A Recent Dance With Pain

A week ago today my right leg was screaming. I had been having some previous twinges, some more intense, but mostly manageable, bearable. I had a recent evaluation which indicated that the hip was not involved and that the most probable diagnosis was either a pulled muscle in the groin or bursitis of the right hip, or both.

Well, three days later, at the end of the day the pain numbers kept ratcheting up and by 10 P.M. I simply turned to my wife and said: "you have to call the ambulance, now!" Whatever was going on, it was not right and the pain was continuous at that point.

The EMT's were great. They put an IV line in and gave me some Fentanyl which helped with the transport. They were focused, very helpful, asked all the right questions, and explained to me each step of the way what they were doing.

In the E.R. things seemed to be going fairly slowly, but at that point the pain had subsided to the point where I wasn't saying ow, ow, OW! over and again. Then the pain came back to the original plateau of "10" and that repeated several times for the next several hours.

Interestingly, as I recall it now, I never asked them to relieve the pain, or to do something about it; my primary comments were "Man this HURTS!" and what is causing this? At that point also, I wasn't freightened because my own assessment was that "I" was ok but my leg and maybe hip wasn't. Another way to say that was that the core of me was safe and well, but a peripheral process was in real trouble right then.

After several doses of a powerful narcotic (dilaudid), the leg started to quiet down. During that time I had a CT with contrast, and I later found out that many of the major nasties had been ruled out: i.e., broken bone, tumor, kidney involvement, deep vein thrombosis, etc. The diagnosis was still fairly vague but the recommendation was clear, admission to the hospital. No argument from me.

I was placed on morphine and started on another medication Toradol. Thankfully the pain subsided after about 2 days and I was able to back away from the narcotics. My sense is that the Toradol was very helpful as both a local analgesic and also a potent anti-inflammatory. The black box warning on the medication states that it in NOT to be used for more than five consecutive days so I knew that it would have to do whatever job it was going to do and either help to resolve the still undiagnosed problem or something else would have to be used.

The money seemed to be going towards a diagnosis of hip problem and that led to a cortisone shot into the hip. I was discharged from the hospital after a total stay of 4 days.

For now just two additional comments. First, in retrospect, I was amazed how rapidly the process of pain, effective immobilization, separation from my usual surroundings, some grogginess from the meds, etc., my world shrank. At one point I found myself sitting with my head down, and just rhythmically running my hand through my hair, all the while wondering where this was all going. My world shrank both inside and outside. Pain can do that to you. Immobilization can do that to you. It's hard to keep your attention on the horizon when your world shrinks. I will have to think really hard on the implications of that process for me and others.

Maybe another way of looking at that is that, thankfully, I / most of us don't have that much experience with intense pain. But based on my experience of those four days, I am aware that I need to learn all the lessons of that experience in that (thankfully) unusual-for-me state of pain. It will help to develop resources and "tools" for dealing with it in the future should the need arise.

Thankfully, I had a great roomate and we became great supports for one another. He has had much more experience with intense pain and his kind and supportive and understanding comments were as powerful as the medicine in some ways. Also, my family and friends were right there for me and the staff was almost uniformly excellent except for one nurse who was too invested in starch and efficiency.

Secondly, after the intense pain subsided, I was left with an apprehension over whether the pain would come back again. That's understandable, of course, and with each day, the nagging vigilance and the emotional vulnerability is subsiding, thankfully.