I couldn’t get my underwear on

I couldn’t get my underwear on 

I was in pain.  It was as simple as that, or perhaps as critical.  I was in so much pain that morning that just maneuvering and getting out of bed took more energy than the average person could imagine. But then, I couldn’t get my underwear on.

I couldn’t get my underwear on

I’m a 53 year old man in otherwise good health, a healthy weight, and great paying job, but I was on the floor unable to get dressed.  Unfortunately this was not the first time and I knew it wouldn’t be the last.  I tried again…

I couldn’t get my underwear on

 —- I snapped —-

Somehow I managed to get a loose tee-shirt and basketball shorts on.  I still couldn’t get my underwear on.  I couldn’t get socks on.  I couldn’t get shoes on.

I had my plans all set and today was going to be the day.  2500+ days of pain. Seven years of pain.  Today would be the last. I managed to get up off the floor, get the keys to the car and drove to carry out my plan.  It was simple, fast, it would be painful but I wasn’t worried.  Seven years of constant pain had taught me not to fear pain nor death.  No cell phone, no shoes, no fear, my pain was about to end.

I’m a grown man, I couldn’t get my underwear on. 

My wife and kids would be taken care of, my will was set, and my estate would cover their education and my wife wouldn’t have to work.  Hopefully she would find someone new to love her that could make her happier.  

I wrote a short note and got out of the car and walked to the beach and stood looking at the water, my feet in the water.  I had spent years in and around water so I know how long this would take and what I would feel, but I was not afraid of the pain nor death.  I started walking when I felt a hand on my shoulder asking me if I was OK.  Startled, I stopped.

That was all I needed to make me realized I hadn’t told my wife goodbye this morning and that I loved her.  Crying, I got into the car and drove home.  I’m going to say goodbye and I have plan B if necessary.

My wife knew there was a problem when I drove into the driveway and jumped into the driver’s seat of the car and started driving me around.

I don’t want to live anymore

My life is nothing by pain anymore

I can’t do this anymore

Please let me go so we are all in a better place and end this pain!

I’m a grown man, I can’t even get my fucking underwear on!

She finally brought me home and hid all the car keys and my wallet.  She forgot about my phone.  An hour later I had an Uber at the door ready to go again.  She gave the driver a tip and sent him on.

I had thrown out all of my medications in the prior 4 weeks after being told multiple times by doctors and family that I’m “addicted”, “taking too many drugs”, “taking the wrong drugs”, “not taking enough drugs”, “not taking care of myself”, “need to relax”, “need to be more proactive”,  “need to exercise more”, “need to take it easy”, “need to exercise less”, the list goes on with one doctor conflicting with the next…

At 6am the next morning she asked me if I wanted to go to work and I snapped again.  This time my wife was there helped me get dressed and drove me to the emergency room and I was taken to the crisis unit.

Once there I told my story to the ER Psychiatrist:

I’m a grown man and I can’t get my underwear on, I don’t want to go on living like this anymore

I suffer from chronic radicular lower back pain and chronic migraines.

I see a pain management doctor, yet my pain had gotten worse lately as my pain medication has been reduced over the last year while my access to medication for flare ups has been completely stopped.  My diagnosis is intractable pain that will slowly increase over time.  At some point I’m told I may not be able
to walk.

The chronic care group at the practice I see had been changing my antidepressants trying to get me on antidepressants that help with pain.   I didn’t think it was helping at all with pain just making me more depressed.

I saw my neurologist recently.  In front of my wife, he straight out called me addict for the simple reason that I take opioids daily for chronic pain.

I saw one of the best back surgeons in the state recently and he said that my back looked fine and I shouldn’t be in any pain.  The pain must be psychosomatic and recommended antidepressants.  Two prior doctors had recommended surgery.

I was getting pressure from friends and family to stop taking the pain medications.  4 weeks ago, without anyone knowing, I flushed them away. 

It was obvious I was having problems moving and getting around due to pain – I using a walker or even wheelchair at times to get around.  I hid my withdrawal symptoms.

The next part of the conversation surprised me when the ER Psychiatrist addressed me:

“I wished doctors dealing with chronic pain patients would spend a week in my shoes to understand how many of them come through here (the mental health unit of the ER).  I’ve seen a huge increase lately with the new opioid restrictions – patients like you are not getting the treatment you need I’ve seen a huge increase lately with the new opioid restrictions – patients like you are not getting the treatment you need.  I can help right now with the pain and anxiety – he ordered strong pain medication and Valium as he talked to me about admitting me into the hospital. If I would agree I would be treated upstairs in the mental health wing.”

I agreed and was admitted.

Once in the Mental Health wing of the hospital I was surprised by what I saw.  A majority of the beds were filled with chronic pain patients.  There were only 3 patients suffering from addiction there.  I would estimate the ratio was 4:1 chronic pain patients to codependent (addiction) patients.

The young chronic pain patients were having the toughest time.  In the week I was there, I did not see any released. They were all transferred to longer term facilities for long term inpatient treatment.

The older chronic pain patients, like myself, were recovering and being released.   If they had attempted or come close to suicide, the stay would be about a week.  The stay was 2-4 days if they were simply suicidal.

A week later I was released to outpatient care.  The hospital had stabilized my antidepressants, anxiety medications, pain medications, and found a preventative for migraines that appeared to be working.  I was no longer suicidal.  The psychiatrist at the outpatient care took over most of my prescriptions but refused to take over my pain medications or anxiety medications.  I was able to see my pain management doctor to renew my pain medications but was cut off from the Valium prescription cold-turkey.

I’ve been diagnosed with Major Depression Disorder and Generalized Anxiety Disorder due to Chronic Pain.  I passed multiple drug tests and was fully compliant with medications and not found to have any addictive behaviors.

3 Weeks later I returned to work.

So All is OK and I’m doing fine?  Not so fast – even with this experience the real world doesn’t care that you spent weeks recovering from a suicide attempt.

I am back on opioids but they have been reduced again, 50% from prior to my suicide, then eventually stopped.

I cannot get treatment for my panic attacks – I’m stuck in a world where no one wants to treat a chronic pain patient who has panic attacks so I “borrow” medications from family and friends or take high doses of OTC medications for sleep.

My psychiatrist says my pain is not under control and wants my pain management doctor to take better care of my pain.

My pain management doctor says I’m having suicidal thoughts because my depression is not under control and I need more anti depressants.  I’m on 2 different antidepressants.  Both are at the daily maximum dosage.

I’m still in pain daily and having suicidal thoughts daily due to chronic pain I still have no fear of death or pain

I still have problems getting my underwear on each morning.

My wife has watched me suffer and told me she is not going to stop me should this happen again.  It’s my choice if I want to live or die.  My kids are worried I won’t be alive much longer.

For those of you who think you might have a image of who I am – here is some background:

I have a great job at a prestigious firm and make a great salary.  You would never know what I deal with on a daily basis if you saw or met me, but it’s a struggle every day just to get out of bed and get dressed.

I attended some of the best schools in the US completing my BS and MS degrees.  I’m still considering a PhD if I can figure out how to do it with chronic pain. 

I attend group therapy where we cover skills such as CBT, mindfulness, meditation, and basic talk therapy. 

I walk 4-5 miles every day, eat healthy while maintaining a healthy weight. 

On my own I practice the skills I learn in therapy as much as possible. 

I’ve been to two rounds of physical therapy this year.  The first left me unable to walk and missing work close to a week so I found a second group that helped me walk again.

I’ve spent a small fortune on acupuncture but it’s done nothing for my pain.

I’ve tried yoga only to find out too late you really need to find a teacher that knows how to deal with severe back pain.  Good luck finding one of those!

I’ve purchased 2 different TENS units but while they help with my localized pain, they will cause my peripheral pain to flare up.

I’ve gone months without any feeling in my toes, which may sound like a great until you think your feet are wet only to look down and find out they are wet with blood, not water.

I been prescribed 1100 mg of Naproxen everyday to help with the pain. The Naproxen replaced the opioids even though I have a history of ulcers including stomach surgery last year.

I rarely drink and if I ever do, it’s a single drink in social settings before I move to water.

My house if filled with all sorts of overpriced items that are supposed to help solve my back pain.  None of the items have ever worked.  Last year I spend over $20,000 in medical care even though I have excellent insurance.

I write computer code for a program most of you reading have probably used and some of you are using right now.  Contrary to common perception, I write better computer code when I am on opioids and my pain is under control than compared to times when I’m dealing with uncontrolled pain.  My mind is not “foggy” and I’m not “high as many would suspect, but rather my mind is able to focus on more complex tasks rather than spending time using techniques I learn in CBT suppressing my pain.

I am the family man sitting next to you in church, the coach of your child’s sports team, the professional sitting next to you at work and your next door neighbor keeping a job, paying a mortgage, and raising his children that is now considered a “drug seeker” or “drug addict” simply because I live in daily pain.

Recent changes in regulations and guidelines have transformed a productive member of society into one that is having difficulty making ends meet and more likely to require public assistance.  At the same time my out of pocket expenses for medical care have ballooned while my income has decreased as I moved to jobs with less stress and more flexibility.