What’s the line between discomfort & pain? I’ve had a sort of bellyache all day that’s made me feel depressed, but it only developed into pain later in the day, at which point I took medication for it. My oncologist says I have a high tolerance for pain (though she probably says that to all the old guys), but the pain I’ve been dealing with lately seems mostly manageable with extended release morphine twice a day. I never know quite whether I should take the short-acting Oxycontin when I feel twinges of extra pain. I guess what I’m trying to sense as accurately as I can the difference between chronic & acute pain. Not that one should feel the need to tolerate chronic pain for moral reasons. How far, then, does one go in treating chronic discomfort? Existing is suffering & all that. There are reasons for not numbing one’s self out, but there are also reasons for not allowing one’s mind to be filled with the distractions & fear of pain. Admittedly, I’m anticipating a time when my pain will certainly be greater. I want to know how best to navigate that coming landscape, which is why I’ve been going over the maps ahead of time.
This is among the most useful short discussions of cancer pain I have run across. Addresses the psychological as well as the physical requirements of patients. This is a doctor who has actually observed patients in pain.
Milky coffee, english muffins, gray sky after a rainy night. It is surprising how normal I’ve been feeling for the last week. Given my disease, I’m grateful that I seem to have found a plateau of ordinary life that is characterized by weakness & mobility problems (still walking with a walker) but without sharp or debilitating pain. Current medication is mostly morphine ER at a low to medium dose, with a shorter-acting opioid for “breakthrough pain,” though I find I don’t need those as often as one would think.
I’ve begun doing some medical research online regarding pain associated with cancer. For quite a while now I’ve set my anxieties aside & just tried to get on with my days, focusing especially on writing poems; but lately I’ve had the sense that I ought to intellectually prepare myself for the progression of my kidney cancer. Perhaps it is time to start sneaking up on reality, though without becoming anxious or obsessive; in fact, I’ll probably want to go back to ignoring chronic symptoms as much as possible for a while. This sort of modulation strikes me as healthy & should allow me to work on publication projects, sending poems out, etc. (A lot of that stuff is easy to shunt aside, but has a remarkably positive physical, intellectual & even spiritual set of effects when I focus on getting such things done.)
So I’ll be listening to doctors, pharmacologists & etc. talking about pain & pain medications on YouTube & following up the very materialist parts of these discussion. (I have little or no problem dealing with the linguistic, metaphorical & spiritual sides of the problem; what I need to do for a while is look more closely at the nitty-gritty.)
Still, a lovely cool morning with mostly bare maple trees out the window, Somehow wet & dusty at the same time. The body adjusting itself to the various fields of force that act on all of us all the time. And acting on me & the qualities of my time & life in the coming months.
We are taught in Zen that even change changes, but we never really believe it. Even in the midst of change we expect to be able to extract moments of stability. Even in the midst of a disease like cancer, which is always changing, I have become lulled to the idea that I will have a period during which things remain more or less the same. I guess, depending on the scale one applies, this is more or less true; but at bottom there is no standing still.
All this was brought home to me this evening by a new pain in my pelvic bones, this time on the right center rather than the left. That is, I have been confronted by the possibility that my disease is spreading away from its site of origin. Actually, it has already done this, way up into my sternum, but there has been little or no pain associated with that spread. Without the pain, that change has seemed unreal.
But this pain has the potential to make walking even more difficult than it is now, which would amount to a major degradation of my condition. Now, a bit of rest seems to have diminished the problem, but it has caused me an evening of distress. I’m going to take it easy & chart the changers tomorrow & over the weekend then make a decision about whether or not to see the oncologist sooner than my regularly scheduled check-up in two weeks.
Itâ€™s not the pain itself
but what the pain itself
Without metaphor. No
walking, just falling in
to the arms of others
(this is no comfort) be
cause then everything
is depending on a kind
of singing. No singing.
After cracking (an apparently not vital for locomotion) part of my pelvis late last week & living though a weekend of increasing pain, I’ve been astonished at how quickly the pain has resolved & my psychological orientation turned around. My bones have been weakened near the site of the tumor around my lower spine because of radiation & chemotherapy, so putting a little extra strain on it by bending to pick something up apparently caused a crack. It began like a bad muscle ache on Friday & got worse until Tuesday when I got in to see my oncologist. (Could have gone to the Emergency Room but wouldn’t have been numbed & told to see my oncologist. Figured I’d just wait.) And I have to say that once I arrived my team swung into action with X-Rays, an IV for morphine, steroids . . . so that by the time I left I was already beginning to feel better. And at this point, about a week after the incident, I feel better that I had before I injured myself. The added attention to the pelvic pain has spilled over & is alleviating some of the more general pain associated with the cancer. It’s not as if I’m dancing–I still walk with a walker–but I feel almost well.
Which is a little unsettling. When I feel this well, it can be hard to recognize that I am still sick with kidney cancer. Most of this is no doubt a bounce-back effect from last week’s misery. When severe pain is reduced the body goes into a kind of celebration & pulls the mind along with it. I’m not complaining. I’ll take it. One result has been a spurt of writing–several short poems (not usually my best mode) with which I am quite happy. I’ve secretly sent a couple to friends for whom I thought they would have special resonance, but amn otherwise holding them close to my chest until I’m more sure of the language I’ve written in, which is much more Harmonium than Spring & All. More lush than I have been accustomed to working in.