I never really gave much thought to pain management; at least in the sense of reducing pain. Don’t get me wrong, I don’t like pain. But when it comes to how much pain I should feel in relation to an injury, for example, I guess I thought of it as either being  “on” or “off”. Obviously this stochastic thinking isn’t very useful in the face of my shoulder injury which has a broad spectrum of pain associated with it. That’s complicated by the risks associated with the drug use to make the pain go away.

I’ve been given opioid pain killers. Each time I take one I wonder if I’m not on a slippery slope heading for drug dependency. I think that my concerns about addiction have caused me to restrict my use of these drugs to the point that I’m not functioning nearly as well as I should.

For example, my appetite has been very poor. Part of the problem is that the antibiotic that was given to me intravenously during surgery distorts my sense of smell and taste. But I don’t think that blaming the antibiotic makes the most sense. The simple fact is that if you’re hurting you will be much less likely to want to sleep, eat, and rest.

Since we are all different, there’s really no way to get good advice as to how much I should hurt before I use drugs to intervene. I’m not even sure how someone could tell me how to judge my pain level in some sort of objective way. The medical people always ask me give me a number from 1 to 10 that represents your degree of pain. I guess I can understand the low end of the scale since one means I don’t hurt at all. But what does 10 mean? I suppose I would have to experience it before I could create some reasonable scale between that first number and 10.

Anyway, I’ve decided that I’ve been too hard on myself and I will now be more liberal with the drug supply. Spending many hours each day unable to get comfortable in any position, food had no interest for me. Finally late Sunday afternoon, I decided I’d had enough and took two of my opioid pain pills (I’m allowed to take up to three every three hours). Within an hour I felt much better.  Mrs. Lion prepared egg noodles with peas and butter for dinner. In my relatively painless state they were wonderful.  It isn’t that I adore eating egg noodles. I think the fact that pain wasn’t competing with my enjoyment of food allowed me to have a good meal.

When I think about it, the dilemma of how much pain medication to take versus gritting my teeth and living with the pain,  isn’t very different from the issues around a power exchange. Managing the complex dance of submission and dominance can only be done through trial and error experiments. Just as I am incapable of understanding how much pain I should accept versus manage, the only way I can understand how much control works in our relationship is to try various levels.

I like to read everything I can find on the subject and become as expert as possible before embarking on actual experience. I can’t claim that all this “book learning” has ever equipped me with the knowledge needed to get things right on the first try. Mrs. Lion  takes the gradual approach to most things. She tends to start at the low end, and increase the volume until she gets the result she desires.

This is the approach I took with pain management. I started with almost none and increased dosage until I could tolerate the pain. I realize now that this approach is self-limiting. I don’t think you can know when you reach the correct point of intensity in anything until you go just past the point when it is too much. I think that my healing may have been slowed because I didn’t continue increasing medication enough to understand when I felt well enough to stop taking more.

Similarly, I think our progress in our domestic discipline, female-led-relationship has been slower than it might be because we never push the envelope beyond reaching an acceptable result. Perhaps, when this surgery and its recovery are behind us, we can take a more adventurous approach to our power exchange. In a way, it’s a different kind of pain management.


  1. Author

    I’ve been living w/chronic pain since my back was broken during the Gulf War. I go to the VA for treatment.

    After using opiates for most of the past decade I’ve found that, although anyone *can* get addicted to opiates, you have to actually make an effort to do so.

    Every pain mgmt doc I’ve had has said some variation of the following: when you’re really in pain, the opiates don’t trigger the mechanisms in your brain that lead to addiction, the mu receptors that bind to opiates (which fool your brain into thinking they’ve got more dopamine than is the case, which makes the pain “not matter”) aren’t overwhelmed; because you’re in pain you are producing less dopamine & your brain is “in balance”. When the pain recedes, if you keep taking opiates your brain will suppress its natural production of dopamine; you’d find that the opiates have become the substitute for dopamine & instead of making you feel good, the opiates become needed to make you feel ‘normal’. Then it takes increasing daily doses to reach normality.

    That is the cycle of addiction.

    Long story short- you can’t become addicted to opiates in a few weeks…you won’t have enough. If you don’t want to become addicted, you won’t do the things that lead to addiction- like crushing the pills & snorting them.

    (Route of introduction is critical in forming an addiction….if you eat the pills they have to be digested & the meds slowly increase their level in your blood serum over a few hours. If you inject or insufflate the meds the blood serum level skyrockets & your brain is overwhelmed, which gives the ” high” that addicts seek. The method of introduction is at least as important as the amount of drugs & the duration of ingestion.)

    I actually get in trouble if I don’t take enough opiates….if my urine tests show I don’t have enough meds onboard they suspect I’m selling them. But sometimes I’m not in pain so I don’t take the pills for a few days at a time & it’s never been a big deal. Several of my fellow patients at the VA are absolutely flabbergasted when they hear that.

    My advice…take the meds. You’ll heal faster if you aren’t stressed out from severe pain. Having been sliced up more times than I can count, I’ve come up with a strategy of learning to move around & rehab myself faster by taking advantage of the pain meds. Just push yourself (safely) and by the time you get to Physical Therapy you’ll be 70% of the way there! Get your stretching out of the way while you have meds to make it easier because PT w/ nothing but ibuprofen suuuuuuucks.

    Love the blog!

    1. Author

      Thanks for the really useful information. I will take the meds regularly.

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