Monday, November 30, 2015


The war on drugs. 
It sounds good. 
Countless lives have been ruined because of them.
But, as usual, things go awry.

It's very irritating to me when I hear that in order to get a prescription at some of the chain pharmacies you have to go through some song and dance and convince the pharmacist that you actually need them. 

Oh, and I'm not talking about the patient.
I'm talking about the doctor.

It's ridiculous when the pharmacists puts your doctor through an interrogation. They want to know if they've tried every other remedy before prescribing opiates. This is absolutely unbelievable to me. When can a pharmacist override the doctor? Who went to medical school??

Why isn't more research being done to bring about pain relief than can block the addictive properties of the drug? Heroin and morphine bind to a specific immune receptor TLR4.  This receptor then becomes an amplifier for addiction. 

Why isn't naloxone being used more? Naloxone reverses the effects of the opioid and could save thousands of lives due to accidental overdose.  Naloxone alters brain chemistry to stop the production of dopamine. So, if it blocks the production of Mr. Feelgood (dopamine) doesn't it stand to reason it would block the craving for the drugs?

You can't tell me that the research isn't there.

There was one published in 2012. Opioid activation of toll-like receptor 4 contributes to drug reinforcement.

They talk about Naloxone in emergency rooms and taking it off prescription and being available to anyone to be used to prevent death from opioid overdose. If it can be used as a stand alone why can't it be used to create pain relief that won't be addictive. 

In October of 2013 the FDA drew huge praises from the addiction community by moving hydrocodone with acetominaphen to a Schedule 2 narcotic. The doctor cannot call in your refills. You must hand the prescription to the pharmacist personally. They have made it harder to get Lortab, Vicodin and other addictive painkillers. They are supposed to make painkillers harder to abuse. For example, they inject Oxycontin with a gel that makes it harder to crushed and snorted. This kind of abuse deterrent is supposed to be a public health priority. 

So what did they do?
They approved Zohydro. 

Zohydro is a long acting opioid. This drug is not intended for as-needed use. This is for patients who need long term, around the clock treatment. This drug is not messing around. You can't drink alcohol. Let's face it, you're not supposed to drink with any pain medication but alcohol with this medication can result in fatal hydrocodone plasma levels in the blood. You even have to be careful taking anything that contains alcohol. This can even mean cough syrup.

I love the insert on this drug. When addressing who should be prescribed this drug they talk about the opioid "naive."  Excuse me??? Zohydro is five to ten times more powerful than the currently available hydrocodone that's on the market. What the heck does opioid naive mean? To my mind? These pills shouldn't be available to everyone. It should be for terminal pain patients. If you're walking around, you shouldn't need Zohydro. It's that simple. The Attorney Generals of 28 states sent a letter to the F.D.A. protesting the approval of this drug. To be fair, the makers of Zohydro have contracted with a Canadian company to come up with an abuse deterrent formula but who knows how long that will take. This drug was meant for cancer patients but everyone knows it will be on the street soon enough. Pill mills will push these babies out and they can be crushed, snorted and will kill people.

So we are back to the problem.

Why can't we have pain relief that helps moderate to severe pain without the addictive properties? 

It's not out of the question.

When you look at all the commercials ....

And the outrageous side effects.........

And it still is approved........

You're telling me it's impossible to get adequate pain relief.....

Without the additictive properties......

I don't believe it.

Thursday, November 26, 2015


Sometimes we forget.
Sometimes we just lose sight,
of what is important.

I'm thankful for the pain so when it ends I know the feeling of relief. I'm thankful for hunger so I know what it feels like to be full. I'm thankful for the tough times so I'll be grateful for the times of plenty. 

I'm thankful that I have a wonderful, beautiful daughter. She's the light of my life. I'm so proud of the woman that she's become. She's a accomplished woman who stands tall. I look at her and marvel that I had a hand in all of this. She's got a tender heart and loves with her whole heart. Her smile lights up the world. To top it all off I have a grandson. He calls me Meemaw and, yes, we are Big Bang Theory nuts. He is my moon pie because he is so num-num-nummy that I could just eat him up. 

I'm thankful for a wonderful extended family that are my daughter and son-in-laws friends who have welcomed me into their homes and their hearts. They love laughter and friends and dogs. It's so nice that their group of friends are all so wonderful. I'm thankful that my daughter has her best friend that is right beside her with children of her own and they can go on this magical ride of motherhood together.

I'm thankful for my best friend of 20+ years. It's the friend that we all need. It's a friend that will laugh and cry with you. A friend who'll have your back and cover your ass as well. (I know where all the bones are buried!)  It's a friend that will tell you the truth knowing that the truth may be painful. A friend that accepts your flaws, applauds your triumphs and cries with you when you're hurt. He's my friend that will always be there through thick and thin. We were brought together by a lingering ex-boyfriend and have stayed friends.

I'm thankful for Facebook. Before you laugh it's been the vehicle that has brought classmates from years past back into my life. We are all friends for life.

I'm thankful that my many annoyances with my health can be managed. I've had friends fighting for their lives with cancer. Some of them lost the fight.  Nothing can compare to chemo and radiation. You see the pain and the suffering. You see hair falling out in clumps. You see realization that even though their desire to fight is strong, they know they may lose the battle. I'm not minimizing Fibromyalgia but if this is the worst that I have to deal with in this life.....well, I'm fortunate. 

I'm thankful for my dog who continually reminds me how to  be content. He greets me with enthusiasm that goes through his whole body.  He knows he has everything he needs and sleeps contentedly with thoughts of snackers and babies running through his head. I'm thankful for Costco because without Costco chicken he wouldn't eat. (Well, we all know he would but I've spoiled him rotten.)

I'm thankful for a wonderful and loving God who doesn't give me all I pray for and yet gives me more than I need. I'm thankful that there is enough food and I'm mindful of those who are not as fortunate. 

So, on this Thanksgiving 2015,

find time to sit back and reflect,

and be thankful,

because no matter how bad it is,

it could always be worse.

God Bless you and your families.

Happy Thanksgiving!

Now, if I don't gain 10 lbs. by morning....

I would not be grateful for that!!!!

Friday, November 13, 2015


I watched 60 minutes.
And my heart sank.
Pain patients don't matter.

I know those people are hurting. They lost someone they loved to addiction and the problem all started with opioids. I basically heard them tell me that I don't know what it's like to lose someone and that it could have been different if they hadn't gotten hooked on opioids.

They wrong.
I know very well what it's like and it makes me angry. 
Very angry.

I'm not angry at the system and I'm not angry at the drugs. I'm angry because the typical reaction is, when any tragedy happens, is to blame the object and outlaw it. It doesn't matter that there are many law abiding people that depend on these medications to live a functional life. The only thing that matters is that some people have died and that they are somehow not to blame; the pills are to blame.

Funny, it doesn't work that way with alcohol related deaths.
We don't blame the car.

Let's put this under a microscope and have people spend more than 30 seconds in pain management. Instead of throwing hydrocodone or oxycodone at patients who have a tooth pulled let's try using some common sense. Instead of spending less than ten minutes with a patient in pain management and leaving with narcotics wouldn't it make sense to have some counseling go along with it? Let's also do some genetic testing so we know what the dosage should be and how it will be metabolized by the individuals system. Instead of throwing prescriptions at people could they just talk to you first and find out what is going on? Would that be too difficult?

And while I'm on the subject.......

All this so-called "shaming." There's fat shaming, body shaming, skinny shaming, illness shaming and now pill shaming..... all this garbage. When is just being mean "shaming." Puts a sweet spin on someone who just wants to be cruel. Everyone has an opinion behind a keyboard. Social Media is wonderful in some respects but, I'll tell you, I'm REAL glad it wasn't around when I was in school. 

If you don't agree with someone it is now ok to be cruel.
No. It isn't.

So we are now going to pill shame. It's not like I've got a boo-boo on my finger and prescribed pain medication. Voodoo pain is the pain that I live with. I know that at any point in time someone is going to stab that little voodoo doll with a pin and I will feel a stabbing pain somewhere. If they hug and squeeze that little voodoo doll I'm going to have a dull ache all over my body. Again, this pain I've learned to handle. It's when the pain increases to whole other level; my whole body feels likes it's being compressed like a junk car that is being compressed to the size of a box of cornflakes. That voodoo doll? It's being stabbed all over....over and over again with a ferocious intensity. 

It is that pain that makes have to take pain medication to make it tolerable.

There are a lot of people like me. Maybe I don't have an addictive personality. I heard that one from my doctor. Maybe it's because I metabolize opioids slowly. I can't take very much because it stays with me. People that metabolize it quickly may have to have a different dosage or maybe that's where the trouble comes in. I don't know. I just think we have to do things differently.

The knee jerk reaction of taking it all away will not work.

It didn't work with Prohibition.

It didn't work with the war on drugs.

All it serves is to push it underground.

Which is precisely what is happening.

Sunday, November 8, 2015


I never would have thought.....

According to the National Institute of Health people in pain use more health resources than people who are not in pain.

Ya think?

Approximately 23 million people catagorized their pain as a level 3 or 4. For the basis of this survey a one was the least severe and least bothersome and the highest was a level for for the most severe and most persistent. It was interesting that women were the most likely to report pain.

So what does this do?

I don't think the sheer volume of people reporting severe pain was expected and maybe, just maybe, they will want to evaluate what can be done for chronic, severe pain patients. The research also wants to look at complementary procedures, such as yoga and massage, that may help pain as well. 

It's clear that shoving strong pain medication to patients isn't an answer. Neither is denying pain medication. It's clear that a different approach is needed. Personally, I think that finding out how a person processes medications is key. Everyone metabolizes medications differently so how can you know how a medication will affect your body unless you test for it?  Part of the problem is I think part of the problem is that most of these people live their lives in an educational bubble. Sometimes I wonder if the people who research chronic pain and Fibromyalgia have ever been in chronic pain. I love reading articles by Ph.D's that feel if chronic pain sufferers would stop thinking about their pain, then they might not experience as much of it.

It's called pain catastrophizing.
It means just what it sounds like and what it implies is also just what it sounds like.

I'm back to central sensitization. People with Fibromyalgia have a lower threshold for pain because of increased sensitivity in the brain to it's pain signals. It's not what happens, it seems to be how it happens. Why they're stuck on cognitive behavioral therapy and trying to blame pain amplification on "catastrophizing" is beyond me. It's almost as if they can't find the on/off switch in our brains so they don't bother.  I really want one of these guys to experience chronic pain and then tell me that if we think good thoughts it will get better.

I've always said that attitude helps us get through very tough and painful times. It helps for a lot of things but it doesn't take away the pain. It is purely a coping strategy. That's all it is. There are affective dysfunctions, central nervous system abnormalities and cognitive dysfunctions. 

Even after all the research the treatments for Fibromyalgia include: Reduce stress, get sleep, exercise and maintain a healthy lifestyle. Boy, I can't tell you how much that advice helps me. Isn't that what we should be doing in the first place?

And I don't buy any of it.

So what to do?

I think they need to recognize the legitimacy of pain.

23 million people are not catastrophizing.

They are in pain.

And something needs to be done.