THE DRUGS DON'T WORK?(!)

I'm having mixed results with the extended-release Ritalin. Yesterday I awoke at two p.m. but had to go to sleep at ten p.m. last night. I was freaking exhausted, despite having taken a Rit promptly upon waking.

Perhaps the release isn't so extended...

But the previous day I couldn't get to sleep until six or seven a.m. I had been awake for what felt like forever, but was probably about sixteen hours.

And now I'm awake and it's eight a.m. However, I woke up at three.

Perhaps in the struggle between Ritalin (amphetamine) and Klonopin (tranquilizer), the Klonopin wins... But K hasn't made me tired for about a decade.

I can't make sense of this.

Perhaps I'm being worked over by the impending decision from Social Security re whether I'm disabled according to them. The sound of the executioner sharpening his blade sings beside my ears...

In other news, I think I could go for a nice round of marcaine shots. My neck isn't as flexible as it used to be and the trigger points in my back make it painful for me to sit back in chairs. Also, my migraines are worse than they used to be.

So it may be time to see Dr 9 for the only thing he's good for and believes in: those damn shots of his. ...My TENS unit just isn't a good enough proxy for those shots.

(Man what a boring post. I should have waited for the Ritalin to kick in before writing.)

Now I have to go hide my drugs. A certain person is visiting today, is a fucking pill fiend, and would rather I wish for death due to lack of narcotics than he be high.

He does have a legitimate problem with his back, but won't get his own Oxy prescription, which he has said time and again his doctors are more than willing to give him. Instead he sticks to taking overdoses of Tylenol through taking assloads of Vicodin and his liver must be as black as our lungs by now (each of us has been smoking for about fifteen years).

How am I to sympathize?

...And now I have Ritalin, which he would be more than happy to ingest like a behind-schedule trucker...

One's possession of heavy drugs easily turns certain of one's friends and loved ones into con men and snakes who search for your the pills you hide and protect like unhatched eggs...

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FIBROMYALGIA TREATMENTS: WHAT WORKS!

I'm posting this so, hopefully, readers who have fibromyalgia can get to this post quickly to find out what works and what doesn't. Here's what works:

1) NARCOTICS.

OxyContin, tailored to the dose you, personally, need, for instance. But different people in chronic pain need different narcotics. Which is to write, as I have before, that some fibromyalgians will benefit most from hydrocodone, some from morphine, and so on.

The take-away from this being that the only thing that will reduce your pain by an appreciable level is a narcotic analgesic. Fuck anyone and anything that touts a "natural" cure.

Well, I got ahead of myself: Fuck anything that says it's a "cure." By definition, fibro is incurable. If you thought you had fibro but it went away through one or another action(s), you didn't have fibro and please shut the fuck up because the people who actually have it are being hoist with your petard by the thousands.

My own mother told me about someone she knows who has fibro, but who does not experience daily, constant pain. I had to refer her to the exact diagnostic criteria to show her she had a hypochondriac (or wicked asshole) on her hands (and wasn't told the name of the person because I wanted to track her down and give her a taste of the pain she, despite "having fibro," wasn't in. ...Such is the insanity induced by my pain.)

Fibro is coming to encompass too many things that it is not because of inept doctors and moronic patients.

Anyone who knows anything about fibro is a pain specialist, pure, simple. And knows: Fibro is pain. Treat it with painkillers.

There are diets you can read about that claim they can cure you. If the diet cures you, you have Celiac's Disease, not fibro. Both cause quite similar symptoms.

Please, everyone who does not have fibro, shut the fuck up so fibromyalgians can be treated properly, so the disorder can get some goddam respect -- stop keeping us in the limbo of having been diagnosed with a pseudo-disorder, while you can simply cut gluten out of your diet and live pain-free, but unable to eat pizza.

...Trust me: Fibromyalgians feel your pain, douchebag.

2) NOTHING ELSE.

Only narcotic analgesics help people with fibro.

Sure, Lyrica may bring your pain down one number on the pain scale, but the extra fifty pounds you gain that it puts on your joints and vertebra are going to put your pain right back where it was.

Cymbalta: Doctors will be happy to give you this, along with thirty-or-so pills/injections that will do nothing or next to it, instead of prescribing you narcotics. (Pain relief from an NSRI. ...If I could laugh at that I wouldn't be able to catch my breath and drop dead, blue as a Smurf...)

However it is, by its weak ability to increase the amount of dopamine in one's brain (not by increasing norepinephrine, as most docs will say) also capable of bringing your pain down maybe one point on the scale.

But you'll still feel suicidally painful if you actually have fibro.

In short: Narcotics are the answer. Narcotics are the only treatment that works for fibromyalgia.

This must be accepted by doctors, and narcotic analgesic treatment must be insisted upon by patients (please see previous posts for all the crap I had to go through to finally get chronic opioid analgesic therapy).

If your pain isn't enough to make you cry your lungs out every day for a dose of morphine or oxycodone, chances are you don't have fibro and you're harming everyone who actually has the disorder. Find out what you really have, and don't let your doctor diagnose you as a fibromyalgian despite the fact you don't have a single trigger/tender point.

If your pain hasn't made you wish you were dead since it started, please get the correct diagnosis and shut the fuck up about fibromyalgia.

Please, as this disease becomes understood, let doctors and patients realize, together, the only effective treatment for it: narcs.

To anyone who can be helped with anything else enough to matter: You don't have fibro. You're not helping yourself by being misdiagnosed with fibromyalgia, and you're hurting everyone who has fibromyalgia by going with whatever bullshit treatment you're being given (I could go into cortisol here) and finding that it helps your so-called fibromyalgia...

I understand that fibro is irresistable to hypochondriacs... Fibro is quite an easy disorder to pretend you have if you do your homework.

The problems is that you fuckers are helped with placebos, with Lyrica, with Cymbalta -- you're in studies yourselves and keeping out true fibromyalgians and making sure that our treatment stays bullshit.

To all fibro-pretenders: Just let me press down with my thumb on a certain place in your lower back for about thirty seconds, and we'll know what you have and do not have.

[Jesus, did the ire rise today. And I've been happy all day, too. ...I never know what's in my head until I sneeze it out.

Pain: 4/5. Debilitating, the best it will get... though I may want to think about upping to 50mg Oxy next month... Still too soon to say for sure -- I need to see exactly what 40mg can do, and it's been only a week now.

Anxiety: 4/10. Debilitating, the best it will get.

I would not dare complain that my conditions are managed as well as they are... I believe I feel the best I possibly can.

Still, I do miss being able to lift more than ten pounds...]

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THOUGHTCRIME!

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Since doctors are loathe to prescribe narcotic medications to fibromyalgians, I'd like to know if anyone gets theirs from overseas, or from Canada, Mexico, American Samoa, so forth through the mail.

As followers of this blog (all the best to you, you beautiful bastards) know, I believe the treatment for fibro should be simple: trigger-point injections performed by a very skilled and knowledgeable doctor, plus continuous opioid analgesic therapy. That's it.

I came to the last deduction (that COAT should be about 50 percent of the treatment) by reasoning that pain should be treated with painkillers (see "I HATE THE WORLD SLIGHTLY LESS!").

Did I just blow your mind? If so, you must be a doctor.

If someone theoretically knows a theoretical Web site that theoretically may be super-reliable and hopefully super-cheap and hopefully has a good supply of oxycodone in various (theoretical) permutations, please post it in Comments. Why oxycodone? Because it's, theoretically, the best pain reliever for at least one person's fibro pain.

So, for the good of all, please write about any theoretical research you've done or theoretical experience you've theoretically had. This could be done both anonymously and theoretically. But for the comment to actually appear, I suppose the comment itself would have to be more than theoretical. Theoretically.

Theoretical love and kittens to all of you

PS: I can't do any theoretical research myself because I have (unfortunately, not theoretically at all) spent every one of my pennies waiting for the Social Security Administration to act on my disability claim. (I leech off my parents, who wouldn't pay for any of these theoretical mailings. Which is strange... I would finally stop being such an asshole, completely theoretically, if my fibro was treated adequately...)

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DRUGS DRUGS DRUGS DRUGS DRUGS!

swallowed, morning
-2mg Klonopin
-300mg Lyrica
-40mg Prozac
-18.7mg Effexor
-50mg Topamax

At the doctor's office!:
swallowed
anti-emetic cocktail

dissolved on tongue, swished around mouth and then swallowed
Maxalt, 10mg
Maxalt, 10mg, headache relieved to 4/10

trigger points injected
-back, right side spine, marcaine (~2" above yesterday's)
-back, left side spine, marcaine (~2" above yesterday's)

swallowed, mid-day
-2mg Klonopin
-Vicodin (7.5mg hydrocodone/750mg APAP) X2

going to be swallowed, night
-2mg Klonopin
-300mg Lyrica
-40mg Prozac
-18.7mg Effexor
-50mg Topamax
-3mg Zanaflex
-10mg Abilify

I don't know what Abilify is. And I hate that, because I pride myself on being a walking pharmaceutical encyclopedia (Google after this). Here is all I know:

I walked into my shrink's office yesterday.

"How are you Mr Macklin."

"Well, I've felt like I've been having a constant heart attack since you both took me off Effexor and lowered my Klonopin dose from six to four milligrams."

"Do you feel anxious right now?" Barely a question, but more than a weird statement (like the above how-do-you-do). "Like you are having a heart attack?" (I don't write stilted dialogue. Guy just didn't use contractions. He spoke in a not-unpleasant, clipped, second-generation American Indian dialect. Which I'm trying to represent. Bonus: I speak just as though I am horribly pretentious.)

"Yes. I always feel that way now." But my detached attitude and learned-helplessness-colorless voice wasn't selling it. Flat affect.

"How is your sleep?"

"I only get four hours a night. Four and a half if I'm lucky. The pain and whole feeling-like-you-re-going-to-die-thing is a sweet alarm clock."

"I'll write you a script for Abilify. It should help you sleep. If it knocks you out the first night and you feel groggy when you wake up, just break the pill in half the second night."

He was writing his scripts, his mind was set, the session was over.

So I grabbed the paper entitling me to a month's supply of what Dr. 9 described today as an anti-psychotic of sorts, 4mg Klonopin per day, and 40mg Prozac per day.

There goes the shrink. I won't see that small man, not even for three minutes, again. Not if I play my cards right.

***
I hate that I can be prescribed what could be, for all I know, Super-Thorazine, in a three-minute session. Based on the fact I haven't been sleeping much? Maybe I was just on a meth binge. Or was it my flat affect?

[Pain, head: 4/10; thorax, 8/10; limbs, 6/10.Anxiety: Mind your own business on this one thing this one time, would you?]

PS: Vicodin X3 now.
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DRUGS TAKEN VARIOUS WAYS!:

.

swallowed, morning
-2mg Klonopin
-300mg Lyrica
-40mg Prozac
-18.7mg Effexor
-50mg Topamax

At the doctor's office!:
swallowed
anti-emitic cocktail (no alcohol. How can something be called a cocktail if there is no booze in it? Especially if it tastes like charcoal, then leaves your tongue, mouth and throat numb?)

dissolved on tongue, swished around mouth and then swallowed
Maxalt, unknown dosage
Maxalt, unknown dosage (second time, charm -- headache mostly gone -- 4/10)

injected, trigger points
-back, right side spine, marcaine
-back, left side spine, marcaine

injected, intramuscularly
-depo-medrol, right "hip" (ass-cheek)

swallowed, mid-day
-2mg Klonopin

going to be swallowed, night
-.5mg Mirapex
-18.7mg Effexor
-50mg Topamax

(I'm sure I'm leaving something out... I just don't feel up to checking my night-time med-sched. [sorry for the rhyme.] It's been a long day... Blowing snow, ice everywhere,... Driving -- being driven about 100 miles from clinic to shrink to psychologist... I hate Wednesdays... But I love my psychologist. He has a bumper sticker on his Jeep: "When the going gets weird the weird turn pro." HST)

[Pain: I have that.

Anxiety: I have that too.]
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MY DRUG DIET, STARRING THE INJECTABLES!:

.
MONDAY!:
swallowed, morning
-2mg Klonopin
-300mg Lyrica
-40mg Prozac
-18.7mg Effexor
-50mg Topamax

injected, trigger points
-shoulder, right, X2, marcaine
-shoulder, left, marcaine

swallowed, mid-day
-2mg Klonopin

swallowed, night
-.5mg Mirapex
-18.7mg Effexor
-50mg Topamax

Tuesday!:
swallowed, morning
-2mg Klonopin
-300mg Lyrica
-40mg Prozac
-18.7mg Effexor
-50mg Topamax

injected, trigger points
-shoulder, right, marcaine
-shoulder, left, marcaine
-skull, base, right, marcaine
-skull, base, left, marcaine

injected, intramuscularly
-Toradol, left "hip" (ass-cheek)
-some anti-emetic, right "hip" (ass-cheek)
-eventually a drug that sounded like "new-caine." Described as "like Demerol, but without the unpleasant side-effects."

swallowed, mid-day
-2mg Klonopin

swallowed, night
-.5mg Mirapex
-18.7mg Effexor
-50mg Topamax

I was at the clinic for three hours this morning (from nine to twelve, and exactly. I mean spot-on), with a headache I knew would take a lot of work. Also I was incredibly nauseated. So much so that I couldn't eat my cereal this morning. It's always a struggle to get food down in the morning, but today... nothing doing. Disgustingly, the Honey-Nut Cheerios actually slid down my tongue and back into the bowl. That nauseated me all the more.

Anyway, I don't feel like writing because of the "new-caine." I feel like napping -- only eight hours of sleep between the last two nights.

I should say that, with all the needlepoint Dr. 9 and 1 did for me today, Humpty is put back together fairly well...

[Pain, anxiety, overall: 4/10.

...Until tomorrow. I fall of the wall in my sleep.

And jesus christ, at times just how self-absorbed an activity this is hits me like we imagine olde-time doctors slapped newborn babies' asses...

Publish!]
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THIS GUY IS VERY FUNNY (OR, WELCOME BACK VICODIN)!

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This Brit living in Australia reviews video games in a very gonzo way and it's fall-on-your-funny bone hilarious even if you're not a nerd:




link:

http://www.escapistmagazine.com/articles/view/editorials/zeropunctuation/2048-Zero-Punctuation-Manhunt

Huzzah and kudos, Yahtzee!

[Pain, overall: 7/10. Was given Vicodin to tide me over until Monday, when I can once again become my doctor's pin cushion. And that's not a complaint, that's a statement of fact. And the fact is one that makes me overjoyed.

And I used to be afraid of needles. Very afraid. Ever since I was about eight and a douchebag doctor tried to give me a spinal tap. He didn't use any anesthetic -- not even local -- simply had me tuck forward as I sat on the paper on the half-table-bed-thing and then there was JAB and SEARCH under my skin and through my vertebrae. I recall my hand going completely numb at one point, and wondering if I had become partially paralyzed at that point.

And, being a kid, I was crying, howling from the pain and the terror I was feeling while the doctor tried and tried again before giving up.

The procedure eventually was finished after my parents calmed me down and I was sedated. My mom held me as I cried for a half-hour, as I was still feeling the needle crawl everywhere under my skin, mechanical, lifeless steel, foreign, an intruder, no business among my living blood and through my bone and against my spine oh my god he almost paralyzed me!

I can still feel where the steroid and Toradol (I think I mistook it for Tagretol in a past post -- which I may have gone back and corrected...) needles went in my hips a week-and-a-half ago. The fucking needles.

But I love the feeling of my skin giving way -- a small depression, a dimple forming around the needle's odd tip that seems to swirl upward, the diameter of a sewing needle that would be impossible to thread -- the instant of clear and bright pain as the needle goes through skin and into muscle, straight into a a ball of pain causing more, the skin behind my closed eyes becoming brighter and clearer, white and translucent and I can almost see the end of the rainbow as my head begins to clear and I can open my eyes and breathe and everything looks different and the world has changed because everything is softer, the hard edges are gone -- everything doesn’t exist simply to injure me through the fact of its existence, the fact I have to see it or try to close my eyes to not see it or be somewhere else to not see it or have to deal with being that batshit insane crazy in pain because the world is kind now and soft and warm as the lighting on a Barbra Walters Special.

...That is to say, I am afraid of needles as a general rule, but I am less-than-afraid of trigger point injections.

Anxiety: 7/10. I am on Vicodin and Klonopin. On considerable amounts of Vicodin and Klonopin.]
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MARCAINE! MARCAINE! MARCAINE!

No more talk of Percocet: The taste of a new generation is marcaine injections!

I saw my new GP two days ago (I'll be staying with this guy at least until I start up my usual drug-seeking), and he gave me Marcaine injections into one trigger point per shoulder. I don't know how he found what were, apparently, the exact places he needed to inject, since my shoulders are (were? I think I get to use past tense about this for once) knotted as a forest of oak trees. (Ugh. What a horrible metaphor. Grade-school shit. And I apologize.... I feel decent right now and don't want to write. If I'm not in withdrawal, pissing off doctors and shrinks or being a general douchebag, where's the drama? What's the pull?... Please see past posts while I work this out...)

But he did find these magical places and stabbed me with needles and injected the Marcaine solution. He then held the needle in my muscle until the headache I've had all my life lifted off my skull, from the injection site upward.

I then repeatedly threatened the doctor with various signs of affection, but didn't follow through because the med student who was with the doctor didn't seem like the voyeuristic type. And he didn't give the shots, so he wasn't about to get to join in.

But as I walked out of the clinic, I began to believe I was getting my headache back. However, it was just my inability to process the fact I was pain-free from the shoulders up. I didn't feel achy or in pain, but... it felt like the shadow of a headache... Like it was a physical entity, a fog encompassing my head, trying to get back in -- pushing inward from all sides.

As of this writing the relief has gone down my back... The day after the injections I could feel the rest of my body for the first time, without a headache. And it hurt like fucking hell. I took half a Percocet in the afternoon because I wanted to outrun my back, where most of the agony came from. I've seen dogs chase their tails, and the outcome is never very good or interesting. Today, though, is actually a good day.

Then again, I've taken today the five pills a friend gave me yesterday. This Person described them as "better than Klonopin." I thought if they were a lot better, she was giving me the cup of christ. But This Person seemed to give them up too easily for me to be receiving that artifact in dissolvable pill form...

However, the two I took in the morning knocked me out for a few hours, which is a tall feat for any drug, so I would have to say they might eclipse Klonopin. Naturally, further study is warranted... But, then, I wouldn't want to get hooked on anything I can't get my own Rx for...

Or this 5/10 day [the pain scale encroaches upon the body text!] is brought to us by the increase in Lyrica and Prozac taking hold. It's been about a month since the increase, and if the extra mgs are going to do anything, the starting gun should be going off about now.

Or the majority of what seems to be a miracle of science is not that at all, and is due to me being in a waning period. I'd hate it to be that, but know it must be a big part of me not being in so much pain.

...Mustn't it?

[I'm going to cause massive civil unrest by ending this post here, lamely. It's been boring as hell anyway.

Anxiety: 5/10

Willingness to crank out crap: Apparent.]

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DR. DOOM!

So the nameless doctor in a nameless place in a nameless state did the following for me: he gave me trigger-point injections in my lower back. The pain was so excruciating I almost bit through my clenched fist, and my screams(?)... sounds kind of effeminate... likely were heard by all the other patients. It was the worst pain I've ever experienced, and I've bruised a kidney, broken a wrist, and have had a really bad paper cut on my thumb. It was such that, when the doctor was done with my right side I said, "Don't do the other."

"But the treatment works best if we--"

"Don't do the other. I can't stand it."

I looked at the nurse, who was looking at the doctor -- I'll call him Dr. Hilarius -- and knew what was coming: five more stabs in the back.

Which is the best way to describe what Dr. Hilarius did for me overall. After giving the injections, he told me to get a prescription for 600mg of Lyrica per day, an increase from my then-current 400. And that's all he did.

I informed the nurse, who was the only one who would talk to me after the injections, that I take Percocet 10/325s (10mgs oxycodone, 325mgs acetaminophen) and, since the doctor had prescribed nothing (I was to get the Lyrica, even, from my general practitioner) I was going to go through withdrawal, and then the pain that returned was likely to be so unbearable that I was bound to think of suicide.

She talked to Hilarius outside my room and came back and had to report what Dr. H said:

"If you have any problems, just go to the ER."

...My parents had told me that he was the only pain specialist in town, and that I had to deal with him for better or worse. So I held my tongue... After I said

"Well, could you please tell him that it's extremely negligent on his part to let a patient go through withdrawal -- and especially one with a history of suicidal ideation?"

The nurse left and came back:

"The doctor says you can get the narcotics through your family doctor. Otherwise, I guess you just have to go to the hospital."

And I held my tongue.

Next week I see a psychologist at the same treatment center. I have come to the early conclusion that I am trapped in a pain management center that manages pain by increasing it or letting it be.

Whenever I enter the clinic doors, I'll be surrounded by doctors who do not believe in practicing medicine.

[Not bad for today... Left a lot out, though. I'll have to tell you about how I now have 150 Percocet tabs, at the cost of being dumped by my GP. In Bush's America, no one wants to prescribe narcotics. They could end up in Bush's niece's hands! (Was it his niece that had the jones for Xanax? ...Anyway...)

Pain: 5/10.

Anxiety: 8/10.

--Anxiety is a new one! Which reminds me to tell you about the shrink I visited November 27th! Wow. It was classic. I've never come so close to hitting someone.

So you have a lot to look forward to. If my Dad still had some Provigil, this would go a lot faster. Oh well -- the suspense builds!]

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