The Snowball Effect

A single snowflake lands on the snow. With a gust of wind it is carried along. It gathers other snowflakes to it (like attracts like) and as it moves it gets bigger. Its size now moves it further downslope and it gathers speed. It doesn’t not take long before it is hurtling down with a destructive force wreacking havoc in its path.

This can happen to me with a single negative thought about my pain. Let me give an example. I have overdone it and caused a pain flare up. Here is the potential progression of thoughts:

 

"I can’t believe I have done this to myself again. I should know better. I am so stupid. Now I need to get help with the (kids/house/work). I’m such a bad (mother/wife/friend). They must be so sick of me being like this. They probably hate me. I hate myself so why wouldn’t they? "

 

Anyway you get the idea? It was that first negative thought. I allowed it to attract more negative thoughts, continuing to catastrophise, I was then led on a destructive journey down a dangerous slope into self loathing and depression. And with this progression comes the associated physical reaction to these thoughts (stress, tension and more pain!). All from one single thought . One single mistake. My thoughts are powerful and this is my snowball effect.

 

When in this state my emotions are high (some would say even out of control!) and as a result my intelligence is low. I make poor decisions regarding my self-pain management techniques (e.g. choosing rest over movement, choosing to buy in to my unhelpful thoughts, choosing anger over just a simple acceptance of the way things are).

 

A less destructive approach is non-judgemental awareness of my own thoughts. I have control over what thoughts jump into my head, over what voices I choose to listen to. If I can stop a snowball at the snowflake stage I have the chance to break it down before it careers downslope. How do I do this? I need to be paying attention to my thoughts. A short breathing exercise or meditation might give me the clarity and awareness to deal with these thoughts. I can challenge or assess my thoughts before moving onto the next destructive level. Is this thought realistic or true? How can I be sure – have I asked that person how they feel? Is there another possible explanation? In addition to challenging the thoughts I also have an arsenal of more helpful thoughts that I can use to replace my initial unhelpful thought. As in my example above “I can’t believe I have done this to myself again” might become “habits take a while to be changed but it is possible” or “You are getting better at this, don’t give up”.  I can choose more helpful thoughts and be kinder to myself. Then the inner warmth will melt the snowball.

Once I have cleared out my headspace, I have the room and ability to implement the right actions. The pain still needs to be dealt with so I will go to one of the self pain management strategies that I know work – go for a walk, do some stretches, ask for help, pace planned activities etc.

It takes time and practice but snowballs do not need to gather strength and destructive force. A single snowflake can be a beautiful thing when it is simply observed.

My Story - Part 2 (AFTER)

Things were going badly and I knew I needed to do something fast.  I sought help from a pain specialist. We tried nerve blocks, denervation (they burn the ends off your nerves to stop pain messages!) These were excruciating to receive and did not even provide much relief.  My wonderfully caring and insightful GP was on the border of diagnosing Post Natal Depression when he delved further into my situation to decide that pain (and my inability to cope with it) was the real source of my depression. He had another solution. He referred me to the Barbra Walker Centre for Pain Management at St Vincent’s hospital. After a 6 month wait and a number of sessions with their psychologist, I was recommended to attend their three week, in- hospital self pain management course. I am not exaggerating to say it turned my life around. The course gave me the whack-in-the-face wake-up call I needed. They supported me to come off all medications and learn techniques to deal with my pain by taking matters into my own hands. I learnt the link between my thoughts around pain and how this impacts on the expression of the pain. I also learnt that a little exercise is better than nothing because resting makes the problem worse. The lack of activity causes deconditioning of muscles leading to increased pain. This course taught me to become disciplined and educated enough to take responsibility for my own pain management. It provided a long-term solution when medical science could do nothing further to ease my pain beyond offering a bandaid (pill) solution. With the assistance of the clinic I came off all my pain medications (a harrowing withdrawal experience!) and have not had a pain killer in the past 6 years!

Since then I have been managing my own wellness journey without medication using exercise and mindfulness techniques. I had a lightbulb moment in (of all places!) the toilet!  While at the pain management course, the hospital toilet door opened outwards. I was not used to opening outwards and every time I went to the toilet I would push and slam into the door. This went on every time I went to the toilet embarrassingly for probably the first week! One day, early in the second week I went in and stopped at the door.  I smiled and I pulled. I got a blinding flash of clarity. Habits can change. Your mind does learn new tricks! This gave me a gleam of hope for my future. If after 20 years of responding to pain with the same automatic unhelpful thoughts and behaviour that I have learnt only amplify my pain, then I can change these thoughts and behaviours. It IS possible to think a different way. Yes, it might take me a while (I have 20 years to bad habits to self correct…) but I can do it. I will do it.

The benefits of this new approach were immediate and substantial. I gained the strength and confidence to resume my social and day-to-day activities with confidence. Regular daily movement is prioritized in my life. I have become better at communicating with my family and friends about how I was feeling, asking for help when I needed it and just enjoying my extremely blessed life. At the pain management course, my long term goal was to be strong enough to try for another baby. Two years later our second daughter Bridget (meaning strength) was born. Self pain management is not an easy road but with discipline, there is such extreme relief and freedom.

After recovery from this birth, I knew there was still something missing from feeling totally in control of my pain. I needed to do more, I wanted the energy to do more! So more recently I have researched nutrition and its impact on the body and mind. I have been following a wholefoods, high nutrient, healthy diet. This was the key to unlocking that final piece of my puzzle. With the right energy in (good quality, real foods) I now have more energy and this gives me greater strength and vitality to continue to manage my pain effectively. It’s an added benefit but I have lost about 10kg during this period (cool!). I am still learning what does and does not agree with my body however I am passionate about maintaining a good diet and want to fuel my body with the best quality foods possible.

I have been blessed with an amazing support team and I could never have progressed in my journey without the love and support of my family and friends. My husband has been down some dark tunnels with me, seen me at my worst, but his strength and love have guided me through. He and the girls will often send me out on a walk or instruct me to do my stretches! My parents, in-laws, and other family and friends have been invaluable support and it’s such a comfort to know I have people in my corner, egging me on for success.

My story isn’t a perfect one and I’m still working on it. I have bad days and unhelpful thoughts creep in and sometimes I still over do it. But now, I don’t beat myself up about it, I just get up, keep moving because I want to be the best version of myself I can be, for myself, and for my family and friends. I want to walk the walk so I can talk the talk. I want to share with other chronic pain suffers that I’ve been down that road too but look how far I’ve come!

And, hey, my journey isn’t over, but if I waited til I was perfect, you would never get to read this! Why not join me for the ride...

My Story - Part 1 (Before)

My story starts with my older sister being a know-it-all! She was studying Physical Education at university and she was learning about scoliosis and decided to use her eleven year old sister to practise her diagnostic skills. She made me touch my toes and announced to my mum that “Yes, I definitely had it”. Surprisingly, no one (not even me!) had noticed - but she was right, I was out of alignment and had a large lump on one shoulder blade and uneven hips! An out-of-date local GP told me I was going to be in plaster for 6 months. We were all in shock! But X-rays did confirm I had scoliosis, and a pretty severe case too. An S shaped curve measuring 52 and 54 degrees.  

I had two corrective surgeries when I was 11 and 16. While I often brush these off in my story, they were major surgeries for a young girl. Weeks in hospital and off school, rehabilitation, I had to wear a plastic brace for 6 months and have on-going therapy. In the end, the surgeons were happy because they were able to correct the curve and now my spine is straight, with the help of a rod, screws and bone grafts. It makes for a good show and tell X-ray.

My spine X-ray taken ~2009

 

I have had chronic back pain nearly my whole life since the surgeries. There have been good days and bad days. I returned to see my surgeon often and I would explain my pain but he would offer no real explanation or solution.  My pain was generally in my lower left hand side of my lumbar spine, generally around the area where vertebrae are fused together. More recently, bone scans indicated degeneration of the facet joints and further surgery (fusion to the sacrum) was suggested.  But I didn’t want to go down the surgical path again. Alternative therapies were tried with limited success. Partially because I think I never fully committed to their suggested exercises/routines because they never “magically” took the pain away, but also because a single physical approach did not address the physiological issues surrounding my pain.  I have also tried most prescription pain medications. The side effects of these are many and varied but I often would suffer severe constipation from codeine, nausea and motion sickness from the morphine based transdermal patches or effects on mood from the antidepressant range of pain killers. With each new drug I tried it wasn’t long before the mild easing of pain became ineffective. The long term use of prescription medication for my chronic pain was not the answer.

My general approach, on a day-to-day basis, was to cram everything I could into days when I felt good, leading to days of suffering because I had overdone it. I would ignore my pain, wish to be “normal” (read pain free – what is “normal” anyway?)  and just power ahead. I didn’t tell many people how awful I was feeling (except the inner sanctum - my husband, my mum). For everyone else I slapped on my brave face (and I got pretty good at it as far as I could tell!) As I have aged my flare-ups got worse and my ability to deal with them drastically decreased.  

My husband and I were always worried how I might go having a baby. I became pregnant in March 2007.  I was working fulltime and after coming home many nights in tears from the pain. I reduced my hours but then decided to resign when I was 5 months pregnant. Once I stopped working, the pain seemed a little better but this was most likely a result of the reduced stress and travel to and from the city. I was induced at 42 weeks and had an 8 hour labour. But it was all worth it when our beautiful daughter, Olivia arrived. She was a calm and easy to settle baby but all the changing, carrying, settling, picking up really took a toll on my back, particularly as she got bigger and heavier. I was having 2-3 days in severe pain (mostly in latter part of the day) and frequently needing help. I was depressed because I felt like I was unable to look after my child properly. I was often in tears about being a bad mother, feeling like I would never be able to run and play with her whenever she wanted to, pick her up and carry her around when she needed comforting. About a year after the birth (as those pregnancy hormones were fading and as she got heavier) I was near rock bottom.

I would become almost obsessed and consumed with my pain. My negative thoughts around my pain would escalate from thinking “I can’t deal with this” to “I am a hopeless mother/wife”, and “I am letting everyone down”. My husband referred to these thought processes as snowballs. I would get wound up catastrophising every idea, rehashing past mistakes, worrying and fearing future unknown pain events and rarely in the present moment. I went from a gentle snowflake to an avalanche, careering out of control down a dangerous emotional slope. I never even realised the destructive power these snowballs had… I was too consumed by my pain. I found it hard to look beyond it to see all the beautiful things that were still good in my life.  I had so much to be thankful for…but I just couldn’t see past the pain. And the difficult thing was I felt so alone. Despite the fact that 1 in 5 Australians suffer chronic pain and that so many people suffer in similar ways to me, I thought I was the only one doing things tough and suffering. I couldn’t see the true impact my condition was having on my family. They suffered too by watching me suffer. I felt I was such a burden to them. I actually believed they would be better off without me. Pain blurred my reality to such a degree that I could no longer see beyond it. I became so wrapped up in my misery that hope seemed an impossibility. 

Please don't stop reading (its a bit depressing isn't it!?)...If you have the time, read My Story - Part 2 (AFTER) because this is when I really changed my life and began to TAKE HOLD of my PAIN!

If you can associate with any of these symptoms, feelings, thoughts, experiences, please comment below and share!

What will this space be about?

A place to share information and support people choosing to self manage chronic pain. I will share my story, my wellness journey, in the hope it will inspire and help others.