Tag Archives: medicine

I’m Not Sick, But I’m Not Healthy Either

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Dr. Lopez after my visits.

Dr. Lopez after my visits.

I recently had my summer checkup with my GP, Dr. Lopez. Even though I think the world of Doc, I don’t hate many things on Earth quite as much as I do going to see him. It’s definitely a top ten pet peeve of mine — nowhere near as loathed as Weed-Eating the yard but quite a ways above a slight paper cut. It’s not that Doc is a bad guy, because he’s not; I simply despise repetitive activity for the most part and my physicals are always extremely repetitive.

First, regardless of when my appointment time happens to be, I’m going to sit in the exam room for at least an hour. I wouldn’t mind if I was confined to the main waiting room. It’s much larger and cooler and the reading material is of a better selection. No, I have to cool my heels in the tiny, windowless exam room with the paper covered table and box of tongue depressors. I’m claustrophobic and after about ten minutes alone in there, I start hyperventilating and the walls begin moving towards me. Then, just as I am about to go bat-poop crazier that I already am, Doc comes in and wonders how my blood pressure can always be elevated no matter what hypertension meds he has me take.skeleton

I could endure the waitings, though, if the consultation wasn’t so negative. Doc always starts with the lab results from the blood I had drawn the week before. (Just as an aside, if you want to see your doctor flip completely out, instead of going in for labs fasting, eat three Krispy Kreme original glazed doughnuts and chug a pair of Mountain Dews about thirty minutes before they draw blood — they’ll send an ambulance to get you as soon as the results come back.) Now all I care about from my lab results is my A1C level and my PSA level. The A1C tells if I’m diabetic or not and the PSA lets me know all is well with Mini-Me down below. He could give me those numbers and the visit would last five minutes — tops. Instead, he starts off with my CHOLESTEROL and TRIGLYCERIDES. I take meds to reduce both and he still isn’t satisfied. Unfortunately, no matter how much I try to convince him I don’t give a tinker’s cuss what my LDL and HDL levels are, I still get The Speech.

The Speech is a variation on “you need to exercise; you need to lose weight, you need to eat healthier.” Depending on the time of year or his particular mood, one of the three will get more emphasis than the other two. The latest iteration focused on diet. Every time he starts the “getting healthier” spiel, I ask him why I need to be so concerned with cholesterol. He always says it’s so I won’t have a massive heart attack and die. That’s when I ask him the same question every time: “What is the single biggest indicator of longevity in humans?” Usually he mumbles a bit then comes out with “Family history,” at which point I say, “Okay, forget cholesterol and tell me my A1C.”

Here’s my line of thinking and it infuriates him to no end — I’m not scared of a massive heart attack. If your heart explodes, you die. Simple. Pour water on the fire and call in the dogs boys because this night’s hunt is OVER. On the other hand, I am terrified of Type II Diabetes or, as we say in the South, “The Sugar.” Diabetes doesn’t kill you — at least not outright. No, first they cut off your toes; then your feet, followed by your legs to the knee, then to the thigh. Before long, you end up looking like an extra from the 1932 Tod Browing film Freaks. Plus, the entire time leading up to your butchery, you have to stab yourself with needles two or three times a day. Needles are the main reason a Skittlesques pack of pills was my drug of choice rather than heroin or morphine when I was a young and reckless lad.

Getting back to family history, though, Granny Matt (my great-grandmother on Daddy’s side) had six sons: Uncle William, Uncle Bob, Uncle George, Papa Wham, Uncle David, and Uncle Jack. Of the six, FIVE died of massive heart attacks sometime between 72 and 76 years old. Daddy has already had one and a half heart attacks and he’s 63. On the other side of my family tree, however, diabetes and cancer, sometimes both, run roughshod through Mama’s side of my family. I’m trying to get Dr. Lopez to see I’m not fatalistic or reckless with my health, I’m just playing the averages and trying to help skew them in my favor.

Eat RightI could cut out everything I love to eat — red meat, ice cream, starches, sweets, cheese, etc — and I could exercise religiously like I see so many people doing around here, but WHY would I want to? Perfect health is simply the slowest possible rate at which you can die. In most ways, we’re dead already. Luke the Drifter said it best when he sang, “I’ll Never Get Out of This World Alive.

I go see my precious Granny every Tuesday. She can’t talk to me anymore. She can just barely feed herself and not even that some days. She can’t walk; she’s in diapers. I love her more than words can describe, but I don’t want to end up that way. Many of the inmates in the nursing home where Granny lives are the last members of their family. No one comes to see them. They are just taking their time dying in a warehouse of obsolete humanity, and there’s not a thing wrong with that, I just don’t want it to be me. Anyway, I was raised all my life to believe this live is just a dress rehearsal for what comes next. That’s where Mama is. That’s where I want to be. Right now, the only thing keeping me here is my Budge. I won’t leave her alone if I can help it.

So, see why I drive Dr. Lopez to distraction? Love y’all; keep those feet clean.

The Perils and Pitfalls of Prescription PAs

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EffexorIt’s been a couple of weeks since my last post and I figured I owe my few but loyal readers an explanation of where I disappeared to for the past fortnight. Quite simply, my meds were screwed up.

For those who are late joining this party, I have some mental health issues that I’m not particularly proud of, but which I don’t make any pretense of hiding either. Without knowing it, I’ve followed the advice Tyrion Lannister sagely gives Jon Snow to “Never forget what you are. The rest of the world will not. Wear it like armor, and it can never be used to hurt you.” I’ve just supposed as long as I’m open about my issues, no one can throw them up at me and I may just help someone else along the way.

But I digress.

First of all, you must know I am thankful for my wife’s very good insurance coverage which allows us to buy medicines with only a small co-pay. I remember some years ago when we went through a period with no insurance at all and it gave me a tremendous appreciation for those co-pays as well as an equally tremendous hatred of pharmaceutical companies which is a rant for another time. During that stretch, my primary anti-depressant — Effexor XR — hadn’t crossed over to the generic side of the street and a bottle of 30 cost slightly north of $200 dollars. Luckily, Mama was still making good money then and carried me for about a year buying that expensive medicine monthly.

Now, though, times have changed a bit. I require two capsules per day to keep on a somewhat even keel. Unfortunately, for whatever reason, our insurance company claims to know more about my mental health needs than my wonderful psychiatrist. According to them, I should STILL only need one capsule per day, and therein lies the rub. In order to get my two capsules per day allotment, I must obtain the dreaded “prior authorization” form and have Dr. Stephens fill it out and fax it to the insurance company.

For those of you who aren’t familiar with some ways insurance screws you over, here’s a jolly good one — they don’t keep you from getting as much medicine as you want. If you have a prescription with six refills on it, you can get ALL SIX refills at one time if you desire . . . but they are not paying for it. I can get 30 capsules (or fifteen days worth) for $12.50 but unless I get the PA signed and faxed, the other 30 capsules to finish the month will set me back over $100 — and Effexor IS generic now.

Oh look! It's a map of the Eleventh Circle of Hell!

Oh look! It’s a map of the Eleventh Circle of Hell!

I’ve had to do this moronic little dance now for over five years. My 12 month PA runs out in November and I have to get a new one pushed through so I can get my December prescription filled. Well, this year when I got my November refill, the pharmacist didn’t put anything on the bottle about my PA running out as she had done for the last several years. That got me to thinking I no longer needed a PA since this was the first year for generic Effexor.  I went merrily about my way and got a refill again on December 26, 2012 and still had no information about needing any forms renewed. When that bottle ran out, I called in a refill once again and picked it up. When THAT bottle ran out, I called in another refill and trouble started immediately.

Apparently, I DID still need a prior authorization back in December, but with no note or anything, I failed to notice the bottle only had 30 capsules in it. Furthermore, when I picked up the second refill in January, that bottle only contained 15 days worth of medicine as well. So when I went back to get refill two for this year, the computer shut me down. I couldn’t get my refill without getting a new PA on file.

Now in the past, the computer would shut me down in November so I would get the 15 day supply, download the form, take the form personally to Dr. Stephens, watch him fill it out, and fax it to them myself. This time, with no note, I didn’t pay attention — which is my fault — to either bottle I refilled so I found myself sitting at the window of the pharmacy being told I couldn’t get my meds without paying full price . . . well over $200, even generic.

I immediately went into a panic because I was OUT of meds. Now that might not seem terrible for any of you who have run out of cold medicine or cough medicine or some such before, but when you run out of psychotropic medicines, it’s a whole new ballgame. If I miss ONE dose of Effexor, I am lethargic all day. If I miss TWO full doses, I get a migraine headache that will incapacitate me for AWHILE, and those are the GOOD withdrawal side effects. Normally, if I see I’m going to run out, for whatever reason, I’ll take a half dose. I still feel like warmed over death on a stick, but I can carry on for the most part, except for the dreams.

Whenever I’m in full or partial Effexor withdrawal, my subconscious really has a field day when I go to sleep. Within a day, I begin having the most vivid, psychedelic nightmares you can imagine. I have been chased by Jason Vorhees riding a transmuted werewolf and leading a pack of orcs and zombies. I have been sacrificed, tied up for the kraken, and more other weirder and more terrifying dreams.

Sleeping. Is. Hell.

If you are here and don't know if you are awake or asleep, it's not ending well.

If you are here and don’t know if you are awake or asleep, it’s not ending well. Just saying.

Budge won’t let me sleep in the bed when I’m in withdrawals; not because she’s mean to me but because she’s looking out for her safety and the safety of our cats. I have woken up from a withdrawal nightmare in full combat mode punching the couch and stomp kicking the coffee table. I’ve woken up by diving off the recliner into the floor and hitting the coffee table on the way down. At a certain point, I start hallucinating and can’t tell if I’m dreaming or in reality. That’s when I stay away from driving and sharp objects. It is miserable and if I go too long and start back taking my meds . . . I get to experience the same effects while the meds ramp up in my system again. Did I mention HELL?

Luckily, the pharmacist on duty was a former student of mine. He fronted me ten capsules and by halving my dosage, I was able to make it til my PA went through, but it was a near run thing. I still had some kooky dreams but nothing like full-blown withdrawal. So that’s where I’ve been, everyone. I just haven’t had the wherewithal to make a post. Hopefully, I’ll be back in the high life again and can start up my former erratic schedule. Here’s hoping anyway.

Until then, keep those feet clean and know that I love y’all.