How I am overcoming chronic pain (and morphine) with physical fitness.
I had brain surgery and a stroke on the same fateful day. Had a ‘bad spot’ removed, a raspberry looking blood vessel, (called cavernous hemangioma by medicine), which might pop. Good news, mostly. But that day messed up my life. The stroke was bad news. I lost a calling I loved, along with 65% of my families income. The last seven years have been one of the great challenges of my life.
That traumatic brain injury left me with Central Pain Syndrome, a burning, (like shingles burning described on TV), on the entire right side of my body for the rest of my life. As many as 7% of stroke victims are afflicted with CPS. I battled deep anger (I was not told of the stroke until nine months after it occurred, when the pain overwhelmed me), leading to years of suicidal battles.
And then five years of needing 2.5 times the recommended daily dose of extended release morphine just to continue to work 1/3 the hours I used to (20 instead of 60) If a person who never used opiates took my daily dose at once, they would most likely die. I am simply not able to move much because of excruciating, intractable pain. The farthest I managed to walk was 400 meters every now and then. After an exertion like that I would be laid up for 3 days. Two years into all this I began feeling brutal pain in my right middle ribs, like somebody punched or kicked me, a broken bone! My liver, rib bones and nerves were checked, everything ok. The pain was a new part of CPS, and I still feel it right now. Dealing with pain is a big part of my life, like it or not.
On Father’s Day this year, I finally decided that I must take some serious steps to make a good finish of the 55 years I have already clocked in. I thought these years would be the best in many ways. I am a grandfather! So far, they have not been the best. Time to fight back.
I quit morphine that day, cold turkey. The next three weeks of detox were brutal. Could not eat for 2 1/2 weeks. I decided to try using physical fitness as a method to deal with my chronic pain, to replace much of the medicines needed to go that route. Instead of large doses of prescription pain medication, testosterone boosters, and anti-depressants, I would try working out (gently at first, with lots of hot tub time during detox). That would be my medicine. If I could slowly improve my actual physical health (as I did much of my life before the brains hit the fan), many other things might improve.
My ‘breakthrough’ came when my doctor and psychologist both said, “really, the nerves, bones, muscles, skin and blood system on the right side of your body are perfectly healthy”. The pain is occurring in the ‘bad spot’ on my brain, not from the nerves themselves. In other words, I feel like bad sunburn all over and a kick in the ribs, in my brain, not because I have those issues physically. So I could actually exercise pretty strenuously, if I could overcome in my mind, the feeling that rose up when I move. I knew that, but I didn’t know how to deal with it.
Seven years later I am finally making progress. Call it ‘mind-over-matter’ or spiritual breakthrough, I don’t know, but I have been training, working out with a strategic focus, to re-enable the very real disability that was slowly killing me.
While enjoying this breakthrough I have learned some important things regarding physical fitness:
1. Superhuman strength can be found -I am able to increase my performance by altering my physical perceptions. Like the man who lifts the car under which a child is trapped. Superhuman strength (beyond my very human minimum) is still available. The limitation of a even a well-trained body is the brain. People are now running 100 mile marathons! For the inactive, even moving a little is against what the body is adjusted to. I use skills like ‘positive self-talk’ and other sports psychology methods. “Right foot, you are lieing to me! That pain is not really there. I can walk as far as I want to!” Exertion feels like pain, until we raise our physical capacity. But we can overcome the pain to push to fresh levels. Momentum in health is important after we have been stopped in our tracks for a while.
2. Flexibility is very important — If I could only do one (minimal) form of exercise (when I’m 95!) I would focus on flexibility. Use dynamic warmup (stretching with motion, watch any pro team get warm) before and after on workout days, with static exercise, sweet stretching (flexibility) on days between. In my rehab I did flexibility training for six months (stretching on the floor twice a day) before I broke out and added strength and endurance exercise. We can walk with increased poise and fluidity, with improved posture and comfort in everyday exertions.
3. Consistency way more important than ferocity (working out ‘hard’, killer workouts). Ferocity can lead to injury, slowing down progress. Measured ferocity can be held for tough reps, intervals are huge for progress (29…come’on…. 30 UuuUgh!). Workout at least 3 times a week, but if we can only do one, do it every week as consistently as possible. Soon after two-a-week becomes consistent, then more reps can slowly be added. I now have to do something everyday, my body craves exercise: stretching day after weight training, long swim after day off, nice weather: bike ride and kayak etc. Trainers say it takes two consistent years to see solid fitness achieved. I’m just in my 5th month, feel much better! Hope to look back after two years and rejoice at continued improvement.
4. Play Games — Find some fun but physical activities to provide workout options. Tennis 2x a week, with bike ride or walk on other day. Options give us healthy choices, helps us to ‘do something’ on tired or bad weather days. Avoid boredom, have fun. I love my bike and my kayak. I have challenged my 33 year-old son (who rides his bike 150 miles a month in summer) to a tennis match. Having fun with a little exertion is a great cheat (instead of beating ourselves with weights and cardio).
5. Keep it as simple as possible-We don’t need fancy machines (we can rent them at a gym- love the back extension machine!). But, simple dumb-weight, jump rope and floorpad is all we need. ‘Body-weight exercise’ can be done with no equipment at all. Use lifting or holding the weight of your body to gain strength and endurance. Push-ups and crunches are common examples, but there are many others. SEALS excel in this, able to hold pushup position for hours! So, keep it simple and enjoyable. I get into a stomach crunching position and hold it, image of a Survivor challenge in my brain, who can hold it longest? Oh, the Plank, I love it: (Lie prone on the floor with feet together and forearms on ground. Draw abs in and tighten glutes. Lift entire body off the ground until it forms a straight line from head to toe, resting on forearms and toes. Hold. Slowly return body to the ground, keeping chin tucked and black flat.)
6. Menu — What we ingest is huge for health and fitness, some say 80–90% of total achievement. We are trying to eat ‘real food’, fruit and nuts and vegetables. Fish and chicken and eggs and cheese. Less fast food and processed food. Less sugar. I’m trying to be a better chef, cooking great meals, with less fat and sweet. Basic training target is: Carbs in morning and mid-day, and protein later in day. No eating within two hours of sleep.
7. Sleep is critical to great health-Some professional athletes average 10 hours per day. We need to work at this, it is 1/3 of our lives! More time in bed, best bed you can afford. No TV, even reading can keep us awake. If trouble sleeping, exercise (stretching or swimming) later in day, get tired. Or try exertion (even 15–30 minutes) twice in a day, then sleep well! Find a way to sleep as long and as many nights as your body truly needs. Use sleep tracking technology to improve. Some say you can’t ‘catch up’, but if you can only take a nap on Saturday or Sunday, I say enjoy it! If we can get enough healthful sleep, with a full cycle, waking up without an alarm, feeling well and fresh, we are ready to workout and eat right. Good sleep is a foundation for wellness.
8. Breathing is Life — Of course, if we stop breathing we die! Many studies show though, that without significant cardiovascular training our lungs deliver less and less oxygen to our bodies, and are less efficient in breathing out carbon dioxide, as we get older. Our lung tissue and even bone and muscle tissue decreases in strength. But now we can use controlled breathing to improve our training capability, and more importantly, our sense of health and well-being. Simple example is weight training. We breathe in as we let a weight down, then breathe out smoothly as we push the weight back up. Swimming I take two strokes then breathe, then count four, and breathe. We should think about how we breathe when walking, and yes, while we make love! All can be improved with thoughtful breathing. Not weird breathing, just straightforward athletic training, increasing our maximum oxygen capacity. Right breathing in training leads to more oxygen always. Most important thing learned: when I stretch and a muscle and joint burn I can breathe and have lactic acid moved out of my body. More oxygen is a very good thing.
9. Sabbath the Body — Recovery is a huge part of improved physical fitness. Muscles do not increase in strength and density while working out, it happens in recovery. So, even an active athlete, must rest at least one day each week. Taking time for hot tubs and sauna, sexual enjoyment, even quiet stretching and other physically relaxing activities help accomplish recovery. Eating right (more protein), helps to provide nutrients for rebuilding muscular strength (density, not mass). So, besides sleep, a day of rest is a must. And sometimes, without feeling guilty for interrupted training, we should take a couple of days, especially when muscles or joints need time to feel right. I make those ‘stretching’ days, but even then make it easy and quick.
10. Endurance Adventures — once in a while I push myself beyond what is safe, or expected. Paddling 14 nautical miles, five hours of kayaking in open salt water (crossing the Hood Canal to get a latte at Pleasant Harbor!), swimming a mile for the first time (working on 2 now), walking much farther than daily walk (7.5 miles, 96 degrees, Houston TX), and paddling down the beautiful Skagit (bounced around pretty exciting by some easy Rapids!), that was my action summer! These exercises taught me that I can do more, more than the average man (when I tell people about these adventures they say they need to get back to the gym!), and much more than my former out-of-shape-sicko man-wannabe. These are endurance milestones, letting me know that when I push myself I can grow in every way. Plus, it can be exciting and joyful. It may be walking around the block more than once, but we feel achievement.
People ask me if the pain has gone away. No, it has not changed, best I can tell. All that has changed is my method of coping with the pain. I use one medicine, called Gabapentin, which came before Lyrica, advertised as the anti-shingle burning medicine. It does help, with few side effects. Instead of using chemicals which overwhelm the brain, I am attempting to retrain my own brain! That is my new recipe for overcoming chronic pain.
I will never forget climbing Mt. San Gorgonio near LA, my family town of San Bernardino, 11,000 feet, 28 mile total, in one day, July 2nd, 1982. We went up to where breathing was a huge challenge, saw the Pacific Ocean, Mexico, and the Mojave on the same day (one amazing view!), climbed down waterfalls in the dark, and have a great story to tell my grandson. We can find adventures and risk our fitness, really put it to the test. That is what keeps me going. I’m going to climb a mountain with my son and grandson.