href="#litres_trial_promo">pp) has a pain calendar for you to photocopy to chart your symptoms on a monthly basis. This will enable you to see if any patterns are repeated in each cycle.
What does your pain feel like?
Some of the words below describe your present pain. Circle ONLY those words that best describe it. Leave out any category that is not suitable. Use only a single word in each appropriate category – the one that best applies.
Figure 4.1
Laparoscopic appearance of endometriosis, vol 1, 2nd ed, Resurge Press, Memphis,TN,1991, pp. Reproduced with kind permission from Arnold J. Kresch, D C Martin, D B Redwine and H Reich.
Figure 4.2
Laparoscopic appearance of endometriosis, vol 1, 2nd ed, Resurge Press, Memphis, TN, 1991, pp. Reproduced with kind permission from Arnold J. Kresch, D C Martin, D B Redwine and H Reich.
COMPLEMENTARY THERAPIES
Over half the women in the survey had used complementary therapies to help control their pain. Nutritional supplements were used by the majority, with D,L-Phenylalanine (DLPA) being the most commonly used. Herbal medicines such as agnus castus, blue cohosh, raspberry leaves, slippery elm, violet leaves, peppermint and garlic oils were also mentioned. Homeopathic remedies had been used by some women and a qualified homeopathic practitioner can advise you on which remedy would be most appropriate for your symptoms. A variety of elixirs, such as camomile tea, raspberry leaf tea, arnica ointment, royal jelly, Bach Flower Rescue Remedy and Indian brandy, were suggested, and yet others used prayer and laying on of hands.
One-quarter of the women had used a combination of orthodox and complementary therapies. Winthrop, the pharmaceutical company, in their booklet Managing Danazol Patients by Richard P Dickey, PhD, MD (published by Winthrop in the USA), mention that irritability, nervousness, anxiety and emotional lability have been associated with a lack of vitamin B6. It also states that ‘pyridoxine (B6) given orally 25–30mg per day may help to prevent headaches and visual changes in some cases’. So it is recognized by one drug company that a mixture of therapies may help. (Chapter 6 discusses the use of the drug Danazol as a treatment for endometriosis.)
A favourite way to treat pain was to curl up with a hot water bottle. Various techniques, like visualization, reading, having a warm bath, self-hypnosis tapes, watching videos and listening to music, or knitting could be employed to try to relieve the milder pain. Some women likened the pain to giving birth, but with no end product, and used the breathing exercises they had been taught for labour pains. The majority of women surveyed felt that trying to do some regular gentle exercise, such as swimming, walks or yoga, helped them most. One woman beat her cushions; another found solace in playing her flute.
VISUALIZATION
Dr Bernie Siegel of Yale University has written books about visualization techniques, which involves making mental pictures. You can imagine the endometriosis is gradually shrinking away. The author used to visualize fluffy white baby goats grazing on the endometriotic implants, making them shrink in size, or imagined a blue healing flame licking all around them.
Positive thinking is vital as it helps the body to heal itself. In illness there are often inadequate T-cells (white blood cells which attack the invading tissue, bacteria or virus). Stress is known to lower the production of T cells and B cells in the body, which weakens the immune system’s response. Natural white blood cell production is known from research to be reduced by psychological factors. Sufferers of AIDS and cancers are seen to increase their white blood cell count overnight by visualization techniques.
However, it is the crisis which comes in the wee small hours which can be the most terrifying. The choice is between staying calm or panicking. Many women take extra painkillers or sleeping tablets. One woman reported, ‘I take painkillers which make me sick and then I pass out’ and another said, ‘The pain is so overwhelming, I daren’t even move and can’t concentrate on anything.’ Others moan the pain like a chant, or find that keeping warm is soothing. Yet others say their body just went into shock and shook uncontrollably; this is serious and a sign that the doctor should be called.
DEEP BREATHING
Steady deep breathing is very important, as hyperventilating (rapid and shallow breathing) can make pain worse. It interferes with the oxygen supply to cells which reduces their production of essential hormones, enzymes, energy and possibly endorphins. Hyperventilation means using the lungs to move more air in and out of the chest than it can deal with. Overbreathing is a reaction to pain and fright, but if it goes on too long, you can experience erratic heartbeats, dizziness, gut disturbances, pins and needles, muscle pain, clammy hands and a flushed face. Hyperventilation is caused by adrenaline pouring into the bloodstream, raising the heartrate, tensing the muscles and sharpening the senses so that we can escape from a potential danger. But if we are ill and in no danger, then hyperventilation begins to upset the acid/alkaline balance of the blood. Normal metabolism is altered, leading to exhaustion and depression. Hyperventilation was first described during the American Civil War, when soldiers were disabled by shortness of breath and irregular heartbeats. The trick to correct the breathing is ‘Lips together, jaw relaxed, breathing low and slow’. It will take practice to get this right but perseverance could help your health improve.1 Wearing warm, loose clothing and breathing deeply from the abdomen can make a difference to your pain.
SELF-HELP GROUPS AND POSITIVE THINKING
It helps to talk with someone who has endometriosis and understands your pain, which is why self-help groups can be so powerful in sharing different pain-reducing strategies. It is important to keep a hold on reality and allow yourself to be pampered a little. Allowing yourself to be ill and recognizing that you will get better helps to pull you through. It can be terrifying when the body goes out of control. We live in a world where we expect to be in control but, when nature takes over, it is very disconcerting. The body is always trying to heal itself and you can make a difference by the way you approach the treatment of pain. Settling into a comfortable position and staying still until the severe pain subsides is best. An occasional orthodox or herbal sleeping tablet to knock yourself out for the duration of the pain can also help.
Be positive about yourself, but allow yourself to grieve for the lost time. Your friends may be getting on with their lives and careers whilst you feel left behind. It is very important to know that the body can get well and that you just need to give it all the things it really needs in order to build itself up again. Persevere with your treatment strategies; when you have been ill for some time, the body needs time to heal, it will not happen overnight. It may take several months to totally heal, although some people feel much improved after a couple of weeks. We are all different.
At 4 a.m. when things look bleak and you feel very alone, remember that there are many women all over the world feeling the same at that very moment, and that you are not alone. Think of each other (mind meld) and pull each other through.
The treatment strategies chosen depends upon each person’s physical make-up, medical condition, their personality and other factors, such as where the pain is seated. We hope that some of our suggestions will be of help to you. Remember that anxiety, anger and guilt can make pain worse; they are negative emotions, so try to be positive. It has been known for over a century that our emotional state influences our physical health. There is a new field of study looking into the mind-brain-immune connections, psychoneuroimmunology. It is known that the activities of the white blood cells of the immune system are influenced by the brain and nervous system, as there are receptors on each which receive messages from the others. What we think and feel are likely to influence the way our immune cells respond.2 It is not understood how these areas influence each other and, as everyone is individual, it will differ from person to person. How we respond to