Today's therapy session has triggered something awful, I just don't know what yet.

The pain started off bad and has only got worse throughout the day. On top of that, I feel very strange and I don't know why. I can't work out what it is I'm feeling, but it's not good and not being able to deal with it is causing the pain to ramp up more and more.

Getting electrocuted by a light switch when I got home didn't help much either...

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Better pill news

I've had a bit more luck with pills today.

Since the awfulness of last weekend, I've kept testing the pills, always as a last resort when the mental stuff fails. Objectively, I've judged that I'm getting at best 20% efficiency from the pills, and often 0%.

Today, the pain has been flaring more than since the weekend, and I could tell it was going to go big. So I had to take two top-up doses (6 hours apart though), plus two increased slow-release doses. The last two days I had to take one slow release and one top-up dose.

Yesterday, though, I focused heavily on the fact that I was taking the pills as a way to take care of myself - a loving, caring act, not one of punishment. Because as I mentioned last week, I think it's the idea of the pills being another way to punish myself that causes them to be so freakin' useless.

This new approach helped some yesterday; today even more so. Today I'd say I got 30% effectiveness out of the pills I took at 3pm, and as much as 50% from those at 9.

This is a massive improvement, and if I can keep it up, it means that I do have something to fall back on when the mental approach fails. Which it does, a lot. I can't even begin to tell you how important this could be. It will go some way to assuage the fear of the pain, and hopefully give me a tiny bit of confidence that I'll be able to cope with all this.

It might also mean I can put off thinking about coming off the pills till the pain is more consistently controlled by mental techniques (or has just gone down a lot). In other words, to when I wanted it to be in the first place.

The downside is that it means even the efficacy of the pills is dependant on me being able to adopt and maintain the right mental attitude. Which is unbelievably difficult when you're in blinding agony. It may require more preventative pill-taking, so my mind is clearer and I can better focus on those mental techniques.

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I've tested the pills twice more since the awfulness of Saturday night. Both times they did next to nothing. But the pain is as bad as ever.

I'm trying really hard to tackle the pain mentally, but it's so exhausting, and when my resources run out before the pain does - like today - I'm fucked. Then, there's no respite from the pain, and nothing I can do about it.

I don't know what to do. I can't live like this. It's worse than the past few weeks, and they were worse than everything that's gone before. What's the answer? What am I supposed to do? I'm tearing my hair out here. God, I only see one end to this and it's not a good one.

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I managed to control the pain mentally all day. Each time it flared, I addressed the issue of self-punishment, thinking about what I might be angry about, what I feel needs punishing. (I carried on with the basic slow-release dose, I just didn't take extras or take quick-release pills.)

It worked all day, but at 8pm a new level of pain started and nothing worked on it. I couldn't find what I might be angry about, I couldn't find what I might be punishing myself for.

So I had no choice but to take a pill - the pain was just too unbearable. This is where the real questions arrive with the pills, and with the question of stopping them.

It's been a good thing to address things mentally all day, and I do always try and do that, it's just that mental approaches tend to only work for a day or two, before the pain takes over again. But if I didn't have the pills to fall back on when the pain gets as bad as it is now, christ knows what I'd do.

Of course I still don't know if it's going to work, and if it doesn't, I'll be no better off than I was before. Worse, in fact, because I'll have nothing to fall back on.


Addendum
The 15mg OxyNorm at 9.15pm did absolutely nothing, so I took 4 OxyContin at 10.15 instead of the usual 2. That did nothing either. I considered calling an ambulance, but what are they gonna do? If morphine's not helping, they won't be able to do anything. I've just taken another 20mg OxyNorm at 11.15pm.

If that doesn't work (75mg Oxy in 2 hours), I'm out of options. I'm left with paramedics who can't do anything, or suicide.


It's 4am. The extra pills made no difference whatsoever. The agony continued unabated. The only reason I'm still here (breathing, and not in hospital) is that I suddenly got really really angry.

I was utterly furious, beside myself with rage, screaming and beating the living shit out of my pillows. Unfortunately, it was 2am, so apart from the initial one, which kind of got away from me, the screaming was very muted - clenched jaws, that kind of thing.

I was furious with my mother and I've just spent 2 hours writing her a very long, very detailed letter about everything she's done to me, and why I never want to see her again.

It's the kind of letter you don't actually plan on sending (though a version of it will need to form the basis of whatever conversation we ultimately have about why I will no longer see her).

At first, all this seemed to help - the pain finally eased and the writing soothed the fury. But now I've stopped, I'm getting angry all over again, and the pain is coming back. I can't express my rage all the time, so what am I supposed to do?

I do think that the time has come to stop the pills though. The medication did absolutely nothing for the pain; it didn't go down till I expressed the anger I wasn't even aware I was feeling. If that's the case, then taking the pills has just become redundant.


Next day
I finally got some sleep after what has to be the worst night I've ever had. I guess I'll have to test the theory again, to be certain, but if it happens repeatedly that the meds do nothing like they did last night, then I'm coming off them - I'm not putting myself through the side effects if I'm still getting pain like that.

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The problem with my ears has been getting worse and worse. As I told the therapist, this was one of the first somatic conditions I ever figured out, and I know it's all about anger.

When I'm angry but can't express it, the eczema I always get in my ear canal becomes acute; the whole area swells up until its completely closed up and I can't hear a thing. Sometimes the whole of that side of my face also swells up like a cricket ball, I can't open or close my jaw, can't chew and am left drinking my meals through a straw.

The therapist suggested the anger was about not wanting to hear something - since I wind up temporarily deaf. I couldn't think of anything. Then she said that somatic conditions can represent something about you, or it can be something about others that affects you. So she asked if I felt someone wasn't listening to me.

That made much more sense; I've been concerned for ages about how I'm ever going to get my mother to understand any of this. How am I ever going to get her to see what it is she's done wrong, when she can't even admit that she favours my middle sister over me and L? I know it's going to be one of those conversations where I feel like I'm talking to a brick walk. She won't hear a word I'm saying, and instead will blame me for being overly dramatic and demanding. She'll turn herself into the victim and once again force me into the role of the 'adult' in this relationship.

My concern over this also explains the terrible sore throat I've had for the past four weeks. When there's something you need to say out loud to someone specific, but for whatever reason you can't, the words get 'stuck' in your throat and cause pain. It's happened before, and I've also read about it in various books on somatic illness.

It's all shaping up to be a very uncomfortable, unsatisfying - and, ultimately fruitless - conversation. Yet if I don't go through with it, I'm likely to be stuck with these symptoms ad infinitum

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Punishing myself

I confirmed to the therapist today that she's right, punishing myself does trigger the pain.

I was able to definitively prove it yesterday; for the first time in a week the pain was bearable, I'd been able to lift the laptop; things were looking up. Then out of the blue, I suddenly realised that I'd forgotten to pay my credit card bill a couple of days earlier. This is very rare for me - normally I'm Mrs Über-Organised - and would mean a late payment fee and interest charges.

I was really annoyed with myself. I called the company to find out what my error was going to cost me (after first paying the offending bill). By the time I'd done all that, I was in raging agony, none of the mental approaches would work and I had to resort to pills. They were bloody useless too, and I had to take multiple doses and go back to bed before I got any relief.

At first, I figured it was just the stress of if all that had kicked off the pain, but the more I thought about it, the more certain I was that actually the problem was that I was really annoyed at myself for being so careless. And I was punishing myself with pain.

Unfortunately, working that out does nothing to stop the agony. I came back from therapy today all chuffed with myself for having worked out such a key trigger for the pain, but within a couple of hours, I was in the same situation again. This time the cause was less clear - I think something I saw on TV triggered memories that then made me angry with myself.

The pain has been out of control ever since and the pills are doing next to nothing about it. I desperately need to find a way to turn the pain off, once it's been triggered, and how to not set it off in the first place. And of course I can't be sure there aren't other triggers too.


Addendum
I'm convinced the reason the pills have been doing nothing / actively making the pain worse lately is that I'm punishing myself for needing / taking this stuff that I hate so much. If that's true, I'd be better off without them.

I spoke to the therapist a few weeks ago about coming off the morphine. I felt (and still do) that if the pain is a construct of my mind, then every time I take a pill, I'm feeding the delusion. I didn't see how I could possibly get rid of the pain whilst I was taking the meds.

She said that although she felt that if anyone could come off the morphine and manage without, it would be me, because I'm so determined, it would make things unnecessarily difficult for me. Given how bad the pain was with the meds, she felt it would be too unbearable without them; she convinced me to stay on them.

All of that is still true, but now I'm regularly finding that the pills either do nothing unless the dosage is ridiculously high (and even then it doesn't last long) or they actually seem to make the pain worse. I haven't taken a pill and had relief FROM THAT SINGLE DOSE in a least a week.

I think I need to do a day with no top-ups and see if things are any more bearable than recent days where I'm constantly chasing an effective dosage.

I still don't know if coming off it would be feasible, but things have been so bad lately on the stuff, it's hard to imagine how much worse it could be without it. That said, several times in the past week it's been bad enough that I've seriously contemplated ending it all, because I simply couldn't bear the pain anymore.

I don't want to do anything that might tip me over that edge, and I feel frighteningly close to it already. But if the pain is me punishing myself, then half of it could just disappear if I no longer had 'morphine' to punish myself for.

I wish there was someone who could tell me what to do.

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At last

Finally managed to get out the house and get petrol and a couple things in Tesco.

Based on the past three days, I went out first thing, before the pain had chance to really ramp up. Even so, it kicked off shortly after I got there, I had to take pills, and I was worried I wouldn't get back.

It was a real struggle, but I did it, and I beat the pain this time. I'm scared to do anything else, though, because I need to be able to drive to therapy on Friday. It's hard to feel great about managing to do something so mundane and ordinary but the therapist keeps telling me I have to reward myself for the victories.

So I'm trying to feel good about it, rather than feeling shit about the fact that I now can't do anything else all day.

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