Posts Tagged ‘Pain Management’

Note: If you are actually suffering from a serious, constant hemorrhoid pain that simply doesn’t go away with any traditional treatment, go to urgent care and see a doctor NOW! And also, feel free to ignore the story and skip to the end of this post for the treatment my doctor recommended.

Over the past two weeks I’ve learned a newfound respect for the casual phrase “pain in the ass.” I don’t think it will ever mean the same thing to me again. I guess it’s almost funny to write about… now. But I definitely wasn’t laughing a few days ago at this time. In fact it was quite the opposite, I was literally crying from the constant, debilitating pain, and the sense of hopelessness it made me feel.

No doubt many people have suffered from hemorrhoids in the past. If you’ve ever had that scratchy, itchy sometimes stinging pain in that area, like there’s a fire burning in your behind, you know what I mean. Possibly, like me, you didn’t really even associate it with the term “hemorrhoids” – generally for me I’d feel it a few times during bowel movements, and sure it might hurt bad for a while, but it would go away in minutes, and then fade in a day or two. It began the same way for me this time, but when I was showering and trying to clean the area, I noticed a rather large bump/growth, which of course scared the crap out of me. No pun intended. I tried to clean it rigorously with soap and water the first few days; in retrospect, I’m wondering now if that just made it worse.

By around the 4th day, I was feeling pain down there nearly all the time. It was still bearable but very uncomfortable to say the least. I bought some Preparation H at the store, hoping for some easy, immediate relief. But no go, it was pretty much worthless. Finally, I got on the internet and read up on the term hemorrhoids, and the descriptions I read sounded exactly like what I was dealing with, so I started reading up on the treatment options. Most of it was similar. Get more exercise (huh? did I mention I could barely walk?), eat more fiber, take warm baths (preferably with epsom salt), take pain killers. Seemed like the consensus was that only in extreme cases you might need to have it surgically taken care of, but otherwise in general it would take a week or two to gradually go away on its own. I tried all the easy stuff mentioned above but it still kept getting worse.

By the end of last week, I could barely walk anymore. I could only move in small baby steps, and with every step came a sharp pain. Sitting down hurt, standing up hurt, coughing/sneezing/laughing, even slightly bending my knees hurt. Essentially any slight movement caused pain. I can’t even describe how horrible it got when I actually had a bowel movement, I was literally screaming and cursing – then for minutes even after the movement ended, I was stunned and doubled over in pain. I couldn’t even move, all I could do was stand there, knowing I still had to face the next pain of trying to clean the area. This was on top of the constant, endless, droning regular pain. The only time I didn’t feel the constant attacks was when I was sitting in my car, don’t ask me why. Somehow the shape and positioning made me feel OK. Unfortunately getting in and out of the car was excruciating.

I decided something was really wrong, and it was time to try to get in to talk to my doctor. I called in and was told I’d get a call back to let me know if he could see me. I waited and waited but nothing. So I went into work and toughed it out. By mid-afternoon I lost my patience and called again, only to be told my doctor wasn’t even working that afternoon. Grrrrr. However, they told me he’d be working the walk-in (urgent care) the next day (Saturday). So I figured I’d just wait and do that the next morning. Of course things got progressively worse and the pain just got worse. The whole evening and night was torture, and even while trying to sleep, any slight movement would cause enough pain to jolt me awake. Some of you may remember the bout with tooth pain incident I had a while back; this has been the only thing that has ever compared. The pain was probably worse in that case, as it felt like it would jolt directly into my eyes – but this had the secondary effects of not being able to walk around, and of course it was all just very embarassing and disgusting to me, which made it that much more difficult.

Finally I got to the doctor. He examined me very briefly, and said it was borderline that it might need operating on. He gave me a referral for surgery but it said something like “may take up to 3 weeks to schedule” so I was pretty skeptical. He kept calling it “angry” during the exam, which was actually kind of funny, but yeah, it certainly felt like someone was angry and punishing me with pain all day long. He then grabbed a napkin and started scribbling down his treatment suggestions, about 5 or 6 items which I’ll list below at the end for those interested.

Ultimately I believe the best call he made was guessing there might be an infection. I did everything he suggested, but within 4-6 hours after taking antibiotics, the constant pain had just subsided. Now maybe that was just coincidence and it was one of the other things, but given a similar experience with the tooth situation, I’m about 99% convinced the infection was what was causing the worst of it.

Bear in mind this is something that wasn’t mentioned in most of the things I read online, so it bears repeating. If you are feeling a really un-natural and constant pain, it just might be an infection that has taken it to the next level, so to speak, and getting antibiotics may be the best way to deal with it. I think the thing with “pain” in general is, there’s just no way to convey it to someone else, even a doctor. There’s no way for them to gauge what your threshold is, whether you might be exaggerating, or what you really mean when you say its constant or sharp or whatever. I’m sure that just makes it hard to diagnose and treat in cases like this. In any case, after it kicked in, I was suddenly able to walk around again. I’ve never been so relieved and appreciative of just the simple act of being able to get around my own house, or even something as simple as bending down to pick up something that had dropped.

It’s now been 3 days since I saw the doctor, and things seem to be getting better. I can get around almost normally, though I still feel it. I also have some general pain/itchiness, particularly after a bowel movement, so I’m hopeful that it won’t get any worse and I won’t need the surgery option. I’m continuing with most the stuff he told me to do for at least a week.

The moral of the story? Listen to your body, and don’t wait/delay to see the doctor when you sense something is really not right. You’d think I would have learned this after the tooth incident. I was lucky because I generally tend to avoid doctors, and I’m not sure I would have gone to the walk-in if I didn’t know my personal doctor was going to be there. Sometimes I’m stupidly stubborn about things like this, and as I mentioned, there’s always a bit of embarassment factor attached to this kind of thing. I’m just thankful that worked out the way it did, and that he prescribed the antibiotics.

– – –

MY DOCTOR’S TREATMENT SUGGESTIONS:

1 – Bactrim (prescribed anti-biotic)
2 – Sitz bath 15-20 minutes with HOT water, 2-4 times a day (purchasable at Walgreen’s/Rite-Aid, etc) – I recommend adding Epsom salt too
3 – Proctosol (prescribed hydrocortisone cream)
4 – Tuck’s Pads (purchasable over the counter, has Witch Hazel)
5 – 100mg Coldace twice a day (over the counter, stool softener)
6 – Milk of Magnesia (I didn’t use this)

And now for something entirely different from my normal blog-fare…

A few nights ago I started experiencing some pain around the back right corner of my mouth.  I had recently (about a month ago) had a tooth removed in the area due to a crown coming off and the tooth being infected.  So I assumed it was some strange after-effect from that.  It was very strange, as it only hurt when I was sitting on my sofa and watching TV.  When I brushed my teeth, the pain went away instantly.  I thought maybe I had some food particles falling in the socket but I later realized it was just the toothpaste itself that soothed the pain.  The pain was bad enough that I had to keep getting up and doing the toothpaste treatment, but when I sat down it would hurt.  Finally I just went to bed and it seemed OK.

Next day, no incident, but at night the exact same thing happened.  Exact same circumstances, same pain and same remedy.  Very very odd, I have had severe toothaches in the past, but they always came in waves of pain, and were never so easily sedated by something as simple as toothpaste.  I took a couple Motrin and slept it off again.

The following morning, things seemed OK but by lunchtime it started hurting more.  I noticed that hot liquids were affecting the pain and would send sharp hits through my jaw.  Though I should have known better, the pain seemed manageable enough so I went to see a movie with my family instead of trying to see a dentist.  In hindsight I should have been calling dentists that day and making a move to get it checked out, but at the time I kept thinking I could handle it with my simple tricks.

By New Year’s Eve, things took a severe turn for the worse.  By mid-morning I was in excruciating pain.  I am talking mind-numbing, eye-searing, death-wishing pain.  And worse, unlike what I’ve experienced in the past, painkillers would not dull the pain, and it didn’t come and go in waves, it was flat out constant and unyielding.  I soon realized the only thing that could counter the pain was ice directly in my mouth around the area.  The odd part was that the ice would instantly calm the pain, usually a jolt of pain and the it would be managed.  Even a tiny piece of ice around the socked would help, but as soon as the ice melted, the pain would be back in full force – literally within seconds.  I tried to go a full minute without ice, and it just would show no respite.

I took a Hydrocodone pill that morning (never had taken one before), and it did nothing for the pain.  But worse , a few hours later after I was coming down from it, I started to experience extreme nervousness and panic.  I could not contain myself, and completely did not know what to do.  I started pacing back and forth like a madman, I felt like I couldn’t breathe so I jumped outside and started pacing some more.  All the time carrying 2 cups, 1 filled with ice, 1 to spit into.  By this time I had consumed so much ice and icewater, it was starting to make me sick.  The need to constantly swap in new ice was really driving me mentally insane and unstable.  At first I thought it was all the aftereffect of the medication, but now I am realizing that was just partially the problem.

At numerous points during the afternoon, the pain literally brought me to my knees in anguish and tears, leaving me cursing life and praying to God for forgiveness, yet wondering why any God would create such an incredible form of seemingly endless pain.   I had to force myself to remember to just breathe, and as others have expressed in their experiences with similar pain, a part of me wished I could just kill myself to end the insane torture.  As I mentioned, I’ve had bouts with tooth pain in the past, and while it made me miserable to no end, I’ve never experienced anything like this where there was simply no relief aside from the ice treatment.  What was even worse was the feeling of utter hopelessness that I wouldn’t be able to get professional treatment for 4 full days.

This being New Year’s Eve (Thursday), of course all the dentists in the area were closing up shop.  I tried emergency numbers, 24 hour dentists, anything in the area I could get someone to talk to.  Everyone was out til Monday.  Eventually, remarkably, both my oral surgeon and dentist called me back.  The oral surgeon prescribed anti-biotics and that became my lifeline.  I don’t know how I pulled myself through those hours waiting for the prescription to be filled but eventually I made it.  Eating was a joke, as I would try to remove the ice, take a bite, then quickly stuff the ice back in before the pain started.  It really didn’t work out too well and I barely managed to stuff some food down.

After a hair-raising trip to the local CVS which involved a lot of ice and covert spitting, and fears of running out of ice, I made it back safely home with the drugs.  The antibiotics didn’t really kick in (and in hindsight, the doctor probably should have told me to take a double dose at the outset, as I was later told by a different endodontist) until late that night.  So it was a long, torture-filled afternoon.  Pain, ice, pacing, fear, nervousness, that’s all I remember now.  My partner sent me to hit the treadmill to just burn off some energy, which actually helped.  I was so incredibly tired and hungry, yet still so wired from the drugs and pain.  The whole evening I was filled with fear of how I was going to get to sleep or even try to sleep when I couldn’t relax one bit.  I eventually took a bath for the first time in years, but even that didn’t help much.  It did soothe my body some, but my brain wasn’t accepting relaxation, and somewhere during the breath I started to feel like I couldn’t breathe, so I just had to get out.

I took part of an Ambien along with more Motrin that night to get to sleep.  I was afraid of mixing in too many new medications, particularly after experiencing the craziness from the Hydrocodone.  I took my glass of ice to bed with me, and proceeded to try to read and continue the ice.  Note at this point I had been pretty much putting ice in my mouth for about 14 hours.  I think the affects of this are still lingering on me mentally.  In any case, I started to feel the effects of the Ambien, as it made me completely unaware of what I was reading, and my brain seemed to form some completely different story than what was actually on the pages.  It was a really weird experience.  Due to the necessity for ice, though, I was unable to fall asleep soundly.  I would drift a bit but then the ice water would fall out onto my shirt, or the pain would wake me.  Somewhere along the night, though, I started noticing that the pain seemed a bit lessened and I could last a little longer before putting in more ice.  At first I thought it was just wishful thinking, but eventually I realized it was real.  FInally somewhere around 5am I actually got a few hours of real sleep, and it was wonderful.

Next day I woke up and life seemed so much better.  The day went on with very little ice, and I thought I might be out of the woods.  That night I went to bed with NO painkillers whatsoever, a bit risky but the drugs were really driving me a bit batty.  I was able to get ahold of my dentist, who then recommended I see an endodontist immediately (we both agreed it seemed most likely the issue was an infected tooth next to my previously extracted tooth which would require a root canal).  The doctors I talked to of course would not be available until Monday at the earliest, and so the waiting continued.

Which leads to today, where the pain started coming back in the morning.  Not as sharp and powerful and all-consuming as it was on New Year’s Eve, but certainly enough to serve as a reminder of who is boss.  More importantly it’s left me with this strange anxiety that I can’t put my finger on.  Every single activity that I would normally enjoy or do to relax I have been unable to.  Any idea that sounded fun I would start but within moments would have to stop as I would feel claustrophobic, or nervous or annoyed by it.  It’s as if my entire life has been flipped around and inside out and my patience for just about anything has been taken away.  In retrospect I think it has something to do with the pain itself, the way it seems to be just lingering in the back and ready to hit me whenever it chooses.  I think the fear of the pain, the fear of the constant ice game back and forth has rendered me unable to relax into some form of normalcy.

Finally I turned to typing on this blog, which seems to have some form of therapeutic quality, or at least has kept me fixed on a single activity for the first time today.   I’ve  finally been able to sit quietly for an hour without jitters or leaving or getting irritated, though the irony is the topic is just all about the pain.  And even still, I have to take a deep breath every now and then to keep myself centered and not get overwhelmed by feelings of claustrophobia (for lack of a better description).  This tooth pain has taken me to new levels of pain and torture, and sadly, I don’t feel any wiser or stronger because of it.  I feel broken, violated and completely consumed by it, and the effect it has had on my daily well being, and I guess the only thing I’ve really learned is to not underestimate the signs again.

36 hours until Monday.