Chronic Illness, Pain, Opioids and the Pain Treatment Centers

4/28/20016

Opioid pain medications and abuse are getting a lot of attention, deservedly so, this is a problem in the United States.  (As I type, yet another report comes on the news.)  Unfortunately, chronic pain patients are not getting the same attention.  It’s important that we remember that chronic pain is also a very real daily issue that affects quality of life for millions of people.  I’m one of them.

The state where I live has had some of the toughest regulations for opioid medications for years now.  There is a huge stigma associated with taking any kind of pain medication.  Admitting going to a pain clinic is tantamount to admitting that you have a drug problem.  This is could not be further from the truth!  

Yesterday was my regular appointment at a pain clinic.  I was not referred to this clinic immediately upon my diagnosis with chronic illness.  I was diagnosed over 15 years ago.  I also was not referred immediately after one surgical complication.  It was months after several surgical complications and nerve damage that I was referred to the pain clinic.  I have tried numerous other therapies.   At home, I still use relaxation techniques, music, heat and ice, stretching and a TENs unit besides pain medication.   Do you know what the only thing readily approved by insurance without limitations and huge expense for me might be?  Yes, pain medications.   I am willing to try any therapy recommended by doctors including acupuncture, massage, hypnosis, aromatherapy and would love physical therapy in a warm pool but it has to be affordable.  Chronic illness is expensive.

When I arrived at the clinic yesterday the waiting room was packed, as it is always.  There are many elderly people.  I’ve spoken to many people who drive three to four hours to get to the clinic.  It takes an hour for me.   The appointments are always the same.  After signing a card with your complete information, not just name and time, I try to squeeze in somewhere in the waiting room.

When my name is called, it’s back to the scales to weigh, get vital signs taken, go through any other appointments you have had, ER visits or hospital stays, medication changes, your pain level on those scales we all know and love/hate and when you last took any pain medication.   I move on to another room where I wait again to see either the doctor or a Physician’s Assistant or Nurse Practitioner.   Each patient only sees the doctor a few times a year, seeing the PA’s and NP’s between.  Then I follow the yellow line to the lab.   Bathrooms and needles wait.  Each time, each patient must leave any belongings in a cubby and urinate in a cup.  There is a big gray tub for the samples.  I place my sample in the tub with all the others and wash my hands in view of the nurses and gather my purse.

Back to the waiting room where I let them know I am finished.  I’ve seen the doctor this trip.  When they call me to the next window I am scheduled for an extra appointment to try an interventional procedure, a steroid shot in my Barbie butt gone wrong.  I’m really anxious about it so I ask for an appointment with a counselor, too. 

Now it’s back to waiting.  The waiting room is so packed there are almost no seats left.  One woman and man tell me they have been waiting for an hour and half and two hours since they saw the doctor or NP.  We must all sit in the waiting now for someone to bring out prescriptions.  They bring out stacks at a time, like handing out fliers.  Only these fliers are carefully guarded.  You have to show a picture ID to receive one, sign your name and initial here, here and here.  There is no privacy; the entire waiting room can see how many fliers you get, even if they don’t know exactly what is written on the flier.  It doesn’t matter.  This waiting room might not be made up of the same demographic of people but we are still all the same, we all hurt and we all feel degraded, shuffled in and out following the yellow and blue lines.

Am I better served here than with my regular doctors?  The government thinks so.  It’s the response to opioid abuse.  I think what happens to me is more likely to fall through the cracks.

Hyperbole and a Half - A different kind of pain scale

http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

Acute vs Chronic Pain

https://my.clevelandclinic.org/services/anesthesiology/pain-management/diseases-conditions/hic-acute-vs-chronic-pain

US Pain Foundation - It's Time for the Pain Community to Organize

http://myemail.constantcontact.com/It-s-Time-for-the-Pain-Community-to-Organize-.html?soid=1103157487426&aid=63ne9zKZsPQ

Dr. Oz on Doctor's and Opioid Pain Medications

http://www.today.com/video/dr-oz-doctors-went-too-far-in-prescribing-opioids-for-pain-673068611543

Opioid Abuse and Chronic Pain - Twin Epidemics

http://thehill.com/blogs/congress-blog/healthcare/276843-opioid-abuse-and-chronic-pain-twin-epidemics?platform=hootsuite#

Forbes - One Orthopedist Prescribing Meditation Over Medication

http://www.forbes.com/sites/jeenacho/2016/04/11/why-one-orthopedic-surgeon-is-prescribing-meditation-over-medication/#44a8e7b945e8