Tap, tap, tap, is this thing on?
As some may recall, four years or so ago I was regularly underfoot, but departed due to one too many ad hominem, unresponsive, and iterative laps around the same track. One of the attractions of posting here is that the level of discussion, even when disagreeing with someone, is more than a step above most forums or whatnot. Generally at least, though there was a topic that regularly led to emotive rather than reasoned exchanges. No longer worth the squeeze, after many laps around a non-responsive track I opted to forgo the juice and left.
The topic in question was the WOD; ironically in the intervening years I gained a unique perspective where that topic is concerned. Towards the end of 2019 I hit the ER due to some GI pain. Having dealt with pancreatitis over a decade earlier, I assumed I was dealing with a return bout and told the ER MD as much, which got the morphine flowing. Bloodwork came back negative, however, which earned me some drug seeking eyeballing.
I was trundled off for an ultrasound nonetheless, with the MD being coy about the results, telling me I needed a CT and to see an endocrinologist, providing a referral for both. Somehow managed to get right in for them, and was referred to yet another practice that specialized in pancreatic issues, and they referred me for an MRI. Elapsed time was about 3 weeks.
Then came the grim conversation: “there is a growth on the head of your pancreas that very well could be cancer, and the best way forward would involve going in, taking a look, and then proceeding accordingly,” once they had a good look. I was scheduled for surgery Xmas eve, though begged of as a nurse I trusted told me holiday surgical crews were more likely to have picked up long shifts and might not be at the top of their game. As such we rescheduled for mid-January, which gave me more time to get all my end of life planning handled as, let’s face it, pancreatic cancer is a DX few have to wrestle for long.
They went in, concluded it was indeed cancer, so I spent about 14 hours on the table having a “Whipple procedure” performed, losing my pancreas, gallbladder, spleen, some intestine, some stomach, as well as my appendix for grins and giggles. I could not have drawn a better surgeon: he’d performed thousands of Whipples, didn’t cherry pick patients for ones that wouldn’t gum up his stats, had a low mortality rate (some surgeons lose up to 10% of their Whipple patients), and was very straightforward, too boot, not varnishing what surgery might bring me while making it clear how well I recovered was up to me.
Earned some impressive scars while on the table & then woke up in GI surgery recovery ward. The surgeon told me the faster I start moving around, the faster I could get out of there, so me and my trusty IV hanger took our first lap around the ward—a large square likely of 300 feet or so—about 6 hours after I came to and continued doing so every couple hours (there was not much sleep to be hand between the poking, prodding, beeping of medical accoutrements, and such), increasing the number of laps with each outing. Pain meds were a prominent element of the poking, though on day 3 when I started eating solid food I was also switched over to oral pain meds. On the fourth day post-Whipple I was released.
Won’t bore you all with further recovery details, but will note pain meds were a prominent feature. I’m told as surgery goes a Whipple’s complexity is just shy of that of a heart transplant and indeed there aren’t many surgeries that require more than a half day of being cut on. Trust it goes without saying that having one’s plumbing rearranged in so major a fashion brings its share of pain along for the ride, everything from topical pain where my hundreds of internal and external staples and stitches were concerned, to deep belly pain as sundry rearranged organs got used to the new order of things.
Alas, three weeks seems to be the max most surgeons are comfortable prescribing narcotic pain meds for, with some outright stating that the feds look over their shoulders, hence the hesitancy. Due to some other pending and already addressed boo-boos I already regularly visited a pain practice—during my hardcore martial art days I ate Ibuprofen 800 mg at a time more than several times a day, which lead the nephrologist to order me to avoid NSAIDs henceforth—and so was already on a low-grade narcotic regimen for chronic pain, with that regimen adjusted post-Whipple.
That pain practice was my then second one. The first was something of an analgesic-dispensing low rent factory: eight curtained exam “rooms” where you could clearly hear other patients describing their woes, as their doctors, or more commonly nurse practitioners (NP), sternly guided their putative patients towards the least amount of relief they could offer lest the feds or whomever swoop in and call them a pill mill. It was a very disheartening scene, but the only pain practice in my corner of the Blue Ridge Mountains. My NP seemed manic depressive, sometime happily trading martial arts stories with me, and the next intimating I was overstating my needs. The waiting room there was often Dantesque, and always depressing.
As such I sought to step up and did what I usually do: sought a practice halfway between home and Washington DC in the hope I’d find a better MD serving the DC exurbs. And the one I found was indeed a step up: the waiting room was less grim, the clientele look less like Walking Dead bit players, the NP didn’t have a switch that flipped into inquisition mode, and so by contrast if nothing else it was the better choice. Still, there was always the sense you were suspected of drug seeking, particularly by the front desk staff, and I did note several incidents that just didn’t sit well.
Once the waiting room was packed, they were running way behind, and there weren’t enough chairs. I offered mine to a woman with a cane, then waited in line at the window to ask if there were any chairs in back that could be used, but was coldly rebuffed. As such I went to roam the halls looking for chairs, found one, only to be snootily told by the desk staff that they had called for me while I was absent. Second time there was a guy in a wheelchair who seemed unresponsive that was accompanied by a couple sixty or so olds that I took to be his kids or similar. An RX form needed signing and the desk woman had come out from behind the glass—that barrier was not particularly wheelchair friendly—and insisted that he sign it. He couldn’t find the acuity to grasp the clipboard, much less the thrust pen, so one of his aides offered to sign the form for him. No can do, the imperious desk jockey declared, he has to sign it or he can’t get his meds.
There were more innings to that one, which finally resolved when one aide held the clipboard while another grasped his hand and pen, forcing it to “sign” the paper, but that was the last straw for me. The desk staff clearly had no customer service skills. They didn’t have to: pain relief was a sellers market and patients could either put up with their shit or go without. I transferred my care to a sister practice closer into DC and did find them far more friendly, but I was still annoyed by the ethics of this pain chain practice and so kept seeking.
As I was sorting that out I began a course of prophylactic chemotherapy. The cancer wasn’t found in my lymph nodes, which would have pretty much been game, set match, so the plan was to do 16 weeks of chemo in case a wan cancer cell or two was missed. Well guess what: chemo sucks. I had to go in weekly to sit in a chair for an hour or so to have poison pumped into me, then had to stick a 3 inch needle in my belly weekly to inject something that encouraged white blood cells to regrow after having been poisoned, all while daily eating a nausea inducing pill a couple times daily, losing A LOT of weight along the way.
Spoke to my oncologist about this; he asked if I had a pain MD. Told him my tale of woe there; he asked if I had tried a practice just up the street from the hospital. Indeed I had prior to the Whipple when dealing with post rotator cuff surgery and other lingering MA injury pain, but had been told that they “aren’t that typed of pain practice,” which I took to mean they didn’t treat random folk off the street lest they turn out to be drug seekers. My oncologist rolled his eyes, picked up the phone, and got me an appointment with them.
Orders of magnitude better, with the downside being this practice was over an hour from home, while our friendly neighborhood feds don’t allow telemedicine for pain treatment, particularly as pissing into a cup is a regular indignity that just can’t be replaced by pissing on the phone. As that may be, eating is nice and sleeping is too so I made the trek and indeed started getting some effective relief. Medical THC is legal in my state, the new pain MD stated many chemo patients get relief by using it, so I jumped through the numerous hoops and got a script.
Oh. My. Goodness. Have you any idea how good food tastes after you’ve lost 50 lbs. and even thinking about eating makes you want to toss cookies? Yeah, THC fixed that. And then sleep! Prior to medical marijuana I slept in 90 minute segments and felt lucky if a night brought me more than four and a half interrupted hours. Eat some THC and I could chow down, catch four hours sleep, wake hungry, eat again, and fall back asleep for a couple hours or more. It was amazing! The dope wasn’t the ditch weed of my misspent youth—learned the hard way that old metrics don’t apply to this generation of weed, with staring off into space and drooling being the major downside—but sheesh, chemo became more than endurable and I was able to cut back on narcotic meds due to the relief THC brought.
The feds, of course, had tossed a fly in the ointment. Though legal in my state, and though dispensaries operated without the DEA crashing through their doors, THC was still on the schedule as a narcotic. No one bothered to mention that as I jumped through the various hoops, but I had occasion to help a friend by a gun and as she filled out the BATFE’s form 4473 there’s a yes/no question about being the user of an illegal narcotic. Hadn’t even thought of that when it came to medical treatment and so researched the topic further and discovered indeed, in the fed’s view if you were undergoing chemo or whatever and had been prescribed THC you nonetheless lost your second amendment rights. Fortunately my guns are in a trust—set up as part of the end of life prep I did—so I could keep kosher by ceding them to a trustee, but that was a temporary fix at best were I to continue my various firearm pursuits.
Won’t belabor things; where I live you have to be annually qualified to continue THC treatment, chemo ended about eight months after it started, leaving me the choice or renewing or not. To put it more starkly I had to choose between sleeping or ceding second amendment protections and rights. I opted to surrender sleep and have asked more than one drug warrior to explain what justifies being put in such a bind. No answer has been forthcoming. I’m not surprised. I’ve been asking a similar question of someone generally able to frame cogent arguments here to name a single criteria by which the WOD can be measured a success, only go earn the full gambit of fallacious “argument” in return. I’ve noted over the years whenever a response hits too close to home this player abandons reasoned discourse in favor of snark and name calling.
Indeed I’ve noted in my absence a couple of posts containing straw elements, generally to the effect that some absent “loonatarian” assured the list this or that ill effect of drug decriminalizing couldn’t possibly occur. Were those comments indeed pointed at me I’d respond by making clear I did no such thing. Rather I stated that, as the WOD has failed by any rational measure, perhaps it’s time to try things other countries have had success with as the trillion dollars spent, the millions of American’s warehoused in prison, the generations of children that have grown up without fathers, the drug lords that have grown rich due to our folly, along with all the dysfunction and perverse incentives this prohibition retread spun off et al and all the unintended consequences that have resulted point to nothing but abject failure. One could hardly do worse.
My cancer journey certainly has shown me that drug warrior interference substantially impacts pain management both post operatively—also had a titanium plate installed in a foot post Whipple that laid me up worse than that major surgery—and where chronic pain is concerned, particularly as I’m no longer allowed to eat vitamin I, as we called ibuprofen where I trained, by the fistful any longer. Moreover it seems every MD now lives in fear of showing up on some DEA list or whatever, and so prescribe pain meds in a manner that seeks to avoid federal entanglements rather than as best serves the patient’s needs. Meanwhile should one find that THC addresses pain and reduces the need for narcotic relief one can indeed get it prescribed, so long as they are willing to cede second amendment rights. All in all it’s pretty freaking silly and utterly par for the drug warrior course.
I can still rattle on, eh? Bottom line is since I’ve departed I’ve had first hand experience where WOD folly is concerned, with that folly impacting me significantly. I’m now 3.5 years post Whipple, get a CT every six months that have been coming back clean, and will be declared cured assuming I make 5 years. I ‘spose it’s also worth noting that if I had gotten on the table a week or two later I likely wouldn’t be here to write this as Covid madness then swept the country, with most hospitals including the one I had surgery at closing down for all “elective” surgery. Pretty good chance that if I had gone an additional six months the cancer would have spread and hence been a lot harder to beat, to name just one element of Covid insanity and how those folks from the government are here to help.
Anyway I’m back and, assuming there’s still little social media asshattery to endure around here, expect I’ll stay. I’ve certainly missed this forum and many of you and hope to hobnob with you all soon.
