What is pain?

20th July 2015: Westmeed Hospital, Sydney, Australia

I am writing this entry, awaiting to be called for my first scheduled operation on my right lung. I am nil by mouth, a factor possibly contributing to my seemingly intensified medicated state. To my advantage, the medication is both managing the pain from the two procedures completed thus far whilst stopping any invasive or worrying thoughts affecting my outlook. The day at a close will be rather eventful, particularly when bearing in mind the story below.

At this moment, I should have had only one procedure, however, two drains adjacent to my wound were required three days ago to release a build up of liquid caused by an infection. Samples since taken have showed the procedure was successful, leading to the removal of the drains this morning. Prior to removing the drains, the nursing staff advised me the specific drain typically causes a degree of pain during the removal process. Interestingly though, the whole process was completed with a level of ease, and it was made possible by identifying with the concept of fear. On reflection, it seems I gained an understanding of the correlation between fear and anticipated pain. The term, anticipated pain was used to separate pain into two domains. One whereby obviously it is anticipated and another type of pain, namely, when it results from a sudden or unexpected event. Basically, I came to conclude if there was no fear, then the body would not be preparing itself for pain in the moments leading up to the expected event. Upon applying this theory, I was able to recognise the information provided by the nurses sent me into a state of fear, and therefore, I was expecting to feel pain. Once this was identified, I was able to draw on an inspirational story of Mick Fanning, a surfer who today was able to escape a shark attack unscathed. I envisioned what he must have been feeling before his encounter compared to the removal of two drains. The mental exercise enabled me to place the upcoming events in context, resulting in a distraction/blockage in my mind. In summary, I was not focused on the anticipated/expected feeling in my body, and consequently, any degree of fear dissipated whilst also leading to a removal of pain when the drains were withdrawn.

Miscommunication in the hospital system impacting patient care.

13th July 2015: Westmeed Hospital, Sydney, Australia

The entirety of the circumstances today has made me feel extremely unsatisfied with the overall level of care I have received since my admission. My surgeon is of course the exception to the rule. An incessant beeping for the past two hours has only heightened my feelings, particularly as the beeping indicates the necessary pain relief medication is unable to be administered.

A list of my eventful day would show:
– I was brought out of my sleep during the early hours of the morning by a nurse who pulled on my IV stand to wake me. Upon rising, I was advised the bed needing to be used, meaning I would be changing wards.
– Two nurses tried to convince me of having the same dosage of medicine required when my pain was scoring an eight opposed to a two (10 is the highest possible score).
– A doctor confirmed my name, however, thought the reason for my admission resulted from liver Cancer, and advised me all prior plans discussed with my surgeon were inaccurate. Just to note, no contact had ever been made with this person before.
– A second doctor reinforced the fact of my admission resulted from having Liver Cancer, and implied I must have been too sedated over the past three days to recall this information as numerous conversations had occurred. Just to add, my mum was in the room throughout this conversation, and I observed her nearly fall off the chair. My mum and I started to digest this new information only to be interrupted after 10 minutes by the same doctor who was apologetic in saying he was incorrect, and I did not have Liver Cancer.
– I was then in pain for over an hour left waiting for a scan to be completed, resulting from the nurse not informing the reception I had arrived nor handing over my notes.,
– Now the incessant beeping has once again commenced leaving me beyond a point frustrated enough to write any further. I am hoping the latest attempts actually bring this annoying sound to cease, and finally a place of respite is found.

Drugs

15 March 2015: Sydney, Australia

It has now been two days since my wisdom tooth was removed. I was amazed at the promptness of the process. Honestly, the entire procedure was completed in 20 minutes, however, the pain that was later felt acted as reminder of past experiences whilst also providing motivation to become well again. For the past two days, I have been in a bit of a medicated haze, particularly on Friday when the local Anaesthetic stopped working. I am not an advocate for taking excess drugs, however, I did not appropriately use pain relief when in hospital recovering last year, so this time opted to apply a different strategy to avoid enduring any unnecessary pain. Consequently, the combination of both Panadeine Forte and Endone sent me to bed with a towel necessary for the excess dribble coming out of mouth. An exact amount of medication consumed on Friday would total 18 tablets, including the regular Chemotherapy, additional Cortisol for recovery, a Valium pre-procedure for the needles, antibiotics x3, Panadeine Forte x3 plus Endone x2.

The excessive amount of tablets brought to surface thoughts about my place in the modern world, and the almost certainty of my death already being a reality without medical assistance. It also brought back memories of thoughts had when I saw my grandfather taking the massive amounts of daily tablets he consumed to remain alive. The contraction once again showing in my life is the very fact of my existence being dependent on the consumption of tablets. To conclude, it is the fist time in two days any sort of mental energy has been used, and consequently, the blue curtains called my eyes are starting to close. Therefore, I will hope to continue with this theme tomorrow.

I am going overseas, so just rip the tooth out!!

9th March 2015: Sydney, Australia

I was correct about the over-reaction to the pain from Thursday. Scans revealed the source of the pain was a swelling of my gums around one of my remaining wisdom teeth. Initially, attempts were made to apply gel to the region, however, three days of pain resulted in the decision to just booking an extraction of the tooth. My thinking was based on two ideas. Firstly, if I am in pain, it is preferable to be in pain knowing the tooth has gone, and secondly, it is far better eliminating potential concerns before travelling overseas during the winter months.

One of the points associated with this process was the delay in getting the tooth extracted, and this derives from the concerns held about the treatment I am receiving. Obviously, it is essential point to be considered, and in all honesty, my Professor made a fairly swift response. It was just another factor reinforcing the restrictions on planning due to my circumstances. Two examples come immediately to mind in regards to this topic. The waiting period as mentioned is one such factor, and the other being the need to be fully equipped for the planned overseas travel to Indonesia over the months of June/July. Factors to consider include a heightened awareness of the food eaten due to concerns and implications with my Cortisol levels should I become ill, the exploration of travel insurance options excluding any Cancer related concerns plus future decisions regarding use of injections and medications whilst away. On reflection, all points should really be factored into travel, so possibly on my behalf it’s more a lack of vigilance in the past.

To conclude, I am completely content with the prospect of being in a pain for another week. My reasoning, I have the knowledge it is simply a tooth ache 😄

Am I drug addict or just reliant on drugs to survive?

25th February, 2015: Sydney Australia

Prior to sleeping last night, a chain of thinking brought to surface a reality in my life about a perceived reliance and newly formed rigidity resulting from the need for pills to be consumed at set intervals throughout the day.

Interestingly, a link to this perceived reliance stems to the corresponding period last year whereby the drug Endone, an opium based pain-relief medicine was essential in managing the period following my surgery. A number of vivid images come to mind when thinking of the time when I was taking Endone, most notably, the ability of the drug to quickly take away the intense throbbing pain associated with the weeping wound. For many weeks post discharge, a typical day would commence at approximately 3am whereby I would painfully reach over to the tablets next to my bed before going back to sleep. The next moment of pain were experienced in the morning when a dishevelled version of myself would be seen to walk upstairs with a sour look on my face. At the time, it seems the face signalled a chain of events to occur, starting with my mum immediately giving me the necessary pills whilst also starting a massage on my back to help reduce any pain. It should be noted that a husky grunt or groan were the only noises heard till I was able to verbally communicate. Usually, the primitive form of communication would last forty minutes till any sort of food would be considered, and just like now, planning would then centre around the timing for having my next set of pills whilst in complete contradiction a battle was ongoing in my mind based on timeframes for when I would no longer be taking any drugs.

I opt for the term reliance, due specifically to both a physical and mental need to consume my current prescription of drugs. Personal observations have brought to mind the switch when recognising I am late taking the pills. It is apparent a psychosomatic reaction is triggered, particularly in relation to the required dose of Cortisol. For instance, any sign of fatigue or nausea is always represented to be directly caused from not adhering to the scheduling of my tablets. Consequently, a sense of urgency rushes throughout my thinking till I have consumed the drugs. I do see some merit in my reaction, especially as my body only obtains the necessary Cortisol in an artificial form, however, I have difficulty accepting the concept of the seemingly adept ability of my body to perform at a usual level till it registers that I am late taking the dose, and that very knowledge places me in the position whereby I see my life revolving around a routine of drugs. A point I do not wish to feature for the rest of my life.

Serious questions need to be asked about whether the easiest option is necessarily the best option?

10th February 2014: Sydney Australia

The events last night stained me with memories forming the basis of this entry. It all started with the ever familiar feeling of a nausea crippling all thoughts, motivation, strength and focus. Moreover, these thoughts were compounded by a repulsive odour that was passing throughout my system. An odour, toxic enough to test the fine line between feeling nauseous and vomiting (sorry if too much details). I recall thinking, ‘just one more year’. Fortunately, I soon realised this chain of thinking was not productive, so I pushed through the discomfort in order to complete some mental exercises enabling me to switch the thought process into a state of acceptance. I need to acknowledge the indisputable fact that side-effects will occur whilst also recognising the many flaws that exist in setting a timeframe for when the side-effects will finish, hence, the reason to instead seek for a degree of acceptance with my circumstances.

I stated many flaws could be outlined, and two main limitations will be explored. To commence, the most obvious point surely must relate to a possible scenario of being placed in a situation in a year from now where the recommendation to continue with the course of treatment is received. The reality of the outcome mush be highlighted, especially bearing in mind the mixed input received from varying professionals who have been involved in my care. An overview to portray the previous point entails a recommendation from the team of doctors in the UK who believe I should remain on the medication for a period of five years, with an indication of a maintenance dose for the entirety of my life. Secondly, my case was presented to doctor from the USA who is a specialist in the area, agreeing with a timeframe of no less than five years till review. Thus, as noted, a continuation of the treatment for more than a year could be a very real possibility. If so, what happens when I am feeling like this next year? What sense of hope can be derived from a situation when faced with another loss, especially with no finish line ahead. It is for this reason why an acceptance of uncomfortable and upsetting situations needs to be found within my life. It is not easy, however, it seems a far better approach than setting in place potentially harmful timeframes.

The second point is the growing inclination to use some form of prescription drugs to just sleep at night as a means of taking away any discomfort. A temporary solution in extreme circumstances, however, if taken on every occasion I feel nauseous, then I believe a reliance could easily be integrated into my weekly routine. Furthermore, serious questions need to be asked about whether the easiest option is necessarily the best option? In addition, I am unable to shift my view of seeing the action of taking a pill to relive any suffering as truly not doing all I can to overcome this situation. Again, this point would be contentious, and all people would vary in their approach, however, I feel a testing of my mind and body is definitely in process. Therefore, what reflections can be drawn from me taking the easy option? I am not advocating for suffering, yet, I would prefer a period of difficult is worked through by building my internal resources rather than a temporary remedy is taken in the form of a tablet. Finally, and is probably the primary reason for not considering use of any substance at this stage is due to very likely sedated effect on my body and mind th following mornjng. Therefore, I actually see the decision as counterproductive, and prolonging the period whereby I am incapable of undertaking routine tasks.

I felt like Ben Stiller from Dodgeball…

23rd October 2014: Sydney Australia

I spent the entirety of yesterday afternoon till the very early hours of this morning wondering why I opted to eliminate solid food from my diet for two days. As noted in the previous entry, fairly positive changes were noticed when commencing, however, it appeared I was extremely naive in what was to follow, especially considering the events last night from whereby I remained crouched in a position, holding my stomach resulting from the hours of nausea endured.

It is now almost midday, and I’m still feeling the effects. The degree of discomfort has most definitely decreased, however, my stomach is still not completely settled nor am I feeling like I have a normal level of functioning. When summarising the feelings experienced yesterday, I can only describe a constant hunger, a feeling of a slight anger at myself for putting myself through this, limited concentration, and an overall unease throughout my body and mind. In addition, there were no noticeable toxins discharged from my body. Furthermore, I am now craving for a burger and chips, some deep fried chicken wings, a can of coke, anything of the type! Very reminiscent of Ben Stiller from Dodgeball feasting on pizza and all sorts of junk lying in a bed of filth. I obviously won’t be opting for any of the above options, however, will be buying a quality cut of leg ham and making myself some sandwiches on spelt bread. Unusual for my typical approach to eating as bread will feature, however, it seems like a more favourable option than feasting on deep fried chicken wings, burgers and chips. All decisions would ultimately undermine the very reason for trailing for fast.

The account is completely personal, and I am still of the opinion a fast/cleanse may be suitable for some people. I would now recommend others seek advice and possibly attend a supervised retreat throughout the period. In regards to my personal, circumstances, consideration of the effects of the chemotherapy, bearing in mind the action it has on blocking the capacity of my body to now create Cortisol needs to mentioned. Furthermore, I had previously known a lack of food caused havoc on my system. I just did not anticipate the removal of solids would have such a profound impact. In conclusion, I may decide to attempt another fast/cleanse in the future, but will most definitely wait till my treatment is over before exploring available options.