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Ask HN: How should one work with severe chronic pain?
I'm in my late 30s and live in California. My health has been on a downward spiral for the last six years. I have severe musculoskeletal chronic pain throughout my body, particularly around the cervical spine, shoulders, and hips.
This physical pain makes concentration extremely difficult. It has become so challenging that I quit my software engineering job of 10 years a couple of months ago due to my inability to focus on the work required.
Severe chronic pain is probably similar to severe ADHD in terms of how it affects productivity, except that attention loss is caused by your body constantly sending pain signals. There are no drugs that I have found to help, at least not ones that don't cause significant harm to the body in other ways, such as opioids.
Unlike ADHD, severe chronic pain is not legally considered for disability, despite its impact on effectively performing jobs that require deep concentration or physical labor. I can still move, my range of motion is good, and my mental faculties are normal, except for the aforementioned ability to concentrate. It's just that I'm in constant physical pain. The U.S. government doesn't consider any of this as qualifying for disability.
I'm currently unemployed with state insurance, but the insurance is more for catastrophic accident coverage (car accidents, etc.) than for helping me with my chronic pain. When I had private insurance, I was never able to get proper treatment despite trying for years, and all it amounted to was enormous medical debt. I could probably find an engineering job, but I fear I would have the same problem of not being able to concentrate with the pain I'm in, despite how much I love programming. It's hard to be around people when you're in constant physical pain. I feel like I have a miasma around me, and I don't want to spread that to others, so I feel I'm better off alone. Previously, I would just hide my emotions at work and pretend everything was great, but the pain has reached a point now where I can't continue to do that (the pain causes me to physically grimace during web meetings sometimes). I'm spending my time now improving my engineering skills (React, Vue, etc.) and doing contract work; it's just an uphill battle with the pain.
I'm honestly unsure about what path to take in life. It's a terribly tragic thing when the physical human body gives up despite the mind and soul wanting to thrive, especially when young. My body has been broken for so long that I can't remember what it's like not to be in physical pain. I see other programmers and think how nice it must be to just code and not worry about pain, and reminisce when I was the same. I've long given up on my body healing on its own. The saying "All things heal with time" unfortunately isn't true for severe chronic pain.
All said, while my body has given up, and despite these depressing writings, my mind has not given up. My only goal in life has always been to live as long as possible to witness and experience life and future advancements in civilization, and that's still the case. I just wish I could have done it pain-free like most people my age, instead of having to live the rest of my decades in constant pain.
- YuriNiyazov 4y agoI've had a similar thing happen to me when I was in my early twenties - chronic pain, incapable of concentrating, grimacing during work, etc. Got fired, got unemployment (this was during 2008 crisis, so unemployment was two years, not 6 months), experimented hard during those two years (basically my full-time job was to find a combination of medication and lifestyle changes that reduced my pain and kept my mind clear). Luckily for me, I succeeded. First thing to handle in this case: if you look around the studies, you will know that chronic pain is a precursor to proper, clinical depression. So, if you are not getting psychiatric/psychological treatment for depression, that's the very first thing to attack. A common response to this is "but I am in chronic pain, not somehow sick in my head!", and if that's an objection that seems to resonate with you, you should get over that objection, fast. Chronic pain causes depression. Your writings sure as shit sound like you are depressed (well, you know, it's not proper to diagnose people across a text forum, but I'll take an exception in this one case). The combination of drugs and lifestyle changes that saved my life were Welbutrin for the chronic-pain-caused depression, and Lyrica for the actual pain, and private pilates workouts for the areas that were actually in pain in order to re-train the nerves and muscles around the area to send proper pain signals, and swimming to maintain general body health. I did nothing other than that for an entire year; sounds like you have a similar opportunity. Onboard yourself onto my cocktail across a period of four months, 1 item per month. Start with either lyrica or welbutrin. Lyrica in low doses makes one drowsy, and in higher doses has a perking-up effect. If lyrica seems to fix your pain but makes you drowsy, the proper response is to go up in dose, not down. Both lyrica and welbutrin are available as generics at this point, so you really just need to see a doctor that would be willing to give you these prescriptions.
- PaulHoule 4y agoThis. Chronic Pain is usually a disorder in how the brain processes sensations of pain.
- prirun 4y agoJust as a cautionary note, I recently had a friend who took Welbutrin to help her with anxiety as she was trying to stop smoking. It ended up causing a mental break, to the point where she was hospitalized and suffered brain damage. Her sister-in-law had been on Welbutrin for years and years with no problems.