Interview CP37

Age at interview: 32

Brief Outline: Bilateral wrist pain due to repetitive work injury, 1999. Treatment: Nurse led pain clinic for medication and advice. Current medication: amitriptyline, menthol cream. Past medication: capsaicin cream.

Background: Production operator (not working); married; 1 child.

Was referred to a nurse lead pain management service where she learnt better ways of doing her...

Each fortnight or month, whenever it was I was to go. When we first went, she explained the pain chart was for different levels of the pain, different feelings in the pain. So they first asked 'Where do you feel your pain?'  It was located right through my wrists.  'What does it feel like?'  It feels like I'm being crucified through my wrists.

The pain is like a gnawing toothache constantly. You have a really bad abscess toothache, it really keeps you awake and you can't concentrate. That's the sort of pain. It's just directly through the wrist. 'Does the pain bore into you? Does the pain eat away at you inside? Does it make you feel really blur sickly?' Yes, not nauseous, but it makes you feel unwell, tired. 'How much tiredness does your pain cause you through trying to concentrate on other things apart from your pain?'  

And so the pain chart itself registered how intense the pain became doing certain things, how much it would hurt during the night in your bed, was it getting alleviated, were you getting to sleep now, things like that. Each question each week, or each fortnight, would be the same. Every time you were asked a question you could understand it each week better.  

So you would know that the boring pain was a pain you felt all the time, the gnawing, sharp pain was the pain you felt when you'd done too much. So you'd begin to understand 'Ah I see, I'm doing too much so, if I stop doing so much picking up toys all the time, stuff like that, if I just now kick them to the side instead of picking things up and just stop doing repetitive things all the time, I would get rid of that boring, gnawing pain'. So that would alleviate it.  

So each time I went in I would say 'Yes, I've done that', I'd say to them maybe 'This week has been really sore, because I've had to use my hands more for something'.  'Oh right, well how can we alleviate that. Let's go through the pain charts'. So they would go through it and they would see that it was intensified at night-time. 'Oh right, so what's intensifying it through the night. Is it more challenging at night?'. 

Generally the questions were always about 'How does the pain make you feel at the end of the day' and it always makes you feel tired, drained, don't want to concentrate, can't sleep, very moody, very snappy, very snappy. So it tells you how to really cope with that feeling.

If you do feel it's getting that bad, stop. Just stop what you're doing, sit down, rest, do what you've got to do to alleviate the pain and then try and forget about it really and think positively. That was one of the main things at the end of each one was try and think positively, don't think of your pain as your, what do you call it? As your enemy. It's there but don't, just don't think about it really, try and put it to the back of your mind.

Tried capsaicin cream and menthol cream for bilateral wrist pain and got some relief from menthol...

Can you tell me what happened when you went to the Pain Management Clinic?

When I first went I went with a complete open mind, because I know there's no cure. I might get better one day, but it could be a long, long process. So, I went with the open mind to think 'Well, if she's, if there's anything there that can help, if they have anything that can alleviate or just help me through the day, that would be great'.  

So I went in thinking 'Okay we'll see, we'll try, I'll just try anything'. We tried different topical medicines, capsaicin cream for osteoarthritis, thinking maybe there was nerve pain connected there. We tried them. The heat within that cream caused the pain to be much more intense.  

So we realised then that cold and ice is the only thing that will stop it. So they've tried amitriptyline to try and block the nerve pain and that's actually helped me get a sleep at night now. I wasn't sleeping for a good few years, my sleep pattern was terrible. So the amitriptyline has helped on that side.  

Then I'm using menthol 2% cream and that freezes from the inside out, very, very cold sensation and that seems to alleviate to a point where I can carry on and do, not more things during the day, but just carry on that little bit longer without sitting back and having to resort to the ice packs and stuff. 

Talks about things that make her life easier when she is out and about, or doing housework and...

If I've got to really pull a heavy door, I'll use both arms or there are gentlemen still alive in the world today, they will open the door for you. But generally a lot of places now have automatic doors, which are godsends.  

But you go into buildings like maybe school buildings or like the local centre, our community centre, where my playgroup's held, where my son will go there, the door there is quite stiff at the bottom so it's one door I have to pull it open and I have to stick my foot in and then use the rest of my body to really shove the door open. So I don't, it's just the initial pull and then getting my leg in behind it and then try and squeeze myself through the gap to force the door open if it's too heavy. So it's really difficult.  

But if my husbands there he'll then help me out and he'll open all the doors and stuff and he carries all the heavy bags. At the shop I might get to carry the toilet rolls, the crisps and the bread, the really light items, whereas he's like a pack horse half the time, and because we've got the baby we've got that much stuff so he's got to take all the heavy stuff first and I take all the light stuff so, in that way, so you know what to compensate for.  

We've got into the routine now where we know right, that's going to be too heavy for you to lift, so I've got to hand. If I'm going out with any of my friends and family, they know as well that I can't lift heavy bags and stuff, so they'll help me out and lift bags for me and open the doors and do things like that for me. If I'm preparing a meal, [husband's name] always there anyway to help me. Like making pots of soup, love making soup.  

So he has to do all the peeling, the actual cutting up of the vegetables and stuff but I find a lot of the time you can buy frozen veg as well. So things like that, potatoes, instead of using potatoes, if It's just me and my son having dinner, then I'll just use instant Smash because I know then I can just mix that up, I don't need to stand and peel a potato and I don't need to go through the pain to make the dinner.  

So there is things that I know I can do easier that I use every day certain things. There is things to help you out, automatic doors and things like that, that's great, they're the best invention in the world really. If you get the odd door you've got to pull, like I say, generally I get help or I use my whole body weight to try and open it.

Advises people to find a hobby to take their mind off the pain and to find out about pain...

Just try and find an escape. Just find something else to take your mind off it, even if it's only for half an hour a day.  Something that you enjoyed. When I was at school, like I say, I wasn't brilliant at art at school. I didn't go forward and do any levels in it or anything, but I was always quite, I could copy things, I could copy a drawing.  

So I thought 'well, why not try it?'  So I tried that and I enjoy it and it's very relaxing, painting or doing a jigsaw, some people might like to do a jigsaw or they might want to get out and, I don't know, film something, a tree or something, just anything, just something that'll take your mind off it for a little while, if it's something that you'll enjoy or something that'll be a challenge to you as well.  

The more challenges you get thrown at you, the more ways you find to overcome them. So that's sort of... and just try and be positive. Don't look for the black side of everything. Don't look for a downside. It's very hard, but just try and be positive and know that one day something, something will give, something's got to give as they say, so at the end of the day it'll get better, or it could get worse before it gets better, but there is something out there that will help.  

Then find it, find anything you can, take any advice you can. Pain management clinics, start there, that's the best starting point for anybody in pain. I would suggest to anybody that's suffering long-term chronic pain to go and see somebody that knows how to manage pain and then they'll teach you how to overcome it and just to concentrate on different things, rather than what you're experiencing day to day.