Going into the final week of this program, I am thinking about change. I came here to find a different way to deal with pain. If this experience is not transformative, then what’s the point? It needs to have a lasting impact. “Re-entry” into everyday life next week will be one of those “rubber meets the road” moments.

I can’t be sure that what I have learned here will consistently lower my pain going forward. There are so many variables on any given day:  Is it some random neurological event? Do I feel better because I am sleeping better? Is it the new dosage of the pain med? Is all the deep relaxation kicking in? Maybe it’s the gluten free diet? Will the warm weather help? I may be carving new neural pathways that will ultimately diminish my pain, but this remains to be seen. But I can already call the program a success in any case.

This is more about managing pain than treating it.  We manage things that we live with, not the things we are trying to rid ourselves of.  Doctors treat pain, but patients need to learn to manage it themselves. Doctors help by prescribing medications -- and medications play a big role. But they are only a part of the picture.

One important change is that the daily ups and downs of my pain don’t freak me out the way they used to. This is, as they say, HUGE. I am learning to internalize the notion that not every uptick in pain is a major flare-up and that a even a big flare-up is not a first step on the road to hell, or an indication that I have an as yet undiagnosed pathology that is going to make life unlivable.  Maintaining my equilibrium is not only good for me; it is good for friends and family who deal intimately with me on a day-to-day basis. I hope I can keep this up.

Chronic pain makes you feel very apprehensive, at least until you get your head around it – and I am finally getting my head around it, after a tough year. But I am pretty lucky. For some people it takes much longer, either because the pain is so bad or because the social, medical or psychological circumstances of their lives make it so hard to learn to cope with this. But learning to be less apprehensive seems to be a crucial step.

This is challenging because when you have a bad day you naturally extrapolate it to the next. This isn’t some crazy personality trait; it is what you instinctively do when things hurt. Your brain tries to protect your body from whatever may be coming next. (You might say: “It’s the neurology, stupid”). So internalizing a different understanding of the ebbs and flows of your pain is an achievement – and I am sure it is something that will require continued effort.  You even need to learn to keep a level head when the pain gets better: Don’t get elated, because the pendulum is likely to swing back. If you do, in fact, have a longer term remission, let it come as a surprise. The important   thing is to actively work at managing pain rather than to wait passively for it to go away or to panic when it gets worse. Easier said than done but doable.

Another change is to understand that the details of daily life really matter. Sometimes the little picture really counts and it is better not to let your ego get in the way of acknowledging that. I have been dealt a hand and I have to play it well. So I need to focus on the details of how I walk, sit and stand --not to mention the CRUCIAL details of how to breathe. Breathing is worth a whole post in and of itself but I am afraid that I might lose some of you if you see what a missionary I have become about the value—for everyone – of learning how to breath diaphragmatically. The point is that medications only get you so far in managing pain but these other things, which are thankfully within my own control, really help a lot. If I structure my days deliberately I can do the things I need and want to do without aggravating my pain to unacceptable levels. I have to accept the fact that I am more prone to fatigue than I used to be but I can still be confident that, with a little forethought, I can get a lot done. And the clearer I am, the more my friends and family can be relieved of the anxiety of worrying over me.

So, yes, I am changing the way I think, walk and breathe and these things make a big difference.  So we will have to see how all this plays out in the weeks ahead when I re-enter the path of  “normal” life. In the meantime, so far, so good. Stay tuned.