Friday, November 21, 2008

Pain Tolerance and OLP

I drove up to San Francisco to see the mouth specialist. She took a good look at my mouth and found the same as I noted in my last blog post. It is much cleared up since that terrible episode in July-August. But, it is still worse than the average person's OLP. It surprises her that I have no pain right now. She has a patient who has less erosion than I do who has more pain, for example. I'm sure that people experience pain in different ways. And it is hard to measure the differences. One person may feel a pin prick as a high pain, and another barely notice it. There is no adequate scientific way as far as I know to measure pain. Just asking a patient to reveal on a scale of one to ten how much is their pain is inadequate. The person asking the question has a different idea in his mind than the person responding.

I think pain is a relative thing. I have had a lot of pain in my life from different things, especially from when I had the cancer, that I have a very high pain tolerance and can go about in my daily life experiencing pain levels that would cause another person to be bedridden.

When I think about that, I wonder. It is a dichotomy to me. I can go around in pain and ignore it and get along with it for quite a while, and as long as nothing aggravates it, I can manage. It is not like I want it to be that way, but I find that taking heavy duty drugs for pain makes me feel much worse in other aspects of my life. Quality is hampered and therefore it is a trade off. Live with the pain the best I can rather than try to eradicate it. So, that might explain the high pain threshold idea.

However, when it gets to the point of no return, where suddenly the pain is too noticeable for me, that is when I question the theory of having a high pain threshold. It is almost like a domino effect. I am going along in a slow incline of pain that grows and grows, still tolerating it. Then suddenly it reaches a peak and I can no longer tolerate it, and suddenly I am in intolerable pain, higher than most would wait to complain about.

What triggers the domino effect may simply be bumping into something that affects an area of pain, my hip for example. I might have been going along in life with a high pain level in my hip, but as long as the pain is steady, I can live with it, but the sudden jolt of bumping into something, will send my pain sensors reeling.

This is a problem where the ongoing care of my oral lichen planus. The other LP sores on my body mean little to me. An annoyance. As long as I leave them alone, they are fine and don't bother me. Digging at them opens the door to infection and that just complicates things. My sister has a skin condition where her medication has an antibiotic in it as well as an antifungal, as well as an immune modulator. I think that would work nicely for my regular LP, except for the idea of being over treated for infection. Our bodies have bacteria all over them that need to survive in order for us to be healthy. Killing off all bacteria is not a good idea.

I think what happens with my mouth is that I keep on living with it as it worsens, and working with it, adjusting to it, by changing my diet so that I am not taking foods that would irritate the mucosa. As time goes by it gets so bad that I have finally reached that "pain peak", and suddenly everything is cascading downward, like fallen dominoes. The pain finally takes over and the worsening condition of my mouth needs immediate attention. I really need to be more aware of this, but I find it annoying that I would have to constantly be monitoring and inspecting the condition of my mouth. One of the problems I see I have with this is that each day it might be growing worse in small increments and I wouldn't notice it as much as if it suddenly got worse overnight. Ah, so, maybe it is best to just check once a week and write down what the appearance and symptoms are for comparison, sort of like when women check themselves monthly for mammary lumps.

Being more aware of how much I am changing my diet to suit my mouth might also be a good idea to keep track of. Getting to the point of gently sipping water, not being able to chew, and eating only jello ought to have given me a broad hint that my mouth was in serious condition.

In the past, I had a really good camera that I would use to take pictures of my mouth when it was badly inflamed. But, I don't have that camera anymore. I have another, but I am not able to get the detail as well as I used to. That is why I haven't posted any pictures lately. I think if I take pictures of when my mouth is healthier, then maybe keep track on a regular basis, it would help me to recognize the changes, since just going by how the pain feels is not an adequate way for me to judge my situation.

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