Day 21; end of work day from hell.
OK so I seriously feel exhausted. Today was beyond stupid busy...it was completely ridiculous. We saw 37 inpatients at just one facility, 12 at another, and held office hours from 9:11:30 and 1:30-4:30 seeing approximately 50 more...and everyone right down to the last fucking patient had a real issue. Like nobody was just a nice easy follow-up "Hi, how are ya? Diet? Exercise? Needs prescriptions? Have a nice day!" No, everybody had some issue or another. During days like this I do not pee, I do not get ANY break, and I do not break for lunch (I eat something I grab from the doctor's lounge while driving from one office to the other). About 3pm, I was wiggling around (I stand ALL day) and realized it was because my bladder was the size of Alaska and I excused myself to go piss. Ugh.
So let me tell you about my last patient. Then I will get to the kratom madness. 31 year old female coming for follow up. She got hooked on roxy's 5 years ago, started shooting them, when that rush stopped she moved to heroin...well she gave herself endocarditis (just like the one I told you about who died). Ended up fucking up her tricuspid valve, became septic (severe blood infection), coded (died and was revived), got pneumonia, was placed on a ventilator, ended up with a trach (a hole cut in her neck to connect her to the vent) and spend 2 months fighting for her life. She presented to me today and I reviewed her chart and told her "You know what the stats are on staying clean?" She knew them. Her answer though was awesome. "I have NEVER suffered so much pain in my life. I have NEVER been so scared. I really thought I was going to die. I remember being shocked with the electricity over and over and over...it hurt like NOTHING else. I have no intent to ever IV anything again and I am going to counseling to try to stay clean." Her chief complaint was palpitations (she is having tachycardia probably still from all she went through) and insomnia. I increased her betablocker and gave her some clonidine and trazadone to help her sleep and we had one hell of a discussion. She is going to go get the yoga book, will start exercising, we discussed eliminating caffeine and sugar (which will continue to light up the same spot in your brain as opiates) and eating whole foods. Mom was taking notes like a mad woman! Got a big hug and both told me I was the first person to treat them with any respect. It's sad really but we healthcare providers ARE jaded when it comes to addicts. We know they are likely to keep coming back and it is sooo very frustrating. I find many who practice in addiction medicine have some personal level of knowledge regarding it and the ones that do tend to be the most caring.
OK, kratom wise...I did good. Took a total of 3 tsps. So I managed to go down!!! I took .5 at 2am, 1tsp at 6am, .75tsp at noonish, and another .75tsp just now. Felt a little withdrawally starting around 3pm when the gabapentin wore off. I just took that but it takes 2 hours to kick in which sucks. But honestly I am not feeling that bad. Not sure if things are starting to ease up some...or how sad is this...that I am simply getting used to feeling super shitty 24/7?? So tomorrow I will move to .75 tsp doses. Once down to like .25 then I need to move the spacing to at least 12 hours and then jump baby, jump!!!!
Really thinking to do this next weekend. The timing isn't awesome because I work Turkey Day weekend (yes, I am ALWAYS fucking working but this is what happens when your spouse is suddenly unemployed but to be fair my jobs just require this level of bullshit. I work 60 hours per week easy and if you add in research, writing, and publication which is expected at university level I am easily doing 70-80 hrs). I like what I do very much and that helps. The flexibility of schedule and a greatly reduced summer work load gives me the opportunity to be at home often (although working) which is good for my youngest child.
I read your comment on my phone while standing next to the doctor I work with about me deciding to be in the 5% and I started to cry. He was like "what the hell is wrong? WHAT HAPPENED??" I am a really tough cookie. I cry in front of nobody. I have no problem sticking up for myself and telling doctors to go fuck themselves if I disagree. Hell the doc I work with and I have been in some fairly nasty heated arguments. We are both the same sign...bad and good combo we are. We are too damn alike really. Anyhow, he has never seen me cry (been together 5 years) and thought someone died or something! I just mumbled something about being emotional around my period (healthcare providers share all shit with each other...lol) and got ahold of myself. He knew I was lying but didn't push. Anyhow, yes, I have DECIDED I am done and I really, really mean it. Does this suck? Yes. Does having chronic pain suck too? Yes. Does being on opiates suck? You bet! The only way out of this Godforsaken mess is just getting out...stopping, quitting, sucking up and just fucking doing it. Yes, I am whining and bitching but you all get WHY I am being such a pansy...I mean really. But yes, I WILL be the 5%. Fuck this shit.
Oh and how cool is it that you used to teach too???
OK, off to dinner. Love you folks and I hope you are all kicking. If you are reading and thinking about kicking, get your plan together and do it. You WILL be happy you did...I am...achy legs and all.
Jungledog added 164 Minutes and 46 Seconds later...
OK I am a complete moron. I did not manage to drop! I held...took 3 tsps. yesterday and today. Damn, Sucking at math and memory at the moment!!! LOL