Thursday, September 07, 2006

Drugs are bad, mmmmkay?

I try hard not to spend more time than I have to researching chronic nonmalignant intractable pain and its treatments. I almost cried reading this just at the description of what patients generally go through to be diagnosed.

This move has been wonderful in a lot of ways, but it made me move far away from my excellent doctor, and to a military doctor giving me the old chestnuts about "an hour or more a day of aerobic exercise will make you better" and "I don't believe in narcotics for this type of pain." First, don't tell me the only thing that's worked while I lived with this for over a decade doesn't work. Second, I was a varsity basketball player, injured and in intensive athletic reconditioning while this escalated and got to the worst point it's ever been--an hour+ of cardio per day as well as stretching and general physical therapy, to the tune of the 2-3 hours daily I'd otherwise have spent at practice, 4-5 days a week. The effect on my body was to make the pain and fatigue totally crippling; I couldn't stay awake in class, or by the time I gave up and left school, walk unaided by supports. By the time I left, I had other people teaching the classes I taught at least a couple days a week because I was too ill and in pain to walk far without vomiting. It took me years to get to where I could work on my feet, walk my son to school, and climb several flights of stairs several times a day, all of which I do now. And even when I feel like another step will kill me, I do it because I do believe I need to stay active, because even if I could fail myself again I can't fail my family.

But the other night after work, I climbed those stairs, and tried to relax a bit. I looked in the cabinet in which the strongest painkiller was now Tylenol, shook my head at the muscle relaxants to which I build a tolerance far faster than to vicodin, shook my head in confusion as to what to do about the pain I was feeling, and decided simply to give up and try to sleep. Once I lay down and my muscles tried to relax, the pain intensified through my lower back, hips and legs to the point where all I could do was shake and cry. I cried hard enough to have an asthma attack, and spent over half an hour fighting to breathe. There was a moment when I could not breathe at all, and only my husband's sleepy worry eventually pierced through the haze enough for that to even bother me... for just a few heartbeats it felt as though it would be easier to not breathe than to live with the pain that had triggered the attack.

My husband made me an appointment the next morning, and I have to go in tomorrow and face the same doctor, whom I cannot help but see as an opponent rather than a help or someone to work with. I found a few good articles tonight, though, to take in, and some of what I found had me wanting to blog (plus, it's been a while).

Quotes and links follow:

"What's the difference between chronic pain from cancer or chronic pain from some other mishap -- failed back surgery, osteoporosis, etc? Why is it reserved for people who are going to die? What about people who are not lucky enough to die and escape this and are forced to live with it for another 40, 50 years?"

ASAP, without this site no discussion on chronic pain and its chronic undertreatment would be complete

An excellent treatment of the issues (sided toward the patients--I have no patience for the other side. I'm not addicted. I have been without opioid painkillers for several weeks. I have had no withdrawal symptoms whatsoever, but have had increasing severe pain--in other words, even when I am not feeling the direct effects of the opioids that "don't work" for this type of pain in the long term, I have less overall pain because it doesn't compound on itself the same way. So I've tried it their way, and I'm calling bull on it)

Finally, I found an article I have had my husband print out for the visit. This points out that several studies have shown benefit to using painkillers to treat pain (DUH. --OK, sorry), in contrast to "I just read a new study last month that stated that this treatment is not standard." How many other chronic pain patients do you have, anyway, doc?

My sister is apparently still a better person than I. She wouldn't wish her condition on anyone. I wish that every doctor who says "I don't believe in those types of painkillers" would have to spend a year watching helplessly and in pain as no matter how they tried to exercise and work hard, their pain and fatigue increased as their productivity levels decreased and they lived with side effect after side effect while medications that helped with few side effects were denied them because of stigma.

The war on drugs has long since been lost in the streets, though we pretend to have a chance to end drug use and abuse to the great detriment and cost of all (the police and the innocent homeowners killed by each other in no-knock raids conducted at wrong addresses, children who get between the armed homeowners--who generally think they're protecting their homes from intruders, as they have committed no crimes, and men in black are breaking down the doors at night--and the mistaken police, the taxpayers in general, and the addicts who would not be criminals at all under a better system). But failing to get drugs off the streets, if we consider that a laudable aim (and there is, of course, room for argument until Judgment Day there), is not a reason we should be fighting to get medicines out of doctor's offices or away from patients who, using the medications to treat real problems, face far less risk to their long-term health on the medications, even with the chance of dependence, than they risk from the side-effects of chronic pain itself, which are very well-documented.

No comments: