Unintended Consequences

Yeah, that's not weird.

And that? Not alarming at all.

denelian, in the spirit of sharing, wrote a comment that made my vagina lock up so tight I may never have sex again (thanks!), including something I thought was just me:

THEN the doc told me i'd be a fascinating case study on how treating a person's pain like it didn't matter produced a person who ignored their body's warnings [pain] until their body just QUIT.

That's not just you, denelian. I do that, too. I end up in the hospital with kidney infections, or a spleen the size of Nebraska, or severely dehydrated, or with a fever so high I'm risking brain damage or an ear infection that's spreading to the bone. Each and every time, the ER doctor scolds me. How could I let it go that long? Why didn't I call my doctor earlier- like a week earlier? You almost died, don't you care what happens to yourself?

Of course I care what happens to myself, I just don't pay much attention to my body. I used to. I used to call the doctor every time something weird happened, which is pretty much every day. I've had two doctors dump me for doing just that. So I stopped paying attention to my body. Pain? That's not important. It must not be, nobody cares about it. So why would I pay any more attention to the pain in my left flank than I do to the far worse pain in my knees- until I start peeing blood, that is.

I tried to tell doctors about the tachycardia and palpitations. They did a couple of tests and politely told me to fuck off. So I stopped paying attention to my heart racing so fast I couldn't count it- until I passed out at Dunkin Donuts.

Honestly, I can never tell if I have a fever. I frequently feel like I do when I don't. I'll be miserably hot when it's 20F (-7C) outside, or shivering when it's 85F (29C) and it's no indication of what my internal temperature is. I've mentioned it to doctors and basically been told to stop being melodramatic. So, no, I didn't bother to check my temperature when I had a fever of over 104F (40C)- until I started hallucinating, that is.

Then I get to have an argument with an ER doctor because it's all my fault. I must be psychologically disturbed. The fact that my problem is a direct result of substandard care. Actually, my real problem is that this care is not considered substandard. Undertreating pain is the goal of modern medicine as far as I can tell. And me? I still have to get through my day, so I just ignore my body. I pay no attention to the most alarming things until my body starts to shut itself down.

I recently went to the doctor because my toes keep turning a dark greyish purple. It's really an alarming color on your skin. It's not related to cold or much of anything else that I can figure out, and here's what the doctor said to me: Does it hurt? No, there's no additional pain when my toes turn purple. Well, then, it's really just cosmetic, isn't it?

Yeah, I'm betting it's not just cosmetic. I'm betting I end up in the ER, again, suffering from something horrible. Again.

The above list isn't everything that's sent me to the hospital in the last 10 years. Not even close. The issue isn't infections or dehydration or fevers, the issue is that I push myself to the limit every day. Some days, with the pain, walking five steps is the limit and I have to go way past that. I don't sleep more than five hours a night because of the pain and no more than two hours are uninterrupted sleep. I frequently don't eat because of the pain. I'm not surprised when my body shuts down. And I can't really figure out why doctors act all shocked and appalled by it. Or why that's my fault.

Too Serious for Numbers

Hyperbole and a Half has clearly been there.

I'm not entirely certain why Christians, specifically Catholics, tend to be so against euthanasia. I didn't understand it while I was Catholic, and I don't understand it now.

Here, allow me to elucidate what euthanasia means to me. Saturday we celebrated my husband's birthday by going to the casino. He loves playing poker and he's good at it, we just don't generally have the $200 necessary to play at the casino. So his brother's birthday present was the $200 stake and his company at the tables. Initially, they were going to enter a tournament starting at 7pm, so we were going to go down at 5, hang out for 2 hours, then the rest of us would leave when they started the tournament. Through an unfortunate series of events, we didn't get there until 9pm, and I didn't get home until 3am. (He came home at 7am, enough up to pay for mastering his album, which is being released the second week of June. I do expect class participation in this project.)

After 6 hours spent on my feet at the casino (they don't have chairs for people not spending money), being up 5 hours past my usual bedtime and getting 4 hours of sleep after that, this was my week:

Sunday: I managed to get from the bed to the couch. I don't really remember Sunday except as a haze of pain.

Monday: The pain was worse, but I was more mobile and managed to take a shower. Mostly, I remember nausea and pain. And everything smelled funny for some reason.

Tuesday: The pain was somewhat better, but my skin felt like it was on wrong.

Wednesday: Delighted to discover my skin was back on right, not so concerned about the pain anymore.

Thursday: Back to a normal level of pain for me. Actually, I think I'm at the level of pain that had me calling the doctor for an emergency appointment, but after the preceding four days, it doesn't seem so bad anymore.

That's my life. What might be a little soreness and exhaustion for anyone else is a sojourn in hell for me. You know what keeps me going? I know that it will end. I know what the typical rebound time for me is. Well, typical rebound used to be one day of feeling not so bad, followed by two days in hell, but it's been years since I tried anything like that. But it does end, eventually. Even in the midst of pain so severe, I was left unable to really care for myself, I knew it would end. By "unable to really care for myself", I mean my husband was carrying me to the bathroom every so often because I couldn't form the proper intent to get there on my own.

If that were my everyday life with no end in sight, you'd better believe I would kill myself. Without hesitation and without apology. I love life, but that's not life to me. As much of an endurance challenge as formerly easy things can be to me anymore, there is still beauty and wonder in this universe for me, but not when I'm in that kind of pain. That kind of pain reduces the world to nothing more than screaming nerves and an overwhelmed brain that's not meant to take that kind of abuse. Imagine walking through a fog so thick you can't see your hand in front of your face. Now imagine that the fog is pain and you are pain and time is pain and the world is pain. Now imagine that is all that is left for you and then imagine what you would do.

If that sounds unreasonable to you, well, you haven't been there. I know Red Cardigan hasn't been there, because this is how she responds to quality of life concerns:

I first saw this article at a news site which allows comments, and the
comments were overwhelmingly in favor of suicide for the terminally ill, the
elderly, the handicapped, and anyone else who no longer enjoys "quality of
life," which is apparently defined by the ability to maintain a trendy home,
dash off on destination vacations, work long hours for the right sort of people,
and shop for cool toys and couture fashion at America's most
religiously-attended structures, otherwise known as shopping centers, malls,
strip malls, or misleadingly named "town squares"
(and this is off-topic, but the couple of times I've had the misfortune of
actually setting foot in that place linked to I have honestly felt like the
whole thing is frighteningly unreal in a rather evil way; but then, I'm a
writer, and thus prone to fits of imagination).

A part of me laughs. She is clearly more concerned with some [follows link] shopping center than she is with another person's screaming agony. On the one hand, most of us, including me, are more concerned with what affects us than with what affects another person we've never met. On the other hand, does she really think that people are stuffing a bag over grandma's head because she can't shop at Coach anymore?

A part of me screams with a rage that has few words. That part of me is still quaking in fear that last week will come back for me, that the all-encompassing pain will return and never leave and it will kill me before I stop breathing, and she's yapping on about shopping centers and being a writer?

Does anyone have words for that? What kind of monster are you, Red Cardigan, that you call a shopping center "unreal" and "evil" when there is suffering in this world, all around you, suffering with no release, not even a pause, suffering ended only by death? You ignore this and call it morality.

I don't even know what to say.

Fads in Fashion Are Fine, but in Medicine?

If you've had chronic pain for the last decade, as I have, you know exactly what the title refers to. If you haven't, you probably think that fads are limited to fashion, music and social networking, but medicine is ruled by science.

Yeah, not so much.

Medicine is ruled by fads, and no, that's not good for the patient. Yesterday, I left my doctor's office with a prescription for Sevella. I've never heard of it, so I looked it up.

Milnacipran is not used to treat depression, but it belongs to the same class of medications as many antidepressants.

Sevella is an SSRI/SNRI, putting it in the same group as Prozac and Wellbutrin (Zyban if you're quitting smoking). When my pain first sent me to doctors for relief, tricyclic antidepressants were the fad, so I took Elavil. Fifteen days after starting Elavil, I tried to kill myself. After that came the first wave of the fad of treating chronic pain with SSRI/SNRIs. "But I'm not depressed," I protested and was assured that these new antidepressants had no effect besides pain relief if you weren't depressed. I can only assume my doctor got that line from the drug rep, because it's not true. My reaction was not unique. Prozac left me despondent, crying until I literally ran out of tears. Wellbutrin turned me into an avatar of rage and I found myself screaming obscenities at some poor guy named Tim when my cable went out. (Sorry, Tim.)

My doctor knows this, I've told him these stories in great detail. My file should have "NO ANTIDEPRESSANTS" written on it in red pen.

After that was the fad for Neurontin, an anticonvulsant. The drug reps were pushing it hard for disorders other than epilepsy, and doctors treating pain patients were delighted to play along, even though there was no evidence that Neurontin did anything for chronic pain. It didn't do anything for me, and my doctor at the time told me that Neurontin was the gold standard for chronic pain and if it didn't work for me, maybe I just liked narcotics too much.

Not one fucking study, no science at all, just a drug rep's assurances, and I was a junkie.

After that came Lyrica. It was a miracle! We would all be saved! I got so dizzy I couldn't stand up. "Wait for it to pass," my doctor said, "This stuff is worth it." I did eventually learn to walk somewhat straight, but my pain didn't go away. After six months, I gave up, but to this day, I still have balance problems, and if I turn my head too fast, I fall over.

Last year, right before my doctor's visit, I saw an ad for Cymbalta. "Here we go again," I said. "He's not going to give you that," my husband said, "He knows what happens to you on antidepressants."

As soon as he walked into the exam room, my doctor was singing the praises of Cymbalta. "Angels deliver it directly from heaven!" I'm paraphrasing, but he was pushing this stuff like the manufacturer had sent an assassin to his house and was holding his family hostage until he prescribed enough of it.

I'd had enough. I refused. He threatened to stop my pain meds unless I tried it. I took the sample pack- and then went home and threw it away. I told him it didn't work, but I had tried.

This year, it's Sevella and everyone's getting a scrip! Pink is the new black, belts are the new gloves and Sevella is the new Cymbalta. Here's a look at the side effects:

Milnacipran may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea

• vomiting

• constipation

• stomach pain

• weight loss

• dry mouth

• feeling of extreme facial warmth and/or redness

• increased sweating

• headache

• dizziness

• blurred vision

• difficulty falling or staying asleep

• decreased sexual desire or ability

• pain or swelling of the testicles

• difficulty urinating

• rash

• itching

Would you prescribe that to someone who just got done telling you that they can't sleep and their gallbladder is sending them to the ER every three weeks? If so, you have what it takes to be a pain doctor- a fantastic commitment to fads and a sociopathic unconcern for the wellbeing of other people!

I can't wait for next year.

Do Doctors Realize How Stupid They Sound?

Me being still obsessed with my complete inability to eat anything, I'd like to share two conversations I had in the ER early Tuesday morning. Both of these happened while I was on a lot of dilaudid, mind you, so I was a bit more, um, direct than I usually am.

Conversation 1:

Dr: We need to test the function of your gallbladder.

Me: Okay.

Dr.: We can't do it right now, you'll have to schedule it later.

Me: Okay. So what does that involve?

Dr.: They'll inject a nuclear dye into your gallbladder to make it spasm-

Me: Wait, wait, wait. Isn't spasming what's going on right now? That's what's causing the pain, right?

Dr.: Well, yes, but we need to see-

Me: So you expect me to walk into a room knowing that I'm going to leave feeling like this, only without the dilaudid and the toridol?

Dr.: Well, yes, but in order to-

Me: Just how many different kinds of crazy do you think I am?

Seriously, how do you say that to someone? "Hey, I've got a great opportunity for you to deliberately feel the sort of pain that makes you beg for death! Sign up now!" Um, no, I'd rather not.

Conversation 2 (after 4 shots of dilaudid and 2 of toridol):

Dr.: If we can't get your pain under control, we'll have to admit you.

Me: And do what?

Dr.: What?

Me: What are you going to do on the 8th floor that you aren't doing here?

Dr.: Um, well, we can work on controlling the pain.

Me: You just gave me enough dilaudid to knock out an elephant, does the dilaudid work better the higher up you are?

Dr.: No.

Me: I can't sleep on dilaudid. I can't stop grinding my teeth on dilaudid. I'd like to go home, wait for the dilaudid to wear off and sleep in my comfortable bed with my pillow that smells like me. I don't see how being in some overly bright room with some roommate who wants to watch Fox News at top volume would be any better.

Dr.: I can't release you with uncontrolled pain. It's against hospital regulations and it's unethical.

Me: and I have insurance, so those things matter, I suppose. My pain's all gone now, get this IV out and send me home.

Really, pain? Don't make me laugh. Me and pain are old friends, the kind that can't stand each other anymore, but we've been together so long we don't know what else to do. Ethics? Every doctor I've ever seen undertreats my pain deliberately because they're scared of the DEA or they think I'm lying, but all of a sudden undertreating pain is unethical? Like you'd care if I didn't have insurance? Fuck off.

Depression Rating Scales and Chronic Pain Patients

I, as a person with chronic pain, frequently get accused of being depressed, by family, friends and medical professionals. I wouldn't mind it if this were genuine concern, which sometimes it is, but in the case of medical professionals, it's generally a brush off. "You're crazy, I don't have to deal with your medical issues." It's a lot easier, and safer, for a doctor to refer me to a psychiatrist, than to prescribe me painkillers in a strength and dosage that actually works.

Consider this: five years ago, I was on (DUMDUMDUM!) 20 mg Oxycontin with Percoset for breakthrough pain. Yes, the evil, dreaded hillbilly heroin- or, as I called it, 12 hours of effective pain relief that allowed me to live my life. I took this medication exactly as prescribed. I never "lost" my medication or took too much or anything else, so I was a little surprised to be downgraded to Vicodin, with nothing else. And then be accused of being depressed. By the same doctor that had previously had no trouble prescribing me Oxycontin in the first place.

I was surprised, that is, until I saw a local doctor sent to prison for "overprescribing". Then it all made sense. The DEA wanted to make some kind of point, so I got screwed. And my doctor couldn't tell me that, so he used depression as an excuse.

What's even worse about that is that chronic pain patients will score as being depressed using depression scales. Why is that? Well, let's look at the symptoms of depression:

Feelings of: Sadness, hopeless, helpless, worthless. Well, sure, I'm sad that I'm in pain. I have no hope of it getting better, and I am helpless to do anything about it.

Feelings of guilt. Yeah, I do feel guilty about all the stuff I used to be able to do and can't keep up with anymore. It's not my fault, it's the pain, but guilt isn't entirely rational.

Insomnia. Break your leg. Now go to bed. Oh, you can't sleep? How odd.

Loss of appetite. Break your leg. Now try to eat a nice, steak dinner. What's that? You don't want to eat? That's weird.

Difficulty keeping up with work and other activities. Break your leg. What? You can't go to work? You can't mop the floor? I wonder why.

Loss of libido. Break your leg. Wanna fuck? No? Freak.

General somatic symptoms. Heaviness in limbs, back or head. Backaches,

headaches, muscle aches. Loss of energy and

fatigability. Well, yeah, that's my entire problem. Oh, it's all in my head. C'mere, I need to break your leg.

slowness of thought and speech, impaired ability to concentrate, decreased motor activity. Break your leg. Now recite the Quadratic Equation. No, that's not it, you must be depressed.

Agitation, including fidgeting, playing with hands, hair, etc., moving about, can't sit still, biting hands, nails, etc. Break your leg. Now why can't you sit still?

Hypochondriasis (and this one's especially offensive) self absorption, preoccupation with health, frequently asks for help. Break your leg. Why are you so obsessed with this leg? Why do you keep bothering me about it? Why are you so self absorbed, I have feelings, too, you know.

Now, imagine being a chronic pain patient and being asked to fill out that depression assessment. Imagine being a chronic pain patient, begging your doctor for help with the pain that is destroying your life, and having him suggest to you that your real problem is that you're depressed, not that you're in pain. Imagine being told that repeatedly by people who haven't spent 5 minutes in your body and are really just trying to get out of dealing with you.

Yeah, I'm a little bitter.

The (stupidestthingever) Pain Scale

If you go to the doctor complaining of pain, you will be asked three questions:

Where is the pain?

What is the pain like: stabby, dull, fiery, electric?

On a scale of 1-10, how bad is the pain?

For a chronic pain patient, the first two questions are frustrating enough*, but that pain scale is ridiculous for anyone. On the left we have "0- no pain", on the far right we have "10- worst possible pain". What the fuck does that mean? The worst pain I have ever personally experienced, the worst pain I can imagine, or the worst pain anyone anywhere has experienced? What exactly is a 10, the pleurisy pain that had my blood pressure jumping up to over 180 or Joan of Arc's final moments?

Holy meaningless, Batman.

One problem with the pain scale is that its ambiguity encourages patients to make up their own definitions. Denelian treats the pain scale like the Richter Scale, i.e., 2 is twice as bad as 1, 3 is twice as bad as 2, etc. I treat the pain scale entirely differently. 5 is normal pain for me. At a 5, the pain is bothering me, but I can work and do housework and enjoy activities like eating and playing video games. At an 8, I can't do dishes or laundry, and I lose interest in eating**. At a 9, I'm restricting water to avoid having to get up to pee and I don't want to play with my dog. By 10, I can't even enjoy video games and I mostly just twist and fidget in pain while tears roll down my cheeks and I yell at my dog if he gets too close to me.

So a doctor dealing with both me and Denelian is getting two different answers when he hears a 5, although he may be entirely unaware of that fact.

Doctors and nurses have their own interpretations. During the incident in which pain was driving my blood pressure to dangerous heights, I told the nurse that the pain in my chest was a 10 when it was hitting. She wrote down "4". I saw this and said, "I told you 10." She replied, "It's not like you're howling in pain or anything. I'm being generous with a 4." So, if I had had any weak spots in blood vessels in my brain I could have had a stroke right in front of her, but I wasn't causing a scene, so no big deal.

I know why doctors use the pain scale. It's easy. It's a single number. A real discussion of pain would involve asking a lot of questions and really listening to the answers. It would involve empathizing with a subjective experience and suspending disbelief. It would involve taking me at my word and trusting that I know my body, my pain and my needs. It would involve understanding that no matter how many years of school you attended, you're not living in my body, and you're not going to have to cope, as well as you can, with less pain relief than you need. Listening. Properly treating pain would involve listening.

In fact, studies have shown that [m]ost doctors, within the first 18 seconds of seeing a patient, will interrupt him telling his story and also generate an idea in his mind [of] what's wrong.

That explains everything right there. Doctors are never going to ditch the pain scale if they can't bother to listen for more than 18 seconds. It would take me the better part of five minutes to list every single symptom I experience, so you're not even getting the highlights in 18 seconds. Don't even get me started on the concept of treating people (or not) with potentially dangerous drugs on the basis of 18 seconds of listening and one number, especially if you've decided that you can tell from a single glance what that number is.


Anyway, I could go on all day about everything that is wrong with health care in America, but the pain scale really freakin' bothers me.








*It would be easier for me to list where the pain isn't. Right now, neither my nose nor my ears hurt. As for the descriptives, I usually just answer "yes". Here is dull, over here is stabby, over there is electric.

**I love food. If I'm not eating, there's a problem.

Now I'm Scared of My Pharmacist

Writing this post made me feel naked and frightened in a way no other post has. I can discuss my breasts and vagina with no problem at all, but this I almost deleted 6 times. Maybe I should have, but I know there are others out there experiencing the same thing and we need a voice. And you need to listen to it.

I am a pain patient. I have chronic pain. Pain has consumed my life, changed me, destroyed the person I used to be. The pain is why I don't believe in hell. I wouldn't wish the last 8 years of pain on Hitler, let alone some random guy who didn't believe the right way. And that's 8 years, not eternity. Think about that for a second. I wouldn't wish this on the worst person that ever existed, but I have to live with it every second of every day.

For this pain, I take medication. Yes, it's narcotics. I'd prefer it not be narcotics, but if you're in serious pain, that's it, the pain or the narcotics. Actually, it's the pain and the narcotics, but I can live with pain at or below a 6 on the (stupidestfuckingthingever) pain scale*, so I'll take what I can get. I don't get high from the medication. That's how narcotics work. If you're getting some kind of euphoria from them, you're taking too much for the pain you're in.

I hate filling my prescription every month. I feel like the pharmacist thinks I'm addict. As it turns out, I'm probably right. This knowledge has entirely ruined my day.

A pharmacy without crackheads would be like a Big-Mac without the secret
sauce. The two go hand-in-hand like fat-chicks and spandex.

. . .

Becoming a successful “crackhead” and inflicting sadist pain upon your
pharmacist is not an easy task. However with these short yet useful tips
you shall have your pharmacist begging you to never return.

Think of a month as not 30 days, but a random number of days between 10 and
25. Most medications will have warnings that say that it must last one
month. However if YOUR month is only 13 days, it means that obviously you
can take more than what is prescribed on the bottle. This is YOUR
medication after all, so it gets to play by YOUR rules and thereby YOUR month.

Yeah? How about all the times I have gotten home and counted my pills only to find the prescription is short? Don't bother calling the pharmacy, they'll just say you can't prove it's them. Oh, and if you insist on counting the pills at the counter before leaving, they will freak.

Don't get me started on months that are 31 days long. Don't know what I mean? You obviously don't take pain medication. Suppose I fill my 30 day prescription on April 16. Now, April has 30 days, so I'm due for a refill May 16. Suppose I fill my 30 day prescription March 16. March has 31 days, so I'm due for a refill April 15, not April 16. Try explaining that to idiot pharmacy tech no. 1,351.

Generally, I refill my prescriptions 2 days in advance, although I don't pick it up until the day it is due. Why? Harrowing experience. If I wait until the day of, or the day before, and the pharmacy is out, I'm fucked. I'll have to go a day or two, or seven the one time, without medication, and if I could do that, I wouldn't be taking them in the first place. No pharmacist would freak out on me for transferring a prescription for insulin in that situation, but pain meds? I'm a drug seeking crackhead.

Don’t use proper terminology or pronunciation when referring to your
drugs. Everyone says “Soma” or “Vicodin”, but having you refer to your
medication as “SOMAS”, “VICO-DANS”, “DAN SOMAS”, or “WATSONS 389″ makes you
really stand out in the pharmacists eyes. Nothing says “I know my pain
pills” than reciting the NDC number on that bottle of Watson vicodin.

I've been taking these pills for a while now. I do have the number on the pills memorized- because I'm observant. I don't refer to them by common name on the phone, I refer to them by actual name of the substance so that people around me don't know what I'm talking about. I don't want them to know.

Develop some good stories. “My medication was lost or stolen” is so
1990’s. You need to think of some good stories to feed to your doctor and
pharmacist so they will feel sad for you. It helps if you learn to sob on
command, or come into the pharmacy loaded so they can really see how much pain
you are truly in.

Have a black cloud of bad luck encompass you always. Be the
unluckiest person on the planet. Have anything and everything happen to
your pain-pills (but not your high blood pressure pills!). Martians came
and a meteor hit your vicodin bottle! Go for the gusto! If you’re
loaded while you mumble this story it makes it more realistic (at least to you)
thereby making you tell it better! Remember, YOUR story plays by YOUR
rules, and YOUR pain-pills make YOUR rules!

Hello, moron, when people steal pills, they don't steal acid reflux medication, they steal the fun stuff. I have had pills stolen from me, once by a family member (because I don't really need them!), once by a (former) friend, once I suspect one of the many temps that pass through the office. I have since learned to keep one day's worth in my purse, not in a prescription bottle, and I hide the prescription in odd places in my bedroom. I never told the pharmacist, I just suffered until the refill was due, but yeah, it happens.

Only chumps get all 90 Soma at one time. Split that Rx up! Even
though you have $5 in your pocket, it should get you at least 3 of the 90 soma
you are allowed every month. Dont worry about such trivial things such as
money management, saving for the whole 90, or the added work your pharmacist
goes through. Remember, YOUR money plays by YOUR rules and YOUR shitty 4
tablet partial fills make YOUR rules!

Yeah, why should poor people be allowed to get their medication as they can afford it? My mom used to do this after my father left her high and dry with no health insurance and a heart condition, and a daughter with severe asthma. Not everyone makes $80,000 a year for counting things, asshat.

PAY CASH! Only chumps use insurance for their pain-pills!

40,000,000 uninsured people in the US, and this asshole is surprised he's run into a few of them?

Money management? Throw all that shit out the window. You need to piss
away your welfare check like its burning a hole in your pocket. In fact,
you have to be so bad that you have to prepay for your soma that’s due TOMORROW
or you’ll spend that $30 on something else.

I work, but yeah, I've done that. You know why poor people do that? Because poor people always need something that they've been putting off forever. So, if I have $30 in my pocket, it could end up going for something else that is desperately needed. If I've already spent the $30 on my prescription, I can't spend it on something else. Thanks for privileging all over me.

Avoid chains! Their computers are all linked up via magic so they know
how much other stores have given you! Go for the mom-and-pop shops!

Yeah, the fact that my local chain has shorted me numerous times, but the mom-and-pop has never done so has nothing to do with my choice of establishment.

Become an active part in your treatment, call the pharmacy every 10 mins to
see if the doctor OK’d the early refills. Nothing says “I take my life
seriously” than being on top of your medication refill requests. It
doesn’t matter if you don’t remember calling 10 mins ago because you were
loaded, YOU ARE TAKING CHARGE OF YOUR TREAT-.. what was I saying again? Oh,
TREATMENT!

Fax machines can break, make sure you call the doctors every 10 mins to
see if they received your early fill request from the pharmacy. Doctors
LOVE patients who are active in their treatment. Remember, YOUR name is on
your early-refill call-tag so it plays by YOUR rules!

Every month, I have to call my doctor and request the refill be faxed to the pharmacy. About 8 months of the year, this works just fine. I call at 9am, and the pharmacy has it by 6pm. Some months, the pharmacy doesn't get the fax the first time. Or the second. Sometimes not the third. I have to call multiple times to fix this because nobody else will. Asshat. Maybe I'm supposed to psychically guess whether or not the refill has finally made it to the pharmacist.

Catch fibromyalgia! That shit is the golden ticket to Watson-Wonka’s
Narcotic Factory! If you catch fibromyalgia you can get ANYTHING!
Plus pharmacists and other health care people LOVE IT when you talk about how
bad your fibromyalgia is.

FUCK YOU. Seriously, FUCK YOU.

Take up acting! Don’t limit yourself to the “OH JESUS IM IN SO MUCH PAIN”
once you hit the pharmacy doors, but also practice it as you walk through the
parking lot. Nothing says that you’re in “OH SWEET JESUS” pain like
stumbling and shuffling about in the parking lot AND in the pharmacy. If
you cannot sustain the act for long enough, make sure the sneaky pharmacy
doesn’t have cameras outside to record you acting normal only to be hit by the
“OH JESUS PAIN” stick once you cross into the store.

Wait a minute, this customer is limping the entire time the pharmacist can see him, but obviously that's because he's faking it? How much of an asshole can one person be?!

This is going to make my next trip to the pharmacy so much fun.



*Another post for another day, but trying to quantify the intensely subjective experience of full body chronic pain on a 1-10 scale is about the stupidest thing I've ever been involved in.

Day Three

migraine, pain, torture,
I'm on day three of the migraine modern medicine can't touch. Day three. In case you've never had a three day migraine: day one, you moan and whinge in a darkened room. Day two, you curse the day you were born, and your parents for bringing you into the world- and its migraines. By day three, you're ready to set your feet on fire for the momentary distraction it would bring from the pain in your head.

I'm at work.

Our holiday policy is that if you don't come in the day before and the day after a holiday, you don't get paid for the holiday. I need that money. Really, really need it.

So here I sit, with the migraine that would qualify as torture under the Geneva Convention, under the bright, flourescent lighting, listening to the ringing phones, the copiers, the printers, and all my talkative coworkers, who each seem to have 12,000 stories to tell from Memorial Day- at top volume.

So, who has a lighter?