The return of an unwelcome visitor

[Dave's Not Here Man]

Terrible problem I had back in 2013-2014 with nocturnal panic attacks. It wasn't until well into the spring of 2015 until they figured out the issue was "probably" being caused by sleep apnea. After months of trial and error with cpap, masks, chin straps, mouth taping, and the shit show that accompanied, it eased until being a non-issue for a couple of years. Especially with the ativan for the "breakthrough" stuff overnight, although the best results seemed to come from the getting the cpap at least somewhat dialed in.

Last 2 nights have been hell. Waking up with heart palpitations, chest pain, drenching sweat, gagging cough, clenched fists and other tightened muscles that have to be told to relax, and the worst symptom which is the "flushing" (feels like cold acid being pumped into my stomach, then chest, then extremeties). I am convinced that's my body producing a ton of cortisol in real time. I wear my cpap when I get in bed every night and keep it on until I have to get up and move (back/shoulder pain) to my recliner, where I fall back asleep for a couple of hours. There's two little faces on the display of the machine. One of them has been a red sad face these past two nights, for air leaks. So that's what they call a clue, I think. I guess I'm going to try a chin strap and mouth taping tonight and hope for better results. I am so freaked out being reminded of the past experience of being afraid to fall asleep.

Oh, and my last office visit they drug screened me and guess what I tested positive for. So add the stress of not knowing if she's going to refill my pittance allotment or not.... during the holidays.... and wife with her compounding health issues. Have you ever heard me say "fuck my life"?

[minx]

Jesus H Christ John!

I think it's only partially the CPAP. You have to have a metric shitton of stress about your wife, and adding on this doctor who doesn't seem to know shit about debilitating anxiety isn't doing a damn thing to help.

In principle, I don't disagree with drug testing. BUT it has to be done for the purpose of counseling for potential dosage changes or missed issues.

So, in your case - high levels of the debil's lettuce. Is it helping with your anxiety better than the benzos? Could it be making things worse? Or is it interfering with the benzos so they don't work properly? Maybe you need more benzos and less weed? And how is it affecting your life as a whole?

Too much micromanagement by insurance, and too many corporations looking at medicine as a for-profit business equals doctors who don't take any time with you anymore. Especially if you have a complicated medical issue.

[Dave's Not Here Man]

As far as I know it's a positive or negative test, and the result was just positive for cannabinoids. My level would have been low since I had refrained for nearly two weeks prior. I'd like to have the conversation with someone that matters about the definition of Cannabinoids since they reside in legal hemp products that are not considered class 1 (stupid enough as it is).  

As for the therapeutic benefits of cans of binnis, like ron white says, it cures the depression I get when I don't have any. But on a serious note, it doesn't seem to affect my anxiety or pain much either way, but it does work very well at regulating my mood and helping me relax when I get worked up (as in hot headed, impatient, etc). It was also useful in helping me fall asleep at first but that appears to have faded. Yes there's a threshold where it can go south but I'm careful and mindful about the how and when, and how much and when. That's the problem with alcohol, it doesn't always work that way and it's a much worse option IMO and why I'm trying to live without it for the time being. Alcohol is 1000 times more risky to consume with benzos, pain killers, etc than Bob's Marley.

They reduced my Rx by 2/3 without pumping the brakes at all, well duh, the patient is left to fend for themselves with what is easy to come by, relatively inexpensive, and the most SAFE. Or suffer. Seems like a natural kind of progression if you ask me... but If I was forced to choose between one or the other I'd go with the benzos, provided I get the dosages I need. But I've got no idea how to get there from here at this point. Put in for the refill this morning so I guess we'll see REAL SOON.

[minx]

Too many doctors have zero experience with tapering off a drug. It's always 'you shouldn't be taking this', then a drastic reduction or none at all.

Then they wonder how people get addicted to street drugs, and end up ODing on Fentanyl.

I know it's not as cut and dried as that, but so many people are on strong opioids, and get cut off completely. And the side effects (not to mention the returning pain) are unbelievable.
Same with things like anti-depressants and benzos. You can't just stop them, or cut them drastically. It's a process to get off them.

And Bob stays in your blood for-ever! Doctor should have some common sense to ask for the level found - the lab can show them that. Again, not enough training on the subject.

[Dave's Not Here Man]

Training?? L.O.L. It's basically a help desk medical field now. They input your data and the goddamn computer, in every single exam room, tells them what treatments and referrals to prescribe, and then whatever the corporate algorithm says is your dx code for all the above. No it's not quite as cut and dry as that but not too far off either. I can't be the only one that sees "telehealth" taking over half or more of so-called health care and if that ain't a help desk I don't know what is.

Last time she was at the doctor, they said they had to over-ride some scripts because the insurance said she had to try this med before they could prescribe that med, and it gave the dosage requirements and duration of time it had to be tried first. UFB.

[minx]

Don't get me started on the 'insurance requirements'. That along with the 'required' instruction sheets at the pharmacy drive me insane!

I've been on this shit for years - YEARS! And the dosage hasn't changed. Don't you think I know about this drug by now?

At least the ACA eliminated waiting periods, exclusions for pre-existing conditions and lifetime maximums. Worked for BC/BS back in the day, and those were some of the most heartbreaking calls I had to take. Someone finally got insurance and you had to tell them their diabetes was pre-existing and not only would it not be covered, but anything considered related to it wouldn't be either. Even worse were people with cancer.

Just inhumane.

[Dave's Not Here Man]

So much to my surprise, Walgreen's called this morning and said my ativan prescription was ready to pick up. Needless to say that's a big relief even though it's still for only 1/3 of my usual qty of 90. Since I had taken my last one at like 6am yesterday, my first and only priority for the day was to do whatever I needed to in order to make sure I was not going to have to suffer like I did the previous 2 nights. I was able to procure a different one yesterday afternoon and THANK GOD because I felt so much better within 30 minutes of taking it, and had no issues sleeping (yes, SLEEP for real) last night or so far this morning. So now I have that one for backup, which reduces my anxiety even more.

As for the PPACA- there are too many people that still think it's a health plan and probably have to correct someone on that a couple times a month. Kind of like the same people that say thank you for your service on MEmorial Day. Anyway, the law did in fact make several extremely positive changes to health insurance regulations with the two main items you mentioned. OBAMACARE excised insurance companies horns by being required to cover pre-existing conditions. Every single insured person in the country benefitted from that and had McCain had turned his thumb the other way...... well, you know, 45 would have released his beautiful plan. In two weeks.

[minx]

I didn't agree with most of McCain's policies, but I am beyond glad that he voted against repeal. Too many folks in this country don't fully grasp what he did for them there.

First call I got when I left training at BC was a dude who's wife was pregnant. Back then, drs didn't check your coverage in advance. So she was 8mo, and he was calling in to check their coverage...Not a fun call at all.

[Dave's Not Here Man]

Ah yes the old days when conservatives and for profit insurers cared so much about babies lives that they made sure women had to pay extra premiums to have them. My how things haven't changed. They still care about those corporate profits, baby, which is another bonus to forcing women to have them.

PS_ I just called my old provider in Lynchburg and was told that in order to be seen by their behavioral health dept (the psychiatric NP I used to see before moving back here), I would have to be in their primary care system too. So I went ahead and made the primary care appointment for Feb with a NP I'm familiar with and she's awesome (was my wife's PCP down there). Also gives me time to see how things go here but to say I'm fed up with Mary Washington's everything is an understatement. As I've said, finding any kind of mental health provider for medication management around here is basically an exercise in futility no matter what group they belong to. I guess if I need to see a doctor for minor stuff there's always the urgent care 3 minutes from here that takes my insurance. thoughts?

[minx]

A doctor or NP who is skilled in medication management is well worth the drive.
My psych is in Woodbridge and I happily take a 1/2 day off to drive up there, cause I know that he actually listens to my concerns and knows what he's doing.

Never found a decent psych down here at all.

[Dave's Not Here Man]

It came back. ER at 6 this morning. Didn't even get a bed. Home by 9.

[minx]

I am sorry John - this new provider is a total asshole.

And ERs are so understaffed that getting a bed seems to be a minor miracle. Friend's mom did get a bed right away, but that was because she was combative from dementia and a UTI and had also tested positive for Covid.

[Dave's Not Here Man]

For me, having them do vitals with an ekg pretty much within 5 minutes of arrival was key for my peace of mind (no pun intended). I have a history of major blood pressure spikes during these episodes. BION, my BP was only like 147/88 which is about where I live even with the meds. I'm assuming they would have moved me into a room if there had been the 211/125 spike like it did in Lynchburg, or if there was anything funky with the ekg. Not sure why they did a chest xray but whatever, that was done within 45 minutes of sitting in that room and saw the doc several times while in there. All in all I was there for a little less than 3 hours, which let me tell you, would've been 12 at MW.

[minx]

That's amazingly fast!

Friend went in with a kidney infection. Running a 103 fever, vomiting, and pain. They left her in one of those reclining chair for hours at MW.
Then when she finally got a bed, and a doctor came in, the moment she mentioned that she saw a GYN in Richmond (she has giant fibroids that can't be removed yet because she also has a giant hernia too) that was that.
Clearly she needed to be transferred to MCV. No other testing, but he did say he'd talk to her GYN before actually transferring her. 2 hours later I stopped a nurse and asked what the status of things were. Oh, they were still waiting to see if MCV had an open bed. Ok, what happens if they don't? "Oh they will, don't worry..."

6am - stop a nurse - doctor hasn't updated us. Can she tell us when he'll be back? "Oh, he's already gone off shift.". Alrighty then. Is my friend being transferred or what? "Oh yes, we're waiting on transport".

She went to the ER at 4pm. They did bloodwork at 4:30pm and started an IV. That was pretty much it in terms of actual medical care.

Oh, and she told me to leave at 7am because I had to go to work. Ambulance guys came in at 10:30a. "Glad they finally arranged for someone to come pick me up" she says. "We've been waiting since 7:30 - no one told us you were ready" was the reply.

Yup, we sure do have the best medical system in the world. Yes we do.

As a side note, she said that MCV was like a fancy hotel compared to MW - lots of care and communication.

[Dave's Not Here Man]

I've heard good things about MCV and also Henrico, and about the same distance as UVA in Culpeper.

The greatest thing about Spotsy Regional is that when you take a right turn out of our subdivision, it's a straight shot to the hospital.

[minx]

That's not something to sneeze at. Helps in an emergency.

[Dave's Not Here Man]

No problems for many weeks and the Fucking Shit came calling again about 0500 this morning. Thought I had it handled but dozed back off and a few minutes later, all hell broke loose. Ativan now taking it's sweet time (2 and a half hours) but seems to finally be on the downswing. God dammit I hate this and absolutely dread another cycle of misery.