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Comment by spain | Hacker News Reader

I used to think that something like this wasn't possible. I always assumed that if you were in constant pain or something you would somehow grow used to it over time in the same way that being subjected to cold temperatures raises the bodies resistance to cold temperatures.

Another example would be drugs and chemical receptors in the brain. Correct me if I'm wrong but shouldn't it be the same as with drugs, the more pain you get the more neurotransmitters are being used and the more are required to make a stronger response? Shouldn't you then technically feel less pain over time if it's constant?

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I suffer from chronic pain (pain 24/7, or at least when awake, varying degrees from bad to terrible terrible pain) and have done for 10 years now.

To answer your question: no. I do know that my tolerance for pain is significantly higher than most people. I still feel the constant pain from when I wake up to when I fall asleep. Its a horrible thing. It affects my mind when I am trying to write code just like it would your mind.

I have had all the best medical treatment possible. There is nothing they can do, so I am voluntarily now off all opioids and other analgesics. I would rather be in pain and have as clear a mind as possible that be high and in less pain ... also the cycle of taking opioids -> tolerating them -> needing them but not getting much benefit -> going off them -> withdrawal -> going back on them ... is not pleasant.

The only way to "win" is to ignore it. To go on with life as if I was not in so much agony. The moment people stop and give up, they are destined for a life of being bed ridden, unemployment, hooked on drugs and even more pain (less exercise, less social contact etc. leads to more pain).

Ignoring it takes an incredible amount of mental discipline.

Plenty of people with chronic pain end up bed ridden, unemployed and sometimes suicide.

I have considered an electronic implant after my docs suggested it. For my specific case its very much experimental. It would cost me a fortune with no guarantee of success ... and always a chance of something bad happening. I don't want to pay for the privilege of being the lab rat so the surgeon can write a paper about me in a medical journal. I will wait and see how this tech develops. When there is a 75% chance of it working I will go ahead. Until then I would rather not have to sell my house.

(throwaway account)

> Ignoring it takes an incredible amount of mental discipline.

This is such an understatement. I don't have 24/7 pain but I have nerve pain that is not very responsive to anything. I can live with the little twinges but if my legs feel like they're on fire, I can barely focus on personal tasks (eating, sleeping, showering, getting out of bed in the first place...) let alone any work. I cannot even begin to imagine what I'd do if it was significantly worse.

I live my life the best I can, but I find myself getting more and more angry, leading to more pain, leading to more anger... there is not even an experimental treatment for my problem, which I'd happily go for. It's only pretty much taking whatever I can tolerate to take the edge off the worst pain for a few hours at best (where it's meds like anticonvulsants and TCAs, not as much opioid use), or something with a side effect that helps - getting really high so I stop caring, or making me really sleepy so I can rest. Add CBT for anger and whatever non-drug options are out there, and it's just workable until this fixes itself eventually, hopefully.

hang in there friend.

As someone with chronic pain, nope, I don't think one builds up a tolerance to it. Instead, I think I'm lucky in that the severity waxes and wanes. Below some threshold it recedes from being pervasive, going into the background and I have to go consciously looking for it to see if I'm still feeling it.

Exceed that threshold and it's always there, front and centre, just pain. At that point, as throwaway91214 says, I consciously try to ignore it.

When it exceed the next threshold, life pretty much stops for awhile until it recedes again. Those are the sleepless nights and long, minimal days.

(I use the notion of thresholds for simplicity, it's perhaps closer to an exponential scale).

I've had mine for about eleven years. Such is life.

I am the same. I can ignore it until a certain level, then I just have to stop being productive and ride it out.

The trick is to not worry about the effect stopping to ride it out has on your life. Worrying about not working/playing/socializing because it might annoy a boss/client/girlfriend/family/friend or because it will mean less money/friends/etc.

Edit, and hang in there friend. I don't know about you but for me its unlikely to ever get better. I am not an optimist, but there is still a lot of cool shit in this world to enjoy. We are lucky to live in the age we do.

That's the funny thing about assumptions...

In truth, what can happen is exactly the opposite: constant firing of pain signals can end up recruiting _more_ cells to transmit pain, thereby lowering the threshold need to signal pain, and amplifying the effect overall.

cf. http://en.wikipedia.org/wiki/Chronic_pain#Pathophysiology

I think it is in Plato's Phaedo where Socrates considers joy impossible without pain. I always thought that this ancient idea of harmony, dating back to the earliest philosophical records and pertaining also to the philosophy of the East, made sense also as a principle of consciousness. So in this respect, the notion of absolute pain (or joy) is disconcerting. Because, where does it reside? What processes constitute pain? Nerve signals, sure, and chemicals. But what is the essence to that? Can the dynamic be abstracted and generalized? Perhaps these questions are the frontier and the real question of the Cartesian ego. Finally, if we don't have answers to this, who is to say then, really, even that there isn't a Hell and eternal pain after death?

>Shouldn't you then technically feel less pain over time if it's constant?

getting accustomed to pain isn't a trait that would be carried through evolutionary selection. Pain is a signal about something that has to be addressed. Out of 2 possible reactions - acting on the signal vs. not hearing the signal the first is obviously evolutionary preferable. An yes, evolution and selection isn't merciful, and here i'm very agree with buddhism. We evolved to be scared and run away from sources of pain and constant risk of pain is what makes us moving through life.

BTW, am i the only one who is WTF??? while reading it:

>In 2006, Justin, an Upper Dublin High School grad pursuing an economics degree at Penn State University, lost 60 pounds over the course of a few months, with no end to the mysterious weight loss in sight. Justin’s doctors, perplexed by his condition, performed surgery on him to install a feeding tube in his small intestine.

I have always thought exactly that to.

On a side note when I have been in major pain at some time I am have atleast been partialy capeble of consiusly ignoring the pain, it still hurts but i just try not to care. Obviously the pain that I have been able to do that with is no were near the pain we are talking about here.

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