Without Prejudice. The posts in this blog are only my opinion, and should not replace or be considered that of a qualified physician. Brand names that are commented on are not meant to disrespect of be defamatory in any sense. The posts in this blog are only based on my personal experience under a doctor monitored and regulated use of opiates as an effective treatment for chronic pain.

Friday, April 2, 2010

Update on Pain Management with Opiods

It's been a long time since my last post.
I am not sure if I even have an audience....
A lot has transformed since November of 2008.
My condition has, at best not improved nor has it degraded to any degree.

I am fortunate to have great doctors that in the region I live are willing to treat me wth Oxy. There is so much bad press about it that Doctors are almost afriad to write a script. And I can't blame them.

I have seem my share of people abusing it. And with the street price of Oxy exceeding that of gold by 28,000 times by weight, it is a cash machine for those who monetize their medication.

I know of many people that sell their scripts for income, but I have more friends and know of more people that use their medication as directed and are responsible with it, such as keeping it locked in a safe, disposing of any evidence, and not letting anyone know that you have a script.

One friend I knew let it slip to someone that he was getting a script. It may have been overheard or gossip may be the devil, but it was not long before the junkies swarmed around him, calling non stop trying to get him as a source.

Learning from this, if you are in treatment, tell no one with the exception of those who may be affected by it, such as your spouse, parents, other doctors, etc. By telling anyone else, you risk that it will only be a matter of time before every junkie has your number, and your refil date and are building a profile on you.

Therefore, secondly, change your refil date and time often, and if possible, change pharmacies once and a while. That way if you are being profiled, you have a less chance of being mugged after picking up your script. Or even better, get it delivered.

If you do have it delivered, count your pills. You cannot even trust the delivery driver.

Third, which is optional and recommended, cede... give in to your doctors advice. I have had many debates with my doctor about what I would prefer, and he takes it into fair consideration, but at the end of the appointment, I do what he says.

Fourth, it will take time to find your best dosage and schedule. For me it has been over two years, and my doctor has allowed me to self regulate within a minimum and maximum dosage. This liberty was a gift, and I have found that there are days I can go without, and days that I cannot. In experimenting I have found a combination of dosage and schedule combined with suppplimentary advil and clonazepam that I can be closer to the minimal dosage range.

This trust with my doctor to self regulate took over two years of monthly appointments and drug screening to gain his trust and confidence that I am not abusing. And I am now considered a low risk....
.... A brief history so that last part is clear:
You see, I was self medicating with many and anything I could during the early years of my "moderate to severe" pain stages, so when I first saw my doctor, he told me straight up that no doctor would perscribe me Oxy or any narcotic since it appeared that I was abusing several substances already including oxy.

The fact was I was desarate and taking matters into my own hands to find relief, and break, even for a few hours from the pain.

I was getting no where with my previous doctor, whose advice was to take advil. But advil at 3000+mg/day minimum can damage your body in countless ways. It is not meant for long term high dosage use. I was also taking the same in tylenol with alcohol to put myself to sleep 6 to 12 bottles of beeer and a bottle of wine, maybe two. But in pain, when you live in century hours, desparate times called for desparate actions and at the time, I was reaching the point of considering suicide for fear of a lifetime with pain. I would have killed myself if I had to live the rest of my life like that. And my doctor understood that. He saw me as not high risk for abuse, but risk for my safety in buying on the street and financial risk at the cost on the street. He also saw how low I had become and the depression.

So I was high risk to other doctors, but to my pain management doctor, I was high risk to myself and my welfare.

Onto the point... once on a perscribed dosage and following my doctors advice, all my habits changed, almost overnight. I stopped drinking heavy, stopped the advil/tylenol abuse and in the year that followed I lost 40 pounds of fat, which I suspect was due to the 12 beers a night before bed.

I am now classed as low risk and do not have to take the drug screening anymore. And my doctor takes my feedback under due consideration.

However, unknown at the time, treatment is where the biggest challenge came in. I was a recreational user of many types of substances. I won't deny. And taking Oxy in a way forced me into sobriety since I could not drink heavy, or risk interactions with other drugs.

Some time ago, I did not know it at the time, but after two to three years, I have not returned to any of my previous drugs, and my drinking is only occasional at family dinners, or a cold beer with my Dad.

I will talk about gettting sober by taking narcotics in another post. But that is what essentially happened. I accepted that in my past, I was a user and abuser, and that taking Oxy brought me to a clean and sober lifestyle.

But I had no basis for coping getting sober since I, and almost all my friends, since the young age of 12 years old, experimented and used a wide variety of drugs and booze.

Much of the fustration and change over the years I have come to realize has been a form of becoming clean and sober.

In the end, I endured what was about 5 years of high stress and pain due to all the internal and external factors. I am now in therapy and see two therapists. One spiritual and the other more clinical. And with their help I am now starting to recover from what I term a Traumatic Stress Anxiety Disorder due to a very prolonged period of extreme stress and pain, during which I had little to no relief.

I have officially taken sick leave and for the first time in a long time I am resting. I am working to develop proper eating and sleeping patterns, as well as meditation to be more "in the moment" as opposed to always stressing about and worrying about events and consequences weeks or months away, even stressing about events years from now that may or may not ever happen.

Not to say that I have stopped setting goals and long term plans, I am just trying not to worry about the things that could go wrong next month, and focus on the tasks and challenges of today, and maybe tomorrow, with a appreciation of the overall big picture.

For me this has been a long journey and my only regret is that I did not blog enough, especially through the hard times.

Regret aside, tonight I am doing OK. and tomorrow, looks like it might be OK too. In fact yesterday I spent my first stress free day since 2004. I realized this when I found myself at the piano, which I have not been withing 6 feet of for,... well, years.

When I realized last night that I was reading, I had played the piano for MY pleasure, and was writing some flash fiction, it hit me that I was finally feeling OK.

Even for just a day, I felt good in spirit, body and mind.

One day was enough of a taste to give me strength until the next Good day. And as I get ready for bed, I realize that today was good too. Two good days in a row, where I would have at best hoped for a good hour or two.

I'm more confident that am on the right path and I am recovering. Slowly, but surely, I am finding myself again. The "self" that I am happy being and the "self" that those who are close to me are happy being with.

In closing I'd like to say somethng I never thought I would hear myself say - "I am looking forward to tomorrow."

And whoever you are, whereever you are, whatever your condition is in body, mind or spirit, if you are breathing, then there is more right with you then there is wrong.

And goodnight.
I will see you tomorrow.