Did I do something wrong in a past life ? Am I just a bad person ? Do I deserve this pain ? Sometimes my brain doesn't stop asking questions like these. Heck after all I am trying to make sense of this. I know I didn't really take care of my back when I was younger and I probably was pretty stupid about lifting stuff that was way too heavy but hey I'm a guy. Watch this ! Famous last words before a trip to the hospital. I know I probably shouldn't have been hauling a 300 plus pound tent canvas by myself but as I said I was young and dumb and invincible ! I'm betting I am not the only person who abused their body in some form when they were younger.
Here's the rub. I don't know my family medical history. I have no clue if any of this can be laid to rest on my relatives's broad shoulders. Heck I don't even know if they had broad shoulders. I know I am a pretty big guy. Even as a kid I was big. One of the biggest in class every year until high school. But who gave me my size ? Which side has the most red heads ? See as a kid I was bright red, a regular ol' Opie Taylor or Howdy Doody. Yeah I know the shows were not in color but if they were Opie's hair would have been louder than Barney's declarations of love for whoever he was in love with. I can remember one year I went off to summer camp and I wore this red checked cowboy shirt almost every day. Talk about stereo types. I could have been used as the guide for Howdy Doody. That ought to tell you the fashion sense of kids. They have none. They wear what they like and screw the rest of the world and what they think. Then they hit middle school or maybe 5th grade but not much older and suddenly what everyone thinks becomes more important than parents.
So getting back to family history I have no clue. I don't know if half the family died of heart attacks at 50 or if the other half had a history of cancer. So it is unclear who willed me my back. I would love to exchange it for any other inheritance just about. My orthopedic surgeon said that Degenerative Disc Disease can be inherited or just be brought on by natural use or abuse. So we do have that history of abuse and use by me. I guess I am to blame. So why does society think it is okie dokie for me to suffer ? Is it that deep Puritanical streak in humans that assumes all pain is good for us ? Why do we as a society want people to suffer ? Who in the hell came up with that crazy idea ? We see it down through the ages that people who suffer are thought to be Holy or something. Hell even the Catholic Church has established suffering in the afterlife with Purgatory where we go to suffer for our sins before making our way to enjoy the bounty of Heaven. According to them I must suffer here then when I die I get to suffer more just to make sure then I get to be pain free. Sounds like a crock to me.
Doctors have finally come around to the fact that we don't need to suffer. At least some of them have. They understand that cancer patients in the terminal stages suffer agonizing pain and so they keep them pretty well doped up. Great, hey I don't want them to suffer. That is a great thing. Now how about the rest of us ? You know the ones who live in chronic pain. The ones who suffer from diseases like Lupus and Fibromyalgia and Degenerative Disc Disease and other diseases and maladies that cause pain. Okay I know DDD is not usually in the same league as Lupus or Fibromyalgia, it is present in every last one of us to some extent. They used to just call it old age, our body breaking down over time. But sometimes when DDD starts it doesn't follow the normal path and evolve slowly. Sometimes an injury can jump start it and boom, it takes off full speed ahead. That's what I have. My orthopedic surgeon says I have the back of a 90 year old, he told me that when I was under 45 so that makes me wonder just how bad it will be when I get to 90, if I get there at all. Will it be the same as 180 year old ? I don't know about you but I don't see many 180 year olds walking around the planet.
Let's head below that funky orange jungle gym. You can go ahead but you might need to wait for me. I take a bit longer to get anywhere nowadays. Feel free to light up a smoke or have a drink while waiting.
Sorry about that. I know it took me some time to get here. I told you I am pretty slow walking now. Now unless my mind is going as well as my back we were discussing society's fascination with people staying in pain. That is just weird. Why the hell is pain considered good ? What freaking purpose does it fulfill in my life ? Sure pain can tell you not to put your hand on a hot stove. It can tell you to stop what you are doing or expect more pain. I guess those can be good, but what about chronic pain ?
Day after day, month after month and year after year I can has more pain as one of those abominable little kitty cats says. Excuse me while I go puke. Well that may just be because of the pain. It does get that bad at times. Like almost every day. Usually about 5 hours after I have taken my last dose of pain meds. They only last four hours and I can't take more until I hit the 6 hour mark. Want to hear something stupid ? My doctor feels this is just fine. Well stop. I can't say for sure my doctor would be okay with that. I have yet to see him in 5 odd years of being with my current pain management clinic. Not once. I have seen the nice doctor who gives the shots. He is a pretty nice guy and I have to say he has got a great touch with the needle. Anyone who has had pain shots in the back knows what I am talking about. But the doctor who runs the clinic ? Nope not even my initial evaluation. That was done by a PA. You would think in 5 years I might have been reevaluated a couple of times to see what kind of progress I am making. Nope never. I have asked repeatedly for an appointment with him but I have never gotten one. I even asked very nicely and said pretty please, as little good it did me. So I don't know that he agrees with me being in pain for 2 hours out of every six. His PAs sure do though. This is a Pain Management Clinic. How screwed up is that. They are in the business of alleviating pain and yet they see nothing wrong at all with a patient spending 8 hours a day in pain. That is 1/3 of a day.
This is a fact of life at pain management clinics across the US. Pain medications will not relieve 100% of pain. Well they will if you don't mind being a zombie. So drugged up you can't function. There are some days I would gladly choose this. Why would I want to be that drugged up ? you ask. That's simple. I have to fight my pain every single moment of my day. Even asleep I get no relief from pain. If I turn the wrong way I wake up to a nice sharp pain saying "You dumbass! You know you can't do that. " Who controls how they roll in their sleep ? Before this all started I was what my wife called a world traveler. I would cover the whole bed a couple of times a night. I was all over the place. Since then I have stopped rolling as much but not completely. Who spends the whole night in any one position ? Not a single person in the world. So yeah I would choose to be a zombie sometimes. I get tired of fighting this all the time. I truly wish it was different.
So pain management can't fix what they are in business for. for those of us in chronic pain it isn't like the flu. It doesn't go away after a week of feeling like crap. We feel like crap 24/7/365. Our good days are when the pain is there but in the background just waiting to pounce if we lower our guard for even one second. My good days are when the pain is at a 5. That is as low as it goes. They could up my dose if they chose to but they don't. They have decided that a 5 is just perfect for me. Woohoo time to celebrate. How come they get to choose and I don't have any say in it ? Does that sound like a good way to practice medicine ? How would you like it if the next time you went to the ER for a broken arm, the doctor said oh we are only going to fix half your arm. Too bad I just don't feel like fixing the rest ? You would be on the phone to a lawyer in about 5 seconds. That is life in pain management. They get to decide what the pain level will be for every patient. They don't discuss this with you. You have no choice in the matter. They get to pick how much pain you will be in for the rest of your life and you get to sit there and take it. Better not react nasty to it. They will toss you out and good luck getting into another pain management clinic after that.
My primary care physician is a great doctor. I guess I got lucky when I found her after my last one left town after selling his practice to a money grubbing idiot. She talks with me. We have actual discussions about my health and my ongoing care. We talk about different treatments and how they may or may not help me. We decide together what would be the best course of treatment. That is how it is supposed to work. There is supposed to be a give and take between physician and patient. When something isn't working we discuss it and decide what to do to fix it. Too bad she will not take over my pain management treatment. I would love that and would follow her state to state if she moved, like a little puppy, happily wagging my tail. She agrees with me that I am not being treated right at my PM clinic and so she is wiling to refer me to another and if that one won't take me to yet another. But that is the problem. They might not take me. They consider it to be doctor shopping. That is something addicts do to find a doctor who falls for their line of BS and writes a script for the pills they want. They don't think about any of the normal things in life that may make you have to change like you have moved, changed jobs or even changed insurances. Your old doctor may not be in network and so you have to find a new one. None of that is taken into account. Just the fact that you are changing doctors.
What can we do to change this ? That is a huge question. Every state has it's own laws and hoops for chronic pain patients to jump through. There are no national laws about PM clinics. There are not any national groups that set guidelines for ALL pain management operators. Yes there are a few organizations that offer some training and do offer to allow PM operators to say they are part of it but most states don't even require PM operators to have this little bit of regulation or education. They have hoops galore for patients but not many if any for those who wish to practice this branch of medicine. In most states you can open a PM clinic with nothing more than the fact that your medical license is in good standing. Don't need any more training. No guidelines to follow. This truly needs to change and quickly. Just as there is a board that regulates surgeons there should be one that regulates those who wish to operate pain management clinics. The AMA should get on the ball and set up minimum guidelines for doctors who wish to specialize in this field. The opportunity for great harm is there but no one seems to be willing to step up and fix it.
So feel free to tell me what you think needs to be done to fix this. If you have a lot of good ideas write your diary and submit it to the group. If you want to make it short and sweet put it in the comments. I may go through them and take the best and make a diary of them. Hmm actually If I can get enough of them you can count on it. So tell us how you would regulate PM clinics. What laws do you want to see ?