Vets: The VA doesn’t feel your pain.

I am being involuntarily removed from my methadone prescription for chronic pain. I was taking 5 mg three times a day. The doctor says she is “weaning” me off of methadone. She didn’t say why.

Some months ago I went to the so-called “Pain Evaluation Clinic” at the Michael E. DeBakey Veterans Medical Center in Houston. I saw a psychologist for about an hour and spent about the same with a physician assistant who proceeded to make clear that I would be taken off methadone. I have taken the drug for more than 11 years. I had a couple of medical tests on the horizon that concerned me so I was spared from the weaning for the time being.

I never really received an explanation why I was being taken off methadone. The PA told me that my prescription for 15 mg was equivalent to 60 mg morphine equivalence. In extensive reading this afternoon, I found nothing to indicate whether this equivalence is accurate due to the medication itself.

The PA, I suppose, tried to scare me out of my methadone prescription. She gave me the impression that I could all of a sudden overdose while taking just a normal dose. I found nothing to support such claims.

It is true that methadone overdose deaths represent about 1-of-4 total fatal ODs. I found this on one government medical site:

“Methadone is a very strong painkiller. It is also used to treat heroin addiction. Methadone overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

 “Methadone overdose can also occur if a person takes methadone with certain painkillers. These painkillers include oxycontin, hydrocodone (Vicodin), or morphine.”

Look Ma, no spontaneous overdose from normal dosage for years.

Don’t bother going to the VA for severe pain. They want you to hurt. I guess service to the country wasn’t enough.

Here is some additional illumination about methadone overdose from CRC Health Group, a West Coast addiction and behavioral treatment group based in California:

“Between 1999 and 2004, deaths attributed to methadone increased by 390%, an effect primarily related to increased utilization in pain clinics , as well as diversion.

 “Methadone accumulation can lead to sedation, respiratory depression, respiratory arrest and even death. Lethal respiratory depressive effects can occur in doses as low as 30 mg in non-tolerant persons

  “Initial efforts to characterize risk factors derive largely from Australia, where deaths related to methadone tablets prescribed for chronic pain increased markedly between 1984 and 1994. Diversion of methadone tablets accounted for about half the deaths, whereas deaths from prescribed methadone declined over this period. “

As CRC quite succinctly pointed out:

  “You must take methadone responsibly and with respect for its power, but the careful and considered use of methadone has proven quite safe, even for long-term consumption. Methadone has been proven not to harm the lungs, heart, brain, liver, kidneys, or any other organ.n 4,000 deaths. However, many of these deaths did not involve methadone treatment for opiate addiction — instead, they involved individuals who were using methadone without medical supervision for pain treatment, or who were otherwise abusing methadone.

 “Methadone use saves far more lives than it endangers. According to the National Alliance of Methadone Advocates (NAMA), opiate addicts who are not on methadone are more than three times more likely to die than are individuals who are using methadone as part of a supervised addiction recovery program.

 “Methadone, much like any strong opiate analgesic, has a respiratory depressive effect. If you take too much methadone, you can stop breathing and die.”

Simple enough!

A registered nurse friend of mine said recently:

 “You’re right that it’s the fentanyl and oxy and it’s the serious main-liners fucking it up for all of us. This entire thing is blown up by big pharma – I’m sure we could follow the $ and figure it all out, but the guy in pain is paying the real cost of trying to make it without his pain meds. It’s a mess,” she said. “It’s horrible and I can’t believe the medical system is letting them interfere with medical practice like this. It’s illegal and malpractice not to treat a patient with the correct medication when it’s available. Period.”

My weaning is in a rapid fashion. It makes me wonder if VA practitioners receive a bonus for cutting off opioids for some old vets with severe pain.

I started with being prescribed 10.5 mg three times per day. This month I received a prescription for 5 mg twice a day. Next  month it will be 5 mg once a day and 2.5 mg once a day.

I was never given a firm reason why I should quit taking methadone. I don’t have to though. It seems most VA top leaders want to look good for their boss in the White House. I doubt he could tell an opioid from a hemorrhoid.

Even worse than how I will fare without methadone from a withdrawal standpoint — almost 12 years is a long time on an opioid — is the pain.

I have not been offered a firm solution to the often severe chronic pain from spinal stenosis in my cervical spine, this despite having two surgeries. I also suffer from excruciating lower back pain that doctors at the VA have never seemed to agree on the reason. It limits my walking and the problem has never been substantially addressed, with the exception of a diagnosis of arachnoiditis. The condition is a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord.  The diagnosis seems dubious after seeing a number of different doctors.

Most disturbing are the VA pain strategies involving high doses of over-the-counter analgesics such as Tylenol or Ibuprofen. For real? Do they seriously believe such OTC drugs will help after taking methadone for almost 12 years?

Other VA “pain control” suggestions include physical therapy, chiropractic, acupuncture and group therapy. I just know sitting with a group singing “Kumbaya” will kill the pain.

I don’t know what will happen in the future. Most certainly, I am scared. I was put on methadone by a VA pain doctor in Dallas who suggested methadone after he told me there was nothing he could do to help. I have tried all the VA has had to offer since 2006 and those strategies that do not work for me have only grown 12 years later.

I can certainly understand why many VA patients may go elsewhere for help with pain. I don’t plan to seek black market opioids. Beyond that, I will do what I need to do to survive severe pain on a daily basis.

The Uber rides to the Texas Senate

Lately I have been transported here and there by Uber.

The ride-hailing firm has received a ton of negativity during its brief existence. From knocking the taxicab business down through some, seemingly, inexperience at the top, there have been some turbulent times.

I am not really interested in the level of intrigue at the corporate level of Uber. I am most interested in making sure that there are Ubers around that will get me where I go during the times I need a ride to hail. Lyft, an Uber competitor recently were approved by the local government here in Beaumont, Texas, where I reside. I may check them out just to see what they like. But so far, I like what I have seen with Uber.

Most appealing to me is that Uber does not stick it to you for a ride like a taxi would. I have taken a Greyhound Bus to Houston and back a couple of times since December, when I had my first cataract operation at the Houston VA Hospital. Last week, I had surgery on my other eye. Both times, since I was not supposed to drive for 24 hours after the cataract surgery, I hailed Uber to take me to the bus station. When I got to Houston I walked the block up from the Greyhound place and rode the Southbound Metro Rail from the Downtown Transit Center to the Texas Medical Center Transit Center where I took the bus to my hotel that was located just behind the NRG Stadium. If I wasn’t riding the shuttle to and from the hospital from the hotel, I used Uber.

For whatever reasons that I can’t wrap my head around, Greyhound decided to move from the station on Magnolia Avenue in downtown Beaumont. Until a few years ago, the station was at that location for many a moon. The bus station was moved to the truck stop in Rose City, between Beaumont and Vidor. Because the physical address is in Vidor, the bus line calls the station “Beaumont-Vidor.” The latter city raises some eyeballs from some African Americans who have never been to the Greyhound station there but have certainly heard of Vidor. The town has a checkered past as a so-called “Sundown town.” It was once pretty much all white and was once a haven for the Ku Klux Klan. Although there are klan members living there some city officials have tried to distance the town from the KKK.

I do not know much about how Uber goes about letting people drive wherever. But there are no Ubers to be found on one’s iPhone app when looking for a ride at the Beaumont-Vidor Greyhound station at the truck stop in Rose City. Got that? I have been told by the service’s drivers that there are no Ubers to be found in Orange County, which is where the bus station is located. I was told a way to circumvent the problem though. One can enter the location of where you want to go and then put a physical address of where to be picked up across the Neches River in Beaumont. I usually use the McDonald’s on I-10 near Martin Luther King Jr. Parkway. Then you can look up your driver’s profile and press a button to call and tell them where you are. I have had no problem. It’s a good $15 or so cheaper that a flat taxi fare of $30.

I have found the drivers for the most part as courteous and nice. Many are just downright personable. I’ve met a couple of military reservists driving. One is a former Navy Seabee and still another driver a former SEAL. Many can make a nice little sum driving around the city. Sometimes the drivers will be asked to be taken to Houston, almost 90 miles away. I was told by drivers that it is almost $100 fare to be taken there with the driver making about $70 of that $100. Those who are not registered in Houston as a “Transportation Network Company” driver — a permit costing about $12 for two years as well as a sticker with an “U,” can drop off but not pick a passenger.

One note here. Uber passengers may only use a credit or debit card for pay. A person may tip a driver, but it isn’t required. I have found a reasonable and appreciated gesture is to give the driver a 4 or 5 star rating when you get the receipt back via e-mail. I point this out, not so specifically to ask one to tip. I am just saying the drivers have little to no cash on board lest one would want to do something stupid. I hope you get what I mean.

Some city governments are downright hostile to Uber or Lyft. Beaumont City Councilman Mike Getz helped these hail-riding firms get a foot hold here. Getz, an attorney, has been quite controversial at times but I feel he deserves much credit for his support of ride-hailing companies.

Those who do not deserve our support are the knuckle-heads in the Texas Senate who want to place stricter controls on ride-hailing drivers.

Senate Bill 176, authored by Sen. Charles Schwertner, a Republican and orthopedic surgeon from Georgetown, authored the bill which is captioned: “Relating to the regulation of transportation network companies; requiring an occupational permit; authorizing a fee.

While requiring some screening measures which some drivers already face in cities where hail-riding companies are allowed there are measures which seemingly regulate the corporations as well. This includes a sliding-scale fee for companies with the highest number of employees to pay $125,000.

I thought Republicans want no regulation!

This afternoon I called the Capitol office of my state Sen. Brandon Creighton, a Republican from The Woodlands to let my voice to be heard. He also serves as vice chairman of the Senate Business and Commerce Committee. That body will hold a public hearing on this bill tomorrow, March 14.

An analysis of the bill by the nonpartisan Senate Research includes the intent of this regulation by the bill’s author. In it, Schwertner’s concerns conclude:

“However, no consistent and predictable statewide regulation of TNCs exists in the Texas. This has resulted in an inefficient and confusing patchwork of rules across local jurisdictions. These myriad regulations are often arbitrary and onerous. As a result, they may inhibit TNCs from growing their business and network or providing their services in many areas. The loss of TNCs results in less mobility and fewer safe transportation options, as well as a withering economic climate.”
Some of the Tea Party/Trump types have a great disdain for government, at least anything above the local level. But I also believe that some locals in many towns across the state have a dislike for technology.
I think that merely piling on regulation to where similar regulation exists would hinder the growth of such business which could benefit many as well as the environment. I especially think that when any amount of money going to the state, whether it comes from a company or a contractor driver, would increase the prices which make such ride services so attractive. This is what I told Sen. Dr. Chreighton’s office this afternoon. If indeed, a ride service being regulated by a local government and the state is allowed to exist, I see a pathway to disaster. Perhaps a reasonable state permitting system with limited cost to the contractors with some city or county government input might just be something acceptable. Then again, maybe not.
I have found nothing wrong nor expensive with Uber on my end and live in a town in which I once could not get ride home from the bus station on a Christmas night when the  station was downtown. And taxis are just too expensive to hire. One may also find that the only game in town gives its employees a sense of entitlement. I know many hard working cabbies, past and present, who drive after coming from another job. Some are bleary-eyed after working a shift in a cab and going to English as Second Language classes or even coming to the job after a grueling afternoon at law school.
Tech has changed the American face. Perhaps grabbing a little here and a little there — the taxi industry and ride-hailing might some day come to pass. It will take a lot of changes in attitudes but, we need to drive on outside the 20th century into the 21st, in 2017.

Scientists: No link between cats and mental illness

Today I read of a study which concluded something very astounding.

Cats do not drive you crazy.

Cats may not drive you crazy but they could drive you to drink. National Archives/U.S. Information Agency

My reasoning as to why this astounds me stems from the fact that I never knew that anyone ever suspected a link between cats and mental illness. That is not to say more than one cat person has said in a faux exaggerated — okay, maybe no faux — manner something to the effect of “Oh that Whiskers. He’s driving me nuts!” I mean, seriously, where was I when such a parallel developed?

Research had established at one time that the parasite Toxoplasma gondii which may be transmitted through infected cat crap might cause mental illness. Of course, someone who eats cat poop might be suspected to have some sort of mental disorder. The study also said the parasite may also be spread to humans through undercooked meat or unwashed vegetables.

The previous study was found flawed by English researchers. The more recent survey studied 5,000 children who had cats in their households and dispelled the link with mental illness. The Avon Longitudinal Study of Parents and Children through the University of Bristol tracked the health of people born in 1991-92 found no significant health risks of those studied. Nonetheless, the researchers could not rule out other health risks from the parasite.

While this finding is reassuring, there is evidence linking exposure to T. Gondii in pregnancy to a risk of miscarriage and stillbirth, or health problems in the baby. In our study, we could not directly measure exposure to T. Gondii, owning a cat during pregnancy we recommend that pregnant women should continue to avoid handling soiled cat litter and other sources of T. Gondii infection, such as raw or undercooked meats, or unwashed fruit and vegetables. That said, data from our study suggests that pregnancy or in early childhood does not pose a direct risk for offspring having psychotic symptoms later in life, the study published in “The Conversation,” a website specializing in news for the academic and research communities concluded.

So you lovers of those furry little bundles o’ felinity may breathe easy. Your cat probably won’t cause you to wander off to the depths of insanity. You may, however, develop a strong affinity for balls of twine.


Dos ojos son mejores que uno.

Yesterday I had a cataract removed from my left eye. I didn’t meet the surgeon until I was in the operating room. That is because the ophthalmologist I had previously spoken with was on leave due to a new baby in his family. I ended up having an equally apt surgeon. Or hopefully it will be the case.

Any sort of surgery is imperfect. Saying, ” … having a cataract removed,” is kind of half of the work performed in 30 minutes or so in the operating room. During the surgery, one’s lens is removed from the eye. And a new artificial lens is implanted, As we age, the lens in an eye often is made opaque. The result is what can be described as a “cloudy lens.” Vision is hampered and colors are less brilliant. In my case, I also see so-called “starburst” halos from light including those from automobiles. I have driven too many times more than I should have with this condition because your depth perception is shot to hell.  Driving becomes dangerous with this condition.

This is what I see at night, plus hundreds of even more lights glaring as such. Hopefully cataract surgery will reduce “starburst” halos.

Cataract surgery is one of the most common surgeries these days.

Most doctors use a technique known as Phacoemulsification. In very general terms the surgeon makes a tiny incision then uses tools to break up the lens and cataract followed by the implanting the new lens.

Different eye drops are used during and after this surgery. Eye drops and a numbing “gel” which enables the surgeon to anesthetize the eye were used in surgery. I was given a little kit at the VA, where my surgery was done Wednesday, that contains an eye shield and three different eye drops. These eye drops are applied for a month or more.

The amount of tape the surgeon used on me could prompt a commercial for whatever company where the medical tape is purchased. I had an IV inserted on top of my hand and it was taped. As the surgery began, my surgeon said she was going to tape head to the bed.

“This is for, in the event that you doze off, you will remember you are on the OR table, she said.

The attending surgeon told those personnel, however many there were, that they and I should not talk when she began to do her thing. And I could only talk if experienced pain. I was given some kind of sedative, I was pretty loose but not knocked out. I must admit when I was rolled into the OR, I felt a small measure of panic. That soon diminished. Although, I was again freaked somewhat when she looked down at me on the table. Perhaps her brown eyes provided perhaps equal parts strangeness and the rest perhaps a bit of attraction. I know that sounds like something George Constanza from “Seinfeld” would say.

After the surgery, the tape was removed on my head. An eye shield was then placed on my eye, held into place by more tape. This was after the other tape holding my head to the table was ripped off and seemingly took skin or hair. Just kidding.

I wore the patch overnight and had to return to see a doctor the next morning. The doctor I saw had been in the OR, but assisted with the surgery.

When she took the tape holding my eye shield, the doctor was careful to remove the tape. The doctor said she was in the OR, and remembered how annoyed I was the day before when that happened. But, I must admit I was pretty stunned when she took off the shield off and everything was, at least from my left eye, bold and beautiful.

“I can see,” I said. The doctor said that was kind of the whole point of all this.

The difference between my left and my right eye are quite stark. When I close my surgically-interventioned eye, the sight from my right eye appeared is if has a slightly brown tint. For some reason, it looks as if all I see from that right eye had been covered in nicotine. It is pretty strange.

My eyesight overall is much better, even using the right eye. I notice some instability in my left eye. But, I am hopeful that I can get that other eye fixed as soon as possible.

I thought about all the precautions given to me before and after surgery. Some of these are common sense such as having someone to drive you. Others were less clear. It is definitely a drag having to take three different eye drop. However, these drops supposedly help healing and preventing harmful infections. This is pretty important for someone like me who has Type 2 diabetes..

I remain helpful my improved and implanted new lens will continue healing and hope my right eye will join its eye brother. To paraphrase an old Mexican proverb, uh well — read the heading.

Hair today. Hickey danger. GOP guy in Mexico.

UPDATE: 5:30 p.m., CNN announced that a report from Reuters said the Mexican president told the GOP candidate that Mexico would not pay for the “wall.” A border wall and having Mexico pay for it has been the central issue in the candidate’s campaign. He told the press this afternoon in Mexico City where he met with the Mexican president that the two had discussed the wall but did not discuss who will pay for it. Not surprising, a lie from the despicable candidate. Too bad the Mexican president didn’t say it while answering about four questions from the press.

While awaiting remarks about the idiot GOP candidate for president and the Mexican President Enrique Peña Nieto, I have decided to do a little stream of consciousness here.

Attention young lovers: There is now evidence that, no matter the passion of the moment, hickeys aren’t a good thing. Speaking of Mexico, reports that a 17-year-old Mexico City youth died of a stroke that was caused by a hickey. Wow. That’s kind of scary.


Also scary, I had my first pedicure yesterday at a local cosmetology school. But even more out of character for me: I had my first haircut in some 16 years. Here is my reasoning.

My avoidance of the shears stems from price but also I kept a hairstyle that didn’t require a trim. The price of a haircut was way more than I wanted to pay around the turn of the century. That’s the 21st century. A cut these days are even more costly. But practicality was probably the main reason for the shaved head.

Since my male pattern baldness reached its peak around age 40 or so, shaving my head seemed like a pretty reasonable hair style for me. The shaved head wasn’t considered exceptionally weird back then, so I would shave my head every other day. Lately, I just became tired of the hassle. I grew what hair I had for a few weeks. It looked like crap on a stick. I then used my shears to cut the hair close enough where shaving my head would not be significantly difficult. I had gone without a shave of my head for about two weeks up until yesterday. Most recently, to paraphrase David Crosby, I almost cut my gray-white hair. But then I had an idea.

I have been growing a beard since using an electric shaver for several months. The contours of my face, I noticed, after a few days was so that I might have a pretty good beard — a Van Dyke of sorts — in the making. So, I let my beard grow out. Along with my hair needing a trim, my beard needed one as well.

It's a beard, by damn!
It’s a beard, by damn!

I have diabetes so I have to be careful with my feet. Yes eight feet deep has to take care of his feet. This is especially so since during the last year or I have had a couple of toenails removed and hammer toe surgery. So, a nurse told me that I should get a pedicure and could get one at a decent price at local cosmetology schools. That is what I did.

The same student, a friendly young lady, did both the haircut and the pedicure. She did a really phenomenal job. My feet still feels good from the foot job. And both the spa pedicure and haircut cost only $23. I think I will begin going back once a month. So …

La CucarachaLa CucarachaLa CucarachaLa Cucaracha

Okay niños y niñas, the Mexican president Peña Nieto  and the GOP presidential candidate-jerk are about to speak. Here they go.

The Mexican president talked about the importance of  NAFTA in both countries. Forty percent of materials imported into Mexico are made in the U.S., Nieto said. He also said that his responsibility is the welfare of Mexicans, both in Mexico and elsewhere. Implicit in those remarks were Mexicans who are in the United States.

The candidate for president repeated many of his contentions he has made through his campaign. Perhaps the central plank in his run for president is to build a wall on the U.S.-Mexico border and to make Mexico pay for it. He said that the wall was discussed. But in some questions from the press , GOP guy admitted:

“Who pays for the wall? We didn’t discuss that.”

Former Mexican President Felipe Calderon, speaking on CNN’s The Lead With Jake Tapper called the GOP candidate “a hypocrite.”

The candidate gives his big foreign policy speech tonight in Arizona where he will be welcomed by his good buddy, sheriff of Maricopa County, Joe Arpaio. I honestly wonder how this d**khead keeps getting elected as he did during the Republican primary yesterday in Arizona. Arpaio has admitted to contempt of court charges for ignoring a federal judicial order. Too bad he wasn’t put in his own jail, in a tent.

What a day off this has been for me. Hopefully, American voters will see through all this bull***t from the candidate, whom I still will not give his name a mention.