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May 02, 2006

Take That Painkiller ... or Not

Donald Pittenger writes:

Dear Blowhards --

I'm not on the subject of really serious pain, the kind one gets after a major wound or from cancer. I'm thinking of minor stuff and different strategies people take when dealing with actual or anticipated pain.

Plus I'm not a pain expert, being pretty fortunate in my life to have avoided (so far) all but one childhood ache in the bone above one ear and some childhood toothache pangs.

I should add that as I've aged, I gotten much less sensitive to the sorts of pains that bothered me as a child. Looking back, I think that I was hyper-sensitive to pain in my pre-teen years.

For example, I've had a few root canal procedures and even more tooth-bulldozings for crowns, not to mention a tooth implant that involved a lot of demolition of the molar being replaced. Each time, the dentist wrote a prescription for a pain-killer. But I found that I almost never needed them. I did take one pill following the tooth removal for the implant, but that was a borderline case and I might have been able to skip it.

Then there is the somewhat related matter of anesthesia when the level is at the option of the patient. Examples include examinations of the colon, esophagus and urinary tract. In each case I opted for the lowest level of anesthesia. The Fiancée, on the other hand, had one of those examinations and insisted on being put completely under.

In no way was I trying to be "macho." There are dangers to being totally anesthetized. Plus, knowing that I'm less sensitive to pain than I once was, I figured that I could get by with lesser amounts of the stuff. And I did just fine.

Finally there is the case of my father. He claimed that when he went to the dentist, he refused Novocain because he feared the needle more than the drill.

Recalling the pain I had felt in childhood from the low-speed drills dentists used then (even having had Novocain), I thought my father was totally nuts. It's possible that he was BS-ing us, but when he kidded us his pattern was to come clean after only a short time. So I'm guessing he was truthful.

Do you have any pain/painkiller tales to tell us?



posted by Donald at May 2, 2006


Donald, I was hit with appendicitis last September. I went into the hospital on a Saturday morning, was operated on six hours later and went home on a Monday morning. By Thursday I had stopped taking the pain pills, though there was discomfort. Since I could sleep without them, I figured I was ok. Though there must be at least 20 or more of those pills left, I put them in my backpack first-aid kit in case they were needed in an emergency on one of my annual forays into the backcountry of the Sierras. I'm no masochist, but if the pain is bearable, you should bear it. The consequences of addiction are too awful to risk.

Posted by: Charlton Griffin on May 2, 2006 10:54 AM

I can't believe this. I wrote on the same subject in my blog about 2 hours ago. Slightly different angle.



Posted by: citrus on May 2, 2006 12:00 PM

Citrus -- In case anyone tries to use your comment as data for a mental telepathy study, let me state that I drafted the article on 24 April. I've been stockpiling posts in the 2Blowhards queue because I'm getting married in a few weeks, and that will cut into my blogging time. The article cache ought to allow me to maintain my normal posting flow rate of about four per week.

Posted by: Donald Pittenger on May 2, 2006 12:35 PM

I've been lucky -- so far the worst pains have been when the nerve in a tooth was in the process of dying (truly intense, horrible, nearly unbearable, but mercifully short-lived) and a temporary gut blockage due to adhesions from abdominal surgery. For the first I received NO analgesic because I was too young and stupid to realize I could request such a thing from my dentist, and for the second I was in the hospital for a week with some almost totally ineffective high-powered painkiller dripping in. I've had the usual sprains, strains, a broken bone or two, all extremely painful, all with no pain medication. But I can't remember anything hurting as much as that tooth. Or maybe it did hurt as much, but it was less focused and less close to home, as it were. Something made the other pains more bearable.

I've never "enjoyed" the pain of childbirth, but I have undergone a hysterectomy due to a rapidly-growing ovarian tumor, and I never once experienced anything more than minor pain post-op or during recovery and healing. (I've had menstrual cramps more painful.) I was equipped with the usual painkiller administrator for whenever I needed it, and I think I used it maybe twice in five days in hospital. I attribute my amazing lack of discomfort almost totally to the skill of (and my complete confidence in) my surgeon. But maybe that's a kind of pain that I just don't experience as intensely, who knows.

Oh yeah, the definition of "minor pain" - any pain someone else experiences.

Posted by: Flutist on May 2, 2006 1:50 PM

The two worst pains I have ever had are in the wake of getting two wisdom teeth pulled (omigod!) and having a herniated disc in my back (double omigod!). God bless modern drugs in both cases. I wouldn't have made it through without them.

Because of my back, I always take an over the counter painkiller (live Aleve) promptly if I start feeling a twinge, because the pain can get out ahead of you pretty fast if you don't nip it in the bud.

Posted by: annette on May 2, 2006 1:53 PM

Wisdom teeth -- y'all are bringing the horror of it back. I had all four out at once, and I pretty much skipped out of the procedure feeling great (still high on what I think was sodium pentathol). An hour later I was moaning in a dark room, where I stayed for the next few days.

My weirdest painkiller experience was my first night after my cancer surgery. I was lying there on my back like a gutted fish, tubes all over the place, pillows around me to keep me from moving off my back, barely sentient, in that silly place you go on morphine ... And every time I dozed off, my epiglottis fell back against my throat. I'd have a flash of a chocking nightmare, awake with a horrified start, and then nod off again, over and over through the night. My soft palate evidently had overrelaxed -- due to the morphone (and maybe due to bruising from the anesthesia tube). It was especially awful because the morhpine made my dreams and fears careen out of control -- I didn't have my usual psychological mechanisms in place, I was scared because of cancer, I was drugged ... The nurses couldn't do much because I couldn't be rolled off my back. Yet I couldn't keep myself from falling to sleep, which each time meant a fresh, drugged nightmare. An awful night -- actually the worst thing about going through the surgery, which otherwise all went pretty straightforwardly.

Posted by: Michael Blowhard on May 2, 2006 2:05 PM

I'm inclined to believe your dad's story. My father had a tooth pulled sans painkiller for exactly the same reason.

Worst pain - internal bleeding after a kidney op.
Waiting for the surgeon to get back from dinner to cut me open again, without pain meds owing to the upcoming anaesthetic, there were a couple of moments when death seemed like a decent option...

Posted by: nigel on May 2, 2006 2:25 PM

Pain is information -- so one wants to pay attention in case it's telling one something important, maybe that it's a symptom of something you wouldn't know about otherwise. But pain can also be "disinformation" about something that doesn't matter or that -- like highway signs they don't take down after the construction is all finished -- it's just outdated. Pain, after all, is not in the damage itself, but in what the brain thinks about the damage. If the brain goes on believing you're wounded, you'll still have pain. Pain can escalate into becoming the wound -- keeping you from thriving.

As I get older and as I watch more people struggle with pain, I become more worried about it. Constant arthritic pain is sneaking around. Some pain killers, like aspirin, are much more powerful than just being pain killers -- inflammation and fever are also addressed by aspirin and other meds. Sometimes I'm not sure whether the aspirin I took got rid of the pain or the cause of the pain.

With diabetes II still new, I do four finger-sticks a day. Pain is so brief and minor, I don't care. But backaches -- what are all these backaches? Why did I swap out the tub for a shower? Where's the heat pad? Should I take a pill or call the doc?

Prairie Mary

Posted by: Mary Scriver on May 2, 2006 3:04 PM

Ha and double ha, on all of you (except Michael and Nigel)

Miscarriage clean-up without even a local anaesthetic, anyone? Drug-induced labor on a plastic-covered cot (in a best hospital in town), 10 hrs w/o painkiller but with drip system not taped to your elbow viens, horizontally-crucified position, resulting in massive black&blues all over your arms and shoulders, and shaking after just 2 hrs?

Not enough? I can add some color (as mental sauce for the main entry of the physical pain)
A miscarriage episode: simultaneous groupping of med. students around the patient (w/o permission, of course) with prof commenting to patient's moans: "you should've thought about it before, when you let that cock inside you". Etc.

Posted by: Tatyana on May 2, 2006 3:33 PM

Novocain injected into my gums when I was 6? Ha. Two hours of tattoo work on my inner forearms? Please. Worst pain ever -- I used to have a problem w/ ingrown toenails on my big toes, and the podiatrist recommended excising a bit at the root & killing it w/ acid so it wouldn't grow back. Sounded great -- no more problems!

Only trouble was the numbing stuff I had to get before he could go in. First he sprayed this pinchingly cold aerosol stuff to numb my toes a bit. Then he took a syringe w/ I guess novocain -- and gave me THREE separate, long injections (two on the underside where the toe meets the foot, and one on top where toe meets foot). I had that done on three or four occasions, all told. I took it well, but was about to punch the doc in the face near the end.

Posted by: Agnostic on May 2, 2006 5:12 PM

Agnostic -
I sure know what you mean about ingrown toenails. Both of my big toes were done, on separate occasions, and each time the podiatrist injected novocaine at the base of each toe after adding the freezing spray. The injections for one toe didn't hurt much, while for the other it was pure hell. The funny thing is that the toe that hurt less had been far more infected than the one which was so horrible.

Posted by: Peter on May 2, 2006 9:40 PM

I've had the usual round of broken bones, the odd 2'nd-degree burn or three (I once worked as a roofer), and I also have had the pleasure of a herniated lower-back disc. All were no fun, and for sheer, short-term intensity nothing quite matches a blob of 450-degree molton asphalt finding its way onto the back of your hand.

And of course, there's always the "kick downstairs", which is a whole lot more than just indescribable pain--it's a whole feeling as if you are dying. It's terrifying and completely disabling, too. You can't defend yourself, you can't run--heck, you can barely even breathe. Against your will, you crumple up into a little ball as the bully who kicked you taunts you, and you know that if he decided to carry out his threats to hurt you there would be nothing you could do to stop him.

But the absolutely worst, most miserable, excruciating experience I've ever had was passing a kidney stone. That pain went on and on, and seemed like it would never stop. It would go from bad to worse to so bad all I could do was writhe on the floor screaming in agony, and then back off again just a bit. I didn't know what I was suffering from, so I drove myself to the emergency room during a period where the pain backed off a bit, but I still nearly crashed on the trip over.

My grandmother used to tell me that she had had a couple of kidney stones over the years, and that she sure hoped I would never have to endure that. Oh well. Looks like I'm the lucky one who got that gene.

I hope none of you who read this ever have to experience a kidney stone.

Posted by: Erik on May 30, 2006 3:47 PM

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