For more than fourteen years, I believed MY Pain had “Gone Away”. But, in December 2013, the Pain decided to “Come Again Another Day”. And, I started to experience both intermittent and continuous pain daily and nightly. The levels ranged from “five” to “ten” on the “standardized pain management scale.”
This “pain flare-up” occurred when I quit taking the injectable drug, Methotrexate, to treat MY Rheumatoid Arthritis. I injected the first dose in 1997 and once a week thereafter until it was discontinued in December 2013.
Toward the end of November 2013, I was hospitalized for treatment of bronchitis. The pulmonologist performed a bronchoscopy procedure while I was in the hospital. Several weeks after being released from the hospital, I followed up with the pulmonologist; and, he shared the results of the bronchoscopy procedure. It showed scarring on MY lungs. Prior to MY follow-up visit, the pulmonologist spoke with MY rheumatologist . Both agreed, this newly diagnosed lung condition was due to the side effects of Methotrexate I was told to immediately discontinue the medication. They offered no options for alternative treatments.
When the Pain Came Back
Shortly after discontinuing the medication, the years of living virtually pain-free ended. I was in pain. I mean really, really severe pain. I first went to see MY rheumatologist and followed up with a visit to MY primary care physician.
The rheumatologist increased my prednisone prescription from 5 to 7-½mg. Several weeks passed with no pain relief; so, he increased the prednisone from 7-½ to10 mg. Still there was no pain relief. Finally, the rheumatologist prescribed Leflunomide, 20mg. But, he cautioned it could take at least four weeks before I saw any improvements. Could I live with this unbearable pain for four weeks? No!!!! I had to look elsewhere.
So, I went to see MY primary care physician for advice and to, specifically ask, if it was okay to take Vicodan. I had eleven pills left from the thirty prescribed in February 2010; when I was discharged from the hospital after an extended stay for the treatment of epiglottitis. He responded in a very patronizing voice, “stay away from pain medications they are not good for you.”
I couldn’t believe he said that!!! Had he bothered to look at MY past medical records? If he had taken the time, he would have noted that during MY more than 20 years as a chronic pain patient (other than the 2010 hospitalization); I never received a prescription for an opioid/narcotic medication When he offered no alternatives for dealing with the pain, I knew it was time to step outside the box.
The Pain Goes Away
I reached out to MY pain management doctor in Wisconsin. She is fellowship-trained in pain management as well as board certified in both anesthesia and pain management. I have been under her care for more than seventeen years. I schedule follow-up visits at least 2-3 times a year when I return to Wisconsin. Under her care, I had managed MY chronic pain without opioid medication and invasive procedures for more than seventeen years. Through a multidisciplinary approach, working together, we developed a comprehensive, individualized treatment plan focusing on: medication management, physical therapy, nutrition/diet, psychological counseling, and a variety of self management tools (exercise, mindfulness, diet/nutrition, sleeping habits, music, relaxation, distractions, etc).
On Tuesday, I telephoned her. She listened to ME. She empathized with ME. She responded to MY needs. She prescribed a non-narcotic pain medication to help ME.
I started taking it on Wednesday. Today, Sunday, as I write this post; I am virtually pain-free. I am able to:
- prepare meals,
- perform housekeeping chores,
- exercise at the YMCA
- shop for groceries and flowers to plant, and
- water and tidy up around our container flower garden.
Come Again Another Day
Since there is no known cure for chronic pain, I am certain it will return. In the meantime, I will search for two new doctors in Florida. Doctors who, I believe, have the capacity to understand and respond to the unique needs of a chronic pain patient.
“Few things a doctor does are more important than relieving pain… pain is soul destroying. No patient should have to endure intense pain unnecessarily. The quality of mercy is essential to the practice of medicine; here, of all places, it should not be strained.” (Marcia Angell)