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Let’s Talk About Sex, Baby — and Chronic Pain

The thing that nobody tells you about Cymbalta is that it takes a machine gun to your sex drive. Seriously. When I was on it, I was so repulsed by sex that I started to think maybe I was legitimately asexual. 

I mean, when the doctor hands you the prescription, it would be nice if they threw in something like, “BTW, you’re never going to want to make passionate love while you’re on this medicine.”

But of course, doctors never tell you stuff like that. And God forbid they give you a handout of some sort that maybe mentions it. No, they just leave you to Google “asexual” at 1 a.m. on a Tuesday night when you realize you’re identifying a little too much with Sheldon on the Big Bang Theory.

Don’t get me wrong, I have definitely been in such tragic levels of pain, that if someone had asked me if I wanted to give up sex so I could feel better, I wouldn’t have even thought twice about cutting off my own vagina and handing it over. 

But the thing is nobody asked me. They didn’t tell me I might have to make that sacrifice when they put me on Cymbalta. So I didn’t even know it was happening. And that’s when you get to some pretty dark places. 

Thankfully, I’ve since gone off Cymbalta, and my sex drive came back like a freight train. 

But that doesn’t mean there aren’t other issues related to sex and chronic pain.

Like when you have stabbing rib pain on your right side, so you can only tolerate sports bras, and then he goes to unhook the back, and it kills the mood because there is no hook in the back of a sports bra. And he’s mad that you’re dressed like someone planning to run a 5K, and then you’re mad that he’s mad that you’re dressed like someone planning to run a 5K, and so you just leave.

Or when he wants to cuddle, and you have to explain that, “Sorry, I can’t lay on my right side because when I do it feels like someone is jack hammering into my bones through the mattress. Hope that’s not a deal breaker!”

Not to mention the fact that when you’re in physical pain, the last thing you feel is sexy. And you most certainly don’t feel like having anyone touch you ever. 

First, there’s just the literal pain that can come from someone passionately throwing you against the wall, or even a pillow top mattress for that matter. When you feel like you always have a broken rib, even passionate love making can make you wince. 

Then, there’s the fact that the pain probably keeps you from showering as often as most Americans believe is normal, which means you probably smell, which means you’re probably not feeling very romantic. 

And of course, there’s the side effects from the medications, which make you gain weight, sleep all day, and zone out in front of YouTube videos about makeup while you simultaneously lose the ability to actually wear makeup. 

Not to mention the fact that it’s just really hard to make love to someone, while you yell things like, “OH GOD! OH GOD! OH GOD!  IF YOU TOUCH MY RIGHT SIDE AGAIN I’M GOING TO STAB YOU TO DEATH!’ or “YES! YES! YES! I NEED YOU TO AVOID MY CHEST AREA AT ALL COSTS!”

That’s the kind of stuff that can turn an evening of “Netflix and Chill” into an evening where you actually watch Netflix and chill. 

But even with so many things working against the sex lives of those with chronic pain, that doesn’t mean people should give up. 

For one, that old saying about how, “You can have great sex without having a great relationship, but you can’t have a great relationship without great sex,” is actually pretty true in my experience. Having sex is an important part of being a healthy couple. Of course, that doesn’t mean partners shouldn’t be understanding of the situation, and our pain levels. What it does mean is that avoiding sex, regardless of how legitimate the reasons for doing so are, will likely put a strain on your love life. 

Also, sex is just a good thing to have in general. It helps your mood, it can be a great pain reliever and stress reducer. And, you know, it’s fun.

So I don’t think patients should just resign themselves to the idea that having chronic pain means giving up good sex for the rest of their lives.

Unfortunately, I don’t have magical solutions to offer people with chronic pain struggling to work sex back into their daily life. But there are a couple things you can at least try.

First, there’s always the obvious “talk to your doctor” advice. Yes, I know that conversation can be awkward — both for the patient and the physician. If you’re up for the conversation though, I definitely recommend it. Your doctor might be able to recommend other medications that don’t kill your sex drive, some less painful positions or other techniques to help you out.

In the end though, I honestly think the best thing you can do is be open about the issues without whomever you’re making love to. Just like with anything, talking about what’s going on usually does the most good.

And if you both decide that maybe you can try to get a wire-free bra with a hook in that back because that’s what he’s into, as long as he promises to never touch your right boob, then great! Or, if you decide that having sex just isn’t worth the pain, then that’s great too.

After all, there’s always Better-than-Sex cake in a pinch.

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What it’s like to be a woman in pain

Being in pain every day, all day, is hard. But when you’re a woman, there’s a whole extra layer to the situation that makes everything that much harder.

It’s not just the expected stuff, like being told by a doctor that your bra is too tight and that’s probably what’s causing the excruciating pain in your right ribs that’s so awful that you literally want to jab a knife into your side and rip the bones out.

Or, after you change your bra, being told by the same doctor to just “calm down” because you’re probably just stressing yourself out, and that’s what’s causing pain so severe that you have to stop mid-conversation multiple times a day and lay flat down on the floor because you just can’t bear the agony of standing up.

No, it’s the other stuff too. It’s the things you don’t expect.

Like being accused of being a sexual assault victim, because that’s the only thing the doctor can think of to explain why it hurts like the end of the world when someone touches your ribs.

Or having a male doctor get uncomfortable examining your ribs because GASP! your boobs are right above them. Didn’t he go to medical school? Has he never seen a cadaver? Would he be so shy if it was a male patient with chest pain?

And then there’s stuff that you can’t even be sure of.

Like did that male doctor just give me Aleve for my level-10 pain because he really thinks that’s going to help? Or did he just think that, as a woman, I was probably exaggerating?

And, did that other male doctor accuse me of being an amazing actress just trying to score pain meds because he does that to every patient he sees on opioids? Or did he do that because I was a wee woman?

There’s also the stuff that bothers you, because you’re a Type A woman.

Like how you suddenly have to ask for help for everything. How you have to literally ask people to drive you to work, and do your laundry and even go over to the dining room table and grab your medication because you’re in too much pain to do any of it yourself.

And how asking for help means giving up control. So suddenly your towels aren’t folded the right way, and you have no idea where your favorite yoga pants are, and you have no say in what flavor yogurt you eat because you’re way too sick to go to the grocery store yourself. And it makes you crazy, but you have no other choice but to let it all go.

Except when you don’t let it go, and you try to do it all anyway. And so you work until you drop, and then you go home and do all the housework, and then you go on a date with your boyfriend and you end up screaming in pain in the ER because you really can’t do it all any more. You can’t even do some of it.

Then, there’s the stuff you hate.

Like when your boyfriend pretends like he understands how much pain you’re in, but then has a totally different reaction when one of his male friends tells him he endured the same thing and it was excruciating. And suddenly your boyfriend is way more sympathetic.

Or when you get genuinely upset about an emotionally abusive situation at work, and your boss tells you that it’s probably just because you’re so moody from all those pain meds you’re on.

There’s also the stuff you hate to admit.

Like how, as a woman, it’s especially hard to endure the most common side effect of medication — weight gain. And how, you hate that so much of your own self-worth is wrapped up in how you look, even when you’re in so much pain that you literally want to kill yourself to make it stop. And how you keep taking the meds and gaining the weight because you have no choice, but you also, simultaneously, fill up with shame knowing that you no longer come anywhere close to society’s definition of beauty.

Or how you can no longer stand up long enough to shower and blow dry your hair every day, and so suddenly you find yourself going a full seven days without a shower. And you know people are totally judging you for it. And they are judging you all the more harshly because you are a woman, and women are supposed to put an effort into their appearance at all times.

Or worse, how you finally decide one day to endure the shower, and hold the blow dryer, and sit on the toilet seat cover so you can do your makeup, and you take 30 minute breaks between each step so that you don’t wear yourself out. And then you put on a nice outfit and you go out to Steak & Shake and you run into someone you know and they say, “Wow! Well, you certainly LOOK great!” implying somehow that you can’t really be that sick if you’re wearing pink lipstick.

And there’s also the stuff you don’t even want to think about.

Like how you’re only 30 years old, but you’re in chronic pain every single day, which doesn’t exactly make you a great catch. So will you ever really be able to have children? And can you even think about having a kid when you can’t even take care of yourself most days? And anyway how would you even carry a baby when you need seven different medications just to survive?

So yeah, being in pain is awful. And being a woman in pain is also awful — but for a whole bunch of extra reasons.

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Looking for God on the operating table

There I was, stomach down on the operating table, in only a hospital gown and my underwear, and I found myself doing the one thing I hadn’t sincerely done in months.

I was praying.

With my whole heart, my whole being, and my whole soul, I was saying the most earnest prayer I could remember saying in a long, long time.

“Dear God. Please, please, PLEASE be with me right now. Please, whatever happens, please do not let them hit a nerve. Please God. I could not handle it if that happened. Please God. You are the only one I can ask for help right now. I need you. I need this. Please help me.”

It was my second trip to the Mayo Clinic and I was in the midst of what was supposed to be a 10-minute epidural that had passed the hour mark. The original doctor had been unable to get the needle through my spine in my middle back, and another doctor had to be called in to consult.

Eventually, they decided to go through my lower back, but to get the medication in the right place, they had to thread a catheter tube up my spine — no easy task. They kept threading it to the left when it needed to go right, and so they had to keep pulling it back down my spine and out of my body and redoing it.

In case you’re wondering, it really hurts when they do that, and you can totally feel it.

Before the procedure, everyone I talked to, from the nurse who checked my blood pressure to the actual doctor slated to give me the epidural, had assured me seven ways from Sunday that this was going to be a quick and easy procedure.

They told me there was no reason to give me any of the sedative I had been given when I had undergone a similar procedure awhile back, because this one was just going to be so dog gone easy.

I should have known then that it wouldn’t be. But I nervously took them at their word.

Eventually though, as I heard the doctor tell his resident, “I’ve just never seen anything like this before,” I started to worry that this whole thing was going to be full of worst-case scenarios. One of which was that they could hit one of my nerves during the procedure, which could send a shooting pain down my leg, that, from what I could gather, would hurt like hell.

So, as more and more things went wrong, I lost more and more faith in the doctors poking me in the spine. And eventually, I turned to the only one you can turn to when there’s nobody else left to ask for help — God.

“I’m so sorry that we haven’t talked much in the last few months. I am so sorry that I haven’t been going to church. I swear, I am,” I prayed silently. “I just really need your help right now. Because I am going to freak the eff out if they hit my nerve. I’m telling you, I could not take that.”

Eventually, about 90 minutes after I first lay down on the table, they were done. The doctors had managed to get the medication into the right spot without hitting any of my nerves.

I could barely walk out of the room to where my clothes were, and it felt like someone had just stuck a bunch of needles into various parts of my back — mostly because they had.

All I could think about was that prayer though. I hadn’t prayed like that in such a long time.

So many people write how having a chronic illness strengthens their faith, how it brings them closer to God than they’ve ever been. But I have no idea how that happens. For me, it’s made me a little bit more of an atheist every day.

When I first got sick, before I was on any medications that helped at all, before I had any idea what might be happening to me, I would lay in bed at night, unable to fall asleep because of the pain, and I would literally cry out to God.

And in those moments, when the pain only got worse, He seemed so silent.

Then, when it became clear that I would have to resign my role as the youth leader at the church I was attending, I started to question whether this whole thing was somehow God’s way of telling me I wasn’t doing a good job leading the youth.

I know, I know, that’s probably not true. But when something like that happens to you, it’s impossible not to have those thoughts.

From there, I started to wonder how any God could ever let one of his children suffer the way I have.

And then, one night a few months ago, I was up all night in such severe pain that the next day the doctor gave me a shot of Dilaudid. Unfortunately, instead of relieving my pain, it promptly made me start vomiting uncontrollably. I literally threw up all night long, with barely enough time to catch my breath between each time.

It was the worst 48 hours of my entire life. And it was then that the questions of where God could possibly be during all of this really started to take root.

I really do believe that life with obscene chronic pain is the worst life imaginable, and I don’t understand how it could possibly lead anyone to have a closer relationship with God. For me, it has only made Him more and more distant.

Maybe I am angry or just confused. And maybe one day everything will become clear. But for now, I am in too much pain to make sense of the fact that a supposedly loving creator would let one of his creations endure such a thing.

And yet, there I was, on the operating table, praying with such a sincere heart that I barely recognized myself.

So I guess when it comes right down to it, I still want really want to believe. I need to.

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