Pain is such an interesting subject. Working in the medical field, I've seen a lot of work aimed at quantifying pain and marvelled at the subjectiveness of rating pain. We'd see patients in the ER that were complaining of a hangnail and rated their pain as the worst of their life (no really, people do that!) and then you'd have someone come in with an obviously broken extremity and they'd rate their pain midway on the pain scale, understanding that they may hurt but it could be worse. With children, we tended to move away from the subjective pain scale and look at more quantifiable signs - were they grimacing, were their vitals elevated, were they guarding the painful area, were they apprehensive?
But what if your body doesn't understand pain? What if your neuro-sensory system is screwed up and you feel things differently than most people? What if your early life conditioned you to ignore pain?
I bring this up because it was something I hadn't thought much about and I feel like I have failed my child in this area. We had a very bad couple of days, some very difficult and unusual behaviors - these were preceded by an illness, a cold/bronchitis/high fever, but M seemed very healthy during the actual days of monsterishness. I exchanged emails with her developmental pediatrician and while we don't really know what triggered M's behavior, she did bring up some awesome points. Even though M was recovered and feeling well, she could have still not felt great. Even something as small as a lingering sinus headache could have bothered her enough to make her come unglued. Even though she was begging to go back to school, her body probably still needed more time to rest. The pediatrician pointed out that kids with sensory difficulties just don't feel things the same. Not only could she have been experiencing symptoms she couldn't interpret, she also did not know how to address them or react to them. So something as simple as shopping for birthday party supplies could be overwhelming enough to make her flip out if she wasn't feeling well (sorry to anyone who was at the craft store last Saturday!).
It really got me to thinking. M is an extremist, all or nothing. When she was an infant, she had ear infection after ear infection. Most of the time these were surprises - found during a well baby visit or when we would go to the doctor for her respiratory illness. I wonder how many untreated ear infections she had in the first 9 months of her life - ear infections that she was not treated for, not comforted for, not addressed at all. How desensitizing that might have been. She's never been a complainer when she's sick. The only two times I've ever seen her "lay low" from an illness were when she had pneumonia and when she had influenza. Even then, she was cheerful, playful, and bounced back incredibly fast. She can spike a temp up to 105 and will only complain of being "a little tired". Her body doesn't interpret illness the way others do.
I said she was an extremist, though. There is a flip-side. M is a drama queen when it comes to small injuries. She probably gets hurt 12 times a day, at least. I joke that she does not get TRAUmatic injuries, she gets DRAmatic injuries. She has only had one injury in her life (knock on wood) that truly needed any care beyond a quick bandaid (and it was a badly scraped knee - a rite of passage in a preschooler). But yet, she can fall down and scream like she's broken bones. So, if she doesn't feel pain or doesn't interpret pain, why the big response to tiny injuries? I have two theories: #1 She is more sensitive to small injuries because her tactile sense is so acute. Yes, she is sensory-seeking in that area (meaning she is hypo-sensitive) but at the same time, she consciously thinks about her sense of touch. Since she craves different sensations to fulfull that senosry need, I think small, unexpected injuries are a disruption to her brain - she prefers deliberate input. Theory #2 is that it's a learned response. We teach our kids through our reactions that boo-boos hurt, boo-boos need attention. They see their playmates (that really do understand pain) have big reactions and get big attention (and big bandaids) and then a learned response is formed. M didn't start having dramatic injuries until she started being around kids in a setting that full of injuries (playground at preschool). So she does what is expected of a little kid when they get hurt - M makes sure you know it!
I'm such a "shake it off, you're okay" kind of mom that I'm going to have to work very hard on tuning into pain. The pediatrician suggested medicating for pain anytime M is sick because she may not articulate that she is hurting (just think how achy you are with a cold). I also need to be more empathetic to her small injuries, remembering that she feels things differently. Ignore the drama, address the boo-boo and the hurt feelings.
Pain. Interesting subject, huh? Such a learning process.
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