Monday, January 5, 2009

Making Pain Go Away

Here's a word I never used in the before time -- titration. I knew its meaning, but it had no function in my pre-illness life. I didn't titrate how many eggs to put in a cheese omlette or how many gallons of gas I needed to make the drive from San Francisco to Mt. View. I just broke eggs and filled the tank.

For the past three weeks my attention has been riveted on titration. Determining how much to go up on which meds at what time intervals to get my pain back in control has been my mission. In the ole days, my mission might have included helping others. But pain makes its own decisions, and I become its loyal soldier. I follow where it leads, head down, tail tucked.

So I make an adjustment to the medication regimen and like a hawk scanning for prey, I scrutinize the meridians of my body for any evidence that this new combination of meds is reducing the ripples of pain. The outside world ceases to exist.

My pain specialist does guide me. But she also reminds me that pain is individual, and I just have to keep titrating until the cocktail works.

There's that word again. Titration. It has come to have a mythic quality about it.

I just want a recipe.

Richard, my voice of reason, reminds me that I will keep trying and I will get better - in a few days, maybe weeks - but not years, not like before. I try to hear him, but often I just can't. Pain is louder.

But I keep titrating. Two pills twice a day. Then three pills two times a day. Scan for a reduction in pain blips. No. OK then. Three pills three times a day. That's my limit. Not because I get impaired by side effects. Luckliy, I have none. But more meds than that and I cross some arbitrary line that exists only in my mind. The too-many-pills line.

Pain and I eventually come to an agreement. This level of medication for my life back.

I take the deal. Gratefully


Keith said...

I love this picture!

Being a 34+ year survivor of CRPS (Complex Regional Pain Syndrome), what used to be called RSD, as well as a few other chronic pain issues and other medical problems I feel like all I have done for many years is take pills. I think if they cut me open when I die they will see pills pour out instead of blood.

Life surely is different when you have a supportive partner. In dealing with this disease for so long, as well as helping others deal with it through our national organization (American RSDHope - ) we have seen the devastation chronic diseases can cause in families. It takes strong men and women to hang in there, be supportive, and understand that we are more than our disease and still have wonderful gifts inside of us :)

Peace, Keith Orsini

Anonymous said...

I just discovered your blog today and have enjoyed reading previous postings. This one especially struck a chord. This is what I do on a daily basis. Sometimes successfully and sometimes not. Some days are just a blur. I'll definitely be keeping up with your blog.

Barbara K. said...

Keith and Prof Sherlock - yup, sometimes it's hard to keep up with the pill schedule. Thanks for your thoughts

Annie said...

It is incredibly hard to find that balance. What I find even more challenging is when you find a balance that works only to have your body build a tolerance to it within a month or two. Argh!!

Sorry for the rant, I like your blog :)

Barbara K. said...

Thanks Annie. I empathize with having to shift med doses just when you think you've got it down.