A chronic pain in the.............

Another day, another posting. That is three days in a row. My surprise appointment with the Pain Management Clinic happened today. The doctor's opinion was to keep doing what I am since it has the pain under control. I asked him if he could think of any options other than morphine. He said that there are some but that he would not prescribe them to someone with Hep C. His feeling is that I should keep taking what I am and then when I finish my treatment we'll reassess my treatment then. Who knows, if the treatment works I'll have more options.

He mentioned medical marijuana (it is legal here). I told him that a few other doctors including two neurologist had mentioned it to me. They all say that it is supposed to be good for neuropathic pain. I told him what I told them. The morphine I take is a low enough dose that I don't get a buzz from it. Anytime I smoke pot I get baked and I don't want to feel that way. Not only because I am a recovering addict, but also because I can function taking the low dose of morphine. If I smoke pot I'll curl up into a ball and be too paranoid to leave my apartment. Other doctors have told me that if you eat it you don't get stoned, but friends of mine who use have said that they get more stoned if they eat it than if they smoke it. I'll believe them.

So I will stay the course until I finish my Hep C treatment. I was a little pissed when he looked over the referral that was sent by my doctor and revealed why I was referred. My doctor wanted him to asses if I was abusing narcotics. Trust me, I have abused drugs. I have wasted them, battered them and spit them out. My relationship with morphine is not abusive.

When I first moved to Toronto and hooked up with this doctor, he was upset that a doctor had prescribed morphine to me. It threw me a bit because I had never heard one doctor criticize another doctor's decision. I find that they are very good at protecting their own. I explained to him that it was not like the doctor just threw the drugs at me. It was a year of trying everything. Several drugs that are used for neuropathic pain were tried. Finally I got a little relief with Lyrica but the pain although a little diminished was still unbearable. The doctor contacted my Hepatologist to see if we could increase the Lyrica (I was at the maximum recommended dose), but he said that he couldn't give his approval because of my Hep C. So our only other option was to introduce pain killers. After going two weeks with no sleep, because of the pain, I finally got some sleep when we introduced morphine. I told my doctor that in all fairness he was not there when I went these two weeks without sleep so how could he question the decision of the doctor who was there? No answer. So to hear that he just wanted assurance that I was not abusing narcotics (and here I thought he was worried about my chronic pain) upset me a little. For the record the pain specialist told me that he was telling my doc that I am not abusing drugs.

I did learn something new. My doctor (the referring one) has told me that morphine doesn't work for neuropathic pain. I have proof though that it is working for me. Twice, I had a day when my pain came back big time. Both times I was a little freaked out thinking that the neuropathic pain was back. "Oh no, don't tell me that the morphine stopped working" was my thought. Then when I took my evening pills I discovered that I forgot to take my morning pills. Both times. So I knew that it definitely was working for me. I ask the pain specialist about that today. He explained that the Lyrica helps with the prickling pain but doesn't do much for the burning pain. The morphine is good for that. That is why I need the two together. So I have my answer. I am not nuts.

This was not the first time that I have felt like I was judged by a doctor because I was honest about being a recovering addict. I feel that it is important not to lie, or hold back information from doctors. I want to be totally honest with all doctors so they'll have the complete pictures. I feel that this has in the past kind of come back and bit me. I have felt an immediate withdrawal once I have mentioned it. The doctor will be warm and friendly and as soon as I say that I am a recovering addict there can be a physical distancing between us. If I am having a procedure done and I am in pain I sometimes feel that I am denied pain relief because there is an assumption that I am fishing for drugs. Please! Having a coloscopy done to get some narcotics is a bit extreme.

So I was feeling a little burned when I left the pain clinic today. If I was a closeted addict, or recovering addict, most of these doctors would treat me totally normal. Like they should. By addressing my problem and getting treatment I get a label and treated differently. No good deed goes unpunished. Isn't that what they say? As I said, I believe in being totally honest with medical practitioners but honesty comes with a price. Lying or withholding information can seem like the answer. Ignorance is bliss. Another saying. I do want doctors to know that I am recovering addict. I want them to be aware of it when it comes to prescribing anything addictive, but shouldn't they be cautious with everyone? Lots of people who do not identified as addicts, are. I don't like becoming a pariah because I was honest.

Regardless of why I was referred to the pain clinic, I am glad that I was. I now have my foot in the door, and I will see what options are available when I am finished treatment. Perhaps I'll get through an appointment with the referring doctor without a lecture on why I shouldn't be taking morphine. I've known for two years now that I am not abusing morphine. I think that fact that I have been on the same dose for so long says that I'm not trying to get high. There are small 5mg pills that are prescribed for breakthrough pain. I think the fact that 30 of them will last me several months shows that I am only using them when absolutely necessary. Since he is the prescribing doctor, he should be well aware of that.

So has this paranoia about me using pain killers come because I am honest about being a recovering addict. We can be painted with a broad stroke. Aren't we all not to be trusted? Aren't we all thieves (if anything goes missing immediately look at us)? This broad painting goes beyond the medical system, but I perhaps foolishly expect them to be more knowledgeable. Call me naive, but I don't like to feel punished for honesty. Those I know who are not addicts question this phenomenon. Am I just paranoid? Could I just be making this up. Perhaps in this case, but I have seen a close relationship go south as soon as I came out so to speak. I have seen a doctor who was warm and friendly suddenly become cold and distant when told. I don't know how to end this post. Situations like this will continue to arise. I refuse to be dishonest or withhold information. That is not the kind of person I am. As much as I hate getting whacked on the knuckles for telling the truth, I will continue. There are several medical practitioners who are knowledgeable and treat me well. The few stand out because of how bad judgment feels but I refuse to let them change me. So to this day and in the future I will remain a no need to ask I will tell you, recovering addict.

Until next time,

David McHep C