Blaming “Big Pharma”…

So Johnson & Johnson just got bitch slapped by the State of Oklahoma for creating a pain reliever it turns out has some addictive qualities. A fair portion of the interwebs are cheering this development.

I’m a contrarian, though. There are some fine points that I don’t quite understand. I have questions.

Opioid pain relievers are, obviously, considered pretty good at what they were designed to do. Without deep diving into the science of how and why, my assumption is they were created principally to reduce / manage pain. It occurs to me, a guy with no medical degree or scientific training, that there are a lot of ways to get after that goal other than opioids depending on the severity of the pain in question.

So now, the question is, what, if anything, is available that’s just as effective at revealing pain as a standard opioid? Then, the question becomes, what role do doctors have in determining the most effective treatment? Finally, we get down to brass tacks and ask what responsibility does the general public have in terms of being informed about what these options are and what they are putting into their own bodies?

You see, I don’t blame the drug companies here – at least not to the level of holding them out as the ultimate bad guy. I suspect in developing bigger and better opioids they were simply responding to a demand signal in the marketplace. That is to say that when given an option, people tend to want to reduce the pain associated with medical conditions or procedures as much and as quickly as possible. I don’t blame them. I’m less than heroic under duress. I don’t want to be in pain any more than is strictly necessary. I wouldn’t do well if it came to holding up under torture. What can I say, I’m a man who knows his own limitations.

With that all said, I’m also a guy who makes his own decisions. I’ve been prescribed opioids on a couple of occasions. Fortunately, the level of pain involved was such that I could manage with a few hands full of 800mg ibuprofen and go on about my business. Even though it was readily available, I opted to bypass the higher powered pain killer because I didn’t really need it. A lot of other people would have made different assessments of their own needs under the exact same circumstance. But everything starts with that choice… and then consequences follow.

But, this is America in the 21st century, so we have to have someone to blame for every bad thing that happens. “Big Pharma” is an easy and tempting target when it comes to who caused the opioid problem. It is their product, after all… even if that product only exists because we collectively have demanded a better and faster painkiller. They gave us a hell of a product. Maybe in the future we we should be a bit more thoughtful about what we ask for and noggin through some of the second and third order effects it might have.

Yeah, right. Like that’s going to happen. Never as long as we have a convenient scapegoat to relieve us of the burden of our own responsibilities.

The sadists among us…

I don’t like going to the dentist. You’d never know it from the amount of money that I’ve dumped into my teeth over the last 20 years, but I don’t. That’s probably why I generally put it off as long as possible between visits. I’ve convinced myself that the most logical approach is not to worry about it until something hurts and then I can have the issue addressed. Yes, I know that idea probably compounds the issues and means more time in the chair… but at least those times are less frequent.

I don’t mean to imply I have a random phobia of the dentist. It’s not like being afraid of spiders or thing that lurk in the dark. I avoid the dentist for good reason, the best reason – childhood trauma. My reluctance to fully commit to a modern dentistry stems all the way back to the early mid-1990s. That’s when the old dentist I saw as a kid decided that since it was a small cavity, he could go after it without Novocain and be finished in a jiffy.

As it turns out, having someone drill on a molar without numbing it up first hurts like a mother. I don’t recommend it. You might say that I’m pain intolerant. Being the rational creature that I am, I seek to minimize painful experiences. Which leads me back to the original statement: I don’t like going to the dentist.

I’m sure they’re perfectly good people and that they have the science to back themselves up… but you’re never going entirely convince me that dentistry isn’t just a vast conspiracy of the most sadistic among us to inflict pain on the masses under their diabolical cover as medical professionals.

Back in my swivel chair…

Today was not an unmitigated success. There were no meetings and, if I’m honest, that goes a long way towards making a day more tolerable if nothing else. Then there was the great cleaning of the inbox. Clearing out near 300 backlogged messages that had no hope of being answered felt like a win… until I then was left to ponder the hundred or so that remained and actually needed some kind of answer. I spent way more of the day plowing through those than I want to think about. The amount of time wasted on email would be spectacular if anyone ever bothered to add it all up. They won’t, of course, because no one really wants to know the answer for fear they may have to do something to make that number more reasonable.

So now I’m back to the office. They say great art comes from great pain. That could very well be true. I don’t know if “pain” is the right word here and I’m in no way vain enough to call what I’m doing art, but my best and most consistent writing almost always finds its source at the office. Sure, that could be because for five days out of every seven that’s where I spend more waking hours than anywhere else. I like to think, though, that it’s because the bureaucracy is a vast treasure trove of stories begging to be told. If I weren’t part of it, I’d have a hard time believing that anything so convoluted could even give the impression of functioning.

I’m not thrilled beyond all reasonableness to be back in my swivel chair, but for the sake of the blog it’s a good thing… and that’s as close to glass full as I’m going to be able to manage.

Approach avoidance…

A few months back I’m pretty sure I cracked a tooth, or to be more specific I’m pretty sure I re-cracked a tooth that I had fixed about a decade ago. It only caused minimal and occasional discomfort and could be easily ignored. We seem, currently, to have slowly worked our way past discomfort and are edging into the legitimate pain category. I’m going to go ahead and blame the sudden appearance of cold weather since it appears to be introduction of cold air that’s set off the sensation of someone occasionally jamming a teeny tiny ice pick into my jaw.

This, of course, is where my problem starts. You see it’s not so much that I’m afraid of the dentist, per se. The one’s I’ve met seem like decent enough human beings and individually are not a fear-educing bunch. I am, however, entirely and completely in favor of avoiding pain for as long as possible. This, unfortunately, has now caused me a dilemma. At some point in the near future this untreated tooth is going to start being more than an occasional discomfort. That may be weeks or months from now. An appointment at my local dentist is a guarantee of pain and a sure and certain time. It’s one of the few occasions in life where I generally prefer the unknown future to the known.

Yes, I know this is a ridiculous approach towards dental health. Yes, I know I should have had it taken care of months ago. Yes, I know it’s utterly out of character for a guy who thrives on adding things to a list and getting them knocked off as quickly as possible. I’m unpredictable like that.

I also know that the last three times I’ve walked into a dentist’s office for anything more than a cleaning I’ve walked out chewing on a couple of thousand dollars worth of bills to pay. Pain in the mouth. Pain in the wallet. Completely ridiculous or not, there’s no doubt in my own head why my approach to “modern, painless” dentistry is so often avoidance.

A real pisser…

Six or so years ago I found myself limping around the house, the office, the grocery store, basically everywhere. It wasn’t quite agony, but it wasn’t pleasant. A trip to my primary care doctor and a referral to a orthopedic specialist later, the diagnosis was plantar fasciitis. It’s a problem of the ligaments of the foot, which tends to cause intense pain after sleeping and long periods of sitting, both of which are activities I participate in on a daily basis. The basic fix was some over the counter anti-inflammatory, some icing, staying off the thing as much as possible, and a fancy set of orthotic inserts for my shoes. It’s all part of my look as the world’s youngest 70 year old man.

Mostly the inserts and an occasional handful of ibuprofen do the trick to stave off any further issues. About once a year though I unwittingly do something to aggravate the hell out of the little bundle of ligaments… at which point I’m right back to limping around from place to place and generally trying to keep off the damned thing as much as possible. It seems that this week is that magical time of year.

So if you see me gimping across the parking lot or I don’t stand up to greet you, a) I’m ok and b) don’t take it personally. I once heard it said that getting old ain’t for sissies. The older I get – and the more wear and tear I inflict on myself – the more I’ve come to appreciate that statement. For good or bad we’re all living in bodies that were designed by biology to last 35 or 40 years, seed the next generation, and then make way for them. We’ve pushed that frontier back through the audacity of our science… but the bits and pieces that wear out and break down along the way are a real pisser.

So apparently it’s not a stroke…

Not long after lunch this afternoon my left eye twitched once and then felt like someone was jamming an ice pick into the socket. My first thought, after the initial WTF, was “Wow, this is how it’s going to end for me… Stroking out at my desk after being utterly overwhelmed by stupid.”

Thirty seconds pass and the pain lets up enough to be mostly a roaring headache situated just behind my left eye… annoying but not debilitating. Since there was no face drooping and no obvious slurring, I went on about my business.

It wasn’t until around 2:00, when I reached for a long empty mug of coffee that reality dawned. I wasn’t about to stroke out at all. I was unintentionally coming down from a years long caffeine high and my brain was rebelling against it. I couldn’t tell you the last time I got so busy that I didn’t reach for a refill until almost the end of the day. It could easily be half a decade or more. After all but mainlining three cups, the pain in the ol’ brain box settled out from a dull roar to nothing at all by the end of tour.

Consider it lesson learned. Now that I know the unfortunate results of under caffeinating, I’ll never, ever let it happen again.

Unsatisfied…

The arrival of spring has created plenty of angst and gnashing of teeth here at Rental Casa de Jeff. The biggest change, of course, is that instead of staying holed up avoiding the sub-zero temperatures of the polar vortex, there’s outdoor maintenance to do. Now, I’d much rather be working in the yard than scrubbing the kitchen, but there’s a problem this year that that I haven’t dealt with before – for the last month, there hasn’t been any real indoor cleaning because pushing the vacuum or bending over with a dust pan sent near-blinding pain rocketing up my back. It’s better now than it was, but bending is still something to be avoided if at all possible. With that said, it basically means the inside of this joint is “grubby” to put it politely.

With the rain and warm weather the past two weeks, the grass and weeds are growing, the shrubbery needs cut back, and the whole yard needs a good going over to get it looking a little less like a foreclosure waiting to happen. Of course, the yard is also a victim of the same problem that plagues the inside – anything that requires me to bend more than 15 degrees off vertical is a fiesta of pain.

I think the compromise is going to be getting the yard cut as best I can with the tractor and trying to hit the most unsightly bits with the weed eater this afternoon. Next week, if the weather holds, I’ll lay down a coating of suppressive fire with weed killer along all the other edges. I hate the idea of things looking less than manicured, but that seems to be the only middle ground between letting the whole damed thing go to seed and well and truly crippling myself getting to 100%. As with all manner of compromise, I find it deeply, deeply unsatisfying.