Ouch! That Hurts!

So, this morning after making my Happy Meadows rounds I wandered into the family room where Mike was watching one of those Sunday AM news talk shows.  They went to a commercial break that seemed to go on forever. Mike said if he knew it was going to be like that he would have timed it and counted commercials. As it was, amidst the enthusiastic promotion of financial services, automobiles,  personal products, and so on there were no less than 3 commercials for stomach acid remedies. Four actually, but one of them was shown twice, so I’m not sure how to count it. Mike said it reflects the expectation that people who watch these kind of programs will get heartburn as they consider our country’s political situation. Watch the news and reach for the Tums. It’s the new popcorn.

Mike brought home the December issue of Arizona Highways this past week. It featured the photography of Barry Goldwater, that fellow who ran for president and lost in 1964. It was probably good for everybody, including him, that he lost. Our country was going through another rough patch back then, and it got worse before it got better. Mike says Goldwater was the first politician he can recall who made a point of believing in conservative values as though that was a good thing. He was labelled an extremist, I think. Maybe he was, and no doubt there is something to a point of view that resists change, even if it is doomed. Everything changes, even the climate. (I saw a news clip last week I think it was, where Spoiled Donald assured the American people that we are going to have a great climate. I’m serious, he really said that.) Goldwater was  passionate about the West, Arizona in particular, and a hell of a photographer. And if you have never been to the American West, put it on your bucket list. Mike and Judy went to the Grand Canyon with friends one November day, and then returned to Phoenix via the Oak Creek Canyon and Sedonna. There is a chapel in Sedonna carved into the red rock. They lit a candle for their friend Michael, who was fighting a battle with cancer. He lost the struggle a year later, but I don’t know that he really lost. He told Mike near the end that his body wasn’t of much use to him any more, and that he was looking forward to what comes next. Mike gave the eulogy at his memorial service, an experience that moved him deeply and will stay with him always.

I hope you are not a chronic pain patient. If you are, you’re screwed if you live in the good old US of A. A year or more ago the CDC, right here in Atlanta, issued some guidelines about chronic pain management. It included a suggested maximum dose of opioid pain medication, based on opinions shared by some doctors that no one, or almost no one, should be on high dose opioid pain management. The context  of this CDC action, of course, is the serious opioid epidemic that has hit our communities. Many doctors, insurance companies, government agencies, and pharmacy management plans have treated the suggested maximum dose (which really is not that high, according to Mike) as a mandated maximum dose. Some patients have been cut off immediately, and others tapered over 3-4 weeks. I don’t think anyone is tracking this, but as powerful as fear of pain can be, a great many of these patients have contemplated suicide, and no doubt some have ended their lives. Other people have turned to illicit sources of opioids, a highly dangerous practice, and more can be expected to do so. They go from using pharmaceutical-grade products that are accurately labelled, to God-knows-what pills or powder that they get on the “street.” Mike says you can detox an opioid addict quickly, but pain patients require weeks to months if it is to be done humanely and successfully. And nobody wants to take care of these patients now. The bulk of pain management has always been done by  primary care doctors. Now, many of them are unwilling to continue managing these patients for fear of intrusion into their lives by insurers and regulators. And many pain doctors don’t want to treat them either. Mike knows of cases in which patients were not accepted into a pain management practice because they refused to have injections and other procedures for which the insurer is billed thousands of dollars. He even knows of patients who have been dismissed from pain management practices where they have been treated for years for the same reason. It is a good example of  the Law of Unintended Consequences at work. Something good could come of all this, though. Medical science has not had a major advance in the treatment of pain, especially chronic pain, for decades. Nothing materially new has come out since the appearance of morphine and aspirin. A lot of research is underway right now that could break new ground. Mike has been saying for years that he hopes to see opioids go the way of  leeches and lobotomies in his lifetime. While science is working on this, society (government) is going to have to figure out a way for these new medications or procedures to be affordable. Let’s hope for better things.

And how ’bout them Dawgs?

I’ll keep it short and sweet today. Best wishes from Happy Meadows!

Author: Black Magic

Black Magic is a handsome, charming, and self-absorbed cat who lives with Mike and Judy Gordon in Marietta, Georgia. He is about 7 years old, and he will remind you at every opportunity that his grandfather was Black Jack, that famous cat who wrote his own autobiography. Black Magic has a great many opinions, and despite his natural feline arrogance, he seems to be genuinely spiritual. But the reader can decide for him/herself.

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