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Having guilt over the pain

Last article, we met Aida, a married woman working in the corporate world. Her job called for travel and time away from home.

Steven, her husband, works at home and is essentially a house husband. They have three grown children on their own and one that still resides at home. Aida focused attention. on a recent history of pain. Onset was approximately nine months ago. She was traveling for her job. She described her activity, which lead to pain that found relief with ice and heat. She ignored the sign until Steven urged her to see their PCP (primary care physician). An appointment was made. She reports that the PCP took vitals and performed no tests since she didn’t realize any pain. (I remember an old expression about car troubles that fail to show up at the garage.) Another one: If it’s not broken, don’t fix it. A subsequent episode occurred weeks later. This one took away her appetite. I looked at Aida who was shaking her head. “I made another appointment with my PCP.”

So then what happened, Aida? Were you in pain at the doctors office? What did he say? What did he conclude, if anything? “I did have some pain, yet not as severe as the two episodes. So, with some convincing, he sent me out for X-rays. Two days later, his office called to announce no remarkable concerns. X-rays proved nothing. I was starting to get frustrated. One of my strengths is controlling my emotions. I got OJT (on-the-job-training) as a mom raising my children. I’ve been able to transfer the quality of control to my work. Negotiations with big-wigs can turn your stomach. I’ve always kept my cool on the job. Being a woman in the corporate world poses challenges necessary to overcome in order to sustain life in the fast lane. Oh, by the way, Steven wasn’t able to come. He assured me he’ll come next time.” Then what followed, Aida?

“I was feeling distracted by the episodes and what appeared to be nonexistent entities from the pain. A couple of weeks later, I was home. Steven and I were on a long walk. My leg suddenly gave out and I fell into a heap. I was in tears. I can’t remember the last time I cried due to pain. Steven held me and said I had to go to the emergency room I resisted but his insistence won out. He called 9-1-1 and soon an ambulance arrived. Quickly, they placed me on a backboard and I was at the local ER. A physician’s assistant checked me out. The pain persisted, though tempered. She was warm and gracious. I gave her my history of recent painful episodes. Another X-ray was ordered. Nothing showed up. I was sent home with pain pills and instruction on how to take them. A follow-up appointment with my PCP was made.”

“I can’t begin to describe the look on his face at my next PCP visit. I read, ‘Oh, you again?’ I was pissed. He looked over the ER report and x-rays. We talked about pain medicine. He discouraged the use of pain pills except for aspirin type. I silently wondered, did he think I was faking so as to obtain drugs? The thought provoked displeasure. I thought about finding a new PCP who would believe me. The ER medication was for 5 to 7 days. I took it as prescribed and felt less pain. My PCP wrote a script for low active pain medicine.” Then what Aida? This is quite a story.

“I took the pain medicine my PCP prescribed. It worked until another painful episode ate me up, Marshall. Another ER visit and another x-ray proved futile. A follow-up to my PCP found him a bit more compassionate. Reluctantly, he ordered an MRI for my upper and lower back. Fast forward, I went in that tube hoping, yet not hoping if you catch my drift, that something would show up. Guess what? Everything was okay. I was grateful for the results, yet anxious about further episodes. He then told me that I needed to see a shrink or some counselor. He gave me your name as well as a list of others. He all but said that my pain is all in my head. What do you say, Marshall?”

I believe you, Aida. Sometimes doctors, even certain tests, don’t show problems that are real. Come again with Steve, please. We made another appointment. Let there be peace on earth and let it begin with me.

Marshall Greenstein, a Cassadaga resident, holds a master’s degree in marriage and family counseling and is a licensed marriage and family counselor and a licensed mental health counselor in New York state. He has regular office hours at Hutton an d Greenstein Counseling Services, 501 E. Third St., Suite 2B, Jamestown, 484-7756. For more information or to suggest topics, email editorial@observertoday.com.

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