Nearly four years ago, I started a program through the Mayo Clinic to get off of the circus of medications I had been on to control my pain. It was one of the most difficult and liberating things I have ever done, and even with the pain I still experience today, I don’t regret it for a second. While in the rehabilitation program, I was able to completely cut out all of the opiate pain medication and muscle relaxers that I took on a daily basis. This wasn’t the first or the last time I would experience withdrawal, even though the opiate withdrawal was by far the most severe of them all.
I want to interject here that I am not a doctor by any means, and that this is my own experience. Any and all medical decisions you make should be discussed and planned with the help of a licensed physician.
Through the course of my first few years of chronic pain treatment, my doctors had put me on quite a few medicines that were ideally meant to help with pain or the symptoms of pain, such as issues sleeping. Of these, I was able to safely quit taking most of them prior to my stay at the Mayo Clinic. Some I was given the go ahead to just quit cold turkey. But others required a gradual cessation plan. Of these was a tricyclic antidepressant often prescribed to chronic pain patients.
At the time over 4.5 years ago, I reduced this medication by just 10mg each time in 2 week cycles, the first week to get used to the reduction, and the second week to level out and establish a new normal before making the next reduction. During this 6 weeks, I slept terribly and was in a lot more pain as my body was trying to adjust to the different levels of serotonin (antidepressants most often effect the rate of re-uptake in nerve synapses). I did this until I just could not handle the next cut, and instead held steady at the same dosage, which I have been taking ever since… until today.
Withdrawal Take 2
In the past 3 years, I have gotten busy and simply run out of the meds a few different times and thought… maybe I can just quit. Then 3 days later, in pain and miserable, I would refill the prescription and crawl into bed exhausted, aching and shaky. Honestly, I don’t know if it was just wishful thinking, but once I really started to think about cutting it out as an actual plan vs. just a reaction to running out and saying “eh, whatever”, I really should have known better. I recall the pain, the lack of sleep, the hours of trashing around in bed, trying to get comfortable while my whole body revolted against the chemical change I was forcing it through. And that was just a 10mg drop each time, remember, not cutting it out cold turkey. Even with this experience… sometimes I just don’t employ logic when I should.
Doing it right
This time around, I sat down with my doctor and had a real discussion about my concerns and questions of whether or not he thought it was a good idea (he did) and then formulated a plan on how to safely and effectively wean me from the meds. He counted up the total number of pills I would need to completely eliminate this medicine based on our plan, and called it in.
Even with the plan in place, even with the prescription filled and sitting on my counter… I kept finishing the meds I had in the previous dosage. I rationalized it that it would be just a waste, or that if they were gone I couldn’t be tempted on a bad pain day to go back up. But I was just kidding myself… the whole bottle costs just $4 and I could have just flushed the extras if I didn’t want temptation.
The truth is… I’m scared.
Hiding behind a prescription shield
Even though I have already faced withdrawal from much stronger drugs, it still doesn’t take away the incredible fear of the pain that I know is waiting. The hardest part of rehab for chronic pain patients isn’t just the withdrawal. Its the fact that we have hidden behind a shield of drugs for years, and by setting down that shield, we have to face this monster head on. We are so incredibly afraid that once the drugs and withdrawal are gone, it will be just us and the pain. We are afraid that we won’t be able to cope with it. We are even more afraid that if we cannot cope that our doctors won’t give us that shield again.
Ultimately, this fear is stronger than the pain. I was talking to Damir just a few days ago and brought up how I was finally going to take the plunge and do the withdrawal, and suddenly found myself crying. As he wrapped his arms around me, I realized that this time is different. Not only do I have Damir, but I have a great support team of family, wonderful friends, and the incredible people I met at the rehabilitation clinic.
Pharmaceutically speaking, it is a smaller dosage to remove this time around, and if I’m honest, my pain is much less of a fixture in my life than it had been in the past. I have been doing better in these last 4 years than I had ever thought possible, and there is still that part of me that is terrified that it could all fall apart at any moment. I don’t want to subject myself to more pain. But I want to be completely free of the medications that I feel are no longer doing me and my health any benefit. I have confirmed this plan with my doctor. I also had his assurance that if I cannot handle it, that he will refill the prescription for me to continue whatever dose I am at.
Here we go!
With all of this happening, I am going to try to keep you all in the loop with me over the next few weeks as I drop my final prescription shield and face my monster head on. If you are going through the same thing, or even thinking about making changes to your medications… it’s ok to be scared. It’s ok to not know what will happen. It’s ok to second guess the decision you have made. Its ok to decide you are not ready. Just know you are not alone.