Chronic: The Pain We Don’t See, Chapter 16

Top illustration by Tim Forkes

Chapter 16: Storms Monday: October 26, 2020

The scientific jury may be out on how barometric pressure affects people who suffer from forms of chronic pain. However, it is more than a coincidence when the weather changes, some of my pain changes with it.

This past week saw morning skies that were overcast and a thick marine layer that lingered throughout much of the day. With the onset of this weather came an all too familiar aching that set in over my entire body. My joints ached, muscles throbbed, and stiffness set into my hips, knees, elbows, and shoulders. I tried three days of pain medication with little relief and followed it up with some Toradol spray that gave me a brief break for a day before the pain returned. It culminated yesterday with a morning bike ride in which the entire ride was spent trying to block out my discomfort. Normally, if I exercise when I feel this way, I get a break from my pain.

Along with the pain came an increase in fatigue. Mentally and physically I felt empty. I was asleep by 7:00 pm and tired the moment I woke up the next morning after ten or more hours of sleep.

Then, this morning, I woke and felt great. My pain was gone as was the stiffness and soreness. I felt refreshed and ready to tackle the day. There was also a big change in the weather overnight. The marine layer was gone and replaced by Santa Ana winds which brought with them a drop in humidity. The air pressure changed and now I feel pain free.

I am reminded of how much I loved the Bay Area days where the skies were gray and threatening. They spoke to me and told me to go out and play hard and I always obliged. After school, I would play all afternoon until it was time to come home for dinner. After dinner, if there was any sign of daylight left, I would be outside playing some more.

By the time I was 12 years old, I began noticing how much my body ached, especially during the late fall to early spring time. I began relying on ice packs and heating pads to provide me with relief. It was the same type of aching I still feel today only my dad, a doctor, passed it off as growing pains.

Throughout high school, I suffered in silence from the same aching after soccer practice. Even after a vigorous game of basketball in a morning PE class would result in me aching the rest of the day. These “growing pains” would stay with me throughout adulthood. By the time I moved to Hemet in the Inland Empire, I noticed a change. With the dry arid weather, there was less aching except during spring. Teaching PE, I noticed we had a lot of gloomy weather from February through April and my body always seemed to ache teaching outdoors at that time of year.

Now I live closer to the coast in Ventura County and it is not uncommon to have weeks like last week where the marine layer is thick, the moisture level is high, and my pain is back in full force. I have mentioned this to some doctors who tell me there is truth behind the effect of barometric pressure and humidity on aches. Others look at me as if I am nuts to believe in this. All I know is there were too many times over the past year where I have been able to link an overall aching body to gloomy weather. This summer was particularly painful for me and it was also one where the June gloom never left until later in September.

I also remember how when this type of weather would strike when I was in a more depressed state, my depression would be worse. To be in a dark place is one thing. To be in pain is its own thing as well. To be experiencing both at a high level at the same time is overwhelming. You put all your energy into trying to fake being alright because you just do not want any attention. When asked how I was doing, I learned if I told people I was fine, they left you alone. Fine meant I was okay, not great enough to want to hear about my day and not bad enough to ask why. Being fine was a way to end a conversation you were not up for having.

When you suffer from pain, depression and fatigue, you just want to be left alone. You retreat into your own world and you hope for whatever it is you are feeling will pass so you can get on with enjoying life. The problem is if left untreated, your mind becomes reprogrammed into thinking what is not normal is now normal. Your brain stops producing feel good chemicals to balance your mood. It’s pain sensors remain turned on so your body is constantly lit up. It forgets how to not feel pain and has to be retrained.

By the time I began seeing a pain specialist in 2014, seven years had passed since my major bike accident. Seven years of constant pain had retrained my brain to think pain was normal. I had to go through three series of injections. I would be placed under general anesthesia and a doctor showered my spine with cortisone injections.

When I would come to, I could look in a mirror and count as many as one hundred injections that ran the full length of both sides of my spine from the back of my skull down to my tailbone.

After the third session, the inflammation was knocked out and my brain was finally able to reprogram itself. No longer would it interpret inflammation as being a normal state of being. The relief lasted for three years before returning in 2017. By then, I moved to Ventura County and the specialist I saw informed me the method I was treated with before is not considered wise because excess cortisone can wear away bone and if it is being injected into the spine, it is a recipe for major spine issues down the road.

Today, I know the difference between Mother Nature induced pain and that which is associated with my neck. I cannot control what nature throws at me, I can only control how I choose to treat it. It helps knowing it is temporary, something that is hard to believe when in the midst of accompanying depression. It is a part of me for whatever reason and it clearly is not going away.

My neck related pain is another matter. It too is not going anywhere for the time being. It’s hard to know when I have done something to irritate it. I do have more control over it in terms of what I put my body through. I limit what I do in the gym. I focus more on maintaining a neutral head position as much as possible. I decide when I need medication for it and what type to use. In this way, I have more control over it than I realize.

If I am unwilling to make changes and adapt to the challenges my neck presents to me, I know I can expect to feel a lot of misery. However, by constantly evaluating what I do, how I do it, and how often I do it, I am able to decrease the frequency of neck related flare ups. While it is the more serious of the two forms of chronic pain I get hit with, I finally feel more in control of it. Other than moving away from this area to one that is drier and warmer, there is little I can do about the local weather.

Knowing we are in control of more things than we sometimes think we are goes a long way toward helping us handle any challenges we face. I may never get to a point where chronic pain is a thing of the past, but I at least know I am approaching a point where it no longer feels like it controls my life. The same goes for my depression.

Today, it was miserable outside. Wind gusts hit 60 mph and there was no way to do anything outdoors. Still, I woke up pain free. I enjoyed a challenging workout in my garage with the door shut and my music up loud. I helped get our water heater changed out, the floors cleaned, and some laundry done. Best of all, none of it felt like a chore because I did not hurt. The weather could change tomorrow. I might sleep on my neck wrong and have burning pain shooting down my arms. None of that matters because it does not change today.

Today was a check in the win column. I will deal with tomorrow when it rolls around.

Saturday: October 31, 2020

My winning ways have come to a crashing halt. This has been a frustratingly tiring week and with each passing day, my tank seems emptier than the day before. I can’t blame any weather patterns, hard workouts, or inflamed discs in my neck. For the most part, my usual pain has been held in check. However, my energy is about as low as I can imagine it getting.

I began noticing increasingly sore muscles, the type that comes from over-working a group you have not worked in a long time. Along with the soreness came a significant decline in arm and leg strength, so I opted to take things easy this week with my workouts. I also made sure to get plenty of rest and eat well.

Tuesday, instead of riding my road bike as usual, I spun at a light pace on my spin bike and followed it up with a good stretch. Instead of getting any relief, by that evening, it hurt just to walk. My arms were no better. From the elbows up to my shoulders, it hurt to straighten or bend my arms. From the elbows down, there was just a general feeling of weakness.

The next morning, I was unable to do much of anything in my gym that required me to use my arms. They felt like they had nothing in them in terms of strength and it was just as well because any full arm movement set off waves of pain in my elbows that was usually preceded with loud cracking. I decided mowing and trimming the lawns would have to do for my exercise that day.

Thursday’s morning road ride was changed again to another easy hour of spinning indoors and followed again with more discomfort. I should add that I have been adding in massaging my legs regularly after my rides to help with soreness. Now they were too sore for me to want to touch. Worse, even though I didn’t do any strength work the day before, my arms now felt like I was walking around and holding sandbags. Simple tasks like reaching for a cup or grabbing a snack out of a cupboard felt overwhelming and often resulted in me dropping or knocking something over.

Yesterday, in my gym, a workout in which I set up a circuit of core exercises followed by a circuit of arm exercises let me know just how far my strength had declined. A year ago, when my fatigue began to be a noticeable problem, I would have done each circuit three times. This time, it was all I could do to complete each one once.

I was still holding out hope that today I would enjoy a nice bike ride. Normally, the type of training I did this week would kick in with me feeling much fresher by the weekend, so I set out to duplicate my ride from two weeks ago. There was nothing in me today. A perfect fall morning was spent with me gassed from the start. I ended up cutting my ride short. There was no point forcing the issue. My legs were done early, my arms hurt, and even shifting gears with my fingers was a chore at times.

While struggling up a climb I easily did three times two weeks ago, I realized I have to get to the bottom of this fatigue. When I got home, I asked my wife to make me an appointment to see the Physician Assistant she works for who does hormone testing and replacement therapy. It’s time I get my testosterone checked. I have been tested by this person before and have had low T levels. I used to receive replacement therapy, but last year stopped while I was being tested for other blood related matters by my primary physician. This year, I have wanted to see if I could remain off testosterone therapy while seeing if my fatigue subsides as I get my pain under control.

It is more than just my fading strength that worries me. Low T levels can also result in other issues, some of which I have noticed more lately. I can’t hold a thought to save my life, my sleep is sporadic, and my sex drive has disappeared. While there is a risk involved with taking testosterone, I also know my life can’t go on where I feel the way I do. Seeing someone who is an expert in this area and being monitored regularly may go a long way for me to get back to feeling a little more like my old self, or rather, my younger self.

Thursday: November 5, 2020

My energy continues to be missing. Each day that passes sees me dragging myself through the day just to get the basics accomplished. I wake early feeling worn out and spent. Food and caffeine fail to jump start my energy. I try and workout only to be unable to get through what I have jotted down on paper. When I am finished, I just want to curl up and go back to bed but I do not dare.

This morning, I was in line early to get my blood drawn. I am anxious for the results. Have my testosterone level and white blood cell count dropped again? If not, then is my thyroid off? Either one of those could explain why I feel so sluggish.

I am also interested in knowing how my cholesterol level is as well as my PSA. In the past, my cholesterol has been a little high so I am on a statin. I am hoping my diet has improved enough to bring it down. As for my PSA, well, any guy my age wants to know his score because no one wants prostate surgery if it can be avoided. Normally, my score is very low.

Another possibility for feeling drained is stress. The presidential election was two days ago and as I write, we still do not have a winner. I would be a liar if I said it did not matter to me who won. It matters a lot. Like many in this nation, I have grown tired of Donald Trump. For the life of me, I do not understand how so many voters see him as a solution to any problem.

Our nation, like my body, seems like it is in a chronic state of pain, fatigue, and depression. The rich get richer, the poor get poorer, and the middle class continues to disappear. Wages are stagnant if you can find a decent job. Health care is under assault. There is no guarantee social security will be around for the next generation. And then there is COVID. Yesterday was the worst day in terms of new cases for the virus and we are now over a quarter million people dead from it, not to mention those who suffer long term or permanent damage after contracting the virus.

We are looking for groups to blame and inevitably, this leads to an increase in hate. This hate has been exacerbated by a president who encourages it among his supporters. Consequently, this election has been fraught with worry over the future of this country and whether we will survive as a nation.

Since my childhood, I have always been interested in current events. I remember as a five year old coming home on the bus from kindergarten and seeing groups of parents in tears over the news of the JFK assassination. Five years later, I was riveted by the coverage of the murder of MLK and my mother woke me up in the middle of the night to watch the coverage following RFK being gunned down while my siblings slept. Politics, race, and social issues have always touched me so I was naturally more on edge about this election than most.

Like my body, this nation has a lot of healing to do. It needs to take a long look at itself and determine what course of action is in its best interest. Failure to do so is just going to result in greater pain down the road and more complex problems to solve.

However, with age comes some wisdom and I have learned all I can control are my actions and the choices I make. In that regard, it is my choice how I move forward in life both in terms of my health and the health of this nation. I gain nothing if I punish someone over who they voted for. The golden rule goes a long way toward helping a nation heal from its pain. I also know I have to follow my own golden rule I use when training others who are struggling. I must continue to listen to my body and respond in a healthy manner. It may not be what I want to do, but it is what is in my best interest long term.

Just as I cannot impose my will on another person who sees the world differently than I do, I cannot impose my will on my own health. The more I push, the more I can expect resistance to the point where I break. I need to remain patient and see the bigger picture. I can remind myself of the ebb and flow of life and how it applies to me as much as it does anyone else. Sometimes I just have to float along with the course of the tide of life and wait for when the time is right to expect more from myself. Now is not that time. Perhaps, in another week or two, this will all change and I can get back to expecting more from me.