Tag Archives: disability depression

Spinal pain treatments and relief

Chronic Pain After Spinal Cord Injury

We take asprin for headaches, broken bones heal in six weeks, ongoing chronic pain however is a never ending nightmare of doctors drugs and treatments that typically yield little success and soon daily life becomes consumed by pain. From getting groceries to attending Susie’s wedding, life decisions are based on levels of pain felt today or of those percieved in time. So how can we ease and free ourselves from chronic pain with minimal drugs and little effort.

Training in the field of psychology I’ve been studying chronic pain more lately and noticed how deeply it is entrenched in lives watching someone close to me battle the condition. The very deadline I set myself for this article passed due to my relative’s chronic pain and her resulting difficulties. Whether you use a wheelchair, have ambulatory difficulties, or have other physical issues, the odds are chronic pain will factor in life at some point.

Who Suffers Chronic Pain

Chronic Spinal Pain

Chronic Spinal Pain

In developed countries, almost 20% of the adult population is currently afflicted with persistent and/or recurrent pain. According to International Association for the Study of Pain (IASP), only 1-2% of that documented chronic pain is attributed to cancer. The majority of that chronic pain is attributed to neck, back, joint, and musculoskeletal disorders.

There’s little wonder why people with on-going, unrelenting pain seriously consider suicide as an alternative to suffering a life defined by pain.

Only recently has the study and appropriate treatment of pain become part of mainstream medical research. Pain study now encompasses interdisciplinary research by psychologists, clinical doctors, biochemists, and neurophysiologists, among other professions. The most recent research has found that the sensations caused by severe, ongoing pain can literally change the chemical mechanisms within the central nervous system. Neuronal changes occur and the brain becomes primed to perceive pain, even after the source of pain is removed.

Additionally, research had found that pain perception is perceived differently based on gender and ethnicity. Believed to be attributed to neurochemical responses, women appear to experience pain far more than men, and those of African descent show a greater tendency to experience chronic pain than whites. When comparing responses to analgesic treatment to chronic pain, particularly various forms of opioids, men and women can expect markedly different levels of relief.

What is Chronic Pain

Pain is defined in three medical stages:

  • 1. Acute pain lasts 30 days
  • 2. Subacute pain spans 30 to 90 days
  • 3. Pain that exceeds these time spans is classified as chronic pain.

Acute pain after any trauma or disease signals actual tissue damage as well as the potential for possible future tissue damage. Acute pain and chronic pain should be addressed and treated differently. The timing of pain treatment is another factor to consider, the longer someone experiences untreated pain, the longer it will take medical specialist to treat and hopefully remedy that pain.

Pain specialists note an individual experiencing severe pain treated within 60 to 80 days from onset, has a probability of becoming pain free near zero percent. If that same individual was treated within the first 30 to 60 days of onset, they would most likely have become pain free.

Economic Cost of Chronic Pain

Chronic pain left untreated or under treated drives the costs of health-care skyward in the form of visits to the emergency room, urgent care clinics, and predominantly extended stays in hospital. In the US alone, there are more than 50 million lost workdays related to persistent pain per year. Translated into cost for businesses $61.2 billion each year.

Cost Following Spinal Cord Injury

Chronic pain in persons with spinal cord injury (SCI) is a common and significant problem. Almost four out of five persons with SCI report chronic, persistent pain. Of that identified group, almost one-third report that chronic pain interferes with their daily activities and quality of life. In a separate study, over one third of participants with thoracic or lumbar SCI pain reported they were willing to trade recovery from their SCI for immediate pain relief.

Recent research has found that adequate pain relief around any spinal cord lesion early in treatment can help prevent later chronic pain. Correlations among those with incomplete spinal cord lesions where abnormal sensation exists near the initial lesion site treated for pain relative to the number who have gone on to suffer chronic pain later in life are also emerging in favor of early pain management.

Spinal pain treatments and relief

Spinal pain treatments and relief

In a survey by Spinal Universe back pain treatments reported as most successful were also the most simple to enact, weight loss, exercise and massage, and furthermore aligned with other studies they conclude prescription pain management is the most effective in treating chronic pain.

Pain Management Narcotics and Addiction

There are numerous things to consider in the discussion of pain: how pain is measured, the sources of chronic pain, how individuals rate their pain, the perceptions of doctors, and the need of the sufferers, to name a few. However, based on my most recent experiences, the most difficult component of pain care is pain management through pharmaceutical treatments. I have found the single greatest fear, among untrained physicians and their desperate suffering patients, is addiction to narcotic pain relievers.

Despite our expectations to the contrary, chronic pain management is not explored in detail in medical school, unless one is going to specialize. The popularly held misconceptions regarding opiates, their derivatives, and the newer non-opioid analgesics are one of the major reasons many suffer chronic pain needlessly. While studying psychology, my primary focus was substance abuse, a field which is complicated and filled with emotional issues.

There is a clear and well-defined line between an individual whose body has sustained trauma seeking pain relief and substance abuse. The concepts of addiction are complicated and fraught with different theories of addiction and treatment. To clearly examine the nomenclature of abuse and addiction to medicinal drugs intended to relieve pain we need to understand that profound differences exist between medical pain relief, substance abuse, and chemical dependence.

Spinal cord injury pain medications

Spinal cord injury pain medications

Substance abuse is defined as the use of drugs or any other chemical substance (legal or illegal) with some pattern of regularity, such as drinking to excess every weekend. Substance abusers are still able to maintain their life roles and responsibilities with some degree of competence. Monday is still a work day and the individual arrives on time, worn out and hung over, but still at work.

Chemically dependent individuals are, however, a completely different story. Chemically dependent individuals devote all their attention, emotions, and thoughts toward every aspect of their addicted life. A chemically dependent person chooses to forgo relationships with their family and friends; their primary relationship is with their drug of choice. Their life revolves around the drug, instead of enhancing quality of life, it consumes their life. It’s rare for a person who is adequately treated for chronic pain to display such behaviours.

While at times chronic pain may seem to overshadows everything in our lives, it is not by choice. When we seek treatment and care for chronic pain, we are entitled to the most appropriate medication possible, whether that is morphine or methadone. When we experience such profound chronic pain, the odds are very slim that we will become addicted to our medication. Unless there is a history of addiction in the family background, it is relatively safe to take powerful medications, strictly according to the prescriber’s orders.

Making changes and adjustments to narcotic pain medication is reckless and potentially life threatening, unless under the prescriber’s orders. If at any time you feel you have become dependent on pain medication consult your physician and ask they re-examine your prescriptions and drug regime.

Conclusions

Chronic pain is frustrating and exhausting. It hurts those who suffer from it and those who love and care for them. Chronic pain is a condition that is often extremely difficult to treat. It can take months or even years to find the right physician, the right treatment, and the right medication. Many find it difficult to stand up to a doctor and tell them we are capable of participating in the choice of our treatment, particularly if narcotics are part of the discussion.

We are all well within our rights to educate ourselves and subsequently advocate for ourselves or a loved one. We are all entitled to pain relief and an improvement in the quality of life. The consequences of inadequate chronic pain relief are potential greater harm than the consequences of addiction. The earlier a possible dependency is addressed the more effectively it can be dealt with. If you have concerns or questions about chronic pain, please contact your physician.

Resources

  • ABC of Spinal Cord Injury, 4th Edition; Grundy, David (ed). 2002, BMJ Books, London.
  • American Pain Foundation;  http://painfoundation.org
  • Encyclopedia of Disability; Albrecht, Gary L. (ed). 2006, Sage Publications, Thousand Oaks.
  • Fundamentals of Substance Abuse Practice;  Johnson, Jerry. 2004, Brooks/Cole-Thomson Learning, Belmont, CA.
  • Health.Com;  http://www.health.com
  • International Association for the Study of Pain; http://www.iasp-pain.org
     
Andrea Dworkin Feminist featured in Life Magazine

Andrea Dworkin Through the Pain Barrier

This is the last piece written by Andrea Dworkin (1946 – 2005), feminist, author, disability activist, composed just a month before she died in 2005. Few knew she suffered from an agonizing bone disease for several years. She describes with grim humor her worst moments and why she felt she was starting to heal.

The doctor who knows me best says that osteoarthritis begins long before it cripples – in my case, possibly from homelessness, or sexual abuse, or beatings on my legs, or my weight. John, my partner, blames Scapegoat, a study of Jewish identity and women’s liberation that took me nine years to write; it is, he says, the book that stole my health. I blame the drug-rape that I experienced in 1999 in Paris.

Andrea Dworkin Feminist featured in Life Magazine

Andrea Dworkin featured in Life Magazine

I returned from Paris and finished Scapegoat over a period of months while caring for my dying father. Shortly after he died I was in hospital, delirious from a high fever, with infection and blood clots in my legs. I was there for a month. John had been told that I was dying. I forgot that in hospitals when one is dying, nurses abrogate the rules. John was allowed in after visiting hours; nurses would pull the curtain around my bed and let him lie with me. This was my happiness. Doctors tell me that there is no medical truth to my notion that the rape caused this sickness or what happened after it. I believe I am right: it was the rape. They don’t know because they have never looked.

“Every three minutes a woman is being raped. Every eighteen seconds a woman is being beaten. There is nothing abstract about it. It is happening right now as I am speaking.” – Andrea Dworkin

A few months after I got out of the hospital, my knees began to change. They lost their flexibility. Slowly they stiffened. As they stiffened they became sore. They started to hurt terribly as if injured but not visibly injured. I got a cell-phone – before they were ubiquitous – so that if I couldn’t walk any more I could call a car. I had given up on New York City subways: my knees could no longer bend enough to use them.

I went to an orthopedic surgeon. I was diagnosed with osteoarthritis in my knees. I was treated with the anti-inflammatory Celebrex and, when that didn’t work, its stronger cousin, Vioxx. Which was recently taken off the market by its makers because of a risk of heart attacks or strokes; I was on it for three years. I had cortisone shots in my knees, followed by prednisone. The cortisone shots, which are painful, worked only once. Then I could walk without pain; in joy I sat on my front steps and talked with my neighbor – inconsequential chat. When I tried to stand up, my knees were rigid and excruciating. I managed to stand and swivel around; I took the remaining two steps up to my front door and used the door to drag me inside. I had had an hour-and-a-half of freedom.

My mobility lessened as the pain increased. Eventually I found myself housebound. I could walk only a few steps at a time, intimidated by the pain and the refusal of my knees to bend. John and I lived in a three-floor house. I could barely make my way up or down the steps. I’d crawl up the steps on hands and feet. I’d try to go down on my butt, step by step. The kitchen was on the first floor; the toilet on the second; my desk, books and shower on the third. My physical world became tiny and pain-racked. I stayed in my bed when I could. John brought me up food. I’d go out only to the doctors.

The orthopedist started giving me narcotics, most of which contained acetaminophen, a common, nonprescription analgesic. My pharmacist persuaded the doctor that the liver damage caused by too much acetaminophen was more dangerous to me than stronger drugs. Through her advocacy I got a drug normally given only to cancer patients. It was a little yellow lollipop and when in pain one was supposed to lick. I licked a lot. I was told that I had to have my knees replaced. The prostheses are made out of titanium and plastic. I had both knees replaced at once, a normal practice now but unusual even a few years ago. My surgeon would later tell me that if I had had one done, I would never have returned for the second. He got that right.

“Institutionalized in sports, the military, acculturated sexuality, the history and mythology of heroism, violence is taught to boys until they becomes its advocates.“ – Andrea Dworkin

I still don’t know what he did to me but I came to the conclusion that the operation was barbaric, involving as it did the sawing out of the arthritis, which meant sawing through bones. It was like being kneecapped, twice, or having one’s knees and bones hammered and broken into bits. After the operation I was in a nightmare of narcotics and untouchable pain. There were morphine shots. I asked for them and got them often. Even morphine shots in the upper arm hurt.

I had a hallucination but it is still real as rain to me. I was in Virginia Woolf’s house and I was happy. But “they” wanted me to go down the stairs. I can’t, I begged, I can’t. My hospital bed was at the top of the stairs and I was afraid that they were going to push me down. I saw the steep decline of the steps. I couldn’t get over my visceral fear of falling or being pushed or being turned over from the bed down the flight of steps. I kept experiencing my bed as being on the edge of a precipice.

One day, I remember, a nurses’ aide braided my hair and I felt cooler, cleaner. I was on the bedpan, but raising myself up to use it – knees – was so fiercely painful that I would rather lie in my piss.

Then the day came when I had to walk. There was a vinyl chair next to my hospital bed. The physical therapist’s name was Carl. He was like a tree trunk, big and solid. You can do it, he said. I’ll help you; we’ll just go over to the chair. It was impossible, outside the realm of the imaginable. Carl let me hold on to him in a desperate, tight embrace as he carried me over to the chair. My legs dangled, my knees twisted, I sweated, I screamed. See, you could do that, he said, without a shred of irony. I had to sit there for two hours, which meant knees bent but not weight-bearing. Nurses came by and gave verbal approval: good dog, good dog. Eventually Carl carried me back to bed.

Andrea Dworkin

Andrea Dworkin

Pain is a four-letter word. There is no way to recreate it through memory. It is not like the flashback arising from traumatic events such as rape or battery. The flashback is as if it is happening now, in the present, even if it is from decades ago. Pain can be recent yet inaccessible to immediate experience. Torturers know that people can’t die from pain. The consequences of pain – for instance a heart attack – yes, but not from pain itself, however intense. The horror is that no one dies from pain. This means that suffering can be immeasurable, enduring, without respite. So it would be for me for the next two years.

I was taken to an institute for physical rehabilitation. A nurses’ aide took me to shower in a wheelchair. I used a walker from the cot on which I slept to the wheelchair, maybe two miserable steps. I had two responsibilities – take my pain medications (Vicodin or Percocet) and show up at the right room at the right time for the scheduled rehabilitative class. I was not allowed to go to class if I did not take the painkillers. In fact, the pain was unrelenting. I lived for the next pill.

Physical therapy is based on tiny movements, increments of change that almost defy detection; it is built on the repetition of the minuscule. Yet to the hurt person these motions or movements or minute steps are hard. The first time is daunting and the 10th is like climbing Mount Everest. I sit in a big room, my wheelchair in a big circle of wheelchairs. Big is good because it means that my turn does not come often. I stand up by holding on to a walker and take a step. Then I step back and sit down. The cycle is hideous. The steps with the walker increase to two, then three. After several weeks I am assigned a means of locomotion: crutches.

Rehabilitation also includes so-called occupational therapy: throw a ball around in a circle; put round pegs in round holes; stand up, arms on a table, and read a page of a magazine; water a plant; play checkers or cards; and the pièce de résistance, cook and serve a simple meal. I am guided in the intricacies of shopping while crippled; I learn how to use a “grabber” to latch on to things I have dropped or cannot reach; I am taught again how to put on shoes and socks and tie shoelaces. I also have to meet the institution’s psychologist once. I keep getting called back. When I ask why, I am told that I am “interesting.” Well, yes, I think, I used to be.

The narcotics help me deal with the psychologist but the physical pain simply marches on. It does not lessen or change or stop. I learn three rules in my occupational therapy classes: never hold on to anything that moves; if it rains or snows, stay inside, even if that means cancelling doctors’ appointments (to those medicalised this is nearly profane); and kick the cat – if a cat curls up in front of your feet, kick it away. I learned to use my crutch to kick the cat. I will go to hell for this.

On discharge, social services are provided. My male partner is not expected to be a care-giver. I am sent an itinerant nurse, a young, poorly paid and badly trained social aide to help me with baths and to do light housework, and a freelance physical therapist who will do the drill: stand up, take steps, bend your knees, and – the killer – stand on your toes. And on discharge a wreck like me is sent to a “pain management centre.” Despite my small successes at physical rehabilitation I am in agony. I spend almost all my time in bed, a bed of nails, all through the knees.

The pain management centre is run by Curly, Larry and Moe. First there is a 10-page questionnaire. Rate from 1 to 10 your pain (I modestly assert an 8; my social conscience, atavistic as it is, tells me that there are others in more pain). Rate from 1 to 10: is your mother dead; how many people in your family have died of cancer; how is your sex life; how many times a week do you have sex?

They want me to undress so they can examine me. This is absurd. I refuse. There is a table they want me to lie on that they claim lessens pain. The bottom line is that New York State regulates narcotics to such an extent that regular doctors are reluctant to write prescriptions for painkillers; and so Curly, Larry and Moe at pain management put you through whatever rigmarole and then write prescriptions, none of which, according to state law, can be refilled. One is in a cycle of coming back for new prescriptions and new indignities every 30 days.

Curly eventually puts me on Percocet, fentanyl patches and methadone. I am on these drugs for nearly two years. I become slightly indifferent to the awful pain. My speech slurs and my memory is impaired. It is during this time that I write my memoir Heartbreak. I want to remember some good things in my life. I work for one hour a day. The narcotics do not make me Coleridge; but I hold my own.

One day I wake up and the pain is gone from my right knee – as if God had intervened. The pain in the left one is the same. I begin to go outside on my crutches. I can walk half a block to my local Starbucks. One day I sit there, still on my meds, and I see the ballet going on outside. The sidewalk is heavy with pedestrian traffic. They are so unselfconscious, these normal walkers. They have different gaits; they move effortlessly; each dances without knowing it. I used to be one of them. I want to be again.

The anti-drama of small gesticulations continues, this time in physical therapy several blocks from where I live. My left knee is still rotten. After another year of physical therapy they give me a cane. I put away all the crutches and other signs of what I call “disability chic.” I can sort of walk. The cane means victory. The pain in my left knee keeps me on my meds. Over the course of another year, that pain lessens. It’s a whisper, a shadow – it goes. I give up the pills, though I go through a nasty withdrawal from methadone.

Alas, there is no happy ending. John and I move to Washington so that he can take a job as managing editor of a large-circulation magazine. We live in an apartment without steps. I am on the cane. I go into physical therapy because, unable to stand up straight, I hunch over the cane. A few days later I am at the kitchen table reading a magazine. I stand up to get something and my right knee cannot bear any weight, none. I can’t use it because I can’t step on it. I have no pain; I have had no warning. I get to my crutches, which are in a closet. I need both of them in order to move. My right knee remains useless.

The physical therapist determines that the quadriceps above the knee has stopped working, because imperceptible pain occasions the quad muscle to give out. Then my knee buckles and I fall. It is dangerous to fall. I see the physical therapist twice a week. The orthopedic surgeon (“a genius with knees,” says my internist) puts me in a restrictive brace that allows my knee to bend only so far. That way, if my knee fails, I am unlikely to fall. After nearly a year of physical therapy my quad muscle is not much stronger and my knee still buckles. The surgeon sends me to a rehabilitation hospital where they make me a new brace, specifically fitted to my leg.

This brace works on the opposite principle to the first one: it immobilizes the knee so that no buckling is possible, thus, no fall is possible. It takes months for artisans to make the brace. It goes from beneath my calf to the top of my thigh. It is made of a black space-age material created to go to Mars or Saturn. Nothing makes it bend or stretch or break. It is completely unforgiving. I call it Darth Vader. It is the principle of evil incarnate.

The straps that attach front to back are Velcro. I am supposed to lock it when I walk and unlock it when I want to sit. The brace is worn under my pants leg so no one can see it. Each manipulation is distinct: in public locking it makes me look as if I am masturbating, and unlocking it makes me look as if I am fondling my thigh. The brace must be very tight and positioned perfectly to work. It takes me nearly two months to learn how to put it on and use it. I lose my balance in efforts to lock it. Once I flip backward, magically landing on a chair.

Self-respect demands that I clean up the faecal mess that my cat has made. It is the immobilized knee that makes bending down to the floor fraught with peril. I start falling and know that I must not hit the floor. I fight against gravity, my fingernails clawing at the walls and my hand grasping for the door frame. I know that if I fall I probably will not be able to get up. Somehow I raise myself. I was slow with the first brace. I had to remind myself to be patient. With Darth I make the turtle look like the hare.

The landscape is one of hazard. Anything can reach up and bite me: a break in the sidewalk; leaves; sand; mud; a sudden slope up or down; a stone; some pebbles. Anything threatening balance is dangerous: first the brace itself; then wind, people running or bicycling or being too close or too many; a fast car; a step; a curb; a puddle; heavy doors; slick surfaces. Crowds are impossible and so are stairs.

I want to be able to carry a cup along with a plate to the kitchen sink in one trip. I don’t want to have to make two trips. The cup slips and breaks. This happens several times. Is it a small thing? I can’t bear it or accept it. I reject the extent of my disability. I find myself in a silent rage that stretches over weeks. I am utterly exhausted by my incapacity. I am worn out from walking. I am sick of physical therapy. There are little humiliations.

Andrea Dworkin Activist Keynote Speaker

Andrea Dworkin Activist Keynote Speaker

I keynote a conference on the Holocaust. The organizer picks me up. She is driving a truck. I try to climb up into it. She physically pushes me under my ass without permission, all the while talking to me in baby talk, put your tooshie there, keep your cute little fanny there. I turn to her and say, I am disabled, not stupid. A friend throws a party for me in Washington. I ask how many steps there are to the apartment. He doesn’t know. I assume he will get back to me. John and I go to the party. There are three flights of steps. I can’t get to the party being given for me. We could have given it in another venue, the friend says the next day. It cuts.

I go to a bar and need to use the rest room. The men’s is filthy, the bartender says; the women’s is two flights up. I use the dirty one. I go to a new movie theatre that has elevators and disability bathrooms but the polished stone of the floor is so slick that my crutches cannot safely navigate it. I am walking with a friend who suddenly looks at my crutches and says, you don’t want to be this way the rest of your life, do you? Her repulsion is barely masked. I feel unutterably alone.

Each disabled person has a story, often including pain, impairment, disorientation and loss of control. Each disabled person lives always on the threshold of separation, exile and involuntary otherness. Only a determined policy of public access can help to mitigate the loneliness. One needs to be able to enter buildings; have a cup of coffee; go to a restaurant, the theatre, cinema or a concert; attend school; go to lectures or readings; use public transport, bathrooms, hotel showers; go to museums and sporting events and political rallies.

One needs equal opportunity in employment. One needs to be integrated into the world, not separated from it; yet one has special needs, ones that able-bodied people rarely consider. The low consciousness of the able-bodied increases alienation. For mobility problems, one needs a new geography: kerb ramps; ramps in addition to steps; handrails; grab bars; high toilets; light doors; wheelchairs; room for wheelchairs in public bathrooms and hotel rooms; elevators; safety in floor surfaces including carpeting; entry and egress from public transport as well as acceptable seating; and a host of other considerations.

Other disabilities require other remedies. In 1990 Congress passed the landmark Americans with Disabilities Act, which articulated in great detail the requirements for making the world available to disabled people. This is a civil rights law that recognizes the exclusion of disabled people from the larger community as outright discrimination. The law had its impact because disabled people found aggressive trial lawyers to sue commercial and private venues for noncompliance. The plaintiffs went after big-money damages for violating the civil rights mandated by the ADA. Eventually it became clear that compliance would be cheaper than continuing litigation. Losing money does put the fear of God into Americans.

I have to say that the ADA increases the quality of my life, Darth notwithstanding. I get through airports in a wheelchair provided by the airline; John takes me to the zoo a few blocks from where we live [and] the zoo provides a wheelchair; local coffee houses to which I gravitate have disability-standard bathrooms; there are special seats for me in cinemas and theatres and in rock venues; there are kerb ramps at pedestrian crossings and ramps or elevators in addition to steps and escalators in most public accommodations.

In my neighborhood I see many other disabled people outside all the time. We are not rare or invisible, because we are not hidden as if in shame. And bless those nasty trial lawyers, whom George W Bush and the Republicans hate so much. Without them the ADA would be a useless pile of paper. For myself – despite physical therapy, the breaking cups, and my immobilized knee – in the middle of the night, worn down, I listen to Yo-Yo Ma playing Bach or Loretta Lynn’s Van Lear Rose; and I am, I think, healing. Surely music must be more powerful than bad luck.

Andrea Dworkin

Resources

The Broken Column a painting by Frida Kahlo

Frida Kahlo Spinal Injury Artist

Frida Kahlo (1907-1954) one of the most influential Mexican spinal injury artists of the middle twentieth century. Frida Kahlo painted images of the disabled female body. Striking self portrait’s of her own spinal cord injury and trauma. As a teenager in 1925 a tram car accident left Frida Kahlo with multiple injuries. She would endure a long and painful recovery.

Broken spinal column vertebrae, collarbone, ribs and pelvis, eleven fractures in right leg, a crushed and dislocated right foot, and dislocated shoulder. An iron handrail from the tram also pierced her abdomen and uterus. In Frida Kahlo’s paintings these injuries and her now seriously impaired reproductive ability transcend from the canvas.

Born in Coyoacán, Magdalena Carmen Frieda Kahlo y Calderón. Frida Kahlo’s artwork interweaves traditional Mexican votive painting and technical images of the body. Modern medical science (x-rays, surgical implements, hospital experience) fused with Christian icons of redemption through physical pain and suffering. In this way, Frida Kahlo painted an entirely new depiction of the female experience and form.

The Broken Column a painting by Frida Kahlo
The Broken Column by Frida Kahlo

Frida Kahlo Artwork

Frida Kahlo’s ground breaking artwork is among the first, and perhaps the most daring, to render a portrait of transparent, explicit, bodily trauma. Prior to her artwork pain was shown through gestures of agony. Scenes of crucifixion or martyrdom, as in the work of Kathe Kollwitz, Picasso’s Guernica. Or explicit gore in battle scenes and beheadings the likes of Salome, Jose Posada’s dancing skeletons, or any number of other mythological illustrations.

“I paint myself because I am so often alone and because I am the subject I know best.” – Frida Kahlo

Frida Kahlo’s artwork is particularly of interest to disability studies. Not only for the auto-biographical renditions of her spinal and other injuries, illnesses, and surgeries, but also because of the nature of the body she invents. Often the interior of the body is visible and continuous with the exterior. In a kind of psychic Mobius strip they become one.

Frida Kahlo Greatest Artworks

In her greatest artworks The Broken Column, The Two Fridas, Roots, The Tree of Hope, and Without Hopes, there is no clear division between inner reality and outer appearance. Thus the un-shareable nature of individual pain becomes explicit and felt. To look at one of Frida Kahlo’s greatest artworks is to punch yourself in the face. Her paintings scream a raging agony. A visible pain taken and shared in empathy.

Frida Kahlo the Movie

My jaw dropped when I saw the movie Frida. Played by Salma Hayek, the only woman who could make a mono-brow sexy. In the opening scene of the movie Frida suffers a chilling spinal cord injury, in a tram car accident. The movie clip below follows with her drug induced hazy dreams of dancing x-ray skeletons. Dreams that are very familiar to me.

Nightmarish visions dancing skeletons plagued my spinal cord injury recovery. All my life I’ve also seen dark shadowy figures like those in the movie Ghost. None bother me though. I get the feeling they are not out to hurt me. This video clip from the movie Frida is a little graphic. Any realistic life-like portrayal of a spinal cord injury accident will make you wince. And so I warn you this video clip from the movie Frida featuring Salma Hayek is very realistic.

Frida Kahlo Spinal Cord Injury Video Clip

Frida Kahlo Spinal Cord Injury Treatment

By the 1930s, x-ray technology had been in public use for some time. X-rays ended the concept of the opaque body. Public hospitals had also been established as places of collective community experience. Frida Kahlo demolishes the idea of a disabled body in pain being a shameful and hidden thing after her arduous spinal cord injury treatment.

Frida Kahlo bravely offers her body up in many taboo contexts. Her spinal cord injury and images of pain are never separate from her life at large. Never represented as a different sphere of experience in kind or degree. Her illnesses are fully in context with the rest of her life.

The examinations of marriage, sexuality, cultural patrimony, and family are the same visual icons as those in mainstream disability. Her paintings in the context of traditional images display the female body as a mysterious, irrational, and secretive vessel. It’s when Frida Kahlo’s spinal cord injury comes in fusion with her life on canvas she parts from, and directly opposes, mainstream disability paintings.

The baring of her body inside and out is more than a simple nude self-portrait. Her body is small and doll-like. It appears as a toy in the grip of immense forces. Not as a mythical goddess-like being. Embedding the matter-of-fact details of her medical experiences within a highly emotional language. Frida Kahlo demystifies disability and presents it both inside and out of mainstream. To open oneself to a Frida Kahlo painting is to feel the vulnerability of one’s own body. To immediately experience its transcendence through art.

Frida Kahlo Paintings Gallery

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Frida Kahalo Fire in the Machine

Another aspect of Frida’s disability paintings is the mutability of her body (a factor of chronic but unpredictable illness). Symbolized in her portrayals of her body in partial trans-mutation with animals, partners, or the natural world in general. One can align her pairing with monkeys, Diego, and the Little Deer, with the way disabled people must render control or custody over their bodies. This is also evident in paintings of her doubled self as a reflection.

A kind of permeability arises, a thinning of boundaries that enables her to see herself as an amalgam of parts. History, love, and culture build her self-portraits. She depicts herself or others in isolation only when in a state of deep emotional pain and despair. Disability is often imagined as a state of weakness and withdrawal. Frida Kahlo gives us a world in which pain becomes a fire in the machine. A state of wild ferocity. A disrobing to reveal a body in full communion.

“I hope the exit is joyful and I hope never to return.” – Frida Kahlo

Frida Kahlo Final Days

Frida Kahlo died on July 13, 1954. The official cause of death was given as PE (Pulmonary Embolism, a blood clot in the lungs). Some suspect Frida Kahlo died from an overdose that may or may not have been accidental. An autopsy was never performed. Frida Kahlo had been very ill throughout the previous year. Her right leg had been amputated at the knee owing to gangrene. Frida Kahlo also had a bout of bronchopneumonia near that time. In her final days Frida Kahlo was said to be ill and frail. Barely a shell of the once vivacious artist. With such a strong embodiment in her paintings Frida Kahlo will always be loved by her fans.

Resources

  • Agence France Presse, Yahoo News (2007). Largest-ever exhibit of Frida Kahlo work to open in Mexico.
  • Cruz, Barbara (1996). Frida Kahlo: Portrait of a Mexican Painter. Berkeley Heights: Enslow.
  • Gonzalez, M. (2005). Kahlo –  A Life. Socialist Review, June 2005.
  • errera, Hayden. (1983). Frida: A Biography of Frida Kahlo.

Websites

Depressed woman after spinal cord injury

Spinal Cord Injury Depression

There was no text message warning ahead of time the impending changes in your life. No phone call telling of what was around the corner. In one unpredictable moment, one split second in the span of a lifetime, your routine suddenly spins out of control. The days, weeks, and months following spinal cord injury turn into a blur of bad news, doctors, therapists and pain meds with strangers tossing, turning, and probing for answers. Few are prepared for such traumatic events that disrupt our lives causing great stress and deep depression.

In any traumatic event which causes such physical and emotional distress we often feel that our safety and sense of security has been compromised, invaded. Regardless of what caused the trauma, the fact remains we are thrown into a world of hurt, overwhelmed and struggling to cope with growing feelings of anxiety and stress. The weight of a whole new world is now on your shoulders.

Depressed woman after spinal cord injury

Depression after spinal cord injury

Coping Mechanisims

Having endured acute physical trauma or serious illness some report they “did not have time to even think about what was happening” to them. Often during traumatic events, we feel numb and helpless, as if we’ve lost control of our lives. Others report experiencing the sensation of being outside themselves.

These coping mechanisms isolate us from the event. By distancing our self from the trauma we can better make choices in our own best interest. Much as if your best friend was sitting on your shoulder.

The impact of a traumatic event does not end when people have mended physically. It is also important to note the passage of time does not always heal the feelings caused by trauma. In fact, often the longer one goes without getting help the more intense the feelings of distress become.

In addition, each time we replay a traumatic event in our mind, that sense of dread, hopelessness, and vulnerability increases. Each time the traumatic event is replayed we may find ourselves portraying a different outcome, or better explanation for what happened. Thoughts of “if only” combined with the lack of a better outcome in reality can increase the feelings of depression.

Clinical Depression After Spinal Cord Injury

Most find ourselves feeling blue from time to time. Sometimes, these “blues” can turn into clinical depression. Depression can develop without warning or result from trauma, either emotional or physical trauma. The occurrence of major depression over the span of a lifetime in “western, industrialized nations” is approximately 7 to 12 percent in men and 20 to 25 percent in women. In individuals with spinal cord injury, the diagnosis of depression increases to 25 percent in men and 47 percent in women. These statistics show after a spinal cord injury the incidence rate of depression in both men and women more than doubles.

The incidence rate of depression before and after spinal cord injury doubles

The incidence rate of depression before and after spinal cord injury doubles

For a number of years, the medical community considered the experience of depression after a spinal cord injury as a “valued” and necessary component to “adjustment” to the injury. However more recently, substantive research has enlightened these attitudes, it is clear that the experience of one or more depressive episodes has no impact on the “successful adjustment to the injury.” Nor does any spinal cord injury automatically trigger episodes of severe depression.

Generally a clinical diagnosis of Post Traumatic Stress Disorder (PTSD) is only considered when the symptoms of acute depression have persisted for a duration of six months or more.

Common Symptoms of Depression

People experiencing depression can exhibit a broad spectrum of physical and emotional symptoms. The following is a list of the most commonly reported symptoms:

  • Angry at medical staff, family members, and friends for “forcing” him/her to engage in treatment
  • Avoidance of talking about cause of paralysis on anything more than a superficial level
  • Avoidance of talking about the new reality of wheelchair life
  • Changes in appetite: either a loss of appetite or increasing episodes of overeating
  • Deliberately provoking interpersonal conflicts in order to push family and friends away
  • Difficulty concentrating or remembering details, difficulty making decisions
  • Feeling tired all the time, feeling as if you have no energy
  • Feeling that life is not worth living since the loss of mobility
  • Feeling irritable or restless
  • Feeling helpless and worthless
  • Feelings of guilt about surviving the accident (or other cause) which left him/her in a wheelchair
  • Loss of emotional expression
  • Loss of interest in activities or hobbies which were once enjoyable
  • Ongoing feelings of sadness and emptiness
  • Ongoing aches and pains, headaches, cramps or digestive problems that do not go away
  • Physical symptoms that are not responding to treatment
  • Problems with sleep: sleeping too much, unable to fall asleep, or unable to stay asleep
  • Recurring thoughts of death or suicide
  • Relationship avoidance: reluctant to form new friendships

A common medical disorder caused by an imbalance of chemicals in the brain, depression is more than occasional profound sadness and more than a serious case of “the blues”. Currently, research scientists cannot identify nor attribute any one singular recipe to the cause of depression. Fortunately however depression is treatable. A combination of antidepressant medication and therapy generally relieves the symptoms and provides ongoing recovery.

Thoughts of Suicide

  • Do you believe that others would be better off if you were dead
  • Do you have a history of suicide attempts
  • Do you have frequent suicidal thoughts and a specific plan to follow
  • Do you have frequent suicidal thoughts but are without any specific plans
  • Do you have profound feelings of helplessness, hopelessness, and worthlessness
  • Do you have recurring thoughts of death or wishes for death

One important thing for all of us to remember is that depression is not caused by personal weakness or a lack of will power. Nobody is at fault for depression. If you are experiencing one or more of the feelings listed above, please consult your doctor or phone your local crisis help line.

Kind Regards
Deb