Charybdis or Scylla: navigating tensions in medication use
This is a contentious issue, an issue, moreover, on which many people like to have opinions. At least it seems like many people like to have an opinion. on what to do for health reasons. Sometimes, I’m not sure which is the worse consequence: disregarding what the doctor feels you should take, or feeling like you are betraying your friends, colleagues, and family when you don’t think you’re the right candidate for the alternative treatment they’re suggesting.
So. Charybdis? Or Scylla?
Not that we’re necessarily dealing with the life-threat that Odysseus had to contend with. Well, maybe we are, when death is a possible consequence of taking some drug or other. But we’re trying to make ourselves well, aren’t we? Or trying to feel as best as we can…
And this is possibly where the necessity of having an opinion on health comes from: we all have it, more or less. We all have some form of health, or, if we don’t, we have some form of health issue.
I’ve been rather reckless in my life when it comes to taking medication. I’ve never hesitated to take an antibiotic when prescribed, or Tylenol for any number of aches and pains. Tylenol has been my go-to medication of choice, not that I’m a frequent migraine sufferer or anything.
I don’t remember being a particularly sickly kid. Sure, I had flus and colds, chicken pox, but I wasn’t the type to spend a lot of time in bed, though I was happily willing to take to my covers if the occasion seemed to demand it. I don’t recall ever trying to “overcome” the illness; there was always a readiness, I think, to find myself healthy again and resume life after.
When I was eighteen, things started to change. I had a wretched three-month long case of mononucleosis that drained me. I lost forty pounds within three weeks. I was, for all intents and purposes, bedridden for those three months. But of course, there wasn’t anything to take for the mono. I just had to let it work itself out of my system.
From that point on, hangovers, flus, anything where my head and gut were not in agreement, my fault or not, I took to my books, my bed, and my bottle of Tylenol. Truth be told, I never took more than the recommended dose, but sometimes I would take another couple three hours after rather than wait the full four hours the bottle says.
Because I was a smoker for something like twelve — thirteen years, I had regular appointments with bronchitis and strep throat, so amoxicillin and other anti-biotics were frequently in my possession. Again, I took them religiously when told to.
I was also diagnosed with depression when I was twenty-something, though it was connected to what was assumed to be alcohol abuse. The truth was, I’d had to deal with bouts of bleakness and sadness for days on end, however, since I was twelve. That was right after my father died, and I was, naturally, an emotional wreck. But, finally, with a diagnosis under my belt, I took to Celexa, or Effexor, or Wellbutrin with a passion. I didn’t entertain any idea of being rid of depression entirely. It still afflicts me. But I handle it with a lot more grace, now.
So while I never experimented with how prescription drugs might affect me without being prescribed them, I nevertheless took to them willingly, however often I needed them.
When I was diagnosed with, first fibromyalgia and then sensory neuropathy, and my GP prescribed Gabapentin to treat it, I was fully on board. There was no reticence on my part to leap into what Western medicine “knew” about how to manage my case (which isn’t a whole lot, as it turns out). My wife was frustrated, though, at that point, beyond the stress of having to deal with a husband on disability, frequently, only in his mid-thirties. She didn’t want me to blindly pop medication without knowing a) what was the cause of the issue, and b) were there alternatives to the drugs prescribed.
Several times, it probably came close to us breaking up over this issue. My wife, who is my hero, still wanted me to fight the symptoms, the condition. Find out what was causing it. Learning about the most recent research in terms of how to treat the pain, yes, but more importantly, for her, learning what caused the mess my body had become in the first place.
It’s been four, going on five years I’ve been dealing with AAG (sensory neuropathy); there is still no known cause for why my condition started, where it will go, or what I will look like in ten years. But, dutifully, every day, I take Tramadol, Gabapentin, Paxil, Imuran, and Nabilone,
At its worst, I had something like thirteen different prescriptions a day (because when you take Prednisone, there are four or five other drugs to take to moderate the horrible effects of that particular drug. I won’t be sorry to never have to take that again!).
I’ve probably forgotten more side-effects than the average reader of this post will ever know. I hope that’s the case, anyway. Because it really is tough to look at a heavily medicated existence, and not think that something negative will be the result.
Some days I think, My body can’t handle what I’ve done to it, can it? But I think it’s kind of cool to see how resilient our bodies can be, though there’s no necessity to be bad to ourselves (i.e., experiment too, too much).
There are two monsters in this story; I’ve designated medication by the name of the massive whirl pool with teeth that Odysseus had to sail around, while avoiding the many heads of the snatching Scylla. This is the proverbial rock and a hard place.
Enter medical marijuana. I’m not sure what the US has done in this regard, being happily Canadian, but since it came on the market, many, many people have asked why I don’t take it. It is, after all, supposed to be particularly helpful with conditions of chronic pain, and others. I’ve heard of a woman whose life was changed by taking cannabis for lupus. And some with Parkinson’s. And I’ve heard tell, too, of Autistic people whose lives have been positively affected. (These are only hearsay; I’ve no evidence in these cases other than what I’ve heard in passing.)
But I’ve resisted, kept it as a last resort, and still don’t feel too keen on taking it. I am taking a synthetic THC medication, in the form of Nabilone, but this is a tiny fraction of the effects that medical cannabis can have on a patient.
My uncle, who is a doctor, tells me that he won’t prescribe it because he feels like the medical evidence just isn’t there yet. That’s OK with me; it’s one more reason not to take it, but there are more important reasons, for me.
Most importantly for me, my wife is not on board with the idea, certainly not of smoking joints or vaporizing around our four-year old (and who can blame her for that?). I’ve been smoke free for over five years now, basically since my daughter was born, and though I swear I’ll take it up again if I make it to seventy-five, I do love life without having to worry about the expense or the potential health-complications that come along with smoking.
Secondly, I don’t really want to give up driving. I still can drive, and I still want to be able to go places with my daughter. There are, if you care to look, many different strains and chemical combinations of THC and the cannabinoids, and a few different ways of taking it. Perhaps there are some that are so low in the THC content that there really is no risk of driving impaired, but I’m not sure that I even want to find out what that might be.
Thirdly, is my own tolerance for pain. I’m in pain twenty-four/seven. The only time I don’t really notice it is when I’m sleeping, so I guard that realm pretty jealously. But, and this speaks to the astuteness of my wife’s perception, when I was on opioids (a tragic experiment if there ever was one), I was engaged in a project of trying not to feel pain. I’m still engaged in this project, only I’ve learnt to ignore, or just deal with pain. I have some pain threshold, and I’d like to think it’s fairly high, but the relentlessness of it is exhausting.
For those of you who don’t know what it’s like to take narcotics like Hydromorphone, morphine, or Oxycodone, the effect is an overall numbing. Far from improving the quality of my life, of making my pain go away, I was numbed into submission; my pain, was definitely less, in some respects, but I was wedded to the couch. I didn’t want to do anything, couldn’t fire up my will to get off the damned couch. Opioids also bring with them an incredible amount of nausea, so I had to have anti-nauseants, Gravol, and so on, as well. I understand that opioids have a use, say when dealing with very acute pain over a short time, but I don’t think they work so well when the condition is chronic.
I’ve been assured that the experience of medical cannabis is much different, but it still seems like early days for a last resort.
I think it is definitely to my wife’s credit that she could look beyond the merely immediate pain. She could see the toll that my body took when I got off the opioids (which was, for me, fairly easy; I hated the way they made me feel, so it was not really difficult to just stop taking them).
But pain is a madness, it is a monster. I call it Scylla, here, though I really hope I’m not torturing the metaphor. Pain produces its own daily terrors, daily hurdles. I unload the dishwasher in shifts, having to sit down between levels. I mow the lawn the same way. I generally have to avoid such tasks as vacuuming, washing walls, etc. as they just take too much energy and create a surplus of pain for me.
Like the many heads of Scylla, lurking in caves in a cliff, pain strikes when it wants, where it wants. My body is this proverbial ship, never allowed to pass between these two beasts. Or maybe that is defeatist talk. I don’t want to give the impression that I’m conceding defeat.
I’m trying to be positive, alive. I’m trying to learn the best way to navigate some of these tensions when they occur, and I’m all-too-aware, now, that these tensions exist: to be in pain, or to medicate? Seems like it isn’t a real choice.
But we always have choices.