I'm writing about pain this week because I’ve had a lot of it
I've actually had plenty over the past 10 years, from mouth sores after chemotherapy so painful that I couldn't eat, to countless sticks in the arm, to lung surgery that made me feel like a Mack truck had hit me.
I've been pretty stoic through most of this, but the pain after removal of a lesion on my kidney July 25 really sent me through the roof.
Combinations of medicines that can be taken by mouth, according the American Cancer Society, can very well control severe pain. These combinations usually include opioids such as morphine or codeine. I found the best relief from a drug of this class called Dilaudid (hydromorphine). Each person reacts differently to each medication, which is why your health care provider might try several before finding the right one.
I overdid it when I came home, which set me back. I did some stretching, walked a bit on the arm of a neighbor, and sat up and down 10 times in a chair to test my quads. I did some laundry and emptied the dishwasher.
Bad idea. When you are in the hospital, all you do is lie in bed and do a little walking. Right when you come home, you should do something like that, building your strength slowly. My doctors wanted me to do the walking, but not the rest.
The next day, I was frantic with pain. I called the urologist’s office and said it was not time to take my pain meds, but I was having “breakthrough” pain and needed to do something. The receptionist said she would mark my message URGENT. I stood in the middle of the kitchen, phone in hand, crying. I felt like I couldn't breathe. An hour passed.
I paged the nurse practitioner who I see at Dana-Farber, and she called right back and said it was OK to take the Dilaudid at that point and to temporarily increase the dose until I got over the hump. If the person you need doesn’t call you back in a reasonable amount of time, call someone else on your care team. (I finally got a call back from the urologist's office at 5:30, which I found quite unreasonable.)
Some people may not want to use these pain medicines because they fear they will become addicted. But people with cancer who have never abused drugs do not usually become addicted or use opioids for pleasure, according to the American Cancer Society. Still, it’s a good idea to be wary of this stuff, and to call before taking more.
Pain medicines work best if they are used around the clock before the pain becomes severe. It takes more medicine to control severe pain than milder pain, so it’s best to treat it when it first starts and regularly after that. Pain is bad because it saps the energy you need for healing.
If the cause of the pain is treated, the need for medicine will slowly decrease or disappear. You don’t need to call if you want to take less. Hopefully, you and your healthcare provider will have found the right dosage: enough to relieve the pain but not so much that you get zonked.
If you have a rough transition from one dose to the next, simple things can get you through it. First, sit down and count your breaths, slowly, from one to 10 and back. If you have a garden, you can pick some flowers like I did. You can look on the Internet or in a book and for a beautiful picture of a setting, and then visualize yourself there. Make a cup of tea or coffee, call a friend, or do some other little thing that calms you down.
And then, although it's hard to believe, you can say to yourself, "This too shall pass."
After a horrible week, I needed the pain medicine less often. I walked a little further and felt steadier.
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