One of the biggest issues for my submissive over the last year has been adequate and appropriate pain management. In the past, when his attacks would last a day or two, he was able to manage with aspirin taken on a regular basis. Even at its worse, he could manage it with an ocassional low dose of generic hydrocodone prescribed by his primary physician.
However during this last year and its unrelenting series of back to back attacks, it has become increasingly difficult to manage his pain. Many physicians’ hands are tied, preventing them from adequately addressing the pain. Any relief they can provide is temporary at best. Finding a specialist in pain management who is acceptable to one’s insurance can be nearly impossible, especially when the diagnosis is not conclusively confirmed by a difficult to perform and easily misinterpreted biochemical test.
Even when adequate medication was prescribed, it was difficult to get him to take it at truly therapeutic levels. Was it a matter of masculine pride to tough out the pain? Was it a fear of dependence on the narcotic component of his medication? Perhaps it was a bit of both. Regardless, the outcome of this self-deprivation remained the same: unrelenting and increasing levels of pain and a steadily worsening damage to his person.
To most people, having a “reasonable” amount of pain is of little consequence to their overall health and well-being. Even short periods of stronger pain are not detrimental if well-managed. Most of us deal with various degrees of pain every day, including chronic pain from old injuries or old age, and suffer no long-term effects from it.
The same cannot be said of pain in the person with acute intermittent porphyria. Pain is most certainly the enemy. Pain is, ultimately, a trigger for increasing attacks by virtue of the fact that it causes stress.
Stress is a huge trigger for porphyria attacks. Even the mild stress that results from a sleepless night can accumulate over time to a level which can trigger or worsen an attack. Because stress is such a strong trigger, it is important to manage it to the lowest consistent level possible.
Remove the things which trigger stress, and you remove a porphyria trigger.
Remove porphyria triggers, and you potentially prevent attacks or lessen existing attacks.
Prevent or lessen an attack, and you give the individual an opportunity to recover and heal.
Sounds logical because it is logical.
Just as it is important to maintain a healthy diet which is free from those foods which are known triggers, to keep a regular and adequate sleep schedule, and to avoid chemicals and medicines known to trigger attacks, it is equally if not more important to prevent stress as much as is possible. One way to prevent a sizable portion of this stress is to make certain that pain is managed to a level which prevents stress.
This brings us to the crux of Rule 9: Nut-up and Med-up. Misplaced medicinal machismo and self-denial are nothing less than self-destructive behaviors for the person with AIP. If one does not have control over some of the other of life’s stress-makers, one can at least have some control over the stress caused by the pain of both an attack and its aftermath.
If you have a physician who has a firm grasp on the type and level of your pain and has prescribed medication adequate for managing your pain, then follow instructions and take these meds As Directed. Don’t skimp, skip, or otherwise ignore your physician’s orders.
Rule #9: Nut-up and Med-up. Take what you are given, as instructed, to eliminate as much pain as is possible, to eliminate as much pain-related stress as is possible, and to help you prevent, lessen, and heal from AIP attacks. If you will not do it for yourself, do it for those who count on you, love you, depend on your service and affection, and from whom you receive much love and affection.
