Managing Extreme Pain

1382 Relax and Succeed - Eyepain 1

I arrived in the Emergency Department with a complex problem. Through no fault of my amazing doctors, I had a rare and excruciating outcome that was largely created by the sheer fluke of how my body is built, and how it subsequently reacted to my surgery. It was like being in ‘pain school’ and I paid close attention to its lessons.

Rather than shrink away from the experience in an effort to wish it away, I tried to make the experience useful by going ‘into the pain.’ For the purposes of this post, I investigated it closely. What was it to be in such pain, and what hidden opportunities did it present to me?

This operation often includes putting a silicon band around the eyeball to change its shape, and thanks to my unusually small eyeballs, the combination of that and the extensive surgery is what lead to my rare outcome. I was told that my pressure situation was possibly the worst case that most if not all of the doctors recalled seeing.

The pressure was the issue, so I will begin by attempting to describe the pain I was in. Normally eye pressure would be between about 10 to 20 mm HG. Doctors become concerned if this pressure rises to anything higher than 24 mm HG. My pressure started off at 62-64 mg HG, then slowly fell over a week and a half to 58, 54, and 37 –which will lead to glaucoma and blindness if not relieved.

Fortunately, the skill of my doctors allowed them to take action that did lower that pressure and save my vision. They lasered some pressure-relieving holes into part of the eye, and the pressure dropped to 34, and by my next visit I was at a safe 24, and soon after saw my pressure lower to a relieving 9 mm HG. Whew.

In terms of my internal experience, keep in mind, this pressure is inside your head. My nose, cheek, and brow were badly bruised, and it placed a great deal of pressure on my eye cavity as well as on my sinuses, which in turn badly irritated the Eustachian tube linking our sinuses to our ears.

In addition, I had a bubble of nitrous oxide gas placed inside the eyeball, which meant I had to constantly look down, which placed a strain on my shoulders and back. Sleeping facing downward was also an issue with badly plugged sinuses. I really didn’t sleep at all for at least a week.

By looking downward, the bubble of gas rises to the back of the eye, which then holds the wound in place while it heals. Looking any other direction made the bubble move, which was also very painful.

It’s fair to say that my extreme case lead to extreme discomfort. People are fortunate that most cases are nothing like mine. Many people have in-office procedures that have them seeing fine in ten minutes, with no pain at all! Do you see why I encouraged you to see your optometrist regularly?

In trying to define the pain associated with that pressure, I came up with the following description, which I’m frankly quite proud of. For turning a feeling into words, I doubt I could have done better than this:

Start off with someone pounding a rough spike or chisel into your ear until it bursts your eardrum and pierces your brain. Then imagine a major league baseball player swinging a bat as hard as they can at your eye socket, where the impact very badly bruises your nose, brow, and cheek bone.

Following that, imagine that this impact drives the eye straight to the back of your head where it hits the skull hard and bruises itself on all sides. Then the bad stuff starts.

Next was the sensation that someone had stuck a long, candle-shaped cone of sharp, burred metal into the black iris at the centre of your eye. That was in turn pushed so hard into my head and eye that the ‘metal cone’ sensation felt as though it had pinned the front of the eye to the back of my skull. Finally, imagine that someone takes a wire brush and rubs the rest of the eyeball roughly.

I’ll say it again: do you see now why I urged in the previous post that you go straight in as soon as you get symptoms? As previously noted, the surgery for just minor damage is itself quite minor and not overly painful. Wait, and you could end up like I did (even though I did go in as soon as I saw symptoms).

1382 Relax and Succeed - Eyepain

One of the doctors described my experience as ‘giving birth through my eye, with no pain medication, for nine straight days.’ Oh yeah, and in order to monitor pressure, you’re also limited to plain old acetaminophen (Tylenol). On scale of 1-10 I’d put this pain at about a 40.

So how did I ‘manage’ this pain? Largely it was practised acceptance. For the first week, I accepted that my identity simply was pain. I had no arms, no legs, no stomach, no feelings like hunger or happiness or exhaustion –just excruciating pain. It keeps a person quite busy, so that may have strangely been the easiest part.

Eventually the pressure dropped to the point where it was still ever-present and super painful, but I also started to have other sensations enter, like hunger, awareness of my sore back, and the desire to have my sinuses clear. That actually felt relieving after how I’d felt.

Everything is relative. I accepted these tiny gains with substantial gratitude, and I reminded myself that my father and uncles were in WWII, and that many people before me had suffered even worse.

Eventually I could slowly start to eat again, I could tolerate normal voices and light, and around this time my gratitude had a surge as I was able to better-appreciate the efforts of my brother and several key friends who not only cared for, cooked for, and visited me, but some also took up caring for my parents as I normally have that responsibility. The people I work with were also very kind with their patient reactions.

There were times when I lamented the pain and pined for relief, but I did manage to spend 95% of my time grateful that I didn’t lose my sight, that my care was so excellent, and I was extremely grateful to all those who expressed their compassion through action, either for me or for my parents.

For my part, much like our fovea controls the focus of our vision, my mental focus was largely controlled, whether I was focused on the inevitable pain, or my deep gratitude for all of the people who were helping me and for my positive outcome. I had done as well as I could and felt good about it.

As I felt better each day my gratitude surged even further. If we can imagine our attention as a hose, and our thoughts as the water that perpetually flows from it, my salvation was that –rather than watering thorns– I kept my focus on the ‘flowers’ that were my various caregivers and compassionate friends. I could never put my thanks into mere words, I’ll just say that I love every single one of them.

There is no getting around the fact that parts of life will be painful, even extremely so. And we can be forgiven for sometimes giving into this as we move through these experiences. There were times where my pain lead me to be impatient and unkind but, overall, I felt like I had been in some kind of pain Olympics, and I ended it happy with my performance.

1382 Relax and Succeed - Enjoy the little things

I couldn’t call the experience a ‘win,’ but I remain very aware that it was also not a loss –I can still see to write this, even if I needed help with the proof-reading for a while. My outcome looks quite quite, although the eye was too filled with blood for the doctors to see if the operation did all it needed to, so we’re still not entirely sure if another operation will be required.

What I can tell you this: I know my immediate future is unlikely to be worse than what I’ve already experienced, and that makes that future feel extremely positive to me.

So what should you the reader take from this? Certainly not that we can avoid pain because we want to. In 20,000-25,000 days of life it’s a simple fact that some serious pain will be in there. But we can remember that it is what provides the contrast that makes normal life feel like a blessing. Right now most of you are reading this largely pain free in relative terms. Be grateful.

Normal is normal; it’s like a fish trying to find water. But once our ‘water’ has been boiled or poisoned, we gain a deep and meaningful appreciation for what not long ago had been the most basic qualities of life.

By having those advantages taken away, we do become more aware of the grace that is created as a part of our everyday existence. And even just by hearing about others situations, if we’re wise, we can look about our own lives with a new vision and a sense of grace.

Imagine never seeing your loved ones again. Imagine never seeing a flower again. Imagine never seeing the sun filter through the trees, or the smile of a child you love. Every day most of us are given these gifts along with life and it is my hope that by reading this, you can spend some time more appreciative for something it’s easy to take for granted: our vision.

Finally, please know that if you ever find yourself in what feels like unbearable pain, be it physically or emotionally, remember that no sensation in life lasts forever. Sometimes the best we can do is endure. But even that allows us to traverse time and to cover ‘distance.’

As a Buddhist monk once said to me, ‘the secret of life is that everything changes.’ If life is good, be grateful. It will change. But if life is bad, be patient. For it will change too. Our job is to merely be grateful no matter where our journey is taking us.

peace. s

PS Special thanks to Doctors Baker and Sia, as well as the entire remarkable staff at the Alberta Retina Consultants. In addition to them, I would also like to thank the support and surgical staff at the Royal Alexandra Hospital, as well as the family and friends that supported me throughout this process, including Don, Anita, Henry, James, Nick, Mike, Kirsten, Christina, Brian, Jarrid, Christian, Sausan, Sue, and for the compassion shown by Tracy, Elizabeth, Beth, Rob, Dwayne and Charlotte.

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