Chronic Pain is Chronically Confusing
May 16th, 2017 by Dr Karma

Tomorrow I’ll have an impacted wisdom tooth taken out. I’m in agony today, but it took me a long time to figure out what was happening.
This kind of thing occurs frequently: chronic pain causes misunderstood pain.
I have TMJ–a disorder of my jaw joint. There’s arthritis there too. I’m in PT (it helps to keep me eating and talking).
I thought it was particularly bad last week.
And then I thought it was getting particularly worse.
And then I wondered at the pain spreading–making the whole jaw sore.
Last night, I couldn’t read, couldn’t focus. My eye on the right side even started to hurt, from the pressure.
And then a little voice inside my head chimed in: haven’t you still got a wisdom tooth up there? wouldn’t it be right by that joint?
Intense pain isn’t unusual. Today–the day before a surgery–is better than most because I have a solvable problem.
But I’m frustrated that I had no idea how to answer my dentist’s question: when did this tooth pain start?

Below Surface Condition
Aug 10th, 2016 by Dr Karma

A submarine is in surface condition when she has sufficient positive buoyancy to permit running on her main engines. (

“This should take about forty minutes,” says the technician. He pushes a button and I start to slide into the machine. Most people compare an MRI to a coffin, but since I’m not claustrophobic, I don’t quite find that an apt comparison. It is reminiscent of something, however.

I relax. There’s nothing else to do. This is one of the few moments in the day when I cannot do anything but think. Today they are scanning my brain and my spine, but I don’t necessarily want to think about that. I’ve already made the jokes about how they’re scanning to see if I have a brain or if my students’ praises have given me a swelled head. I’m not sure if the jokes are for me or for the audience of my loved ones, but in my family, I know they are a survival strategy.

If we had a family crest, it might well be “And if I laugh at any mortal thing, ‘Tis that I may not weep.” But we don’t have a family crest. And if we did, I would have to invent it. My family doesn’t read Byron, and I don’t think they’d go for something that artsy. Or that honest.

This isn’t the first time I’ve been in one of these. I’ve had several, for different body parts. I wonder if I’ll be able to get the technician to give me a hint. After my first MRI, the technician said “Good luck” with a tone of sympathy I understood when I saw the report, which indicated I needed surgery to remove a herniated disc. Another technician was kind enough to show me the picture of the cyst in my ankle when I asked.

I tend to like technicians more than surgeons. My back surgeon, with the bad bedside manner and the inability or unwillingness to discuss the future of a back with degenerative disc disease, woke me from my blissful slumber with the news that my hernia was the biggest he’d ever seen. “I showed everybody!” he said. He sounded so proud, you’d think he grew it himself. He remarked upon its size three more times before I was discharged that day.

My ankle surgeon, with a name as unique as mine, Scarlett, was nicer, but was also happy when my cyst turned out to be something she’s never seen before. “I had to look it up!” she proclaimed. “I’ll always remember you because of this.”

As I have several chronic, but nonfatal, diseases, I see doctors a lot. I’ve always found it hard to get them to see the pain in me. Part of living with chronic pain and remaining productive is the ability to mask it. Maybe because of my theatre degree, I can do it better than most. The only person I’ve ever known who was able to tell when I had a singularly bad headache was a former boss—she could read eyes like no one else.

I’ve had a headache, one that changes in form and intensity, since I was twelve. It might be due to TMJ, to stress, to muscular problems in the neck, to the twisted vertebrae there, or, more likely, it is the product of all of these things. I only say I have a headache when I have a guillotine day. These days find me daydreaming of guillotines—of the cold metal relieving the pain by removing the offending part. Guillotine days find me unable to concentrate. The pain reduces my abilities to move information from one synapse to another. I take enough drugs to kill animals bigger than I am. I worry when my breathing slows. I wonder how the medications can be shutting down vital systems while not even taking the edge off the pain. Over the years, my tolerance for these has become dangerous, yet they have not yet put me on anything effective enough to cause addiction.

I can understand their reluctance—we are currently in a political climate where Americans in pain cannot be given anything strong enough to help, unless they’re Rush Limbaugh, because they might become addicted, like Rush Limbaugh.

And I’m young. When I first tried to tackle this problem, one doctor dismissed me completely: “You’re too young to be in that kind of pain.” I agreed, but I still was.

I have had my eyes checked; I have a weekly massage; I do yoga; I take painkillers; I am regularly chiropracted; I have tried cranial-sacral therapy; I have tried herbs; I have tried acupuncture. I even allowed one healer to lance and cup me. When I was younger, and a Christian, I was prayed over. My headaches were attributed to the devil and I underwent Deliverance, the Protestant form of exorcism. It did not deliver me. At home I have various massage toys, a TENS unit, and something that gives electrical charges to my shoulders in vain attempts to make the muscles release.

When one chiropractor I dated proposed after two weeks, I was sorely tempted.

Despite all of this, few people have caught on. It took one practioner several months before he diagnosed me: “The more you’re smiling, the more you’re hurting.”


Lying restfully in the machine, I listen to the different noises. Occasionally, when they hit a certain frequency, I can feel it in my thighs. Other frequencies resonate in my hands. Being in the machine is like living within a loquacious tube that talks in fire alarms and sirens. One of the noises is a pinging. It reminds me of naval movies, and I realize that this machine is more like a submarine than a coffin. Ping. Ping. Ping. The pinging of the torpedo on radar is frequent—the missile is close, but is not coming closer. There is prolonged, impending contact.

It occurs to me that only 10% of the submarines in WWI ever returned home. What relief they must have felt, coming up into the light.

I never cry in doctor’s offices; I save that for when I walk outside, putting my sunglasses on in the inevitable glare. Crying has only happened three times. Once, when a doctor told me that perhaps I should be evaluated for fibromyalgia. My doctor friend told me that fibromyalgia was code for “hypochondriac” in files. Because doctors don’t understand it, it doesn’t exist. Restless leg syndrome did not exist until there was a cure. Yet part of me longs for the fibromyalgia diagnosis. Maybe I could tell myself to take more time off; I could become Flannery O’Connor—sickly, but writing. In my imagination, she is praised for simply getting out of bed every morning, because people understand that what an achievement it is. She has a condition, and there’s great power in naming it.

At one point, I was referred to a neurologist. He put me one medication after another. They constipated me (no one ever warns you about that). After four, he told me that there’s nothing more to try and that he was retiring, anyway. I repressed the urge to question his field—they only have four drugs? I asked him what he was going to do with all that free time. I pretended that he had not just crushed me; that I did not feel abandoned. It took a few minutes of crying in the car before I could drive home.

A year or so later, my primary care physician sent me to him again–he was seeing patients in retirement. I told my doctor the other doctor had given up on me; he couldn’t believe that was true. And then I was greeted with, “What are you doing back here? I told you I can’t help you.”

When I was a graduate student, I was sent to a specialist in neuro-muscular pain. He examined me briefly, told me he was worried about my bitten nails and cold skin. He informed me that there was no reason for me to hurt and suggested I try past life regression therapy. I thought at first that he was making a joke about my name, but he wrote the name of a book on his prescription pad. When I looked at the nurse, she seemed bewildered, but would not meet my eye. I did not understand how knowing that my skull was crushed a few hundred years ago would take the pain away, but I read the book.

I went to a psychic, who told me that one of the women my father cheated on my mother with put a curse on us when I was a baby. She could take it off for $2000. As she was Catholic, she did not believe in past lives. After paying for the consultation and being blessed with holy water, I went home and cried at the absurdity of it all.

Remembering this, I start to tear up in the MRI machine. Crying doesn’t count as moving, but wiping the tears would, so I stay motionless. Saltwater fills my little sub. I have stopped by the time it’s over, when I am moved back into the light.

“See anything interesting?” I ask, feigning disinterest.

“I don’t read them.”

I look into his eyes, but I can’t read them, either.




(I wrote this piece half a decade ago, but realized I’d never shared it with you.)


2013 End of Summer Wrap Up
Sep 28th, 2013 by Dr Karma

It’s easy to get discouraged these days.

I’ve had a bad headache for almost two months now.* It’s exhausting. Eula Biss, in her essay, “The Pain Scale,” argues that one of the worst limitations of how we measure pain is that we don’t have a metric for how long it lasts. I’ve gone through the summer without a break, and I’ve been sort of beating myself up because I don’t have any more money than I started with and a lot of “to do” list things didn’t get done. And my oven broke about an hour ago. Flames shot out of it.

Thus, I have had to give myself little lectures on what got done this summer. They help.


I taught four classes (successfully).

We judged the Prized Writing submissions, then I edited the publication, and now it’s out.

I prepped my five Fall classes.

I served on two Campus Book Project committees.

I paid the “pay off the credit card in three years instead of a billion” amount.

I was given a new crock pot, and I tried out a bunch of new recipes.

I got two new kitties.

I fixed one expensive thing on my car and two on the boy’s.

I went to London to be in the wedding of two people I love dearly.

I spent quality time with my son, my friends, my man.

I’ve done a lot to try to make this headache go away–switching drugs (including going off the one that caused hallucinations), massage, chiropractic, physical therapy, lots of doctors’ appointments.

I went to Ashland with Vanessa and Kevin, where we had good food, good drinks, and saw five amazing plays in three days (The Heart of Robin Hood, A Midsummer Night’s Dream, Cymbeline, The Tenth Muse, and King Lear).

My fractured tailbone healed.

I kept the house reasonably clean.

In addition to the plays I’ve already written about in past blogs, I saw Patrick Stewart and Ian McKellen and Billy Crudup in No Man’s Land (not my favorite play, but it didn’t matter!).

I chose essays for an edited book proposal I’m about to send off.


There, now I feel better. Time for more painkillers.





*For those who don’t know, I have a low grade headache every day. This has been the case since I was 12. It’s always there. All of my treatments over the years are to minimize the days it’s bad–the days it’s debilitating–the days I identify which muscle groups I would like to inject with some miracle that would make them release–the days I fantasize about guillotines. It’s been almost two months now of those days.

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