Tuesday, August 18, 2009

Pain, pain, go away, I don't want to live this way...

I faxed Rav Firer this morning with the information about the PVNS, together with the letter I wrote with questions. Five pages in all (my letter, the MRI evaluation, the biopsy report, and two pages that Dr. Raht wrote summarizing my exam with him). Tomorrow I (we) leave a message with my phone number, and then wait for the Rav to call back. Stay tuned...

Today I went for the first time to a pain specialist who was recommended to me by Hilary (and Dorit has also heard of him). I told him the very shortened version of my story, and told him that the Percocet isn't doing the job for me, and I don't like how it makes my body feel. He explained that pain relief is not a science. We try one thing, and if it isn't good, for whatever reason, we try another. The idea in the beginning is to check out the side effects, not necessarily the pain control. The beginning dosages are low, and not expected to control the pain. If there are no side effects, the dose gets raised. He said to me we have many options; that was comforting to me.

His suggestion was to start me with a medicine called M.I.R.; Morphine Immediate Release. It is exactly what it says it is, a quick zap of morphine into the blood stream. To start off, he told me to take a half of pill, see how it feels, then the next dose to take a whole one, and keep it up if everything is good.

Well, turns out that everything is not good. I took the half pill at 6PM, ad now it's 8:45PM, and I've suffered a spacey high sensation almost the whole time. It'd be fine if I was looking for a spacey high, but, ummm, I'm not. And the hip pain was no less, unfortunately. I know we are checking side effects now, not pain control, but with such a heavy first time side effect, I'd have thought it was heavy duty enough to knock out some pain. Nope.

So I called the doctor back, and he said to stop the M.I.R. Wait till the side effects wear off, and take a half of Percocet for the night. Tomorrow morning he wants me to try Percocet syrup, where we can precisely tailor the dose, not just a half or whole pill dose. He said that incidentally, this is the best way also to taper off Percocet, if that is desired. The syrup can be more precisely controlled. He said he will stay with the opiate family for now, since it is established in my system. There are other choices, but it entails switching drug families which can be unpleasant.

So I'll pick up from him tomorrow the Percocet syrup and go that route.

It really is a science to control chronic pain. I feel that by starting this process with a pain specialist, I am subscribing to a "fact", sort of, that I have pain that will not go away. I don't want to subscribe to that thought. But I do have pain that will not go away. But I want it to go away by itself.

But it's not.

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