Category Archives: Healthcare

Blood, Meds, and Tears

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Today’s post is a mixture of my continuing medical saga, and a rant about drug laws.

Follow-up on doctor stuff:  I saw my primary care doctor on Friday 9/26.  He listened to my symptoms, wrote a lot of stuff down, joked a bit (one reason why I like him), poked and prodded and did all those doctory things, and sent me on my way with a paper to take to the local lab.   So, on Tuesday 9/30 (yesterday) I went to the lab and they filled up a lot of tubes with my blood and had me pee in a cup.  I don’t have a problem with tests – gotta have them to see what’s going on.

Later that day I got an email with my test results!  Wow is that quick or what?  Turns out nearly everything is normal except for 2 tests that came back indicating inflammation.  That could mean anything so no big deal; after all, I have had a fever for a very long time and lots of achiness and so on, so inflammation was kind of a no-brainer.

There are still 2 tests out, an ANA and a double-strand DNA, which look for autoimmune disorders specifically.  So hopefully someone can see what’s causing the inflammation.

Edit (10/4): Got the labs back for the antibody tests…and they were all negative. Still, at the bottom of the report, it said

“The possibility of autoimmune disease remains.”

Your guess is as good as mine why this was included.  I guess more testing is needed, though no one has called me to schedule any.

I have an appointment in November with a rheumatologist who, from what I could find out on the internet, is one very smart woman who studied at Stanford and Johns Hopkins (#1 place for rheumatology and autoimmune disorders), and wrote an impressive research paper on inflammation and cell function in autoimmune disorders.  I didn’t understand most of it.  Anyway, here’s hoping Dr. Okoye can get to the bottom of everything.

Original post: So I am not worried today.  I am a bit concerned the other tests won’t show anything, as last time I was diagnosed with lupus they had to draw blood every week for months just to catch it when it appeared (that was 20+ years ago, though).  It’s somewhat common for people to test negative, and it is also common for people to be told to forget about it when they do.

Since autoimmune symptoms are so weird and varied, there is always the risk of sounding like a hypochondriac – though at least my doctor could actually SEE the dry eyes and dry mouth (and fussed at me about not carrying around water at all times), validating the Sjogren’s diagnosis (which is an autoimmune disorder).

Of course he didn’t see the Raynaud’s (fingertips changing color in response to cold) as it wasn’t happening that day, but he felt my hands and said he could feel inflammation (how, I don’t know but his intern could too) and told me “the good news” was that I don’t have rheumatoid arthritis.

Edit (10/4): See?  I could sort of see that coming!

Worrying doesn’t affect anything in the material world, so it doesn’t help for me to do it. I still feel crappy but at least I know it’s not as crappy as it could be.   Oh and gross!  He also scheduled me for a colonoscopy ewwwwww.   I will get that at the end of this month but I won’t be happy about it!  (Don’t worry, I am NOT going to blog about it!)

Tell you what, though, I am going to have it done without anesthesia, as I am afraid it won’t play nice with the pain meds I already take on a daily basis (if anyone would like to share if anesthesia is really warranted for this procedure, feel free)….which brings me to my main topic for today…

…pain medication and the controversies surrounding opiates and pain management.  Medscape reports that a doctor (yes, just one) has come out with a statement on opiates for patients suffering from non-cancer pain (“New AAN Position Statement on Opioids for Noncancer Pain”, Medscape, 9/29/2014). Oddly, this is taken to be a policy statement from the entire American Academy of Neurology, even though there are no other authors or even other doctors who signed it in agreement.

This doctor, Gary Franklin, in my opinion, hasn’t seemed to have thought this out well enough, as he cites some statistics but comes up with some pretty weird (to me) interpretations of them.  He starts out by saying (about the use of opiates for pain):

“The evidence of harm is high, and the effectiveness is low,” Franklin told MedPage Today, calling attention to a graphic in the statement that shows the imbalance. “That is the whole story.”

Is it really the whole story?  As a former alcohol and drug counselor, I think it’s a bit more complex than that.  Let’s take Pennsylvania as an example.  According to The Philadelphia Inquirer (“Drug Overdose Deaths Up 7%, Far More in PA and NJ”, 8/20/2014) , we have moved from #14 in the USA for prescription overdose deaths to #7, in just a year.  Yikes!

And if you look at the details more closely, you see that 55% of the people who died or had a problem with opiates got the pills “from a friend or family member” ( “Results from the 2010 National Survey on Drug Use and Health: volume 1: summary of national findings”. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2011).  Yikes, again!

People are having their scripts filled and then handing them over to their friends or families?  Um, I don’t believe so and I will tell you why in a minute.

But first I want to comment on these statistics: As you can see, the article about where people get their pain pills from is from 2010, and it is cited in a CDC report from 2011 (“Policy Impact: Prescription Painkiller Overdoses”).  At the top of this article it states that

“This web page is provided for reference purposes only. It was current when produced, but the most current data can be found on the Drug Overdose Fact Sheet.”

It should be noted, however, that even this information is not current.  If you follow the links, you find that, ultimately, this too is from 2011 (“Prescription Drug Overdose in the United States: Fact Sheet“) – oh, the article itself is dated July 2014, but the statistics cited/linked to are from 2011.

I don’t know what to make of it.  I can understand the spin that anti-pain medication folks want to put on the (non)issue, but I have always had the utmost confidence in the CDC to get their facts straight.  And they did, they are just not current.  I can only imagine that this is due to bureaucracy.

So suddenly there is this big brouhaha about an epidemic of painkiller abuse and overdose deaths.  As I continue my search for what’s behind this, I will get back to you on what’s driving this glut of “scare porn”.

But one thing that struck me is that NO ONE who quoted these stats in the various articles I read in order for me to cite them (thanks to a friend/mentor who suggested I do so) made any mention of what year the stats were from that they were quoting.  That would cut down on the hysteria, I suppose.

Then there is the attempt to link this to heroin overdoses because, as quoted in a Medscape article dated 10/3/2014 (“Opioid, Heroin Deaths Continue to Climb, CDC Says” ), Leonard Paulozzi, MD, MPH, a physician and researcher with the CDC in Atlanta, said

“…about 75% of heroin users say they started out by using prescription opioids.”

Is it just me, or is anyone else reminded of the arguments against legalizing marijuana here?  “Heroin users say” is about the most preposterous start to a debate about prescription opiates I have ever heard.

I take back what I wrote earlier about the CDC – my confidence in them is getting lower by the minute.  How many heroin users smoke weed?  Anecdotally, I can tell you that at every place I worked at as a d&a counselor, most – if not all – addicts routinely “tested hot” (tested positive) for that.

So would’ve the counselors, by the way, had the company tested them too!

There is no relationship between pot use and heroin use, any more than there is, say, between eating potato chips (which most of us do) and heroin use.

Between eating potato chips and pot? Well of course, but it’s the pot causing the munchies, not the munchies causing the pot smoking. See how stats can be twisted to say anything you want?

How many users take benzodiazepines and muscle relaxers?  I will counter that with another question: how many people are familiar with the expression “holy trinity” as regards to addiction?  Holy trinity: opiate pain meds, benzodiazepines, and muscle relaxers.  Get you high as a kite and then often kill you.  I guess those drugs are next in the line of fire.

Are we going to make those difficult to get, too?

Oh! How many heroin users smoked cigarettes before they tried heroin?  Smoking is way down in PA (“Current Cigarette Smoking Among Adults – United States, 2005-2012″ by the CDC ) but, according to sources already cited here, heroin use is not, so…

And what about beer?  Come on, people, let’s use some common sense here.  Many (most, in my opinion just from work/life experience) people who use benzodiazepines, muscle relaxers, smoke cigarettes, drink beer, smoke pot, do NOT then go on to use heroin.

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The Empowerment of Cyberchondriacs by Health Forums

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This is one of my latest pet peeves: pulling up a health forum to look for information about a condition, local groups or clinics, or tips on lifestyle changes that can improve someone’s health (a good example of this would be losing weight to help control blood pressure) – only to find page after page of angry, hysterical, write-in-all-caps posts that don’t do anything but get the OP (original poster) a lot of attention and sympathy.

In looking at the other posts an OP has written – and there are usually a whole lot of them, each one posted on several different places on the forum – it becomes evident that most likely there is nothing at all wrong with them.

Welcome to the world of cyberchondriacs!

Cyberchondriacs are folks who spend hours on the internet looking up symptoms and
convincing themselves they have one or more diseases. Once they have decided on an illness, they haunt the various online forums to: whine about how ill they feel, bitch about the (many)
doctors they have seen who insist there is nothing wrong with them, yell (in caps) about family and friends who have been mean to them by not listening to them or ‘being there’ for them when they are in the throes of (pick a disease), or ask for health advice.

I should qualify that – ask for ‘alternative health advice’, because “the medical profession wants people to stay sick” and the only people who listen to the cyberchondriacs (and gladly take their money) are the many hucksters selling cures online.

It’s often easy to spot the cyberchondriacs if you peruse the post titles (“Help! Someone please help me!” – I promise you that is a direct quote), but oftentimes they will hijack a perfectly good thread in order to get the attention they so desperately seek. There is one forum I have found that is so rife with garbage like that, that if I were a member of the foundation that runs the forum I would be really embarrassed.

It’s not a surprise to me that hypochondriacs (or as it is now politically correct to say, “those with illness anxiety disorder”) have flooded the internet with wild abandon. After all, they have a built-in audience of possibly millions of people who can meet their need for attention, 24 hours a day. The reason I don’t think “illness anxiety disorder” is a correct name for this is that it leaves out the manipulative aspect of this behavior.

Hospital employees are all too familiar with “frequent flyers”, particularly those who routinely check themselves into psych wards, and I haven’t met anyone who works in this field who hasn’t faced the wrath of a hypochondriac when challenged. And by “challenged”, I mean everything from gently suggesting their doctor might be right to outright getting them discharged when it is clear they have no intention of complying with the rules (such as taking their meds). And by “wrath”, I mean everything from writing grievances to contacting CEOs to demand the healthcare worker be fired.

These people WILL get their attention OR ELSE! How much easier, though, to just log in and get your needs met whenever you feel like it?

It doesn’t matter if the illness is physical or mental, check any forum and you will usually find at least one small group of cyberchondriacs. They tend to bond quickly with others of their ilk, and routinely defend each other and make attempts to run people off who tell them to stick to the issues and/or go to the doctor.

They wear their ‘illness’ like a badge – that is, if they even are ill, which I suspect many are not – and complain frequently and loudly that no one understands them but the people on the forum.

Who does that, actually WANT to have a chronic illness? That’s a rhetorical question, of course.

It has been suggested that we really ought to feel sorry for people like that, but I disagree. They usually have personality disorders and are often out for blood – Goddess help you if you are their target! I don’t feel sorry for people who knowingly inject themselves into someone else’s life (or a forum), mess it all up, and then leave a trail of damage behind them.

They know what they’re doing, or they wouldn’t be so good at it.

And to do that on a forum where the majority of people are already suffering and do not need that kind of stress (because it can aggravate the condition) is….is…..well, it’s just evil and there is no excuse for it.

You guys who know me are thinking, “Oh, I bet she shot her mouth off about something and got a group of people upset!” and you would be right. I had the audacity to write something in a journal (not in the open forum, mind you, because I do not impose my uhem strong opinions on others) on the forum I mentioned previously that has a glut of cyberchondriacs.

I had been watching as member after member was attacked and run off because they wouldn’t play the sympathy game. All I did was appeal to people to stop being cliquish and stop insulting others, and for the most part I got a good reaction to it. I won’t post it here because it is very long.

But I also had 2 people respond with such vitriol it was almost shocking – and I deleted both their posts. I added a note asking again that people keep their nasty comments to themselves or publish those on their own journal. I reiterated that I wrote this on my own journal and not in the forum so that if people found it upsetting – for whatever reason – they didn’t have to read it.

Why was it necessary for me to write that upsetting people by name-calling and passive-aggressive behavior aggravates the very condition people are there to get support for? That is, of course, also rhetorical, because it’s obvious these folks couldn’t care less about what effect their behavior has on others.

The experience didn’t run me off – y’all know me better than that – nor did it cause a major flare-up, tears, or yelling. Hey, that’s why I write rants like this, to get it off my chest in a healthy way. I did, however, set the privacy settings for that particular entry to “friends only”, because I just can’t be arsed checking my journal every day in order to delete stuff.

So…what’s the most annoying/oddest/head-scratchiing forum you’ve read lately?

This is the 2nd weird news item of the day, because I wrote 2 posts today, and it comes from the Pennlive website  http://www.pennlive.com/

It’s a story about 2 Huntingdon County women (that’s not too far from Hollidaysburg) who got into a fight and started attacking each other with deer heads! Of course, the deer heads were mounted and not attached to deer bodies (wouldn’t that have been something if they had been though!), and both were arrested. One sustained a slight injury from an antler heh.

This kind of thing is why I will always refer to Central PA as “Mayberry on acid.”
Here’s the link:
http://www.pennlive.com/midstate/index.ssf/2014/08/women_attacked_each_other_with.html

2nd movie recommendation of the week: If you like psychological thrillers that do NOT contain the usual gore and hackneyed plots, check out a film called “Knife Edge” (2009) starring Hugh Bonneville and Natalie Pressman. It’s a good story with some twists, and it will keep you on the edge of your seat. It’s available on Amazon and Hulu.