More news today — some good, some bad:
We’ll start with the good news. I got five rows pencilled today. I was pretty achey when I was done, and it was time for my first visit to the physical therapist, so off I went. Aches aside, I was actually feeling pretty good.
More Good News: Of all the medical attention I’ve recieved since getting injured, the winner of the “I felt decidedly better all the way around after you finished with me” award goes to the physical therapist. Not even the drugs made me feel as good as a heat treatment, massage, and some electrostimulation. My shoulder felt BETTER. This wasn’t endorphin-powered euphoria, either. This was “hey, the pain is gone for the first time in DAYS.”
The Physical Therapist was also impressed by my level of knowledge surrounding my injury. He said “you’ve sprained your AC ligament” and I said “Oh. Type 1 Shoulder separation, then.”
Him: “You’ve had shoulder troubles before?”
Me: “No. Google is my friend. I researched shoulder separations based on what the Family Doctor said, and determined that my symptoms were either a Type 1 or Type 2. Either way, no surgery.”
Him: “Good work. You may want to research “impingement” as well. It looks like you’ve got a little bit of that, and that’s part of what we’ll be treating.”
Needless to say, it’s a pleasure to work with a Doctor who trusts me and who won’t treat me like I’m incapable of understanding big words. And as I mentioned above, it was also a pleasure to be feeling so much better.
To celebrate, I drove to a movie. Charlie and the Chocolate Factory was very, very nice. It was like a cross between “Batman” and “Pee-Wee’s Big Adventure.” Never having read the book, I can’t judge the film by its true-ness to Roald Dahl’s writings. I will say, however, that I missed the “Oompa-Loompa” song. The Elfman-arranged, Dahl-lyriced, Elfman-sung songs were excellent, but I wanted “Ooompa, Loompa, doompedy-doo.” Oh well.
After the movie I bought some groceries and headed home.
Now for the bad news.
At home I found out that my insurance provider won’t cover physical therapy unless I’ve had surgery. Great… the best medical attention I’ve had since this affair started is the only attention that isn’t covered. I started tensing up immediately, and the pain was back. Grrrr… It hurts just writing about it.
So I took some of my new painkiller, Ultram. Twenty minutes later I had this distinct feeling of “this isn’t doing anything,” followed by “but it’s been a long day, and I wouldn’t mind a nap.” In short, it made me drowsy, and tricked me into thinking it was a NATURAL drowsy.
Then the scary bit: as I lay in bed thinking “maybe the drug is making me drowsy” I noticed that my breathing had slowed down. WAAAY down. I wasn’t doing nearly enough of it. I vaguely remembered reading something about “difficulty breathing” under the list of “rare side-effects,” and decided to call out to Sandra for a little help. Then I fell asleep. When I woke up an hour later I still wasn’t breathing well, but I was pleased and just a tad surprised to still be breathing at all. I staggered downstairs, and announced to Sandra that Ultram was now on my short list (along with Demerol). I won’t be taking any more of it.
So… as I’m writing this my breathing is still shallow, but not nearly as labored as it was three hours ago. I’ll have to settle for some Ibuprofen for pain this evening, since hydrocodone is on the “contraindicated” list for Ultram, and the Ultram won’t be out of my system for another couple of hours at least. The BOTTLE of Ultram, however, will be out of the house in very short order.
Now for the worst news of all: Reading back over this post, I sound like a whiney hypochondriac. GRRRRR.
(crap. I tensed up the shoulder again.)
–Howard
You can’t take Demerol? Man… Demerol is good stuff. I’ve had to have it exactly twice. It was remarkable how much better it made me feel. It stopped the pain.
Loxley
Intraveinous Demerol didn’t just make Howard loopy, it put him so far toward unconscious that I had to sit next to him and remind him to breathe. It was seriously scary. Howard doesn’t remember much of that hospital visit. He does however very clearly remember the circulatory problems in his demerol IVd arm which he suffered through for two years.
Hmm. I’m starting to think that Howard’s body just doesn’t like painkillers at all.
Scary about the Ultram! Throw that crap out. I’m always wary with new drugs, and that’s exactly why. Every time I take something new, I’m like, Is this a symptom? Is my heart racing? Oh, now it is! Am I gonna die? Oh, now my breathing’s shallow. Is that a symptom?
You are not a hypochondriac. Trust me.
Naw. It’s not hypocondriac to be worried about strange drug effects, particularly when you haven’t taken the drug before, and particularly when they interfere with breathing or heart rate. It’s -smart- to be worried about this, and you’d be surprised about how many people are clueless and unobservant about such things.
That being said, yeah, you should probably cut out the ultram, though slow respirations don’t necessarily mean trouble breathing. On the other hand, a lack of oxygen caused by respiratory suppression would certainly lead to tiredness.
I’d definitely ask for a different scrip. While opiates are all of the same basic group and have generally the same method of action, people have different reactions to different specific drugs among the group. I also wouldn’t be worried about dependancy, the way that you’re taking the drugs — that seems to me to be one of the primary reasons for the existance of ultram.
The insurance not covering the physical therapy really, really sucks. You might be able to do something about it, but I don’t know what.
Sandra hauled the Ultram out to the trash for me very cheerfully when I told her “I think if I take two of these instead of one, I’d die.”
I was probably exaggerating.
Probably.
I still have the Lortab, which, though it makes me loopy, does okay at managing the pain. I also have my old friend, Vitamin I (ibuprofen), which doesn’t do crap for the pain, but whose anti-inflammatory properties are probably a Good Thing.
I’m going to see about inking a few rows tomorrow. I don’t know yet whether I’ll put in my shift at the Temple. I’d like to be able to do it, but I suspect I wouldn’t do them or me any good.
–Howard
No more Ultram for you!
I also have my old friend, Vitamin I (ibuprofen),
Heh. Never heard of it mentioned in that manner.
It’s good stuff, though.
….NOT! You don’t sound in the least hypochondriac. A hypochondriac would have been asking the PT, “Are you sure it’s not more serious? Oh my, impingement… That must be BAD, huh?”
hypocondriac? nah…
First, your insurance provider is idiotic. Why not call them and explain the situation, and how it would cost them less to just pay for physical therapy than let your situation worsen until you need surgery and they have to pay for both surgery and therapy?
By the way, having had whiplash now for over three years, no, you don’t sound like a hypocondriac. I mean, I can go entire days, weeks sometimes without any real pain… and then a weather system goes through and all at once I’m in significant discomfort for a month or two.
Doesn’t help that I built up a tolerance for all over-the-counter painkillers. Except Tylonel, which NEVER worked for me. *sigh* The one med that a doc tried putting me on (which was actually an antidepressant but was considered good for healing “nerve pain” (ie, whiplash) ended up making me feel like I had a massive sunburn all over my entire body the next morning after taking it. In a completely darkened room. I called the doc who said there are no side effects for the medicine because it’s 40 years old. Took half a dose and the effects were much worse with a longer period of time before they went away. The doctor once again claimed that it wasn’t the meds because the side effects listed (which included sensitivity to sunlight and skin sensitivity like I was suffering from) were actually just generic side effects put on ALL medicines.
Or in other words, he didn’t want his kickbacks to lessen. Shmuck. Quack. *shakes head.
Hope you’re feeling better soon…
Robert A. Howard, Tangents Webcomic Reviews
http://tangents.keenspace.com
Re: hypocondriac? nah…
This post reminded me of a friend’s story. He tried to use logic in court to prove a point. The judge laughed at him.
You don’t sound like a hypochondriac, you sound like a man who had a bad experience with a drug that you’d prefer not to repeat. That’s ‘sensible’, in my book of definitions.
crappy!
And you don’t sound the least bit like a hypochondriac. You sound like a well informed health care consumer.
Someone previously had suggested the tylenol/ibuprophen cocktail. I’d think that’d probably going to work better for you. When I get killer from hell death “lady pains”, I take 800mg of ibuprophen and 650mg of tylenol. That usually helps. I’d suggest tylenol with codiene (500mg tylenol with 30mg codiene), but a) i don’t know if you can get that over the counter in the states and b) if you’re having respiratory depression from a non-opiate analgesic, you shouldn’t be taking codeine, which is an opiate.
the exciting thing about Ibuprophen is that while you can build a tolerance to it (need more for the same effect), you can’t become addicted/dependent (need need need, regardless of effect).
Let me know the next time your doc prescribes something – I’d be happy to look it up in all it’s glory again.
Oh, and the obvious warnings with tylenol aren’t necessarily something I’d be worried about with you – it can cause hepatotoxicity in patients who use it in conjunction with alcohol. 🙂
With regards to the physio – it sucks when good tings aren’t covered. But you can emmulate those good things at home easily. I wouldn’t go as far as to do the exercises unsupervised, but you can definitely alternate heat and cold at 15 minute intervals (heat for 15, nothing for 30, cool for 15, nothing for 30, repeat) Typical warnings here include “don’t put it directly on your skin – wrap both heat and cold in a towel”
Again – heal soon, and good luck with the pain control.
Nurse Jo
Will your insurance cover a chiropractor? If so, you will get just about the same level of service & help from them (especially from one that works with sports teams) as you would from a physical therapist.
Being worried about the situation when your medication begins altering your breathing is not hypochondia. This is a serious concern, one of which the pharmaceutical company is aware, since they saw fit to place the warning in the first place. Leaving aside the concern about complete resperatory arrest should you happen to fall asleep (a valid concern, by the way), it’s still serious. While you’re doing other research, check out “sleep apnea” as well – particularly the non-headline grabbing effects. Yes, it can be fatal, but even when it’s not, it can still have other detrimental effects – and it sounds to me like the Ultram is inducing apnea, waking or sleeping. (Yes, apnea also occurs while sufferers are awake. Happens to me regularly, though fortunately I can override it if I’m paying attention. It’s still not fun when you realize you’ve gone over a minute without breathing, but at least I’m aware of my own metabolism to take heed when I start greying out.)
The good side to all this is it sounds like you’re in the same boat as me as long as you’re awake. If you’ve still got any of it in your system, just stay alert for a while. And make sure you let your doctor know about the side effects! This is a very good reason not to use the stuff any more, and it needs to go into your medical record so that he (or another doctor) doesn’t prescribe it again. There are other painkillers out there – avoiding one which interferes with your continued breathing sounds like a very good policy to me.