‘Make an Appointment to Worry’

Edward Michael Supranowicz is the grandson of Irish and Russian/Ukrainian immigrants. He grew up on a small farm in Appalachia. He has a grad background in painting and printmaking. Some of his artwork has recently or will soon appear in Fish Food, Streetlight, Another Chicago Magazine, The Door Is A Jar, The Phoenix, and The Harvard Advocate. Edward is also a published poet who has been nominated for the Pushcart Prize multiple times.

Make an Appointment to Worry

Two facilitators passed out papers and markers, for name tags. I wrote my name in huge blue letters. I looked around, I was the youngest in the room by a generation. The people I saw had walkers, wheelchairs, one even had a partner there to help write. I had finally gotten a referral to a pain clinic. But before I could even talk about medication, I had to take a class about pain and pain management. I confess I was insulted. I could run a class on pain.

"Let's do some introductions and get to know each other," they said. "If you're comfortable, you can tell us a little about your condition, like when your pain started."

The elderly patients talked about fibromyalgia, arthritis, Ehler's Danlos, Lupus, cancer, injuries that refused to heal right. They had been in pain since they were 40 or 50.

"My name is Katie, I've been in pain since I was ten."

It's not like people were talking over me, they were respectfully quiet. But when I said that, they were stunned quiet. "I was diagnosed with endometriosis at the age of 25."

I think then it was confused silence, but I was used to that. They passed out binders with worksheets. The cover featured a photo of an elderly couple walking happily with a cane in one hand and a leash to a basset in the other. Actually, all the photos featured happy white-haired folks. We flipped to What is Chronic Pain? Can I test out of this? Because I'm well-acquainted. I'll never forget the first page, a double-sided justified list of "200+ ways to reduce your pain."

Imagery. Music therapy. Self-hypnosis. Fresh fruits and vegetables. I wish I was making this up. Drink water.

"Acute pain lasts for less than 3 months. Chronic pain lasts longer than 3 months." Rocking. Smooth Move tea. Treat side effects.

"Your brain reacts the same way to acute and chronic pain. Your body sees harm and pain as a threat. With chronic pain there's no new harm, but the nervous system has changed, you can see changes with an fMRI."

Cranberry juice. Share a memory. Puzzles. Frozen Dixie cup massage.

"It's important to try to intervene in pain."

Oh my god honestly? I'm TRYING. Treat anxiety. Treat depression. Discover and seek your passion.

"The altered nervous system can get you stuck in fight/flight/freeze."

Family therapy. Vitamin C. Make an appointment to worry.

"Your sympathetic nervous system..." is what activates fight-flight-freeze, yes I know.

"So you need to trigger your parasympathetic..." to activate feed-breed-rest-digest. Yes, I know.

"One way to activate your parasympathetic nerve system is through diaphragmatic breathing."

Body awareness. Delegate responsibility. Take a short walk.

"Let's all sit up straight and breathe out. Now we're going to breathe in for a count of four..."

Use a wagon to move gardening supplies. Peppermint. Loofah sponge.

"Hold your breath for four. One, two..."

Oatmeal biscuits. Pedometer. Distraction.

"Breathe out for four..."

Develop a positive relationship with your primary care doctor.

Yeah I fucking tried.

Say thank you. Respectfully, No.

"Hold for four seconds."

Lava lamp for relaxation. Appreciate nature. Ground flax. kp.org.

"Now take a moment to check in with your body. How do you feel now?

Displeased, thanks for asking. See, I said thank you and I still hurt.

Assertiveness training. Learn anger management.

"Ok we have a video to show you. You're going to see someone who is very knowledgeable about pain and its effects on the body." Yeah, in a mirror. Get a pet. Get/give a daily hug. Set realistic goals.

"This is a brief Ted Talk by physiotherapist Dr. Lorimer Moseley at TEDxAdalaide. He and Dr. David Butler wrote the book Explain Pain." Volunteer. Draw a picture. Forgive.

He describes the way signals go from your body to your brain, about nerves and neurotransmitters. Says that pain happens in the brain, not your body. Pain is a result of messages out of balance: your body feeling endangered or feeling safe. When danger signals outweigh safety, the result is pain.

Let go of shame. Support group. Refuse to feel guilty.

"Dr.'s Moseley and Butler designed an accompanying text for monitoring your pain levels and factors that can lead to your pain, it's called The Explain Pain Handbook, Protectometer."

"If anybody wants to look at it," I pulled it from my bag. Full of bright illustrations, charts, and a fold-out page for laying out factors in your life that contribute to messages of "Danger-In-Me" vs. "Safety-In-Me." Complete with color coded sticky notes, which you would use to weigh these factors and rate your pain... on a scale of 0-10.

Make a list of free or inexpensive activities that bring you joy. Protein shakes. Grow your own food.

"Thank you for bringing that to share with everyone. Can you pass that around?"

Vitamin D. Lose weight but don't skip meals. Hold hands.

"Let's practice something you can do this week. Go ahead and sit up straight and put your feet on the floor directly in front of you."

Realistic expectations. Rediscover a hobby. Practice saying no.

"Gently lift your left foot, just enough to move it. Slide your foot forward and back, drag it across the carpet."

Control fears. Smile. Sing.

"Great, we're just warming up those leg muscles, let them know we're gonna get up."

Overcoming Insomnia program on Kaiser Permanente website.

"Return that foot to a resting position and do it with your right foot."

Help someone else. Practice effective problem solving. Laugh.

"Can you feel your thighs warming up? They're ready for you to stand. See how much more secure that feels?"

Tush cush. Chair dance. Purchase a small timer.

"Let's look at the worksheet for Developing my Care Plan. Use this to describe your goals for managing your pain more effectively. What will you do, and when?"

Affirmations. Make an appointment to worry. Foot massage with shoe box full of marbles.

I made it to page 30 of the Protectometer Handbook. The one titled "Will I get better?" with an unequivocal, unrealistic "Yes" printed in red. Make the system work for you. It was an 8 week class. $55 copay each week. I didn't go back. Visualize success.

Katie Pippel is a resident of the Pacific Northwest and is an English Language Arts teacher, artist, and dancer. Her writing is shaped by her experience with chronic illness, specifically endometriosis. She endured 4 surgeries in her treatment, including a hysterectomy at age 31. She hopes her writing contributes to the rising tide for this debilitating disease.