THE PAIN CHRONICLES

ONE MAN'S LIFE-CHANGING, BODY-ACHING, DRUG-ADDICTIVE STRUGGLES WITH A
DEVASTATING INJURY

What I am is a person in pain. Chronic pain. An ordinary guy who just
hurts like heck. All the frigging time. Day in, day out, 24-7, 365
days a year.

There's nothing funny about the predicament of chronic pain. It is
truly an Equal Opportunity Affecter. It doesn't care how old you are,
what color you are, what gender, what creed. It doesn't wait for
convenient times or logical circumstances. It creeps in like a thief
in the night and day, robs you of comfort, agility, dignity and
energy. It hardly ever, ever takes a break.

It is real. It is serious. And it hurts.

I am a 45ish-year-old Caucasian male, about 6-foot-1, 185 pounds. In
another life that seems so long ago, I was a fairly decent tennis
player. I could run a six-minute mile. I enjoyed golfing with friends
about three times a month. I could be up and out of the house with a
quick shower in less than 15 minutes. I played drums for almost 25
years in various rock 'n' roll bands from Nashville to Chapel Hill. I
could ride an exercise bike for 45 minutes.

Not anymore. In my present and most probably permanent state, it takes
me somewhere around three minutes just to get out of bed. My morning
ritual involves waking up with what feels like a rusty dagger stuck in
my cervical spinal cord. I then roll over on my side, letting my legs
swing off the bed until they touch the floor. I use my stiff right arm
to push my trunk up into a sitting position. I do a series of stiff
head rolls to try and loosen up my shoulders and neck, my face
contorting and wincing. I make Linda Blair look like a rookie.

Having performed these movements and resigning myself once again to
another day of chronic shoulder/neck/limb pain, I lie back down on my
back and attempt right and left leg lifts. Then I pull them up toward
my chest. The legs don't go very far, but the movement shakes up the
muscles and the nerves a bit.

I cannot do anything about the constant tingling numbness of my left
and right arms, from my shoulders all the way through the tips of my
fingers. The worst is my left arm. And, hey, wouldn't you just know
it, I'm left-handed.

The next morning step in my therapy involves the shower. I turn the
water valve to a temperature as hot as I can bear it, placing my neck
and shoulders under the stream. After five minutes or so, I reach down
and, all at once, turn the water valve to where it is as cold as it
can get. I shriek. I stand there screaming for as long as I can stand
it--my record so far is about 40 seconds. I'm sure everyone in my
condominium complex is convinced that every morning the shower scene
from Psycho is being re-enacted. (Did you know that "hydrotherapy," or
using hot, then cold, water as a device for relieving chronic pain and
muscular problems, has been around since the mid-19th century?)

So how did all this come about? How did I become another statistic
among the number of chronic pain sufferers throughout the country?

The truth is really unremarkable. I wish I could say that all this was
the result of my performing some heroic deed. Like saving a busload of
nuns from a biker gang, or lifting a ski boat off of an infant in
front of thousands of witnesses. But my injury is the result of a head
full of shampoo and a cough.

I was in the shower one February morning in 1996, and I had my head
all lathered up with shampoo. When I threw my head back after rinsing,
I felt a small prick-like sensation in my neck, just to the left of
the top of my spinal cord, at the base of my skull. I didn't really
think much of it. As a tennis player, I had a history of minor back
spasms and some stiffness, so I simply tossed it off as lingering from
the previous day's exercise. I stepped out of the shower and felt a
tickle in my throat. That subsequent simple, stupid cough changed my
life forever.

When I coughed, a stabbing, burning pain in my neck literally made me
drop to my knees. I felt dizzy as my brain tried to register the force
of it. I quickly got out of the shower so I wouldn't collapse onto the
cold wet tile. I felt sort of off balance, and, when I coughed again,
I thought I was going to lose consciousness. Immediately, my left arm
and shoulder tingled with numbness all the way down to my fingertips.
I was scared to move. I was scared to breathe. I was convinced I was
having some kind of stroke. My left arm twitched involuntarily.

I thought it had settled down some and, rising off the bathroom floor,
I actually thought I could make it to work. By the time I got to the
interstate, about three miles from my home, I was screaming in pain at
the top of my lungs. After pulling into the office parking lot, I
walked in, doubled over, and went straight to my office and slammed
the door. Needless to say, several fellow workers rushed in to see
what was the matter. They saw me slumped over my desk, rocking back
and forth. My partner, Rick, asked what the hell was wrong, and I
tried to speak in gasping syllables as I reached for the phone book. I
screamed that I needed an ambulance. Rick dialed 911.

Within minutes, a paramedic was shooting morphine in my neck, and in a
few seconds the pain had vanished. In the emergency room, a
neurosurgeon was called and immediately ordered an MRI and a
myelogram. They kept me doped on the morphine so I could get through
the procedures.

Over the course of the next few days, I learned that of the seven
cervical discs in my neck, three had exploded, sending bone
fragments--or bone spurs--into my spinal cord and making it ripe with
"foraminal stenosis." What this meant was that the cord had closed
around a bunch of nerves, crushing some beyond repair, which caused
all the pain and numbness. I was given an epidural block, a procedure
that required doctors to shoot a numbing, Novocain-like "block" into
my neck that would hold me until the major surgery portion of my program.

The interesting thing was that my two doctors--the neurosurgeon
(nerves) and the orthopedic surgeon (bone)--considered my condition
congenital, meaning that I had suffered this plight in an unrealized
form since birth. No trauma had made this occur. It just finally
happened from years of left-handed, right-brained abuse to that part
of my system...playing drums, tennis, bad golf and, of course, a weird
alien abduction incident. But I digress.

Early one morning in mid-February, the doctors prepared to filet open
the back of my neck in what was being routinely referred to as a
"radical procedure." While one doctor reamed out my spinal cord to
relieve the nerves, the other would use a bone graft from my left hip
to fill in the cracks left by my discs that had gone bye-bye.
Theoretically, the bone graft would form a "bridge" from unexploded
cervical disc to unexploded cervical disc. I was in surgery for over
five-and-a-half hours.

The first two things I noticed when I woke up in recovery were a sharp
pain in my left hip and a throbbing headache. It didn't take long to
explain both. There was a scar about 4 inches long in my hip where a
chunk of bone had been whacked off to put in my neck. Also, I was
wearing what they casually call a "halo."

Folks, words don't do justice to the name of this device. It is a
metal cage attached to your head by four heavy metal screws driven
into your skull--two in your forehead, two in the back. The cage
itself sits about a foot over your head, and it is harnessed by a
large plastic shawl--like a shoulder pad with thick cotton fleece, as
a cushion between the cage and your bare shoulders. The thing weighs
somewhere in the neighborhood of 15 pounds.

The purpose is obvious. You are completely unable to move your head or
neck in any sort of swivel whatsoever so the spine and graft will have
time to attach and heal.

Besides freaking out big-time with the claustrophobic effect of the
halo, I was totally unprepared for what came next. I assumed that this
type of treatment was only for the first few days, maybe a week, to
let everything get on a healing track. I asked how long I would have
to wear it, since I'm a manic claustrophobic. I had to wear it, the
doctor told me, until the end of September, maybe October.

It was Feb. 16. I banged the device onto the bowl of the toilet as I
tried to throw up.

In between whining about the halo and screaming for medication, I
noticed that the numbness and tingling were still very present in my
left arm and right leg. They became really prevalent when I would get
up and walk around--I needed a cane to steady myself. The doctors
explained that when they got into my spinal cord and neck, they found
much more than they had anticipated. I had a strong case of arthritis
around my cervical discs, and some of the nerves were unavoidably
damaged in the surgery itself. Some of those nerves were the ones
reaching to my leg. The ones to my arms had been damaged virtually
beyond repair, and the doctors' only hope was that they had stopped
any further deterioration and prevented any reoccurrence.

This is when I first heard the term "degenerative nerve disease." It
meant that the arthritis was steadily creeping around my nerves and
remaining discs and would most probably render me unambulatory as time
wore on.

I spent five days in the hospital. They hooked me up to a self-pump
device that would inject morphine into my IV every time I pushed a
button. It would ring like a hotel desk bell when punched. For two and
a half days, my hospital room sounded like the lobby of the New York
Hyatt on New Year's Eve. At one point the nurses came in to tell me
that I had injected five or six days' worth of morphine in half that
time.

I left the hospital with a sheath of prescription sheets--everything
from Medrol dose packs to Neuratin nerve stimulators to Carisprodol
muscle relaxers to Lortab painkillers. I was headed home. Well, not
home, really. My parent's house.

Let parental bonding begin.

I lived on my parents' den sofa, in the halo and on medication, for
almost nine months. This alone should make me (and my parents, I must
concede) a shoe-in for the Congressional Medal of Honor. Since both of
my parents work, I needed someone to tend to me like I was some old
Mr. Potter wheeling around an old mansion with a shawl wrapped gently
over my lap. We hired an elderly lady for three days a week to come
over and "nursemaid" me in every sense of the word: make my lunch and
dinner, change the bed sheets, do light housework like dusting or
vacuuming, and, yes, my friends, bathe me.

Now, had this been Morgan Fairchild or Elle Macpherson or Nicole
Kidman or even Marlo Thomas, I'd have looked forward to it. But I got
Olga, the Viking Goddess of Agony and Torture.

Every day found me getting up and beginning my daily ritual of
memorizing the scripts of The Dick Van Dyke Show, Matlock and McGyver.
I would then get my medication from Beatrice (a.k.a. "Olga"). Then it
was Law & Order and Mad About You. And then I'd sneak some more
medication halfway through NYPD Blue while Beatrice was doing laundry
or making lunch. My worst fear became that the batteries in the TV
remote control would go dead.

Meanwhile, the screws in my head felt like bullet holes. The stabbing
pain along my shoulders felt like the bass drum in a marching band. As
the pain not only continued, but also increased, I went to see the
doctors for routine post-surgical follow-ups. Tests revealed that the
bone graft had not adhered to the bone spurs in my neck and that the
subsequent arthritis and stenosis had become worse. Another surgery
became the best solution.

During this surgery, doctors would insert three titanium plates and 12
hardware screws. The plates would be screwed directly into the bone of
my spinal cord. The titanium plates and screws were to be permanent,
and I was informed that I would always be in pain, sometimes very
aggravated pain, for the rest of my life.

I was back on my parents' couch for five months. This time around,
friends and family were bringing food and sympathy cards and flowers
to my parents, not me. By now, Mom and Dad were asking to share my
medications.

Late summer was hot and the brace I wore made it even hotter. It acted
like a heat-seeking missile, a sun magnet when I'd sit out on our
terrace to get some fresh air. Of course, Beatrice and the quilt she
was making would join me. About every 15 minutes, she'd come over with
a cotton ball drenched in cold rubbing alcohol and swab the points on
my head where the screws had been and which were now oozing pinpoints
of pain. When I went to "go to the bathroom" and sneak a couple of
more hydrocodones or Somas, that was really nice, too.

October came around and I was feeling like I could make it on my own.
The parents helped me pack. They took me home, helped me inside and
got me settled. My mother, with eyes only a mother could have, looked
at me and told me that they would always be there for me, would always
be nearby to help in any way they possibly could. They turned one last
time at the door, waved a silent goodbye and left me alone. I
immediately heard a rousing chorus resounding from the parking lot.

Of course, I jest. Without them, I couldn't have survived the turmoil
and frustration, or, truthfully, the day-to-day operations of living.

Chronic pain sufferers (CPSers, for short) tend to look for anything,
absolutely anything, that will alleviate the pain. Oh, sure, aspirin
relieves fevers, Ibuprofen relieves aching joints and arthritis,
Tylenol helps us get through the cold and flu season. These don't do
squat for the CPSer. I'm talking about "prescription drugs," the good
stuff, the stuff that invariably costs more than $4 apiece. We CPSers
know that the degree of relief is directly proportional to the amount
of money it costs to get it. If it costs $114.84 for a dozen after the
insurance co-payment, we get very excited.

It's really easy for someone who's not in the throes of chronic pain
to turn his nose up at those of us who rely on prescription
medication. "Oh, you're an addict," they say, or "You can't quit
taking those, can you?"

Screw all that. They have no idea in hell what it's like. I've been
there when these things turned on me--Benedict Arnold in a small blue
tablet, Judas in a capsule form. If someone had told me way back when
that I would end up a slave to a pill that would allow me to go get
the mail, write a check, get out of bed, I would have laughed at them.

Painkillers took over my life for almost three years--especially Soma
muscle relaxers. But don't get me wrong. I literally could not have
gotten through the post-surgical acute pain without those damn drugs.
I was so hurting and so begging for relief (especially with that
"halo" on) that I truly needed them, no question about it. And there's
no shame whatsoever in alleviating pain with painkillers when you are
really hurting. It's when you start taking the pills for "fun" that
the problems start.

One day, I found myself "flopping" the dosages. (If the prescription
reads one every four hours, and instead you take four every hour,
that's "flopping" and that's a problem.

To wit: One night, I invited a couple of friends of mine, Sarah and
Carl, over for dinner. I was in the kitchen cooking up a storm, and
the time rolled around for me to take another pain pill. I popped two
and went back to my stove. I was stirring and checking baking times
and chopping lettuce and gulping down a few beers. The next thing I
knew, I was waking up on a hospital bed. There was a doctor leaning
over me and my friend was at the end of my bed. My head hurt.

"Do you know what happened?" Carl asked me.

"Uh, no."

Then the doctor leaned back over me and said, "You've received quite a
trauma to your head. I had to give you eight stitches."

Turns out, when Carl walked into my condo, he found me lying on the
kitchen floor with a big pool of blood around the top of my head. He
got me to the hospital.

There were a number of other incidents. Waking up and finding out it
was Thursday instead of Tuesday. Hearing from my friends that I fell
down a flight of stairs at a Super Bowl party and having no
recollection of it. Walking into my kitchen in the morning and
wondering why the stove was still on. Dead-bolt locking my door and
hiding the key before I took the next dose, hoping I wouldn't be able
to leave home during some somnambulistic tirade.

I had become addicted to pain-killing drugs. They had become not
simply a relief for the pain, but a steady diet, as much a part of my
daily routine as brushing my teeth. And I have to admit, there was a
long stretch that they made me feel good. Real good. It got to the
point where I would relish my pain because it gave me a viable excuse
to pop more pills. Does this sound insane? Neurotic? Obsessive? Pathetic?

To a normal person, it must. But chronic pain suffers aren't normal.
Normalcy doesn't include being in pain all the time. And pain-killing
drugs are our saviors. Yet, we need to keep a clear head, as much as
we can, when it comes to medications. The easiest thing in the world
for us to do is administer scripts to ourselves and hope that the
false relief they bring will take us through. To the next meal. To the
next friend's visit. To the next time that I can go back to sleep in
some sloppy dream-state and hope I don't wake up in the middle of the
night when nothing good is on cable.

The pain of addiction is a pain of the soul; it can be as traumatic,
disheartening and deadly as any chronic physical pain we endure. As it
turned out, I needed help.

If you think I was depressed because of chronic pain, you should have
seen me going down that driveway to the Pain Management Center, one of
seven such facilities in the nation, where I would spend the next
seven weeks. My father had driven me. About a half mile before the
entrance, we passed a little roadside beer joint. I couldn't help but
wonder how much they made off addicts either stopping in for one last
shot before being committed, or as the first oasis they could reach
after they'd been through the program.

I had an appointment to be admitted at 1 p.m. and that morning, before
I left, I sat around my apartment scared to death. What really scared
me was that the place might deprive me of my medications. But the
first thing they did upon my admission was give me a Valium or a
phenobarbital. Maybe it wouldn't be so bad after all, I thought. But
then I found out those pills would only be offered to me twice a day.

I freaked. Completely. TWO Valium, TWICE a day.... That wouldn't get
me through 10 a.m. But then I learned that I would receive a thorough
examination, and a doctor would prescribe a "treatment program" that
would include narcotics. The narcotics would be dispensed only at
certain times, and I would gradually wean off them to a safe level.

I breathed an audible sigh of relief. The nurse just looked at me and
smiled. She'd seen 1,000 others like me.

As the drugs kicked in, this orderly ransacked my luggage. He asked me
to remove my belt and shoelaces, took away the only necktie I'd
brought with me, and also confiscated my cash, so I couldn't call a
cab or pay a sneak to kidnap me.

When I hobbled out into the barracks-like unit, I noticed locks on the
outside of my bedroom door. Seeing the patients wandering around the
"lounge" area, I thanked whoever developed Valium many times over. But
some of the other boys and girls needed nothing less than a Zulu
blowgun tranquilizer dart to the neck.

One fellow patient, right before dinner, began throwing his body, full
force, against the glass partition that separated the room from the
nurse's station. He was screaming in pain and anger, throwing up quite
a bit, and I learned later that this was the result of a fairly
routine Dilaudid withdrawal, characterized by uncontrollable muscle
cramps, major nausea and frantic paranoid hallucinations.

Around 6 o'clock that evening, the head nurse gathered us together to
walk to the dining hall. I told her I wasn't hungry. She didn't give a
flying flip. That first night, I lay on my bed, trying to read from a
magazine left in the lounge. I couldn't help thinking about how, if I
had been at home, I'd probably have just popped about five
amitriptyline, a few Valium, a Soma and a Percocet or two just for
good measure. It was then a nurse came around and gave me a
phenobarbital and a Valium to help me sleep. I wanted to nominate her
for sainthood.

I was awakened the next morning at 7 a.m. A young woman who had been
admitted earlier that morning had already been caught shooting a
Dilaudid in the bathroom. She was now restrained by small leather
wrist straps and was sleeping.

"Your 'buddy' will be here in a minute to help you get to the
cafeteria," a nurse told me.

My "Buddy"? Oh Jesus, what the hell was this, Camp Chickamuaka
swimming class? I wondered why I needed a buddy to get about 70 yards
to the cafeteria.

I quickly found out why.

When you walked to the cafeteria, the driveway out of the place was
right there, beckoning you to head down the pavement toward that
little beer joint. Or, you could slip behind the building and shoot up
a Dilaudid you sneaked in under your sock when no one was looking.

My buddy's name was Mike, and he would escort me for my first three
days there.

"I want you to try and walk with me to the dining hall without using
your cane," he said.

"There's no way I can do that," I told him.

"We're going to see what we can do about that when we go see Dr.
Bradley. But I want you to try and walk just from here to that
building over there without using it, OK?"

I handed him the cane the way a 5-year-old would try and wean himself
from his blankie. Sure enough, when I tried to stand up from the bed,
down I would go. But just as sure, Mike was there to catch me and hold
me upright.

"You're doin' good, doin' good," he said.

I got about a third of the way with the support of Mike's arm.
Entering the cafeteria, I stood in line quietly, leaning on the cane
that Mike had been nice enough to return. The chow line gossip was at
a frenzy. Through eavesdropping, I learned that someone had
successfully committed suicide last night in the detox wing, two doors
down from my room. It was the young gentleman I'd seen flailing
himself against the nurse's station window. He'd used the spring hooks
from his bed frame to slash his wrists. I moved on down the line.

The place was alive with noise, laughter and conversation. I got
enough on my plate to feed, possibly, a small earthworm and I slouched
to an empty table. My buddy Mike came up and sat down beside me. He
asked me questions as he shoveled from the pile of food on his plate:
where I was hurt, how it had happened, how long I had been on meds,
which was my favorite one. He told me that I had 20 minutes before
roll call.

Roll call was a trip, literally breathtaking. There were Dilaudid
junkies, spina bifida patients, people both knotted and deformed,
Demerol and Seconal downer babies, folks in wheelchairs and walkers,
wanton and wasted wackos, tranq freaks, boys, girls, blacks, whites,
Indians, women, men, Polo shirts and tank tops, all slowly limping or
rolling into the roll call room and taking their seats. No one went by
anything more than a first name and a last initial, all part of the
anonymity thing.

Soon I had been assigned staff people to handle my program. I had a
case manager, a process therapist, a spiritual guidance counselor, a
medical physician and a psychiatrist. And I quickly learned that I was
the envy of almost everyone there. My condition allowed me to take
lots of medication: three Actiq lollipops a day (a sucker-like thing
that is actually a combination of fentanyl and opiates), four
baclofens, then a Valium and two amitriptylines at bedtime. I had
people bidding everything they owned for just a bit of what I was getting.

As time went on, you grew to know people who were beyond belief,
beyond your wildest imagination, and unfortunately in some cases,
beyond help. Yet, through the six hours a day in different therapy and
community groups, you began to feel a weird, platonic, even cosmic
bond with your classmates.

Take Monty. Monty was a pediatrician from Pittsburgh, and he was here
because the Drug Enforcement Administration had raided his practice
and found a bag of 1,000 Valium under his desk in his gym bag. They
concluded that Monty didn't require Valium--certainly not that
quantity--to practice his field of medicine, and the subsequent plea
bargain in court had landed him at The Center.

There was the ob-gyn who used the bathroom of his patient's delivery
room to swallow three or four hydrocodones for his back between her
contractions. I met a sweet and beautiful nurse, an RN no less, with
horrible leg cramps, who divulged she would replace her terminal
cancer patients' morphine with a saline solution and use it herself.

I spent a whole lot of time in groups and doctors' offices. There were
group therapies and spirituality sermons that cascaded me further and
further away from the outside world and deeper and deeper into some
parallel universe where everyone and everything was going to be just
fine.

I finally felt a refreshing order in body, mind and spirit that I
truly had never even thought possible. Sure, my pain was still there,
still reminding me with each step. But I felt revitalized,
rejuvenated. Part of me had never felt as safe and lucid as I felt in
these confines. But the other part of me was so excited about getting
out, getting on with the rest of my life. A life free from the bondage
and the hassles and the nightmares involved with using the pain pills
that I had constantly craved.

I can honestly say I've been sticking with an aftercare plan that
includes pain medication on a very strict regimen that I hope will
last me the rest of my life. I'm proud of the fact that I'm sticking
to it. Believe me, there are times when I'm hurting like hell and
there's pain relief less than a foot-and-a-half away. But I won't take
it until it's time, and that makes me feel as good and as proud as
almost anything I do.

I thank God every day that I have a bevy of friends who take sympathy
to a very high degree with me. They are there for me, in every way.
They drive me, they constantly offer to help in any way they can:
getting groceries, picking up my dry cleaning or stopping by the
drugstore if I need toilet paper or dishwasher soap or whatever,
helping me up and down stairs and roadside curbs, offering to get my
plate at a buffet supper--all the things that CPSers sometimes find
virtually impossible to do.

That's all we really ask of people. Not that they empathize with what
we're going through, because we'd never wish our condition on anyone.
But we do ask that they understand that chronic pain is exactly that,
with us all the time.