Today's prompt: Pain medication prescriptions are difficult to obtain and scary to use. What horror stories do you have because of new laws? Maybe you have been treated badly at the pharmacy or by family members?

RA and pain are no strangers.

There have been times over the last thirty-eight years that I've had this disease that I didn't think I could go a day, an hour, or a minute longer. The pain of RA is never constant.

There's the one I call "knife arthritis", which feels as if someone is taking an icy cold knife and moving it up and down the inside of my legs. Suffice to say, I just squirm like a worm that knows it's going to be cut in half by some curious child. *Ahem!* Fortunately, I rarely get that one.

Then there's the pain that comes from hot swollen joints. Let's not forget the pain that affects the surrounding areas where the joints are dislocated, deformed or fused. Morning pain. Weather-related pain. Medication side-effects pain. Surgery pain. Injection pain. One, I hope you'll never experience - the pain of a dislocated hip. Once wasn't enough for me though - I had to go and do it twice.

Whatever way you look at it, it's a P.I.T.A. (I'll let you figure out what that means!) Areas that receive a lot of snow or rain often have a big list of words from which to draw upon to describe the differing qualities of that particular type of precipitation. Pain is no different. When you need to describe your pain, check out this post: Another Word for "It Hurts!"

The last ten years have been kind to me. I believe a large part of that has to do with the fact that I have taken much more responsibility for my health and wellness. I attribute a lot of that to the transition into Auntie Stress. The techniques, tools and strategies I use go a long way to addressing and undressing my stress. 

Stress has a huge role to play in what happens in your body. Like that Mousetrap game of long ago, one thing triggers another, which triggers another. Chronic stress can contribute to immune dysregulation; not only does it have a role to play in physical symptoms, but stress can affect you emotionally (depression, anxiety) and mentally by firing your brain's CEO - the prefrotal cortex (PFC).

So, back to me. Things happen that stress me out. Fortunately, unlike previous decades, I am able to turn off the taps to those stress hormones. Stress techniques have given me a safety valve. Less stress also means I am much more diligent about looking after myself.

Your health and wellness picture is comprised of a number of components; the more you attend to, the better off you are. Whether you are in an acute or chronic state, the list can be overwhelming, but I advise you to start somewhere. Why not do step onto the observation deck for five minutes?

The pain of pain medications

As much as you want to avoid pain medications, there are times when you just can't live without them. Your quality of life becomes non-existent. Your needs are great and varied. Family, work, commitments, vacations, special events can be in competition with that loud cry of pain.

When I was in my twenties, I swallowed boatloads of acetaminophen. Not far behind was ibuprofen. In addition to this concern: Why acetaminophen is the 'most common cause of liver injury' in Canada, Harvard discovered that both acetaminophen and ibuprofen lead to hearing loss. I have severe hearing loss in one ear and poor hearing in the other. There are times when I feel that hearing loss is more isolating than RA has ever been. But that's a topic for another post!

These days, I rarely need to take anything for pain. I hope that you can get to this point, too.

Here are some things to practice:

• The Brain Pain Connection
• The Painless Game
• Memory and Chronic Pain
• Exhaling the Pain
• Pain, Pain, Go Away!

As I mentioned yesterday:

"Find what works for you. I liken life to a living lab, with the chief scientist being you. When it comes to RA, I always think about how many decades I’ve had this disease, and when I try some new strategy, tool or technique, I remember that it will take time to notice changes. Get curious and be willing to safely experiment."

Pain management is a process, as is life. It takes time to build up the practice. Give yourself that gift. In the meantime, do what you need to do to manage your pain.