25 February, 2008


You likely know from Dr 9's records that, through his treatments we have been able to reduce my head pain from a baseline 10/10 to a 7/10. Also, trigger point injections were able to make me fully feel my left leg again.

However, the pain in my head being a 7/10 on a daily basis literally remains a threat to my very sanity. And while I prefer to feel my left leg rather than not, we must not forget that all I feel from all parts of my body except for the palms of my hands, base of my feet, and a certain region between my legs is unremitting, horrible AGONY.

This pain is best described in the terms of Hell: I live in a constant state of agony that I cannot get used to. From my Catholic upbringing, this is what I understand life in Hell to be.

And I live there.

And I do so because I have been treated with everything -- and I can safely say EVERYTHING -- that one can swallow, inject IM or inject IV.

The only long-lasting pain relief I have known was when I was on 50mg oxycodone via Percocet per day -- which was not sufficient to make me pain-free, but was much better than anything else I have ever been on. I was able to have a life when I was on Percocet: I worked at The Washington Post and lived by myself in Washington DC during this period. Now I live with my parents in the same house I grew up in and am waiting on Social Security Disability.

Last Friday I went to the Crappity Crap Crap Head Pain and Neurological Institute. They wanted me to check into a hospital for two weeks so they could do every treatment Dr 9 already has tried. I did not agree with their methodology because I remembered what Einstein said: "Insanity is doing the same thing over and over and expecting a different result."

Therefore, I considered their treatment approach insane.

No one will treat me with Chronic Opioid Analgesic Therapy, although current studies show that people in chronic pain do not develop tolerance or addiction, and that it greatly improves their lives.

COAT is my only hope, as absolutely every other avenue of treatment has been explored.

I may seem to be a drug-seeker. In fact, I am a classic pseudo-addict. Pseudo-addiction is an iatrogenic syndrome -- meaning, literally, that it is caused by healers. Pseudo-addiction is the rational response of a rational being whose pain has been undertreated ever since he has had fibromyalgia.

As of today, I am all but hopeless. I have an [acquaintance] who has with chronic back pain who is treated with the maximum amount of Vicodin one can take without suffering from Tylenol toxicity. But a person with fibromyalgia -- me -- who is in exponentially more pain has been made to try every treatment under the sun and kept in such misery that he has, at one point, about a year and a half ago, planned out his own suicide. It is not a coincidence that this happened after my fibro diagnosis and before Dr W put me on Percocet.

I fear that I am a victim of the political climate more than anything. Doctors are afraid to prescribe COAT because they are -- reasonably so -- afraid of the nationwide witchhunt on doctors who bravely manage pain with opioids when they are the only tools left to them.

In short, COAT is my only chance at living a life that is short of complete and utter misery. It is well-documented that I have tried absolutely everything else. And it is also well-documented that patients with chronic, non-cancer-related pain do not get addicted to or build up tolerance to opioids. Plus, for what it's worth, I have the anecdotal evidence an acquaintance provides: He has [some disease that causes neuralgic pain], and has been on the EXACT same dose of morphine for about six years. Once the "magic dose" was found, there has been absolutely no need to raise it.

Please, if you feel you can do nothing yourself, refer me to a clinic at XXXXX or a doctor who you feel you can consult with and who WILL put me on COAT. I am steadily running out of reasons to stay alive, and no one seems to care. And it is not depression that makes me say this, it is the fact that daily I become more and more convinced that my pain will never be treated appropriately.

If nothing else, please treat my back pain with oxycodone. It rates 15/10 due to my trigger points, which have made me unable to sit back in a chair for years.

If you feel uncomfortable putting me on COAT, especially since I am likely to need such a high dose of oxydone -- put me on ANY OPIOID AT ANY DOSE until I can get on a program, PLEASE.

Perhaps this program could be started at XXXXX's Adult Pain Clinic or Acute Pain Management Center. I do not know.

All I know is I need help and no one will give me what is most certainly necessary. I need a reason to have hope and to look forward to tomorrow and the day after and so on. And one cannot do that when one is in 9/10 overall pain on their absolute best days.

Thank you for any help you can give me, and for listening.

PS: My IBS pain has become so severe that I have lost 17 pounds in the last month. Physical therapy only makes this pain worse. I currently struggle to eat more than once per day -- and what I am able to eat passes right through me. I also struggle to drink more than one sip of water at a time without gagging on it, and am chronically dehydrated. Please see the blown-out vein in my right forearm as proof that my dehydration is such that it makes it incredibly hard to even start an IV for me.

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