Painkillers for Cancer-Related Pain

Before I had cancer, my experience with pain was limited. I was healthy and never broke a bone. I had my appendix removed when I was a child, and my tonsils were gone too, but those events occurred so long ago that they are barely a memory. I had suffered from crippling migraines in my 30s and 40s but their pain had diminished as I got older. Now I know what pain truly is.

I don’t remember post-surgical pain being discussed when I saw the surgeon just before my mastectomy. Perhaps she or the nurse brought it up but I was still focused on the abstract word “cancer” and the alien notion of voluntarily allowing her to remove a breast, even if it did have cancer. But that afternoon, someone did say something about painkillers. In the few days between that office visit and surgery, whenever the idea of pain entered my mind, I quickly banished it. I had other things to think about and I didn’t want to think about pain.

When I woke up in recovery, I felt fine, just like I had taken a nice nap. I was moved to my room and felt well enough to walk around. My first visitors arrived in the form of my best friend and her husband, whose first wife coincidentally had died of breast cancer a few years before. They didn’t stay long because they didn’t want to wear me out and probably because all three of us were walking uncertain ground. After they left, my supper came in. I always have an appetite and gladly chowed down since it had been a long time since dinner the night before. My sister and mother arrived but also didn’t stay long. I became aware of the pain after they left. I guess whatever they gave me during surgery had finally worn off.

I buzzed the nurse and told her about the pain. She promptly produced a little pill. About an hour later, I buzzed again and asked when the pill was going to start working. I noticed that my breathing was rapid. I felt physically stressed and could think of nothing but pain, pain, PAIN. The nurse called the resident in and a second pill was authorized. That did the trick.

I was relieved to find that my health care providers believed that I should be pain-free and gave me the tools to be free of pain. The next day, I filled a pain prescription as I left the hospital. I’m a bit of a dork and always read the information that comes with medication. That’s how I found out it was oxycodone and that oxycodone was an opioid. Until then, I didn’t know the name of any opioids. Stories about opioid addiction popped into my head but I didn’t care. Oxycodone became my new best friend. Opioid or non-opioid didn’t matter to me as long as I had something that worked. And Oxy worked.

Over the next week or so I went from two pills down to one and then none. I cannot emphasize the relief I felt that my pain was taken seriously and dealt with effectively. I had so many other things to deal with and wouldn’t have been able to deal with anything if all I could focus on was pain. I understood why people are afraid of pain. It can be mind-numbingly all-consuming.

I began chemo the month after surgery. I was on a three-week cycle and the day after my cocktail, I would start a series of ten daily injections of Neupogen to stimulate my bone marrow. The day after the first injection, I could barely get out of bed to go to the bathroom due to severe joint pain the likes of which I had never imagined possible. I called oncology and was advised to take the oxycodone pills left over from the surgery. The pills helped, but it was a rough weekend.

On Monday, I wasn’t up to driving so I had a nephew take me to the oncologist. My doctor set up a plan for pain management, alternating with oxycodone and over-the-counter drugs, with oxycodone started before the pain from the injections kicked in. With each chemo cycle, the bone-breaking pain lasted for most of the days of the Neupogen injections. Even with my new best friend, I was barely able to function on those days.

Chemo ended and so did the injections. No more pain, so no more pills.

A month later and it was radiation time.

It’s funny how the body works. Normally you aren’t consciously aware of movement. You just move and that’s that. But even moving my right arm slightly engaged what little muscle remained on my left chest. I must have been a sight to see — still bald from chemo with no eyebrows or eyelashes, staggering when I walked due to neuropathy and keeping my left arm pinned to my chest to minimize movement and therefore minimize pain. Now I can say it was the worst sunburn I ever had, but at the time it wasn’t a laughing matter. After two weeks of radiation, there was an open gash on my chest an inch wide and eight inches long. Talking hurt. Breathing hurt. Walking hurt. Wearing a seatbelt hurt. Clothing really hurt. Well, if you have been there, you know what I mean. If you haven’t been there, I am sure you can imagine. Back to my friend Oxy for a month.

I know opioid addiction is a problem. From personal experience, I know that when you have a lot of pain, taking opioids can diminish the pain enough for you to focus on other things, like sleeping for a few hours, fixing and eating a meal, going to work or doing laundry so you have some clean clothes to wear to work. I have been told that when you don’t have a lot of pain, taking opioids can make you feel really, really good and therein lies the root of the problem.

I feel for those who suffer from this addiction and for their loved ones who suffer along with them. Greater minds than mine will have to solve that problem and related issues. I am just glad that relief from pain was available for me when I needed it and I hope that it will always be available for me and for others who need it on a limited basis.