Borderline Character Dysfunction and the Ache Paradox

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As I get better from my current surgical procedure, I proceed to expertise periodic ache in my stomach the place the surgical incisions had been made. The ache will not be coming from the incisions, however appears to be coming from deep inside my stomach. Lower than per week after the surgical procedure, I used to be doing properly, managing my post-op ache solely with Tylenol, when the ache out of the blue grew to become insupportable, and I went to the emergency room. They did a CT scan of my abdomen and couldn’t discover something. I noticed the surgeon a few days later and he additionally had no rationalization. The ache has decreased some and I handle it with Toradol which doesn’t make me drowsy. I’m wondering how lengthy it’s going to final, and whether it is me somatizing—or if the medical doctors someway lacking one thing?

I started to marvel about my degree of ache tolerance. Ache is so subjective. My brother underwent an emergency appendectomy on the identical time I had my surgical procedure; he had tolerated his ache for 2 days earlier than he went to his PCP and he or she despatched him to the emergency room. It turned out his appendix had ruptured.

I feel again to after I was symptomatic with borderline character dysfunction (BPD) and actively slicing myself. Like so many people who’re identified with BPD, I didn’t really feel the ache of the slicing; I reduce to numb myself from the insupportable emotional ache I used to be always feeling. I nonetheless have scars on my forearms and higher arms, although I by no means wanted medical consideration for my cuts.

In a research by Randy Sansone and Lori Sansone, “Borderline Character and the Ache Paradox,” the authors state: “The intersection of BPD and ache is a fancy one. On the one hand, sufferers with BPD look like impervious to acute ache, which is often reported throughout episodes of self-mutilation, equivalent to slicing. Alternatively, scientific experiences and empirical findings with continual ache counsel simply the other—that sufferers with BPD are extra delicate to ache than people with out this Axis II dysfunction.”

I ended slicing after I entered transference-focused psychotherapy (TFP) with my then psychiatrist, Dr. Lev. After I initially agreed to work together with her, I signed a contract and one merchandise on the contract was if I reduce myself, even a scratch, I needed to search medical consideration earlier than I may return to remedy. I pictured myself going to a physician with a scratch on my arm and feeling embarrassed. The final time I truly reduce myself was in 2006 when, to retaliate in opposition to Dr. Lev as a result of she hospitalized me, I snuck razor blades into the hospital and reduce myself early one morning when the hospital workers wouldn’t let me sit within the hallway and journal. It was a silly factor to do because it solely obtained me placed on one-to-one remark for per week.

I began seeing the neurologist who’s my headache specialist for my migraines in 2013. She can be board-certified in psychiatry. Following my suicide try in 2014, she may inform I used to be not myself and I confided in her, together with my historical past of BPD. I had come such a good distance working with Dr. Lev utilizing TFP that she had a troublesome time reconciling my prognosis of BPD with the one that stood earlier than her. I don’t know if she held among the misconceptions of sufferers identified with BPD: manipulative, attention-seeking, and so forth.

At the moment, I used to be seeing her for Botox injections each three months and nerve block/set off level injections each two weeks. Each remedies concerned a number of injections within the face, head, neck, and shoulders. The injections by no means bothered me. When her new fellows began each July, typically she would ask me if I minded in the event that they practiced their method on me as she knew I wouldn’t flinch. I at all times mentioned I did not thoughts.

A research from earlier this yr echoes the reults cited above and states that “BPD has been related to larger continual and on a regular basis ache and, in distinction, diminished sensitivity to acute ache. This obvious contradiction has been termed the ‘ache paradox’ of BPD.” I carry amongst my myriads of medical diagnoses fibromyalgia and an autoimmune sickness (undifferentiated connective tissue illness), each of which trigger continual ache. For fibromyalgia, no medicine is efficient and for UCTD, I’m prescribed Plaquenil for which I have to have biannual eye exams for it carries a threat of harming the retina. My rheumatologist lately lowered the dose which I understood the necessity for as I’ve been on a excessive dose for years. It’s a balancing act between ache and threat degree.

As the brand new research stories: “Individuals with BPD make the most of healthcare providers at charges larger than the final inhabitants, and but, many who search therapy for continual ache expertise obstacles to accessing therapy, which once more underlines the necessity for scientific consideration. Persistent ache is a subjective expertise and medical suppliers should depend on affected person stories of their ache experiences. Nonetheless, sufferers with BPD could also be perceived as untrustworthy by healthcare suppliers, even when their prognosis will not be recognized.”

I do know that I entry healthcare providers extra steadily than others and don’t like that about myself. I’ll debate at house earlier than calling the physician’s workplace or going to the emergency room. The final time I went to the ER, I debated into the night and didn’t arrive till 10 PM. I waited three hours to be seen by a doctor’s assistant and by the point I used to be discharged and obtained house, it was 6 AM and it was time to leap within the bathe and prepare for work.

Do I strive more durable to tolerate ache? I get right into a debate with myself: What whether it is one thing? What if it is nothing? With my intensive historical past, I can by no means make certain. I consider the instances I’ve gone and I used to be admitted as a result of it was vital. And I consider the instances I’ve gone and I used to be discharged as a result of there was nothing. It is an ongoing dilemma with no good reply.