Last night, just as it appeared my pain might be manageable, I had a night from hell. Peaking at 9 out of 10 on the pain Richter scale was the worst of it (around 3:30 am), but the pain was never below a 6. What I discovered was that the oxycodone was ineffective against the general rectal area pain. I also realized that a single tablet was almost useless. I had to up the dosage to 2 tablets every 6 hours to establish a baseline for the rest of the pain distributed everywhere else.
It's difficult to describe pain like this. The rectal pain is a kind of diffuse pain which comes in waves and is greatly increased merely by moving. Getting off the couch feels like someone stabbing me in the buttocks. Walking is very difficult - only moving very, very slowly helps. Bending over can be excruciating. The waves of pain are directly related to the "mechanical" sensation of needing to pass gas or have a bowel movement. BMs, however, have become a kind of Marquis de Sade experience.
At least with the two tablets of oxycodone and a couple well timed BMs, I was able to avoid a trip to the emergency ward of the hospital.
To say I am a wreck is a real understatement. My tactic is very simple - keep almost completely still, take 2 oxycodone tablets every 6 hours, and hope that BMs will relieve some rectal pain.
Oxycodone has some very odd mental side effects. Vivid, nightmarish dreams are one part. But what is worse is that my thinking (if you can call it that) is very fuzzy and nonsensical.
Last night, for instance, I remember thinking that I needed to carefully distinguish between the types of pain I was feeling and what was working to alleviate each. So I'd closed my eyes and then try to separate the "mechanical" pain of constipation/diarrhea from the general pain, only to find myself "thinking" that there was a third pain, one which could be treated by other patients looking at me and directing special pain-killing thoughts over a distance to me specifically. If we established eye contact, some kind of telepathic connection was created; the person could immediately discern what was going on and then respond with a healing thought sent my way. Of course, it was reciprocal, so we'd have to negotiate a quid pro quo arrangement (telepathically, of course).
As I rehearse this nonsensical thinking, I realize that most of my logic has departed. Too many variables, drugs, decisions, symptoms. Pain holds the trump card right now. All I can do is ride it out and depend on my caregivers to see me through this.