Depending on how you read it, you could say the appointment went very well or very badly.
* He signed me off for another month
* he told me he's not allowed to post prescriptions for controlled drugs any more, and so gave me a month's worth today
* he was fine about any repercussions from my letters re him stuffing up the medical report
* he had never heard of the new drug the Pain Clinic mentioned, but understood my reluctance to try it
* he agreed there's no point seeing a psychiatrist since they'll only prescribe more pills, and that's the last thing I want and any way 'I don't think you have a psychiatric illness, do you?'
* he gave me a big hug as I left.
The positive side of me wants to think that he understands I can't work, so doesn't put me through having to defend being signed off every time. That he trusts that I'll handle the vast amount of morphine responsibly (which he actually said, and I almost completely agree with). That he's genuinely happy to help with the insurance claim. That he understands how hard it is to try new drugs and respects my decision not to. That he understands how draining it is to keep going over everything with new people, and he knows it's just depression. That he genuinely cares, and thought a hug might help me feel better.
But the negative (and currently winning) side says there's so little chance of me ever getting back to work that he doesn't even bother to ask any more. That there's nothing he can offer for the pain but masses of drugs, so he just hands them out. That he knows my career is over and I'm going to need that insurance money. That he knows nothing will work, so agrees there's no point trying any new drugs. And that I'm in such a shit state and I look so bloody awful that I need hugging.
I know I should go with the positive version, and I know that objectively it is more likely to be the truth. But I feel so utterly crap and dejected and hopeless.
I really did need that hug; though I'd managed for once not to burst into tears, I'd spent the whole appointment on the verge of it. Talking about the new drug, and my major concern, that there's a ceiling on the daily dosage, I said that at least at the moment if things get really really bad, I know I can always take a big dose of morphine, wake up a few hours later and think 'well, at least I didn't have to experience those hours'. It sounds so melodramatic and over the top, but it's true, and the knowledge of that is all that gets me through sometimes. Every time I say it out loud, though, it makes me cry, simply out of relief. Even if I'm not conscious of them at the time, knowing that those few pain-free hours have been there is a huge relief.
I was relieved, too, that he didn't try to push me into trying the new drug. Every drug trial is such hard work, and you always know it's potentially all for naught. But he feels a responsibility to encourage me to explore all avenues, and that can be very pressurizing. I felt the same way over the psychiatrist idea - the last thing I need is to have to go over and over the horrors of my life with someone who thinks the answer to everything is to throw more drugs at it. As if I wasn't out of my face enough! It was nice to hear he doesn't think I have a psychiatric illness, though slightly galling, since I wasn't aware there was even a hint of that.
And then there's that massive prescription. He said there was always the worry of an overdose, when giving out that much, and he asked if I was worried about that. I said 'no, I'm really careful to avoid accidental OD' and that I wasn't thinking of doing it intentionally.
I knew that last bit wasn't really true, I think about it all the time. But I said it because I don't think it'll be yet, and when it does come to it, OD wouldn't be my primary tool. So for now, I guess it's OK. But it felt weird saying it, knowing how much I think about it, and how desperately I want this all to be over.
I'm rambling now. I'm tired and drugged and I want to cry but I can't raise the energy (and anyway it would hurt too much).
It's just this enormous, never-ending, mind-blowing abyss. After four years, I still don't know how to do this. Or why.
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