(Nothing in this post is put forth as an absolute. I stand behind what I say here simply because I have seen time and again how this all comes into play in the lives of so many different people I have been honored to have been a caregiver for. Being an RN for 38 years has taught me, above other things, that each individual is different and while some of what they were dealing with could be covered by the generic approaches given in books and seminars, without the effort to apply that information to the specific individual in front of me, my experience was more often a tendency to have to deal with hurt feelings and lack of participation in self care due to miscommunication. Being able to hear what the "problem" patient is saying is a lot more helpful in the long run than butting heads simply because we assume they are a "problem" patient. They may indeed be an unpleasant individual who will be unpleasant no matter what we do, but again, my experience has been that is the exception and not the rule. Most folks were simply in pain and feeling no one was listening to them.)
Pain should not be measured in a way that one person's pain competes with someone else's for a spot on the podium. Each individual deserves to have their pain evaluated based on how it effects them. These days, however, there is a tendency to judge the pain of others the same way we judge a beauty contest. Who gets the highest total score, wins.
Triage is a valid concept when there is limitation of resources and far too many in need of them. The classic situation where one solder is given morphine to reduce his pain but does not get further attention because the odds are high he is going to die even getting additional medial aid at the time, but another is seen to have a higher chance to survive if the resources are spent on him instead. If there are enough resources available for both solders, most of us would see it as negligence or malpractice to use the process of triage to allot medical care. It is a necessary ugliness of life that triage needed to be developed in the first place. How one sets up the protocols for determining who gets the care and who doesn't will always need to be reviewed and revisited. But I digress......
Your pain may indeed be having a much more drastic effect on your life than mine does on mine, and there may come a time when that needs to be added into the equation of when to focus on yours, more than mine, when both can't be treated equally. But it is my view that such times are less prevalent than some would like us to believe.
There is also the element that some pain truly is the "normal" aches and pains that go along with certain times in our lives. Changes in our bodies as we age, requiring us to make changes to our daily routines. A 70 year old struggling with chronic pain is not the same as a 70 year old dealing with the "normal" changes that can go along with the aging process. I use quotation marks for normal as not every 70 year old experiences life the same. Some bodies are better able to keep going without the slowing down, lack of energy, loss of balance others experience. If you are in your 90's and still able to hang with the big dogs, praise be, but others of us are not. That, in and of itself, is not a given for anyone. Diet and exercise can indeed make a difference, but not always. I know folks who did everything "right" to take care of themselves and ended up in really bad shape, and I know folks who did everything "wrong" to prevent problems in their later years, and are doing great. But again, I digress......
Chronic pain is the topic I want to focus on here. It can happen to anyone at any age. It's not the same thing as growing old, although it does seem to appear in a lot of elderly folks. But if we discount the chronic pain of our elderly friends as "growing old," we fail to understand what they are dealing with. So request number one is please don't assume that chronic pain is the same as "normal" aches and pains that can accompany life's changes.
Second, the longer someone deals with chronic pain, even "mild" pain, it can wear down their ability to deal with other mishaps in their life. Their ability to control emotions can be weakened and they can be quicker to snap at things that prior to the chronic pain were very easy for them to handle. Throughout my nursing career I was very good at handling stress brought on by other people acting out in the health care environment. My peers would call on me if such situations arose because I did have a way to deescalate situations quickly. After 6+ years of constant 24/7 back pain, I no longer have that skill at my command. If I'm doing ok at the moment it happens, yes, I can still pull it off, but most of the time my own fuse is so short that I have a greater chance to escalate things far more than deescalate.
Add into the mix ANY previous personalty traits the individual had going for them, (or maybe against them), and whatever "normal" changes they might be going through, and it can indeed seem like they are a completely different person. I am just now, at 70, learning to talk about some of the coping skills I learned to develop in order to survive the previous 70 years. Some healthy, some not so healthy. While it is still my responsibility to learn new ways and adapt old ones in order to deal with things in as healthy a way as possible, understanding what might be going on when you are dealing with somebody who has chronic pain, can help avoid some complications in our personal interactions with each other.
Closing this post for now, one the things I am finding really can tilt my being calm is the frustration I feel when I have enough energy to go do something, but expend it all in the process of getting ready to be able to go and do it. I have to prepare in advance for doing many things. My energy level is really crappy these days. If I go shopping, I often find I can do nothing else for the next few days. Same with going to some public activity. This results in me doing less and less due to a tendency to get overwhelmed emotionally when worn out physically. Some days I can take a shower and have enough energy to take in a basketball game that my granddaughter is in. Other days I have to make sure I get the shower in the day before or else I do not have enough energy to also go to the game. A "simple" solution might be to move into an assisted care facility of some sort, but that's another whole can of worms I don't want to open at the moment, maybe some other time.
