Pain is an asshole screaming in your ear.

You do what you can to get him to go scream in the next room, or even outside the house. If you're lucky, you can close the windows, turn up some music or read a book, and ignore him.*

But he's still an asshole. He'll be back, screaming at you, in a few hours, even if you didn't do any of the things that piss him off, like sleeping too much or not enough, or eating the wrong things. Even if you do all the right things, even if he stays outside for a few days or weeks (or months, if you're really lucky), he's still coming back.

Chronic pain, like any asshole, is mean and petty and sneaky. It'll take things from you - your sleep, your social life, your humor, your sanity. It doesn't care if you have commitments or goals - schedules mean nothing. Invisible to most, impossible to objectively measure, stubborn as hell.

At best, chronic pain is utterly useless. It's not a warning sign that something's gone wrong, like the pain that comes with a running injury. It IS the thing that's gone wrong. Pain begets pain begets pain, setting off a cascade of negative effects:

"''Chronic pain uses up serotonin like a car running out of gas...If the pain persists long enough, everybody runs out of gas.'' Thus...not treating ...pain aggressively because [the patient is] ''tense'' is like ''not rescuing someone who is drowning because they're having a panic attack.''...Difficulty breathing triggers panic as reliably as pain causes depression. When serotonin is inhibited in laboratory animals, morphine ceases to have an analgesic effect on them. Medications that treat depression also treat pain. Depression or stressful events can in turn enhance pain.''**

You can't hide from chronic pain - my own particular asshole has been screaming for 20 years now. I'm still trying to figure out how to keep the volume down. What I have learned is that there are things I can do that make it easier to live with the pain. They won't necessarily make the pain any better (though not doing them will probably make the pain worse), but they help me feel better even when I'm hurting - running is one of these things. 

There's some evidence that exercise can help people cope better with chronic pain - the idea is that while athletes aren't less sensitive to pain, they've just learned how to put up with more of it longer. But what if it also goes the other way? What if having chronic pain helps you deal with pain from training or racing hard because you already know how to live with pain? Might the flip side of “athletes can just stand more of it longer” be that people with some types of chronic pain might succeed as endurance athletes?

My theory is that pain from racing or training is a choice - it's pain I choose to feel, rather than the pain I live with that's beyond my control. Exercise might improve pain tolerance and reduce depression & anxiety (physiologic consequences of chronic pain that also increase sensitivity to pain - there's that asshole again). For me, hard training and racing provide a temporary escape from constant pain. It's still there, still screaming, but I'm running outside.

*Credit for this metaphor to Alexandra Lynch, Daily Kos commentor
**Melanie Thernstrom, Pain, the Disease, New York Times, 12/16/2001

Fun time is over. Long live fun time.

Every year I like to have at least one good chunk of time free from structured training - I call it fun time. Fun time after Lake Stevens 70.3 in August went as planned, with lots of activity and a general reignition of the training spark. I had just started marathon training when my headaches flared up at the end of September and life became distinctly un-fun - increased daily pain and increased migraine frequency. My training was so disrupted it's probably a good thing I didn't have a marathon to run, after all.

I'd love to say that my second round of fun time in November worked, that the rest was restorative and the headaches backed off, but other than a few good weeks here and there, that's not the case. Instead, I've got no base, no speed, weird aches & pains, and side effects from new headache meds. 

A half-baked plan?

So, a little background.

It turns out I'm not so good at marathons: four attempts in two years and only one finisher's medal to show for it. (Granted, the latest attempt was derailed by an act of Nature, but still.) I could continue trying to prove the adage that insanity = a persistent insistence that x + y will yield z when instead it gives you stress fractures, pulled muscles, and an empty bank account, but this year I'm going to work with what works.

Edited to add: 2013 turned out to be not so fantastic, and my plan to run 13 half marathons last year was laid waste by near-daily migraines.