Achy breaky

I conducted a full concert last Friday for a live broadcast, Musical Menagerie, the first full program I’ve conducted since I was in Tulsa in October (I’m shaking my head as I write this. I mean, under pre-Covid circumstances I would have had 50 concerts in the last 11 months, not 6. I digress). It was amazingly awesome to work, and to be playing such a huge role – I conducted, hosted, played the harpsichord during the performance and helped to script and produce too, offstage. If you want to see the fruits of my labor, check out this link to the Minnesota Orchestra website; you’ll need to create a sign-in but it’s totally free!

It was also the first time in a while in which I was waving my arms around for hours a day, and running around the stage and hall in 5-inch heels during the broadcast (I know they’re not the most comfortable thing, but I love my heels and I love being tall!). Conducting is actually quite a physical pursuit, and I’ve been really mindful of keeping my arms and shoulders in good shape with weight lifting and functional workouts. No workout quite duplicates an active conducting week, however, and now, a few days post-concert, I find myself with unusually achy shoulders, upper back and neck.

At its core, pain is helpful – it informs us that something is awry, and that we need to do something differently. Our survival as a species is predicated on our pain response. But pain, in any form and to any degree, is uncomfortable, and it’s a very human reaction to attempt to alleviate discomfort as fast as possible; I’m certainly reaching for my ibuprofen. I think most of us have experience periods of physical pain that are resolved over time. It’s unpleasant, but we can prevail knowing that there is most likely an endpoint.

What’s more challenging is chronic pain. Many of us live with that as well. Roughly defined as any ongoing pain that lasts over 6 months, it’s most often the result of injury or illness. Inflammation or nerve damage/dysfunction is the most often diagnosed cause, but the science of pain is complicated. Generally, we think of it in terms of being controlled but never fully cured; pain management as opposed to pain elimination.

Chronic pain is all about the management of expectation and the tolerance for discomfort. In my case, an early-teen surfing incident (I grew up in Hawaii) cause acute nerve compression and minor nerve damage (it was an L4-L5 issue). It hurt like hell for a few months, and then gently faded to a general ache. I assumed it would fade further, but it didn’t. For decades I’ve carried with me the chronic ache in my lower back and right leg.

It generally doesn’t dramatically affect what I do; I’m certainly more careful about the area in my lower back and keep the muscles around it strong. I do have days when it feels worse, and I’ve learned to be flexible in my approach to my body when it’s not at optimal function. It’s always there, and it’s most probably never going to go away, so I’ve learned to tolerate it.

Easier said than done. As I said, toleration of discomfort is not our natural human tendency. We would rather run away from it, wish it weren’t so, make it go away. And when none of those things happen, we feel a level of desperation, of being caught in a sensation not of our choosing, an unpleasant feeling. I know all about that.

What helped me early on, and still does now, is mindfulness, and a conscious focus on not the actual feeling of pain but the feelings around the pain. Pain is a physical sensation that can precipitate an emotional reaction. The trick is being able to separate sensation from reaction.

Here’s an exercise that has helped me from day one. Identify the source of pain, and go to it. Your back, your wrist, your hip. Examine the sensation of the pain; is it stabbing? throbbing? burning? dull? sharp? What color does it evoke? When you close your eyes, do you see it taking any sort of shape or form in your mind’s eye? I often think of it as looking at a sculpture in the middle of a room, walking around it, taking it in at all angles, finding all of the details of it.

Then: what does the sensation make you feel? anxious? angry? What feeling does the color, or the shape, evoke in you? disgust? confusion? What are you emotions around this sculpture in the middle of a room?

Of course, to be able to examine both the pain and your response to it, you need to remove yourself from both. And it’s in that removal from the source of discomfort, of being able to face it for what it is that takes away its power. My own pain is blue and squeezing; it makes me feel sullen, slow, resentful. And in facing it and naming it, the pain just becomes something that is simply a part of my experience of the world and of myself, something that is known, not mysterious and frightening. And that makes it tolerable.

As with most things in the world that frighten me, when I face it and walk towards it, its power diminishes, and mine grows.

For those of you with chronic pain, I’d love to hear about your own experiences and coping mechanisms – it’s always useful to add ideas and approaches to our arsenals – share your thoughts!

10 thoughts on “Achy breaky

  1. It is gratifying to see with the enthusiasm you relate the extraordinary display of your skills. A complete concert, with the enriching experience of conducting, performing, creating, and producing. So you see: “life finds its way”, where life is your ability to control more or less a hundred musicians, make them sound like your eyes and smile, and offer us that manifestation of life for our delight, or as whether it impacts our spirits hungry for such stimuli.
    Regarding your reflections on pain, curiously I have had to experience it these days. And to this rare coincidence, another one is even more curious. There were times when the pain was so intense and constant, that I instinctively appealed to those tricks you share. The example of the person walking around a sculpture, apprehending the balance of its forms, serves perfectly to illustrate what I practiced: taking a rational distance from the pain stimulus, considering it as a phenomenon, and seeking control of my reaction. And to my satisfaction, indeed I was no longer a captive of suffering, but part of a system in which I could act.
    Sara, I hope I don’t bother you with these reflections from a complete stranger. And I mean that your writing is intelligent, unaffected, and of a rare and highly refined humanism.
    ———————————————————————————————————————————
    Español:
    Resulta gratificante ver con el entusiasmo que relatas el extraordinario despliegue de tus competencias. Un concierto completo, con la enriquecedora experiencia de conducir, interpretar, crear, y producir. Así que ya ves: “la vida encuentra su camino”, donde la vida es tu capacidad de controlar más o menos cien músicos, hacer que suenen como lucen tu mirada y tu sonrisa, y ofrecernos esa manifestación de vida para nuestro deleite, o como sea que impacte en nuestros espíritus ávidos de tales estímulos.
    Respecto de tus reflexiones acerca del dolor, curiosamente me ha tocado experimentarlo en estos días. Y a esta rara coincidencia, se suma otra más curiosa todavía. Hubo mementos en que el dolor fue tan intenso y constante, que instintivamente apelé a esos trucos que compartes. El ejemplo del que camina alrededor de una escultura, aprehendiendo el equilibrio de sus formas, sirve perfectamente para ilustrar lo que yo practiqué: tomar distancia racional del estímulo del dolor, considerarlo en tanto fenómeno, y buscar el control de mi reacción. Y para mi satisfacción, efectivamente ya no fui un cautivo del sufrimiento, sino parte en un sistema en el que yo podía actuar.
    Sara, espero no importunarte con estas reflexiones de un completo desconocido. Y quiero decir que tus escritos son inteligentes, sin afectaciones, y de un poco frecuente y muy refinado humanismo.

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    1. chefdorch says:

      These are wonderful reflections, and I absolutely agree that finding a rational distance from our pain can help us from being, as you said, a captive of suffering.

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  2. I watched your program last Friday afternoon and as always enjoyed it thoroughly. Your visits to the MN Zoo were right up kids’ alley I’m sure, and the music was outstanding. I even heard music new to me, which I love to do. On to chronic pain, I’ve had versions of that since I was 9 having had polio and now, as an old coot comparing my age with dirt, new chronic pains have come about from many other orthopedic incidents compounding what was already there. I have never equated the pains with colors, emotions, or shapes but have done a pretty good job of managing it my way so that I can get other things done without the pain getting in the way. When I concentrate enough on what I’m doing, the pain is almost unnoticeable, and I carry on. Not nearly as fast or efficiently as in my youth, but I do carry on.

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    1. chefdorch says:

      You’re right, we each have to find a way of managing our own pain, and carrying on. I, too, feel pretty pain-free when I’m really, really focused on the task at hand.

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  3. Bon matin, to you La Maestra, Paul & Pink. I was going to write Bon après-midi (good afternoon) realizing it is 10:30 am here and 7:30 am in SF.
    I liked reading your posts. I didn’t have a chance to watch the concert on PBS but I will next week. It’s a great idea and the fact that you conduct, produce,… give you some tools for the future. PBS is often a partnership of Télé-Québec (which is our public tv) as TVO (TVOntario). It would be fun to have it there for people who don’t have computer. We have a zoo called St-Félicien Zoo. It is located in the Saguenay. It is a nice place but a good 5 hours drive up north Montréal. At that zoo you’re in a cage like in a kind of train and the animals are free. There is obviously a fence who surrounds the zoo otherwise there would be a sudden decrease in the population.
    Thank you to share your experience in regard of the pain. Pain is complex and multifactors is linked to it. You would be a great rn, np or Dr, Sarah. I used the ruler with faces and colours when I assess the pain. A smile face is no pain and so on with awful pain red face. I could use the scale from 0 to 10 but sometimes patients have a hard time giving you a number. You don’t either want to put a number in their mouth. So the scale with faces and colours is much better.
    My sister (yep, she was a rn but she is now a specialized educator in mental health) suffers from fibromyalgia for years. She does a lot of stuff (meditation, exercices and Rx (pills), creams, doTERRA essentials oils,…). Some people might not be aware that anti-depressant Rx like Effexor or Symbalta prescibe at a low dosage has a good impact on relieving the pain.
    Being on the road to do home visits to provide health cares brings a lot of back problems among rn and Dr. I had L5S1 spondylolisthesis grade II. I now have 2 plates and 4 screws all in Titanium. Don’t worry I’m not whining but just sharing my experience. I did ask my surgeon in 2004 (an anglophone guy from Ontario who spoke a good French) to give me a paper in English and French just in case I would have to go to the states or to Europe. The little sun of a gun gave me one: “My patient has a f*ck*ng b*mb in his ass. Mon patient a une b*mbe dans son c*l”. I told him: “you’re not serious, Dr Jarzem. Aren’t you? He started to laugh. Me too. Lol. He finally gave me a professional note just in case some detectors would go crazy and start to buzz at the airport or wherever.
    Finally, Sarah, let me know if you need snow. We had another snowstorm (15-20 cm so +- 1.5 foot. In Canada we use the metric system but with the USA it is in., Farenheit,…). I’m used to it and a use my my cell phone if I’m not sure. Thank you again for sharing your story.
    Stay healthy and safe, all of you and your families.

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      1. Ah!Ah!Ah! This is what my son and my wife replied. They said just after their laughs: “make sure no bomb has been written on your paper because at the custom they will send all of us to Guantanamo”. I got it, I replied.

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  4. seskona1icloudcom says:

    Yep! L4-5 for me as well…in moments of intense pain I allow my mind to accept it as it is, then seek a pathway toward transcends- music as Art speaks in a transcendent way that is without words. When one listen to music, sees art, smells the flowers about you- the mind becomes one with the far, far, greater depths of the human heart/soul. Pain is then relegated to an passing part of the universal human experience called ‘life.’ Transform your pain into a window or calling to greater things…then take Alleve!!!🙃

    Liked by 1 person

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