| MANAGING PAIN |
The best way to start here would be to describe what type of pain I have and set a
"standard." Pain can be rated on a scale of 0 to 10, with 0 being no pain and 10 being
"unbearable." What I consider to be "10" pain is "the worst pain I ever felt" and that
would be when they removed the foot-long drains from my abdomen. I never heard screams
like that before, and they were mine.
Some people with Crohn's disease experience arthritic type pains in their joints. I get
this pain almost every day, mostly in my hips, knees and ankles. Pain associated with the
disease itself can best be described as a cramping or stabbing pain in the abdomen.
Imagine someone grabbing ahold of part of your bowels and squeezing as hard as they can;
this is what the pain is like. The intestine is a smooth muscle that normally contracts every
90 seconds or so. When there is a blockage or adhesion, the intestine squeezes to try to
push fluid through, but encounters a narrowing or blockage. Have you ever held onto part of
a balloon while blowing up the rest, it is kind of like that. Pressure still builds, and with no
where to go, pain can be very bad.
Now people think that you can become "immune" or "used" to pain. The opposite is true.
When nerve cells become used to sending the same signal over and over again, they actually
become sensitized. So over time, what might have been a "3" pain has now become a "5."
All of this I learned in pain management.
In my case, pain is worse when I eat something I shouldn't. I cannot eat any fruit or
vegetables or anything else bulky, dairy products either. So my diet consists mainly of
meat, pasta and other starches (except fried potatoes), and lots of sugar. I must take in
about 5,000 calories per day to maintain my weight. Once in a while I get really stupid and
eat something like popcorn, which does not digest. This flows down my intestine until it
hits an adheasion, narrowing or blockage. It kind of "clogs the drain" but pressure
continues to build behind it. Until something happens and the popcorn passes, I am in agony.
Those of you who have had abdominal pain know that since your abdomen is the center of
your body, movement of almost any body part becomes difficult when your tummy hurts.
There are many ways to manage pain. There are many wonderful drugs on the market that
help make life more bearable. However, taking a narcotic at the first sign of pain is not
only overkill, it is irresponsible, like putting a cast over a cut. I was once addicted to
narcotics and had the "joy" of withdrawal. Narcotics have their place, but they should only
be a last resort.
When I wake up, I usually have pain level 1-3 going on. When I take my morning meds I will
take tylenol if need be. If the pain gets worse or does not go away, I will take Ultram.
Ultram is a great drug; while it may not take all my pain away, it lessens it enough so I can
function and does not sedate me. The only drawback to Ultram is that it takes about an
hour to kick in.
When I bowl I usually am in a great deal of pain (level 6 or 7) by the third game. I used to
take Ultram before bowling started, in case the pain became bad. Since it took an hour to
kick in, this was my best option. This is kind of like using crutches in the morning in case
your leg hurt at 4 pm. However, one of my doctors recently prescribed toradol. Toradol is
like Ultram in that it does not sedate me. Also, I inject it into my thigh, so it only takes
about 5 mintues before it starts to work. This is great for when I bowl or for when it
hurts to put anything, including oral medicine, into my belly.
The last resort is narcotics. I only use narcotics when the other pain medicines have not
reduced the pain enough for me to sleep, or after a surgery. Not sleeping properly will only
make me worse, so I break out the big guns when I have to. While narcotics kill the pain,
they make me dopey, a feeling I do not like. Again, their addictive properties make them
an absolute last resort. I beat addiction to them once and do not care to go down that path
again.
One final treatment I use for pain is my red clown nose. While it does not take the
physical pain away, it reminds me that for myself pain, like vomiting, etc. is a fact of life. I
can't let the pain I feel ruin my day. I refuse to let pain take away my smile.
"standard." Pain can be rated on a scale of 0 to 10, with 0 being no pain and 10 being
"unbearable." What I consider to be "10" pain is "the worst pain I ever felt" and that
would be when they removed the foot-long drains from my abdomen. I never heard screams
like that before, and they were mine.
Some people with Crohn's disease experience arthritic type pains in their joints. I get
this pain almost every day, mostly in my hips, knees and ankles. Pain associated with the
disease itself can best be described as a cramping or stabbing pain in the abdomen.
Imagine someone grabbing ahold of part of your bowels and squeezing as hard as they can;
this is what the pain is like. The intestine is a smooth muscle that normally contracts every
90 seconds or so. When there is a blockage or adhesion, the intestine squeezes to try to
push fluid through, but encounters a narrowing or blockage. Have you ever held onto part of
a balloon while blowing up the rest, it is kind of like that. Pressure still builds, and with no
where to go, pain can be very bad.
Now people think that you can become "immune" or "used" to pain. The opposite is true.
When nerve cells become used to sending the same signal over and over again, they actually
become sensitized. So over time, what might have been a "3" pain has now become a "5."
All of this I learned in pain management.
In my case, pain is worse when I eat something I shouldn't. I cannot eat any fruit or
vegetables or anything else bulky, dairy products either. So my diet consists mainly of
meat, pasta and other starches (except fried potatoes), and lots of sugar. I must take in
about 5,000 calories per day to maintain my weight. Once in a while I get really stupid and
eat something like popcorn, which does not digest. This flows down my intestine until it
hits an adheasion, narrowing or blockage. It kind of "clogs the drain" but pressure
continues to build behind it. Until something happens and the popcorn passes, I am in agony.
Those of you who have had abdominal pain know that since your abdomen is the center of
your body, movement of almost any body part becomes difficult when your tummy hurts.
There are many ways to manage pain. There are many wonderful drugs on the market that
help make life more bearable. However, taking a narcotic at the first sign of pain is not
only overkill, it is irresponsible, like putting a cast over a cut. I was once addicted to
narcotics and had the "joy" of withdrawal. Narcotics have their place, but they should only
be a last resort.
When I wake up, I usually have pain level 1-3 going on. When I take my morning meds I will
take tylenol if need be. If the pain gets worse or does not go away, I will take Ultram.
Ultram is a great drug; while it may not take all my pain away, it lessens it enough so I can
function and does not sedate me. The only drawback to Ultram is that it takes about an
hour to kick in.
When I bowl I usually am in a great deal of pain (level 6 or 7) by the third game. I used to
take Ultram before bowling started, in case the pain became bad. Since it took an hour to
kick in, this was my best option. This is kind of like using crutches in the morning in case
your leg hurt at 4 pm. However, one of my doctors recently prescribed toradol. Toradol is
like Ultram in that it does not sedate me. Also, I inject it into my thigh, so it only takes
about 5 mintues before it starts to work. This is great for when I bowl or for when it
hurts to put anything, including oral medicine, into my belly.
The last resort is narcotics. I only use narcotics when the other pain medicines have not
reduced the pain enough for me to sleep, or after a surgery. Not sleeping properly will only
make me worse, so I break out the big guns when I have to. While narcotics kill the pain,
they make me dopey, a feeling I do not like. Again, their addictive properties make them
an absolute last resort. I beat addiction to them once and do not care to go down that path
again.
One final treatment I use for pain is my red clown nose. While it does not take the
physical pain away, it reminds me that for myself pain, like vomiting, etc. is a fact of life. I
can't let the pain I feel ruin my day. I refuse to let pain take away my smile.
