It's not what you are eating, it's what's eating you…

Archive for the ‘severe chronic pain’ Category

How many MORE people are going to have to DIE , before we can talk about Opioid addiction and other addictions without STIGMA???

(Extremely important disclaimer: I’m NOT  a clinically trained professional. If you or someone you know is in acute medical or mental health crisis, PLEASE seek immediate/acute professional help, in an acute care facility.

Because this blog is about the fact that clinicians are only human and can be in crisis, too, this is WHY I’m pressing for honest dialogue in our society about the Opiate Epidemic and removing the stigma that exists that presents a barrier for so many people being able to get the help they need that hopefully, save their lives)

http://www.cnn.com/2017/5/24/us/drug-counselors-overdose/index.html

Most of my blogs, as of late, have had to do with the opioid epidemic. Some of the blogs, have been out of concern of the war on drugs, having a potential to harm those who use prescription opiates, responsibly, but as a last resort to treating severe chronic pain.

Some of them have included though, the very real crisis that we are in because of opioids both prescription and illegal opiates.

My very last blog (which was extremely wordy, even for me) , had to do with my getting labeled at a an appointment with a pain management specialist, who had labeled me, due to my mental health issues and that I had very temporarily abused opiates, both almost 9 years ago (for 5 days leading up to an intentional overdose with pain meds that had been prescribed for me) and almost 7 years ago for 2 days both situations involved both being in medical AND mental health crisis.

And I’ve discussed those issues ad nauseum, in previous blogs, quite a bit, since I’ve launched this blog, almost 4 years ago.

I also had mentioned in my last blog, that I had done an internet search on that physician, prior to that appointment almost 2 weeks ago and had found that pain management specialist I had seen, in addition to being “pro Butrans”, which I didn’t think was appropriate for me, neither did she, also had nearly had her own medical license suspended due to opioid addiction, less than 2 years ago. And had multiple conditions to be able to continue having her suspsension stayed, by not being able to prescribe controlled substances, let alone be in possession of them.

It was never my intent in my last blog to shame that provider. What I did find offensive, is my history being a barrier in my getting medical care, with bias, because I had been labeled PRIOR to ever being on opiates and as someone who has a very short history that I’m not usually believed by most providers, with temporary drug abuse, just because I have mental health issues and even BEFORE my mental health issues were diagnosed in my late 30’s, just because I was a bariatric surgical patient.

The above link on my blog, that I just came across tonight, was about 2 drug counselors in a addiction facility who overdosed on heroin/fentanyl combination in Pennsylvania on Monday.

I have never not known or acknowledged that the Opioid Epidemic, not only is a VERY real crisis, not just nationally but globally, but that clinically trained medical and mental health professionals, whether they are physicians, drug counselors or any kind of practicing clinician, also can be patients with the propensity to have serious addiction problems that can be fatal, just like to any other human being.

Also, I’ve said as a mental health activist who’s also written multiple blogs about murder/suicide, what I talk about is, NOT the means of how people choose to kill themselves and MURDER others , but the desire to kill to begin with.

It’s not to minimize when I bring up gun control initiatives when talking about that. I say, with being crystal clear, that I’m not a medically or mental health clinically trained professional and/or in public safety or law enforcement professional, that taking away the weapon of choice, isn’t getting to the heart of the matter, when it comes to these tragic deaths.

That if people want to kill, if they can’t get a gun, there are many other ways that they can and WILL find to kill people.

The same applies to drugs, when it comes to addiction. If people even start out honestly because of severe chronic pain or any kind of severe pain, such as surgical or due to an accident  and whether or not,  it becomes their gateway to drug addiction and/or they just go straight to illegal drugs for emotional and or mental health health pain and find a dealer, unfortunately, it’s not always predictable who will find themselves in crisis of life ruining, if not life ending consequences due to that addiction.

Or ANY type of addiction and that’s one of the  the points of this blog. If we can’t talk about the multiple ways and multi-faceted reasons that play into addiction, honestly without stigma, whether it be drugs, alcohol, tobacco, food, social media/internet/phone that present potential for abuse, addiction, the risk to public safety/personal health threats on humans and the fatalities that are occuring , we don’t have a prayer of reducing them.

It’s becoming obvious and it doesn’t take a clinically trained professional to state, that you can’t legistlate away addiction, it can make it only slightly harder to get drug of choice, it doesn’t take away the propensity for addiction, away.

Unfortunately, while it’s a lot easier to identify what barriers we are experiencing as a society when it comes to these threats, it’s a lot harder to find out what it’s going to take to make inroads in reducing addiction and both accidental and intentional overdoses.

But we  can’t just continue to believe it’s the epidemic itself, that’s killing so many people and/or ruining their lives.

Because the truth is, the STIGMA  and reluctance to have an open and honest dialogue is equally to blame.

This can’t continue to be a “don’t do drugs” or “ban all drugs” conversation, as prevention initiatives just aren’t working for so many. I’m in no way discounting them. They have value, it’s just not enough.

It has to become, why we are a globally, humans who can be prone to addictions of different natures that can be life ruining and life ending for almost anyone and everyone, which almost all of us, know someone who’s life has been ended too soon or ruined due to addiction, as well as loved ones who are effected by these crisies.

How many people are going to have to die, until the dialogues start and more initiatives are in place for study of, evaluation and better treatment options of disease of addiction themselves that don’t have the potential to lead to other addictions or other potential serious medical/mental health issues????

Note: I’m hoping this starts an honest dialogue to help. I always appreciate differing opinions if shared respectfully and responsibly.

Any comments that could be potentially triggering or are not constructive, will NOT published.

(Edit Note: Unfortunately, slight edits that were made before publishing didn’t take when blog was posted. It didn’t effect greatly my intention with this blog, just clarifying that I apologize that, it wasn’t as clear as intended it to be, from the start but also with the fact for new readers, I am a disabled blogger who writes about disabilities, in addition to topics like this one, that I feel passionately about)

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“MD-PTSD”….When doctors do more harm than help…

May is Mental Health Awareness Month, and I hoped that the next blog that I would write, would be in the realm of activism regarding mental health,  not talking about another devastating encounter with a new physician.

I admit that I  not an easy patient to treat. As I’ve said in previous blogs that my disabilities make it hard to express myself in logical sequence of order and in complete thought processes, which can make me difficult to understand.

It’s compounded a bazillion times, between anxiety, due to the fact I do have mental health issues, I have temporarily abused drugs, twice, in my life, that I’m quite forthcoming in this blog about that and the labeling I’ve experienced.

I had seen my long term PCP 2 weeks ago. Because we were at an impasse with my medication management, I had agreed to see a pain management specialist to give insight to the both of us, of what would be the best course of action.

As my physician didn’t feel comfortable increasing my dosages and I metabolize meds or have bad side effects to so many medications.

Or they just don’t work at all.

I was able to get into pain management today. I had anxiety of course, which I explained and it was hard for me to be concise.

While the pain management specialist was forthcoming about that she didn’t necessarily agree with my medication regimen, she didn’t agree or understand that after all the doctor visits I’ve had in my life, in the last 10 years between mental health and my gastric bypass complications, that I at this point didn’t want to see a bunch of doctors again and because of the severity of side effects from so many drugs, I didn’t want to try any new medications.

Nor did I want to be taken off the medications that I was currently on.

It was a long intake appointment with the understanding that while she didn’t agree with my being on opiates, that she’d leave that up to my long term PCP and she said, very clearly, that  she wouldn’t interfere with that.

So I did shoot off my prescribing physician, a few hours after I got home, a message of what transpired in my visit with her, while it was fresh in my mind, as I knew that it wasn’t a stellar visit for either one of us.  I detailed what she agreed with my physician, and of her urging me to be under the care of clinical mental health professionals and follow pain management modalities .

Unfortunately for me, I took her at her word that she said she would NOT interfere with my doctor continuing on my current medication regimen. That she appreciated as a pain management specialist, that I am concerned between having mental health issues, that I don’t want to have addiction issues and I would rather not be medicated at all for pain then risk addiction and becoming either a prescription drug addict or trying street drugs, something I’ve never done.

I try to treat myself, from a patient perspective, because I have an addictive personality and mental illness, of knowing that could be the case and it’s a mixed blessing that opiates don’t work as well as they should, because if they did, my circumstances could be a whole different story, and I’d have full blown addiction issues, which I don’t, but it’s nothing short of a miracle that I don’t.

Things that I’m completely honest about. Among other humiliating things in my life.

So imagine my surprise, after shooting my long term physician,  a recap of my visit, tonight, then deciding to check out my after visit summary from my appointment this afternoon, that not only did she think I was somewhat a mentally unstable non compliant  hypochondriac but that she was recommending I get taken off my medications.

Which is a complete contradiction and LIE, from with her at the end of my appointment clearly telling me that she would not interfere with my medication management being done by my long term provider.

Unfortunately for me, it’s my word against hers, a physician.

I’ve had doctors tell me, straight out,that they think I’m a drug addict. I’ve had ER docs when I’d be in the ER for my gastric bypass complications, at Fairview University Medical Center,  even bringing my meds and being compliant with controlled substances, having a ton of them, in their bottles, of them thinking I was drug seeking, when I wasn’t looking for drugs, but diagnostics such as with the pesky intractable projecile vomiting blood due to my ulcers both prior to gastric bypass reversal and after it.

Just based upon the fact I was a bariatric patient with my one and only suicide attempt, trying to use controlled substances to intentionally overdose, that’s explained on my 1st blog on here, in greater detail .

As well as being honest about an inability to be compliant on non controlled substances like ibuprofen (which I didn’t take much of prior to my gastric bypass reversal or of meds like Imitrex, PPIs, and meds in other therapy classes, other than controlled subtances, because I metabolize medications so bizarrely).

Which I’ve been quite forthcoming with providers as well on this blog. There are shades of grey, with patients’s prescription drug use. I’m obviously not compliant with most meds, it’s impossible to be, because my tolerance to so many meds, in so many therapy classes, not just with narcotics, is so high. But I by no means habitually abuse controlled substances, something that she said herself and somewhat congratulated me for, towards the end of my appointment.

Both unfortunately for me and HER, the pain management specialist I saw today,  I did do a Google search before my appointment, to get an idea of her medication philosophies (usually pro Butrans, something she thought I should consider, but apprently not, given her recommendation to my long term provider).

I also found that she nearly had her OWN license suspended due to drugs. Almost 2 years ago and the conditions of her “stay of suspension”, so that she could keep practicing medicine. Her conditions of being able to retain her license, which she is now under, is the fact she can’t be in possession or write a script for controlled substances for 5 years, in addition to other requirements for her to retain her  license and/or be eligible to apply for losing those conditions.

I don’t take any satisfaction in that. Both as a patient and as an advocate who’s trying to de-stigmatize and create dialogue about drug addiction amongst both providers and patients.

As well as in doing all the research I had to do past blogs, as a medical activist, as well as make an informed decision about my medication management I’ve thought about discussing physicians who struggle with drug addiction and trying to de-stigmatize that, too.

Because I fully am aware and sensitive to the fact, that physicians are patients, too.

It’s absolutely  NOT  okay, what I was put through today by her. It’s now going into a weekend.  I can’t talk about this to my own provider, until early next week. I did write a scathing message to the pain management specialist about her lie, and I am now  going to  be filing a grievance against her with the hospital system. And also against the hospital system, themselves.

Which I’ve talked about “md-ptsd” and I have filed one grievance before, with that hospital, which is in another blog.

I’m just beyond stunned, of  the hypocrisy that the hospital has, as well as that provider. They have a a more stringent standard of expectations on their patients, that they don’t even have for their OWN physicians. As it’s a travesty that my suicide attempt and being mentally ill, that history is held against me, apparently for the rest of my life by any provider, but her own isn’t?

How is that ethically fair? To not only as me, as a patient but any other patient who is seeing this physician, have any chance to be treated ethically and honestly, as she has bias, in addition to her own mental health issues and addiction issues  that create an inability for her to be effective of in providing fair  care to her patients.

Especially, especially, ESPECIALLY given the specialty she’s treating patients….

Lisa definition of “md-ptsd” (a “Lisaism” you won’t find in DSM V) – extreme psychological and physical distress of seeing clinically trained medical and mental health physicians, due to my being labeled as drug seeking hypochondriac, post epic mental health breakdown and suicide attempt in 2008. But I have also mentioned that I was drug tested prior to being put on opiates, during ER visits, since I had my gastric bypass.

So now, it’s made my “md-ptsd” expotentially  worse. I don’t love when doctors treat me like crap. That’s why I rarely seek medical attention, any longer. What I usually did in the past with unpleasant encounters when I’m being treated clearly with bias, due to having mental health issues, is I leave. I’ve left ER visits, including ones that I needed further attention. I’ve left appointments in the middle of a visit. I can be mean and not mince words, when doctors treat me like an unstable drug seeking hypochondriac, but I only use words and leave, if I’m going to be reactive (which most of the time, I’m NOT) . That’s it.

You want an example of that? Certainly. I’ll say to a doctor when they come off condescencingly and judgemental that I’m a mentally unstable and drug seeking hypochondriac with maybe other bias towards me (such as weight and being a cigarette smoker) that I’ll say “Wow, I didn’t know Walmart had a school of medicine!!!”.

I’m appalled and devastated, though that a pain management specialist with her own drug problems would do that to a patient who admitted everything I’ve said in this and in past blogs, would lack empathy and lie to me.

I’m devastated that I can’t trust most  doctors not to label me for the rest of my life, given my complicated issues with compliance of non controlled substances due to how bizarrely I metabolize most medication or have severe side effects.

I’m incensed as an activist that other patients might have gone through this and they don’t have a voice. I know almost 9 years ago, when I was acutely suicidal and in so much physical pain and had mentally disintergrated, that  I didn’t have a voice and no support. I write this blog, so that other patients don’t nearly lose their lives from being treated this way or have themselves AND their care compromised due to bias.

I’m hoping that if anyone has gone through this, they will message me privately, if they don’t feel comfortable commenting on my blog.

But I am going to fight back, an ethical fight. By filing a grievance and while I said in my very concise message to her that I hope she loses her license, I hope really she learns from this and at least gets reprimanded.

Although if she doesn’t learn from what she did to me today and has done that to other patients, maybe she should NOT be practicing medicine, any longer.

Because no mentally ill and medically disabled patient who’s been as forthcoming with providers, should have to go through what I keep going through with most physicians.

Actually, it’s been my hope as an activist and blogger, for years,  to encourage honest dialogue between patients and providers, whether mental illness is a factor or NOT, that patients aren’t necessarily penalized with non compliance of ANY medication.

Not only does that increase the risk of patients LYING to their doctors, if they are abusing drugs, it puts them at risk of getting involved with street drugs and the risk of safety and or accidental overdose and addiction to them.

And I didn’t fight so hard to stay alive and try to retain what’s left of my sanity, to let a doctor do something so unconscionable like what was done to me, today (It’s still  5-12-2017 in MN), but I’m going to try that some greater good comes out of it.

For both patients AND providers.

Not just for myself, but for many patients who experience bias and compromised medical and mental health care because of bias that physicians carry due to mental illness and other still stigmatized patient disorders.

Wish me luck…

Note: I have no problem publishing differences of opinions, if stated respectfully. And unfortunately my normal disclaimer of “seeking professional clinical trained professional guidance when in medical or mental health crisis”  doesn’t apply, because I’m not at that point but I’m seriously distressed that my anxiety is in overdrive and my medical care has been compromised by a doctor that knew fully my history and lied to me that way.

Especially given how vulnerable I was due to my medical health issues at that appointment and my mental health issues, as it was difficult for me to get to that appointment with my barriers, as I was exhausted physically and mentally frazzled due to some scary encounters on 2 crappy local buses and walking part of the way in the sun, which I have photophobia.

Again, I own what’s multiply frustrating by me, for ANY provider, including the most non biased clinical professional, of what it’s like to treat me. I’m not a fun patient to treat and I can get defensive. I’m wordy and all over the place. But I tell new providers that those are my barriers, from the start.

And the truth is, most patients are vulnerable, in some way, when seeing a provider, especially given all the factors that played in my visit.

Also,  I don’t believe all doctors are bad. Largely due to my long term physician, where we have a stance to agree to respectfully disagree, given what I’ve been through with mental health and having weight issues even with my needing a gastric bypass reversal.

And I realize other Fairview medical professionals who I know are excellent and ethical physicians, as well as other physicians from different hospital systems both locally and globally.

But regardless of a terrible experience with a doctor, I’m going to ALWAYS recommend that if a patient-provider relationship is not working for a patient, that they try to get help from another provider, whether in acute crisis or not.

Just please forgive me for being kind of a hypocrite about not being too terribly excited about seeing new doctors, in the short term, given my circumstances.

Also note: Unfortunately, I had to do some major editing, 10 hours after I first published  this, because I was so frazzled between being in a lot of physical pain and heightened anxiety, which was was made so much worse, after her saying one thing to me and a few hours later, she completely saying another, as far as her final recommendation would be, made this not as clear as I would’ve liked.

This still isn’t clear, due to the fact I am a disabled blogger who writes about disability and bias. But I feel like I’ve honestly and better presented a fair description of what I go through as patient, but at the same time, being fair with providers who have to treat me.

need 2 find a____ ??? …… reflecting on the 1st anniversary of Prince’s death….

 

It bears repeating my normal disclaimer with this blog, that anyone in medical and/or mental health crisies need to seek immediate help from emergency services such as calling emergency services and/or immediately getting to an  acute care facility i.e. hospital ….

Okay, with that being said, the last thing I want to do, even though my blog regarding Prince is drug related, it’s with trying to be crystal clear, that I don’t think that Prince’s legacy should ever be him being the poster child as a warning for accidental overdoses and that should hopefully never taint his legacy, as I go further along, I’ll make it clearer that in this blog, I’m only highlighting certain issues, in respect. I go in more detail about medication issues in past blogs and will continue to do so, in future blogs.

The irony is in my case, personally , is that I haven’t left my house in almost a week due to running out of pain meds a day after a refill was due. Which confines me to home and not capable of much and my life circumstances allow for that. Even though I’m not going through withdrawal, I’m more vulnerable than usual, not being able to get a handle on severe chronic pain.

Where I tie in my personal medical complexities, such as a unique body physiology that drugs of all different therapy classes, in all different delivery systems (IV, oral and patch) I metabolize bizarrely or have awful side effects, or I have a good outcome but potency and longevity of a medication is compromised.

I did have an issue when put on a trial of the Fentany patch at a low dosage that I’ve discussed that with perfect compliance that 24 hours on that patch knocked me in a horrific opiate withdrawal for 5 days, almost 6 years ago.

My blogging about Prince’s cause of death and my own issues with opiates,  isn’t to talk about removing stigma, in this case. I don’t think that in his particular case, it would’ve helped him much and that’s not the reason for this blog.

To make sense though maybe for me and others would be discussing the absolutely appalling lack of options in 2017 that patients with severe chronic pain issues have for treatment options that unfortunately can play into addiction and abuse and sadly, what we are now in, Opioid Epidemic with tens of thousands of people dying every year due to opiate overdoses.

Even drugs like buprenorphine, which was being brought to Prince, when his body was discovered, in hopes he’d go to California for rehab, people struggle with addiction to that medication as well, and people have died from accidental overdoses and a few from perfect compliance with buprenorphine and Suboxone.

How is it that we have 100 different ways and options to send a pic of a lunch we can take and send via a cell phone, to someone halfway around the world , if not in Space, but we have such AWFUL options, when it comes to so many major medical issues, that go beyond just medication, in this day and age???

I do have a few more things to say and I said some of it, in a blog that I wrote about Prince, 6 months ago. As horrified as I am, in how he died, I’m slightly only less horrified in what’s happened after his death. I don’t think the public needed to know every minute detail surrounding his death, when he couldn’t have made it clearer, how much he valued his privacy, when he was alive.

I, for once, don’t have much more to say than this. That’s due to respect and the sadness I have surrounding his death, that words are failing me, out of emotion, in this case.

Other than he and his music will reign supreme for so many,  for  many more generations………

Note: Same rules apply. Respectful dialogue is encouraged even if it’s with a differing opinion. Triggering or disrespectful comments will not be published…..

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