LET'S GET ADEQUATE PAIN RELIEF

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.

IT'S 5 O'CLOCK SOMEWHERE UPDATE

So..........

moderate drinking eases Fibromyalgia.

Gee, ya think???

They needed a study for this??

I published this post a couple of years ago but another study has surfaced and maybe it's time for me to dust this one off again. I guess it's been shown that people that drink have less trouble with the symptoms of Fibromyalgia and a better quality of life. Now, I'm not Einstein but I don't think you have to be a Mensa candidate to figure this one out.

Moderate drinking is categorized as more than three but less than seven drinks a week. Okay, so if I knock down a few after dinner I guess I'll be able to handle the pain in a more ladylike fashion. Here's the trouble......

I have NO tolerance for alcohol.

This started after I had my daughter. In college my girlfriend and I used to win shot contests and still be standing straight. Something happened to my body after I had Danielle. I get buzzed really, really fast.

Buzzed?
I've been known to drunk dial after one.

It doesn't help that I really don't like the taste of liquor. I have to hide it in fru-fru drinks like Mudslides or Pina Coladas or, if I was back in the old college days, Everclear 151 and fruit punch. If I can't taste it and the rest of the drink tastes good I'm in trouble. I forget the stuff is in there.

So, back to the study.

Who wastes time with this??

Of course, if you're half lit you're going to be able to tolerate the pain that bombards our bodies. It's interesting that some of the patients reported that they also cannot tolerate alcohol so that is why they abstain. Also, there are medications that absolutely should NOT be taken while drinking. 

If you're in a lot of pain and take opioids, you should DEFINITELY NOT resort to moderate drinking to relieve symptoms. People with Fibromyalgia have low GABA levels (gamma-aminobutyric acid). GABA slows down the activity of the nerve cells in the brain. Alcohol increases the action of the GABA receptor. This may be a reason that the pain volume is turned way up in people with Fibromyalgia. Low GABA, high pain, huh?

Like I said.....if you're half lit......who cares??

Of the 2200 people (and over 57% of them were women) who participated in the study it was founds that they had lower BMI (I guess if you drink you don't eat) lower unemployment and higher education. (You can tell that from a margarita?) At least the U.S. researchers said it was the wrong approach to take for dealing with pain.

They urged people not to start drinking to relieve pain.

They couldn't figure out why the alcohol helped with the pain.

They actually studied this???

I have to stop writing....

my margarita is waiting for me.

After one of them I won't even be able to spell margarita.

They call this "an alternative experience."

I'm still shaking my head.......

Here's the link......you've got to read it.  Study on Drinking

THE MAGICAL TIN FOIL CURE FOR PAIN

I'll admit.

I can be a tad gullible.

But this?

No way.

For those of us who have been lucky enough to have been inducted in the Chronic Pain Hall of Fame, I have stumbled upon a treatment that is easy, inexpensive and "WORKS!"

Can't you just feel the sarcasm?

This treatment involves isolating the painful point on your body and then covering it with tin foil. You should cover the painful point and keep it there all day and night for 12 days. Then take a break for ten days and repeat as necessary.

The tin foil has an anti-inflammatory effect. 

Really?

Now, I didn't find a lot of information about this and I'm not surprised. Let's look at this logically. We would have to make ourselves into the modern day mummy and totally wrap our entire bodies in foil. Most of us can't isolate a few spots that have pain. That fact alone makes this "treatment" unrealistic. Can't you just see wrapping yourself in foil from head to toe??

When I was sixteen someone told me that I could evade radar if I put tin foil in my hubcaps. So, what did I do?  I stuffed my hubcaps with the stuff and took off down the street. Speed limit? What speed limit?

Everything went well until I heard the sirens and saw flashing lights do a u-turn in my rear view mirror. Well, I did what any sixteen year old would do. I took off down the streets. To my credit, I lost the cops. I was lucky enough to find a detached garage with the door open. My niece and I hid in there until we were sure the danger had passed. 

Very slowly, I made my way home.

I just forgot ONE, TEENSY-WEENSIE little fact. My father had put my name on a personalized license plate. Fortunately, back then, Las Vegas was kind of like the wild west. By the time I got home the cops had already filled in my dad. Trust me, I would have preferred dealing with the police than my father.

I lost my keys and got grounded.

Last time I believed that tin foil could be the answer to my problems.

I can't believe I fell for it the first time.

So when I saw this.....

ask me if I believed it.

NOT A CHANCE.

The tin foil cure

STOP, DROP AND PUT IT IN NEUTRAL

It's been well documented that our physical and emotional wellness intersect. We need management tips and we need them bad because, let's face it, there are days that everything is just overwhelming. Everything we read tells us to sleep and get rid of the stress in our lives. What happens when we just can't seem to do that? 

The one thing we don't want to hear is the rest, move and sleep platitudes. Like I said, very good things but those words tend to really irritate us especially when we are really hurting. We would do those things if we could. Don't compound the situation by telling us what we already know. 

So?

Stress makes us crazy. That old pesky fight or flight light that goes off and sends cortisol running through our body.  I remember the feeling. My muscles would tighten and my heart would beat faster. It seems like your senses are sharper. I thought I would thrive in that environment and I loved it. However...... If chronic stress can rewire the brain then I must be really screwed up. The body needs to shut off the switch and therein lies the problem. The stress felt so normal for so long that it tends to give you a warm, fuzzy feeling but the price that you pay for that over-achieving, perfectionist, familiar feeling is a very heavy toll on your system. 

You put a bulls-eye on your back.

Put the effects of stress together with a central nervous system dysfunction that is found in Fibromyalgia and you have a recipe for disaster. We have to find a way to breathe through the stress. Do whatever it takes because we have to. Try yoga, aromatherapy, acupuncture, massage, biofeedback.....anything.....going outdoors and looking at the sky......whatever it takes to relax.

If there is a great deal of stress that is overwhelming you the best thing you can do for yourself is to take some time for you. I find that a bath is a real lifesaver in those situations. I'm one of those people that thinks a bath helps everything. Feel icky? Get in the tub. Stuffy nose? Get in the tub. Stressed? You got it......

Having said that, removing yourself from your mind isn't easy. The wheels keep turning. There has to be some way that you can shut the door and stop. Even if it's just for a few moments. Put on your headphones and listen to some of your favorite songs. Place your head on the pillow and shut your eyes. Go to the beach or to the place where you felt warm and safe and stay there for a little while. Sit outdoors and look up at the sky and just "put it in neutral."

I love that  saying.

Our support group is focused on emotional wellness this month. I really needed to hear it this month. I'm in one of "those places." What was said was so simple but it was brilliant. It was something we all can relate to and know exactly what it means.

Put it in neutral.

When you feel yourself caving and life seems stressful take that gearshift and place the car in neutral. I was amazed at how simple, effective and how much it helped. 

That's all we need to say to ourselves.

Stop.

Drop.

And put it in neutral.

As an added FYI Judith Westerfield posted about "I'm safe" on her website. Read this as well. It truly helps!!!  

THE PHARMACISTS PARADOX

The more I read,

the angrier I get.

When did a pharmacist get the power to override or even question a doctors choice of medications? 

The ones at Walgreen's do.

All it takes is an 80 million dollar fine for violating the rules on dispensing controlled substances and now a Walgreen's pharmacist can call your doctor and question him/her on your diagnosis and if prescribing a controlled substance is actually what they should be prescribing.

Oh, also, they can question how long you need to be on it.

According to an article in "The National Pain Report,"  there are red flags that can prompt a call to your doctor and, possibly, your prescription being denied. Some of those red flags I can understand. If you're seeking an excessive amount of pills or a multiple doctors prescribing the medication it makes sense that the pharmacist could exercise some caution. When you're on the prescribed medication more than six months, well, that isn't a flag. Chronic pain sufferers are just that. Chronic. What about cancer patients?

Don't even get me started.

Walgreen's calls it their "Good Faith Dispensing Policy" checklist. 

Here are some of the points the pharmacist is to go over with the physician.

• the diagnosis
• expected length of treatment
• use of alternative or lesser medications for pain control
• the regimen is within the standard of care
• date of last pain assessment

I understand abuse and addiction. I've seen what it can do to lives. I think pharmacists have a duty to be observant and cautious. Doctor shopping for pills, filling prescriptions early tend to signal there is a problem. Not always but, in most cases, I would agree that using caution is prudent. Having said that I think it's absolutely ridiculous for Walgreen's to have the ability to override a physician. I wouldn't fill a prescription at Walgreen's anymore. I have nothing to hide but when they start questioning chronic pain, I draw the line. When I need my prescriptions filled it isn't for fun. A few days or weeks without them mean I'm in a great deal of pain.  

Pain that a couple of Tylenol won't touch.

Oh, another little tidbit..........

If you go to Walgreen's and your prescription is denied?

That denial is entered into your profile.

It's seen by all of the Walgreen's Pharmacies (more than 8300).

It also notifies the DEA that your prescription has been denied and they must justify the reason.

However, if YOU want to know why????

Good luck.

I can't be sure but click here for the link to a possible copy of the checklist.

THE REVERSE WAR ON DRUGS

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??

Well, it seems it's happening every day.

I understand that there are pill mills out there. It should be fairly easy to catch the ones who doctor shop and refill scrips from different doctors at different pharmacies. I will agree that they are abused, HOWEVER, why do we have to start living our lives from the position of the abuser? When is the pharmacy allowed to use CYA (cover your a**) as a legitimate tool for dispensing prescriptions given to you by a doctor? 

I will agree that people need to be conscientious and responsible. You don't leave them about when you have children in the home. You need to understand their power but that doesn't mean that the people who are responsible and need them to actually function on a daily basis need to be looked at as some kind of addict. 

Pain is debilitating. 

I also understand overdose but if it can be caught before it's irreversible why isn't naloxone being used more? Naloxone reverses the effects of the opioid and could save thousands of lives due to accidental overdose.  Addiction is a whole other animal and unless the root problem is dealt with all the naloxone in the world won't help. 

It just sounds like anyone who uses opiates is automatically labeled an addict.

That is SO wrong.

Where is the balance?

As usual, when it comes to legislation...

Common sense and balance are missing.

HELGA'S HOUSE OF PAIN

I don't think my doctor believed me.

He does now.

Pain management is a funny thing. Obviously, you have issues otherwise you wouldn't be there. If you don't have much pain you don't need medication. If you have too much pain you're probably neurotic.

I must have fallen somewhere between the two.

He has been pressuring me to get a discogram for over a year. I gave him the report from an MRI but that wasn't good enough. What is it? They don't like reports other doctors get....they want to see for themselves.

OK, so I finally gave in. 

I TOLD him I was terrified. 

And I told him why.

I know what disks are bad. I researched the discogram and the more I read the more terrified I became. You can't be totally out because they need the feedback from you about the level of pain. If you're disks are bad you're in for a rough ride.

So...........

They give you a mild sedative. They put on the fluoroscope and put a few needles out there to numb the area.

It didn't work.

When they put the first needle in, I can tell you that I have NEVER had that kind of pain in my life. I went through 28 hours of labor and that was a walk in the park compared to this. Let me say, as I've said in posts before, I can take a great deal of pain. I've had stitches without Novocaine in my forehead and didn't move a muscle.....and I was 6 years old. I have sprains and breaks and got through it by almost having an out of body experience and talked myself out of the pain.

That's whats so weird. I can do it with some types of pain. 

Anyway, that first needle hit and I grabbed the table and screamed. Literally screamed. I was crying and screaming and endured that through 5 disks that he examined. It was the most painful thing I've ever been through. 

And that doesn't even adequately describe it.

There truly are no words.

So I've spend the last week getting through the flare that the test has brought. It's raining again so between the test and the weather I've just been a peach. 

The one good thing?

The lady that came after me came in and her face was WHITE. She was devoid of color...trust me on that one.....

Her words to the doctor?

"Oh dear God, please don't do to me what you did to that other lady."

I went home before she started screaming.

I think he finally believes me.

And I don't think he'll ask me to repeat the test.

IT REALLY TICKS ME OFF....BIG TIME

Unbelievable.

It reinforces my belief.

A lot of doctors suck.

Big time.

Okay.....I have health issues. I know that. Heck, everyone knows that. What I expect when I go to a doctor is a little knowledge and conversation and possibly....quite possibly.....a way to fix the problem.

Apparently, that is asking too much.

I've gone to doctors that have refused to name Fibromyalgia on my chart. I've gone to doctors that look at the kind of pain I'm in and give me the "oh, suck it up" look. The last one I went to looked at my skin peeling under my nails and offered the following comment...."well, you do live in the desert." 

No duh.

I've lived here 47 years and I've never had skin peeling from under my nails. I've got alligator skin, thyroid problems and the bimbo says....."you live in the desert??????" WTF????

I go to pain management every month. While I appreciate the fact that pain doctors are incredibly busy, when a doctor walks into your room....takes a look at you and then the chart and WALKS OUT.....well, that is beyond ridiculous. I'm serious. This doctor was not in the room with me for more than 15 seconds.

Do you believe that one??????

I go to another endocrinologist on Monday. I can't wait to find out what this person will do. Although I hope I can be pleasantly surprised.....trust me,  I have just about had enough. What is it with Las Vegas?? If a doctor can't get licensed anywhere else do they all just come here?

Health care has become beyond terrible. What kind of arrogance causes someone to look at you in disdain when they take an oath to "do no harm?" How do they justify spending less than 4 minutes with you and then bill your insurance an exorbitant amount of money? No wonder health care is so expensive....no wonder there is so much fraud.

I'm convinced that Buster gets better care than I do.

That wonderful doctor comes in and talks to Buster. 

Asks how that sweetheart is doing and Buster's tail goes a mile a minute.

If there is medication it's explained what it is for and how to use it.

If there is a problem they want to get to the bottom of it.

And they REALLY LIKE PETS.

Maybe I should go to a veterinarian.

Boo bear......you don't know how lucky you are.