Three Kinds Of Pain

The pain has not been quite so bad today; the shingles pain is still right up there by I don't seem to have a lot of ALS related pain. Yesterday shingles was attacking the lower left quadrant of my trunk while ALS attacked my arms, shoulders and neck. Today it's down to shingles alone, still painful enough to make me want to stay in bed all day but not quite as bad as when in combination.

What I did learn today was that it just won't work to have range of motion exercises while I am dealing with shingles. My care worker came in and we tried a couple of different stretches. The pain rose in waves, taking it from uncomfortable to awful while she moved and held my feet and legs. I asked her to stop; she did. Two simple motions for the day and I was done. I stayed in bed as she did some homecare work and then left. I stayed in bed, sleeping, thanks to advice from Anita. Sleep works, it works well.

The whole shingles pain is not one kind of pain; it's actually three kinds. The first is the internal muscle pain in those muscles directly along the line of, and beneath, the affected nerve. The muscles are constantly clenched, sometimes loosely and sometimes twitching to full tightness, causing the rest of me to twinge and wince. This pain is bearable, rather like having hurt your back lifting something overly heavy. It's constant and mostly low-grade except for the momentary flareups that come along every 10 or 15 minutes. Then the vice tightens and the pain level spikes.

Then there is the nerve pain itself. Oddly enough ALS has taught me the difference between muscle pain and nerve pain. If muscle pain is a vice, nerve pain is a blazing knife, searing its way along the nerve path itself, as if the nerve was being zapped by a precisely followed electrical current path. It kind of makes sense, given that nerves are exactly that, electrical pathways. This searing, transient pain happens every hour or so, but when it does it completely immobilizes me, sometimes momentarily and other times for a minute or so. It is intense, running hard and fast, lightening in miniature. The underlying muscles seize and I groan.

Finally there is the pain of the blisters on my skin. In milder cases they are simply itchy. Mine are mostly like that except for a few spots where they evince a kind of stabbing, burning pain, rather like I would imagine a hot poker touching and stabbing into me. They surface lesions hurt like this mostly when contacted, but sometimes they just do it on their own, seeking to remind me that they have their own nasty part to play in this drama.

Take all three together and it is hard to relax. Painkillers help. Beer helps. Scotch helps. Sleep helps. I think that's my plan for the next week or so.