In The Not So Still Night

In the early hours of this morning – when I woke up for maybe the third time in what should have been a full night’s sleep – the strangest questions crept into my half-drowsy mind: What if the high dose of pain medication I’ve been taking since my surgery is the dose I should have taken all along? What if I’ve been looking at this all wrong? What if I kept landing in the emergency room as often as I did before was because I wasn’t prescribed the correct level of pain medication? After all, the doctors at the pain clinic had expressed a fear of not being able to manage my post-surgery pain if they prescribed a higher dose of pain medications before my surgery.

That had been the point of the nerve block – to give me more pain relief without prescribing more oral opioid pain medications. But what if my nervous system is so damaged by whatever underlying illness caused the pain to begin with that I needed more pain medication or possibly a different kind to manage my pain? Instead of feeling this high level of anxiety about taking more pain medication, shouldn’t I think about how many times in the past two years I landed in the emergency room for extra pain relief or the countless sleepless nights I had because of the pain? Shouldn’t I feel more positive that the pain specialists recognize the need for better treatment for me?

I just stopped writing and thought about those things for a moment. I haven’t landed in the emergency room since surgery, but I’m still having the sleepless nights because of pain even with the higher dose of pain medications. I still can’t travel in a vehicle without feeling pain afterward that forces me to rest to recover from what shouldn’t be an ordeal; and walking any significant distance is out of the question. Unfortunately, stopping to think raised more questions. The main ones being, what if pain medication isn’t the answer for me or what if I need an alternative method of pain management that hasn’t been tried yet? And worst of all what if I am as unusual a case as they think that doesn’t come with a straightforward cure.

So why am I awake in the wee hours of the morning ruminating over these torturous questions? Do I or don’t I need more pain medication? Should I have had this higher dose sooner? How long should I take it at this high dose? Should I focus on lowering the dose – if the higher is what I need – so significantly so soon after surgery, and if not, how much harm will extended use cause me?

How many more days and nights will I wake to find these types of questions pouring out of me in small trickles or gushing as if busting through a dam? Maybe what’s doing more harm is my inability to just allow myself to be sick and count on my body to do what it needs to do to heal itself, instead of forcing my mind to hold all my pain.

Kim Carnes – Crazy In the Night


2 thoughts on “In The Not So Still Night

  1. What constitutes a high dose of opioids? Some patients find codeine too strong, and some find it doesn’t help at all. Finding adequate dosages of the drugs that help the most depends on a lot of things, and should be looked at on an individual basis. I’m not sure of the costs involved, but it might be worth it for you to get your DNA checked. Some pain patients do not metabolize pain medications the way most people do, and so larger doses are required.

    Asking these kinds of questions is important, especially when contemplating long-term care for pain management. Real answers are hard to come by when dealing with chronic pain, but you will find that your own opinion is more important than that of your doctors. After all, you are the one that has to live with the pain, not your doctors. Trust your judgement. And don’t be afraid to change your mind.


    • I’m now taking just over 3 times dose I was taking before surgery. I know that my surgical pain had to be managed but the pain I was experiencing before surgery has not changed
      I’ve been told that in some uncommon cases there are patients who have pain conditions where the root cause cannot be identified and I might be one of those patients. May pain specialist has no concern about prescribing the larger doses and she is allowing me to use my judgement to decide how much I need to take to manage my pain and to work at my pace to taper down the doses. Her trust that I am the best judge of that means a lot too me.
      I will ask about the testing. It would be interesting to find out if my body isn’t metabolizing the pain meds well. After all, this situation is teaching me about other things my body can’t cope with which includes some other typed of medications.
      Thanks as always for your insight 🙂

      Liked by 1 person

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