As many of you know, early in May we lost Dr. Field very suddenly. This has been a very difficult time for the staff and the patients of North Shore Pain Management, and we will continue to struggle with grief and shock for quite a while. We at NSPM believe that Dr. Field would have wanted us to continue his mission of caring for people in pain and that this is the best way to honor this extraordinary man.
Grief and Pain
Unfortunately, grief is something that will happen to all of us. We will all experience loss at some point in our lives, usually multiple times, and in many ways. Grief causes feelings of sadness, but it is much more than that.
The brain reacts to grief in a way similar to how it reacts to physical injury, by releasing floods of hormones and chemicals that trigger stress-related responses throughout the body. This reaction ebbs and flows, resulting in times of feeling relatively normal, and times of severe symptoms that may be quite distressing. Sometimes we know what will trigger this response, and sometimes it seems to come out of the blue or be triggered by something small.
There are many physical manifestations of grief, which are uncomfortable, sometimes painful. It is for good reason that we speak of “the pain of loss” and “heartache.” Increased muscle tension can lead to headaches, migraines, chronic muscle spasm and increased muscle pain. Breathing can become more rapid and shallower, which can trigger asthma or panic attacks. There can be increases in heart rate and in the force of heart contractions, leading to a feeling of the heart “pounding.” Blood pressure, blood sugar, and cholesterol can increase. In the phenomenon known as Takutsubo cardiomyopathy, or “broken heart syndrome,” the heart undergoes rapid changes and becomes very weak as a result of a sudden emotional upheaval – fortunately, this usually heals in a few months, but can be quite frightening when it happens.
Other body systems are affected. The stomach and bowel, sometimes called “the second brain” because of the enormous number of nerves in these organs, can have problems, including heartburn, reflux, stomach pain, cramping, nausea, constipation and/or diarrhea. Eating habits tend to change – we eat more, or less, and often less healthy foods, which can throw off gastrointestinal function even more. The sexual function becomes disrupted, leading to erectile dysfunction in men, changes in menstruation or menopausal symptoms in women, and reduced libido in both.
Insomnia is common, which causes increased pain perception, and memory lapses may occur. We can forget, or just not feel like taking, important medications. There is a widespread inflammatory response, and other effects on the immune system, so chronic diseases such as rheumatoid arthritis, lupus, inflammatory bowel disorders, and IBS can flare, and we can become more susceptible to viral and bacterial infections.
In short, grief can cause increased pain in all sorts of ways. The body and the brain are wounded, and grief, like all wounds, takes time to heal. Grief, like all wounds, is uncomfortable and distressing, but using medications to suppress normal grief responses will backfire, in the long run. Instead, there are a number of healthful ways to manage grief symptoms.
- Breathing exercises are very simple and surprisingly effective. Take a few minutes several times a day, or whenever you feel the need, and breathe in slowly and deeply, through the nose if possible. Pause, then breathe out completely, taking longer to exhale than you did to inhale. Repeat this cycle a few times.
- Eat in moderation, even if you don’t want to. Choose healthy foods, low in sugar, salt and fat, avoiding processed foods. This is not a time for “comfort foods”, unless your comfort foods are lean grilled chicken and steamed fresh vegetables with a squeeze of lemon! Don’t forget to stay hydrated, and limit or avoid alcohol.
- Exercise, in moderation. Movement helps the body reset and recover, stimulates the immune system, and helps muscles relax. Maintaining your usual exercise program as much as possible may be the best plan.
- Make sure you allow time to rest. Often after a major loss, it seems there are a million things that need to be done right away. Do your best to prioritize – what really needs to be done right away, and what can wait for a while.
- Talk to a grief or trauma counselor. These are people with training and experience in helping people navigate the healing process after a loss. They can help normalize and demystify the emotional and physical sensations that are part of the grief process.
Be kind to yourself, be gentle to your body and mind. This will pass, you will heal, life will go on, the pain of loss will ease. It takes time, but it can and will happen.
At North Shore Pain Management we provide advanced, evidence-based, multidisciplinary and cost-effective pain management. Our goal is to improve your ability to return to the activities you have been missing as well as provide a meaningful reduction in pain.