Stories From A Life

Been there. Done that. Writing about it.

Sally Swift

Sally Swift
Location
Philadelphia, Pennsylvania, USA
Birthday
June 14
Title
VP, Repartee
Company
Swift Retorts
Bio
sally: a journey, a venture, an expression of feeling, an outburst, a quip, a wisecrack ... me

MY RECENT POSTS

DECEMBER 8, 2011 11:35PM

How Bad Is Your Pain? UPDATE: Reality Post-Op Pix

Rate: 39 Flag

hand foodie

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.



Me at PT, recovering from rotator cuff surgery. Some of you are on my chest.

os collage rehab

 

Me, directly after 2008 surgery on my left hand. Oh, and I'm allergic to lots of meds, as you can see, including most pain meds.hand wrapped 


Recovery
I'm a master of rehab, love the ability to push myself, go for Personal Best, use all the strength machines to sneak some workouts in with the physical therapy.

My hand surgery starts with that monster wrap above, then I get two alternating splints, one to straighten the hand, one to bend it, then pressure cuffs on each finger, worn inside a full pressure glove. Each one is 24/7, hand elevated as high as possible.

Me (skin and bones) in Israel holding a new baby, still wearing the glove  3 months after surgery. But at least allowed to get on a plane.

hand with baby

My recovery this time will take many months. There will be setbacks, successes, frustrations, achievements, lots and lots and lots of hard work. And even after the worst is over, a fair amount of pain. 

Oh, and one more thing. Vanity. I've always had nice hands, slim, long fingers, smooth skin, dainty nails. My mother's hands, in fact.

Not any more.

~~~~~~~WARNING:  UGLY HAND PICTURES AHEAD!~~~~~~~

This is what they're going to fix, just in time to stop my hand from becoming an unusable claw.

hand 4 

 

hand3


It's okay. My left hand looks and feels fine now. Most important, it works.  And it doesn't hurt. Because I really, really can't stand the pain.

I'm determined to achieve the same results with my right hand. I need to be able to applaud my friends and family, cook my Chanukah brisket and tweeze!

How's your pain? I hope it isn't too bad. If it is, seek help managing it.

Oh, and not surprisingly, Judy's in the house. I'm blessed to have a big sister who's also a nurse and my Person. I feel better already.

 


NEW WARNING!! NON-MEDICAL PROS OR NON-HORROR MOVIE FANS SHOULD NOT VIEW THESE PHOTOS! (unless you ate too much and want to lose your cookies).

My sister Betsy's in the house now. Like Judy, she's fascinated by the gore of about 50+ stiches in my hand. If you chose to look, you might be too.

READY? OKAY, YOU ASKED FOR IT...

Not too bad. But wait.

back of hand 

 Good hand, bad hand, swollen much?

both fr back 

 Close up, knuckles, not so bad:

swollen knuckles 

 Serious grossness ahead...

palm 

One more, close up:

palm close

  Yep, Hubby's right, looks like it got caught in a garbage disposal. Improving every day. I'm betting all good thoughts and wishes are helping a lot. Thanks!

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Oh my goodness, well I guess I won't be whining about how nobody suffers more than I do because I carry the troubles of the world on my shoulders! At least, not on this blog. (I'll find someone else's.)

I hope and pray this surgery goes well for you so you can cook that brisket, hold that baby and do everything else you want to do.

Yes I've read about pain so brutal people wish for death as a release. And there are some cases where doctors can't even pinpoint the source of it let alone give the patient anything to numb it. I know pain management is a growing area of medicine; hopefully there will be breakthroughs in the near future.
That is a *nasty* tendon, sally. Holy crap. No wonder you have to get it fixed - I can't imagine your right hand is much use now, notwithstanding the pain. And I know a thing or two about excruciating pain, too; you've got the motto down pat: stay ahead of the pain.

I'm hoping the surgery goes as well as the left hand one did, that you have a an excellent result, as many drugs as you need, a great doc and an amazingly fast recovery, surprising every medical person on your case. If you want Candy's World Famous ______ food care packages overnighted to Philly, just say so.
Oh my. Whether the pain is temporary or permanent is a giant factor in pain management.


The sick problem is that with permanent and chronic pain, the doctors are getting people hooked on nonsense like Oxycontin, then telling them that they have to quit. WTH?

There is just not enough money put into understanding pain or developing strategies for pain management.

It all goes to the next drug that will make money for the legal drug cartels: big pharma.

I had the post surgical pain and was determined to get off of the hard stuff right away. Now I have whole body arthritis and actually use movement more than I use drugs. The heaviest thing that I take is Tylenol, but I have Vicodan and other goodies. Darth Doctor has had it with me.

I'm terrible and grind my teeth a lot. Darth Dentist gave me a tooth guard and I bit through the gel in one night...that sucker had holes in it!
Margaret, your pain is your own, feel free to complain, misery loves company.

Candy, the big tendon is just the most obvious. One snapped and is lodged in my pinky. Another is what's pulling my middle finger sideways. And more are in the top of two other fingers. A mess, but nothing like what you're going through. Please keep me posted. Care packages always welcome!
Zuma, why am I not surprised you have pain and kick its ass. You inspire me as always.
The pain you have shared with us reminds us how fragile we can be. Thanks for the different levels too. I just had a horrible neck problem and could not move my neck for days. It was a killer come bed time.Thanks again.
Sally, you know my thoughts and prayers are with you. I'm so glad Judy is there. I'm there in spirit.
(I think the picture of you with the baby is beautiful.)
xoxo
I read an article in England that said that researchers had pretty much documented that redheads are more sensitive to pain than other people.
Yikes, Sally! I woke up this morning thinking of a great post for today - about the arthritis in my right shoulder and how hard it is to get comfortable when I'm trying to get to sleep. There. That was my post. Lordy, lady, my sympathetic best wishes are with you, for as long as you need them.

I do envy your T-shirt.
Heading to the hospital. Thanks for all good wishes here and any I won't see til later. I'll be reading when not floating on a painkiller cloud.

Tell us about your pain. Really. Let's share war stories and support. What're friends for if not to commiserate and cheer each other up.
Dealing with ANY kind of pain is difficult Sally and from the looks of that hand has to be hard.
I have full body chronic pain from my curse of lupus and fibromyalgia. I use meditation, gentle stretches and lots of warm water soaks.
I sure hope the surgery goes well and you recover fast and easy...
That picture of you holding the baby is wonderful this morning..
Best to ya..
I am so sorry to hear about this. Pain robs us of so much, too much to list. Glad you have help. Keep us posted somehow.
I always fear they will stop filling my pain pills for my neck disk problems and I totally agree staying on top is whay works even if it means taking a little more now and then less later BUT your hand looks so painful and I am so sorry you need to go through this yet again. I'm glad your sis is with you and will help take some of the pressure off you to do things to soon you shouldn't. Take care and on ly positive energy going your way.
It is one thing to endure pain that was not expected. To leave the house as you just did KNOWING you will wake up to months of relentless pain is damned courageous, Sally. I so admire you indomitable spirit. See you soon, I hope, haze and all.

Lezlie
I thought there was something to that forgetting of childbirth pain. I hadn't realized it was like that for everyone. All the best for your surgery and recovery.
Sally, here is wishing you healing and fortitude in keeping with your last name. Strength and all best to you in all aspects of this ordeal. (Surgery is one synchronicity situation I wish we didn't share.)
Holy moly, you've been through a lot! Surgery turns the body into a big circus-dripping, draining, hurting, ballooning out of this and that, wild new colors, not to mention what weirdness the brain contributes. Yet a veteran of a couple of surgeries myself, I was surprised to discover that a bout with Ehrlichiosis involved the most pain I'd ever experienced, way more than mastectomy and excision of twenty two lymph nodes, a relative cake walk in comparison. Thank goodness for that button.

So you have an idea of what lies ahead and how to deal, so it will be better. A big part of the stress is not knowing how you'll wake up each day. Best wishes for the best results!
Hi, Sally. Good to see you here again, even if under such trying -- and painful -- circumstances. Hope the surgery goes OK.
I hope you find permanent relief for your pain. Please eat other vegetables besides catsup.
Sally,
Was your surgery related to carpal tunnel? If so, I can relate. After years of pounding on keyboards in newsrooms, I'm am susceptible to paralyzing pain in both wrists. When I was working for the AP, I used to have to pop three or four Aleve just to make it through the work day. And, you're right. Nerve pain is the worst. Nothing seems to help alleviate it. Hope you are feeling better soon. ... And Malusinka is right. I remember the 2009 study about redheads and pain because some of the study's authors are from Colorado. Here's a link to the NYT story: http://tinyurl.com/kjefoh
Well written and absolutely true, nerve sensation is often a mystery. When I had appendicitis the ER doctor came in after reading the nurse's chart notes and asked what the problem was with my very high blood pressure. I explained I thought it was my appendix, apparently my inability to feel or exhibit a huge amount of pain confused her and she forgot to note what I told her about the pain in that area. Luckily he understood and the tests proved my suspicions right, it was removed before it burst.

Unfortunately I also don't feel tooth pain until it backs up into my sinuses where it brings me to my knees. It's not courage, I just don't feel much pain. Others tell me I'm lucky but I just had two badly infected teeth removed. Pain can be a gift, without it, we don't know the body is in trouble.

Good luck, I hope this surgery goes perfectly and there's less pain than the last.
Oh, Sally. Two things: first and foremost, I hope the surgery goes perfectly and that you are always ahead of the pain. Maybe it will be a little better this time, since you've done it all once and know what to expect? I know that probably heightens your anxiety, but it might also help with pain management if you feel a little more in control because it's not all series of shocks. Second, pain management is a subject near and dear to my heart for many reasons; when I was a Social Security Disability lawyer I used to see people in chronic pain having totally inadequate amounts of pain meds given to them so that they wouldn't get addicted, and I see my own parents refusing to take enough medicine to do any good because they don't want to get addicted. As you are well aware, when you are really in pain there isn't much of a "buzz" involved, just the ability to function without wanting to die.

I'll be thinking about you and hope you will keep us updated here and/or on Facebook, even if someone else has to type for you.
I have been lucky so far as far as phyical pain goes but can't stand to watch my mother going through pain in almost every part of her sweet body. She just got rotator cuff surgery and became delirious. I thought she was just high off fthe pain pills when she was sure that "handsome Mexican Men," were dancing by her bed as well as " a good looking guy, in white shorts, had just gone to buy her roastbeef." Adorable and funny but scary as hell to me too when I began realizing this wasn't a perdodan high. My point: Don't put these surgeries off cause when you are past 65, I understand, it's much more dangerous.
Sorry you've had to feel and see so much pain, Sally. Sending out vibes for a speedy and less painful recovery.
Wishing you only the best through this!
You poor thing. Pain is no joke. I had a pinched nerve in my cervical spine (cervical radiculopathy) back about 6 years ago that made me almost a cripple for about a year. I found a homeopathic pain management doctor who gave me weekly lidocaine shots in my shoulder, but the relief only lasted for an hour or two. I saw a chiropractor (swore I never would) which made me worse, saw my orthopedic surgeon who wanted me to go for an epidural and then said we would have to discuss spinal surgery if no improvement was forthcoming. I became addicted to Vicodin, then Percocet, was in constant pain and unable to sleep. I'll cut to the chase now: my then-boyfriend (now husband)'s kung fu teacher also was a reiki master and he slowly, but surely healed me and unpinched the nerve. I'll still go for treatments from time to time. So in my case, Eastern Medicine saved me.

I hope your pain becomes more manageable, Sally.
I have had very bad dry, cracked, itchy skin on my feet for a few months and have wanted just to cut off my feet. I am such a crybaby! It's a good thing I'm as healthy as I am because I could not tolerate any of what you and some of the commenters have to deal with.

I wish you all the luck possible, the speediest healing, least pain and anything else you can think of to want even drugs.
There is a newer surgery for those tendons where it is relatively simple to heal...they scrape the scar tissue from the tendons, they do not have to cut them. I hear recover is much quicker. My father had your surgery a decade or so ago, I remember his pain was horrific. I have the problem too, but not as bad yet. I'll be researching docs in my area for who does the latest.

If I had not had 1 1/2 years of pain in my right hand (finally diagnosed as rheumatoid arthritis) I could do nothing with it at the end. That pain is now gone (cortisone helped) but I am left with the knowledge it can come back and then there is the whole other specter of the tendon issue coming down my road. Sigh. Best of luck with your pain management.
I have echoed so many of your questions to my own doctors that it is mind boggling. The 1 to 10 scale is so inaccurate it is worthless. While the profession has gotten a bit better about relieving pain it has a long way to go. I live with chronic pain. I know that my normal day would rank as an 8 or 9 for some people but for me it is just the way things are, do I rate that at what I think it is or what the doctor would consider it? If I say it is a 5 then they pull my meds and I am in agony. If I say 9 they look at me like I am just another "drug seeker". Truth is that I am a drug seeker, I spent years fighting pain that went untreated because of the DEA. Compound that with an allergy to synthetic pain meds. I have been forced to try them all in order to get the opiates that work and leave me able to function. I have been fed pills and injections that made my blood pressure spike to dangerous levels, those that I had anaphalactic reactions to, ones that caused me to vomit and be unable to even feel any relief to pain. Still every so often some doctor decides to force me on to some "new" non narcotic. They do not work and many carry worse side effects than addiction. Personally my pain is pretty bad, even more so now that the ambulance crew that helped to save my life accidentally tore my right rotator cuff getting me on to a gurney. Between heart and lungs I am not currently a candidate for anesthesia so no surgical repair at this time.

I wish you success in the surgery Sally, like most chronic pain sufferers, we often just grit our teeth and do what we need to despite the pain but hey, you already know that. Have a wonderful Hanukkah and for what it is worth my own sincere wish for you to have a positive result and that it is all worth it.
My thoughts and best wishes are with you. Although she hasn't developed the tendon troubles you have, Ms. Stim gets a shot in her palms when needed to loosen up the main tendon.
There is a better pain chart!! Allie Brosh of Hyperbole and Half has created it. I've posted it just for you.

http://open.salon.com/blog/kh3333/2011/12/09/pain_chart_for_sally_swift
Wishing you fast healing. The best thing about doing this a second time must be knowing you will survive and get through this and your hands will be restored.

My family prides itself on stoicsm. I never answer the "rate the pain" question honestly because I don't want to a whimp. I think I need to get over that.
You have been through so much--best wishes for the best possible outcome and superb pain management and recovery.
Sally, I wish you all the best as you go through this next surgery.

When I was undergoing PT for a dislocated elbow a couple of years ago, I saw many people who were doing PT after hand injuries or surgeries. It made me realize how delicate our hands are, and how difficult it can be to regain function. The assortment of tools used in therapy was amazing. It made me really appreciate the work that physical therapists do.

Also, my mother has major problems with her hands. Trigger fingers all the time. Cortisone shots and surgeries. And still so much pain.

I hope you'll keep us updated on your progress.
I sincerely hope that all goes well for you and in record time you are back to be wonderfully fine. I understand whole pain thing, having had some very interesting procedures, etc. I do not pretend to feel yours, only send you mountains of sympathy and billowy clouds of caring to let you know you will be thought of and missed while you healing. Best to you.
on the pain scale my diagnosis' rate a 12.9
helium works wonders
Based on the photos, I think I may have the same thing as you. It hurts some in the early morning, but that's about the only time. It has made my little finger look pretty deformed. I'm not doing anything about it until I can no longer use that little finger for anything. Good luck to you!
Sounds horrible and I wish you well, Sally. Imagine what it must have been like before anesthesia.
I wish you well, also. It will be better this time around!
my god i'm sorry to hear this. it looks and sounds horrible. there are ways to convert pain to energy, but i'm not sure it will offer much support at this stage. it certainly sounds like you have a wonderful and full life, however, that makes going through it worthwhile.

All the very best,
Goodness gracious - I'm so sorry about all that you've endured. I've had awful migraine strength headaches and have read about people who actually band their heads on the wall so the pain from that will make them forget their migraine. I wish you well and thank you for writing so openly about your pain.

R♥
Sending my best wishes Sally for a successful surgery & recovery.
sending love and thoughts of healing
I was on the pain diet myself one summer after back surgery. Lost 25 pounds.Couldn't eat anything but oatmeal. I don't recommend the pain diet either no matter how much you want to lose weight. Good luck Sally. Chronic pain is debilitating in so many ways as you point out.
You made me look.
Heal, Sally, heal...
I've had this done twice, and even after three hip replacements, they were nothing compared to this. The first one, for 4 days, was a burning pain, like someone held a Bic lighter under my hand for 24 hours a day. Pain pills were useless. I also promised never to do it again, but...The second hand I had to let a surgeon at the VA do. She bragged how many she had done, how was an expert, I was told. She made the hand worse. It took 6 days for the burning to stop. Unlike the first doctor, she placed the bandages different, so the burning pain was on top of the hand, and it was terrible. The first hand may have to be done again in a few years. But, the surgeon from the VA, missed something, and didn't give the ligament in my little finger room to grow, now, the whole hand is growing together. I have to do it again, and I would almost rather lose the hand. There is no 1 - 10 level with this pain. Believe me, I do feel your pain! (my hands are ugly too !:-)
I know the anxiety of going into a painful experience fully aware of how painful it's going to be. You're brave. And very savvy to have your pain management lined up before hand (no pun intended). Pain is exhausting, and pervasive, and consuming. I was on very high doses in the burn unit, and still suffered terribly, because dosages move through cycles just like pain does, and the waves did not always correspond perfectly. When there was nothing to be done, the only thing that helped was music that I could lose myself to. Music can be magic. Exhaustion lowered my pain threshold more then anything else, followed closely by stress, worry, anxiety. So finding ways to stay positive and calm became necessary and helped. With your terrifically proactive attitude your hand stands the best possible chance for optimal recovery. Your doctors and therapists must love you for your participation and drive. Wishing you rest, calm, music in your spirit and whatever inspires it there, and the smoothest, quickest recovery. BTW, your hand doesn't look too bad - all the parts are there.
Oh my. I have every sincere hope that you are now feeling much, much better. Best to you.
I just reread the comments and am so comforted by all the good wishes. Plus, misery apparently does like company... not that I'd wish pain on anyone, but your stories have helped me feel less alone in the dark.

The pain's as bad as I remembered, in fact worse because the surgery was way more expansive. Plus, so much nerve work was involved that as the nerves regenerate they let me know loud and clear they're baaack.

Bottom line, pain is exhausting, frustrating, depressing and a giant challenge. I'm focusing on facing and conquering it -- but not without pain meds. Hey, every challenge requires some backup.