Wednesday, May 31, 2017

The Real Solution, Part 1: Bedeviled by Forbidden Fruit

[After further contemplation, I opted for a different title, and reorganized the blog so that it was not as long. It is my intention, however, to complete this series by the end of June and then edit and compile all blogs-to-date in a PDF brochure-type document that can be printed and shared.]

Everything really serious with my condition started really in early 2004, but it was only a couple of years into its progression that things really . The exact diagnosis had not yet been ascertained and I was not even sure that I would even live much longer. From the procedure that first set off this condition of mine, it took relatively little time for me to progress from Vicodin (a combination of Acetaminophen and Hydrocodone) to much more potent medication like Percocet (Acetaminophen and Oxycodone) and then eventually to just Oxycodone. Then I started taking progressively higher doses of Oxycodone, but the intensity of the pain would return every few hours and when it did, it was a miserable block of time waiting until my next dose could be taken and then "kick in." Finally, the best solution was to combine the Oxycodone with Methadone. Without experiencing any benefit from the pleasure-filled, euphoric effects that makes drug users seek so intensely after these very medications, I continued needing more and more of each medication--less because I was building up a tolerance to them, but more because the intensity of my pain continued to significantly increase as time when on.

A little more than two years after the initial incident, I was faced with the very real prospect of having to retire early from teaching. I had reached a point where I was taking 10-15 mg of Methadone and about 30 mg of Oxycodone every day and relying heavily on stirring up my own Adrenaline to punch my way through five consecutive work days so that I could recuperate over the weekend. Even at those dosages, however, it still only took the sharpest edge off of my pain, and my ability to think clearly and remember things accurately was fading in very obvious ways. That, along with the intensity of the actual pain, made solving physics problems quite challenging, even for me with both a college degree and a natural gift for physics and math.

Following the surgery in May 2006 to implant my spinal cord stimulator, I was able to enjoy a few months following the surgery where I went down to just a half dose (2.5 mg) of Methadone and only using a single Oxycodone (5 mg) when the pain was at its worst, but it was so much better (relatively speaking) that I thought I might be able to go back to a nearly normal life. Unfortunately, it took less than a year before I was back on a regimen of Methadone and Oxycodone that was again interfering with my thinking and memory recall.

This is the perpetual danger that those with chronic pain conditions must face: there is an ongoing temptation to rid yourself of pain, but the only way to effectively do it is to take so much opioid medication that you effectively change your personality and lose your ability to think as clearly. While the pain eats away at you and takes away the things that make you human, the medication that eradicates the pain does little better. While functional, when using the traditional (what doctors call "full agonist") opioids, your personality is radically altered and you lose bits of your working memory, so you become a different person. Either way, you are no longer you.

Either way, once you become afflicted with a pain condition, your life will change. The only thing over which you have some control is how it will change. As is true with so many other things in life, you are faced with determining, and then subsequently choosing, the lesser of the evils.

But what if there was a third option? One that required sacrifice, but one that was the "least" evil?

Next blog (to be posted on or around Wednesday, June 14th): The Real Solution, Part 2: Climbing Everest

Wednesday, May 17, 2017

Bad Solution #3: Just Deal with It

Another way to look at this solution is just to not look at it, or let the status remain "quo." 

The most popular way of dealing with this problem is to simply ignore it. It's the path of least resistance because most people who have a chronic pain condition slowly fade out from the lives they used to have. They stop going out with friends. Many lose their jobs and are no longer able to work at all doing anything because employers are no required to accommodate conditions that are completely intermittent and unpredictable in their intensity and duration, nor should they be. However, one consequence is that those with chronic pain soon become a forgotten people and no one remembers them who do not go out of their way to maintain those bonds.

That, of course, is hard to do because if you do care, you feel helpless when you cannot do anything to comfort that individual and you may even think that you are harming the situation to visit and remind your friend of the life that they used to have. While there is certainly some of that, it wouldn't be inappropriate to have that conversation directly with your friend. Just ask the friend directly; they'll be glad you recognized the need and cared enough to ask.

Other than the incident of a person who overdoses (and apparently was some kind of angel right up until that incident), the media and society don't seem to care much about those with chronic pain. The issue of opioids and who is taking them doesn't seem to matter until someone gives in to their addiction and takes too much.

You won't, however, often see a pain victim overdose on opioids. We can't afford to risk that. If we are at that point of being genuinely suicidal, most will do something far more abrupt and more likely to be successful than taking pills. Pain victims also live in fear that any act of straying from their prescribed regimen might put them at risk for a doctor cutting them off from more medication, making suicide the only option left.

Sadly, depending on how bad the pain is, some chronic pain victims can't reach that euphoric state that makes opioids so tempting for others. Without even considering issues involving tolerance build-up, chronic pain victims first have to relieve their pain before any pleasure can be felt. The amount of medication needed to achieve that would be enough to cause serious problems and slowing respiration.

I hope that this series has been informative for you thus far. My next few posts should be more regular now that the school year is ending... not that don't work over the summer months. Even after 20 years, I still spend many days over the summer preparing things and planning lessons for the coming year.

As the blog continues, I will present my thoughts on a real solution for the so-called opioid epidemic. My solution is not complicated and it is a genuine solution. My solution is one that doesn't blame or hurt those already dealing with a legitimate pain disorder and and also one that acts prohibitively against abuse from those seeking to get high leading to the complications of overdose.

Next post "The Real Solution, Part 1: Remove the Temptation," will be published on or about May 28, 2017.