Fentanyl: Dealing with Chronic Pain
Updated: Sep 27, 2019
Many of you know that I suffer from chronic pain due to many injuries and illnesses. I have been managing pain for more than 40 years and, unfortunately, in the last stage of treatment options. I remember clearly when my last pain doctor threw up his hands and said there was nothing else to be done. I left his office and tried working with a doctor who had a time consuming and expensive approach that failed to manage my pain for more than a few days. But it was his referral that led me to a doctor that understood the different causes of pain and the different types of treatment. What makes him a great doctor--and I have found this to be a common trait in the best docs --is that he is curious. His desire to understand and fix a body that is uniquely broken helped him create a treatment plan that allows me to live a somewhat normal life.
He assembled my current plan which is a combination of a Fentanyl patch and a unique physical therapy program developed by a Colorado doctor to treat stress-related pain. Through this program my doctors have learned how much of my sympathetic nervous system is damaged, to uncover an undiagnosed traumatic brain injury and to dig deeper into how each of my illnesses might play a role in creating pain. For example, I am having increasing problems with headaches. My neurologist leaped to migraines since I’ve had then before. But my pain doctor saw the area where the headaches were focusing and subscribe traction (not a favorite approach) but we will see how it works.
Deciding to take Fentanyl was not an easy decision. I have taken every pain medication such as Percocet, but it has been a long while since any of these medications had any effect. My approach had long been to work through the pain. But having gotten to a point where I was bedridden and not wanting to live made me give this protocol a try.
As my pain has been under control for quite some time using this therapy, I began to wonder whether I still had such a strong pain problem. And thus, I was not paying as close attention to my medication as I should. I ended up running out of patches and not being aware that I was walking around without one for several days. When I figured out what was going on I hurriedly went to get a refill and was reminded again how much this drug is managed. I could not get my normal amount because suddenly my doctor needed to sign a form from our insurer and his office was closed for the day. I could feel the pain beginning to take hold of my body and told my pharmacist to get me whatever amount he could. So, I paid the normal amount for half the number of patches (god forbid that Mylan not make their money).
Unfortunately too much time had passed and even though I had the patch on I went through a full-on pain episode that lasted for two days (you know the kind where they ask you to name your pain number and you are at a 10+). It was the first time I understood how a person could add another patch just to try to reduce the pain and end up in an overdose. This is what happened to Prince. I was alone as my husband who does a good job of monitoring my Fentanyl was out of town. (He couldn’t reach me once the pain cycle began.) It was a bad situation.
After I began to return to normal, I thought about whether I was addicted to the patch. I don’t think I am, but I now know that I can’t handle the real pain any longer. I had become used to having a certain level of pain all the time but now my mind and body is used to a low level of pain. To go back to any higher level would have such a negative effect on my life that I’m not sure how I could tolerate it. So, I worry not about addiction, but that because of the opioid epidemic I could lose access to my Fentanyl or that the manufacturer would increase the price so much that it could be unaffordable. I do feel strongly that this type of pain reliever should only be given to those of us that are disabled with pain. And I do feel that people have to learn to tolerate a certain amount of pain, so they don’t get started down this path too early. And I believe that anyone that is on a pain management protocol should also be seeing some type of mental health professional who can watch for signs of addiction and help with the emotional issues that generally accompany chronic pain.
We are clearly not dealing with this issue from a macro level which is necessary if we are going to achieve real results. And that’s why we need to have a comprehensive public health care system. The piecemeal approach where drug manufacturers and insurers are in control will not stop our growing number of health care crises. And we can’t continue forcing people to stay in jobs where they are over-worked, under-payed with no path to a better opportunity just to get mediocre health care benefits.
As for me, I’ll continue to pray that no one takes away my Fentanyl patch. And I hope that doesn’t make me an addict.