One of my favorite lines I preached to my patients as a hospital nurse… “There’s no Gold Star for pain!” Anytime I was given push back on taking medication for pain. I always kind of envisioned giving my patients those gold foil stars, for a “job well done!” like our teachers used to put on our papers in school, way back when… remember those?!?
I was taught in nursing school that a body in discomfort will not heal as quick or as well as a body that is resting comfortably. So my charge as a bedside nurse (as well as a gazillion other things) was to keep my patients as comfortable as possible, so their bodies could do their best job to heal. Most of the time I could convince them to pop that pill. At that point I had not yet been a patient myself. I was drawing solely from my education, not from my actual experience of healing.
Fast forward to me being in that bed. Tiny tubes running into the nerve space via my groin, bathing my raw nerves post-knee replacement surgery… I woke up from that surgery relatively comfortable. I remember my surgeon peeking in on me a few hours after the procedure, I had been in and out of sleep, snoozing off the anesthesia. I heard him ask my husband how I was doing- and I remember- groggily, but happily lifting my legs up to show him my new knees! Ahh! “She’s going to feel that tomorrow!” he remarked. All I knew at that point was, I was comfortable, and I was healing. I pressed my button for more “juice” through my tubes when I heard his comment… ooops. Maybe I shouldn’t have lifted those legs so high!
Day two post-op, not quite so sunny and happy, way more uncomfortable…. they had taken away my magic button… and wait, what? Get UP? Oh no. Take a pain pill? A pill? Is she kidding? I need ten pills! Slow and steady wins the race. I did not do well with the getting out of bed thing. It hurt. A TON. And then I remembered. “There are no Gold Stars for pain.” What, was I insane? This pain nonsense is for the birds! I paid close attention to the schedule of medication, even closer than I had been. I made sure I asked for that pain pill 15 minutes before I needed it- I knew exactly what happened at those nurses stations and out on those hospital units- emergencies! Someone else’s need could trump mine at any time- better to have a little wiggle room than mess up my pain and let it get ahead of me because it was a beast. If I let this beast grow to large, I’d never get done what I needed to- getting out of bed.
Each and every day after that was much of the same- a constant battle of taming the beast- the pain, and tackling the task at hand- whatever stage of physical therapy I was in at any given moment.
About six weeks post-op, I went to refill my prescription for my pain medicine. Six weeks, that’s just 42 days post surgery. A surgery, let me remind you that cuts bone apart. It takes, on average, six to twelve weeks for bone to knit back together, for it to heal. So theoretically, I was likely about halfway to healed bones. The pharmacist refused to refill the medication. (Say what?!?!) He has that right professionally. Of course, I had words with the pharmacist, explaining why I needed the medication, to continue my course of physical therapy. He felt I had been on the medication long enough. He was concerned about me becoming addicted. I left, found a new pharmacy and got my prescription renewed there. I remained on that medication, for many more months. I did not become addicted. I used it as prescribed. I needed less and less as time went on, but I DID need to to be successful at each session of therapy AND to sleep comfortably most nights.
Addiction is a real problem, a real issue. I applaud the pharmacist for being aware of that real issue. BUT, pain is also REAL issue. I watched other patients fail at physical therapy and require revisions to their knees, maybe not necessarily directly related to not tackling their pain adequately, but certainly in part to not being able to fully participate in their physical therapy sessions. Could that have been due to pain? Possibly, there are other factors out of our control- infection, scar tissue formation, etc., that may have caused the need for a revision, every body is different. What the take away is here, is we, as patients, can do our best to control our pain, get the rest we need, remain hydrated and fed with healthy, nutritional foods that will build muscle and heal bone. That in turn, gives our therapists the best possible body to work with- helps us in turn to heal optimally.
I do believe being in pain directly decreases the effectiveness of any situation, especially a physical therapy session. You cannot be a motivated patient or even concentrate, if you are in pain. Do you remember Brian Willams, a former NBC News anchor? A few months after my surgery, he had one of his knees replaced. He sat down for a 3 minute interview with Dr. Nancy Snyderman. He talks about being a motivated patient- and how vital that is to recovery from this surgery. He reminds us that this is elective surgery, and yes, we can go to our grave with bad knees, albeit in much pain- but this illness is not life threatening, so keep it in perspctive! Enter the North Stars. He identifies folks he admires, folks who are brave and amazing. Incredible individuals who would never give up, no matter how dire the circumstances. Those people, those North Stars helped him through those dark days of recovery, the days he just felt he could not do this anymore. You will have days like that. You will get through them. You are stronger than you think. Remember your North Stars.
Let’s revisit surgery day again… when I opened my eyes in the recovery room, I kind of took a silent inventory. I wiggled my arms, scrunched my nose… gingerly walked my fingers down my thighs to feel my bandages around my knees. I laid very still to dial into listen to my body- as I mentioned before, I was not in much pain at all. The Pain Management Team at the hospital I had my procedure at was super! What I did notice immediately- something was missing- the dull, familiar, pulsing ache, deep in my knees… that was gone. I think it worked! No- I KNOW it worked! From that moment, I KNEW, that sharp, acute surgical pain had nothing on me, that would eventually go away. I did not have to live with chronic pain anymore! I could do this, I would do this. I was not sure how, I would figure that out later. For now, I was going to close my eyes and sleep it all off. That my friends was a Gold Star!
Be Well!
-Laurie
