Why do some people get pain meds and some people don't?
We shouldn't let sweeping bias against opiates control medical decision makers.
Pain can rule your life making the daily tasks of life insurmountable. I don't normally tell stories of pain and seldom describe pain at it's worst. It's too ugly. People don't like ugly. It's better to protect others from the weight of it. And mercy is the last thing to want. I'm using a blog to report a reaction to pain that surprised me and to encourage common sense around the issue of pain meds.
A. By late afternoon yesterday I found myself sobbing in grief. A storm of cramps hit hard. I was on the floor shaking and twitching and helplessly moaning. Nowhere to run.
B. By today I'd already forgotten about yesterday. I think that's extraordinary, and that's also why I'm writing this post.
People living with pain are probably familiar with tricks our brain will use to protect us, can't be only me. They also must be experiencing new and interesting ways of coping. For example, pain yesterday put me in a sobbing puddle of squirming and pleading out loud for relief, I was stunned such massive red hot pain can be put into a human body, yet only a day later I'd already forgotten about this new benchmark.
I awoke, made coffee, checked the news and weather as if an average life. It was late the following day when I remembered my life's worst pain. How dare my brain forget something so terrible? Normal folks wouldn't forget the greatest pain of their life, greater than any pain they felt before. Their 'personal peak pain' would tattoo their memory.
It seems my brain is learning to edit trauma, to erase it. I'm intrigued how easily I shoveled away such a terrible event.
Neuroplasticity in so many forms.
Pain attacks me. I'm an older fellow with no illness except severe and permanent pain without a known cause. My heart is healthy, blood flow is excellent; "Not a speck of cholesterol," the cardiologist reports; no tumors, not diabetic, weight is good. If I can walk and be active, I'm eager to do it. But peripheral neuropathy arrived in my life about three years ago.
Pain is always. Never goes away. It began as a feeling of cramp in the front of my right foot while helping a neighbor build a fence. I walked home limping ouch to ouch. The first doctor's advice was tonic water for the quinine. By the third or fourth appointment, pain was rising and falling as if a thousand nails were driven into the bones of both legs.
Life became grimacing. Only exhaustion let me sleep. I'd squirm in bed until I passed out. Pain would wake me in an hour or two... cycle, repeat. I stood to try to stretch it away or hung from the trim of a doorway to try to twist it away. Or push ups off a chair or walk barefoot on the cold 4AM driveway or try a hot epsom bath or try a cold epsom bath or re-read Advil bleeding and death rate warnings until too tired to stand up, return to bed, squirm in bed, pass out until pain wakes me. Rarely out of the house, I mean rarely, maybe two trips to the supermarket in a month, mailbox every second day, the next appointment might blow off another several weeks.
It's hard to comprehend how I endured it. After neurology tests confirmed nerve disease, the prescription changed to a real pain killer. Nine months of agony before some hyrodcodone. Nuts. I've never used oxy. Still don't understand the differences.
Damn Damn Damn Pain Pain Pain
I now have three implants to help deal with pain. A neurostimulator implant cuts away peaks of boiling hot pain and gives the chance to walk around a bit; drive for groceries, appointments. The second implant pumps pain meds directly onto the spinal cord. I can now walk through a supermarket without grimacing or leaning on the shelving through an attack. Less dope in my blood lets me feel more awake. Seemingly unrelated to a pain condition, the third device is a pacemaker to boost signals of misfiring nerves that have let my pulse drop, luckily in the ER, to as low as 19 beats per minute, a beat or two away from dead. I tease doctors and staff there's room for extra implants too.
Pain is always. Never goes away. But it's half what it used to be. Pain management and pain implants have helped. I now sleep when I'm tired rather than when I pass out after too many hours merely enduring... cycle in and out... repeat day after day. Rather than a thousand nails hammered into my bones, for several months I'm somewhat mobile. Levels of pain range from a medium headache to wearing scalding knee socks and increasingly there's spaces in an hour when pain disappears. With less pain I can be busy, active, doing something, fixing something, cooking, reading, watching movies, fathoming the web, doing enough to ignore it; favors and fun.
When pain is too great, when more meds will either daze me or kill me, when the implants or calming or ignoring or stretching fail to defeat pain, sadly yesterday when I swear the attack was higher than the ten point chart, well, that's just outright nuts.
Pain is nuts and nobody knows what to do about that. Except, maybe, my own brain, (neuroplasticity in so many forms), but when will my brain or your brain become adept enough to forget pain while it occurs?
Never. And I wouldn't wish the experiments on you.