Author Archives: Annie

Construction in Progress: Revisions to Resources List Underway

Hang in there, Doll - we're making the site better for you!

Hey Dolls! Just wanted to alert you that the Resources page is being revamped. We’re adding subpages by condition, so it’s going to take a while to get the list back up and functional.

But once it is, we think you’re gonna dig it for sure. Hopefully, it will be easier to find exactly what you’re looking for, and that’s our raison d’etre, so to speak!

Pain In the Butt: Relief for Sciatica

Woman in pain from sciatica

A little lower ... sciatica can be debilitating but it can also be relieved with yoga.

Over on Twitter, I’ve noticed a few conversations about “back pain” — that actually turn out to be … well, how can I say this delicately? … more of a pain in the posterior, than in the back.

That, my Doll friends, is (most likely) sciatica.

And despite what you might think if you’ve never actually experienced it, sciatica is not just some old person’s disease that’s more funny than seriously painful.

Sciatica can be a debilitating, constant pain that interferes with your life in a big way. I know this from bitter personal experience.

But there are some things you can do to relieve that awful pain. Some of them don’t even require a prescription!

What Is Sciatica?

First, let’s make sure we understand what sciatica is. Running down the length of each of your legs, from the middle of the butt cheek all the way down to the heel, is a long nerve called the sciatic nerve.

When that nerve gets irritated or compressed, either due to a structural problem (like scoliosis or a ruptured disk in your spine), you experience the wonderful world of sciatica. Sciatica can also be caused by a tight piriformis muscle.

Even if a tight piriformis isn’t to blame, though, stretching that muscle can relieve the sciatica (more on that later).

Sometimes that pain will run all the way down the leg, possibly even interfering with your ability to walk or stand for long periods. Sometimes, it will remain in the gluteus maximus area. It might hit one side or the other, or both, depending on the cause of the irritation.

What to Try First When You Experience Sciatic Pain

Of course, the standard disclaimers apply: I am not a doctor, and you should absolutely NOT take anything in this article as medical advice. Please talk to your own doctor first.

What I’m about to divulge is a narrative of the things I tried when I was pregnant and couldn’t take any medication stronger than Tylenol(tm).

The Single Best Yoga Pose for Sciatica

I won’t make you read the whole article for my best trick: a modified yoga pose I call “Threading the Needle.”

  1. Lie down on your back, with your knees bent. You might want to use a pillow for your head and neck.
  2. Slowly bring your left knee to your chest and straighten your right leg almost all the way. NOTE: it’s really important not to straighten it completely, even if you can do so comfortably. For some reason, it’s that “almost straight” posture of the right leg that really gets the left piriformis going. Hold that pose for 30-60 seconds, breathing deeply the entire time.
  3. Now, bring the right knee back up to a bent position and simultaneously lower your left leg, so both your knees are bent.
  4. Next, again bring your left knee to the chest, but this time, you’re going to cross your left leg over the right, resting the left outside ankle about three inches above your right knee. Gently stretch the inner thighs by pressing the left leg away from your torso, using the ankle on the knee as leverage. Do NOT strain here!
  5. Now, here’s the really kick-butt part: with both hands, grab your right thigh. If it’s possible for you, grasp your hands behind the leg. If not, just grab hold on either side.
  6. Now, slowly, and without straining, pull your right leg up closer to your torso, with the left leg still resting on the right. Hold it for 30-60 seconds, breathing deeply continuously.

After you’ve stretched the left piriformis, gently take the left leg off the right, lower your legs to the ground and shake them out a little. Then reverse the entire sequence on the other side.

If you know what you’re doing with yoga, you can also try this pose, King Pigeon pose. It accomplishes the same thing — stretching the piriformis — but goes much deeper.

Please do NOT try this unless you’ve done yoga for awhile and you know what you’re doing!! This is NOT a beginner pose.

Conservative Treatment Options for Sciatic Pain

In addition to the yoga sequence above, you can try the following options at home. Remember that sciatica is most likely not going to vanish overnight. It will require consistent attention over the course of several days before you see significant relief, in all likelihood. Don’t give up!

  • Ice massage: Take a styrofoam cup and fill it full with water, then stick the whole thing in the freezer. After it’s frozen solid, remove the cup, tear off a one and a half inch band around the top of the cup, and use the exposed ice to massage the skin around the most painful part (usually the middle of the butt cheek). Use as much pressure as you can comfortably. (This is a great one to ask your significant other to do!)
  • NSAIDs: The basic problem behind sciatica is usually an inflammation of some sort, so NSAIDs do work. Just be careful to take them only as directed, and never exceed the maximum dosage, as serious side effects could result.
  • Posture Check: Every so often, remind yourself to check and adjust your posture. Envision creating additional space between your vertebrae, stretching the spine on a vertical axis both upwards and downwards gently.
  • St. John’s Wort and Turmeric are two herbs/supplements that have produced mild relief from pain for me and others. Turmeric actually has some science to back up its anti-inflammatory properties.
  • Acupuncture and acupressure have both helped others. I have to admit, acupuncture never worked for me, and any direct pressure on the trigger areas for the sciatic pain just made things worse for me. But you might consider giving them a try for additional relief.

When to Go to the Doctor for Sciatica Pain

If you’ve been dealing with sciatica pain, trying these conservative approaches for a few months without success, you may want to think about going to see a doctor for a possible evaluation for surgical intervention, assuming your sciatica is caused by a ruptured disk as mine was.

I dealt with sciatica for nine months before considering surgery — of course, I was pregnant at the time, so surgery wasn’t an option for me then.

The microdiskectomy that was performed by my neurosurgeon on the L4/L5 ruptured disk area was a complete success for me. I woke up from the anesthesia in the hospital and was immediately aware that I was pain-free (well, at least from the sciatica).

But something like 20% of people who undergo this surgery for relief from sciatic pain due to ruptured disks do not experience significant relief, according to my neurosurgeon.

It’s something to be aware of, but I don’t believe you should immediately discount surgery out of fear based on anecdotal evidence. (Just like I don’t think you should press for surgery out of hope based on anecdotal evidence, from me or anyone else.)

As I always say, do your own research, get the facts, and talk with your doctor.

Sciatica: The Gift That Keeps On Giving

Either way, surgery or no, you can kick sciatica in the butt.

Just make sure you take care not to reinjure yourself, because once sciatica occurs, you’re more likely to experience it again in the future.

 

What’s the Difference Between Addiction and Dependence?

Image of Martini Glass Full of Colorful Pills

It seems like you can’t browse the web or flip through a paper or magazine these days without coming across another dire warning about the epidemic scourge of addiction to prescription pain pills.

One question nobody seems to be asking is this: Is it really that bad?

Nobody can really argue with a straight face that addiction to prescription pain medication doesn’t exist, or that it isn’t an increasingly occurring problem. But in the great debate playing out in the national media, I suspect that fear-mongering and sensationalism are being fed by a radical misunderstanding.

Put simply, I think a lot of media outlets, journalists, and anti-pain medication advocates are confusing addiction with dependence.

(NB: Yes, I’ve written about this before, but the issue is of such importance and complexity that it bears further discussion.)

Comparing Addiction and Dependence

The first thing to understand is this:

If a person is addicted, she is suffering from an abnormal physical & psychological disorder. If a person is merely dependent on medication, she is experiencing a normal physical response to the medication.

Another key difference between addiction and dependence is that an addict takes medication to achieve a “high,” whereas someone dependent on medication simply takes the medication to function.

Complicating the matter, however, is a set of behaviors that has been termed pseudo-addiction by some experts. It mimics addiction in some ways – a frantic, clock-watching anticipation of the next dose, for instance – but it is caused by the person’s experience of pain, possibly breakthrough pain or possibly pain that is not being adequately controlled by the prescribed medication.

Hallmarks of Addiction to Prescription Pain Medication

The following behaviors can indicate a potential addiction:

  • Taking pills more often than prescribed dose;
  • Taking medicine via an unorthodox method (i.e., crushing, snorting, injecting, etc.);
  • Going to a number of different pharmacies within the same time period;
  • Repeatedly refilling prescriptions before the medicine should have run out according to the label information (i.e., number of pills and frequency of dosage);
  • Doctor shopping;
  • Difficulties in socializing with others, where socialization came more easily before the medication usage began;
  • Increasing isolation from family, friends, and life activities previously enjoyed; and
  • Overall, a sense that the person’s life is in a downward projection, increasingly spinning out of control.

Comparing Drug Dependence to Addiction

It might sound bad – after all, who wants to be dependent on anything, let alone prescription pain medication? But dependence as a biological state is not inherently morally blameworthy as addiction is often viewed as being.

Dependence is simply the body’s natural acclimation to the drug.  It is probably more accurate to say that the body is dependent on the medication, rather than the person.

Some of the characteristic hallmarks of drug dependence, as contrasted with the hallmarks of addiction set forth above, are:

  • Medication taken as prescribed, both in amount and frequency;
  • Medication taken via prescribed method – i.e., no alteration of the physical form of the medication;
  • Patient may need an eventual increase in dosage, but compared to the addict’s self-administered increase, this increase is done under supervision of doctor and according to prescribed instructions;
  • Patient may exhibit anxiety in anticipation of next dose, but once pain is relieved, that anxiety goes away;
  • If pain is being managed, patient is able to function in her life activities and continue to socialize as before; and
  • Overall, a sense that the patient’s life is progressing in a positive direction, given the patient’s diagnosis and prognosis.

The Real Risk of Addiction

I can’t fault the growing numbers of chronic pain patients who express fear and repulsion at the thought of taking prescription pain medication. I was one of them, not that long ago. I completely bought into the hype that everyone got addicted, or could get addicted, to a long-term use of any prescription pain medication.

But that’s simply not true. The studies that have been done on addiction in chronic pain patients do not bear out the fear-mongering we see in our headlines every day. One study looked at over 24,000 chronic pain patients who were administered opioid medication. The number of addicts that resulted? Seven.

Not seven percent. Seven addicts. Out of 24,000.

Yes, I believe the crisis of prescription pain abuse has been somewhat overstated. And I believe that this unfortunate slant has resulted in a climate of fear that in turn results in fewer and fewer chronic pain patients being treated assertively for their pain.

Look, I am all for exploring conservative, non-prescription pain relief methods first. I am also completely in favor of looking at alternative treatments for chronic pain symptoms.

But when you’re in so much pain that you cannot function in your life, I believe you have the right to access any treatment that can restore that function, and that includes prescription pain medication.

It’s true that prescription pain medication, especially in chronic pain conditions that are poorly understood and for which there are currently no cures, will not address the root cause of the illness. Again, I’m all for getting to the root of the problem.

And I agree that most chronic pain conditions are rooted in a complex machinery that combines lifestyle, anatomical, biological, chemical, environmental, and, yes, emotional factors, and thus one pill isn’t going to solve the problem.

My point is that none of us is required to suffer needlessly with pain while we explore that machinery and get to the root of the problem, especially not on the basis of some exaggerated claims about addiction risk.

Bottom line: Know the facts, educate yourself, and make the best choice for you.

 

Going Mediterranean: Healthful Eating Choices Can Minimize Chronic Pain

Image of olive oil, tomatoes, peppers, garlic and pasta on burlap cloth with black background

Now, admit it: doesn't that look a wee bit delicious?

“Conflicting diet advice” – can we add that to “taxes” and “death” under the category of “Sucky Things We KNOW We’re Gonna Get”?

It’s become a joke at this point. Some studies say the controversial Atkins diet minimizes cardiac disease risk. Others say it exacerbates the risk. Scientists used to caution us away from eating eggs; now we find out they actually contain a cholesterol-lowering ingredient.

I threw my hands up a long time ago and decided that if the scientists couldn’t figure it all out, there was no way I could either. So, that being the case, maybe it didn’t make a whole lot of sense that one kind of food would be so much better for me than another. Or some other food would increase my symptoms so much more than another kind of food.

Maybe, it occurred to me, just maybe it made more sense to get back to basics …

Mediterranean Diet: The Back to Basics Way of Eating

And that’s pretty much what I found in the so-called Mediterranean Diet.

Right off the bat, I have to caution that there really is no such thing as “the” “Mediterranean” “Diet.” People on a Greek island don’t necessarily eat the same foods as Sicilians. Heck, they might not eat the same things as people living in a Greek coastal village. There is no one list of acceptable foods or foods that you can never eat, no one set of recipes, not even one set of guiding principles that are universally acceptable all over the Mediterranean region.

What we do have, however, is a list of generally accepted principles for what’s come to be called “the Mediterranean Diet.” And it’s a winner, in my book.

For me, this way of eating is terrific because, quite simply, I like the way it tastes. I love the “sensory” aspect of the dishes — the textures, the flavors, the colors. Mediterranean dishes really appeal to every one of my senses.

It’s also pretty darned simple, and that fits the way I generally cook. I don’t like to follow recipes usually. I prefer just adding a few ingredients to a basic “structure” and seeing what comes out. This way of cooking lends itself really nicely to that approach.

Since I’ve been eating this way, I can say I have lost quite a bit of weight, though I can’t attribute that entirely to the diet. More importantly for our purposes, my pain levels have tapered off and diminished in a few key respects. It’s not gone, but I “feel better.” And that’s worth just about any change of diet, in my cookbook.

Principles Behind Mediterranean Diet for Health Management

The general approach is pretty simple: Heavy on the fruits and vegetables, fish and chicken, light on the red meat; whole grains; low-fat dairy; olive oil and olives; and red wine (optional).

There’s no trick here – no super-secret science at work that will suddenly heal your chronic pain, I’m sorry to say. But it is a healthful, balanced approach that will reduce your overall health risks (especially for diabetes and cardiac illness), increase your general wellbeing and energy, and possibly reduce inflammation, which in turn can reduce your chronic pain levels.

Getting Started With the Mediterranean Diet

There’s no need to go buy a ton of new cookbooks, if you want to implement the principles behind the Mediterranean Diet into your own nutritional program.

Start simply and colorfully by choosing whole fruits and vegetables at the local produce market: carrots, colored peppers, broccoli, squash, berries, apples (go for organic if you’re concerned about pesticide use in your area, or if you don’t have access to a farmer’s market or co-op).

Add some olives. I love kalamatas, but there are several delicious varieties available at most chain groceries. Get a good-quality olive oil, while you’re at it. Cook with it (watch carefully and make sure it doesn’t hit the smoke point before you add in your meats and veggies) and add it to salads with some balsamic vinegar for an awesome and cheap salad dressing.

Rely on non-farmed fish and chicken, with an occasional dish including red meat (experts recommend twice a month or less, though I confess I eat it more often – more like once a week). Do a meatless meal once or twice a week; use beans and pasta to supplement veggies. Experiment with various spices – basil and oregano are my two go-to favorites – and garlic, which has some antibacterial and anti-inflammatory properties.

Now, about that wine … many iterations of the Mediterranean Diet recommend a daily glass of red wine, which some studies suggest reduces the risk of cardiac disease. Other studies suggest that it might increase inflammation. What’s a poor Doll to do?

Personally, I skip the wine because I take prescription medication. If you’re not taking medication, or at least not taking medication that’s contraindicated for alcohol consumption, you might want to try it once in awhile. I have to say, I do miss that occasional glass, even though I was never a big drinker. (Pause while all my college friends stop laughing…) But stick with just one a day, no more.

Resources for Further Reading on the Mediterranean Diet

If you want to experiment and play with these principles, I encourage you to check out two cookbooks that I’ve particularly enjoyed.

One is called The Mediterranean Prescription: Meal Plans and Recipes to Help You Stay Healthy for the Rest of Your Life by Angelo Acquista, M.D.  (affiliate link).  This book is more geared towards weight loss than general health, and it’s got a definite Sicilian bent. But whether you’re aiming to lose weight or just get healthy, the recipes are amazing.

The other is called simply The Mediterranean Diet(affiliate link), and it’s coauthored by Marissa Cloutier and Eve Adamson. It’s strong on nutritional information and also contains a seven-day meal plan suggestion, as well as a little exercise program you can try (though it might be unsuitable for chronic pain patients).

You can also take a look at the following links that I can personally recommend:

Buono appetito, and here’s to your health!

URGENT: Call to Arms for All Chronically Pained Dolls – A Sister Needs Our Help

You will not read a single blog post, Facebook status update, tweet, or news article today that’s more important than what you’re about to read right now. I promise you that.

This is a call to arms to all women with chronic pain, and every single person out there who knows and cares for them. A woman in Vermont needs help desperately.

The stakes couldn’t be higher. She is quite literally on the verge of being out on the streets at the age of 49, where she will have to deal with chronic pain, a recent traumatic injury, harassing debt collectors, joblessness, and hunger – not to mention the grave physical danger that women face every single day on the streets of our cities – alone.

This post is my attempt to prove to her, and to all of us, that she is not alone.

Meet Your Sister

Her name is Alexandra Jarrin, and she’s a remarkable woman.

Last fall, when Senator Bernie Sanders made his courageous stand for all the millions of unemployed Americans everywhere, Alexandra organized the “Letters to Bernie” campaign, where she encouraged others who were unemployed like her to send their written stories to the Senator’s office.

She became a face for a group that’s generally thought of as faceless by our more fortunate fellow Americans, and her efforts were highlighted on major media outlets like the New York Times, CNN and Huffington Post.

Then she lost her housing. She’d been staying with a friend, but that friend’s landlord issued an ultimatum to the friend: “Kick Alexandra out, or get evicted yourself.” With the generosity of friends and strangers, Alexandra has been able to stay in hotels since then but won’t be able to do so past today, as of the publication of this article at Huffington Post.

Alexandra is coping with a major knee injury, along with …

High blood pressure, diabetes, Fibromyalgia, Hyperparathyroidism, gallstones and kidney stones and God knows what else they are going to find. The worst thing I ever had to deal with was several kidney stones and the treatment for them.

Like the vast majority of unemployed Americans, Alexandra wants to work. She’s applied for over 3,000 jobs in the three years since she lost her job. Her car payments are late, and the lender is hounding her several times a day. Without that car, she has no hope of finding a job or getting to her doctor’s appointments.

Like the vast majority of unemployed Americans, Alexandra is not looking for a handout. She doesn’t want to get rich off public funds. Alexandra’s goals are a little less lofty: to find a job, to locate a safe place to live, and to make it to her fiftieth birthday later this month.

Senator Sanders’ staffers said they’d helped her, but it turns out what they did was tell her what she already knew: the names and telephone numbers of local agencies in her area.

My readers know I’m familiar with Alexandra’s situation, because I’ve lived it all too recently. Now that I’m climbing back on my feet, what I want most in this world is to win a lottery so I can turn right back around and help people like Alexandra, the way others helped me.  Barring that, what I want is for each and every one of my sister chronic pain cope-rs to join me in helping Alexandra with $5, $10, $50, or whatever they can spare. (I’ve sent $50. You send what you can.) I don’t want one more woman to lose almost everything because of chronic pain, the way I did.

Conventional wisdom says “Don’t give money to individuals. If you want to help, give it to reputable agencies.” I’m here today to tell you that this advice, however well intentioned, is wrong. It’s wrong for right now, at any rate. In this environment, yes, agencies are hurting. But people are skating the line between survival and not-survival.

The stakes could not be higher. Nothing else you read today will be as important as this.

I’m here today to beg you to help an individual. To help this individual. And if you’re not comfortable with that, then by all means go out and look for an Alexandra on the street corners in your own hometown. I promise you, you’ll find her.

And when you do, help her. Give her money. Get her a hotel room for a night, if you can. Buy her a phone card or a meal or a tank of gas. Help the person right in front of you.

Alexandra is the person right in front of me.

How to Help Alexandra Right Now

Alexandra can receive PayPal transfers at ajinvermont@gmail.com. If you want more information about her, to put your mind at ease before you send her money (perfectly understandable), Michael Thornton from Layofflist.org (who wrote the two HP articles I’ve linked to in this post) has offered to serve as a point of contact. You can write to him at mike@layofflist.org.

Spread this link to everyone you know. Tweet it, put it on Facebook, write it down on a sticky note and put it under the windshield wipers of every car in the lot of the local mall. No, it won’t solve the larger problem. It won’t save every Alexandra. But it will help save this Alexandra. And nothing else you do today will feel that good.

If you just cannot spare $5, how about volunteering your time? I don’t know what she needs besides money, but will attempt to find out.  When I was going through what Alexandra is dealing with now, I know that people who offered to do things – scour Craigslist ads for housing opportunities, for instance – were truly angels in human form to me.

The stakes could not be higher. Nothing else you read today will be as important as this. Alexandra could be any of us. She is any of us.  Please help her however you can.

 

 

 

 

 

Link Between Ultra-Flexibility and Migraines Discovered

Picture of a Woman With a Migraine

Migraines: Not your ordinary headache ...

“Hi, Annie. I’m Migraine. Nice to Meet You …”

I never had migraines until last summer. After a particularly stressful series of events one day, this blinding, throbbing pain began tormenting me.

I took three Excedrin, crawled into bed, turned out the lights, and covered my forehead and eyes with a cold wet cloth. A few hours later, the pain had faded enough to allow me to get vertical again. It happened two more times last fall, each incident separated by a few months.

Then last week, my eleven-year-old daughter, in obvious distress, began reciting an all-too-familiar list of symptoms—her head hurt, she felt sick to her stomach, light hurt her eyes, and sounds were too loud.

Before these personal experiences, I didn’t really give much thought to migraines as a source of chronic pain, I confess. Now, I’m in tiger mama mode, researching juvenile migraines and scheduling a visit to my daughter’s doctor.

(There’s another post for another day: why do we race into overdrive when it’s our family members in pain, but we often put up with our own pain?)

Stretchy Body, Stretchy Blood Vessels?

And that’s how I found this piece from MSNBC.com: “Ultra flexible? You’re at triple risk for migraines” (Reuters). It reports on a recent study performed by Dr. Vincent Martin, professor at Ohio’s University of Cincinnati College of Medicine, which showed that women with joint hypermobility syndrome are up to three times more likely to experience migraines than their less flexible counterparts.

Joint hypermobility syndrome isn’t really a pain condition—it normally requires no treatment. (A more severe form called Ehlers-Danlos syndrome is a whole ‘nother kettle of fish.) But it can be an indicator of what Martin calls “stacks” of other medical conditions that do cause pain, such as fibromyalgia, chronic neck pain, and sleep disturbances—and, apparently, migraines.

Martin’s working hypothesis was that JHMS, marked by “extra-stretchy” collagen in joints, could also be an indicator for increased risk of migraines. This is because the collagen (a crucial component in body structures like joints and blood vessels) should be overly elastic throughout the body. And if that’s true, the collagen in the blood vessels would also be overly elastic—and that, researchers already believed, is associated with chronic migraines.

Martin’s Findings: 75% Increased Risk of Migraines in Hyper-Flexible Women

Martin expected an increased risk but the actual results surprised him. The rate of migraine occurrence in the control group was 43%, but in the test group, the rate shot up to 75%. After factoring in age and medication usage, this figure translated to three times the risk for migraines for women with joint hypermobility syndrome, who also experienced migraines more than twice as often, with an increased occurrence of aura.

Researchers had long suspected a link between JHMS and migraines. Dr. Blair Grubb, a professor at the University of Toledo Medical Center, said “It’s one of those things where everybody knew it, and somebody just got around to publishing it.”

Of course, as we know, that “publishing” part is pretty critical in order to support further studies and advances in treatment.

Migraines and Euston Arch

Do you have migraines? Tell me what you do to make yourself feel better in the comments!

I’m especially interested in hearing from moms of young children who experience migraines.  I got a few great tips from Twitter the other day (I’ll be asking Princess’s doc about Maxalt, and we’re looking into nutritional changes as well—thanks, tweeps!) but information is power, Dolls, so let’s share!

Trauma Doll Thursday: To Medicate or Not to Medicate

 

Broken Doll

The 411 on the Rx

It’s not a question you should ignore, but it’s also not a question to take lightly. Medication is serious business. And once you start, you sometimes can’t just stop without serious physical consequences. But you also have to give a new medication sufficient time to work before throwing in the chemical towel and moving on to something else, or another medication.

It’s no secret—at least to anyone who’s been reading this blog more than a day—that I do not exactly share the mainstream media’s freakout over pain medication. To the contrary, I heartily encourage anything that gives a chronically pained sister or brother the kind of relief that allows us to—y’know, function. If that’s a weekly massage and a few Tylenol ™ — fabulous. (And go read some other blog because chances are, you’re just either accident prone or getting older, not chronically pained.)

And if that’s a daily dose of little white pills, then that’s fabulous, too. (As long as you take it as directed and get it legally—i.e., from your doc.)

It’s about doing what works, whatever works, as long as it works. And when it stops working? Move on to the next thing.

Are You Ready to Dose Up?

So, how can you tell when it’s time to talk to your doctor, as the commercials say? Well, there are a few questions you can ask yourself, but be warned: this list is purely from my own perspective and experiences. Ultimately, the decision is intensely personal and you should trust your gut. (Unless, of course, it’s your gut that’s causing the CP.)

Have you exhausted all non-medication alternatives that fit your lifestyle?

Look, as much as I’m a fan of medication because of what it’s done for me, it isn’t for everyone, and there are some downsides to turning to prescription drugs too soon. Drugs can and do reduce the pain so you can function again, but they also can mask the source of the symptoms. Turning to drugs too soon after diagnosis or onset of symptoms can sometimes lead us to the false conclusion that the problem is solved.

Explore the conservative measures first—but don’t make the mistake of thinking you have to exhaust ALL conservative measures. If a suggested regimen has you turning cartwheels to down 40 supplements according to a complicated schedule and radically revising your diet to boot, and that’s not for you, don’t be afraid to say “no.” Quality of life is a complex calculation, folks. Pain or lack of it is an important facet, but it’s only one of many.

Have you done your research?

Do you know what your options are? Check out the more reliable medical websites and find out. Look at the side effects and the frequency and risk of each. Check out contraindications.  And then throw your hands up in confusion because none of it makes any sense.

Yeah, you’ll get that on medical sites. That’s OK. Don’t let them make you feel stupid because you can’t understand every eighth word or insane because they all conflict with each other.

And then ignore the ones that confuse addiction with dependence.

And all the ones that preach about how eeevil prescription pain meds are, no exceptions.

And the ones that say all you need is a bajillion supplements—or, worse, just one (patent pending, completely proprietary, insanely expensive) supplement that’s only available at that site.

Yeah, it’s a jungle out there. Arm yourself with objective information wherever possible, and write out your questions.

Are you prepared to put in the time?

God willing, you’ll get lucky on the first pitch and that prescription will hit it out of the park. But that doesn’t happen often. In my own case, lucky me, I rode the Bextra carousel for a while (and then they pulled it from the market) before I found tramadol.

In any case, you can expect that it will take several weeks before you and your doc find the right prescription in the right dosage. In the meantime, you’ve got to take the medication as prescribed, and keep a log of any side effects.  You also have to continue doing all the other things that foster good health—it’s not a case of “one pill and I’m done.” So those nutritional improvements, the nightly “sleep hygiene” routine, the daily gentle exercise—keep ‘em around.

Are you ready for the potential fallout?

And now the unpleasant, cold, hard truth: people can be idiots. Especially about prescription pain medication.

You may have to educate your significant other, family members, and friends. Hell, you might have to educate your doctor. There could be unwanted effects on your job performance, especially as you work out the dosage. (I could tell you a funny story about me and tramadol in the early days…and I will, in the next Trauma Doll post.)

Bottom Line

If you know in your heart that whatever you’re doing right now isn’t giving you the level of functionality you need to live your life, then it might be time to explore medication. Do it with open eyes and go in armed to the teeth. Be prepared for a fight but don’t anticipate one. Enlist your doctor as a team member, not some authority figure to whom you owe obedience. And be a patient patient—it takes some time to get it right, so don’t give up too quickly!

Yeah, Yeah – Bad Blogger. I Know.

So, you may have noticed that I haven’t been blogging recently …

OK, so it’s true. Every time I checked this site over the last several months, and saw that “October 26, 2010” entry on the last post, I threw up a little in my mouth. Guilt, thy name is blogger.

Here’s what’s been going on.

2010: The Year I Made Contact – With the Bottom

Readers who’ve been around for a while might recall that I posted a cringeworthy confession of sorts last summer, admitting the dire straits that chronic pain had thrown me in over the last few years. I’m happy to report that I was able to avoid the homeless shelters—on occasion, by the skin of my teeth, but still, I’m proud of that. I wound up near Asheville, North Carolina, where I’ve longed to live for many years. I’m proud of that, too.

And I’ve started making a little money—enough to pay (barely) for a place to live for myself and my daughter and the necessaries (food, gas, etc.). I’m by no means out of the woods, but overall, things are definitely on the upswing. I’m extremely proud of that.

That was my 2010. How was yours?

Decisions, Decisions …

And so the next question became “What’s next?” It’s a new thing with me. Thank you, Aaron Sorkin and West Wing.

And whatever would turn out to be the next thing … well, it was clearly a crucial choice I was facing. I considered some options. My novel was almost finished late last fall when the computer crashed and died a horrible death, causing me to lose all but the first six and a half chapters. (That actually turned out to be a good thing, because it forced me to reevaluate the plot, which in turn led to a much stronger story.) So, I started working on it again a few weeks ago, and now am up to Chapter Nine. Yay me!

But let’s be realistic. As my friend Lex says, “Expecting to pay your bills by selling a novel is like counting on a winning lottery ticket.” Well, she’s mostly right (though there’s a good bit more control inherent in novel-selling than in gambling, thank God).

So, I also applied for the scant few jobs I heard about that I could feasibly do, given all my myriad “issues.”

Ooh. Humorous anecdote time: When my daughter was about three, her dad was struggling one day to get our Norwegian Elkhound, Thor, to stop begging for food – unsuccessfully, of course. Exasperated, he said, “Dog, you’ve got issues.” Princess (who was actually shorter than the dog at this point) looked down at Thor’s paws and back up at her dad and said, confused, “Daddy. Thor don’t got shoes. Thor got FEET.”

Well, my issues notwithstanding, I had no luck with the job-hunt. After a lot of soul-searching, and with a huge surge of will to overcome my irrational resistance to the prospect, I made an appointment with a disability lawyer. That’s pending, and it’s another post entirely.

Still, that process takes forever. Something like 80% of all applications are denied initially. It can take years. That doesn’t put the ramen noodles on the table.

Distractions, Distractions …

And I kept coming back to this site. To that book I’d planned to write so long ago. Now, I confess, I also kept coming back to all those other great ideas for books I had along the way. You see, I’ve come to realize something about myself: I do not lack ideas. I lack commitment to a single idea.

It’s not a conscious choice. I mean, I’m aware of this fault, and I try to put everything else aside so I can concentrate all my efforts on one undertaking. It’s just that … I don’t know. The other ideas – whatever I’m not working on – start to look so much better than the project at hand. And I second-guess myself. A LOT.

“Hey, You Crazy Kids—Get Off My Lawn”

Ultimately, what finally persuaded my rational mind, at least, to get its ass off the fence and firmly in the middle of the Tramadol Diaries yard was the logic of it. This site – that book – this project – it’s so much further along (believe it or not) than all those other potentially brilliant ideas. And the need is immediate.

So. Here I am. Back in the blogger chair, my blogging hat firmly pulled down tight on my head, my blogging blinders squarely affixed thereto, in order to block out the enchanting brilliance of all distractions.

Let’s go!

Actavis Announces a Voluntary Recall of Transdermal Fentanyl 25 mcg (UPDATED)

2D structure of fentanyl
Image via Wikipedia

UPDATE (10/28/2010): Was just alerted to the following additional information provided by Actavis, the drug manufacturer involved in this voluntary recall. This was included in an email update from the American Pain Foundation:

“We have no interest in adding to the discomfort of patients who are using this product to help alleviate moderate to severe pain however, and therefore, as an accommodation to consumers/patients, if they have an Actavis 25 mcg/h Fentanyl patch, we will work with them on returning the product”, was included in the correspondence from Gerard Farrell of Actavis Corporate Communications.

Individuals who have these lots in their possession and want to return their 25 mcg/h Fentanyl patch can call # 877-422-7452 and an Actavis representative will assist them with their return.  They have also posted helpful information to their website: www.actavis.us. Look at the lower right corner of the home page for “Fentanyl Recall Information.”

Reminder: For a listing of the affected lots, visit the Actavis website: http://www.actavis.us/en/Fentanyl_Recall.htm

Just got the following in my inbox courtesy of the American Pain Foundation. Read carefully, and follow the instructions if you’re affected by this:

Actavis, a generic drug manufacturer, issued a voluntary recall of 18 lots of their 25 mcg Fentanyl patch on October 21, 2010. One lot was found to be defective, causing the medication to release too quickly into the bloodstream. This lot, along with 17 others, has been recalled. According to Actavis, the Food and Drug Administration (FDA) and wholesale and retail pharmacies have been notified.

For a listing of the affected lots, visit the Actavis website: http://www.actavis.us/en/Fentanyl_Recall.htm

Regretfully, the company has failed to require the public to return their affected lots. As of October 25, the company’s website states, “Consumers are not being asked to return any product as this issue does not pose a threat of a serious injury or death.” Rapid absorption could lead to unintentional side effects such as increased sedation, nausea, vomiting and slowed breathing. The American Pain Foundation strongly urges Actavis to reconsider its first advisory and extend the recall to consumers.

Individuals who have these lots in their possession should:

  • Contact Actavis and demand a consumer recall and proper replacement. According to the FDA press release, Actavis has operators available to help customers, health professionals and consumers with the following information:
    • Medical Issue/Adverse Event/Product Questions:  1-877-422-7452 (24 hours/day, 7 days/week)
    • Return/Reimbursement Questions:  1-888-896-4562 (24 hours/day, 7 days/week)
  • Contact the FDA and report your experience. Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA’s MedWatch Adverse Event Reporting program either online, by regular mail or by fax. Online: www.fda.gov/medwatch/report.htm
  • Contact the pharmacy where this medication was filled and report that you are in possession of an affected lot.
  • Notify the health care provider who writes your pain medicine prescriptions and ask for guidance.
  • Notify your insurance provider should a new prescription be written, so that it will be covered.
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