… or is it a train coming at me!?!?! Sometimes I wonder!

Today, after over a year of waiting, I saw a doctor that deals with chronic pain. I met with her to be interviewed and assessed to see if I meet the criteria to start having intravenous IV treatments of a drug called Ketamine. Originally developed as a horse tranquilizer, Special K, as its known on the “streets” is a very potent medication that only in the last decade has started to be used for chronic pain. The doctor spent an extensive amount of time reviewing my medical history, what surgeries I’ve had, what medications I take and or have tried; where I feel the pain; how intense the pain feels to me; how does it affect my life physically AND psychologically. She wanted to know about my daily routine…what are my interests and passions and what am I doing to support my mental health?!

That was a tricky one. I told her about this blog and how writing helps me cope with things. I explained to her that I can express my emotions, fears and anxieties far easier on “paper” or more realistically on a computer screen, than if I have to verbalize them. Talking about things makes me emotional. Of course, just by saying this out loud, I started to cry…no sob. Oh god, you should have seen the look on this doctor’s face as the tears poured from my eyes. It become impossible for me to speak and breathing became difficult as my mask, which of course we all now wear due to Covid, was completely stuck to my face and nose.

“How about we give you a break from questions, and I will do some talking for a bit,” she said as she handed me a box of kleenex. I nodded my head, took a deep breath, adjusted my mask and tried to compose myself.

The doctor started to explain how the procedure would take place. The Ketamine infusions would happen in an operating room where I would be hooked up to several monitors to continuously gauge my heart rate and blood pressure as Ketamine can cause a severe increase in both.

“If during the procedure, I think you are in any danger, I will immediately stop the infusion. We have a crash cart in the room just in case and of course we can get you to the E.R very quickly.”

This was NOT helping my anxiety.

“Of course the one side effect that all my patients experience are hallucinations. Sometimes patients say that they see me with three heads, or they feel like they are out of their bodies, watching themselves from above. Others start to feel paranoid and can become quite agitated. If a patient becomes too frantic, we again stop the infusion.”

Just breathe Patti.

“Ok, now that I’ve given you a break, let’s get back to some more questions.”

The doctor started to ask again about my mental health. How often am I anxious. Am I depressed. Do I ever think people are watching me? Do I hear voices? Do I see things or people that aren’t really there? Have I ever had suicidal thoughts?

I explained that the “breakdown” she had just witnessed was not a daily occurrence. Yes, I do get anxious, but I manage. No I don’t have suicidal thoughts; nor do I think people are out to get me, etc. Yes, I sometimes have days that I feel blue and yes, even depressed, but they don’t keep me from getting up and pressing on. I told her that I try to find the good in each day and in my life. I know I am so much better off than so many and I celebrate all my blessings. I told her that I have been waiting for over a year for this appointment and the relief of finally getting to see her has made me a bit more “emotional” today. Also, I explained that with the nerve pain, I don’t sleep. I am lucky to get one to two hours at a stretch. I have terrible nightmares; like being beaten with barbed wire and then I wake up in terrible pain.

“I am in pain, all day, everyday, but nighttime is the worst. My witching hour, as I call it, is between 2am and 4am. That is always the worst. I am desperate for a good night’s sleep. My nerve pain started with my mastectomy and has increased with each subsequent surgery. I have been suffering for over two years. I know there are a lot of side effects with Ketamine infusions, but if it can provide me with some relief I am more than willing to try it out.”

The doctor explained that if I prove to be a candidate, it will still be many months before there will be an opening. Once I start on the infusion program, I will receive the treatment once a month for a maximum of two years. After that, the risks are too high for liver and kidney damage…as well as a myriad of other issues. Each infusion will take an hour plus prep and recovery time; so I should budget for approximately three hours. I must have a drive home and someone to be with me for at least 24 hours and until the hallucinations subside.

I was then given a physical exam. Blood pressure, heart rate, urine sample, etc. My blood pressure was a little elevated; the doctor commenting that it was probably due to “white coat syndrome”. Geez do you think the list of side effects she just told me about might have also contributed?! She re-read my file, and then said ” I think you are a good candidate, Patti. Do you have any questions or reservations?”

I told her that I appreciated all the information she had shared; including the fact that these treatments are not a cure. Unfortunately there is NO cure for chronic nerve pain and I can only expect a 20 to 40 percent decrease in my pain while having the infusions. That said, I am open to anything at this point. I told her yes, I would like to be added to the wait list and to please let me know if there were any cancellations that I could jump on. She filled out a slip of paper, told me to give it to the nurse on my way out and that was that.

I have done a lot of research on these treatments. I know there are a lot of negative side effects and that the positive effects, if any, are only temporary. But I know that I have to try. I know what I am getting into and if at any time I want to stop the treatment, I can. So, its full steam ahead. Like with every hurdle I’ve experienced on this journey, I will face this one head on.

Is that a train whistle I hear?!

#chronicpain #mentalhealth #anxiety #breastcancer #mastectomy #survivor #positivementalattitude

Uncategorized chronic pain mastectomy