tinyurl.com/ybwlkr -> www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/11/03/DDGT0M2RS953.DTL&hw=cancer+alicia&sn=001&sc=1000
entertainment links At the end of September, I suspected I had a drug problem. For almost six months I had been using Actiq, a powerful opioid painkiller shaped like a lollipop. The fast-acting lollipops helped me with breakthrough pain: the pain, often sharp, that pops up despite twice-daily doses of OxyContin. My pain doctor had told me three a day was the highest I should go. As far as I can remember, I spent 12 of the 14 hours I was awake with a lollipop in my mouth (and often 10 of the 10 spent sleeping because I'd fall asleep with it). Because of the alveolar soft part sarcoma growing in my right hip ... I have pain, yes, and some days lots of it, shooting down my right thigh or throbbing in my hip. But I was also depressed: because I had cancer, because I was tired from my cancer treatment, because I just plain get depressed, and -- get this -- because I was so drugged up all the time. So, without thinking about it, I "coped" by getting more drugged up. Some days I was so stoned I didn't even know if I was in pain. Finally, after a weekend in which I did nothing, thought nothing, washed nothing and entertained myself with nothing but TV, I undrugged myself long enough the evening of Monday, Oct. If I was going to spend the next year the way I had spent the last three days, I would rather die immediately. What follows are snapshots from a few of the first days, which were also the roughest. Two weeks ago I packed up some clothes and my dog Clarabelle and moved in with my surrogate mother, Sally, but I'm still in the middle of this mess and haven't had enough time or space away from it to be able to process. They didn't seem particularly surprised, nor did they seem particularly disappointed in me. I was still in my pajamas from the night before as I said it. The night before I had left her a message, asking her to ask me about the lollipops, a fail-safe so that if I lost my nerve to confess, I'd be trapped into telling her. I walked into her office and immediately told her that the lollipops "have become a problem." Marks said she couldn't advise me on how to get off them. But she said that by our next appointment, the next week, she wanted me at least to have an appointment scheduled with UCSF's pain management clinic -- the place that prescribed the lollipops, and the place with doctors who know the most about the complications of pain, narcotics and narcotic withdrawal. Marks and I did make one deal: I needed to try to shower every day. I could tell when the long-acting, less mind-numbing OxyContin kicked in because I felt happy, strong and calm. I called Clarabelle onto the couch with me and stayed there, one arm behind my head, one hand petting Clara, for about an hour. I probably looked relaxed and content, but really I was thinking about scores of things, minuscule and life changing, and marveling at how quickly and deeply I could think. I didn't want to spend any more time watching the clock slowly tick away, waiting two more minutes, then five, then 10 ... before slipping the lollipop into my mouth, rubbing it against the inside of my cheeks and letting my body absorb the acridly sweet narcotic. I left a sleeping Clarabelle in her crate and turned on the living room TV. I don't know what I watched for the first half hour, but at 8 am I found a "JAG" rerun and watched as I very slowly ate a small bowl of cereal and a plum. the rest was spent on keeping myself from leaping off the couch and grabbing one of the lollipops I had stored in my nightstand. I kept repositioning myself, holding my hands different ways, because I couldn't sit still. My vision was blurry, my head was stuffy and I had the beginnings of the chills. I didn't have a solid game plan for going off the drugs. Every minute, I was trying to hold out as long as I could -- until the tightness in my chest or the chills or the anxiety paralyzed me. I lasted through most of "JAG" before getting the lollipop. I felt relatively present throughout most of the appointment, as Dr. Henry asked me how many lollipops I had been taking (six a day), how many I was taking now (two) and what my goal was (to quit). She came up with a substitution plan, the painkiller addict's version of methadone maintenance: Whenever I felt any kind of physical withdrawal symptoms -- chills, nausea, flushed face, stuffiness -- I was to take a 5 milligram pill of oxycodone, which had been originally prescribed in January to help with pain that might arise despite my long-acting painkillers. Henry's thinking -- the thinking of any kind of "maintenance" detox program -- is that instead of shocking the body by withholding all of the problem drug (which can cause physical stress and, in severe cases, can kill), it's better to use a less-addictive form of the drug. Since I had been using oxycodone for months without popping them, it seemed a safe bet to use those pills as my substitute. I listened to her advice and decided that I'd do it her way until Oct. I cried and screamed that I couldn't go through this for days or weeks. I tried to remind myself that fever chills feel the same as anxiety in my chest, but the anxiety was already full blown. I used a lollipop and eventually was able to lie still and stare at Clarabelle's muted spots as Lauren read to me from "To Kill a Mockingbird." I was Mrs Dubose from the book: I was crotchety and frustrated and doing all I could to last a little longer each day, each hour, without a fix. I pushed myself to attend a biweekly dinner with some high school friends; While waiting for the pizza, I got antsy and started fantasizing about the lollipop in my purse. But instead of lying down or reverting to a fetal position, like I would at home, I started moving around. I held onto the side of the kitchen island and did squats as Jill showed us the new band for her watch; I sat on the floor and straddled the corner of a cabinet, swaying forward and back, as Jenny and her boyfriend, Garrett, described their recipe for a mean salad dressing. When the conversation lulled, just for a moment, I walked up and down the long hallway with my glass of water, thinking only of how many sips I had taken and how my feet felt on the hardwood floor versus the multicolored rug. Dianna wandered in -- knowing Dianna, she probably came to check on me -- and became my official timer. I wanted to wait 10 more minutes until I got out the lollipop. We talked for a few minutes and had served dinner when my deadline came. I was distracted, so I asked her to give me 10 more minutes. Then I got caught up in the conversation, and what do you know, I didn't grab that lollipop until 9:05. The girls all cheered for me, then Jill said, "Hey, maybe next week you can wait an hour, huh?" Alicia R Parlette was 23 last year when she was told she had a life-threatening cancer. This is one in an occasional series of articles about her experience.
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