See, it’s an acronym, but it sounds like a snake. Ffffsssstttt. OK, I am easily amused.

When I began work at this full-time job, I asked my doctor if I could increase my Vicodin dose to 3/day.

I don’t take them strictly on schedule, but it averages out to about that amount. I’ve been taking Vicodin this way for half a decade now. I began at 1.5 pills per day, average, which barely allowed me to make it through two semesters of college, earning 15 credits altogether. Since then, punctuated by periods of rest and inactivity, I’ve started my first job ever, six to eight hours a week; then moved on to my first Real Job, twenty to thirty hours a week; then spent some time stutteringly employed before beginning this job, the much-talked-about nine-to-five, with a real salary and my very own desk. Up until that last, my painkiller use increased, overall, to 2/day.

Which is surprisingly stable, considering Vicodin is a narcotic painkiller typically used for acute, not chronic, pain. Most doctors (the ones who at least pretend to care, that is) are eminently afraid to prescribe the Vikes for chronic pain, fearing tolerance, dependence, even abuse. (The last cannot be fairly grouped in with the first two, but that’s another post.) It’s very, very easy for a patient taking narcotics on a regular basis to build up a tolerance, needing more and more to less and less effect, which can head to a very dangerous place very quickly. And this fear on behalf of doctors is eminently understandable.

But here’s my problem. I already take a shitload of other medications. And I’m close to maxed out on each of them. I could probably increase my dose of a couple meds modestly, but I have been very careful not to approach that max, fearing what I know is inevitable: some crisis, some downturn in health, when I need something more to help out, but find that I have already exhausted all my options.

And the non-pharmaceutical treatments? Yeah, look, I’ve been living with this condition for twenty-three years now. I know sleep hygiene intimately. I have to pay very close attention to how I sit, to what I wear, to how I move, to how I speak, to where I go, to what I carry — every second, of every day, because I have identified many of the things that make my pain burden worse. And I avoid those things, so that there’s less pain to treat in the first place.

I make sure to get enough physical activity, but not too much. And the right kind, for the right amount of time. I’ve learned to balance on the edge of the knife, constantly monitoring everything around me, everything I do, every tiny movement I make. It is a complex, nuanced, organic dance, on the tips of my toes while juggling all the hundreds of concerns every healthy person needs pay no mind to whatsoever. And if I slip, I have to know how to react swiftly to regain that balance right away — because it’s a hell of a job to build that balance from the ground up all over again.

I’m already doing just about everything I possibly can be doing. And it’s not enough to allow me some semblance of a normal life. And, ideals and expectations of normalcy be damned, I have to do more than that. I have to push forward. I have to keep going. I have a husband. We want a home and a family. And for the here and now, we have bills to pay. And my own emotional health demands I get-up-and-do. I go stir-crazy sitting in the house by myself every day. I want to go out and do something. And we aren’t privileged enough to be able to afford for that to be art classes and volunteering.

Because of all of this, I take Vicodin. Anybody who wants to fight with me at this point about it can go suck a rotting tree stump. It’s my fucking life, and I know what works for me. Piss off.

***

Two and a half months ago, now, I asked my doctor to increase my dose to 3/day. I did a lot of thinking and I really felt like that would be a sufficient number. Over the first couple weeks I settled into a schedule. One half pill when I woke up in the morning, and thereafter one half pill at every two-hour interval (conveniently coinciding with my breaks) until the work day was done. Considering I wouldn’t need as much on the weekends, that left me a bit of a buffer, just in case.

For the first month and a half, that worked great. I got my first refill right on schedule. I was proud of myself.

The last month, though, threw me a bit of a curve. I got several headaches, which meant increased use. (My headaches are such that I have no other way to address them — I have to take medicine, or it will get much, much worse.) And I was a little incautious about it. I was still adjusting to this new schedule — where I spend approximately four waking hours not in a work environment every weekday — and trying to make sure I would be able to sustain the work I was doing.

So, this week, a week before I was due for my next refill, I ended up a little short. Officially, I ran out of medicine halfway through yesterday. And I had to ask my supervisor if I could go home — for the rest of the week.

Fortunately, I am limited-term. I have no benefits. As such, there is no leave to deal with. But I skip work at the grace of my extremely understanding sup. I can’t abuse that privilege, or I may not have a job to come back to.

My doctor won’t let me refill a day early. I think he is becoming concerned. And, again, I undestand why. But.

I’m concerned myself. The past couple weeks, during which I saw this whole ordeal coming, I have been chewing on things. And I’ve decided not to pursue the highly-unlikely-to-happen-anyway permanent spot in this office. (Thank Rendell for that. They could lose five clerical employees and they’d be lucky to be allowed to hire back one.) So long as I stick the job out until its end, I have recall rights next fall. And I am moderately likely to be able to collect unemployment in the intervening months. It won’t be much, but it’s income.

More importantly, it’s income that affords me a chance to rest. I really don’t think I can handle doing this year-round. More and more, I am grateful that the hiring freeze came down. It took away my chances at a permanent state job. But it meant I jumped at the chance for this job when it came down the line. And all things said, this looks like a good deal for me. Work full time through the winter — rest in the spring and summer. And thinking long term… it’s the best chance I have to be able to keep working through pregnancy, childbirth, and early motherhood. It gives me a schedule. Life rarely works out on schedule, but I’d still have a chance. I wouldn’t have to be altogether out of work.

In the meantime, I am sitting at home and resting. I see my doctor tomorrow, and we will talk over my options. Because I want my life to be sustainable. This is the best chance I’ve ever had at that goal. And I don’t want to lose it.