The Painful Wake-Up Call
Being awakened by pain is often unavoidable. Rolling to one side or the other or just lying in one position too long can cause painful wake-ups. How you respond to this wake-up, however, will determine what happens next. Getting upset, agitated, or frustrated will simply make it that much harder to relax and go back into sleep. Try not to let that happen. Utilizing relaxation techniques at these difficult moments can help minimize the impact of the painful wake-up and lead to a much better night’s rest.
Gerald came to see me three months after he slipped and fell while on the job in a department store. A customer had spilled a drink only moments earlier on the concrete floor, making it slippery, and Gerald had taken a hard tumble. Luckily, he didn’t break any bones, but by the time Gerald came to my office, he was hurting all over. On his pain diagram, Gerald drew “Xs ” on his trunk, back, neck, and all four extremities. He also complained ofpain around his right ankle, left knee, lower back, right hip, neck, and left wrist.
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Gerald had initially gone to an urgent care center, where X-rays were taken of any areas that were symptomatic. The doctor told him that all the results were negative, but because he kept hurting in so many places for so long after the accident, Gerald grew increasingly worried. By the time we had our first meeting, he was wound pretty tight and urged me to order five different MRIs—for his right ankle, left knee, lower back, neck, and left wrist—and refer him to a neurosurgeon, an orthopedist, and a podiatrist, right away.
Gerald’s situation was complex: He was symptomatic in so many different areas, the pain in each of those areas could negatively affect the others, and he was very anxious. It is challenging for a doctor to get a handle on complex presentations like Gerald’s, and I can tell you that no insurance company wants to approve five MRIs and three specialist referrals right out of the gate. I needed to come up with a plan agreeable to both Gerald and his cost-conscious insurance company, one that would also lead to a successful, timely recovery.
The American health system is confusing, costly, riddled with contradictory advice, and designed to whisk patients through exams, procedures, and hospital stays as quickly as possible. That’s because, in most cases, the faster the patients move through the system, the more money everyone else makes. Unfortunately, speed doesn’t always equal success, especially in cases of chronic pain, which are usually layered like an onion, with problems at the physical, spiritual, and emotional levels.
Some of my patients have said that being “in the system” is like being strapped on a conveyor belt and worked on by one doctor after another, stopping only a few moments at each station before being whisked on to the next. “One doctor tweaks me here, the next one there, and I just roll on by,” one patient told me.
This approach may be fine for manufacturing cars, but unfortunately you can’t manufacture recovery or relief from chronic pain.