“How would you rate your pain right now? One means no pain at all, and ten being the worst you’ve ever felt.”
For a long time, I didn’t know how to answer, because I didn’t think I had really experienced a ten. I’d given birth at 22, and of course that had its moments, but I’d had a successful epidural and comparatively minimal things to deal with in the recovery phase, so that didn’t stand out in my mind as a painful thing. Plus, I tend to forget pain fairly quickly after it goes away; a habit I did not deliberately cultivate but for which I am deeply grateful, because I think it’s quite adequate to remember that something was painful without reliving it.
Then I had appendicitis, with a non-laparoscopic surgery because they weren’t quite sure when it might burst, and spent several days in the hospital, followed by several weeks of recovery at home. When I realized that I couldn’t cough without rushing to clutch a pillow to my midsection and sneezing seemed like a particularly cruel and unusual cosmic punishment, then I thought, “Oh, here. Here is what a ten feels like.” Those early days were punctuated by sharp bursts of misery, and that became the milestone to which I compared other pain.
A year or so later, a C-section reminded me of just how difficult abdominal surgery is, and reaffirmed that definition of “ten.”
In the past four months, I have given birth without the benefit of medication, though that certainly wasn’t in the plan: two failed epidurals plus a quick labor meant this baby was coming out the natural way, like it or not. (I don’t think I’ve ever told Isaac’s birth story here, have I? Too busy almost-dying in the weeks following, I guess… I’ll get around to it sometime, he deserves his little moment in print). Immediately afterward, my whole world became shaded with different styles and shapes and colors of pain, from the initial “lower right quadrant discomfort” that started it all, to waking up with one 10-inch-diameter wound in front and a 5-inch-diameter hole all the way through my abdominal wall on the side and trying to roll over in bed so that my linens could be changed when I couldn’t sit or stand by myself, to the white-hot agony that was a VAC dressing change (or, rather, two at once, but who’s counting?)… I’ve had lots of new tens, each one replacing the last as a new pinnacle for “worst ever.” I hadn’t even realized there was a contest; I would much have preferred to abstain from that particular sort of competition, given the choice.
I’ve also had the constant background noise of the spondylitis, the nasty ache and grind of my lower back, which has effectively erased my memory of the one-through-three zone. I simply cannot remember the last day in which I had no pain at all, and have learned to function through – sometimes ignoring, sometimes white-knuckling through, sometimes medicating into submission – this constant background pain. I consider a three or four to be acceptable; not likable, but livable. It crunches my pain scale down, and makes me wonder if I should start calling my normal day a one, now, just to give myself a little more descriptive space when other stuff pops up.
The problem is, when other stuff pops up, as it has a few times this summer, it seems to blow through the roof very quickly. I don’t know if that’s because the events – ongoing wound care issues, and two seromas in the past two weeks – truly are independently, seriously painful, or if, as some doctors clearly believe, I have just destroyed my pain tolerance through ongoing opiate usage. I suppose they could be right, I could be pathetically incapable of handling the slightest insult to my body now… but somehow I tend to think that having a scalpel pushing through to open an inflamed pocket of fluid a full inch inside my abdominal wall, suddenly and unexpectedly beyond the reach of the surface-level lidocaine numbing and thus a shock to the system, qualifies as actually painful. Somehow I think that waking up the morning after an inch-long incision was carved deep into my flesh without benefit of systemic anesthesia (i.e., no Ativan, no Versed, just some topical numbing and a shot of Dilaudid before it started) would be associated with a serious spike in pain, especially when the surgery was unplanned and carried out when I was alone, and scared, and confused, and sad.
Or maybe I’m just delusional, allowing my psyche to completely overstate the intensity of the situation, playing it up for the audience, perhaps just med-seeking in the first place. Maybe I somehow willed these seromas into being just so I could have the singularly delightful experience of begging for medication and receiving that judgmental, head-shaking attitude while they begrudgingly doled out medication. Don’t get me wrong, psychology does matter – says the former psychologist – and I am certain that my mindset plays a huge role in my ability to mediate pain… but apparently taking daily doses of an opiate simply destroys my ability to accurately perceive my own experiences.
I don’t know. I do know that I have, once again, redefined “ten,” because the combination of a scalpel reaching past the numbness, an inch into my body, to abruptly collapse a cavity that had spent the prior several days swelling and inflaming the tissue around it… plus a day of aloneness and fear in the ER… those add together to create yet another high, in a contest I would really, really like to stop entering.
I’m home now, and able to smile at my children and walk myself to the bathroom – skills I temporarily lost, over the past two days – so I can, once again, start the recovery process. And maybe this will be the time that I can actually advance farther along that road, from “healing” into “better.” Maybe.