In the spotlight

Having joined the Royal Navy in the late 1980s, I picked up a serious ankle injury very early in training. There was little in the way of rehabilitation available at the time, and as a result I have lived with ankle pain ever since. As I got older this pain became more of a problem, and I was diagnosed with degenerative arthritis in my right ankle in 2007. This was made significantly worse in 2009 when I was injured again, this time shredding a ligament and permanently damaging a nerve in the left side of my pelvis.

Although I was able to get into the military rehabilitation system after this second injury, and subsequently have surgery to repair the ligament, it became clear that nothing could be done for the damage to the nerve. By 2011, I was experiencing significant levels of pain which had an increasingly detrimental effect on my life. My mobility was – and still is – poor and I struggled to manage the normal tasks of daily living. My levels of pain were becoming overwhelming, and even now are a daily challenge.

LIFE AFTER SERVICE

I was medically discharged in 2012; a process that I would describe as hideous. On reflection, I now see that I was very unwell at the time, and I found myself at a loss as to how to deal with the seemingly endless challenges that I faced.

Life was made even more difficult in early 2013, shortly after medical discharge, when I collapsed at home after developing a left-sided weakness and tremor brought on by the stress my body had been under. Life was suddenly very different; I was still overwhelmed by significant levels of pain and I could make no sense of my situation. It was only with the incredible support of my immediate family, significant help from Blesma and others, and the excellent treatment I was able to access at the Bath Centre for Pain Services that I was able to start to make sense of what had happened to me.

It was during the NHS Chronic Pain Management Programme in 2013 that I was given a diagnosis of Chronic Neuropathic Pain, something that allowed me to better understand my condition and what this meant in the longer term. Essentially, my central nervous system is always on high alert, so my body reacts adversely to any painful stimuli; making even the most minor injuries far more painful than normal. This was a permanent change that could not be cured or controlled by medication, intervention or surgery.

I was also told that it was not unusual to see other seemingly strange symptoms in patients with chronic pain, so my tremor and left-sided weakness also needed to be managed in the long term.

It was only after completing the pain management programme that I began to understand my symptoms and realise that my chronic pain had to be managed holistically if I was ever to regain some quality of life. It has been a long journey.

My pain levels remain high and my mobility remains poor, and I now suffer from analgesic migraines as a result of the medication I use.

Nevertheless, I now know that if I pace activity and take steps to manage the pain and fatigue I am better able to do more of the things I enjoy. I will always have pain, and acceptance that it will never go away will always be difficult and distressing to manage.

There are still too many days when I am overwhelmed by pain, tremor and fatigue, and I cannot remember my last pain-free day. However, an understanding of what I can do to regain some quality of life helps a great deal.

GIVING BACK AND HELPING OTHERS

A decade on from medical discharge, I now undertake some voluntary work in an attempt to give something back to the wider community. I was recently appointed to the Patient Voice Committee of the British Pain Society, a group that aims to support patients and carers by representing their views based on experience, and is influential in the design and delivery of care.

The committee recently commissioned a national survey that hopes to capture the experiences of patients as they access specialist pain management treatment. Once the results are known, this will help shape the way in which services might be delivered in future. I am an ambassador for Help for Heroes and am part of the Beneficiary Advisory Panel, a role that allows direct beneficiary/trustee contact. It is proving to be a fulfilling experience, and it is my hope that this work adds value, highlighting some of the specific challenges veterans face, while at the same time developing links into the wider community in an effort to get a better understanding of the challenges that come with chronic pain across all walks of life.

I have come to see that once you learn to manage your pain, there are opportunities to undertake fulfilling and meaningful activity. As I continue to move forward, I acknowledge that my condition does not get any better – if anything it is getting worse – but I prefer to be challenged and am now considering a return to paid work. I think that transparency and honesty will be key to success, and I expect that there will be issues to manage along the way.

If you struggle with chronic pain, I think the hardest part can often be asking for help. I never underestimate the moral courage it takes to recognise that you are in need of support, but there are organisations that can help with pain management. I do think chronic pain has been a hidden issue for many veterans and there is no doubt that living with pain is very challenging.

I think it is far harder than anything I did while serving, and once I acknowledged this, life could become more fulfilling.

There are a number of support services available to veterans. For more information, or to talk to Nick about his experiences and recommendations, please get in touch with your BSO or Outreach Officer initially