Pain Management and Migraine Relief

Celebrating Independence

2008-07-02T12:23:00.001-04:00

Well, here we are preparing to celebrate Independence Day when in fact many people struggle with the fact they no longer have independence. People with chronic pain and disabilities often long to experience independence they may never see.

What is independence for many who rely on wheelchairs or assistive devices and don't have the luxury to take a trip to the beach and walk along the sand? How about wading in water? Playing in the surf?

Some people may dream of cooking on a BBQ grill and having friends over for a picnic to celebrate the 4th of July but are unable to manage the tasks required of it. Some will try very hard but may hurt desperately later on. Others have too may barriers to even try.

This blog post starts out sounding rather depressing. However, it is important to try and think of the positives in life. And yes - people with chronic pain and physical limitations can continue to enjoy some independence in their life, although they may have to accept the support of others in order to enjoy it.

How about getting together with some true friends and watching fireworks at a public place? Most public places are required to be handicap accessible, so take advantage! Maybe you can't get right on the sand, but how about getting to a boardwalk and overlooking the sand and surf? Enjoy the sounds and smells of the seashore. Picture in your mind the sounds of seagulls flapping their wings and screeching at the people as they wait for food scraps to drop.

Can you enjoy a caramel apple or some cotton candy? How about some popcorn or a slice of pizza? Funnel cakes are one of my favorites.Oh they are messy - but that is okay...bring some moist towelettes along and use them to freshen up and clean up any sticky powder sugar and such.

What about using your backyard to host a few friends? You supply the grills and some food and they bring along anything they like to cook. Maybe you or some one in your family can make a great salad and assist with the side dishes while someone else runs the grill!

Be creative! Sure there maybe some things you will have to forfeit this 4th of July. But remember the things you can do and set out to do them.

To avoid the inevitable aches and pains that come with extending yourself, consider taking a little medication prior to events so you can feel more comfortable during and require less meds after. Put in a plan to rest briefly between major events like traveling and eating or eating and then watching fireworks. And how about planning that nice warm tub of bubbles to end your day so you can feel refreshed and relaxed when you do hit the sheets for the night.

If you travel, plan to break up the trip with short stops to get out and walk about rather than driving non-stop for hours. Plan your timing to help avoid the heavier travel hours. Give yourself plenty of time.

Even though you may need to be creative and cope with a few barriers, it is okay to get out there and celebrate independence. There is so much to be thankful for. Focus on those things. Try it! You may be surprised and pleased at just how great a holiday weekend you may have! I look forward to hearing about your holiday on either my Pain Management or Migraine message board here on WebMD.

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Technorati Tags: chronic pain, independence, holiday, positive attitude

Proper Body Mechanics

2008-06-03T06:45:00.002-04:00

This is just a reminder to always use proper body mechanics when moving, lifting, pushing, pulling, bending, etc. When lifting, be sure to squat down, bring item close to your body, lift with your legs and maintain good posture. If something is too heavy to lift, don't lift it. It isn't worth it.

Avoid bending over to place items on the ground. Instead of bending at the waist, bend your knees and use your legs - not your back. Don't be afraid to ask for assistance. It is better to be safe than sorry.

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Technorati Tags: back problems, body mechanics, lifting, pain management

Frozen Shoulder

2008-05-27T16:46:00.001-04:00

Frozen shoulder (adhesive capsulitis) can be so severe it can rob us of our quality of life. Sleeping with pain can be almost non-existent and it can cause a host of other problems.
Here are some options for managing this painful condition:

Muscle relaxation is important because relaxation means less guarding of the muscles in that area. Less guarding and relaxed muscles decrease the release of damaging and aggravation of inflammatory chemicals in the tissues that can lead to swelling and tenderness.

Cold compresses may also help decrease inflammation and improve comfort. At this point they are considered the gold standard of therapy/treatment for this painful condition.

Physical therapy is important because therapists have the ability to offer a varied approach to treatment that includes ultrasound, gentle range-of-motion as well as massage and specialized exercise programs to assist you as you heal. Constant motion is important in order to maintain functionality , decrease swelling by increasing circulation to the effected areas.

If you don't have a cold compress available, try putting uncooked rice in a sock and stick in the freezer. The result is a pliable pack that you can place across your shoulders for relaxing and comfort.

I never forget the potential for the use of heat as some folks find heat to be more comforting than cold. And if your doctor does not disagree, then I encourage its use.

Are there other folks out there suffering from the severe pain of frozen shoulders? Feel free to share some of the remedies you find to help you get through the pain and limitations of this painful condition. Post your responses on my Pain Management message board here on WebMD. I look forward to hearing from you and getting to know you!

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Air Travel - How Do You Manage?

2008-05-20T05:49:00.004-04:00

Last evening I returned from an educational trip. It started like most of my trips. Even though I am a careful packer, it is hard to travel with a light suitcase when you are going to be gone close to a week. I managed to fit everything into one big case and I put the rest of my items with my laptop in my backpack and took off.

When I arrived and finally made it to my hotel room, I noticed severe aching and tenderness in my shoulders and arms - mainly my right arm. It ached like a tooth ache and intensified around my elbow and down into my hand. There was tenderness but no signs of redness or bruising. I did feel like there was some swelling however. The interesting thing I noticed was that it intensified when I wore my backpack at the airport.

I talked to my husband the night before flying home and shared my concerns because I had a lot of paperwork I gathered at the seminars that I needed to bring home. The weight felt extremely heavy. He had a great idea. He suggested I ship some things home so I wouldn't need such a heavy suitcase. I could then transfer some items I didn't need to carry in my backpack to the suitcase and check it. There happened to be a business center/Kinko's located at the hotel where I was staying so I went down and purchased a box. I filled it with items that I didn't want to carry and I shipped it home. This enabled me to use my suitcase and lighten my backpack a little bit.

I cannot say that I had dramatic relief. However, my right arm is feeling less tender today. It is important for people like myself with chronic pain to be creative sometimes and do things like this to help ourselves when we need to. I may have to give up my backpack completely. I notice there are backpacks with wheels built right into them. I plan to invest in one of those in the near future.

Have you ever found yourself in a situation where you needed to be a creative traveler? How about sharing some of your ideas on either my Pain Management or Migraine message boards here on WebMD.
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Part VI: Total Knee Replacement Outcome

2008-05-16T10:04:00.001-04:00

During the last few months I have been sharing the experience of my husband's total knee replacement. We are pleased to say he is just about finished with his therapy and ready to go back to work.

His surgeon says he has a "state of the art" knee. My husband spent some time in a painful lull and then bounded forward with improvements. He can now go without pain meds. He walks without a cane and no longer limps. He walks longer distances than he did before but still finds some limitations when he tries to walk too far or push too hard. (Keeping it real).

But his overall improvement and outcome is more than we had hoped and we are both grateful. His doctor says the rest of the residual swelling should subside in the next couple months and he should return pretty much to normal range of motion. Since much of the swelling from behind his leg has been gone since surgery, his range of motion is already better than pre-surgery.

The next step will be for my husband to return to work and he is more than ready (smile).

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event
Part III: Coming Home!
Part IV: Healing Continues
Part V: Total Knee Replacement - And the Beat Goes On

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The Pain of Obesity...Bariatric Considerations

2008-04-30T13:07:00.002-04:00

Recently I attended a seminar with my daughter regarding obesity, weight loss, and surgical alternatives. My daughter has struggled all her life with weight issues and has tried many things to lose weight. At the age of 25 she has several co-morbidities that are most often seen in the older adult population, i.e.: high blood pressure, asthma, GI problems, arthritis, low back pain, and fertility issues. Three of her doctors have recommended surgery and will be providing statements of medical necessity for her.

The biggest challenge has been insurance coverage which has kept her from even considering this option in the past. Then she found an organization at one of the local hospitals that gives hope to the obese and support to the many that pass through their doors to get surgical assistance that might not only improve the quality of their lives, but may even save them.

I was glad to see this program requires all of the necessary pre-assessments prior to acceptance into the program. We don't foresee my daughter having a problem and pray that the insurance coverage will be sufficient. She emphasizes this is not a cosmetic move. She has a loving husband now at her current weight and she feels blessed. This is for her health and quality of life. She feels that once she gets the weight off, she will be able to pursue a different line of work and become more financially stable. She sees this as a new lease on life - the beginning of a new one in terms of eating and nutrition and other behavioral considerations that are so often linked to unhealthy eating patterns.

I am thrilled to see my daughter pursuing this alternative since she has tried diet after diet, prescription meds, and exercise (which usually leads her to a back spasm and PT). She needs to get some of the weight off so she can start to exercise regularly and continue a more active lifestyle. Right now she is exercising at home using a TV stretching and aerobic video because she is embarrassed to walk outside. She has lost over 50 pounds. However she has issues with an inability to keep the weight off once she loses it. And when it comes back, it comes with a few extra pounds besides.

My daughter is diligently researching the surgical procedure. She is talking to people who have had it done to hear their experiences and outcomes. She is linking up to networks to build her support group. She has looked into the dietary supplements she would need to take and also the protein supplements. Being lactose intolerant, we were concerned about her finding products to work with but she has at a local supplement store. The store manager has been supportive and willing to help her learn about the different products that are used for nutritional supplementation after bariatric surgery. She wants to have a comprehensive understanding about what it will take to make this a positive experience and a new lease on life. She is not looking for miracles. But like many of the close to 100 other people attending the seminar, one would be welcomed I think.

These past few days I have seen some positive changes in my daughter. She is brighter and more energetic. She is becoming quite educated on the subject of bariatric surgery and weight loss. She feels she may have found her only hope after exhausting all of the other less invasive approaches. I am proud of her for pursuing this. I am going to be her biggest fan as she finally begins to feel better about herself and her pain begins to decrease and resolve.

I told my daughter she is a beautiful young lady and she is...regardless of her weight. Being healthier and beautiful at the same time...It can't get much better than that.

I'll keep you posted.

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Technorati Tags: weight loss surgery, bariatric, gastric bypass, lap band

Part V: Total Knee Replacement - And the Beat Goes On

2008-04-16T16:20:00.000-04:00

Up until about a month ago, my husband continued working hard to recover from his total knee replacement rehabilitation at home. He spent a total of 6 hours a day on the CPM (continuous passive motion) machine in addition to other exercises his therapist prescribed. Then one day we hit a major road block that put a halt to the formal rehabilitation and threatened my husband's positive recovery experience.

Feeling proud of his accomplishments, my husband met with his surgeon for a follow-up. Expecting my husband to be using a walker and ambulating at a slow pace, the surgeon was surprised and very pleased to see him ambulate with one crutch at a regular pace. Watching him maneuver the exam table and sit with his knee dangling close to 90 degrees brought a big smile to his face. Significant swelling remained and pain continued to rise to a moderate level by the end of the day when there had been a lot of activity. But my husband remained very motivated to recover so he could get back to work. So the surgeon discontinued the home therapy and ordered an outpatient PT evaluation and treatment plan.

The next day my husband contacted a couple of outpatient centers in the area and gave them the disability/insurance information so they could set up the reimbursement process. Then the phone call came telling us that it was now over 6 months since my husband worked and both his disability and his insurance benefits had been exhausted! With mouths agape, we just stood looking at each other. Here we were with a need to finish therapy in order to get back to work - but without insurance and with no income, my husband had nothing to cover the therapy. He even asked about performing therapy at home and then going to the surgeon for a follow-up, but that was unacceptable. He was in a catch-22.

The first reaction was to panic; then we stopped. We needed to focus our energy on finding a solution. I had recently accepted a position myself and was therefore in the midst of benefits transfers. Now I needed to get my husband onto my insurance as soon as possible. Then he would need to find a therapy center and get going with the therapy. So I went to work on getting this switch to my insurance accomplished.

Two and a half weeks later, my husband was covered. Today he had his evaluation for outpatient therapy. The key to his ability to continue progressing forward in the interim was his unceasing desire to heal and get back to work. Every day - several times a day - my husband performed exercises to keep his range of motion. He practiced stretches using stairs and a chair; he walked up and down the flight of stairs a couple times or more every day without fail. Following each session, he iced his knee and when the going got tough, he took some meds and elevated his leg until he was back up and about. What could have been a set back in terms of regaining function did not because of the consistent and persistent exercise my husband did on his own.

This has been a learning experience for us, to say the least. Now my husband is prepared to work on continued therapy and strengthening. He is hoping to get back to work soon. Based on our experience, we encourage anyone who must undergo a surgery or problem that may lead to more than 6 months off the job, to file for social security temporary disability insurance benefits early. Don't get caught off-guard like we did.

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event
Part III: Coming Home!
Part IV: Healing Continues

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Technorati Tags: pain management, knee replacement, recovery, disability

Cool Idea for Your Pain Management Toolbox

2008-03-20T10:23:00.000-04:00

One of the things my husband has needed to do is ice his knee before and after using the CPM (continuous passive motion) machine or having the physical therapist work with his post op knee. This is what we were told to do:

Take paper cups and fill with water. Place in freezer. When needed, take a totally frozen paper cup and peel around the cup edge exposing the ice surface. While holding the paper cup, rub the ice around the knee area. You can either put the rest of the frozen ice back in the freezer to use later or toss away.

This tool can be used on many parts of the body that need icing. Use any size paper cup you want. The larger sizes are great for low back and large areas. For headaches, perhaps a smaller cup would be fine. It is an easy tool to create and inexpensive as well. Give it a try!

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event
Part III: Coming Home!
Part IV: Healing Continues

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Technorati Tags: pain management, ice, knee replacement, recovery

Part IV: Healing Continues

2008-03-17T22:13:00.004-04:00

It has been roughly 4 weeks since my husband's total knee replacement. He remains on crutches and finds challenges getting into and out of vehicles and managing stairs, but he has improved significantly. He is tired at times, yet his attitude remains positive. There are times when he feels extreme pain, but he sees the value in the continuous passive motion (CPM) machine and he continues his exercise regimen faithfully.

I am thrilled when he is blessed by his efforts. He finally walked around the house with his crutches feeling no pain which is something he has not experienced in years. And he is bending his knee further and further each day. Outpatient rehab comes next for further strengthening we are told. I bet it will be a short course.

My husband will be going for his post-op visit to see the surgeon soon. I hope he is as pleased at my husband's progress as we are. I will keep you posted!

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event
Part III: Coming Home!

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Part III: Coming Home!

2008-03-12T19:31:00.005-04:00

After three days in the hospital, we learned insurance wouldn't cover the level of care my husband needed following his knee replacement surgery. They decided to send him home and set him up for home care and home PT (physical therapy). At first I panicked because I knew he was going to be home alone about 12 hours a day and they seemed a little too eager to discharge him. So I went with him to PT and watched him walk with walker and crutches and manage stairs, etc.

I was literally trembling as I got into the truck to swing by the front of the hospital where they were bringing him. His pain levels were through the roof and getting him into the truck with the knee immobilizer on and the crutches was an ordeal. With sheets of exercise regimens in hand we headed home.

We got home and made it up the steps. He was a little off balance when the dog ran to greet him and I was glad to be there to support him and help him regain his balance. Just the ordeal of getting home tired him, so he settled into bed to rest. It is very difficult to sleep in a hospital and he was exhausted period.

From the start my husband had a very determined and motivated attitude. He was warned it was going to be painful, but he was not going to let it keep him from doing what he needed to do so he could get back to the business of living a "normal" life.

The first few days he slept a lot partly due to the pain meds and also because of the exercises he was doing throughout the day. He used the crutches and walked short distances around the house. He didn't push himself, but he exercised regularly.

Many nights my husband wakens with stabbing jabbing pains down his leg; and yet with so little restful sleep, he doesn't complain. He accepts it as part of the healing process. His visiting nurse and therapist feel he is really doing above the average in speed of healing in spite of the mess the surgeon found when he started his work. He did a wonderful job on the inside and out. We feel very thankful and blessed.

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event

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Part II: Total Knee Replacement - The Big Event

2008-03-04T15:42:00.008-05:00

The big day of the knee replacement finally came. Emotions were high and included apprehension and relief. For someone who suffered with this chronic pain as long as my husband had, it was a relief to know there was a light at the end of this tunnel. Apprehension came from the concern about any issues that might arise from having such a surgery.

We arrived at the hospital and went through all of the necessary paperwork. Our wait in the same day surgery area seemed endless, but finally my husband's name was called. He was escorted back to be prepped before I was able to re-join him. Soon my name was called and I went in to join my husband who by now had surgical gown on along with an IV line and multiple ID bracelets. Shortly after, he was whisked away to a holding area where I was unable to follow. My wait had just begun.

For the next four hours, I sat in a surgical waiting room while others came and went. Family were told when loved ones went into the OR, went to recovery, and when they were going to their room or preparing for discharge. I already knew my husband would be staying, so it was going to be a while before I would get to see him. I prayed often for him hoping everything was going as planned but after two hours and then three, I began to be concerned. Why I was not receiving notice of his going to recovery?

Four hours later, my husband's doctor came out to see me. He told me his condition was much worst than the x-rays revealed. He had a lot more work to do before he could replace the joint. He said there were also some issues with anesthesia; they had to switch to general anesthesia during the procedure. I was shocked that a spinal would have been considered when it was already confirmed my husband had a serious problem.

My husband remained in the post-op recovery room for four hours before he was assigned to a room and arrived there. That wait was endless. I couldn't concentrate on any reading. I went down for a bite to eat and quickly returned, eager to hear that I could see my husband.

The call finally came and I was directed to the orthopedic floor. My husband was awake and talkative. I figured that was due to the meds he received. He described the experience of inefficient sedation and remembered feeing severe pain and seeing his knee opened and bones exposed. He remembered people pulling his arms away from the surgical site before he "passed out"... I guess this is what the doctor was referring to when he described the need to use general anesthesia during the procedure.

Photo Credit: José Goulão

Before long, the nurses came in and gave my husband a pain med IV. He began to relax and get drowsy. He enjoyed some jello before dozing off. I quickly got his supplies taken care of and I decided to head home so he could get some rest.

During the night, my husband called me in severe pain and told me he was getting meds hourly that were not touching his pain. This bothered me. I called and spoke to his nurse directly to find out what he was receiving. The meds he was receiving should have held him except the nurse was not giving him a dose sufficient enough to address his pain issue. I discussed how she could better use the meds that had prescribed by his doctor. My husband later called to say he received a variety of meds and began feeling a little better. He even managed to rest a little. I was very relieved.

Stay tuned for Part III: PT and DC

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Total Knee Replacement - One Man's Journey

2008-02-19T22:16:00.003-05:00

Photo: Gary Minnaert

My husband's preparation for a total knee replacement started weeks before he finally received a date and time for the procedure. Being unable to work, he remained home on disability. This entire issue of seeking financial support was incredibly stressful and he suffered financially while he waited several months for a payment. Countless phone calls and faxes and emails went back and forth between his employer, union, health care providers, and insurance company. It seemed like no one wanted to help him.

His disability was actually canceled because they didn't feel that he really needed it. Yet he had documentation from doctors and consultants attesting to the extent of his limitations, pain, and suffering that he endured. Doctors even wrote that he needed a total knee replacement It seemed like the left hand didn't know what the right was doing and the stress of trying to keep on top of everything really limited his ability to cope with his situation.

My husband's initial injury to his knee occurred at the age of 14. He fought for years to try and have his joint repaired however no one wanted to do so because he was "too young"... So he suffered for over 30 years while his knee joint steadily declined in function and his pain levels continued to rise. He suffered and worked full time. As a commuter into NYC he walked city blocks from bus stations, ferry landings, etc. until his knee started buckling. He fell on numerous occasions and had many close calls. By the time he had surgery, his knee was buckling while walking in the house. Several falls and near falls led to minor injuries on top of the major problems.

I began to seek assistance for him to try and get him cleared for surgery. Here is a man who enjoyed his work and who wanted to work and maintain responsibility for his financial obligations and yet was made to suffer months without any money and a need to appeal decisions that were made using inaccurate information.

All the while the pain he experienced became severe and persistent, requiring heavy medications which often left him groggy and unsafe for travel or basic functioning. Like so many people, my husband feared drug addiction and refused to take pain meds for a long time. Finally I was able to convince him he needed to try taking meds to gain a level of comfort to sustain the ability to manage activities of daily living independently.

Once the dates were set for pre-op testing and surgery, my husband began focusing on strengthening muscles he would need to assist with ambulation and normal function. He wanted to be sure his legs were in optimum condition in hopes of a speedy recovery. He made sure to eat well balanced meals and rest frequently. He didn't want anything to occur that might delay his surgery any further.

I must add, my husband recently learned he was diabetic which concerned us with his ability to undergo successful surgery and proper healing. It seemed like something was always being added to the stress this man was already enduring. Thank goodness he maintained an optimistic view and relied on his faith to get him through.

Part 1: Total Knee Replacement - One Man's Journey
Part II: Total Knee Replacement - The Big Event
Part III: Coming Home!
Part IV: Healing Continues
Part V: Total Knee Replacement - And the Beat Goes On

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Technorati Tags: pain, knee replacement, disability

An Ideal Pain Management Plan - You Describe!

2008-01-29T07:02:00.000-05:00

I was recently asked why if I am a pain specialist, I write about loss, sadness, and other things that don't seem to relate to pain. This question enabled me to discuss the complexities and the interrelationships between physical pain and the many topics I write about.

I view pain in a very broad and comprehensive way. My personal/professional definition of pain relates distress of any kind in some or any aspect of life to the experience of pain. Pain is so much more than just a physical experience. It touches on the biopsychosocial and spiritual aspects of a person's life as well as effecting the life of those close to the victim.

To treat pain, it is vital to explore all of the areas of a person's life and take these into consideration. To prescribe treatment for only one aspect and neglect to investigate the others often does a great injustice to the patient who suffers.

If you were to define an effective treatment approach for victims of chronic pain, what components would it include? Please share your answers and comments on either my Pain Management or Migraine board. I look forward to talking with you!

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Sticks and Stones...

2008-01-23T08:52:00.000-05:00

The other evening I watched a TV show about a heavyweight teenager. She put up with a lot of ridicule and pain from her peers. But she also experienced a lot of ridicule from her own mother. The effect of this was very damaging to her. I was glad she became angry and determined to make something positive out of such a negative and destructive experience. It would have been so easy to turn her anger inward and become depressed. In that state, she might have tried to harm herself as a way to escape her pain; that would have been devastating. This girl made a lot of very important points about the fact that people link heaviness and obesity with ignorance and often use these victims as scapegoats to promote their own popularity.

I have been heavy most of my life. Pictures of myself as a kid showed I was a big kid for as long as I can remember. I remember being the brunt of other people's jokes on more than several occasions. I remember how it made me feel then and it hurts to this day when I think about it.

As a parent of a larger child, I made a point of letting her know on a regular basis how beautiful she was and how proud of her I was. She struggled through school and was also a victim of many cruel kids. Every time she came home in tears, I hurt right along with her. I wish for once people would stop before they speak and think about what they are saying.

One of my favorite sayings:

"What a person says about someone else, says a lot more about the person speaking than the one they are talking about."

~Indie

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Technorati Tags: teen weight, body image, healthy weight

Exploring Our Pain Management Toolbox

2008-01-15T12:40:00.000-05:00

Pain management tool boxes are a concept I have discussed on occasion. I would like to ask folks what they have added to their tool boxes for 2008. What I am hoping to do is get an idea what types of things folks find helpful to add to it. It is my hope that folks will read the content of others' tool boxes and see what they lack. Those items can be explored further to determine if this might be a great addition to their own.

Way too often folks are too quick to say something will not work when in fact, they have never tried it or found that to be true. I would like to us to explore this to determine why people do this and where do they get the preconceived idea that something won't work and it is not worth trying. For some it might be the opinion of someone they hold dear. For others, it might be a stereotype that many folks adhere to and which often is scarred by misconceptions and myths that have come down through the ages.

I encourage people to write their responses to my blogs on my pain management message board here on WebMD. Start the thread with "Exploring our Pain Management Toolbox". When I review the board, I will read posts and respond with comments or thought provoking questions to clarify anything I am not sure of. I encourage others to comment or post your views on another's posts so we can develop a rich thread of feedback on this topic. I think this will be a great thread to share and learn more about don't you????

~Indie

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Technorati Tags: chronic pain, pain tool box, pain management, health and wellness

Priorities for Pain Syndrome Victims

2008-01-13T11:32:00.000-05:00

Well I think it is going to storm. I woke up this morning hardly able to move. Every step I took grabbed me and stabbed me. My first concern was the amount of work I had to accomplish today. Medications tend to make drowsy and good for nothing. I usually end up falling asleep and and feeling groggy when I wake up. So how do I handle this dilemma?

When I feel upset about how I feel and how it impacts my life, I immediately take a look at my priorities . I look at deadlines, and I check to see what is on my calendar. Flexibility is key. Those items that can wait must do so. The issues that must be dealt with take first priority. And the second priority is placed on my calendar. Only track the two most important priorities on your calendar. Write in the additional items and keep them handy so if you can get to you have the necessary information.

Begin working on your priorities as soon as possible. Seeing what needs to be done and the accomplishments you make will be an incentive to keep going. Block out a chunk of time to devote to the priorities and stick with it.

Being organized is key. Have a plan in place and follow it. Have the tools you need to do the job. And set it up so there is as little set up time as necesssary. Taking these steps can help you be productive in spite of pain and dscomfort.

Have you developed a plan? Is there a chance you need to get organized? How about sharing some of your plans and accomplishments with others? What are your plans for 2008?

Please post on either my Pain Management or Migraine boards where I can respond along with others! I look forward to talking with and learning from everyone who shares and cares!

~Indie

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Where Did 2007 Go?

2007-12-31T17:36:00.000-05:00

It seems like it was Thanksgiving a couple of weeks ago and somewhere along the way Christmas came and went! They say time flies faster and faster as you get older and boy, the person who said that was right on the money!!!

With the end of the year comes a great deal of preparation for closure of one year and the opening of another. There never seems to be enough hours in a day or days in the final weeks. It is so easy to get stressed and overdo and for anyone with chronic pain, this can lead to disaster and added frustration and limitations.

2007 was a very difficult and painful year for me. It seems I spent more time in bed than I normally do and when you begin to feel your heating pad is closer to you than your spouse is, then you know there is a significant problem. I have a birthday coming up in about a week or so and I will be reaching a milestone--the big 50! The number doesn't really bother me but can someone tell me why I feel like I am approaching 60 instead of 50? With all of the aches and pains I have been dealing with, I can only hope that 2008 will be kinder to me!!!

I guess the important thing for me to do when I stress and start overdoing is to stop and prioritize. Plot out a strategy for getting the important things done and be forgiving of myself for putting a few things on the back burner temporarily until I can regain my balance.

My New Years resolution is to get more organized. I already purchased the items I feel will help me accomplish this...now if only I can find the time to do just that!! I think if I cut back and plan to do one little thing at a time then I will manage to do what I really need to do...And I am making sure to plan some down time for resting and using my heating pad so I can try and stop any brewing spasms at the pass...Well it is really late and I need to get some rest. It is important to do so in order to stay as healthy and strong as I can. And hopefully I will be able to cope with the discomforts that I fight with daily...

I want to take a moment to wish everyone a happy and healthy New Year...I look forward to visiting with old friends and new ones I will meet along my journey and on my Pain Management and Migraine Boards here on WebMD.

Indie

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Technorati Tags: 2008, resolutions, new years, chronic pain

Photo: iStockPhoto.com

To Take a Med or Not Take a Med: That is the Question

2007-12-07T14:34:00.000-05:00

Photo by: plasticrevolver

I notice quite often on my message boards people who are trying to wean themselves off of their prescribed medications. For some, the reason is because of becoming addicted. For others it may be they are feeling better and don't think they need to be on them anymore. Sometimes people lose their insurance and can no longer afford their meds. And there are yet other reasons.

It is very important for people to take meds as directed. Be very careful about weaning off meds without consulting your doctor first. And avoid stopping meds suddenly and going "cold turkey" as they say. Doing so can be dangerous and even life-threatening.

There are times when people are feeling great and when they start going off their meds they begin to wonder why they start to feel poorly again and why their symptoms return. Well, the reason is because the medication was helping and you are taking it away.

There are times when folks need to be on medications whether they want to or not. Certain conditions require the use of meds. Think of an insulin dependent diabetic trying to go without medication. It can be disastrous and even life threatening.

People in chronic pain may also need meds in order to function and leave a life of any quality. If it takes meds to accomplish this, then take them. As long as they are effective, remain on them. If they are not effective, talk with your doctor about your regimen and seek a change. Always involve your doctor with you decisions. That way if there is a complication, he/she will be aware of the potential reasons and be able to provide appropriate care.

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Technorati Tags: pain medication, pain management, chronic pain, health and wellness

Are You Ready for Winter?

2007-11-27T14:48:00.000-05:00

Photo Credit: dobienet

Fall is definitely here and the first hints of winter are now apparent. I watched a flock of geese heading south honking in the V formation and I know that snow and cold weather are not far behind. I dread the cold. I don't tolerate it well. I have arthritis and painful conditions that seem to be aggravated with cold or dampness. But since I am not moving anywhere, I need to accept it and prepare for it.

This past week I had a vehicle serviced and prepared for winter and this week I will have the other one done. I have begun digging out the warm hats, gloves, and scarves and winter coats and boots and made sure they are washed clean and ready for wear. I turned the furnace on low and set to 68 degrees and I pulled out my warm clothes. Blankets were changed on the beds and comforters added. Air conditioners were taken out of the windows and stored until warmer weather returns. I also checked to be sure all my heating pads work and I have some bubble bath and Epsom salts up in the bathroom. This is for those times when my muscles really hurt. I can relax in a hot tub with some epsom salts or bubble bath and enjoy relaxing after a long hard day at the office. I also placed some aroma therapy candles around as well.

This year I am striving to keep stress and pressure off me during the holidays. These steps will help me prepare for the winter and be more ready to meet it head-on and deal with it in a comfortable way.

Are there any things you have done to prepare for the winter that I didn't mention? If so, how about adding them here. Let's see how many things we can come up with!

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Technorati Tags: winter, stress management, pain management, health and wellness

My Special Holiday Gift

2007-11-26T12:02:00.000-05:00

This past week I had the opportunity to celebrate a very special Thanksgiving. I have to say it was the best one I have shared in a very long time. As I look back on it, I think about all of the things that made it special - made it stand out above the rest.

My special Thanksgiving plans began several weeks ago. During the past few months, my mom lost several very dear friends. In fact, two of them died 2 days apart. And with my mom's failing health, I couldn't let her be alone on Thanksgiving. No one is promised a tomorrow and in my heart, I wanted her with me. My husband was very understanding and supportive of my decisions and plans. And he did everything he could do to help me accomplish my heart's desire. He is a precious man - truly a blessing.

With the Christmas holiday not far away from Thanksgiving, I thought it might be nice to celebrate them together so I began thinking about what I might do to make a nice holiday for her. I knew that whatever I would do, it would be received in phases over a couple days time.

I knew my mom was missing my little brother. In fact, so was I, so I decided to make a visit to see him a part of her holiday gift. Tuesday after work I threw some clothes together and grabbed some things I needed to take with me and began my mom's special holiday gift. I drove over 3 hours to my mom's - much longer a ride than usual due to the traffic and driving conditions. I stayed until early morning when we left for my brother's house.

My little brother lives about 4 hours north of me in a quaint little home nestled in the pines east of Troy, NY. Whenever I visit him, I come away feeling rested and refreshed because I am able to relax and enjoy his cozy place. And I always take a few moments when I arrive to just smell the pines and enjoy the setting. It is not uncommon for me to just relax on his plush carpet watching a special movie and sneak a catnap. This trip was no different and the short nap I took felt like I had slept the whole night!

In the past, there were little family traditions we shared when we could all get together. One of them was watching a special holiday movie. We enjoy watching The Homecoming and this year we watched Christy and White Christmas and it seemed like they opened the holiday season for us. We exchanged small meaningful gifts with each other and enjoyed a wonderful lunch together. It was not a big feast but it was one of the most special meals I ever had and what made it special was the fact I was with family and we were sharing this meal together - just the three of us. I have to say, my brother's new little kitty made sure she was close by to investigate what we were doing. She is a sweet little playful ball of soft fur and when she got used to us, she let us cuddle her. That was also very comforting and relaxing. We had fun - visited for a while, took some pictures. Then came the next phase of my mom's special gift.

My little brother and I planned to surprise mom and take her to visit two of her sisters that she hadn't seen in years. So we got into our vehicles and headed the 1/2 hour further north to my Aunt KP's home. It was a wonderful visit even though we didn't have a lot of time. My aunt is in her mid '80s but remains active in spite of her failed sight. Her sense of humor keeps her young at heart and her humor makes me laugh as it brings joy to my heart. When I was young, I lived about 2 hours north of my Aunt's home and at that time, she lived across from me. I have many cherished memories of her and am thankful to have her in my life. Mom was surprised and I enjoyed watching her excitement. At Aunt K's we had a chance to catch up on how our relatives were doing. We were shocked at how fast many had grown. We were sorry that my Aunt RN was unable to join us as we had hoped. She had undergone a medical treatment that made her uncomfortable and she felt the need to just stay home and rest.

Aunt R is another very special aunt in my life and I miss her dearly. As kids, my sister and I used to see her and her family on weekends when Uncle JN drove north to visit Aunt K and Uncle GP. My cousin PA would run across the road to our house to hang out and we hated to see her leave on Sundays. In the winter we would all ride snowmobiles through the woods and enjoy hot dogs and hot chocolate over an open fire on one of the frozen ponds in the Adirondacks.

Like Aunt K, Aunt R also has a sense of humor and I have many fond memories of them. In fact, many of my mom's relatives are fun-loving people and one can always expect to have a lively time when they would all get together. Sadly Uncle GP and Uncle JN (aka Wilbur - his nickname) and several other relatives have passed on, but I will always hold fond memories in my heart for each and every one of them. And I do plan to make another trip up that way as soon as I can so I can visit some of the rest of my relatives I was unable to see during this brief trip.

We visited with Aunt K for a short while and I was able to take some pictures of the two sisters enjoying each other's company. I can tell they were happy because when they are, they start giggling like kids and singing little songs they remember - all the while cracking jokes and picking on each other. Just watching them relax and be themselves was a treasure to see. I was thankful to have been able to give this gift to my mom.

Our visit with Aunt K was short and I hated to leave so soon, but I had limited time and the next part of my mom's holiday gift was about to begin. After gassing up my Explorer that late Wednesday afternoon, we said goodbye to my little brother. That was hard because we are close and talk to each other often on the phone. But I still miss seeing him and spending time with him. I was very thankful for the chance I did have to see him and share the holiday.

The time had come for the next phase of mom's holiday gift to begin. She was coming back to my house in NJ for Thanksgiving. Mom and I left the Albany area and started the 4 hour trip to NJ. Yes, I had done a lot of driving but this - in fact the entire trip - became as much a gift to myself as it was intended for my mom. And again I am thankful.

We got to my home late Wednesday evening and after a brief visit with my husband and a chance to meet and play a little with our dog Duchess and our two cats Jazz E and Gracie, I assisted mom slowly up our stairs and helped her settle in for the night. I watched her follow her nightly routine of preparing her meds for the next day and organizing the area around her so she could find things as they were needed. I saw a precious lady - my mom - striving to maintain independence in spite of the painful and frustrating limitations she has that effect her breathing and mobility. She has periods of confusion and memory loss that come partly from her medications and also from the natural process of aging. As I settled her into bed and bent to kiss and hug her good night, I saw a vulnerable yet determined lady. She has endured and overcome tremendous trials over the years that have left behind a few scars along with some life lessons.

I remembered the time when we didn't get along and I left home. During that time I had emotional ambivalence about her place in my life. But my formal education along with my own lessons learned in life enabled me to better understand and clearly see what was in front of me during that time. Thanks to my Lord, my faith, and the passage of time along with my own maturity, I was able to overcome the inner battles and finally come to peace with all of that. And I can honestly say I felt blessed and thankful now to have her with me in my home.

It didn't take long for me to fall asleep that night. All of the driving and the excitement of the day caught up with me in a single moment. I layed down with my CPAP machine on and fell right to sleep. I slept well and woke with less pain and stiffness than I had expected. For that I was thankful.

I was also excited because this was the next phase in my mom's holiday gift - Thanksgiving Day. And for the first time as far as I can remember, and thanks to my wonderful husband, I was able to take it easy and relax that morning since he chose to prepare the entire holiday meal for all of us. It seemed strange to be relaxing in bed at my leasure while he worked steadily in the kitchen. I offered my assistance several times but he always encouraged me to just relax and rest. My husband is truly a blessing to me. His kindness and compassion toward me is a reflection of his love for the Lord. I still marvel at the way He brought us both together and we know God doesn't make mistakes. My daughter, her husband and his sister - a very dear young girl who I enjoy and love as one of my own - joined us for the holiday and it was wonderful to have everyone together.

We all visited and waited for the last preparations to be made while the traditional sounds of sports played on the TV quietly in the background. My wonderful husband had everything under control in the kitchen and boy did he create a festive meal! He prepared both turkey and ham along with many of the traditional dishes and the flavors blended beautifully. The turkey was moist and tasty and I have to say that even though the spices he used were different than the ones I use, the flavor was incredibly delicious. And for someone who doesn't usually eat much ham, I enjoyed a nice portion of the specially seasoned and glazed meat along with everyone else.

At the last minute, I did get to create my traditional cranberry/celery/walnut salad and I let mom help me. That salad has special meaning to my daughter and I as it was first made by her grandmother (dad's mom) who was a very dear friend of mine for roughly 25 years. I never considered her my mom-in-law because that often holds a negative image/meaning. She was a wonderful lady and truly my friend and I will always hold a special place in my heart.

During the day, calls were made and calls were received by all of us from family and friends we hold dear. And although they could not be with us, we knew we were in their thoughts and hearts and they in ours. Yes...I am truly blessed and thankful.

After the meal and relaxed conversation, my daughter, my mom, and I decided to take a ride and show mom some of the sights in the local area. We returned to my house and just relaxed and enjoyed being together - the three of us girls - while my husband went to share a little time with his folks in NY. We finished the kitchen cleanup and took care of the leftovers, nibbling and chatting as we went along. Then we watched a movie together while my mom enjoyed working on a little project I had saved for her. She loves being helpful when she visits and I appreciate her help. And I now have a nice organized draw of paired socks thanks to her!

My holiday gift to my mom was coming to an end as we got up early Friday morning so I could take her home. She had an important medical appointment to keep, otherwise I would have had her stay for the entire weekend. We drove back to her home and I helped her with a few things around the apartment and I took her to her appointment. While waiting for her in the waiting room I could hear her excitement sharing the events of the past three days with the office staff and I was thankful to have been able to give my holiday gift to her. After the appointment we took care of a couple quick errands and I made one more stop before taking her home.

My mom enjoys eating at KFC but it is hard for her to get to one because she has to rely on buses and such to get around. It is often too painful to walk any distance, so it is rare that she gets to go. I remembered that I had promised her we would eat at one the next time I went up to see her and I wanted to keep that promise. I also knew my mom was tired from all the excitement of the pass couple days and I wanted to make sure she had a warm meal before I left her to drive back to NJ. That way she could just relax and take it easy when she did get home. We enjoyed a quick meal together talking and laughing about all that had occurred during the passed couple days. Mom was happy but also tired and I knew she needed to get back home and rest. Once I got her safely there I headed back to mine. Driving home alone gave me a chance to think about a lot of things. I was so thankful the weather remained dry and nice so I didn't have to worry about wintry driving issues.

I thought a lot about family - especially those who were not with us. It would have been nice to see my sister and her family but I knew they always had big plans on Thanksgiving and she wouldn't have been able to make it. I miss her greatly but was thankful to say hello and chat briefly during Thanksgiving day. My older brother in VA has a large family and he had his plans already made but while mom was at my house, she decided to accept his invitation to visit for Christmas. I was thrilled she had chosen to go. It would give her time with her oldest son - her first born- and I knew that it meant a lot to both of them to be able to spend a little time together. It gives her something to look forward to and I could hear the gladness in my brother's voice when we talked about her decision to go. He was gearing up to prepare for her arrival as if she was coming in a couple days rather than a couple weeks. I could hear the excitement in his voice and I was happy for the both of them. My sister-in-law and best friend died several years ago from complications of a severe car accident. She and my brother have 12 children of their own. Since her death, my brother has been raising at least five of the youngest ones - home-schooling them and all. I admire his strength but also know it is extremely hard on him in every way. I thought about my one nephew I hadn't seen in a long time and I said a prayer and hope he is doing ok. Yes, Mom's decision to accept his invitation will be good for both of them.

While I continued to drive, my thoughts turned to my work. I am thankful to my boss who allowed me to take the time off from work to do all of this. It has been busy at my job lately but I had PTO days in my bank and she OK'd my taking the time off, even with short notice, because she knew how much it meant to me to be able to give this gift to my mom. I am fortunate to have a boss who cares about her team and supports them in many ways so they can come to work and feel good about it in spite of the many challenges and frustrations they face that are common in many areas of health care. Our department is close and supportive of each other. We are a professional team that has been enabled to produce quality outcomes - both on demand as well as through formally organized orientations and educational programs. Even after 7 years I can still say "I love my job"...and I do...and I am thankful for all that I have been able to achieve over the years working there. And I thought about all of the people that have come into my life at one time or another. And I am thankful for the positive things they brought into my life and the life lessons I was able to learn from them.

When I finally reached home, my odometer said I had traveled close to 900 miles over the past couple days and I was beginning to feel it myself. But as much as it was, I wouldn't trade it for anything in this world. Over the years my mom put up with a lot from me too but she never stopped loving me through it all...I was glad to have the chance and the support of my loving husband so that I - no - we could give this special holiday gift to her. She is worth every bit of it and much more.

Now many of you who may have read this story probably had very different experiences than mine. But the one thing we all shared and still share is the opportunity to look at what we have and be thankful for what we've got. It is not about buying lavish gifts or providing expensive entertainment in order to share love and thankfulness with people. Some of the most precious gifts are the ones that come in the form of a simple hug or kiss. It might be a "thank you" or an "I love you" or it may even be "I forgive you" that you may have been planning/wanting to share but just never took the time. It may be a matter of making the time to do it. No one is promised tomorrow, so we need to make the most of each day we are given.

I suffer chronic pain and am dealing with it one day at a time like so many other folks are. But my desire to give this gift to my mom was strong enough that I was determined not to let my own problems get in the way of my doing this. I took care of myself and thought wisely about the activities I did. I rested when I had the chance. I took time to get out of my truck and stretch during the trips. I traveled with my heating pad and my meds but you know I didn't need to use either one! And when I got to my brother's home, it was so relaxing that just being there was therapeutic in itself. This weekend has been very quiet for me - by choice. It is my chance to give my mind and body an opportunity to rest. And knowing I could bring happiness and contentment to my mom for the holidays and realizing all the things I am blessed with and thankful for- all bring comfort to me.

So if you may be struggling financially and you don't know what to do for the holidays, consider ways you may bring joy to the folks you love without spending a lot. Write a letter, place a call, stop by and visit them. Help someone in need to finish a project. Watch someone's children so they can have a break to do something for themself. Help someone by doing errands for them or assist them with housework if they suffer pain and limitations. I remember my daughter giving me an envelope years ago with a little handmade card. In it she wrote that she was donating a certain number of hours to her mom to help with house cleaning; not only was I touched, I made sure I received those hours!! I also remember a similar gesture right after my daughter was born, a friend of mine gave me a certificate for 4 hours of free babysitting so I could go do something that was for me. What a thoughtful gift. These gifts show how much you care. And gifts like these are often priceless!

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Technorati Tags: Thanksgiving, holidays, family, gifts, faith

The Pain of Losing Children - Regardless of Age

2007-10-22T21:05:00.000-04:00

Photo Credit: Zenera

I can not begin to realize what it must feel like to lose a child of any age. I pray mine lives forever so I don't ever feel the pain of such a loss.

I recently read of a horrific fatal car crash where 3 young kids in their teens and early 20s were killed. One sole survivor remains in serious condition according to the newspaper I read online. These kids were all from the surrounding area where I grew up and lived over 30 years of my life. I knew and worked with a relative of one of the victims. My heart goes out to her and her family. Reading the articles and seeing the photos of the mangled mess of what once was a vehicle, my heart aches for the loved ones that are left behind. And I pray for the lone survivor who is fighting for her life right now. I don't know her personally but that is okay. The Lord does and He hears my prayers.

It will take some time for many of the folks in these small towns to get over the tragedy of this accident. It will not be easy to get over the pain of such loss. I have always felt that emotional pain can be harder than physical pain. Physical pain can be horrible but it often goes away over time as physical healing occurs. Emotional pain on the other hand can last a lifetime and it can invade a person's life as fast as a momentary thought or painful memory is realized.

It is my earnest hope and prayer that the folks effected by this tragic loss will come together and support each other during this most extremely difficult time. Put away any petty grievances or strife they may have and use their energy to cope with the grief they all share. I pray they help each other and support each other as they work through the pain of their loss.

I pray they will find and lean on faith as they travel along their personal life journey. And I hope they will one day reach a point of comfort and emotional healing.

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Technorati Tags: grief, death, faith

Open MRIs: A Comfortable Alternative

2007-10-19T09:14:00.000-04:00

Recently I needed another MRI of the low back because of a lot of burning pain in the lower thoracic and lumbar areas of my back. I remembered the last experience I had getting an MRI of the back and I felt very apprehensive about needing and getting another. I remembered the anxiety of feeling so tight and unable to move. There was only a very few inches between my face and the top of the tube I was in. And I couldn't see the other end of the machine at all from the position I was in.

I also remembered fearing I would not be able to get out of the machine once I was pushed all the way into it - although I was told by the technicians that they never lost anyone in their machine before. Everyone that went in definitely came back out!!

Well since that last MRI, I had actually lost a little weight and I was trying to remain hopeful that I would feel easier about this one. However I noticed that padding was added to the sides of the MRI since the last one I had and the technician also placed pads between the side of my body and my arms. He said it was to keep me from feeling too warm. Well with all of this extra bulk around me, I was unable to move into the MRI machine at all, so the test was canceled that day. Luckily I was able to find an MRI site with an open MRI and obtain an appointment for the next afternoon.

The next day I arrived at my appointment a few minutes early. I tried to keep my anxiety down. I am not sure what I expected. I still had to enter a "tube," however this one was larger and less confining. The length of the machine was about 4 feet long so I could actually see out the other side of the machine if I tipped my head back a little. What a difference! I was able to manage the procedure much more comfortably. My anxiety dropped considerably. The machine was just as loud but I had ear plugs and there was also a radio playing that I could actually listen to during the whole time I was in the tube. I had to have an injection of contrast dye again, however I had no problems or reactions to it. I was very relieved.

From now on, if I have to have another MRI, I am going to opt for the open MRI. It is well worth it.

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Technorati Tags: MRI, anxiety, back pain, health and wellness

Walking

2007-10-12T08:02:00.000-04:00

Photo: Brook Riddick

Sometimes I feel so jealous as I watch people walking or skipping along their way. Every step I take is slow and deliberate and often painful somewhere in my body. I find myself wishing - if only I could bounce so freely as they do. Being able to walk along without a second thought is something that is often taken for granted.

People do not realize how lucky they are to be able to walk freely and without pain. They probably will not realize just how lucky they are unless they find themselves in a situation where they can no longer do so.

There are times when I need to walk with a cane. I remember the first time I tried to maneuver a fast food restaurant alone while walking with a cane. I found it difficult to carry a tray one-handed without spilling anything. This is something that many folks take for granted. I was overwhelmed by the situation and just left the restaurant without eating.

Since that day I have realized the importance of not taking what you have for granted. You never know if the time may come when you lose the ability to do what you do so naturally now.

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Technorati Tags: chronic pain, walking, health and wellness