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Healthy Insurance Part Three: Pain, Pills, Pot and Sleepless in Seattle

March 18, 2010

If you’ve been following along with this saga then you know that I have a badly broken neck. I’m not sure there’s such thing as a goodly broken neck, but in my case, I have a bone chip floating around near my brain stem, and a cyst forming on my spinal cord as the result of a car accident. It sucks. There is not currently any way to fix the primary problems – bone chip and cyst. So we are working on healing it via PT and pain management, preferably via massage. But Premera Blue Cross of Seattle doesn’t seem to think that either of those things are necessary, seeing as they don’t directly treat the problem.

(Note to self, ask doctor to change primary condition diagnosis to chronic pain, maybe that will help?)

If you knew me prior to this series about our screwed up health care system, then you know that I’m a health nut. I absolutely adore my body and do not put processed food in it. I go to great pains to eat food that is whole, organic, unprocessed etc… I have bees and chickens and fruit trees and veggie gardens. I even make my own soap and shampoo and lotion so that nothing goes ON my body that I wouldn’t put IN my body. (Or, as I like to say, it, I make sure that I am 100% edible at all times!)

So, imagine my horror at being presented with the options for dealing with chronic pain.

First, you need to understand what chronic pain is, because I know I didn’t “get it” until I was faced with it. And the side effects of it are worse than the problem itself.

Chronic pain is, simply, pain that never goes away. At the very simplest level, I have had a headache for more than a year now. Generally speaking, it starts under my occipital bone, and then makes spiraling pain around my temples – in a pattern that would look like the ram’s horns painted on the side of the Ram’s football helmets. The intensity of it varies from annoying to red-hot pokers. When it gets really bad, it shoots down my neck and sometimes makes it most of the way to my lower back. Sometimes my hands and feet are numb. On a very few occasions, I’ve lost sensation in my mouth.

I can mostly deal with this during the day. I can think my way through it. The main problem is at night, I cannot sleep. And we all know what sleep deprivation does to you. This brings on what my doctor called “The Chronic Pain Feedback Loop.” Pain + Insomnia = stress. Pain + Insomnia + Stress = Anxiety. Pain + Insomnia + Stress + Anxiety = Greatly diminished ability to cope with anything. And it all snowballs. They feed on each other and pretty soon you’re an emotional mess.

Yup. So you have to start dealing with any of it. It almost doesn’t matter which ingredient of the neurotic brew you start with, but you have to fix the problems. (Trust me, I am a mess. Neurotic, crying all the time, exhausted, pissy, you name it, it’s me.)

In some ways, I was greatly comforted to talk to my doc about this – to find out there’s a reason that I feel so crazy. But the solutions that he had to offer seemed worse than the problem.

This is where it matters that I love my body. My doctor knows me very well, so it was with great compassion that he looked at me and said, “I don’t know Alyssa, there’s always the Rush Limbaugh route, but then who knows where that can lead, you may turn into Glenn Beck.” It was funny, but what he was referring to was not funny at all.

In order to relieve chronic pain, the pharmaceuticals available are really quite scary, and I don’t want to take them. Percocet, Oxycontin, and so on. These are the drugs that keep the show Celebrity Rehab on the air, that kill rock stars and movie stars alike. It’s not because a few pills now and then are deadly, but because they are wildly addictive. Your body first becomes accustomed to them so that you need to take more in order to have the pain relieving effect. Then your body becomes physically addicted to them. And that scares the crap out of me.

And there is also, for me, the very nebulous – but no less real – fact that these are scary manmade chemicals. I understand that food is chemicals, pot is chemicals, all sorts of things are chemicals. But for some reason that I cannot explain, I believe that the natural and organic organism that is my body (and yours) is better equipped to metabolize other natural organisms than it is manmade compounds.

All chemicals are not the same. Your body can metabolize real fat, it cannot metabolize man made trans fats, and that’s why trans fats are being removed from food now after years of everyone saying they’re ok. Sugar is fine with your body, man made high-fructose corn syrup is a medical crisis. Why would pharmaceuticals be any different than trans fats and high-fructose corn syrup as far as my body is concerned?

“I’d just hate to see that happen to you,” he said. But we have to do something. We talked about things like Zoloft to try and get me out of the reactionary and anxiety laden feedback loop. But now that I know what’s going on, I’d like to try and think my way out of the “crazies” first.

And then there’s a silence.

“To tell you the truth, Doc, I’d really rather just get a little stoned before I go to bed.”

“To tell you the truth, Alyssa, I’d really rather have you do a bong hit and take some Tylenol than take any of these drugs.”

Deal.

Now, to be clear, back in the old days of being a drama student, I was a quite accomplished pot head. And in my adulthood I have been – and will continue to be – a very outspoken advocate for the legalization of marijuana, though I partake very rarely. The hypocrisy of having cigarettes and alcohol be legal while pot is illegal is just nonsense to me. Not to mention the tax revenue and crime reduction.

That said, it’s mostly illegal, and I have a daughter, and don’t feel like I need to be teaching her to break laws – even stupid ones – just yet. (Though she can pretty much tell you all the reasons pot should be legal.)

So yah, I wanted the legal permission to do the one thing that I can do to relieve the pain and sleep at night. Just so I can show my daughter that you can play by the rules while working to change the rules.

The result? Well, for 2 consecutive nights I’ve gotten 5 hours of sleep. It’s not enough, and I’ve got a huge sleep deficit to work my way out of, but I’m actually moderately optimistic.

So back to the insurance bullshit. While it is legal, in Washington State, for me to smoke a bowl before bed (thank goodness!) insurance obviously doesn’t provide me a little baggie of comfort for my $10 copay. Which is fine. BUT, why is it so happy to pump us full of pills that really just mask problems. We must know that there is some collusion between pharma and insurance! Really.

While I am perfectly happy with this course of treatment, it is yet another example of how I have no control over how my body is treated within the system. I know, and my doctors know, that all I really need is massage, PT, and periodic imaging, in order to fix this problem. Insurance thinks that I don’t need those things, but I could have surgery, inpatient rehab and pharmaceuticals – which cost a ton more, and I DO NOT need or want.

It’s ridiculous. We need to fix the system so that control over treatment is in the hands of the patients and the doctors, not the insurance executives.

In the meantime, I’m still sleepless in Seattle. But it’s better. At least now when I’m lying in bed awake at night I’m horny rather than angry. And I can fix that, without a pill. (Though a little help wouldn’t suck.)

__

Healthy Insurance Part One

Healthy Insurance Part Two

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