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