Ballet has long been my portal to a happier place. While dancing, I can keep my head in the clouds and my feet firmly connected to the ground. But in 2009, ballet betrayed me. After a few years of warning twinges and soreness, a major ligament in my right hip ripped in two. My labrum was also torn, and there was a mess of fibers embedded deep within the tendons surrounding the joint.
Imagine a serrated knife slicing against the grain of a grapefruit, juice and fibers erupting like a volcano out of its fleshy core. That is what a split jump (grande jete) feels like when a ligament in your hip ruptures.
And so began my odyssey into pain management.
While waiting for surgery, I experienced suicidal ideation on a near-daily basis.I had no quality of life: I couldn’t get that gnawing rat out of my hip. When I moved, the rat metamorphosed into a shard of jagged glass, grinding my flesh into shreds. Sometimes I thought I might be hallucinating, the pain was so bad I thought perhaps I had already left my body and I was simply pain itself, a throbbing, writhing, hopeless embodiment of a condition, not a person at all anymore.
Comment: this is an insightful and frighteningly accurate description of what chronic pain does to a person
Eventually I had a lengthy arthroscopic surgery, which I was damned lucky to have the insurance to pay for. There was some immediate improvement.
There was also hope: yes, recovery was a long process — it took six months to get off crutches alone — but there was light at the tunnel’s end. Eventually I’d balance on my own two legs, I’d turn and jump once more and I would be free from pain.
Wouldn’t I? Yes and no.
It’s been six years since my surgery. I’ve subsequently endured a pregnancy on a gutted hip and three and a half years of carrying a child on that hip— yes, the bad one because I can’t seem to balance a kid on my left side. I’ve been under the ministrations of many physical therapists who knead and rub and press my mercurial, angry psoas. The psoas is the Sunset Boulevard of tendons: It is endless and wraps around so many major routes of the body that to suffer pain and weakness there is to live with a body in revolt against walking, breathing and serenity.
They sigh, they shake their heads and say that soft-tissue damage and repair often leaves a person with residual pain.
There is nothing left for a surgeon to do, except to wonder why some people’s pain pathways are more persistent than others and why some parts of the body regenerate and some don’t.
I’ve been back in class for a few years, but the rules have changed. I don’t allow my body to release all the potential energy that once made my jumps explosive
What I can’t do is stop dancing. Even if I could bear to give it up, I would relinquish my health if I were sedentary. Exercise is one of the most important weapons we have against life’s most common ailments. And every form of exercise exerts pressure on my weakened frame. Here lies the pain management conundrum.
So six years after my injury and surgical odyssey, I am still going to my pain management appointments, discussing prolotherapy and cortisone shots and vitamin D intake and NSAIDS and Pilates and yes, opioid use with my rational, caring doctor. There is no solution; there is only management.
Opioids are under intense governmental and social scrutiny right now, as the media reports on an epidemic of addiction. I read about cases of lost souls, overdoses, suicides, black market pills, portions of towns laid waste by narcotic abuse, and I worry. I worry for the addicts, but I also worry for those of us who would not be able to carry on without responsible pain management.
Tramadol, in small amounts and scattered carefully throughout the month, is a part of my regimen. So too are very hot baths, mineral ice, cortisone injections, ice packs, stress management (um, exercise) and modifying my plans on a daily basis according to my pain level.
I never take more than one Tramadol in a 24-hour period. Why? Because I learned very quickly that the second dose never works as well as the first
Also, the longer I can go without opioid use, the more I can count on it working when I desperately need it. I have much motivation to avoid using the pills. This makes me lucky: The side effects stand guard against addiction.
Still, if I didn’t have a small bottle of painkillers in my drawer, I could never risk exercising or even walking down the street for more than a few blocks. I would live a life of inhibition and confinement, instead of the life I live now: one filled with movement, dancing and meaningful work, with love, child-rearing and long walks in the park.
As society wrings its hands over allegations of doctors handing out pain pills like candy, or over the rise of pharmaceutical companies and their “evil empire,” my feelings are—to say the least—conflicted. I understand why I must submit to the urine screen and to the signed agreement that gives my doctor and my pharmacy the right to share all my records and communicate with other computers in a vast network monitoring controlled substances.
It’s humiliating and it feels personal, but I know it isn’t.
How does society sort out the responsible drug takers—who depend on small doses of opioids to live functional lives—from those who are abusing drugs? I suppose by monitoring people like me: by counting my pills and watching my pharmaceutical records.
Each time I take my painkiller prescription to a pharmacy, I can’t help feeling suspected of a crime.
I’m grateful for a doctor who knows my pain is not manageable without the intervention—at select times—of opioid use.
No one else can feel what someone else is perceiving, and that most certainly includes pain.
My doctor has evaluated me and concluded after a year of watching me and listening carefully that we can manage the pain—together, imperfectly, and with the help of a highly controversial substance.