Monday, May 23, 2011

On Mom and Pain and Broken Bones

No, Mom hasn't broken anything.

First of all, when this imports to facebook I think I'm going to tag quite a lot of people. I don't like that, I feel embarrassed to tag so many; like I'm standing in a crowded room, waving my arms and yelling, "Look at me!  Look at me!" Especially unsettling when the blog post is on such an uncomfortable subject as pain, and it doesn't really build to a hopeful point.

But there are reasons to tag you all, as individuals. I have so many family members, to start with. Okay, that makes it sound less individual, but still, this is relevant to all of you, I think. Then there's my home group at church (spiritual family), other people I've had conversations with about Mom, people who've said they're praying for me, and other very good friends. There's SLOBS -- I don't attend very consistently and I don't know many of you super well, but I like you, I consider you friends, and, well... shared books are a strong bond, I think.

I might have whittled down the list the more I thought about it, instead of adding to it, but some of you are going through your own immense pains right now, and... maybe this post will be helpful. I'm really not sure. Despite the lack of a general tone of positivity, it was helpful for me to think through. Maybe it will be for you, too.

If you mind being tagged for whatever reason, please let me know. If we don't have that close of a relationship and I'm making you uncomfortable, if you always read my blog posts anyway and would rather not be tagged as well... whatever. Or, if you're reading this and I didn't tag you and you'd like to keep reading updates, please let me know that, too.

Alright. Remember my comment from my original post about Mom's dementia, "I can think about everything else relating to her dementia, in the present and in the past and in every aspect of my own reaction to it, but the future... I think maybe one thought, then flinch away, like the instinctive reaction to testing a broken bone"?  Well, recently I've thought of a lot more similarities between this experience and my one experience with a broken bone. Physical and emotional pain and injury have a great deal in common, more than I realized.

The more I think of it, the more I see and find. I can't count the number of things they share, not without writing them down. I'll try to remember everything I've thought of so far, though. Wish me luck.

So here we go, but first, a little background: In February of 2004, I played a game of Ultimate Frisbee. I played it barefoot, because I'd found that was more enjoyable for me than playing with shoes on. I felt lighter on my feet, faster, even. Certainly faster at changing direction, which is important in Ultimate.

I'd do it again, in a heartbeat. Barefoot Ultimate is FUN. Risky, maybe, but so is driving a car.

The game was not unusual, although I think I hadn't been playing as much as I'd like around that time. That wouldn't be unusual, either. Anyway, in the course of the game I jumped up to block a throw to my brother Nathan, and as I remember it, rather than landing on my feet wrong and from there crumpling to the ground... well, there was no pause in the motion. My descent was one smooth and seamless event, from the brief fall through the air (brief because I'm no impressive jumper) to sitting on the ground in pain. Someone said they heard a crack. I didn't hear it, but I guess my body was busy doing other things instead of listening.

Despite this, it pretty much felt like any other time I'd landed wrong or twisted something a bit. I figured the pain would go away soon. The biggest difference I'd observe between a broken bone and pain that goes away in a few minutes or hours or days... well, I've given it away already, haven't I?  It's that the pain doesn't. You keep expecting it to (if you're like me), but it doesn't.

But I'm getting ahead of myself; talking about my thoughts and reactions gets into territory of similarities with emotional pain. Background. That's what we want now.

So... I didn't get X-rays until a few days later, as I recall. The day after, people advised me that I should probably get it checked out. Eventually I agreed enough to go to the Health Center at Biola. A doctor there told me I'd probably broken the base of my fifth metatarsil -- a very common injury, apparently, at least for athletes. (See, playing Ultimate barefoot must have little to do with it -- he didn't mention an epidemic of barefoot athletes.) But they don't have X-ray machines at the Health Center. I had to get a ride to the ER (ended up making more sense than making an appointment with someone, though it didn't feel like too much of an emergency anymore), and I don't think I did that right away, either. But eventually I did, and they confirmed it was broken. The base of the fifth metatarsil, by the way, refers to your little toe -- but the bone connected to it higher up in the foot, by your ankle.

This was my first broken bone and is still my only break thus far -- hey, I drank a lot of milk. And it wasn't a very bad break. No one really deigned to explain it to me, to tell me it was a "hairline fracture" or anything else, but I did get to see the X-rays. And I couldn't see it. Not that I'm trained, but still.

On to similarities.

1. Both learning to live with Mom's dementia and breaking a bone are like other experiences I've had, contiguous so to speak, but simultaneously Other.

I've already mentioned how it felt like any other time I landed wrong. Well, that's true enough. But it taught me all kinds of new things about pain, too. On the first day, for example, I couldn't make myself put my weight on it any more than I could make myself put my weight on a piece of paper (I've never been good at those fall-backwards-and-I'll-catch-you games). My brain just wouldn't let me, it felt impossible. That was different. Feeling the pain fade a little, and then moving my foot to test whether it was better now or not and seeing spots in front of my eyes, deciding that the foot movement might not be a good idea after all -- well, that was different, too. Lying in bed trying to find a comfortable position for it, with the sensation that my foot was hanging by a thread, though it quite manifestly was not -- that was different. I'm still not sure that it's the most pain I've ever experienced. I wouldn't say so, I don't think. But it was pretty close, and despite the similarities to other events, it was different.

Well, Mom's dementia has maybe less in common with other events than the bone breaking did. But there are commonalities. I've certainly been depressed before, I've grieved before. Depression caused by self-loathing and depression caused by loss... it's kind of surprising how subtle the difference is, actually. The flavor is different. Depression caused by loss feels a little more powerless... no, only because now I know how to deal with self-loathing, I can bring myself out of it. At the time I couldn't, or it was much harder at least, so the powerlessness was similar, too.

Still, pain about Mom is certainly different from other emotionally painful events. Some of that will come out as I continue to write about the similarities with physical fractures. Some of it, like the pain of the break not going away, is just in the length of the pain. That, on its own, makes it so, so different from other painful events.

Oh, but speaking of which:

2. "It's not that bad."

I didn't feel guilty for feeling pain in my foot. But I DID think at first that the pain would go away. I certainly didn't think it was broken.

I'm not terribly close to my mom. And I'm not living with her, not a caregiver. She's not all that far along. So it shouldn't be that bad, right?  Heh. I think it's still broken. And limping over to the doctor's office to confirm something's wrong does hurt... So does not taking painkillers, but you don't want to numb the pain, walk on it, and make it worse. Yeah.

3. The ups and downs, the pain and the fading.

This is fairly self-explanatory, I think. Even in the first days, when the pain was constant, the intensity level still varied slightly. Pain about Mom also comes and goes. Sometimes something seems to set it off, sometimes it seems to start throbbing for no explicable reason. I suppose just because it's broken, that's explanation enough.

This is not quite the same thing as, but very related to:

4. The testing of the pain.

Here's one of the things the analogy is really helping me understand. I can't process all the pain about Mom all at once. I mean, when it's really bad, it feels like it's the entire weight of pain all at once, all intent on killing me -- but it's not. And the important thing, for this particular point, is that I don't have to feel like I'm "supposed" to process it all the time. It may even be healthy to run away from the pain, at times.

Now, in order to heal a physical break, one doesn't have to test the movement at all, really. Processing emotional pain and healing a physical injury don't have a direct one-to-one relationship. If you keep a bone immobile forever it's the muscle that will be harmed more than the bone, right?  But still, you do have to test it at times to figure out how much it's healed, to see if you can use it again. Doctors help, you don't have to test it as much when you know you're supposed to wear your ortho shoe thingy for six weeks or whatever it was... but until you see the doctor, it's the small experiments and the resulting pain that tell you you have a problem. They're necessary.

But you're not going to go testing it all the time. You'd faint, for starters. (Even if you don't think it hurts "that bad" -- your body may be shielding you from the full force of the pain, you know.) And you'd probably do further injury to yourself.

The cycle of thinking about Mom and retreating, pain and relief, feels very similar. Both the pain and the flight from pain are necessary, I think. It gets to be too much, I have to retreat sometimes. But I also need to process it. This is also related to:

5. Peripheral pain, and circling around the actual injury.

I don't know that much about how the body's designed. I know extreme trauma can cause you to go into shock. And I know an injury in one part of the body can cause the area around it to feel pain, too. Sometimes the pain in the surrounding area can be so intense, it's hard to tell what's actually broken.

For all I knew, I'd sprained or broken my ankle. It's not like I was set on that as an explanation (as the doctor I saw seemed to assume), but it worked as well as anything else for me. My ankle HURT. It took the doctor tapping on my ankle bone to show me the ankle wasn't the issue.

As I "test" my emotional pain about Mom, it also feels like I'm circling around the real issue. (Writing about it, incidentally, is a more distant pain. I'm thinking about it, but not as much as when I started composing the post in my head. Mostly I'm thinking about the writing, the word choice and phrasing and how to fit in a new thought without interrupting the transitions. It's easier.) Here, again, the analogy is helping me to understand, to view this as a healthy thing. The pain is too great NOT to test it gingerly, not to circle around it. Don't want to go around whacking an injury, just to make sure nothing's really wrong...

The way I had been looking at it, though?  More like: "Good grief, I think this hurts so much, but I'm not even really thinking about Mom, am I?  Just self-centered things, like how stressful this is, and how it's affecting my work, and observations about pain... But what pain?  What am I feeling pain about, when I'm not really even thinking about Mom?  How pitiful is that!  It's like I'm trying to make a big deal out of nothing, feeling sorry for myself, taking a sick sad comfort in a new identity as someone whose mom has dementia, when in reality I don't even care about that, do I?  If I did care I'd be thinking about that, not this."

I had a feeling there was a flaw in that thinking somewhere. I knew it was a big deal. Remembering how my foot felt helps me see the flaw though, in a way I couldn't before. Surrounding pain doesn't invalidate the injury, it's more like the true measure of it. When your whole foot turns black and blue you don't say, "Oh look!  It's only a bruise!  What are you whining about?"

And that is a relief. I think it might be natural and healthy, as I process this, to spiral inward. As I mentioned in point number four, I can only take so much pain at once as I test the injury. So I start by processing the pains that are more peripheral, and only when they're less overwhelming (when thinking about them isn't going to make me faint, to extend the metaphor) do I move on to more central issues. That sounds right. And that process is pretty instinctive, it's not something I have to think about very consciously. This exercise is just helping with the reduction of guilt, I think I'd still be doing the spiral thing whether I ever understood the reasons behind it or not. Well, definitely. That's what I was doing.

6. Control and lack thereof.

I can't go back and keep the injury from happening. And beyond that, when I broke my toe/foot I couldn't move across campus to my classes nearly as quickly. But I could adjust to that fact, learn to account for it.

It was exhausting. My body was working hard to heal itself, plus pain itself is draining, plus walking became a lot harder, took a lot more energy. I couldn't change that. I could... well, I could sleep. That helped. I could go easy on myself, allow myself to heal.

I couldn't walk normally, but I could hop. I could wrap my foot with an Ace bandage and kind of limp, I could go to the doctor and get crutches, go to the ER, get X-rays and an ortho shoe, and then I could limp around a little better.

Speaking of control brings me to a big reason I'm writing this, though it has less to do with broken bones.

I started last week to read Ambiguous Loss: Learning to Live with Unresolved Grief. It explains why (with a multitude of reasons) this sort of ambiguous loss is so stressful. I won't bother to explain all of that here. The important thing... before this, I wouldn't have said I find ambiguity to be all that difficult, or that I need to be in control all that badly. But now... well, evidence seems to speak to the contrary.

Lack of control is harder with this than with breaking a bone. Breaking a bone wasn't so much an ambiguous loss. Writing about Mom helps, though, I think. Helps me make some sense of it, understand it... it helps a little with the perceived lack of control. Maybe writing is my ortho shoe, heh. At any rate, analogous to physical injury or not, writing helps.

On the other hand, I guess the point of contact between physical and emotional pain in this area seems plain enough: I can't fix it. I can learn to cope with it. Whatever that means.

7. Learning to cope is not an easy transition.

The only way to learn how long it would take to limp from my dorm room to a class across campus was to do it. I couldn't account for it with perfect accuracy at first. It's sort of a hit-and-miss, hunt-and-peck, learn-by-failing process. Right after the game of Ultimate, before I had any bandage, crutches, or ortho shoe, when I couldn't put any weight on the foot and was hopping everywhere, how to climb stairs?  Tried hopping, figured out it didn't work, crawled.

Again, I think the similarity with emotional pain is pretty evident. I don't know how to deal with this yet. I can only figure it out by living it, I think. Advice can help, but it's hard to communicate things like levels of fatigue, subjective, "in-your-head" things that vary based on so many factors. Mmm, but advice is welcome, that's for sure.

8. It helps when people know.

I mean, then they do things like offer to go back and get the textbooks for you that you forgot, so you don't have to trek all the way across campus all over again. And they give you chairs to put your foot up, and they forgive you for missing your cohort group meeting because you fell asleep (day after the break, if I remember correctly). These are good things. It's hard enough already. No reason to turn down sincere offers of help.

Of course, when one is crawling up stairs, or hopping across campus, or severely limping, or using crutches, or wearing a bandage or an ortho shoe... Obviously it's easier to tell that something's wrong. Random strangers will ask what happened when an extreme limp is advertising the pain you feel at every step.

Emotional pain can be harder to see (if you're not crying). It can be tempting to wear one's heart on one's sleeve, just to be seen. But then it's also not tempting. I mean, you don't necessarily want to cry, either. And talking might lead to that... The whole thing's dangerous, darn it.

Do I want people to cut me some slack right now, because of Mom?  No... wait, I mean, sure!  Heh, not about anything in particular. If I'm doing a poor job in some area of my life, I'd like to know. And it may not be because of the stresses... But still, more generally speaking, support is a good thing. Sharing the burden is a good thing. I could write all this stuff in a journal without publishing it online, and it'd probably still help me to think through the issues and clear my head, but it wouldn't be the same.

Finally, and not so relatedly:

9. Thinking about Mom and testing the break can both make you feel like you're going to faint.

I've fainted before, and I've come so close that I've blacked out before, so I know what it feels like. Oh, thinking about Mom doesn't make me feel very close to fainting, but the physical symptoms are the same, if much lessened. A little queasy and sick to the stomach. A little weak. A little lightheaded.

I'm careful, thinking about it when I drive. I know from the time I blacked out that thinking about feeling like that other time when you almost fainted can make it much, much worse, so even though it doesn't feel at all close to fainting, I'm careful. Don't want to black out while driving.

I've felt a bit of that physical sickness while writing this (thinking about broken bones on top of it probably didn't help, I suppose), although on the pain scale this writing hasn't been nearly as bad as other parts of my day, "testing" this injury by thinking about it. Maybe it's time to go read a novel.

There are still other similarities to list. But it's getting a bit late to write them all, if I'm also going to read before bed, and this post has probably gotten long enough, anyway (ya think?). So... maybe I'll post more of them later. Broken Bones and Dementia, Part 2. Something like that. Even if I've listed all the main ones already.


Father David said...

You're doing well, Marcy! Great job! Blogging, which is both writing and sharing and inviting response from people who care about you, can be marvelously therapeutic. Keep going! God is effectively working in all of this.

Dana said...

Marcy - what a gifted writer you are. I am so sorry that you have to go through this but I think you are right. Sharing may help ease the pain and those who love you will want to share the load. Thank you for "tagging" me. I feel honored to know you.