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Friday, September 4, 2015

In Praise of the Epidural

On Wednesday, my sweet friend Angie took me to town for my epidural injection of steroids. Two college graduates had a little trouble finding the location, but we arrived on time—or so I thought. I was an hour early. Great.
A little back story. After being “down in the back” in a spectacular way, I only had four pain pills, 5mg Lortab. My dentist gave them to me back in March when I had a dental problem. I doled them out to myself as though they were little pellets of solid gold, and when my back pain finally eased, the day before the epidural, I had only a small stash of the miracle workers. 
On Tuesday, a nurse from the anesthesiologist’s office called with instructions. It was simple enough: nothing to eat or drink after midnight except a sip of water if I needed a pain pill. When I quizzed her about what to expect, she said I should have immediate relief that would last about 24 hours. She then told me after that, I might have pain for several days even worse than I had been been experiencing before being comfortable again. It might happen, it might not.
“Is he going to send me out of there with a prescription for something for pain?”
“No. He doesn’t prescribe pain meds. You’ll have to get a prescription from your back doctor.”
A feeling a dread perfused my entire being. I endured ten days of back pain with lightening bolts shooting down my leg even with the help of Lortab, and the thought of anything worse was almost more than I could comprehend. Tears welled in my eyes. After I composed myself, I called my back doctor’s assistant to ask for a prescription. 
“Dr. XXXXX has a policy of not prescribing narcotics for his patients.”
The tears started up again.
“Are you telling me that a doctor who treats back problems doesn’t prescribe pain meds for them? I find that absurd. I’ve been warned that my pain may return for a few days and that it might be even worse than before. What does he expect me to do? I’m not at all sure I want to be associated with a doctor who won’t treat my pain when needed. I’ll have think about this. I may cancel the procedure and look for a reasonable doctor. I just don’t know. 
I was babbling. Weak and exhausted from the recent siege of pain, I couldn’t imagine things being worse, even for a couple of days. I knew my small stash would not be enough to keep me comfortable if the worst happened. I explained I had tried a milder medication but it made me itch to the point of not being able to sleep. She was unmoved.
“I want you to go ask him. Better yet, I want to talk to him.
“He won’t be back in the office until tomorrow.”
“My appointment is at ten. Will he be back by then?
“I think so.”
For a moment I was speechless, a rare occurrence for me. 
Then, “When he gets there in the morning, ask him to give me something for pain and call me. Remember my appointment is at ten.”
“Yes, Ma’am.” Finally a modicum of respect.
The next morning, as I was checking in for the epidural, my cell phone chimed, and it was the nurse at Dr. XXXXX’s office, telling me he had written me a prescription for FIVE pain pills, and that I could pick it up at the front desk. Five pills? Now isn’t that just a party in a bottle? 
I finished my paperwork and told the receptionist I was going to run out for a moment to pick up a prescription. I was, after all, an hour early. She looked as though I were pointing a gun at her and blurted, 
“But I can’t send your chart back unless you’re here!”
The poor thing had completely lost her automaton-like boredom-ridden cadence she used on every patient as though we were all so many cattle being moved through a chute. 
“I’m an hour early. I need to run this errand, and you can transfer my chart when I get back. This is not a problem.”
“Let me know the minute you get back!”
Like she wouldn’t see me coming through the door of the tiny and badly decorated reception area. I was frankly happy to escape the dull green walls adorned with nothing except xeroxed notices and reminders for patients to not eat or drink anything. Interestingly, there was a coffee urn for the fortunates who were only the chauffeurs. And there were the sad faces of the other patients, their pain reflected in their eyes. There was a stack of current copies of Golden Isles Home and Garden on a table littered with pamphlets about pain management, and I picked up two copies for Angie and me.
She drove me to the other office, and I waited while two patients were checked in. I identified myself and the reason for my visit. 
“Do you have your ID?”
“It’s in the car.”
“You’ll need it to get your prescription.”
All this for FIVE pain pills. What did these people think? That I was going to take them downtown and sell them on the street? I went back to the car and got my wallet. The receptionist requested my driver’s license and made a copy of it and the prescription on the same page and offered it to me for my signature. All for FIVE pills. I scribbled my signature and we were back at the other office in ten minutes. 
I waved at the receptionist, who looked inordinately relieved that I had returned. She had forgotten to give me a paper where I was to mark where my pain is/was on a drawing of the human body. 
Well, clutch the pearls! I had thrown a monkey wrench into her routine. I filled out the page, which she directed me to keep and take when I was called to the back. I was still 20 minutes to appointment time. I opened my copy of the magazine, which was interesting. An article about the warblers who will be passing through on their voyage south caught my attention, and I made a mental note to put up a suet cake for them. 
At 11:20, I closed the magazine and looked up. A man in a wheelchair and his wife were seated directly across from me. He turned his chair to face her and put his foot in her lap. She pulled the velcro straps on his shoe, loosened it and took it off. Fortunately I was called back as she was pulling off his sock to unleash whatever aroma it might produce.
The the nurses were efficient and kind. The doctor came by and introduced himself and explained the procedure. An IV access was established on the top of my right hand and I was quickly wheeled to the procedure room. It was over in a flash, and I was unaware of anything. One of the most impressive things about the whole adventure was that my IV site looks exactly as it did before the catheter was inserted—not a bruise, not even a hint that it was ever there. A nurse notices these things, and I want her next time. The doctor came back by and said I would need a series of injections and would be coming back in two weeks.
The outcome? Almost no pain in my back, not even enough to take an aspirin, but more lightening strikes. I’ll take it. I’ve slept like a baby for two nights and feel so much better it’s hard to imagine how awful the last few weeks were. The nurse just called and said the strikes should decrease over the next few days. And oh, I didn’t fill the prescription. I’m saving it for an emergency. 
Color me happy.

Copyright 2015 cj Schlottman

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