Oh wow. That's quite a life-story. I should remember things like this when I find myself giving in to the temptation to feel sorry for myself and think like a victim.
This is also one of the reason why the Federal Government's morally bankrupt prohibition on medical marijuana really pisses me off. There are people who experience very substantial pain-relief from using cannabis, and this relief restores functionality and quality of life with minimal side-effects to an amazing extent for these people. But these individuals are deprived of their medicine because of some other people's dogma, and because Big Pharma doesn't want people getting relief from a plant so easy to grow that even Loveandlight can do it without fucking it up. (Disclaimer for Big Brother who more likely than not is watching: That was a long, long time ago.)
On the same note, the Federal Government has been known to harass and persecute physicians who in their estimation are too generous is prescribing opioid pain medications to patients dealing with chronic pain. The result is that a lot of people have to live pain they shouldn't have to live with because of this reactionary zealotry.
Have we always been such a nation of utter ignorami? 
You know what, Loveandlight, I don't believe that about the first substance you mention.
It may work as "supporting" medication, to quote Jesse (NOT that Jesse was referring to the same substance you are, Loveandlight, when he used that phrase). But an actual pain reliever? Only for the mildest of pain, at best. I mean, it just doesn't work that way.
Everything else -- including the government being morally bankrupt on the whole issue -- I agree with. I just don't agree that it is a direct reliever of real pain. And you're completely right about the danger some of these pain management specialists are in from prosecution. It's awful, our government's policies on drugs, just awful.
But, that's what you get when you criminalize health issues. Addicts? Lock those evil junkies up! Unless they're the president's niece.
That's not to say there aren't issues of abuse that need to be dealt with were things to be made legal. There was actually a big piece on the situation in California over on CBS.
But, the government policies are just psychotic about this stuff. All the illegal things? Ohhh -- tools of the Devil! Beer, wine and hard liquor? To paraphrase Jon Stewart, it's magically delicious!
In a way, it's flip sides of the same attitude. Instead of seeing these chemicals and what they do to people as they really are -- judgements on health, not morality -- the government and I think the vast majority of the people in this country choose to treat these things like they're magic or something. And they're not. They're chemicals which can be damaging to one's health and need to be treated with the respect that they deserve. Acting like getting smashed on booze at the end of a hard week is fine -- like that's any kind of indicated use, good God, it's practically the definition of contraindication -- but trying to alleviate nausea from chemo is legally wrong illustrates just how insane we've let our government get.
wow that is like the longest one yet... whew.
Brian Bell:
Well, medical marijuana wouldn't be appropriate, I don't think, for the sort of thing Jesse is coping with, but I have read anecdotes about how it has brought relief for people experiencing pain from some condition or other that they have to live with.
Somewhat off-topic: No wonder this country is so ignorant and fucked up.
And damned if there isn't a human-interest news story on the CNN website about managing chronic pain.
Washington State? Pain Control?
I was expecting sneaky medicinal marijuana story. Seriously. Of course you being a Dr and all, you'll blow that one off.
Brian Bell - try living with chronic inflammation. God given pain,, none of this "I fucked myself up doing something stupid" pain.
Therapeutic marijuana is a fact. No medication is 100% effective for all patients. For some it just doesn't work, for others the side effects are worse than any gained benefit.
Celebrex "heart death"
Enbrel "lymphoma or death"
Pot "munchies"
And let's not talk about anal seepage.
And let's not talk about anal seepage.
Yeah, I really don't feel like talking about Dick Cheney right now, either. 
doc, mad props on a well written article.
i struggled long years (pretty much since taking an AK round in the hip in '69) with chronic pain and the resulting dance with trying to navigate the shoals of the "i can handle the pain, or i can handle my life" choices which are so often the only, mutually exclusive zero sum choices presented to those in chronic pain.
i got very lucky 14 years ago. i, by sheer blind luck, was treated, while detoxing from my heroin habit again, by an MD who had dual speciality. pain management/substance abuse. i will be forever grateful to this fine physician for treating the entire mess that was my life. i could not function without some kind of medical intervention, because untreated, the only thing i could think about was how badly i hurt at that moment. just like you discovered, if i took the various drugs offered, the essential core of my self was the casualty. more than one doctor got told straight out that "if you won't treat my pain, paco will."
as long as we have the DEA and the justice department interfering in medical treatment we will have this mess.
right now i am on a multifaceted approach which keeps my pain, for the most part (there are still some days that simply suck out loud), within manageable parameters. sometimes i need to haul out the big guns, most days not.
my own personal theory is that there really isn't any such thing as a pain killer. most of the drugs out there are merely pain postponers
sooner or later, ya gotta feel that shit.
Loveandlight easy answer...YES. in fact we as a nation are a lot less screwed up right now then in the recent past (thats a very scary thaught)
OT: what the hell is with the charts...white, non-hispanic, black non-hispanic...jesus, where is my white nonitalian, white nonanglosaxon, white nonceltic catagories.....these charts are just more examples of the explosion of subtle racism in this country.
And BTW marijuana prohibition shouldn't be trivialized for a lot of reasons, but this is my current and long time favorite
A watershed moment for the power elite in this country came when people accepted routine drug screening as a condition of employment. As a litmus test it demonstrated using "people with nothing to hide have nothing to worry about" was an effective strategy for accumulating power.
So I guess Iraq is really the fault of that damn subway train engineer who wiped out and put the fear into everybody.
So I guess Iraq is really the fault of that damn subway train engineer who wiped out and put the fear into everybody.
I remember hearing about that. What I heard is that he turned off the alarm that signified trouble because he didn't want to be bothered by it. That guy's problem was more his personality than it was marijuana.
TLG -
Oh hell no. We've had longer posts. Trust me. *smiles sweetly*
minstrel -
Yeah, it's not even the pain itself or the living with it. It's the annihilation of the Self.
No shit, I literally did not know I wasn't me from roughly 2002-2006. I thought I was just a wrong, bad person who was doing wrong & bad things (through 2005ish). That I'd somehow become evil. It never even crossed my mind once that all of this could be a function of medication issues throwing me back to being, more or less, a teenager in a man's body. But as soon as we changed the meds, all of a sudden who I was...*poof*...was different. I no longer had the same interests, wants, desires, concerns, interests. The internal conversation I had with myself (that voice in one's head) was different. Everything changed. It was the fucking meds.
And I thought it had been me who was just wrong.
Once the possibility of it being a medication issue even occurred, that is, once I figured out that might be going on and brought it up with my therapist, then we started checking it out, looking at past specific dates of specific incidents, comparing them against specific drug prescriptions, the whole thing just unfolded. After which is was a question of lowering dosages, and the more we did, the clearer I became, the more I returned to myself.
I wept, as I became I again. It isn't as if I feel guilt. How can I? (Though I have to watch it because some of what happened during those years very much tends to throw me towards being guilt.) But there simply was no "I" there during those years who was "me"! Who was in my body was a biological-pharmacological-historical construct using my body and early childhood/teenage emotional sexual & relationship memories and triggers as its personal fucking playground. Identity and "self" are very tricky concepts. Literally for four years, there was nobody home in my body. Or to the extent there was, it wasn't who I, my mother, and my children know as me.
In addition, my physical pain is now manged most days. This is what comes from working with a first-rate pain management physician.
Jesse:
MANY thanks for your post. I was routed to pain management back in 1999. It took about a year to get everything figured out (my tailbone is 90 degrees to the rest of me, and had accumulated scar tissue that was like "concrete." Try sitting on that for days). Throw in a slight curve in my lower spine, and I'm arthritic a-go-go. Even the pain management doc said "eeeeeuuu!" when he saw my spinal x-rays.
While I can't bike, I can get on the NOrdic Track Ski machine. ANd yeah, I've been on a combination of opiiods and anti-inflammatories ever since.
My personality changed quite a bit. I'm not NEARLY as anxious. Seems I was born with the spinal curve--which has left me with chronic pain my entire life (until diagnosis). The snapped tailbone was the proverbial icing on the pain cake. However, with the pain under control, no anxiety, and I'm a much nicer person.
But it took a while to the dosage right.
I don't drink, I try to exercise, and I'm diligent about my drug schedule (what dosage to take when). I quickly learned that if didn't manage the damned pain, it managed my life in ways I didn't like. So, pain is like diabetes, in my book. Can be deadly and is always insidious.
Again, thanks for the post--it was very brave.
brat -
I'm happy for you. *smiles* Thank you for your story.
Watch out for the feds. My late husband died because of them.
http://www.drug-rehabs.org/con.p...2&
state=Montana
DEA Raid on Billings Doctor Brings Pain Wars to Montana
Montana - The Drug Enforcement Administration's (DEA) war without quarter against what it sees as corrupt, pill-dealing physicians who are fueling a crisis in prescription drug abuse came to Montana last month. But with the raid on Billings physician Dr. Richard A. Nelson, who has been treating patients with opioids for chronic pain from cancer, arthritis, and other conditions, that all-too-familiar narrative has been challenged. An uproar that has yet to die down has gotten the attention of local media and at least one US senator as patients complain bitterly of being left in the lurch and national pain advocates arrived to press for justice for Dr. Nelson and his patients alike.
The DEA's War on Pain Doctors
Some in the medical community call it “a war on pain doctors,” or “state-sponsored terrorism.” However you describe the current campaign, Frank Owen writes, the DEA’s hardball tactics have scared physicians nationwide to the extent that legitimate pain sufferers now find it increasingly difficult to get the medicine they need.
http://www.villagevoice.com/
news...en,48381,1.html
Jesse:
Thanks. It was a scary time back in 1999. The original doc, an orthopedic surgeon, had suggested permanent disability, which scared the hell out of me. I was only 36 at the time and found that prospect intolerable. But for what is "wrong" with my spine, there is no surgical fix.
So, I was quickly compliant with the pain management doc, particularly about documenting what worked and what didn't. I've never NOT worked (since age 15), so was delighted that I could remain employed.
The hardest thing to let go of was the fantasy that the pain would vanish. Once I got over that big hurdle, I could really focus on management. It's why I think the diabetes analogy works for me. The chronic pain will always be there, but it ebbs and flows depending on stress, lack of physical activity, too much of the "wrong kind" of physical activity, etc. But how and to what extent it shapes my life is largely up to me.
I really have a certain amount of antipathy towards US Pharma. Case in point: I'm on a low dose of Ultram, and have been since 1999. It works REALLY well for me. But originally, Ultram didn't have an ER version, which meant a pill every six hours, around the clock. I hated it, but I had to get up at 4 AM to take a dosage. Now, the company that makes Ultram could have made an ER version back in 1999, but it waited until the regular Ultram went off patent to market the ER version.
Basically, to help their bottom line, I had 8 years of interrupted sleep. I was placed on Ultram ER as soon as it became available. Biggest difference, besides no 4 AM pill? I don't have the spikes in pain every six hours to remind me I need a pill. But this medication could have been available back in 1999. Grrrr.
Excellent excellent post, thank you for being so candid. At some point, you might think about posting up some suggested resources re: pain management.
I have a lot of pain clients and it is very frustrating trying to find resources to plug them into. There's a guy who comes to see me , former Navy S.E.A.L. who has come in to see me waving a gun and ranting, weeping, redfaced and yelling, and we get on the phone and start trying to get some help. He's been thrown out of pain clinics and threatened with lawsuits if he comes back, he's been tossed in the slammer -- the whole 9 yards. He's not that difficult to deal with either. The wild-man stuff just spooks people. But yes, this is someone who is in PAIN.
I do various kinds of bodywork, exercise and acupuncture -- have had some success with holistic stuff, but don't kid myself as to what I can do and what I can't. And yes, a real live working pain management from the medical end is vital.
I've sent guys to docs who've "lectured them about their addiction to pain meds" until they cried. Stuff that just makes you shake your head and wonder where the sane people are.
Just like in the real world.
However you describe the current campaign, Frank Owen writes, the DEA’s hardball tactics have scared physicians nationwide to the extent that legitimate pain sufferers now find it increasingly difficult to get the medicine they need.
Am I the only who suspects that a lot of this sort of thing is being driven by religious zealotry? It seems like every day I can't help but have a little more insight into why so many of my fellow progressives are militant atheists. Fortunately the Spirit of universal love Who has saved my sorry bacon more than once does not inspire to be a "Jerk for Jesus".
dreaminginthedeepsouth:
If it weren't for the fact that I don't gamble as a matter of principle, I'd be willing to bet that your Navy SEAL friend has had docs tell him that his pain will go away if he "accepts Jesus" and prays about it. That same kind of thing was what made me run screaming from orthodox New Age theology.
For my own experience, not nearly as bad as some, see:
http://www.nipissingu.ca/departm...rs-pay-
heed.htm
I believe that some kinds of back pain can be alleviated without drugs. I've had results with yoga and Pete Egoscue's book Pain Free at Your PC. It's worth a try. Nothing to put you in legal jeopardy, either.
sm;
The Egoscue stuff is quite helpful. It's not the holy grail, but it's helpful -- really across the boards. In my experience ANYONE can do the exercises, even 90 year olds in pain. It's worth a look. I do some work with that technique 1 on 1 and it does work, maybe not as a quick fix, but over time.
Loveandlight:
Fundamentalisms and Orthodoxies of all sorts love to lay the sinner-man or what-thought-did-you-have-that-caused-this.
on people. It'd be nice if it helped.
Unfortunately, that sort of blame and evaluative commentary tends to cause a wild-animal reaction that sends people damn near 'round the bend. It doesn't matter if it's the local groovy mega-church, the fundies, the Scientologists, or the Quakers. Sometimes real healing begins with atheism.
I think it's best to be very practical and nuts-and-boltsy with people re:pain. Offering a sermon as a way out of pain is just deeply insulting. I don't have the answers, but have found that adopting an attitude of Doctor Watson and Sherlock Holmes and listening carefully to what someone is saying helps to go look for resources that will be helpful. I wish I had more docs around here who were helpful in this regard. A lot of them are frightened of getting censured for "creating addicts" or somesuch.
*aside*
File under "O My God":
"Raytheon unveiled Silent Guardian, a
device that radiates unbearable pain. "You don't have time to think about it," said an executive. "You just run." The ray gun, Raytheon promised, will not be sold to countries
with questionable human rights records, although it will be used by the United States in Iraq."
(from Harpers)
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