Wednesday, January 11, 2023

Thoughts about Sgt. Bob, and living with pain


The recent tragic death of Sgt. Bob, and his reasons for taking his life, had a big impact on me.  In his final blog post, he wrote:

The time is 10:38 a.m. Eastern Time, 31 December 2022. I just swallowed 10 capsules of Lisinopril. I want the pain to end.

Around 7 a.m. I searched to find out if Lisinopril is an effective method for suicide. The internet gave no yes or no reply, but did list the drug’s usages. There were several suicide hotline numbers as well. I am well beyond hotline information.

I just want the pain to stop. Drugs do not help. Physical therapy has not helped. A dozen doctors of medicine did it listen when I told them of my pain and my idea that it was related to the 1986 cerebral aneurysm and a diagnosed right side focal dystonia. Doctors said, “There must be a problem with your lower back. Let’s get X-Rays of your lower back.” When nothing showed on X-Rays, the doctors said nothing.

So, since medicine cannot stop the pain, I have used medicine to do it.

There's more at the link.  Please say a prayer for Bob's soul, and for his surviving family.  They all need it, I'm sure.

I'm very familiar with the effects of long-term pain.  I've suffered from it since February 13, 2004 (yes, it was Friday the 13th!), when I experienced a work-related spinal injury that's left me partially disabled ever since.  It's grown worse over the past year, because as one gets older, the spine deteriorates, and that puts greater pressure on the injured nerves.  That's been particularly frustrating to me, because it's interfered with my ability to write and produce more books.  I'm still able to do so, but only when the pain level is low enough to not distract me from being creative.  When it gets too high, a lot of things grind to a halt.  Creative writing is one of them (at least for me).  Pain gnaws on you, like a dog gnawing on a bone.  It grinds, it tears, and it rips you in mind as well as body.

I know, too, what Bob went through in trying to get doctors to deal with his pain.  I have a lot of sympathy for the doctors, too:  they're trying to treat something that's often nebulous, hard to pin down to one specific location or organ or injury.  Furthermore, if they treat the pain more or less effectively, they may cause other problems (up to and including shortening the patient's lifespan, or making him a danger to himself and/or others if he drives or uses machinery).  To add to their difficulties, many of the most effective painkillers are severely restricted due to problems with addiction, and can't be freely prescribed (particularly for extended periods) without attracting official scrutiny.

After my injury, I was put on a "cocktail" of three medications to manage my pain:  Gabapentin, Ultracet and Flexeril.  Sadly, the combination made me feel like a zombie, as if a permanent gray cloud had taken up residence in my head and was blocking me from enjoying life.  It didn't take me long to figure out that was no way for a man to live.  I abandoned the "cocktail" and learned to live with a higher level of pain, using OTC analgesics to cope most of the time and Tramadol to deal with the worst days.  I've been doing that for sixteen years now . . .  (After my injury and resultant surgeries, I was also prescribed Percocet for the worst episodes of pain;  but nowadays that's no longer so freely available, thanks to official restrictions.  Fortunately, one can take multiple Tramadol tablets per day if necessary, which is almost as effective.)

So, you see, I really can understand how Sgt. Bob felt.  There have been days when I've felt the same.  I'm not suicidal at all (I have a very strong religious prohibition against it to sustain me), but there have been bad pain days when I've understood very clearly - experientially! - why some decide to check out rather than carry the burden any longer.  I've never taken that step, and please God I never will:  but I'm here to tell you from personal experience, pain can come to dominate your outlook on life to the point where it removes almost all hope, unless one has a very strong will to live.  It's no surprise to me that many people in that situation say simply, "I've had enough.  I can't take any more."  Sgt. Bob was far from the first to make that call, and he'll be far from the last.

I've been very, very blessed by my wife in dealing with pain;  and I think I've been a blessing to her too.  You see, she was also badly injured earlier in life.  One of her knees was shattered into tiny pieces when she ended up the meat in a two-car sandwich, and her shoulder has been dislocated multiple times.  She's no stranger to pain in her own right.  When sudden changes in the weather are imminent, both she and I have built-in pain barometers that let us know all about them!  That may sound like a recipe for an unhappy marriage, but with us it's the opposite - it strengthens our bond.  When one of us is having a bad pain day, the other can say from all too much experience, "Yes, I really do understand how you're feeling!"  We stand by each other, make allowances for each other, and generally try to be helpmates for each other.  That mutual support is worth more than gold to us.

I'm still trying to re-balance my life in terms of the increased pain I've experienced over the past year.  I have to keep on writing:  it's almost the only way I have to earn a living, given my physical limitations, but the pain has certainly slowed me down.  I have multiple books very close to completion now (over 75%), and I hope to publish several this year if my body backs off a bit and lets me finish them.  I hope my readers will forgive the delay.  I really don't want it, but there are times when I simply can't produce quality output that meets the high standards I set for myself.  I'm doing my best.  Unless I find a literary sugar-daddy (a critter I don't think exists), I'll have to continue to earn my bread by the sweat of my brow in the old-fashioned way.

I guess the point of this rambling discourse is really to say:  try to understand the people in your life who are afflicted by ongoing pain issues.  It's the most debilitating, depressing, exhausting thing you can imagine, far more bitter in its effects on your mind than it is on your body.  It's a burden you can never put down.  You can only learn to live with it.  If some people find they can no longer do that, and decide they have to end it, please don't condemn them for that.  It's hard enough on those they leave behind, many of whom can't or won't understand why their loved one would "abandon them" like that.  They can't understand from the inside that the burden of pain can grow so great, one can't think of anything else, and can't bear it any more.  I can only thank God that so far, I've not been driven to that extremity.  By his grace, I hope never to get there.

If you know a person who's battling with chronic pain, please try to help them as much as they'll let you.  They probably won't take kindly to someone trying to "mother" them, or be a Karen, or smother them with unwanted assistance.  Take the time to get to know them, and for them to let you through the barriers hurting people always erect (I know this:  I've done it myself).  Then, find out how you can help.  Go the extra mile for them, if you can.  Precious few others will do so in this largely uncaring world.  They may even have been abandoned by their family because they're "difficult", or "troublesome", or whatever.  Perhaps you can help fill that gap, and bring at least some healing to them.  For those who are Christians, this falls under St. Paul's admonishment to "Bear one another’s burdens, and so fulfill the law of Christ".  Pain is a heck of a burden.  Some, like Sgt. Bob, find it so hard to bear that it eventually becomes impossible.  Help them bear up under the load before things reach that stage.

To all my readers who suffer from ongoing pain:  find others you can talk to about it, people who'll understand.  A listening ear and a shoulder to cry on (sometimes literally) can be a life-saver.  We can also learn from others what's worked to help them, that we may be able to try for ourselves.  If we help each other stay upright, we can stagger down the road together a bit further.  That's a whole lot better than despair.



BobF said...

First surgery of several was 2005 and that was putting it off until I couldn't stand it anymore. After last one, in 2020, the surgeon told me "A zero pain level is an unrealistic goal." He was absolutely correct. And VA seems to be on a PR campaign of getting EVERYONE off opiods regardless of situation. Screw the patients -- got to have those stats look good.

Don C. said...

Hi Peter,

I am sorry to hear about Sgt. Bob and his journey with chronic pain.

I am a longtime daily reader (not much of commenter, though) and love your blog.

My son had a long journey with chronic pain (almost 20 years) and found tremendous help in Postural Therapy. Here is a short video of his story - and how postural therapy helped him.

He is now the lead postural therapist for Posture Strong (it is his life mission to help others through debilitating pain now). You can get a free consultation to see if he could help you - and I suspect he might be able to do so. He has helped me tremendously after back surgery, both knees replaced, and both shoulders having rotator cuff surgery. Here is a link to book a consultation:

I hate making recommendations like this as a comment on your blog - it sounds like I am taking advantage to sell something - but I know with your history of injuries that you are in a lot of pain at times. I love your blog - the stories, your experiences, and the information you share in addition to your own knowledge. I wish you a long and pain free life for the selfish reasons listed above (I want to read your blog!) as well as on general moral principals.

Good luck and God speed.

Don Clark

BillB said...

A group of some old guys were on thhe way to a dinner meeting last night. We were talking about some of our health issues. Somewhere in that one of the guys threw in that "growing old ain't for sissies".

edtheham said...

After watching my mother in her last years, I realized that if you want to break someone down, don't use acute pain. Constant, low level pain with no hope of stopping will do the job very well.

My sympathies to you and Dorothy.

By the way, I teally enjoy your and Dorothy's books. I recommend them to my friends every chance I get.

LindaG said...

My husband and I are right there with you and your readers, Peter. Praise God for His love and strength.
Be safe, God bless you all and lend you His strength.

Kansas kid said...

I have suffered with chronic pain since about 20 years old. I told some some friends once that pain was an emotion. Of course, they asked why. Because when I am mad as hell at something I don't hurt at all was my answer. They then asked when did I have time to ever asses.

Well Seasoned Fool said...

My youngest son was a 100% disabled Army Medic. He suffered from chronic pain and his long time damaged left ankle developed sepsis. He insisted amputation was needed. The VA kept stalling. Just to keep functioning he self medicated on morphine. Unfortunately he also kept drinking beer and one day drank too much, or used too much morphine, and it killed him.

My reason for sharing this is the hope that someone in his situation will heed the warning.

boron said...

I will not bore you to tears with all of my very recent (only within the past 5 years, Thank G-d) problems, pain, and (corrective?) surgeries. What I'd greatly appreciate is further discussion about how the Government's "War on Drugs" (oxycodone as just one example) impacts those in severe pain.
Does the U.S. Government have the right to limit a patient's access to pain obtundants; particularly since there are so many ways to become addicted to so many other (easily obtainable) substances, alcohol being a prime example.
The Government (which is practicing medicine without a license) and physicians (now under complete Government regulation) feel it is better for the patient to take a cocktail of a myriad (stomach-upsetting) medications rather than one pain-alleviating pill every 4-6 hours; we're now living in George Orwwell's worst nightmare.
Suicide: An Option
Do we have Free Will?
Will/Does G-d punish us for deliberately ending our life?
Read Dante, read Niven & Pournelle's modern update.

Aesop said...

This just confirms my humble opinion that people don't commit suicide because they're tired of living.

They do it because they're tired of living in unending pain, and they just want to make it stop.

Pain, on the whole, is a gift. It tells you when you're pushing too hard, and it reminds you of the cost of carelessness or foolishness.

But only when it can be stopped.

Because while we remember pain, we don't feel it when we remember. Of the actual sensation, when it's gone, it's over.

When it cannot be stopped, it becomes a metastasized monster that consumes everything, including the very will to survive. Doubly so when the cause is undiscovered; if you know what causes a pain, you know removing the cause will end the suffering. But when you don't know what starts it, you don't know when it will stop, and you regress to being a two-year old, when your entire life is NOW. And that now is one of never-ending pain.

It doesn't matter if it's physical pain, or mental pain. Intractable anguish eventually reaches the point of insufferability if it's dialed to "11" long enough. Every person has their breaking point. Bob must have passed his.

I didn't know Sgt. Bob, but I know where he must have been to choose a permanent solution to a temporary problem, and my heart goes out to him and his family, as the ripples of his unending pain now spread to those who knew him, and are left to deal with his "solution".

But seppuku when encountering the Kobayashi Maru scenario isn't the way out, and no one is beyond the help available on a hotline. Or from friends and family who won't let you go.

I'm sorry anyone choses that way out, but while I understand the agony that drives people there, I reject it as the right choice for anyone not hip-deep in flaming lava.

Whether you're the one going through it, or the one watching someone else do so, reach out, just as you would to someone being swept towards a waterfall. There's always another way out, and it's better for all concerned than watching them swept over the edge and into oblivion. That departure sends ripples God alone knows how far, and leaves holes that never completely mend.

James said...

I had a serious back injury when I was thirteen, sixty years later it still affects me. I truly sympathize with those in chronic pain, it is like the kind of anchor they drag behind a boat to slow it. It is always a struggle to function past a certain level. I've never taken heavy pain meds because addiction is prevalent in one side of my family including some very close relatives, and I fear it. Unless I get a bad flare up, it is just background noise now to go along with all of the other pains from aging. With the meds I now take for a cardiac condition, thanks to the same side of the family that has the addictions, I can't take any over the counter pain meds but Tylenol. That is totally ineffective.

Timbotoo said...

Has anyone tried acupuncture as a means of reducing constant pain?

Old NFO said...

Yep, definitely MORE accurate than the weatherguessers... sigh

jxbdz said...

I don't agree with Aesop's opinions. Sgt Bob had every right to end his life of pain. By what authority does Aesop rule that Bob's decision "isn't/wasn't the way out?" If Bob had been experiencing intractable, unending pain to the point of "insufferability" what gives Aesop the authority to know "there's another way out" that is better for all concerned". perhaps his wisdom gained from the StarTrek series or perhaps his injection of "God" into the argument and his deep understanding of God's will?

Howard Brewi said...

I had back surgery in 2011 which stopped sciatic pain but left me residual nerve pain plus I have gouty arthritis. I was in the hospital a year ago on another matter and the doctor tried to give me oxycodone plus my gabapentin for my pain but refused the indomethacin which actually helps the arthritis pain. Result one 48 hour and one 36 hour period of zero sleep. Oxycodone dis the do a thing for my pain cocktail. I said a lot od decades of the rosary and I now tend to use the translation “do not put me to the test” instead of lead us not into temptation. Moving around often helps but I’m trying to minimize steps right not to reveal the ulcer in my feet so laying around can be painful!

Peter said...

@jxbdz: Neither Aesop nor I see it your way, I'm afraid. As a pastor, I had to deal with the aftermath of several suicides. The one thing they all had in common was that, while the deceased's troubles were now over, he/she left a grieving spouse and children who were devastated by their unanticipated loss. A lot of them blamed themselves for not understanding, or not caring, when in fact they'd done all they could for the deceased. Their grieving was thus made worse by a sense of guilt.

A suicide never considers that he/she may die alone, but others have to live without them and with the memory of their loss. Is it ever justifiable to inflict such deep, long-lasting wounds on other people? I venture to suggest that it's not. That won't stop the truly desperate from committing suicide anyway, and if their pain or mental anguish is deep enough they won't even consider it, but it remains a factor.

As for God, most major religions share pretty similar views on committing suicide. You may not believe in God at all, and reject organized religion. That's your right. However, I can't believe that all those faiths came to that similarity of understanding in isolation. As a man of faith, I accept that God has made his will known through many different channels, and somehow most religions have tapped into that particular channel and adopted it. Makes sense to me, anyway.

jxbdz said...

Peter, sounds like you want it both ways, saying, don’t condemn those who can no longer bear the burden of intractable pain, yet you paint this person as inconsiderate of others’ pains from his death. And, you say It’s my right to reject God and organized religion, yet you judge others who aren’t guided by His word. I say suicide sometimes can be a reasonable choice if a person is not shackled to religious dogma. There is a subtle arrogance to your judgements. I respect your ability to struggle along with your pain, and I respect those who can't.

LindaG said...

@Timbotoo. My husband had a spinal fusion a few years ago. The rods and screws and such. He tried acupuncture a year or so ago. It seemed to work while he was on the table, as he said he slept well. But after waking up, not so much.

E M Johnson said...

the acumulation of misc damage during my 20 years navy and 14 as a prison guard have been topped off with psoriatic arthritis. pain is a constant companion. I shy from pain meds because of addiction issues. tens device, otc nsaid, heat and occasional massage are all I have but the support of my wife makes it tolerable.

Hamsterman said...

When I had a Major Depression, while I was not suicidal, I felt I could understand those that were, as it was essentially major unrelenting pain located in my head. If I had determined that it was permanent and no relief was available, I strongly suspect I would have become suicidal. Fortunately for me, it was for less than a year.

Thus, I can sympathize about your pain. All I can offer are my prayers.

Andrew Smith said...

One way of describing suicide is that of being tortured to death. They may well be on to something.

BobF said...

@Peter: "A suicide never considers that he/she may die alone, but others have to live without them and with the memory of their loss."

Rather presumptuous, isn't that, Peter? I respect that you may have counseled many in your years of experience, but if you presume to know what I and all others who have been in chronic pain have considered when they hear of yet another pain-induced suicide, well, that's just plain arrogant.

I can't speak for others, but if the day ever comes, and I hope and think not, that I make that final decision, the thoughts of the effect on others will have a trail of a very long time. I think in some (many?) cases it has been considered long and hard over time and the scales just finally tipped.

Peter said...

@BobF: You're right. It was presumptuous to say "never". I should rather have said "seldom", and added "in my experience". I apologize.

Bibliotheca Servare said...

Been suffering with chronic pain since I was 15. Been on tramadol (among other drugs that didn't work or had worse side effects, now I'm back down to basically just the tramadol alone for pain mgmt) for it since 17. It dominates your life. It's constantly gnawing, draining... Like being exhausted every day for the past 15 years. Clouds your mind... and the side effects of being unable to do the things you want or need to do...add depression to the mix. And the impact of long term tramadol use (it's an incredibly weak narcotic esp compared to oxy etc -which I've never taken TBTG- but it can have androgen suppression effects among other things) are just another happy wrinkle.
I'll pray earnestly for Sgt. Bob's soul, and for his family.

And I'll say, there's three things that have kept me from taking his road.
In order:
The effect it would have on my family and loved ones, the possible consequences for my immortal soul (could also be phrased as "my faith in Christ"), and the fact that..damnit all I want to live! Even if it's in pain. I don't want to die. But some days that last one is hard to remember.
That's when the other two are most important.
Pain means you're alive, but constant pain is a piece of living hell.

I just try to remember (and ask for help to remember) that in the end it's temporary. All suffering is. And we're not promised an end to our suffering during our time here... But we are promised relief when we return home.

God bless and keep y'all.

Anonymous said...

I had a chronic pain disorder for years. I wanted to die.

Eventually, I was able to recover. I am glad I did not kill myself.

If you are tempted to kill yourself over chronic pain, please reconsider.

Not only is it a cruel thing to do to your family, but you also eliminate the possibility of a future recovery.

Firehand said...

Couple of years back I had a back problem that was, well, bloody awful. It taught me something: prior to that I'd understood that pain, especially unending pain that you have no hope of ending, or sometimes just making livable, could drive someone to killing themselves. After that... I had a pretty good hope that they would be able to treat what was causing the pain, but it still drove into the gut that "THIS, if you knew it would never stop, that could do it." When just getting out of bed in the morning involved at least two or three tries and a fair amount of near-screaming and cursing, it makes an impression.

Thank you God the treatments worked over time, though I dread the idea of it flaring up again.

I'll also note that the pain med prescribed, one pill did nothing. Did some checking and started using two, and that would allow me to sleep 3-4 hours. So many doctors are so spooked about prescribing meds/doses that actually work because they can wind up losing their license and being prosecuted if some bureaucrats decide "You're giving people too much of the wrong stuff."