The Pain you are expected to endure with many chronic illnesses outside of a hospital would seem inhumane to a healthy person. For the uninitiated, that’s like planning to relax on Sunday night and getting lost in watching “Kourtney and Kim take New York” but then all of a sudden Kris Humphries appears on the screen.  Friends look on as you double-over to bear down and “make yourself small” as that somehow helps in staving off sheer agony (and it simultaneously makes it difficult to see Kris Humphries constantly look like he thinks someone farted on the show yet he can’t quite figure out whom) or you are overheard writhing in pain from the closed bathroom door, but there’s nothing they can do.  Taking you to a hospital is pointless because some chronic illnesses routinely cause this type of frightening pain on a daily or hourly basis and as long as you are not in jeopardy of dying, our healthcare system steers such a patient to a “Pain Management” Doctor.

Escaping from Pain with Dreams

What are you then to do when even a doctor trained in treating pain can’t alleviate the debilitating effects of these unexpected pangs of gut-wrenching debilitating events of suffering?  (Insert your own Kris Humphries metaphor here but “moving to Minnesota” is not a bad one.)  I try to sleep through the bouts of the most debilitating pain episodes hoping the world of REM sleep and its resulting colorful dreams will take me out of reality and into a calm, pain-free place.  But after just so many dreams of being the only one to show up naked to school or realizing at the end of a semester that I forgot to drop a class and now must cram an entire year’s studies into one night, the pain becomes so pervasive that the “Director” of my dreams actually incorporates my pain into the storyline.  For example, it is not uncommon for me to suddenly wake up screaming and kicking to get off of a hospital gurney on the way to the operating room to have my stomach cut open for the 15th time all the while lying still in my bed.  It sounds a bit creative to mix the world of Dreams with the reality of pain but it’s actually sadistic and a symptom of Post-Traumatic Stress Disorder.  That or my Dream “Director” is trying way too hard to win an Oscar.  You’d know exactly the feeling I’m describing if you tried to sit through Martin Scorsese’s 2002 film, “Gangs of New York” or his 2004 effort, “Aviator.”

 What does the Pain feel like?

People always ask, “What does it feel like?” While doctors order you to “rate the pain on a scale of 1 to 10.”  To the caring people I answer: “Think about the pain of child birth during the most intense moments of Labor except remove the expectation of a beautiful baby being the reward for coping and conquering the pain and replace it with a fear that the pain may never end and that there’s no consolation prize for being tough as nails.”  As for Doctors, they mean well by seeking to devise some type of “Scale of Pain Relativity” because then they can most effectively treat your pain and possibly even use your experiences to help other patients with your same chronic illness.  Accordingly, you tell your physician of a morning pain of “4,” an afternoon “7” and an evening “9” but do these seemingly “universal” ratings cross over into all chronic illness?  For example, is a Bone Cancer “6” Pain Rating the same as a Rheumatoid Arthritis “6” Pain Rating or is it more aligned with a Crohn’s Disease “10”?

Universal Ratings for Pain and their Ramifications

Some pharmaceutical companies follow these Pain Scales and create narcotic Pain Medications specifically for certain diseases as if the intensity of “Pain” for any one disease feels differently to a patient than another.  Health Insurers follow their lead in terms of coverage and reimbursement such that if a Pain Medication created for a Cancer Patent helps one with Crohn’s Disease, the Insurance Company will not cover it being dispensed for Crohn’s Disease.  In some states, doctors might also be prohibited from such “off-label” prescribing practices.  (I experienced this a few years ago with the pain-killing drug, Actiq.)  Just as disconcerting is the subjectivity and individualized nature of pain which always makes me think of the futile attempts by Internet Dating Sites to create a Scale or Rating System for “Attractiveness.”  But is a woman who is a “10” in Iowa equal to one who is a “6” in New York or does access to, or importance of, style, have a modifying effect on this proposed  system of “Good-Looking-Ness”?  Moreover, my “9” might be your “7” and vice-versa.  There are just some things in life which cannot be quantified.

Lest we not forget that when you seek unemployment benefits but suffer from a chronic illness and the pain affects your work availability, you will be denied those Unemployment Benefits.  Yet, when you suffer from so much chronic pain that it is impossible to hold down a job, especially one where you must show up, interact and report to others, you are also often denied Disability Benefits or you must pay an attorney to sue for them on your behalf.  In such scenarios, you are deemed too sick to work and too healthy to be disabled.  Huh?  That’s what chronic illness and pain does to your life.  They cause enough medical difficulties so that you can’t plan to work or have a meritocracy-based professional career but you can still watch “Kourtney and Kim take New York.”

Summary

Thanks to Pain Management Doctors, people who struggle with severe and chronic pain can aspire to live some type of desired lifestyle but in order to do so they must have a sense of humor about it all as real serious pain has no consistent side effect-free solution.  However, “Pain,” as a problem by itself, deserves more respect as a debilitating cause of poor or unreliable health.  Just because degrees of Pain can’t be standardized doesn’t mean they aren’t’ by themselves “paralyzing.”

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