Gretchen

After seven years of dealing with chronic pain I felt like I was going to lose my mind. The constant pain, the ups and down that I had experienced with treatments to manage the pain. With all the meds that confused my mind, with all the devices that were used to fight the pain, nothing worked. The pain was still there! There was no relief, nothing to stop it from hurting me. It robbed me of the joy of living and drilled down to my core and started killing me a small peace at a time. I prayed for an answer, but none could be found.
Several months went by then a friend told me about a therapist who worked with chronic pain patients. As a Paramedic I had seen firsthand how some people were helped by good therapist and I had seen some of the bad results. As reluctant as I was I knew that I needed to try.
I did not know what to expect when I went in for my first appointment with Gretchen. I had seen two therapists before, one that was part of a hiring process and the other was before my first pain pump was implanted. The one that was for the job was to see if there were any flaws in my character that would lead me to steel or not be a good fit for the company. The one that was required before I got my first pump was to see how well I could live with the knowledge that this machine was inside me. This was different. I was going to see a doctor whom I hoped could give me relief from the pain that had consumed me for the past seven years.
She was businesslike in the way she dressed. The manner of her speech was proper but it had a calming tone. There was also something about her that made me feel like I could trust her. In the first session we went over my background, family, and the medical problems that I had. Then just before our time was up she told me something I did not expect, she said that the pain was not going away but there were ways for me to learn how to live with it and overcome its hold on my life.
I had only known her a short time when I developed a problem with my pain pump. I knew something was wrong. The pain was out of control, I was having the crawling sensation on my skin. There was a heaviness in my chest, I was feeling confused. In the week leading up to this I had days when I could not stay awake. I had times when I could not sleep and my body was racked with extreme pain. I knew from experience that I was going through withdrawal on some days and was being overdosed on others.
I was admitted to the hospital and they started an IV to give me enough morphine to supplement the amount that my pump was not giving me. The IV pump was set at a certain amount and I had a control button that I could push once every 20 minutes if I needed additional amounts of morphine for the pain. With all of this I still had problems. The amount was out of balance and I was getting more and more confused. I had episodes where I became nervous. Sounds thundered like lightning bolts through my mind. The small hospital room had two beds crowded into it. At first I was the only patient, but later toward night fall another patient was brought in. I never found out who he was or what it was that brought him in. I could tell he was very sick by the way he sounded and by the way the nursing staff was getting things ready for him. The curtain between his bed and mine was left closed. He never talked but he was moaning and making other sounds that you would hear from someone who was in a lot of pain and discomfort.
As the evening went on, the suffering inflicted on me by the malfunctioning pump got worse. With every passing minute the sounds from the other bed intensified. I tried to think through this, but it was making my skin crawl and pushing me deeper into the pain that comes when you are experiencing withdrawal. I was feeling intense guilt because I wanted to get away from this man who was suffering so. It wasn’t his fault what was happening to him. I just could not deal with the sounds anymore. I normally had some reprehension sharing a hospital room with anyone under normal conditions. I called the nurse and asked for another room. None were available.
Throughout the night the pain intensified. I wanted to sleep; it would be an escape from my torment. I only dozed from time to time when the pain and my mind would let me. I longed for morning, and for the test that were planned. I knew that once the problem was identified my doctor could bring this nightmare to an end. I made it until 8:00 am when everything came to a head. The physical pain was intense and still getting worse. My mind was like a ship that was tossed around in a storm. I tried to focus, just three more hours until the test. I was fighting to hang on. The room was getting smaller and the sounds from my roommate were getting louder. He started to cough and through the curtain I could see his shadow as he started to trash about, and then I heard him throw up. I pushed the button to call the nurse. It was an eternity before someone at the desk answered the call. With the sounds in the room, I did not have to say much for them to understand what was going on. In less than a minute two nurses came into the room and passed by me and went to the other side of the curtain. I could not stand it anymore so I grabbed a blanket, and the IV pole then I fled the room. I found a couch in a nearby lounge and that is where I planned to stay.
I sat there feeling all sorts of emotions that included shame and guilt. What had become of me, here I was a Paramedic fleeing from a medical emergency. I had been there about 15 minutes and at the time when I had thought I had reached my limit Gretchen walked by. I called her name and got her attention. She turned toward me with a look of surprise in her eyes and said, “I was on the way to your room to see you. What are you doing out here”? I just shrugged and told her “I can’t go back in there”. She could see the stress in my face and the look of pain in my eyes. She assured me that she would be right back because she had to check in at the Nurse’s station. I could only imagine what they told her.
As luck had it there was no one else in the lounge at that time of day so when she came back we were able to talk freely. It seemed like we were there for days as she helped me work through the torment and confusion in my mind. She gave me anchor to hold onto and helped me to focus my mind to combat the withdrawal. The time passed until it was time for me to go for my test. She told me that she would call me later to find out how things went. She was just about to leave when the nurse came in and told us that they had found a room for me and it would be ready when I got back from the test.
The test came back negative. The diagnosis was that I was having a bout of breakthrough pain and because of that I was having an anxiety attack. They were wrong. I had been through withdrawal before and I knew how it made you feel. Why don’t they believe me…Why don’t they believe me? Things got even worse when I was told that I would be discharged the next day. How will I live with this? The despair moved in because I knew what kind of pain I was in store for.
It was about 4:00 when Gretchen called. I filled her in on what had happened. I talked to her about how scared I was to face the pain and despair that was waiting for me after I was discharged. She made things a lot better with just three words. “I believe you.” She told me to hold on she would be there in the morning before I was sent home.
It was just after supper when the nurse came in and told me that she had orders to change the settings on the IV pump. The pump was then set where it would only give me a small dose of morphine every 20 minutes if I pushed the button. During the evening I tried to go longer and longer between the times I used the pump. I waited until the pain got too much and the withdrawal symptoms moved in. I tried to think of other things, but I knew that when I was discharged there would be nothing to help. I tried to find something on TV that I could concentrate on, but that didn’t work. My vision was too blurred to try to read. It was a restless and a long evening that turned into a long night. I guess it was about 1:00 AM when exhaustion took over and I fell asleep. It was around 4:00 when I woke in a cold sweat with symptoms of severe withdrawal. My heart was beating out of my chest, my skin was crawling, and I was feeling the deep pain in my mind and body. It is a pain that I have never found the words to describe. My thoughts were tangled, I tried to focus, and I didn’t know what to do next. I finally found the call light and I called for the nurse. It seemed like hours before someone answered. I had to think, what was it I need to say? It was hard to break through the barrier that was closing in. I got through enough to ask them to send the nurse. I guess they could tell that I was in rough shape because it was less than a minute when the nurse came through the door.
He could see all the signs and how much destress I was in. He could see the pain in my face and how real this was. He told me to press the button to get a dose of morphine. I refused. I told him to check my blood pressure, get an EKG, and do whatever he needed to do to prove to the doctor that this is real case of withdrawal. Only after that was I assured enough to press the button.
All the information was gathered and the doctor on duty in the hospital was called. He gave the order to reinstate the morphine at a continuous rate. After a while I finally went to sleep.
True to her word Gretchen came by first thing in the morning. Again she helped me to focus and take control of the fear and anguish. She assured me that I would not be sent home until things were better. Almost on que the nurse came in and told me that another test had been set up for just after lunch.
I can’t say how much Gretchen had to do with keeping me in the hospital. I don’t know if it was her or the nurse’s report that convinced the doctor to check further but she helped me more than anyone because she believed me. The test they did that day found the problem and confirmed that at times I would get too much of the morphine and at times would get too little.
Over the next 13 years she saw me through three more times when I was suffering from withdrawal. She was there when I had to face another six surgeries. She helped me to deal with all of the constant pain and the self-doubt that goes with it. At times I would feel that I had no purpose and had lost my own sense of self-worth. She gave me the courage to continue on. She helped me to see that I had reasons to keep fighting. She acknowledged that everyone was entitled to a pity party once in a while, but then it was time to get up and get going.
Although I did have some warning, it came around to quickly. Gretchen was retiring. At first she went to part-time and I was one of the patients she kept on seeing. She worked hard to match us up with other therapist and prepare a transition for her replacement, but she did not get any help from her bosses or her replacement, and her last days did not go as well as she wanted them to. Finally came the day when I went to see her for the last time.
I did not sleep much the night before my appointment because I was trying to think of a way to say goodbye. How do you say goodbye to someone who in many ways knows you better than anyone else? Someone who has walked with you through hell and helped you find a way out. How do you say goodbye to the person who believed you when no one other than your family did? She was like a family member, but not like a family member. She was like a best friend, but not like a best friend. She knows so much about my life but I know little about hers. She has been there for me when I needed her but I haven’t been that for her. Was she my Guarding Angel? I never saw wings. It was so hard to wrap my thoughts and emotions around saying goodbye to her. I know I have a love for her, but not like someone you are in love with. It is not like a sister or other relative, nor even like a close friend. It is all hard to define and I may never be able to organize it in my mind.
The last session came and we talked about basic things. I knew there was no next time and I did not want to get into any discussion about how I was feeling. I didn’t know how I was feeling. The time passed too fast and it soon came time to say goodbye. We shared a friendly hug. I turned and as I started out, I choked back my emotions and said; “Have a good life”.