Thursday, July 18, 2013

Pain medication and quality of life

Roll the die to see what happens
The photo to the right shows a fist-sized twenty sided die usually used for tabletop role playing games.  The "20" is face-up.  It sits on an envelope that says "do not bend" handwritten and in a red stamp.

TW: brief mention of disordered eating and dieting behavior

Ever since my last couple appointments with the pain management doctor at the orthopedic clinic, I've been trying to wean off my opioid medications even though I'm still in moderate to severe pain.  It's amazing how, even though I don't believe the research he cited is sound, even though my physical therapist said that medication is fine if it keeps me as active as possible, even though my pain levels contribute directly to unhealthy markers of higher blood pressure (mine is usually normal if I'm not in pain) and mental unwellness, and even though I'm still healing from surgery six months post-op, that I still internalized the messages about how narcotics are BAD and EVIL and I shouldn't use them.

I feel like this is a scary game I'm playing, whether consciously or not.  I'm currently at work, writing this in between phone calls, fighting myself on whether or not I should take the medication.  It makes me groggy.  It makes me overly chatty.  It messes up my short-term memory.  I haven't eaten enough to take it properly.  I'm leaving work in about an hour and a half and I can't/don't/won't drive impaired.

There's a part of me that loves it that I made it this far....but it feels like the old ghosts of diets past, just in a different form.  Instead of "good job for not eating breakfast and only eating carrots for lunch," that little voice is saying "good job for not listening to the pain signals and pushing through"....even though I will be completely shot and out of spoons for doing anything when I get home, whether that's my scholarly work, working on relearning choreography, or fun stuff like reading or video games.

What makes this different is that while food is fuel, and denying myself the fuel necessary for life, it could be argued that the medication isn't necessary.  The medication gives me side effects that I find obnoxious.  If the medication more consistently would allow me to be a functional member of society and have a better overall quality of life that allows me to pursue my goals (get my PhD and be able to dance), this probably wouldn't even be an issue.  The medication involves a metaphorical dice roll in which sometimes I roll a 20 (like Tuesday night with the dance class) and sometimes I roll a 1 and then I lay in bed pretending to comprehend the hours of Star Trek: Deep Space Nine that I stare at on my iPad because my brain is too foggy.

Roll the die, take the pill, have an Alice in Wonderland moment?


  1. This comment has been removed by the author.

  2. I am completely there with you, though my situation is different, and a lot easier in general. The decision about whether to medicate is always always a figurative pain in the ass.

    I have had a magical two weeks without significant pain, but before that I had moderate to severe pain every day for three months. Sometimes I'd find my jerkbrain yelling something at me like "the pain that keeps waking you up is just a pathetic attempt to get more medication!" I got really worked up about it at more than one point. It helped to try to artificially simplify the decision (take medication or don't, make the decision and stop fussing over it) but it IS complicated, and being in pain makes making a decision about something like this even harder.

    I'm also super, super lucky that my job is such that I can usually still be at least slightly productive even if I keep forgetting what I'm doing, and I can usually bike or walk where I need to go rather than driving, which while still risky for me to do while opiated, is not as risky for other people. So while I have a knee-jerk terror of addiction (family history) it makes it easier to make the decision to take meds when I need them, because while I hate the side effects, my life is such that I'm usually able to deal with them more easily than the level of pain I often get.

    I have no clue if, when, how my pain will come back, though I assume it will. Endometriosis is like that! Roll of the die, I suppose.