The Last Resort

This is just one of the hundreds of tragic stories in the CDC comment section:

http://www.pharmaciststeve.com/?p=13140

http://www.regulations.gov/#!documentDetail;D=CDC-2015-0112-1530

I write this from the intensive care unit waiting room, a suicide letter on my lap. My beloved wife is currently an ICU patient due to under treated chronic pain.

10 years ago we had it all. 3 beautiful children, a lovely home in the suburbs. We were “the American Dream.” I had a job that allowed me to take on the household expenses solo so my wife could be a stay at home mom. In a moment it all shattered.

My wife was rear ended by a kid who was on his cell phone while driving. Her injuries, besides the regular bumps and bruises included a stress fracture in her back, a sprained neck and wrist and a concussion.

Doesn’t sound bad, does it? Except that for months, the pain increased almost daily. Physical therapy did not help. The trips to the chiropractor left her in tears afterwards from the pain. Almost a year after the accident, I came home from work and she was in bed still, in so much agony she couldn’t move.

A MRI shortly after this day showed multiple damage to the discs in her neck and back, the stress fracture not healed properly and severe spinal arthritis. It was then she was referred to pain management. Her PMP was amazing. She was treated with dignity and respect. She was put on anti inflammatory medicine, along with ER OxyContin and 10 mg oxycodone for breakthrough pain. With this my wife could almost go back to her “old life” as she called it. Yes, she had some bad days. But on good days she could do light housekeeping, a little bit of yoga, even work part time. She did every single thing the PMP asked of her. Not once did my wife break her pain contract. Several times her provider called her “an ideal patient.”

9 months ago he took early retirement. The new PMP has been the polar opposite. Immediately he cut her pain meds to less than half her previous doses (which never increased since she went on them), increased her anti inflammatory meds and put her on Neurontin (by now she’s started having severe sciatica). He said that “All his patients will be off opiates in a year unless they’re dying of cancer.” Several weeks later, her pain was increased dramatically, her behavior was erratic and she developed a GI bleed. She took up smoking cigarettes and stopped doing self breast exams because “If I get cancer he will at least treat my pain.” I truly believe that by now the Neurontin was affecting her behavior, as was her increased pain. Her PMP’s solution? He added Lyrica to her prescriptions, instructed her physical therapist to “challenge her” and told her to “Stop trying to make me your dealer.”

This lack of compassion, professionalism and accusations has destroyed what self esteem my beautiful wife had left. Up until recently she fought her pain with every step. She started eating healthier, she exercised as much as she could, she tried every legal option she could think of. Opiods are a last resort for her. The severe pain she faces every minute of the day (which has been made worse by the naproxen thanks to kidney disease and stomach ulcers), to be treated in such a derogatory manner, coupled with the Neurontin and Lyrica became too much.

The love of my life attempted suicide in a last ditch effort to stop her suffering. She will survive….today. However her blood pressure is incredibly high, as is her heart rate. Her kidney function is so poor she may need dialysis. She is requesting to be DNR. And even now, the doctors are refusing to give her pain medication.

Chronic pain does kill. It has destroyed the beautiful woman who I love so much. It has killed us financially. It has ruined my children’s lives. It has destroyed our faith in the medical profession.

Please, don’t let this happen to another family. Please allow doctors to treat all pain patients with what works for them, including the option of opiods.

I thank you for your time.

Pain is an illusion?

One of the treatments that pain patients are likely to be offered during the opioid war is pain education. I would never pay for something that I can get for free on the internet (thanks, TED Talks):

Experts believe that if pain patients learn about how the brain works when it’s dealing with pain, it will help us to better manage it.

I’m all for patient education — you can’t make good choices without it. And this video is entertaining and uses symbolism to describe how it all works, without all those big medical terms that us patients can’t understand. (Yes, it feels like he’s talking down to me… just a little.)

Dr. Moseley uses the term “meaning,” which I take to mean our “perception” of pain. He goes on to try to convince the audience that “pain is an illusion 100% of the time.”

Dr. Moseley shows us an optical illusion, and I guess we’re supposed to jump to the conclusion that we should manage pain by convincing ourselves that the pain is just all part of some grand illusion. Our brains are trying to fool us, you see. The lesson being, if you can convince yourself that you’re not really in pain — Viola! The pain will disappear! I’m thinking it’s almost the same talk about chronic pain that Dr. Clauw gave in that video I posted yesterday, just a little more entertaining.

I think educating myself about the brain and pain has helped me make better decisions, but I would never say that this information has allowed me to better manage my pain. Knowing how amazing the brain is has not helped me at all…

Well, I guess educating myself has helped me to let go of doctors and the medical industry — an addiction that was extremely hard to break. (Doctors suck.)

The Curse of Thinking Too Much

“I think I think too much.” Crackerman, Stone Temple Pilots

I’ve often thought that I think too much, but as I sit here thinking about thinking too much, I have to wonder — how often are we supposed to think? Aren’t we always thinking? Aren’t our brains always working? Even when we sleep?

Just thinking about thinking is… (heavy sigh)… exhausting. 🙂

I had to drag my ass down to the DMV today to get my license tags renewed. When I lived in Texas, you had to renew your license tags (through the mail), but you also had to get your car inspected (which included an emissions test). In New Mexico, I had to pay about $26 for an emissions test, plus $60 at the DMV for the license tags. (It would have been $110 for two years… not much of a savings.) The trip took a couple of hours, but since I thought it would take longer (and since Bud was waiting for me at home), the experience wasn’t too bad.

It’s a cloudy day:

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Not good for taking pictures when you’re stuck at long red lights. But as I was driving around, my boredom caused me to start checking out other cars to see if their license tags were up to date.

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You can’t even see the tag on this Benz. But really, it’s hard to see the tags at all — they’re too small. I was wondering if the police in Albuquerque had a habit of giving tickets for expired tags, so I asked the guy at Jiffy Lube, who said, not so much.

I asked the lady at the DMV why I didn’t get a notice in the mail about the expiration of my tags, and she told me that they used to send out “courtesy notices,” but not anymore. Good to know.

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This Ford has an expired temporary plate from Colorado, but I was curious about the meaning of this:

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What was built without our tax dollars? The car? The Ford dealership? Considering the tax benefits that corporations get from cities and states, it’s hard to say anything is built without tax dollars. Today, I paid about $90 in taxes (I mean, fees, which is the same thing).

Then I spotted this sign:

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I guess this is how they do public announcements in Albuquerque, but I haven’t noticed this sign before, and since it’s out of date anyway, what’s it still doing there?

During one of the long red lights coming home, I spotted some graffiti:

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What do you think this dude is trying to say? I was here? Yeah, dude, we’re all here — is that all you have to say? Freaking kids, get off my lawn!

And this is what happens when you think too much. 🙂

Kratom

http://www.nytimes.com/2016/01/03/us/kratom-an-addicts-alternative-is-found-to-be-addictive-itself.html?_r=0

Some users embrace kratom as a natural painkiller and benign substitute for more dangerous substances that, in most states, is legal…

Concern is particularly high in South Florida, where a rising concentration of drug-treatment providers has coincided with the sprouting of kratom bars. But kratom is now available around the country. Powdered forms of the leaf are sold at head shops and gas-station convenience stores and on the Internet. Bars have recently opened in Colorado, New York, North Carolina and other states where customers nurse brewed varieties, varying in strength, from plastic bottles that resemble those for fruit juice.

Kratom exists in a kind of legal purgatory. Because it is categorized as a botanic dietary supplement, the Food and Drug Administration cannot restrict its sale unless it is proved unsafe or producers claim that it treats a medical condition…

The Drug Enforcement Administration has listed kratom as a “drug of concern” but not a controlled substance, which would require proven health risks and abuse potential. Indiana, Tennessee, Vermont and Wyoming have banned it on their own; several other states, including Florida and New Jersey, have set aside similar bills until more is known about kratom’s health risks. The Army has forbidden its use by soldiers…

Some kratom advocates claim that it helped wean them from stronger and more dangerous opiates. Susan Ash of Norfolk, Va., said she had taken kratom during treatment for dependence on prescription painkillers, and now uses a small amount daily for chronic pain and depression. Last year, she founded the American Kratom Association, a consumer group of more than 2,000 members that lobbies against state bills to ban the substance…