Coping with Pain: A COVID Story
I’m coming up for air after a pretty grueling bout with COVID.
I’ve had COVID now three times, and in many ways, this was both the best and the worst cycle. This time, intense existential dread, body inflammation, gnarly headache, and fever were all known bedfellows, but no significant coughing or sinus conditions. My last bout had me fatigued, shaking with chills, and primarily bedridden with coughing for two weeks.
The new addition to my COVID journey is called “COVID tongue.” My whole mouth was covered with sores, especially the tip of my tongue and behind the upper dental ridge. It has made eating and drinking agonizing, speaking an exercise in pain versus reward, and even breathing through my mouth caused a giant spike of pain.
I’m having trouble conveying that this is an extreme amount of pain, but it felt as though someone was placing a lit flame onto the tip of my tongue when it touched anything, and the same goes for everything behind my upper teeth back to my molars. I’d rate the lit flame burning experience as an 8 out of 10 pain experience. It was shocking, made me gasp, and was painful enough to wake me out of sleep several times this past week. The gum sores also produced an aching pain that shot up into my eyes at about a five pain level. Eating caused these experiences to be near constant and increasing. Twice, I lost sight in my right eye from just the pain while eating a bowl of soup. Two spoonfuls in a row, it seems, was too many.
The COVID headache was particularly severe this time and centered almost entirely around my temples. Consistently a five, sometimes up to a seven, and not amenable to ibuprofen or Tylenol. I couldn’t help but wonder whether this meant that The Headache had returned.
So for about a week, I could only eat and drink in agony; I was full of nihilism and dread of my future; I was plagued by an old evil chronic pain that had been reborn by COVID; I couldn’t speak without either suffering or badly slurring my words to prevent my tongue from doing its job to enunciate against my teeth. Yikes! Despite all this, I learned some compelling lessons from this experience.
Lessons:
1) I talk a good game about pain but am miserable in chronic pain. It sends me right back into the pain and depression, and I must dig deep for morale. And the more it hurts, the more grindy it gets. I’m in awe of past Christo, who made his way through the daily chronic pain for so long. That dude is tough as nails.
2) A few years of practicing Stoic and Buddhist indifference have been honestly helpful. I’m a complainer by nature, but when it was time to eat or drink, I gritted my teeth and did it without hesitation. It’s just pain, after all, and it will pass or it won’t. It’s not a sustainable mindset to hold all day long, but the steely indifference was always there when needed.
3) Oral pain is a special breed of pain. It feels like there is less of a filter on oral pain than other pain in my body. I can’t table it in the way I can other pain. It just hijacks straight to the pain center.
Likewise, the pain cave never showed up. Perhaps because no endorphins were released or because the tongue pain was never constant, but there was never a point where I could duck into the zone of total ambivalence—all presence with pain all the time.
4) Being unable to communicate through speech was a wildly difficult experience. Every word I uttered had to be weighed whether it was worth the pain. I’ve never had my everyday speech be so costly! Choose: take a lighter to your tongue and say, “yes, I’d love some breakfast,” or remain silent!
5)The oral pain had a half-life. Once I had spiked the tongue pain, it couldn’t trigger again for about a second. I imagine there wasn’t enough neurochemical juice to trigger a response in my tongue or whatever spot in my brain is responsible for tracking tongue pain.
6) The hardest hit thing in this was my morale. I felt depressed and ground down. Every time my pain spiked, I worried that it would never end and I’d be stuck in terrible pain for the rest of my days. Some of this is being out of practice of managing these pain thoughts. Some of this is just the par for the course with COVID, which seems to wage a special type of psychological warfare on my existence. (I am not alone! COVID existential dread is a real symptom!) This is the reminder that there is a war on two fronts when it comes to pain: there are the direct feelings of pain and your condition, and then there are the ways that pain causes you to feel. I did a poor job managing the latter.
Key takeaways and questions:
1) I need a mechanism to coach individuals with chronic sharp, and unexpected pain. Most of my techniques are for the heavy, grindy pain, but back pain and other pain have the same shocking and sudden quality that my mouth pain did during this bout of COVID. It’s plausible that sharp pain can be just as much a “fake” signal during chronic pain as persistent aching pain, but I need new techniques to help people address it. It’s just a different monster dealing with surprise versus persistence.
2) How might I safely explore whether sharp gaspy pain can produce the pain cave? Getting into that headspace is one of the safety havens for long-term pain, but I don’t currently see an avenue into it with gaspy pain.Are these types of pain distinct from one another? What chemically or physiologically distinguishes these types of pain, if anything? And if they do the same thing, why is some pain “sharp” and some pain “achey?” Does it have to do with diffusion? The intensity of the trigger?
3) I’d love to understand the mechanism in play for the pain blindness that occurred a few times during eating. I suspect it's somehow related to what a migraine does to sight, but it might just be a sensory overload. It’s wild that I can lose a sensation rapidly just from pain.
4) Is there a way to get regular repetitions on managing pain thoughts when I am healthy? The COVID mood problem was severe and I’d like to be a bit better equipped in general to manage that? It’s not ideal to only have to lift heavy when I am at my worst? What would the lifting program look like to ensure I was ready for next time?
