Monday, October 6, 2008

A Very Bad Day


I am very cranky today. It has been a very emotional day and I cried and I've already stated how I feel about that, so I have a horrible headache, I've had a fight with my husband, I got some frustrating medical news and I am EXTREMELY cranky. So please forgive me ahead of time for being direct.

If I hear one more person say to me that their doctor got them hooked on pain meds I am going to scream. Where was the gun to their heads making them take more meds than directed. I am sorry and I know addiction is a disease, but there is only one person to blame and that is the addicts. There are compassionate doctors out there that know that the only thing available to give a patient a remotely "normal and productive" life is with pain meds. More often is the case that the DEA has made it so difficult for a patient that suffers from chronic or intractable pain to get anything, let alone an adequate amount of pain meds, to properly manage their pain. So many doctors have stopped prescribing pain meds instead deferring to pain management docs so they can have nothing to with it. I love it when I hear that a person's doc denied giving them pain meds because they said they couldn't prescribe pain meds anymore. That is a lie to get out of prescribing. Yes their have been a few docs who have lost their prescribing privileges, but if they are still practicing medicine and they prescribe other meds like diabetes meds, blood pressure meds etc., they can prescribe narcotics.

The hoops pain patients have to jump through in order to get pain meds is ridiculous, and this is all thanks to the people who have abused the system, the docs and whoever else in order to get high. As a ill and disabled person, it is difficult for many chronic and intractable pain patients to go out. Most of us used to be able to go to their pain doc for follow-up appointments once every 3 months if they was stable on what they was taking which for most people was most of the time. Now thanks to the current situation, we must go every month. In order to be put on these meds, we must sign pain contracts which depending on the doc can have numerable rules such as not getting pain meds from any other doc, agreeing to surprise urine tests, pill counts, some have rules about a patient not allowed to go to the ER if they are going for the issue their pain doc is. We must go to the same pharmacist every time, and if they have forgotten to order my meds, I have 2 choices, go without until the order comes in, or if they have some of the med, they can do a partial fill. The problem with that is if they do a partial fill, I cannot get the rest of the medication. That is the law. Some pharmacist still do partial refills and then give the rest when it comes in, but many others do not. Some pharmacies have decided not to keep these kind of meds in stock so if this is your first prescription or your doc changes your med or dose, it can be difficult to find a pharmacy. Again, some docs only give 30 day supplies and you cannot get your refill until you are completely out. In those cases, you are SOL if for whatever reason you cannot go that very day. What if there is a hurricane or something? I live in Florida, so that is a legitimate concern.

By being on pain meds, we have the privilege of being treated like a drug seeker from other docs, pa's, nurses, office staff, pharmacists and pharm.techs. If we have to go to the emergency room for anything that is painful, we can almost predict that once they see the meds we take they will automatically assume we are drug seeking and anything else we say from that point on is in one ear and out the other. With my illness, I get chronic kidney stones and years ago my husband was working and I went to the ER by myself with a stone. I was in agony and watched them call everyone else in but me, I knew something was up when they called the kid with a cut on his finger in before me. Not only was I in horrendous pain, but hurt from being treated that way(to be fair, I have also had excellent care from hospitals).

If we drive and are in an accident, we can be charged with dui, although most of us drive better with our pain under control. If anything there should be a DWIP or driving while in pain. If you doubt me, the next time you have a migraine, or kidney stone or are in active labor, get behind the wheel and see how well you can concentrate. I AM NOT ADVOCATING THIS, IT WAS SAID TO MAKE A POINT!

If you are on pain meds, don't plan on going on vacation, or make sure you plan on working around your meds. Most insurance companies allow early refills once or twice a year for vacations. If you are on a schedule II, that may not be the case. Many insurance's do not allow that for schedule II narcotics and plan on being an expert in math if you still want to go because there is a formula they use to figure how many meds they can give you ahead of your scheduled refill.

I have probably missed a bunch, but you get the gist. Try pulling this on patients who get other type of meds and you would have a revolt. But to get the meds we need to live a somewhat productive life, we do these things. What we don't need is addicts making this process anymore difficult than it already is. And to blame the doc for your addiction is tantamount to blaming the credit card companies for your debt, when you were the one charging them up. Yes we get a tolerance to the meds and will need a taper plan when or if the time ever came to stop taking them, but many meds that are not narcotic need a taper plan to come off of them and it's not an issue because you are not mentally addicted. If someone is freaking about coming off of a pain med, they are addicted. Most of us take them because we HAVE to and dream of the day to not need them anymore. Unfortunately many of us will have to be on them for the rest of our lives.

We need more compassionate doctors who are not afraid to treat pain just as aggressively as they treat other disorders. Pain meds by their nature must be respected and followed diligently, but for so many people they are a safe and effective way to manage otherwise debilitating 24/7 pain. The only person to blame when someone gets addicted is that person. And until they can acknowledge that, they will continue to struggle with their addiction. I know it's so much easier to blame everyone else for our problems, but as the saying goes"when you are pointing the finger at someone else, there is 3 more pointing back at you. I know addicts destroy their own lives as well as their families, but it has so much more far reaching consequences than that. If they cannot quit for their families, how can I ask them to stop for someone they have never met? But I have to try.

Sorry to rant. I got some health news today that as usual is confusing with no clear cut answer. I will elaborate more when I know more, but the more time goes by, the more areas this disease invades. When or where does it end? Hhhmmn, I might not want to know the answer to that!

Good night!
Melissa

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