On Tuesday morning I had a nerve block. According to the pain specialist who performed it, the procedure couldn’t have been more perfect. The needle was easily passed through my tailbone to deliver the anesthetics to my nerves – this may be the one thing about my condition that has played out as described in a medical textbook. Because they inserted the needle into my tailbone, the area has been incredibly sore so the only way I’ve been able to sit is straight upright as if I have a plank in my back.
Ganglion Impar Block
For the past 48 hours, I’ve been dutifully keeping a log of my pain improvement progress every two hours. Overall, I’m not pain free but I have less pain than before the procedure. I still have my right-side oriented pain in my lower abdomen, back and leg but I’m experiencing what I’ll characterize as a constant low level of pain on the pain scale. This probably means that combined with the nerve block, I’m feeling the benefits of my pain medications for the first time in a long time. My hope is to lower the level of pain medications I take over the next few months so when I have surgery the doctors will have room to treat me before reaching the maximum limits of pain medication doses during my recovery. The pain specialists have told me that my case is very complicated and the possibility exists that my pain will be difficult to treat post-surgery. This nerve block will be a good indicator of what they can expect.
I’m also hoping to go for a few walks before the effects of the nerve block wear off. Walking for a significant distance is something that I have a lot of difficulty with these days. With the weather being as wonderful as it is, it would be nice to pack a lunch, walk to the park, and sit in the sun for a while. That’s such a simple thing to wish for, but it’s something I badly want to do. However, I know I’ll have to take things slow because I just came back from an appointment and the car drive there and back has affected me negatively and increased my pain. I’ll dream about the walk to the park while I rest my body.
“I just want to see what kind of high they give me,” he said.
Every so often these words pop into my mind. They are a painful reminder that someone I considered a close friend cared so little for my well-being he was willing to take from me the only things managing my pain and keeping me out of the hospital emergency room. He wanted me to give him the tiny, pale, green, opioid pills prescribed by my doctor in meticulously measured quantities to cover two weeks of pain-filled days. He justified his request by saying, “Your doctor will write you a prescription for more pills.”
How did we arrive at “I just want to see what kind of high they give me”? About six months into my illness this friend started to express a lot of interest in what kind of pain medications I was taking and how much of them I needed to take to get some pain relief. I saw it as genuine concern because we had been friends for about a decade and my pain medications just became a natural part of the conversation when he touched base to see how I was doing. We talked about the various pain medications I had been prescribed and I remember during one phone call he googled a comparative pharmacology chart to see the differences between these pain medications. He expressed a particular interest when he learned that the Dilaudid I now take is “3 to 4 times stronger than Morphine”.
About a week or so later he told me he would be in my area of the city for a meeting one day soon and offered to come by to have lunch with me. He said he missed hanging out with me and it would be good to see me for a few hours. The idea of his visit made me happy. He came to my apartment with some delicious Indian food. I didn’t have the appetite to eat very much, but I was so happy for company in the middle of the day it didn’t matter. As it always was, our conversation was punctuated with laughter and sarcastic barbs. He sat with me for a long while and asked questions about how I was coping, why it was taking my doctors so long to figure out exactly what was wrong with me, and when I might get better. Then it was soon time for him to head back to work.
As we walked toward my front hallway he stopped in front of my kitchen doorway and asked if he could see my medications – all my meds were in plain view on top of the fridge. Being more than a little bit spaced-out and very naïve I didn’t think there was any reason for concern. I showed him the various bottles and explained the contents of each. He noted that the Dilaudid pills were very small considering their strength. As I was putting the bottles back on top of the fridge he asked if he could have some Dilaudid. I laughed because I thought he was joking. He asked again and I realized he was serious. I told him I couldn’t give him any for a number of reasons: they were prescribed for me; they are narcotics; they are a controlled substance and it’s illegal to share them; I needed all of them to manage my pain; and if I ran out of them I would end up in the emergency room because of the pain. That’s when he said, “Your doctor will write you a prescription for more pills.”
This disregard for what would happen to me if I ran out of pain medication stunned me. He kept asking and trying to persuade me until I felt uncomfortable and all I wanted was for him to leave; so I gave him one pill. He wasn’t satisfied with just one. He said one wasn’t enough to see what kind of high he would get from them and whether it would be worth having his “guy” go to the trouble to get some for him. I felt instant nausea. He wanted me to give him pills I was depending on to cope with debilitating pain for his recreational use. I held firm and told him even one was too much for me to spare. He finally stopped asking. He was clearly disappointed. He walked to the front door. Put on his shoes. Gave me a hug and left. I’m not sure how long I leaned against the door feeling numb because my anger couldn’t break through the muddiness of pain and medication.
I will never be able to forget this happened.
He wanted my pain medication to get himself high.
He also confirmed what I suspected for a long time. He is an addict.
He labels himself a “recreational drug user”, but there was no fun in what he did to me that day. He has often said that he ingests substances – cocaine, mushrooms, MDMA, Oxycodone, marijuana, alcohol, caffeine tablets, and energy drinks – to enhance and heighten his experience of life. From what I have witnessed it’s more likely he’s trying to escape parts of his life.
He didn’t care about what would happen to me if I didn’t have enough pain medication. But I knew: if I ran out of pills early I would have to call my pharmacist to get a refill; my pharmacist would look at my file and see that it was too soon; he’d tell me he could not be refill them yet because they are narcotics and Controlled/Monitored Drugs and question why I had taken that quantity so quickly. Then because of strict regulatory policies the pharmacist would not contact my doctor’s office on my behalf to get authorization for a refill, but he would advise me to contact my doctor immediately to be assessed.
My doctor would hear alarm bells when I told her I was out of Dilaudid before the end of the two-week period. She would assume I had taken them all and she would be concerned that my pain was becoming more severe, or worse, that I was abusing my pain medication. She would bombard me with a million questions and I would most likely lie to shield my friend, to hide the crime I had committed – giving someone even one of your narcotic pain pills is breaking the law – and to get replacement pain medication so I wouldn’t land in the hospital. From that point forward she would monitor me even more closely and probably request that I pee in a cup more often to check the level of Dilaudid – and other possible substances – in my system. And I would have degraded my doctor’s trust.
Thankfully these things didn’t happen. But his actions and words caused me to feel so stressed and paranoid I started hiding my pain medications in dresser drawers in my bedroom. I also distanced myself from him because he made me feel unsafe and I didn’t want him to believe what he did to me was ok. I haven’t seen him since that day over a year ago. And I can no longer consider someone who would put me at risk my friend. Nonetheless, my hope for him is that one day he recognizes the harm his addictions create and then engages in the work needed to repair and balance his life, family, and his relationships.
Yesterday, as I prepared to take a shower – yes, I have to prepare to take showers now and I know that there are many people who can identify with this – I realized that the harder hit I am by something the longer it takes me to share it with the people in my life or write about in my journal, or here. I had to think about that for a bit. What is it that is blocking me from opening up about things, even in this anonymous setting?
I’ve always been a thinker, but I believe I am truly suffering from what I keep seeing referred to as ‘brain fog’. It’s taking me longer to process things emotionally and intellectually. I’m used to emotional delays because I tend to compartmentalize my feelings to deal with them when it feels safe or when I’m forced to because anxiety gets the best of me and I have to unpack some of my baggage. However, I’m usually pretty good at sifting through logical puzzles by taking information in, synthesizing it and then applying it in relevant situations.
But not now. Not since my illness arrived.
Now my concentration is spotty. I will have the intention to talk to someone about something significant that happened in my day then that conversation won’t happen. Because I don’t remember or I’m too overwhelmed by emotion not to cry. I will have the intention to write about an experience then that writing won’t happen. Because the words needed to articulate the tale don’t show up or come in such a rush they get jumbled. I will have the intention to journal to sort through the mental and emotional tangle but that detangling won’t happen. Because the effort to put pencil to paper or fingers to keyboard feels too great.
Those few moments of introspection made me see that I’ve been looking for a defect in myself where there isn’t one. My thoughts and emotions are out of whack because of my pain and the pain medications I take to manage it. Intellectually I know this, but in the moment when something goes askew I forget and I beat myself up about what I should have done and question why I didn’t when the answer is obvious. I don’t do or remember to do because my brain is submerged in a soupy fog for many hours of each day.
I read about this same experience in the lives of others daily. I have great compassion for each person who shares their struggle. Now I have to be compassionate with myself.
My Small Surrenders 