“So it’s chronic pain that brings you in?”
Dr. Mary looked up from her clipboard, a smile on her face. She tapped a pen against her chin as she listened.
“Yeah, I think that’s the problem. The pain levels are worst in the mornings. And then I sit for my job most of the day, so the pain just kind of intensifies throughout the day. It gets better a little bit when I move around. But definitely worse in the mornings.”
“Hm. And where do you tend to notice the pain most? And rate it on a scale from 1 to 10.”
I shifted my weight, hearing the rustle of the paper that lined the raised seat in the doctor’s office. “In the mornings, I’m stiff and sore from the scoliosis. I get back head aches and neck aches, and my back is really rigid and achy. More like a 6 to 8. Then after I eat and shower, it gets a little bit better, closer to like a 4.”
Dr. Mary jotted a few notes down. “And what helps to relieve the pain?”
“I usually take a few Ibuprofen in the morning, and a few more in the afternoon. That helps. And food and eating seem to help for some reason. Sometimes I use a heating pad on it.”
“What are your food habits?”
I clicked meals off on my fingers. “On a typical day, I’ll eat two bowls of cereal for breakfast plus a few slices of toast with peanut butter and a glass of orange juice. For lunch, maybe a hamburger and French fries, with maybe chips and a cookie. I’ll snack on a bag of microwave popcorn and a liter of Pepsi at work, and the caffeine helps the headache. And then dinner is variable. Maybe Little Caesers, or my wife might cook roast and potatoes and chocolate cake, it just depends on the night.”
Dr. Mary had me step up on the scale. I was 30 years old, I was 5 feet 11 inches tall, and I weighed 245 pounds.
“You’re a little overweight,” she said, when the truth was I was obese. “I think you might also be struggling with some depression. Between your job doing therapy for others, your Church callings, and your responsibilities at home with your wife and baby boy, I could understand that.”
As she tapped the pen against her chin a few more times, thinking through ideas, I wondered if there was anything she could do to help me. I felt like a shell of myself. I wasn’t sleeping, I didn’t like myself, and my marriage was beginning to feel a bit empty, a routine of church service and watching the DVR. Because of my weight, I was constantly out of breath and sweating all the time. I didn’t have any close friends, and I had just become accustomed to pretending I wasn’t attracted to men. Depression was definitely part of the picture.
“Okay, Chad, here’s what I think we are going to do,” she muttered while scrawling down a few things on a prescription pad. She was silent until she finished, then Dr. Mary looked up at me, the smile back on her face. “Trust me, I think this is going to help.”
Over the next few minutes, Dr. described the regiment of pills she was going to put me on. “I want you to start taking Cymbalta. It’s an anti-depressant. It should help your mood and your sleep. There can be weird side effects at first, some people feel electric buzzes in their brain at the beginning but it goes away, and it can result in more weight gain, but I think it will help.
“I’d also like you to begin a regimen of painkillers every two hours throughout the day. We’re going to go up to the maximum dose on those. Now, the warning labels scare some people off, but you can actually take a bit over that dose when necessary. But we are going to tackle this from two different directions. You can take up to 500 milligrams of Tylenol every four hours, and up to 800 milligrams of Ibuprofen every four hours. So I figure if you take the Ibuprofen with food and water when you wake up, say at 6, then at 8 you can take the Tylenol, and at 10 you can take more Ibuprofen, and you can alternate that schedule throughout the day. You don’t have to do this every day, but it will help on the difficult days.”
My eyes widened as she presented me with three prescriptions, for Cymbalta, for Ibuprofen, and for Tylenol, all prescription level doses that would have to picked up through a pharmacist. She told me that I might expect some digestion issues based on the high doses of Ibuprofen, and that the meds could cause long term liver and kidney problems, but that those weren’t things I needed to worry about for now.
And then Dr. Mary left, and I sat in the room for a moment, stunned. Pills. Lots of pills. An anti-depressant, multiple painkillers, and multiple anti-inflammatories every day. Would that help my headaches? Although I hadn’t had a clear agenda going in, I was a therapist by trade. My doctor had just diagnosed me with depression in a swift paragraph, yet she hadn’t recommended going to a counselor, and hadn’t asked me any questions. She’d noted that I was overweight, but she hadn’t recommended a diet or even limiting food, or exercise, or more regular physical activity.
A few hours later, I had a new bag of pill bottles in my car. I sat outside the pharmacist and I placed my first Cymbalta pill on my tongue, swallowing it with a swig of Pepsi, then I did the same with the large chalky Ibuprofen. A few days later, the electric zaps in my brain that she’d mentioned would start, and the stomach issues would follow. My head aches and body aches grew numb with the pills, but they never went away. Within a few weeks, I needed the pills to feel normal, the pain intensifying without them. And within a few months, I gained another 10 pounds.
Before I quit the pills cold turkey, just three months later, I felt my depression get worse. The decision to quit the pills and replace them with nutrition, exercise, and therapy came suddenly.
But for that time before that change, I was just a typical American, as fat on the outside as I felt on the inside, and using pills to numb the pain.