I was 28 when I suffered the injury after which the pain never stopped. The reactions to my complaints were, "Your x-rays are within normal limits and you're not acting like you're in pain so I don't believe you", or, "You're obviously just in here looking for drugs".

I had a couple of things working against me. I wore my hair long and I was in superlative physical condition (I was a martial artist, a rock climber etc.). My normal resting pulse was low, as was my blood pressure. When I presented with a pulse of 90, a BP of 130 over 86 or so, and not screaming in pain, I suppose it made my position look a little unbelievable. I also have an inherited abnormality; for me, centrally acting substances either don't work right, don't work except in a huge dose, or don't work at all.

Meanwhile, I would work for as long as I could, when the pain would either physically stop me, or my irascibility would get me fired. There was a long time there when I wasn't really sane. My father was abusive, so I learned as a child to shut down until I finally lost my temper - a VERY rare happening. As time passed, as sleep or any kind of rest became more and more difficult to come by, as my self-esteem was eroded and the pain never went away, I reverted more and more to this behavior, which of course didn't help me in finding treatment.

Let me give you an example of what I mean when I say wasn't quite sane during this period. When one doctor told me I was just trying to get pain meds, before I realized what I was doing I had him by the throat and had every intention, I think, of killing him. Because of this incident, I was put through drug rehab, or at least started through it, but the rehab people said I didn't have a drug problem, I had a pain problem. By this time, I was in many ways emotionally childish; either withdrawn or very short-tempered.

After over a year going to this hospital, and a new doctor every time I went, one of them finally ordered a CT scan. It showed enough damage that he ordered an EMG, which showed severe nerve damage. I almost cried from relief. Unfortunately, it made little difference. They wouldn't operate, and by now it was the "Just Say No" years. They sent me to a pain clinic, which didn't work as I couldn't convince myself that pain was a good thing. Afterwards, again, sometimes a doctor would give me a little medication, sometimes not.

About 11 years after the injury, I was in such bad shape that I could barely move at all. Two disks had finally fragmented and ruptured, and a facet joint had broken. Finally, my girlfriend took me to a civilian hospital for the first of three operations. After the operation, all they would give me was morphine at an inadequate dose. I refused a second dose and demanded they call the doctor and get the hydrocodone reinstated. Six weeks after the operation, I was operated on again, as I had gotten as bad as I had been before the first. Even before the second operation, the doctor was convinced I was a narcotics addict because the 5 mg hydrocodone hadn't worked, so afterwards, he refused to see me again. The second operation reduced the pain somewhat, and I went to counseling for three months afterwards. This helped me to realize what I'd been doing emotionally, and to correct it.

About a year after that second operation, after I had come here to Oregon, I was operated on a third time. The neurosurgeon said that whoever had operated on me before had made a horrible mess of things. After more doctor shopping, and the familiar horrors that entailed, I finally found the doctor at VAMC Portland I am now seeing. It took a little over a year for us to find the proper amounts of the right medications, and I now realize that it took that long for me to get over my insecurity about not having the medication available. When the VA finally left me with this one doctor long enough for him to get to know me (this is a new policy), I told him how much of what I wanted and why, and we agreed to try it out. In over two years, the amount of medication I'm taking has actually dropped. The per-dose amount hasn't changed at all.

The emotional ups and downs have been as difficult as the physical pain. What do doctors think someone is going to act like when they are in so much pain ALL THE TIME that they not only can't sleep, but also are exhausted from spending so much of themselves all of the time fighting the pain? Additionally, I had to endure the pressures of having to survive on an SSDI check (I'd have to quit eating for the last week or so before the check came in) and the pressures of trying to interact with other people.

It has now been a little over two years since I found a doctor who gave me some pain relief. I have been very happily married for over a year, am resting more than I have in over a decade, and am working with Vocational Rehab to try and do something useful. Three years ago, I couldn't have imagined any woman wanting to marry me, or even considering trying to work again.

I dread the day my doctor retires or is transferred, . Despite the facts that I've cut my medication levels myself, that I've turned down drugs any junkie would kill for, or that my tests all show that I SHOULD be in pain, I have no doubt that if something happens to this treasure of a doctor who listens and believes, I will be back to doctor shopping and defending myself against the charge of "addict".

Really, it's taken not only this irreplaceable doctor, but a lot of hard work and soul-searching on my part, and the love and patience of this extraordinary woman I married to get me to where I feel like a worthwhile human being again.

Sincerely, Dan Schweitzer wdsmith@madras.net