Pain and Sleep

At this rate they were afraid we would soon be driven against the rocks along the shore, so they threw out four anchors from the back of the ship and prayed for daylight. —Acts 27:29

This verse from Acts 27 comes in the midst of Paul’s journey to Rome to stand for Christ before Caesar. The author tells us in verse 27, that this is the 14^th night of the storm. If you read the entire chapter (which I highly recommend), you will see that this was a harrowing journey. The text doesn’t state it specifically but I am almost certain that no one had gotten any sleep for two weeks at this point in the story. As I read this, I thought about those of us who live with chronic pain and other health issues, who often endure sleepless nights. Some rarely sleep at all and others must take powerful pain medications to get enough relief even to doze off. So, let’s see how this passage can encourage us.

Two things caught my eye here: The sailors took practical steps to address their situation, and they prayed. First, let’s look at the practical steps they took: They bound ropes around the hull to strengthen it, and they lowered the sea anchor to slow the ship down (vs 17); they threw some of the cargo and gear overboard (v 18); they ate to sustain their strength, as they had not eaten anything for two weeks (v 35); and they listened to the one who had listened to God.

So, what’s the application of all this for those of us who are lying awake, desperate for sleep? First, I think we need to ask ourselves whether we’ve done all we can to help ourselves. I believe these practical things are often overlooked when we are feeling desperate. When pain is relentless night after night, we can get caught up in it and forget to do some things that could help. How is your sleep hygiene? Are you following all the rules for a good night’s sleep? I am very grateful that after a few years of intense nighttime pain and many sleepless nights, the Lord has allowed me to sleep pretty well recently. But I have not forgotten how easy it is to get caught up in that cycle of pain, sleeplessness, and frustration, which inevitably leads to more sleeplessness.

One thing the Lord taught me in those years came from Paul again, in Philippians 4:19: But my God shall supply all your need according to his riches in glory by Christ Jesus. The word that jumped out to me here was need. I understood that while I wanted more sleep, the Lord must have determined that more sleep was not a need, because He was not providing it. After that, whenever I couldn’t sleep, I told myself that the Lord would provide all the sleep I needed, and if it wasn’t as much as I’d like then He would sustain me through whatever was coming tomorrow. God knew my needs better than I did, and He would meet them. This freed me from the pressure I would sometimes put on myself: “I’ve got to get to sleep! I will be completely useless tomorrow if I don’t. My pain is always worse when I don’t sleep, and my thoughts are foggy. I need a clear mind tomorrow. I HAVE TO GO TO SLEEP!!” As you know if you’ve struggled like I did, this kind of thinking rarely leads to the restful sleep we crave.

This brings me to the second thing those sailors did: They prayed. The Bible tells us that they prayed for daylight. Daylight would show them how far they were from the shore, and make it easier to navigate the storm. Do you pray as you are lying awake at night? While it wouldn’t be our choice to be so wakeful, it really is an excellent opportunity for prayer, if we will only use it. These quiet hours can provide the time that many of us say we don’t have for prayer. I’ve spent many nights praying for my friends, my family, and other loved ones who don’t know the Lord. During these sleepless nights, we have the luxury of no time limits on our prayers. Often, when I’ve spent this time praying, I find that I fall asleep in the midst of it. There is something about prayer that brings comfort to an aching body.

My dear sister, our God knows our needs, and rest assured (pun intended), He will meet them. You and I must submit to the Lord in this, and allow Him to determine what we need. Once we have done what we can practically do to make the best of our night, we must leave the outcome in His hands. He knows exactly how much sleep we need and he will provide it. Like those sailors, we pray for daylight and anything else the Lord brings to mind, and trust in this simple promise:

The steadfast love of the LORD never ceases; His mercies never come to an end.

They are new every morning. Great is your faithfulness.  

The Life You Hoped Would Be

“Occasionally weep deeply over the life you hoped would be. Grieve the losses. Then wash your face. Trust God. And embrace the life you have.”   John Piper

This quote came across my Face Book news feed recently, and it impacted me deeply. I rarely allow myself to think about the life I’d hoped would be. Since my life has forever been changed, I have thought it quite futile, and perhaps even harmful to think about what might have been. What-if’s and regrets often try to enter my thinking, but I’ve trained myself to resist those things for the most part, and move on.

But, every now and then, the thoughts and feelings come on really strong, and I find that I cannot resist them. So I struggle in my heart and head with how to deal with them. For example, I often see grandparents with their grandkids in the park and at community events, and I see the joy they get from playing with them, showing them the beauties of nature, and just running around together. I wonder sometimes what it will be like when my own children begin to have babies. Will I be able to play with my grandchildren when they get to that park and playground age? Unless something changes dramatically, no. How will this affect my relationship with them? Will they love their other, more capable grandma more than me? Will they want to spend time with me if all I can do is watch them from the park bench? These are the “already-not-yet” kinds of thoughts that can bring me down.

What about you, friend? How are you doing with the loss of the life you’d hoped would be? I wanted to share this quote with you, just in case you are struggling with whether you will ever get over your loss. I love the way John Piper has worded this permission to grieve. I have never believed that we can get completely over any loss, and a life lived in chronic pain or disability is certainly a loss. It is a loss of what could have been, what we’d hoped would be. And it is a loss that is renewed each day. You can’t “move on” from chronic pain and disability when you must face it 24/7/365.

And so, as John Piper so graciously says, we must occasionally “weep deeply over the life we hoped would be.” It’s OK to think about the fun you would have had, the functional body you would have enjoyed, and the simple pleasure of just being comfortable—pleasures that now, without a miracle, will never be yours this side of heaven.  And when you think about it, it is OK to cry, and to cry hard. You absolutely must grieve when grief comes too fast to outrun. And so, as you cry over your loss, God collects your tears in His bottle. He does not forget your pain, your loss, or your sadness.

Why does Piper say, “Wash your face?” I had to think about that a little bit. After crying hard, it does feel good just to soak a washcloth in hot water and lay it over your face. This does two things—it brings comfort, because it feels really good; and it gives you a moment between crying over the loss of what you wanted, and returning to what you have. A moment to pray; a moment to thank God for His comfort; a moment to grow in your faith as you learn to trust Him.

And then what? “Embrace the life you have.” Notice he doesn’t just say, “Accept the life you have.” There is a big difference between embracing and accepting. Accepting says, “Oh well, it is what it is. I’ll have to make the best of it.” Accepting means I will do my best to keep doing as much as I can, but some things will have to go. Accepting implies defeat.

Embracing, on the other hand, says, “This was not in my plans, but it obviously was in God’s, so I will trust Him for the outcome.” Embracing a loss requires a decision on my part. I must decide in my heart that I believe God when He says He knows what’s best for me (Jeremiah 29:11), and that He will see me through it (Proverbs 3:5-6).  I must decide to follow and obey Him no matter what is going on with my body.  Embracing implies welcoming God’s provision; his plan for making me more like His precious son. I have seen many good things come from my own loss, as I’ve shared with you here a few times. Christ is a redeemer, and He redeems not just our souls, but our lives. There is no loss you have suffered that Christ cannot replace and then some, if you are willing to embrace His plan and look for His purpose in it.

My dear sister, whatever loss you are facing today, I hope you will join me (and John Piper) in grieving it honestly, trusting God fully, and embracing the good things you are sure to gain. He is faithful, and He loves you. Watch and see the glory He will bring from your loss. And when you see it, praise Him! Hallelujah! What a Redeemer! What a Savior!

Trouble

Are you in trouble today, my friend? Does your pain seem to be more than you can bear? Are the bills piling up, but the paychecks running dry? Do you see a mountain of responsibilities before you, yet feel you haven’t an ounce of strength to begin to do any of them?

Sometimes, we just want to run away from it all. Our flesh fails us, and we think that there is no escape from the pressures of needing to get things done in a body that refuses to cooperate. I don’t know what the source of your pain is, my friend, or how disabled you are today. But as for me, there are a few things I do know.

I know that the Lord will help me.  Psalm 46:1 says that God is our refuge and strength, a very present help in trouble. Read that carefully. It doesn’t say He will send help. It says that He Himself is our help! Imagine that. The Almighty God of the Universe is our help! How can we possibly fail? If He has called us to do something, He will enable us to do it! When we want to run away and hide, He Himself is our refuge, and He bids us come! So, when I need help, I run to my Savior in prayer, enjoy His sweet and loving embrace for a moment, and go and do the next thing, as He enables me.

I know that the Lord never changes, even when I can’t depend on my own strength.  Psalm 46:2 says that no matter what changes, even if the earth crumbles under my feet while a tidal wave washes over me, I don’t have to be afraid. Think of that. Imagine the mountains slipping into the sea and the earth quaking violently. That is a scary picture! But, in the same breath, my Lord tells me I have nothing to fear! Now, look at your pain and disability from that perspective. Though pain can be a fearful thing, and thoughts of our future can at times leave us trembling, our God is rock solid. He has been with us up to now, and will stay with us forever.

I know that the Lord loves me and sustains my faith, even when doubt creeps in. Psalm 94: 1 says, “I cried out, 'I am slipping!' but your unfailing love, O Lord, supported me. When doubts filled my mind, your comfort gave me renewed hope and cheer." If I’m honest, I have to admit that I sometimes have doubts. Satan loves to put doubts in our minds, and He often uses our physical incapacity to raise the volume of those doubts. I believe he is the source of the thought that comes to my mind at times that says, “God couldn’t possibly have called you to ministry. If He had, He certainly wouldn’t have allowed such a setback! Your physical limitations are a sign that your calling wasn’t real, and God won’t use you.” When doubts like these enter my mind, this Psalm is a lifeline. God’s unfailing love supports me, and His comfort gives me new hope. I know that He can use me, in whatever physical condition I’m in, in whatever way He wants to! As long as my heart is in line with His, my body will do all that He calls me to do!

My dear friend, are you discouraged today? Take heart! If God wants something done, He will make a way! I can’t imagine a better closing argument for trusting God than this one, from Psalm 91:

He who dwells in the secret place of the Most High

Shall abide under the shadow of the Almighty.

I will say of the Lord, “He is my refuge and my fortress;

My God, in Him I will trust.”

The Importance of Flexibility

When all kinds of trials and temptations crowd into your lives, my brothers, don’t resent them as intruders, but welcome them as friends.      

                                               James 1:2, Phillips                                                                                                                                                                   

Most of my physical challenges are due to the misalignment and flexion deformity of my knee replacement. One of the biggest problems with this knee is the very limited range of motion.  I do my daily PT routine, but the things that I can do on my own are not enough to keep the deformity of my knee joint from getting worse. So, every couple of weeks, I see a manual therapist to help stretch the soft tissues and break up fascial adhesions around the joint. This is very helpful, and together with my daily routines, keeps me walking and able to do steps.

These last couple of weeks, I wasn’t able to do my regular PT because I came down with a bad respiratory virus. Because of that, my most recent visit to the manual therapist was quite painful. (Hang in there, I’m really not just going to complain through this whole post!) He did a technique called “muscle stripping,” which is very effective for breaking up those adhesions and stretching out the soft tissues around the joint. It is a more intense kind of therapy than what I usually get. He’s had to do this a few times, and it is always very helpful, with lasting results. On the down side, it is also extremely painful, and although I knew this from experience, I was eager to receive the treatment.

I needed this treatment to address the stiffness of the leg that was partially caused by neglect of my daily routine. Now, let’s think about our spiritual “stiffness.” The above verse from James, from the Phillips paraphrase, tells us that we should welcome trials as friends. There is nothing like a difficult trial to show us our spiritual range of motion. Sometimes, when we get focused on the troubles of our lives, we can forget to seek wisdom in Scripture, to pray, and to cry out to God. Instead, we try to “fix” the situation ourselves. When this happens, we become weary and begin neglecting our spiritual disciplines. In the process, we can get worn out, worn down, and spiritually stiff.

James tells us a better way. Instead of resenting the trial and seeking to escape, which draws us away from Christ and toward self, we should look at them as friends sent to help us become more like Christ. Read the next part of the above passage in James:

Realize that they [trials] come to test your faith and to produce in you the quality of endurance. But let the process go on until that endurance is fully developed, and you will find you have become men of mature character, men of integrity with no weak spots.

While I don’t enjoy muscle stripping, I do call it my friend because I know that it will help me gain the flexibility I need in order to be able to strengthen the muscles around that joint. One of the biggest problems with an inflexible joint is muscle weakness. If you can’t bend the joint, you can’t challenge the muscle to grow. Trials are like muscle stripping. They are unpleasant and often painful, but they are necessary if we want to grow spiritually. Through trials, God strips away the stiffness that enters our hearts through sin, neglect of spiritual disciplines, emotional pain, or idolatry.  All of these things can cause us to turn from Him.

While I was suffering with the flu, I couldn’t muster the energy to make myself do the home therapy necessary to maintain my knee. I am so thankful that my therapist knows what to do! Through a painful process, helped me get back with the program and keep my mobility from spiraling downward. In the same way, I am very grateful to God for sending trials to accomplish the same things on a heart level. Don’t get me wrong—I’m not giddy with anticipatory glee when trials come. But I am very thankful that my God loves me and desires my growth in Him, and this is what enables me to be thankful for my trials. Thankful for the stripping away of the sin that sticks to my heart and makes me stiff. Thankful for the softening of stubbornly knotted rebellion, allowing humility to grow in my heart. Thankful, indeed, that my Therapist knows what to do. Hallelujah! What a Healer! What a Savior!

Looking For Encouragement?

I’ve been preparing lately for a workshop I’m going to give at a BiblicalCounseling Conference in my area. As I am making my notes, I am planning to offer a disclaimer right at the start, and it’s going to go something like this:

“Most of you in this room are far more experienced counselors than I am, and could probably teach me much more about biblical counseling than I can teach you.  But I do believe that I have something to offer in the area I’m going to talk about, because of the many years of experience I have with it.  I’m going to talk today about self-pity, and my journey to break free of the bondage of feeling sorry for myself. I hope to offer a counselee’s perspective on this kind of thinking. What I have to offer is not a new technique, but a personal testimony of the work that Christ has done in my heart, and the people and things he’s used along the way.”

As I’ve been preparing for this talk, I keep going back to the books God used as sort of rungs of a ladder, if you will, as I climbed out of that sinkhole of self-pity. If you struggle with your thinking as you endure your physical affliction, then I know that any one of these titles would be an encouragement to you. Here are just a few of the books that have helped me. I hope they might do the same for you.

God’s Healing forLife’s Losses, by Bob Kelleman

This little book is just over 100 pages, but it packs a great deal of truth, compassion and encouragement in that small space. It is somewhat of a journaling book, in that it includes several “grief and growth workbooks,” with questions for the reader to answer. By the time I’d finished this book, I’d written over 40 tear-stained pages as I poured out my heart to the Lord. Kelleman has a way of blending truth with compassion in a way that produces repentance and relief for the sufferer. This book taught me that it is perfectly acceptable to God that I am grieving the loss that I suffered. It challenged me to see my loss as a type of death, and to grieve it biblically. My biggest takeaway from this book was that there are many “deaths” in this life besides the final one, and that it is right to grieve them. Reading and journaling through this book helped me stop stuffing my sadness and denying the pain I felt, so that I could look at it clearly through the lens of Scripture, grieve it rightly, and think about it biblically.

Pain: The Gift NobodyWants, by Dr. Paul Brand with Philip Yancey

This is a book that I read with the book group that I attend weekly. It is the story of a surgeon who worked among the Lepers in India. I hadn’t known this before, but true leprosy is characterized by a gradual loss of sensation in the extremities. The basic premise of the book is that pain, though it is often seen as the enemy, is really a friend to us. It signals that something is wrong, so that it can be addressed. Sadly, Brand acknowledges, with some kinds of pain, there is no solution. Woven in among stories of leprous patients and other pain narratives is information about how the mind perceives pain, and helpful modalities for minimizing pain without medication. I have put some of these things into practice, and have found them to be quite helpful. This is a book that is inspiring, but not necessarily inspired. There is not a lot of doctrinal content, but the overall tone is quite encouraging, and the selfless and loving way that Dr. Brand offers his skill to his patients taught me much about how to offer compassion when the pain can’t be stopped.

The Attributes of God, by AW Pink 

This book is, of course, not about pain, but about the sovereign, good, loving, merciful, patient God who has ordained it. This book, more than any other, solidified for me who God is. This is the book that convinced me of my favorite (though unoriginal) saying: “God is God, and He is who He says He is, regardless of my circumstances.” One of the key questions my biblical counselor asked me was, “How would God be different if your surgery had gone as planned?” Though I wanted to answer, “If God had done things my way, then he would be good and merciful,” I knew that was not right. This book firmly planted my view of God in Scripture, and it has become deeply rooted as I routinely review the attributes of God with my counselees, to help them line up their view of God with Scripture, not their circumstances. (This one is also available in PDF format, free of charge, here.

Pain: The Plight ofFallen Man, by Dr. James Halla

Dr. Halla is a rheumatologist who is also an ACBC certified biblical counselor. The information on the back cover says that it is a book on pain management from a Christian perspective, and that’s true. But it is more than that. What I got from reading this book is a great deal of help with how to think about my pain. The beginning part of the book gets into facts about the anatomy of pain, and is quite technical yet written in a way that a lay person can understand it. After laying that foundation, Dr. Halla talks about how our thinking either magnifies or shrinks our pain. I have found this to be very true as I have worked on thinking biblically about my pain. I know for a fact that I have the ability to make my pain better or worse, just by how I think about it, and this light dawned for me as I read this book. It is packed with facts, information, and encouragement that will change the way you think about your suffering, always directing those thoughts through a biblical filter. This book was another turning point for me in my thinking.

There are many other books and articles I’ve read that helped to change my perspective. Almost any book by Joni Earickson Tada will convict and encourage your heart. Spiritual Depression: Its Causes and Cure, by D. Martin Lloyd-Jones will help you to turn around the sadness and despair that often accompany chronic pain and disability. Surrender, by Nancy Leigh DeMoss is another very short book that is long on encouragement, and will help you to release your desire to control your circumstances into the hands of the loving God who ordained them.

Do you have a book or author that has been especially encouraging to you? If so, will you share it in the comments below? One thing I have always wanted this blog to be about is mutual encouragement among sufferers. Let’s share together the things that have helped us!

My Strong Weakness

As, therefore, God’s picked representatives, purified and beloved, put on that nature which is merciful in action, kindly in heart, and humble in mind. Accept life, and be most patient and tolerant with one another, always ready to forgive if you have a difference with anyone. Forgive as freely as the Lord has forgiven you. And, above everything else, be truly loving, for love binds all the virtues together in perfection. (Colossians 3:12-14, JB Phillips Paraphrase)

I have really been enjoying reading through the New Testament in the JB Phillips paraphrase. I love the way he words some of my favorite passages in a way that helps me to better understand what they mean. The above passage is no exception. I got such joy from reading it that I wanted to share it with you, and tell you how it spoke to my heart in this season when the pain I experience is more intense and limiting.

First of all, this passage tells me that, regardless of how physically able I am, God still picked me to be His representative. So, that means that I can honor and glorify God even if I can’t leave my bed! I am able to fulfill my God-given purpose, which is to glorify Him (Is 43:7) regardless of my physical condition, and this encourages me to persevere. Since I have been purified, and because He loves me, I can be merciful, kind and humble. I don’t have to give in to irritability and the tendency to be short-tempered when I am hurting. He has given me a new nature so I can overcome these things.

As I accept what is happening, the patience and tolerance that follows will make my relationships more peaceful. Because I have been freely and fully forgiven, I can practice that same forgiveness with others, even when I am in pain. I don’t have to be unhappy or discontented. I am loved by God, and He has enabled me to love Him and others. As I love God and others, those virtues of patience and tolerance that are available to me will flow into and out of my heart, because of the perfection that He conveys on me.

The best thing about all of this is that these qualities and actions of God enable me to join with Him in making something good out of my pain. As Joseph said in Genesis 50, though spiritual forces of evil would try to use our pain in their favor, God intends for our pain to do us good. I believe that our enemy knows about our pain, and is crouching at the door, waiting for us to give in to the impatience, irritability, and strained relationships that can come so easily when we are hurting. But God has ordained this pain for me, and he has also chosen me before the foundation of the world to be His!

So, as I am determined to represent Him well, I gain strength for the battle against my flesh. I put on that nature which is “merciful in action, kindly in heart and humble in mind,” and I wear it into the battle. It is my joy to remember that physical strength is not what is needed in this particular war . Spiritual strength is what is needed here, and the very weakness that would disqualify me for a physical battle is the key to my spiritual strength!

So, for the most important battles of my life—the ones that involve my relationship with God and with the people that I love—I am fully equipped. Second Peter 1:3 tells me that I have everything that I will ever need for life and godliness, so I can be sure that no circumstantial limitation will ever change that. Only the One True God could orchestrate such a mercy. He makes all things work together in such a way that even on our most painful and difficult days, when we feel old, wretched and useless, what we really are is brand new, purified, and chosen! Hallelujah! What a Reality! What a Savior!

Fear of the Unknown

Anxiety in the heart of man causes depression,

But a good word makes it glad.

Proverbs 12:25

I’m so glad that this verse is in the Bible! I have always believed that there is a link between anxiety and depression, and who better than our all-wise and loving God to provide this verification? Those of us who suffer with chronic pain or other health issues are all too aware of this link. While it is true that anxiety in general, about almost anything, can lead to depression, there is a unique kind of link between the two when that anxiety is about our physical bodies.

Think about the last time you experienced a new or unfamiliar symptom. If you were already struggling with the “normal” pain and disability to which you'd become accustomed, then this new pain or problem probably struck fear or panic in your mind. Maybe it went something like this: “Oh, no! What could that be? Is this my disease process ramping up? Am I going to have yet another source of pain to deal with? How will I cope? How will this new thing affect the other things I’m dealing with?” The questions and worries come faster than you can address them, and soon anxiety is in full swing and depression is close behind.

But does it really have to be this way? Well, that depends on what your peace is planted in. If you believe that you can have peace only when there are no unknown or unexpected problems, then peace will be elusive during these times. However, if your peace is rooted and grounded in the all-sufficient grace of Christ, then it is not going to be shaken no matter what symptoms pop up, or what test results change.

Many Bible scholars believe that the thorn in the flesh, of which Paul speaks in 2 Corinthians 12, was a physical ailment. I think so, too. Paul says that He asked the Lord three times to take it away. I have prayed this prayer many times myself, and it is usually when my pain is particularly bad or something new pops up. Perhaps the apostle was in a similar place each of the three times he asked for relief. I can imagine Paul struggling with a recurrence  of malaria, or perhaps worsening eyesight, and pleading with the Lord to take it away.  

Implied in God’s answer are Paul’s unspoken fears: “How will I cope? How will I continue this ministry if my body won’t cooperate? How will I serve and glorify God if I can’t physically do the things I need to do?” God’s answer, if I may paraphrase: “By my grace you will do all that I’ve called you to do. By My grace you will be able to endure the pain. By My grace you will encourage, love, and lead the churches. By My grace you will preach the Gospel and reach the lost. Because My grace is sufficient. Your weakness makes My strength perfect: Perfect for your need. Perfect for those you are ministering to. Perfect for My glory.”

God is calling Paul to take his thoughts away from the thorn in his flesh and put them on God. This is our solution too, my friend. When new pain, worsening symptoms, or frightening diagnoses come, we must respond as Paul did: Ask the Lord for healing. If the answer is no, then trust in His grace to strengthen you in your weakness. It was indeed sufficient for Paul, as you will see if you read the rest of the New Testament. 

It is also sufficient for you. The key is to take your mind off of yourself and your pain, and put it on God. Trust Him to give you the strength to fulfill your God-given responsibilities, whether those involve ministry in the body of Christ or making dinner for your family. Whatever He has called you to do, whatever pain He allows, His grace is sufficient for you. This good word will make your heart glad, and the anxiety that was trying to weigh it down will lift as find your peace firmly rooted in the all-sufficient grace of God. Hallelujah! What a Sustainer! What a Savior!