic type of pain relief in case you have never tried ice.  You don’t need to adopt my  practice of constant ice packing but I can say for myself that it has never given me an adverse effect in all those years. It has actually helped me to chill out mentally too – my mind can switch off from the pain for a while.  Many is the time I have gone to bed not with a hot water bottle but with an icepack wrapped around my buttock!

NOT snug as a bug