Thursday, November 22, 2007

Choosing Between Pain or My Brain

From all outward appearances, this blog ought to be jam packed with entries -- at least one a day, if not more. After all, I like to write, have never been lacking for something to say, seem smart enough to put thoughts together, and don’t have one of those pesky job thingies that tends to eat up so much of most people’s time.

And yet, only 30-some entries in six months. Just. Plain. Sad.

The reason is that really great drugs ate my brain. But not in the George Carlin, psychedelic-era, “Doesn’t my hand look weird? Ooh, say hand out loud, doesn’t that sound funny?” kind of drugs. (I wish.) Sadly, these drugs are the harder to get, by prescription only, cost you a fortune, give you a life if you need them but steal your life if you don‘t prescription drugs. Taken is pretty large doses, every day.

Now I’ve taken drugs that screw my brain before. Back in 1991, I started taking an antispasmodic medication called baclofen. This drug is terrific at calming down misbehaving muscles, but taken orally it can knock you out. Fortunately, your brain gets used to it being in your body and you soon don’t notice it at all in terms of awareness and mental agility. At my peak dosage, when in Las Vegas at a work-related conference, I was so immune to the mental slow-down baclofen causes that I was able to wash down my dose of baclofen and a Darvocet with half of a James Tea Kirk (basically a clear glass bucket of blue Long Island Iced Teas with gummy worms in the bottom that’s served at Quark’s Bar on the Promenade at the Las Vegas Hilton). Not only was I conscious after this risky little adventure, I managed to leave the bar and make well-received contributions at two conference breakout sessions and then win several hundred dollars by hitting a royal flush on a nickel draw poker machine. (Responsible adult and CMA note: This was a really stupid thing to do -- the mixing drugs and alcohol thing, not the winning money at draw poker thing. No one should try it, especially those fond of breathing and thinking.)

When it came time to go off of oral baclofen (it eventually became ineffective on my muscles, so I traded up to Intrathecal Baclofen Therapy - IBT), I was told by my doctors that even though I didn’t think my brain was foggy, I would be shocked at how much more clear my thinking became. This scared the behoosis out of my husband, who sometimes had a bit of a time keeping up with my hyper thoughts when I was under the influence. And they were right -- I did pick up some mental acuity that had been lost to the baclofen. After I started IBT, I got to take my brain for a run for the first time in 10 years. It felt good. It was something I could get used to.

It was something that was all too short-lived.

A few months after the transition to IBT, my chronic pain began to get worse -- a lot worse, and fast. Over a vew short period of time, I went from happily existing on the occasional Darvocet to taking Oxycontin and Oxycodone, the big dogs in the pain management park. And these big dogs started eating my brain.

At those early doses, it wasn’t too bad -- certainly no worse than I was on a bad day when I was on the baclofen. But now that it’s necessary for me to take pretty high doses of these narcotics just to stay comfortable, I‘m paying a high price for that comfort -- and I’m not just talking about the criminally high prices charged by the pharmaceutical companies. I used to be able to manage three or four tasks at once, then I could only do two, and now one, if I take a lot of distraction breaks. I was never able to just sit and watch TV or a movie in the days before the Oxy drugs became a way of live-- I had to do something else like play a game or write or do some crafty-type project so I didn’t get bored. Now, it’s necessary for me to give certain fast-paced shows my full attention, or else I turn into that annoying person who keeps talking over the action to ask who said what or did what to whom. But my biggest loss, the one that I grieve for most, is my ability to read for long periods of time. But with the opioid-soaked brain, I’m lucky to be able to focus long enough to get through a chapter now and then instead of knocking off a novel every couple of days.

Now don’t be mislead by my pissing and moaning…I’ve not been reduced to a glassy-eyed simpleton who now considers the funny pages challenging reading. By all accounts, I’m still better off brain-wise on drugs than some folks are at their best. But when you’ve spent your life knowing that your body is probably going to self-destruct, you get pretty darn attached to keeping yourself mentally fit. So it’s been difficult to accept that my choices are to be in pain (which plays its own form of hell with being able to think) or to be somewhat comfortable but a lot foggier than your used to. Still, when it gets down to brass tacks, it’s a no-brainer. Literally.

So while I miss being a walkie, I miss my brain more. And that means that my secret hope for a short-term medical miracle isn’t a cure for paralysis, it’s that they develop a drug that will kill the pain, without killing your brain along with it. And I bet I’m not alone.

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