Warning! This post is filled with curse words and otherwise offensive content.
So my landlord decided to not let us renew our lease, because apparently we were supposed to read her mind and just know the exact level of anal retentiveness she expected with regards to the yards, because tenants are defactor landscapers or something, and even though the only thing she expressed was to water and mow the lawns, which we’ve done, and apparently that wasn’t good enough, not that we had any warning regarding this complete and total lack of proper communication on her part. We’re broke as shit and have 2 months to find a new place, and since my diagnosis we’ve been evicted and filed bankruptcy, which means that if we’re going to find a landlord willing to take us (and almost undoubtedly said landlord will have to be the caliber of crazy as the current one, because that’s just my luck), and the only place to find such rentals is Craigslist. So, apparently in Denver and LA I now know for certain, at least 90% of the ads on craigslist for rentals are actually scams. In Phoenix, almost zero housing scams, and you’d think it’s because Phoenix is so shitty that no one would possibly want to live there, but eerily it’s the opposite. Phoenix was growing so quickly that the housing market decided to try to get ahead of the population boom so they built houses like gangbusters, and since everyone and they’s mama’s dog could get housing loans back then, they were snatching them up quicker than they could build them for a while, (some of them even smart enough to sell their crappy old house in the ghetto for 2 or 3 times its value to buy a nice new one not in the ghetto…but not many people were that smart), which brought even MORE developers and more new houses being built, but they literally couldn’t build them fast enough so then like a totes redique number of apartment complexes, no matter how shitty or how ghetto the neighborhood decided screw this rent noise, let’s just turn them into condos and sell them! Unfortunately for them, not a lot of people were willing to buy a shitass 1 bdrm apartment for $150,000, so they were just having to keep a bunch of them vacant because they had them slated to sell, some kind of bullshit city tax business. So anyway, it was pretty hard finding an apartment there for a while but fortunately I lived in LA where finding an apartment is fairly easy if you’ve got about $2k/mo to devote to rent and don’t mind a 2hr commute one way (and if you think you’re getting bent over a barrel by the rent, wait til they tell you that you have to buy your own fridge).
Anyway, housing bubble burst, tons of people in Phoenix lost their brand new houses and anyone with a house lost a whooole lot of equity overnight so they weren’t about to leave. With all the empty houses people just started renting them out and all the sad families who lost their houses happily moved into a brand new rental house that their kids could destroy to their little hearts’ content and the parents would only be out a stupid deposit, so big win win there. Meanwhile…still no one bought any condos, and by the time they converted them back from condos to regular rentals, they pretty much had to lower their standards because everyone was in foreclosure and bankruptcy. Unfortunately this meant they still could jack up their prices, because people gotta live somewhere. Fortunately though, Phoenix rent was never too high to begin with. And, still and yet, it’s damn easy to find a place to live there, even with bad credit.
In LA, there are scams because of the aforementioned totes redique rental prices, so they post something in a so so neighborhood with plausibly lowish rent and scam away. I’m sure they have many many marks, because LA people think they’re savvy, but most of them have their heads so far up their asses it’s a bit difficult to be anything but a goddamn, shit eating moron.
Turns out in Denver, the population is also exploding, lucky me, only Denver’s all like “if we build too many houses and apartments it’ll like, ruin the natural splendor, man. *puff puff*”, and nearby Boulder is all like, “If we build too many houses and apartments it’ll like, feed all them corporate interests, man. *puff puff* Worker’s of the World, unite!” Or is it Dyslexics of the World, Untie!… Anyway, additionally, the population of both cities is exploding with: college students, young professionals, young professionals by day and stupid hipsters by night, and at least 2/3 of those groups have money, little to no debt, and I’d be willing to bet actual money that nearly 100% of them got no kids. So they can afford whatever dumb hipster apartment or house they’d likely tell their friends is “clutch” or “dope”, both words that in no way describe a domicile, but sadly I’ve heard them both used in such a context and can only assume it means…Good?
Anyway so, not enough places, too many people, and I think we may literally be moving into a basement next month, and we’ll be damn lucky to get that much.
But wait! Despite all of this, something made apartment/house hunting totally worthwhile today. One of the scams claimed that the house had a fantastic ocean view. And as if that’s not hilarious enough, after laughing so hard I nearly threw up, I managed to say (between giggles and chuckles), “A view so fantastic it can only be found in…The Twilight Zone.” At that point I was feeling about ready to stop trying to kill myself slowly with cigarettes, and instead much more quickly (albeit painfully) by setting myself on fire. So, scammers helped me avoid a wickedly painful demise today.
And if you’re wondering why I keep saying “totes redique”, I saw that on FB today and thought it was…totally rediculous. I unfriended that person. Not so much about the ” totes redique”, more because I never talk to that person and figured now is as good a time as any.
So, I realized this morning that it’s been too long since I’ve written anything here. My reasons for that are both good and terrible. Short answer, I got a new phone. That may sound like a ridiculous reason to stop posting, but hear me out! On my old phone, I had links to my WordPress account saved in my bookmarks, I click one, it automatically logs me in. Ta da! Technology at its finest. When I got my new phone I was standing at the counter at the phone store and the guy tells me to back up all my info, reset the phone and remove my sd card. Oh no! Backing up my info is something I should’ve done last night! So I quickly did a backup of everything I thought was important, pictures on the SD card, check! Contacts all conveniently attached to a Gmail address, check! Bookmarks attached to Chrome, check! Without thinking to myself, I didn’t always use Chrome. I had manymanymany bookmarks still listed under the Android browser. But, I have MS, my brain doesn’t process as quickly or clearly as it used to. I honestly didn’t even think of all those bookmarks to research I was conducting, and to important sites like, yep, my WordPress account.
The aforementioned inability to process as quickly or clearly as I used to, plus my swiftly waning superpower of remembering everything, it was literally a case of out of sight, out of mind. Without the helpful bookmarks that would magically transport me through cyberspace and automatically log me into my WordPress account, I literally forgot that I had one. Of course, I’m a dead brain walking, so cut me some slack.
So. After several weeks the little hamster in my brain woke up and slowly and rotundly began ambling along in his wheel, and a couple of lights flickered on and off in there, and eventually I realized, egads! It’s been ages since I posted to the blog that I suddenly remembered that I have! I’ve got so much research that I’d planned on writing about and it’s all right here in my bookmar…oh. Those bookmarks have long since disappeared into the aether.
Another few weeks went by, and occasionally I’d kick that fat, lazy hamster in the ass and tell him, run damn you! I know there are ideas in this damaged brain of mine, I need more power to light the dusty and disorganized mental file room! The fat little hamster just ambled slowly along in his squeaky wheel, and the lights flickered on and off some more. Having no idea of what I should research for my next article, I opted to watch more Netflix.
But then this morning, after waking in tremendous pain, and while reaching for my glasses so that I could take some medication and get up and stretch, I instead knocked my glasses onto the floor. Finding and picking things up off the floor is not my forte if I CAN see. Oh, if only you could see me struggle to first get down on the floor, then after some short while of searching I either find what I’m searching for, or decide that being on the floor is entirely too painful, then struggle with much straining and shaking of unused muscles, a behemoth struggling against both the forces of gravity and inertia, slowly and unsteadily amidst a cacophony of moans, grunts, and cursing at the gods I eventually rise. Upon standing (if you could call the hunched and uneven posture of pain and disappointment to be a standing position), I mentally, but certainly not physically, throw my arms into the air in the classic Rocky pose of triumph, then swiftly collapse onto the bed to recover from my ordeal. This, all on a good day.
However, today, since it was pain that woke me in the first place, and since it was my my glasses that I needed to retrieve, I decided to err on the side of caution. I figured I was likely to find myself stuck on the floor, and even more likely to break the glasses I was trying to find. Guess what happened to the last pair of glasses I couldn’t find on the floor, may they rest in peace. So…this morning I decided to reach down and feel around on the floor for them. Of course, this particular pair of frames are brown on top and clear on the bottom, and my vision is very swiftly waning, having jumped a full -2 points in less than 6 months time, (thank the lord that there are multiple sites from which I’m able to order extremely reasonably priced frames and lenses, however, I still spend more on the lenses than on the frames, anti-glare coating and shipping alone), but point being, I cartainly couldn’t SEE the glasses on the floor, and needing two hands for my divining rods, but only able to reach one from the bed to the floor, I proceeded to feel my way along every surface, examine everything that came into contact with my hand, and the longer I laid there, half hanging off the bed, arm extended to its furthest reach, muscles screaming in protest, I found myself cursing under my breath, apparently more forcefully than I realized, because the husband I was trying not to wake at 6am murmured resignedly, “What did you drop?” Well, too late, he was already awake, so in comes the cavalry! Two seconds later, glasses in hand, I heaved myself from the bed and decided to sit outside, watch the sunrise, and wait for the bulk of my aches and pain to subside. It’s been an hour and I’m sad to report, “No change! No change at all!” Soon the hideous doctors are going to send in an equally gimpy representative from the colony of gimps where I will henceforth be secreted away. (Not those kind of gimps! Get your mind out of the gutter…)
So, sitting outside, trying to enjoy the sunrise and ignore the screaming pain thundering throughout my body, the fat and lazy hamster who keeps my dying brain in working order woke up, climbed into his wheel, and ran for all he was worth! Lights came on all over the place! My brain shouted: WordPress blog, time to write! But then the lazy hamster ran out of breath and went back to sleep. I had no ideas for what I might research and what I might write about, but those ideas slipped off into the aether and joined my lost bookmarks.
Still, I would not be deterred! No! I was going to make an effort to make a blog post, and nothing short of death or a narcoleptic sleeping fugue would stop me!
First order of business, login! Soo…what was my password again? Twenty minutes and several tries later, eureka! Then I began to write, and that brings us up to this very moment. We are now all on the same page, provided I haven’t already bored or scared off anyone. Maybe you are my one remaining faithful reader. That’s right…YOU! Right there. Thanks for hanging in there. 🙂
There will be more to come; soon I hope. In the meantime, if you have any questions about MS, psychology, chronic pain, or even life, the universe, and everything, feel free to ask. You may leave any questions in the comments section. This will help me out, as I lost all of my previous research, and even if I don’t know the answer to your question, I do love a good research project. 😀 Just…nothing math related, please. Math has never been my forte, and now so much more difficult due to my lack of cognitive abilities and memory loss. But, anything besides math, I’m all ears. Er, eyes. 😉
(Written but not dictated nor read. 03/10/2015)
I’d say, overall, it wasn’t a bad year for my first public blog. Haven’t posted much in a while as much craziness abounded. My house flooded twice. I’ve been to the hospital a couple times, and otherwise my health has been precarious, especially after a very long drive to east Texas and back. I went a full month without any pain meds, thanks much to the DEA for making sure the pharmacy can’t stock enough to fill demand. Then finally, I’ve moved from the hovel I was renting that seems to think rain goes into the house, not outside. Soo…it’s been a hellish few months, but I’m hoping next year to get back on track and start posting answers to any questions you might have about MS, psychology, and life, the universe and everything. 🙂 Have a happy new year everyone!
The WordPress.com stats helper monkeys prepared a 2014 annual report for this blog.
Here's an excerpt:
A San Francisco cable car holds 60 people. This blog was viewed about 350 times in 2014. If it were a cable car, it would take about 6 trips to carry that many people.
So…site (to remain anonymous, but suffice to say it is a reputable and nationally read news publication), tells me I must register to comment on an article. Fill out the registration form, it says I’m already registered. I try to log in but cannot remember password, so click and fill out password retrieval protocols, site emails me a link, click link, redirects back to site and reset password, successfully log in. Now site tells me in order to comment on article I must confirm email address. In order to do this I’m asked to fill in a form which will generate a link sent to my email which I must click and will redirect me back to the site. Didn’t I just do that? Whatever. Click and fill out email confirmation protocols, site emails me a link, click link, redirects back to site AGAIN aaand email address confirmed! Go back to original article only to discover…all comments gone. Only a heading stating “Comments”, poised over a blank white space that used to house a comment box and many comments. Refresh…still no comments. Grr.
Open different browser, return to site and see comments! Hooray! But wait, site tells me I must log in to post comments. Crap! Log in to site and…all comments gone again.
Is this some kind of non-hilarious programmer’s joke? I did see people had commented so apparently there is some form of magic at work here of which I’m unfamiliar. Secret e-handshake? Incantation? Sacrifice an e-chicken to the internet gods?
Needless to say, my comment was not added to the mindless rabble which had so infuriated me in the first place, sparking my need to add my nickel’s worth of free information to the mix. I suppose, in the grand scheme of things, it’s probably for the best. I really should just stick to utilizing my own blog as a means for disseminating whatever idiotic crap I feel like sharing with the interwebs.
I hope you enjoyed today’s installment of Typhany’s Rants and Ravings. And now a word from our sponsors…
I’m saddened and chagrined that I have to revisit this topic so soon, but apparently the state of Massachusetts is making efforts to ban Zohydro in their state, regardless of the fact that the FDA determined it safe enough for the country at large to use. Now typically I’m a big fan of states’ rights, and not particularly a huge fan of the FDA in general, but if I remember my US government classes sufficiently, (and it’s quite possible I don’t, I do have the brain lesions), all state law is pursuant to federal mandate. That’s why states ultimately have to concede to constitutional edict. But, Massachusetts is so afraid of people possibly misusing a pain medication that hasn’t even hit the market yet that they want to try to supersede the Feds. Fortunately, for the time being, their ban has been reversed. (1)
The sticking point that keeps being cited in these articles seems to be that Zohydro has no acetaminophen, which they believe acts as a deterrent to addicts. Their primary concern is that addicts will overdose on Zohydro and die. So…since when has acetaminophen been safe? It’s not as if people don’t die from tylenol overdose far too often, and the reason being that many people don’t realize just how harmful that medication is, and it can be purchased over the counter in 500mg pills in bulk sized containers. You don’t see Massachusetts, or any other state, banning acetaminophen, or even trying to create barriers to its purchase as has been done all across the country with opioids. No one has their hackles raised about the dangers of acetaminophen because there are no addicts seeking it, only people who are trying to relieve pain…so here is the true crux of the problem. Opioids are fun! Right? People take them to get high. They’re not reeally trying to relieve their daily, incessant, mind numbing pain, they’re just looking for a fix. No one has sympathy for an addict, even if that person’s chemical dependency exists only because they have to take daily pain medication to ease their suffering. People are actually UPSET that a dangerous substance is not being added to Zohydro, “to act as a deterrent”, nevermind that it’s slowly killing the livers of pain patients, and could very quickly kill the liver of an addict because it’s not as if they’re keeping track of how much acetaminophen they’ve ingested. And as it turns out, there are more accidental acetaminophen related overdoses due to their inclusion in hydrocodone products than for any other reason, because often the physician prescribes maximum, or even GREATER than maximum daily acetaminophen dosage with hydrocodone, so all it takes is for that patient to take another combo drug with acetaminophen (like Nyquil), and they wind up in the hospital with liver damage. (2)
The makers of Zohydro have proposed adding niacin to their medication to act as a deterrent. This would be safe to anyone who uses it correctly or incorrectly, but to those who choose to abuse the drug to get high, they will have one nasty experience. Anyone who has experienced niacin flush can attest to that, and it would certainly make them think twice about abusing their medication again. Still, people are not mollified. (3)
I can’t stress this enough and I’ll say it over and over again, the best thing that can be done for pain patients everywhere that isn’t being done is to provide education. People don’t understand how opioid medications work, they don’t understand chemical dependence or withdrawal, they don’t understand the ratchet effect with regards to tolerance. I’ve known many people who were placed on high doses of pain meds following a surgery or medical procedure and didn’t have any idea what to expect, how best to take their medications, how or when to discontinue them, and they weren’t properly titrated off of them even though they were on them long enough to develop a dependence, because their doctor decided that they weren’t in pain anymore so they didn’t NEED them, and they just had to sweat out the withdrawal. How does any of this make any sense? Some people who are on pain management are told that they absolutely must take their full dose of prescribed pain meds every day, because the doctor fears that they will overdose and their solution is to keep them on a very high maintenance dose, the dose they’d need for their worst pain days, and take that dosage even on days when they have little to no pain, pushing their tolerance so high that when their worst pain days hit the medication is no longer effective and they have to ratchet it up yet again. How does this make any sense at all? People’s hypervigilance is causing them to enact bizarre treatment decisions. The state of pain management in this country is a sorry affair. No one should have to suffer. Educate them. Tell them what they need to know about their treatment. Every person should be an expert regarding their own disorders and treatment options, and any doctor who becomes angry because a person spends time and energy researching their own health issues is not a good doctor. Forced random UAs and physical prescriptions are not going to help anybody, but education and understanding will. It’s quite possible that some people might opt to not use opioids after they understand how they work, and that would be their decision, but it’d be an informed decision. It’s better than having someone say, “Take these pills, take them exactly as prescribed. Good luck!”
I hate the term “privilege”. I’ve seen this term pop up so frequently recently, and I fully understand what it’s supposed to convey, but to me it seems to carry a very negative connotation, and apparently I’m not the only one. An article was written recently on Everyday Feminism to help people not guilt themselves about their own privilege. Apparently people are wandering the country with privilege guilt, feeling bad for being born into a real or perceived higher status in life. Within this article is a particularly sickening quote: “When spaces are open to those striving to be allies (keep in mind that not all spaces will or should welcome people of privilege), show up.” So basically, people of “privilege” are expected to be discriminated against, and somehow that’s okay. From the same website, another article tells us that while it’s okay to want to remain in touch with our European heritage, and that not all white people are bad, whiteness itself, in fact, inherently is. I find these statements amusing and unsettling. Much of my “European heritage” is Jewish. Does that absolve me of this privilege guilt that’s supposed to weigh heavy on my heart? Or am I supposed to do as these articles state and get in touch with my roots in a positive manner, understand my privileged place in society and use that to enact change? I have quite a diverse mix of ancestry, it’d take quite a lot of time to research all of that, keeping it all positive of course, reminding myself at every turn that whiteness is bad! Whiteness is bad! Then use my new found knowledge to help others who are less privileged than I? It just amazes me that a site that prides itself on being so open, inclusive, and anti-discriminatory would so blatantly socket so many people into a category of which they have no control, and is so broad stroked that you couldn’t possibly know for a fact who fits this category without an intimate look into their personal upbringing and experiences.
The idea of privilege is just too subjective, and it seems like it would be easy for some to make assumptions about another’s privilege without knowing enough about their background that I don’t feel comfortable applying the term to any person, creed, group, what have you, as we’re all individuals with vastly different backgrounds and coming from different places in life. When everyone is screaming that equality is so essential, why single out whole groups of people based on their gender, religion, sexual orientation and race and tell them that they must ADMIT to, even SUBMIT to, the fact that they’re perceived by other groups to have been dealt a better hand in life? It is discrimination come full circle, and I’ve never been willing or able to abide discrimination in any form.
As one with “privilege”, (being white apparently gives me privilege…but being a woman does not, and I suppose neither does being disabled, so do those two things cancel out my one privilege point?), I grew up dirt poor in an equally poor neighborhood being one of the few white children at a primarily Hispanic school, and had the misfortune of being painfully shy, nerdy and always at the top of my class. I got beat up by other kids on a regular basis and they expressed so much rage at my very existence. They accused me of incurring favor with the teachers, not receiving my high marks for actually doing well in class, but solely because I was white. As they stood around taunting me and kicking me with their high dollar, stylish LA Gear shoes, and I lay curled in a ball crying, wearing my sister’s too large hand-me-downs filled with holes that I’d poorly patched myself, I just didn’t understand. I was so completely colorblind as a child, in so many ways, and their rage at something about me that seemed so without grounds or merit was puzzling to say the least. I obviously knew that there was historical racial tension, but to my childhood mind that was a thing of the past. I didn’t have any comprehension of racial tensions, stereotypes, or the anger that these children presented to me. As far as I was concerned, we were all just kids. I wondered where these kids got the idea that my skin color gave me an advantage. As far as I knew, it was more likely my huge forehead, or rather the giant frontal lobe encased within, that gave me what was basically my only advantage at school. I certainly wasn’t any good at sports or fitting in and making friends. It’s tough to make friends with people who hate you simply because your skin color doesn’t match theirs.
When I was 13 I was outed by one of my closest friends at the time, because I confided in her that I felt more attraction to women sometimes than men, and even though at that point, as I told her, I wasn’t even sure what I was or who I was or what I liked, she took it upon herself to tell our entire circle of friends that I was gay. I didn’t realize the waves this would make with my classmates. I expected they’d be more understanding, and had no idea that being gay or bi would cause such a scandal. I was outright crucified for something that I didn’t even know for sure yet might grow to be a permanent part of my life. I was taught by my mother that being gay wasn’t a bad thing, that people are born that way, just as people are born hetero, and in my mind at that time I honestly thought that confiding in my friend was not a big deal. After all, being gay is normal, why would it be a bit of juicy gossip?
I got married very young, while still in college, because I thought that’s what people do, but maintained an open relationship because being bi and monogamous with a man was never going to work for me. Because of my experiences, I applied to volunteer at the LGBT center near my college to work with teens, remembering how painful and scary my surprise outing was, and how confused I had been with regards to my sexuality. I was none too politely declined because they stated that, being a married woman, I’d have little experience with “alternative lifestyles”. I was beyond hurt by their remarks. I explained my history to them, but apparently I was still too mainstream to be of any use to needy teens who may benefit from someone who might understand them. So it seems that I do both have privilege and don’t, and those people who should be most open minded about the state of my privilege or lack thereof are the first people willing to judge me based more on what they perceive that I have, rather than on the struggles I’ve dealt with that make me such an oddball and so likely to be cast out by “privileged” society members.
It’s just too easy for someone to make assumptions about another person’s place in society. We’re such complicated creatures. Some things may seem inarguable, that yes men get paid more in the workforce overall, and that yes in general western culture is heteronormative and cisgendered, but that doesn’t necessarily mean that each and every person from that pool of people does, or is able, to reap the benefits of these skewed standards, and it doesn’t mean that people outside of those circles cannot find their own niches in which they’re able to flourish and compete on an even footing, and it certainly doesn’t mean that the “privileged” members of society are so high up on their ivory towers that they can’t possibly grasp or engage in the struggles of others. Pain is universal, and empathy is a natural reaction for most people.
The social services industry is dominated by female workers, even to the highest levels of management. Payscales at many of the organizations where I worked were preset, if you got the job you got paid for that job, same starting salaries for each position across the board, and if any of us were ever lucky enough to get a raise, which would occurred if the budget allowed and we weren’t on a corrective action plan at the time of our annual assessment, those were all scheduled in advance and given to each of us in the exact same increments, regardless of race, religion, sexual orientation, facial piercings and etc. If I was still able to work, I could still be climbing that career ladder if I so desired. One thing I absolutely loved about working there is that no one was ever discriminated against for their tattoos or piercings, and I worked alongside many members of the LGBT community at all levels, from entry level to upper management. I was treated with just as much respect as the next person, regardless of my mods or sexual identity. So despite people’s insistence that one may be given a better footing as a white male, I’ve worked in at least one industry where this rule of thumb doesn’t apply.
I’m certainly not saying the world is a perfect place, I’m just saying that when we stress that we should make efforts to be mindful of our language and our approach to how we treat people of different backgrounds and affiliations, it’s important to be mindful of ALL of it, and the idea of being a person of privilege implies across the board that that person has something more or better than the rest of us, and from my standpoint, I find that hurtful both as one who would be deemed with privilege, and without.
By accusing someone of having privilege they’re being set aside as different, as unable to understand another’s struggle, as being above any possible personal struggle or status that may make their lives more difficult simply by being who they are. Isn’t that exactly what making them “privileged” society members does to them? It sets them aside as a group to be hated, despised, avoided, and on whom we can place all manner of blame. Isn’t that the exact kind of discrimination we’re trying to avoid?
Despite all my hard work in school I had very few opportunities for scholarships or grants, those being reserved for, not just underprivileged kids, but underprivileged MINORITY kids. I’ve had difficulty finding jobs due to being monolingual. I even had to fight tooth and nail to get promotions in some workplaces for which I was more than qualified simply because I was deemed too young at the time. Within each group, and each subgroup, there will always be barriers, there will always be those who incur favor, there will always be, in one manner or another, inequality, because humans are, after all, only human. Flawed creatures. Prone to creating and staying within niches and protecting their own. Do we really have to create another group to be angry with? Do we really have to build more barriers?
Perhaps those people who are so keen on breaking down preexisting barriers should make more efforts to not build more, to include those who are different as they would like to be included, rather than make as much effort as possible to make them feel guilt, or at least feel keenly aware, of things beyond their control, particularly who they are and where they came from. They would never stand for being made to feel guilt about such things in themselves, why go to such lengths to put that burden on others?
In fact, why don’t we all just sit down and have a freak out about pain medication, in general. After all, it is an “epidemic”. It’s an all out free for all out there. People just scarfing down pills for no reason at all OD’ing left and right, and no one to blame but that goddamn Big Pharma trying to make a buck off all those poor souls who have no control over themselves, right?
Well, let’s try this again, only with a little logic thrown in just for the fun of it.
There are people out there with legitimate pain needs, and there are people without. There’s no test for pain, only self report, and the one they use is pretty damn subjective. “On a scale of 1 to 10, 10 being the worst pain you’ve ever felt in your life, rate your current pain.” Well what’s the worst pain a person may have ever felt in their life? That all depends on A) their experiences, and B) their pain tolerance. So what could be the worst pain? Childbirth? Breaking a bone? Losing a limb? Ruptured disk? Ruptured appendix? And once having experienced this severe and awesome pain, doesn’t that sort of skew the curve? For me, I have many pains that others might consider unbearable. I have TWO ruptured disks, multiple sclerosis which causes quite a lot of painful symptoms, and my neurologist is pretty sure that much of my “MS” pain is actually the result of fibromyalgia, for which I’m scheduled to see a rheumatologist to determine whether this is the case. These are my day to day pains. One of the most painful things I ever experienced in my life was, when I was 12 years old my mom and I used to work summers cleaning an old couple’s house and one day a hot pot (which was a very old school model and was basically a big, metal, electric tea kettle that had been heating all day) fell onto my bare foot and was so hot it stuck to my skin and pulled quite a bit away with it when I kicked it off. I had no painkillers stronger than tylenol, it was the middle of the summer in Phoenix so at least 115° outside, there was no way to cool it off except my dad’s brilliant plan of putting it into a tub of icewater that was more ice than water. Then my parents loaded me up into our van (with no a/c) to take me home (where there was also no a/c) and stopped at the grocery store along the way to get some type of burn salve. I was left in the van in the heat, screaming in pain, with an ice pack, just some ice wrapped in a washcloth. By the time my parents returned 45 minutes later with a cart full of groceries and chicken from the deli the ice pack was bone dry and my foot felt like it was on fire. (Nice parenting skills, eh?) If I call that instance of pain, which was quite acute, a 10, that would make many of my day to day chronic pains fall somewhere in the 3-4 range. But it’s all relative. It doesn’t mean that those chronic pains aren’t quite painful and disruptive, only that in comparison to the worst pain in my life, they’re significantly less. If I drop out the “worst pain in my life” aspect, I live with a chronic pain aspect, day to day, that falls around the 7-8 level, and shoots up to 9-10 when the pain becomes more acute (say when my back or joints are flaring up). So, there’s really no easy way for any one person to even measure their own personal pain level, let alone the medical community measure and track the pain of patients by and large.
Still, they like to think that somehow they can, and they just love to postulate pain levels based on various illnesses and injuries and decide proper course of pain treatment accordingly. Nevermind other variables such as medication tolerance, pain tolerance (or intolerance), that make this particular “science” pretty much as individual and subjective as medicine can possibly get.
So we’ve got lots of people going into ERs, general practitioners and pain management clinics and complaining of chronic pain. Much of this pain is, to some extent, verifiable. There are MRIs to show disk degeneration, signs of arthritis, tests to be done that can reasonably prove to some Drs that a person suffers a pain related disorder like fibromyalgia, but there is little consensus as to what should be done from there.
In the past, (and I’m talking maybe 5-10 years ago, not the glory days of yore when Bayer produced heroin headache medicines or one could pick up any number of straight opiates, barbiturates or hallucinogens from the corner doctor/barber for whatever ailed them), Drs would decide whether a patient required long term pain management, would choose a medication, (quite frequently some form of hydrocodone), would increase the dosage until the person gave a thumbs up and they were good to go. They could call in new prescriptions to the pharmacy, could call in as many in advance as the Dr saw fit and prudent, and the patient could pay for as many advance prescriptions as they had on file. For a person with legitimate, chronic pain needs, this was great. They could work with their Dr to treat their pain as the responsible, intelligent adults that they were and there were no issues.
Unfortunately there’s this nasty little disease called ADDICTION. Addiction makes people do funny things. Many people abused this simple and easy system. A lot of people with legitimate pain concerns were lumped into a group with a very nasty title known as “med seekers”. Once one was labeled a med seeker, the chances of them having their chronic pain issues addressed suddenly became slim to none. People with legitimate pain found themselves pulling some of the tricks that addicts did. They did what was known as “hospital shopping” or “doctor shopping”, trying to find someone willing to write them a prescription, and sadly they looked just as desperate and needy as any addict who was doing the same because they WERE. For any person who doesn’t live with chronic pain it’s difficult to understand just how terrible life can get when every movement, every MOMENT, is a struggle. It’s a special kind of hell. Many Drs would kindly not even differentiate between an addict (and we’re talking about a person who is using these medications solely for the purposes of recreation, escapism, or physical need/craving), and a person in pain (seeking medication solely for the purposes of alleviating pain not caused by withdrawal symptoms). As far as they were concerned, if a person used pain medications long enough to develop chemical dependency, they were an addict plain and simple. And MANY people share this same view.
So before we get into how and why things have changed in the last several years with regards to pain management, let’s talk a little bit about addiction. The big scare drug that’s got everyone rattled right now is Zohydro. It’s a slow release hydrocodone. Everyone is calling it “the next Oxycontin” and they’re trying to say it as a means to frighten people, but from a medication perspective they’re not wrong. The only difference between oxycodone and oxycontin is that oxycontin is CONTINuous release. It’s a slow release form of oxycodone, so it comes in higher doses because it’s supposed to last for 12 hours, but this varies depending on the person’s pain level, their tolerance level, and how quickly they process out the medication. So, Zohydro is the equivalent form of hydrocodone. It’s a slow release tablet in a higher dosage so that it can last longer in the person’s system, giving them continuous pain relief. There are two major differences between the two sets of medication. One is that oxycontin pills are suspended in a gel making them difficult to crush, cut or chew. This helps ensure that the continuous release effect remains intact. Still, if one were able to crush and snort 20mg of oxycontin, it’s still basically 20mg of oxycodone. The continuous release aspect would no longer apply, but one could still conceivably crush and snort two 10mg oxycodones and get a similar effect. They do refer to oxycodone as “immediate release”, as opposed to “extended release”. The other major difference is that with hydrocodone, the regular tablets are paired with acetaminophen, which is Tylenol. Many people believe that this pairing is a deterrent to abuse, as acetaminophen overdoses are deadly. However, having worked as a substance abuse counselor for many years I can tell you, this is no kind of deterrent to an addict. They don’t care.
Addiction is a terrible thing, and by and large what I’m seeing in the articles proclaiming Zohydro to be the deadliest drug to date, people’s concern is that addicts will misuse and abuse the medication and do themselves harm, and they’re probably correct. Addiction (to substances) IS to misuse and abuse a substance without concern for one’s own personal welfare, without concern to risks to one’s interpersonal relationships, job/career, and/or ability to support oneself and conduct day to day activities. That’s it, in a nutshell. So if a person shows up to work high on pain pills and loses their job, they may have a problem. This is where things get a little fuzzy and the distinctions between a person who uses medication for pain relief and a person who abuses medication for other purposes get a little thin. The thing is, a person with legitimate pain issues is far less likely to develop long term, debilitating issues with their medications, provided they’re taking their meds to treat pain and for no other purpose. Not to unwind after a long day at work, not as a means to escape, but to treat pain and only treat pain. They’re less likely to take more than is necessary, less likely to form unhealthy habits surrounding the use of their meds, and will even have less issues with chemical dependency. This does not absolve them of all risks of chemical dependency, however. Opioids are among many medications that, when taken long term, require the dose to be titrated off, or tapered off, in order to discontinue taking them to avoid withdrawal symptoms. MANY medications have such dosing requirements, and you will often hear in commercials, or see in the dosing instructions of medications, “do NOT discontinue this medication without consulting your doctor”. That’s not a suggestion. The great thing about opioids, as opposed to many of these other medications is that they can’t kill you during withdrawal. You just feel like crap. Aaand…that’s probably the understatement of the year. Many people are under the mistaken impression that heroin withdrawal can be fatal. This is not true. Only two commonly abused substances are deadly during withdrawal phase and will warrant an immediate placement in a medically managed substance abuse facility. They are benzodiazapines, which are by prescription only (but are frequently sold on the street as well) and include such medicines as Xanax, Ativan and Klonipin. They are often prescribed to treat anxiety, but have many other applications. The other substance is alcohol. Good ole legal alcohol, and both can cause seizures and death during withdrawal. It’s certainly not something to be taken lightly. Withdrawal from opiates is definitely very uncomfortable, but not fatal. It can cause chills, sweats, nausea, vomiting, and diarrhea, and typically acute withdrawal lasts a few days to a week at most. However these side effects are so unpleasant that many people continue taking medication or enter into a methadone program to try to alleviate withdrawal symptoms to the best of their ability.
So this is where the line between addicts and pain patients may become fuzzy. Pain patients may find themselves taking a maintenance dose to avoid withdrawal symptoms. While they’re far less likely to develop unhealthy habits regarding their pain management, over the course of years of treatment their dosage may need to be adjusted to account for increases in tolerance to medication, increases in pain due to their condition, or generally lessened effectiveness of the medication over time. Coupled with chemical dependency and almost immediate withdrawal symptoms upon discontinuing the medication, they may continue to take a maintenance dose even on days when little to no pain is present. At this point, however, their tolerance is such that they’re likely no longer experiencing any of the “fun” side effects that others seek out when taking the medication recreationally.
From an addict’s perspective, this tolerance is the real, and literal, killer. It doesn’t take much to build a tolerance to these medications so for a person who is now taking a maintenance dose to avoid withdrawal, their tolerance continues to increase and in order to experience any recreational effects, if that’s their goal, they need to increase the dosage and/or change the route of administration. They may crush the pills and snort them, or inject them. This is one of the big sticking points for Zohydro madness. As stated earlier, Oxycontin is suspended in a solid gel to prevent people from crushing them and using them in this way. Zohydro currently has no such safety mechanism, although the maker’s have stated that they intend to lace the pills with Niacin to deter people from snorting or injecting them. Now, while acetaminophen would be a very poor deterrent, Niacin would likely be a very effective one. Anyone who’s experienced Niacin flush would not like to experience it again, and while addicts may skirt danger by taking too much acetaminophen, they certainly aren’t going to continue to try getting their high off a drug that essentially spoils their high with extremely uncomfortable side effects.
Still, people are unhappy with this solution and they have asked, who will receive Zohydro? The makers give examples such as a woman with metastatic breast cancer, or a man with 2 failed back surgeries and debilitating back pain. They say that’s all well and good but how long before people with arthritis, low back pain and fibromyalgia begin to receive it? No lie, I’ve seen these questions asked. And I say, why are the latter people’s pain less intense or debilitating than the former’s? What scale are they using to decide whose pain is worthy of a stronger medication? Do people with arthritis and fibromyalgia not suffer enough? Must a person with low back pain need also suffer failed back surgery before their pain is taken seriously?
There are many inherent risks to long term pain management through opioids. People with chronic pain should definitely be educated more strongly on the risks they face when they choose to embark on that journey, but right now, there are very few choices in long term pain management, and when you live with pain all day every day the risks start to seem less important if only you can get some relief.
When my back first started to deteriorate, before I’d gotten proper imaging and even knew what the problem was, I was back in my general practitioner’s office speaking to the physician’s assistant, barely able to stand, shaking with the amount of pain I was in, and practically begging her to help me. She looked at me so exasperated, chided me for having come in again, that it was the 5th time that year about the same problem! She threw her hands in the air and said, “well all I can do for you is prescribe you more pain meds!” I told her that if that’s all she could do, then do it! That if she had some other magic that could make this all go away I’d love to hear it, but if all she could do way prescribe me meds then prescribe them already! I wasn’t asking her to move mountains, just take the pain away. Which honestly, moving a mountain might be easier.
Today, everything has changed. The Feds have made certain that anyone on a schedule II medication (which includes oxycodone and oxycontin, and now will include hydrocodone and Zohydro), must have a physical prescription from the Dr and take it themselves to the pharmacy to be filled. For a person with chronic health issues that require such medications, this is no easy feat. But in order to protect all the addicts, we have to go through this charade. Before Zohydro hit the market, hydrocodone meds were schedule III, they could be called in to the pharmacy. In addition to this, while taking long term pain medications at a pain management clinic, I have to submit to random drug testing to ensure that I’m actually taking the medication I’m prescribed (not selling it), and that I’m not taking any other medications not prescribed to me or any illicit substances. The drug tests are not covered by my insurance, the Dr’s office, or the Feds, and they run upwards of $80 each. If I refuse the test, I don’t get my prescriptions. I also have to notify my Dr’s office if I ever fill my prescriptions at a different pharmacy, which happens often because the Feds have also limited the amount of pain meds any one pharmacy is allowed to carry. I often spend hours sitting in my car calling around to find out who has them, and it’s Walgreens’ policy to not give out that info over the phone, just in case I’m planning to rob the place, so since I don’t intend on driving to every Walgreens in a 50 mile radius, they’ve permanently lost my business. The Feds say this is all meant to “protect” the patient, but it’s really meant to prevent people from taking advantage of the system. They make no secret as to why they now hide all the pseudoephedrine behind the pharmacy counter, and I’ve picked up prescriptions for oxycodone AND oxycontin, while at the same time purchasing pseudoephedrine, and you know which one I had to sign a registry for? Not the scary opiates. I don’t know why they keep making claims of protecting people by making seriously ill folks have to jump through so many hoops just to be treated for pain.
There will always be addicts. Addiction is a disease, and people who suffer from it deserve to be treated for it, not shunned, blamed and cast aside, and those people who take their medications responsibly should not have to suffer the punishment that is meant to be incurred on these people.
One of the Drs who is vehemently trying to block the sale of Zohydro stated that the moment this medication reaches the public, people will die, and he’s probably right. There are loads of irresponsible people who couldn’t be bothered to educate themselves about their meds, or who are so deep in their addiction that they don’t care, and it’s unfortunate that this is the case, but it’s also unfortunate that there are so many people out there who are suffering BECAUSE of those people. Because those people are going to do what they’re going to do and everyone else has to suffer the consequences. Enough is enough.
If the Feds really cared about saving people from their addictions, they’d invest in sound, scientifically proven substance abuse treatment programs and help them, and just maybe they could invest in safer methods of long-term pain management. Their token gestures of imposing strict rules and sanctions feel like airline security protocols. They all LOOK like they’re doing something to keep us safe, but it’s just smoke and mirrors, just going through the motions so they can say they’ve satisfied CYA and so everyone else feels a bit more secure, when really their methods are little more effective than doing nothing at all.