"United we bargain, divided we beg."

Sunday, August 2, 2015

Out of Order (Pain and Pride)

I haven't been writing about the farm because I haven't been taking care of the farm. I've been pretty much confined to bed the past 10 days as the result of a tonsillectomy at the ripe old age of 43. After battling strep throat three or four times a year for the past several years, my doctor referred me to an Ear, Nose and Throat specialist who told me "you are a walking advertisement for tonsillectomy." I meekly agreed and scheduled the surgery for a few weeks out.

Looking back, I think why didn't I keep in mind that he is a SURGEON and makes his LIVING removing tonsils? What else is he going to tell me?

I'm not being fair. Obviously I did need to get my tonsils out. I saw them after the surgery, and they were disgusting - scarred, blackened, weeping pus, enlarged. I could tell at a glance that those hideous diseased lumps of flesh were better off thrown into the trash than staying in my throat, seeping toxins and harboring god knows how many strains of vicious bacteria yet to be described by science. I am optimistic that having them removed will result in overall better health and a decreased need to ingest vast quantities of Amoxicillin on a weekly basis.

But I am still resentful and angry at my ENT. He lied to me. He looked me in the eyes and said the recovery would take a week. "It's a week of a really bad sore throat," he said. "Then it's over."

A few days before the procedure, I did some online research. No website I saw - including Medline, The Mayo Clinic, and other well-researched sites - stated any recovery period of less than two full weeks, and some said recovery takes up a month. I perused several forums for adults recovering from tonsillectomy and saw a disturbing number of repetitions of the phrase "the worst pain I've ever had."

The day of the surgery, in the two-and-a-half minutes that you get to talk to the surgeon before they put you under anesthesia, I said "I'm really concerned about pain control afterwards."

"Don't worry," he said, "we'll take care of you."

That first night, I didn't sleep at all, because any time I started to drift off, I began choking on my saliva. The pain, even when I had taken the maximum dosage of pain killer he had given me, was a solid 8 on a scale of 10. At 6 in the morning, after exactly zero minutes of sleep and several hours of weeping, I paged the doctor, who more or less told me to suck it up.

"I can't give you any more pain medicine." he said. When I said I thought I was going to aspirate on my own saliva because I couldn't swallow, he said "that's normal."

I won't go into all the details. If you've been through it, you know what it's like. I'll just say that as of now, my personal pain scale goes from 0 to tonsillectomy. No, it's not the worst pain I've ever experienced - that would be unmedicated childbirth - but it's the worst pain I've ever experienced that lasted more than an hour or two. It hurts more than all of these things which I have actually experienced:

- three broken ribs and a medium-serious concussion
- a completely severed ACL
- viral meningitis
- having all 4 wisdom teeth out at the same time
-second degree burns over 5% of my body

the pain is approximately equal to:

- being 7 centimeters dilated
- having three broken vertebrae
- the worst migraine headache in the history of migraine headaches

But whereas most of the above conditions are either of short duration - a day or two at most - or taken seriously enough to be prescribed heavy duty painkillers, this pain lasts for weeks at a time and warrants only standard Vicodin. In the US, anyway. Some of the forums I was reading are from the UK and apparently there adult tonsillectomy patients get morphine and liquid lidocaine.

I consider myself to be pretty stoic about pain. When I had knee surgery last year, I took approximately 1/4 of the pain pills I was prescribed and turned the rest back in. I suffer from a hereditary chronic pain condition and I am accustomed to being in some degree of pain more often than not. Additionally, I am a migraineur and am used to terrible, debilitating headaches a couple of times a month. I like to think I handle all of that pretty well, with a minimum of whining. I have never had a regular prescription for pain killers in my life, and I am ridiculously loath to ask for more pain meds.

It does annoy me - no, I'll be honest, it seriously pisses me off - that I was given one weeks worth of pain medication for an operation that is universally described as taking two or more weeks to recover from. I hate being put in the position of having to ration my medication, of being eternally anxious about what to do when it runs out, of having to call and ask for more and risk being seen as a "med seeker."

In nursing school,  I was taught that adequate pain control is a fundamental human right. I was also  taught that adequate pain control is a prerequisite for optimal healing. The former may be debatable - the latter I know is true. I have lost 12 pounds in 10 days, because I am unable to eat. At the peak of my medication's effectiveness, I can force down a few spoonfuls. Otherwise, I can only drink Ensure and plain water. Not that losing 10 pounds is a tragedy for me - I see it the only silver lining to this situation - but it is a measure of how poorly my pain is controlled.

I am wavering about calling tomorrow and asking to speak to the doctor. Aside from pain, I still can't swallow correctly - liquids keep pouring out my nose. I have been so conditioned not to complain, not to make a fuss, not to annoy anybody with my personal needs that so far the idea of calling and asking to be evaluated is more uncomfortable than the pain I am in. I can't decide if it is more ridiculous to ask for medical care or NOT to ask for medical care.

I once read an article about a woman who died of a ruptured bladder when her request to use a restroom on a public restaurant was refused. Rather than demand access or - god forbid - pee in the alley where she might be seen, this woman simply stood there and allowed her bladder to literally split open. When I read this, I shook my head and wondered how it was possible for a grown woman to so ignore her urgent bodily needs, but really it isn't hard for me to sympathize.

Obviously I don't think I am going to die. I'm certainly going to heal and be okay. But... why, in the absence of any medical reason, ought I to suffer severe pain? Why shouldn't I have a few more days of pain medicine? Is this a moral issue? Why shouldn't my inability to swallow correctly be evaluated? At what point would it be considered "okay" to ask to be seen? After how much pain? After how much weight lost? After how many weeks of liquid dribbling out of my nostrils?  And who is stopping me here? For all I know, if I were to call the surgeon, he'd schedule me the same day and call in a scrip.

How much am I going to make myself suffer before I ask for help?


HelenB said...

Since nobody else has said it, I will. Don't ask for help; demand it. If your current doctor seems dismissive or unresponsive, find another doctor. You should not be in so much pain for so long.

Aimee said...

Helen - thanks for your concern. It's a few days later, and I am feeling much better. As I wrote in the last few paragraphs, it's really my own fault for not calling the doctor. I finally did - spoke to his nurse, and was given a prescription for more painkillers and for steroids to reduce the swelling. I find it's very tempting, when suffering, to blame others regardless of their actual culpability. It's true he didn't tell me the truth about the recovery period (and he HAD to know), but when I girded up my loins and called and asked for help, he gave it to me right away. I don't know why it was so hard for me to admit I needed more medication - my mom, sister, husband, and random readers of my blog all told me call, but I waited until I literally couldn't stand it anymore. It's almost as if I thought I was going to win some sort of prize for holding out. Not so, alas. Not so.