Tuesday, 21 March 2017

MS Pain: The Reality

I'm in the second week (feels like lifetime) of the worst pain I've ever experienced thanks to the MS Hug.  It sounds so lovely, a cuddle from MS, but believe me it's torture as the MS Trust explain.

I started off determined not to take any pain killers beyond the neuropathic pain relief I take every day; but within 48 hours I gave in and took the prescribed analgesic and 24 hours later doubled the dose.  At this level I don't actually have less pain, but at least I can sleep through most of it which makes each day more bearable.  

In my windows of consciousness I am spending quite a lot of time thinking about pain and it's causes; it's different forms especially of MS pain and pain relief.  I haven't come to any great conclusions; but thought my ponderings and diagrams (created to help explain my pain to Mike and Rachel) might be interesting to others.  If you'd like actual facts about pain then I recommend Pain by MS Trust.

I'm sure most of you have been asked to rank pain you've experienced in your life.  From 0 for no pain to 10 for the worst pain you've ever experienced.  I never got much above 5 with childbirth but way up at 9 with gallbladder pain.  But this pain, on my old scale, is way over 15 which probably just means I was over-judging the gallbladder pain.  I've been wretching with this pain and a few times have thought I would pass out, it's not great at all.  

I've made my own pain scale diagram to help see the funny side of pain.

  1. Pain
  2. noun
  3. highly unpleasant physical sensation caused by illness or injury. "she's in great pain"
  1. mental suffering or distress. "the pain of loss"

Until the last few months I'd never really thought about pain and what different people might be experiencing every day or when they're in pain.  According to this dictionary definition, pain is a highly unpleasant sensation caused by illness or injury.  But what about pains which are just part of life?  I have had strange physical sensations which I guess might be considered unpleasant.  Have you ever thought about  what you feel and if it's normal?

On a normal day; what do your arms feel like?
How about your legs?
Your stomach?
Your head?

I don't remember a time when my left arm doesn't feel useless.  I mean that it's always heavy and feels dragged down and takes a huge amount of effort to move it.  It's been like that since my teens at least and I put it down to being very dominant right handed and therefore my left arm is a bit useless. 
 Is this normal?  

And my stomach, it has always rumbled and been sore after every meal, that's my normal and I just assumed everyone could feel their stomach moving after meals.  
Is this normal?

How about loosing the feeling on your face?  I often can't feel my face especially my left cheek and forehead and then it will come back and feel strangely warm.  I never even thought about why that might be.  
But now I'm wondering, is this normal?

Perhaps these were and are all symptoms of MS?

MS Pain
I have broken down the various pains and other strange feelings I have experienced into seven forms. 
I think about them as building blocks, with the lower numbers being annoyances which I've got used to; and the higher numbers having a dramatic impact on my life.  The higher the blocks of pain stand on any given day, the worse I feel and the more my day is negatively impacted.

0. Strange Sensations 
The foundations of MS pain are not pains, I have named them as strange sensations like temperature changes or tickling feelings or the current super strange sensation of my knee bleeding.  They are not debilitating, they can be quite entertaining to identify, but they are all part of the pain structure and they do take part of my brain time to process and they can be very distracting.

1. Pins and Needles
I get pins and needles in my limbs all the time, I've even had it in my tongue or in patches on my body.  They are a huge annoyance and a distraction which I can ignore through mindfulness or by applying pressure on points elsewhere on the body.  They bothered me a lot when I first got them, but not anymore.

2. Numbness in limbs
I often loose the feeling in my left leg and I don't think I've really felt below my left knee for about 6 months.  I get bruises on my left foot and have cut myself and not noticed.  It doesn't bother me although I've come to realise I do need to be careful.  More recently I can go numb in the right leg, which isn't funny when the left leg is also being useless; or in my arms which means I drop things. 

3. Shooting pains in limbs
These are like electric shocks and they can happen in any part of the body.  They demand my attention, especially the first few times they happen in a day; but then I can normally distract myself from them.  After an hour though they're tiring and mean I can't concentrate properly and get exhausted quicker than normal.

 4.  MS hug low level
I used to think this was horrid, but since I've had the proper full on MS hug I long for those days.  This lower level hug, once I've got used to it, can be blocked out but that takes energy and concentration, I need to lie down to get any relief of any sort and this is a huge impact on my day.

5. Spasms in limbs
I tend to find them funny in my legs, although means I can't walk safely, but really difficult to deal with in my arms because can't do anything reliably, tend to tense muscles so need to be constantly aware of this and relax, stops my ability to think clearly; 

6.  MS hug with spasms in torso
I can't distract myself from it, every breath hurts, can't get comfortable, pain moves as spasms move and then I find myself tensing other muscles to try and get relief.  It takes all my cognitive ability to relax and cope, pain killers have their own side effects including sleep which doesn't solve the exhaustion and disrupts my day.

7. Headache/Migraine
 I often get a headache, mostly associated with optic neuritis and therefore through the eye balls which affects my vision and really gets me down.  I can't distract myself and can't sleep with this which makes me really irritable.  Sometimes I get migraines, these are impossible to ignore and I need a  complete shut down and sleep for a few hours.   

But that's not the whole picture!
This is....

There's more to pain than just pain.  There's the ability to cope with pain.
I can cope better with any of these types of pain, or buildings of pain, after a good night's sleep.  

How the building combination is made up of these different pains complicates how I feel.  And when they change in a day that means everything is up for grabs.   If I'm ill, especially with a temperature or with swollen glands, then everything is exacerbated. And then of course there's the constant tinnitus which is at two pitches all the time and sometimes as many as four and is really distracting.  Everything is worse in a noisy or busy place because that's too much sensory information to process.

And MS likes to throw in fatigue and exhaustion separately into the mix, and this is like a load pushing down on top of the pain making it all so much heavier and harder to lift off.

And then there's the pains of mental health, both because I'm feeling rotten and that's depressing and because the cause of pain is anxiety inducing and also because MS affects mood.  Put this anxiety and depression into the foundation of the pain blocks and the whole system becomes less stable and more inflamed; an even harder situation to manage.

PS. There's a TBA box on the top.  
I don't know what this is, but I didn't want to tempt fate by saying I had this pain thing all sorted out, so this allows for something I'm yet To Be Advised about.  I'm hoping I never get the memo.

PPS. This is not a pity party.
Please don't think I've written all this by way of getting your sympathy. 
I have written this as a way of trying to understand my own pain and my life and how I can manage my pain to live life the best I can.  I have written it because I have family and friends who want to try and understand what it's like and I hope this might help.  And I have written this because writing and creating diagrams is a great distraction from pain and has been helpful over the last week, although I've been typing too long now and I'm tired and in pain so there I'll stop.


Liz said...

Thank you for writing this. I can understand more now X

Annemarie said...

What an amazing blog. I'm currently experiencing a flare up and while the clumsiness is and lack of grip is frustrating the pain I have is hard to put into words. As a nurse I know that pain is not just physical but psychological and I can lower my pain score for most of the day focusing on other things. Late afternoon it starts to become more difficult and as the days pass with no sign of this relapse passing it gets harder to deal with. Best wishes xx

Roland Clarke said...

MS Pain is so hard to explain to people, except other MS sufferers or carers. A month ago mine was terrible but it's dulled down. But when I last saw my neurologist, a few weeks ago, I said there were days that it was at 12. That's when everything aches, and my digestive system is rebelling - and I can't to anything. Pacing my days is one answer but doesn't always work. Blessings and light.