Monday, December 08, 2014

Indiana's Attorney General, Pill Mills, and an Apology from Lara (aka The Sinister Porpoise)

It was a cool spring morning in Terre Haute as I pulled into the Vigo County Annex. The press secretary for Indiana Attorney General Greg Zoeller had sent out an e-mail about a press conference his boss planned to hold in Terre Haute.  As had been the case with the previous e-mail, the mailing did not discuss the topic of the press conference in length.  He also had sent the e-mail out the night before, giving reporters little time to do any research on the topic.  As with the previous press conference I had attended, I expected it to be a chance for local politicians to further their own career while a politician desperately attempted to carefully control the information given to local reporters.

As I went into the building, I sat down and saw the attorney general wave at me. Someone cracks a joke about how a certain Indiana town is pro-amendment. Another attendee asks if the person who made the statement counted the number of gun stores in Terre Haute.  A few minutes later, everyone settled down and the press conference began.

Zoeller highlights two laws he proposed, both of which eventually passed. The first one provided stiffer penalties for people engaged in human trafficking and added legal protections for victims who came forward to report the case.  It seems harmless to me, and I jot down a few notes in my reporter’s notebook. 

He moved on to a bill addressing the problem of pill mills when he finished talking about human trafficking. As a former Mormon with anti-drug views, this interested me more. Despite my libertarian-leanings, I liked what I heard.  Zoeller’s new rules would force doctors to treat all opioid prescription painkillers as class 2 substances.  Patients would need to get a written note from their doctor every time they need a refill. The hard-line anti-drug Mormon in me rejoices. By now, I should have learned how mistakenly self-righteous I could be.  It never crosses my mind that this might make it harder for someone with chronic pain conditions  to access medications that provide a moderate amount of relief.  It did not occur to me that Zoeller's overreaching law might ever affect me.

I go home and write my story covering the event.  The tone taken in the piece suggested that the attorney general solved a drug problem plaguing our communities, although it did not explicitly use those words. At the time I held the opinion that everyone who used these drugs long-term was an drug addict. 

The story might have ended there. It would have if I had not developed fibromyalgia nearly a year later.  At first, I thought it was not a big deal. It just felt like cramping. Working out and spironaloctone from my hormone replacement therapy seemed like possible causes. I did not have health insurance, so I let it slide.  The pain started to get worse. One morning, I even woke up with pain in my thigh that lasted all day.  I started to worry and went to the emergency room.  The emergency room tests my electrolyte levels, rules out a blood clot and then sends me home with a prescription for 800 milligrams of Motrin.  I take the medication, but it does nothing for the pain.

Going to the emergency did little except give me a $780 bill that I am slowly paying off.  As the pain increases, I try to figure out what the problem is on my own. As I had been working out, tendinitis seemed most likely.  I started icing and wrapping the area above my knee. I also do my best to stay off that leg.  This does absolutely nothing. By now, cramping at night is keeping me awake. I even start complaining about it on Facebook.  

I realized that the emergency room and my own diagnosis were probably incorrect. After hearing my coworker talk about it, I decide to go to a new free clinic that opened up in Terre Haute.  It took several hours to get into see someone, but the appointment seems to take much longer than it should. The doctors here checked for diabetes, asked questions about multiple sclerosis, a few other conditions I do not remember, and they acted acted in a bizarre manner. Eventually one doctor comes in with a smile on his face and simply says it's a pinched nerve in the hip. His diagnosis fit the symptoms and I stopped worrying. He did nothing for the pain, however, other than to tell me to lose more weight. 

I did not go back to that clinic because I realize I needed a longer-term solution.  I remembered a health center ran by the Sisters of Providence in Terre Haute. I set up an appointment there. The pain starts to spread to other areas of the body, but it starts out as just minor cramps again. She asked questions that amused me as a transgender person, but also prods the knee above the actual painful area. She claims she gets me to jump. I went home from that appointment with a knee brace and an X-ray order.  When the clinic gets the order back, they admit, as I had told them, that the knee was not the problem.

When I got health insurance coverage again, I went see my regular doctor. Towards the end of the visit, my doctor took out the pad and started writing prescriptions. He gives me a prescription for tramadol and a prescription for a muscle relaxant. I asked my doctor what they are for, and he told me I had fibromyalgia.  He also orders a hip X-ray, which I get done the following Saturday.

My primary care physician does no additional testing, and I never manage to convince him that such testing was necessary.  I fill his prescription and start ta king the medication.  For the first time in months, my pain levels drop to the level of aches from the flu. Of course, there are still days when my pain soared to higher levels, but the painkillers allowed me to function at work.  Even though I wished my doctor had gone to other options first, the synthetic opioid allows me to work without too much complaint, and I can stop using a cane most of the time. 

I have only used tramadol* since October.  I’ve stopped taking it because of a possible allergy.  I have not developed an addiction or dependency yet, although it is possible that I might in the future.  The situation forced me to change my perception of prescription pain medications and those who use them.  A small percentage of people have abused them, but many people who use them are following their doctor’s instructions and trying to get through a bad situation.

Developing fibromyalgia and chronic pain has also caused me to realize that I owe everyone who uses pain medications to function in their daily lives an apology.  Society sends constant hints that no one really needs these drugs.  These messages come from people who either never have or never will face that type of pain.  Facing this particular chronic illness also makes me realize that there are many more things I will never be able to understand because I will never go through them.

*I do not think I should have been prescribed the medication the way it was. The directions say 1 tablet, 3 times per day with meals.  I have talked to other people who have taken this medication and prescribing it this way is unusual.

Note: I have also sought out a second opinion and went to a doctor who ordered tests to rule other conditions out. While I was  going through all of  this, I learned that rheumatoid arthritis runs in my family.  The blood tests, along with the X-rays on my right hip and right knee, do not completely rule out RA in its early stages, but they do make fibromyalgia more likely.


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