Opiates and Nipples

Genitalia Discussion, Anyone? Oh, wait! First a news flash. I had to sign a Pain Contract with my new internist. New contract meant a piss test. So I gave them my sample and get this — the nurse called me to let me know I “passed my drug test”. “Well, hot damn!” I told her, “I kinda’ thought I would.” Fortunately, being me, this 61 year old, looks-like middle-class educated white woman schtick I do pays off with repartee’ and comedy routines with doctor’s office personnel. Odd thing here is, after 4+ years at my previous pain clinic, no one ever reported my urinalysis results to me. And I was assured they weren’t “actively looking for” pot, it’s the meth, the bad ass amphetamines that matter. Oh, and heroin. I knew I was safe from the state’s probing ways, but it did strike a chord that no one ever talked about my piss tests at Dr. Billy’s.

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Back to our regularly scheduled Opiate Discussion. This one’s really physically personal.

The body changes in ways you can’t imagine — once you leave opiates behind you. The way opiates rewrite the body? Probably not noticeable because the changes take place over a long period of time. Insidious changes. I can only relate to what happens to a woman. For men? Get yourselves out there and write about it and let me know.

1. When one enters a cold room, we all know what happens to our nipples, right? Honest Effect #1. Your nipples begin to react to cold again. On opiates, I would suggest that nipples don’t respond to cold temperature changes. Wow, it’s hard to be honest, but it might help someone so …. Here goes:

2. Nipples reacting also means other body parts are waking up. My opiate withdrawal was post-menopausal (ugh, once again, how personal can I get?) Menopause takes a woman’s WomanHood and removes it. So, if you’re taking hormone replacements or using an Estring or Premarin (by the way, don’t use Premarin, it’s made out of pregnant mare hormones and that creeps me out)  you probably won’t notice the effects of the opiates. Once you stop using opiates, you’ll KNOW you don’t need to use hormone replacements any longer. All your woman-bits come back to life. Yes, I could write that out in some sort of labia-vulva-related jargon, but come on! Do you really want to read that? If you’re a woman, you should get my inference. If you’re a man, write your own reactions to getting off opiates — except instead of post-menopausal, you’ll say post-mid-life crisis.

3. The numbing of genitalia (that’s a good way to put it) by opiates makes perfect sense. The purpose of the pain medication is to stop nerves from reacting to pain… and to any stimulus. Hence, opiates will kill your love life. Men will take Viagra or some miracle pill and women will suffer through mare urine lotions or the Estring which can just plain hurt.

Is that enough the personal? Being 61 (now) and having opiates in my system from 51 to 60 put my taking pain meds smack in the midst of the post-menopausal dance we all must endure.

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When a woman in menopausal, everything and I mean everything, body related is due to the hormones saying “good bye”. Headaches, body aches — this is my theory. I believe it’s difficult, if not impossible, to separate the body’s withdrawal from hormones to the the need for pain relief. Some day, hopefully in my great-granddaughter’s lifetime cuz it ain’t happening any time soon, the medical/scientific world will be able to assist women through pre- to post-menopausal times of their lives. As women live longer, it matters more and more. (Don’t double up on superlatives or descriptives, yes, I hear you O’Writing Teachers of the Past.)

When women died before or around 70, post-menopausal “comfort” was not discussed. For my mom, who had a hysterectomy at 50, she got monthly hormone shots from Dr. Kutait. Daddy lived until 72 and Mom didn’t remarry — she didn’t need what women today will need as they remain sexually active into their 80s. (Oh, that’s so weird, so not what I can picture but hell, it’s reality.) If your sex drive is diminished or even non-existent and you take opiates — I’m telling you what’s happened to it. I could be more graphic, but my little diatribe above should suffice.

As a footnote, one’s mate and one’s family are paramount in this world of opiates = Oxycodone and Oxycontin. From the first pill you take until your last. It does take a village — sure — the House of You best be populated by understanding, caring people and then you can consider how your much your village needs to know about your opiate withdrawal. I’m wandering all around the point here.

I’m going to research how opiates affect other parts of the body that depend upon how the brain gives messages to nerve endings in order to function properly. Perhaps saliva? Mucous? Since opiates are now known to cause Central Sleep Apnea (read about CPAP use and how not using your CPAP can quite literally kill you when you have CSA), what else do they affect? And the effects are insidious, occurring over time so you truly believe they are part of your disease of pain and not a reaction to the drug.

Chronic Fatigue Syndrome

How I Came to Receiving a Prescription for Opiates

In 2004, for about three months, my day began with getting my husband off to work (breakfast, etc) and shoving him out the door so I could go back to bed. My Mom lived with us, she was 86 and still fairly spry and active, especially her mental acuity. I’d fake it until I made it, wandering around starting some laundry or doing the dishes. Trying to act as if I was going upstairs –not to bed — but to write. She knew better.

I bought a Kindle Fire and binged watched “Midsommer Murders” and other shows with multiple seasons, as well as any and all movies available. Six to eight hours a day. The sheer number of shows I’d consumed was not apparent to me until recently when I scrolled through my Netflix history.

This timeframe is my first honest to goodness, I have a regular Rheumatologist moment. I began to go to Brody Medical School on ECU’s dollar due to a special program for those without insurance in rural areas. The precursor to Obama’s healthcare initiative, I suppose. My doctor there (who doesn’t need to be named) treated me for fibromyalgia, CFS, and he believed I had SLE (Lupus) so I was on Tramadol, anti-malarial drugs (Plaquenil for Lupus) and I received injections of B-vitamins and other boosts to my system. Plaquenil requires eye exams every 3 months. A complicated world of getting the eye exam, then sending results to the Med School, and orchestrating it all so that the results were available before my next rheumatologist appointment. What a dance! All of this with a mind-numbing fatigue crippling me from performing even the most mundane household chore.

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I received Social Security Disability in 2006. I could choose a new rheumatologist, outside of the med school, and so I changed doctors. This was mostly because of the waiting room time at Brody. My appointment would be for 1:00pm and I would find myself being escorted by the lobby security guard to my car, in the dark, around 7:00pm. (I have waiting room tales that could fill a book, when you sit next to someone for 3 hours, eventually they begin talking to you, it’s like being stuck next to a Chatty Cathy on a long airplane flight.) It became annoying and ridiculous after a year, hence the search for a new doc.

I found an arthritis center (no longer in business, doesn’t matter who they were) that took Medicare. This doctor believed in prescribing exactly as the pharmaceutical company said to prescribe. This is shocking, in today’s pharmaceutical criminal world, in NC legislative terms. Back then, if Vicodin was prescribed as a pain killer to be taken every 4 to 6 hours, then a month-long prescription meant a bottle filled with either  120 or 240 Vicodin. I shit you not. 750/500s, if you know your Vicodin numbers.

(Here I was, receiving this bucket load of pain meds while my neighbor, bless his soul, was about to get busted for buying 2 Vicodin from undercover narc at $10 a piece. He couldn’t get any more meds from his doc because he’d been labeled a “drug seeker” by local pharmacies. I’d like to note here that he was dead from the waist down, car wreck, DUI, and 23 years old, pushed himself in a wonky wheeled chair down to the park four blocks away to buy Vicodin whenever he could. This is a weird world we live in. Now we have Pain Clinics, Pain Contracts, and piss tests.)

I’m getting this insane amount for $6. Can anyone not see the recipe for abuse? I only took a couple a day and had plenty in my bureau drawer for the rest of the world — were I a sharing person and I were not. Ever. Never ever shared.

The Vicodin probably helped. I was in such a fog, I don’t remember. All I remember is the CFS and being scared that I had Lupus.

CFS Information:

Chronic fatigue syndrome has eight official signs (and I had them all) and symptoms, plus the central symptom that gives the condition its name:

  • Fatigue
  • Loss of memory or concentration
  • Sore throat
  • Enlarged lymph nodes in your neck or armpits
  • Unexplained muscle pain
  • Pain that moves from one joint to another without swelling or redness
  • Headache of a new type, pattern or severity
  • Unrefreshing sleep
  • Extreme exhaustion lasting more than 24 hours after physical or mental exercise

I’m going to stop here, this has been exhausting and it began with opiate effects on the body and the effects of withdrawing from the drugs and it ended with my medical history, up to 2006. That’s quite enough for now.

Just found this quote in a USA Today article on Oxycontin class action lawsuits.

“Ellis blames only himself for his addiction and says only God could free him from its grip.”

Now that’s powerful.

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The Effects Begin … Opiate Withdrawal

What began as a “what the hell?” moment quickly turned into my own personal hell. The story could be told in a day by day diary of the effects but I feel that’s too personal so I will combine what happened into a paragraph or two. As long as everyone understands, this withdrawal process took months.

The first thing realized? I had to replace my “habit” with another one. Not that I took Oxycontin all day long — I took it in the morning and again at night. But something had to replace my mental state. Strange as it sounds, I came up with smoking cigarettes again.  I smoked, on and off, for decades. Quit for ten years, five years, and the last time, 13 years. So I was confident that it would be a short-lived habit. Rob went to the corner store for some Camel Blues and there it was. When the day-time jitters began, a cigarette stilled my mind.

Getting off of Oxycontin is about rewiring your brain. It’s about neural pathways. While wiring for nicotine might sound stupid, it’s not as dumb as it sounds. A pleasure neural pathway … in a bit, there will be scientific explanations of this neural rewrite but let me tell you how it really feels.

Picture PAIN as the LA Freeway. Not the straight line highway you saw when OJ was chased. I mean the convoluted string-theory that is the LA Freeway. On ramps in the sky, twisting and turning and shooting out into who knows where? Envision a bird’s eye view of one of those Freeway On – Off ramps through hell.

That’s your brain on PAIN. All the neural pathways at the base of the brain, the nerves shooting out of the foramen into their proper brain trails. Okay, they’re all lit up like a Christmas tree. Each nerve ending demands attention, quick! Look! Here! This one, that one, all DEMANDING  attention, like a toddler in a room full of adults who are paying no mind to the cuteness, the dancing and twirling of that awesome little doll child you created wearing a ballerina costume and twirling until she becomes dizzy and crashes into MeMaw’s glass topped coffee table.

PAIN DEMANDS ATTENTION. Oxycontin (opiates) go in and say, “Hey, take my hand, I’m going to tell you how cute you are and soothe that wounded spirit.” Opiates rewrite your neural pathways, opiates send that pain onto an off-ramp and re-direct it away from the center, away from attention. When you cease taking opiates, those highways become confused off-ramps to hell again.

The days of agony, of Restless Less Syndrome (my Dancing Nancies) began quickly, before I had a chance to realize what was happening. Like the pre-flu day you get. The physical warning that something bad will happen and you can’t stop it. My body jerked around all day. Keeping busy kept my mind off the dance, physically busy. No relaxing with a book, sometimes, just sometimes, I could sit bouncing on the couch and watch TV. This is what I did when the grandsons were here (and they are on a daily basis). They knew “Nana was stopping her pain medications” and that I didn’t’ feel well. That won’t stop an 11 year old from spending the night, he got to stay up really late and watch Amazon Prime with me. The joke became: “What murrrrrrder shall we watch tonight?” as I frequently pulled up anything from Masterpiece Theater (Midsomer Murders, etc) and binge watched until the Nancies mixed with the Lorazepam and Lyrica and slowed to a waltz rather than a cha cha cha.

I should call it all The CanCan Dance of Withdrawal. My muscles began to ache from the constant twitching. I couldn’t sleep more than a few hours at a time.

I finally found my peace. At last. Not binge watching TV. It came in the form of Audiobooks. Terry Pratchett’s Discworld series. Read by Nigel Planer or Stephen Biggs on Audible. I think it’s Stephen Biggs, will check on that name. Nigel Planer put me into a relaxed state and yes, there is a turtle, flying through space, with four elephants on its back holding up a disc shaped world. Immersing myself in Discworld took my mind off the opiate withdrawal. I still use Discworld to put me to sleep, listening to a chapter a night as I work my way through Pratchett’s over 70 titles.

That’s enough for now, more later. I’ve got to get this printed out for my therapist. She wants me to share my experience with others… so I’ll turn all this into a PDF for her. It’s over 20 pages so far, I’m using Scrivener software to compile it. Cannot recommend a better software program for writers. I use it for the Civil War book about my great-grandfather as it compiles information, added bits, and it will even post to twitter or elsewhere, should I desire it. Buy Scrivener if you’re a writer and take the time to learn it.

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Dismissal from The Pain Clinic

It’s hard to describe what it feels like to be dismissed from a facility I’d been part of for over four years. Dr. Smith administered steroid injections, he prescribed my pain management protocol and above all — he was approachable and humorous. Once he remarked “You’re the only patient I have that knows how to read, there’s no one to show it to” when I tried to comment on a New York Times article I’d recently read about how to rate pain. I considered my relationship with his staff to be above the cordial receptionist-nurse to patient repartee.  We chatted often about family and life in general. Dr. Smith’s nephew was a massage therapist, with a massage business in the pain clinic office, and I’d often availed myself to his services — trying to loosen up the muscles in my neck. A half-hour massage was $35, cash, and apparently Medicare paid for part of it but a full hour was not covered at all and cost $60.

Information from the NC Medical Board on prescribing pain medications, pain contracts, and ethical responsibilities as well as licensing requirement.

One particularly important paragraph that apparently did not apply to my pain clinic:

Information obtained from the CSRS should ideally be used as an intervention tool to improve patient care, not to exclude patients from care. Although not currently considered the standard of care, I believe routine use of the CSRS should be a part of the practice of any physician who prescribes controlled substances for chronic pain. As with all assessment tools, data from the CSR system is not infallible and should not be the only factor considered when making patient care decisions.

Over the years with Eastern Physical Medicine & Rehabilitation I’d received left and right hand carpel tunnel hand splints, a $795 TENS unit (Medicare did not cover because the paperwork for the device was incorrectly coded. Fortunately, Medicare also sent a letter saying I was not responsible for payment of the device.) The coding problem persisted throughout my visits there, often finding a bill of thousands for injections or devices when I checked in and the receptionist requested my minimum payment, then seeing the total due reduced to a manageable amount by the next visit.

–>not online yet(Click here to read a Controlled Substance (Narcotic) Agreement). If you’ve never read one, let alone signed one, it’s interesting to note what patients go through to get pain medication. The promises they make, the requirements placed upon them. I was thoroughly humiliated the first time one was presented to me for my signature, but the nice nurse lady said, “Oh, this isn’t about you, honey, this is for the other people … we have people here on meth!”

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Once the full brunt of what was truly a betrayal by Eastern Physical Medicine & Rehabillitation and Dr. Smith became obvious, I knew what I had to do. By researching NC legal statutes, it became clear that one must send a certified letter to the clinic stating they were no longer to be considered said patient’s pain clinic. Yes, legally dismissing them from service, stating the pain contract with Eastern Physical Medicine & Rehabillitation was no longer valid. The 50 mile round trip to Greenville could be tedious, so I found a new internist locally. My first appointment was in four months.

Then it hit me. No more pain meds. No more scripts. Four months until I talk to someone about my pain.

Whatever Oxycontin and oxycodone I had at the time — that was it. I counted out the 40mg. Oxy’s. There were 12 left — figuring I could half them and take only one a day and up my Lyrica to 150mgs twice a day instead once. Then it hit me again. The reality that I had to withdraw from Oxycontin and all pain meds by myself.

This started an internet search for information. Rather than rage at my fate, withdrawal became something I could do. Seeing myself sitting on the bed, gut pinched, and syringe at the ready — I knew I must do whatever it takes to get off the stuff — or, as Larry would say: “there ain’t no question about it”, it could be done. Hell, I’d survived worse — I thought. Divorce, death, quit smoking, moved many times … and so much death. My sister, brother, mom, dad … what can be worse than that?

First things first. I called both my daughters to tell them what needed to be done. Then I told my husband. It was truly a “Whoa, are you serious?” moment for them all. No one doubted my sincerity. No one doubted my ability to “get off” Oxycontin. The concern centered around my ability to handle the pain.

That’s when the real story begins. My withdrawal and my method for doing so. After considerable online research through forums and pharmaceutical company information, I hit upon the Thomas Recipe.

Next post will contain the entire Thomas Recipe and the effects of Opiate Withdrawal. Tune in tomorrow…

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I will provide a copy of the “Vidant Internal Medicine of Washington NC Controlled Substance Narcotic Agreement” on a Page in this blog in the future.

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And we’re close to getting Thomas’s Recipe … read on.

ok, like I said before, you need to go to July 18, 2016 and read forward to this post in order to get the flow of the article if you’re just starting to read it. This is the raw, unedited version of my pain meds withdrawal story, so it’s subject to change, to misspelled words, to the need for links and citations. Regardless of all that, it is raw in another sense — emotional. Seven month later and it’s still amazes me that I did it. I left Oxy behind me and learned to live with the rollercoaster of pain.

Thomas Recipe posted on its own page.

People say they will not let their disease “define them”. That’s not true.

The Disease called PAIN  provides the background noise for everything you do, whether you admit it or not.

A good sense of humor, love of family and friends, good physicians and physical therapists all make for a more complicated definition. Pain, in and of itself, is beginning to be understood as a disease, perhaps more correctly, a syndrome.

There are two stories here. One involves the definition of pain, the discussion of pain medications, and the treatment of patients by doctors, lawyers, the government, and law enforcement. The other is the personal story of pain, of how it takes over a life and controls daily activity from the moment I wake up and all through the night as I attempt to sleep. Oh, CPAP, you define my sleep. I keep forgetting I have Central Sleep Apnea, not snoring, it’s much more insidious. A more silent killer causing heart attacks, high blood pressure and more. New research shows that pain medications can cause Central Sleep Apnea so I’m hoping that my flight from Oxycontin reveals a trip down No CPAP Lane.

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This story just seems to go on and on as more articles about the side effects of Oxycontin become available. All I knew about was the constipation, it wasn’t until I began writing this that I realized it probably caused my CSA. The story here is my personal journey through withdrawal, interspersed with Oxycontin details (pain medication discussions will develop over time, especially information from online forums.)

Read the definition of oxycodone, if you haven’t already done so.

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New post:

My next appointment with Dr. Smith’s office is in January 2016. I only have to go in every 2-3 months because of who I am as a patient. Never abused a medication, never asked for an early refill, never asked to titrate up unless my pain levels reached above a five on the happy/sad face chart. In November 2015, I’d worked my way up from regular non-time- release oxycodone, 10mgs as needed to 40mg Oxycontin x 2 a day with the 10mgs for breakthrough. It took almost five years to reach that level of medication. The 10 mg Oxycontin time release worked for a few months but it was obvious it wasn’t stopping the disk pain. Popped up to 20mg Oxycontin which again, worked for about a year(?) before the disks began to do their Pain Dance. The 40mg Oxycontin x 2 a day protocol created a working me, at least a working wife, grandmother, functioning person — not an in bed whiner with a heating pad and a dime novel.

And then, with no letter, no formal notification — Eastern Physical Medicine & Rehabilitation, Greenville NC — My pain clinic — Dr. Billy Smith’s office, dropped me a as a patient. The medical staff I depended on for years did not work with me or notify me that I’d been dropped from the practice — they just ignored me. There are links a the bottom of blog post detailing how a patient involved in a pain management program is supposed to be treated. Let it suffice to say, those are not my stories.

So, what the heck’s wrong with you, Valerie, you look fine to me. Your gait’s a little wonky but all in all, here you are, an artist and a writer. Working in the yard, walking to the park with the grandsons …

In 1988, I had lumbar fusion. Titanium steel rods held in place by screws, bone graft accomplished by harvesting bone from my right hip, in essence, breaking my hip. I was 34. By the time Dr. Stephen Grubb (NC Spine Center, Chapel Hill, NC at the time) performed the surgery, I could only walk a distance of about 10 feet at a time. I utilized wheelchairs at every Lowe’s or Food Lion, never walking through a store. I could get from the house to the car, so I could still drive my two grade school age daughters where they needed to be, but I couldn’t get out of the car and walk to the auditorium to see their performances or stand by the sidelines while they played softball. My disks were completely deteriorated, gone, and as Dr. Grubb illustrated by making two fists and holding the thumbs together and grinding them. “This is your spine,” he said showing me each fist, “in between each fist, there should be disks, the disks protect the spine, cushion it. You have no disks. None. It’s called degenerative disk disease and yours has advanced beyond that of someone who is 80 or more years old.” He told me I was lucky, I’d never let anyone operate on my back before coming to him. He could fix it. Eight hours of surgery. Months of physical therapy which I enhanced by surf fishing at Hatteras every chance I got.

A year in a body cast. A 15″ scar down my back. It’s almost 30 years later here in 2016 and that fusion still holds. It does not cause my pain. I see those titanium rods as part of a swing set, holding up the rest of spine, keeping it swinging. The disks above the rods would continue to deteriorate, to bulge or herniate, to eventually stop supporting my spine. As I understand it, the spine has holes in it, called foramen, and as the disks began to crumble between the vertebrae, the foramen began to narrow. Nerves run through the foramen — which acts as a protector for the nerves. Well, my nerves were beginning to fray inside these slowly narrowing foramen.

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That’s the pain. The electrical buzz of my nerves being squeezed and tortured by the narrowing. The bone, the vertebrae, seems to twist and turn and pull on the nerves, specifically up the left side of my neck and my left shoulder. C3-T2, I think.

Many back patients, sufferers of serial surgeries and attempts at pain medications to resolve their pain issues, many of them can tell you the exact dimensions of their insult to their bodies. They use their diagnoses, their surgeries, like business cards at the end of their emails or their online forum posts. I’ve never been that precise with my spine. Lumbar fusion? Check. Which vertebrae? Uhh, lumbar. Cervical disk problems? Which ones? Uh, C3-T2 because I finally downloaded a MRI reading and tried to decipher the radiologist reading. The most information I derived? The words “severe” with each disk evaluation. Say no more, I thought, say no more. I get it. And the Dancing Nancies I get every night when I try to go to sleep — well, if you look up Restless Leg Syndrome, you’ll find it can be whole body movement. That’s why I call it the Dancing Nancies. I’m jumping around like a frog in a science experiment — you know – the wire the dead frog one?

Oh yeah, there are more physically painful, weak areas in my body to discuss. Osteoarthritis, which “everyone gets”? I got the adult version early on. Hence the fusion at 34. I have a metal joint in my right big toe to make it bend correctly. I’ve had basal thumb surgery, rebuilding my right thumb. Interesting surgery, I’ll outline the process later, it is the gold standard for repairing the ravages of arthritis to the thumb. There have been other, more minor surgeries, on my feet. Throw in a hepatic resection and the removal of my gall bladder and the parade certainly becomes a long one. Reciting one’s surgeries or vagaries, the insults upon my body politic — it bores me and certainly must seem tedious to anyone reading this — I won’t go into any more details now.

Let’s go back to the tooth extraction. I called Dr. Smith’s office in January, asking for a call-back for a Provigil refill. After waiting two days, I called back. No return call. It was time to make my next appointment. I called the receptionist and she hung up when I said my name. Thinking we’d been disconnected by the questionable skills of the front office staff, I called back. Same response.

As Larry the Auctioneer up in Williamson always says, “Ain’t no question about it,” as he offers up an item. Well, ain’t no question about it, I’d been dropped as a patient. Someone in Dr. Smith’s office must’ve found the Vicodin prescription. What Billy Smith’s office did was not only unconscionable, dropping me as a patient with no warning or notice, it was illegal. NC law clearly states all pain clinics must titrate patients off of their pain meds.

This is getting too long for one blog post, you’ll have to let me split it up, post again tomorrow with more information. Thomas’s recipe posted on its own page, see header of blog.

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REFERENCES

 NC Statute citation regarding pain medications

here is citation to NC Medical Board recommendations referred to in the blog posts.

 

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Second Verse, Different from the first …

and so the story continues, if you don’t read these posts in reverse order, there might be a bit of confusion, so go back to July 18, 2016 and start there, moving toward each post. BEGIN: Oxycontin, the patent-protected time-release pain medication and its kissing cousin, oxycodone the generic non-time-release, had only been around since 1995. Was there really enough research on long-term use?

Back to the scene, me on the bed, a pinch of stomach gut in my hand, getting ready to plunge a syringe into my skin so that I could go to the bathroom. My mother never allowed any cute phrases in our house, you either “went to the bathroom” or you “had a successful BM” — when you talk about BMs to a grade school age kid, you get laughter, not a bathroom report. My mother insisted on saying “BM” until she was 93 and died. Talk about old school. She was born in 1917, so we can all cut her some slack.

Speaking of my mom, if you live with, talk to, walk by, sit near, are in a room with, someone over the age of 75, they will talk about their bowel movements. It is number one on the chart for how they’re feeling, what they’re going to do that day, and whether or not they’ll even get dressed. They will start the day with a Milk of Magnesia cocktail. If my mom didn’t poop after her first cup of coffee and cigarettes, she panicked. She over-dose on MoM and then spend the rest of the day denying it while I plied her with anti-diarrhea meds, trying to stop her from becoming dehydrated enough to warrant a trip to the ER.

Me, on the bed, thinking of Mom. Thinking about spending the rest of my life trying to poop, going from one medicine to the other, and now — here I was with a syringe in my hand?

No way.

I had to get off Oxycontin and oxycodone. Now. 

Skip back a month. There’s more than one reason I put my friend, Oxycontin, behind me. My qualifying for SNAP (call it by its old name, food stamps) also meant qualifying for a LifeLine phone as well as Medicaid. This is in North Carolina. Medicaid here means dental insurance with a $3 deductible. I had a broken molar, repaired many times over the last 10 years that needed yanking out. I’d had my teeth cleaned on a fairly regular basis, keeping up with dental care meant always saving, constantly, to get to the $250 it was going to cost here in Washington just to get my teeth cleaned, to get a check-up. Crazy, huh? I went to the only dentist within 20 mile radius who took Medicaid patients. There’s a whole ‘nother story in that son of a bitch, the sadist who treated his patients like shit, never spoke to his patients or told them what procedure/atrocity he was about to commit upon their mouths. What a jerk. After he pulls my tooth, he asks me if I have a pain contract with anyone. I say “mfffffhgghgsss” which means “yes”. He tells me I need to be on antibiotics, do I have any allergies, blahblah? The dental hygienist hands me a spit cup and a script in an envelope and says, “call us if the bleeding doesn’t stop in two hours.” Ahhhh, Dr. Tripp, your past will catch up with you.

My husband drives me home. Yes, the bleeding stopped, so don’t worry. He goes to the pharmacy, gets the script filled and comes back home — handing me two bottles of medicine. Two? I’m thinking, two antibiotics? Oh no, this guy writes, on the same page, two scripts. One for Vicodin and one for amoxicillin. Oh shit. NC Pain Contract, signed with Dr. Billy Smith, just violated. I panic, call the pharmacist who says to calm down. It’ll be ok. Only the DEA (the DEA!) and the doctor himself can check pain meds records. Not the staff, not the nurses, only the doctor, so my doctor is probably not going to check my record. I’ve been a loyal, law abiding patient for over five years. I always pass my piss test with flying colors. Nothing to suspect, nothing to check on.  I put the Vicodin my medicine drawer and get on with my life…

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Kicking Opiates After a Decade of Use

Life Beyond the Fray: Recovering From Four Years of Prescription Oxycontin by Valerie MacEwan, written the month of July in the year 2016, seven months after detoxing from opiates. The first in a series outlining my withdrawal from pain meds after being prescribed Vicodin, Tramadol, Oxycontin, Oxycodone for over ten years. How I did it. The Thomas Recipe and the betrayal of my pain clinic — and more. It’s going to take some time to write it all. I’ll publish it in bits.

My last appointment with Dr. Billy Smith’s pain clinic in Greenville, NC took place during the week before Thanksgiving, 2015. Dr. Smith handed me three boxes of Relistor, all labeled “Sample – Not for Sale”.

“Your insurance probably won’t pay for this but here are some samples and we’ll write a script, just in case you can get it. Since the Linzess isn’t working for you …”

I took the three boxes, along with the written scripts for Oxycontin 40 mg x 2 a day, Oxycodone 10mg as needed for breakthrough pain, and another script for Provigil 200mg x 1  day. My internist, Dr. Thomas Ellis, prescribed Lexapro some months earlier. (Each prescription drug discussed here will link to information about the drug through both the pharmaceutical industry and the online discussions about the medication.) Let me say first and foremost, I never abused pain killers. My recovery, my withdrawal, was not from overdoses or misuse. My drug use was always on the up-and-up. Pain clinics, pain contracts, no abuse — just doing my thing taking what was prescribed as it was prescribed.

Relistor. Methylnaltrexone bromide, subcutaneous injection. 12 mg./0.6 mL per syringe. That’s the medication in the boxes, the one my insurance company probably wouldn’t pay for because it hadn’t hit the mainstream oxycontin bowel effect circus of medicines yet. The latest in oxycontin “news” involved oxy’s affect on the intestines had just become available to patients by way of new advertisements on television.  Initially meant for patients suffering from Irritable Bowel Syndrome, the pharmaceutical company found a gold mine is constipated oxycontin users.

I’d tried Linzess, the first line of defense against oxycontin’s constipation. Why is this important? I mean, so gross a subject right here at the beginning of my story of how I kicked Oxy?

Relistor. Subcutaneous injection. That’s why constipation is important. Gross as it is.

Absorb the scene for a moment. Here I sat, on my bed, the week before Thanksgiving, with a syringe in my hand and I’d just pinched my stomach out enough to drive the syringe into my gut.

What the hell was going on? After over 10 years of Vicodin, Oxycodone and Oxycontin, my gut shut down. Linzess gave me raging diarrhea and dehydrated me. Now my only other option was to give myself an injection, a shot, in my stomach.

I was 60 years old at the time, just a few weeks shy of my 61st birthday. Planning to live at at least 80 (statistical possibility for sure), I glimpsed myself shooting up, in my gut, for 20 more years. Or what? What else was the Oxycontin going to shut down? It already rewrote my neural pathways, trying to subvert my pain into reasonable bits allowing me to function — or so I thought. It shut down my intestines. What was next? My liver? My kidneys?

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Dogs are healthy and hearty — hale and all that!

Tblue-buffalo-basics-adult-salmon-dry-dog-foodhompson is keeping food down again. He was throwing up every meal, no matter what I fed him. At 15, it’s rough to be a Jack Russell and try to keep up with the 3 year old Monkey Dogs (part feist, part ? but Zooeybutt really looks like a miniature pit bull, very funny — obviously she’s not but one day someone stopped me to ask what breed? and I said mini-pit and she believed me. Duh. Not true.) Anyway, after a week of rice and chicken thighs, we tried him on the  Blue Buffalo Basics. It only has 6 ingredients and apparently, those were the six he needed. It’s $50 a 34 lb bag, so with 4 dogs to feed, I think the need for the GoFundMe was obvious. Amazing stuff for an ailing loved one.

 

 

blue-buffalo-basics-adult-salmon-dry-dog-food

I was ready to say good bye to Thomp. He’d lost so much weight, skin and bones and lots of skin because his hair was falling out. Poor old guy, we thought, as we lifted him onto the bed at night. We’d already put the box springs and mattress on the floor about 6 months ago, so he could jump up — but he’d lost that ability. We put a pillow on the floor for the jump-down part of his morning. Anyway, now he’s eating the Basic with some really high end wet food thrown in and he’s gained weight and goes up and down back porch steps with the other dogs. Who knew!? Right? Ready to take him to the dog house in the sky and he bounces back.

That’s yall’s doing. Or as someone dear to me says, Yall’s’s. Yall’s is, pronunciation. Love my southern children.

Again about the Blue Buffalo Blue Basics Limited Ingredients. No renumeration for mentioning them but by golly, I had 2 sick dogs and a couple of hyper from the wrong food Monkey Dogs but the Blue Buffalo straightened them all out. My guys eat the Salmon and Potato recipe and I cannot recommend it highly enough. My theory has always been to give dogs high quality dog food and they won’t need a vet. Not picking on vets but if you keep your dogs rid of fleas, intestinal worms, and feed them high quality food, your vet visits are limited to check ups and vaccines.

Roxanne’s skin cleared up within a week. No more red spots and squirrely chewing. The Shar Pei part of her really has skin trouble. Someone told me pit bulls have a lot of food problems that bug their skin so I followed the Get High Quality Dog Food hints from forums as well as the Stay Away From Chicken in the food because of allergies advice. Not picking on chicken bits, chicken meal gives dogs some needed nutritional elements — it’s just not for my dogs.

Thanks. God bless you all.

 

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GoFundMe campaign to feed my strays

Help me feed my dogs through August 2016 go to gofundme.com/crashmacewan or see widget on left for link

started a $500 go fund me campaign for my dogs. I’m not sure what else to say, it’s all on the site

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If you don’t do it every day, you are damned to extinction.

 

List of daily living requirements:

Wear your CPAP device for a minimum of 6 hours.

aurora ferry, ncWear real clothes and change out of what you slept in — into clean clothes. Even if you don’t think you need to do it, take a shower.

Fluff your pillows. Make your bed. Pick your clothes up off the floor and put them away where they belong. Closet, chester drawers, dirty clothes hamper.

Update your technology.

I repeat:

Update your technology. And be willing to update the technology and teach the new requirements of said technology to your neighbors and relatives who are over 75 (or younger, trying to be nice here)

If you don’t keep up, you won’t be able to function. You’ll spend all your time installing updates and none of your time working.

Recharge your devices. If you live in a 100 year old house with a fuse box and a maximum of two (ungrounded) outlets per room, this is a difficult reality.

 

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The All Day Song of Pancakes

McSweeney’s Internet Tendency finds necessary the tracking of the whereabouts of Dr. and Mr. Doris Haggis-On-Way and requests reports of sightings of the ersatz couple. Obviously the two attempted to enter eastern NC via the Roanoke River but this writer will not reveal the true whereabouts here, on this website, as the current tracking requires sightings be recorded via email through the customerservice area of the website.

Why am I telling you this? Dear friends, as we shift on our sanity pedestals, let us herein reveal the photographic evidence of the couple. Attachments to sighting emails will obviously be rejected due to to the current situation.

Once I publish the photographic evidence of the whereabouts, I will endeavor to publish the True And Written History of Washington, North Carolina, USA.

Photographic incontrovertible Proof of my visual sighting of Dr. and Mr. Doris Haggis-On-Whey on the pocosin:

weldSandy

 

 

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