Monday, November 19, 2007

Medicine Dance

A good number of friend (internet and face2face alike) have asked me what I will do when confronted with the vast array of painkillers and other medications that are part and parcel of having ortho and dental surgeries.

It's a very valid question and one that has faced many folks in recovery. I have personally seen many good folks go down to addiction when dealing with this issue and I've been close myself on more than one occaision. I've developed some coping skills of my own, some of it is very common recovery knowledge, some of it is just ways I've figured out for myself. Often I forget which is which and I don't feel like scrabbling through the AA Big Book or the NA Basic Text to get all the different citations, I'll just try to explain it the best way I can. I follow these rules when doing the medicine dance.

1. I deal with informed physicians.

One of the sad truths of my body is that over the years of my shooting, snorting, smoking and otherwise flooding my bloodstream with opiates is that my brain has developed more opiate receptor sites than would be found in somebody who was never addicted. None of those receptor sites know the difference between a drug that is ethically and legally prescribed and something I am using to get myself high. The body doesn't know. That's why everybody I work with in the process must be informed. Every dentist, every doctor needs to know, from my own mouth, that I am an alcoholic and addict in recovery.

One of the most common mistakes people who have gotten some recovery time together can make is to become complacent. To figure "Hey I've been sober now for a while, I don't have to tell every doctor I see about my personal life." Then, the doctor, being a doctor, uses the full range of medication available, the alcoholic who was so concerned about their "privacy" takes the medications, as prescribed, at first, and off we go again. Every doctor and every dentist I use knows, because I tell them in our first meeting that I am in recovery. It doesn't mean that in an instance where pain management is called for there are medications that aren't used, it just means that I have to exercise a higher degree of awareness and discipline when it is called for. We don't get extra brownie points for suffering.

I will only use them for legimate conditions.

I have had physicians take a look at the scars all over my body and surmise that if I tell them I'm having pain, it probably hurts pretty bad. My left leg has long, surgical and other scars running all up and down its length. All the way around. That shit looks like it hurts even when it doesn't hurt at all. When I tell a doctor that I'm in pain I have to be explicit about the where and the severity of the pain. Before I sobered up I was a master at hitting docs up for bottles of pills. I at one point had five different docs prescribing me 80 double strength vicodin a week. There were times when that wasn't enough. Another round of office visits or phone calls would usually get the percs and other stuff flowing. And, of course, there was always the black market. I had to quit acting like that in recovery. No more making such a pest of myself that the doctor would write a "get the fuck out of my office" prescription in self defense. Opiates work pretty well on emotional pain too, it is on me to be honest with myself first about the pain that I'm in and then carry that honesty through with the doctor.

I also need to remember that there will be times when even though I have taken legitimate prescriptions as written that I will still be under the influence.

I have also seen people in recovery just flying off of prescriptions bounce off the walls. I need to keep in mind that even when I follow all the rules and take every step I need to take that there will be times that I am simply fucked up on pills or what ever else they give me. Usually when I'm taking a stronger pain medication if I go to a meeting I will just sit there and shut the fuck up. Of course, that's usually what I do anyway, it's just that if by some strange chance somebody asks me what I'm thinking or what's going on I will simply decline. With or without explanation.

I have put a higher value on my recovery than on my pride.

That's harder than you might think. It's a very easy thing to slide into the whole "I've been sober for over fourteen years, I can handle this." The last bad patch of pain that I went through brought me the choice of taking vicodin or staying in bed. That's what I had. I chose to take the medicine and get out of bed. I reached a point where it was harder and harder to keep taking the medicine only as prescribed. Some of it can be a subtle thing, like if it says "take one or two every four hours as needed for severe pain" it can be very easy for me to read it like this take two every three or four hours. I have to remain aware that this is something I am perfectly capable of doing. If I find myself considering doing rewrites on the prescription or fudging the levels of pain I need to either trash the meds and call the doctor or pass them to somebody who isn't me for them to handle. I've done this before and it's saved my ass. On matters of recovery I'd rather save my ass and let my face take care of itself.

Those are the steps I take for dealing with this process. Another strong argument that was in favor of my having this stuff done in California is that the Betty Ford Center in Palm Springs has a great program for folks in recovery that are having pain management issues. I can have my surgery done at Eisenhower and do my post op recovery right across the street with the good folks at Betty's.

3B's

10 Comments:

Anonymous Lisa said...

Dear MB,

My very best thoughts are with you for getting through this ordeal. I do not envy you your dental surgery, but I also know it will be for your betterment in the long run.

I just came across the following, apropos of nothing, but maybe it will give you a smile as we have touched on the topic before:

“There is a particular disdain with which Siamese cats regard you. Anyone who has walked in on the Queen cleaning her teeth will be familiar with the feeling.”--Douglas Adams

12:06 PM  
Blogger seventh sister said...

Best wishes with all of this. It doesn't sound like fun. Bad teeth are nothing to mess with, though. You can get serious infections ffrom letting that stuff go too long.

Will you be starting after Thanksgiving?

12:56 PM  
Blogger Brave Sir Robin said...

You will be in my thoughts. I have no doubt that your inner strength can surpass this test.

Be well.

12:59 PM  
Anonymous constant comment said...

I'm wishing for you all the physical, mental and inner strength necessary for you to get through this. It speaks well for you that you are onto your own bullshit techniques when it comes to the use of pain meds, though...and it's great that Betty can be a resource for you! Something good from a Republican...you don't see that every day! ;) When do you start with all this?

2:25 PM  
Blogger Maggie Rosethorn said...

MB...those are great steps, and kudos to you to being alert to the risk of relapse. Good luck to you for your surgeries. You will be in my thoughts and good wishes.

3:08 PM  
Blogger Sherry said...

i had forgotten about that. i should have thought of it because my dad was a recovering alcholic and pain meds got to be an issue after 28 surgeries at the v.a. to save his arm.

i should have thought of that.

take care, be well. i will keep you in my thoughts and seen good vibes your way.

3:28 PM  
Anonymous Anonymous said...

Hi
Yes as some one that used for along time also I do make sure every Dr. knows this fact. Going to the Dentist is hard the pain killer is a joke to 25yrs plus coke user it always takes a lot more and a few days for the craving to go away.
Just had hernia surgery the pain killers are still on the kitchen counter. Good surgeron and not a lot of pain.
Good Luck on the on going battle.
jo6pac

6:03 PM  
Anonymous tw said...

I saw this interview last week and I thought of you. I know you're a Steve Earle fan, probably not only because of his musical talents but also because of his successful struggle against his addictions. Steve's been clean now for over 13 yrs I think. Anyway, I hope it brings a smile to your face and anyone else who's struggling with these problems. I saw it on Canadian TV(why won't they let us see Canadian TV down here? Hummmmm!)

www.cbc.ca/thehour/video.php?id=1811

Our thoughts are with you but you'll do fine I'm sure.

4:41 PM  
Blogger seventh sister said...

Thanks for your reminder about the Shaker Pie. My myers are macerating now. Have you thought about organizing some of your recipes for a book? It would be something to occupy your mind while you recuperate whether you ever published it or not.

8:50 AM  
Blogger konagod said...

I've never thought about anything like this before -- the whole addict/recovery thing and pain pills or whatever associated with major dental work.

Obviously it's a big issue but at least you are aware of it and going into it with a good deal of thought and planning.

Be strong and you'll deal with it just fine. And thanks for highlighting an issue that many of us have probably never contemplated.

God, I'm so glad I never got hooked on any pills, shooting up, etc. People still offer me shit, whether it's a Motrin or a Xanax, and I absolutely won't even consider it. They think I'm strange. I have enough problems with tequila. I don't need to compound the problem.

3:23 PM  

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