2012/12/12

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Da Goddess @ 23:00

I guess it pays to sit in someone’s office and cry for 45 minutes.

Monday, following my tearful doctor’s appointment, I walked over to the attorney’s office. He happened to be there as I was talking with one of his assistants, noticed I was in tears, and asked me to hang around until he was finished with his client so he could talk with me. I did. And all that bullshit I was hearing for the past month of “oh, he’s working on that for you” became obvious that no one had worked on it at all. However, since I was there, sobbing like a child who’d had his lollipop stolen, he got on the phone and started working on things right away.

Today, I got a call. Not from an assistant, but from the attorney himself. Things are happening. Granted, I’m still likely a month away from medications, but at least something‘s happening.

I go through this every couple of years with the insurance company — them denying some part of my treatment and throwing my whole pain management routine off. It’s so difficult to explain what this does to me. Let me try.

Every single day of my life is spent trying to minimize the amount of pain I have. Normally, I have medication I can take at the end of the day to help keep it to a dull roar. I also normally have medication on hand if I have breakthrough pain that isn’t kept at a manageable level with Tylenol. This is all day, everyday. I don’t get a break on weekends or holidays. Everything I do revolves around keeping my pain at a livable level. When things are relatively well-controlled, I get to lead what passes as a normal life. I can do things. I try hard not to OVERDO things because that sets a whole cascade of trouble in motion. Without medication, my day is spent trying to keep a thousand angry bees in a bag with nothing more than my bare hands and sheer will. Or at least that’s what it feels like. Except that it hurts more than bee stings. And once I’ve maxed out on Tylenol for the day, I got nothing else in my arsenal to fight the pain further. If Tylenol doesn’t do much for me when I’m on all my other meds, you can pretty much guess how well it works for me when I don’t have other meds on board. Yet it’s the only option I have at this point. I can’t take anything in the ibuprofen or similar NSAID family. I can’t do homeopathic. And I don’t do illegal drugs.

One of the medications I’ve been on for the past year and a half or so is Cymbalta. It’s an anti-depressant that’s been approved for use in chronic musculoskeletal and neuromuscular pain. It was a bitch to get used to. I was sick for a full three months plus when I first started taking it. The only reason I pushed through and kept taking it was because it absolutely made a difference in my pain level. Plus, I was losing weight. Yeah, it wasn’t pleasant, but it was, in my mind, worth it. Anything that decreases the level of pain I was feeling was worth it.

With drugs like Cymbalta, you’re not meant to suddenly stop taking them. You’re meant to taper off if you need to stop for any reason. Why? Because even with tapering off slowly, “withdrawal symptoms and signs can occur on the discontinuation of such medications as clearance of drug can occur at a rate faster than the brain can readjust to the absence of medication”. In other words, no matter how slowly you taper off, you can still have severe withdrawal symptoms. When you stop the medication abruptly, you’re shocking your system even more. There’s no way to counter the affects. SSRI (and SNRI) discontinuation syndrome is kind of a big deal.

“Common responses to dose reduction or cessation include dizziness, electric shock-like sensations, sweating, nausea, insomnia, tremor, confusion, nightmares, and vertigo.” Can you say check, check, check, check, check, check, check, check, and check? I’ve experienced every listed symptom and more. Nobody tells you about these things when you start taking the medications, they only tell you NOT TO DISCONTINUE THE MEDICATION ABRUPTLY. In severe cases, the body cannot handle the withdrawal and shuts down completely. For me, it’s been a struggle to deal with the pain and then, to top it off, I get this shit. The depression and anxiety (mind you, I was not depressed…I was placed on the medication to help manage pain) have set in since I’ve been off the meds have been overwhelming. Sitting in the doctor’s office and the attorney’s office crying are the least of my problems, but it’s a big enough problem on its own.

I don’t feel strong enough in any way, shape, or form to deal with this on my own. Yet, I have no choice. I have to power through somehow. But when you combine the physical pain with the depression, anxiety, and lack of sleep, it’s a no-win situation for me. The job I was supposed to do last week? Between what I’ve been going through and the guy who wanted me to shoot changing the compensation on me, I didn’t do it. I had to make a serious judgment call and that was to not go. I couldn’t even consider carrying around my gear and standing for hours without a break while I was already hurting because — you guessed it — I had no way to combat worse pain. No amount of money would have been worth it. Okay, maybe a couple grand would have been worth it because I could have paid for the meds on my own (they’re not inexpensive; the Cymbalta alone is a few hundred bucks each month). But that’s not what was offered to me and I couldn’t afford to risk exacerbated my back.

This puts me in a horrible position: I needed the job to have a little bit of money so I could buy Christmas gifts (or even supplies to make gifts) and I needed to pay the two bills I have each month. This does not include payments on a loan from a friend (who has been magnificent about all this). I can’t pursue jobs of any sort as long as I feel like this and not being able to pursue work means I can’t afford to pay for the meds out of pocket either. So I end up sitting here feeling like a fucking loser who can’t do anything. Guess what happens then? Oh yeah, the depression and the anxiety worsen.

Isn’t my life so amazingly glamorous and fun?

That the insurance company lets this happen is unconscionable in my book. I know I’m not the only person they do this to. But because it is happening to me, it’s…just…the worst! I don’t know how I can get around this. I don’t know how to deal with anymore. Beyond the crying, I mean.

The other difficult part of this is trying to do the best I can for my dad. That’s the whole reason I’m here: to take care of my dad. I feel like I’m letting him down in so many ways. I do my best to keep things taken care of at the bare minimum, doing more when I feel up to it, but it doesn’t feel like it’s enough. Thankfully, all the work we did before my dad got home has made it easier to maintain a basic level of cleanliness. It just doesn’t feel…enough. I also cannot — CANNOT — allow my dad to see me upset. Not as upset as I feel. He takes that on and personalizes it, which isn’t good for him. So I hide it. But I’m crumbling.

And this, my friends, is also why I’m failing to post regularly unless I prep posts ahead of time. I’m unraveling. And I don’t know what to do. I’m all out of ideas. Unless it involves sitting in someone’s office and crying uncontrollably. I can do that. I can put in the face time and make everyone uncomfortable. Do you think I should see if the attorney will go to the insurance company’s office with me and watch me cry? (I’m not allowed to deal with them myself since I’m represented.) Do you think the adjustor would care?

4 Comments

  1. I’m not surprised the squeaky wheel theory works, now you must sit and cry in every office related to your case. It’s not a daily phone call, it’s immediate and affecting them.
    I don’t think they’d care, I think they’d want you out of their office [if we’re being honest] but if that’s what it takes to get what you need, what you deserve, then by God, do it.

    You’re too nice by far; it’s time to unleash the kracken.

    Wish I were there; I’d go with you and cry as well. We’d be like the Double mint twins of sorrow and pain.

    Comment by pamibe — 2012/12/13 @ 05:55

  2. What makes it worse – as you know only too well – is that in addition to the very real withdrawl that follows abrupt cessation, pain meds tend to shut down the body’s production of it’s own natural pain killers (endorphins and such). As a result, pain levels that may have been a 9 on a scale of 10 without the meds in the first place suddenly become an 11. That’s another reason for medically supervised tapering, to allow the body time to start regenerating natural painkillers. You’re getting it from both sides now; withdrawl on top of pain that’s worse than the pain they were treating in the first place. No fun.

    Hope you get it resolved.

    Comment by Stu — 2012/12/13 @ 06:24

  3. Praying for you, kiddo. This sounds horrific.

    Comment by Scott — 2012/12/13 @ 07:22

  4. I’d throw a group hug smilie in here, but I don’t have one. So…*group hug*

    I gotta laugh because Pam said “Double Mint twins of sorrow and pain” and the Stu chimes in, which makes me think of Bonamassa and “Pain and Sorrow” and somehow it all makes me feel less alone.

    As you all know, I prefer to stay busy. I like to shoot. I like to be with friends. I like to have a life. This crap is making it impossible to do any of those things. I’m not LIVING right now; I’m EXISTING. If I were an animal, I could be euthanized.

    Also, the longer I’m not able to get out and work, the worse I feel. Not only do I have bills to pay, but I have basic needs that aren’t covered: deodorant, shampoo & conditioner, socks, a warm jacket (because I left my leather jacket in Vegas, in storage because I honestly thought I’d be back there by now to get all my stuff), sweat pants. Stupid shit that I need. And then there’s the other stuff like meds. If I could at least pay for them myself, I could take the receipts into court and the judge would order the ins co to reimburse me (although I *am* still waiting for them to reimburse me for meds I had to pay for out of pocket in early 2010, so I don’t hold my breath on these things…but I’d still be covered!!).

    I don’t feel human anymore. I certainly don’t feel like me. And I can’t fathom waiting another month or two to get this straightened out and to get back on the job hunt.

    Gaaaaaaaaaaaaah!

    Would you care to sample any of my other whine selections?

    Comment by Da Goddess — 2012/12/13 @ 12:04

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