Pain has been on my mind a lot lately. Mostly physical pain but some emotional pain too. I'm having complex, delicate surgery on the palm and fingers of my right hand. A lot of nerves are involved. And I am really nervous about the pain.

I know this pain and it knows me. I had the same surgery on my left hand in 2008. The post-op pain is brutal. Unrelenting. Impervious to all but the strongest pain killers. It can last for weeks, even months.

Well, hey, it's just a hand, right? Oh no. Pain from any source can literally take over your body. Force you to use all your inner resources to fight it. Especially when nerves are involved and you lose the use of an arm or hand. It's exhausting.

After my 2008 surgery I vowed out loud, Never again in this lifetime! Yeah. Fat chance. So here I am again, facing an indeterminate future of serious pain. I am better prepared this time -- got the surgeon and my primary doctor on board with the reality that I will need some serious help.

It wasn't hard. This surgery is known to be so painful it can bring big, tough, grown men to their knees, crying like sissy-mary babies. I say that with compassion, believe me. Especially when there's a 65-85 percent chance of losing some function.

Medical attitudes about pain have changed a lot. Still, physical pain is the most difficult medical symptom to accurately measure, quantify and treat. Pain signals travel to and from our brains through similar pathways, but we're all different, each brain unique in perceiving and responding to pain.

Levels of Pain

Doctors ask us, "On a scale of 1 to 10, how bad is your pain?" That's a start, but your 3 might be my 7. Your 8 might be his 4. It's inexact and frustrating for doctor and patient. Who need to communicate and trust each other.

We can all agree on some universally shared pain. A wrenched back. Migraines. The I-swallowed-razor-blades sore throat. A sharply banged knee. Childbirth's ginormous pain nature helps us forget, else no woman would even contemplate more than one child.

They say serious burns cause the worst pain. So unbearable that burn victims are often heavily sedated. You only have to burn your finger on a hot pan, feel it throbbing, hurting, engulfing all your attention to begin to imagine that kind of pain spread out over your body.

Imagine. That's the key. We can only guess at how another feels pain. Even if we've had the same surgery, injury, disease, each of our responses to that pain will be different.

Worse, it's hard for anyone hale and hearty, even a doctor, to imagine we're in as much pain as we claim. To be fair, some of us aren't. But most of us are. And conventional medicine is finally beginning to catch on to that reality.

Managing Pain
Over-treatment of pain during World War II is largely responsible for gross under-treatment until very recently. Back then, morphine was given freely in large quantities to injured soldiers, inadvertently turning many into full blown addicts.

Doctors began worrying so much about pain-killer addiction they lost sight of the genuine need for adequate pain management. It's different now. Pain Management is a medical speciality. Thank god.

When my niece Karen was battling cancer, our mantra became, "stay ahead of the pain." Take aggressive control, don't let it reach a level that requires even more pain meds to relieve it. Most of the time, that worked. Thank god.

It's been my mantra through rotator cuff repair on both shoulders, knee and back surgeries, killer migraines, even sinus infections. I'm not a pill head (okay, I am a little), but I learned the hard way that toughing it out, manning up, ignoring serious pain only makes it worse. And is bad for our overall health.

Pain raises your pulse rate, respiration, blood pressure ... all bad for the circulatory system. Pain can cause major stress, depression, anger, lowered immune system, loss of appetite. While that last one might sound appealing, I do NOT recommend the Pain Diet. 

The body needs healthy fuel to heal. It also needs a calm, relaxed nervous system to support a positive, can-do recovery. I'm aiming for all of that and more.

The first step is drugs to manage the pain. That photo up top includes my pain meds for a then recent rotator cuff surgery.

Next step, physical therapy and regaining the ability to sign my name, brush my hair, cut my own meat, apply mascara, open a bottle of water, dress myself ... all those everyday things we take for granted. Until we can't do any of them without help.