Positive thinking or denial... .

Earlier tonight I had a discussion with a friend who told me she was very concerned that I was still taking drugs at this point. "That's not normal," she said. I haven't taken a survey. But I suppose it's probably not normal to still be needing pain medication five weeks after the surgery. That is to say, it's probably not average. But what is normal when you have the knee replacement?

Yes, I still have pain. I don't like to dwell on it. But it is fairly substantial. Which is why I'm taking drugs.

But yes -- I worry too (unfortunately I'm not taking enough drugs to send me off into some never never land where I have no idea what's happening): What does this pain mean? Is something wrong? I mean is something structurally wrong with my prosthesis? Is there an undiscovered infection? Has it slipped? I don't even know all the things that can go wrong. Because I haven't dwelled on them.

I'm not so worried about becoming a drug addict; I'm pretty well monitored by doctors and the pills are providing me much-needed relief. I know how much pain affects me. And medication and enables me to function. It does have a purpose, despite what my friend thought. It isn't just about making me feel good. It's about providing relief so I can continue with my therapy and continue feeling. Many studies have shown that pain can impede healing.

So, I think about this a lot: is there something wrong with my knee? I guess that's the question everybody has. Why does it hurt so much? Is this about tolerance? I don't think so. And my mom assured me that I have always had normal pain tolerance -- at least as a kid. Trust me, she'd tell me if I didn't. Maybe it seems like I'm in denial because I haven't really talked so much about the possibility that something is genuinely wrong. And here's the deal: I realize that it could mean something. And I don't think I'm in denial, but I'm trying to deal with this pain as calmly and dispassionately as I can. What is the root cause? Why does this pain persist? Is this normal? Is this within the realm of normal? Recently I've talked to several health-care professions about muscle memory. That's what one therapist calls it. The pain doctor in the hospital didn't call it a name for me but she basically said that I might be feeling pain from the past. It's a weird concept. I mean, I understand that I can have psychological issues with memories. But that's not what this is.This is real pain. As in, OUCH, that hurts. The thinking goes that I've had so much trauma and pain that it's like it's embedded in my cells. Does this mean it's all in my head? Honestly? I'm not sure. It's possible. When I was nine and had my first surgery it was terribly painful and terribly traumatic. The five surgeries since then (not counting this) have also been traumatic --although none rivaled the first or this,what I hope will be the last.

I've had more than one doctor say to me something to the effect of: Janet: your knee doesn't know the difference between having surgery and getting hit by a car. All it knows is trauma. In a way I'm hoping this is it. Another friend and I discussed it and she was talking about phantom pain: the fact that amputees often still feel their limbs as if they are still there. And it's real pain. Maybe I'm feeling phantom pain from previous surgeries and years and years of arthritis. But how do I know? And if I do know, how can I stop it? When I was in the hospital I asked that first pain specialist if I should undergo hypnosis. I was kidding. Sort of. I actually think hypnosis can be great. She said no -- you should just take more pain pills that work. But now I wonder.

So all this is to tell you that I'm grappling with this and trying to figure it out. If I stop taking the drugs altogether (assuming I do it in a way that is safe) I will be in too much pain to do my exercises. I have a fairly high tolerance for pain but it can literally make me nauseous to try to bend my knee. And I have been making so much progress. So I want to get feedback from people. But I don't want to dwell on the negative. If something is truly wrong with the implant, it will become apparent and I will find out. At least that's what I'm trusting. I guess I've never really thought of myself as a terribly positive person; I worry about it (yes,I realize this is ironic). But I realize that I have been really focused on the positive with this. In a lot of ways that's what this blog is about. At least that's my intention. I mean, I'm putting out some fairly intimate personal feelings. And I honestly have no idea who is reading this. And I guess I'm doing it with the hope that it will do more good than harm. I'm sort of trusting in the universe. I, probably more than anyone else, understand how this works. I've been writing about the Internet for more than a decade and I get it; words persist. Words can come back to haunt you. But words can also heal. . .

Anyhow, I am really looking for feedback -- honest feedback, so please share. I'm about to go to sleep. Tomorrow morning I will be going to the new pain specialist and I will be sure to bring up all the issues with him. Until then. -- Janet

PS the picture above is from NASA and is of the Nile. Get it? de Nile? denial? ok,weak but.. .