Within the depths of
pain
In some ways, I
probably have a very high pain threshold, but in late 2009, my pain tolerance
was completely overwhelmed when I had cancer in my left foot, with fungating
tumours and blackened skin lesions, both deadly and deathly.
Standard painkillers
(paracetamol) and stronger medication (tramadol) failed to relieve the pain. It
was so intense that I could not put my foot down without crying. In the
hospital, I was given morphine, but that only lasted two days before I was
vomiting everything.
The Search for
Effective Pain Relief
Then came OxyContin,
but I was not given enough of it. The nurses seemed to be rationing it even as
I begged for relief. However, when I was discharged after 18 nights in the
hospital, my pain medication was adjusted. Multiple types of pain relief were administered
to target different aspects of the pain.
Paracetamol,
oxycodone, and a fentanyl transdermal patch; all that, and pain still
persisted, sometimes taking centre stage. I resorted to almost hysterical
laughter to release endorphins as a form of palliative coping.
After another
consultation, I told the doctor I was still experiencing pain. In his view, my
medication should have been sufficient; it was not. He doubled the dose of the
fentanyl patch, and only then did I achieve what might be called pain relief.
The Path to Recovery
I was on pain
medication from late September 2009, and by the end of January 2010, the
tumours were gone. I had fresh, pink skin on the soles of my feet, a miracle of
medicine, but it involved gruelling treatment, including chemotherapy and its
dreadful side effects.
The pain had gone by
March, so I removed the fentanyl patch. Big mistake. I salivated excessively,
spat out mouthfuls of saliva, and became severely diarrhoeic. I had to reapply
the patch. From this, I learned I needed to wean myself off it gradually. I
kept it on for twice as long while gradually reducing the dose by halving the
patch at each change.
It took three months
to fully stop using the patch, long after I no longer needed any sort of pain
relief.
Understanding
Fentanyl's Role
Without fentanyl for
this level of pain, life would have been unbearable, almost not worth living.
One day, the patch fell off. Not knowing you could cover it with a transdermal
sticker or plaster to keep it in place until the new patch was ready, I was laughing
deliriously. My friend thought I had lost my mind; it was a protective
mechanism. If I hadn’t been laughing, I might have been dying from unbearable
pain.
Today, fentanyl
should only be taken under medical supervision. I also understand that not
everyone has experienced the severe pain I did, nor have suffered the
otherworldly pain others endure; my pain was eventually brought under
control, subsided, and disappeared entirely. I consider myself extremely
fortunate.
My body became so
accustomed to fentanyl that I couldn’t simply stop using it. It took willpower
and determination; perhaps a rare gift. We all have different physiological
responses. I am not seeking praise for that.
A Broader Perspective
Beyond the need for
medication for chronic pain, there are issues of susceptibility to addiction,
both requiring a sensible, empathetic approach under medical guidance across a
broad spectrum of related conditions.
Regarding fentanyl as
a narcotic, I feel ambivalent. People don’t become addicts solely by enjoying
sweets; there are complex circumstances that I believe cannot be addressed
purely through criminal justice.
Labelling fentanyl as
a weapon of mass destruction would be narrow-minded and lacking understanding
of human suffering, especially in pain management.
Learning from Recent
Experience
My perspective is
personal. I am cautious with medications, aware of their addiction potential.
Recently, I used codeine, which converts to morphine in the body, to manage
penile and urethral pain during the fourth week of radiotherapy for prostate
cancer.
Prescribed to be
taken up to four times daily, I rarely exceeded two tablets a day. After three
days, I only took one tablet at night. I still felt pain and discomfort, but
consciously avoided the lengthy process of weaning off codeine once my body
adjusted.
As long as those who
truly need such pain management are not disadvantaged by misguided policies, I
hope this decision by the White House does not, in pursuit of an ideal, create
suffering for many who simply seek relief.
Pain in my blogs
Blog - In
hospital to kill the pain
Blog - Getting off
the pain train
Blog - Generally
responsive and dealing with pain
Blog - Stronger
medicine and another course of chemo
Blog - Boldly
tell your doctor everything
Blog - Off and
back on the pain patch
Blog - Opinion:
Where addiction and tragedy can confuse issues
Blog - Knowing
pain is personal
