And it has nothing to do with the Halloween decorations that have been up in this neighborhood for at least a week. They new way to rush "the season" apparently is to put up fake cobwebs, hanky ghosts, witches, big fakey spiders and scores of pumpkins all over your yard, door, trees. It's like Christmas only more orange. While I sort of kind of dislike spiders in any form, that's not what scared me.

It was this week's visit to the doctor. I'm okay, I'm okay. I just am required to see my doctor every three months. This tiresome, but occasionally useful bit of routine comes from whoever oversees the use of Oxycontin or opiate drugs. I don't know. I never had to when I was on anything other than Oxy, but now I schlep to the doctor's office four times a year for conversation and refills. Usually. I went this week to discuss upping the ante. I had, a couple weeks ago, discussed the same with my physiatrist, Dr. H, a young woman who is easy to talk with, gets what I need and speaks to me as if I have brains and am at least as smart about my long-term condition as she is. Because I am - in so many ways. But not all doctors get that.

My primary care doc, Dr. S, who's been my doctor for oh man, what 15 years? and I discussed the fact that the dosage/drug I'm on is not as effective as it's been. We could up the ante - I'm on a relatively low dosage of Oxycontin (a time release narcotic pain medication. PLEASE do not comment on Rush l or any other rotten scumbum addicts. This is a truly useful drug for people with chronic serious pain and I detest that is has been made into such a joke.) My physiatrist had pointed out something remarkably obvious that I had never thought of - that one can go off a medication for a while and return to it. I know that may appear obvious to you. To me? No. I assumed once you were done with a pain killer you were done. Dopey of me - why would you be? Unless you maxed out. I don't know. It's just that I never did that before. So rather than increase my Oxy dosage, we're trying a new medication. And it's got me spooked. which is very very very d-u-m-b. There is no reason to react that way. So sue me.

I'm switching to MScontin. This medication is nothing more than extended release morphine. It is, in fact, as I've been told, less potent, not as strong as the Oxycontin I've been taking for the last couple of years. My physiatrist, as well as my primary doctor both help me work it out. At this level, says Dr. H, most pain medication does the same thing and is as strong as the other stuff. What matters is that the different medications work on different pain receptors in the brain. Good. Sure. That works. Because maybe trying a new drug will affect me in a different way. Fine. So why am I so twitchy about it, when I have not been about Vicodin or Oxycontin when I went on those? Because MORPHINE is big juju medicine. Because somewhere in my mind I think "whooo-hoooo serious end-of-the-line" stuff. Because yeah, it used to be, didn't it? It used to be "if all else fails" medicine. It's not now. No how. Nowhere close. There are a number of options, more every time I check. These not only include simply higher dosages of Oxy than what I take, but meds ranging from Fentanyl to methadone.

That knowledge comforts me in a major way. Knowing I will want effective pain medication for the rest of my life, and given that I'm in my mid-50s, it's really cool knowing that there are lots of options available now, and more to come. I'm starting at the lowest dosage of MScontin that there is. It's just a name. And i'll get over it. But I sure find it interesting that the word had such weight. Boooga-boooga! Morphine! Boo!