I’ve had a lot of people sound scared or intimidated by the amount of medication that I’m on lately, and who’ve actively shamed me for what I take. People have been sceptical about the good that it does (suggesting acupuncture, homeopathy, aromatherapy, etc instead) and generally insinuating that I’m just being weak in needing to medicate my pain away.
Firstly, getting pain under control isn’t just a matter of comfort or preference. Pain causes real, physical damage. Pain causes spasms, which can rip connective tissue, snap bones, crush nerves and blood vessels and result in damage that takes weeks to heal. Pain causes insomnia, which reduces concentration, increases blood pressure and cortisol levels, and results in heart problems and digestive issues. Pain causes nerve damage and long-term chemical changes in the brain, meaning that harmless stimuli like gentle touching or the movement of fabric on skin can be processed as harmful, causing more pain. Pain shortens lives. Pain is bad.
Secondly, I coud write a whole post about pain levels and types, and I probably will do that either later today or later this week. Suffice to say, if someone says they’re in pain, just believe them.
Apropos of all this, I was taking photos of pills and their packaging for my sister today, since she’s doing an art project involving them, and that’s left me with photos of the packaging that my medication comes in. So I thought I’d use that as a stepping-off point for a post about what I take and why I take it.
This is a month’s worth of medication, with an average day laid out on and around the notebook in the corner;
Yes, it’s blurry. Sorry about that, but it does illustrate pretty well that I have shaky hands at the moment, caused by the damage to my right arm after yesterday’s debacle.
Top to bottom, we have;
Paracetamol 500mg: Two boxes of a hundred pills each. Up to eight a day PRN. The familiar painkiller and anti-inflammatory, available over-the-counter but since I get free prescriptions I get it prescribed. I hate it, it makes me gip when I take it, and it unsettles my stomach. On the other hand, it deals well with opiate-induced headaches really well. I avoid taking it as much as I can. Prescribed by Dr A earlier this year to replace the Naproxen, even though the Naproxen has less side effects and helps more. I’ve obviously kept taking the Naproxen.
Naproxen 500mg: Two boxes of twenty-eight pills each. One every morning and one every evening, allegedly with food but usually with a soy shake. A non-steroidal anti-inflammatory, and basically Ibuprofen’s bigger sibling. Slightly less powerful than Diclofenac, but I find that it has very few side effects other than slightly burning the back of my throat if I take non-coated versions of the pills (I prefer the bright yellow Aurobindo ones, for ease-of-swallowing). All NSAIDS have the potential to damage the stomach lining and put stress on the kidneys, but I find that I barely know that I’m taking Naproxen, until I stop. And then I’m really, really sore all over. First prescribed by Dr A, along with Codeine Phosphate, last March (2013), before I was even diagnosed.
Laxido: Four boxes of thirty sachets each, up to eight sachets a day PRN. I try not to need this more than one a week. Laxido is a laxative which works by binding water to macrogol, a sugar which can’t be absorbed through the gut wall. This results in a lot of water being directed into the intestine, rehydrating the faeces and making it softer and easier to pass. It deals nicely with both constipation and full-on faecal impaction, but it also causes horrible gut cramps and makes me feel like a walrus. It also takes a day or so to work, and then suddenly works really immediately, meaning that after starting a course of it I have to basically stay at home and near a toilet. Mixing eight sachets into a litre and a half of a strongly-flavoured fizzy drink or juice, and then sipping it all day is my preferred method of intake. You really need to take a lot of fluids with it, since it’s a very dehydrating stuff. Prescribed by the very sympathetic Dr D in January, at the walk-in clinic.
MST Continus (Morphine Sulphate, slow release) 5mg: Two boxes of 60 tablets each. Two tablets, twice a day. My standard morphine which I always take, which acts as a background painkiller. I’ve not noticed any particular side effects from this, but then again I don’t have a car and thus my reaction speeds are never brought into question in dangerous situations. It does notably numb a lot of sensations though – Papercuts, mouth ulcers, stubbed toes and the like hardly register as pain nowadays. Prescribed by Dr B in January, after I started having skin reactions to either Buprenorphine, or the glue from the Buprenorphine patches. Dose doubled by Dr B last week.
Baclofen 10mg; One box of 86 tablets. Between one half and six tablets a day PRN. My new antispasmodic, which I got prescribed yesterday and am just trying today. So far, no ill effects, but no positive effects either, and I took it several hours ago. And I’ve heard horror stories about its prodome and withdrawal. I do feel rather sleepy though, so it could be that. More information to follow. Intended to replace the Diazepam, but currently it looks like I’m going to phone back Dr H and tell her that I don’t like it. Prescribed by Dr H on Tuesday.
Oramorph (Morphine Suplhate) 10mg/5ml, 300ml bottle. 10-30mg per dose, up to 4 times a day PRN (Yes, I could really use being given more morphine, so that I’m not having to ration it out at the end of the month). I use Oramorph about two days in three, usually only 10mg per day, going up to around 100mg in crisis, and it is my most reliable go-to painkiller. At 10mg, it gently kills pain, at 20mg, it almost completely removes both the pain and the fear associated with it for up to three hours. I honestly do think that half of the effectiveness of opiates is in their ability to relax and soothe the person taking them – No longer fearing your own pain will go a long way towards making it manageable, and that physical relaxation promotes sleep and good-quality rest, which also help to heal whatever was causing the pain in the first place. It also acts as an antispasmodic (Again, it relaxes the person taking it, meaning that muscles in spasm will often relax out of spasm), allowing dislocated joints to be reset with a minimum of force and trauma. It is also relatively quick-acting – The first effects are noticeable within about five minutes (Hence the mantra central to my crises; “Take this, and count to three hundred.”) and it gradually gets stronger over the period of around the first hour. At the lower doses, if the pain is caught early enough, I’m able to continue working/studying/attending lectures/being out and about, and basically nobody can tell that I’ve taken it. At the highest doses, I’m best off if allowed to curl up in a pile of soft sheepskins and pillows and listen to either gentle classical music or meaningless conversation. At high doses, I’ll also feel quite vulnerable and emotionally receptive, so if someone else is present I might want to either tell them how wonderful they are, or hold their hand. The need for physical contact does dovetail neatly with the fact that being this relaxed is also the best and most efficient time to have anything that hurts or cramps massaged out (safer for me, as there’s less chance of something being pushed into spasm, easier for the person giving the massage since they’re not trying to knead rocks), so a back massage will kill two birds with one stone. The day after a heavy dose of Oramorph, I’m often a little bit languid, a bit light-sensitive, and a bit prone to getting emotional, but that fades pretty quickly, and at least for that day I’m usually not in pain either. Prescribe by Dr A last October (2013), after Tramadol and Codeine Phosphate had failed to get my pain under control.
Diazepam 2mg. One box of 28 tablets. 1-2 tablets per day, PRN. I use this as little as I can (I’ve had about six tablets in the past two weeks), since it’s not available on repeat prescription so I can’t guarantee always having more of it. It’s an extremely good antispasmodic, but works in a kind of scatter-gun fashion; I’m not just relaxed, I’m positively fluid, suggestible, and frankly would be an uncontrollable idiot if I had any energy, which thankfully I never have when I’ve taken it. It’s a drug of last resort, at least for me, but it is always extremely effective. I spend the next day or so lying in bed and sleeping heavily, and by time I wake up whatever was in spasm has relaxed. Prescribed by Dr S at an out-call to my house last month.
Lansoprazole 30mg. One box of 30 tablets. Once per day. This is a protein pump inhibitor intended to make my stomach lining suffer less from the action of the NSAIDS. Unfortunately, it also makes me violently travel sick, even more so than I usually am. Other than that, I barely know that I’m taking it. Prescribed by Dr A earlier this year, and I really had to fight for it, since she wanted to take my Naproxen off me and not replace it at all.
Fultium D3 (Colecalciferol UI 800). One box of 30 tiny blue jellies. Once per day. These are the prettiest pills I have, and are a three-month course intended to increase my Vitamin D levels, since I’m badly deficient. They actually seem to be doing their job really well, since I have more energy now, but we’ll see if that’s all just the placebo effect once I’ve had another blood test taken after the course has finished. Prescribed by Dr F, after having been suggested by Dr S at a call-out to my house.
…And that’s the lot. Well, plus Pro Plus most days, Nytol a few times a month, daily multivitamins with iron, calcium supplements and the odd glycerin suppository. It’s not actually all that much.