What this is. This is the promised post on the matter of pain. It has come about because of a peculiar attack of physical pain that hit me at the end of January: with intermittent, sharp, stabbing pains in different areas of my back. The attacks lasted about six weeks before I sought relief. Soon, however, my physical pain was overshadowed by mental and emotional pain, and that's really the bigger issue, and the reason for this post.
You see, it MAY be (and the verdict isn't in, yet!) that there is a form of pain relief that I haven't known about, due to other-than-medical reasons. That's a BIG deal to me; I suffer from chronic pain, due to an inherited condition called ankylosing spondylitis (AS), a systemic auto-immune disease which manifests in my case by a little bit of spine problems, and a BUCKETLOAD of inflammation.
Act One: My intro to chronic pain, and pain management. How much is a bucketload? Well, there is something called "C-Reactive Protein." That's a substance your liver makes, in response to inflammation.
Normal range is 0.0 - 4.9 mg/L. In September 2004, they tested me.
Mine was 12.4 mg/L.
So, they tested me again. My doc was worried there was something wrong with my heart. (SPOILER ALERT: THERE WASN'T). This one specifically rated my C-Reactive Protein level as a cardiac factor; because if there is inflammation of the cardiac arteries, that could indicate a heart attack is likely.
A reading below 1.0 mg/L means you are in good shape. From there up to 3.0, not much issue. Above 3.0, you are a high risk for a cardiac event.
My level was 14.5 mg/L, the second time they tested it. Obviously, something was WRONG!
BUT, all the tests I had been taking to study my heart showed it was in great shape.
In May, 2005, they discovered I was a Neanderthal, by detecting the presence of Human Leukocyte Antigen, subtype B27 (HLA-B27). I was good with that. I rather admire Neanderthals, and it comforted me to know that all the pain I was experiencing was real, and not in my head. Unfortunately, there is no cure. Keep as flexible as you can, and the pain is managed by medications.
Act Two: How that turned out. Unfortunately for me, the level of narcotics I needed to manage my pain also tended to make me non-functional. Two years later, I was forced to take a medical retirement from a job I loved, because between the pain, the side effects of drowsiness the meds caused, and the insomnia the meds brought, I was no longer safe to have around a middle school. And two weeks later, I discovered my marriage (29 years, at that point) was over.
So, I sat down. And I didn't do anything for three years. But then I stood up, and re-entered the world, and met my gift-from-God, happily-ever-after trophy wife Vanessa, the elegant, foxy, praying black grandmother of Woodstock, GA, on Christmas Day, 2010, and you can read THAT story here.
In March of 2012, my daily dosage of morphine was 120 mg of extended release morphine, plus (3) 15 mg tablets of fast-acting morphine, for a total daily dose of 165 mg. That's a lot; one citation I read said that a lethal overdose can happen with a dose of 200 mg.
My last prescription bottle for 120 mg morphine
A Butrans patch
I wasn't dying, but I knew I wasn't able to be the husband and father I was called to be, so I quit. I went cold turkey on the spot, and after I had gone through the worst of it, I called the pain clinic to tell them what I had done. As expected, they freaked a little.
I didn't care. I remained their patient, and at the suggestion of an orthopedic surgeon who had put plates in my neck several years prior, prescribed a powerful non-steroidal anti-inflammatory drug called meloxicam (Mobic). They gave me a scrip for 30 hydrocodone tablets as emergency pain relief, which lasted from April through the end of the year. It was a great arrangement, and it lasted until my gut started to bleed in December or January.
It's an unfortunate side effect that hits some people, and it means they won't ever be able to take NSAIDS, not even aspirin.
But, without the meloxicam, I HAD to have something for the pain. I wasn't about to go on morphine again as a matter of pride. Sure, it may be a trivial, or only symbolic victory, but it's MY victory, I paid for it, and I'm keeping it. That is NOT meant as a criticism of ANYBODY, particularly anybody who is currently having their pain managed for morphine! But I wasn't going to take that medicine again.
Fortunately, there was another pain management tool that was available at that time: the Butrans patch. It dispenses tiny doses of medication, every hour, for a week. And, it did NOT goof my head, make me drowsy, or cause constipation. I couldn't even tell that I had the medication in my system; except that, when I was trying to see if it really DID work, and left it off for a day or so, the pain came back with a vengeance. I was prescribed the patch, and (initially) (4) 10 mg hydrocodone per day for break-through pain. Since that time, my dose is down to three per day. Some days have been a little rough, BUT:
Butrans gave me another chance at life.
END OF ACT TWO.
~
INTERMISSION
I think that's a good stopping place. I'll pick this up tomorrow.
Peace be on your household.
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