Tag Archives: Ankle

What Is It Like?

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I was asked recently what morphine withdrawal feels like. When I am experiencing pain from CRPS or, like recently, the physical withdrawal symptoms that come with tapering off of morphine, it can be so difficult to try to imagine what it’s like to have never felt something like this so that I can explain it properly. I think of things like shards of glass embedded in all my joints, acid slowly eating through my bones, the hottest hot pepper burning into the skin around my ankle.

All these abstract metaphors made me realize that I’ve not yet described how I feel when I’m in pain on my blog, and how difficult those descriptions are. It made me want to describe a little better how I’ve been feeling lately.

Today I had a hard time getting up. I had the dogs trained to my schedule, with their first walk around 11 or noon and their second at 8 or 9 pm. But over the last week when I was having such bad days from my morphine taper that my sweetie was walking them, they became accustomed to getting up a bit earlier, and today they decided they just couldn’t wait. I am usually awake by 7, but I normally have a chance to get a little caffeine in me and let my body catch up to my brain before I get moving. Today our schedule was wonky and it felt like my arms and legs were full of sand. It wasn’t that I was sleepy, but like I couldn’t get the motor running fast enough to get moving. I got myself downstairs for food and coffee, but the dogs still had to wait another hour and a half for their walk before I felt like I could do it.

Before I got CRPS, the closest experience I’d had was the aches and pains of a very bad flu, where all your bones and muscles hurt from the fever. That’s still not all that close, although if you take that pain, spread it out a bit more so it occupies more of your body tissue, make it sharper, give it some hot-pepper kind of heat, and turn the level of pain dial up more than you previously believed possible, you get closer to what a CRPS full-body flare feels like to me. The opioid withdrawal symptoms add a spiky sharp jabbing, cutting feeling to each joint in the body. CRPS joins in over any pain–withdrawals, stubbed toes, healing wrist–it gleefully joins in for a pain party with any excuse. It lives in my ankle and foot, at times seeming to hibernate down to just a boring, nagging, drilling ache in the tendons and bones of the top and outside of my foot, muscle soreness on the outside of my lower leg, and heat of the skin on my ankle. That is the best it gets, and it never stops, sometimes bringing me to the point that I will bang my knuckles on something just to pull my attention away from that never-ending ache in my ankle, because with a flash of new pain I get a moment of not noticing the old.

When the CRPS wakes up, because of other pain, or because of emotion, or lack of sleep, or myriad other things, the first thing to hurt is my right hip, since it makes my leg muscles tense and tighten and pulls on that side of my body.  Then the heat seems to spread, radiating from my ankle, and at some point of no return, as the pain increases and increases in intensity, my elbows and knees begin to hurt and then the full-body flare breaks like a wave over the rest of me. It can be impossible to stay silent when the pain is at its worst, as much as I would wish to be a better stoic, and am embarrassed by the whimpers, groans, or tears that may happen despite my best efforts. It isn’t a call for attention, just a failure to keep it inside.

My maintenance medications turn down the dial. Every success with a new medication or dosage has felt like someone found my volume dial for the pain and turned the knob down a notch or sometimes even a few notches. The goal is not to feel no pain–while that would be wonderful, it isn’t necessarily realistic, and luckily, it isn’t what I need to enjoy my life. My goal, instead, is to have may pain controlled. Pain patients and doctors use that word a lot, “controlled.” To me, my pain is controlled if I can concentrate on something else more than how much my ankle hurts, and if I have something I can do to avert a full-body flare. It means that I have choices with what I do with my time and when I do it–when the pain is in control, my choices are much more limited.

I’m looking forward to one week from now. In that time, I will have stopped taking that last bit of daily morphine, and had time to go through the withdrawals from doing so. I should be starting to get some energy back, just a little, and will know that as my body continues to recover from the painful seven weeks it has had, it will feel better and better. It’s been a long and difficult time to get myself off of this medication. It will be wonderful to get back into feeling like I’m making progress in my life, instead of just waiting and doing my best to just outlast the reactions of my body to the lack of this medicine. I’m glad I had it, because it let me live more comfortably, and I’m even gladder I don’t have to take it any more. I’m not entirely sure how my body will do without it, but I’m very hopeful that it will do well, maybe even as well as I was doing when I decided I didn’t need it any more.  At the very least, I will have no more withdrawals to look forward to, and that is a wonderful thing.

Wish me luck!

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Aside

Before my wrist surgery, I had a chat with the anesthesiologist. I thought what he said was really clever. He said that when the brain goes haywire and won’t turn off, it’s a seizure. That’s basically the same as what is happening to the nerves in my ankle, so the way he thinks of CRPS is that my ankle is having a seizure. Makes those anti-convulsant medications I’m taking make a lot more sense!

Lateral view of the human ankle

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Your ankle is having a seizure.