Monday, November 06, 2006

From 3 to 4 a Day

Continuing backwards from what I've been up to since May, here's the skinny on my continued battle with chronic pain and my medications:

The pain is worse. No surprise. But you never are prepared or can really mentally adjust prior to a greater amount hitting your body. It's human nature to resist not accept pain (unless you're into the S&M, but believe me...I don't believe pain = pleasure -- no judgment on those who do; it's just not my thing). As a result, as much as I've known it would get worse, I was not prepared for the increased amount of pain. The only choice was to go back to my pain management specialist and get an increase in medication. After consulting with him, I'm up to four Hydrocodone (aka Vicodin) a day.

Whereas at one time I could get at least four to five hours of relief from a single Vicodin, that declined to no more than three hours of relief. I put up with the gaps in comfort for almost a month-and-a-half, but Laura and my friends just didn't understand why I would suffer when I could get relief. The truth is that an increase in pain medication would mean further acknowledgment of my decline. It sucks! As much as my psyche intellectually understands that decline is inevitable, emotionally, I want to rail against it. I want to scale the mountain and scream to Heaven...STOP THE PAIN! But that's not how it works. And, so, I headed back to my pain management specialist and an increase in pain medication was prescribed.

I joked when my use of Vicodin for pain management started that I really was like the FOX TV character House, who, if you don't know, uses Vicodin for pain management and also walks with a cane. Of course, I imagined that he probably took more than three a day, but now that I'm taking four, I'm thinking I'm right with this fictional bastard.

I'm not sure if I previously discussed why my two pain management therapists felt comfortable about prescribing an opiate that generally is viewed as an addictive agent that has, according to the media, destroyed lives over and over again. In general, there are two types of physicians, those who understand chronic pain and those who do not. Those who do not still view pain as a nuisance not a genuine condition or disability that deserves treatment. The other school of thought is that chronic pain is a legitimate condition that should be treated based on a patient's individual need to be comfortable.

My pain management specialists have determined, based on examination and testing that I have a physiology and psychology which can utilize opiates without the grave danger of addiction which the general public assumes everyone in the world will succumb to. The fact is that when the body is in pain, opiates work in such a way that the body doesn't become addicted to the opiate because the body is already addicted to the pain. The chemistry of the body and brain has been permanently altered by the continual assault from pain so that it doesn't become addicted like a "healthy" body and brain does.

A chronic pain victim has a difficult enough time coping with the pain itself, they shouldn't be made to feel like a drug addict because they want relief from it. To make someone who suffers constantly feel worse for wanting relief is pathetic and downright cruel.

In addition to the change in my Vicodin regimen I am now on a drug called Cymbalta, which, as you might have seen on TV commercials, is largely prescribed as a depression medication. I have since over the course of this year previously been prescribed Lexapro and Effexor for my depression as well as chronic pain. I've been switched to Cymbalta because in addition to depression, Cymbalta is also prescribed for neuropathy related to diabetes. I don't have diabetes, but the hope of my therapist and myself is that it will work on my neuropathy as both Neurontin and Lyrica haven't yielded comfort without serious side effects worse than pain relief.

I don't know how much someone who doesn't exist without medication can appreciate just what a bitch it is to have to constantly juggle monitoring the effects and administration of drugs. I have to make sure that every four hours I pop a Vicodin, and that's something easy to forget. But when the pain hits, boy, do I realize I forgot to take my medication thirty minutes ago.

In addition to my change in medication, the complications from the chronic pain have increased and begun interfering even further with my ability to do what I love to do...write. Sitting has been one of the problems, but now it's downright hellish. My ass hurts all the time! The base of my spine feels like swords are being stabbed into it. My legs feel weaker and my feet...well, my feet hurt all the time...ALL THE TIME!

OK, I'm really writing a depressing entry here...and I don't want it to be totally depressing. But the complications from sitting are leading me and Laura to discuss getting a voice program so that I can continue to write while shifting between sitting and standing. This difficulty sitting has kept me from writing as much as I want on this blog as well as my fictional writing. I'm going to work very hard to resolve this, because writing is what I do best.

As much as altering my writing habits are a necessity, each and every little thing I do in and around our apartment is being adjusted. I've always prided myself as a dude who knew how to keep his domicile clean. Making the bed, mopping, vacuuming, washing dishes and cleaning out our cat's litter box make me feel like I'm in control of my life and contributing to the well-being of the family. Now, even these mundane tasks result in my feeling unbearable pain afterwards. So, my incredible girlfriend, who works a full-time job, has to come home and do chores which I at one time was able to do myself.

The loss of personal freedom and the functionality to control your environment wreaks havoc with the mind of the chronic pain sufferer. So much of what a healthy person can do on a daily basis becomes unappreciated and taken for granted unless it can't be done anymore. Because I've had severe arthritis my entire life, I've always told people, you have no idea of how important joints are until you don't have them. They are vital to each and every physical action taken no matter how mundane. Now, more than ever, I believe that but not just about the joints. I believe that about each and everything a person can do no matter how mundane the action appears to be. This is one reason I am such a huge football fan. When I see those athletes performing on the field I am in awe because at no point in my life have I ever or will ever be able to do even a tenth of what they can achieve.

For those of you who love someone suffering with chronic pain, please understand that each and every action is meaningful for the sufferer and never take for granted even the most menial task. For those of you who do suffer with chronic pain, please pace yourself. Your body will tell you when too much is too much. You must listen to it. If you have to go from doing dishes once a day to every other day or every third day, do it. Don't be afraid to ask those you love to help you. Because they feel helpless in the wake of your condition, those who love you will find comfort in doing more around the house because it gives them an ability to help participate in your relief which will help them not feel so powerless.

Compensation and improvisation is the key to battling chronic pain. It can't be regimented for long and it keeps you on your mental toes, but at least it helps make you realize that no matter how bad your condition is, you are still in control of your life.

All right, my friends, that's it. My butt hurts. My legs are stiff. My feet are hurting. And I've done all the writing I can do for today.

Peace!

2 comments:

Abigail said...

Thank you for taking the time and energy to write this, revealing an experience that is invisible to those living without chronic pain. I was reading it thinking, this kinda reminds me of House, and then you said it! I trust that you are a kinder person, however! Voice recognition software keeps getting better, and I have been told by a couple of voice-only computer users that Dragon's newest version (9.0?) of Naturally Speaking is very efficient and easy to "train."

Matthew Van Vlack said...

Thanks so much, Abigail. My goal is to try and help people understand what living with chronic pain is really like. I hope I'm nicer than House...my family and friends might say different. And thanks for the suggestion of Naturally Speaking! I'm definitely going to check it out.