Chronic pain is a funny thing…and by that, I mean a pain in the ass. Now that is funny because my ass doesn’t hurt at all. It’s a pain in my neck, my low back, my left arm and hand, my hips, knees, and feet. That’s all. It’s on my mind today because I woke up at 4 this morning. I woke up because I was in so much pain. I tried going back to sleep until 5:22 and then thought, “Fuck it” and I got up. I feel like I’ve lived a whole day already and it’s 9:53. Might be a long day.

Pain is on my mind because Friday I’m going to a new orthopedic surgeon to discuss my elbow. That is never my favorite conversation. When I fell and broke my arm, into several pieces, and dislocated my elbow two years ago, the surgeon told me that it was “reasonable” to try one more time to put a new implant in and see if it would stay in place. After that he said he would recommend removing the replacement elbow and putting nothing in its place…an arm with no hinge. He told me, if that occurred, I would still have partial use of my hand. And he said his patients that have had their artificial joint removed, without replacement, are happy with the outcome because they have no more pain.

Sit with that for a minute. No more pain…go from daily pain, that ranges from frustrating to intolerable, to none. None. Nada. Zippo. It’s hard for me to even imagine. It has been a long time since my elbow didn’t hurt. I should mention the reason for a new doctor is not because of a problem with the old one…and he isn’t old at all. My insurance changed, and he is no longer in network. That is very sad. I thought about changing my insurance back but the costs of everything would be so much higher, I can’t do it.

I got a recommendation for an “excellent” orthopedic surgeon from a physical therapist I trust. PT’s know all the best doctors…nurses do too. So, I made and appointment and waited three months to see him. Let me back up and say that my elbow has been hurting for the past year and a half. I know the replacement is loose. How do I know it’s loose you wonder. Because this has happened three other times. And those three times I have had revision surgery. The humeral component, in my upper arm, was removed and replaced…hence the term revision…in case you’re wondering…you’re probably not. I should also mention that I can’t always straighten my arm anymore because it gets stuck. When that happens, I push my arm and force it straight. It feels like trying to shift gears on your bike…but the chain is clanking around trying to connect…and the peddles don’t work until it does. My arm grinds and pops when I push it straight. Not my favorite feeling.

So, for a year and a half my old doctor has repeatedly asked me what I wanted to do about my elbow. I have always told him “Nothing.” I haven’t felt like the pain was bad enough for a surgical intervention…and that is the only intervention left. That is until now. Because now I can’t stand the pain anymore. I feel like it’s taking a toll on my body and my mental health…because I feel hopeless. Like I’ll be stuck with this pain, grinding, and popping forever. That’s depressing.

Okay, so now, back to my story…I went to see the new doctor. He said my X-rays looked “good” and my arm looked “good.” My arm is hugely swollen and it looks deformed. If that’s your idea of “looking good” then there’s a problem…we have a problem. Aside from when I broke my arm and dislocated my elbow, my X-rays have always looked fine. The loosening had never been seen until I had a CT scan. I don’t know why that is…different imaging or better imaging, I guess. I just know it’s true.

I told the doctor what my previous orthopedic surgeon said, and he looked at me like I was a lunatic. I felt as though he thought I was casually discussing having my elbow taken out…like I’d talk about what to have for dinner…as if it’s no big deal. It’s a fucking huge deal. I can’t begin to describe how big of a deal. If he had asked me, I would have told him it’s taken a year and a half to even consider this possibility. And I would have said that I’d been practicing doing everything one handed to get an idea of what it would be like. He actually said, “You know you won’t be able to use your arm because you won’t have a joint. Your arm will just hang there.” WTF!? Are you fucking kidding me? Thanks for mansplaining that to me because, dopey me, I didn’t know an elbow was important. That’s what I wanted to say but I refrained. He didn’t ask me anything. He spent all of five minutes with me before he referred me to a different doctor. He said if I needed my joint removed that would be the guy to do it. Obviously, I was a problem he didn’t want to deal with, so he sent me away.

He didn’t ask about the history of my elbow or the eleven earlier surgeries, including the three revisions and the infection that took six months and three surgeries, including several months with no joint, to treat. He asked nothing. I felt invisible and pushed aside. Disregarded. Like I was a problem he didn’t have time for…or any interest in solving. I was depressed, and it took me three weeks to even be willing to make an appointment with the next doctor.

This decision is not because of one failed elbow replacement…every replacement has failed. This is the fourth failure…fourth and final. I cannot keep doing this. This is a huge decision and it’s a painful decision…one I’ve considered for a long time. This was not an easy decision, and certainly not one I’ve taken lightly. It’s scary. I feel afraid. But I cannot live with the constant pain or continue to have my joint locking…or dislocating. My arm isn’t functioning now even with the joint.

So, is it better for me to be in constant pain, needing ever increasing amounts of pain medication. And I need stronger medication because what I have doesn’t work anymore. Is it better for me to lack sleep because of pain. Or to dread each new day because it’s intolerable. Because that’s what chronic pain does…it causes dread. Dread and fear and anxiety. It wears you down day by day…little by little.

Chronic pain is a challenge because other people don’t necessarily see it. I get up each day, take care of the dog, I cook meals, run errands…all the “normal” things. Someone observing me would not see my pain. It’s not like I walk around moaning and crying. I’m not big on complaining…it doesn’t help anything. But because you can’t see my pain you might not know it’s there. That’s a difficult thing about chronic pain…it is frequently invisible. Just because you don’t see my pain does not mean it isn’t there or that it isn’t significant.

I am a strong person. I know that. I’ve been through a lot of shit…and I keep going. In my family, I was praised for being strong. Praised for not complaining and for my ability to handle anything. I wanted the praise, and I wanted to be strong. And I am.

Now I’m learning it is not a sign of weakness that I need something done to help me. I’m not failing because the pain is too much to bear. I can’t take it anymore. I’ve dealt with it for over 7 years…that’s a long fucking time. Maybe my strength now is the realization that I need help. Maybe it’s finally having the ability to ask for help. To seek help. I wonder if at some point it goes from strength to stupidity to just pretend everything is fine when the pain is unbearable. Maybe that’s just denial…or fear…or both.

Chronic pain is a reality for millions of people in this country…including people you know. Chronic pain isn’t just physical pain. It’s also emotional pain. The fear. The depression. Feeling disregarded or disrespected. Dismissed…tossed aside for someone else to deal with. Told, without words, to be quiet and stop being a problem. Be an obedient and quiet little girl. Don’t make waves. Listen to the doctor…he says nothing is wrong…and his opinion is the only one that matters.

Now I doubt this doctor intended all of that…at least I hope not. He could have been having a bad day. I have no idea. But I am not just an elbow. The elbow in question comes with a person…me. And I need help. Seeing a doctor when you’re in a lot of pain, or there’s a problem…or both, is a very vulnerable position to be in. I was there because I needed you to help me.

I came to you sad and scared and I took the risk of sharing that with you. I came to you vulnerable. Don’t send me away. Don’t get me out of your office as fast as you can. Don’t mock me by imitating what my arm will be like without a joint…flailing it around, as you speak to me like I’m crazy. Understand that my pain must be fucking awful if I’m willing to consider such a drastic last resort.

When I come to you and tell you who I am, listen to me. And when I share my pain, believe me. I’m taking a risk to tell you…don’t make we regret it. Because then my pain will go back underground and remain buried until I’m willing to take another risk, if I ever am. Don’t teach me it’s not safe to trust.

In the end what matters is how we love people. Love the people in your life who are in pain. Believe them. Listen to them. Divine is the task to ease pain. Let’s ease each other’s pain…that is divine.