Category Archives for Spoonie Problems

Cleaning For My Cleaner

Every once in a while, I do something that makes me question how rational, maybe even how sane, I am. Friday was one of those times. On Friday morning, I had my first appointment with a new cleaning person who came highly recommended by my friend R. She works with the cleaning staff at R’s work site. A few months ago when I told him what happened with the woman I hired to clean my place and do my laundry, but who chose to take advantage of my situation instead, he put out some feelers to see if there might be someone willing to work for me on a casual basis. Lucky for me, someone on his staff responded to his request. After playing a long round of phone tag, we finally connected, and I laid out for her the kind of things I need done and the rate I’m able to pay. She accepted my offer then we agreed on a day of the week that works best for both of us.

Here’s where my insanity kicked in. Before she arrived on Friday morning, I felt panicked. My place was what I consider a disaster area. Although, to most people who come to visit me it still looks clean and organized, I can’t cope with the mess I see. I got out of bed earlier than I needed to and started cleaning up. I put away the pile of clothes that had grown on the side of my bed I don’t sleep on either because they were not put away the last time my laundry was done or because that’s where they land when I decide an item of clothing isn’t what I want to wear. I rolled up my yoga mat and put away my sneakers. I washed the pots, measuring cups, utensils, and bowls I used a couple of days before to cook asparagus and mushroom risotto, but then didn’t have the strength to clean up after eating what turned out to be a delicious meal. Then I turned my attention to the growing assortment of art supplies I have, which I packed into one of the many boxes they arrive to my home in that needed to be put out for recycling.

I know how this sounds, but I couldn’t help myself. The clean freak that’s been living in my head since I was a little girl insisted that I make a good impression on the person who was coming to clean my home for the first time. I still can’t believe I did that: I staged my home to look less messy so I wouldn’t be judged. Even pain can’t override the unachievable expectations and rules hardwired into my brain that make me behave irrationally. I’m so embarrassed that I did this I haven’t told any of my friends or family. The funny thing is that if one of them told me they did this I would laugh at them and tell them how ridiculous it is to do something like this when the purpose of paying someone to do it is so you don’t have to. DUH!

Being a perfectionist has been a significant issue throughout my life that stems from a need to control things. Even though there has been an upside to it, like having a strong work ethic and being independent, the downside is tremendous. Feeling that other people in your life can’t live up to the standards you set for yourself is one of them, especially when it’s impossible for you to meet them yourself. It also becomes a problem when, like on Friday, you hire someone to do something for you but question whether he or she will judge you because you can’t do it yourself or if they are competent enough to do what you need – she did an outstanding job by the way.

One of the things I’m learning about perfectionism is that even if you don’t ask the questions out loud, your actions ask them for you. I clearly still have a lot of work to do to overcome the need to control my environment and my image; and I must let go of this need soon because the potential downside now is the added harm to my health.

 

Enchanted – Happy Working Song

Opioid Induced Constipation & The Undignified Big Pharma Response

Last Sunday, like millions of other people, I watched Superbowl 50. As usual, there were some great commercials throughout the game. However, I can’t forget one commercial from the 2nd quarter. Not because it was funny and creative like most of them were, but because of the targeted medical condition: opioid induced constipation (OIC). The reason I can’t forget it was how embarrassed I felt as my friend with whom I watched the game laughed at the inappropriate humour the pharmaceutical company used to promote its product. For those of you who don’t suffer from chronic pain or have never had the need to take opioid (narcotic) pain medications for pain relief, I assure you this condition is a real thing. The Australian Pain Society states, “One of the most common adverse effects of chronic opioid therapy is constipation. Up to 95% of patients prescribed an opioid report constipation as a side effect, which can occur soon after taking the first dose.”

Opioid induced constipation is also known as opiate bowel dysfunction (OBD); and according to the American College of Gastroenterology “constipation may be debilitating among those who require chronic analgesia [pain relief]. OIC/OBD affected an average of 41% of patients taking an oral opioid for up to 8 weeks.”   The reason for this is that “opioids cause constipation by binding to specific receptors in the gastrointestinal tract and central nervous system, resulting in reduced bowel motility through direct and indirect (anticholinergic) mechanisms.”  In short, the opioid pain medications delay or block messages throughout the body that tell you when you need to empty your bowels.

I understand that a commercial’s purpose is to grab its audience’s attention in a short time. However, the tone of this commercial failed to convey the seriousness of this condition, while using lowbrow humour to flog the product. Practical Pain Management, a publication founded and written by pain experts, notes that although opioids have been in use for centuries; it’s only in recent decades that this kind of medication has received any significant attention and investigation. Sadly, “we are only beginning to understand and identify the many side effects of opioids. Constipation, nausea, emesis, pruritus, respiratory depression, and somnolence are well known. However, not so well known are effects on immune function, urinary retention, endocrinopathies, gastroesophageal reflux (GERD), gastroparesis, sleep apnea, cardiovascular system, osteoporosis, emotions, dentition, and renal function.”

This lack of knowledge about opioids begs the question, how many people know that if a patient that has OIC/OBD does not receive the proper medical treatment it “may cause rectal pain and bleeding, abdominal pain and distension, urinary incontinence, faecal impaction, rectal tearing, and, in very severe cases, bowel obstruction and colonic perforation?”  How aware are people that OIC/OBD can reduce a person’s quality of life as much as the chronic pain doctors prescribe the opioid medications to treat? The Australian Pain Society also notes that, “Some patients would rather endure chronic pain than suffer from the severe constipation that can arise with long-term opioid therapy. One study found that approximately one-third of patients missed, decreased or stopped using opioids in order to make it easier to have a bowel motion; the majority (86%) of these patients experienced increased pain as a result, which reduced their quality of life. Reducing the opioid dose is not considered useful, as analgesia [pain relief] may be compromised and constipation may not resolve.”

I know that 30 seconds isn’t a long time and not all the points I raise most likely could have been touched on in that amount of time. However, I do know that the pharmaceutical company could have approached this issue in a more dignified way. When the commercial ended – and my friend’s laughter died down –, I did educate him about the seriousness of OIC/OBD, and how I’m affected by this condition because of the large doses of opioid pain medications I have to take to manage my pain. I hope that others who might have been in the same situation during the game were able to have similar conversations. If not, here’s a link to a therapeutic brief from an Australian Pain Society study that gives information about OIC in plain language in a downloadable PDF file: Opioid-induced constipation– a preventable problem

 

Bob Dylan – Dignity

This Big Girl Cries When She Hurts

After locking the door behind me when I came home today, I started crying uncontrollably. I used every ounce of emotional and physical energy while I was at my doctor’s appointment and then when I went to pick up my medications from the pharmacy to hold myself together, but there is so much grief and pain building up inside me that I needed to let some out. The past few weeks are coloured with disappointment and uncertainty about whether I’m ever going to get better and those feelings are adding to the size of my ball of grief.

Crying helped to release a small piece of my grief, but I still feel what remains sitting heavily in my body. A glance in the mirror revealed how much the saltiness of my tears irritated my eyes as I looked into the red puffiness that stared back at me. My nose and cheeks reddened with a bright tint from the pressure that built up in my head from the rapid rush of blood. There is congestion in my nose because the overflow of tears that couldn’t escape through my tear ducts had to go somewhere, and my lips still trembled even though my sobbing stopped. My body is numb now because my tears carried so much of my unwelcome emotions away with them.

Sadly, I can’t think of what else I can do to cope with what I was told and the grief it is causing except to cry.

 

Big Girls Don’t Cry – Frankie Valli and the Four Seasons