It’s a brand new day. Except if feels alarmingly like the last one. Full of pain.
I ran out of endone. Immediate release oxycodone. I’ve tried pretty much all the opioids, and this one works the best. It gives quick relief and quite good relief, obviously how much relief is dose dependent. Enough endone to give complete relief would also put me in a coma, so that’s the impossible dream…
I also take slow release oxycodone. Oxycontin or targin. My doctor prefers me to take slow release, and has been asking me to increase my slow release, so as to decrease my endone use. I have been trying.
But endone works better. Here’s why. It works within 30 minutes. I feel a noticeable reduction in pain within 30 minutes. I also experience nausea and dizziness. But there are always side effects, and I can work through nausea and dizziness. When the pain is knock down pain, I can’t work through that. So nausea is better. So I take an endone when I need to get something done. When I need to shop. When I need to clean the house. If I need to go to the school. Even so that I can go do a gym workout. Then when the endone wears off, I can rest. Or take another if I still have more things that I MUST do. Endone gives me more control, because its fast acting, though not long lasting.
I usually take the same dose in slow release at the same time, so when the endone runs out, there is still some oxycodone kicking around. So on a not so terrible day, I can get away with two doses of endone. Because my GP really wants me to cut down on the endone and rely more on the targin.
But when I don’t take the endone, just the targin, I don’t get that quick reduction in pain. I just get the nausea and dizziness. And, funnily enough, a headache. I’m sure the pain level is dropping, but slowly. Almost imperceptibly. And the nausea and dizziness and headache without a reasonable reduction in pain means I still just want to lie on the couch. Hours later I notice the pain isn’t so bad. But the pain gets better over the day anyway. And then returns.
I have been explaining this to my GP for months. But he continues to ask me to do it this way. I read a study that stated slow release pain meds have less addiction potential. I bet that’s why my GP wants it done this way. So I try. But I consistently go over my allowed dose of endone, because I need the quicker pain relief. To function. To get through things that must be done, and then once it’s done, it doesn’t matter if the pain levels rise again, because I am back home and can slow down and rest.
This all sound fun, right? It’s a well honed system, that does work for me, except that I need higher doses than my doctor wants to prescribe. I know he has my best interests at heart. But the major problem with opioids is tolerance. I have a pretty high tolerance. I am going to need every increasing doses to maintain the same level of pain relief. This is a known fact. Not much I can do about it.
It is much harder to endure pain when you know it can be reduced if not relieved.
This weekend I ran out of endone. I was sure I had another box. But I didn’t. Now I really realise just how effective endone is for me. Just how much I rely on it to function. Even though I am taking 15mg of targin morning and night (and last night I took much, much more) my pain levels are out of control.
Almost every joint aches constantly. And I have sharp, stabbing, icepick-inserted-in-joint-and-twisted pain in my wrists, some fingers, my ankles, knees and hips. My shoulders, elbows, ribs, and jaw are just a dull ache today.
The last two nights without endone have been unbearable. Some of the worst pain I have ever experienced. Last night I took 30mg of targin (I think). I drank more than a bottle of wine to kick it along. Then I took two valium, because I still couldn’t sleep. And a couple of ms contin (morphine sulphate).
That was insanely stupid. It was far too much medication, and in the cold light of day I realise how dumb that was.
The point to be realised though, is that I was in too much pain to think straight. I had taken too many drugs to think straight. And I couldn’t cope with the pain. I am no longer super woman re: my previous post. I am not as strong right now. There is a little part of my brain that is utterly ashamed that I am writing this, and admitting this, and telling me not to be such a wussy.
That little part of my brain is wrong. This is too much for me to cope with right now. I need better pain relief. I don’t know if this is a worse flare than usual, or if this is just what every day would be like without endone.
Messing around with too many drugs like I did last night is dangerous. Isn’t it better to give me a higher dose of the drug that works for me? Isn’t that less dangerous? When you’re in a lot of pain and have been for a long time, sometimes you break. Sometimes it’s too much. Once you have let the pain get to an extreme level, you can’t get it under control so easily again. Better not to let it get that bad. And sometimes you’ll do anything to make it stop. That’s when accidental overdoses occur. NOT when appropriate doses of pain meds are prescribed.
Hopefully tonight will be better. I’ve just taken another dose of targin. Double my usual dose, so that I can get moving today. I would normally take that much endone on top, so we’ll see if that helps.
It’s Sunday. And chances of me getting an appointment with my doctor tomorrow are slim. But I will go down there and beg for endone.
Or I need to up my prednisone again.
Or I need to wait it out. See if it’s a flare and it passes, or if it’s normal life. I spend so much time in this shape that I believe its normal life. Every time I have an ultrasound the tech can see active synovitis. Even though there is no conspicuous swelling. Much as professor dipshit would like to keep telling me my rheumatoid arthritis is under control, I know it is not.
I need to have that bone scan to prove that there is something wrong with me. I’ll need some endone to get there though.
I will be on the phone first thing to my GP to beg for an extra box, because I can’t get my usual refill until Wednesday.
And I will be back on the phone to my rheumy and leave yet another message. In fact I’ll just go ahead and make an appointment so she can’t ignore me. I might need to find someone to drive me there though. Depends if my GP gives me the endone.
In the meantime, I’ll…do nothing.
I know that my desperation for endone will sound like addiction to some people. This isn’t the case. Endone relieves a large proportion of my pain. Of course I want it quite badly. It takes me from couch bound to functional.
That isn’t addiction. It’s trying to live.