Friday, January 21, 2011

America --- Let's Put Her on Pain Meds

I have an autoimmune disorder, which is rare and basically causes my vascular system to attack itself.  This, in turn, causes painful ulcers where the blood supply is compromised because of restricted blood vessels.  Enough said about that.  Other than the fact that it took two years, four doctors and a trip to the Emergency Room before I was properly diagnosed and treated, I am in relatively good health now.  I did lose two years of my life to pain and misery though, and I blame it on what's wrong with America.

America is a land full of substance abusers.  I'm not so sure that it's because people here have more addictive personalities than people elsewhere, or it is a normal reaction to a profoundly sick society, or a combination of many factors, including the fact Americans want instant fixes for whatever ails them.   To be perfectly honest, I used recreational chemicals in my younger years.  Thankfully for me, I woke up one day after quite the party, and realized I needed to use about three different chemicals just to feel normal enough to take a shower.  At that point, I understood that if feeling normal was the goal, then doing normal things did not include abusing substances.  I call it the day I got my sunshine back.

When I started to show symptoms of my autoimmune disorder, my regular doctor was an internist who had taken relatively good care of me.  In retrospect, that he missed this diagnosis completely, and even pooh-poohed me when I mentioned that I wanted him to look into the possibility makes me wish I had sued his pompous ass, but I just wanted to feel better, not enrich myself.

To make matters worse, he was convinced I was suffering from something I knew I was not suffering from.  So he put me on medication for the illness he thought I had and sent me for lab tests to confirm his diagnosis.  Meanwhile, I was in enormous pain; pain that woke me up, kept me up, made talking difficult, pain that was a ten on the one to ten scale, twenty-four/seven.  And because my internist was from that school of medicine that believes everyone is an addict and everyone is drug seeking, he told me to take aspirin. He also failed to even look into the possibility of my autoimmune disorder, so convinced was he that he was right.  Had he done so, he would have realized that he was putting me in severe jeopardy as this disease takes many courses, none of them good.

I will say this.  Pain is a terrible thing.  Eventually it wears a person down and the pain becomes the focal point of their life.  One year into not being diagnosed, my life was painful episode after painful episode, and my internist continued to tell me to take aspirin.  I will never forget the look of surprise on his face when he opened my chart and discovered the lab report stating I did not have what he believed I had.  So a year had gone by and we were back to square one.  He was surprised, but I was suicidal.

I realized it was time for our relationship to end.  I paid a visit to a new general practitioner, who took one look at me and my very visible problems and prescribed three different pain medications, all narcotic and all that put me in a complete fog.  But thank God for her.  I think I might have just given up had I not gotten some relief at that point.  I still had no diagnosis, but I had a doctor who was treating me for my symptoms, not assuming I was a drug seeking addict.  Before we could even start the investigation into what was ailing me, I had an episode of severe pain.  I ultimately ended up in the emergency room of a big medical center, where a young doctor, probably one year out of medical school, listened to my symptoms and correctly diagnosed me, referring me to a rheumatologist at the center.  The rheumatologist has taken excellent care of me ever since, although my disease has flares and I have occasional bouts of moderate to severe pain.

Here's my point.  I saw my rheumatologist last week, as I had been having issues related to my disease and was experiencing some rather severe pain.   I was actually afraid to ask my physician to prescribe pain medication for me for fear of a negative reaction.  Imagine my surprise when my physician actually agreed with me that to suffer pain so severe it prevented me from answering the telephone was, indeed, ridiculous and did not have to be tolerated.   I almost cried and I am so very fortunate to have a physician in charge of my health care who actually cares about me and does not assume that I am a junkie.

What is really interesting about this story is that I had never, in the five years I had seen my previous internist, asked him for pain medication, or any other habit forming drug.

I don't like taking pain medicine; it makes me feel not quite normal, and normal is the goal.  I guess my "normal" is an okay place for me to be and I'm lucky for that.   But pain makes you abnormal, too, so taking the meds is the lesser of two evils.  Meanwhile, I am following physician's advice, and doing everything I need to do so that, hopefully, the prescription for pain medication will end up sitting on the shelf for a long time, unused and unneeded, after my current situation resolves.

Because Americans are emotionally sick, American physicians are doubly challenged to get to an accurate diagnosis and treatment plan.

Americans are emotionally sick because our culture is dysfunctional.  The cultural dysfunction manifests itself in very real and obvious ways, and extremely subtle and barely noticeable ways.  However it manifests itself, we are a nation of obese people literally starving to death, both physically and metaphorically.  We have everything and it turns out that having everything is the same as having nothing.  Whatever it is that we lost along our path to the misconception that we are vastly superior in the world, we'd better rediscover it.   I see us perishing in our vast emptiness.  America is suffering.  And no one can diagnose why.

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