1/14/2006

Pain, Morphine, and Lies

The problem with having an acute illness is that every so often it reminds you of your limitations. You can be marching along for weeks and months on end, and then, all of sudden, you're bedridden. In my case it's a chronic pain condition that debilitates me and necessitates continual medication to allow me some semblance of a life. Unfortunately the medication I'm on, morphine, is looked upon by some doctors as more dangerous than the physical condition you could be dealing with. I had not realized how fortunate I'd been until this past month. I had been with the same family doctor for close to thirteen years and she had seen me through numerous illnesses and a variety of treatments. Back in 2001 when it became apparent that the pain was extreme enough to be affecting my abilities, she started looking for a combination of meds to help me cope. Of course we started on the low end of the narcotics field, Oxycocete, then gradually developed a dose of morphine that allowed me to be functional. Morphine comes in two forms; quick acting low doses, or time released high dosages. By seeing how many of the 10mg pills I was being forced to take in a day, my doctor was able to figure out a long term dosage that would work. Once you acclimatize to your dose this system is far healthier for your body and for cutting down on the slim chances of addiction. It maintains a threshold where the pain is pretty much always under control. On the occasions it peaks you can take one of the 10mg pills to bring it back into control. I've also not limited my treatments to drug therapy. I've been a patient in the Kingston General Hospitals pain clinic since 2003, where the specialist I work with has been using trigger point pain block injections to try to eliminate the causes of the pain. The problem he's been having is managing to get at the root cause of the damage. The focal point is in the vicinity of my prostrate, which makes it one of the most inaccessible parts of the male anatomy. He's had some success with providing temporary relief to some of the topical pain points, but because of the nature of the beast, they always flare up again because the centre remains untreated. I'm his favourite guinea pig, in the best sense of the word, because the incidences of male pelvic wall damage are very rare: so rare in fact that I was only his third patient of that type. The other form of treatment I've been working on is psychotherapy. The same centres of the brain control memory and pain. It's how we learn what is safe, and what is unsafe. You touch a hot thing and remember the pain so you won't do it again. Unfortunately it also means that memories could potentially be the stimulus for your pain. If, like me, you have suffered traumas in the past, those memories can be expressed through the remembered pain of the events. Through as system known as Eye Movement Desensitization and Reprocessing (EMDR) my therapist and I have been going through my memories of the trauma in a manner that allows me to finally rid myself of reliving them as falshbacks. So far it has had no direct affect on the pain, but has helped me significantly in other ways. So that leaves me still dependant on morphine to even get out of bed and do the things I'm able to do. The gratitude I have for this drug knows no bounds. Although I'm unable to work at a job, I'm able to write on a daily basis, with something close to coherency. I can take short walks, and enjoy my life to a certain degree. Of course it's still severely limited but much better than any alternative. This last point was driven home quite forcibly in the last week. My family doctor closed her practice in October of 2005 to go into teaching. Kingston is experiencing a chronic shortage of family doctors so my wife and I considered ourselves lucky that we were able to hook up with a family practice clinic. But from the get go there were warning signs this was not going to be the right place for us. Mysteriously my medical files never were forwarded, while my wife's were. I phoned them in the third week of November to book an appointment to renew my prescriptions only to be told that I couldn't be seen until January 6th. Fortunately, my pain doctor did me the great favour of renewing what I needed over the phone. Then on the morning of January 6th the clinic phoned to cancel my appointment and rescheduled it to the following Tuesday. That too was than cancelled until the next Friday. What this meant to me was that I would miss two days of medication. By the time Friday rolled around I was bedridden, unable to move because the pain had begun to get out of control. When I was finally seen by one of the doctors he turned out to be someone who would didn't believe in prescribing morphine. In the end I ended up spending eight hours in an emergency room so I could get enough pills to carry me through to my appointment next week in the pain clinic. Hopefully my doctor there will be willing to take over prescribing my medications. It should not be his responsibility, but I seem to have no other choice. When pain is allowed to escalate past a certain point it takes a substantial amount of medication to bring the level back down to manageable again. It once took two days of intravenous injections every three hours to restore the balance. Thankfully I hadn't gone too far this time, and just a little extra dosing managed to restore the balance. It's a horrible thing when your well being is dependant on the whims and prejudices of other people. Why is it there are doctors who refuse to treat a patient with the same medication they have been taking for three years? Hospitals have no problem using morphine as pain medication, or sending a patient home with a prescription for morphine after they are released, so why are there doctors still allowed to practice who refuse to recognise its benefits? The whole addiction myth has long since been disproved. If you are in pain morphine is not addictive. I have been easily able to stop taking it on many occasions by properly through properly weaning myself down to zero. There have been none of the symptoms commonly associated with withdrawal. Having been down the road of stopping various addictive behaviours I was anticipating all sorts of problems; sweats, chills, cramps, and the rest. But because my body no longer needed the drug for relief of pain, it was easy to rid myself of the need to take it. As far as I was concerned I was put through living hell for two days by the bigotry and antiquated ideas of an incompetent doctor. It makes me wonder how many people are now needlessly suffering from pain that is eminently manageable. As a nurse in emergency said to me last night: "It's amazing how people who have never experienced pain can "know" so much about treating it"

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