Left of Tomorrow

by Wendy J. Lyons

  The experience of pain is totally personal. Only words can describe the pain we feel and what it does to us physically and emotionally. However, words conjure up different things to different people, depending on their past experiences and their interpretation of these words. There are many factors that influence our response to pain. Stress makes us less tolerant of any situation, as does lack of sleep. One’s state of mind plays a significant role as well. Anxiety and depression also lower the level of pain tolerance.

  I decided to find out about pain management clinics and to discover what they had to offer. I had obtained a referral to one from my local doctor and went to my first appointment with this specialist. I learnt that there was a pain personality and that most people suffering from chronic pain take on these traits. These patients are both obsessive and perfectionists. The fact that they cannot control their pain is intolerable to them and makes them feel imperfect. This results in a loss of self esteem and deepening depression. However, some of these people do enjoy their poor health and either use this to make their friends and family feel guilty or as an excuse to avoid any activity they dislike. Chronic pain patients can also become addicted to their pain. As I had been experiencing the central nerve pain for over six months, the specialist assessed me as suffering from depression and chronic pain syndrome.

  He explained that the way one sees or perceives pain can be changed by the use of various medications and special techniques. Understanding the pain and learning skills to cope, control and tolerate it, helps overcome the feelings of loss of power that can develop. Focusing and concentrating on other activities can distract the mind from the pain experience. This therefore, raises the pain tolerance level, giving one back a sense of control. Medication in the form of tranquilizers, muscle relaxants, sleeping pills, stimulants, anti-depressants, mood elevators as well as pain killers from mild to the heavier narcotics such as morphine, all have a part to play in the management of pain.

  Addiction and tolerance often follow the use of the narcotics in the treatment of chronic pain. The receptor cells in the nervous system readily take up the external narcotics. The body uses these in preference over its own natural painkillers, the endorphins. Other treatment modalities under the umbrella of pain management include acupuncture, hypnotherapy, relaxation and meditation as well as group therapy with a psychologist. It was good to know all this research had been done to investigate pain and its accumulated side affects and I was willing to follow the advice of this learned man.

  He explained that he would start me on medication and told me that the central nerve pain I was experiencing was very difficult to shift. The area of the bleed in my brain was the very area where pain was registered and the slightest injury to these specific and particular nerve cells caused the pain. He prescribed a number of drugs for me to take. I was to introduce them one at a time to assess tolerance and to be sure that the side effects did not outweigh their benefits.

  Chemistry

  The first medication I was given was Symmetrol, an anti-depressant drug, which left me feeling very vague and drowsy, but did not reduce the pain I was experiencing. Next, I was given Luvox (Fluvoxamine Maleate), which is used for treating Obsessive Compulsive disorder and severe depression. It was suggested that I take one 100mg tablet per day, but the initial dose was to be half a tablet. I did exactly as directed, but the next morning I could not open my eyes or even manage to speak. I thought at first I was having another stroke, but this sensation of paralysis affected both sides of me. I felt so drugged I could not get out of bed, so stayed where I was, eyes closed until the following morning. Concerned, I called my pharmacist and was informed it was an allergic reaction to the drug. I contacted the doctor who could not believe the gross side effects; stating it was as though I had overdosed on two full tablets.

  The third prescription I was given was for Endone, a synthetic Morphine-like drug. This was successful in reducing the intensity of the pain; however, it was effective for a period of three hours only, and I was allowed just two tablets per day. This meant that there were very large gaps in the pain management plan. The violent reaction to the Luvox, and the effects of these chemicals on my mind and system were of great concern. There surely must be a safer and less invasive way of controlling pain.

  Dragonet

  I remember visiting my good friend Peter, a hypnotherapist, when I had severe nerve pain in my left arm and shoulder some years earlier. This was a result of the neck surgery I had after my work accident. I decided it was time to visit Peter again as his treatment had been successful, and I had enjoyed a positive outcome.

  On my first visit to Peter in 1996, he encouraged me to imagine this pain as an object, to give it form, shape, substance and colour. Immediately an image of a large chunky starfish formed in my mind. It was mud coloured and rough textured, like thick bark. Its stubby short arms clung tightly onto my left shoulder, its body pressing heavily into my neck. I could feel it drawing out my vitality through the many rows of suckers on its underside.

  Peter was happy with this imagery and we started the hypnotherapy, he leading me into a meditation. He had me imagine myself walking along a beautiful beach listening to the sounds of the surf and the call of the sea gulls. I saw the waves breaking on the sand and the shapes and patterns of the water’s edge as it ebbed and flowed. He suggested that I remove the starfish from its position on my neck and place it on the sand above the high water line. Then I continued my walk, enjoying every sensation, the smell of the salt, the texture of the sand beneath my toes, the colour of the sky and ever changing shades of the ocean. Occasionally I returned to the starfish and noted its change. It gradually became less fleshy and lighter in colour until it was dry and brittle, blending into the surrounding sand. On my last trip back to view it, I noticed it had lost its shape and form and had dissolved into grains of sand.

  These sessions with Peter were very successful, and I began to experience less pain. However, I realised that there was still something lurking in the dark at the back of my mind. I recognized that this thing was fear. Fear of the pain, and fear that the pain would return. I used Peter’s techniques to solve this problem. Find an image to describe this emotion or state, and give it shape and form. A huge fire-eating dragon manifested itself in my mind’s eye. Working on this image by myself I was able to recognize that fear is the irrational extension of caution. Without being cautious we would forever be in danger, but when it becomes unrestrained, it controls us.

  Over a few days, I reduced my fear dragon to a tiny little dragon about two centimetres tall. He is no longer threatening, instead he is rather cute. With big bug eyes, tiny wings and his tail wrapped around his chubby tummy, he sits like a cat on top of a large rock. Each day I face him and laugh in his face, or stroke his scales or just flick him off his perch with my little finger. I reported all this back to Peter, at my next visit, and he kept smiling and nodding his head. When I had finished my story, he reached over to the shelf above his desk and lifted down a tiny carved dragon! I knew I had to have my own as well and after a prolonged search found my own fear dragon. He is made of pewter, and is just a baby with his large tummy and tiny wings. I call him Caution and he is now part of my life, although just a little part.

  Riverside

  I decided to see if Peter and hypnotherapy could in fact help me with this unrelenting burning pain. Peter started the session by asking me to describe the pain and I explained my image to him. A petrol tanker, with its tap open was continuously pouring petrol over the whole of my right side and then someone had tossed a lighted match onto me. I was continually being burnt. It was hard to believe when I looked at my right side that it was not black and blistered, but still pink and normal.

  Then I was asked to think about a pleasant peaceful place and chose the banks of the Yarra River at Warburton. We started the meditation. This time my journey was beside the river, taking in the smells of the gum trees and other plants. I heard the sounds of the birds warblin
g, the wind rustling through the leaves of the eucalypts and the blue wattles. And in the background the sound of the ever present babbling of the stream of water as it meandered its way over the stones. Peter suggested that I place my hand and foot into the water and feel the coolness on my damaged side. I had to imagine the water and its healing powers dispersing the pain, and sweeping it away down the river and out to the ocean. He encouraged me to follow the path of the river upstream. When I reached its source in the high mountains I was to bury the dreadful acid burn in the snow. In this frozen place it would not harm anyone and I no longer needed to carry it.

  When the session finished, Peter sorted through his collection of small stones and handed me a highly polished black stone, smooth and warm to the touch, with a flaw down one side. I accepted it enthusiastically. Yes, it had a flawed side, just like I did. It was not perfect, but it was beautiful. Now it is my responsibility to remember these images and my flawed memento is my link and my reminder. This stone had been rough, with sharp edges when it first went into the river. Over time the water had not only washed it clean, but had polished it brightly and smoothed its corners. Now it was something to be admired.

  Lost in space

  It continually amazes me how our brains function. How can something so incredible and so sophisticated in its processes still be unable to see its own inconsistencies. I have often tried to point out to my brain that it holds two opposing and contradictory statements and has not successfully resolved this issue. There is one little group of cells whose job can be likened to those fire watchers who spend their days on the top of the fire watch towers ready to report the first sighting of a bushfire. My brain cells keep calling out a warning that my right side is on fire. Meanwhile there is another group of cells close by who continually chant this mantra, ‘There is no right, we’re all that’s left’ Neither group is prepared to acknowledge the other’s existence and I am stuck in the middle of this farce.

  I am reminded of that terrible television show of the seventies, Lost In Space with the ineffectual robot flapping its vacuum cleaner hose appendages while its mechanical voice repeated over and over, ‘warning, warning’ and Dr. Smith ran around like a headless chook. Meanwhile the Robinson family took little if any notice of these two and calmly continued on with the business at hand.

  I do acknowledge the work of the fire sentry cells and check out their information. I thank them for their steadfastness in continuing to function. However, I would really like them to take some time off and have a break and give me one too. I try shouting out to the other group that I do have a right side and if the cells next to you can recognize it, why can’t you? They are so busy wallowing in their grief and loss they can neither see nor hear what is going on around them. I feel their pain, I share their pain but I really would like them to have some closure, particularly as their anguish is not based on reality.

  I still need to concentrate every day and think out each action rather than take them for granted. It certainly is mind over matter – my mind and my thought processes controlling the grey matter of my brain. If I left this organisation to my brain alone my life and movements would be a mess.

  My mind is always active calculating my sense of balance when I walk. When someone grabs my arm to support themselves my mind goes into overdrive. I now have to add the weight of their body to mine to keep my centre of gravity balanced or we will both stumble and fall.

  Since my stroke and the subsequent loss of consciousness of my right side I am left with an undefined mass of heaviness that weighs me down and anchors me to the ground. It feels as if I am bound by solid balls and iron chains that constrain my freedom to move.

  Part 8

  Breathless

  In March, I visited my doctor complaining about a pain in the back of my neck. After an examination, X-ray and ultrasound we discovered that I had a frozen right shoulder. The weight of my weak right arm had caused the joint to become solid and it was only when my back and left side of my neck were involved, that I actually felt anything. With no feedback of pain from my right side, I was unaware that this painful condition had arisen. I mentioned all this to my good friend Nola and she suggested that I visit her wonderful physiotherapist, Melanie.

  Melanie was both enthusiastic and dedicated. She saw each of her patient’s suffering as a challenge to overcome. She worked hard to understand and resolve our problems. Melanie explained that the ‘frozen’ shoulder was caused by reduced muscle tone in my right arm. This flaccidity resulted in weakness and loss of strength. We worked at improving the muscle tone.

  ‘Push against me,’ Melanie would say, and together we would have a battle of strength. I tried my hardest to overcome her resistance. My face would turn red with the effort, and I would feel about to burst until I suddenly remembered that I had forgotten to breathe.

  I would look at Melanie and discover the same look of concentration on her face as I felt on my own, and I realized I was not the only one who had not taken a breath. We would burst out laughing, recover our breaths, and resume our exercises. It was so wonderful to have someone working with me and for me, devising new ways to improve my muscle tone. I listened intently to everything Melanie said, but in my happy and relaxed state the words just flowed over me. I knew what I was doing and what I needed to practice at home, and why, I just could never remember the names Melanie gave these particular exercises.

  She explained that after a stroke, the body naturally changes its posture. The affected arm has a tendency to pull in closer to the body and chest, and the hand to become clenched and twisted. To counteract these actions Melanie demonstrated some exercises for me to perform; for example, stretching my right arm above my head with fingers extended, and holding this position for some minutes would unlock the frozen state. The I want more food, and take it away, actions involved me rhythmically moving my hand and arm towards my body and then away from it. This was to encourage my brain cells to repattern the responses from rigid closure to a freer, more relaxed movement.

  New leaf

  As I read over these few last paragraphs I begin to feel guilty. Here I am espousing how important a patient’s input into their rehabilitation is, and that their motivation is the key to producing the best results, and to make a difference. However, I realise I am lying back and passively allowing Melanie to do all the work. Even if I am physically contributing to the session I am aware I have divorced my mind from it.

  So I will start anew and consciously attend Melanie’s instructions, albeit the peacefulness and safety of her presence, and will direct my thoughts to the job in hand. I know that I am not alone in my response to Melanie. Nola and another good friend from stroke support group, also succumb to the magic that Melanie exudes. Each of us has been guilty of staying a little bit longer, stretching our five minutes of relaxation on the treatment bed a bit further or actually giving into the sensations and having a quiet sleep in these peaceful surroundings. We feel so safe and secure and can relax our strong grip on our bodies when we are with her.

  Many exercises we have done seem to be so simple and yet are so effective. I use weights in my hand to strengthen it, and stand like a stork on my right leg, each day increasing the number of seconds I can hold this position. By leaning on my right hand I force the muscles in my arm to respond to the weight of my body. The exercises are neither difficult nor complicated, yet each one forces another set of muscles to perform their function and strengthen this side. These exercises can be incorporated into my daily life. Peeling vegetables can still be done on one leg, while weight bearing can be achieved when I am vacuuming the house. I push the cleaner forward with my hand, pull it towards me and use the resistance of the carpet to counteract my actions. My house gets clean and the dinner is prepared and I also grow stronger on my right side.

  Acidity

  Many months later I was having a follow up session with Melanie. I commented to her that coping with the acid burn pain I was experiencing in the back of my right th
igh was still my greatest challenge. Melanie suggested that she would investigate it and see if anything could be done to reduce the intensity and severity of the pain. We were both amazed to discover that the region where I experienced this pain was the area that covered the hamstring muscle. Melanie examined the muscle and discovered that it was so tightly contracted that it was as hard as a rock.

  She spent some time massaging the area and we could both feel the tension lessening. The massaging needed to be very deep and it was excruciatingly painful as she worked on me. Over the next few weeks I used heat, massage and Tiger Balm ointment to continue the work. I was thrilled with the results. Within that space of time the size of the painful area was reduced from a postcard size to an almost insignificant postage stamp and the intensity of the pain was also much easier to bear.

  I was informed that my description of acid eating away at my flesh was possibly accurate. The lactic acid trapped for so long inside my hamstring muscle could account for all this pain. We had all dismissed this pain as being the result of the damage to my brain cells, when in fact it could have been as a result of this muscle caught in extreme tension. The affected area did not disappear but over time it has also not increased in size and as a constant it does not loom so large in my mind.