Having fibromyalgia, pain is something that I think about a lot. Mostly because it's a constant companion in my life these days. I was chatting with one of my best friends about this just yesterday, in fact. She asked me if everything hurt, which is kind of a complicated question. I had to stop to think and decide how to answer. At the time, I was having a pretty good day. So the most basic answer was "No." But that doesn't really give the full picture. What I told her was, "No, not everything hurts. But there's never a time when *something* doesn't hurt." Which she said made sense.
I think pain is something that most people have a hard time understanding. It's not usually something that's visible to the naked eye. And, let's face it, most types of pain are things that eventually go away. That broken bone or sprain heals and stops hurting. That headache goes away. So it's normal for them to expect the pain from fibromyalgia to go away, too. After all, isn't that what the medication is for? To make it so that you don't hurt? That's what the ads you see on television seem to say, anyway. The reality is that it's not nearly that simple.
Yes, there are now medications approved to help treat fibromyalgia pain. Three of them, actually, have now been approved by the FDA specifically for that reason. What people don't understand, though, is that these medications don't eradicate the pain caused by fibromyalgia. What they do, under the best of circumstances, is to take that pain down to a manageable level, a level that enables you to still function on a day to day basis. For example, since I started the Cymbalta and got up to the full dose of 60 mg a day, my pain levels are generally somewhere between 2-4 on the pain scale. For me, this is a manageable and tolerable level that still allows me to function. Being at a 0 on the pain scale is something that I can't even really fathom at this point. It's been a really long time since I've been there and I no longer remember what it's like to not hurt somewhere.
Today, however, I woke up in a flare (when your pain levels and symptoms increase, in spite of medication and your best coping techniques) and started out the day at about a 7 on that pain scale. Today's pain is centered around my lower back and hips and radiates down my legs, making them feel weak and achy and unwilling to move or carry me about. I would have liked nothing more than to take a pain pill and crawl back into bed or kick back in my recliner and let it take me back down to that manageable 2-4 level. Unfortunately, I missed so much work in the fall, when I was going through trying to be diagnosed, that I feel incredibly guilty for any time I take off now that the diagnosis has come in and I'm on medication.
So, I forced myself to get ready for work, drove the 25 miles from home (most mornings that's about 40 minutes in the car), dropped my son off at the high school and continued on to work. I really don't like to take pain medication when I'm at work but as the alternative is to stay home when I'm at a high pain level, I figure it's the lesser of two evils. It's also a commitment that I'm going to stay at work for at least 3 hours because once I take that little prescription pill, I know I shouldn't be driving for at least that long. Plus, that gives me enough time to assess whether it's going to be successful in taking me down to a level where I can still function and get things done at work. Luckily, my schedule today was pretty light, mostly desk work in my office with a couple of meetings thrown in.
I'm now 4 hours into my day and I can tell that my pain meds are beginning their downward slope towards wearing off. I can't say I've been fantastically productive here at work but I have gotten things accomplished and decisions made during a planning meeting. Now, however, it's crunch time. I need to decide how to handle the rest of the day. Isn't there a song that goes "Do I stay or do I go?" That's kind of how I'm feeling right now. My shoulders and neck are beginning to ache and I can feel the start of a headache. I have another meeting later this afternoon that will undoubtedly make my stress levels skyrocket, because this meeting (it's a regular event) always does. Stress, unfortunately, usually exacerbates fibromyalgia pain and flares. Which means that things are likely going to get worse rather than better.
That last paragraph sums up a lot of what living with fibromyalgia is like: a constant round of decision making, based on a multitude of criteria. I must be having a bad day because just the thought of having to make a decision, on anything, right now makes me want to cry. If I stay, I'll undoubtedly need to take another pain pill (which I can do at 1:00). Will that be enough to counteract the stress of the meeting that's scheduled for 1:30 - 3:00? If I take that pill at 1, I'm committing to being here for that meeting and to stay until at least 4:00 because it's not safe for me to drive until then. To say I'm feeling overwhelmed at the moment is an understatement. And there's a part of my brain that knows that this shouldn't be overwhelming. But that, too, is part of fibromyalgia. Having things that normally wouldn't bother you or that you wouldn't think twice about become huge, stressful, overwhelming issues.
I still don't know what I'm going to do. But I think I should probably end this post before it deteriorates any further. Sorry about the whining. It was not what I intended when I started writing this a few hours ago.
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