I opened the tamper-proof bottle, poured the two white tablets in the palm of my hand and stared at them. Flashback to the gym. In the morning, my body had said, “I’m not anywhere near twenty years old, so go easy on me,” and my mind had replied, “fuck you, I’ve got energy, and I’ll do what I want.” So, I pumped too much iron, burned up the spin bike, and now, I was paying for it big time. If I didn’t want to walk like a zombie for the rest of the week, I’d have to swallow those two pills. I should take them, I thought hesitating. I need to get rid of this pain. In the past, before my third liver/kidney transplant, I’d relied on painkillers to make it through the day. That didn’t work out too well for me. One must learn from ones mistakes at some point in time…at least one would hope one does...


20 million Americans take prescription painkillers daily. Every year, 70 billion over-the-counter painkillers are sold. Advil, Aleve, Anaprox, Aspirin, Anacin, Ecotrin, Excedrin, Motrin, Nuprin, Voltaren, Celebrex, to name a few, are all NSAIDs or Non-Steroidal Anti-Inflammatory Drugs. There are more commercials for painkillers in the United State than in any other country in the world. Unless you live under a rock, you’ve heard of these drugs and have probably taken one or the other. Here’s what’s going on in your body when you do.  


First, what’s pain? Pain is the result of chemical messengers (prostaglandins), which alter the make up of your cells wherever you hurt yourself, have physical damage, or develop a headache. This change in your cells alerts the nerves and spinal cord and they send an electrical signal to the brain. Voila! You’re in pain! Chances are, according to statistics, you’ll grab one of the above-mentioned pills, just like I had.  


Meet COX 1 and COX 2 (cyclooxygenase). These enzymes promote fever, inflammation and pain, which is a good thing because they’re our primary alert and defense systems. COX 1 can be found in most of our tissue. Besides bringing about the things we dread, this enzyme helps make mucus, which protects our digestive tract from its own (battery acid) juices, thus making sure the flora and fauna, so to speak, in our stomach and gut is healthy. COX 1 also manages blood flow in our kidneys, which keeps them working properly. COX 2 is responsible for inflammation (arthritis, menstrual cramps), but also manages our platelets so that they don’t clump together and cause high blood pressure or put us at risk of a stroke or heart attack.  


NSAIDs are COX blockers. Well, not exactly, but pretty close. They’re COX inhibitors. When you take a couple of Advil, it impairs all of the COX 1 functions. Much like bringing your little sister on a date, it stops you from having…pain. It also diminishes kidney function and mucus formation in your digestive tract. When you take Celebrex, currently the only COX 2 inhibitor still on the market (Vioxx and Bextra are no longer available), you’re targeting inflammation without impacting kidneys, stomach or gut. However, there is a potential for high blood pressure, stroke or heart attack because your platelet protection is suppressed right along with inflammation.


But fear not. If you only take NSAIDs when you really need them, none of the side effects matter. The astounding machine, which is our human body, bounces back. It continually seeks balance because that’s what it’s programmed to do. Take it from a pro that has unbalanced her body more often than I care to remember. Hell, I’m well acquainted with both my digestive tract juices and the effects of too many NSAIDs, but you’ll have to read the book (coming in September) for those stories. I’m not alone though, because every year over 100,000 people are hospitalized for NSAIDs related gastrointestinal problems.


Like all NSAIDs, Aspirin is harsh on the stomach, but it has stood the test of time. Probably one of the oldest medications ever, It’s been around since 400 BC. Hippocrates (you know, the one from the doctors’ oath) gave women willow leaf tea, a plant that carries the pain-killing component, after childbirth. Aspirin later became folk’s medicine, and then evolved to be a painkiller. In 1897 the German pharmaceutical company Bayer patented the current form of Aspirin (they added the component, which makes it less harsh on the stomach). Aspirin, among all NSAIDs, is unique because it’s the only one that keeps platelets nice and loose and prevents them from clumping together and causing a heart attack.


Back to the two pills in the palm of my hand. Tylenol (Acetaminophen). The only over-the-counter painkiller I can take. A wonder drug. No really, scientists wonder how it works. This one-of-a-kind pill isn’t a NSAID. It’s not a COX inhibitor either, and it doesn’t impact the kidneys or the stomach. They think it works with the central nervous system but the debate is ongoing. Tylenol has one drawback: it’s quite toxic for the liver.


I stood there, weighing the pros and cons of swallowing the pills in the palm of my hand. Yes, I’ll feel a lot better, but if I don’t absolutely need it, why bother? Then I realized: one had learned something after all. One had learned that one mustn’t turn to pills for ones own fault by overdoing workouts. I placed the pills back in the bottle, and walked over to my computer…like a zombie.

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Tags: COX, NSAIDs, Tylenol, aspirin, kidney, liver, transplant


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Comment by Connie Austin on February 21, 2012 at 10:18am
I want to add that it's PICC line (peripherally inserted central catheter) Also shortened to PIC. PIC is the most commonly used. Also, D&C (dillatation and curettage.)
Comment by Connie Austin on February 18, 2012 at 9:14pm

Hi, Gloria!  I'm about 3/4 of the way through your book.  There are a few things you wrote about that I'd like to comment on, but not here.  Please e-mail me if you see this.  E-addy is in my profile.




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