Author Topic: Back home from hiking in AZ  (Read 3654 times)

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Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #15 on: July 12, 2016, 11:58:40 AM »
At the hospital in Arizona when they released me, they gave me three prescriptions for pain melds. Slow-release morphine 15 mg one tablet twice a day; oxycodone 5 mg one tablet every 4 hours as needed for pain; and oxycodone 5 mg + acetaminophen 325 mg two tablets every 4 hours as needed for pain. They gave me a one-month supply, but since I've taken less than the maximum amount, they've lasted me longer. For a while I was taking the morphine at night only, until someone told me the morphine is supposed to be the base med, and the oxy for breakout pain. While the prescriptions clearly allowed me to take one oxy AND two oxy-plus each 4 hours, I've never taken more than two tablets total at a time, and sometimes just one, and often waiting longer than 4 hours, depending on the pain.

I have my second followup with the orthopedist's P.A. this Friday, but at the rate I'm going, I was going to run out on Wednesday, so I called and got a refill prescription. They gave me oxycodone 5 mg + acetaminophen 325 mg, but this prescription is one tablet every six hours.

I'm going to continue as I've been doing (one or two tablets, as needed, every 4 hours if needed, plus the morphine twice a day) until my followup appointment, since that's only a couple of days after the old prescriptions run out, and I'm going to ask the doctor this question then, but, WTF, do they really expect me to go from 30 mg of morphine plus 40 mg of oxycodone per day to just 20 mg of oxycodone per day just like that? It still hurts like fuck when I wake up at night and takes two tablets 15 or 20 minutes before the pain has subsided enough to get back to sleep. One tablet just doesn't do it. I've tried. They told me at the hospital, and others have told me as well, to stay ahead of the pain and not wait until it hurts too much.

I don't expect medical advice here. I'll get that from the doc on Friday. I'm just venting about the very drastic apparent reduction in my pain meds. Daytimes are not too bad, but nighttime is hell. My butt hurts from sleeping sitting up, and my arm hurts something fierce every time I wake up. And just to make matters worse, my stomach hurts more or less constantly. I'm taking Alka-Seltzer Gold (that's Alka-Seltzer without the aspirin) for the stomach.

I'm very much a wimp about pain. I cry easily. And I complain. I don't ask "Why me?" Because the obvious answer is "Why not me?" The universe doesn't give a fuck about anyone or anything. And I don't get suicidal, because I know I'll be all healed in a year. But I fucking want the pain to stop. I want to be able to use my arm again. I want to be able to wash my left arm and my left armpit when I shower. (The broken arm can't reach the opposite armpit to wash it!) I want to be able to jog. I want to be able to use the arm to lift my butt off the seat of the exercise bike because after a half an hour without a break my butt hurts so bad I cannot continue. And I'd like to be able to drive, though at least with Uber and Lyft I can get where I needed to go.

End rant. Thanks for listening.
Daniel
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"Anyone who has ever looked into the glazed eyes of a soldier dying on the battlefield will think long and hard before starting a war."
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Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #16 on: July 22, 2016, 01:58:44 AM »
It's been a rough few days. The orthopedist's P.A. Wanted me to switch from oxycodone to tramadol, which was horrible because tramadol is about as effective as ibuprofen, but finally he agreed to extend my oxycodone prescription. I'm taking much less of it now, tapering off, because the stuff is highly addictive. It's essentially synthetic heroin. So I have more pain than before, though not nearly as much as when I wasn't talking any. And I have some withdrawal effects, including difficulty sleeping. So I'm up now, way past my bedtime.

So I decided to google "x-ray of normal shoulder" and I got this picture:



My shoulder, as posted in another thread, from a photo of the P.A.'s computer screen:



So two things I notice: The notch at the top of the ball, which I thought was a chip taken out of it, is actually normal. And my shoulder appears to be way out of joint, much lower than the normal shoulder. But the P.A. never said anything about it. I can bend the elbow, but I cannot move the arm at the shoulder more than a few inches in any direction without severe pain. OTOH, when I look in the mirror, my hands and elbows seem to be at the same level on the right arm as the left. So I don't know what to make of this. I'm concerned this indicates more damage than just the break: the joint may be ruined. Of course since I can't sleep, and it hurts, I've got nothing better to do than worry that my arm will never work right again and will be crippled for the rest of my life and I'll never be able to paddle a kayak again.
Daniel
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"Anyone who has ever looked into the glazed eyes of a soldier dying on the battlefield will think long and hard before starting a war."
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Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #17 on: July 22, 2016, 11:29:28 PM »
I had my first physical therapy session. My clinic's P.T. place could not get me in for two more weeks, but one of my home caregivers recommended another place. I phoned them this morning and they got me in this afternoon. All the muscles around there are atrophied, which is why I cannot move the arm. And the explanation of the above x-rays is just the angle of the shoulder. Nothing abnormal there. Now I'm looking at 8 weeks of therapy to restore the arm & shoulder to normal function. I'm glad I'm getting started now rather than in two weeks.
Daniel
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Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #18 on: August 03, 2016, 09:23:15 AM »
The day before yesterday the physical therapist noticed the big, painful bulge on my arm. He called it a tuberosity, IIRC, and said we'd have to do something about it. "You're not going to like it," he said. Then he pulled out an enormous pair of scissors. Fortunately, he just used them to cut some fabric, which he placed on the arm. Then he slapped the arm hard a bunch of times. It still hurts. Also the joint hurts from the manipulation and the exercises.

Then yesterday at the oral surgeon's office they removed the 4 stitches, which hurt. The surgeon said my mouth is healing fine and is in excellent shape, but it hurts like fuck!!!

So I'm sitting here, I've been taking a whole Percocet every 4 hours, and the pain is excruciating. I've just taken my last 15 mg. slow-release morphine tablet, left over from what they gave me at the hospital in AZ. It's too soon for that to kick in, but right now I truly and honestly wish I had died in the accident. The pain is as bad as it was the day of the accident, and I'm a fucking wimp. I cannot endure pain. Unfortunately I lack the courage to kill myself, since my remaining oxycodone and a bottle of cooking sherry might be sufficient to do the job. (The sherry really is for cooking. I use it in the marinade I use for fish and for tofu. Alcohol makes me kind of dizzy and sick.) I'm a fucking hypocrite, because I know that once I'm dead, which will happen eventually, nothing that went before will matter, and life is pointless, but I'm scared to just get off the stinking ride. If a burglar were to ring my doorbell right now and say "Your money or your life," I'd say "Fucking kill me already!" A little human contact would be nice, but I lack the courage to call an escort, so all I can do is kvetch and complain at a bunch of strangers on the internet who, if they're smart, have learned by now not to even open this thread, or if they do open it, are unlikely to read this far. I'm not sure if this has been the worst two months of my life, but I think it has been, and no prospects of its getting any better in the next two months.

Sorry for posting this, but thanks for reading if you've got this far.

Daniel
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"Anyone who has ever looked into the glazed eyes of a soldier dying on the battlefield will think long and hard before starting a war."
-- Otto von Bismarck

Offline petrolpetal

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Re: Back home from hiking in AZ
« Reply #19 on: August 03, 2016, 02:59:37 PM »
Hey! Sorry the pain is so bad. Stick to being conservative with the doses though ... you've already been on it long... I have no first hand knowledge but them opiates can be dangerous. Hang in there ...

Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #20 on: August 03, 2016, 03:47:07 PM »
Thanks. Once the morphine pill kicked in, it wasn't quite as bad. But it's pretty miserable. I'm in constant pain because I'm taking the lowest dosage that can bring me to a barely-tolerable level, but often at night it goes well into intolerable and I wake up wishing I had died in the accident. Sometimes life just isn't worth it. I'm definitely regretting getting the oral surgery. It was actually getting almost tolerable before that.
Daniel
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Offline Billzbub

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Re: Back home from hiking in AZ
« Reply #21 on: August 04, 2016, 10:49:47 AM »
You should definitely try acupuncture, hypnosis, homeopathic pain meds, placebos, chiropractic, and an all-natural, organic diet.

Seriously though, it is great to see you posting so much here.  If I were in your shoes, I would be wasting away watching TV and going in and out of crappy naps while getting no real sleep.  At least you have the mental fortitude to read all of our inane chatter and comment on it.

I wonder if there are any legit pain management research studies going on wherever you are.

Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #22 on: August 04, 2016, 12:10:06 PM »
You should definitely try acupuncture, hypnosis, homeopathic pain meds, placebos, chiropractic, and an all-natural, organic diet.

Seriously though, it is great to see you posting so much here.  If I were in your shoes, I would be wasting away watching TV and going in and out of crappy naps while getting no real sleep.  At least you have the mental fortitude to read all of our inane chatter and comment on it.

I wonder if there are any legit pain management research studies going on wherever you are.

I know how to stop the pain: two Percocet every 4 hours. I also know how to get deeply addicted to synthetic heroin: two Percocet every 4 hours. What I don't know is how deeply I can go into the addiction and still be able to pull back out once the jaw and the arm are healed. My doctor wants to see me before renewing my prescription, but doesn't have an opening until Tuesday. At the rate I've been taking them (5 tablets, or 30 mg oxycodone per day) I'll run out late on Sunday. If I can cut back to 4 per day I can make it until the appointment.

The thing is, I totally accept my doctor's judgement about the use of narcotic painkillers. I just want to see him sooner to explain about the oral surgery, which was referred through my dentist, not through him, so he might not be aware of how extensive it was, and how much pain there is, and for how long.

In a hundred years it won't matter in the slightest whether I died today or in 20 years from now. So what's the point of suffering? What's even the point of being born? Nothing. There is no point. It's all just crap. ("Life is shit and then you die!") so why not just die now? No reason at all. I have no dependents. I have no girlfriend. Nobody would care all that much. A few people would say, "what a stupid fuck, to off himself just because of a tiny bit of pain," and a few people would say "good riddance." My very few friends might have a moment of silence, and then get on with their lives. I really wish I wasn't such a fucking coward.

So I'm taking half a Percocet every 3 or 4 hours, which takes the edge off of the worst of the pain, and maybe a whole one when it's really unbearable. And usually there are a few hours during the day when it's not bad at all. Nighttime is the worst.

Lots of people have it a lot worse. That doesn't make me feel any better. It just reminds me of what a goddamn wimp I am, complaining this much when people in the world are starving, or getting limbs blown off by all sides in every stupid war, or dying of cancer, or rotting away in destitution. I still wish the pain would stop, or at least I had someone to hold me.

And it's all my own stupid fault: one moment of inattention on the trail.
Daniel
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"Anyone who has ever looked into the glazed eyes of a soldier dying on the battlefield will think long and hard before starting a war."
-- Otto von Bismarck

Offline lonely moa

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Re: Back home from hiking in AZ
« Reply #23 on: August 05, 2016, 10:19:01 PM »
I'm surprised they haven't given you liquid morphine.  I found it worked a treat for the radiation burns in my throat.

They give it away here in the right circumstance; it's cheap.  The crown pays about NZ$12 for a 200 ml bottle.  I could have sold them on the street for a grand.
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Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #24 on: August 05, 2016, 10:47:11 PM »
I'm surprised they haven't given you liquid morphine.  I found it worked a treat for the radiation burns in my throat.

They give it away here in the right circumstance; it's cheap.  The crown pays about NZ$12 for a 200 ml bottle.  I could have sold them on the street for a grand.

Not sure, but I think oxycodone is stronger than morphine. It's basically synthetic heroin. It's pretty cheap as well. The stuff works great if you're not concerned about getting addicted. I'm taking less than enough to completely kill the pain because the more I take, the harder it will be to kick it later. However, I've taken more today than the last few days because it's been pretty rough. It's a balancing act, pain control vs addiction.
Daniel
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Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #25 on: August 10, 2016, 09:43:05 PM »
Update.

Yesterday I saw my primary, and today I saw the orthopedist's P.A. I have a lot more mobility, and a wee bit more strength, in the arm than I had even a week ago, which I attribute to the physical therapy. I go twice a week, and I have exercises I do every day, 2 or 3 times. They were all range-of-motion exercises until a week ago when they added in some isometrics for strength. Actually, to "get the muscles used to working."

As mentioned in another thread, my primary wants me to wean myself off of the oxycodone. So this week I am to take no more than 5 per day, which is what I've been taking lately. Next week, no more than 4 per day. And so on until I'm off it in 5 or 6 weeks. He gave me enough prescription for that plan. I think I should be able to do it.

The orthopedist's P.A. said that, based on today's X-Rays



the bone is healing. He said the bone should be all healed in another 3 months. But the rotator cuff will heal more slowly, and the risk if I lift anything heavy too soon (or attempt kayaking) is that I could tear the rotator cuff, which they had to cut to set the bone and install the plate. So no hiking or kayaking for a year from the time of the accident.

But he said that I could probably drive now if I was not on the narcotics, and that the arm will definitely be okay for driving once I am off the oxycodone. I forgot to ask him when I can jog again, but I know I could not jog yet, and I see him again in another month, and I'll ask then. He was less optimistic about pot as an analgesic than was my primary, but had no objection to my trying it if I like, as long as I'm not merely trading one dependency for another. The difference, of course, is that unlike people less fortunate than myself, I can expect my pain to go away as my injuries heal, so I shouldn't need any analgesic in a few months from now. I have not yet decided.

I think maybe the jaw pain has been a wee bit less today.

And I'm gaining weight. I need to get back onto healthier eating, though it's hard when I still cannot chew on the right side of my mouth, have a missing lower right canine, and some pain/discomfort in the upper right incisor. The crown will not go on for another 3 1/2 months. I'll probably see my dentist soon about the incisor.
« Last Edit: September 06, 2016, 06:52:52 PM by daniel1948 »
Daniel
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"Anyone who has ever looked into the glazed eyes of a soldier dying on the battlefield will think long and hard before starting a war."
-- Otto von Bismarck

Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #26 on: August 26, 2016, 01:15:06 PM »
Time for another update:

First off, the statement that they cut the rotator cuff in order to install the plate is apparently erroneous. I've carefully read the surgeon's report, and there's no mention of any such thing, though he did suture the plate to the cuff.

The mobility of my arm is continuing to improve. The physical therapy is very painful, but I believe it's helping. Subjective experience is not scientific, but this is my subjective experience, and PT does, I think, have science on its side, or I presume my doc would not have prescribed it. For a short while he had me doing isometrics, but now I've graduated from that to isotonics, using an elastic band. The arm is still extremely weak, but I think it's improving, as I would expect it to with the exercises. Of course there are also range-of-motion stretching exercises.

I use the sling now only when I go out, and only as a precaution, except that I do need it when I take long walks as the shoulder gets very stiff and sore otherwise.

My regular doc wants me to wean myself off of the oxycodone, and we agreed on a regimen of no more than 5 pills per day that week, then no more than 4 per day the next week, and so on, until I'm off it. The pills are generic Percocet: 5 mg oxycodone with 325 mg acetaminophen, immediate release. I am ahead of schedule, taking two per day at present, in 4 half-pill doses. (The pills are scored, indicating that it's okay to split them.) I'm in almost constant moderate pain. My doc said I'd have pain for a few days each time I cut back a step. So I just need to suffer. It's not nearly as bad as it was a month ago.

Sometimes the shoulder itself hurts, but more often the pain is from a large swelling of the deltoid muscle at or slightly above the deltoid tuberosity. The physical therapist says that's caused by the stress on the muscle at the tuberosity resulting from the extreme atrophy of the muscle itself. But while he's told me why I have the swelling, he's not told me what the swelling is. Just an inflammation, or something more serious?

I've been taking one small hit of pot each day in the late afternoon or early evening to help me sleep. With an N of 1 and no blinding, there's no way to know if it's really helping, but I feel as though it is. I feel that I'm sleeping better and awakening more rested. The variety is an indica called Lilac City Lavender and is a mild, relaxing high. It's labelled THC 0.53%, THCA 17.7%, Total 16.1%, CBD <0.1%. I bought a gram and after two weeks it looks like I've used around 1/4 to 1/3 of the gram. It's mild enough that the effects are most noticeable when I sit in my easy chair and put music on. I'm quite partial to Yo Yo Ma playing the Bach unaccompanied cello works as music to accompany a pot high. The amount needed for a high is so small that a piece any smaller would fall through the hole in the water pipe. The pipe would be more suitable for the quantities we needed to smoke in the 1970's. Today's pot needs a water pipe with a smaller tube. I've thought of getting a vaporizer, but it hardly seems necessary for the tiny amount I'm smoking. That little chunk is all burned at about 1/4 of an inhale, and then I fill my lungs with room air. I don't intend to continue smoking once my arm is healed enough to sleep normally.

I'm still gaining weight. Yesterday was the first day I managed to eat my regular shredded-cabbage salad. Chewing was too difficult before. It's still kind of hard, but I managed it, and being able to fill up on salad should help me cut back on my total calorie intake. Getting off the painkillers and back to a healthier diet is now my priority, along with my PT exercises. Once I'm off the painkillers I'll be able to drive. (The doc okayed my arm for driving, once I'm off the narcotics.) That will be a great boon. I sure wish I had a self-driving car right now.

Graphic pictures of the arm, showing the atrophied shoulder and swollen arm:

(click to show/hide)
Daniel
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-- Otto von Bismarck

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Re: Back home from hiking in AZ
« Reply #27 on: August 26, 2016, 02:16:15 PM »
You, sir, are a badass and a rock star.  Congrats on your hard-won progress.
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Offline daniel1948

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Re: Back home from hiking in AZ
« Reply #28 on: August 26, 2016, 08:37:15 PM »
I'm actually a wimp. I cry a lot and I complain constantly. But life without outdoor activities such as hiking and flatwater kayaking would not be worth living. So I do the work my physical therapist gives me, and I follow my doctor's recommendations for health (e.g. weaning myself off of narcotics) so that I can resume the activities which (in the absence of someone to have sex with) are the only things that make life worth living.
Daniel
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"Anyone who has ever looked into the glazed eyes of a soldier dying on the battlefield will think long and hard before starting a war."
-- Otto von Bismarck

Offline Desert Fox

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Re: Back home from hiking in AZ
« Reply #29 on: August 27, 2016, 06:30:38 AM »
I'm actually a wimp. I cry a lot and I complain constantly. But life without outdoor activities such as hiking and flatwater kayaking would not be worth living. So I do the work my physical therapist gives me, and I follow my doctor's recommendations for health (e.g. weaning myself off of narcotics) so that I can resume the activities which (in the absence of someone to have sex with) are the only things that make life worth living.

That is how I feel as well. I got really sick this spring and actually missed a couple of days of work. Within about a couple of week I was back to my routine while one of my roommates let the illness stop them for a month or more.
« Last Edit: August 27, 2016, 06:33:09 AM by Desert Fox »
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