Just need to vent

[marileew]

Today my GP / Pain Specialist (he is the same doctor) asked me why I scream and cry during the most severe migraines.

I was sort of shocked and confused by the question. I didn't even know how to answer. After a few seconds of thinking I said "because the pain is so severe. The pain is so severe that I actually have trouble imagining what it is like now that I am not in that sort of pain at the moment. It gets so bad that I want to bang my head against the wall and eventually I think I might kill myself. That is how severe the pain is. I can't even imagine it now."

Then he said "Don't you think you're just making the pain worse by screaming and crying and thinking about killing yourself? Don't you think you're just making the pain last longer? You are inducing a stress response. You are making the situation worse." I responded by said "On the weekend, after doing breathing and relaxation exercises for half an hour, I stopped screaming and I didn't start screaming again, but the pain was still as severe. I still couldn't sit still for very long. I had to keep pacing even after I stopped crying and screaming. The pain didn't stop or get any better even after half an hour of deep breathing exercises and not screaming. So no, I don't think that screaming makes it any worse and I have trouble controlling how I respond to the pain when the pain is that severe, but I do try to control how I respond."

I know he was just trying to help. I know that screaming and crying and acting hysterical can induce stress responses and make the situation worse... I totally understand that. I know that is why it is important to stay calm... and I know that's why it is so important to get out of pain quickly. That is why I try to treat the pain and why I am so aggressive about treating the pain. That is why I have so many back-up methods of acute treatments if one fails.... Triptans - Naproxen - Metoclopramide - Hydromorphone - Gravol - the hospital. And why I have all the other things that go along with the medication like: ice, peppermint oil, methyl salicylate patches, hot water, magnesium, rubbing trigger points/massage, rest if possible, dark rooms, physical therapy exercises, breathing exercises, meditation, etc.. I know how important it is to stop a pain cycle, and that is why I try my best to stop pain cycles before they get out of control... even though it gets hard sometimes because I feel like my medical system makes access to treatment difficult sometimes. But I do my best and I always work with what I have.

But, even though he was trying to help... it still left me feeling just... awful. I left the appointment feeling completely... hopeless. Like... how am I supposed to control a natural response to severe pain that I already try to control the best I can? I don't LIKE waking my family up so early in the morning... even though my mom always says "wake me up if you ever hurt or need help!" I don't wake her up ever because my mom has enough to deal with. I will go downstairs where my family can't hear me and I will try to breath through it and I will try to sleep it off and I will try to imagine it all away. I will try my best not to cry. Usually an hour will go by before I start crying out loud. I might cry for half an hour or an hour before I start screaming. But... if the pain is severe... and I can't get the pain under control... and if the pain goes on for too long... I can only control my response to that pain for so long before I lose it, before I stop being me and the pain takes over. And... I just don't know how anyone would expect me to control that, especially a doctor. Or why someone would suggest that I'm making the pain worse, especially a doctor. I scream because the pain is severe. I don't make the pain severe by screaming.

I cried on my way home. Tears just rolled out of my eyes. I'm still crying, not in a loud sort of way like when I'm in pain, just in a quiet emotional sort of way... a pain doctor asking my why I screamed and cried when I was in pain was just too much to take after such a horrific headache on the weekend, I think it was the last thing I was expecting from him. I'm going to pull it together now so I can go to school and do work, but I just needed to get that off my chest. I know you all will understand.

Thank you for the support.

[rudyhorse]

Poor thing...that is a terrible feeling.  Even if I don't seem to notice, when I have severe headaches tears just stream down my face.  So it isn't something you can even control.  Has this Dr ever broken a bone, tore a ligament, or had a severe injury?  If you have then you know that in severe pain you cry, even unintentionally.  Uh duh!   I recall football players crying on the field from injuries, aren't they just making it worse............nooooooooooo, they can't help it, it hurts.  Tell you GP that is what your friend wants him to know...pain makes you cry, period, no matter what kind of pain it is.  I too can force myself not to cry, however, now I just let the tears come because it is natural to respond that way.  Plus I am just mean in my old age....and don't care what others say or think if I do cry.  My Dad was pretty tough and we had to go to school many times very ill, so I used to hide my illnesses, but not anymore.  It is all what works for you.  Most of the time we are all just doing the best we can, so pooooo (that is the nice word :) ) if others do not understand.  

On the flip side I do have to try not to tense up because I know it makes it worse but it takes effort not to.  I am so interested in the SE, never tried it. How does it work?  I do relaxation just to maintain and not make it worse, but that doesn't make them go away.  I used to do acupuncture and that did seem to help.

Wow did that get me on a rant. hehehe LOL  Sometimes I agree crying can make the migraine worse, but on the other hand it just is what happens when we are in pain.  Glad you could vent to us..........
Hugs,
Tracy

[dame_wilbur]

I know exactly how you feel. A couple years ago my neuro completely balled me out for "acting sick." My average pain was an 8/10 that year. I was surprised and hurt. He forbid me to wear my sunglasses inside, and said that if I continued acting the way I was, he would be forced to stop treating me. I freaked and did as he asked.

I know now that he meant well. It turns out that, unknown to me, my docs were giving me 2 years to live if I didn't turn around because I was shutting down my body because of the pain.

As for the crying, I think I have an advantage over you (maybe?) in that since I've had severe migraines for as long as I can remember, I grew up with different coping techniques. The fact that I had an emotionally abusive parent who got triggered when I cried was extra incentive to not cry. I can literally will myself to stop crying. What I do is basically do what I used to do, and start to shut down my brain. I just stop receiving the pain signals as well. It's not perfect, and it'll still hurt like hell, but at least I can stop the crying.

Have you tried biofeedback or Somatic Experiencing as a way of learning new/different coping methods? I found the SE to be a great help.

good luck,

~Dame