Post-surgical notes on pain: Tolerance, Perception, and Ego
Post-Surgical Notes on Pain: Tolerance, Perception, and Ego
The Joyful Path LLC
by Lydia Lowery Busler
I tend to think of myself as hard-to-kill. I've had a great many catastrophic events in my life, months at a time hospitalized, and have died and come back. I've also grown back parts of my body thought impossible. It tends to make one think of oneself as impenetrable. It's not even something I think to discuss. It's just like having an arm. "Yup, that's my arm. I've had it a long time."
So many who know me think of me as a survivor. That's fair, though personally I'm working toward a more peaceful existence these days. Others have noticed my extremely high pain threshold. I'd never really considered it strongly, I just don't fear pain and what I feel about it has been me all along. Why make a fuss?
Quite recently, I had major abdominal surgery. You see, one of those events earlier in life left me with some missing organs and just bits of others. Turns out that had been creating a whole lot of inconvenience for me for the last 5 years. Once things get mixed up in there, space is replaced by scar tissue that attaches in weird ways. Organs that no longer exist don't help support the rest of the functioning organs. Between wear-and-tear and time passing, the entire system wasn't working well at all but it was difficult to pinpoint what exactly my configuration would be in there until I was opened up and the organs were held back in place via some lovely modern tailoring.
It ended up being a long surgery that went into the night and I had some time in the hospital to think. I've also given myself the entire month of March to recover. I had a couple of experiences that gave away my pain threshold.
This got me thinking about my pain threshold. How do I know others just feel pain more strongly than I do? In fact, how can we compare? We can't use bio feedback very easily. The thing about me is that I don't flinch, my breathing doesn't change, and my heart rate stays steady. So how do we know I'm actually feeling pain at all? Well honestly, I can assure you that I feel pain quite thoroughly, but if I can bear it, how do we know I don't feel it less?
I realized that our pain sensation/tolerance is not able to be measured by anyone else or even ourselves. Allow me to explain.
The macro is that we are either:
TOLERANT or INTOLERANT as defined by our behavior, our internal definition, or arbitrarily.
Here's a breakdown:
TOLERANT
- Highly sensitive - tolerant
- Perceptive - tolerant
- Unperceptive - tolerant
and
INTOLERANT
- Highly sensitive - intolerant
- Perceptive - intolerant
- Unperceptive - intolerant
We can’t know the details of another’s level of perception. But we can tell their tolerance. We can tell our own tolerance based on feedback. There’s a grey area when someone is screaming from some bodily harm most people would consider to be highly painful.
The question is, are they feeling that highly painful thing as much as someone else?
I am highly pain tolerant. This doesn't mean that I don't ever react to pain, but I don't react until what's occurring is far beyond where most people would react.
"I’m now playing with the idea of my perception."
Accepting pain - is that mindset? If so, is it advantageous? Some people unabashedly call themselves wimps and are supported by comforting measures. They may be squeamish around needles and there's no shame in that. Staff will usually support you if you faint, give a topical anesthetic, or try to make you laugh and sneak the needle in when you least expect it. So I haven't come up with a true advantage to the grin-and-bear-it method.
I’ve watched my own surgery when I could; I watched my foot surgery on a screen. I usually watch my needles, too. I’m pragmatic and curious. But it doesn't necessarily mean I'm sensitive. It still doesn’t speak to perception.
I had an ingrown toenail cut out once with no local anesthetic. Honestly, it hurt. Still, it was ok, there was no reason to make a fuss. So I still can’t tell if I perceive as much pain as someone else. How can one compare?
Several dumbbell weights fell on my foot from a high shelf when I was hanging out at a friend's house as an early teen. At the time, I hopped around and said “ow ow ow”. My friends laughed at my antics.
Later, the hospital found I'd completely crushed my foot/phalanges. Doctors were shocked by the level of damage, yet it tells me nothing of how much I feel. I may be just a good actor!
Last week, I was given a drug in the pre-op while testing with another practitioner (if you've never been in pre-op, it can be a very busy and multitasking place). The nurse didn’t want to interrupt my test, so she administered the drug into my IV site as slowly as possible while I was busy.
About ten minutes later, I inquired if I'd received all my shots by then. The nurse acknowledged, saying she’d administered the last drug for now. I mentioned feeling a strong burn in my groin a few minutes back. Her jaw dropped; turns out this nurse had past experienced that the drug she administered gives a groin itch if given fast; while it’s given quickly to those already under anesthesia, she noticed that they all respond by reaching down to scratch. After inquiring about the scratching trend, she was told about the groin itch some people get and that the remedy to avoid this is simply slow administration. So she assumed I’d felt no itch because nothing showed on my vitals and I didn’t flinch. Yet to me, it had quietly burned quite a bit…
Last, I didn't accept anesthetic before my spinal last week. I wasn't concerned. When the spinal was inserted and kept there, deepening, I felt it. It was curiously nasty, unpleasant, and long, but it wasn't worthy of a moan or flinch. Apparently nothing showed on my vitals. They said, "wow!" Do I get an ice cream?
I think only the groin burn tells me anything about my perception - they saw no sign that I felt an itch while I felt much more than an itch. Every other example is inconclusive/subjective, and there's really no good reason for me to accept pain.
Then there's my migraines. I have a TBI or Traumatic Brain Injury, and it's par for the course for me. Migraines don't always hurt, sometimes there are just neurological symptoms: my vision goes backward, I feel like I am at a steep angle to the earth, I feel like my body is detached and far-flung, I lose my ability to speak, I can't keep things in my hands without tossing them. I give myself a shot nowadays to keep that from occurring. Still, migraine pain still occurs and used to get me a lot. I'd go blind and deaf and be left with the pain.
Migraines like that change the scope of a pain chart. I told my primary once that I had a migraine and he asked the pain level. I said it was a 7. He said that I shouldn't be working. I countered that it was only a 7! I'll stop if it got worse! The doc said that he and his colleagues go home when pain hits a 3. In contrast, I'll keep going and stop when it hits a 9 because I want to do something about it before the pain goes all the way.
I've learned to medicate so I'm not a burden on others - and now, I value myself enough to take it for me, too. It's a mixed bag - the meds cause me to feel sort of toxic. Still, they help. Yet if it goes to a 10, I sometimes find that I have no idea what the scale is anymore, because it keeps getting worse...11...12...13...
Now that's my 11, my 13. It may be worse than your 13! It also may not be as bad. Perhaps we all feel it the same, we only anticipate it and react to it more or less. But I doubt it.
Why it matters to me is that I care, and I'm curious and have time to think about it right now. I've noticed that I feel much more peaceful as I commit this month to nothing but healing. In past emergency situations, I haven't had this luxury because rest was enforced by months-long hospital stays and I worked hard to get better. Being intentional frees me to surrender to the process of healing and do what feels right as well as receive care. Nothing else needs to get done. I can do something that I choose if I want to. If I overdo it, there will be feedback, but no shame - just the experience of the feedback.
There was a point to this, just before coming home from the hospital, in which I felt dehumanized and brought to my core. I had to center myself in my body as I realized that I had no idea how I was going to go forward with my body the way it was because it suddenly seemed as though it wasn't working.
As it turned out, when I asked for help, I found that my body had still not completely woken up and a dosage of medication was too high, causing dysfunction. Allowing myself a fretful moment had caused me to fear that dysfunction was going to be my life! As soon as I stated that this was not acceptable, however, a solution presented itself.
Coming across these thoughts of being dehumanized, I realize there's ego involved with our humanity. Being dehumanized is what brought me to my core. Now, every day brings ups and downs, and the lower the lows, the higher the highs. It's a tiring but beautiful process. It's another part of the journey.
I recommend this journey to you. I'm so calm. Allow yourself to really feel and then time to be - just see if you can do it without incisions. See you next time.
I tend to think of myself as hard-to-kill. I've had a great many catastrophic events in my life, months at a time hospitalized, and have died and come back. I've also grown back parts of my body thought impossible. It tends to make one think of oneself as impenetrable. It's not even something I think to discuss. It's just like having an arm. "Yup, that's my arm. I've had it a long time."
So many who know me think of me as a survivor. That's fair, though personally I'm working toward a more peaceful existence these days. Others have noticed my extremely high pain threshold. I'd never really considered it strongly, I just don't fear pain and what I feel about it has been me all along. Why make a fuss?
Quite recently, I had major abdominal surgery. You see, one of those events earlier in life left me with some missing organs and just bits of others. Turns out that had been creating a whole lot of inconvenience for me for the last 5 years. Once things get mixed up in there, space is replaced by scar tissue that attaches in weird ways. Organs that no longer exist don't help support the rest of the functioning organs. Between wear-and-tear and time passing, the entire system wasn't working well at all but it was difficult to pinpoint what exactly my configuration would be in there until I was opened up and the organs were held back in place via some lovely modern tailoring.
It ended up being a long surgery that went into the night and I had some time in the hospital to think. I've also given myself the entire month of March to recover. I had a couple of experiences that gave away my pain threshold.
This got me thinking about my pain threshold. How do I know others just feel pain more strongly than I do? In fact, how can we compare? We can't use bio feedback very easily. The thing about me is that I don't flinch, my breathing doesn't change, and my heart rate stays steady. So how do we know I'm actually feeling pain at all? Well honestly, I can assure you that I feel pain quite thoroughly, but if I can bear it, how do we know I don't feel it less?
I realized that our pain sensation/tolerance is not able to be measured by anyone else or even ourselves. Allow me to explain.
The macro is that we are either:
TOLERANT or INTOLERANT as defined by our behavior, our internal definition, or arbitrarily.
Here's a breakdown:
TOLERANT
- Highly sensitive - tolerant
- Perceptive - tolerant
- Unperceptive - tolerant
and
INTOLERANT
- Highly sensitive - intolerant
- Perceptive - intolerant
- Unperceptive - intolerant
We can’t know the details of another’s level of perception. But we can tell their tolerance. We can tell our own tolerance based on feedback. There’s a grey area when someone is screaming from some bodily harm most people would consider to be highly painful.
The question is, are they feeling that highly painful thing as much as someone else?
I am highly pain tolerant. This doesn't mean that I don't ever react to pain, but I don't react until what's occurring is far beyond where most people would react.
"I’m now playing with the idea of my perception."
Accepting pain - is that mindset? If so, is it advantageous? Some people unabashedly call themselves wimps and are supported by comforting measures. They may be squeamish around needles and there's no shame in that. Staff will usually support you if you faint, give a topical anesthetic, or try to make you laugh and sneak the needle in when you least expect it. So I haven't come up with a true advantage to the grin-and-bear-it method.
I’ve watched my own surgery when I could; I watched my foot surgery on a screen. I usually watch my needles, too. I’m pragmatic and curious. But it doesn't necessarily mean I'm sensitive. It still doesn’t speak to perception.
I had an ingrown toenail cut out once with no local anesthetic. Honestly, it hurt. Still, it was ok, there was no reason to make a fuss. So I still can’t tell if I perceive as much pain as someone else. How can one compare?
Several dumbbell weights fell on my foot from a high shelf when I was hanging out at a friend's house as an early teen. At the time, I hopped around and said “ow ow ow”. My friends laughed at my antics.
Later, the hospital found I'd completely crushed my foot/phalanges. Doctors were shocked by the level of damage, yet it tells me nothing of how much I feel. I may be just a good actor!
Last week, I was given a drug in the pre-op while testing with another practitioner (if you've never been in pre-op, it can be a very busy and multitasking place). The nurse didn’t want to interrupt my test, so she administered the drug into my IV site as slowly as possible while I was busy.
About ten minutes later, I inquired if I'd received all my shots by then. The nurse acknowledged, saying she’d administered the last drug for now. I mentioned feeling a strong burn in my groin a few minutes back. Her jaw dropped; turns out this nurse had past experienced that the drug she administered gives a groin itch if given fast; while it’s given quickly to those already under anesthesia, she noticed that they all respond by reaching down to scratch. After inquiring about the scratching trend, she was told about the groin itch some people get and that the remedy to avoid this is simply slow administration. So she assumed I’d felt no itch because nothing showed on my vitals and I didn’t flinch. Yet to me, it had quietly burned quite a bit…
Last, I didn't accept anesthetic before my spinal last week. I wasn't concerned. When the spinal was inserted and kept there, deepening, I felt it. It was curiously nasty, unpleasant, and long, but it wasn't worthy of a moan or flinch. Apparently nothing showed on my vitals. They said, "wow!" Do I get an ice cream?
I think only the groin burn tells me anything about my perception - they saw no sign that I felt an itch while I felt much more than an itch. Every other example is inconclusive/subjective, and there's really no good reason for me to accept pain.
Then there's my migraines. I have a TBI or Traumatic Brain Injury, and it's par for the course for me. Migraines don't always hurt, sometimes there are just neurological symptoms: my vision goes backward, I feel like I am at a steep angle to the earth, I feel like my body is detached and far-flung, I lose my ability to speak, I can't keep things in my hands without tossing them. I give myself a shot nowadays to keep that from occurring. Still, migraine pain still occurs and used to get me a lot. I'd go blind and deaf and be left with the pain.
Migraines like that change the scope of a pain chart. I told my primary once that I had a migraine and he asked the pain level. I said it was a 7. He said that I shouldn't be working. I countered that it was only a 7! I'll stop if it got worse! The doc said that he and his colleagues go home when pain hits a 3. In contrast, I'll keep going and stop when it hits a 9 because I want to do something about it before the pain goes all the way.
I've learned to medicate so I'm not a burden on others - and now, I value myself enough to take it for me, too. It's a mixed bag - the meds cause me to feel sort of toxic. Still, they help. Yet if it goes to a 10, I sometimes find that I have no idea what the scale is anymore, because it keeps getting worse...11...12...13...
Now that's my 11, my 13. It may be worse than your 13! It also may not be as bad. Perhaps we all feel it the same, we only anticipate it and react to it more or less. But I doubt it.
Why it matters to me is that I care, and I'm curious and have time to think about it right now. I've noticed that I feel much more peaceful as I commit this month to nothing but healing. In past emergency situations, I haven't had this luxury because rest was enforced by months-long hospital stays and I worked hard to get better. Being intentional frees me to surrender to the process of healing and do what feels right as well as receive care. Nothing else needs to get done. I can do something that I choose if I want to. If I overdo it, there will be feedback, but no shame - just the experience of the feedback.
There was a point to this, just before coming home from the hospital, in which I felt dehumanized and brought to my core. I had to center myself in my body as I realized that I had no idea how I was going to go forward with my body the way it was because it suddenly seemed as though it wasn't working.
As it turned out, when I asked for help, I found that my body had still not completely woken up and a dosage of medication was too high, causing dysfunction. Allowing myself a fretful moment had caused me to fear that dysfunction was going to be my life! As soon as I stated that this was not acceptable, however, a solution presented itself.
Coming across these thoughts of being dehumanized, I realize there's ego involved with our humanity. Being dehumanized is what brought me to my core. Now, every day brings ups and downs, and the lower the lows, the higher the highs. It's a tiring but beautiful process. It's another part of the journey.
I recommend this journey to you. I'm so calm. Allow yourself to really feel and then time to be - just see if you can do it without incisions. See you next time.
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