Last week I agreed to my oncologist’s suggestion of treating my apparent depression and anxiety disorders as a quality of life issue, and accepted my GP’s prescription of an SNRI. I know that objectively that was a good decision. I know that this is one way of taking care of myself and being sure that my needs are met.
Nevertheless, it feels like humiliation. I wrote about that recently, so I won’t repeat myself here.
Back to pain management, a quality of life issue par excellence. For a year or so now I’ve been white-knuckling, trying to avoid taking the narcotic pain relievers and when I eventually do take them, I’ve been taking minuscule doses that have little or no therapeutic effect. It’s not like I don’t know that; I’m reasonably conversant with these dosages.
As I’ve written before (as in this post from about nine months ago), my issues with narcotics are dual. On the one hand, I hate the way they make me feel. I hate that sleepy-dopey feeling, the impaired judgment, the excessive emotionalism, the lack of impulse control, the inability to do things that have to be done. I live alone. I have a house to maintain. After requiring my medical retirement, my employer was kind enough to give me alternative employment that I can do at home when I’m up to it. That has to get done if I want to keep getting a paycheck.
The other issue with narcotics is that I’m mildly allergic to them. My whole body starts itching, inside and out, and so I have to take an antihistamine at the same time as the narcotic. Antihistamines feel yucky, too.
So the decision for me involves balancing two elements. Which will be worse at any given moment: the narcotic-antihistamine impairment and discomfort or the unmanaged pain?
Last night I realized that (yet again) I’ve been an idiot, that my pride and self-will, my “machisma” has been causing me to make really bad decisions. I took a ridiculously tiny dose of Percoset last night and not surprisingly was up pretty much the whole night in pain.
So, a bit more of my self-image crumbled away last night. My image of myself as strong in body, mind and will, as a person who copes, a person who is in control… *poof*. I need to find a new base to stand on, and I’m going to try to start thinking of myself as a person who does whatever is necessary to take care of herself, even when that means adjusting long-held ideas and values.
Reality changes. Fundamental human values, in my opinion, do not change, but other kinds of ideas do. It is time for me to adjust the way I gauge my personal strength. It is time for me to step out of these last tattered remnants of denial and squarely face the reality of where I am with this disease.
I have metastatic breast cancer. I will never be healthy again. My pain and disability will increase. That is reality plain and simple, and as I wrote in a post about another issue:
Accepting an unpleasant or bad situation – war or abuse or cancer, for instance – doesn’t mean that I endorse it or like it. It just means that I have looked at reality and noticed that it is real. Not accepting reality is fairly insane. I can’t even work to change something until I have noticed and accepted that it is real.
At the same time, I am still the same person I was before diagnosis. I am still bright, I still have talents, I still have the ability to love and be loved, the ability to work effectively. The disease has not yet taken everything from me, and I still have the ability to cook, to watch movies, to read or listen to books, to be in touch with friends, to tell abysmal jokes, to help others and be helped by them. I can be grateful for these things while still acknowledging the devastation my disease has wrought.
It’s not going to be easy, but I’m pretty sure that this what is the landscape of the next part of my journey will look like.