Working through pain
It may feel like moving mountains, but 'doing the work' despite the pain is what keeps Nancy Hiller in this game we call life.
“As I tell my kids, my students, and just about everyone else, I try to tell myself…when things get fogged, just do the work. Always just do the work. If there is little else that may deserve a pat on the back, doing the work will always suffice.”— Steve Latta
Everyone has a bad day once in a while. Most people will succumb to the occasional few days off work due to a seasonal flu. And many of us will at some point face illnesses of longer duration.
When sickness hits, it can leave you reeling. I remember recovering from a bout of influenza in my late 30s that left me so weak and exhausted that I wondered whether I would ever feel like myself again – and I’m happy to say that was well before the extended period that I now recognize as my prime. It doesn’t matter how tough you are; serious illness packs a punch and can sometimes make it feel impossible to “do the work.”
Now, along with many others, I’m living with cancer. My experience with this condition shifts as time goes on, with changing symptoms and side effects from treatment, whether chemo (at the beginning) or opioid pain medications at night (more recently). Until January I was able to work, albeit at a slower pace than normal. But for a few weeks starting in late January the pain became so intense and unrelenting that I couldn’t bring myself to focus on much else; I was literally counting the hours until I could start participating in a clinical trial and then have a nerve block. So here we are in March, three weeks into the trial and post-nerve block, the effects of which have been more subtle than I had hoped. A couple of major work deadlines are looming, things I said yes to in large part because I knew I could leverage them as motivation, even if times got harder.
Times did get harder, and I need that motivation more than ever. Plus, I’m totally over being sidelined. But can I do the work?
What does all this reflection on pain have to do with woodworking, and why is it appropriate for a post at the Pro’s Corner blog? Answer: I’m far from alone in facing this dilemma. The past few weeks I’ve been floating on a tide that alternates between sleep at night thanks to painkillers, and hours torn by pain, doing my best to stretch out the time between these when my mind can focus on other matters such as work, whether that work is writing, design, or building in the shop. While this experience is new to me, I’m increasingly aware that many others live with chronic pain brought on by all sorts of conditions, from broken bones to long-term neurological or gastrointestinal problems; many of us need ways to refocus in order to function. I offer what follows in the hope that something here may help fellow furniture makers faced with debilitating injury or disease.
Analyze the problem
In my case, as I understand it, pain is caused by tumors pressing on nerves in surrounding tissue, as well as by blockage of some large blood vessels. The little varices (blood vessels) that formed to take over the load that would otherwise flow through the Trans-Alaska Pipeline portal vein – a wonder of the body’s creativity in response to disease – are under pressure after I eat even a small amount of food, which translates to discomfort. These and other forms of pain, both chronic and acute, are accompanied by a general feeling of unwellness and lack of appetite.
“How does the pain feel?” asks my oncologist, in an effort to help with prescription medicine. Here are a few descriptions I noted one evening over the course of about an hour:
- Shooting pain on my mid-left side
- Stabbing pain on my right side
- Wrenching back spasms in the mid- to lower back
- A deep, dull, burning ache in my left back
- Pressure at the head of my pancreas
- A deep, bruise-like ache in my lower back
- The sense that there are large rocks with sharp edges jammed into my abdomen.
At times the pain is intense enough that I just want to escape from my body – and this is pain I still rank below a 10 on the doctor’s scale. Fortunately I have access to various pain medicines, our bed, and blankets, in addition to hot water for baths; my heart really goes out to those enduring illness or injuries in a war zone such as eastern Ukraine today.
Paradoxically, paying attention to the pain can make it easier to bear. At its worst, my pain has felt like bad period cramps. Not something I can recommend. But comparing it to something that I lived through for year makes it more bearable. What differentiates my pain due to pancreatic cancer from that of bad period cramps is that this pain has no expected end date of three to seven days from its inception. The only way to make the pain go away is to shrink or remove the tumor. With many other types of pain, anticipating relief can have a modulating effect. Intractability makes pain harder to take; it feels inescapable. Even when you can get some relief, it’s hard to avoid dreading the next onslaught. With an incurable condition, there may be no expectation of extended relief, short of that brought by heavy-duty drugs available through hospice. I find it helpful to remind myself that the pain itself  is less severe than the impact of its sheer relentlessness.
When the pain was first developing, it was mild enough that I refused to call it pain. I called it discomfort. This was not just a matter of semantics; it helped me deny the pain’s power over myself and my daily activities. It’s easy to give even minor pain enough power that it keeps you from doing things that will make you happier. I have observed this in my own life, as well as others.
This precision in defining pain helped me keep on working. My plate rack photo shoot with Anissa Kapsales took place during this time; I was still able to tell myself that the pain could be increasing simply because I was on a less-toxic form of chemotherapy than the one I’d been on before, which had miraculously obliterated all of my bodily pains, not just those from cancer, while I was on it. In other words, the pain might not even be due to the cancer, a possibility that robbed it of at least some power. It was a plausible explanation, even though I acknowledged it might be off the mark. And since there was nothing I could do differently at the time in terms of treating the cancer, this mental strategy caused no harm.
For those wondering why I keep emphasizing the importance of continuing to work, this is not about work addiction or simply needing to earn income (though that remains part of my reality). Nor is it about self-validation. More than ever, I need to work for the sake of my sanity. Work keeps me in the world – and never more so than during a pandemic when my husband and I have been hard-core isolating due to my sometimes-immune-suppressed condition. Through work, I get to interview people and give talks, visit with colleagues who have become friends, collaborate on the occasional project, and bring drawings developed from inchoate concepts to three-dimensional life. That’s real-world magic. So you can be sure I want to work. And whatever helps me keep working is something I want to do.
Second-guessing strategies for managing pain
But then I second-guess myself. Pain, after all, is a warning, an indication that something’s wrong. I ignored the pain that I now know was related to my developing pancreatic cancer. I ignored it for years, because it was minor and annoying and I’m not a hypochondriac. Nor do I make medical appointments lightly; I have no interest in abusing what access I have to medical services. So maybe I should be paying more attention to my current pain, rather than less, in an effort to avoid further damage? Maybe I should just accept that my working life is over?
I’m not ready for that. I have spent the past month in this second-guessing business, in part because I have two professional obligations that I really want to fulfill: Even if I could find a way to stop or significantly diminish the pain through mental and pharmacological interventions, is it responsible of me to do my best to see these work commitments through?
Anissa and I have been waiting for more than two years to do the shoot for my article about a Voysey two heart chair; we’re planning to do that toward the end of this month. I’m also scheduled to give a talk in person at MESDA on March 19, which means getting my body from south-central Indiana to Winston-Salem, North Carolina. (The painted chest at the head of this post is in the MESDA collection. It’s one of their holdings that will be part of my presentation.) My plans for that trip were vague and involved driving, until my husband pointed out a few days ago that it would be foolish to drive 10 hours alone, given what my body has gone through over the last several weeks. Even sitting in a vehicle for 10 hours if he drove would be hard in my current condition. At this point I have acknowledged that I am no longer the paragon of productivity I once was. I do not have the physical stamina, nor the mental agility to multi-task. I can focus well, as long as the router, phone, and UPS delivery person aren’t clamoring for my attention at the same time.
So I lay out the salient strands of my current reality and consider whether anything here constitutes a reason not to pursue these work commitments:
- I have a deadly condition that typically comes with a short life expectancy. I guess it’s possible, in theory, that I could develop some kind of gastrointestinal blockage that could make me incapable of driving, walking, or flying home. I wouldn’t want to be in a hotel room in such circumstances, a long way from help and home. But my oncologist told me he saw no reason why I should not go to the conference. He’s the one erring on the safe side of everything, so if he thinks it’s fine, I’m not going to argue.
- On the other hand, provided that my condition does not take a precipitous turn for the worse over the next few weeks, I should be able to pull off what I need to do. My oncologist was not concerned that it would be dangerous to travel to North Carolina, as long as I don’t sit still for more than two hours at a time and so risk deep-vein thrombosis; any kind of stroke is more likely with pancreatic adenocarcinoma.
- I am participating in a clinical trial of a promising new targeted therapy. Although I haven’t noticed any improvement in the three weeks since starting the trial, it took this medication 45 days to show effectiveness in mice. It’s not as though I’m neglecting my health; I’m doing all I can. And there is no compelling reason to put the rest of my life on hold in the meantime.
- I now pay attention to my pain and am trying to learn how to manage it so that it won’t dominate me. People have been telling me for years not to push myself so hard. I have finally listened.
- I know that when I am engaged with other people – as long as I have the energy for that engagement – I benefit from my body’s production of adrenaline, which helps me focus even more and also diminishes pain. Yay for that.
I also continue to discover easy, simple things that help:
- Super-hot baths with rosemary oil.
- A hot water bottle (or, when in public, a heat patch).
- Walks in the cold outside, or just standing outside in the cold with too few clothes on, to shock my nerves out of focusing on the cancer pain.
- Lifting weights and other forms of exercise also seem to distract the nerves from focusing on the cancer pain (or maybe exercise, like a hot bath, diverts blood flow in a way that reduces the pain).
These helpers go hand in hand with regular visits to the oncologist and complementary protocols such as reiki, acupuncture, a healthy diet, daily exercise, etc.
Treat yourself to a dose of inspiration
Illness is a challenge. Every person I’ve spoken with who has lived years following a diagnosis of Stage IV pancreatic adenocarcinoma has been through intense periods of pain. They – we – have all been told that they would not live for more than six months, etc. etc., even though those with whom I’m in touch have lived for six, eight, and in one case, a whopping 21 years. So far, they have prevailed. I look to their examples for my own strength to prevail. If pain is part of that, at least in the short(-ish) term, I will grit my teeth and endure it.
I also remind myself often of inspiring people I know who have lived with their own challenging health conditions. Although most people don’t talk about pain (which is why I decided to write about it here), a surprising number of people you know may be living with it, whether acutely or long-term. A couple who come to mind for me are Jeff Miller, who has lived most of his life with serious kidney disease, and Danielle Rose Byrd, who demonstrated shrink pot making at FWW Live! in 2019 while working through the pain of a kidney stone. Imagine fighting waves of nausea while presenting to a crowd (and using a sharp hatchet). At one point, she thought about running into the hallway to find a trash can. “I was just about to push into the T auger and the force of it almost did me in,” she wrote, describing the experience. “I ended up having a horrible pain and nausea attack after my second presentation, took a 2-hour nap after my anti-nausea meds kicked in, and then decided to bolt home while I was still feeling good.”
Meanwhile, my own schedule feels like a wasteland tied to a pile of signed proposals for which I have not taken any deposits and which are all based on my clients’ and my mutual understanding that I may never get to the jobs in question. I could just cancel them all, but I really want to do the work. I just finished a kitchen design job that was well over a year past the proposal date. All of this is par for the course since my diagnosis, and it grates on me as someone who has prided herself on being dependable. So it’s time to get back to work.
—Nancy Hiller is a professional cabinetmaker who has operated NR Hiller Design, Inc. since 1995. Her recent books include English Arts & Crafts Furniture, Making Things Work, and Shop Tails. For ordering information see Nancy’s website.
 Men, I have no better comparison, so please ask one of the women in your life to describe their worst period pain.
 I am not a candidate for surgery, which is rarely performed when people have metastatic pancreatic cancer.
 “The pain itself” is a problematic expression, because pain does not exist separate from one’s experience of it. In other words, there is no such thing as “the pain itself” – as though it existed objectively, apart from the person experiencing it and separate from whatever else is going on in that person’s life that may alleviate or exacerbate the pain. Even so, comparing the nature and intensity of the pain to other forms of pain one has experienced in the past makes it possible to define the pain somewhat, to circumscribe it, and so keep it from dominating one’s awareness completely.