![]() I'm nearly 47 years old. I've been living with chronic pain since at least 1995. I question - on a daily, hourly basis - how much pain I'm in. What can I do at the moment? Do I need to rest? Do I have the energy to talk, do a chore, play guitar, check emails, write a report, go in to work. For the last 6 months I've been recording my AM/PM pain levels in a journal. I use a standard 1-pain scale (1. least imaginable to 10. worst imaginable). I've found I basically score myself as 5-7 on a daily basis: 5: Able to handle the pain and do regular activities 6: The pain is interfering with activities but can still work as needed 7: Work is really difficult - take day off or avoid if possible I average maybe a full 7 every 1-2 weeks. But it is subjective and I have maybe two or three 6/7's every week, The main stress, apart from the simple discomfort, comes from duties and expectations - mostly my work. If I don't do a good job, or take hybrid days, I feel I've let people down. But I'm averaging 2 sick days a month (7's), and this creates considerable financial impact. With a daughter going to college, and wanting to provide for vacations, etc., I've taken on some extra hours via remote work, which is much more manageable on bad days. When I look back over the past year, the past five years, ten years - I find it hard to accurately assess how much pain I was in. The depression has come and gone, and with it my ability to cope. There have been times of considerable pain, but if my mood was good it didn't seem as bad. And when my mood is down, the pain is always worse. This has always been the fundamental predicament - not only having to assess my pain level at any moment, but how much it is affected by my mood.. What is my pain? What is my mood? I referred to gaslighting in a recent post, and this gets at it: even in pain, voices (my own, as well as from society) tell me to cheer up, as this will reduce the pain. When the pain doesn't reduce, then I'm not being cheery enough. It literally feels as though someone is telling you to smile while the thumbscrew is tightening. I realize there is truth to this, and apparently research bears out mindfulness techniques. But what is the ethically appropriate level of work one ought to be asked to do when in pain? On one level, there is a preventative aspect to "pushing though it", in that find a way to engage in activities when in pain can ultimately be fulfilling and provide a happier life. But the opposite can also be true: by forcing myself to work when I am in pain, and deal with the stress and anxiety about bills and social expectations on top of that, can make for an unhappier life.
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