Polly had an appointment with her orthopedic doctor today. Major surgery is in the future for her — when is yet to be determined. Afterward, we drove to Archbold to eat lunch. We planned to eat at Samuel Mancinos, but the restaurant is closed on Mondays. Instead, we ate at a Mexican restaurant. I ordered a #18 — a taco, burrito, and rice and beans. I took three bites of the taco and some of the beans and rice before my ever-present nausea turned into feeling like I needed to vomit. I took some Zofran to lessen the need to vomit, sparing me the indignity of throwing up in a public restroom. Our server came to collect our plates. When she saw most of my food went uneaten, she asked, “You didn’t like the food?” I explained why I couldn’t eat my food. She genuinely felt sorry for me, taking my meal off our bill.
This is my life with gastroparesis — an incurable stomach disease. Every day, every week, with no respite in sight. In two weeks, I will have an endoscopy and colonoscopy. After that, I plan to have a gastric peroral endoscopic myotomy. This will hopefully reduce my symptoms. It is NOT a cure.
I have had numerous tests in recent weeks. A stool sample revealed I have an uncommon disease called exocrine pancreatic insufficiency. My pancreas — for an unknown reason — doesn’t make enough digestive enzymes. As a result, my body can’t properly digest food and absorb nutrients. This may be why I am anemic and have low B12, potassium, Vitamin D, and testosterone. I will likely have to go through pancreatic enzyme replacement therapy with expensive drugs.
Throw in fibromyalgia, osteoarthritis, and degenerative spine disease, and I am in a world of hurt. My life is dominated by managing my health and lessening symptoms. My life has been reduced to striving to live another day. Joys that I once took for granted are gone. Eating is one of those joys, and not being able to enjoy food is so depressing I wonder why I keep trying.
As you may have noticed, my writing production has dropped dramatically. My life has pretty much come to a standstill. I am trying, but readers should no longer expect me to generate as much content. I cannot do so, and it seems evident, at least to me, that this is my new normal. Readers should expect less content from me, and if you notice my writing pace has picked up, don’t assume I am “better.” I am not, and I fear my best day is today, with more suffering and pain in my future.
I am 90 days behind on answering emails and social media messages. There’s nothing I can do about this. I will answer them when I can, and, quite frankly, some of them will go unanswered. I have had thoughts about hanging up my blogging spurs, but I enjoy writing, so I can’t bring myself to throw in the towel. All I know to do is manage my symptoms, rest, and do what I can.
Please don’t offer me medical advice. I am seeing competent doctors, to whom I trust my life. They are the experts, and unless given reason to believe otherwise, I trust them. I appreciate your friendship and support, but sending me links to articles and blog posts or questioning my diet, is not helpful. I appreciate your understanding.
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and sixteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
Your comments are welcome and appreciated. All first-time comments are moderated. Please read the commenting rules before commenting.
Newly elected House speaker Mike Johnson is a Christian nationalist (Southern Baptist), a right-wing Evangelical. He thinks Gilead is a wonderful place to live.
Mike Johnson’s election clearly shows that the MAGA wing of the Republican Party and its fascist leader Donald Trump are in control of the GOP.
Our democracy will not survive the re-election of disgraced felon Donald Trump. We are on the threshold of the collapse of the United States and its democratic institutions.
Ohio Governor Mike DeWine and his wife deliberately lie in their “Vote No on Issue 1” TV ad. Not a difference of opinion — lies, lies, lies.
Mike Johnson wants to criminalize abortion and arrest, prosecute, and imprison women who have one.
Israel continues to slaughter innocent Palestinians in Gaza. Joe Biden says nothing of substance as hundreds of Palestinian children are bombed and killed every day. It seems Biden is intent on letting Israel get their pound of flesh from largely innocent people.
Apple raised its monthly streaming fee by 43 percent to $10. Other streaming services are doing the same, forcing users to jump from one service to the other to manage costs. So much for streaming being “better” and cheaper.
I am no longer a Democrat. I may, on occasion, hold my nose and vote Democrat, but I no longer support the party.
American bombs, bullets, and armament are killing innocent people in Palestine. The West is outraged over Hamas’ use of Iranian weaponry, but silent over Israel’s use of American designed and manufactured weapons of mass destruction. All of us have blood on our hands.
Despair. That’s what I feel right now. I see little to cheer about these days.
Bonus: Gastroparesis is an incurable stomach disease. I plan to have a pyloroplasty procedure done in November. Last ditch effort to lessen the nausea and vomiting. It would be nice to have just one day when I didn’t have to worry about what I ate or running to the bathroom to vomit. Where’s God when I need him? 🤣 It is what it is, but I’m tired and worn out from daily battles with nausea, vomiting, bowel pain, and loss of appetite. Some days, in moments of despair, I find myself thinking, “I don’t want to do this anymore.”
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and sixteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
Your comments are welcome and appreciated. All first-time comments are moderated. Please read the commenting rules before commenting.
A quick public service announcement from Science-Based Medicine, or at least from me: hitting children is fundamentally wrong. It’s also not effective when done in an attempt to improve their behavior. Back in 2014, I wrote about the use of corporal punishment to discipline children, mostly focusing on its use by caregivers in the home. Sadly, not much has changed since I wrote this opening paragraph:
One of the most commonly practiced strategies used by parents to alter the long-term behavior of their children is corporal punishment, commonly referred to as spanking. But the use of the term spanking is problematic in that how caregivers interpret it varies widely, and there is frequent overlap with what pediatricians consider to be abuse. Despite a great deal of evidence showing that spanking is ineffective, is a risk factor for greater forms of physical abuse, and can negatively impact the behavioral and cognitive development of children in a variety of ways, it remains a controversial issue in the United States. The American Academy of Pediatrics and numerous other professional organizations have come down firmly against the use of physical punishment by parents, but unlike 34 other developed nations, there are no federal laws banning spanking.
There are still no federal laws banning spanking, either in the home or in schools, which is what today’s post will focus on. Pediatricians, though not all of us, unfortunately, are generally united in their stance that this is a problem. The American Academy of Pediatrics is naturally opposed to the practice of physical violence against children in all forms and recently issued a policy statement to specifically address when it is used as a form of discipline in schools.
….
Why is beating children in schools allowed? Great question. In 1977, the Supreme Court had an opportunity to protect children but failed. A 5-4 decision in Ingraham v Wright provided constitutional cover for school-based physical punishment, saying that 8th Amendment protections against cruel and unusual punishment don’t apply to students. They left it up to the states, many of which are seemingly incapable of thinking about the (born) children in any meaningful capacity.
….
The majority of children being hit at school in the United States live in the South, with the majority (nearly 3 out of every 4) living in Alabama, Arkansas, Georgia, Mississippi, and Texas. Mississippi and Texas are the worst offenders, with a third of all kids being attacked by teachers or other school administrators living in those two states. It gets worse.
When a school allows faculty to hit students, which students tend to get hit? Another great question, and one that requires a thoughtful and nuance re..black kids. It’s black kids. Children with disabilities have it the worst, however, with national data showing that 16.5% of kids who are hit at school being served under the Individuals with Disabilities Education Act. The tragic reality is that the more marginalized a child is, for example, a black child with autism, the more likely they are to be physically attacked at school by someone charged with their education and safety.
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and sixteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
Your comments are welcome and appreciated. All first-time comments are moderated. Please read the commenting rules before commenting.
Republicans want to cut food, heating, and housing subsidies for poor children and families.This tells me everything I need to know aboutthe Republican Party.
Senator Bob Menendez should be forced to resign from office by his fellow Democratic senators.
It looks like Trump not only inflated his dick size, he also grossly inflated the value of his real estate and business assets.
Some Democrats are calling for candidates to run against Joe Biden. I support this call in the primary. However, come November 2024, the only thing that matters is keeping Trump out of the White House.
Upwards of twenty-three raccoons frequented our backyard this spring and summer. And now that fall has arrived, the raccoons have disappeared, making occasional raids on the food we put out for feral/stray cats.
Chronic illness and pain affects every aspect of my life. Telling me to “put mind over matter” is never the right thing to say. When you say this, I say to myself, “Go fuck yourself.” Continue in your insensitive behavior, I might say this to your face.
“Looks like you are feeling better today,” well-wishers often say. They wrongly judge the quality and level of my suffering by what I do, failing to understand that looks can be deceiving. Just because I’m smiling, doesn’t mean I don’t want to cry. I often smile for others, hiding my pain from them.
Hey, Joe Namath. You had a lifetime 50% pass completion rate, worse than embattled New York Jets quarterback Zach Wilson. STFU. Give the kid the break. Nobody wants to hear from ancient old ex-players. Different era, different game.
Travis Kelce, a Taylor Swift dating, Bud Light drinking promoter of COVID vaccines is upsetting right-wingers with his “woke” behavior. OMG, the meltdowns are fun to watch.
Kevin McCarthy says Biden is to blame for the threatened government shutdown. Sure, Kevin, sure. I bet the hemorrhoid in your arse you affectionately call Matt Gaetz is telling you to say this lest you lose your speakership.
Bonus: I’m increasingly disillusioned with what I see and hear in the larger atheist community. Maybe this is on me. I’ve moved on from the “angry atheist” phase of my life. I’m not that interested anymore in debates about the existence of God.
My partner, Polly, and I traveled to Toledo, Ohio, last night to listen to Trae Crowder at the Funny Bone Comedy Club and Restaurant in Levis Commons — a sprawling outdoor shopping center. Big fans of Crowder, we’ve been looking forward to hearing him for months. We listen to his weekly podcast, along with the short videos Crowder puts out several times a week. Crowder, an agnostic, calls himself the “Liberal Redneck.” While Crowder, age 37, currently lives in Los Angeles, he came of age in rural Tennessee. Crowder attributes his liberal/progressive political and social beliefs to his family’s abject poverty during his childhood years.
Our hillbilly mansion. We lived in this 720-square-foot mobile home for five years, all eight of us.
Having grown up in similar circumstances in the 1960s-1980s, I find Crowder’s humor appeals to me in ways other comedians don’t. When Crowder talks about “white trash” or “trailer trash,” I understand. When uttered by people who have never experienced real poverty, I bristle and often give them a buffet-plate-loaded-up-on-seafood-night response. However, when someone from the poverty fraternity satirizes these experiences, I laugh — been there done that — but the trauma of those years still lurks in the depths of my being. I no longer live in abject poverty. I am more “fashionably dirt poor” these days. Roof over our heads, food on the table, bills paid (albeit a few days late here and there), and taxes up to date. Life is good, even if the Bengals are 0-2.
Crowder delivered as advertised. We got the opportunity to meet him afterward, shake his hand, and have a picture taken. We live in an area where seven out of ten voters voted for Trump in 2016 and 2020. God, Trump, Guns, and Evangelical Christianity rule the roost. For godless liberals such as Polly and I, we are foreigners in the land of my birth and the home of our six children and grandchildren. Hearing Crowder was a brief respite for us from incessant right-wing extremism.
Unfortunately, the “experience” itself was, to put it mildly, less than optimal, and, at times, downright frustrating and painful.
We arrived at Funny Bone at 6:00 p.m. Unable to find a parking space, we were forced to park three city blocks away from the venue. Neither the sidewalks nor the parking lot were ADA-compliant. We entered the doors for the club around 6:15 p.m. The doors were challenging to enter. Technically, ADA-compliant, it took Polly several attempts to get my wheelchair through the glass doors (there was no automatic door opener). Once in the lobby, we found no staff to assist us. The club itself is on the second floor. On the desk sat a sign that said there was an elevator in “back.” Back where, exactly? No directions, no arrows pointing to the elevator. Being first-time visitors, we were left with figuring out what “back” meant. Polly walked the stairs to the second level, hoping to find anyone to help us. After being unable to find someone to help us, Polly came back to the lobby and told me that she was going to walk around the back of the building to see if she could find the elevator.
With the elevator found, we thought we were home free. Little did we know, the worst was to come.
Out of the inadequate doors we went, around to the elevator, only to find more doors we had to contend with. Barely wide enough for a standard wheelchair, none of the doors had automatic door openers. Fortunately, we had the elevator to ourselves. Easy in, easy out, straight. . . to . . . the . . . venue . . . now, right? Nope, there was another door we had to enter to reach the club. Thanks to boxes stacked near the door, Polly could not push my wheelchair through the door. She had to move the boxes so we had enough room to barely navigate through the door. This door gave way to a hallway that led to the hostess station. The hallway was narrow, and ADA compliant only if there were not boxes or people taking up space. In other words, it was difficult to navigate.
Finally, we made it to the hostess station. I had called Funny Bone the night before to remind them that I was in a wheelchair and would need accommodation. “No problem,” I was told. A few feet in front of the hostess station was a transition between flooring types. Paying no need to ADA compliance, Funny Bone used a raised transition instead of a flat one. Of course, hitting this speed bump nearly tipped over my wheelchair (with me in it). Thoroughly embarrassed, Polly eventually righted my chariot, and onto the main floor we went. The Funny Bone is laid out like a supper club. They could have parked my wheelchair in any number of out-of-the-way places, but the staff decided to sit me at a table that was pushed up next to another table, near where there would be a lot of foot traffic. I spent the rest of the night being bumped into by patrons and employees alike. Telling the crippled guy “sorry” might make you feel good, but it does nothing for the person physically harmed. I suspect if Funny Bone received a spot fire inspection or ADA compliance inspection, they would have failed miserably.
Crowder was as advertised. Afterward, we waited for most of the venue to clear out before leaving. We do this to avoid having to deal with rude, thoughtless people. That and the fact that it is impossible to push a wheelchair anywhere in a crowd. So we waited to make our escape. After retracing our steps, we finally made it to the parking lot at the back of the Funny Bone. We started out on the sidewalk, only to find out it was a dead-end, running into a metal gate. This forced us to take the parking lot, complete with speed bumps to our automobile. Adapt and persevere, right?
Polly wheeled me about ten feet into the parking lot, when all of a sudden my chair stopped, Polly screamed “Oh no!” and I went flying head-first onto the pavement. As I lay prostrate on my right side in the parking lot, Polly steadied herself and came to my aid, Others were nearby, but ignored what was playing out in front of their eyes, Finally, a young man rushed up and asked if I was okay; if I needed any help. Filled with embarrassment and pride, I thanked him and said I would be fine. He waited while I climbed on my knees to the wheelchair, locked the wheels, and pulled myself up. Polly apologized repeatedly as we made it back to the car. I told her, “It’s not your fault.” While on my knees I found the culprit, a chunk of asphalt was missing, and one of the front wheels on my chair sunk into the hole, sending me flying into the crisp fall night.
For those of us who use wheelchairs, walkers, and canes, doing simple things can prove to be a challenge — sometimes, dangerously so. I am not a disabled person who expects the same treatment as able-bodied people. I do, however, expect reasonable accommodations. Levis Commons and Funny Bone failed on this account.
How do I feel today? Time for a shovel and a six-foot rectangular hole. Either that or lots of pain meds and muscle relaxers. Polly couldn’t find the shovel, so we are going the medication route. 🙂
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and sixteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
Your comments are welcome and appreciated. All first-time comments are moderated. Please read the commenting rules before commenting.
I have never been an Aaron Rogers fan, but after watching him on Hard Knocks, I’m more sympathetic towards the man. Rogers blew out his Achilles tendon minutes into the Jets’ first game and is done for the year. I genuinely feel sorry for him.
Jets quarterback Zach Wilson will not lead the team to the Promised Land. The Jets need to sign a seasoned quarterback; someone who is a caretaker. Don’t throw the ball away and let the defense do the rest.
Last night’s low was 45 degrees. Where did summer go? I wanted to turn the furnace on. My bed partner didn’t want to crank up the heat. Who won? I froze.
I introduced my five-year-old grandson to newspapers — a sales insert from a farm supply business. Made his day. Sadly, children born over the past ten years know no little to nothing about newspapers.
Our six children grew up in a home that received a morning and evening newspaper every day. They especially remember Dad’s paper rule: keep the sections in the proper order. They also remember that on Sundays no one read the paper before Dad (though I think they sometimes ignored this rule, reading the comics and sports sections, and then putting them back in place — Dad none the wiser).
I no longer subscribe to any newspaper, getting my daily news from a plethora of online sites. I miss not physically reading a daily newspaper. Both local papers are dying. Outside of finding out who died or what Ney’s council did at their meeting, local newspapers offer little value to me.
I set a record yesterday: 12 vials of blood were drawn from my left hand — over $1,000 in tests. The pessimist in me wonders if any of this will matter. Every specialist interprets the numbers differently.
I’m anemic, with low potassium, B12, and testosterone numbers. Supplements keep these numbers hovering around low normal. I reminded the doctor that I was taking significant levels of supplements to keep these numbers out of the basement. Without the supplements, I would be dead. The question, then, is why I have these deficiencies. So far, no doctor has a clue.
Ohio State will not play in the national championship game this year. Neither will Alabama.
My youngest grandson found a cricket in the living room and freaked out. I stopped him from killing it. At Grandpa and Nana’s house, if necessary we capture and release. Spiders? More often than not, we ignore them. Polly swears a big wolf spider is stalking her. Maybe. 🙂
Bonus: Out of all the serious health problems I have, nausea is the worst. I’m nauseous every day, often without relief. You can’t escape nausea. Eating is one of the few pleasures I still enjoy, but nausea often ruins this pleasure. Hard to enjoy eating when you feel like throwing up. I take Zofran to limit the vomiting, but that dull, achy nauseous feeling remains.
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and sixteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
Your comments are welcome and appreciated. All first-time comments are moderated. Please read the commenting rules before commenting.
Recent years have brought an endless stream of rules, regulations, and demands from governments, doctors, and pharmacies meant to battle the evils of opiate addiction. What was once between a chronic pain sufferer and his primary care physician is now a multi-person group fuck. I don’t blame doctors or pharmacists. Government has forced upon them numerous rules that make it harder and harder for chronic pain sufferers to receive relief.
I am required to see my primary care doctor every three months to continue to receive narcotic medications. I currently take Vicodin (Hydrocodone), five tablets per day. Three scripts at a time are sent to the pharmacy. I can’t fill the prescriptions early. They must be filled on the day listed on the script. This means you are typically out of medication on the day you fill your prescription. Of course, if you don’t get to the pharmacy at the right time or they are OUT of your medication, you are screwed. Long-term narcotic pain meds users are not addicts. They are, however, physically dependent on narcotics. When pain medications are suddenly stopped, the patient goes through horrific withdrawals.
Last year, the pharmacy I use was out of Vicodin. Well not “out.” They had enough of the drug to give me a partial fill, but according to the pharmacist, CVS was not permitted to give patients partial fills for narcotics.
“Fine. Please transfer my prescription to another pharmacy.”
“I’m sorry, but we are not allowed to do that either.”
“You do know what happens if I suddenly stop taking Vicodin”?
“I understand, but there’s nothing I can do. We won’t have any Vicodin until Wednesday (four days).”
This was on a Saturday. My prescribing doctor was out of town until Monday. I knew calling the on-call doctor was a waste of time. He would think I was a drug-seeking addict.
Fortunately, I only went without Vicodin for thirty-six hours. I borrowed some Percoset from a dear friend of mine to tide myself over. Of course, doing so was a crime. On Monday, my primary care doctor was able to fix the problem for me by sending the script to a different pharmacy.
Keep in mind ALL narcotic prescriptions are tracked with software. All doctors and pharmacists have access to this system. It is IMPOSSIBLE to abuse legally prescribed narcotics. I can’t think of one way a patient can game the system. Scripts are no longer handwritten. They are transmitted digitally, straight to the pharmacy. The prescriptions can’t be filled early. There’s simply no way for me to abuse the narcotics I take five times time a day. Yet, here I sit tonight, unable to fill my August 8th prescription until August 13th.
My doctor prescribes me a thirty-day prescription of one-hundred-fifty tablets every twenty-nine days. This means I have an extra five tablets each month. Five. Not twenty. Not fifty. Five. These five tablets provided me a monthly buffer in case of a pharmacy problem or I have a really, really, really, really, really bad pain day. Five tablets. Unbeknownst to me, the pharmacy was tracking these five extra tablets, and today was the magic day when they decided to bring the hammer down on me.
The pharmacy will not automatically fill a narcotics refill. Even though my doctor digitally sends the script to them, I must call them to have it filled. That’s what I did today, only to find out that they would not fill my prescription until August thirteenth. Five days of no medication. I have nine tablets on hand, so I have to cut my medication by seventy-five percent — two tablets a day. Why? Five tablets. Five tablets each month for six months is thirty tablets, the pharmacist informed me. I tried to explain things to her, but it mattered not. All she saw is what she called a “retention issue.” Those tablets I “retained” were actually used when needed. Long-term chronic pain sufferers learn to manage their narcotic meds, adapting usage to pain levels. None of this matters. Fundamentalism rules supreme when it comes to prescribing pain medications. “These are the rules. Obey. Don’t obey, we will punish you.”
Will the War on Chronic Pain Sufferers Ever End? I ask in the title of this post. Death, that’s what will put an end to this pernicious war against chronic pain sufferers. Patients who have their medications suddenly cut off have a higher risk of suicide. Despair sets in when you think, and often know, no one is listening to you. Allegedly, the goal of the medical profession is to alleviate pain and suffering. My primary care doctor had that as his goal when I first started seeing him twenty-seven years ago. And he still does today. The only difference, of course, is that twenty-seven years ago no one stood between us. Today, the FDA, the state of Ohio, pharmacies, pharmacists, and insurance companies stand between us, materially affecting the prime directive: alleviate pain and suffering.
It remains to be seen how the next five days will go. Polly is fearful that I might kill myself, but I told her as she left for work, “Don’t worry. I’m fine.” She asked me “Why aren’t you more upset over this?” I replied, “I have no control over any of this. None! Yes, I am angry, beyond angry, but all the rage in the world won’t change the fact that my prescription will NOT be filled until August thirteenth.”
My singular goal is to make it to the thirteenth. Will one tablet every twelve hours, lots of Tylenol, and aspirin be enough to stave off the worst of withdrawal? I doubt it, but what else can I do? Maybe drink Jamison for breakfast, lunch, and dinner?
I plan to take a drive to Michigan where marijuana is legalized. According to state law, I can’t legally buy cannabis, but Michigan dispensaries will sell it to Ohio residents. Rumor has it that the Ohio sheriff’s departments that border Michigan — particularly Williams and Fulton — are using off-book undercover officers to write down the license plate numbers of Ohio residents who dare to visit Michigan dispensaries. Yes, indeed. Crimes of the century are taking place just over the state line.
Writing helps distract my mind from my ever-present pain, so if you see a flurry of new posts, you will know why.
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and sixteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
Your comments are welcome and appreciated. All first-time comments are moderated. Please read the commenting rules before commenting.
Twenty years ago, the U.S. government forced doctors to move from paper to electronic records. The result? Many doctors spend more time staring at a computer screen than they do interacting with their patients. The goal becomes inputting data, and not attempting to understand why the patient is there and what treatment plan is best for him.
This move to data-input medicine has led to doctors increasingly relying on numbers to measure patient health. I want to talk about some of these numbers, sharing my experiences and concerns.
Pain Chart
“On a scale of one to ten,” the nurse or doctor asks, “how bad is your pain?” Instead of talking to the patient about his pain, he is expected to diagnose his pain on a subjective scale. First, pain is subjective. My pain is very different from your pain. As a redhead, I have increased sensitivity to pain. All pain is relative. Remove a bandaid from my grandson’s leg and he will scream bloody murder, saying, “doctor, it’s a ten!” To my grandson, his pain is very real, but he has no real-world experience with actual pain. Grandpa has sixty-six years of experience with pain — horrible, debilitating pain. I have had tests that were painful; procedures that have left me in tears. Polly gave birth to six children. She understands pain. Three years ago, she had major abdominal surgery and spent twenty-one days in the hospital. Again, lots of pain.
I have had family and blog readers minimize my pain. They believe if I can walk or stand, I must not be in pain. Never mind the fact that walking and standing require psychological and physical contortions from me. One look at my face will tell you everything you need to know. But, people don’t make eye contact much these days. We no longer read body language. If they see me getting out of the car or walking in the store, they assume I must be fine. I’m not fine. And I am never, ever going to be “fine” again. Life for me is pain and endurance; of wondering whether I want to keep living,
Second, people with chronic pain quickly learn that if you tell a doctor nine or ten for your pain level, he will automatically think you are a drug addict looking to score some narcotics. Tell the doctor one, two, or three, he will wonder why you are there. So, I typically say five or six. Bullshit numbers; meaningless numbers, but there ya go doc, you have a number you can input in your digital records program.
Third, I can’t tell you the last time I had a doctor sit down with me and comprehensively talk to me about my pain. Where? How severe? What makes it worse? Do medications help? What physical activities are you able to do, not do? How does your pain affect your sleep; your sex life? Of course, doctors don’t have time to interact with patients this way, especially primary care physicians. They have patients scheduled every 15-20 minutes. No time for personal connection and investigation.
Weight and Body Mass Index (BMI)
I’m obese. The BMI number for me on the doctor’s digital screen is a blinking red number with an exclamation point. This tells the doctor that his patient is fat, as if his eyes couldn’t tell him that already. According to the BMI chart, my “healthy” weight is 140-170 pounds. I weighed 160 pounds at age eighteen; 180 pounds at age twenty-one; 225 pounds at age twenty-five. Was I obese at 225 pounds? Is that even a relevant question? At age twenty-five, I was physically fit. I played basketball and softball. I hunted, hiked, and fished. I cut wood in the fall. I was a physically strong man, yet according to the BMI chart, I was obese.
The BMI number says nothing about the fitness of a person. Most NFL players are obese. Are they unfit? Of course not. I have a big frame. I lost 100 pounds over the past three years, yet I look the “same.” Why? I don’t have a beer belly or ass. I’m built like a fireplug. Certainly, I knew I had lost weight. I dropped two shirt sizes and eight inches in my waist. Yet, to the casual observer or inattentive doctor, I look just like I always have — fat.
Squeeze My Hand
When doctors want to check my strength, they ask me to squeeze their hand. Without fail, they will tell me “Good. You are strong.” My complaints about weakness and debility are dismissed, all because I passed a subjective hand squeeze test.
How does this test tell doctors about the level of my strength? First, isn’t the doctor judging my strength based on his subjective measurement of strength? Second, shouldn’t the measurement of strength be based on how strong or weak I was in the past? Using that criterion, I have lost over half of my physical strength. Sure, I can still squeeze your hand, doc, but there was a day when I could have broken your fingers.
Temperature
“Normal” body temperature is 98.6 degrees, patients are told. That’s what mine was for the first thirty-four years of my life. And then, I contracted mononucleosis and almost died. Mono can be deadly for adults. Afterward, my “normal” body temperature dropped to 97.0 degrees. And thus began a never-ending fight with nurses and doctors about my body temperature. “Doc, I have a fever.” “Your temp is only 99.0. It’s normal.” But . . . he’s already stopped listening. I can’t have a fever, in his mind, because 98.6 is the standard. He doesn’t believe me when I explain mono changed my body temperature. Dare to object and his notes will say, “difficult patient.” And since every other doctor in the practice can see his note, soon the other doctors you see will deem you a “difficult patient.”
Blood Pressure and Glucose Levels
While these numbers can be helpful in diagnosing and treating a patient, they are only a snapshot of a moment in time. Typically, my blood pressure and glucose levels are normal, even exceptional. I get a star by my name for 120/80 and 90 blood sugar level. But, do these numbers tell the whole story about my health? Of course not. I have landed in the ER twice with sky-high blood pressure for no known reason. I have had several instances where I woke up in the night, only to find my blood sugar level was 48 and 50 respectively. Not good. Again, no explanation for the low numbers.
I stopped checking my BP and glucose levels every day. I found the varying numbers too stressful. Occasionally, I will check my numbers, but I typically leave it to my body to tell me what’s up or down, especially my blood sugar levels.
Advice to Doctors
Stop typing. Look your patient in the eye and let him know you care. Ask lots of questions. Pay attention to what his body language is telling you. Use your gifted hands to touch and probe, interacting with the patient all the while. See him as a fellow human being. Never forget, you will be in his shoes one day.
Of course, doing these things takes time, and therein is your problem. Corporate medicine demands efficiency, treating patients like they are line entries on a spreadsheet. The bottom line is more important than the welfare of your patients. Surely, this is not why you got into medicine.
Several years ago, I wrote about a doctor named Bill Fiorini. He’s the kind of doctor I’m talking about. You can read this post here.
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and sixteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
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Medical doctors are very much a part of my life. I see my primary care doctor four times a year, a dermatologist twice a year, a cardiologist once a year, and other specialists, as needed. Today, I saw an orthopedic doctor for pain in my left hip and a carpel tunnel-like problem in my left hand; a problem I had surgically fixed in 2010. While I was lying on the cold table for an X-ray of my hip, the festering cyst on my upper back — which I had removed a few months ago, but has returned — burst, leaving a wet, bloody, puss stain on my tee shirt. “Wonderful, right?” I have an appointment with a dermatologist tomorrow to figure out what, exactly, to do about the cyst. (I have an ongoing problem with cysts here and there on my body. I have spent thousands of dollars getting them drained and incised. More often than not, the cysts make repeat appearances.)
The orthopedic doctor walked into the room, and after we exchanged pleasantries, I told him why I was there today. The doctor, whom I have seen before, had no recollection of my medical history, including the fact that I have widespread osteoarthritis, and was diagnosed two years ago with:
Disc herniation (T7,T8)
Disc herniation (T6,T7)
Central spinal canal stenosis (T9/T10, T10/T11)
Foraminal stenosis (T5,T6)
Disc degeneration/spondylosis (T1/T2 through T10/T11)
Facet Arthropathy throughout the spine, particularly at T2/T3, T3/T4, T5/T6, and T7/T8 through the T12/L1 levels.
Hypertrophic arthropathy at T9/T10
The orthopedic doctor was unsure what the problem was with my hand. Scar tissue from my previous surgery? A new problem? He ordered a new EMG — a nerve conduction test. As far as my hip was concerned, he decided my pain was caused by the aforementioned back problems. Solution? Live with it.
And then came the lecture . . . “have you thought about losing weight?” I told him I had lost one hundred pounds over the past three years . He asked, “How?” I replied, “Gastroparesis.” I added, “Nausea, lack of appetite, and vomiting, will do that to you.” I quickly determined that he knew little to nothing about gastroparesis. This, of course, is not surprising since bones and joints are his specialty. His cluelessness didn’t stop him from suggesting I see a different gastroenterologist to get a “second opinion.” Second opinion, for what?
Gastroparesis is an incurable stomach disease. The treatments are limited: medication to manage symptoms, feeding tubes, and experimental procedures. I hate when doctors think they always need to be the expert in the room. I have no doubt that I know a hell of a lot more about gastroparesis than my orthopedic doctor did. I have read the relevant literature, and know gastroparesis is a miserable disease; that no miracle is forthcoming. I take medication, vomit, forego eating, and I had an experimental procedure done under anesthesia last year (to no effect).
Ignoring everything I said, my orthopedic doctor suggested I contact the practice’s weight loss clinic for a consult. He said, “You know, if you lose more weight, it will lessen the pain in your back.” By this point, I wanted to scream. “Are you not listening to me? “Or do all you see is the fat guy?”
Had my orthopedic doctor asked, he would have learned that I started having back problems at age twenty. I was first diagnosed with narrow disc space in my lower back when I weighed 225 pounds and still played competitive sports. My spine is literally falling apart. Losing weight won’t fix structural problems. I have had back problems at various weight points throughout my life. Lose, gain, it matters not, the pain remains. I am a living study that shows that the idea that losing weight will fix whatever ails you is untrue. As I mentioned, I have lost one hundred pounds. The only thing losing twenty-five percent of my body mass did was improve my glucose levels and provide me a new wardrobe. That’s it. My debility and pain remain the same. But, hey, I love my new Charles Tyrwhitt shirts.
I am comfortable in my own skin. Lecturing me about my weight is not helpful, nor will losing weight magically cure my fibromyalgia, osteoarthritis, or gastroparesis. While there certainly could be benefits from losing more weight, I doubt dropping another twenty-five to forty pounds will lessen my pain.
What I most wanted my doctor to do today is see “me;” to listen to me; to consider the totality of my health. Since that was beyond his “expertise,” he is no longer my doctor. In fact, I am done with doctoring. When I leave their offices worse off than when I came in, I wonder “why bother?”
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and sixteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
Your comments are welcome and appreciated. All first-time comments are moderated. Please read the commenting rules before commenting.
On Monday evening the Hicksville Village Council passed an ordinance prohibiting the establishment and operation of medical marijuana facilities within the village limits.
This is in response to previous sessions in which the possibility of such facilities coming to town was addressed, although no definite plans had been revealed to council by any such entities. Council had received strong support against these facilities by Police Chief Mark Denning and pastor Steve Eyers; no one has spoken out in their favor at any recent council sessions.
Pastor Steve Eyers of Lifeline Connect Church stated he has done sizeable research on medical marijuana since the last meeting and believed the jury to still be out, with no solid documentation existing substantiating positive claims about such facilities; he did observe that medical marijuana is not on the “approved” list of the Food and Drug Administration.
Eyers suggested council speak to state lawmakers and those in other municipalities which have approved medical marijuana production facilities about the results of such places, noting, “Once you open the door it will be difficult to close.”
As readers will note, the main objector to medical marijuana was Steve Eyers, pastor of Lifeline Connect Church. At a previous council meeting, Eyers, a Fundamentalist Southern Baptist, used the “slippery slope” canard to argue against medical marijuana. In Eyers’ world, every perceived negative (sinful) behavior is a step farther down the slippery slope that leads to Hell. I am sure Eyers believes that marijuana is a gateway drug, and once people start toking mary jane they will soon be hooked on crack, cocaine, heroin, or other highly addictive drugs. Funny how Eyers’ “sizeable research” didn’t turn up any evidence to the contrary:
The “gateway hypothesis” or theory refers to the idea that one substance — marijuana, in this case — leads to subsequently use and/or abuse other drugs. If [Governor Chris] Christie’s point is simply that the use of marijuana tends to precede the use of other drugs, then he is correct — but that’s not the whole story.
Though studies of large populations of people have indeed found that those who smoke marijuana are more likely to use other drugs, these studies show a correlation without showing causation — a commonly misunderstood phenomenon in science. In short, just because marijuana smokers might be more likely to later use, say, cocaine, does not imply that using marijuana causes one to use cocaine.
A 1999 report from the Institute of Medicine, which is part of the National Academy of Sciences, laid out this issue clearly (see pages 100-101): “In the sense that marijuana use typically precedes rather than follows initiation into the use of other illicit drugs, it is indeed a gateway drug. However, it does not appear to be a gateway drug to the extent that it is the cause or even that it is the most significant predictor of serious drug abuse; that is, care must be taken not to attribute cause to association.”
We spoke with several experts and reviewed the available scientific literature on gateway theory. Christie’s definitive statement is unsupported by evidence — there is some evidence in favor of a gateway effect, but the scientific community shares no consensus on the issue and there is little evidence on the underlying cause of that effect. — Factcheck.org.
Evidently, the good pastor was absent the day his teacher covered correlation and causation in science class.
There is no question that medical marijuana can and does help with many medical maladies, including chronic pain. Numerous readers of this blog can testify to medical marijuana’s efficacy and how it has improved their quality of life. It is absurd to oppose any drug (or treatment) that will reduce pain and suffering. But, Bruce, people might get “addicted’ if they start using medical marijuana. So what? Should it matter that a drug is “addictive” IF it’s helpful? Shouldn’t the goal be reducing pain and improving quality of life? Besides, moral crusaders such as Eyers usually confuse addiction with dependency. Addicts misuse drugs, using them for the sole purpose of getting high. Most people who use medical marijuana (and opioids such as Hydrocodone and Oxycontin) are not addicts. They use the drugs as prescribed to relieve pain and improve the quality of their lives. Long-term users can become dependent on such drugs, but, again, why does that matter? I have been on narcotic pain management drugs for fifteen years. Does this make me an addict? Of course not. I take the medications as prescribed by my family doctor. I have taken a variety of pain relievers over the years, but I have not, one time, abused them. Using these drugs for long periods has certainly made me physically dependent on them. If I were to stop taking Hydrocodone, for example, I would go through withdrawal. And believe me, that’s not fun. Several years ago, I stopped taking Tramadol. I had been using Tramadol on and off for managing mild pain for over a decade. It took months of suffering to successfully wean myself off of the drug. The withdrawal symptoms were so severe that I had to sleep in the living room so my thrashing and crying wouldn’t keep my wife awake. Yes, I survived, but at no time was I addicted to Tramadol. Dependent, yes. Addicted, no.
Count me as one person who is fucking tired of moralizing preachers such as Steve Eyers. First, they are hypocrites. Why did Eyers decide to take a stand against medical marijuana and not the drugs that are widely abused by Hicksville residents, including nicotine, caffeine, alcohol, and religion? Alcohol, in particular, causes all sorts of physical and social problems. Yet, crusading preachers are eerily silent on the subject — outside of an occasional anti-booze sermon. Why is that? Second, they attempt to force their personal or sectarian moral codes on others. There are times I wish that the Steve Eyerses of the world would come down with a debilitating, painful disease; one where relief could only be found through using narcotics or marijuana. Then, and only then, would they understand why chronic pain sufferers need drugs. Of course, I wouldn’t actually wish that on anyone, but there’s nothing like first-hand experience for revealing ignorant beliefs.
If Eyers and others like him want to live in pain, have at it. Taken literally as a moral prescription for living, the Bible encourages enduring pain and suffering. Just pray to God and trust that Jesus will be with you every step of the way, right? No thanks. As a humanist, my goal is to reduce suffering and pain, not only for humans, but all living animals. The greater goal is happiness and well-being for all. While suffering and pain can and do teach us valuable lessons, only Evangelical/Catholic sadomasochists think pain is desirable or necessary. Of course, when you believe the world is a shit hole ruined by sin, that all humans are born sinners/haters of God, that life is to be endured until the rapture, and that the grand goal is eternal life in Heaven, it should come as no surprise, then, that you don’t put much emphasis on the here and now.
Medical marijuana sale and use is legal in Ohio, and there’s movement towards making all use of weed legal (it could be on the ballot this November), All praise be to Shiva. Sadly, some Republican state legislators — who are overwhelmingly Christians — and regulators have gone out of their way to impede the opening of medical marijuana growers, processors, and sellers. Just over the border in Michigan, marijuana use is legal and much cheaper than Ohio’s medical weed. Sellers abound. Further, here in the Land of God, Guns, and Republicans, most doctors refuse to write prescriptions for medical marijuana. The insane government war against opioids has scared the shit out of medical professionals — fearing the loss of their licenses — so they refuse to act in the best interest of their patients. Ohioans can go to one of the few doctors approved to write medical marijuana prescriptions, but this could cause them all sorts of problems with their primary care doctors — including the refusal to treat in the future. (Please see How the War on Opioids Hurts People With Chronic Pain, A Plea From a Chronic Pain Sufferer: Please Be Aware of Others, Medical Marijuana and Relieving Pain and Suffering, How Fundamentalist Prohibitions Cause Needless Suffering and Pain, and Understanding and Helping Those Who Live With Chronic Pain.)
Years ago, I helplessly watched a devout Evangelical man suffer horrific pain as he slowly died of bowel cancer. He refused to take pain medications because he believed Jesus was better than morphine; that his suffering had some sort of redemptive value. My late father-in-law often went without pain relief because he believed drug “addiction” (I tried to explain to him the difference between addiction and dependence to him, without success) was sinful. As a pastor, I watched countless dying congregants forgo narcotic pain management because they wanted to be clear-headed when they entered the pearly gates. They needlessly suffered, and for what? Remove God and the afterlife from the equation, and I suspect most people will say YES to anything that reduces their pain.
If Steve Eyers wants to suffer for Jesus, have at it. All that I ask is that he not stand in the way of other people getting the help they need. Jesus is called the Great Physician. The gospels detail many of the healing miracles the Son of God purportedly performed while walking the dusty roads of Palestine. Be like Jesus, Steve, Be like Jesus. If you can’t heal people, Steve, at least let the sick and hurting among you have access to people and drugs who can.
Pastor Eyers lost his battle against weed. Four years after his lies and distortions before the Hicksville Village Council, a new marijuana dispensary opened this week ten miles from his church in the village of Sherwood. Hicksville said no to the dispensary, as did the village I live in. Both Ney and Hicksville council members put their religious and personal beliefs before what was good for their communities. Tax money that could have helped fund local services went — dare I say it? — up in smoke.
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and sixteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
Your comments are welcome and appreciated. All first-time comments are moderated. Please read the commenting rules before commenting.
