#Doctor for Neuropathic Pain

[chicagoneuropain]

Dr. Michael Rock, MD is a Pain Medicine Physician and Anesthesiologist at Chicago Institute for Neuropathic Pain.

[beautifully-tantalizing]

On today’s episode recap of J’s Beautifully Tantalizing World, we start with having a flare up that lasted all day. Excruciating to a point of needing my crutches.

had an appointment with the new team of mental health professionals sometime today and got absolutely nothing figured out.

Doc basically went “ADHD no more, those hyper focused times where you refused to sleep is looking closer to mania. Surprise we are now looking into Bipolar disorder. The ADHD thing is something we will visit after your vacation”

And we close with the fact that I haven’t slept in 30 hours and I’m leaving for a 20 day road trip vacation in under 5 hours.

[misseyres]

crying in the club except the club is the office

[valiantverses]

Tremors II

-

Part I

A therapist's waiting room wasn't exactly the place to have the most engrossing conversations. People were usually jittery, tense, or straight-up despondent. Somehow, you manage to strike a strange sort of connection with the retired military couple that had the Thursday slot just after you anyway.

Trigger Warnings: Angsty. Mentions of medical conditions. Chronic pain discussion. Post couple argument. My characterisations may not be your cup of tea, they can be problematic, but hopefully in a realistic way.

A/N: Not gonna lie somebody sent me an Ask about Tremors and I had this written out the same day I read it lmao my brain is so monke

If you'd like to tag out of the tag list, just message "Tag out" in the notes!

His hands were shaking again. Callouses stretching and wrinkling together as he rested his hand on the doorknob. The metal was biting in the winter chill, but the physical sensation helped drag him back down to reality.

To his home— his actual home. Surreal still, after more than a decade of thin barrack mattresses and rocky dirt beneath thin sleeping bags. The one-story house was quaint in a way he never would've dreamt of living in when he was younger. His home, with its barely managed lawn. Creaking doors. Brick and dark woods— juxtaposed against the hard plastic wheelchair ramp next to the steps.

His home, where Johnny was waiting.

Rough fingers fall away from the doorknob. His head dipped as he exhaled sharply— burning shame, a semi-permanent grimace on his lips.

It had been a bad day for Johnny's chronic pain. A string of them, really. Simon could feel the exhaustion carved into his bones, the weight of caring for Johnny entrenched into his marrow.

Johnny was waiting —barely able to sit up and have breakfast today after waking up wracked with neuropathic pain— and Simon couldn't even bring himself to open the damn door.

Bitter miasma clawed at his gums, self-disgust brewing at his inability to be more human, more empathethic. At his desire to be away. At the way he wanted press pause. Johnny couldn't press pause— he could only wait.

A notification pops up on his phone. He doesn't check, knowing it'd be the therapy appointment app. Life was now just a cycle of doctor's appointments, tests, physical rehabilitation, bills, and therapy. He had gone from the steady drumbeat of barracks life to— this.

With a huff, he forced himself to open the door, as gently as he can manage so as no to wake Johnny in case he had fallen asleep.

They had never argued before the incident at the Channel Tunnel. But now, on bad days, when Johnny was in too much pain and Simon too frayed, tension would spark and light into flame. Ultimately they were former soldiers and fierce words, aggravated outbursts came naturally.

Sometimes the heated words would morph into the heated press of skin on skin, slick bodies and open mouthed kisses as they fought for control. Captured moans as their bodies sought purchase and rutted into each other.

Other times, like today, it would end in the gentle but firm closing of a door. Silent retreat as they distanced themselves. In the quiet of the after, where harsh words were mentally rehashed and their tempers reigned in— Johnny's a storm clearing, Simon's receding tides— the unspoken apologies as they met each other's eyes again, a silent covenant to try and do better.

Johnny was waiting.

The blond eased next to his sleeping form. Even asleep in their bed large enough to fit two well built men, his face was scrunched up in pain. Gently, Simon reaches out and smooths the furrow of his brow, powder- blue eyes opening hazily and meeting his. Then Johnny cracked a smile, leaning into Simon's touch.

"Ello' there. Been waitin'." He murmurs, voice thick with sleep.

Simon's answering chuckle reverberates through both of them "Hi." His chilled, calloused hands card through Johnny's hair. "Feelin' better?"

The hum he receives in response fills him with a quiet sort of relief. Johnny looked more serene now, with that light smile on his face. The last time he looked this peaceful was almost two weeks ago— talking to the pretty little thing at his counsellor's. Johnny had seemed to brighten in their presence, had even mentioned the interaction to the shrink jovially. It was the first time he'd had a proper conversation with a stranger since his brain injury. Simon nursed his pang of regret at cutting off the conversation so abruptly, but he had seen the reticence in Johnny's eyes and had felt his hackles rise, the need to protect so desperate—

The smaller man shifted next to him, voice muffled against the pillow "S'good of ye to run away everytime we have a row. Big of ye." His eyes sparkled with teasing.

Simon huffed, hands roaming against Johnny's skin as he pulls him to his chest, tucking his chin into the crook of Johnny's neck. Simon casually gestures at the shorter man's leg—it had to be augmented with metal bolts after the incident. Johnny could walk, but excess running would trigger his sensitive nerve endings. Simon's breath was warm against Johnny's ears as he spoke.

"Not like you could be the one running, ey, luv'?"

And then his head was being shoved into the pillow, Johnny laughing breathlessly. His arms were full of exasperated Scot as they both guffawed madly, the tension from that morning dissipating.

Later, when Johnny had drifted off again, Simon turned to tap at his phone and confirm their Thursday therapy slot. Unbidden, his thoughts drift to you. To how, inexplicably, you had managed to get Johnny to smile. He selects the same slot they got two weeks ago, hoping maybe it might mean running into you again. Seeing Johnny smile more. Then, his attention turns back to the sleeping Scot beside him.

Johnny was waiting, but he was never truly alone. He would always carry a piece of Simon with him.

[badxwolf]

“None of us know for sure what’s out there. That’s why we keep looking. Keep the faith. Travel hopefully. The universe will surprise you constantly.” - The Doctor

I don’t talk about it very often on this blog but I have a rare neuropathic condition called Complex Regional Pain Syndrome. It causes me constant, debilitating full-body pain along with a host of other symptoms that affect every aspect of my life.

I got sick when I was 9 years old. I am 25 now and over the years my condition has deteriorated. I’ve developed several comorbidities which in combination have become life threatening.

In 2021 I was admitted to hospice. I was only able to make it through with the support of my friends who found new treatment options and set up a fundraiser for me. I’m beginning another round of treatment soon and with your help I will be able to afford the care I need during this lengthy recovery process.

These last few years have been the hardest of my life, but also the most hopeful. This disease has taken so much from me but I refuse to give up. I know I have a future, I just need help getting there.

You can learn more about my story here:

TV Interview // Radio Interview

You can help by donating, reblogging this post and sharing my fundraiser. Every bit helps!!!

🌟 LINK TO MY FUNDRAISER! 🌟

[softest-epilogue]

chronic pain + illness besties:

what pain management do you have prescribed/use? because with my pots I can’t smoke 🍃 anymore since it’s a vasodilator and lowers my bp too much so it makes my symptoms worse (I smoked everyday for almost 10 years before my pots manifested and then had to quit immediately and I’ll cry if I think about it because I miss it & it’s pain and anxiety management) and obviously using Tylenol everyday is not happening. my doctor tried cymbalta and my body decided I was allergic to it after a month of using it and actually tolerating it, but it didn’t do shit (obviously I know it wasn’t long enough but still). I wish I could prescribed actual fucking pain meds because anything for neuropathic pain seems to just be not it because I’m not sure if my pain is neuropathic (I really have no fucking clue. they’ve given me a fibro diagnosis but my primary isn’t too sure and honestly it’s just exhausting going to & waiting for specialists for months to try to get answers and knowing I never will). my pain is bone fucking deep, my arms and legs and back/spine just hurt all day everyday for 2 years now and it’s miserable and I fucking miss drugs.

[no-stupid-questions-official]

how does nerve pain feel like? looking on google and i don’t really understand the way it’s conveyed. i have pains that i suspect/have been told may be neuropathic but i just Don’t Understand (and it’s hard to talk to a doctor about sensations you can’t quite describe, i have been brushed off many times)

so i’m basically asking to people with neuropathies, how would you describe they feel like for you? (and also, maybe, how do you talk to doctors about stuff like that without sounding like you’re making stuff up)

-

[dimancheetoile]

uh, hi.

maybe you're seeing this on your dash and thinking "hum, this username is kinda familiar". maybe you do remember me, in which case, again, hi.

i've been gone for an entire year. it hasn't been a great one. for those who read my posts before, you might already know this, but for everyone else, I was born with a rare genetic condition. on top of that, i had a very serious accident at 13 that more or less destroyed my right leg. i haven't been able to walk right since then, and it hasn't been helped by the following years of botched surgeries, complications from the operation, misdiagnosis and medical malpractice. i'm left with a barely functional leg that has a permanently torn set of ligaments, collapsed nerves and debilitating, constant, torturous chronic pain.

then i had a weird relapse of sorts. a bucketful of symptoms. hives and flushing, limbs and joints swelling, rashes, trouble breathing, sudden drops in blood pressure, heart rate above 100 at rest, stomach cramps, nausea, headaches, migraines, chronic fatigue, confusion, memory loss, dizziness and loss of consciousness. it's called MCAS.

i can't describe to you what it's like to never be well. to never wake up in a body that feels right, even just ok. to always have something going wrong, something painful, something that doesn't work right.

i'm hooked up to an oxygen machine twice a day. i wear a compression garment that goes from my ankles up to the tips of my fingers. i have to do two self-injections every month. i live with additional compressive equipment for both my knees, both my ankles, both my wrists, an elbow. i have a machine with electrodes i can put on painful areas to electrocute them and sometimes, it helps with the pain. i have to use pain-relief plasters and poultices a couple times a day.

i have premature arthritis. the arthritis in my back ate all the cartilage of my last three vertebrae (the ones above your tailbones, your lower back) so i'm like a car with no suspensions. my vertebrae are rubbing against each other with nothing in between to protect them, my discs are crushed, i have severe sciatica. chronic light sensitive migraines.

my joints don't hold. since january, I dislocated my left knee leading to a synovium effusion (big pocket of the lube in your joint that gathers and forms a ball and it pushes on your nerves, ligaments, tendons and tissue); i sprained my left ankle and it tore my external ligament and heel ligament. i dislocated a bunch of my fingers multiple times.

oh, i also got diagnosed with endometriosis and PCOS.

i live bedridden now. i have an entire grocery bag of medication sitting by my bed so i can reach it easily. opioids, neuropathic pain medication, anti-inflammatory medication, a medication that completely stops my period.

and that's without mentioning the hours and hours of hospital visits, specialists, family doctors, physical therapists, etc.

i'm gonna be honest. same time last year, i was having a hard time. i had turned 25 in january and moved into my first apartment since uni. it's in the same village as my mom which is the only reason i could live independently. so i was just 25 and all the MCAS stuff was happening on top of everything else and i had this realisation that this was what the rest of my life would look like, but worse, because my disease is degenerative. it gets worse as you age.

so i was just 25 and i realised i had the next 50 to suffer through this and more, and suddenly i didn't want to be here anymore. there was no ideation, it was more a complete break down of my hopes for the future. what was my future going to look like in this cursed body?

anyway, i collapsed under the mental pressure, my health continued to worsen. what i used to be able to do was no so much harder, and sometimes impossible. i was a 25-year-old in a prison of their own flesh. i couldn't deal with the rest of the world, so i cut myself off from it.

i'm doing better now, mentally. physically, it's only gotten worse. as i write this, i'm reaching for my pain meds because everything below my right knee is screaming in agony and i have a splitting headache. this is a good day for me.

thank you, if you've read this far. thank you, if you thought about me even once in the past year. i'm not asking for anything, except maybe to talk with you if you have a similar story. i feel so alone in this hell, it'd be nice to talk to someone.

i love you all.

-mako

[txpainspecialists]

Relief From Neck Pain Conditions: It’s Within Your Reach

Nearly 80 percent of people suffer from neck pain during their lifetime. Several Americans suffer from chronic neck pain. The neck consists of several components, including muscles, ligaments, and tendons.

The neck is a body part that is vulnerable to several painful conditions and injuries. This is because there is an extensive range of neck movements that happen throughout the day. Also, the ability of the neck to function optimally is also dependent on the muscles located in the chest, back, and shoulder.

If neck pain is left untreated, they can turn out to become chronic. Neck pain conditions may include stiffness, soreness, or pain in the neck with limited mobility.

Causes of neck pain conditions

Neck pain is also known as cervicalgia. It is the pain experienced in or near the spine or beneath the head. Neck pain conditions are quite common. Most individuals have neck pain at some point or the other in their life. It is a widespread problem affecting diverse age groups and lifestyles around the world. 

Some of the most common causes of neck pain include:

Holding the neck in the same position for a long time.

Injury to soft tissues (tendons, ligaments, and muscles) within the neck.

Poor body posture with head flexed in the forward direction.

Pressure on the neck causing strains and sprains

Some other causes that trigger neck pain conditions

Whiplash injury

Awkward sleeping position

Mental stress or worry

Cervical spondylosis

Degenerative disc disease

Herniated disc

Osteoarthritis

Rheumatoid arthritis

Cervical spine injury

Spinal stenosis

Compressed (pinched) nerves

Worn-out joints

Inflammation

Abnormal growths such as bone spurs, cysts

Meningitis 

Symptoms of Neck Pain

The symptoms of neck pain vary widely from person to person. Here are some of the most common symptoms of neck pain conditions.

Muscle tightness

Soreness and stiffness

Numbness or tingling sensation

Reduced ability to move the head

Trouble in lifting or gripping objects

Muscle spasms

General weakness

Frequent headaches

Sharp shooting pain

Feeling of fullness

Difficulty in swallowing

Radiating pain into the arms and neck

Visiting a Texas pain specialist for neck pain

Neck pain is not constant. It comes and goes frequently, or may come back intermittently. If you are suffering from neck pain, the major question that arises is when should you seek medical attention or go for neck pain therapy Houston?

In most cases, neck pain goes away on their own after a few days. However, if the neck pain lasts for several days or becomes worse and continues to interfere with day-to-day activities, it is advisable to seek medical help immediately or visit one of the top pain management clinics in Texas.

Sometimes neck pain conditions may arise due to an underlying medical condition such as inflammation, tumor, meningitis, spinal nerve compression, or any possible infection.

You should consult a Texas pain specialist for neck pain immediately if you face the following:

Sudden neck stiffness with difficulty in lifting objects.

Fever and chills

Excruciating pain radiating into the arms and legs

Problems with body balance and coordination

Unexpected weight loss

Bowel or bladder dysfunction

Numbness, weakness or dizziness

Swelling of lymph nodes

When it comes to the health of your neck, it is better to be safe.

Diagnosis of neck pain conditions

Most neck pain conditions are diagnosed and treated based on the symptoms and basic examination.

The best pain management clinics in Texas perform a comprehensive examination and consultation.

The doctor collects information about your medical history and asks questions about the discomfort that you are facing.

During the examination, they will check for any possible signs of swelling or abnormalities.

During diagnosis, a Texas pain specialist for neck pain may also guide you to perform a series of movements and stretches to gauge the pain.

Occasionally, the doctor may also recommend diagnostic imaging tests such as X-ray, CT scan, or MRI.

The imaging studies will provide the doctor with detailed information about the tissues, muscles, and bone surrounding the neck.

They may also help rule out other major underlying causes of neck pain.

Neck pain treatments

While most causes of neck pain eventually disappear within a day or two with rest and self-help treatments at home. However, complex or continuing neck pain conditions may require other pain relief treatments and therapies. These include:

Stretching and muscle strengthening exercises for the neck.

Pain medications and muscle relaxants (anti-inflammatory steroidal medications)

Transcutaneous Electric Nerve Stimulation (TENS)

Steroid injections

Traction

Special neck collar

Hot and cold therapy

Acupuncture

Relaxing massage

Alternative therapies

Deep breathing exercises

Meditation

Stress-reducing techniques

Surgery, in rare cases, if a nerve or spinal cord is being compressed

Preventing neck pain conditions

Here are some of the ways to improve your neck health.

Maintaining an upright body posture

Minimizing the amount of time spent on mobile devices

Stay active and exercise regularly

Stay hydrated throughout the day

Adjust your workstation so that you don’t have to keep your head tilted up or down

Texas Interventional Pain Specialists: A Reliable And Trusted Name for Neck Pain Therapy Houston

The dedicated and compassionate team of doctors at Texas Interventional Pain Specialists led by Dr. Edward Baumgartner diagnoses and treats the cause of neck pain, providing effective pain relief. This pain management clinic in Texas follows minimally invasive pain procedures for treating neck pain conditions effectively.

The unique approach and targeted therapy followed at this clinic minimizes neck pain with a shorter recovery time for patients. This Texas pain specialist for neck pain clinic focuses on alleviating neck pain, increasing mobility, and accelerating healing through minimally invasive pain procedures.

Prior to starting the neck pain treatment, a meticulous examination of patients is carried out at this pain management clinic in Texas. This helps in identifying the underlying cause of the neck pain.

If you are experiencing neck pain, don’t wait till the pain gets worse.

Neck pain conditions should be treated immediately without allowing them to become more severe.

Are you looking at a speedy recovery from neck pain conditions? Do you want to keep your neck pain from returning repeatedly? Schedule an appointment with Texas Interventional Pain Specialists for a personalized pain relief treatment from neck pain.

[jam-the-hologram]

Debunking the House M.D Fabry’s Disease episode!

So, some background! I have Fabry’s Disease (I was diagnosed with it in 2020 after a chain of family diagnosis’s). It’s a pretty rare condition so there isn’t much media that has ever brought it up. So when I saw that House MD, the “he needs mouse bites to live” toxic gay doctor show had an episode on it, I had to check it out. Btw this is a *long* post.

Some background on Fabry’s Disease itself (you can’t know what they did wrong if you don’t know what the disorder is!). It’s a rare X-linked genetic condition caused by the build up of a fatty substance in the cells- in layman’s terms? The Recycling Plant of my cells doesn’t work- and because the cells can’t recycle the fatty globules they just litter. This causes many problems as the fat messes up wherever it ‘lands’ (I am streaching this metaphor to its breaking point I fear)- this could be the heart, the nerves, the brain, the eyes, the sweat glands- anywhere! There are many different symptoms associated with Fabry’s Disease- two people could have Fabry’s Disease but be affected completely differently by it!

In any case, it’s House MD time. The episode in question is episode 2 season 6 ‘Epic Fail’.

It starts out with a VR game developer (the episodes patient) saying that his hands [feel like they] are on fire. While it is correct that this is a symptom of the disease- nerve damage caused by the cells being fucked (in fact, I have this symptom myself- I take *a lot* of gabapentin for neuropathic pain), the manner in which he responded to it made it seem like he was experiencing it for the first time. This is strange because this symptom is usually the first you experience- my hands and feet have hurt like this since I was around 5 years old (within the past year or so my knees has also started to hurt in the same manner). If you are wondering what it feels like (unmedicated) imagine that tingling feeling of pins and needles. Now imagine that those pins and needles are rusty and molten hot. The redness of his hands whilst feeling the pain was correct (my hands/feet/knee also swell up slightly when aggravated by movement as well as turning red and hurting like a bitch)!

While there is a later-onset type of Fabry’s Disease which could explain why he is only now feeling these symptoms- though that usually just shows itself though renal or cardiac problems- and with less severe symptoms overall. They also don’t mention this as a possibility in the episode.

After a couple of failed tests (why the doctors didn’t just ask if anyone in his family has had similar symptoms is beyond me- it’s a genetic disease after all), they find that the patient has a thickened left ventricle in his heart- this is in fact a symptom (I have to have bi-annual check ups to make sure that my heart hasn’t thickened)! People with Fabry’s Disease are a *high* risk of both heart attacks and strokes.

After this the doctors come up with even more incorrect theories. The patient then complains of a 3 hour erection. This is *not* a fucking symptom. I genuinely don’t know where the writers pulled this from (their arses most likely).

After even more failed tests and treatments the patients lymph nodes swell up- particularly on his neck. And while Lymphoedema can a symptom of Fabry’s Disease it is *very, very* rare, and only affects the arms or legs.

After the doctors start the patient on steroids to treat his lymph node swelling he starts hallucinating and has a high fever. This is also definitely not a symptom of Fabry’s Disease (though maybe it was meant to be a reaction to steroids?).

After putting the patient in an ice bath for a couple of hours and getting the diagnosis wrong again, the doctor finally cracks it! It’s Fabry’s Disease! Did he come to this conclusion through genetic test? No, of course not! That would have been reasonable! He came to the conclusion because the patient didn’t have pruney fingertips after being in the ice bath for so long. Only- that’s completely wrong. Your fingers can still prune in water when you have Fabry’s Disease- mine do! I’ve got to be honest- that ending pissed me the fuck off- and that’s why I wrote this long-ass post!

I hope you enjoyed this and maybe learned a thing or two about my genetic disorder! Here are some websites to learn more about Fabry’s:

<https://rarediseases.org/rare-diseases/fabry-disease/>

<https://www.healthdirect.gov.au/fabry-disease>

<https://www.fabry.com.au/signs-symptoms/>

TLDR:

In the Fabry’s Disease episode of House the patient has several symptoms. Some are right, most are wrong. The symptoms are=

- A Burning feeling in the Hands, also causing redness ✅ (though dramatised)

- Thickened Heart causing a heart attack ✅

- 3 Hour Erection ❌

- Swollen Lymph Nodes ❓(very very unlikely, also not in the same place his Lymph Nodes swelled up. Dramatised)

- Fever and vivid hallucinations ❌

- Fingers not pruning after long exposure to water ❌

[phoward89]

hey, so I have kind of a really weird request that I was hoping you could help me with. So I have high cholesterol and I’m pretty sure I also have low iron. They both run in the family so it’s not my fault, however I have to take care of it, and I haven’t been lately with everything going on. I’m not eating as well as I should, and I was hoping I could ask for this, because I just love your fics so much, and I think it would help me to see reader going through it and Coryo helping her.

Could I please get one where reader has both of those things but they don’t know it. She’s been having the symptoms though and it’s been concerning them. So one day after Coryo gets back to the residential wing he finds reader passes out, and rushing her to the doctor. The doctor explains everything to them, and gives her a diet and food to stay away from. As well as medicine for the cholesterol and supplements for the iron.

however she ends up being allergic to the cholesterol medication, and she she has to treat it all on her own. And of course Coryo is a very loving and devoted husband helping her whenever her symptoms are really bad. And he’ll do the diet with you because he knows how much you hate it. And he won’t allow any of the foods you see told to stay away from inside the presidential palace unless it was a special occasion.

Symptoms of high cholesterol-

sore hands and feet, frequent tingling, left chest pain, frequent headaches, depression and fatigue.

low iron systems-

Shortness of breath, chronic fatigue, brain fog or lack of focus and concentration, clumsiness lack or balance feeling faint and numbness, dry skin, tingling and pins, neuropathic pain, burning in legs and feet, ringing and buzzing in ears, mood swings depression and sleep deprivation, and weight loss and loss of appetite.

sorry this is so spastic, no pressure to do it. Thank you:)

No problem at all. I'm almost done with this. Just finishing up the end. I'll be posting it soon.

[possessedopossum]

Fucking finally. Got diagnosed with carpal tunnel syndrome after fighting medical gaslighting for 7 years. Literally no one believed an afab kid with neuropathic pain. Even after I became a legal adult doctors continued to act like I'm insane or make stuff up or have pms or poor relationships with my dad. I started to doubt my own sanity. But no, my illness is real. Fucking finally I've found a doctor who is not a misogynistic piece of shit and actually listens and cares for patients. He is even budget friendly and not so far away. Thank God or whoever is responsible for this. My suffering will come to an end soon enough!

[daerm20]

late night thoughts/venting

what I’ve actually got from antidepressants:

the destruction of all my past relationships cause of impossibility to ejaculate

1 1/2 semester of dizziness and apathy of which I don’t remember almost anything and in which I didn’t do any exams effectively sabotaging my uni career for years to come, thing that will warp any expectation I put upon myself in the future

neuropathic leg pain and fear of dementia

distrust in doctors, specifically psychiatrists aka what would’ve been my future career choice (and still is)

all of this to stop from pulling my hair out and be less anxious

great

[gumnut-logic]

Em Harris has bad days.

There are days that start shitty and will likely end shitty. Days where she is reminded, that yes, she is paraplegic and look, now a double amputee to polish it all off. Days when the nerve pain gets her down. Days where the bare necessities of survival get ahead of her and existence just sucks.

At home, she would call in sick - her practise has back up plans for this exact reason - they’re doctors, they know the deal. She would hole up at home and just get through the day. If it got really bad, she had the visiting nurse to call. There were ways and strategies to get through the suffering and out the other side. Ways to rebuild her core, reinforce her shields and get herself back out there, usually with a smile to face the world.

It was necessary. It happened. She managed it.

But today she wasn’t at home. Today she was on a sparsely populated island in the middle of the southern Pacific.

She had woken to find Scott gone. This was nothing new. The man was a rescue operative, for crying out loud. IR had callouts around the clock. But the moment she gained consciousness, she knew it was going to be one of those days and just for once she granted herself enough selfishness to wish he was there to hold her and simply tell her it was going to be all right.

But she was Em Bloody Harris and she had been doing this alone for a long time. Get your ass out of bed and get the necessaries done, because not doing the necessaries of paraplegic existence really weren’t worth the neglect.

So she got out of bed and to the bathroom and did what she had to do. If there was a moment or two that found her cheek leaning against the coolness of the tiled wall, so be it. She had to get through this, so she would do it any way she could.

By the time she got through her routine, she was exhausted.

The irony of neuropathic pain was that while it damn hurt, it was all fake signals. There was nothing wrong with her beyond what was always wrong with her. It was just a seriously damaged nervous system doing its best to do its job when it couldn’t anymore. Pain was the result and days like today, it could get bad enough to break through her reserves and take her down.

So Doctor Harris downed some painkillers and prescribed herself a day in bed. Curling up under the covers, she closed her eyes and willed the day away.

Unfortunately she forgot to tell the Tracy family.

Sometime after no lunch there was a discreet knock on her door.

She blinked herself awake. She had finally managed some sleep, but her brain hadn’t let her fully escape, providing warped dreams where she was falling and Scott was desperately trying to catch her, but never quite fast enough. Her whole head had spun and it was only the sound of knuckles on wood that had stopped her plunge.

“Em?” Virgil’s voice. “Are you okay?”

Her head was full of cotton wool. The medication had the lovely side effect of dulling her thought processes along with her nerve pathways.

“Em?”

She opened her mouth to reply, but her body chose that exact moment to spasm and instead she found herself curled up working through a wave of pain. There may have been a whimper.

She didn’t hear the click of the door’s lock being overridden, but the voice exclaiming her name and the gentle touch to her forehead was enough to shock her brain into functioning at a bare minimum.

Virgil was crouched beside her bed, worry in every line of his face. “Em, talk to me.”

“Virgil, w-what are you doing in here?”

“Grandma was worried. It is unlike you to miss a meal, much less two. What’s going on?”

She closed her eyes and rubbed her face with a hand. “I’m fine. Juss a bad day.”

She didn’t want to look at him. Em Harris didn’t like vulnerable. Her medical status put her in that position far more often than she preferred and she put up with it, but this was new. This was her boyfriend’s brother, her boyfriend’s family, and to top it all off, Virgil was also one of her patients.

Vulnerability was not an option.

“I’m fine. I just need to get throu-“ And yes, her nervous system was the master of betrayal as it paired up the previous spasm with a lovely demonstration of exactly how bad, bad could get.

She grit her teeth and worked through the pain. Goddamnit, why did it have to hurt so much. The fog in her head wasn’t strong enough. She was due for another dose. She screwed up her face and tears leaked out of her eyes. A moment and she was gasping. Okay, okay, that one sucked. Where was her damned medication?

She opened her eyes to find a hologram of her own body floating above her.

What the hell?

“Em, what medication have you taken?”

“Wha?”

“I need to know what medication you have taken for your neuropathic pain.”

She pointed towards the bedside table and the bottle of pills. Red flannel danced in the shadows.

“I want you in the infirmary.”

“Virgil, I’m fine. I’ve got this handled.” She was so proud of actually finding her voice, she almost missed what he said next.

“Doctor Harris, the patient is in chronic pain, dehydrated and, no doubt, suffering from a low blood sugar level due to self neglect. Our infirmary has equipment that can help. I want you there and I want you there now.”

“I’m the doctor.” It was a stupid thing to say, but her reserves were shot and the thought of being paraded through the house on a stretcher sent chills up what was left of her spine. He would see her. See her injuries. See the real Em Harris. The broken mess under the facade. “No.”

“Em.” He sighed and she suddenly realised she wasn’t talking to Virgil, Scott’s brother. This was emergency responder and medic, Virgil Tracy. The man knew what he was doing. “Trust me.” The voice so many desperate people had heard in the most dire of circumstances.

As with many a rescuee, it worked. “Okay.” Her voice was so small, it was pathetic. So bloody embarrassing. She closed her eyes and hid her face behind her hands.

“C’mon, let’s get you out of that bed.” She couldn’t see him at that exact moment, but she knew he was offering her his arms.

So bloody embarrassing.

She pushed her self up, but, of course, today was a bad day so her body protested.

Loudly.

He caught her as she fumbled, scooping her up with a ridiculous lack of effort and held her close as she rode through it. She ended up gasping, her head on his shoulder, and she discovered he used the same aftershave her father had.

And then she was in tears.

Oh god. Em Bloody Harris bawling her eyes out all over his red flannel shirt. There were comforting noises, his chest rumbling with his soft voice. There was movement. She clenched her eyes shut, desperate to keep the world at bay.

And then he was laying her down on soft, cool sheets. There were beeps of medical machinery. The gentle touch of his warm hands on the skin of her back.

And the pain disappeared.

Oh god, the relief had her sagging into the bed. All her breath rushed out in a whimpered sigh.

Warm fingers brushed her hair out of her eyes. She looked up to find worried brown looking down at her. “Better?”

“Better.”

A small smile of relief flashed across his face, but then he was fiddling with an IV bag, hanging it far above. Exhaustion washed over her.

She didn’t feel the prick in her arm as sleep finally took her.

-o-o-o-

The next time she opened her eyes she encountered a pair of worried blue.

“Em?”

She swallowed. “Scott.” He was sitting beside her bed. She was in the infirmary. How?

Her brain finally decided to start functioning properly and memories lined up in all their embarrassing glory.

Shit.

“Uh, uh, uh.” His hand came down gently on her shoulder, holding her in place as she made to push herself up off the mattress. “You are staying here.”

“But I’m fine.”

A single arched eyebrow. “Tell me what happened.”

“Nothing happened. It was just a bad day.”

“That has you curled up in bed in pain.”

“It happens. I deal with it.”

His lips thinned. “Em, you’re not alone anymore.”

She opened her mouth to scoff at his words, but then their meaning sunk in and her mind jack-knifed.

Her hand was wrapped in one of his and she frowned at it. His other hand reached up and caressed her cheek. “We are not unfamiliar with the effects of injury in this family, Em. We help each other. Yes, there are bad days. We all have bad days. But those days pass better with help.” A ghost of a smile. “This family specialises in help.” He swallowed. “The thought of you hurting alone...I am so glad my brother is a stubborn ass who will chase up any member of this family hiding a damned illness. Please, Em, we’re here. There is no shame in asking for help.”

Her heart was in her throat. It had never occurred to her. She had not even thought about it. All she had seen was embarrassment and inconvenience. His fingers were so warm on her cheek. She closed her eyes and revelled in his touch.

No longer alone.

Oh god, it had been so long.

She bit her lip and was astonished to find herself holding back a sob.

Bloody hell, not again! What the hell was wrong with her today?!

His fingers brushed away a tear. His shadow fell across her eyelids and his lips touched her forehead. Whispered. “Think about it.” A smile against her skin. “I love you, Em Harris, and with me comes a large, bumbling family. You will never be alone again.”

His words had her eyes open and seeking to look at his expression, but he was too close and his lips were brushing hers, his hand in her hair. Ever, ever so gentle. Her gorgeous Scott Tracy.

She fell into the moment.

But he eventually broke it off and she missed his touch as he stepped back, sitting in the chair beside her bed, that still slightly smug smile of his knowing exactly the effect he had on her.

“Virgil says he is going to order a second TEEPS machine for you. Until then you can use Gordon’s as needed. Knowing Virgil, he’ll go and pick it up himself just for peace of mind. No doubt the second machine will be here before we have to worry about the both of you needing it at the same time.”

She blinked. “Why does Gordon need a TEEPS machine?” The thought of the cost of one, much less two, froze her brain for a moment.

“Ah, you’ll have to speak to Gordon about that. You’d be the first one to kill me if I divulged my brother’s medical information to you.”

Bloody hell, yes, she would be following up on that immediately. She had to know this stuff. What if she had to treat him? What if he needed her help? An image of the younger Tracy’s laughing face danced across her mind. Why did he need a TEEPS machine? She was almost terrified to find out.

But then she had seen Virgil’s medical records. Why wouldn’t his brothers’ medical history be any different? Her heart clenched.

“Hey, Gordon’s fine. It’s managed. And yours will be, too.” His hand tightened briefly on her arm. “Now, you focus on you.” And his hand was touching her cheek again. So distracting.

He leant in again. Another kiss.

Oh.

Perhaps he was right. Perhaps her bad days could be a little less bad. Perhaps...and her mind lost its train of thought as his tongue begged entry.

Oh god.

-o-o-o-

[contentment-of-cats]

Understanding pain.

Level 0: No pain at all.

This is normal. Normal life means no pain - not that you've adapted. No pain at all.

By the numbers

Level 1: Very mild and intermittent pain, but it can be ignored.

Level 2: Pain is frequent and needs effort to work around.

Level 3: Pain is consistent but flares into stronger spikes.

The first triad of pain can be handled with occasional OTC painkillers, hot/cold therapy, and resting the affected area. It can interfere with some tasks, but overall your life is pretty normal.

~

Level 4: Pain can be ignored when you're absorbed in something, but is much more difficult to deal with.

Level 5: Pain interferes substantially with concentration, but you can 'push through.'

Level 6: Pain is impossible to ignore or 'push through.' You can't concentrate on anything but the pain.

Moderate pain means consistent use of painkillers, including narcotics. There are times when you can't do simple things like taking out the trash.

Level 7: You can't concentrate on anything, you can't do anything unless it's with a massive effort. The pain wakes you up or will not let you sleep in the first place.

Level 8: The pain is intense, even to the paint of making it hard to think of speak coherently. You can't move easily, even if it's from the sofa to the bed, or to get something from the kitchen.

Level 9: You can't think. You can't speak. All you can do is cry or moan. Moving is enough to make you scream.

This is heavy meds pain. For me, Level 7 is when I take my top dose of pain meds - 10mg oxycodone + 300mg gabapentin + 800mg extended release Tylenol + 500mg of robaxin. It takes 45 minutes to work. I can only lie there and breathe.

Level 8 and 9 is what I call 'hospital pain.' That's when you take your pain meds, call an Uber, and get your ass to the ER.

~

Level 10 is the worst possible pain. You're delirious from it. You're incoherent. It's the closest thing to Hell. You pass out from the pain, then you wake up screaming. You beg to die. It hurts too much for tears.

This is the pain I woke up with after an 8-hour surgery that resectioned my colon, my ureter and bladder, removed 22 lymph nodes and my uterus/tubes/ovaries and gave me an ileostomy. I woke up from the anesthesia screaming in pain. I begged someone to kill me. I'd pass out, wake up and scream some more. They noted it in my record, so I know it was not a nightmare. Other patients were calling their nurses to get me something for the pain. Morphine is your friend after a surgery like that.

You'd think that was the end of it. That I healed up and got better.

That surgery was the middle of November. I could not stand up in the shower until New Year's Eve. I had eight incisions aside from the ostomy opening, and the hysterectomy incision was four inches horizontally at the top of my pubic bone. Coughing was a 6. Sneezing kicked me to an 8. I couldn't lift anything over 10 pounds by doctor's order.

Even though I was and am experiencing pain, learning to understand it is a journey. Pain is a generic word. A patient without the vocabulary can't communicate anything more than, "It hurts. Make it stop." Hospital personnel are also trained to look for 'drug seeking' behavior. There are three types of pain:

Neuropathic pain is nerve pain due to nerve disorders - in my case a tumor pressing on a nerve. Later complications include neuropathy secondary to chemo and radiation and radiation fibrosis. Neuropathy secondary to chemo symptoms include paresthesias, numbness, balance problems, and weakness in the feet in hands. Symptoms of radiation fibrosis are muscle spasm; muscle weakness, atrophy, or tightness; changes in the appearance and texture of the skin, and decreased joint mobility. In my case my fingertips are tingly, and I feel as if I am wearing the thickest possible wool socks. From time to time, I will get jolts of pain in my toes. My hands are stiff, and from time to time I feel as if nails are being driven into my palms. Neuropathic pain feels like burning, or tingling, or sometimes a stabbing or shooting pain that radiates out like ripples, or follows a path like lightning. During chemo I would have an electrical buzzer feel - like someone pushing a buzzer three times. Opioids by themselves do not help much, so a doc will often recommend an antidepressant like Gabapentin, and might also add anticonvulsants or a benzodiazapine like Ativan.

Somatic pain isn't like neuropathic pain. It stays in one place, but that can be a pretty big place. It feels achy, sometimes a throbbing pain. Muscle relaxants like Robaxin help.

Visceral pain is something everyone has had from time to time. Think of the worst case of food poisoning or a stomach bug. It's often experienced by patients after surgery on their stomach, intestines, and/or colon. Opioids are the treatment of choice as they famously slow down peristalsis.

For most people, pain is transient. For others like those with autoimmune issues, it's relapsing and remitting. For others. it's chronic and needs to be managed along with the patient's mental health.

~

Breaking the taboo

Pain and pain management is a taboo subject. People with pain are afraid of what people think of them being in pain or that people will look down on them for seeking treatment for pain. Part of this has to do with not wanting to be labeled a junkie and the taboos surrounding opioids and benzodiazpines, and mistaking the anxiety and depression pain can cause as 'drug seeking.' Some of the bullshit people in pain have internalized is below.

Pain is a part of life. Suck it up.

I can't take my pain meds when I'm low on the pain scale or I will build a tolerance.

I don't want to get addicted.

My meds can cause constipation. I shouldn't take it.

I don't want to bother the doctor for a refill. They might think I'm drug-seeking.

My family/friends think I need to stop my pain meds.

Anyone who tells me that [pain is a part of life has never been in chronic pain. One friend was 'concerned' that I am on meds and that I ought to stop and 'get used to' the pain. I could always use cannabis anyway. I can agree about developing a tolerance to the pain. I did not know how much pain I was in until the ER doc ordered a shot of morphine, or how much anxiety I was having until the doc on my floor ordered Ativan. Expecting someone to live with pain, it's side effects both mental and physical is barbaric and sadistic. Telling them to medicate with your personal choice of painkiller is vainglorious and cavalier.

~

Adjuvant therapies are self-care

These are the things that have worked for me, and allow me some relatively pain-free days and a lower dose of pain meds. Of course, there are still days when I need the full dose four times per day. Pain is not there or not, it's far from binary, and you can have different levels and types of pain in different areas of your body at the same time. For instance, as I write this, my feet are a Level 1, but my hands are a Level 4, my lower back is a Level 2 - and this is with pain meds, low dose, and an extended release Tylenol.

Tai Chi - I have found these exercises very helpful and the shorts are not distracting, letting me focus on the movements. I do 10-15 minutes morning and evening.

Soft tissue manipulation - massage works for fibrosis, but the best tool I have is... a silicone rolling pin.

Lymphedema self-massage and care - terrific tutorials! 10-15 minutes alternating days with Tai Chi.

Resistance bands and balance - these videos are very helpful not just for seniors, but anyone with muscle weakness and balance issues.

Peddle machine - 30 minutes every day. The movement of my legs helps with lymphedema from those 22 absent lymph nodes.

Warm baths with epsom salts.

A full body ice pack like this one.

TENS unit.