Tuesday, March 15, 2016

Opiate Abuse (Surgery without Sedation)

Last week I had minor surgery of my left hand and arm. #OldPeopleProblems Previous surgeries (gallbladder removal! wisdom teeth! appendectomy!) required that I be knocked out, but I had the option of staying awake for the work on my arm. In fact, because the doctor planned to block all feeling in the limb, I didn't even need to be sedated if I didn't want to.

I'm a hugs, not drugs (or maybe neither hugs nor drugs) kind of gal, so I told the anesthesiologist that I'd keep things clean. She was supportive of my decision, but assured me that the drugs would be nearby and easy to add to my IV at a moment's notice should I change my mind. She told me that if the time came, I could still decide the degree of sedation.

As they prepped me in the operating room, a nurse tightened a tourniquet high around my arm. I'd be warned about it and told it might feel "a bit uncomfortable" for 20 minutes or so.

Inhale.

Exhale.

I could see this getting more than a little uncomfortable Then they started the nerve block. My fingers tingled. Then they burned. Then they were on fire. I did some quick thinking. Who cares if I get sedatives? There's no medal of honor, not even a special cookie for making it through with my senses intact.

"Uh, yeah, I think I'll take a bit of sedative after all."

I'm not sure what she gave me. It didn't put me to sleep, but it did put me in a happy place. I didn't babble on (I don't think), but I did ask to see this bit they removed (as much as I could see without my glasses, which is not much). I did learn that a body part can survive about 2 hours in a tourniquet without long-term harm. Not much else happened.

I didn't expect a whole lot of post-surgical pain and I'm not a fan of the dizzying effect of Vicodin, which has now fallen out of favor for a low acetophetamin pill, Norco. Both are opiates. Both can be a gateway to heroin abuse. Unless you are like me and they just make you want to vomit. That kinda ruins the appeal.

At any rate, I'm not a fan of the drugs or having them around the house, but they seemed to really want me to have some just in case the pain got bad.

"Can you just prescribe, like two or three pills?" I asked. I'm a small person.

"Here's an Rx* for 30!" The nurse cheerfully hand me a piece of paper. (Maybe not so cheerfully. That sedative cocktail was good!)

30 pills? What the hell? 

"Oh, and be sure to take a stool softener with them," she practically sang. (And suddenly those commercials about the drug that helps you poop while you are on other drugs had a meaningful context.)

Anyway, so now I have 29 potentially addictive pills left. What do I do with them? What's the street value? "Probably about $5 a pill," guessed my mom.

Apparently she's right. Uh, Mom? How did you know that? (I'm going to assume it's all those True Crime TV shows.)

To be clear, I would never sell these. I know a nearby medical waste collection spot, so I brought them there.

At any rate, opiate abuse is a large and growing problem and today the CDC released new guidelines for prescribing opiate painkillers. It's mostly due to doctors overprescribing these meds for chronic pain, but I still take issue with the large amount relative to my needs.

*If I was inclined to take the pills, this might have only be a few days' supply: 1-2 pills every 4-6 hours. But it still seems like a lot pills given the fact that I didn't expect to take more than one or two to begin with. Also, I'm not clear if that dose is designed for someone my size or more of a one-size-fits-all dose.


Tuesday, March 08, 2016

Important Message for Illinois High School Seniors!

So I was going to write this post titled, "Shonda, two ways." I was going to talk about Shonda Rhimes' new book, Year of Yes, which I recently read and enjoyed And then I was going to talk about the Yiddish term shonda, which means shame. Only it's more than just shame, a shonda is, like, SHAME. With the second shonda, I was going to talk about the budget crisis in Illinois and some of the services that are being cut because our state has not had a signed budget since the end of the last fiscal year in June 2015.

Anyway, I never got around to that post, but the budget crisis persists. Many Illinois residents who are most in need of social services are not able to get them. This Illinois Budget Clock, a product of a weekly civic hack night meet-up in Chicago, provides an update on the length of the crisis as well as stories of how it's impacting my state. Today I received an urgent note from the college counselor at my son's school, which prompted me to finally write something.

The Illinois Monetary Awards Program (MAP) provides a limited amount of grant money to low-income college students who attend approved colleges in the state. As with so many other bills, the MAP grants have gone unpaid since the current fiscal year. This means neither the students nor the schools are receiving this money. From what I can tell the schools are doing their best to try to support the students who are not able to pay the related chunk of their tuition, but just because the state is managing to avoid paying its bills doesn't mean other institutions and people have the same luxury.

So anyway, the urgent note from the college counselor warned that Illinois students must submit their FAFSA* (federal student aid report) by March 9 to be considered for an Illinois MAP grant for the 2016-17 school year. MAP will be suspended by March 10. (Of course, this assumes that the state will make good on its current obligations and then have money allotted for the program during the next fiscal year...)

That gives you 24 hours, peeps. Go!

*Even if family income is such that the student will not be eligible for aid, many colleges request or require this form.