Pain Management without Pain Medication

"Are you sure you don't want me to prescribe some pain medication?” The emergency room doctor looked at me in disbelief. I doubt he often has people refuse this offer.

I was in the hospital last Friday afternoon with severe neck and face pain. It doesn't seem to be anything serious, more than likely a combination of my dystonia, being at the dentist for a check-up, and perhaps a type of migraine that hits in the area of the carotid artery, right behind the ear. There's nothing to do now, but wait to see if it goes away or gets worse, and manage the pain.

I'm a medication wimp. Side effects are me. It's not only medications, either. I envy people who can drink a couple glasses of wine without feeling ill or smoke a joint and get that nice, “ooh, life is good..” sort of feeling. I have a tiny bit of medical marijuana and I get that, “ooh, the room is spinning and I feel like throwing up..” sort of feeling. Prescription meds aren't much better. Past experience with pain meds have led me to expect one of three different responses:

1. I will puke my guts out until I am severely dehydrated and end up in the E.R., in much worse pain.

2. My pain will go away, but my breathing is depressed. I'll lie on the couch, not able to move or speak, or sleep, while my breathing becomes shallower and shallower till finally I stop breathing altogether for 30 seconds or so. That's when I suddenly gasp for air in a panic and the process starts all over again...over and over and over.

3. Once in awhile I get lucky and it works, without causing any puking or breathing problems. I will only try this if I'm at the hospital and being monitored. Otherwise, it's not worth the risk

This means I've had plenty of times when I've had to practice pain management without any medications at all. After this last episode, a friend asked if I would share some of the techniques which have worked for me. I don't guarantee they will work for anyone else. Everyone's systems are unique and there isn't an easy answer, but this is what I do:

For chronic pain and to prevent acute episodes:

1. Drink water. Unless I'm puking my guts out, I try and drink as much as I can. Being dehydrated makes pain worse.

2. Yoga. My dystonia can twist me into positions that are not normal for the human body. If I'm already twisting into weird positions consciously, my body doesn't rebel as much with the dystonia.

3. Exercise. Walking is difficult for me, but dancing is delightful. If I'm sitting and working on my computer, I get up and stretch often.

4. Laughter. For me, this means being with real people, family and friends, chatting, telling jokes, sharing funny stories, and laughing at my challenges. It also means writing funny stories and sharing them in this journal, and coercing family and friends into reading them.

5. Massage therapy. Whenever I can afford it. When I can't afford it, I hope to see the “free 5 minute chair massage” sign at the Farmer's market.

6. Balance. Get out of the house. Do housework. Rest. Don't plan more than I can comfortably do without becoming fatigued. Say no when I need to say no.

Okay, I'll admit it. The last one is impossible for me. I've tried. Well... okay...honestly? I haven't tried. My philosophy has been, “If I do this now, I'll be useless later, but if I don't do this now, I'll feel useless all day.” This attitude can be somewhat good for my soul, but the physical body eventually just has to rebel. When it does, I end up exhausted and with acute pain in some form or another. One challenge is, I don't know how much activity will cause me to become exhausted. It varies.

Techniques for managing acute pain:

1. Stay away from screens – TV, computer, cell phone, e-reader. When I am not feeling well, looking at screens will make me tense up. My neck and back will become stiff, my dystonia kicks in, and my vision gets blurry. No screens. (As I love to write, this is hard for me, too.)

2. Drink water and hot tea. Drinking hot liquids helps keep the digestion going. For me, that's essential to pain management.

3. No sweets and no heavy meals. I stay away from sugar and too many carbs. Overeating, if I have any pain at all, will make me feel very ill.

4. Hot baths. This is one of the most effective ways for me to relax.

5. Rest. Rest. Rest. Sleep if possible.

When the pain gets really bad:

1. Lightly stroking the skin. A massage therapist taught me this and it is how I got through a Cesearean birth without pain medications. Any place will work, it doesn't have to be done where the pain is located. It works better if you don't go in circles (don't ask me why) but just random designs. It also works if someone else does this for me. Some people cannot tolerate this gentle touch, but for most of us, it's a simple way of releasing endorphins to help with pain.

2. Focus. This is hard to explain and I couldn't find anything written about it. This is what I've developed for myself. More than likely, someone will write to tell me what it is called; I doubt I invented anything new. I'll try to explain...

Lying down, covered warmly, I start with breathing. In yoga, I learned how to breathe in deeply and breathe out, emptying my lungs as completely as I can. It helps to count. Whatever number you count to as you breathe in, add several more numbers to your outbreath, making sure your outbreath is longer than your inbreath. This helps to calm the nervous system. No, I don't have a scientific study to back this up, but I do have a wonky nervous system that agrees with it.

As I breathe, I start to calm myself. Now, where others might tell me to go to a happy place and not think about my pain, I do just the opposite. To do this effectively, I need to know where the pain is coming from. The more I know about the exact process that's going on, the better it works.

When I know where the pain is coming from, I focus on the pain as objectively as possible. I still feel the pain, but I don't feel the panic that often comes with pain and I don't feel the need to take it away. I just contain it. I mentally let it be in whatever part of my body is hurting, and I try to allow the rest of my body to feel okay, unaffected by the pain.

It doesn't work all the time. I toss and turn and try to get comfortable. Often, though, it is when the pain is at its worst that this technique works the best for me.

Make sure you talk to your doctors about any pain you are having. They can tell if the pain you are describing is something which needs to be checked out at the office or emergency room. Then, of course, if you're not as sensitive as I am, the doc may prescribe pain medication. Take it, zone out (at home), and file this list away for another time.

Ooh, life is good!