• Yoko Nogami

On Pain



At 650 miles of trekking something like 12-16 miles a day, I have quite a bit of aches and pains. I have not yet met a hiker along this Appalachian trail that does not have some pain associated with the long and repetitious movement of walking, carrying a big pack, day after day.

The pain is a nuisance. Our only task each day is to walk. And the pain simply gets in our way. It is a delicate dance you do with your mind and body. The truth is that our body is the boss in this situation. Without a functioning body, there is no walking. The mind’s job is to trick our body long enough to complete the miles, 2190 of them, without completely breaking it down.

I have been very fortunate thus far to not carry any illnesses that prohibited me from being active. I had my share of high blood pressure and cholesterol, triggered by work related stress, but nothing unmanageable or serious. Upon quitting my job to do this trail, my blood pressure returned to normal. A good example of mind playing tricks with the body.

Smokies on the Appalachian Trail is a huge hurdle. The National Forest places harsh rules and requirements to complete the nearly 80 mile stretch of the trail in 8 days. As still beginners on the trail, thinking of doing 10 miles a day seem daunting to the hikers. We are also required to stay in shelters and not stealth camp on this stretch. This places you in a time and mile management that is stressful. Add the terrain, weather and bears, and for the busiest time of year for hikers, overpopulation in shelters bring about added pressure to the rules we must follow. The rule abiding is closely monitored by the ridge runners and they come around to check on your permits and make sure you are keeping your pace.

My Smokies did not even start until the snow storm passed, which held me hostage at the most luxurious shelter called Fontana Hilton. The name due to the hot showers and flushing toilets available with the largest shelter, which fits 28, on the AT. The Fontana Village, a popular resort is a short shuttle ride away which is also a great place to hang out until your ascent into the Smokies.

The snow storm came and left, it was time for my departure, a sunny 60 degree weather with glistening sparkles of snow on the trees and trail, until shortly they all melted and turned to mud. The next several days turned into rainstorms which transformed the trail to a muddy creek.

When I was in 4th grade, I went to a summer camp hosted by my alma mater, Nishimachi International School, in the mountains of Gunma Prefecture in Japan. The camp, called Kazuno, was four weeks long. It was rare for a 4th grader to stay the entire duration of 4 weeks away from home but going to this camp was one of my first scheming success to get me out of an otherwise horrible homestay with an American family on a military base. I learned early in life a technique to find a solution to get out of things which I hated to do. This was definitely one but a success story, which in fact ended up shaping my life. I attribute this camp as the reason why I am on this trail.

At this camp, one of the activities we were able to sign up to do was called “river running”. It was just that. We started at the bottom of a mountain in a big river, with sneakers, socks, jeans and t-shirt adorned, the task was simply to hike up the river, not by the river but “in” the river, until the river turned into a stream then a creek and a trickle, which brought you to the top of the mountain. We were soaked from top to bottom, inside out. Sometimes we swam fully clothed in the deep ravines. That is what we did and I thought nothing of it.

That was summer. When the Smokies hit me, it was still March. I mean, it snowed. So, “river running” on the trail in the Smokies in March was not the same. I was also now 40 odd years older, sloshing in the slippery mud with a pack that weighed good 35 lbs was not what my body really wanted. In “river running” we always climbed up, not down. Walking down a muddy stream with rocks is a game of how to stay upright and not twist your ankle while you noodle around in your now wet supposed to be waterproof boots. Your pants are caked in mud up to the knees, also soaking wet from the pouring down rain. Little did I know that at that time, since your boots are soaked anyways, you are supposed to just walk straight through, in the muddy stream which was the trail. Instead, I walked like a walking Eiffel Tower, teetering, trying to walk avoiding the river below.

When I reached New Found Gap, the midway point of the Smokies, my left knee was like a balloon. It also decided that it was going to stop bending. When Randy picked me up for a Zero day (day you do not hike) and result, I was not sure what had happened to my leg. All I knew was that my squatting days were over. This was a big problem.

Most hikers carry a bottle of ibuprofen. They pop them like candy everyday, many pop three or four at a time, few times a day, especially after the original suggested dosage stops working. I am not a pill taker. I would need a pretty serious threat to pop a pill. I am also not an addictive type so I have never been dependent on any sort of substance for pain or mood alterations. This was about to change.

When you are in constant pain, and when you find the solution which takes that away, even for a few hours, you love this solution, good or bad. When you are in pain, everything you do revolves around this sensation. The pain takes over your life, either in a debilitating way or an addictive way, where all you can think of is to alleviate it.

I have an incredible high tolerance for pain. I proud myself in birthing my daughter, drug free. I believe that pain is a communication from my body to my conscience to pay attention to the needs of the body. And I like to help my body with what it needs for a cure, not for the pain but to heal the cause. I also believe strongly that the body is able to heal on its own and pain is part of that process. So painkillers are usually not part of my drug cabinet staple.

Now that my knee was a balloon, but I needed to keep going, I took my ibuprofen. The key phrase is that “I needed to keep going.” One, 200mg ibuprofen, the little brown pill. Overnight my knee shrank and I was mobile. No squatting yet but I was able to walk with significantly less pain. I would continue to take this nearly everyday for three weeks. I was afraid of the ballooning and pain to return.

I worked with many clients who had substance abuse disorders. I also had friends and loved ones with addiction problems. Because I am a non-addictive type, all I could do was to empathize with the concept of addiction, as the need for something that is knowingly harmful for you, but you cannot stop doing it. But now, I finally understood in my little addiction to 200mg of ibuprofen, what pain relieving felt like. If you are hurting, you want it to stop. If your mind and conscience is hurting, you want to numb it. And if there was a pill, a drink, a smoke or harmful habit that made it better, you want that. The side effects and risks seems less than the pain you are under. In pain, you can not make good judgements.

There is also fear. Once you are alleviated of the pain, you dread and be fearful of its return. You want to be ready to pop that pill again so even a small lapse of the pain, you may not have to experience.

The cure and treatment of the underlining cause of the pain is where we should be. In my case it meant to sit out for a week or so to get the knee feeling better and start back up. That was not what I wanted. I knew I had to keep going because I have a deadline. For me, I was now in an athlete mode where I had a finishing line and a timeline to get it done. I must hike on. I have to trick my poor knees to think they can go on with a little help from our friend ibuprofen.

Along with the pill the knees were now taped with kinesiology tape for extra support and a knee brace. I also boosted my diet with turmeric and ginger supplement on top of the fish oil and collagen powder. These were items to promote the healing so I can be off of the pills. These proved to be good and my knees eventually started to heal and ibuprofen was not necessary anymore.

The taping reminded me of the sumo wrestlers in Japan with skin toned tape all over their body. The taping looked painful on their giant bodies. Knee injuries were common with the sumo wrestlers because of their weight. My dad, a martial arts fanatic of sorts would tell me how to take out an overweight opponent if they attacked me. He always felt I would be attacked and needed to know how to defend myself. “Kick the knee from the front. Fat people have weak knees. Kick from the front and they will break!” And he would show me his pow pow moves. All I could see in my mind was a horrific image of knees bending backwards and a big guy falling in absolute pain. Well, with a swollen painful knee, that imagery became all too real. I can certainly see what that might feel like and that would be the end of me.

Pain, which can be of your body, mind or soul. Fear of pain can drive one to do things you would not ever imagine doing. Pain can be good, in ways it will recognize the places of attention it needs for a cure. But until that happens one is always at risk of doing unbelievable things just to get away from it all. In recognizing this, compassion for those in pain and in addictive behavior is needed.

Stigmatizing people with addiction as ones with bad habits is a shallow understanding of what drives them to such harm. I now know the tip of the iceberg of this notion and I am glad to understand this better. I also know that there is no magic pill. A cure is hard work and one which requires patience and understanding from all that surrounds the person in pain. To find the right cure is worth the attention and time for a prolonged quality of “a pain free” life.

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