CW: medical, medical malpractice, ableism, near-death experience, medical violence, suicide, MAiD, eugenics
Note: this entry will focus on conditions in the US and Canada, because that’s what I’m familiar with.
On October 27, 2022, I almost died.
I was under general anesthesia at the time; I was undergoing surgery to repair my paraesophageal hernia. (A paraesophageal hernia is a large hole, larger than the natural aperture should be, in the diaphragm around the esophagus.) Not only was my stomach protruding into my chest cavity, my lungs had fused to my esophagus. No, I don’t know how that happens either.
I experienced cardiac arrest and double pneumothoraces. In layman’s terms, I had a heart attack and both my lungs collapsed. I was rushed to the ICU, where I was intubated (tubes were inserted into my lungs to reinflate them). I was in the ICU for six days. This included a spell of ICU delirium, which is a state of severe confusion that afflicts some people who have been in the ICU, especially those who have been on breathing machines. And apparently, delirious!Amaranthe was PISSED. I had to be put in a four-point restraint, and I was fighting tooth and nail. According to my wife, who witnessed this, there was some surprise regarding how strong I was. (I mean, I did martial arts for 20 years.) I’m very glad I have no memory of this.
Once I was awake, lucid, and stable, I was sent home with only ten (10) hydrocodone pills and guidance to only take them if I absolutely needed them; otherwise, I was to take ibuprofen and naproxen. When I used them up, I was told that I was not going to be prescribed any more narcotics. This despite the fact that I was experiencing post-surgery pain that regularly hit an 8 or 9 on the Mankoski scale. NSAIDs didn’t help. Even kratom, the only thing besides narcotics that can touch my menstrual cramps, didn’t so much as touch the pain. On one occasion, my vision began to dim and become gray due to the intensity of the pain. (Yes, I should have gone to the ER, but I knew I couldn’t afford it.) Because I hadn’t been at my current job as a full-time employee for at least six months, I had to use sick days for my time spent recovering from surgery, and I had to go back to work after a scant two weeks off. The pain interfered with my work performance.
At my post-surgery follow-up appointment, which I showed up to looking wan and exhausted with an electric heating pad practically attached to me, my surgeon told me to take Aleve.
After almost dying.
And starting to lose my vision.
My attempted appeal to crapitalism (“I can’t work with this pain”) didn’t even make him budge. So I went home and asked my PCP if she could prescribe narcotics since my surgeon wouldn’t, and my PCP backed my surgeon. This is because my surgeon is a general in the war on pain patients, and apparently my PCP is a soldier.
What do I mean by “the war on pain patients”? Well, it’s often called “the war on drugs,” but “war on pain patients” is more accurate. Really, pain patients are collateral damage in the war on drugs. The war on pain patients includes fearmongering and misinformation about opioids (including fentanyl), addiction, and refusal to prescribe opioids to people who need them. The hatred of opioids in the medical community is truly baffling to me; I mean, my surgeon told me that opioids “don’t help, they just numb your senses.” YES, SIR, THAT WOULD BE WHAT I WANT TO HAPPEN. I FAIL TO SEE THE ISSUE HERE.
The CDC, who I’m extremely pissed at for the way they’ve handled COVID, is somewhat to blame for the hatred of opioids in the medical community. The CDC’s guide to prescribing opioids was restrictive enough that doctors who listened to it—or who already hated opioids and were using the CDC’s guide as an excuse—didn’t just minimize the number of opioid prescriptions that they wrote, they cut people off who were already taking opioids. This resulted in pain patients being tapered off their medication too fast or even abruptly going cold turkey. Can this cause withdrawal and other severe issues? Of course, but do doctors care about pain patients’ health as long as they can say they don’t prescribe opioids? Pffff, NO.
Okay, that’s not entirely fair, but even doctors who know that they should be prescribing narcotics are screwed because of the DEA (Drug Enforcement Administration). Doctors who write “too many” opioid prescriptions can lose their ability to write controlled scrips or even their medical licenses. So even doctors who know that their patients need opioids balk at actually writing the prescriptions because they’re too afraid for their careers to properly treat pain.
It’s not just me saying this.
One of my closest friends, who is a chronic pain patient, recently told me that doctors who refuse to prescribe opioids to patients who need them are violating the Hippocratic oath, and I completely agree. She knows what she’s talking about, too; she takes ADHD medication, which is controlled and could fetch a higher street value than narcotics, and despite her being compliant and safe with those meds, she has been denied opioids that she genuinely needed. She also did a sensitivity read of this blog entry, during which told me about how pain clinics and/or pain management are, and I quote, “a steaming crock of shit.” Many “pain clinics” don’t prescribe any opioids, period. Most will make you sign a contract in order to be treated, and said contract includes bullshit requirements such as random drug tests, random pill counts, a proscription on getting opioids from anywhere else (even the ER), and forcing obedience to their rules in exchange for any medication whatsoever. Many “pain clinics” will fire patients—yes, really—if they admit to kratom or cannabis use (and the clinics drug-test for both). The friend who taught me these things about “pain clinics” was once being treated at one of these bullshit places and lost an oxycodone scrip because a random drug test revealed that she was negative for hydrocodone, which is different from oxycodone.
Another friend described to me how her partner has chronic pelvic floor pain but his insurance will no longer cover his pain medication. This same friend also told me about how her mother recently had kidney surgery and was sent home with no narcotics whatsoever and told to take Tylenol. Yes, Tylenol, the trash drug that barely works better than a placebo and has a high likelihood of damaging your liver. (More from Rebecca Watson: https://www.youtube.com/watch?v=GH1sEGmOrT0)
Why is the war on pain patients so harmful?
Well, you know what happens when pain patients can’t get the pain control they need? Not just intense suffering, which leads to increased disability (trust me, pain is disabling). Sometimes pain patients die by suicide because they would rather die than live with their pain. I would imagine that sometimes death by overdose when pain patients turn to street drugs happens too, but I don’t want to make claims that I can’t substantiate, so I can only speculate on that. (I also live in the Midwest US, where fearmongering and misinformation about opioid overdoses—from both illicit and prescription drugs—is common, and it’s hard to sort out fact from fiction.) It’s not just the Midwest, either; any former industrial area seems to have more of a fentanyl/heroin problem than other places. This isn’t just because of economic depression leading to drug use as a coping mechanism, either; workplace injuries contribute to need for pain control. Also, Canada is now pushing MAiD, medical assistance in dying, on Disabled people who are slipping through the cracks in the social safety net. That includes pain patients who are being denied opioids, many of whom can’t work as a result of their uncontrolled pain. When Disabled people in Canada who can’t work request services, MAiD is suggested to them in order to save money. The war on pain patients is literally killing people.
“But Amaranthe,” you might say, “what about addiction?” Well, what about it? If you had chronic pain, chronic pain so terrible that you couldn’t so much as move without opioids, chronic pain that kept you from basic activities of daily living without the medication you needed…wouldn’t the fact that you genuinely needed opioids long-term look like addiction to an asshole doctor who hated narcotics? There’s a conflation of addition with actual need in conversations about opioids. Yes, being dependent on an opioid can happen, but that happens with plenty of medications that are needed long-term. Hell, I’m dependent on my antidepressant, without which I become to much of a suicidal mess to function. Opioid dependence is erroneously seen as addiction, and addiction is still better than, you know, death.
Fortunately, my post-surgery pain is almost completely gone, and I’m recovering well. But there are still thousands of pain patients who are suffering from both pain and discrimination, and being labeled drug-seekers and being denied adequate medical care. And that needs to change yesterday. Honestly, I feel bad just writing about this topic now—I’ve been planning on it since I first started this blog—but I didn’t have the requisite experience to write about it from my own perspective until recently.
I think that’s all I have for now. Sorry it’s been so long since I updated this blog; I did almost die.
More on the CDC fuckery: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm