In the darkness the trees are full of starlight (henwy) wrote,
In the darkness the trees are full of starlight

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Hello Darkness, my old friend

Things have not been hunky dorey lately. Right around the time that I stopped updating the live journal I ran headfirst into a pain relapse which has stretched on and on. It's always hard to judge, but I would say that this is probably the worst run I've had so far and it caused a lot of problems. First and foremost, it caused a huge run on my stockpile of pills. Ever since the early days when I first started having problems, I've always tried to hoard opiates whenever I managed to run across them. It's no wonder considering that I often had doctors who were very reluctant to prescribe anything. I still remember telling one about the pain issues and having her write me a 'script for horse pills of ibuprofen. Considering I was already downing around a handful of those a day on my own, I was less than impressed with her treatment regimen. Still, back then it was possible to eek out a dollop of Tylenol-3 here or a dash of small perc'ies there. To make sure that I would have enough in a pinch and for the end times, I tried to hoard whatever I could.

That continued even after I managed to get a steady supply and if I wasn't completely miserly about it, I still tried to save whenever possible. I certainly never took more pills if I wasn't currently in pain, unless it was a preventative situation where I knew I would have to actually leave the house or needed to be sure I was able to function. Each pill saved was a pill earned and went into the stash. It was a lucky thing I had my nest egg too, since the equivalent of the market crash hit several months ago. In addition to just a worsening of the pain situation I also ran into a drug reformulation problem.

It's a well-known fact that there are many, many crackheads out there who take oxycontin to get high. It's no wonder that it's known as hillbilly heroin and that, for a time, people would rob and shoot pharmacists to get their fix. To mute the outrage of anti-drug crusaders, the company which makes oxycontin undertook a reformulation of the drug which would make it harder to abuse. In the past, all a crackhead would need to do is to crush the pills with a spoon, mix it in water, and inject it into their vein of choice. What the reformulation did was make it so that the pills are harder to crush and turn into a viscous gel when placed in water instead of dissolving. While this made life harder for addicts, it also had a side-effect in reducing the effective dose of the drug. It no longer acted as fast, nor as well, though supposedly it would last a bit longer than it used to. I started having pain issues where my pills no longer seemed to work as well as they used to right around the time of the reformulation. I just assumed it was a down cycle in the normal ups and downs of my situation, and it never occurred to me that the changes in the drug itself might be contributing to the problem. That is, until my sister the pharmacist mentioned how all the local crackheads who visit her pharmacy for their fix were complaining about the new drugs and requesting the old ones left in stock. Unbeknownst to me, she had funneled as much of the old stuff as she had to me but eventually the supply ran dry and I was hit with the switchover too. That was when the stockpile came into play.

If you think about it, it's sort of like the parable of the grasshopper and the ant with the difference being if I had actually followed all my doctor's instructions about when to take my pills, I would have had none left over for the harsh winter ahead. I was able to keep things under check by popping pills from my stash during periods of breakthrough pain. It still wasn't a pleasant time by any means since I was still experiencing way more pain than normal, but at least it wasn't absolutely horrific. The problem I had was that my stash, no matter how big it seemed, was finite and I was bleeding through it at a terrible rate. Things weren't getting any better and it didn't seem like I could simply wait out a bad spell. The bad spell wasn't a spell; it had become the new normal. That meant that I had to get more drugs somehow. Of course, that's easier said than done.

I only have a doctor's appointment with the pain specialist once every 2 months and no doctor ever seems to want to pass out more opiates willy nilly for fear of creating another crackhead. That being the case, it took a couple of visits to convince him that something more was needed, and even then it was a half step. I had been taking 20mg of the oxycontin 3-times a day but now I also have a 10 mg supplement twice a day. That makes the total daily dose 80mg instead of 60mg, a 33% increase. Considering that I had already been popping the oxycodone I had like it was candy, it probably wasn't an effective dose increase as much as it was stopping or slowing the drain on what little I had left of the stash. Even as it stands now, pain is a constant issue multiple times a day and there's not much to do other than to try to grit through it. There are still stretches where everything is fine, but stormclouds now loom on a daily basis. I have no idea if tolerance or just a general deterioration in the pain situation is to more to blame but it's certain that things suck more than they used to. It's hard to know whether things will ever improve again or if this is the new normal. Considering that it's been at least 4-5 months now, chances are good it's the latter rather than the former.
Tags: chronic pain, drugs

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