Two years and change and everything is different, and yet similar enough to be uncomfortably familiar. It feels like I’m on a road that, while I’ve never exactly traveled it myself, I’ve observed folk walking it for a while. I’ve seen the Google Street-views. I’ve looked at the maps and the obvious landmarks. I’ve been on my way to this road for a long time.
Recap: in Feb of 2014 I started having severe back pain. Osteo-arthritis, of the type experienced by folks of advancing age, except I was 37. My career was devolving into a job, my romantic efforts imploded, my finances were floundering, and Everything Hurt All The Time. I put up with it for a long time, trying to find different ways of managing the many fraying threads of my life. And, as one does when one has a modicum of faith in any massive institution, I finally turned to the health care system for help. I did wait until I had lost all ability to function outside of work. Priorities, ya know. And then when I did go to the medical-industrial complex for assistance, I found that I needed every ounce of energy and capacity I could muster to navigate the continual comedy of errors that is the scheduling, billing, referral, and appointment practices that have become the standard of care in this fine nation. I’m not talking Affordable Care Act stuff. I’m talking standard employer provided Cadillac insurance funded care. Since my “diagnosis”, I’ve had 7 surgical procedures, 5 of which were administered with little or no anesthesia. Of all the things I thought I knew about myself, the ability to not flinch while a doctor inserts a 3′ needle into the joints in my spine was not on the list. But turns out one can learn to do astonishing things when one is lying on a metal table in an operating room with one’s arms and legs pinned down by sympathetic nurses while a surgeon repeatedly attempts to hit the right nerve in the right joint as guided by an X-ray with Zero tolerance for vibration. (Fyi, the worst of it was a total of 42 attempts at 6 injection sites. That was not a good day.)
When you’re dealing with this kind of physical struggle, it’s easy for the mind to lose balance. Add in job stress and failed relationships and a prediliction for depression, and you’ll find yourself alternating those visits to the spine clinic with visits to the psychiatrist. Next thing you know you’re on anti-inflamatories, muscle relaxers, anti-depressants, anti-anxiety meds, meds to make you sleep, meds to help you wake up, meds to keep you from freaking out, and meds to counter the side effects of the other meds. You’re picking stuff up from the pharmacy weekly, and in bulk. Something is ALWAYS running out of refills, and you have a collection of translucent orange pill bottles that spill out of the cupboard every time you open it. You have reminders set on your phone to tell you when to take what so that you keep some semblance of routine, and your life just sort of fades into the background – it’s what happens between the reminders.
Or at least that is what happened to me.
Tonight I can delete the reminders.
First, I got a new job. I almost blew it 9 months in when my sixth surgical procedure (neurotomy) wore off and the pain came back. There was some drama. Soul searching happened. And I pulled my head out of my ass and tried to really understand what was happening to me. The drugs. I was on too many drugs. I started dropping them one by one. First the anti-anxiety meds, then the sleeping meds and the wake-up meds. Then the muscle relaxers. One by one I weaned off each of them. All but one. Cymbalta. Oh god, the Cymbalta.
Cymbalta, for the uninitiated, is an anti-depressant that is also used to treat chronic pain. It works, sort of, at least for me it sort of worked. It dulled the pain – especially the nerve pain that was a byproduct of my rapidly degenerating spine. As for the depression – I quit thinking about suicide all the time, which is good. But then I also quit caring about much of anything. Probably less good, but at the time I didn’t care, so there is that.
Cymbalta was marketed as a wonder drug for people afflicted with depression and chronic pain, and I took it as prescribed – right up until that week last summer when I ran out of refills when my doctor was on vacation and had to do without for 4 days. Note the “was marketed” in the prior sentence. Somewhere in the standard list of 99 side effects there should have been some warning about what happens when you quit cold turkey and go into withdrawal. Something, anything, even in the tiny print, even that would have been helpful. Nope. No warning – not from the drug provider or my doctor, and while I wasn’t in tip top shape at the time, if someone had mentioned to me that coming off the drug was very much like getting the flu, a migraine, and a hangover all at once, while feeling like you’ve just come off the teacups at the County Fair, I might have elected for a different treatment. Oh, and the flu-migraine-hang over-teacuppiness? It lasts for days. Weeks even. It depends on how long you’ve taken the medication. I had been taking it for 18 months when I had that first taste of withdrawal. It was enough to get me to raise a ruckus and get my prescription refilled pronto.
But it got me thinking. What is the difference between what I was doing and an addiction? Was it actually helping? What, outside of work, was going even remotely right in my life? I’d given up all of my sports and athletic activities. I’d quit going to the gym on any regular schedule. I’d given up on my music and my social life and relationships. All I did was work. It was all I had the energy for – put in my time, come home, pour a drink, and lay on the sofa until it was time to go to bed. Oversleep the next morning because it was so damn hard to wake up (I could easily sleep 12 or 16 hours night after night – not good sleep, weird creepy nightmare sleep) and then do the whole thing again. Weekends I slept. Holidays I slept. If I wasn’t working, I was laying on the sofa. Or I slept. How was the Cymbalta improving this lifestyle? It wasn’t. And I realized then that it wasn’t something that I could just quit either. Not without losing a couple of weeks of work being almost unbearably sick. So I did my homework and came up with a detox scheme.
First this, the scariest and hardest thing about coming off Cymbalta has been the uncertainty. A flu eventually goes away. A hang over lasts a day or two. A migraine will respond to a heavy narcotic if nothing else helps. Teacups just require a bit of puking and you’re good to go. Cymbalta withdrawals last anywhere from a week to months, depending on your metabolism and the length of time you were on the drug and countless other factors that have never been studied because the drug manufacturer decided that only 1 to 2 percent of people have withdrawal symptoms. Actually withdrawals happen to between 50 and 80 percent of people who take the drug, and more than 50 percent of people who experience withdrawal symptoms have them for more than 2 weeks.
None of that is in the marketing.
What all this means is that no matter how well you plan your detox, you still have no idea how long it will take, how long you will feel like shit. There are things you can do to make it as short and as tolerable as it can be for you, but you will still have withdrawals, they will still suck, and you still won’t know how long it will last.
I’m on day 6 of withdrawals today. Today I went to work. I walked my dog. I did laundry. And I’m writing this post. And the next post because I don’t want to make anyone looking for potential support in kicking this drug to have to read through all of the above…
TBC.
SecondHand Saint 