By Nancy Thornton

Wow. Yeah. I had to go to DETOX.

How I ended up here is a long story with lots of twists and turns. I guess the root causes would have to be my autoimmune disease and chronic pain. Those two are always giving me new experiences, most of which I’d like to have postponed indefinitely. Trouble is, I don’t get to choose a lot of what happens inside my body, such as the cascade of drug reactions I had this year.

I ran out of my regular NSAID and decided to try Aleve. I got hives after 3 days. Shortly after that, Indomethacin, an NSAID I had taken for years began to make my heart race every time I took it. My rheumy switched me to Nabumatome.

The next week, I was exposed to both flu A and B at a kid’s birthday party. I came down with what was presumably A first since my daughter tested positive for that strain and it was very hard on both of us. In my case it turned into bronchitis, due to my immune- lowering drugs. I had one course of antibiotics that didn’t do the trick. A second, Cephaclor, made my face numb for a day but I ignored it. By the forth dose numbness was also in my left hand a half hour after taking it. Then by an hour after, numbness in both hands was creeping up my arms. I was glad I had read the info about the new drug so I was aware this was an emergency. (always, ALWAYS, read those leaflets!)

Mom drove me to the ER and I had the worst sense of impending doom I have ever experienced. I recited the 23rd Psalm internally just to keep myself from screaming and slapping people. I literally felt like I was going to die, even though rationally, I was in good hands. When medical personnel just would not hurry fast enough I wanted to rip their heads off. I’m not that lady that yells and swears at nurses, but I could have become her. (severe anxiety is a known adverse reaction to Cefaclor) My throat was closing after I arrived. It was anaphylaxis. That’s probably the most terrified I have ever been and the anxiety was worse than the physical symptoms, but anyway, the ER team saved me.

I took my next antibiotic and it was almost gone when I started getting hives from Nabumatome, along with wheezing. (I was on 30 mg of Prednisone had just stopped Benadryl) My rheumy said I now had a drug class allergy. I was never to take ANY NSAID again, not even aspirin or ibuprofen or any product containing them.

After those hives began to heal, I noticed more appearing again. It took me a few days to figure out it was Tramadol. I had been taking Tramadol for about 6 years combined with an NSAID for my autoimmune arthritis.

Chemical Dependency Vs Addiction

I knew from running out a few times that I had become chemically dependent upon this medication. The hot and cold sweats, anxiety, uncontrolled jerking, nausea and sleepless nights were maddening, not to mention the return of pain. If I had to take this medicine for pain every day, what did it matter if I was dependent? This is an issue with which many chronic pain people continue to wrestle.

Chemical dependence and addiction are not the same. For instance, we are ALL chemically dependent upon a substance called H₂O. So much so, that the average person will die after 3 days without it. Diabetics are dependent on insulin. Millions are dependent on antidepressants so they don’t commit suicide. People without spleens are dependent on antibiotics. There are hundreds of examples of people who do not bear the stigma of “addict” simply because their chemical substance is not a pain reliever. So what’s the difference?

Addiction usually involves craving more and more of something, inability to stop, negative social and financial consequences of using. These can happen without chemical dependence (i.e. gambling, sex addiction). Chemical or physiological dependency involves your body’s need for a substance, with negative physical and sometimes psychological symptoms as a result of withdrawing from that substance. There need not be cravings, abuse or any of the stuff addiction entails.

Getting Help

So I was dependent upon Tramadol, which was advertised to doctors a drug with low dependence and addiction risk. It turns out Tramadol is habit forming and has difficult, long lasting withdrawal symptoms. Having been on it for 6 years, a pharmacy friend had told me there was a risk of seizures. I knew I needed some help, so I called my rheumy, but got no support. My rheumy told me through his nurse I would be fine because they had taken many other people off of Tramadol without any issues. To me, the hives and the withdrawal symptoms were equally annoying. Both also could be equally dangerous. What was I to do?

I was sure I couldn’t handle this on my own. Having been sick(er) for over a month, I was SO TIRED.  I cried a little, terrified at what it would mean to be in detox.  What would my family and friends say? I didn’t want to be another person in chronic pain they could point to and think I was just a drug seeker. I decided to keep most of them out of the loop until it was over. I pulled up my big girl panties and took the phone a friend option. I called someone I knew that had experience with such things. She had me call a treatment center. (I sobbed between phone calls). They said I should call an advocate because unless I needed the full 90-day treatment program, they couldn’t help me. So I called the advocate, who said no one would take Medicaid, which was my only healthcare option. (more sobbing, this time on the phone). The advocate said I should call one more person who was leaving work in an hour. I called repeatedly, leaving messages. He finally called me back and gave me the name of 3 different places to try. I took a look at all 3 on the web and checked that they would take my “insurance”. Check. Looked at what others were saying: all had good reviews.

Then I called the one that seemed to have the highest amount of good press. They said I NEEDED help and that I could come in any time of the day or night and they would see what they could do for me.

It was 3 hours away. My mother lived only half that distance from them and I needed moral support. My son would stay with his father, and my grown mildly autistic daughter would stay with my parents. My son’s father would take care of our pets and get the mail. It was a big step. I won’t say this was easy. None of this was easy. It was the beginning of summer, so we were all off. Putting your life on hold, even for a week, even when you have HAAD to many times before in our chronic journey is never easy. Doing it by choice, even if it’s not really much of a choice is terrifying. When your life and body are out of control, you grasp at anything you can reach to try and control some aspect of it. I know. I know.

I had a 2-hour drive to my mother’s house. I had been off of Tramadol for 12 hours and was already twitchy, sweaty and nauseated. I decided to take more Tramadol and risk more hives rather than a seizure while driving (plus I hate puking with a passion). When we arrived at Mom’s, she was ready to drive for the last leg of our journey.

Arrival

The lobby was bright and calming, full of light and had a large fish tank, which helped me feel better. I summarized my reason for coming on a small slip of paper at the desk and the receptionist smiled kindly. Then I sat waiting with my backpack. I had stuffed 3 changes of clothes, all my meds, supplements, phone, netbook, chargers, pain relief rubs, patches, my plush, extra-large heating pad, my water bottle and miscellaneous items into it.

I saw a series of 4 different people, intake workers, and nurses who asked me more and more in depth questions. I had to give a medical history, mental health and abuse histories, plus reiterate why I was there. They had a bed for me, but because of all my health issues, had to admit me through the emergency department.

I took another Tramadol at the usual time, because my pain was exacerbated by stress. I regretted it as soon as it began to kick in at the ER. Hives intensified, and my face began to swell around my left eye with crushing cheekbone pain. The docs gave me some Benadryl and an ice pack, and increased my prednisone to 60 mg. I took a short ambulance ride back to the behavioral health building. My mother wasn’t with me for the next part.

I had to sign myself into treatment, which meant I could leave any time. The detox program is 3 to 5 days. I would not be able to legally own a firearm for the next 5 years. I don’t have one now and probably couldn’t pull a trigger with my arthritic hands anyway. I had to give them my backpack to be inspected for contraband. That would include all drugs, electronics, sharp items, weapons and strings. One of my shirts was rejected because it had a string. I also had to surrender my shoes or have the laces confiscated. I chose to wear socks. The contraband rules were there because of people in the same building and possibly on the unit who would harm themselves or others with those items, and because they want us to detox from electronics for a time as well. If I smoked or vaped, that was also contraband at this particular center, though not at every center. I had to submit to a body check. Nude. In front of two people. It was not fun, but it was over quickly. They have to be sure you aren’t sneaking anything in, for one thing. For another, they have to document all tattoos, bruises, cuts, scars and rashes. Of course I had hives from head to toe and about 50% of my body was already covered with psoriasis, so there were lots of questions.

Treatment

During treatment I Reacted to both of the detox drugs (Subutex and Soboxone they gave me, so I ended up with Benadryl injections and steroid cream for my hives. So I detoxed with minimal help. I had to stay a few days longer because of my allergies. Everybody was given a blood pressure lowering patch. We could get Tylenol, Ibuprofen, our regular prescribed meds, anti-nausea meds, or hot and cold packs if we asked for them. Vital signs are checked every 4 hours. There is a headcount every 15 minutes and daily room checks.

Time sort of stands still in there. They keep you busy. I can’t tell you much about the inside because of privacy laws. I can say that while there, we had group discussions on addiction and recovery a lot of the time. We also had art therapy and other things that were fun. The fed us well and the food was OK. The people were amiable, each with different issues than mine, but all there for chemical detox. We actually laughed and cried together, watched old movies and played games. It was like an extended family, with all ages and walks of life represented. It was a challenging and life-giving time and one of the best weeks of my life.

They treated my pain with gabapentin, and it made me feel dizzy/drunk for about 2 weeks. I couldn’t drive, so ended up staying with Mon and Dad after I was discharged. It gave me really intense stupidity   brain fog for about 2 months. I was used to a sharp mind, and that was probably the hardest part. No way could I have handled that during the school year. Eventually the gabapentin really worked for me. I had to wait it out, and I am on 3200 mg daily which is a lot, but it works for my every day pain. I still have to add Tylenol arthritis on top of that a few times a week and it helps some as well. I’m at a pain level of 3 most days now, going up to 5 tops.

So it didn’t turn out too bad. I was right to take initiative and get myself healthier, and lucky to have had the ability to do so.  I had some support, although most people I know didn’t have a clue about it at the time. In the end, my stay was funded by the hospital itself, because they did not actually take the kind of Medicaid that I have. If you ever think you might need this kind of help, don’t be afraid. Be proactive. It can be a great experience if you approach it with an open mind and heart.

Nancy Thornton, is a former homeschooling mom of 3, living with Psoriatic Arthritis Mutilans for the past 8 years. She decided to follow my dream of getting a science degree after her diagnosis. She has an AS in Biology and minor in Environmental Studies. Her goal is to be an Agricultural Extension Agent and community educator and  she is embracing the journey. What gives her joy and courage: her family, nature, faith, music, fellow Spoonies and her cat George Purrington Silverstripes.