Bleh…

So. Tired. Have I mentioned how much I hate being hungover and/or stoned? Ugh.

I have decided that it’s wrong to have patients show up 30 minutes before their scheduled appointment when it’s the first appointment of the day.

Seriously, show up at 645am for a 715am appointment? Whatever. I suppose this takes into consideration that some people just don’t show up on time. At least I didn’t get forgotten or lost in some paperwork shuffle, as is the usual norm for me when getting tests like these done. But still, my brain and body don’t cooperate at that hour!

As an aside — The Hubbs was extremely pleased to be in and out of the PLC in 15 minutes. That included: walking to and from the parking lot, walking all the way to Nuke Med, and having my head scanned. Impressive… now if only some other appointments could be that quick when needed… (Cow Stamp Docs need not apply, thank you very much.) We even got home in just over an hour from when we’d left this morning.

The rest of the morning consisted of:
A) Trying to get back to sleep, to sleep off the Dilaudid
B) Trying to wake up from trying to sleep off the Dilaudid, with the aid of a coffee-smoothie-thingy, so I could see Family Doc this afternoon.

So Family Doc.

Heh.

Three things of note — 1) I know how to use the term ‘spiffy’ in a negative form 2) I got him to swear 3) We had a brief discussion about Medical Marijuana(!)

1) Fam Doc gets great pleasure in hearing the term “spiffy” used in general conversation. For whatever reason, he enjoys it immensely — he’ll use the term with his patients for a couple of days and then promptly forget about it until he sees me again a month later and I drop a ‘spiffy-bomb’ somewhere during our visit. Today, I decided, to use the term “less than spiffy“. It’s still using the word spiffy, but in a negative connotation. Albeit, it also kind of sugar coats how I’m really feeling, which is at best absolute crap, because I’m still hungover from last night’s Dilaudid trip.

He got huge giggles out of that — in a ‘OMG THE WORD SPIFFY!’ type of way. Obviously me not feeling in top form isn’t great, but the fact that I will admit to it is helpful in the long run.

2) So me not feeling so great, was the basis of most of today’s conversation. I feel awful from being full of pain (and pain meds, don’t forget) and increasing the Anti-D’s for the last month just took me on the worst pain trip imaginable — as I’m sure everyone by now knows given how many times I’ve said that I’m stoned in the last four weeks either on LJ or in channel.

The first words out of Fam Doc’s mouth after he had finished transcribing everything I told him, was absolutely priceless: “Shit… Oops!” He felt the need to explain himself: Seeing as we’ve been on this path for four months now with no effects, he certainly wasn’t expecting the Anti-D’s to cause me great amounts of pain. Using the term ‘shit’ is about the only way to describe the way things have gone.

So frustration has set in. Sorta. He now knows that this past month, with the pain being so insane, I’ve resorted to increasing the Dilaudid to 20mg at a go and as well, I’ve started taking the Ativan at 2mg just to calm me down until the pain goes away. Not a good sign.

The biggest problem with trying to find the right combination of pain management is figuring out when it’s the right time to up my baseline as opposed to just tossing another drug into the fray. Taking the Hydromorph lasts up to 12 hours, I know this. We’ve had this discussion before and it’s pretty much up to me as to how we proceed with things.

He gave me two options: A) 12mg Hydromorph, twice a day B) 12mg Hydromorph + 75mg Lyrica at bedtime.

I basically told him that as fun and exciting as my days are currently, if I take the H-morph 2x/day, I would basically end up sleeping 24 hours a day. So I was swaying more towards trying the Lyrica. We talked about what it’s generally used for, what dose he’s game to try me at and the conference he attended a couple of weeks ago where the doctors present (GPs + Neurologists, no less) discussed their experience using it and his own opinions of how well it worked. Biggest side effect, of which is no surprise: drowsiness. So if I feel the need (or if I feel adventurous, depending on how you look at things) I will be taking the Lyrica after I taper down the Anti-D’s over the next week to ten days.

Technically there is a third option, and that is do nothing but wait to see how things feel next time I see him, which is end of April. Cuz we could actually be going about this whole pain thing all wrong — perhaps there is no need for us to be giving me cocktail after cocktail after cocktail of drugs. Keeping me on just the one combo of drugs could be okay… *tragic sigh*

3) Going somewhat along the lines of not taking more drugs (depending on your definition of “drugs”, mind you), I finally got the balls to ask him about his thoughts on Medicinal Marijuana. He wasn’t terribly fazed by the question, which is kind of awesome. It’s rather nice to know I can sometimes come and ask him a question out of left field and he won’t freak. Not that I really expected him to be the freaking-type at this stage of things.

He had a couple of thoughts on it, mainly that if I’m considering taking the medical/government issued stuff, it’s like smoking rice paper and I would probably get a better result if I got something off the street — NOT that he’s recommending that I go that route! He did offer me up some information to do some research for my own interest/information’s sake. If I think it might be a better option for me, he could prescribe Cesamet. It’s basically a synthetic cannabinoid, which mimics the main ingredient of marijuana (THC). Chemically, it’s similar to the active ingredient found in naturally occurring cannabis.

So yea, some stuff to think on in that department. Thusfar, my thoughts have always been that it’s a last alternative treatment. My opinions might change in the future, depending how my other options pan out, but for now, I have decent information to sit and stew upon.

[Edit: OH! We also talked about the mythical “Clinical Triage” with the whole new specialist referrals. Fam Doc has letters from both Hawt Doc & Rheumy regarding who they’d both like me to see next. Rheumy II for Rheumatologist and Liver-Guy-As-Yet-Officially-Named-for-LJ-Purposes. So I am in the pile, it’s just a matter of when my files will get transferred to the right people… all in due time. Cross your fingers I don’t get lost in the shuffle.]

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