Thursday, August 1, 2019

Dan You Have Cancer - The Pain of Pain


The scan I had during my week vacation at Community General Hospital revealed not only cancer under my jaw, in bones and on my liver but it also shared with those reading the results that I also had a broken sternum and multiple broken ribs. These were explained to me as being possible due to the amount of calcium leeched from them by the cancer.  Knowing this did not account for nor did it make sense of the amount of pain I had in my back. I had a spot on my right side below my ribs and above my hip that was excruciating. There were several things that made it worse. First was the fact that I could be pain free and then suddenly without warning I didn’t know if I should sit or stand, laugh or cry. If you’ve ever walked barefoot through a dark room and stubbed you toes on the coffee table that isn’t there during daylight hours you sort of, kind of relate to my situation. One minute you’re whistling the next minute your saying words you had no idea were in your vocabulary. Sit? Stand? Laugh? Cry? Feel my pain yet. This same spot on my back limited the time I could sit at the kitchen table, sit at my computer or sit pretty much anywhere. It also limited the time I could stand at the kitchen table; stand at my computer; stand pretty much anywhere.  The pain of getting in and out of cars was greatly surpassed by the pain of riding in a car. Every dip, rumble, pot hole, manhole or patch in the road provided me with more pain and discomfort than I ever imagined having. I always felt bad for Ann as I knew she was trying to avoid the road hazards that caused such discomfort but her chances of doing that were equal with her chances of hitting the Irish Sweepstakes. To be more relevant I should say Power Ball or Mega Millions. I believe this pain was nerve related, generated by a combination of the cervical fractures I had in my spine and the tumors growing there.

My oncologist sent me to a pain doctor better known as a palliative care physician. I had originally spoken with others from the same practice in the hospital but this was serious stuff now. Quality-of-life they call it. The theory goes that one heals better when they are not in pain.  I whole heartedly subscribe to that theory, even more so now that I look back on it through a clear, pain free mind. In the moment everyone seemed more concern about my pain level than anything else.

“Daniel, how would you rate your pain?” Do you mean right now or when I can’t stand, sit or see straight because it feels like someone is using my back for a dart board or worse yet rattan cane practice. “Zero means you have no pain and ten means well let me just say; do you have a living will and medical power of attorney papers with you?” The more I was asked this question the more obstinate I became in answering it. I became so irritated with the question I refused to provide a straight answer to it no matter who asked. I never said I had pain greater than four (4) only because at some point in a hospital hallway while I was lying on my back, yes, yes, yes in severe pain, I looked up and there on the wall was a poster asking, “What is your pain level today?”



I could relate to the dark green face on the left and to the light green face labeled 1-3. Yellow moderate even made some sense. From there on I struggled. What If I said my pain today was 10 and tomorrow it was worse. Where do I go then? Does that invalidate all my other pain ratings. Can I be charged with “Pain Fraud” or perjury by my palliative care physicians when that happens? Oh, the pain of it all! God have mercy! Cancer sucks!

I hesitate to tell anyone how much pain I have for several reasons. First I think Gibbs has a rule saying to share that information is a sign of weakness. Secondly, as soon as you say you have pain someone with more college loans than you or I have wants to give you a pill to ease the pain. Not make you better but make the pain go away. For me most if not all of those narcotics provide me with my very own version of Nightmare on Elm Street. Sleep, which is brought on and lengthened by those magic pills, unleashes ugly, flesh-eating monsters that always chase and catch me in the dreams I can’t wake up from. I’d rather have the pain. Pain and prayer.

Taking this all in my palliative doctor prescribes a mild pill, an opioid that lasts for 4-hours. The four hour time frame described was right on. I’d take the pill. Forty-five minutes later I could feel it working as the pain rapidly subsided. I was the pan free for two hours and forty-five minutes until I could feel the effects of the magic pill wear off. What I learned through this process is that there is truth in advertising. The TV and magazine ads say take our product if you are taking opioids as the will make you constipated. This is the truest thing I’ve ever heard on a TV commercial. The price of each hour an opioid relives your pain is equal to one full day of being full. Bowels shut down. Close up shop. Leave town. Go on vacation. Whatever, they cease to work. So the algebraic equation goes like this:

excruciating pain + opioid = excruciating pain relief + pain and discomfort of another kind

Needless to say I only used the opioids for about two weeks. They tried to counter the opioids damage by giving me one that was milder over a longer period of time. I still couldn’t say how bad my pain was because I made pain a relative thing in my life. I simply refused to accept it. When I hurt badly, I thought of something else. When pain came knocking at my door I refused to answer it. When it showed up in my in-box I redirected it to Trash. Doctors and nurses had a difficult time excepting or believing that but that is exactly what I did. Other than Tylenol I didn’t take any pain medication after Ground Hog day.  I told anyone who asked that I really could not say what my worst pain was as I had yet to experience it. Four was my apex, my zenith on the pain scale.

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