Pain mania

     The psychiatric definition of mania is "profuse and rapidly changing ideas... irritability, and decreased sleep" (Random House Unabridged, 2006). It doesn't mention anything about emotional instability; it seems to do more with cognitive misfirings.

     In any event, I am concerned to the point of sleeplessness (would that be overly concerned?) about my prescriptions for nerve pills and pain medication running out. The more I hurt, the worse it is, predictably. Not only did I awaken several times last night frantic that I wouldn't have enough pills to get me through today, but I dreamt I had run out of pain medication. The label says to take a pill every four hours as needed. Lately, I've been living in four hour increments, with the goal of waiting perhaps four and a half hours, even five -- to prove to myself and Dr. J that I am not yet at the point of needing the ghastly Fentanyl.

     Cancer presents all manner of choices. Would I prefer to be needled in the arm, or in the chest catheter? Would I like to lose my appetite due to chemo or disease progression? Would I rather be incapacitated by pain or by narcotics? The answers are not as clear as you might expect. Catheter-chemo-narcotics seems logical, until you consider what you're giving up. When the nurse draws blood from the catheter, you are very much, undeniably, for all to see, a cancer patient. When you lose your appetite due to chemo, your strength is depleted exponentially -- not only are you unable to eat enough to sustain your body, but the chemo is making its own caloric and nutritional demands, so it's just freaking impossible to keep up, and you start looking like wasted Cancer Girl (or, in my case, Cancer Boy, as my figure is gone and my britches are all satchel-ass). Narcotics relieve the pain, but they also relieve you of the capacity to think, to write, to recall, and to stay awake for stretches longer than the average three month old baby. Driving is out of the question. Wine. Reading a story to A.

     The trick, see, is to hold the need for these choices at bay for as long as possible. Resistance may be futile, but so is drooling one's way through the day.

     My friend Amy (my very wise therapist) reminds me that pain is in itself stressful, and crazy-making. Relieve the pain, she says. 

     I'll pop a nerve pill and consider it. And in the meantime, I will be willfully grateful that I still have choices.