By Marie Colantoni Pechet
As a Stage 4 colorectal cancer patient, I have had experience with palliative care doctors.
Fortunately, I haven’t had the need to meet with one in a few years.
But recently, I started experiencing pain that didn’t go away with my normal methods. I have a high pain threshold, and when I do have pain, I view it as a message from my body and I do my best to work with it. I also have a number of mind-body methods that I use to manage the pain.
I can’t recall ever taking drugs for pain. Even after my mastectomy, I didn’t need any pain medication.
But when this recent pain couldn’t be managed by my usual approaches, I resorted to taking two Tylenol, which I considered to be strong medicine (well, outside chemotherapy drugs!).
Still, the pain, even after taking Tylenol, was debilitating, so I decided to ask for something stronger. Asking for pain medication was new territory for me, and a big step.
I wrote a piece about on how wonderful I found palliative care doctors, and I made the assumption that they were all the same. So when my palliative care doctor couldn’t see me for a week, I agreed to see a different palliative care provider.
In this case, she was a nurse, though I don’t think that is the relevant difference. I walked into her office, nervous about starting on pain medication. Here are some assumptions I had about pain meds and cancer patients:
1. It isn’t a temporary situation and the dose only increases until you die.
2. You can’t drive while taking them, so your life is even more restricted than it already is.
3. They can be addictive.
4. Pain gives me a message about how my body is doing, and without feeling that, I would be out of tune with my body.
5. You are to take pain medication before you really feel the pain, to “stay ahead of it.” But what if I take it when I don’t really need it, when the pain would not actually get worse?
6. Narcotics cause constipation, which is a problem for me to begin with.
I explained all this to the nurse, and the fact that I really don’t take pills. I also explained that I tend to vomit during chemotherapy, which makes it difficult to swallow pills. I told her that I wanted to understand more about what I might be taking.
She sat quietly and let me speak, then she said, “You need to take this” and wrote out a prescription for a narcotic.
I was stunned and didn’t know where to begin.
“Is there something I can try that is between regular strength Tylenol and a narcotic?” I asked her.
“I believe this is the best for you,” was her firm reply. Continue reading