Pain Management

I’m back! It is Day 11 following lung surgery on March 3 to remove the upper lobe of my left lung along with the shrunken remains of a cancerous tumor encased therein. I got a very encouraging pathology report—the radiation/chemo treatments really worked—and anticipate one more round of chemotherapy administered out of an abundance of caution. You can read more medical details at my Caring Bridge site.

Lacking strength for more than one big task a day, I have been collecting topics to write about as my stamina returns. In the next few days I will be sharing some of the vivid experiences of my hospital stay, but be assured I am now well past the pains and discomforts of major surgery and on the mend. Daily progress is noted, and one sign of that progress is that I can finally write about it.

Pain management is a major focus of surgical care. A few days prior to my surgery, a nurse called to explain how that worked and what was important to remember even as I was waking from anesthesia. An anesthesiologist specializing in nerve blocks called me the night before my early-morning appearance at the hospital to explain the purpose and method of his procedure. The idea is to deaden certain nerves to give local pain relief during and after surgery, reducing the need for morphine. When we finally got to it early Monday morning, I demonstrated a rather dramatic intolerance to the nerve block (I fainted—oops) so it was Plan B for me and another opportunity to trust God.

When you wake up after a major surgery like this and cough that first time, you know why your caregivers were concerned about pain control. I was hooked up to an IV dispensing 10mg of slow-drip morphine per day (not that much it turns out) and handed a “Patient Controlled Analgesia” (PCA) button to push whenever I needed an extra boost of pain relief. This arrangement managed the situation quite nicely for the first 24 hours, and after the nurses realized I wasn’t using the PCA anymore they switched over to a non-steroid anti-inflammatory called Toradol, which worked great for another 24-hour period.

The surgeon came in for the daily visit on Wednesday, 48-hours post-op, and declared me free of all contraptions, hook-ups, drains, and aids of any kind. She said, “Okay, now if you need something for pain you have to ask for it. We have to get you ready to go home, able to manage things on your own.”  This turned out to be an interesting exercise. Up until then, I really had not experienced pain past maybe a 4 (on a scale of 1 to 10); it was more accurate to describe what I was feeling as discomfort. Wednesday proceeded nicely, but by Thursday morning, I was feeling an upswing of that internal torso pain that had been masked by medication all week. So for the first time, I requested pain meds because I was finally face-to-face with the real thing. [I have to say here how great my nurses were, and how responsive they were to my participation in decisions related to my care.] It turns out, I needed only one more dose of the good stuff and then we devised a plan that enabled me to go home late Thursday.

Upon reflection of this experience, I realize there are some spiritual parallels worth considering as we think about how we live day to day. Many of us live with chronic pain of one kind or another: grief, heartache, psychological pain caused by abuse or abandonment, fear that God has it out for us. We may become highly skilled at medicating ourselves with a slow drip of alcohol, Ambien, or other anesthetizing substances. We may avoid ever being alone. We may keep the music playing, the television on, or the computer humming. Because if we were to unhook ourselves from these props, we might very well discover that coping with pain in the silence or inactivity is impossible.

There is an upside to pain, however. I remember years ago when I had a severe back spasm that had me flat for ten days straight, it was the residual pain that instructed me in new body mechanics. Yes, it is humane and compassionate to alleviate pain, but not without addressing the root problem causing it. Pain draws attention to what is broken.

God is very good at spurring on this necessary process of discovery. I believe, in some way, that God allows pain to break through just so that its underlying cause can get our attention and move us to seek help. God knows it isn’t just the pain that is the problem, but the brokenness and the sin underneath it crying out for healing and forgiveness. God turns us over to it long enough for us to realize our deep need for his presence and power, moving us to ask him to set our spiritual bones and release the spasms of our rebellion. Then we can heal under the lovely ministrations of “the balm of Gilead” (Jeremiah 8:22).

The Psalmist understood this concept well. In Psalm 32, David observed that as long as he withheld confession of his sin, he withered. But when he admitted his guilt, he was restored:

1          Happy are those whose transgression is forgiven,
                        whose sin is covered.
2          Happy are those to whom the LORD imputes no iniquity,
                        and in whose spirit there is no deceit.
3          While I kept silence, my body wasted away
                        through my groaning all day long.
4          For day and night your hand was heavy upon me;
                        my strength was dried up as by the heat of summer.
5          Then I acknowledged my sin to you,
                        and I did not hide my iniquity;
            I said, “I will confess my transgressions to the LORD,”
                        and you forgave the guilt of my sin.

The message here is, “Don’t suffer needlessly! Ask for pain relief, but submit to healing where things are really broken! God will help you!” May the Lord surround you with loving people with whom it is safe to say, “I am hurting because of [this]. Will you pray for me?”