High Noon

Good news. After an emergency appointment with my lovely specialist yesterday, I have new drugs.
I explained the whole work thing, how I am constantly tired and so on. I got a little bit emotional but managed to wheel out the stiff upper lip.

Me: I never wanted to go round the world on a skateboard before I had Crohn's, and I still don't, but I do expect to be able to go to work and not have to go to bed at 8pm.
Him: Not unreasonable
M:To give you an idea of how crap things are, I did two loads of washing yesterday and washed up - then had to have a lie down
H: So you would describe your life as?
M: In all honesty, crap. If this is to be my life, I'm not sure I want it.

Dr looks through huge file on me, being careful to keep a firm hold on it lest it slip off the desk and render the 2ft tall nurse unconscious.

H: Hmmm. Yup, your recent bloods suggest that you are indeed feeling like crap, physically. And I'm not surprised you are at the end of your tether with work.

I know he believes me, as under todays date in the file he writes ' X is feeling crap, employers being ridiculous.'

Here somes the sticking point. We both know that a steriod called Prednisolone will fix me up straight off. But we also both know that I will have to be off work to take the initial big doses and that eventually, steroids will make my arms and legs fall off.

There is an audible bing - followed by more leafing through the file - and a lightbulb goes on...

H: I've never given you Budesonide, have I?
M: No, but I have read about it
H: So you'll know it's a steroid, but with far fewer side effects than Pred?
M: Yes
H: How have I never given you this before? Humph

Dr tuts at hinself for a bit.

A shaft of sunlight enters the room accompanied by a choir of angels.

H: Right, lets do that then. You should feel better in about a week.

And just before I fall to my knees to give thanks that there is hope,and that there will be no hospital admission, he also says:

H: And if your enployers give you any more problems, refer them to me. You've been through a hell of a time in the last few years. I'll either speak to them or write to them, the idiots. Pfft.

And off I trot the hospital pharmacy to pick up my new drugs.

Drug Abuse?

It's Saturday night and I'm staying in. It's cold and dark, I have an appointment with the specialist on Monday morning and I thought it might be nice to give him a set of blood samples that are less than 14% ABV.

And I'm in a tiny bit of pain. And I'm bored. But does this justify having a Tramadol?

For those who are not aware, Tramadol is an opiate based painkiller, that, as I understand it, works by increasing the flow of endorphins to either block the pain, or to make you not notice it. And by being an opiate, obviously.

Now, I'm a lucky odditity, as was discovered after my surgery a few years ago. I had the standard morphine push button drip wired up, but was still so stoned post-op that I had misheard almost everything the staff had told me, so thought I could get a hit about every 25 minutes, and jolly nice it was.

Sometimes I didn't need a hit for pain reasons, but took one from time to time as the ward was pretty chaotic and grim, so I guess you could say I used it for mental health reasons.
The days passed and the pain managment team turned up to assess me. And were very impressed by how little morphine I'd used.

Turns out I could have had some every five minutes. Bugger.

This and my reactions to other sedatives led to the conclusion that I have overdeveloped opiate receptors, which means any moderate dose of opiate painkiller works exceptionally well, and I also get all the good side effects - improved mood, a deep fascination with small things and generally have a very nice time.

Consequently, a single Tramadol would do nothing for most people, or at best might give them 3-4 hours pain relief, but leave me happy as a sandboy for about 8 hours.

But opiates can be habit forming (i.e. heroin), so must not be treated lightly. In theory I could take some paracetomol and hope for the best, but if I take some tramadol, I know it will work and also give me a good night being delighted with the thread count on my Egyptian cotton bedsheets....*

So I guess I'm wondering, where is the line between prescription drug use and prescription drug abuse?




*I spent a happy evening in bed after some tramadol pondering the egyptian cotton, thinking about the Nile tide irrigation system, the family that had grown it and how it had got from the cotton field to my bed and being generally grateful for the whole process.

A Polite Conversation

I arrive at the GP's surgery. It is quiet. And I mean quiet - there are two other people there. The receptionist is new. She isn't chewing gum in a slack jawed manner and wearing a tabard, but you get my point.

Me: Hello, I've come to pick up a repeat prescription and a sick note
Her: .................................
I notice her jaw slacken sightly. Does this mean she has heard me? As her eyes don't focus, I have another go.
Me: I've come to collect a repeat prescription and a sign off?
Her: Oh.
Very Long Pause
Her: So have you got one then? They take 48 hours you know.You can't just have one you know.
Me: Yes, I know. I rang up and ordered both on Tuesday. Today is Thursday.
The expression on her face leads me to suspect that the fact that today is Thursday is news to her.
Another V.L.P
Me: Would you like my name then?
Her:Er...............yeah
I give my name.A third V.L.P. She doesn't move. I can see the box with my repeat prescription and sign off. It is, at best guess, 12 cms from her left hand.She won't even need to stand up. I smile and nod encouragingly. Perhaps she thinks I am 'a wierdo'.After all, I am not wearing any gold, I am over thirty and do not have any children with me. I have all my teeth and no tattoos. I haven't sworn at her. I am not grey and shaking and demanding my 'script'.
A further V.L.P. She turns her back on me.
Her: Well, I'll have to look for it. Sighs. You'll have to wait.Sighs.Would you like to take a seat (this was not a request).
Now, this could have gone a number of ways, save for the floor to ceiling bulletproof screen and the fact I'm in quite a good mood.
Me: No, thank you. I would like you to look for my repeat prescription and my sick note and give it to me, now, please.
Her:.....................
The jaw slackens yet further in what I can best decribe as shock. Some doctors' receptionists' think they are on a par to God. I, however,think not.
After further heavy sighing, she drags herself along on her wheeled chair.And gets the repeat prescription and sick note. And hands them to me. Very slowly. The last person I saw moving that slowly was an in-paient on a zimmer frame.
Me. Thank you.
Her ...............sigh.

Some years ago, I had cause to go through a formal complaints procedure with my surgery. The were several problems, but the B12 was the last straw. I need weekly shot of B12. The surgery don't keep it.Methadone yes, vitamins....no.
I was told I'd need to make an appointment to be prescribed it. I would then need to collect the prescription, store it at home and make a second appointment to have it administered. Two appointments that would a) not be available to people who needed them and b) because of the distance I live from work, mean 6 hours off a week.
I was not a happy kipper.Things were eventually resolved, and I'd noticed a massive improvement in the surgery in the last 18 months. They've employed some additional GP's, who are excellent, and the appointments system has been over hauled.The phone lines open earlier, and there are a lot more clinics and longer opening hours. Trying to be fair and even handed, I was going to write to them. After all, I'd complained, so shouldn't I also give credit?

Then it took me 10 minutes to get a piece of paper to travel less than a foot.