Morphine - day 2: The plot thickens

Things are a lot worse today - I was awake from 5am but the back pains were so bad I had to get up at 6. I took the first morphine at 7 but my back didn't really start to ease till after the second at midday, and even then not by much. I know the back pains come from the Tramadol, so I figured it was just that it's leaving my system and the low-dose immediate release morphine just isn't enough to make up the shortfall. I was back in bed by 7.30am, feeling absolutely exhausted, aching all over and having a really upset stomach. I couldn't even lift my head off the pillow for several hours.

I didn't find this last time, but the Tramadol back-pains didn't really start till after I went back on it after trying the morphine, so that didn't seem all that surprising. I've been saying to the doctors for ages, though, that I was worried that these back pains might be indicative of dependence on the drug, because they only happened if I missed or was late with a dose, but they kept telling me not to worry. After I tried coming off it altogether late last year (to see if it was actually doing anything for the shoulder pain - it was, so I had to restart it) the problem got worse, and it seemed to go critical when I tried reducing the dose by just one pill per day a few months ago, so I had a bit of spare capacity for the bad days. I told both the GP and the pain specialist about all this, and said I was worried my body was becoming dependant on the Tramadol, but they just made non-commital noises (presumably because they had nothing else to offer).

But I've now realised that in actual fact I AM dependant on Tramadol; I've just been doing some research and discovered that most of things I had taken as side effects of the morphine yesterday, are actually Tramadol withdrawal symptoms! It didn't happen last time because I wasn't dependant at that point.

So everything that I'm going through at the moment - the overheating then feeling freezing, not being able to sleep, the back pains, the upset stomach, feeling so weak and tired I can barely move - that's all down to the Tramadol. Most of it I've had on and off for a while, but never all at once. Fortunately, it never in all these months occurred to me that increasing the dose might ease those symptoms, (I guess I'm a bit thick, but under the circumstances, I'm quite glad). The only time I considered upping it was recently, when the actual shoulder pain was getting so much worse and I just wanted to test if the reason was that the Tramadol was failing.

What's really scary about all this, though, is that I'm what you might call a 'diligent patient' - I'd read all the literature, I knew there was a 'small risk of physical dependence' and I brought it up with my doctors as soon as I became concerned. But all they did was prescribe another drug to combat the effects (which, by the way, caused serious depression)! They didn't say 'yes that's what it is' and give me the choice to do something about it, they just stepped round the issue. If I'd realised, I would have insisted on coming off it long ago!

Healthcare needs to be a partnership between practitioner and patient, but how can that be the case if there isn't honesty? I feel really betrayed by the people I trusted with my health, and health is too precious a thing to gamble with. I wouldn't do that knowingly, so why should I be put in the position where I'm doing it inadvertently? Just because I believed what my doctors told me? Morphine's no safer, either, so the same thing could happen again. At least this time I'll know not to rely on the doctors, but to trust my own instincts.

When I started writing this, I was feeling really embarrassed to have found myself in this position; I always thought (unfairly, I now realise) that these sorts of things happened to people who were weak or lazy, people who weren't really in pain or simply didn't try to stop. Now, I just feel upset and angry that it can happen to you even when you're on the look-out for it, and your doctors, far from helping prevent it, actually let it happen.