Chronic pain, chronic illness



The headaches start with a twinge at the temples. It slowly grows stronger over the course of several hours until it feels like hot pokers are being forced in behind my eyes. The sensation of pain is accompanied by nausea, the combination of which often makes it difficult to remain still. Sometimes I vomit. It usually continues for most of a day. Often the pain will wake me from fitful sleep. Sometimes it's not even gone by morning.

These headaches were, varying in severity, a near-weekly occurrence for me at least as far back as middle school. Usually made worse by lying down—I've always been a side-sleeper—I'd often have to position myself sitting up to moderate the pain enough to sleep. Sometimes that wasn't sufficient, and standing up and walking around was the only way to tolerate the pain. Watching comedy is a good distraction. I've seen South Park: Bigger, Longer & Uncut a lot.

Pain and chronic illness go hand-in-hand. To live well with chronic illness requires learning how to listen to and understand pain. This is my experience with chronic pain.

A little history

I was diagnosed with an autoimmune disease, Hashimoto's Thyroiditis, around the age of 10. I saw several endocrinologists for thyroid hormone supplementation management over the course of the next decade. A typical visit involved reviewing blood thyroid levels, a short physical examination, and recommended changes in dosage for my Synthroid levels. As is typical with a lot of modern doctors, no real effort was made to address or explain the core causes of my disease.

The patterns of pain didn't change much for many years until I went to a new doctor during my first years of college. Based on research linking autoimmune thyroid disease to diet, he recommended a gluten antibody blood test. The test came back moderate-positive—not celiac, but not normal—so I went gluten free.

Healthy eating was, especially at the time, not something I did well. Although of a low-normal body weight (which is attributable to my continued gut dysfunction), I occasionally flirted with pre-diabetic fasting blood glucose levels and had had chronic mild-to-moderate depression since high school. Dietary changes were a new idea for me, but my mother and sister were diagnosed with gluten-intolerance as well (they also have Hashimoto's) and the team effort made things easier.

Through the nutritional journey, I learned that the symptoms of my autoimmune disease were strongly linked to gut dysfunction. Leaky gut was a particular suspect. My tendency towards being sensitive to everything lent weight to the leaky gut theory, as well as my propensity towards developing new food sensitivities for foods I consumed frequently.

Going gluten-free ended up being only the first step. Eventually I removed dairy, then soy, then went paleo, then nightshades, experimented with GAPS and PHD, and finally ended up on Autoimmune Paleo.

Back to the pain

There's a tendency for chronic pain sufferers to see their pain as unavoidable: It's just something you have to suffer through. You can try to mediate it with pain killers, but ultimately it's just a burden you have to carry.

For a long time, I thought this way, too.

First clue

I remember one of the first clues I had about the origins of my headaches was while attending a pair of family weddings in San Francisco in high school. One of my relatives is a massage therapist and he had been learning about trigger point therapy and referred pain. While sitting in a playground in downtown SF one evening, the topic of my headaches came up, and after describing the pain to him he pinched a spot on my trapezius muscle at the top of my shoulder that immediately caused a headache to bloom briefly in my temples.

This was a big breakthrough at the time, and gave me tools for moderating the pain. Pinching on the trigger point in my shoulder could sometimes help to alleviate the pain after 20-30 seconds of applying pressure (and worsening the headache many times while doing so). Applying hot pads also helped sometimes. The trigger point handbooks pointed to computer use as a potential cause for this particular referred pain, and so I endeavored to improve the ergonomics of my computer environment and take more breaks. This helped somewhat, but hardly solved the issue.

So it continued for several more years.

Nutrition helps

Although going gluten-free reduced the frequency of my headaches significantly, they'd still come back every few months and were as severe as ever. As I continued changing my nutritional plan, things slowly improved, until finally landing on Autoimmune Paleo almost eliminated the headaches.

I did not initially attribute these improvements to diet directly—or, rather, I did not link the cause of the headaches directly to food sensitivities. My overall health and well-being was improving significantly, thanks to the nutritional improvements, so I figured the chronic pain was improving along with it.

The last piece

It wasn't until relatively recently that I finally made the direct connection between food and the headaches. One of the symptoms of leaky gut is the tendency to develop new food sensitivities. I still occasionally lose foods that I overeat—sweet potatoes, coconut oil, dates, and carrots have all been victims of my gut dysfunction. It was the carrots that finally made the final connection for me, though.

One of my favorite dishes to make for a long time was boiled carrots with ground meat, lots of salt and pepper, and a big helping of pastured lard. It was after making myself a large batch of this that I noticed my chronic headache starting just after taking my first bites, and worsening with every bite after. A few weeks later I had a similar reaction to another favorite: dates.

This finally solidified the connection for me. My chronic headaches were linked directly to what I was eating. This made sense, as I recalled several experiences in middle school where throwing up some gluten-laden meal had immediately improved a set-in headache.

Pain is a teacher

Pain is a powerful tool. Especially for people with chronic illness. It took me 15 years to figure out what one of my chronic pains was trying to tell me; but, in learning to understand what that pain is communicating, I turned pain into a tool for managing illness. Now I know: if I get these headaches, it's because of something I've eaten. I can use that information to avoid food or modify what I'm eating in some way to prevent that pain in the future.

Anecdotal evidence from friends and family members suggests this, too. One of my aunts linked her chronic migraines to a shellfish sensitivity using a food calendar. Pain is your body trying to communicate something to you. The hard part is figuring out what.

Pain is not something you should just suffer through. It's a tool you need to learn to use. It's a tool you can learn to use. When you do, you become that much more empowered to manage your illness, and each step down that path is a step towards less pain, more energy, better days, and better living.