In 2010, I experienced aggressive treatment for Stage 4 cancer of the tongue. When a doctor says aggressive, beware. I knew trouble brewed when the nurse came in with my first round of chemo wearing a HazMat (hazardous material) suit. She donned not one pair, but two pair, of rubber gloves to handle the “medicine” already in a plastic bag to set up the IV drip.
The treatment left me hairless, emaciated and shaken. But it worked. Early on, the doctors prescribed pain medication. I resisted. I let them know about my recovery. They still thought I should take it; to stay ahead of the pain. I resisted. My years in recovery trained me to resist, that taking pain medication threatened my recovery. So, I resisted; until I could not resist any longer. The pain became too intense. Eventually, I ended up on three different types of narcotic pain medication just to make my condition tolerable.
The treatment left my mind jumbled and my moods erratic. One morning, I sat and sobbed on the couch. Sandy came in and gently asked if I had taken my medication.
“No.” I choked through my heaving chest.
She came back a few moments later with a tiny pill – oxycodone. I held it between my thumb and forefinger bewildered how such a tiny tablet held so much relief and so much danger. Twenty minutes later, I felt fine! The sobs left, a wonderful feeling coursed through my body and I ventured out for a short walk. As I walked, I became concerned. Perhaps, I enjoyed the powerful drug a little too much.
The next time I saw my doctor, I voiced my concern about the medication and my recovery status. He look puzzled. He replied.
“Why that’s the euphoric effect of the narcotic medication!”
“I know! That’s what worries me!”
The doctor saw the benefits while I saw the danger. Then he said something that I initially dismissed, then gradually grasped the wisdom in the words.
“Simply take the medication as prescribed.”
As I healed from the treatment, I continued to take the opiate medication as prescribed, but I wanted to get off it more quickly than the doctors recommended. I did. And again I paid for it. I shook, I quivered, I sweated, and I felt nauseous for a few days. Afterwards, I told the doctor what I had done. He had a look of “why would you do that?”
I am grateful for the chemotherapy and the radiation. The last nine years have been filled with wonder. Yet there are still small costs to pay. Collateral damage remains. In 2018, I had four teeth removed (radiation and teeth don’t play well together). The sockets on the radiated side have not healed. When I looked up fancy terms like osteoradionecrosis (bone death) and osteomyelitis (bone infection) and temporomandibular joint (TMJ) pain, the definitions do not do justice to the pain associated with the conditions. In fact, through several rounds of antibiotic and increasingly large doses of ibuprofen, the pain escalated. Fierce jaw pain often sent tentacles of fire behind my eye, into my ear or into my teeth. The intensity fascinated me. How was it possible that something could hurt like that? My regimen of ibuprofen stopped providing relief. A full nights sleep? Impossible.
I went back to the cancer center at the advice of my dentist, and after a battery of tests, cancer did not return. My cancer doctor, who I trust completely, became concerned when I described the pain. He prescribed 36 tabs of 5mg oxycodone. With hesitation, I filled the prescription. The instructions on the bottle say,
“TAKE 1 TABLET (5 MG TOTAL) BY MOUTH 4 TIMES DAILY (EVERY 6 HOURS) AS NEEDED FOR SEVERE PAIN”
The rules are clear, or are they? The amount (1 tablet) every 6 hours. But what is severe pain? And do I need it? Some would argue that no pain is severe enough for an opiate. Some would argue that no one needs an opiate. I understand these arguments. They occur in my head all the time.
At this point in my recovery, more than 31 years, and after several months of continuous discomfort, I talked with Sandy about my situation. At the time, Sandy managed some serious pain of her own, having suffered a brutal break of her shoulder. I monitored her pain medication. We agreed, she would monitor mine.
So six times over a two-week period, before bed, I took the medication. In my estimation the pain warranted the dose. The medication helped. I slept. I took the medication as prescribed. The only person who truly knew whether or not I used the medication properly was me.
Today, the jaw slowly heals, thanks to hyperbaric oxygen treatment. Yeah, I have to spend a couple hours in an acrylic tube every business day for 30 days, but it’s worth it. I’m taking a couple ibuprofen once every few days to manage the pain. The oxycodone sits in the bathroom closet ready to be disposed of soon. I use this story to make a point.
Recovery coaches are not doctors, yet we all have opinions about medication from a variety of perspectives. All are valid. One person taking a medication is not a threat to anyone else’s recovery. Yet often recovery coaches feel threatened. Or concerned. Or judgmental. Or dubious. Or righteous. I’ve felt that way. I’ve had to manage my own stuff.
When a recoveree opens up the subject of pain medication, a few good questions to have in your toolbox are,
“How do you feel about being prescribed medication?”
“Talk to me about the benefits and concerns, if any.”
“Are you taking the medication as prescribed?”
In 2015, I finished a thruhike of the entire Appalachian Trail, a trek of 2,189.2 miles. It took 189 days and 6 pairs of boots. During all that time alone with my Creator, my purpose in life became more precisely defined. I am, simply, to coach recovery. Recovery saved me from an early demise and brought purpose to my tattered life. I have learned that I’m a coach to my very core. I am blessed to put the two together. I started work at the Connecticut Community for Addiction Recovery (CCAR) in 1999. I became the Executive Director of this recovery community organization in 2004. I have trained the CCAR Recovery Coach Academy© dozens of times and have a hand in modifying, improving and adapting various recovery coach curricula. I’m old enough now to start considering my legacy. This is a way for me to share things I have learned in my recovery, in my role as Executive Director and a trainer. I find that when I speak I present the same messages over and over. It’s time to write them down.
Phil “Right Click” Valentine
Recovery established 12.28.87