Saturday, April 4, 2015

A New Insight Into Addiction

First, a little back story:

About a year ago, The change of Companies brought a change of insurance providers and plans, and a consequent change in handling of prescriptions (actually I found myself questioning the legality of this from an anti-monopoly perspective...). The new insurance provider doesn't allow 90 day prescriptions from a local pharmacy, only through CVS mail order. a 90 day is the same price as a 60 days prescription. So you are essentially forced to use the CVS pharmacy. Additionally the new insurance doesn't cover Pentasa, which I was taking for Crohn's.

I was thus moved to Balsalazide. And I have been going downhill ever since. It started with Reflux problems, which I suspect were triggered by the Balsalazide, but so far the Dr. aren't interested in that theory.

I was put on a a few different proton pump inhibitors to deal with the reflux, but long term use of them seems to trigger Join and muscle pain. (Going on and off the meds a few times on my own, I have established at least a correlation to support these therories of mine).

An NSAID was added to the regimen, after which things have taken a serious turn for the worse. The past couple weeks have been agony.

The primary, root symptom is a sort of spasming in my upper abdomen, right around the solar plexus. This have been fairly constant, and ranges from moderately uncomfortable to excruciatingly painful. Presumably as a result of this, Muscles elsewhere in my body tense up as a sympathetic response, leading to pain through my back, and radiating into my chest and lower abdomen.

Curiously there appears to be a certain weekly cyclic nature to it, Tuesday it is quite mild, By Wednesday evening it begins to increase in intensity. The increase in discomfort/pain continues through the remainder of the week, Peaking somewhere late Saturday or early Sunday. Then late Sunday or really Monday the intensity declines somewhat. I am very curious as to what is driving that.

Anyway, two weeks ago I finally went to insta-care who referred me to the ER (concerns of pancreatitis among other things). They weren't able to give me a diagnosis (not uncommon for abdominal issues. But they were really great!). They threw the whole pharmacy at me to try and alleviate my symptoms, mostly stuff focused around indigestion and ulcers. None of it seems to be helping my symptoms, but  it has added nausea, loss of taste, loss of appetite and fatigue, dizziness and exhaustion to my list of symptoms.

They referred me to a Gastroenterologist, who has started down his list of procedures. Of course those all have to be scheduled, so It was a couple days before the Hida scan, and a week after that to squeeze in the Endoscopy (That is this coming Thursday, and I suspect it was only that soon because the GI told his nurse to schedule it for is lunch break). In the meantime, the pain and discomfort remain.

Last night I hit a new peak (Though the way I am feeling at this moment, I stand a fair chance at beating it this evening). The whole of my abdomen was a mass of burning, swelling and cramping sensations, and the massive piles of drugs were doing nothing but adding nausea to the mix. The Er Dr. prescribed a Narcotic Pain-killer, just in case. I had been trying to avoid using them.
1. Their are only a very few of them, and I want them to be around for the really bad days.
2. I generally try to limit pain killer use, as they can mask symptoms.
3. I have been well indoctrinated on the dangers of Addiction.

This however seemed to meet the criteria of a "Really Bad Day". The instructions were to take one or two pills every 4 hours as needed. I took one, and waited. Nothing.

I took a second one and waited. Nothing.

Twenty minute later, and I REALLY wanted to try a third, or a fourth. I mean REALLY. I stood in the bathroom, holding the pill bottle reading the label over and over, wondering how much fudge room there might be in the dosage restriction.

That is not typical for me. Ask my wife, she has on more than one occasion had to practically cajole me into taking a Tylenol.

But that much pain for that long... It wore me down. I was desperate for a break, just a few minutes of relief even.

This morning, I think I gained a new insight into narcotic and alcohol addiction. Not necessarily every case; we know genetics plays a role in addiction, but how many of these cases of addiction are cases of people in pain, desperately self-medicating in an attempt to just get a break?

An interesting thing about pain; it is - in a way - all in your head. You feel pain because nerves in your body respond to certain stimuli, and send an impulse to your brain.Your brain interprets it and tells you what you are feeling: warm, hot, cool, cold, pressure, pain... That means, everyone's interpretation of pain can be different (extremely so in some cases, such as Ashlyn Blocker's. Can you imagine going crying to her about a second degree burn you got from touching a hot stove and being told "Oh suck it up you big baby"?). One person's paper cut could very well be another's severed limb.

And can emotional pain be just as... painful... for some? How much of addiction is an attempt to deal with chronic pain that isn't recognized, or properly managed?

How can we measure an individuals level of pain, relative to their pain threshold, relative some relate-able standard?

When we talk about solving the growing problems of addiction, of the war on drugs, of dealing with alcoholism, is this another case of hacking at the limbs, rather than the root cause? Would we be better served if that energy was instead directed at a "War on Pain"?

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