An Introduction to Pain

My life has seen moments of dabbling in psychic pain, but my 5-1/2 decades on the planet has somehow spared me the experience of severe physical pain. Up to now, I've broken no bones, had no surgeries, no serious burns. My physical traumas have been limited to an occasional sprained ankle, many cuts and bruises, but nothing whatsoever that's more serious than than that. I've been exceedingly luck and blessed that way.

Last week, though, fates gave me just a small taste of real pain. It was a lesson my education has been sorely lacking.

On Father's Day, I slipped down the back stairs, and upon planting one foot on the bottom step in an effort to catch myself, the major tendon and smaller ligaments in my right knee said "oh no, you don't," and turned loose of their grip on the surrounding bones. In scientific terms, it was a "complete rupture of the patella tendon, and partial rupture of anterior patella ligaments." Among the symptoms was a knee cap that decided it would rather take up residence floating above the muscle in my lower thigh, rather than over the knee joint itself.

All I know is that it hurt, big time. It hurt in the way that causes you to gag and pass out, even when doped up on morphine, at the moment the paramedics try to lift you onto the stretcher.

I"m on the mend now, three days after surgery to repair on the damage, and the pain is now entirely manageable. I now find myself, though, with the utmost respect for those folks who deal with serious burns, or joint problems that create steady, neverending pain. I don't know if I could do it, as this little, ordinary, garden variety tendon tear is just about as much as I care to deal with.

I've observed some things about this kind of sudden physical injury and associated pain.

• The shock is to the system as much as to the pain endings. To suddenly have a perfectly serviceable body part stop working entirely throws the system into disarray. The notorious pain from the first few days was largely a product of associated body parts shocked at the disruption to the status quo. Pain spasms in butt mucles, lower calves, toes, stomach unrest, were all just about as debilitating as the ache in the knee itself. In fact, the lessening of pain over the last few days has been largely about coaxing the rest of my body into relaxing the tension they were holding out of empathy for the knee parts.

• A good part of the pain is entirely mental. In this case, the physical pain itself was greatly increased by the simple mental thought of knee parts disintegrating within. It was a shocking thought to me, and hence the pain was equally shocking. At the point where I began to understand the mechanics of the various holes and loops and sutures the surgeon had drilled and threaded and sewn, the whole thing became much less threatening and hence less painful. Knowledge ameliorates pain, it appears.

• Pain management medications can and do work, but like everything in life, there are tradeoffs. The benefits, other than obvious pain relief, is that the colors on your flat screen TV become considerably more intense, the music more compelling, odors from the garden more intense. The drawback is that you will invariably deal with a little bit of sweating and irritability as each dose wears off, not to mention the disappointment when television is no longer interesting. For myself, anyway, I'm following these guidelines: pills to reduce pain and allow sleep: yes: Pills to make daytime television seem more interesting: no.

• Severe pain tends to be undifferentiated pain. In the process of getting better, the global throbbing ache has given way to a series of clearly identified pains of the various incisions and stretched body tissues. On one level, the pain is probably just as severe as it was early in the week, but now somehow understanding the locus of each throb, being able to identify and understand it, makes it considerably more manageable. I take this to mean that attention and focus have some benefits for dealing with pain.

• Don't listen when nurses tell you that pain medications will constipate you. Under no circumstances should you take the recommended laxatives, because a single small dose will open the floodgates for many days to come. No minor thing, when partial disrobing is required for each use of the restroom.