Department: Think About It
According to Dahlhamer et al. (2018), 20% of Americans report having chronic pain. The American Academy of Pain Medicine stated that the number of Americans with chronic pain is more than those affected by diabetes, cancer, and heart disease combined (2012). This issue's feature article is about chronic nonmalignant pain management, a topic relevant to many readers, and an issue with personal significance.
Eight years ago, I had a life-changing skiing accident. New to Colorado skiing, I was far from experienced, and during a last run down a relatively easy slope, I had a serious fall. The ski on my left leg did not detach, and the crash into the snow was accompanied by excruciating pain in my left knee. After being carted down the slope by a rescue crew, the first examination revealed an evulsion fracture of the tibia and likely torn ligaments. My left leg was immobilized in a stiff brace. The following trips to the internist for severe leg cramping in my left calf showed a blood clot due to the trauma, and the orthopedic surgeon explained that I had torn the three major knee ligaments (ACL, MCL, and PCL), leaving little to stabilize the knee. Major reconstruction would be required and would not guarantee a positive outcome; an Anterior cruciate ligament (ACL) repair was the best option. However, the surgeon would not operate until the blood clot had fully resolved, which took nine months.
During that time, I learned a new meaning for pain, as I dealt with severe swelling and bruising, and used a wheelchair and crutches. Then began a long, slow therapy regimen to regain strength in preparation for surgery, all while worrying about the blood clot dislodging and causing fatal harm. I was impatient, irritable, and sometimes angry. The healing process was taking too long. I couldn't do my regular activities and had to rely on my family to help. Months after my accident, I could walk, but the knee was unstable; I had a noticeable limp and daily pain. During my recovery, I meditated on Scripture and prayed. James 1:2-4 was key. We are told to count it as pure joy when we endure trials because the testing of our faith produces patience and makes us mature and complete. Romans 8:18 notes that our present sufferings are nothing to be compared to the glory that awaits us in heaven. During this time, I learned to rely more on God for strength and patience. The accident became a blessing to my spiritual life by forcing me to slow down and listen to God.
A year later, ACL surgery and more therapy helped restore my ability to walk more conventionally. As my body had forgotten how to walk with a normal gait, this was a tortuous process. Therapy sessions were preceded by pain medication. The sessions were unbearable, due to manual bending of the knee by the therapist to regain range of motion. The left knee will never be the same and caused complications, such as plantar fasciitis and back pain. Although I have regained functional use of my knee, some losses cannot be fixed. I will never be able to kneel, do a full squat, crawl, or sit cross-legged. No more sandals, high heels, going barefoot, or having nice dress shoes. And predictable chronic pain comes with activities that challenge the knee, such as walking on uneven ground or sand, which cause pain for days.
Yet, through this experience, I have learned to be more patient and thankful for activities I used to take for granted. Years later, I am grateful for the ability to walk and for only periodic pain. God gave me a new perspective on caring for patients with pain, and those in rehabilitation with their many complexities and variations of disabilities. I am a better nurse and a more thankful person because chronic pain has become my reminder of God's goodness and mercy.
Dahlhamer J., Lucas J., Zelaya C., Nahin R., Mackey S., DeBar L., ..., Helmick C. (2018). Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016. Morbidity and Mortality Weekly Report
, 67(36), 1001–1006. doi:10.15585/mmwr.mm6736a2