I have had chronic pain for nearly 8 years now, I guess it will be. I have also suffered from depression my entire life (major depressive disorder), though that has gotten much, much worse during these last 8 years.
I'll apologize in advance here for such a long post...
My original injury was a piece of my vertebra in the S5-L1 (I believe it was that area, perhaps S1-L5, but I know it was one of the two...) area at the bottom of my spine broke off in an accident and lodged into the nerve bundle down there. I underwent surgery to have the piece of bone removed.
After the surgery, the numbness in my left leg and foot went away for the most part and the sharp, stabbing pain wasn't constant like it was before. I could stand straight up again, walk normal, sleep better, etc.
Well, it wasn't maybe 6 months after that that the pain started coming back, sometimes pretty intensely, with the same sharp and stabbing sensations, pain shooting down my left leg like before, but not as bad this time. Basically it hurt but didn't feel like there was a bone lodged into my nerves.
I went back to my GP and he put me on Ultracet or Tramadol, I forget which, though I am thinking that I was on both. A few more months passed and the pain began to get worse, and the prescription he had given me also was not working nearly as well.
So he prescribed Vicodin for me, which he gave me a max of 20 a month and was very reluctant to even give that many. As time went by it got to the point that 20 a month simply wasn't cutting it. I needed a dose for the morning and one for the evening. The pain was ruining my life again, and all I really wanted was to live like I used to, normally, to work and raise my family. That's all I want to this day, tbh.
My GP bumped my up to 2 pills a day, max, and stressed that that would be the end of it, he was at his limit.
I guess after a year, the Vicodin (5mg) began to diminish in it's effectiveness just as the Tramadol did and my pain levels began to get worse as well, often lasting all day and night.
He would later bump me up to Oxycodone, again reluctantly, but suggested that I see a pain specialist for further treatment.
I suppose I should add here that I have always had a high tolerance when it came to meds, alcohol... anything throughout my life. Not sure why, but one doctor pointed to my high metabolism, height and weight (5'10", 200lbs) as the reason that my body needed more than, say, my grandfather - who would take half a 5mg Vicodin and pass out at the dinner table.
I started out with a couple of the 5mg pills and it just didn't cut it, so he put me on the 7.5mg pills and had me taking 2 of those, and that worked a lot better. No high or buzz, just relief.
Anyway, I went to see the pain specialist.
She diagnosed me with scar tissue from my surgery, a dry disc (whatever that is), degenerative disc disease (who doesn't have that, right?), minor scoliosis, arthritis, a herniated disc and one other condition that I can't seem to remember. By this time my neck was beginning to give me fits also, after a snowmobile accident where I jammed it really bad in an awkward position. It would just ache really bad for days on end and led to headaches that were pretty intense.
So she put me on Oxycontin, 40mg twice a day. She told me every time she saw me that I was on an extremely high dose of medication and I shouldn't be taking it until I get buzzed, or "high", but that the point was to take it for the pain. I always hated it when she said that because it made me feel like a junkie, like I was doing something wrong, when in fact I wasn't. I got no buzz or high from the medication by that time. I just shrugged it off and smiled through it though and agreed with everything she suggested. I knew by this time through experience with doctors and my back issues that the patient is at the complete mercy of the doctor, and the doctor is the only thing between living a normal, pain free (kinda) life and having nothing at all for the pain and living in misery.
She also prescribed me 20 short acting Oxycodone per month for breakthrough pain as needed.
My problem began when I had an impacted wisdom tooth and woke up one morning in extreme pain. I was literally in tears. Never felt anything like it. I can liken it to post-op surgery and the pain I was in lying in recovery, only in the back of my mouth rather than in my back.
I took my breakthrough meds, all of them, over the course of 5 days. I called in and told her what was going on, and that I used the breakthrough meds up dealing with my impacted wisdom tooth (which a week later I had surgically removed... ouch) and she was simply unforgiving. She said she had an impacted wisdom tooth once and it didn't warrant taking all that medication in 5 days.
She cut me off completely just a few days before my long acting medication was due for refill. I went through horrible withdrawals and insufferable back pain to go along with the tooth issue. I contemplated suicide. It was all just too much combined, and I nearly went through with it. But, luckily, my GP was kind enough to prescribe me just enough meds to wean off the dose that I was on, but over the course of 4 weeks had took me down to zero. He wanted me off the narcotics all together.
So... I did. I went back to physical therapy and began taking OTC pain relievers for the better part of 3 months. My life quickly unraveled, completely, from the pain and he releneted and sent me to a new pain specialist.
This new woman was from India, originally, and rather than talk about my condition, she instead lectured me for close to 40 minutes (I watched the clock...) about how overweight Americans were, how over medicated and how we Americans feel a sense of entitlement to prescription drugs, especially for pain.
She suggested a strict plan of Tylenol and Aleve coupled with physical therapy. I told her that I had been taking the narcotic pain relievers for a few years by this point, and if the OTC stuff worked for me that I wouldn't be sitting in front of her. I asked if I could just continue the prescription that I had been on before, the long acting, under her supervision. She adamantly refused and began scribbling furiously on her notes and dismissed me. I was kinda taken aback, tbh.
When I went back to my GP for a followup, he shook his head and said he was sorry about how the meeting went with the pain specialist, and that the notes she sent back to his said "drug seeking behavior".
Great, I thought. That's just what I need.
Well, he continued with the 2 pills a day, that was his maximum limit, of the Oxycodone and sent me to another pain specialist maybe 6 months later.
This new guy, I thought, would hopefully be easier to get along with.
From the beginning of the appointment he was very brief and what I considered to be pretty rude and cold. He told me that I was too young to be taking prescription narcotics for pain (I was 32 at the time) and he would be happy to give me the injections that he specialized in if I was willing to try something "that didn't come in a bottle/pill form" of treatment.
Again, stupidly, I asked why I simply couldn't continue with the long acting medication that had worked so well in the past for me. He and his nurse both just stopped and looked at each other and I was left wondering what in the world the problem was. Apparently the key is to never ask for what works if it happens to be the narcotic pain reliever and to just hope they offer it I guess.
So, I accepted the injections that he recommended and set up an appointment for a few weeks away.
When I went back to my GP for yet another followup... this jerk had also written drug seeking behavior in his notes. Needless to say I went home and canceled the other appointment I had with him.
Back with my GP, the pain in my back was still not letting up or getting any better. Eventually my depression had spiraled out of control and he decided to put me on the long acting Fentanyl. I was so happy that finally, finally I would get this pain under control, as I had hear so many great things about the Fentanyl.
He started me out on the 12mcg strength, then the 25, and at last the 50s, which took care of the pain enough that I could work, sleep through the night for the first time in years and start doing things with my wife and children again. The only problem, though, was that it made me nauseous. Horribly nauseous. And not just a little bit, but to the point where it didn't quit and I would even vomit a few times a week. No appetite, either.
So I requested going back to the Oxycodone, which he reluctantly did, but still just 2 pills a day (7.5mg). I was back to picking and choosing which part of the day I wanted to feel ok and which part I wanted to feel like crap. Some days I would take it in the morning and get some work done, other days I would take it at night so I could catch up on sleep after becoming exhausted from 3 days or so of only sleeping 3-4 hours a night at the most.
Then in April I ruptured another disc just loading up some wood into the trailer. Nothing big, maybe 30lbs, but the work needs done regardless of how you feel, you know?
My GP upped my dose to 2 pills every 12 hours, of which I would get 4-6 hours of relief, hurt for 6 hours, then take my next dose.
Last week my back began hurting extremely bad. I was afraid to call my GP again because he is always so stubborn and actually seems to get angry when I ask for extra medication from time to time as my condition flares up. He just makes me feel guilty, like I am doing something wrong or asking for the world when I am only wanting to keep the pain levels down to a workable place. He has always been pretty consistent in saying not to even ask for an increase above 2 pills a day. I had to practically beg him to up my dose to twice a day when I ruptured the other disc in April.
Turned out that I ran out of medication 3 days early on my 2 week supply of 2 doses a day. My back had flared up to the point that I could not sleep. I slept 2 hours one night, less than an hour the next, and none the next night when I had run out of my medication. My back was hurting worse than it ever had, and my left leg felt like someone had run over it with a truck.
My wife finally insisted that I go the the hospital and get checked out and get something for the pain, as I was sweating like a pig at that point and utterly exhausted from the lack of sleep.
I went to the hospital, and of course they asked me who my doctor was, what my prescriptions were, etc. I told them that my back and leg had been acting up worse than ever and that I had run out of my medication a few day early and I couldn't bear the pain any longer. I just wanted something to get the pain under control so I could sleep. I'm sure some of you have been to the hospital for chronic pain and can relate here; it's no picnic. They treat you like a drug addict. Believe me, it's the last place I ever want to go. Ever. I have been there before a number of years ago for back pain (pain specialists orders, go to the ER if pain becomes too bad) and they treated me like dirt then too.
I think when a 30-something guy comes in for back pain they automatically think "drug seeker". I'm sure they get their share, but it doesn't make me feel any better about being treated like that.
Anyway, they gave me a shot of Toradol, refused a shot of narcotic ( I didn't ask for any, but they made it a point to let me know that I wouldn't get any, either ) but sent me home with a script for a dozen Oxycodone that I could fill in about 5 hours. I left in pretty much the same shape I went there in.
Two days later I got my refill from my GP. I figured he was aware of the ER visit since they normally contact your doctor anyway, at least they had always done so in the past. (I had went in twice over the last two years, once for an alergic reaction to a new medication and another time for the back pain flare up).
Apparently they didn't call my doctor until the day after I got my refill from him. The phone rang that morning and it was his nurse on the phone. Didn't ask how I was or why I went to the ER, if my condition had changed or anything (not that I want the pity or drama, but since they are my primary care provider I thought they may ask), all she wanted to say was that my doctor was aware of the fact that I had medication filled from the hospital and that he would be extending my next refill date by 5 days. That was it. She hung up.
I have an appointment with him next week, per my usual two week visits if I want to get my refills, and I have a feeling things aren't going to go so good.
I was talking to a friend of mine from town though yesterday and he noted that I looked like crap. I told him I hadn't slept much and that my back was acting up again, and he said, "you know - why don't you just go over to Dr. lastname? I have friends that go there and he sends them out the door with whatever they ask him for. No hassles, you don't have to feel guilty about wanting meds with this guy, he just takes care of people."
But it made me think. Everything revolves around that little narcotic pill for some of us. When nothing else works except those pills, we are really left with no other choice, unless we just decide to suffer through each day, day in and day out, through each sleepless night, because we're stigmatized as druggies, or drug seekers and can't deal with the shame.
For me, it's to the point where I am ashamed every time I have to ask for something to control my pain. My pain specialist had called the pharmacy that I use when I took the breakthrough meds too quickly a few years ago and I'm not sure what she told them but I have never been treated the same since then. They look at me with undisguised contempt and disgust at times. If I need an early refill some months, they always call the doctor, speak loudly enough that I and anyone else standing there can hear them, and give them the date of my last refill and the fact that I'm a couple days early, get the ok to fill it, then do so while shaking their heads or something similar. I'm left there to stare at the floor, humiliated, because I took an extra dose of medicine twice over the course of two weeks. And my personal options, in my life outside of the pharmacy, are suffering through it alongside my family or taking an extra dose of medicine that day and going back to the pharmacy a day or two early to stare at the floor again and feel like a junkie because my pain flared up and I chose to relieve it.
I suppose I will give Dr. lastname a try, but who knows if he will have those wonderful notes to read through from the pain specialists that drew their conclusions immediately upon my asking about getting a medication that gave me relief in the past. And even if he does treat me and gets my medication to a level that I can finally live a more "normal" life with and stay comfortable, sleep like a normal human being, play with my kids and be a father again, even then I still get to go back to the local pharmacy with even more meds to fill, which in their minds I am sitting at home getting blooped out of my mind with. I could change pharmacies, sure, but I shouldn't have to.
I guess the point is that I (we) didn't wake up and ask God to give us chronic pain. To be treated like a criminal by so many in the medical community just rubs salt in the wounds imo, when all I want is to not feel like there is a screwdriver stuck in my back 24/7.
And if it's that little pill that takes that pain away... so be it. They're not the ones living with it, we are. I'm sure it's pretty easy to tell someone that they're going to be in pain for the rest of their lives and they just need to learn to live with it... as long as they aren't the ones that suffer it.
I'm not sure what to do anymore. I'm honestly about to the end of my rope. Tired of hurting, and just as tired of being made to feel guilty about wanting relief from the constant pain.
It's crazy. That one little pill and all of the turmoil, dirty looks, stereotypes and stigma that comes with it. Nobody has a problem with it if you're taking as much asprin as you need to get through the day, but add a little narcotic to it and you've just become a scumbag.