Taking the Stairs: May 2011

Tuesday, 31 May 2011

You know, it's a scary state of affairs when you have so much first hand experience of medication, that you can sit watching a medical drama and point out the factual errors.

Like them saying 'Give him Gabapentin' as then-and-there pain relief, when we all know it's a long-term treatment - it has no immediate effect on pain.

Careless, schoolboy error, people.

Well, things didn't get any better today.

I've spent the whole day in bed, unable even to raise the strength to sit up. I've felt tearful and hopeless and in pain. The one good thing today was a surprise visit from a friend, who kept me company, ran some errands for me and even made me something to eat. It was a good job she was there - I wouldn't've been able to make more than a sandwich on my own.

I still feel pretty crap. I've got the pills right this time - ie I've taken everything - and I'm going to take two sleeping pills so I can try and get some rest.

I really hope it works, I feel absolutely shattered and I can't bear another day like today.

I feel exhausted and tearful today, and I'm in a lot of pain.

Despite a sleeping pill last night, I still woke up at 4am. It was actually the pain from the trapped nerve down my leg that woke me. I dozed from then, but it wasn't proper sleep.

I'd already got the pain pills wrong that evening, in that I thought I only needed one Oxynorm at 7, not two. So then even though I took two Oxycontin at 10, I was already 'behind' in terms of pain control.

I'm going back to bed now because otherwise I'm just going to sit and cry.

Monday, 30 May 2011

Fear not, balance is restored.

I feel as shit as ever.

Sunday, 29 May 2011

Following orders

This evening I've done as I was told and taken 30mg of slow release morphine.

As a result, I haven't needed any quick release since tea-time. I feel pleasantly stoned, and more importantly the pain has gone down. I'll be taking the sleeping pill shortly (I don't want to take it too close to the 10pm Lofepramine, in case they interact).

Also, for the first time in three months, I've found myself wishing I could go back to work. It's since my doze this afternoon. I've been feeling stable, low pain and not so exhausted. And I've quite fancied the idea of doing some work.

Wouldn't it be incredible if the key to navigating the current levels of pain and depression were something as simple as getting enough sleep!

I remember when I first started one of the anti-seizure drugs they tried for the pain (either Gabapentin, or Pregabalin, Son of Gabapentin) - for the first few weeks it made me sleep all the time and the pain levels dropped dramatically. Unfortunately, it didn't last, but I remember the pain consultant agreeing that the right amount and kind of sleep can be central to managing pain. I'm sure the same must go for depression.

Please let this be an ongoing feature, not just a blip to tease me with.

I dozed off this afternoon, and it's amazing how much better you can feel after a bit of sleep.

Obviously it wasn't just the doze, it was the sleep last night, but I do feel a lot brighter. Even if it only lasts a few hours, it's a nice break, especially as the pain went down for a bit too (it's back up now).

Ok, still here.

Felt no side effects at all. In fact, I don't know if it worked; I did sleep, but I still woke up at 6 and the dozed for a few hours.

Maybe it worked, I do feel more rested than the last time I got any sleep, though I could quite happily go back to bed, and I probably will.

Saturday, 28 May 2011

I'm so scared of taking this sleeping pill that I'm sitting here at nearly midnight, playing Solitaire and watching Silence of the Lambs.

It's fucking ridiculous. So here goes. I hope I wake up in the morning.

Sleeping pills

I have very mixed feelings about starting these sleeping pills tonight.

It was a struggle just getting hold of them -my normal pharmacy didn't have them in and I nearly disgraced myself by bursting into tears when she said it would be Tursday before she could get them in.

Fortunately, I managed to talk her into calling other pharmacies to see if anyone had them in stock. Someone did, and what's more it's a place I didn't know about, so it gives me another one to try each time. It's nearby, but requires negotiating a nightmare roundabout where you can sit and wait for hours.

Anyway, I got them, which means I'll be trying them tonight, but I'm scared of the kind of drugged-out feeling you often get with these types of things. But at the same time, the thought of actually getting some sleep is very attractive.

There's also the minor point of the side effects. I didn't read them all, but I could miss seeing the warning about it causing depression, psychosis and nightmares - a cheery thought. Oh, and guess what - they contain bloody lactose!!! Sigh.

I stupidly overdid it this morning after I got back from prescription-hunting.

I was looking for some paperwork and I got carried away, using my bad arm even though it was in the sling.

I've had nasty neck pressure and a hideous headache ever since, as well ad bad shoulder pain.

Stupid cow.

Friday, 27 May 2011

Even more pills

I came away from the doctor's today with yet another handful of prescriptions.

It wasn't my intention, but because the drive had so aggravated the pain, he said I could call rather than drive for the next appointment, meaning I needed a month worth of meds, not two weeks.

On top of that, he gently told me off for being so insistent on reducing the long release morphine, when the pain is so bad it's keeping me awake every night. He's right, of course, but I just, as a matter of policy, want to minimize how much I take. It sounded pretty lame when I said it to him and he was kind enough not to point out how stupid it was under the circumstances. It's probably an indicator of how tired and befuddled I am from no sleep and loads of meds, that it hadn't occurred to me to revisit my decision.

So, I'm supposed to go back to 20mg of slow release morphine - on top of whatever quick release I need - and even increase it to 30 if necessary. I guess I just have to get out of this mindset of worrying about how much I'm taking, and always trying to reduce it. The purpose of the morphine is to make life more bearable. It can't do that if I refuse to take it.

On top of all this, he's now prescribed me sleeping pills. It's something we've discussed in the past, but he and the pain consultant have always gone on about 'quality' of sleep rather than 'quantity'. As a result, they've both been very loathe to give me them in the past (and I've never been hugely keen on the idea myself).

I think the sleeplessness, and it's effects, have reached a critical point, though. Getting one good night's sleep used to be enough to refresh me and wipe out the tiredness from multiple nights without rest. Now though, I've had so many sleeplessness nights that when I do finally get a good night, it simply isn't enough. In fact, it makes me feel even worse; I feel even more exhausted than on the days when I haven't slept at all. I guess the doc could see the exhaustion on my face - as well as the fact that I was sobbing from the pain, which he said he hadn't seen before.

So now I've got something called Zopiclone. Apparently they're addictive, so I have to be careful about how much I take, but they're OK with both the long and quick release morphine. I just hope they work, and I can finally get some rest.

Driving limit

So, the maximum amount of time I can drive before the pain becomes completely unbearable is now just 40 minutes.

I found that out going to the doctor's this afternoon. It's a 50-min journey - I kept going for those final 10 minutes because I wasn't sure once I stopped if I would be able to move again soon enough to make it to the appointment.

He was running late, so I had half an hour to wait before I saw him and by then I was still in agony. I could hardly walk into his office and cried through the whole appointment. It was only force of will that had kept me from crying in the waiting room - partly from the pain, partly the stress of people chattering around me (and there were only a few of them, but to me, the noise was unbearable).

It's 1am and the pain is keeping me awake, again. I should've taken the double dose at 11, as I suspected, but I thought I could get away with a single. Or I wanted to think I could, at any rate.

Thursday, 26 May 2011

Feeling too shit to actually write anything. Pain, depression, exhaustion.

Why won't it stop?

I'll give you everything I own, if you'll just take away the pain.

Everything except the chins. You're not having my babies.

Wednesday, 25 May 2011

Completely unprompted, my friend suggested coming up with increasingly outrageous answers to questions about what happened to my arm. Here are a few we started off with:

I tripped on the way up into the spaceship
I was base jumping off a windmill and forgot about the sails
I was trampled by a wildebeest

Let's see what else we can come up with.

Thank god for friends.

I was feeling completely shit earlier on -the pain had been bad all day, the neck pressure was bubbling away, I was feeling exhausted and bursting into tears all the time.

A friend was coming over this evening, but the way I was feeling, I really just wanted to cancel. I figured it would probably do me good to see someone though, so I didn't. She was very understanding and just kept me company watching TV; by the end of the evening, I was feeling a bit better. I could at least stop crying anyway.

The pain flared again, so I've had to take even more pills, but a while not crying is good.

Finally got some sleep, thank god, but there've been so many sleepless nights latelt that I still feel completely exhausted.

Also feel very low, miserable and I just want to curl up and cry. Or something that rhymes with 'cry'.

Tuesday, 24 May 2011

Very very bad.

Wish I could just rip off my life.

Was longing for my mum earlier; not my real mum, the mythical one that would actually make me feel better. But nothing ever does.

Just want it to stop.

Lactase enzyme

Apparently, you can get pills of 'lactase', the enzyme the body needs to break down lactose, and which is missing in people who are lactose-intolerant.

I'm seeing the doctor on Friday, and I'll ask him about it then. I don't want to take it every day - I'm taking enough pills, thanks very much - but apparently it's good for one-off situations. So for instance if I have a friend coming to stay - like last week - or just coming to visit, like tomorrow, I can pop a pill or two and then get away with eating like a normal person.

If I'm ever again feeling up to going out to eat, it would also mean that I could order off the regular menu. This lactose-intolerance thing is so limiting, it would be nice to feel that ocassionally I could be free to eat what I want.

Horridly spaced out today - partly the meds, partly the fact that haven't slept for two days.

Pain bad, neck pressure not great either.

4.30 ... and when I finally manage to doze off, the pain shocks me awake.

AAAARRRRRRGGGGGGHHHHHHHHH!!!!!!

All I do, day after day, night after night is take pills.

Pills. Pills. Pills. Pills. Pills.

I can't begin to tell you how fucked off I am with it. And with lying awake night after bloody night.

Someone had better come up with a reason to keep doing this pretty damn quick, because I'm all out.

Monday, 23 May 2011

Oh god. I had to get up at 10.45 to take the Lofepramine (I've already missed one dose today due to this morning's stomach problems, I can't afford to miss another).

Just the action of turning off the TV, taking the medicine and scrubbing my teeth was enough to kick off the awful back spasms I had last week.

I put the heatpad on my back as soon as I could, but that's making my shoulder worse, and its causing the rest of my back to tense up. I haven't been able to get undressed because the spasms and the shoulder pain are both so bad. And now I'm getting shooting pain down the numb area in my leg.

Christ, will this never end?

Paralysed by pain

Stuck in my armchair, paralysed by pain.

Took second slow release pill at 9 and was planning to take two quick release at 10, but it's flared so badly, had to take them early.

Can't go to bed, because can't get up. Struggling to breathe. Can't reach for my drink because it's too heavy to lift from the shelf next to me. Also feeling very sick from all the morphine; glad I left a box of the ginger chews within reach.

Good job the phone is always on the arm of the chair, so I can get at it in an emergency.

Neverending

What a shit 24 hours.

The awful pain that kept me awake all night backed off for a few hours this morning, but then started up again. I didn't get any relief though, because the stomach problems caused by the morphine came to a head.

The shoulder pain started again around lunchtime, and its been getting steadily worse for the past several hours. I'm dreading tonight.

I've taken 70mg of morphine since midnight, I'm going to need at least another 10 quick release, and I'll have to take an extra slow release pill to help me get through the night.

It's hard to believe that just a few days ago, I managed a whole day on just 35mg.

On top of the shoulder pain, there's the continuing numbness in my right leg, niggling neck pressure and rising anxiety that's making me want to hide under the covers, burst into tears, or both.

I just feel completely overwhelmed by the endless symptoms and problems. There's never any let up. I don't know how to keep doing this, I really don't.

The good thing about having lost the sensation down my right leg is that whereas I used to get a lot of pain in my right hip from lying on that side for so long - obviously a pressure point - I now can't feel it.

That's particularly useful, having spent the whole of last night lying awake - I couldn't sleep because of the pain - and trying, unsuccessfully to catch up on that sleep all afternoon.

Fallout

Chatting with my sister this evening was lovely, and I managed to only cry once, but now I'm feeling really low and angry and anxious.

I think it's because talking to her made me think about very 'normal' things like work, and the thought of that still scares the shit out of me.

I'm getting periods now where my mood is more normal, but it's interspersed with periods of very not-normal. Like this morning, where I just kept bursting into tears, the point talking to my sis about something which really didn't deserve tears, but I couldn't hold them back, and now, when I'm so anxious I want to scratch off my own skin, and I can't decide whether to sob hysterically or throw things around the room.

I'm terrified of the doc forcing me to go back to work in this state, simply because there are some steady periods, because I know I'll only last half a day before I go to pieces, and and then off again.

But what if I can't convince him that I'm really not ready? That's what the anxiety is all about, and the tears and the anger - that I can't make him understand.

The appointment's not till Friday, and I don't know how I'm going to get through the next four days.

2.15am. To cap it all, I can't sleep and the panic attacks are very bad. I'm constantly terrified because I feel out of control and powerless to protect myself. I can't make people do what I need them to do in order to stay safe, and that terrifies me.

3.30am. Still no sleep and pain awful again; four pills since midnight. Shit.

The pain has been pretty bad today, particularly this evening.

I was on the phone with my sister during the latter part, and so I didn't go to bed as soon after the 9.30 morphine pill as I normally would. A lot of times that doesn't matter, but today it's a problem because the pain is building again and I'm going to have to take more if I'm to have any chance of sleeping.

The good thing today, though, is that (largely because I spent most of the day in bed) I've managed to go without the sling, and just rest my arm on a cushion. It's the first time in weeks that I've been able to get away with that, so it is a victory.

Now, final pills and bed.

Sunday, 22 May 2011

Crap day. Depression really bad - only just managed to drag myself out of bed. Spent half the morning in tears.

Nausea really bad and have no appetite.

Yesterday's better pain day wasn't worth today.

Is there any way that the sudden loss of sensation in my leg, stemming from a nerve problem that always affects my neck, could mean that the whole shoulder problem is linked to the numb patch on the inside of my left knee, that I've had since the accident?

The leg problem proves that everything is more interconnected than I thought; maybe it goes even further than that?

Loss of sensation

I can't feel the outside of my right thigh, and i'm starting to get shooting pains down there.

It seems like sciatica and I think that during the last session of severe neck pressure, either the episode itself or the TENS machine to ease it trapped a new nerve, and it's not coming free.

I've had this from time to time since the accident, but never this bad or for this long. It's only ever lasted a few days and been mild numbness - never total loss of sensation or any pain.

I don't know what to do about it, save try the TENS machine again. The last thing I need is another chronic problem. It worries me though.

Saturday, 21 May 2011

I've taken the necessary doses of quick and slow release morphine. I've closed the windows because I was chilly (sorry chins, you'll just have to cope), and I've found a comfy position to sit in.

It's nice.

Could be worse

I know it's a mistake to say this out loud because it will jinx it, but physically I haven't felt too bad so far today.

I've only taken one quick release morphine pill (yesterday I was an hour shy of numbers 5 and 6 by this time), the pain is bearable and the neck pressure is causing only a small headache. I do still have that numbness all down my right thigh, which is a bit disconcerting, and I'm having to wear the sling because my shoulder is too bad without it.

Compared to yesterday though, that's all pretty good. Mood-wise, things aren't so great - I've been feeling pretty fragile and on the verge of tears all day. That might be down to yesterday's shrink appointment, or it could just be how I'm feeling.

9.30pm. Today has been the best pain day for several months. I haven't done anything to test it, but I've only taken three quick release morphine pills, and that's with having halved the overnight slow release dosage. So my total morphine intake today has been just 35mg, compared to 90mg a few days ago. I hope it can continue, but who knows.

Friday, 20 May 2011

Since the latest flare-up of neck pressure, I've had numbness all down the right-hand side of my right thigh.

The neck pressure is caused by trapped nerves, so I can only imagine that although the nerve has release as far as my neck is concerned, it's still trapped for my thigh.

Update

It's been really nice the past few days, having my best mate staying. It's a lot easier to bear the awful pain kick-offs when you're not doing it all by yourself.

There has been quite a bit of pain. There were the terrible back spasms on the first night (see my earlier post) and then I woke up in the very early hours of yesterday morning with terrible shoulder pain.

I thought I was going to have to take a couple of pills, which obviously I didn't want to do. As a last resort before that, though, I tried some of the mindful breathing techniques that I've been using against the panic.

I wasn't all that optimistic, but it did seem to help, and I was able to fall back to sleep without more pills.

The pain didn't start off too bad the next day, but a trip to Tesco was enough to bring on another flare/up that took several hours and pills to go down.

Despite all that, though, I was still determined to keep trying to reduce the amount of morphine I take, so last night I only took one slow release pills, instead of the usual two. Not only does this mean less morphine, it also means less lactose, because any slow release opiate contains lactose (must be something to do with the hydrochloride that makes it slow release).

I'd had about 36 hours of agonising stomach cramps due to lactose already, so the more I can reduce it, the better.

I was reasonably OK last night pain-wise, though I did have to take extra quick release pills, but pain levels are high today - I'll have to see how it goes to decide if I can carry on with the experiment tonight.
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Wednesday, 18 May 2011

New nightmare

What a bloody awful day yesterday!

The neck pressure was bad from the get-go but the burns on my back from the TENS machine the day before, meant I couldn't put it on again. I decided to try a hot bath instead, as that seemed to help the other day.

I was feeling too weak to manage sitting in the shower, so lying down in the bath seem a safer idea. Unfortunately, although it did help the neck pressure, the heat seemed to sap every last vestige of strength I had.

It was a terrible struggle just to get out of the bath, get dried and dressed, and then I collapsed into bed. That was at 12.30, and I was stuck there until 7pm. I just had no strength at all - I couldn't even raise my head. I ached all over too. It didn't help that the shoulder pain started to flare again shortly after the bath, so I had to take the second double morphine dose of the day. That also knocked me flat. Luckily, a friend is staying for a couple of days, because it would have been a bloody miserable day on my own.

I finally managed to get up in the evening, but then I must have twisted funny opening the Lofepramine bottle at 10.30. Within minutes I was in absolute agony, doubled up with my back in spasm. It started with the muscles where the TENS pads sit going into spasm, then it spread into horizontal bars across my back, then the bars quickly joined together. I couldn't talk or move, it was agony just breathing.

I took a double dose of morphine, but it just wasn't working fast enough and I was panicking it would eventually get too hard to draw any breath at all. I felt like heat might help, but it needed to be hot water, not the heatpad, and I didn't dare try the bath, because even with my friend there, I wasn't sure I'd be able to get out again.

The only option seemed to be the shower: my friend got it going, then helped me in there, fully clothed (getting undressed was completely impossible). I sat on the floor of the shower for ages with her firing the hottest shower possible at my back.

Gradually, the heat and the pills kicked in and the spasm released enough that I could get up and make it to bed.

Unfortunately, that wasn't it though - my back was still very tight all night, my shoulder kept kicking off, I felt very out of it with all the meds, but to take more and more of them because if my shoulder. I got no sleep whatsoever, and god do I feel rough this morning!

Monday, 16 May 2011

Immoral

With all this time off sick and unable to go out or do anything, I've had a lot of time to spend in front of the TV, and I have a question.

With all the terrible things that happen in the world - war, murder, genocide, earthquake, volcano, tsunami, domestic violence, child abuse and god knows what else, why is it necessary to create disaster movies?

Is there really not enough horror in the world, that we feel we have to create it for 'entertainment'? What kind of a society are we, that we get our jollies watching innocent people go through hell?

I know it's supposed to be about escapism. It's people overcoming adversity, surviving against the odds, doing things they never thought they could, and so on, but there are people out in the real world who do that, and more, every day.

If we want to look up to someone for their resilience or ingenuity, we shouldn't be looking at the box in the corner of the lounge, we should be looking at each other.

There's now even a programme based around therapy sessions, for god's sake. As someone who has worked through endless incredibly difficult and traumatic therapy sessions, in order to resolve deep-seated problems, the last thing I want to do is to see the process trivialised for the edification of brainless viewers.

Sunday, 15 May 2011

If things carry on as they've been going, I'll've taken half as much morphine today as yesterday.

That sounds like a big deal - and it is - but it actually says more about yesterday than anything else, because the pain was so bad yesterday that I ended up having to take twice as much morphine as the 'norm' of the previous week.

I've been aiming for a max of 60mg a day this last week, which is 20mg less than most days for the previous three or four weeks. Yesterday, it was 90mg.

I'd like to get the daily dose down even further, but we'll just have to see how it goes.

Never should've opened my mouth. 9.40 and pain has picked up a lot, so had to take extra morph with the last dose of the day. Let's hope that's it, but it's really not feeling good.

10.30 I bloody hate being forced to eat when I'm not hungry, just to boost the morphine. I bloody hate it!

Cramps

I've had terrible stomach cramps all afternoon.

It's been ever since I had lunch, which was quorn escalopes with a mozzarella and pesto stuffing, plus veg. I haven't had them for a long while, but I used to eat these all the time.

The cramps feel like lactose intolerance; I'm wondering if the lactose-laden Lofepramine pills I had to take till we could find the liquid form might have made my intolerance worse.

If so, rather than experiencing intermittent nausea when I take in too much lactose, I'm looking at these much worse, painful cramps.

Do I never catch a break?

Disaster

Oh god. Just put the TENS machine on because the neck pressure was really bad - and discovered that one of the leads had failed so it wouldn't work.

This was a huge disaster - I really really need it today. Have managed to get one of the old leads working and will order new ones tomorrow. Just hope the stand-in lead - which was replaced because it had become unreliable - can last.

Think I'd better order two sets tomorrow, on urgent delivery.

Please. Please. Please.

All I want is to get some sleep.

Please take the pain away and make the panic attacks stop.

Please.

Saturday, 14 May 2011

The pain has been very bad today, and the only solution has been to drug myself to insensibility.

I've had to take double doses of morphine all day, close together, and still it was only late this afternoon that I finally got some relief. By that time, there was so much in my system that this period of 'relief' basically meant I was so zonked, I couldn't stay awake.

Unfortunately, despite a dose less than a hour ago, there's now not enough morphine in my blood, and consequently I'm back in pain. There *is* enough though that I feel fairly out of it, so hopefully I'll manage not to care.

Paracetemol changes

To try and get the maximum benefit out of the morphine, I'm changing how I take the Paracetemol.

I've already discovered that it can help the morphine release into my system, so I'm now taking single Paracetemol every four hours, as before, then another pill half an hour after each morphine pill. This should make the morphine more useful, and avoid me having to snack (another way to boost the morphine) which will in turn reduce the likelihood / seriousness of the nausea.

If I'm less sick, I won't feel so crap all the time, and I'm more likely to be able to eat proper meals - obviously a good thing.

Wanderlust

As I was lying in bed last night, trying to sleep, I was thinking about how much I miss travelling. It always used to be my favourite thing.

I miss thinking about all the things I might be doing while I'm away, and packing for every eventuality. I miss reading up about my destination - I was a Lonely Planet and Rough Guide junkie.
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I miss the excitement of getting up in the early hours to travel to the airport. I miss Travellers' Cheques and exotic currency. I miss getting a map of a strange town and heading off by myself to explore.

I miss unfamiliar public transport systems and the thrill of successfully making it to my destination. I miss the scenery and the architecture, the shopping and the food. I miss taking hundreds if pictures and keeping journals of where I've been and what I've done. I miss buying presents for people, imagining their faces when they see them.

I miss getting back and telling people all about my adventures. I miss creating photo albums and scrapbooks of my trips, and randomly flicking through them, reminiscing about what I've seen and done, who I've met and where I've been.

I miss all of it.

These are the places I've been:
Colombia x 2
Mexico
Peru
Cuba x 2
Jamaica
Spain x 4
Belgium
Holland x 2
Germany
Corfu
Denmark
France x 3
Ireland
Egypt
USA

The pill / food timings are all messed up for today.

I had a really bad night - the pain wouldn't go down, despite extra pills, i was having awful panic attacks, and I just couldn't sleep. I was awake for hours.

I took the early slow release pill at about 6.30am. I must have fallen asleep at that point, though it didn't seem likely at the time.

Anyway, I woke up at 10.45. Since I hadn't taken any of the other pills, or eaten anything, I couldn't take the 11am Lofepramine (well, not without feeling sick all day, and I'm just not up for that).

That's the big problem with everying being contingent on everything else, rather than arbitrary times - if it goes wrong, you spend the whole day trying to work out what to take when.

Friday, 13 May 2011

Compressed pain

I seem to be having a whole day's pain in one evening.

Things were bad first thing, but after a hot bath, the pain eased. I did alright for the rest of the day, but the it flared up around 5.30pm.

Since then, the pain has been on max. I've been trying all the usual stuff to activate the morphine - snacks, extra Paracetemol -but it's taken so long that by the time it's finally working, it's also starting to wear off.

And so it all begins again. I'm on the second cycle like this of the evening and this time it never did seem to kick in properly. Which will probably mean even more pills before I can get any sleep.

Medication rules

I originally posted this last night, but it got lost when the parent site went down...

I've been doing quite a bit of experimenting lately, so here are the latest findings re food / medication timings and interactions, designed to minimise nausea and get the maximum benefit from the meds.

•Food:
- 1.5 hours BEFORE Lofepramine (except morphine-boosting snack)
- 1.5 hours AFTER Lofepramine
- 1.5 hours AFTER Oxycontin
- best effect from 30 minutes AFTER Oxynorm

•Morphine-boosting snack:
- 30mins - 2hrs AFTER Oxynorm
- 30mins - 2hrs AFTER Oxycontin
- 30 minutes BEFORE Lofepramine

•Lofepramine:
- 30 minutes AFTER Oxynorm
- 1.5 hours AFTER Oxycontin

•Oxynorm
- 30 mins AFTER 10mg Oxycontin
- 1hour AFTER 20mg Oxycontin
- 30 mins AFTER Lofepramine in emergency

•Extra morphine-boosting Paracetemol (scheduled doses reduced to one, to compensate)
- 30 mins - 1.25hr AFTER Oxynorm

Lost my voice

9am The blog upload site has been down for nearly 12 hours now, and I'm finding it really hard not having that outlet. I feel like one of my support mechanisms has been torn away, and it makes me feel very vulnerable having to cope without it.

The outage also robbed me of the opportunity last night to post that I was actually experiencing a rare moment of optimism.

5.15pm Another 'working' week over. Another week that I've been forced to spend mostly in bed. Another week of pain and tears and hopelessness. Of feeling lost and adrift and completely out of control.

When do the weeks of improvement start? One, two, three months down the line? Jesus Christ.

5.45pm The pain improved significantly after a hot bath this morning, giving me a somewhat better day than expected. It's flared up again now though, and is really bad. On top of that, I'm feeling very sick, because I had to take big doses of morphine, but I was starving, so had to eat too close to the pills.

Wednesday, 11 May 2011

It's required extra morphine and my back is breaking open from all the TENS usage, but I'm finally getting a bit of relief from the pain.

I think if it kicks off again before I can fall asleep, I'll just say the hell with it, and take whatever I need.

Oh, and this time, I'm not going to fuck it up by moving.

I've done it again.

For the first time today, I actually felt I could move around just now, so I cleaned out the chins (none too soon - they absolutely reeked), and as that had gone well, I vacuumed round the cage. It was absolutely fucking filthy because it hadn't been touched in weeks.

I was really careful, kept the sling and the TENS machine on, took breaks etc, but now I'm in freaking agony and have had to go to bed.

I might as well just stop trying to have any kind of normal life, and be a complete bloody vegetable. Oh no, wait, the Government, in it's infinite wisdom, tells me I'm not that disabled and the only thing I can't do is cook a meal. Thank god. For a minute there I thought I couldn't cook, clean, go out, shop, or carry out basic personal care. Because your poxy form is clearly more revealing than MY SHITTY LIFE.

Why worry?

What really is the point of worrying about rising morphine levels?

I don't envisage a post-morphine era. It's not like I'm looking ahead to a time when I can come off it again. It's not like a see a future of any sort.

Surely it makes more sense to take whatever I need in order to be comfortable - as close to pain-free as is possible. And when I reach the point where they won't give me enough for that any more, or it simply stops working, then I end it.

At least that way, I could have a bit of time in some relief. Of course, I still wouldn't be able to work because the morphine causes depression, so that would rise in direct proportion to the pain relief.

Which is better then - being debilitated by pain plus depression, or having less pain but still being debilitated by depression of a higher level?

Tuesday, 10 May 2011

Have you ever thought about the fact that every year, we celebrate the anniversary of our birth, but every year, the day that will become the anniversary of our death passes by, unseen and unmarked?

It's kind of creepy, when you think about it.

I've always wondered how you tell which of the blood vessels you can see at the wrist is the artery. It occured to me this morning that it's the one where you can feel your pulse (bloody obvious, when you think about it, but still).

Actually, there are two arteries in the wrist. The radial artery where you can feel your pulse (beneath the thumb) and the ulnar artery on the opposite side of the arm.

I guess it's not hard to figure out why stuff like this goes through my head.

8.45pm And right now, facing another two months of this - at the very least - all I really want to do is cut it.

No words

Oh. So now I know why the doc signed me off for another month without even discussing it.

I thought it was because he suspected it would take the full four weeks for the Lofepramine to take effect. Turns out, you have to wait three MONTHS to know for certain if it's working and how well.

I've just been in to see him. Had a hideous trip over - despite the TENS machine and my special driving cushion, by the time I got the I was in such agony that I couldn't get out of the car. (I'm writing this from the cer park st home, since I can't actually walk yet.)

When I did finally get in there, I told him that things are currently a lot worse than before. Also talked about the nightmare headaches and sickness. He then proceeded to tell me that we have to wait another two to three months from this point before we cab start adding anything to the Lofepramine. In that time, it could start to help both the depression and the pain. But we can't do anything before that.

So basically, I'm now stuck waiting, for at least another two months. I'm so angry and upset I can't speak. Two Fucking Months. Why bother? Why fucking bother?

Monday, 9 May 2011

Managed the whole day out of bed yesterday. Unfortunately, lasted less than an hour this morning. Hope it's not down to the pill reduction, but it probably is.

Meant to be going to shrink today - who knows if I can.

Sunday, 8 May 2011

On my own

I should feel good this evening. I've managed to cut the morphine by 20mg today, through a combination of the TENS machine, the sling, refusing to move and staggering the two slow release pills across the evening instead of taking them both together.

Rather than feeling good and proud of myself for what is, in reality, a huge achievement, I just feel miserable and shit.

My sister phoned earlier, and although we had a really nice chat, and she was lovely as ever, she said she can't come and visit at the moment because of car trouble.

It's a perfectly valid reason and I know she wouldn't say it unless she had to, but it still really upset me. I couldn't help crying while we were in the phone, and I kept bursting into tears for hours after.

It's left me feeling completely crap. I just feel miserable and empty and low. I'm dreading the start of yet another day, yet another week.

I'm in love with my TENS machine. I would have babies with my TENS machine if I could.

Me and my raisin...

I had an amazing experience with a raisin this morning.

I realise that sounds weird - and vaguely pseudo-sexual - but it's true. I did the 'mindful eating of a raisin' meditation from the new book the meditation teacher recommended, and it was really interesting.

The meditation basically has you eat three raisins whilst giving your entire attention to the process. You look at, listen too, smell, taste and finally consume the raisin with total concentration. It's amazing how different an experience it is from eating normally. Crucially, doing that redirects your attention, so for a little while at least, I wasn't conscious of the pain; that, of course, was the whole point of the exercise.

I've never had any time for people who whinge and complain about a situation, but then refuse to do anything about it.

Like someone complaining about their awful husband - it's your choice to stay. If you don't like it, leave. Or the person who complains about their job but won't look for a new one; moans about their house, but makes no effort to move. The list is endless, you get my point.

Whenever I've been in situations like that, which I haven't been happy about, I changed them. I left the relationship, I changed jobs, I moved house.

But what are you supposed to do when there *is* no solution? If there was something that could be done about this pain, I'd jump at it, but there isn't.

SO WHAT THE FUCK DO I DO?

Saturday, 7 May 2011

Hopeless

I felt like I'd done quite well managing the pain today: I'd managed to lengthen the gaps between morphine doses, but the fact that I keep needing double doses means I still ended up taking 8 top up pills. On top of the 40mg of slow release, that's a total of 80mg.

That upsets me because I had to work hard at timing the doses and tolerating the pain to not take more, and interlacing it with the other meds to minimise the nausea, yet the reward I get for all that hard work - and believe me, it's really hard - is knowing that I've taken as much as I used to be on before. And in reality, if I'd been trying to do more than just stay home, I needed more.

And it worries me because I remember how evil it was coming off morphine before. This was only ever supposed to be a temporary measure, but now look - I'm on the same amount, so getting it back down again will be awful. Not from the pain perspective - ignore that for a minute - but from the body's-tolerance angle.

Yet I don't see any alternative. The pain consultant always says it's a question of whether the pain is better or worse on the morphine. If it's better, it's worth taking. Well, it is better, but it's still not enough to actually make life bearable.

So what the hell am I supposed to do?

Medication jigsaw

In the four years since the accident, I've taken so many different medications. It's often been quite a logistical nightmare to fit them all into the day in the right places, to minimise the negative interactions.

For the first time, though, it's not just about the interactions between meds, it's also - and crucially - about the mixing of meds and meals.

It's easy enough when what you're taking has to be 'with food' or 'after food'. But when it's a question of having to take one thing 2 hours after food and something else 45 minutes after eating, but they can't be taken any closer to each other than 2 hours, you start running into trouble.

You end up with not enough hours between meals, not enough 'eating events' in the day and simply no way of making the jigsaw fit. And getting it wrong leaves you with either unbearable side effects or ineffectual meds. It's a nightmare.

Flattened

God, every night I get flattened by the morphine, so I wind up dozing in front of the TV like an old lady.

I think it's because it's the only time I take the Oxycontin and Oxynorm close together; in the morning, there's usualy about a 5 hour gap between them, but by the evening the pain is so bad that I rarely manage 2 hours. And even though I've changed my eating habits so I'm only having a sandwich in the evening, that's still enough to trigger the morphine and zonk me out even more.

It's not like I have a social life at the moment, but if I did want to go out, I don't know how I'd ever manage it.

I found myself in something of a quandry last night.

I'd had a really crap day, in tears on the phone to a friend, morphine not working so pain bad, fighting neck pressure headaches - the usual.

I couldn't sleep, so had been lying there for hours, then there was a massive roll of thunder. Normally, I'm not particularly bothered by thunder, but I was already jumpy from the panic attacks, and this time it scared me to death. I was awake for hours after that, with the lights on, waiting for more, which actually never came.

I became terrified that lightning would hit the building, come in through the window, and hit me. Childish fears, but there you go.

The quandry part, though, came when I found myself thiking 'I don't want to die'. For months now I've been fantasising about dying - doing it myself or hoping fate would step in. Either would've been fine, as long as I wound up dead.

In all that time, I would have welcomed a lightning strike with open arms. But there I was, wishing it wouldn't happen. I didn't want to live like this - still don't - but I didn't want to die. Which leaves me in a quandry.

Thursday, 5 May 2011

Call yourself civilised?

I get so sick of writing the same thing over and over. I get so sick of being in pain all the time.

Why does it never change? Why does it never get any better?

I don't know how I'm supposed to just keep going and going, in a situation that can never change. Where am I supposed to get the energy, the motivation to get up each day, when I know that all I'm looking at is pain and fallout from the pain?

When you're in a crappy job that causes you nothing but trouble, everyone tells you to move on. When you're in a shitty relationship that causes you nothing but grief, you leave. But when the root of the problem is your own body, you're supposed to just put up with it.

No-one in their right mind expects someone in an abusive relationship to stay there, but when it's your own body causing the pain, that's somehow meant to be OK. It wouldn't be OK for an animal, so why should it be OK for me?

I don't understand. Everything in society seems to be geared around extending my suffering. In any other situation, it would be not only acceptable but morally expected for someone to do everything they can to get out of that situation. But I'm supposed to just accept it and carry on. Any talk of taking action to redress things is somehow wrong, little short of a crime.

How can it be that the 'crime' is ending someone's suffering? How can any 'civilised' society, any religion, any government claim it's right to force a person to live in endless agony?

It doesn't matter how many times I write about it, the situation never changes. I'm still looking out over the same bleak landscape.

I wish I could just give up and do it.

I'm currently in the position where both the slow release morphine pill from 5pm and the two quick release ones from 6.30 are all releasing together. Unfortunately, all I'm getting is major side effects - I feel off my face - but no pain killing benefits. Which means there's no point taking any more, because they simply aren't working. Terrific

BOGOF offer

Do you know how horrible it is to go through life constantly feeling like you're drunk?

It's horrible. You feel unsteady on your feet every time you stand up. Your head feels wobbly and like it's not properly attached. You feel faintly sick all the time, and when you get hungry and eat anything, you feel even more sick. Your limbs feel weak and useless and you can't focus your eyes properly.

What's worse, I think, is the way your brain feels like it's operating through sludge. Like it's immersed in goo. It functions, but at one third speed. All of the processes are slowed down and every output needs to be double checked, since you can't rely on anything it tells you.

That's how I feel all the time at the moment on all these meds. I know there are some people out there who enjoy that feeling - of course there are, that's why people take the stuff recreationally. But for me, it just feels like an added disability.

So I get a very unwelcome two-for-the-price-of-one: my actual disability, and a spare one, just from all the meds.

Bloody heatpad

The heatpad. The bloody heatpad - that's what's been causing the neck pressure, screwdriver headaches and migraines!

I've been using it every morning because my back has been so stiff and sore getting up. It's helped my back, but has obviously been causing muscles to contract and pinch the nerves leading up into my head.

Once it's started, I'm stuffed; there's nothing I can do to relax the muscles unless I can get into a steam room or fall asleep. Within minutes, the screwdriver headaches start and the migraine isn't far behind.

Once I'm in that position, it turns into a cycle - the heatpad has caused the tense muscles that lead to the neck pressure and headaches, but in response to the pain I'm in, I tense up even more. That causes more shoulder and back pain, and I need the heatpad to relax it. Which only compounds the neck pressure problem.

My only chance is to remember not to put it on first thing. That's what I did today; it seems to be preventing the neck pressure, but my back is so stiff I can't stand up straight, and I have to move very very gingerly, otherwise I can feel the neck pressure starting anyway. Obviously, whatever nerve has been getting trapped is still very vulnerable.

Wednesday, 4 May 2011

Shut up and drive

I've worked out the key to who I can cope with being around at the moment, and who I can't.

It all comes down to their ability to put my mental state above their own desire to have their say.

Most people, it seems, say they'll listen and will move on from a topic if you tell them it's too difficult, but in actuality, most of them are fundamentally incapable if doing that. You always end up with some variation on 'yes, but...'.

For example, you tell them you don't want any questions about work, and you get 'OK, fine, but you're still going in, are you?'. Which part of 'no questions about work' didn't they understand? Or you say 'I can't cope with problems, yours or mine' to which they reply 'sure, but god I'm just having such a bad time with...'. Perhaps my all time favourite (not) is when they feel that they absolutely must put a positive spin on the conversation before letting it go. 'But it won't always be like this' or 'it's bound to get better' for instance.

It's infuriating, it's rude and it only makes the depression worse. Because there I am, opening up and telling them what I need from them, as people who care about me, and their response is to ignore me and do what makes then feel best. It trivializes the hideous time I'm going through, and demonstrates just how little they really understand it.

Don't get me wrong, I'm not suggesting I'm more important than they are, or that I should always come first. But at the moment, when they know things are really bad, you'd think they could manage to shut up and listen for a change.

All I do all day long is take pills and potions.

Little white pills, little blue pills, little pink pills. Orange and brown capsules, red and white capsules. Pus-coloured medicine, white chews. Yellow lozenges, green lozenges.

And when I'm not taking pills and potions, I'm taking things to make the pills and potions useful. Ginger drink, ginger chews. Nuts, raisins, berries, seeds. Rice cakes, fruit bars.

And when I'm not doing that? I'm doing other things governed by the pain. Snooze in the lounge, sleep in bed. Switch pillows, trade cushions. Heatpad on, TENS machine on. PainGone Pen, meditation. Movement exercises, steam room, swim.

Every minute of every bloody day revolves around my shoulder. Nothing I do is spontaneous or unconnected with the pain.

Well, staggering the Oxycontin, per my post yesterday, was a resplendent failure.

It left me feeling extremely sick all day long, and the neck-pressure headache has been even worse than usual. I have managed to take less Oxynorm, but it's so not worth the suffering.

If I can't get the morphine levels down, and I can't resolve the headache and sickness, I just don't see how this situation is tenable. Something will have to be done, or I'll never get back to work, regardless of the depression.

Feel like shit. Lonely and in pain. This is never going to end.

Tuesday, 3 May 2011

I've been feeling really angry all day today. It's like the depths of the depression have been replaced by a raging fury.

I've had a couple of days of not wanting to die. Right now, I don't feel like I'm drowning in the depression, I don't feel overwhelmed by that blackness. But I am thinking about dying.

I'm thinking about it in a more detached, clinical way than over the past few weeks. I want there to be a way of ending on an upnote, combining achieving one last ambition, with an end to all the pain. I just don't know if that would ever be possible.

I feel very very sick. The ginger's not helping, the Cyclizine's not helping, nothing is.

I'm also finding it hard to breathe and I can't keep my eyes open. I'm having trouble remembering what pills I've taken and what I haven't.

Staggering Oxycontin?

I find that I don't generally have to take a top-up pill for a couple of hours after taking the Oxycontin. That suggests that although they are slow release, the Oxycontin doesn't release evenly - you get more benefit from it at the begininning than at the end.

I'm thinking that maybe I can use this to my advantage; instead of taking two Oxycontin in the morning, as I have been doing, maybe I should take one then and one at lunchtime, like I did today.

Hopefully, I would get the same couple of hours of benefit in the afternoon as I do in the morning, and that would mean I could get away with fewer top-up pills during the day. If it works, I could try the same with the evening ones.

I'd only be taking the same amount if Oxycontin, but staggering it might enable me to reduce the Oxynorm, which would being down my total morphine intake. It's worth a try.

Shivering

Who else but me could wind up with pets that have to be kept cool, whilst being on medication that leaves me freezing cold on a flaming hot day?

I'm sitting here with the curtains closed and the windows wide open to keep the chins cool, whilst being wrapped up in blankets and resting on a heatpad because I can't stay warm.

When I'm not freezing cold, I'm baking hot and sweating. But that doesn't necessarily mean it's time to reach for the aircon; half the time I'm frying, but it's not even warm in here.

So, when I could do with windows open and a chilly breeze, the chins aren't bothered, and when they're feeling the heat, I'm doing my Eskimo impression. Brilliant.

My morning

I'm feeling truly awful.

I popped into town this morning to look for ginger chews to try and ease the sickness. I lasted less than an hour before the pain and the neck pressure built into a blinding headache.

I made it home and took another slow release pill (I'd tried cutting it down to one this morning, but once again it was a bad idea). I also had to take a migraine pill. and I realised that I'd forgotten to take the paracetemol this morning, so I took that too.

Nothing helped though. By 12.30 the headache was still blinding and I was feeling horribly, horribly sick. I knew I should eat something, but I could barely manage to stand up in the kitchen to defrost a baguette. And the last thing I felt like doing was eating it.

So, even with the depression easing a bit, I still can't function.

Monday, 2 May 2011

The Abyss

My mood has been stable for two days now. Not 'good', not 'happy', not even really 'functioning', to be honest, but stable.

There have been moments - some of them measured in hours - of sadness, some where the tears felt like they were only a heartbeat away, but then things have settled again.

The sucking void of blackness that has dominated my world for several months is still there, below me, like the pool of water at the base of a well. It waits beneath a mesh that hides it from view, but allows the feel and the stench of it to rise up. You sense somehow that if you wanted to, you could push down on the mesh and it would first stretch, moulding to the shape of your hand, then finally give way, with a sickeningly fleshy-sounding 'pop'. And then you would be there once more, floundering, drowning in the abyss.

The only thing I don't know is how much pressure the mesh will bear. I suspect, at this point, very little. So I dare not probe it, because who knows, once you fall through, whether you can climb back out again. Or how long it could take for the scab-like mesh to grow over again.

Better not to touch it, not to test the strength of it for a while yet. The longer you leave it, the stronger it will get. Till hopefully you can jump around on top of it and still not fall through.

Of course, even with all that care and attention, there's still no guarantee that something won't cause the fragile membrane to rupture. So I continue hiding from the world, avoiding anything that could put it at risk. The fact that I have no idea what might or might not harm it only makes it more difficult. Gingerly I test it from time to time, just to make sure it's still in place, then move away, lest checking it's integrity causes exactly the kind of damage I dread finding.

11.30. Unexpected discovery: the panic attacks and the abyss of depression are somehow the same thing. As I settle down for sleep, the feelings of impending panic start, and I realise they actually feel the same as when I reach down to touch the edge of the blackness.

The fear over that discovery is enormous - not only the existing fear of the panic taking over, but outright terror that if the panic does break through, I'll be overwhelmed once more by the hideous depression.

The problem in fighting this new, two-fold attack, is that the panics have always felt very external to me, and I've countered them by envisaging myself inside a protective bubble. But the abyss is deep inside; I've overcome that by not probing too far down. But how do I fight something both internal and external at the same time?

Normally, when the panics take over, the best thing is to relax, see myself safe in that bubble and just let go. But when I try that now, I find myself falling down the well into the abyss, and the blackness starts swallowing me up. It's like the mere act of relaxing is pushing me down through that mesh.

After some experimenting, the solution seems to be to relax *around* the well, rather than falling down inside it. It's not easy, but when I do manage it, there are no more panics. I think all this must mean that the panic attacks have always represented the deepest parts of the depression. I thought they were somehow separate, a symptom, but not the core, but it looks like I was wrong.

Sling success

I've managed to alter my sling to make it front-fastening.

This is a big deal. I haven't been able to use the sling for months because I could no longer put it on because of the way it fastened at the back. But I've really needed it, but in terms of a visual reminder to people to be careful when I'm out and about, and simply to support the weight of my arm.

For the past few weeks, I've needed to have my arm supported wherever I was sitting or standing, but the only way I could do that was with cushions or the zip on my jacket. Moving around, even just at home, it was very difficult and pretty ineffective. Going to fetch prescriptions and such like was a real problem, and I was always terrified of someone bashing into me.

That could still happen, but at least with the sling on, people can see there's a problem and hopefully will be more careful.

The other advantage of having sorted the sling is that the horrible headache that's been coming directly from the shoulder pain all day has finally eased. You have no idea what a relief that is. Nothing else has worked - heat, pills, food, lying down, it's still always been there.

The reason I had to fiddle about with my existing sling, though, is that almost all of the ones on sale fasten at the back. Why do manufacturers assume that everyone with an injured arm has someone around to do the sling up for them? It's ridiculous. There are injured and disabled people out there, you know, living alone. It's shocking, but it is true.

Of the two - two! - front-fastening ones I could find, one was only available from the US, and the other was made from recycled car seatbelts (I kid you not), and looked like something out of some dodgy S&M movie. Pathetic.

Morphine not working today. Why is the morphine not working today? So much pain. Why does there always have to be so much pain?

Angry over eating

I hate being forced to eat like this.

I'm not even a tiny bit hungry, but I've got a raging headache and based on the past few days, if I eat lunch, it'll go away.

But I don't want lunch and it makes me furious that I'm being forced into it.

The last thing you want to do to someone who has suffered from an eating disorder, is create a situation where they are forced to eat. Eating disorders are all about control, and this is making me feel I have no control.

The pain is very bad again today. I feel sad and low and ready to cry, but at the moment it's not dipping down into that hideous blackness. I hope it stays that way.

Sunday, 1 May 2011

Slightly better day

Well, my mood stayed relatively stable throughout the day, up until now.

There were a few near-tearful moments on the phone earlier, but only because I was talking about how bad things have been lately, especially last weekend. The rest of the time, although the tears were within reach, they stayed where they're supposed to be, out of the way. It might just be that I'm tired that I'm starting to feel a bit emotional now, but I can definitely feel things starting to close in on me. I've had to turn off some stupid documentary because all the screaming kids were making me want to cry. Even reminding myself that they're not real didn't help.

The pain has been as bad as ever today - I'm still on double pills, and though I managed to stretch them to four hours instead of three, it was a mistake. I don't want to take any more, but current pain levels suggest I'll have to, if I want any sleep. I just hope I don't get any more side effects.

The slightly more stable mood has meant that today is the first day in several weeks that I haven't spent time sitting around thinking about suitable ways to die. Again, until now; I really hope the good record for today doesn't get screwed up by a last minute flip out. I'm feeling increasingly fragile though, so I'll sign off before I kick things off myself by accident.

10.50. Pain has just gone interstellar; can't breathe. Should've taken the bloody pills sooner.

Jeez. Major side effects moment.

I took the last dose of morphine at about 6.45. I wasn't really getting any side effect problems, till I had something to eat about half an hour later. Then I started getting very dizzy and floaty. It got worse and worse over the next hour, and I started getting very nauseous too. All I ate was a sub.

It's bizarre the way the same dose can have such different effects at different times. I've taken the same dose as that twice during the day, with no side effects at all, then this time I feel like I've been out on the lash all night. It's bloody horrible.

And to cap it all, the pain killing effect of those pills is already wearing off.

Once again, I can't seem to stay awake. I don't know what's causing it.

I have managed to go four hours between morphine doses today though, for the first time in about three weeks.

Now all I need is to be able to stay awake for four hours at a stretch.

4.30 Going four hours between pills may have been a mistake; the latest dose isn't working.

I don't want to jinx anything, but so far today, I've felt a little bit better. Not pain-wise - that's just the same - but mood-wise.

I can feel the blackness down there - I can reach out and touch it and it feels very much like it would suck me down at any moment if I kept on looking at it, but so far I've been able to pull away.

I'm currently back in bed, because I took the bin out and that seemed to be enough to completely wear me out.

I managed a whole day yesterday without crying. It was a bit close at times and admitedly I was asleep all afternoon, but even so. A whole day without crying.

Chain reaction

I just need a slight chink to open up in the cycle of depression and pain, to give me a foothold to start working from.

There's the rest of the meditation course, the book that goes with it, and the new book the meditation teacher suggested, plus things like swimming and steaming. They would all help - releasing endorphins, raising my mood just enough to change my experience of the pain and allow me to reduce the morphine, easing the depression through the body's own natural responses, plus the reduction in side effects from fewer chemicals.

Once it gets started, it'll be like a chain reaction. The problem is that the chain reaction operates in both directions, and at the moment it's spinning the wrong way. It's like one of those ridiculous disaster movies, where the earth has started spinning in the wrong direction and the hero needs to put it right. Once it's going the right way, very little energy is required to maintain it, it's the initial shift that's the problem, because there's do much inertia going against you.

Creating that inital foothold, making that crucial shift is all down to the Lofepramine. But it also depends on me making sure that I don't push too hard.

It would be all too easy for me to see a tiny improvement and jump on it, but I have to avoid that, because it'll only set me back again. As frustrating as it will be, I need to go really slowly, so that each step builds on the next. It's like getting a scooter going; if you try to start too fast, you fall off, so you have to build up speed gradually and stay safe.