Choice? What choice?

I wish I was dead. I know it's not real, I know it's the pills talking, and if it follows the usual pattern, it should only last a day or two. But right now, the thing I want most in the world is to be dead. I'm sorry, I know I shouldn't really say stuff like that, but I can't help it. I just wish I was dead.

I haven't been able to write for weeks because the morphine leaves me so foggy, and because right now, writing about it breaks my heart. But it's breaking anyway, so why not.

I went to the Pain Clinic on Monday. He totally floored me by saying, very directly, that if the morphine's not helping the pain, and the side effects are so awful, there's no point taking it. I should just come off it. But he has nothing to offer in it's place, so he's talking about no pain relief at all.

It's not like I haven't thought about this myself - hell, I went in there planning to raise exactly the same question - but I was expecting him to tell me I was in too much of a hurry again, to give it time, that I was still on a low dose. Instead, he tells me that if it hasn't worked by now, it's not going to, so I might as well give up.

I've had this thing in my head all along, that 80mg would be the magic number; that that would be the point at which it started doing some good. Don't ask me why - there's no reason for it, it's just always been there. I was on 60mg when I saw him, planning to increase to 70 that day. I told him my instinct was to keep going to 80, just to satisfy myself; either it would work, and prove him wrong, or it wouldn't, but at least I'd know I'd tried. Because the side effects are so evil, there's no way I could go through all this again if I regretted not finding out.

So I did the increase on Monday, as planned. I don't know whether I'm being particularly sensitive to them because I'm hyper-observant looking for any improvement in the pain, but the side effects seem so much worse this time. The panic attacks at night are so bad I can't even describe them. Then there's the breathing problems and the dizziness. I itch all over, I'm starving hungry but feel sick when I eat. I can't think straight, I can't write, I can't follow simple instructions or do the simplest of tasks. It's wretched. And then there's the emotional turmoil - the rage, depression, weeping, 'pseudofeelings' (reacting to things as though I'm feeling one way, when actually I'm feeling something completely different, so everything seems fake and superimposed). Oh, and then of course there's the fact that the pain is worse than it was before!

I don't think I can do it all again, just to get to the magic 80mg. But if I don't, then I went through this for nothing, because there's no improvement in the pain, so all the higher dose has done is cause more side effects. If I do go through with the final increase, I have to have all the big side effects again, worse, then just sit and tolerate the ongoing breathlessness, fatigue, and emotional wobbles for weeks, to be sure there's no improvement in the pain, and to see they ever actually go away. I stayed at 60mg for 3 weeks and was still cycling through depression, rage, pseudofeelings and oversensitivity at the end of it. I was still getting breathing problems and dizziness almost daily. So either that's 'normal' on these meds, or it takes more than 3 weeks for it all to settle down. (For me - apparently, it's only supposed to take 3-4 days!)

So after going through all that, I'll then have to decide which is worse - living in a drugged-out haze where I can't trust my emotions, where it's actually the pills that prevent me doing things and where the pain's still there; or go through months of decreasing the pills - which will be as bad as increasing, if not worse - to end up with no pain relief whatsoever.

Some choice! I know that some of the pain I get now is caused by the opiates - (the back spasms) and I also know that the shoulder pain itself is different on these pills (more crampy and made worse by heat), so I realise it's possible things could be better on no meds. I've heard of people who've found that. But none of them seemed to be as debilitated by their pain as I am, so maybe it just wasn't as bad (or maybe I'm a wimp).

But at this point, I don't know what to think, what to hope for, what to do. I feel like shit on the meds, but if they suddenly kill the pain, will that seem a fair price for the stranglehold they have on my life? But just how bad would the pain be on no meds? Would I be able to think enough through it to appreciate the fact that I've got my brain back? Even the pain itself makes me dizzy and breathless when it's really bad, so things could be just as bad.

What the hell am I supposed to do?