- I have a high tolerance for pain, so I am choosing to take advantage of the fact.
- I don’t like how they make me feel. I don’t like that woozy, dopey feeling, that ongoing drowsiness that turns day into night into day. Narcotics(*) cut you off from feeling not only pain, but life.
- I have a mild allergy to opiates (narcotics). When I take even a small dose my whole body starts to itch, even inside my ears and nose. It is intolerable. Therefore, if I have to take narcotics, I’ll have to take antihistamines with them – and I hate the woozy antihistamine feeling even more than I hate the opiate feeling.
- Once I start down the opiate road, I’ll be taking these drugs for the rest of my life, however short or long it may be.
The last reason I give is closely tied with what I think is the psychological underpinning of my reluctance. I think I have an irrational sense that starting on narcotics will mean that I’m at the end, that all that is left for me is death. The thing is, whether or not I start using opiates now, the fact remains that I have a terminal disease, that I will die sooner rather than later. My irrational feeling is that taking these drugs will hasten the approach of the end. I know this isn’t true; the fact remains: that’s how I feel.
I use some techniques besides medication to control my pain. When I pray I sometimes go into an altered state that would probably be an alpha state(**) if anyone was looking. I can also achieve this state through progressive relaxation of muscle groups. When I’m “there” I am aware of pain, but it doesn’t bother me. Hard to explain.
Then, there is endorphin production. I touched on this in a previous post, Kindling the Lights of Fire. We can stimulate endorphin secretion in a number of ways – physical activity is one. Laughing uproariously is another; so is crying. There are even certain foods that help. Endorphins are hugely important to how we experience pain. This is a link to the abstract of a slightly technical article on the subject.
Other non-pharmaceutical measures include doing my best to eat a balanced diet, getting balanced amounts of rest and exercise, and maintaining relationships, hobbies and interests so that I don’t spend all my time thinking about myself.
Having written all that, I feel less guilty about refusing the opiate option for now. I’m going to try a prescription NSAID that my doctor suggested and my hope is that in combination with these other measures, it will be enough for now. Even if my feelings about opiates are irrational, it can’t be a bad thing to avoid them for as long as I can.
I am coming back a few minutes after publishing this post to add the following:
I am completely in favor of availability of strong opiate pain relievers to people with metastatic cancer. No one should conclude from what I wrote above that I am advocating withholding or refraining from them. It all just has to do with me, right now, and my own feelings about my own illness.
(*) In this post I’ve treated the words “narcotic” and “opiate” as synonymous.
(**) An awake, relaxed state associated with a lack of psychological tension and decreased attention to external stimulation. Measured on an EEG (electroencephalogram) at frequencies of 8-13 Hz and amplitudes of 20-200 μV. (Yes, I’m showing off. I can’t remember names of everyday objects or find the right word in the right language for what I want to say, but dammit, I still remember factoids from my training in the 1980s.)