07 February, 2007

Why I Hate That Stupid Sherrif Dude and Dr. House

This is a post I've been dithering about for some time now. I've wanted very badly to write it because of how central the issues are to my life. But I've been very afraid to write it because of the misperception that is sure to follow. But as I sit here at my desk, tears streaming down my face, I think it's finally time for me to say something.

The Sherrif of Williamson County was arrested for having a bunch of pain pills. He claims they were for his personal use, despite having enough on hand to have taken 17 pills a day. He's now in rehab for drug addiction.

From Matthew Perry to Michael English to Rush Limbaugh to Nicole Ritchie. There is always someone famous who is public about his or her addiction to painkillers.

And thanks to these people I am forced to live 80% of my life in excruciating, debilitating pain. (Yes, I realise that sounds like a drama queen of the first order and I'm sorry for that.) I have two chronic conditions, the overlap of which means that I am generally in pain for one thing or the other. Just to give you an idea, both conditions--severe endometriosis and chronic kidney stone formation--are deemed to cause a pain equal to (the endometriosis) or far worse than (kidney stones) the pain of childbirth.

I have found myself unwittingly in the middle of a large debate in the medical community. Out of fear of board sanctions, most physicians are undertreating chronic pain. That basically means that doctors know their patients are hurting and still refuse to do what is necessary.

The misperception about patients with chronic pain continues. Medical experts agree that most pain patients can successfully use narcotics without consequences. Folks like me who take pain medication for, you know, actual pain do not feel the euphoria associated with the abuse of pain medication. The likelihood of a chronic pain sufferer becoming addicted to their pain medication is somewhere between 3 and 14%. Yet we have to put up with the Dr. House character on TV, a chronic pain sufferer shown as a blithering addict. The last episode of the show I watched had him begging for a spinal morphine injection, being given a placebo and exhibiting relief. Everyone seemed to think that was a wonderful way to prove to the world that the use of pain medication by chronic pain sufferers is an unnecessary weakness.

I would estimate that 75% of my waking life is spent in attempts to manage chronic pain. I have drastically changed my diet and learned self-hypnosis. My husband has learned acupressure techniques. All of these help to a degree, but generally involve my doing nothing more than sitting in a chair or laying on the couch trying to overcome the hurt. (Did I mention that I also take about 30-32 advil a day?)

What does help in my case are opiod pain relievers. Just to give you an idea, I receive 12 Lortab a month. (Remember, the sherrif had enough to take 17 a day....) I save my stronger drugs for times when I absolutely must be able to move without pain. You know what? This makes me angry. But thanks to the well-publicised fools who love to abuse these drugs to get high, I can't even have enough to make it through more than 5 days a month without crippling pain.

28 Comments:

At 9:39 AM, February 07, 2007, Blogger Chance said...

A good argument against the drug war.

 
At 10:09 AM, February 07, 2007, Blogger Slartibartfast said...

Kat,

Thank you for sharing this. I've had a very similar situation in my life, and I thought it was unique, till I read this post.

When my parents temporarily moved back to Nashville a few years ago, my mother slipped and fell on the front porch, cracking her tailbone. The break healed, but the pain never went away. She was in excrutiating, chronic pain. Hearing her moan constantly was almost too much for a son to bear.

Her doctor, for well over a year, told her there was nothing that could be done. Mom never said why until recently. Apparently the doctor was afraid she'd get addicted to narcotics.

Fast forward to this past year. My parents run away from home again and settle into their new home in Florida. She finds a doctor down there, and he puts her on a pain management program. For the first time in years, my mother is pain free and can move around pretty well again.

I praise God for that, but thinking about all that time here in Nashville in horrible pain (FOR NO REASON!) makes me so angry I could get violent. In fact, if that doctor ever runs into me, he's due a couple of punches to the face and a swift kick to the groin for good measure.

I get so mad I start shaking just thinking about it.

And I hope, like my mother, you can get into a good pain management program and finally be free of the pain.

 
At 10:39 AM, February 07, 2007, Anonymous nm said...

I'm with ya. I've also got a chronic pain problem. It's nowhere near as severe as yours, and is manageable without opiates. But I know how much it takes out of me, and I can't imagine how I would function if it hurt as much as what you're going through and I couldn't get sufficient medication.

I also know a guy who is on prescription oxycontin for pain. I've never seen him act high, and he says the worst it does is make him a little spacy at certain times of the day; I'm sure the untreated pain would be far worse for him. This is an issue that just makes me crazy with the wrongheadedness of it all.

 
At 11:34 AM, February 07, 2007, Blogger Heather said...

I can vouch for endo flare ups being worse than natural childbirth.\

Not only do you have nothing to look forward to, at least in my case the endo pain was constant, labor I could gasp for breath and refocus.

 
At 1:24 PM, February 07, 2007, Blogger Lynnster said...

I don't even want to ask this because I'm sure the answer is a resounding "OF COURSE!!!" But you have been to one of the local Pain Clinics there, I'm sure? I know they are often not of much help either.

We had two really good docs in the UT Pain Clinic down here at one time and unfortunately one of them has relocated out of state.

My feelings about it all are much along the same lines as yours. Unfortunately I get (or probably someday really will) to witness another aspect of such problems with those in my family/future family who are narcotics addicts. My better half has been mostly successful in years of recovery, but even still, were I to have to go on chronic pain medication for anything, I would never feel comfortable about having anything such in the house without it being under lock and key. That's a bridge we'll likely have to cross someday for sure, and his history of addiction (and every other addict's in this country) pisses me off for the same reasons it does you and affects me the same. In fact, I thought about this very thing the last time I had a severe UTI and was offered nothing for the pain. It all sucks, and it breaks my heart to hear you are having to deal with such strife on an ongoing basis.

 
At 1:53 PM, February 07, 2007, Blogger Ivy, the Great and Powerful said...

I feel your pain, although it's in my jaws. I had surgery to correct this, and it got better for awhile, but it is coming back and the very thought of that makes me want to cry. My doctor, although he is a great guy, is extremely stingy with pain meds, and while I understand where he's coming from, I feel like he should know me well enough by now that I am not going to abuse the pain meds. I only want to live a normal life without this horrible pain in my jaw. Bah. It pisses me off.

 
At 2:28 PM, February 07, 2007, Blogger Nate said...

As a resident DrWho had to rotate through the pain clinic for a few months. I don't know if the english language is suficient to describe the red tape she had to wade through to help someone.

And plus... the worst part of it is... there are so many drug seekers... its unbelievable. It got to where, even someone as kind-hearted as her... by the end... she was having to consciencely remind herself that all paitents were not just drug fiends.

I asked her how many legitimate patients see thought she saw in a day... she said most days none.

Its a bad situation for all involved... and the true patients living with real pain get the worst of it. Because so many doctors get so jaded, they just end up treating everyone like a piece of crap after a while.

I don't know which was the bigger mistake... the War on Drugs or the War on Terror. Right now I think the WoD... but then again... WoT is just getting started.

 
At 2:49 PM, February 07, 2007, Blogger Ginger said...

When I worked in Work Comp Case Management, there was a doctor in Madison -- Dr. Ensalada -- who was a pain management specialist. I wonder if he could help you.

As for the endo, why on earth hasn't your doctor suggested 1) uterine ablation, or 2) hysterectomy? I also had debilitating pain that I had gotten so used to that I didn't realize how bad it was until after my hysterectomy and couldn't believe how much better I felt. As difficult as it was to have the surgery, I am SO thankful I did.

I truly hope you won't give up and keep on these physician's asses. Don't back down. I had to keep on my doc until he finally realized I wasn't just whining...and I'm talking months of continuing to complain to him...

As for Dr. House... well, he's just so cute, but I'm afraid the gimick of the show is getting tiresome.

 
At 3:24 PM, February 07, 2007, Blogger Kat Coble said...

Ginger,

To answer your questions I've had two surgeries to remove adhesions--the endo equivalent to ablation. (Ablation is inside the uterus and is for heavy bleeding and internal fibroids.) I'm holding off on the hysto until I'm at least 45, because I'm still trying to have children, and also because a hysterectomy doesn't always cure endo. (funny.hahaha.)

Pain management specialists are thin on the ground here in Nashville, and they do tend to be visited by a lot of drug seekers. I'm leery of attending one because a) I can't stand to have doctors poke and prod and b) I'd much prefer for either my gyno or urologist to manage my pain. They both know the ins and outs of my system as it were. Bringing a third guy into the mix is not my idea of fun.

Slarti, your mom probably had more luck in Florida because the palliative thinkers are more concentrated around the senior population. It's far easier to find adequate pain management specialists in places like Florida and Arizona.

Not only do you have nothing to look forward to, at least in my case the endo pain was constant, labor I could gasp for breath and refocus.

Except for those brief moments during an endo flare up where you pass out. Those always help.... ;-p

Its a bad situation for all involved... and the true patients living with real pain get the worst of it. Because so many doctors get so jaded, they just end up treating everyone like a piece of crap after a while.

I don't doubt that she was jaded. I've been to the E.R. on a late Saturday/early Sunday. The number of drug seekers there is obvious. The note of surprise in the doctors' voices when the get my CAT scans back is always amusing. ("This one actually HAS a real kidney stone!") I've been there and heard people with bleeding gums begging for a shot of morphine for their mouth pain. I can imagine that 80 hours a week of this bull would make a sceptic out of the softest heart.

I don't know which was the bigger mistake... the War on Drugs or the War on Terror. Right now I think the WoD... but then again... WoT is just getting started.

From what I've seen the WoD has punished and damaged far more lives at this point than the WoT. But what do I know?

 
At 4:32 PM, February 07, 2007, Blogger Nate said...

Indeed it has Kat... I was just thinking that the WoT hasn't really gotten revv'd up yet. I fear the worst is yet to come.

When comparing the evils, and they are both vile evils, I am reminded that the WoD has had its claws in us longer. Its had a bigger opertunity to rack up the trophies.

10 years from now though?

Maybe someday after the Revolution we can discuss it over their corpses.

To much to hope for?

 
At 4:33 PM, February 07, 2007, Blogger Ginger said...

I think I'm confused, Kat...when you say "endo", I thought you meant endometriosis, (which, for anyone who may not know what that is, is the lining of the inside of the uterus growing on the outside and into the abdominal cavity.) The ablation would burn out the inside lining of the uterus to stop it from spreading to the outside organs causing more adhesions. (I can attest that this did help for a few months, and then all of the pain came back). A total hysterectomy would clear out the endometrium from the abdominal cavity and then it wouldn't be possible for it to grow out if there is no uterus. However, neither of these are an option if you want to have children. Is endometriosis what you are meaning when you refer to endo or is it something else?

eh, regardless, I will keep you in my prayers regarding this...I truly know what it is like to live in constant pain.

 
At 4:35 PM, February 07, 2007, Blogger Nate said...

Kat,
My wife has not done a fellowship in Pain Management... but she is an Anesthesiologist.

Would you like to talk to her?

I think you might be suprised at just how far in the dark ages most OB's are when it comes to pain. There are OBs out there that to this day try to refuse their laboring mom's epidurals.

Lemme know.

 
At 4:43 PM, February 07, 2007, Blogger Nate said...

and for the record... 12 lortab a month is nothing. Sounds like they don't take your pain seriously at all.

 
At 4:47 PM, February 07, 2007, Blogger Nate said...

Ginger,
The surgery doesn't have 100% success rate. Sometimes they come back.

One thing that is known to help is birth control pills.... but not really an option for Kat.

Sounds to me like this is a rock and a hard place issue.. because even if she does get good narcotic pain relief... when she gets pregnant, she'll have to come off of them.

Then what?

Tough situation indeed. Prayer is indeed in order.

 
At 4:58 PM, February 07, 2007, Blogger Ginger said...

Nate, If you are saying that birth control pills have a better cure (or control) rate than hysterectomy...I never heard such a thing, and I am pretty studied on the subject since I suffered with it since age 13. I did the birth control, Lupron, uterine ablation, and laser surgery to laser the endometriosis out. Nothing worked. Not until I had the hysterectomy did it stop. Yes, it could grow back if there are remnants of the endo embedded in other organs, but if not, there is no possible way for it to recur if there is no endometrium lining for it to come from. Please let me know where you got your information from. Thanks!

 
At 5:46 PM, February 07, 2007, Blogger Kat Coble said...

Yes, it could grow back if there are remnants of the endo embedded in other organs, but if not, there is no possible way for it to recur if there is no endometrium lining for it to come from.

I do have unremovable lesions within kidneys and on the bowel and the bladder.

A hysterectomy would not cure those.

 
At 7:38 PM, February 07, 2007, Blogger Ginger said...

oh, that sucks!!!

I did some research into what Nate said, and it concurs what both he & I were talking about. Yes, it can indeed grow back if it is embedded in other organs...ugh...I sure hope they got all of mine, but I doubt it...my doc said the pathology showed it embedded all over the place. Shit.

You're in my prayers, Kat.

 
At 8:33 PM, February 07, 2007, Blogger Nate said...

Its ok Ginger... I've not been the most polite commenter at NiT... I can hardly blame anyone's skeptism.

I got my information from my anesthesiologist wife of course.

I think at this point prayer is the best option Kat has. She'll be in ours.

 
At 10:48 PM, February 07, 2007, Blogger Kat Coble said...

Nate,

I have to admit that after all your recent bitter comments about overweight at NiT I'm quite puzzled at your gestures of kindness over here.

I'm not upset about it, I just quite honestly don't know what to make of it. I've truly appreciated your insight and concern and offers of prayer. I'll take prayer wherever I can get it, of course. But I'm just truly puzzled. Truly.

 
At 12:08 AM, February 08, 2007, Blogger Nate said...

Seperate issues completely. Think about it. I hate homosexuality. Does that mean if I saw a gay man get hit by a car that I would laugh and point at him?

What does getting hit by a car have to do with being gay?

Nothing.

Just like your weight, whatever it is.. I neither know nor care... has nothing to do with the pain you're in.

One of the problems with comments is that people read all sorts of emotion into them that isn't necessarily there.

I'm sure you guys think I am the most bitter... angry... permanently pissed off dude in the world.

Like the comments you're refering to. You clearly took it personally. Like I was saying it just to be mean.

I wasn't. I've never seen any of you... besides britney. I don't know who's fat and who isn't. I don't care. I was just stating my position in the affirmative and I wasn't sugar-coating it.

The tone of voice in your head is probably hate filled screaching.

But that's because you can't see me smiling and laughing while I type it.

At anyrate... my explaination may help... may not... either way... hopefully you understand that my consern is sincere.

 
At 7:15 AM, February 08, 2007, Blogger Ginger said...

oh, I just thought you finally found Jesus.

(jk!) :-)

 
At 7:51 AM, February 08, 2007, Blogger Malia said...

Hey friend, I wanted to comment yesterday but Blogger was having one it's "issues" while I was online!

I don't have anything really profound to say, just that I'm so sorry you have to go through this and that I'll be praying for you and that the war of drugs really does suck in how it effects the innocent. I do have to agree with Nate, though ::shock!:: ::gasp!:: (Just teasing, Nate!) Another doc, like an Anesthesiologist will have a different school of thought on how to manage pain and may be more willing to prescribe the correct amount of meds for you.

Just think about it.

 
At 9:07 AM, February 08, 2007, Blogger Kat Coble said...

Hey, Malia. Blogger did the same thing to me yesterday. I wish they'd get their act together.

Once things settle down on other fronts I'm going to be pursuing some pain management. Other doctors I've talked to (besides my own) think it's a good idea and are telling me that I am undertreated. I am leery, though, because alot of Pain specialists really DO seem to be junkie mills. Not interested in that.

I'm sure you guys think I am the most bitter... angry... permanently pissed off dude in the world.

I did have that impression, yes.

But that's because you can't see me smiling and laughing while I type it.


Perhaps throwing in an emoticon or two would soften the blow. As a general rule I hated emoticons but with the amount of time I spend communicating online I think they've become a necessary evil.

 
At 8:41 PM, February 12, 2007, Anonymous Liz said...

Thank you thank you thank you. I hate the way doctors treat pain and chronic pain patients and I just want to thank you for sharing your experience.

I find that Nashville area hospitals are even more intolerant especially in pediatrics, and I have found through research and google, that there are other hospitals willing to treat children and families with chronic pain sufferers better, and give them more options.

Once again, thanks for sharing and commenting on my blog!

 
At 8:51 PM, February 12, 2007, Anonymous Liz said...

ALSO: My mom and I both have chronic pain and my mom is a nurse. She says that it is ABSOLUTELY ABSURD and UNHEARD of to give someone with horrible pain only 12 Loritabs PER MONTH. That is disgusting.

And she knows of someone here in Nashville that is a good doctor for those with chronic pain conditions. If you want we can exchange emails sometimes.

Just a warning: taking that much advil a day is dangerous, because advil can cause severe liver and kidney problems if used excessively. I understand that it's the only way you can receive any relief and I think that just totally sucks and shouldn't be the way you have to live.

And once again, I totally agree about Dr. House (though I love most of the show, just not that part) and the fucking sheriff.

Again I hope we can exchange emails!

 
At 3:29 PM, March 16, 2007, Anonymous La BellaDonna said...

I've been to two successive Pain Centers for treatment of chronic pain; first one closed, then the next one, and now I have to find another one - if I can. One that I can get to on public transportation, since I don't drive. One that I can fit into my schedule, since I'm still working full time.

I always wondered why at the Center they would ask every month, "Are you still working full time?" I would answer,"Yes," thinking, Has anyone here recommended me for permanent disability yet? Then how else do I manage the health coverage??

Chronic pain changes who you are. It changes how you spend your time, your goals, and how you see yourself. Regardless of who you were before, it shrinks your world into a couch and a heating pad (when not at work). And most people don't understand that just because you're taking a lot of medication - if you can find a doctor to prescribe - that doesn't mean you actually feel well. Or "fine." Or "normal." Or even "OK." It means that you haven't decided to take the whole bottle at once this month, or to figure out where you left the ammo for the shotgun.

I take Percoset with a side prescription of Oxycontin every day, and unless there's a big bunch of milligrams in those Lortabs, and I hope there is for your sake, they wouldn't see me through three days, never mind a freaking month.

I told one doctor who was expressing reservations about Tylenol that my liver was going to have to look after itself. He seemed to think he could do better for me than that - but he was with one of the centers that closed.

I hope you find someone who can actually help you.

 
At 3:49 PM, June 04, 2007, Anonymous Anonymous said...

I feel your pain. I also suffer badly from endo and Im pregnant! I have heard it suposed to help it but I'm apparently I fall in the few that have more severe pain while pregnant. My Dr. assures me taking loritabs wont hurt the child but I try and still take less but I do take three to four a day to manage the pain.
I would suggest finding another Dr. In my case, I live in a larger city and sometimes I think I get them too easily.
I hope you find a better Dr. who can help you.I know what it is to live in constant pain. It tears you down..

 
At 2:50 PM, July 04, 2007, Blogger localinsight said...

Hey everyone,
This is the first club I have joined in a long time. You all have my sympathy and best wishes. I suffer chonic pain, have been with systemic inflammation for about 17 years. I turned down narcotics for a long time, trying to experiment to finde the cause. When houseboun, wracked with pain-induced insomni and inability to bathe, burning skin, the works, I finally made it to a pain specialist in CA upon the recommendation of my mediation teacher. My doctors would do nothing. I was advised to leave CA for cost and medical care reasons, just before I was diagnosed with Lupus and a rare disease. Perhaps a type of arthris (atypical) rather than lupus. Upon medical advise, I came to MN instead of NV, as I had planned. MDs here took me off steroids and Norco (hydrocodone) without a pain specialist. According to them I am malingering or psychotic.
I have to find someone to fill out a disability form. They are messing with a seriously tragic life - tough to finance a move across 2 timezones after supporting oneself on disability/medicare since 1992. Medicare the joke. Have spent average $200.00/mo on chinese herbs to take the edge of pain and minimize major illness sx since last Sept.
I am going broke fast in MN. No MD here will disagree with another MN MD even though the know the CA diagnoses and medications. Not to mention the suffering which comes with relocating from a desert to a humid plains state.
I went to a writers workshop last weekend to geton with my life and fell on the concrete floor. My back/neck is so out of kilter from pain after sitting erect for more than 4 hours. This is all documented but not by these MDs.
I need to get back to the southwest, drier country, to minimize medication anyways. Don't know how, not even unpacked after steroids wore off useless.
Looking into el paso, tx, las cruces, NM for cost reasons. Any one know about medical care there? I have medicare but if HMOs rule, everyone but MD family members get same treatment. How is pain management in NM and west tx?
I never felt euphoria on norco. I did have to go to detox because of extensive protocol by a neurologist - very expensive for us medicare types as well. Unhealthy in everyway. When norco and milk thistle would be much better. People in the detox program who did abuse took three times the amount I was taking at my max. It's obvious who is abusing.
I believe a movement should be organized to tell the story of the needless suffering and loss to society resulting from undermedication of those like us (not to mention mismedication and psychiatric hospitalization costs). Perhaps if I can get treatment I will have cognitive energy to get the word out more lucidly. In the mean time, if you want to give it some more thought, now may be the time, with Sicko just out.

What would your community enjoy from your talents if you did not have to spend all your energy trying to get medical care and suffering? Think about it.

 

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