Well, that didn’t take long. Even though the surgery was less than a month ago, I was back in full-on, Type-A Ape mode in the lab last week, happily doing whatever was asked of me, including a generous complement of pipetting. And Tuesday afternoon, sitting in a powerpoint presentation put on by a visiting researcher, I became aware that my right shoulder was decidedly more displeased with me than it had been before I came back to work. I shifted in my chair and found I was able to lessen my discomfort somewhat by resting my elbow on the desk. Disturbingly, however, I was unable to make it go away.
As I have finally come around to accepting that I need to pack it in once the pain breaks through whatever I’m doing, I forced myself to leave the research facility as soon as the presentation was over. I suppose I should congratulate myself on having learned to attend to the information on my body’s billboards. However, I’ve also learned that if my body has resorted to billboards, it means I missed a road sign or two a few miles back.
Fortunately, before Self-Destructive Ape was able to fully assert her dominance, I was able to take a breath and set about objectively assessing my situation. I’ve just had a major surgery wherein they carved out a hand-sized chunk of tissue and bone from my back and shoulder, the equivalent to sustaining a complete bone fracture and considerable damage to the surrounding tissues. Those types of injuries take months to heal, and here I was, not three weeks later, on campus for 8 to 10 hours a day, using my arm for anything that didn’t involve carrying weight, and more or less acting as if the last year and a half never happened. I was forced to [grudgingly] admit to myself that perhaps, maybe, it might be within the realm of possibility that I ought to slow down.
At my post-op follow-up, when the surgeon asked how I was doing and I responded with a heartfelt “awesome,” he didn’t share my enthusiasm.
“Really,” he replied. “Already? Usually people don’t recover this quickly.”
I grinned. “I feel so much better. I am so glad we did this.”
“So, physical therapy starts in a couple of weeks—”
“I can’t start right now?”
“No.” I got a more pointed look. “You haven’t been overdoing, have you?”
“Now, whatever you could you mean by that?” I joked, hiding the fact that the thought had not actually occurred to me. While it was ridiculous to assume I could go straight back to doing whatever I wanted so soon after being divested of several grams of bursitis and scapula, I’d apparently made that rather considerable leap without even realizing it. Case in point, my physical therapist, more accustomed to my M.O., didn’t even bother to temper her displeasure at my activity. “You’ve been going to work? Seriously?”
“You should not be working right now.” She had the look. That I know what you’re up to, sister, and it ain’t gonna fly with me look.
“Light duty. Really.” I backpedaled. It was sort-of-true.
“Whatever. You can’t be doing things with that arm. I mean it.” She went on to explain that because of my pain, my shoulder had been virtually immobilzed for over a year. As a result, the rotator cuff and back muscles that enabled my shoulder and arm to work as they were designed to were considerably atrophied. It wasn’t that I shouldn’t be doing things; I simply was not able to do them, and it was going to be a while – months – before I was.
Once back at home with ice on my shoulder, reality started to sink in. I know I need to be more careful. I have known it; it’s not like it’s news. If nothing else, the amount of pain I was in the first week after surgery should have been enough to keep that firmly in my mind.
But of course I’d been overdoing it. Anyone would be, after the fifteen months I’ve had.
Before the surgery, the total number of days my pain level dropped below a 6 did not exceed my ability to count them on my own digits. Now I hadn’t managed to clear a 2 in almost a week. It was no wonder I took off like I’d been shot from a crossbow. And who could blame me? If there wasn’t much pain, it couldn’t be that bad, right? Well…not exactly. It’s a bit more complicated than that. (It always is, it seems.)
Pain scales are defined by our experiences; your “10” is the worst pain you’ve ever had, and since that can increase, so can it. Because of the way pain signaling works in the body, though, there’s a tradeoff for this elongated span. Over a small field, our internal signaling mechanisms are capable of making fine discriminations among stimuli. But if you keep raising the top end, you lose sensitivity in the low-to-mid ranges. As such, when your “10” has been raised as high as mine has, it takes a substantial pain increase to kick it up from “practically nothing” to “gee, I guess that hurts a bit.”
So a lot of stuff really doesn’t hurt the way it used to, and my pain level for the last several days (up until this past Tuesday, that is) was only registering at about a 1.5. There were even times when I was not consciously aware of being in any pain at all. Back when I was still bouncing from doctor to doctor, Momma Ape told me to add three to my pain level number whenever reporting it. At this point, though, I have no idea what it means to be, say, a 5 as opposed to a 2.
I’m so far and so long removed from my pre-injury relationship with nociception that it’s impossible for me to imagine where I’d place what I have going on right now. Maybe a 4? Or should I say a 6? After all, I’ve spent the last year and a half creating as much mental distance as possible between my pain and my awareness thereof; too little pain and it’s pretty well out of reach. And to be honest, it’s been kind of nice not to register the lower levels, which are more annoyances than anything else anyway. Pain can be awfully damned inconvenient.
However, pain insensitivity is not necessarily a good thing. Physical pain didn’t evolve to give us something to complain about. It’s an important survival response that tells us to get away from or stop engaging in whatever is causing the pain. But in this new milieu of all but undetectable sequelae, I’ve been mindlessly ignoring such subtle clues as to what I should and should not be doing. There had been a slight increase in soreness after each round of pipetting, but I took that to mean that I was done pipetting for the day – not that I shouldn’t have been pipetting in the first place.
Because even after all this time and all of these damned posts, I still suspect that I “should” be able to do more than whatever it is I am currently doing, however little or much that might be. I had a little debate with myself (another activity I still engage in despite full knowledge of the futility thereof) about whether or not I should be reducing my commitments. It was with trepidation that I finally pulled up my schedule and cut my time spent on campus to no more than six hours per day, and subsequently emailed my supervisor to apprise him of the downshift.
I wasn’t happy about it. The six hour cutoff meant there was one day a week I couldn’t be in the research lab at all, because with a three-hour class and then lunch, there wasn’t enough time left to even bother humping it over there. And full disclosure, part of my displeasure was rooted in the tiny wave of relief that lapped at my legs once I decided to click “send” on the email. Why was I happy that I was going to have these big chunks of unstructured time in my week? Me and unstructured time, we shouldn’t be together too often. Not good for me, to only have the ape in my head for company.
Then again, it appears I’ve already forgotten that I had planned to leave chunks of unstructured time in my schedule if/when my condition improved. I hated, really and truly hated, being as crammed and busy as I was before. I never would have admitted it, but I was miserable; stressed out, always rushing, unable to enjoy what I was doing even if I liked it. There weren’t any opportunities to just sit down and relax for a few minutes here and there, and I suffered for it.
And for the first time in a long time, sitting down is comfortable. It no longer increases my pain. For the first time in a long time, I can thoroughly relax and let my mind wander. For the first time in a long time, I am untethered from the perpetual state of agony that hounded me for nearly a year and a half. Even though there is more pain now than a few days ago, it’s nothing like it was before. It’s a mellow sort of pain, easy on the senses. I can hang out with it and not flinch when I happen to rub up against its dull, plastic edge.
I’ve been spending more time meditating. I’ve been spending more time simply enjoying being inside my body, in a way I never did even before this happened. I like it so much, I’ve started searching out opportunities, whether stopped at a traffic light or waiting in line or whatever, to revel in the fact that I can do whatever it is I’m doing, even if that’s nothing, for as long as I want.
Because it doesn’t hurt any more. Just doing nothing actually doesn’t hurt any more. I’m still awed by the fact; everything I see and do is unfamiliar and exciting, like being dropped into an alternate reality. It’s an unexpected gift, and I’m very lucky to have received it, and I shouldn’t be so quick to take it for granted. There’s a sort freedom that emerges when I am able to just be aware of everything in and around me without interacting emotionally with any of it, without having to suppress the emotional reactions that resulted from my constant pain.
And after I sent the email, did my supervisor email me back and tell me that he was disappointed in me, or that he wasn’t going to be able to work with me, or that he was going to report me to the lead researcher who would then decide he didn’t want me in his lab after all? (Yes, I thought all of those things.) Well, big surprise, none of that happened. In fact, he didn’t seem to care at all.
So perhaps I shouldn’t care so much either. I think I’ll work on that.
Indeed, it would be good to “work on that.” I should, too!
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