Okay, before I dive into this blog, let me tell you a vaguely amusing side story. This blog was originally going to be titled "Kiss my eyes and lay me to sleep", the lyrics from Prelude by AFI. I love that song, and it would have been an appropriate title, as it would match the thoughts and emotions of this blog. However, it was a metaphorical phrase I could not carry for long. So, I was going to change it to something that matched my mindset better, "Managing the Symptoms"...however, this morning I changed the title so it would jog my memory when I had time to sit down and blog. When I sat down two minutes ago to start writing this, I realized that in my exhaustion, I had accidentally entitled my blog, "Managing the Sleep". Perhaps that is only funny to me because I'm so tired, but I felt it was amusing enough to share with you; so, there you go.
So, as I lay awake last night trying to cope with the pain deep in my soul (the soul part is important to remember so that you don't think I'm ignoring a tumor or something), I contemplated all the ways we cope with soul pain and how we so often provide ourselves with supportive care, rather than curative care. The goal is generally pain management through pharmacological and non-pharmacological interventions. I mean, last spring, when my counselor determined (through the use of her computer quiz thing, which I probably could have found on the internet on my own) that I was actually struggling with anxiety as opposed to depression, she was quick to offer me a prescription for anti-anxiety meds. I'm not into using pharmacological interventions as a first line therapy; so, I turned them down. I, instead, have turned to tons of non-pharmacological interventions. I've tried to manage my pain through bubble baths and relaxation exercises. I've used quiet times at the beach and journaling. I frequently use distraction for pain control. One of my favorite ways to do this is to find a task to busy myself with that will keep my mind off the pain. This is very effective for me because in my busy life, there is so not a shortage of available tasks/distractions. I can use other people for distractions -- their lives, their problems, their joys, their stories. I can use purposeful tasks such as cleaning or fixing things or building/making things or shopping. I can use a good book as a distraction. Or if all else fails, I can distract myself by focusing on a very specific problem instead of my systemic aching.
My absolute favorite method of distraction as pain management is music. I have found it very effective to wear headphones. When I have my music on, I can live half in the real world and half in the delicious world of music. I find it to be the non-pharmacological intervention that most closely mimics meds. I mean, I am aware of what's going on in the world around me, but I'm not fully engaged. I'm a bit detached and removed. The real benefit comes from the fact that half of my brain is engaged in the music and the other half in real world awareness, leaving no brain left to register any pain. The problem comes in the fact that I can't always have my headphones on. Sometimes my battery dies before I can get to the one in the charger. Sometimes I find myself in situations where headphones would be considered rude -- when my friends need/demand my attention, when I'm in class, when I'm at work/clinical, when I'm driving (though then I have the radio).
Now, until recently, these interventions have very effectively managed my pain. However, my level of pain has increased significantly recently. Last night, I actually couldn't manage my pain with music. I found myself lying awake listening to music but still feeling an ache intense enough to prevent me from sleeping. Honestly, my pain recently has averaged to be about 8. Yesterday morning, it peaked at a 10 on a scale of 10, in all honesty. Last night, I didn't think it was a 10, but it was definitely too high for me to handle and too intense for my typical pain management regimen. Needless to say, I was frustrated by this. I started thinking of new ways to manage my pain. I realized then why people self-medicate. At a certain point, you realize that your pain is so great that you need to up your therapies, and it's a well known fact that pharmacological interventions can nearly eliminate pain (at least for a time), and if you use round-the-clock dosing, you can sustain a nearly painless state. Now, generally, I'm a law-abiding goody-two-shoes type person...generally...so, being 21, I thought of the two most obvious options for self-medication (tobacco and alcohol, in case you couldn't figure that out). I'm so not a fan of tobacco; so, I quickly threw out that idea. The second, I contemplated rather seriously, as it was feasible and would probably be effective. However, the adverse effects of that particular therapy were too unappealing for me to follow through, especially at 2:30 in the AM when I'm already in my pajamas. It was at that point that I realized that I had been to this place before, that I'd seriously considered self-medication before. However, the medications I was going to utilize would have appeared more benign (just not in the doses I had planned). It saddened me that I would be even considering self-medication...it frustrated me that I couldn't take advantage of a pill-pushing counselor at that moment. However, I was very pleased with myself for not considering any more permanent interventions (if you catch my drift).
I then started thinking about how the sensation of touch can block pain sensations from registering...something about the pain sensations traveling faster or competitive inhibition at the receptor...I forget the actual mechanics. Anyway, point is, I was thinking about that as I caught myself trying to clutch at the location of my own pain. Unfortunately, you can't hold your soul and make it feel better or massage the pain away. I will say, though, touch does help. I figure this must be related to why some find themselves using physical intimacy to cope with the spiritual/emotional pain. Lord knows I've wished I could. For a while now, I've been painfully aware of the lack of touch in my life. I read a study once that found that 5 hugs a day improved your mental/emotional health. If that's the case, I'm chronically and dangerously deficient. I think I've probably received 5 hugs in the past month...maybe I've had a few more, but I'm pretty sure the number's in the single digits.
I suppose it doesn't matter too much, though. As the title of this post suggests, it would just be symptom management. While pain may be an immediate concern, it is a symptom of a much deeper problem, and until I treat that problem at the source, I can never be truly rid of it. I will admit, I am at least closer to identifying the source, which is necessary in order to treat it. It makes it possible for me to utilize interventions that treat my problems on a much grander scale. However, as any good nurse knows, if you want a patient to be able to participate in the activities necessary for treatment, you must administer analgesics before the activity is performed. So, while I need to treat the problem at its source, my pain must be managed so that I am able to take the steps necessary for therapy and rehabilitation. I can't participate in my treatment unless my pain is under control. So, I guess I must develop a better, more complete pain management regimen so I can begin to incorporate more invasive treatments into my care plan.
In closing, it's interesting to analyze your own care...to serve as both nurse and patient (obviously under the Great Physician, if you will)...it's interesting, to say the least.