By Bob W Kirkpatrick
I'm a junkie. I didn't start out to be one, it just happened. I don't skulk through back alleys and share needles with society's human effluence, but all the same I have a monkey on my back. It takes a measure of control over myself away from me, because a halt to my use of narcotics will result in withdrawal symptoms, some of which can be fatal. That puts the morphine I take in the driver's seat whether I like it or not.
I'm a cancer patient. I was diagnosed with non-secretory Multiple Myeloma two years ago after years of hospital ER visits for extreme chest or lower back pain. The chest pains were always blamed on my smoking habit, and my back pains were blamed on strain. It turned out that bone marrow cancer was the culprit, and it was found when a doctor finally went beyond a cursory inspection and ordered a CAT scan and a bone marrow biopsy. It's kind of funny; all those years I had physicians intimate that I was trying to get pain killers for a little mental recreation, and they went out of their way to make sure that didn't happen. Now that I have been diagnosed, the medical community can't seem to satisfy itself that it's given me enough medication for pain.
The type of cancer I have causes severe bone deterioration and also generates tumors called plasmacytomas. Both the deterioration and the tumors are incredibly painful. It takes a serious pain killer to dull the agonies, but no medication can actually eliminate the pain (which is a great motivator to continue taking the narcotics they give me). Dulling the pain is the best I can hope for because using too much of the pain killer has disquieting symptoms --ranging from uncomfortable dizziness up to outright overdose. As with much in life, moderation and compromise is key.
Like many who become addicted, for me it started out with codeine in gradually greater doses, and then a jump to morphine sulfate when the weaker medications no longer did the job. Over time, the body accustoms itself to the medication, building tolerance. So it takes more and more of the drug to maintain its effectiveness. But then, that's how everyone becomes a junkie: it sneaks up on you. In my case, I knew addiction was coming because I knew that the pain wouldn't stop until I died. It also implied that I would need to employ caution in my use of the pain killers.
Pain elicits fear. Which is to say that anyone who feels pain doesn't want to feel it again. Knowing that the body builds tolerance for the pain medications motivates me to want to delay the point at which it becomes ineffective. That entails a trade-off, exchanging a little more pain in the present in order to maintain my pain at that level for a longer period of time than I might otherwise. It's a tightrope act where the rope is made of eggshells to walk on. I have seen other people who feel chronic pain do all they can to eliminate all of the pain, and I watched them speed through the graduation to higher dosing only to be left with greater pain that's more difficult to control. So in essence, one needs to embrace some pain in order to feel less of it overall. It requires a "big picture" perspective; looking at the short term only sets the stage for greater, less manageable pain later on. It is fearing the greater pain later that moderates my seeking comfort today. I believe that it's better to suffer an ache today than an agony tomorrow.
Dealing with pain is a personal matter because people react to pain differently. Pain threshold is extremely personal and for that reason I don't have much respect for the 1 to 10 pain scale used by so many in medicine today. For me, my pain is logarithmic in the way it rises. My pain scale goes 1, 2, 3, 7, 11... I have experienced cancer pain severe enough to beg those about me to bypass any attempt to comfort me and just put me down. The 1 to 10 scale doesn't appear to me to include that super level of pain. Instead it merely associates agony with a happy face whose smile is upside down and has tears coming from the eyes. I think of that as meaningless; they should have a photo of Jack Kevorkian at level 10 instead. It is the patient and not the doctor who should determine the appropriate medication dosage because an unhappy face character allows for a lot of room for error.
We patients must walk a compromising line that balances the efficacy of our drugs with our personal tolerance for pain. So for me, moderation and compromise is key. Pain being the strong motivator it is can urge its victim to try and eliminate their painful condition, with the problems doing so might create later dismissed as irrelevant. Moderation can sometimes be a difficult row to hoe.
I'm a junkie. I didn't start out to be one, it just happened. I don't skulk through back alleys and share needles with society's human effluence, but all the same I have a monkey on my back. It takes a measure of control over myself away from me, because a halt to my use of narcotics will result in withdrawal symptoms, some of which can be fatal. That puts the morphine I take in the driver's seat whether I like it or not.
I'm a cancer patient. I was diagnosed with non-secretory Multiple Myeloma two years ago after years of hospital ER visits for extreme chest or lower back pain. The chest pains were always blamed on my smoking habit, and my back pains were blamed on strain. It turned out that bone marrow cancer was the culprit, and it was found when a doctor finally went beyond a cursory inspection and ordered a CAT scan and a bone marrow biopsy. It's kind of funny; all those years I had physicians intimate that I was trying to get pain killers for a little mental recreation, and they went out of their way to make sure that didn't happen. Now that I have been diagnosed, the medical community can't seem to satisfy itself that it's given me enough medication for pain.
The type of cancer I have causes severe bone deterioration and also generates tumors called plasmacytomas. Both the deterioration and the tumors are incredibly painful. It takes a serious pain killer to dull the agonies, but no medication can actually eliminate the pain (which is a great motivator to continue taking the narcotics they give me). Dulling the pain is the best I can hope for because using too much of the pain killer has disquieting symptoms --ranging from uncomfortable dizziness up to outright overdose. As with much in life, moderation and compromise is key.
Like many who become addicted, for me it started out with codeine in gradually greater doses, and then a jump to morphine sulfate when the weaker medications no longer did the job. Over time, the body accustoms itself to the medication, building tolerance. So it takes more and more of the drug to maintain its effectiveness. But then, that's how everyone becomes a junkie: it sneaks up on you. In my case, I knew addiction was coming because I knew that the pain wouldn't stop until I died. It also implied that I would need to employ caution in my use of the pain killers.
Pain elicits fear. Which is to say that anyone who feels pain doesn't want to feel it again. Knowing that the body builds tolerance for the pain medications motivates me to want to delay the point at which it becomes ineffective. That entails a trade-off, exchanging a little more pain in the present in order to maintain my pain at that level for a longer period of time than I might otherwise. It's a tightrope act where the rope is made of eggshells to walk on. I have seen other people who feel chronic pain do all they can to eliminate all of the pain, and I watched them speed through the graduation to higher dosing only to be left with greater pain that's more difficult to control. So in essence, one needs to embrace some pain in order to feel less of it overall. It requires a "big picture" perspective; looking at the short term only sets the stage for greater, less manageable pain later on. It is fearing the greater pain later that moderates my seeking comfort today. I believe that it's better to suffer an ache today than an agony tomorrow.
Dealing with pain is a personal matter because people react to pain differently. Pain threshold is extremely personal and for that reason I don't have much respect for the 1 to 10 pain scale used by so many in medicine today. For me, my pain is logarithmic in the way it rises. My pain scale goes 1, 2, 3, 7, 11... I have experienced cancer pain severe enough to beg those about me to bypass any attempt to comfort me and just put me down. The 1 to 10 scale doesn't appear to me to include that super level of pain. Instead it merely associates agony with a happy face whose smile is upside down and has tears coming from the eyes. I think of that as meaningless; they should have a photo of Jack Kevorkian at level 10 instead. It is the patient and not the doctor who should determine the appropriate medication dosage because an unhappy face character allows for a lot of room for error.
We patients must walk a compromising line that balances the efficacy of our drugs with our personal tolerance for pain. So for me, moderation and compromise is key. Pain being the strong motivator it is can urge its victim to try and eliminate their painful condition, with the problems doing so might create later dismissed as irrelevant. Moderation can sometimes be a difficult row to hoe.
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