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It Never Wears Off

Drugs are not my first choice. Frankly, they rank somewhere on the third or fourth sheet of choices rather than the top ten. I despise pills and medicines. I was reminded of why this weekend.

Off and on over the last few years I have posted about pain. I live with a fairly significant amount of it on a daily basis, but I have intermittent pain which is crippling. Let me put it in terms which put us all on this page together.

Inane

Some bean counter promulgated a form for all triage personnel to use which asks patients to rate their pain on a scale of one to ten.

 

Jim Kirk and Bones

Pain is subjective. You can get any random ten women in a room and each will tell you childbirth is:

  1. The reason drugs were invented
  2. The most horrific pain
  3. Endurable
  4. Meh
  5. Piece of cake

Compound this with factors like some had drugs, some did not, some had more than one child, some had complications,… The variables which go into pain are virtually innumerable.

Since we are doing math with irrational numbers anyway, let’s add in pain threshold.

I can stand…

On your pain meter what is:

  1. a broken metacarpal (hand)
  2. a broken zygomatic (cheekbone)
  3. a stab wound from a knife (3/4″ wide by 1″ deep)
  4. third degree burns to the bone (foot, both hands)
  5. 13″ incision in the belly with a soldering iron (Cesarean with no anesthesia)

I ask the foregoing of everyone who asks me to rate pain. By the time I get to #4, most of them are over 10. When I get to #5, their heads are swimming, and they stop asking me questions.

The Road to Hell

If you were not tuned to the latest issues of The M3 Blog, you may be unaware I escaped the TCH. One of my first stops was at a medical facility, where I met a physician who asked if the doctor in whose care I was in SC was actually a neurologist. I answered,

That is what the license on his wall said.”

Feeling better already! A doctor who recognized I was not getting the care I needed. He ordered tests which were what the other alleged doctor should have ordered.

Next, he performed (not had someone else do it) tests. I flunked. No great surprise. He asked about another disorder of which I do not complain (for which other patients routinely have surgery to alleviate their “insufferable” pain). I noted it does not bother me and was not the reason for my visit. My complaint was pain which far exceeded what others consider “insufferable”.

Based on his own results and his examination he asked me to take medicine pending my other tests. I balked. I always balk.

You are a PITA.

Why yes, I am. I feel my status as a pain is plausible for the following reasons:

1. Until you can tell me what we are fighting, we are shooting in the dark.

This has been my refrain for the last five years. I am not one for Russian Roulette, with three refills and a follow up appointment in three months.

2. While I do not know everything, I know my reactions in the past… a blank noticeably missing on your form.

I got to reason number one from shooting myself in the head with a few pills before.

3. Give me three reasons.

I am a rational being. Give me reasons why I should take this medicine, and I will be more likely to listen, albeit no more likely to be compliant.

Reasons

1. It has worked before.

Q. For whom? How similar are our histories and symptomologies? For what? Do I have that?

2. It treats the symptoms.

Q. What are they symptoms of? If we mask the symptoms, how will we know when the problem is abated or the symptoms have disappeared?

3. I want to alleviate your pain.

Q. I also want the pain alleviated, yet giving me a pill for pain will not remove the railroad spike through my eyeball which is causing the pain to return when the pill wears off.

Happy Face

I put on my nicest smile and explained I was likely the most non-compliant patient he would meet in his career. I was not in awe of the time he spent in medical school despite my appreciation of the fact he plays an elemental role in our societal construct. I was aware he studied science and not some mystical art to which I was not born of a class privy to the knowledge; therefore, I did not find my requests for plausible reinforcement of his decisions based on information to which I had a right unreasonable.

We made a deal. Based on my scrutiny of the information, I would agree to take yet another new medicine until the results came back.

And I did. Until this weekend.

Beware

Anticonvulsants require a titration period. That is doctor talk for you have to take a little bit of the medicine until your body gets used to it, and then you take more and repeat until you get to the dose you really need to stop seizures. While no doctor has pinned a conclusive seizure diagnosis on me, doctors have been testing me for seizure disorders since I was 14 years old.

All of the drugs in this class come with laundry lists of possible side effects. The sheets are so commonplace and the side effects are so similar to nearly every other drug, the warning labels have little or no effect on most everyone but me. I read them in their entirety. How many of you have seen this or something very similar before?

Antiepileptic drugs (AEDs), including Zonegran, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.”¹

Sounds scary until you plug in the numbers. “[T]he estimated incidence rate of suicidal behavior or ideation among
27,863 AED-treated patients was 0.43%”.¹ Statistically, it is an almost nothing chance, right? Less than half a person out of every hundred.

Queen Red Dwyer

Queen of Statistical Improbability

I only have two words of advice. Yes, just two.

TELL SOMEONE!

I had never had suicidal thoughts. I was never the one irritating me; ergo I would have never considered eliminating myself as a solution. Until this medicine. Until this last week. Until it was time to take more because I obviously needed more since my pain was on an scale most cannot comprehend.

I sat at my computer and wrote. I put on headphones to fill my brain with someone else’s sounds to interrupt the synaptic activity. What I did not notice were the tears streaming down my face. My child did. “Why are you crying, Momma?”

Math Functions0.28 seconds of mental math produced results I had cried more in the two weeks on the medicine than I had in the prior two years. The tears had been silent but there. They interrupted the broken sleep and invaded my dreams, the one place where I had been able to escape medicines before.

No, I did not tell my child. I told an adult. My best friend, in fact. We pinpointed the only change in the last month was the medicine and my more-than-just-nebulous thoughts of killing myself and my children. The next person I told was the doctor. We shall see what he has to say about the entire affair when he returns from his vacation.

If you ever feel like you should or need to harm yourself or kill yourself or think the world would be better without you in it, tell someone you trust to help you.

Red Signature


Have you ever had an adverse reaction to a drug? What would be a more effective way of communicating pain to a physician? Do you read about the possible side effects of your medicine?

Hashtags: #sideeffects #suicide #drugs

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¹ Patient information for Zonegran. USFDA
Photo credit: Star Trek, Desilu Studios

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