A Refresher on Pain

27 Feb, 2020 Mark Pew


Have you ever thought you knew something but then realized you didn’t really “know” it until you experienced it? Especially if you have never experienced it or it has been a long time since you experienced it. If you’re being honest, the answer is “yes.”  So let’s decide to be honest for a few minutes. 

I am blessed to be 59 years old and not have any significant chronic pain or need to take any daily medications. That does not mean I have had a pain-free life. Physical, emotional, psychological, relational, grief, financial – I have had every possible kind of pain, just like every human being. I have sprained my ankles and wrists, broken bones, sciatica and lower-back pain, cancer surgery on my nose, crazy shoulder pain for about a month, and a host of other aches and pains at various times. But it has been 2+ decades since I haven’t been able to walk. Until February 1. The refresher on pain personalized a lot of the things I speak and write about.


My cousin and I decided to hike Blood Mountain in north Georgia on that cold and drizzly Saturday. The six-mile loop is part of the Appalachian Trail. We had tried it one time previously but missed a sign and ended up doing every nearby trail except Blood Mountain. I love hiking and enjoy new challenges (it has a steep incline with very unpredictable rocky terrain in areas, requiring constant focus), so the less than optimal weather (it briefly snowed at the top) was not a deterrent. 

Around the fourth hour of the hike I twisted my right ankle between two rocks. I heard and felt it pop. An immediate and intense pain put me on my back. Since we were still an hour away from the trailhead I kept my boot on, took some Advil with PowerAid and limped (often needing my cousin’s help over/around rocks) the final distance. Fortunately, he had driven the 60 miles to the trail but when we got back to the park-n-ride I had to drive home (very slowly and sporadically with my left foot). 

After seeing it unwrapped just prior to the start of the Super Bowl the following evening, my wife (and, virtually, my daughter) convinced me to go to an Urgent Care facility on Monday. Then, when it wasn’t getting much better that week they convinced me to go to a podiatrist the following Monday. I really enjoy visiting with doctors, just not at their office, so it took awhile for me to make the appointment. I do not like waiting rooms plus I come from a long lineage of “rub some dirt on it” pain management techniques. The good news was the ankle/foot was not broken. The bad news was that it was a significant Grade II sprain and would take time to heal sufficiently. The good news about that was there should be no lingering effects, but the bad news was that I had to do what the doctors recommended (RICE). For the first time in several years I had pain that was going to be with me for awhile.

This refresher course on managing pain brought to life many of the things I talk about, including:

  • Catastrophizing – I always made sure I included “and I had to hike the final hour out to the car” when retelling the story. Just like above. Not sure why. It just seemed like the cool thing to do.
  • Not following doctor’s orders – Since I work from home it did not impact my work schedule (in fact, my Preferred Medical colleagues are going to be surprised to hear this story). Although I tried to keep my foot elevated it wasn’t exactly RICE. Actually, it was not RICE at all.
  • Not doing my homework – I thought five days post-accident would be enough time to switch from ice to heat (specifically an Epsom Salts soak). I was massively wrong because it made matters much worse – literally my foot felt like a balloon. “You can switch to heat when the ankle swelling goes away.” Oops.
  • Frustration – Healing happens on its own time, and when it did not match my expectations or I regressed (aka Epsom Salts), it became very frustrating. Not just from the pain but also what I could still not do. Even now, 25 days after the injury, it hurts at night. Seriously?
  • Lethargy – Although the podiatrist said I could do exercise other than the treadmill, I didn’t. Yes, it was inconvenient to my work schedule. But my lack of initiative to stay in shape may have been because of …
  • Fear Avoidance – You know, it hurt!

So as I write this on February 26 (with my ankle propped up on my desk), I have learned – again – that being educated does not always mean you leverage that education. Although I had a smartphone available for research, helpful advice from clinicians, and hundreds of my own PowerPoint presentations that discuss proper pain management, I still did less right than a coin flip. So I understand, again and better, what it’s like to be physically impaired and what that means to your heart and head. Not that I wanted the lesson, but a refresher course every now and then isn’t a bad thing.


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    About The Author

    • Mark Pew

      Mark Pew is a passionate educating and agitating thought leader in workers’ compensation and award-winning international speaker, blogger, author and jurisdictional advisor. He has focused on the intersection of chronic pain and appropriate treatment since 2003. He is the driving force and co-founder of The Transitions and just recently launched The RxProfessor consulting practice at https://therxprofessor.com.

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