Entry 3

In mid-July the details in my medical records was beginning to get quite lengthy and was starting to fit with what I was telling the doctors. I also started my PT (physical therapy) and to get started was a FCE (physical performance testing) test and damn if I didn’t take more Norco than prescribed that day. Lol! The next appointment was next week and it was with Dr. Rib. for the results of my MRI.

Dr. Rib. told me that for the most part the MRI didn’t show anything that was causing pain and no fractures either. After I received the records for the MRI, I looked over them and there was more information on it than what the doctor told me. This was a minor details that I failed to investigate further as I had a lot to handle with the RSD issue. I visited Dr. Rib. twice that month because the MRI report was incomplete at the first visit. My next appointment was with the referred doctor from Dr. Rib. and this doctor was a pain management clinic and his name was Dr. Stan. I was supposed to be looking forward to a procedure called a SGB!

Doctor Stan. was a very thorough, informative, and seemingly caring doctor. He is the type of doctor everyone wants to go to. He went over every detail over what I could expect in the future and the possible treatments of RSD. Then we went over the procedure (SGB (Stellate Ganglion Block)) he wanted to try and how it might help and what is done during the procedure.  At the time of this appointment I was not taking the Lyrica prescribed to me because I was driving heavy duty truck and equipment as part of my light duty and I was told that when you first start taking it that you shouldn’t drive. I was waiting for a couple of days off work but that hadn’t happened yet.

            I was very nervous about the SGB because of all the dangers and how it was performed. I am a very cautious person when it comes to going to a doctor anytime let alone someone sticking a needle in the neck and injecting something in an area that could permanently damage nerves. Yes I was being a coward! I am the type of person that their blood pressure and heart rate go thru the roof just for a check-up. LOL

            When I told Dr. Stan. how nervous I was he suggested that I begin the Lyrica for a couple of weeks to see if I improved any and if not then we would proceed with the SGB and I agreed with him. He seemed disappointed but also very understanding about my nervousness. He told the safety officer with me that the employer that they had to give me at least 3 days for me to get used to the medication to make sure I could drive with the medication. He also told him that if I could not drive under the medication that they would have to accommodate another light duty position for me.

            I was set for the next appointment with him at the end of August and to go back to my other doctors until then. I was very impressed with Dr. Stan. and would recommend him to anyone in the Dallas/Ft. Worth area for pain management!

            On that same day I had an appointment with Dr. Rib. again to go over what Dr. Stan. and I discussed. He was disappointed that I had not gone thru with the SGB because he had told me that he thought all my problems would be over with it. I had researched RSD and SGBs by this time and how it was not a cure for RSD but it could give short or long term relief. I was looking forward to some kind of relief but I thought I would try meds over procedures or operations.

            In the middle of August I had an appointment with PA Schul. And during this appointment I discussed what happened with the MRI and with Dr. Stan.. Every time I went to another doctor I passed all the records to the WOL Clinic so they could review what the company doctors were up to. I was also on the Lyrica and getting some relief from the “pins and needles” feeling and pain. Of course I was encouraged that it was starting to work and maybe it would hold off the SGB.

            I had also come up with the theory that my high blood pressure was not only caused by the pain but also from the constant stress from my employer, having RSD, and the planning of appointments and hours I was working. Now that I am not dealing with the employer, lawyers, and constant doctor visits my blood pressure is leveling out. It is high on my bad days but for the most part it is good. I am still on meds for it but that is me being cautious I guess. The other part of all this problems is that for the most part I have gotten over the anxiety of going to routine doctors. I am grateful for that I promise!

I  think that I may have the audio problem out and going to try it out for entry 4.

Thank you all for your support!!!!

David

My Journey with RSD - Entry 2

Well scratch the audio version of my entry; I can’t get the audio work so I will have to try again later.

For the past week I have been digging thru what seemed like Pandora’s Box looking for visits to doctors. This was a major feat due to my lawyers lack organizing skills and I thought I did pretty good job keeping thing straight but I was half ass also. I guess with all the stress just made me think I was better at it than I was. I kept any and every piece of paper I got during the suit and placed them into folders but without order(oops). This also opened up old wounds that I was finally getting over, like the anger that I had at my job and their insurance company.

I hadn’t opened the box but just once since the suit was over and that was just to get a copy of my medical records for my current doctor and didn’t look then just grabbed one of the envelopes the lawyer sent me. So any ways here is the next entry……

Entry 2

Ok I got hurt on May 20^th and took a few days off but then it took until June 4^th before I started to see the company doctor. I saw P.A. Tan. three times during the month of June. All three time he diagnosed me with Carpel Tunnel Syndrome. The treatment was 2 wrist splints (one I had to pay for) and aspirin or Tylenol only to have him tell me that the splints were making the injury worse and I shouldn’t wear them, like the splints were my idea (ass). I had told him before that the splints hurt severely but I was wrong and he was right, and after the 3^rd visit he referred me to Ortho Dr. Rib. Mind you, I never got an X-Ray or any other test besides him twisting and poking the area that hurts. After this I decided to get my own doctor and happen to schedule their new doctor with my doc the same day.

During the time between to upcoming visits my employer decided that I need to try to get back on full duty since PA Tan didn’t say otherwise even though I had been on light duty before. In between my first three visits my employer kept pressuring me to get back to regular duty with the splints on since they protect my hand and even after my protesting when trying to use the hand. By my employer I mean my direct supervisor. If a little thought had gone into his actions instead of just being a dick, had my injury only be temporary, the use before healing only prolongs the time of being on light duty (duh). This guy was a constant pain throughout this whole journey and he even continued talking about it after I was no longer with the company. I did hear the guy is still in the same position since I left hmmm wonder why.

Towards the end of June I visited Dr. Rib. and guess what, the first thing was an X-Ray then I saw the doctor, and after seeing him he scheduled an EMG. Wow two procedures scheduled or performed on my first visit. He was a very good about going over everything and listening to me about where and what made the pain worse. The one main thing that I noticed about the doctor’s dictation was that in one section he notes that there was sweating in my hand but in another section he notes not sweating. Some doctors I swear need to pull their head out but I guess with a good thing he needed to counter it by putting contradictory notes.

On the same day I visited the doctor’s clinic I found during work one day. I first saw a PA for the first several visits which bugs the hell out of me. I believe that when someone goes to a clinic or office the first visit or 2 you should see the doctor then maybe see the PA. Nothing against PAs but I go to Dr. “Such N’ Such” to see that doctor not to see PA “So N’ So” and makes a new patient feel unimportant. Ok back to my visit at Dr. Wol.’s clinic to see P.A. Schul.  

I received the common poke and prod of any doctor and the questionnaire I also had another X-RAY P.A. Schul. Prescribed Naproxen, back on light duty, and put in the request for Physical Therapy. His diagnosis was pretty much the same as Dr. Rib. Which was crush injury, hand and wrist derangement and possible Carpel Tunnel but Schul. wasn’t quite for sure what else to put down or the extent of the injury.

July rolled around and first on the list was an EMG that supposedly showed nothing. I say supposedly because I watched some adjusting happening to the results by the technician. This just helped my insecurity of thinking about how my employer was putting pressure of these guys to get me back to work. My employer sent someone with me every appointment I went to but, with my doctor they never showed up.

My next visit was to see Dr. Rib. And get my EMG official results and for a follow up. Sweat was present again and my complaining of the pain still. After talking about problems I was having he said that he was inclined to say I had RSD but not too worry because it is fully treatable and curable but until it was contained I would be uncomfortable. (Don’t know what he was thinking) He told me my next test was a MRI and he was sending me to see another doctor for a SGB. His official written diagnosis was crush injury and traumatic carpel tunnel nothing about RSD.

That same day I went to see P.A. Schul. for a follow up and discussed all my issues again. Repeating everything over and over even the same day is something that is tiresome but also you kind of get used to doing. Light duty was to continue but higher restrictions because the weight limits and time was too hard for me. He also prescribed Lyrica and a light dose of Norco. My PT had been approved and started the next week.

Mind you I had to drive at least half my day getting to and from work during my job and doctor visits but that was no concern to my employer.  When I first began my meds I had a few problems driving but I had to or worry about repercussions from my boss. This does become a major problem later on because I pushed the issue. That comes later.

Thanks for your support and please send me feedback.

This entry was rushed because I told you guys that I would have it up by now so some of it is jumbled, I apologize for this!

Painkiller sales soar around US, fuel addiction

My opinion is on the bottom of this story in red.
Thanks,
David

By CHRIS HAWLEY | Associated Press

Sales of the nation's two most popular prescription painkillers have exploded in new parts of the country, an Associated Press analysis shows, worrying experts who say the push to relieve patients' suffering is spawning an addiction epidemic.

From New York's Staten Island to Santa Fe, N.M., Drug Enforcement Administration figures show dramatic rises between 2000 and 2010 in the distribution of oxycodone, the key ingredient in OxyContin, Percocet and Percodan. Some places saw sales increase sixteenfold.

Meanwhile, the distribution of hydrocodone, the key ingredient in Vicodin, Norco and Lortab, is rising in Appalachia, the original epicenter of the painkiller epidemic, as well as in the Midwest.

The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems in New Mexico, Nevada, Utah, Florida and other states. Opioid pain relievers, the category that includes oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone, and the death toll is rising, the Centers for Disease Control and Prevention says.

Nationwide, pharmacies received and ultimately dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year for which statistics are available. That's enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in the United States. The DEA data records shipments from distributors to pharmacies, hospitals, practitioners and teaching institutions. The drugs are eventually dispensed and sold to patients, but the DEA does not keep track of how much individual patients receive.

The increase is partly due to the aging U.S. population with pain issues and a greater willingness by doctors to treat pain, said Gregory Bunt, medical director at New York's Daytop Village chain of drug treatment clinics.

Sales are also being driven by addiction, as users become physically dependent on painkillers and begin "doctor shopping" to keep the prescriptions coming, he said.

"Prescription medications can provide enormous health and quality-of-life benefits to patients," Gil Kerlikowske, the U.S. drug czar, told Congress in March. "However, we all now recognize that these drugs can be just as dangerous and deadly as illicit substances when misused or abused."

Opioids like hydrocodone and oxycodone can release intense feelings of well-being. Some abusers swallow the pills; others crush them, then smoke, snort or inject the powder.

Unlike most street drugs, the problem has its roots in two disparate parts of the country — Appalachia and affluent suburbs, said Pete Jackson, president of Advocates for the Reform of Prescription Opioids.

"Now it's spreading from those two poles," Jackson said.

The AP analysis used drug data collected quarterly by the DEA's Automation of Reports and Consolidated Orders System. The DEA tracks shipments sent from distributors to pharmacies, hospitals, practitioners and teaching institutions and then compiles the data using three-digit ZIP codes. Every ZIP code starting with 100-, for example, is lumped together into one figure.

The AP combined this data with census figures to determine effective sales per capita.

A few ZIP codes that include military bases or Veterans Affairs hospitals have seen large increases in painkiller use because of soldier patients injured in the Middle East, law enforcement officials say. In addition, small areas around St. Louis, Indianapolis, Las Vegas and Newark, N.J., have seen their totals affected because mail-order pharmacies have shipping centers there, said Carmen Catizone, executive director of the National Association of Boards of Pharmacy.

Many of the sales trends stretch across bigger areas.

In 2000, oxycodone sales were centered in coal-mining areas of West Virginia and eastern Kentucky — places with high concentrations of people with back problems and other chronic pain.

But by 2010, the strongest oxycodone sales had overtaken most of Tennessee and Kentucky, stretching as far north as Columbus, Ohio and as far south as Macon, Ga.

Per-capita oxycodone sales increased five- or six-fold in most of Tennessee during the decade.

"We've got a problem. We've got to get a handle on it," said Tommy Farmer, a counterdrug official with the Tennessee Bureau of Investigation.

Many buyers began crossing into Tennessee to fill prescriptions after border states began strengthening computer systems meant to monitor drug sales, Farmer said.

In 2006, only 20 states had prescription drug monitoring programs aimed at tracking patients. Now 40 do, but many aren't linked together, so abusers can simply go to another state when they're flagged in one state's system. There is no federal monitoring of prescription drugs at the patient level.

In Florida, the AP analysis underscores the difficulty of the state's decade-long battle against "pill mills," unscrupulous doctors who churn out dozens of prescriptions a day.

In 2000, Florida's oxycodone sales were centered around West Palm Beach. By 2010, oxycodone was flowing to nearly every part of the state.

While still not as high as in Appalachia or Florida, oxycodone sales also increased dramatically in New York City and its suburbs. The borough of Staten Island saw sales leap 1,200 percent.

New York's Long Island has also seen huge increases. In Islip, N.Y., teenager Makenzie Emerson says she started stealing oxycodone that her mother was prescribed in 2009 after a fall on ice. Soon Emerson was popping six pills at a time.

"When I would go over to friends' houses I would raid their medicine cabinets because I knew their parents were most likely taking something," said Emerson, now 19.

One day she overdosed at the mall. Her mother, Phyllis Ferraro, tried to keep her daughter breathing until the ambulance arrived.

"The pills are everywhere," Ferraro said. "There aren't enough treatment centers and yet there's a pharmacy on every corner."

The American Southwest has emerged as another hot spot.

Parts of New Mexico have seen tenfold increases in oxycodone sales per capita and fivefold increases in hydrocodone. The state had the highest rate of opioid painkiller overdoses in 2008, with 27 per 100,000 population.

Many parts of eastern California received only modest amounts of oxycodone in 2010, but the increase from 2000 was dramatic — more than 500 percent around Modesto and Stockton.

Many California addicts are switching from methamphetamine to prescription pills, said John Harsany, medical director of Riverside County's substance abuse program.

Hydrocodone use has increased in some areas with large Indian reservations, including South Dakota, northeastern Arizona and northern Minnesota and Wisconsin. Many of these communities have battled substance abuse problems in the past.

Experts worry painkiller sales are spreading quickly in areas where there are few clinics to treat people who get hooked, Bunt said.

In Utica, N.Y., Patricia Reynolds has struggled to find treatment after becoming dependent on hydrocodone pills originally prescribed for a broken tailbone. She said the nearest clinics offering the rehabilitation programs she wants are full and not accepting new patients.

"It's a really sad epidemic," Reynolds said. "I want people to start talking about it instead of pretending it's not a problem and hiding."

___

AP Interactive Graphic: http://hosted.ap.org/interactives/2012/painkiller-nation/

Associated Press interactive producers Phil Holm and Michelle Minkoff contributed to this report.

What most people don't realize is that not everyone taking these pills are addicts or out of control! Some of us really need medications to function throughout the day and wish there was another way to handle our chronic pain. For me, trying to find a doctor that would give me pain medication was a pain in the a$$, but I didn't go fishing around to find them. These people that find doctors that give them large amounts of pain meds and keep finding many them must be very determined or down right lucky I guess. I have seen over 8 different doctors since my onset of RSD and I only found 2 doctors to give me pain meds. The first gave me a really small doses and never increased the dose even after I told him that it didn't help and talked about taking me off of the meds. These recreational and out of control users need to realize that they are hurting not just themselves or their family members but they are also hurting the people that really need the medicine.

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David