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The Pain Companion

Rated: 2.73 / 5 | 972 listing views The Pain Companion

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  • Sarah Anne Shockley
  • January 23, 2016 04:40:55 PM
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Insights, wisdom, and practical tips for living better while living with chronic pain

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How to Create a Pain Diary That's Easy to Keep and Actually Useful

A pain diary is a daily record  you keep for yourself detailing the nature and levels of the physical or emotional pain you are experiencing.Why would you want to keep a record of your pain? Chronicling pain sounds like one of the least appealing things you could do.Yes, I know, but there are a number of reasons why it can be very helpful for people with chronic pain to do so. Read on.Why Keep A Pain Diary?How To Set Up Your Pain DiaryKeep It Clear And SimpleRemind Me Why...

A pain diary is a daily record  you keep for yourself detailing the nature and levels of the physical or emotional pain you are experiencing.Why would you want to keep a record of your pain? Chronicling pain sounds like one of the least appealing things you could do.

Yes, I know, but there are a number of reasons why it can be very helpful for people with chronic pain to do so. Read on.

Why Keep A Pain Diary?
How To Set Up Your Pain Diary
Keep It Clear And Simple
Remind Me Why I’m Doing This

Why Keep a Pain Diary?

Here are some valuable reasons for making the effort (sometimes painful, I know) to monitor and record your pain experience:
  • To provide credibility about the nature and level of your specific pain(s) that you can show to medical practitioners and therapists, particularly if they have difficulty understanding the intensity or duration of your pain.
  • To provide important details for your physician about how your medication is working or not working, and any side effects.
  • A pain diary can be helpful to share with caregivers so they can better understand your needs.
  • Tracking your pain levels helps you see when your pain tends to be most intense so that you can plan rest, appointments, and work accordingly (at least as much as is possible).
  • A pain diary helps you more clearly see which activities affect your pain levels for good or ill.
  • Sometimes these records are useful for insurance or legal purposes.
OK, you say, I can see some of the uses for a pain diary, but how do I go about creating one that’s easy to keep, easy to refer to, and actually useful?

How To Set Up Your Pain Diary

Here are some simple guidelines that have worked for me. Modify as needed, of course.
  • Plan to keep the diary for at least one week, but longer is highly recommended if you’re up for it (since it provides more information over a longer time span).
  • Use a small notebook that’s easy on your hands and a
  • felt tip pen or other writing utensil that’s easy to use and writes clearly.
  • At the top of each page write the date.
  • Make notes on pain at least four times a day, if at all possible (upon waking, mid-day, afternoon, evening) and note specific times.
  • At each check-in time, note your overall pain level, and any specific pains and their levels, noting changes in pain quality or intensity.  Use descriptive words (see list below for ideas.) If things are pretty much the same, just write “Same.”
  • In addition to the above, in the first notes of the day, jot down how much sleep you think you got and the quality of sleep: Did you sleep fitfully, or not at all, or only doze now and then, or get up in the night?

Keep It Clear and Simple

If you only have energy for the minimum of four check-ins a day, do that.

For a more complete diary, and if you want to track the efficacy (and side effects) of medication and/or the effects of physical therapy protocols, then I suggest adding the following into your daily notes as well:
  • Medications taken and at what times.
  • Any exercise and physical therapy you do, the time you did them, and duration.
  • Note periods of rest.

Keep it simple so that doing this does not become a burden. These are notes, rather than an old-fashioned Dear Diary description of everything you do and feel. (I recommend a separate Pain Journal if you wish to go more deeply into what you’re feeling and experiencing.)
  • Use phrases instead of full sentences.
  • Use highly descriptive words (see suggested list below).
  • Use the 1 – 10 scale consistently, and in a way that makes sense to you so that you can easily communicate it to others.

Sounds like a lot, but you can use shorthand. For example, if you have a regular routine of physical therapy exercises you do, just write PT and the time. No need for further details.

The following lists of descriptive words are offered to make it easier for you to express yourself and help you find the words you need. The lists are not meant to be exhaustive, but I hope they show that descriptive words communicate much more clearly to others than just the words pain or hurt do by themselves.

Physical Pain:
sharp, dull, twinge, sting, shooting pain, tender, irritated, raw, spasm, pulling, cramping, needle-like, achy, stabbing, throbbing, burning, numb, tingly, tight, sore, queasy, flu-like, dizzy, fatigued, exhausted, listless, light, deep, intense, excruciating, brain fog, easing, releasing, letting up.

Emotional Pain:
low, depressed, angry, despondent, frustrated, hopeless, hopeful, numb, scared, terrified, anxious, confused, stuck, sad, lonely, isolated, ashamed, resentful, sinking, uplifted, tense, relaxed, relieved.

If you are keeping a Pain Diary of physical pain, it’s up to you whether or not you want to add your emotional state into your notes and how comfortable you feel sharing that with others.

Remind Me Why I'm Doing This

Why not just explain all this verbally the next time you see your doctor?

Mostly because our brain in pain doesn’t work well: we often can’t remember details, the right words don’t come easily, we’re exhausted, we can’t think straight, and we used up all our available energy just getting to the appointment.

If the Pain Diary sounds challenging to set up, feel free to download my Pain Diary PDF. You can print it out and write on it or use it as a basis for your own and modify as needed.

I hope this is helpful. Please feel free to share this post and the template with others.
(This article also appeared in The Mighty.)


Take Back Your Life From Chronic Pain

(This article was posted on The Mighty as My 3 Steps to Finding Hope and Relief While Living with Chronic Pain) Despite trying to keep a positive attitude, other people and I can find ourselves feeling worn down and hopeless when we’re living with chronic pain. We’ve tried everything to heal our condition and to relieve our pain, yet we’re still in it. What can we do? A Daily Act of Courage Sometimes it’s easier for us to fall into a kind of...

Despite trying to keep a positive attitude, other people and I can find ourselves feeling worn down and hopeless when we’re living with chronic pain. We’ve tried everything to heal our condition and to relieve our pain, yet we’re still in it. What can we do?

A Daily Act of Courage

Sometimes it’s easier for us to fall into a kind of grim resignation than to keep putting energy and hope into treatments and practices.

Over time, we can sink lower and lower emotionally, into a kind of omnipresent depression. Here, life seems gray and lifeless, and it becomes a major act of fortitude and resolution just to get up and face another day. I think of this as a kind of seeping loss of hope that can drain whatever remaining well being we have if we’re not careful. Giving up, giving in, abandoning hope, and abandoning ourselves may be just around the corner.

When I feel like this, I have to remind myself that I’m in some kind of process or practice. I’m either moving towards a better place, or I am allowing the pain in my body to decide for me how I feel about myself and about life.

If I insist that pain must leave completely before I can be happy again, then I am making it the master of my emotional well being.

The Practice of Finding Balance

This effort, to live with pain and not succumb to depression or despondency, is an effort to find emotional, mental, and physical balance within and around the pain. A balance between not forcing myself to be unrealistically bright and cheery, but not allowing myself to wallow in self-pity either. This takes mental and emotional discipline. It becomes a form of daily spiritual practice.

Certainly, living with pain is not a path anyone in their right mind would consciously choose as a spiritual practice for themselves. It is a difficult and lonely path that we walk out of necessity, quiet and internal,  but it can also be surprisingly deep and rich.

It’s not that being in pain is inherently spiritual, despite the fact that some religions consider suffering to be a holy sacrament — a concept I don’t embrace. For me, it’s certainly not the suffering or the pain or some kind of sacred martyrdom that gives a spiritual quality to the path through the pain.

It’s how we are with the pain. It’s what we do and don’t do with it and through it. It’s the positive choices we make for ourselves on a daily basis.

Standing with the Self through Pain

For me, the spiritual aspect of the journey isn’t that you try to be cheerful or that you think positively or you try not to complain and be the perfect patient. In fact, those things can be very counterproductive. No, it’s first and foremost the choice to stay with myself, so to speak, to be true to my own feelings and to learn to stand by me. I am there for me.

And that standing with the self, believing in the self, not giving up on the self, whatever that looks like for each of us, can be incredibly hard to do. To not take the path of hating life, of hating who we are, of hating the circumstances, is the path.

And when we find the bitterness, the anger, and the hatred rising up  —toward ourselves or toward the circumstances — we can feel it and let it pass through. We choose to honor what’s coming up, but we choose not to live there.

It’s a daily spiritual practice to constantly return to openness. This takes a very deep spiritual practice. It takes courage and fortitude, resolution and determination, and an inner choice which we must constantly renew to stand with ourselves, and remain the center and the heart of our own lives.


7 Ways Chronic Pain Taught Me to Honor Myself: Video

This is the short video summary of one of my popular recent posts which lists 7 important ways that chronic pain taught me to take care of myself and  create greater well being, even while living with pain. [...]...

This is the short video summary of one of my popular recent posts which lists 7 important ways that chronic pain taught me to take care of myself and  create greater well being, even while living with pain.


Being in Pain Does Not Make You a Failure

Everyone who has been in pain for some length of time has probably asked themselves these questions: Why is this happening to me? What did I do wrong to deserve this?Many of us struggle with feelings of guilt and shame for needing help, for not being able to fix ourselves, for probably asking too much of everyone around us, for causing people to feel bad for us, for needing financial assistance.To add insult to injury (literally), there is a prevalent New Age attitude that says if you...

Everyone who has been in pain for some length of time has probably asked themselves these questions: Why is this happening to me? What did I do wrong to deserve this?

Many of us struggle with feelings of guilt and shame for needing help, for not being able to fix ourselves, for probably asking too much of everyone around us, for causing people to feel bad for us, for needing financial assistance.

To add insult to injury (literally), there is a prevalent New Age attitude that says if you just visualize and think positively, you can change anything you don’t like into the way you want it to be almost instantly.
The secret to the perfect life is “in our heads.” If we’re poor or unfulfilled or in pain, we just need to “think differently.”

Just Think Positively...

Don’t get me wrong, I’m all for thinking positively. I practice it every day. It has made a huge difference in my life many, many times and still does. But the idea that people who can’t move out of pain have somehow failed as people has to go.

After years of working through all manner of New Age palliatives to change my beliefs, the way I speak, the way I think and how I perceive myself – resulting in very little perceptible change in my painful condition – I’m here to say that sometimes, when you’re in pain and you can’t get out, it’s not because you’re not thinking positively enough.

Some pain comes in and won’t leave. There may not be a tidy explanation, but it doesn’t mean we are off our center, or lacking in some fundamental way, or not good people, or not in alignment with God or the Universe, or haven’t prayed or fasted or meditated enough, or burnt off our karma yet.
Being in pain does not automatically put you at fault.

The fact that you don’t have an off switch for your pain does not mean you aren’t trying hard enough or that in some insidious way you must want to be in pain. It does not mean you have failed, or must have been a terrible person in a past life.

Asking Different Questions

Being in pain doesn’t prove anything negative about you at all. An estimated one in three Americans are in pain right this moment. That’s a lot of people.

So, the questions we might want to begin to ask about all this pain may be more about ourselves as a culture rather than ourselves as individuals.

Yes, we may want to ask ourselves, What can I do differently in my life to relieve this pain?, but we also may need to ask, How are we, as a people, creating so much unrelenting pain? Then the answers become less of a private struggle and more of a community effort toward greater harmony and balance at all levels of our lives.

And if this epidemic of pain is as much of a collective as a private experience, then maybe part of the solution is to understand that we are, somehow, all in this together.

That the healing needed may not be only along a solitary path, but something we need to address as a society. We have somehow created a culture where violence and alienation is the norm and, perhaps, our painful bodies go hand in hand with that. Isn’t it even remotely possible that some of us may be feeling this collective alienation as illness and pain in our bodies?

And This Helps Me How?

And you might well ask, how does speculating about this help me with my pain today?

For me, as much as I would not want to wish this experience of pain on anyone, it eases my mind to know that I’m not alone in it, that there seems to be something bigger at work here than my own private path through it, and that, while the answer may not be easy, it may also not be entirely up to me to figure it out all on my own.

And, right now, today, that is something of a comfort.
(This article also appeared on The Mighty.)


Sadness, Loss, and Chronic Pain

When we’re in severe or chronic pain, our normal life is not available to us in the way it used to be. It isn’t the same as going on vacation, or moving to another town, both of which we consciously choose as enjoyable breaks from the everyday.Instead, living in pain feels like being taken out of life. Our normal life recedes to a distance at the same time that the feeling world of pain becomes incredibly close, immediate, and demanding. Pain becomes our experience of life.We...

When we’re in severe or chronic pain, our normal life is not available to us in the way it used to be. It isn’t the same as going on vacation, or moving to another town, both of which we consciously choose as enjoyable breaks from the everyday.

Instead, living in pain feels like being taken out of life. Our normal life recedes to a distance at the same time that the feeling world of pain becomes incredibly close, immediate, and demanding. Pain becomes our experience of life.

We may still be physically present, but most of our energy and attention is busy elsewhere, trying to attend to pain or keep it at bay or heal our bodies or worry about how it will all work out. We simply aren’t available to, or involved with, everyday life in the same way, and it does not feel like everyday life is available to us, either.

The time spent in pain can feel like lost time. This is particularly sad when you cannot attend or participate in important events, or when you must do so in your aura of pain. Even when you can participate, pain limits your enjoyment and leaves you with a feeling of not having been entirely present.
My time in pain has been particularly heartbreaking for me in terms of being a parent. I have been unable to participate and contribute in many of the ways I have wanted to, and I have felt an immense sense of loss.

I used to be a world traveler and very active, so I had planned to travel and go backpacking and camping with my son. When I was injured, I was in the process of teaching him to swim, and we’d gotten our bicycles tuned up for some long rides. All that went out the window.

In addition to that loss, I was no longer able to work, which meant that I lost not only my ability to support myself financially but my hopes and dreams for my career. This was also true of my avocations. I had begun a series of watercolor paintings and had some interest from art galleries, but my injury forced me to put that project on the shelf indefinitely.

Anyone who experiences pain over time has stories like these. You feel sadness and loss not only for the time and experiences that are eaten up by pain but also for lost dreams and goals, as if your connection to the future is being consumed by pain, as well.

Following are three suggestions for ways to relieve the sadness and loss inherent in living with pain.

View Pain as a Landscape You're Passing Through

Since pain feels all-encompassing while you are experiencing it (I think that’s why we describe it as being in pain), it’s easy to lose the ability to imagine anything else. It can be really difficult to remember what it feels like not to be in pain.

One day I woke up and realized I didn’t have a sense of a personal future anymore. I had simply stopped dreaming, because it seemed like my life was just going to be an endless stream of days in pain. So I started to think of pain as a landscape that had edges. It had a beginning, therefore it must have an end. Somewhere.

The landscape was nasty, ugly and burned-out, but it was only a landscape, a place I was walking through, not the entire world. I told myself that I would eventually reach other landscapes. I was just passing through this one.

This helped restore a sense of having a future. Soon after creating and working with the various exercises and antidotes in my book, The Pain Companion, I began noticing more green on the horizon of my pain landscape, buds on the blackened branches, and a rustle here and there in the bracken denoting small things coming back to life.

Look for the Gold in the Ashes

I have found it very difficult to deal with the sense of loss I feel due to the amount of time I have spent in pain. I have had to reframe the way I see those years. Instead of representing life lost, they represent a different kind of life, equally valuable, even if I couldn’t yet completely see how.

When I went in search of the gold in all the ashes, I realized that my son had learned some valuable life lessons through my painful condition.

He learned to think about someone else’s well-being other than just his own and not to take life and health for granted. He learned that he was important and his contribution really counted, since I needed his help daily to do basic household tasks.

Living in pain can give you valuable insights. You will be bringing back a greater awareness of what others suffer and greater compassion for others. You can develop a fuller sense of gratitude for all the relationships in your life and a deeper appreciation for your body.

If you decide to delve more fully into the emotional aspects of being in pain, you may find expression for difficult feelings that need to move on. Working through these emotional aspects can allow a greater sense of freedom in life, even while you are still in pain.

Choose New Meaning

And, finally, when it feels like life in pain is meaningless, I remind myself that it is I who chooses the meaning of my life.

I can decide that I have wasted or lost the years I have been in pain, or I can choose to see them as years with a different kind of meaning.

Through my time spent with pain, I have, sometimes begrudgingly, learned a great deal about what it is to be a human being and how to find a deeper sense of an overreaching arc and flow in my life and the value of life’s natural vicissitudes.
(This article appeared in The Edge Magazine and is excerpted from The Pain Companion: Everyday Wisdom for Living With and Moving Beyond Chronic Pain by Sarah Anne Shockley (New World Library, 2018)


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