Medical meddlers: It’s my body, not yours!

Cary’s classic column from WEDNESDAY, JUL 15, 2009

My mother and my boyfriend want to tell me how many pills to take


Dear Cary,

When I was 18, I had my first kidney stone. I had lithotripsy for another at 19 and a very serious bacterial infection in my kidney in between. I am now 25, and have spent seven years with intermittent pain and urinary tract infections. In the past year, the pain has gotten to the point where I experience it in various degrees on a daily basis — sometimes it is so bad I just want to cry. On top of this, I have gone through a series of doctors who have all doubted I have any problem at all — the “stones” don’t show up on CAT scans and they can’t find any other reason for my pain. I have been called a drug seeker, and told I am making it up. I know some of them — male urologists — think they are dealing with a hysterical female.

I have finally got a diagnosis from a new primary care physician and gynecologist of interstitial cystitis (pelvic pain/urinary problems) with kidney stones. These doctors at least believe me — when I have days of pain, followed by voiding debris, it seems the logical explanation. We are proceeding slowly toward more complete treatment — because of the seven years of missed diagnosis and rude doctors, they are making sure others I am referred to are aware of my condition and will be sympathetic toward it. We are still trying to get to the root of the stones, and specifically why my pain has only ever been on the right side of my body. They’ve also referred me for pain management, which is going to be a huge relief.

My problem comes from friends, my boyfriend, and relatives — specifically my mother. They have been supportive and helpful during these times, especially when I haven’t been able to be a pleasant person or reciprocate their kindness immediately. But now many have started focusing on my use of painkillers.

When I hadn’t started a drug regime for my IC, I was taking three Lortab a day. My mother even went so far as to count my pills and lecture me over the phone about being a drug addict. I now take tramadol for daily pain, and have Lortab for when things get really bad. Many people ask how much I have taken, express concern over the number of pills I use (I never exceed doctors’ recommended dosages), and make comments about how they are afraid I have an addiction problem. I also suffer from anxiety — and this only makes it worse. I am very aware of the danger narcotics pose. And I suspect I might have some symptoms of addiction, such as getting overly fixated on getting more pills when I am running low. But this is because my pain is under-managed. All I want to do is feel normal. I’ve tried to explain that pain medication is part of my treatment, but people seem to take such a sharp view toward the drugs. My mother is a nurse and makes comments about the “addicts” in their office who get 90 Lortab a month (what I used to take, meaning three a day). My boyfriend is always inspecting what pills I am taking, asking if I really feel that bad, and saying he doesn’t like it when I’m “stoned” on my medication.

Obviously, there is no way to not have these people involved — they support me through all my trials, pains and rough spots. But I can’t deal with the questioning and accusations anymore. When I tell them there is nothing wrong with taking pills as prescribed, they think it is my endorsement of them. They tell me I need “help.”

I do need help. I need proper medical treatment for my condition. I need to get better. And until then, I am going to use painkillers so I can lead a normal life. Despite these difficulties I’ve maintained good grades and have my dream job. I have friends, relationships, hobbies — but in order to enjoy these things, I can’t be in excruciating discomfort. How do I deal with this situation?

On Meds, Not a Junkie

TuscanAd_09122015

Dear Not a Junkie,

Since I’m not a doctor, let’s talk about this as a relationship issue. Let’s just say that in your relationships with people, they keep interfering in something that is basically none of their business. You are looking for a way to draw boundaries, or say no, or get some control over a part of your life.

There is an area of your life that you want control of. You don’t want to discuss it with certain people.

There are ways to do this. They range from blatant refusal to polite refusal, but they are all about refusal. You have to refuse.

How are you at refusing? I’m betting you’re not very good. Neither am I, frankly. I’ve got a little note in my wallet that reminds me to think before saying yes. I also tend to disclose too much. I like to talk about my life but then find I’ve disclosed more than I’m comfortable with and then people give me advice and question my judgment and then I get resentful and start to sulk. You don’t want to see me sulking. It’s unpleasant to behold. Yeah, I’ve got boundary issues! Like right now, already, see what happened? We were talking about you and all of a sudden it’s about me. That’s a kind of a boundary thing, too: I’m trying to say I identify, but then I’m also switching the territory.

So let’s keep talking about you.

One way to draw the necessary boundary is to have a blanket statement that you use on all people who are not your doctor. You might say something like, This is a medical issue and I only discuss it with my doctor.

It may sound weird at first. People may make a joke, or react with anger. Keep your calm. Don’t give in but don’t explain yourself either. Explaining yourself (I’ve learned this with salespeople) just gives them an opportunity to overcome your objections. So, just say no.

The idea is to have a stock policy you adopt with everyone, even your mother, that you just don’t discuss your medical treatment with people who aren’t your doctor.

Now, I have a family. I know about families. You’re supposed to play your part. When you make boundaries, you’re sort of changing the rules. You’re saying, I don’t really like my part that much. But they like your part. It’s the part they want you to play. They can’t play their part if you don’t play yours. They don’t like it when you change the script. So be prepared. Stand your ground. Quietly stand your ground.

Just make it a blanket statement. And then go to the movies.

Cary Tennis Newsletter Sign Up

Turning 50: It’s all downhill from here

 

Write for Advice
Cary’s classic column from TUESDAY, OCT 6, 2009

I’ve got only a genetic disease and old age to look forward to


 

Dear Cary,

I have been reading your column for a while and always find your advice useful in a roundabout way, but I especially find it honest.

I’m going to be turning 50 this year and have learned I have a fairly rare genetic disease that will (and, indeed, has already begun to) cause great suffering in the years to come, though it likely won’t end my life prematurely.

Unfortunately, I have seen what this disease has done to my father, who is now in his 80s, and I have no desire to go through the endless hospitalizations, treatments, etc., that he endures just to keep on living. I feel tense and anxious most of the time, and also sad.

I’m realizing, however, that the disease is not the only factor in my feelings. Frankly, life in middle age is a tedious, boring chore. I become sad when I think back to my 20s, which was really my peak — a series of endless mental and physical challenges, pleasures and obstacles to overcome.

I’m stuck in an unchallenging but well-enough paying job that I despise. Leaving it would mean competing with people half my age for less pay, and I probably can never get health insurance again, so that option is out.

My home life isn’t much better. I’m stuck with a partner who offers, at best, extremely mediocre sex once every couple weeks. I watch porn to remember the types of adventures I used to have in real life, but it only makes me more sad, angry and resentful.

I’ve given up most of my hobbies as they were fairly pointless wastes of time. Even volunteer work became unsatisfying. For every person or animal I was able to help, there were hundreds of others for whom I could do nothing.

My one true pleasure, hiking in the hills with my dog for hours on end, ended when the dog became severely ill and I had to euthanize her a month ago. Yes, I could get another dog, and yes, I realize everyone anthropomorphizes their pets, but this dog was indeed unique and irreplaceable and her spirit is sorely missed. Her sweet nature and enthusiasm could melt even the most cynical heart.

Well, I will stop with this pity party, but it seems to me that nature had the right idea with human life spans that used to be so short. Now it seems we get 30 or so good years, then 50 years to sit around and wait for the inevitable.

In youth, there is excitement of the unknown. Unfortunately, at this point, I pretty much know how my life is going to go: a slow, steady, physical decline; deaths of more friends and loved ones; and a relationship that will become nothing more than buried resentment over a complete lack of sexual fulfillment.

Frankly, I see very little to look forward to, and I’m not even sure what I’m asking you.

Nothing to Look Forward To

TuscanAd_2015

Dear Nothing to Look Forward To,

Well, my friend, I don’t have the skills to persuade you of what I intuit, or the power to compel you to do as I ask, nor do I have the kind of deep responsibility toward you that a family member or loved one might feel, so I am just going to say what is clear to me and hope that you can overcome the voices in your own head telling you the contrary long enough to act on my suggestion. First of all, and I don’t know why I really want to say this, but I’m just going to trust the impulse: You are going to be taken care of. You’re on a road. You’re not just a forlorn sack of chemicals in a marriage; you’re a human being; you’re a person; you’re a being; you have a place in this world. I also feel this: I feel that you are grieving. You may be depressed, but “depressed” feels vague. To me, you are grieving. “Depression” feels like the damming-up of that grief, not the grief itself. You are grieving the loss of your dog and your connection to nature. You are grieving the loss of your dog and your connection to nature but you are also berating yourself for your grief, perhaps to protect yourself from its full, wracking extent.

You also sound like you are grieving for your youth. For that I salute you. Yes, I salute you. Why don’t more of us openly grieve our youths? Why don’t more of us admit that when we wake up one day and find ourselves no longer 20 and hard, indefatigable and quick, irresistible all night, a world ahead of us just for the asking, etc., etc., (I’m not trying to lyrically eulogize it; I’m just trying to name it), why don’t more of us admit that we are filled with a deep and painful sadness? Why don’t we have rites for this? Why do we have to say goodbye to our youth alone, in the shame of our advancing decrepitude?

(I tried to do this publicly, in a way, seven years ago, back in 2002, and indeed it did help to acknowledge publicly that I was no longer 20, although of course it did not arrest the arrow of time.)

You are grieving the loss of your youth and the loss of your dog and you are also living in fear of the future.

That makes you a perfect candidate for membership in the moment.

So, my friend, make your application now!

Yes, you, my friend, are a perfect candidate for membership in the moment. There is always room for one more. So welcome. Come on in. Welcome to the now. Welcome to the now that’s up on the trail, the glistening, humming, vibrating, iridescent, incalculable, inescapable now: Welcome to this very moment, wherever you are. Unless one of us is traveling faster than the speed of light, you and I are both inhabiting this mathematical simultaneity we call the now; we are in it, you and I, right now, so it might be said, though it sounds silly, that we are even together in the now, that as I sit near the window of the cafe in early morning, shivering in the first frost (there was ice on my truck this morning, for heavens sake!) and wondering idly why the employees have the windows and the door open (I know, it gets hot back there) that you and I are, in this moment, perhaps sharing a breath; perhaps as I breathe in you are breathing in too, and the innumerable creatures and souls who also inhabit this moment are also breathing in or breathing out, and the unfathomable underpinnings of our enterprise are operable; the equations and magics of chlorophyll and ganglia are in effect; the infinite, expanding factory of existence is running all night; it’s all going on right now. Welcome.

In this moment you have many choices. You can concentrate on the breath alone, climbing the breath like a rope into the heavens, following the breath back to the beginning of time, rising and falling with the breath like a column of smoke, with every inhalation and exhalation rehearsing the beginning and the end, the creation and the obliteration of the cosmos and the beginning and the end of your life, your wakefulness and your sleep. You can do that in this moment. You can do that in this moment and it may free you momentarily from your stranglehold on the future, or the future’s stranglehold on you, or however you want to place subject and verb in expressing that asphyxiating entanglement.

You can also in this moment allow thoughts of your next move to arise. You can, for instance, determine to contact a cognitive therapist and see about pruning some of the vines.

Yes, you can also in this moment choose to contact a cognitive therapist and get to work on that pattern of thinking that has overtaken you like a vine overtaking a healthy tree. You are wrapped in vines of dread, vines of grief. You are wrapped in vines. You have fed them and given them a home and now they are suffocating you. But you are not yet so completely entwined that you cannot reach out just far enough to gain the attention of a skilled cognitive therapist who can show you how to clip the vines back and get some air.

It is both the joy and the curse of this job that I cannot make you do this. If I could make you do this, my job would be unbearable; every time I failed to make someone do something I would be burdened; every time someone exercised their freedom of choice I would be a failure. Every time someone failed I would fail as well. Luckily, that is not the case. I can say what I say and that is that. We are just two living strangers inhabiting the same moment. It is as though you might overhear me in a cafe advising someone else to go get some cognitive therapy to clip back the vines of depression. I am speaking to the wind. That is fine. I am happy doing that. I am happy speaking to the wind.

But I speak hoping you will overhear me and take it to heart.

Cary Tennis Newsletter Sign Up