Opioids: The pendulum has swung too far in the wrong direction

I’m a 43-year-old physician who retired due to illness at the age of 39. I have a rare genetic disease called acute intermittent porphyria (AIP). It’s an extremely painful and disabling illness. Due to an enzyme deficiency in the heme biosynthesis pathway in the liver, porphyrin precursors accumulate and are neurotoxic causing visceral neuropathy. The symptoms of the disease are neurological with the most notable being abdominal pain. It is a neuropathic pain which has a burning sensation that is unbearable. The pain is similar to what I’d imagine it would feel like to have a blowtorch against my stomach and my back. It also causes peripheral neuropathy in hands and feet. Along with the pain comes severe nausea, vomiting, headaches, fatigue, muscle weakness, motor neuropathy, fluctuations in blood pressure and pulse (autonomic neuropathy). About 10 percent of AIP patients have a severe form of the disease referred to as “high excreter, recurrent attacks.” Unfortunately, I am one of those 10 percent. Initially, I only had monthly attacks lasting three to five days starting in late teenage years. Somehow, I managed to complete education and training and become a physician despite this. I was not diagnosed with this rare disease until the age of 39 when I suffered a life-threatening porphyria attack and then it was finally diagnosed. It was almost too late for me at this point as the disease was so severe that I stayed in back-to-back attacks and was no longer able to ...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Pain Management Primary Care Source Type: blogs