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Coping with catastrophe and chronic pain

Last updated: 02-24-2020

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Coping with catastrophe and chronic pain

“In December I started packing for a gruelling (as it turned out) stint of "scribing" for a Firefighting Strike team where it turned out we successfully defended a number of properties in East Lynne and Brooman. This was the day the Cooraban fire expanded from ~2000 to 40,000Ha, crossed the highway and threatened/ took out houses in N. Durras Depot Beach etc. Day 1 was 21 hrs ending in a bed at 3.30 AM. The next day was shorter…in bed at 2.30 AM! (After having been the lead driver in a convoy where we drove through a fire storm and the back of one of the trucks caught alight.)

Needless to say I needed pain killers to get through. Since then I have been on a couple more strike teams, and was packed to do a stint in Moruya headquarters on New Year’s Eve day when at midnight the fires burst out of the wilderness in Brogo and I enacted our street fire phone 'tree' and we ended up with quite a party in our safe earth integrated house. At 5.30 I went into town to help start up a communication cell at our local fire HQ. 

Been there most days ever since! Sitting talking on a radio is agony for my back but being at the centre of directing fire trucksis very distracting to the mind! Balance between pain control with drugs is ever present in my mind and I am now only offering myself on alternating days. In fact this week we have the State Sherriff's office doing coms and I have 6 days off (though' always on standby for local knowledge). 

So now I have time to help out mates who have been burned out. It is very hard to know what to prioritise as every day I learn of another friend burned out...and it is still happening. Last night I got up and put my glasses on to verify that the blur I was seeing was in fact a star...My first for 36 days!

We are surrounded by burnt area so now my wife can begin to relax, but she did ring me a couple of times in the early days to ask me to remind her why I was safe at work and why she was at home!

Whatever the schedule for the day I (have to) start the day with an hour in my spa but have had to take up a low level of opioid to get through the day. I am very mindful that it is the equivalent of post op self-prescribing and is for current trauma and not chronic pain, though' the way this summer is going.... My wife, Fiona, is very worried that I may slip back into addiction and is already noticing negative character traits developing- she says because of the drugs- I say because of focus on crisis…

As to others living with chronic pain through the fires , personally it seems not much different to living through the drought. More work, for less result and seemingly no end in sight. Whether burned out or not, these whole communities are going to suffer long term pain. There won't be any unemployed psychologists for years to come! The communities are showing remarkable resilience and self-help from the ground up, but what is happening inside individual minds may take a long time to 'heal'.

Personally I have temporarily swapped straining my back from lifting heavy buckets of water to wrist pain from scribing- in fact I have just made an appointment to hopefully have yet another wrist operation to relieve wrist pain - seems it is easier to work on hand than wrist pain.”

These are the words of Don Firth from Brogo in Bega. Don is one of the inaugural members of Painaustralia’s Consumer Advisory Group. He has been a long time front line firefighter, and this combined with building and farm work took its toll on his body and in 2011 he became a disabled pensioner. With a full knee replacement and several back and shoulder injuries, he was forced to greatly reduce his physical activities. But Don maintained a gentle balance with Tai Chi, singing in choirs and daily spas working together to improve and maintain the fitness of both his body and mind. Over time Don had been gradually able to reduce his dependence on medication and increased his physical activity with the aid of courses in mind training and pacing. That is until the start of this summer.

To say that 2020 has started off on a sombre note in Australia would perhaps be too much of an understatement. Here in Canberra through December and January we have woken up each day  to terrible air quality that is unmatched in terms of severity, duration and extent, with fast moving, emergency level fires the norm, and a quarter of the Capital Territory consumed by flames.

We have a big agenda ahead for this year, as we enter a crucial phase of adoption and implementation of the National Strategic Action Plan for Pain Management, the blueprint for a national approach to pain. With the bushfire catastrophe and the looming impact of climate change, this task has now taken on an unprecedented level of urgency.

The evidence on the health impact of climate change related catastrophes like these bushfires is stark and clear. Climate change is the biggest global health threat of the 21st century, as underlined clearly by the MJA-Lancet Countdown 2019 report on climate change and health in Australia. This will particularly impact people living with chronic pain, as research has already shown us that changes in weather influence pain.

The Lancet-MJA report also shows that catastrophic fires are just one way that worsening climate change has an impact on the health of Australians, finding that overall the intensity of hazard posed to human health by heatwaves has increased by 33% in the past 20 years. Climate change is not just an unprecedented public health threat, but also a threat to multiple organ systems. Most concerningly, the report also finds that In Australia, hot days have a damaging effect on whole-population mental health equivalent to that of unemployment and hospitalisation for self-harm. As Don points out, the communities that have been impacted, infact almost every Australian will feel the angst of these flames long after they have been extinguished.

We already know that everyday millions of people battle with the physical, mental and emotional toll of chronic pain impacting every facet of their lives. Nearly 1.45 million people in pain also live with depression and anxiety. Much evidence shows that chronic pain does not exist in a vacuum, but has varied co-morbidities and far-reaching consequences. Painaustralia has welcomed the additional mental health support services that will be immediately provided to all those affected by the bush fire emergency from firefighters, emergency personnel to individuals and communities impacted by the ongoing bushfire crisis.

Our submission to the Victorian Royal Commission into mental health outlines, despite a strong link between pain and mental health, chronic pain remains a poor cousin in policy priority and public awareness – in short, it remains misunderstood and neglected.

Now we need to see similar support for people living with chronic pain who are already uniquely vulnerable to the devastating impact of catastrophes like these bushfires. Just like Don, there will be many other people, who live each day as a fine balancing act with their chronic pain, only to have catastrophic events present a barrier in more ways than we can recount.

If anything, we now have more of a responsibility to advocate for the implementation of a national biopsychosocial approach made accessible for all Australians. As the National Action Plan progresses to Australian Premiers at the Council of Australian Governments, we hope that they will all take this significant step towards ensuring that Australia will lead the world in both implementing best practice strategies to tackle chronic pain and also prevent the prevalence from rising with increasing risk of climate induced catastrophes.

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