A pain in the…

March 17, 2008

Plenty of eloquent and wise people have blogs for many fine reasons — to keep in contact with friends, to write their experiences for a larger audience, to give voice to various social issues, to make others laugh…lovely reasons, all, and probably reasons that I, too, have put my hat into the blogosphere ring.

But there is another reason one blogs, or at least if one is honest, one must admit that a blog provides a good forum for venting one’s spleen (and what the hell does that mean anyway?) about some of life’s stupidities, small and large.

So, heeeere’s my spleen.

Background: Since 2002, I have been plagued, on and off, with intractable low back pain. I have had practically every “procedure” and such known to man to help with said pain: physical therapy, water therapy, epidural steroids, facet injections, trigger point injections, 2 separate disc decompression procedures…the second of these disc procedures actually helped me tremendously for nearly three years before I started to have, once again, the constant and steady pain with which I now live every day. And in the course of this time I have taken narcotics. A whole variety of narcotics. Baggies and baggies of…no, wait. Not really that.

But you see, here’s where perception and reality conflict with one another. The perception of someone who takes regular opioid medication is that said person is a junkie. An addict. A malingerer. This is the perception of society at large, and it is unfortunately perpetuated in all sorts of ways. One that comes to mind right now is the Fox TV show House, which incidentally, I love. On the show, Dr. House has sustained an injury to his leg that causes him to be in excruciating pain all the time, and a conceit of his character is that he’s constantly popping vicodan. Don’t get me wrong, House is a complete ass who is hardly a paragon for emotional stability, and he goes about procuring his pain medication in inappropriate and sometimes illegal ways. But hear this too: the man is in pain, and to function in his position as “Ridiculously Brilliant Doctor,” the man needs narcotic pain medication. Just because he’s developed a physical tolerance for said medicine, it doesn’t make him a junkie. It doesn’t make the needing of that medicine a weakness, any more than a diabetic’s need for insulin should be viewed as weakness.

But the crux of the issue comes down to this perception of drugs as evil in and of themselves, which by extension tarnishes those who need them. I have countless stories in my own experience of being treated poorly and inadequately with regard to pain medication, and all of these stories go back to the central assumption that those who claim to be in pain may not actually be in pain and may be seeking pain medication for other recreational uses. But let me tell you: I’ve sat in a couple of local pain clinics at various times in the last several years, and what I see doesn’t even begin to bear out that assumption. I have seen elderly people clearly dying and in pain. I have seen young people clearly dying and in pain. I have seen people in wheelchairs and with canes. I have never failed to be humbled, sitting in the waiting room, at the incredible level of pain that some people suffer. Yeah, my back hurts, I mean it really hurts, but wow. Lots and lots of people suffer in far greater ways than I do.

But you see, it’s not about the patients. It’s about protecting the doctors from liability and government regulations. It’s about providing half-ass cared to the above patients and passing the hot potato of medication so no one medical person or practice gets left holding the bag labeled, “I prescribed this guy too much percocet and I am now being investigated and could lose my licence.” It’s about patients, many of them elderly as I said, jumping through ridiculous hoop after hoop to prove their fitness to have their pain treated.

And here’s where it gets personal. I’m in pain right this minute, less than I have been some days, more than I have been others. In the coming months I will have to make some difficult decisions regarding surgery for my back, when surgery has a substantial risk of either not helping or making things worse. If doctors can’t fix my back surgically, they frankly may not be able to fix my back. My family physician, a competent and kind woman, referred me to a “pain specialist” (Okay, the quotes are a little snarky. I’ve been watching too much House.) who wants me have (yet another) injection in my back that he freely admits may or may not help and a discogram (Which no, isn’t John Travolta coming to your house and singing and dancing, as I had wondered previously. It’s actually a really bitchy procedure involving a needle and a doctor trying to poke your back in the exact place to reproduce the most pain, for the purpose of figuring out that exact location. I’ve had two discograms to date — good, good times). In the meantime, I’m in pain medication no man’s land. The family physician isn’t comfortable prescribing me anything (though I’m pushing that point), and the pain specialist doesn’t prescribe anything until…and this is awesome….I have a psych. evaluation.

I don’t begrudge these folks taking a gander at my psychological makeup. Have at it. But somehow, my ability to have my pain treated is dependent upon this evaluation, which I just discovered in making the appointment, involves 90 minutes with the psychologist and another 90 minutes of personality testing. I could tell you now that my personality is well and truly fucked, but I guess that’s another story. Do I think that the doctors requiring the evaluation have a deep concern for my mental and emotional states? Really no. I think that it’s part of the giant ass-covering game that needs to be played. And did I mention that I’m in pain? Like kind of a lot of pain? And that now I have to beseech my family physician to please, please, please, and I’m sorry, so sorry, please, help me out until I’ve completed the hours long psych. evaluation, and that information gets faxed back to the pain specialist, who then can determine whether I’m worth the malpractice insurance and regulatory agency risk to actually, you know, treat my damn pain?

Man, I’m tired. I hate fighting battles that shouldn’t have to be waged in the first place. And I’m not going to apologize for hurting.

Edited to add:

My family physician stepped up to the proverbial plate today and prescribed me enough pain medication until the whole psych. evaluation, etc. is resolved.  I’m grateful.  I really am.  Sadly, choosing to prescribe pain meds is, in fact, probably a professional risk for her.  But she believes me.  And I’m grateful for that.  I had my injection today, and mighty heavens, it was unpleasant.  But here’s hoping that it provides some benefit in the long run.  And I must add that the pain specialist was incredibly kind to me today, as were all the nurses with whom I came into contact.  Kindness does indeed make crappy situations slightly less crappy.

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18 Responses to “A pain in the…”

  1. I’m so sorry, Beth.

    I’ve only known you for a couple of years, but of all the people I know who really should be taking lots of drugs, you’re near the top of my list.

    If your “specialist” can’t help you, I’m sure we can find some other “specialists” who’d be willing to “prescribe” some appropriate “medications.”

    No, really. I am sorry.

  2. bethkoruna said

    Sad thing is John, I sometimes wish that I had access to such “specialists.” I get why people go about this whole thing illegally.

    And if I should be taking drugs, then shouldn’t you be taking drugs too? I’m just saying.

  3. kjames said

    that totally sucks! i hope you get some GOOD drugs.

    have you tried a chiropractor?

  4. bethkoruna said

    I have not tried a chiropractor, frankly out of terror (and I mean this) that I could be adjusted into feeling worse. I had a “therapeutic” massage at one point that nearly sent me to the ER, so I’m really leery of anyone manipulating my back.

    That said, if you have a good one, I’m running out of options and I wonder how much worse off I could be. So I’m taking recommendations! 🙂

  5. sarrica said

    Having lost a very dear friend of the family to a botched back surgery, and having heard nothing but horror stories about back surgery prior to that, I would tell you to put it off as long as you possibly can. I don’t think back surgery has evolved at the same incredible pace as the rest of medicine — it still seems medieval, it’s still too much of a blunt instrument when some finesse is what is needed.

    I think it is Nautilus that has a specialized line of machines for use in spinal therapy. The reviews I read (years ago) were very positive. Have you looked into their technology at all?

  6. Who says I’m NOT taking drugs? I’m just saying.

    On another note, I’m a bit leery of chiropractic as well, but I’m 100 percent into “cupping.” Non-invasive and feels nice…

  7. Not to be confused with “spooning,” which feels nice, is non-invasive (depending on who is involved), but doesn’t help your back.

    http://en.wikipedia.org/wiki/Cupping

    Seriously. And you get some really cool marks on your skin.

  8. bethkoruna said

    I will look into the Nautilus stuff — sounds potentially really really good. (Steve? I assume that’s who you are — thanks for reading and Tim says, “Hi!”)

    John — I don’t even want to speak of the images conjured up that the word “cupping” brings to mind. But I’m all about cool marks on the skin.

  9. BTW, it was probably bad form to joke about drug use. I have lots of friends who have ruined lots of relationships with drugs, legal and not.

    That having been said, I’ve never heard of anyone whose life was ruined by some good cupping.

  10. Bad form on my part, that is. Not dissing you.

  11. Liz Riggs said

    I can relate to dealing with major pain and doctors and all of that crap that one goes through and add to that for me that I used to abuse drugs so even more reason the doctors think not to give me much of anything now even though I have been clean and sober for fifteen years now and had lots of ideas like just getting a week at a time..etc….and i am always honest when it comes to this stuff so it is a pain the butt well for you a back and for me my legs. I do get some pain medication but it does not really do much sometimes it takes the pain like from an 8 – 6ish. I just mainly wanted to say that even though it is different pain that I do get what you are saying. One more thing is that unless something major happens in the next two years my doctor thinks that I will be in a wheelchair and one would think one would give ample pain medication so one could exercise to help decrease the likelyhood of that.,

  12. bethkoruna said

    One WOULD think that they would give you enough pain meds, Liz. I’m sorry — that stinks. I’ll pray for you, friend.

  13. Jackie Reeks-Tracy's mom. said

    After reading your blog I just had to write a comment. I am 69 yrs.old and have been fighting arthritis pain and fibromalogia since my early 20’s, and believe me I can relate exactly to what you have been through. I have practially had to beg at times for pain medicine from doctors. They have a way of making you feel guilty, like you are a drug addict. I have had some of the procedures you have had and I agree with you that after you had them they can help for a while, or not. Then you are back to the same old problem. I have finally found a good doctor who knows how I feel and has prescribed medicine in the amount that I need. Good luck, and hope you feel better on your new medicine.

  14. Would you find it offensive if I referred to you as “drug addled?”

    What if I just referred to you as that only among close, mutual friends and family members?

    Are they any other kinds of “addled” that would be more accurate?

  15. Jillian said

    I read your comment on Dad Gone Mad responding to my comment and I wanted to thank you for the encouragement. I would love to be able to reach out to you and talk and find some ways in handing this.

    If you wish to do that, please email me.

    Jillian

  16. Liz Riggs said

    Beth it was so good for me to be able to touch base in person about the woes of doctors and pain medications people NEED as you and I do. I though did later feel like afterwards I should not have mentioned the using of pot around your duaghter and for those who are reading this and know that I am in recovery no i am not smoking it now just at times when pain is really bad well when it is really really bad I should say it is tempting to use it

  17. sarrica said

    The inventor of Nautilus went on to found MedX. They are online here:

    http://www.medxonline.com/

    I don’t know anyone who has used their equipment, but the philosophy behind it certainly made sense to me (in an article I read a lifetime ago…).

    Yes, it’s Steve. Hello to Tim! 🙂

  18. sarrica said

    My email for Tim doesn’t seem to work any more… please send me his email address at sarrica@umich.edu.

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