December 4, 1999

      We all have bad days.  Now that winter weather has settled in, I seem to be having more bad days than before.  Or maybe I'm just getting older.  Whatever the reason, I'm finding that managing my pain can still present a real challenge at times.

      At first I felt anxious and discouraged.  Just when I think I have everything under control, I get surprised.  It shouldn't be any wonder to me that pain management is something I can never take for granted.  Knowing that I have some control over my pain takes away its ability to become overwhelming.

      I was a classic Type A person: pushing, driving, over-extending myself.  And, yes, putting others first.  I took more pride in how well I took care of family and friends and in how great I was doing at work than I did in how well I took care of myself.  Looking back, I'm not sure that I even knew how to take care of myself properly.  Simple things like eating the right foods, getting enough sleep, and taking time for rest and relaxation weren't at the top of my list of priorities.  I was usually too "busy" to stop and smell the roses.  And, of course, I felt indestructible.

      Living with chronic pain eventually taught me something about myself: I was an "other-directed" person rather than being self-directed.  I didn't know how to give myself permission to slow down, to say "no", or to put things off.  Clearly, I didn't know anything about pacing.

      Pacing means changing the way you think, changing the way you feel, and changing how you do things.  Changing the way I think helped me to regain my sense of control.  Learning all I can about managing chronic pain helps me to think about my life more realistically and positively.  Thinking positively gives me encouragement.  More often than not, I'm able to act on the pain rather than react to it.  I've learned to do only what I CAN do, and at my own pace.

      Learning how to pace myself was the hardest thing I've ever had to learn because it meant changing something fundamental in myself.  It required me to break old patterns and habits that I've lived by all my life.  In short, it required me to redefine and reshape myself.  I had to learn to accept my limitations and regain a sense of balance and purpose.

      I think the hardest thing about pacing involves expectations.  We all have expectations of ourselves, and other people in our lives have learned to expect certain things from us.  When our life becomes changed by chronic pain or illness, we can no longer meet many of these expectations, at least not in ordinary ways.  Our relationship with ourselves and others changes as a result.

      Eventually, I learned that my first obligation is to myself.  For some time I had felt angry, frightened, depressed, and frustrated.  At some point I realized that I was still trying to do most things the same ways I had always done them before my injury.  It was so hard for me to accept the permanency of the changes brought about by my chronic pain.  It was even harder for me to believe that there are some things I can no longer do.  Hardest of all was realizing that it's okay for me to just be me, chronic pain and all.

      Just being me means taking extra special care of myself.  It means doing only what I CAN do and doing it WHEN I can do it.  It means asking for help and knowing that no one's expected to go through this alone.  I know that asking for help from others means I have to be honest with them about my feelings and let them know what I need.  Accepting help means surrounding myself with people who are willing and able to be loving, open, honest, caring, and supportive.

      Pacing is my priority these days.  Pacing means choosing my activities wisely and placing limits on my time.  It's okay for me to curl up with my heating pad and read a good book instead of vacuuming the rug.  It's okay for me to say, "No, I can't do that today."  It's okay for me to use a cane or a handicapped parking plackard or any other special aids that are going to make me feel better and make pacing easier.  It's okay for me to ask for and take medications that will ease my pain, but it's important for me to still recognize when I'm pushing myself and know when to stop before I cross the sometimes fine line into a flare-up.       Today is a good example of what I'm learning about pacing.  There was SO much I had looked forward to doing.  But I woke this morning with all the signs of a weather-induced pain flare.  A soak in the tub and a "rescue dose" of medication didn't improve things much.  I knew if I went out and did the things I'd planned, I'd probably flatten myself big time.  Again.  The price of pushing when I shouldn't just isn't worth it.  The reward of taking care of myself is.  :-)

      Have a pain-free day, my friend.