Wednesday, July 6, 2011

The Medication Game

Part One of Arthur Rosenfeld's book The Truth About Chronic Pain: Patients And Professionals On How To Face It, Understand It, Overcome It covers the stories of people who live in chronic pain.  Most of these stories mirrored, in part, S and my situation.  For example, Mary Vargas' husband sees her pain as the third partner in their marriage.  Allyson Gabrey comments "I don't want to spend the rest of my life lying on the couch, why should I?"

Both S and I have had those types of thoughts many times.  Whenever I plan a trip or function, I have to think about how the trip will affect S's pain levels.  Is it a "change the patch" day?  Can we schedule the trip during medication peak?  How will the pain be when we get there?

The same is true for day to day activities.  S is not working, and I work from home, which makes things easier in some respects.  We also send the kids to daycare so that he gets a period of "downtime" during the day.  But, because of his pain levels, he cannot plan to do anything during the hours the kids are at school. He needs to keep himself as pain free as he can so he is not already in the hole when they get home.  This could change if he could increase his pain medication, but the doctor will only prescribe a certain dosage.

This seems to be a common fight for people in pain.  Dr. Gerald Young says it best (in Rosenfeld's book) when he says "Very few doctors look to titrate up to where the patient says, "Hey, this is great! I feel good!"  If the patient says they feel good, it's time to titrate down!"

I understand that doctors are afraid of addiction and the DEA, but why in this day and age should a person live in constant pain.  They are only given enough medication to "take the edge off?" but not to be pain free.  Yes, chronic pain sufferers become dependent on their medications, but so do individuals with chronic depression, diabetes, and heart disease.  The pain sufferers are not addicted, they are dependent.  There is a distinct difference which I will discuss in tomorrow's post.

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