The inside out and back again pain issue

There were no nerve blocks for two weeks and the pain that had barreled through my lower abdomen quieted itself. Instead, the sharp discomfort migrated to my upper spine causing so much inflammation, a small hump of swelling developed where upper spine meets the base of the neck. It hurt. A Lot. By the end of the day, my arms felt heavy as if I were wearing a wet woolen coat.

I went to my scheduled appointment with Dr. G this past week, expecting another round of nerve blocks and pressure point manipulation of the obdurator internus. Think about the picture and make your own conclusion how this particular body part is access for manual (digital) therapy. When it's inflamed, nerves in the entire area become compressed. It hurts. A lot.

Maybe it's the physical pain. Maybe it's the ongoing, seemingly relentless medical appointments. Maybe it's the frustration of shingles pain that won't quit. Maybe it's the disappointment of having a body and brain that are extremely dysfunctional and riddled with problems too personal and stigmatized to discuss. Whatever the cause, the sadness that weighs on me is profound and seemingly ingrained in my personality. Except it doesn't show because I swallow it.

I told Dr. G that I was sick and sad and discouraged. She asked me about being sad. I told her that I was tired and it felt like the stress in my upper back was the burden of hiding everything that causes me pain, especially bipolar disorder. I explained that as I became stable after the Big Melt of of the mid-2000s, I vowed to act as I had before my illness became manageable only through medication and self-discipline. If the people around me were unable to believe the illness was nothing more than self-indulgence, then I would respond by proving that not only was I OK and functional, but that my illness would never, ever visibly manifest itself. In other words, I put a tremendous amount of energy and effort into acting as if I had no illness at all.

Dr. G listened. She found it very troubling that I was putting so much pressure on myself. She was appalled when I said it might be self-pitying and weak to feel sad, frustrated, and cheated of a life I had lived with enthusiasm. I may have survived periods of true suicidal threat, but I felt no victory on this point. Instead, I could only see the things that had been taken away from me, along with everything the central pain syndrome had stolen, as well. Although the loss was a tragedy, it did not serve me in any way to feel sorry for myself. I just wouldn't.

Dr. G was deeply concerned. She explained that when chronic stress--be it physical or emotional--is placed on the brain, the result is a gradual shutdown of the nervous systems, but only as progressive damage and inflammation consume the body.

I shrugged. Dr. G leaned in close and said, "May, listen to me. As your doctor I must tell you. You are literally killing yourself. If you keep living your life this way, you...are...going...to...die."

A tear rolled down my cheek, quietly followed by several more. I wanted to dispute what Dr. G was saying. I lacked the ammunition and the energy. I told her that I was capable of doing and being so much more than what had become of me. By allowing myself to be ill, by even accepting it, I would never achieve my true potential.

Dr. G thought about that for a second, her brow furrowed and her head tilted to the side, looking at me with a frown. She took a breath and said, "Where is it written that you have to achieve your potential. Geez, were you nothing but hypomanic for three decades straight? Do you understand that what you accomplish in that state is not on the scale of 'normal?' Overachieving tends to benefit more people in more ways than it ever does for the overachiever, you know."

Dr. G stood up somewhat abruptly and said, I have some prescriptions for you. She rummaged for a pad, and once she found it, she scribbled quickly. I wondered what new drug I was going to have to take on this quest for a body at peace with itself. The eight daily medications I take already seemed excessive. How could there be even more?

Dr.G handed me the two little blue papers. The first said,

Allow yourself to feel:
--sad
--cheated
--a sense of loss
--tired

The second had the name of two therapists Dr. G believes are effective in their practice and a good match for patients like me. There are other patients like me? Dr. G assured me I was not alone. She asked me how many times the gynecologist had recommended I see Dr. G. I thought about it and said, "Many times over the course of three years." Dr. G. leaned in close and said, "I am not Jacki. I am not going to 'suggest' this, and that's why it's a prescription--you need a therapist."

"Why? So I can accept and commit?"
"Yes," she said. "It may be the only thing that calms your nervous system, relieves the pain that has remapped your brain, and rebuilds your immune system."

After the appointment, I sat in my car in the parking lot and cried. I disagreed with my beloved Dr. G on every point. I did not feel it was OK or even safe to accept my feelings of devastation or my disappointment with my life. It was as if she hadn't heard me about not wanting to accommodate the illness. Overachieving put me on the fast track to being the person that other people actually admired and liked. It has always been the thing I have valued most about myself, and I believe this is true of those who know me. Without that, I would be nobody, an unremarkable woman who nobody else would even remember.

Sad. Cheated. A sense of loss. Tired. Allowing myself to feel those things will surely be the first step toward slipping away, to becoming forgotten and insignificant. I am not ready to be nobody, especially a sick, tired nobody with the dreaded, brain-eating bipolar disorder that embarrasses me and a nervous system that is equally defective. I may never be able to accept and commit to being this person.

Not yet.

Painting by Morwenna Morrison