Monday, September 7, 2009

Permission Granted (Via Lengthy Rationalization)

When I got sick as a kid, I'd tell my mom my symptoms and how badly I felt in the hopes that she would decide whether or not I should stay home from school.

Essentially, I wanted permission. I didn't want to make the decision on my own, but from a fairly young age (I don't remember exactly how young but definitely starting before I got to junior high), my mom made me make the call myself.

And I would dither and go back and forth. It's hard to know right upon waking up whether feeling yucky would pass or get worse as the day went on. Sometimes my mom would lose patience with me and my wishywashiness over whether I was too sick to go to school or not. But mostly she would simply say something like, "Only you know how bad you feel, so only you can decide if you're so sick you need to stay home today."

Sometimes there was no choice. If I was running a fever or throwing up or something like that, clearly I couldn't go to school. But colds or tummy aches or, once I hit junior high and developed migraines, bad headaches, those were all something of a coin toss.

The consequence for staying home from school sick, though, meant that I wasn't allowed to do anything "fun" until I'd been back to school at least one day, even if I later decided I felt better. Which meant I'd try hard to drag myself to school on Fridays (or, once I had a part-time job, on a day I had a work shift) no matter how lousy I felt unless I was sure I'd be sick all weekend! :-)

Since I started the Prednisone taper and my pain levels skyrocketed, I've wavered on whether to talk pain meds. I'm not supposed to take ibuprofin because of my propensity for peptic ulcers caused by NSAIDs (and even the Prednisone irritated my stomach so it's probably a good thing the doctors made me taper off). Tylenol rarely helps my pain. I take Flexeril, a muscle relaxant, and I know it helps because I can feel the difference if I skip doses, but my pain has still been out of control.

But I haven't taken narcotic pain relievers since around Thanksgiving, when I went cold turkey to see if a neurologist was right that my fatigue was caused by my pain meds. She wasn't right, but it seemed like a good idea to resist going back on the pain meds just for philosophical reasons.

But lately, I've been passive-aggressive looking for someone to give me their blessing to take the edge off my pain with oxycodone. I told my internist that my pain was so bad lately that I'd taken to looking wishfully at the bottle of pain pills. She was unhappy to hear that, but didn't overtly give me the permission I thought I was hinting at but didn't outright ask for, which is silly because she told me all along that I wasn't addicted to the pain meds and it was OK to take them if I needed them.

I've cried to Scott about my pain levels, and he's supportive and sympathetic but clearly not a mind reader either.

On top of the usual aches and pains, my back and neck have been way worse than normal lately too. And I've been having really severe headaches daily lately that I thought were caused by my weird eye pain and odd vision but now that the ophthalmologist ruled out eye problems, I think it's the headaches causing the eye issues. And the Midrin I've been taking for headaches for a year or so doesn't even touch them lately. (Since the headaches have become a daily event, my internist had me start a daily drug that hopefully will cut down the frequency and severity. Hasn't kicked in yet, though, as far as I can tell.)

My sleep is affected because it's harder to fall asleep when pain is bad and I'm more likely to wake even more frequently than usual, which means I'm either extra tired on top of my normal high fatigue levels or I'm relying on Benedryl or Ambien to help me fall asleep and stay that way.

This weekend, I finally decided that, just like when I was a kid deciding whether I was too sick for school, only I could decide whether or not I needed pain meds.

So, approximately 9.5 months after the last time I took a narcotic painkiller, I took another one. And you know what, it helped. I think it's a reasonable thing to keep in my arsenal, especially if I only take them occasionally, which will keep them more potent on much smaller doses. I plan to limit my usage and not slip back into taking narcotics daily.

But being a martyr and suffering needlessly wasn't beneficial to anyone. So I gave myself permission to do something about it when it got too intense.


Shiri said...

I'm glad you took it. I know this feeling, the wanting someone to say its ok to do what you know you need to do. I think part of it, for me, has always been the look of sadness or disapproval someone will give me when they find out I'm back on meds, or the excitement they feel for me when I'm off. I've realized lately (after almost a year with no drugs besides Aleve, etc) that these looks are related to them thinking I'm better or worse because I'm taking the drugs or not. They have no idea that whether I swallow those pills doesn't reflect how my body feels but more how my head seems to feel about my body.

I'm glad you gave yourself the permission. Pain can wear you out, make fatigue worse, weaken your immune system. But most importantly, I think, is that taking what you need means you're taking control.

Aviva said...

Aw thanks, Shiri!

I think also there's the assumption by many people that if you're taking pain meds regularly or with any frequency at all, you must be addicted. I think you're totally right that I needed to take that control back for myself and, hopefully, keep my pain from spiraling further out of control.

Shiri said...

Yes, there is that assumption. I haven't taken opioids in a long time (they make me so sick!) but I know that feeling. There is always someone saying that for any pain drug. Part of me wondered, so what? The other part needed to prove my pain, as though they could validate what I was feeling. Neither part won out... its a battle.

Lisa said...

Another awesome post! I think back to those days of deciding whether I could "push through" to go to school and that mentality stays with me. I'm never sure where the line is. I'm glad the pain reliever helped and as always, I wish you many things including answers and lasting treatment.

Lisa, your chronic illness twin

Melissa, Multi-Tasking Mama said...

I go back and forth as well. I can't take anti-inflammatory meds anymore because I am on blood thinners and tylenol just doesn't cut it sometimes. But, I don't feel like an adequate parent when I take narcotics. I usually end up saving them for really bad days and take them after the kids go to bed.
I don't think there is a right's individual. Thanks for sharing your story.

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Auckland property manager said...

First of all ,I would like to tell you the feeling that I get from your article,you are really sickly.And secondly,I'd like to say that you took it finally.I wish you can live a relax life then.

Mary333 said...

Your post reflected my own thoughts on meds. Like you, via lengthy rationalization, I gave myself permission :) I am a "sick momma" too. Have they helped me? With certain symptoms. I don't have a definitive diagnosis yet. We are calling it fibromyalgia for now but this will likely change as my dad has polymyalgia.