Living a Healthy Life with Chronic Pain (12 page)

Many people worry about changes in their memory, particularly as they age. Although we all forget things, some people with chronic pain have memory problems that are not a normal part of aging. For people with chronic pain, memory problems may be caused by medications, other symptoms like depression, or other illnesses like dementia. But changes in memory and in thinking can also be a symptom of the pain condition itself. Scientists think this happens because of multiple changes in the brain caused by the constant barrage of pain signals. People with fibromyalgia seem especially prone to problems of memory and concentration. This is commonly referred to as “fibro fog.”

Fibro fog and memory problems related to other chronic pain conditions make it more difficult to complete everyday tasks. You might feel confused. It may be challenging to think clearly, pay attention, remember new information, or concentrate on new things. Although this can be upsetting and frustrating, there are things you can do to manage this symptom.

As mentioned, memory problems can be a sign of other disorders, such as depression or disease, or they may result from some of the medications you take for your pain. Be sure to talk with your doctor openly about your problems with memory, concentration, or thinking. He or she will be able to assess your situation and help you manage your memory-related symptoms.

Not being able to work at one’s occupation is not a symptom like fatigue or depression, but it can be a consequence of chronic pain. A change in your employment status may be one more change in your life that requires major readjustment.

Questions like “What do you do for a living?” or “Are you back to work yet?” are commonly asked in everyday social conversation. When we are not working due to a problem like chronic pain, questions about employment, however well meaning, can be awkward, discouraging, and even infuriating. It’s natural for others to be interested in your work life, but it’s also natural if you become sensitive about the frequent inquiries.

For most people, work is how we define ourselves. Telling others where we work and what we
do has become a standard way to introduce ourselves and communicate who we are. For example, someone may introduce himself by saying, “My name is Joe and I’m the manager of Ace Business Products.” In this scenario, Joe’s roles and interests as husband, father, scout leader, computer enthusiast, and gardening expert are treated as secondary information. When not working we are forced to redefine our lives more broadly, not just by our place or type of employment.

Your reaction to losing employment depends on a number of factors.

• How did you feel about the job?
  Did you like or dislike the work and environment?
  

• How attached were you to a particular workplace?
  How long did you work there? Did you plan to remain there long term? How positive were your relationships with coworkers and superiors?
  

• Do you have prior experience coping with crisis?
  Have you successfully coped with previous periods of unemployment or other obstacles in life?
  

• What is the nature or degree of your physical limitation?
  Are you able to assume different responsibilities or change positions within the workplace or company?
  

• Do you have advanced or special education or transferable skills?
  Are you able to utilize related skills in another position or organization?
  

• What is your financial status?
  Were you in a short-term or permanent position? Did it have disability benefits or a pension? What are your current financial demands?
  

Regardless of your reaction to or even the cause of your unemployment, the impact is significant on many levels. Unemployment challenges your well-being in three areas of your life: emotional, financial, and social.

Figure 4.2
The Emotional Impact of Unemployment

Unemployment has been described as an “emotional roller coaster.” It’s a time when people may struggle with many issues such as anger, loss, hopelessness, and discouragement, as illustrated in
Figure 4.2
.

The stages and emotions in
Figure 4.2
are common to anyone who experiences job loss. It’s a time of challenge and, for some, defeat. Therefore, it is no wonder that emotional reactions are even more complex when chronic pain is part of the equation. Job loss for someone with chronic pain might be a major contributor to anger and stress—key symptoms that we discussed earlier in this chapter. However, by identifying the specific factors that are affecting your emotions, you can become empowered to manage what you can and to learn to live positively with the rest.

The impact of reduced or lost income depends on individual circumstances. Financial constraints may prevent you from providing for basic needs. Car payments, rent or mortgage payments, heating bills, medical bills, and children’s expenses can become great stressors. Or financial loss may affect your ability to accomplish your life goals, ambitions, and dreams. It may create a dependency on family, friends, and systems that you have not relied on in the past, thereby affecting your relationships and your self-esteem.

Changes in employment can alter your interactions with others. When you are working, you are in contact with coworkers, customers, and clients. A large network generally develops through daily conversation, service provision, committee work, and social activities related to work. It is natural to miss this contact when you are no longer able to work. It may become a challenge to avoid isolation and remain socially connected when you no longer are working every day.

Unemployment can also affect family roles and responsibilities. When a parent or spouse is “at home”, the expectations of everyone in the household can change. This is not necessarily negative; it may be an opportunity to redefine
roles in a positive way (e.g., you can spend more time with family or be more involved in household tasks, if you pace yourself appropriately).

Coping with unemployment requires a range of strategies. Many of the techniques to better manage pain and other symptoms can also help you take control of life while out of work. You can:

• Maximize physical functioning through pain management strategies such as exercise, relaxation techniques, improving sleep, and pacing your activities
  

• Work at maintaining personal relationships. Talk with friends and family and try to understand the reactions and expectations of others
  

• Make an effort to remain positive and to redefine yourself outside of work
  

• Commit to a daily routine
  

• Engage in volunteer work to reinforce or broaden your interests, build self-esteem, and gain skills and experience
  

• Seek financial counseling
  

• Develop new friends, hobbies, and interests
  

• Obtain employment counseling from an agency that assists persons with special considerations
  

• Consider a new career path, further education, part-time or contractual positions, or self-employment
  

Living without work, with all its uncertainty and turmoil, is a challenge faced by many in today’s society. If you are out of work, you are not alone. However, being unemployed while living with chronic pain can be particularly difficult. The techniques and skills outlined in this book, along with support from family, friends, and your health care team, will help you meet this challenge.

In this chapter we have discussed some of the most common symptoms experienced by people with chronic pain. In addition, we have described some tools you can use to cope with your symptoms. Taking action to deal physically with your symptoms is necessary for coping with your condition on a day-to-day basis.

But these tools are just one part of managing chronic pain. Every day you will need to escape from your surroundings and experience “your time”—a time that allows you to clear your mind, calm your nervous system, and gain a fresh perspective. The following chapter presents different ways to complement your physical symptom management with thinking techniques—using the power of your mind—to help reduce and even prevent some of the symptoms you may experience.

To learn more about the topics discussed in this chapter, we suggest that you explore the following resources:

Bourne, Edmund.
Coping with Anxiety: 10 Simple Ways to Relieve Anxiety, Fear, and Worry
. Oakland, Calif.: New Harbinger, 2003.

Carter, Les.
The Anger Trap: Free Yourself from the Frustrations That Sabotage Your Life
. San Francisco: Jossey-Bass, 2004.

Casarjian, Robin.
Forgiveness: A Bold Choice for a Peaceful Heart
. New York: Bantam Books, 2010.

Caudill, Margaret.
Managing Pain Before It Manages You
, 3rd ed. New York: Guilford Press, 2009.

David, Martha, Elizabeth Robbins Eshelman, and Matthew McKay.
The Relaxation and Stress Reduction Workbook
. Oakland, Calif.: New Harbinger, 2008.

DePaulo, J. Raymond, and Leslie Alan Horvitz.
Understanding Depression: What We Know and What You Can Do About It
. New York: Wiley, 2003.

Donoghue, Paul J., and Mary E. Siegel.
Sick and Tired of Feeling Sick and Tired: Living with Invisible Chronic Illness
, 2nd ed. New York: Norton, 2000.

Foreman, Judy.
A Nation In Pain: Healing Our Biggest Health Problem
. New York: Oxford University Press, 2014.

Gardner-Nix, Jackie.
The Mindfulness Solution to Pain: Step-by-Step Techniques for Chronic Pain Management
. Oakland, Calif.: New Harbinger, 2009.

Gordon, James S.
Unstuck: Your Guide to the Seven-Stage Journey Out of Depression
. New York: Penguin, 2008.

Hankins, Gary, and Carol Hankins.
Prescription for Anger
, 3rd ed. Newberg, Ore.: Barclay Press, 2000.

Jacobs, Gregg D.
Say Good Night to Insomnia
. New York: Holt, 2009.

Kabat-Zinn, Jon.
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness
. New York: Bantam Books, 2013.

Kabat-Zinn, Jon.
Mindfulness for Beginners: Reclaiming the Present Moment—and Your Life
. Louisville, Colo.: Sounds True, 2011. Klein, Donald F., and Paul H. Wender.

Understanding Depression: A Complete Guide to Its Diagnosis and Treatment
, 2nd ed. New York: Oxford University Press, 2005.

Kleinke, Chris L.
Coping with Life Challenges
, 2nd ed. Pacific Grove, Calif.: Brooks/Cole, 2002.

McGonigal, Kelly.
The Willpower Instinct: How Self-Control Works, Why It Matters, and What You Can Do to Get More of It
. New York: Avery, 2012.

McKay, Matthew, Peter D. Rogers, and Judith McKay.
When Anger Hurts: Quieting the Storm Within
, 2nd ed. Oakland, Calif.: New Harbinger, 2003.

Natelson, Benjamin H.
Facing and Fighting Fatigue: A Practical Approach
. New Haven, Conn.: Yale University Press, 1998.

Rosenberg, Robert S.
Sleep Soundly Every Night, Feel Fantastic Every Day: A Doctor’s Guide to Solving Your Sleep Problems
. New York: Demos Medical Publishing, 2014.

Sobel, David, and Robert Ornstein.
The Healthy Mind, Healthy Body Handbook
(also published under the title
The Mind and Body Health Handbook
). Los Altos, Calif.: DRx, 1996.

Stahl, Bob, and Elisha Goldstein.
A Mindfulness-Based Stress Reduction Workbook
. Oakland, Calif.: New Harbinger, 2010.

Torburn, Leslie.
Stop the Stress Habit: Change Your Perceptions and Improve Your Health
. Bloomington, Ind.: iUniverse, 2008.

Turk, Dennis C., and Frits Winter.
The Pain Survival Guide: How to Reclaim Your Life
. Washington, D.C.:, American Psychological Association, 2006.

Williams, Redford, and Virginia Williams.
Anger Kills: 17 Strategies for Controlling the Hostility That Can Harm Your Health
. New York: HarperCollins, 1998.

Williams, Virginia, and Redford Williams.
Lifeskills: 8 Simple Ways to Build Stronger Relationships, Communicate More Clearly, and Improve Your Health
. New York: Three Rivers Press, 1998.