I just got liposuction, and I had to get a note from my sponsor for pain pills, even though I'm 6 years sober

• I've been sober for six years, and I've tried to balance my physical and emotional health.
• When I found I was still unhappy with some things about my body, I decided to get liposuction.

My love handles were gone. Just under $20,000 was the price I paid for my vanity, a 41-year-old gay man and former child actor clean from a meth and alcohol addiction for six years. I'd focused on changing my insides but still couldn't shake trying to improve my outsides.

"OK, it's been four hours," Walker, my fiancé, said, as he sat on the bed next to me. He looked concerned as he handed over a pain pill and a glass of water. I had just had liposuction.

Since I've gotten sober, I've tried to refocus my priorities

Although I've been sober for six years, it's still a tightrope of knowing that how I look is not my top priority while still wanting to feel my best. I've always worked out and been mindful of what I eat, even while I was in the throes of my addiction, but tending to aesthetics alone never kept me sober, and it took time to reconcile that.

Keeping my most important relationships healthy — including the one I have with myself — and being a good partner, friend, son, and employee is what I've seen work. Still, I live in Los Angeles, the land of airbrushed perfection, and I can't completely squash the need to tend to how I look.

In high school, I was obsessed with six-pack abs and perfectly spiked hair. The ecstasy I took at raves masked my insecurity; I was consumed by looking perfect. After years of using meth, booze, and pills to blot out the feelings of being a failed actor — and being blind to how my addiction further blocked any success I could have created for myself — I landed in a last-chance recovery house at the base of the Hollywood sign with nowhere else to go.

I celebrated my 35th birthday with other homeless addicts, many of whom were dodging prison or just needed food and shelter.

Jamie, a trans woman, was like our den mother in the house. "Honey, just pick something to wear. Who are you trying to impress? You've bottomed out," she said. I tried on some of the donated designer castoffs; some cashmere sweaters and well-cut trousers still had tags on them.

"I want to feel good about myself again," I said. We were in Hollywood, after all, even if it was in a crumbling Victorian with an algae-filled pool. We were fortunate to be alive.

"Oh, sweetie. Gucci ain't gonna do that," Jamie said. My self-esteem took a huge hit in rehab. I was raw and messy. When I'd showed up I was rail-thin, but with the lack of exercise and the well-meaning boxes of delicious pastries, I packed on a few extra pounds.

My body had changed since I'd gotten sober. I had stopped focusing on diet and exercise. I wanted to be happy in my skin, but there were areas that I felt myself poking at in the mirror, and I was sure that no amount of Peloton or CrossFit would get me the desired results.

I had been thinking about liposuction versus more extreme dieting for a few months before talking it over with Walker and then my therapist and my sponsor in Narcotics Anonymous. Finally, I decided that was what I wanted to do; however, I wasn't going to fool myself into thinking it was a magic bullet. I knew that it wouldn't solve all my problems, but I hoped it would kick-start better choices about my overall health moving forward.

When I decided to move forward with liposuction, I received an unexpected request from my doctor

After several consultations, I went with a doctor who had a protocol for pain management that would work a little differently for me than some other patients after I checked a box confirming my addiction struggles on the medical-history form.

"I'd feel more comfortable with a note from your sponsor," he said.

My first impulse when the doctor said that was to laugh it off. But I know that's my addiction talking. I called my sponsor for the note; I already knew he'd have no problem, given that in the past he's told me I should be able to take medication as prescribed when it's necessary. We talked it over, and he agreed to write the note for me.

"Nick will be fine taking a few pain pills as he recovers from his surgery. He has been in recovery for many years now and has shown the ability to make sound judgements to avoid drugs and alcohol. In this situation, it seems essential to have pain medication. He should only need enough medication for a few days," it read.

My sponsor understands how crucial it would be for me to have medical supervision and emotional support while I address the physical pain of the surgery — essentially, it's a matter of life and death.

I understood that the doctor didn't want me to relapse and that this sponsor note gave him peace of mind. I don't want to relapse, either — after all, I'm a sponsor, too, and help others the way I've been helped. Even if it was an extra step in the process, I was happy to get the note.

I'm grateful to my doctor and the suggestion to request permission from my sponsor to take pain pills after the surgery. Not only that, but requesting it also meant I'd have to inform my sponsor I had pills in my possession, which kept me accountable. Because if there's one thing I've learned with six years clean and sober, it's that my thinking can't always be trusted. And as I continue to heal from my surgery and run my fingers over the wounds on my hips, I'm reminded of the pain I had to feel while my insides healed, and I know it's all worth it.