Pain Management Ideas From A Kidney Donor

In 2002 I donated a kidney to my brother in an open surgery (rather than keyhole which is being used more widely now.)  It was a bit sore for a while afterwards (to put it mildly!)  In the days, weeks, months and even years afterwards I've listened to a lot of theories about pain management – put them to the test, and these are some of the tips that I've learned that I'd like to pass on to you.

Pain is all in the mind.  It is simply your central nervous system transmitting electric impulses – and as with all things, the mind controls it.  So, theoretically, you shouldn’t need any painkillers or help after giving a kidney… if you are a Buddhist monk.  If you are an average person, who hasn’t spent several years meditating on top of a mountain, you’re going to need all the help you can get.

One of the scariest times, when I was wishing they would give me a little something to take the edge off (and I wasn’t even in any pain yet!) was when I was going down to surgery.  Every other operation I’ve had they’ve given me a pre-med, so I was already drowsy – but I suppose because of the length of the kidney operation they didn’t want to give me anything “unnecessary” – in other words they were saving the good stuff (and it is good stuff.) 

I suppose it is a bit harsh to make someone actually get on to the operating table stone cold sober, ulp!, but then the anaesthetic made a little scratch on my hand and finally gave me the "joy juice". All the fear went away and I was just left with the beauty of what I was doing, I cried big fat happy tears as I said to the transplant co-ordinator, "it's such a beautiful thing".  She nodded, completely unphased, and that's all I remember before they turned out the lights.

PCA or Epidural

When you wake up you may be attached to either an epidural or a PCA (Patient Controlled Analgesia).  The main difference between the two is that an epidural provides a preset dosage directly to your spine, whereas with the PCA you choose the dosage by pressing on a button (the patient controlled part) but if you press it too often it can switch off (not good.)

The nurses told me to get the PCA, but the anaesthetist told me to have the epidural – in her words “when it works it’s great and if it doesn’t work we can always put you on the PCA.”  (Unfortunately mine stopped working in the middle of the night – an experience I wouldn’t wish on anyone), but my brother had PCA and had problems getting started with that.  The advantage of an epidural is that I woke up one happy bunny – high as a kite – convinced that I would get up that day – ready to run round the block.

In hindsight whichever you choose make sure you know what the procedure is if it stops working – and, if it does, make a lot of fuss and don’t be embarrassed to demand to see a doctor or an anaesthetist (whatever time of night it is!)

Traditional Painkillers

My first piece of advice for pain management is that whatever you use, take control of your own pain management as soon as you can.  The nurses in hospital are really tight with drugs.  I was only allowed them every four hours.  One time I actually managed to distract myself for six hours and when I asked for my pills they said I had to wait for the next lot – another two hours.  Well I never missed them after that!

When I left the hospital I carried on the regime. They became less effective, and eventually my stomach couldn’t take them – and throwing up when you have just donated a kidney is incredibly painful.

I went to see a GP after the op because I just couldn’t get any sleep. She was a lot less stingy and prescribed cocodamol, valium ("Take one in the evening with a glass of wine like me", she recommended), and hallelujah! dihydrocodeine. 

What I did then was to use the cocodamol whenever the pain got too bad in the day, effectively taking one dose a day, usually mid afternoon – and then taking just one dihyrocodeine (I was allowed two) at night – which conked me right out and I was able to get a whole eight hours sleep! 

The valium was for whenever I needed it – even if I had a headache or period pain (fantastic for both), and it’s fabulous stuff because it doesn’t take the pain away, but it makes you not care! 

Ibuprofen is worth taking for period pain – the renal doctors and nurses told me not to take ibuprofen, but my regular GP told me to ignore them because it reduces bleeding so it doesn’t just help period pain, but also the underlying cause.

Drugs will only help you so far, but sometimes it’s far enough, and if you also use them with other pain management methods they can give, if nothing else, a good night’s sleep; which is often the best medicine.

(They can also give you constipation if they are morphine based – so be careful with them).

Another trick is the power of suggestion. I take the tablets and, as I'm waiting for them to kick in, I tell myself “Wow I’m so stoned I’m going to pass out”. So rather than taking the tablets and lying there thinking “Are they working yet?  How’s the pain?” you think “wow – these are some strong drugs – I can’t stay awake” – go on give it a try, can’t hurt.

The mind is really much more powerful than the body, and by using this type of self hypnosis, you can strive towards Buddhist monk type pain management.

Oh yes, and be kind to your stomach.  Always try and take any medication with food (even if it doesn’t say it on the packet.)  I found it a very good idea to keep a biscuit tin by the bed if I had to take pills at night.

Natural Remedies

Apparently stem ginger is a natural painkiller and anti-inflammatory.  If you get really nice stem ginger cookies they are also excellent for taking your tablets with. 

Although it’s not strictly speaking a natural painkiller, I do highly recommend an Aloe Vera Colon Cleanser (despite the name!) as it is a gently laxative that helps your digestive system, and constipation was one of the biggest sources of pain for me post op.

Meditation

I would highly recommend meditation to everyone.  I used to do it on the Tube on my way to work and it made my journey really beautiful. You can do it anywhere and it really can make seemingly stressful situations much easier to handle.  It has definitely improved my life, pretty much every single day.

Focus On The Pain

What we perceive as pain is simply the overstimulation of your nervous system as your body tries to communicate to the brain “Houston – we have a problem!”  Usually your body is communicating something simple “Don’t do that!” or “Don’t do that again, you idiot!” or “That pan is really hot!” In this case your body is trying to say “Look I know you don’t want to hear this, but somebody’s taken away a major organ here, you’ve got extensive bruising and you’d better not move or try and get out of bed until we figure out whether it’s safe to do that.”

If you take that simple analogy, you can imagine also that by trying to ignore the pain, or dull it with painkillers, your body responds by turning up the volume – trying to make you listen and make sure “you do not reach for the remote control again like that because it’s bad for your damaged muscles.”

And the way to make your body stop shouting is to listen.  Focus on the pain, and then tell yourself “Yes I know those muscles are bruised, thanks for telling me.”  Open up, feel the pain, accept it, acknowledge it, have a little cry if you want, and then let go.

Distraction

One of my favourites; lots of TV, your favourite movie, tasty dinners, magazines, laughter, talking on the phone, reading a book, a nice foot rub, anything that takes your mind off your situation.

Hot And Cold

I was on a flight to LA and had hurt my back working on a film.  I had taken my painkillers (strong ones!!) but they weren’t having any effect.  I was three hours into an eleven hour flight.  In vain I went to the stewardess and asked for another pillow to try and get comfortable, she told me there weren’t any and I burst into tears. Luckily she took pity and gave me a hot water bottle. I put it on my back and conked right out (much to the relief of the poor guy next to me).

In LA I visited the Beverley Hot Springs in Korea Town. I waded into a natural hot spring pool and it was heaven!  Then I waded into the cold pool – complete pain wipe out – I highly recommend it.  Should you ever find yourself in a situation – run yourself a cold bath – as cold as you can take it – or even a cold shower on the affected area – it’s damn good and unlike painkillers you can have as many cold baths as you like.