Trading Pain for Side Effects

Six months without pain.

Six months of sleep.

Six months of feeling like I had my life back.

After living in survival mode for over a year, that relief felt miraculous.

But it didn’t last.

When the pain returned, I scheduled another hydrodistention, hoping for the same result.

Unfortunately, it didn’t work the second time.

The relief was minimal.

So we increased the amitriptyline.

From 10 mg to 50 mg.

Then higher.

The medication continued to help the pain, but something else was happening.

I was gaining weight.

At first, I tried to ignore it.

Stress, I told myself. Hormones. Recovery.

But the numbers kept climbing.

By the end of the first year on the medication, I had gained forty pounds.

If it’s not one thing, it’s another.

When I went back to my urologist, he confirmed what I already suspected.

The amitriptyline was likely causing the weight gain.

For those of you taking this medication, know this: it can be incredibly effective for nerve-related bladder pain, but weight gain is a very real side effect for some people.

I stayed on it from 2021 to 2023.

Eventually, my dose reached 100 mg.

That’s when a new problem surfaced.

My heart rate began climbing.

Resting tachycardia.

I didn’t need another medical issue layered on top of everything else.

So I stopped.

And just like that, I was back to square one.

How do you manage chronic pain when the one medication that worked is no longer an option?

We tried other medications.

None of them helped.

That’s when I was referred to a pain management clinic.

The hope was that nerve injections might quiet the signals my bladder seemed determined to send.

The pain clinic didn’t just handle injections.

They also managed my pain medication.

Before I could receive anything, I had to sign a contract.

A formal agreement outlining rules, expectations, restrictions.

Random drug testing.

Strict refill timelines.

No early refills.

No exceptions.

To receive ten pain pills.

Ten.

Ten pills that had to last at least thirty days.

I understand why these systems exist.

The opioid crisis is real.

Abuse is real.

But sitting there, signing paperwork, agreeing to drug screens, just to access a small number of pills for documented chronic pain felt surreal.

Humbling.

Heavy.

I wasn’t asking for excess.

I was asking for functionality.

For a few nights of sleep during a flare.

For the ability to get through a particularly bad day.

As part of the protocol, I was also prescribed Narcan.

I remember the look on my face when she told me.

Narcan?

The medication used to reverse opioid overdoses.

Never in my life did I imagine Narcan would sit in my medicine cabinet.

Navigating this new world affected me in every way possible.

My personal life.

My work life.

The medications made me drowsy. Heavy. Foggy in the mornings.

I had to carefully calculate the best time to take them, balancing pain relief with the ability to function the next day.

Too early, and the pain would break through.

Too late, and I couldn’t wake up.

There were mornings I could barely pull myself out of bed.

I was constantly late to work.

And when I did get there, I wasn’t myself.

Chronic lack of sleep makes you short-tempered.

Impatient.

Worn down.

I was becoming grouchy.

Not because I wanted to be.

But because exhaustion changes you.

From the outside, I looked perfectly normal.

I showed up.

I smiled.

I worked.

But underneath it all, my bladder constantly felt like it was on fire, a burning that followed me through the day and into the night, never fully letting go.

No one could see the layers underneath.

The contracts.

The drug tests.

The Narcan in my cabinet.

The medication calculations.

The sleepless nights.

No one understands what it’s like to walk in your shoes when they’ve never had to wear them.

And chronic pain is invisible.

Which somehow makes it even harder.