Tag Archives: chronic pain

The new exercise regime

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The new exercise regime

I have been wondering for some time how I can do some exercise to help my other areas of arthritis – essentially everywhere – without dislocating my hip. I have tried walks, but it is not far before I am in too much pain in my spine and exhausted. The pain lasts too, which is rather off-putting to try again. I was reluctant to go to the local swimming baths. Besides them being slippery and noisy, my husband would not be able to be with me to shower and change in case of difficulty. It is also cold. By chance, we heard of a local farm that rented out their pool. The three of us have been going weekly for a few weeks now. It is quiet and is like having a private pool. The water is warm and salty rather than chlorine. Swimming and floating there is a blissful relief from most of the arthritic pain.

I have done yoga though since I was seven years old and got up on Sunday mornings before anyone else to follow the yoga routines on tv. I’m reasonably sure the lady was called Lynne and that it was about 7 – 7:30 on a Sunday morning. I tried to do these myself for the rest of the week. In addition, as I got older, I would spend my time listening to the Top 40 on Sunday evening and spend this time in gentle exercise and stretching too. I was always flexible – hyperflexible even – which is most likely the main cause of my problems now.

So in addition to swimming, yoga was the exercise I missed most. I have thought over a long period of time what I can do to still manage some of these stretches safely. For the last few days, I have built up a new routine while not as challenging does give some stretch and strengthening relief and is something that can be built on. I doubt I will ever be doubling down to the floor again, but with a yoga mat, a chair, a gym ball, 2 x 1kg weights and a couple of cushions, I have a plan.

Warm-up:

Breathe.

Gentle arm raises to the side and over-head x 3 stretching spine.

Raise arms to Mountain pose – bend gently left then right x 3.

Raise arms forwards and with full lung gently stretch back in Sun Salutation. Bend forward slightly lowering arms and holding hands behind back pull up to stretch behind – movement x 3.

Arms out to sides at shoulder height. Turn palms upwards. Bend gently to the right bringing left arm over-head towards the right palm. Hold for 8 seconds. Repeat movement to the left.

Roll shoulders back then forward 3 times each.

Neck – forwards and backwards, turn side to the other side, bend one side to other side x 3 then roll neck fully in both directions. 

All this works on my spondylosis, lordosis and scoliosis – with my trapped nerves in neck and shoulders and my recently acquired occipital neuralgia!

Main:

Holding a chair, bend gently into lunges to both sides, Downward Dog with legs wide and leaning arms at chair height – not floor! – stretch the spine in Cat, then lower to the floor gently.

On each side: Clam x 8 and Side Leg Raise x 8 in 3 blocks. With no abductor muscle on my left, this is little more than tensing the remaining muscles and with a pillow between my knees to stop me rotating forwards and dislocating my hip.

On front: Cobra – hold for 8 seconds, followed by Plank held for 8 seconds, and Swim 8 times each leg. Repeat sequence 3 times.

On back – knees bent and gently rolling sit-ups – just enough to stretch – dragging hands from waist to knee as a guide (to be honest I couldn’t get any further now anyway!) x 8, Bridge held for 8 seconds. Repeat routine 3 times. 

Pillow between knees and lift both legs together. Slowly lower (Clock) to a count of 8 and repeat 3 times.

Sit: Use a cushion to push the pelvis forward and settle into postion where the back is straight. Sit with legs wide and stretch hip tendons. Pull right leg into cross leg position. This is my stiffest hip and knee now so I relax into the pose then pull a little bit further. Release then repeat with left leg. Having had no hip joint here for two years and no abductor muscle it is easy for this leg to flop into a cross leg bend. Relax then pull right leg back to stretch and train into full cross leg position. Relax into soles of feet touching and pull back carefully to stretch tendons again.

Stretch up into sitting mountain pose. Rest arms at breast height on each other and push together – 4 up and 4 down – repeated 3 times.

Pull arms behind back, hold hands, pull up and hold for 8 seconds x 3 repeats.

Roll onto front and repeat adapted downward dog along with cat stretches leaning on a chair before lifting up back to feet. I can’t do this on my hands and knees because my knees are too sore. My left knee is already a full replacement and my right knee is about ready for one.

Gym ball and 1 kg weights. Sit on the gym ball. Raise weights in hands 8 times to either side, 8 times in front to side – like a chest pull – then above head 8 times on either side. Hold weights while doing a gentle figure of eight rotation in both directions 8 times. Repeat – yes you guessed it – 3 times!

Stand and sit on a chair for short meditation to cool down.

It took me about 45 minutes to do this morning and that feels about right. It doesn’t relieve the pain completely, but it does feel better and that at least I am doing something to help myself. 

Bear in mind I have no qualifications or experience beyond what I have learned works for me. When I get to see a physiotherapist again next week I will ask if what I am doing is ok and see what else can be done to strengthen my neck particularly to help the occipital neuralgia. However, it is very calming – and that is an excellent thing :-).

white concrete buddha statue

Photo by Pixabay on Pexels.com

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The nightmare of metal on metal hips continues.

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Whenever there are ‘ups’ it seems there are also ‘downs’. Life is a bit of a rollercoaster. We managed fine last summer. We had a holiday on the south coast and Kent. We managed to find self-catering accommodation with wet rooms etc that I could get into. We visited places that, mostly, I could access by wheelchair. All was well enough that my surgeon booked me in to have a new hip fitted in January 2018.

During surgery, he aspirated over a litre of murky turbid fluid and for a short time I had no huge lump on my left side. He told me though that he had removed so much tissue and muscle that he had stopped just short of plastic surgery, my femur bone was ‘spongy’ and my leg now looks like a relief of the Malvern Hills.

However, it was not to stay that way. Within days the fluid was coming back and swelling my leg and side up again. I was in pain as I stood on the hip and soon it had a significant swelling and was strangely bruised. X Rays showed I had not damaged the bone graft, fortunately, that had been put in to try to hold the hip in place as there was insufficient socket left and no adductor muscle.

I did some research online as I was trying to make sense of what my surgeon was telling me. The particles of cobalt and chromium from the original hip resurfacing do the damage to the tissue but are so small it is almost impossible to remove all of them, so they keep doing damage. My surgeon has already removed a lot of necrotic tissue and bone, the whole of my adductor muscle and part of the gluteus muscle. There are still areas affected but he cannot get to those because they are too close to major blood vessels, so chances are, like any tumour, these will keep re-growing. The x-ray does not show the fluid build-up, but he suggests in a few months we do MRI again, though watch its progress in the meantime. It could dislocate my hip, and also there is a one in three chance it will also happen on the right side. He hopes (!!!) – as do we, that things go better now, but there are no guarantees.

I started to have physiotherapy to build up strength, especially around the rotator cup in my hip. On March 25th on a trip to Bath, my hip dislocated while I was sitting in my wheelchair having lunch. We had an hour and a half drive back to the hospital. I was in hospital for a few days with the dislocation until my own surgeon could do the reduction as he thought he may have to open the hip. He also wanted to prepare a different cup to make it more manageable to keep it in place. He had great difficulty getting the hip back in, as it is a cup designed to be hard to dislocate, but managed to do it closed. Afterwards, he could not dislocate it again, and he is a big, strong man! He aspirated the fluid and took out one and a half litres of turbid fluid that also had large blood clots in it. It seems now that blood vessels are also compromised by the metal particles and tumours. The tumours, he believes are in my pelvis now and, once swollen, the pressure dislocates the hip. I was allowed out of hospital once I was fitted with a brace. Unfortunately, after three days of nil by mouth waiting for surgery each day, I had a urinary tract infection to contend with too, so a trip to the out of hours GP was necessary.

Within a couple of days, there was another bruise on my left side and pain in my groin. There is a concern about an aneurysm. I had a CT scan with dye, but unfortunately, the images were not good enough to see where the bleeding was coming from. Six weeks after surgery my hip dislocated again as I was sitting in my chair and reached to my right side to pick up my coffee from the table beside me. This is now the twelfth surgical procedure on this hip in less than five years – my fifteenth general anaesthetic and surgery altogether. It was reduced by a different surgeon as an acute case. However, we cannot carry on like this. Both my husband and I are struggling with chronic anxiety and depression and finding work difficult now. We have tried to be ‘normal’ in significantly abnormal circumstances for too long and are burned out.

The way forward now in summary.

My own surgeon can do no more and is referring me on to a Plastic Surgeon in a different hospital, as he can do more radical surgery. He:

Feels there may be enough tissue to manage removal and reconstruction.

Can feel at least two tumours.

Considers a 2-stage approach is necessary over 6 weeks to 6 months but is a major undertaking (his words!)

The first stage is complete removal of the prosthesis, cement, cadaverous bone and tissue, preparation, and biopsies to try to make a sterile space.

May be able to use quads muscle as a flap.

He has warnings regarding: 

Bleeding (to the point of exsanguination – though fortunately, they have a cell harvesting system – at least, I hope that’s good!) and that with internal bleeding already it may be that they can’t do anything safely.

The radical approach required will leave a large cavity

Issues related to lots of previous surgery – may not be able to find a way to work easily and cause both more damage and bleeding

Sciatic and iatrogenic nerve damage and femoral vessels – pain and weakness and possible paralysis

Inability to find enough tissue to work with once open

Infection is now about 10% instead of 1%. Actually, they both think the infection is still there but lying dormant

Length of first surgery would be about 4 hours followed by high dependency unit

He feels the waiting list is about 6 months – so we may yet be back to my local hospital with dislocations!

The other new consultant is a trauma hip reconstruction surgeon who works with the plastic surgeon. He:

Feels there probably is still some residual infection ‘hiding’ there.

Would want to do possibly 4 intermediate washouts and tissue debridement between stage 1 (removal of all joint and affected bone and tissue) and 2 (new replacement).

IV antibiotics again!

Will probably put in complete constrained hip – very limited movement – at an eventual second stage.

He warns regarding:

Infection – 10% risk

Inability to put a hip in and may be left without – known as a Girdlestone procedure and long-term antibiotics. I did have no hip at all from April 2016 to January this year, so we are used to that, although it being forever feels like a very big thing.

Despite this, both surgeons did inspire confidence in us and were open and honest.

All this ‘lovely’ news cost us £500, a 150-mile round trip and a panic attack from my autistic son because we were there so long without supper.

We have talked to our GP about funding now for this through NHS, although we are talking about a possible move to the area I can have plastic surgery. My husband’s parents have recently sold their house and are talking about pooling financial resources and us finding somewhere together so they can be on hand to look after us!!!

So … nothing to worry about!

In the meantime, the legal case against DePuy with a group action of 312 people with damage from metal on metal hips has failed. This means that my own group action against the pharmaceutical company is compromised and we do not yet know if a legal case can be taken forward. However, while at first, I had lots of time, there is a time limit on these things and for me, the legal process must start before the third anniversary of my first problem with the hip in October 2015 or I cannot take it to court against the company. They win in all ways while we continue to suffer from what feels to be their neglect in testing.

 

 

 

 

 

Two years down the line.

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It’s been some time since I posted and thought it about time I considered my progress here. 

I successfully got myself off the Tramadol completely. It was an awful month and I felt unwell for another month after that. Not helped of course because when you come off something it needs to be replaced by something else – and that wasn’t there. The effects of the Tramadol made me feel still as though I had a bad flu.

Help was at hand eventually. As nothing surgically could or would be done about my spine (and I don’t much want yet more surgery anyway) I was sent by my GP to Physio. After a few sessions I was referred on to Dr Graeme Brown, who wrote a book I already had on my counselling shelf http://www.amazon.co.uk/How-Liberate-Yourself-Pain-Practical/dp/1899398171/ref=sr_1_fkmr1_1?s=books&ie=UTF8&qid=1439909927&sr=8-1-fkmr1&keywords=graham+brown+pain

and then to his physio team who put me on a functional restoration course. I was sure if this meant I was going to be stuffed, upholstered and auctioned off, but I was happy to give anything a go. It was an assessment, twice a week for 3 weeks and then a final assessment to see what progress was made. Five of us started in week 1. By session 2 there were 2 of us. Not a great start! At one session there was only me. So much for the group experience. The course was a system of exercises to show whether we were responding in a boom or bust fashion and to learn how to pace ourselves to increase activity, in addition to building flexibility and strength. There were talks on realistic goal setting and it was all very much CBT based. However, for me it worked. It gave me permission to not give up and decide I couldn’t do things because if I worked at it then – just perhaps – I could.

I could walk about 500m with sticks and swim 1km. If only I could swim everywhere! I built up little by little with walks with my family, swimming weekly and doing a mixture of the physio exercises with Pilates to make a programme of my own.

Cutting a long story short then.

I do seem to have reached a plateau where I get to 2 – 2.5km and don’t seem to be able to improve. However, I just did 2.3km this afternoon without any sticks. Admittedly I was limping by the time I got home, and this is not necessarily a good thing, but I still did it. I find after about 800m I can feel my left hip swelling. My left side continues to be noticeably weaker than my right and I don’t seem to be able to progress this strength with exercise. That is also the side affected by the nerve pain from my spine and had both a hip and knee replaced.

We took our holiday on our boat. Only a week out of the two, but I walked between locks and managed lock paddles and gates too – often twice each when they were not set in our direction. The worst day was the mistake of walking 2/3 km – a big misjudgement on the map – which wouldn’t have been too bad had it not been in the middle of working through 9 locks.

I can climb the stairs without much thought – usually without holding the banister, unless I am tired. 

I have been doing some gardening, albeit much more restricted than a few years ago but considerably better than more recent years.

Pain is not bad – certainly not worse than it was on Tramadol. It was replaced with Naproxen which I take with Paracetamol. The Paracetamol seems to enhance the effect. I take 2 Amatryptaline (I know that spelling is wrong!) at night to help with the nerve pain. It does seem to be better, unless I overdo things.

There are down sides – I can feel arthritis pain in other parts of my body – further up my spine aches badly and wants to bend me forwards when I walk, my left shoulder and down my left arm, and more recently my hands and feet – especially hands, have become acutely painful and I have take care of them now. Sometimes I watch them pull into spasms I have to gradually ease out of them again.

But what would it be like if I hadn’t had the replacements? It has been hard, especially having them so close together. It made me very weak and unfit and it is a lot to pull back from. But two years down the line I can do these things. They might not be much more than before the surgery – but it’s certainly not worse, and the experience of my upper body tells me by now they would have been much much worse. Two years ago I was in a wheelchair much of the time if I got out of the house at all. Now I’m walking to the river and back with my son.

It was worth it!

The end of the Tramadol tale – I hope!

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I have had no Tramadol for 9 days. Last time I was splitting one capsule into two and taking one half in the afternoon and one half at night. It wasn’t pleasant but I knew by now what the alternative was, and I couldn’t face it again just then. I knew I had to get through a working week. On Friday 6th I took 1/2 capsule before seeing an afternoon client. However, at bedtime I decided it was all or nothing now. I had a weekend with my husband around, so if I was ill then so be it. I couldn’t reduce the individual doses any more. 

Typically I didn’t sleep well on the Friday night, but it seems that was something I know just have to get used to anyway. Saturday and Sunday I spent under blankets on the sofa, chilled and shivering but sweating – I wish I’d remembered heat packs before now because regular top ups of heat into my back made a big difference to my comfort. I ached everywhere. I can honestly say the pain of withdrawal was worse than the pain I was taking the Tramadol for in the first place. I was more used to that pain and it was more predictable and less wearing than the aches. However, I have since discovered aches and pains the Tramadol was masking, even if it was apparently doing nothing for the sharp pain in my lower back and left hip that is stopping me walking far. I had diarrhoea again, very bloated and gassy, nausea and acidic.

Gradually over the week I have felt better. I have found I am exhausted by 4:00pm, but this may have absolutely nothing to do with it. I am not sleeping well because, other than Natrasleep with valerian, I have nothing to make me sleep now and I am sore and hurting, so can’t get comfortable. I’m getting roughly a 1 hour cycle (should be 90 minutes) of dozing between waking and needing to move. I can relax – that is well practised – but unfortunately as soon as I do I start to hurt in my upper back and muscles start to become agitated. The feeling of agitation generally has been frustrating and I spent a good part of Wednesday in tears. 

Things have picked up since though and I think we’re there now. I no longer take Tramadol. I can go and see a new doctor on Tuesday and say I only take Ibuprofen and Paracetamol and this is where I am with pain and movement – not something hidden by Tramadol. I have been swimming as usual and keeping up my yoga and Pilates with my physio exercises. I am personally shocked at how weak I have become over the past 18 months. My muscles and tendons, despite regular exercise, are tight and guarding and exercise stretches that used to be easy for me are now worryingly difficult. However, you get nothing without trying and I’ll carry on. It has occurred to me though that, while surgeons say it is ok to have so many joints replaced so close together, the reality is that you feel as though you have been in a car crash. And in many ways, you might as well have been!

I am still having problems sleeping, but I am waking in the morning feeling brighter than I did regardless of that. My joints and muscles are getting stronger again – I can lift my left leg against gravity 10 x 3 times (with just some pain and effort!) – a few weeks ago I couldn’t do it at all. I am in pain, but I am looking for a different way of managing it. I will not be going back onto Tramadol.

Onwards and Upwards 🙂

Tramadol – the ongoing saga

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When I wrote a couple of days ago, I received some really helpful advice from a person who read the post. It seems from this, and other things I’ve picked up online, that coming off Tramadol is neither straightforward nor easy. 

Certainly it is unpleasant. Yesterday I chickened out. I set myself 3 days for each decrease and it was going to be by a whole capsule. I did feel much better yesterday I must say. I was quite chipper all day until about 4:30 – 7 hours after my previous dose. I’d slept quite well with only one episode of discomfort and agitation – although admittedly it was about 2 hours that I was awake trying to get back to sleep. Again, it was roughly the time my body had metabolised the drug and was asking for more. By 7:30pm I was very pleased to be able to take another and could’t face going all evening and night without.

The person who responded to my last post suggested halving and then quartering the dose. Good advice! Unfortunately not so easy with capsules. I did consider asking the GP for tablets, but decided against it – hoping I’d be off these before the script was even signed and ready. I had a reasonable night last night and this morning also felt ok and not so desperate for Tramadol. I am in quite a lot of pain, but possibly no more than usual. I came down to breakfast – usually I have to take the Tramadol 1/2 hour before getting up just to get out of bed. It was hard work but fine. I felt sufficiently ok to cut the caps in half and give a half dose a go. The rest of the powder is sitting in a spoon for later (possibly for taking with a bit of jam!!) – hopefully this evening and not this afternoon. 

I have got through the morning, and I had client work. It kept me occupied although I confess to being a bit distracted. It feels as though all my nerves are back on the outside of my body and I’m freezing cold and shivery. I also notice, as I did previously, that when I need (!!) a dose of Tramadol my temperature seems to go up and I feel flu like symptoms. However, balanced with the constant tiredness of living on Tramadol, perhaps that’s not so bad, and I know now what to expect and that it will eventually go away. 

So – 2 1/2 doses today, tomorrow and Sunday – maybe Monday too – and then we’ll try reducing again.

The best thing the person who wrote to me said though was a very helpful reminder. The difference between addiction and physical dependency is the addition of psychology. Remembering this is a physical dependency over which I have control makes a lot of difference.

Tramadol Withdrawal

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It’s been some time since I wrote. The new joints are brilliant and I’m so pleased I had them done. The only thing I think is that I hoped I would be able to kneel again, but while the bend is good, I cannot get my left knee sufficiently bent to do that. I’ll keep trying – and I’ll keep working on the sitting crossed legged too 🙂

I had felt my left hip wasn’t improved as much as I’d like, but discovered later it was not pain from my hip but from my spine. It would seem I’m bent in two different directions – scoliosis and retrolisthesis, have osteoarthritis on a variety of discs (well I am getting on a bit) and that I have some vertebral displacement as a result which may be irritating the nerve sheath (otherwise known as slipped discs and trapped nerves – which are not really trapped at all). It has caused some issues with mobility and pain. I’ve seen a specialist doctor but surgery is not the way forward (thank goodness!) and also a physiotherapist. He has referred me on to a more specialist pain physio and he has referred on a gain to a Dr Brown. Turns out he is the same Dr. Brown who wrote a book that I happen to have as he is also a Human Givens Therapist, in addition to his many other skills. I look forward to meeting him in a couple of weeks.

Since I had the surgery, and ongoing as a result of all this, I have been taking Tramadol. It seemed, especially as I am sensitive to Codeine, that Tramadol was the wonder drug. What I now feel it is, is nasty and insidious. I was at one time taking up to 7 a day and got that settled around 4 (sometimes 5). Occasionally I would try to drop it to 3 and feel so unwell and everything so painful that I’d take it back up to the 4. A couple of weeks ago talking to my physio, we got to the point of things being difficult for me because of the pain – hence the referral on. What I went home thinking though was – I’m taking a strong analgesic, a morphine replacement and controlled drug – why can I still not do things because of the pain? Perhaps actually it is not doing anything for the pain at all. On seeing the specialist physio, it suddenly dawned on me when telling him about what Tramadol was like and what it was like when I didn’t have enough – I wasn’t talking about my arthritis, I was talking about drug withdrawal symptoms. That was when I decided I really didn’t want this in my system any longer. Being addicted to pain killers for the rest of my life is not appealing.

The next day – Friday – I dropped to 3 and stuck to it. It wasn’t nice. The Saturday was worse. I felt as though I had flu. My bones and muscles ached and I felt exhausted. However at the weekend I had my family around to distract me. Worse was to come. Sunday I felt shivery and cold. My abdomen was bloated and tender. That night I lay awake agitated for a couple of hours – as though I had drunk too much alcohol and it had metabolised. I felt very nauseous. I was sweating and my skin and pjs were damp, but I was freezing cold.

On Monday I had a stomach upset. Numerous trips to the loo. I was now sweating during the day too – baking hot one minute and freezing cold the next. Icy fingers ran over my skin. I didn’t want to eat – I felt too sick, but made myself have carbohydrates and salt and fruit, and a LOT of water. I wasn’t sure how I would manage, but I’d done a lot of reading online about withdrawing from Tramadol. The symptoms were all typical but the post I most noticed was the one that said the longer I was still on Tramadol the longer the withdrawal symptoms would last. Obviously stopping altogether was not a good plan. Thank goodness my body was only used to 4 a day and not still used to 7 – 8! I decided I was going to try to only have 2 – the one I’d taken in the morning to get me out of bed, and 1 at night. I couldn’t have coped until bedtime. At 6pm I had to take it or supper would not have been made, but I didn’t take another at bedtime. I slept on a 1hour 20 minute cycle through the night waking from vivid dreams in REM sleep each time and agitated. I had to go to the toilet. I was wet with sweat and shivering with cold, but I got through until morning. At 7:30 am I took my next tablet.

Tuesday was not quite so bad. I phoned my GP surgery and explained to the doctor what I was doing. He was quite happy with my decision and my gradual reduction approach. I didn’t feel so sick, but had a lot of pain. What I felt was interesting though was the pain for which I was taking the Tramadol – in my back and hip – was no different to what it had been before. Certainly no worse. Was it actually making any difference to me in the first place? Admittedly I was taking full dosages of Ibuprofen and Paracetamol, but then I’d been taking those all along too. It may have been masked by the withdrawal symptoms, but I’m suspecting not. The pain – the nagging ache in my hands and shoulders and back was bad. I had a splitting headache and the icy fingers started again about 5 hours after my tablet. I’d had a reasonable morning – my body had had its fix! – but by 2:30 I couldn’t function and found the only thing that came close to relieving it all was curling up and staying warm under a blanket. I made myself get through until after supper when came the decision. Better evening or better night. I opted for better evening and took Tramadol 12 hours after the previous one.

I slept better. There was another period of sleeplessness and I woke regularly but it didn’t feel as bad as the previous 2 nights. I woke fully at 6:45 am and counted the minutes until I could have my next tablet at 7:30. I gave in at 7:20 when I didn’t feel I could stand it any longer. The nausea has gone. The stomach issue has settled. It is now 6 hours since my last Tramadol. Only 6 hours to go!! – and it’s just going to get worse from here.

I’m undecided. Do I stay on 2 a day until everything settles down and then reduce to 1, or do I go down to 1 tomorrow for 3 days, following my pattern so far. I’m not sure. It depends how long I can put up with this and my resolve holds. My husband says I am doing well and being quite phlegmatic about this. I think that’s because it’s my choice. I have the power and the control. I can take the drug if I want to – but equally I can choose not to. My body is trying to dictate because it is the easy option and it has become lazy – not producing it’s own innate pain relief. It needs to re learn!

I’ll post again in a few days. We’ll see how I get on and how things change. I suspect going down to 1 and then none might mean continually going backwards for a few days, but we’ll see. Just have to try to find plenty of distractions and relieve the pain as much as possible. Then I can see whether it was ever really helping me and start afresh with a new coping strategy for pain relief.

Arthur the Elephant

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I have an elephant in the room. Well I have a couple actually, and I don’t usually disclose either at work, because they don’t affect my work usually. But it’s been difference and diversity discussion time both on the course I teach and the course I’m taking. 

One of my elephants is called Arthur. (Arthur Ritus – get it?!) elephant

 

 

 

 

This is a story about a cow. It could be an elephant just as well – but this time it’s a cow. It was shared by a friend of mine in a teaching session about chronic illness, and it is just so apt I want to share it here too. It’s part of a story I haven’t read but I’ve put the reference at the end. 

“Having a chronic illness, Molly thought, was like being invaded. Her grandmother back in Michigan used to tell about the day one of their cows got loose and wandered into the parlor, and the awful time they had getting her out. That was exactly what Molly’s arthritis was like: as if some big old cow had got into her house and wouldn’t go away. It just sat there, taking up space in her life and making everything more difficult, mooing loudly from time to time and making cow pies, and all she could do really was edge around it and put up with it. When other people first became aware of the cow, they expressed concern and anxiety. They suggested strategies for getting the animal out of Molly’s parlor: remedies and doctors and procedures, some mainstream and some New Age. They related anecdotes of friends who had removed their own cows in one way or another. But after a while they had exhausted their suggestions. Then they usually began to pretend that the cow wasn’t there, and they preferred for Molly to go along with the pretense.”
Alison Lurie – ‘The Last Resort’.

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It’s the last line especially that always gets me – they pretend the cow (or the elephant!) isn’t there and they prefer it if we go along with the pretence. I wonder how many of us that applies to?! It’s easier on everyone to ignore the elephant, even to push past it, than to acknowledge it and accept it – and especially to have to feel it is imposed on someone else.