2015… Another Parole Hearing for Numbnuts

Here we go again.  The numbnuts (does he deserve a human term?) who raped, sodomized, and beat me for 6 hours in 1987 is up for parole… again.  The same numbnuts who has been on parole at least 5 times since he was 18 years old, and NEVER got off parole before offending again, with increasingly more violent crimes.  He’d been out for less than 40 days when he raped me.  SO what other reasons could I have that I haven’t  stated before, for keeping him behind bars for at least another few years?

Carl Edward Chambers TDCJ # 453210 Convicted rapist

Carl Edward Chambers
TDCJ # 453210
Convicted rapist

I want him in prison for my own peace of mind.  There.  I said it.  Maybe it’s selfish, but that Saturday morning in January 1987 changed my life forever.    I don’t want revenge- I want the sentence he agreed to when HE changed his plea mid-trial, and said he was guilty.  He agreed to a 60 year sentence, and he’s proven repeatedly that he can’t function on parole.  He does something to get back ‘in’. Every. Single. Time.   I realize that there are mandatory release dates- and he’s already blown through one of those.  He will reoffend eventually if he’s let out- and at what cost?

I protest his release because of what he’s capable of doing to someone else.   He’s 56 years old now, and I have no doubt that he still  has the strength to repeat what he did to me, and possibly ‘finish’ what he started, and actually kill someone.   I have no doubt that he would have killed me had I not escaped.  He’d talked about it, and ‘acted out’ dismembering me.  I knew his name, where he was staying, his sister’s name (it was her baby I was taking care of that even put me on his radar- before he stole my address and phone number from her purse, and hunted me specifically- I looked like his first wife). He couldn’t leave me alive.  He plans and carries out his crimes.  His last victim before he attacked me (for whose crime he was on parole) said she would have fought harder for a better sentence if she’d known what he could do (he put a screwdriver to her neck at an Austin bus stop). That means he wouldn’t have been out of prison that Saturday morning, and I wouldn’t be writing this.  I do know what he can do, and I won’t just sit back and let him slink around the justice system without my presence ( if only on paper) being known.

I had always dreamed of having a husband and a bunch of kids.  January 10, 1987 changed all of that.  My first experience with sex was being brutally raped at 23 years old.  And it was my last.  I don’t want anybody that close to me.  I don’t want to smell someone’s breath in my face, or feel their sweat against my body.   I don’t want to be a body orifice for someone else’s ‘amusement’.  I don’t ever want to feel that pain again.  Numbnuts impregnated me. I had his offspring inside of me- but evidently it was defective, because after a lot of cramping one morning,  it fell out into the toilet about 10-12 weeks after the rape.  That’s a visual I can’t unsee… the tiny placenta and jagged edges of tissue sitting in the toilet.  I didn’t want that baby, but it was still a baby.  The only one I’d ever carry.  It was a blessing to lose it, since I couldn’t imagine any of the other alternatives.  But it added to the pain of the entire situation.

If he got out because I didn’t remind the parole board what he’d done to even BE in prison, and did something to someone else, I couldn’t live with myself.  I have to be active in this process, and yet I hate it.  I hate knowing that the date/year is coming up AGAIN, and I’ll have to think even more about that morning, and put something into words that will make some sort of impact on those who decide MY fate with his freedom… or hopefully, continued incarceration.  I shouldn’t even know about the parole process.  Nobody should.

I hate the word ‘victim’.  I was a victim while he was hovering over me, beating me, fucking me (it wasn’t  sex;  it was a brutal, vulgar act- I don’t use that word lightly), sodomizing me, and holding a knife to my neck.  Or spine.  He had me get on my hands and knees when he peed, and used one hand to trace the knife along my spine.  But when I got away from him and got to the phone in my neighbor’s apartment to call 911, I became a survivor.  Or at least I had the chance to be a survivor.  It took a while to actually morph into someone who wasn’t defined by what happened that day.  It took a lot of work.   When the parole reviews come up, I feel that ‘victim’ thing all over again, and that makes me feel like I’ve failed at surviving.  But in the end, he doesn’t define me.  He changed a LOT in my life that day, and in many ways my future was murdered.  At least the one I’d dreamed about.  But Carl Edward Chambers, career criminal, doesn’t. Define. Me.

I was able to have a good nursing career until 2004 (and very briefly in 2005) when I became permanently, physically disabled. Twenty years. Too short, but it still mattered.   That was what defined me.  It still does, even this many years after having to stop work.  I will always be an RN, and even though I’ll never use it again, I keep my license active.  I don’t want to say I was an RN.   I AM an RN.  I was raped, but I am a nurse.  I’m a daughter, cousin, niece, and friend.   I was never a wife, mother, or grandmother.   He took that.  But he didn’t take the things that really made my life mean something.  I was able to help people, and show some compassion.  I have been able to answer questions for family and friends who were facing medical challenges or terminal illnesses, and needed someone who they felt was a reliable resource during those chaotic and painful  times in their lives.  That is what defines me.  My mission has been, since the decision to go to nursing school, to be useful to others.  He didn’t change that.

I believe that things happen for a reason.   I also believe that I don’t always have to make sense of the reason… that God has it figured out.  But just maybe He allowed me to be raped because I won’t sit back and do nothing about his parole reviews. Maybe I can help keep someone else from knowing what this is like.  Maybe that is my purpose in this.  The rest is up to those who vote on numbnuts’ parole  status.   At least I know I did what I could.  Sometimes, that has to be enough, but I hope with all I am that his parole is denied.

Rape Reporting… If You Want Justice, You Must Participate and Report It !

This week,  an article about a famous individual who was raped many, many years ago and opted not to report it showed up online.  It came up during a radio interview, and the one who was raped moved the conversation along, not dwelling on it, or even bringing it up intentionally, to begin with.  Then the online comments started flowing about how hard it is to report rape, how bad rape victims are treated, blah, blah, blah.  But, these folks also seem to know  that they’d be treated horribly, even though they never came forward.  That, along with someone who was beating a dead horse, and more of a troll than anything else (I’ll call her ‘Inot’), really got to my belief that if someone wants something to change in their life, or a part of their life, they have to show up and contribute to the process.  For rape, that means going to the police and doing the rape kit at a hospital.

*For the purposes of this blog, I’m referring to females, but there are a LOT of  reported and unreported cases of male rape.  The stigma is even worse for them.  I still encourage them to report the rape/assault to the police, and seek justice.

*My main points refer to “general” rape (stranger/acquainance), one-time attack- which can be minutes to weeks in length (or longer- look at Elizabeth Smart and Jaycee Dugard).

Justice isn’t passive; it requires participation.  Being a survivor, vs. a victim, takes work.  The victim mentality is absolutely repulsive to me.  I don’t have sympathy for those who won’t take part in their own recovery and justice process.  Staying mired in the traumas of the past is as good as that person’s life will ever be- and that’s a choice. That isn’t the responsibility of the one who did the abusing- OR the justice system. That’s on the one who has to go on living.  It requires a lot of work to work through sexual assault and trauma recovery, but the alternative is to go around feeling defined by victimization, stuck in the memories of what happened.  Working through rape doesn’t mean the memories ever go away… it makes it so the attack isn’t the defining event in someone’s life.  Rape doesn’t define survivors.  It defines victims.  And survivors don’t use the rape to manipulate others- whether for pity, a means to be taken care of, or anything else that is age inappropriate, or indicative of regression to an earlier developmental stage.  It isn’t the focal point of the life of a survivor.

Once the man who raped me was no longer ‘in’ me, my survival and recovery were on me.  Not him. Not ‘the system’.  Not the courts.  Because no matter what happened, my life had to go on.  I’m an RN.  I’m a dog owner, a doll artist, a gemstone/mineral collector, a daughter, and many other things.  The rape was 6 hours of my life- that’s it.  With his imprisonment, I became the strong one.  He became the captive.  His parole protests are still hard, but I’m still the one who ‘won’. 

As I’ve blogged before, I was raped for 6 hours at knifepoint in 1987.  I managed to escape when numbnuts fell asleep after  exhausting, constant sexual assault and beating of me.  The police came and shot him in my bedroom, not killing him.  I went through the trial process, and long story short, he’s either in prison (as he is now), or on parole until 2047.  He’s my bitch now.  I showed up to make sure of that, and I was a 23 year old ‘kid’, who had no experience with being vocal about anything to do with sex, or crime.  I wasn’t brave, but I was determined.   I wouldn’t accept the lower number of years offered in the plea bargain that happened mid-trial after I’d testified after 2 hours.  I went ‘all out’ to get the maximum punishment possible.  I could sleep better at night knowing I did all I could to keep him off the streets- for myself, and whoever else he might have gone after, for as long as possible.  He has a very long list of convictions for progressively more violent crimes.

I was treated very well by the police, District Attorney’s office, judge, rape crisis personnel, detectives, people at the hospital, and pretty much everyone but my employer at the time (being off work as an RN is very much frowned upon, and they actually “encouraged my resignation” about 2 weeks before the trial, because I was distracted – ya think?- … so sweet of them).  My apartment complex also tried to bill me for the damage to the sliding glass door in my bedroom, as well as the carpet, from the shooting (bullet damage and blood).  Otherwise, the actual people in the legal process were extremely compassionate.   In 1987, in good-ol’-boy Texas.  And things are improving all the time..

For those who don’t report rape, that’s their decision.  I get it.  It’s not an easy thing to discuss, and while I disagree with that decision to let someone stay on the street to rape someone else, I know it’s  ultimately their  decision.  But then they have no room to whine about the system, or how rape victims are treated (since they have no clue).  IF someone wants ‘the system’ to treat rape victims better (but hasn’t gone through the process to actually know what that is), they have to show up and report what was done to them.  Show up or shut up.  Get some help in making that decision if needed. Rape crisis centers have hotlines, and trained folks to help with these things- they’re free, and available 24/7.

There are situations that make it more difficult to report…

For those who were raped by people in their families (no matter how often), or friends they’d known for a long time, it’s more difficult. I understand that.  I’d encourage them to report the situation as soon as possible.   Someone can call a local rape crisis center to find out where to go for kit collection, without naming names at the time, and to get some counseling for the violation aspect of what happened.

For children, it’s even more difficult- especially if they don’t tell their parent/ guardian because of threats or fear.  But if a parent knows about incest or non-familial sexual assault, it’s really not a favor to the child to try and pretend it didn’t happen (think future addict to numb the pain of the memories).  Rape crisis centers can also help with kids.  And if you know your kid was molested by someone you know, don’t make the kid see them socially.  I’m not sure what could make someone want contact with their child’s molester, but I’ve heard about it repeatedly.  That in itself is abuse, and continues the pain.

No matter when someone is sexually assaulted, their life changes.  If they don’t deal with it, it can become a chronic ‘victim mentality’, and the chances of meaningful recovery dwindle, and increase the risk of drug/alcohol addiction.  That healing process starts when someone seeks justice, and deals with the emotional and physical violation.  There are statutes of limitations on rape… it differs by state, as well as when it happened (i.e. if someone was raped as a child, but doesn’t disclose it until they’re 18, the clock starts then, I believe; each state is different there, as well).  But, at least for now, there comes a time when the rape can’t be prosecuted.  Better to deal with things sooner than later, whenever possible, before the choice is taken away in an already “powerless” situation.

For someone in a domestic violence situation, it’s even trickier.  There can be threats that are very real  if the victim has been physically injured before by the perpetrator.   My suggestion to someone in that situation would be to do as much documentation as possible, including photos, and keeping any clothing that they’re wearing in the photos, to at least have something if they report the crime later.  Having a trusted friend keep the evidence, so it’s not discovered by the perpetrator, might also be something to consider. Obviously, the best scenario is to get away from the abuser and report it immediately to police, for collection of evidence (rape kit) ASAP.   But, I understand that sadly there are  situations when someone’s safety after the rape might be even worse than during it.  Safety is always the priority.  Domestic violence shelters can be a resource, knowing that getting away is a delicate process.  They can offer support and advice.

The military and university campuses have notoriously been lousy at listening to someone who makes accusations of sexual assault.  They’re getting better, but it’s not great yet- but those who have been assaulted still need to TRY !  If you don’t do anything, you’ll get nothing in terms of help- or improvements in how cases are handled. 

The rape kit isn’t horrible.  It’s not painful- but does require some intrusive things that can be very hard after being violated.  But it’s one of the best ways to convict someone.  Now, with DNA, a rape kit can link other rapes, and get serial rapists off the streets (think if someone had done that and gotten your rapist convicted before he got to you).  Mostly, it’s swabbing the mouth, vulva, anal area, collecting hairs, trimming fingernails, and taking photos of any injuries.  That can be very daunting after something so traumatic, but it doesn’t take that long, and HELPS the police when a suspect is found.  It will prove what happened, in terms of the physical contact.  Knowing the purpose of the kit made it easier to tolerate for me.  There are backlogs of kits that haven’t been tested, but the more information someone has to give police (including the information in a rape kit), the faster they can find a suspect.  There are many states that are making rape kit testing more of a priority.    You might also be fingerprinted, to corroborate who touched what and when.  It’s not to make you ‘complicit’ in the rape, but to clarify what is going on with the evidence.  I had to do that, and it was just to see if my fingerprints were on some of the things used to penetrate me (they weren’t).  They must have the evidence to make sure the chance of conviction is as good as possible.

Dealing with the detectives was sort of hard for me initially, but not because of them.  It was only 6-7 hours after I’d gotten free, and I was still a little shocky.  But they made it as tolerable as possible, and had me come back the next day to finish when I was getting sort of punchy from being exhausted and overwhelmed. It required detailed descriptions of what happened. I talked with two male detectives, and that wasn’t an issue, as I knew they had a job to do. They were very professional, and I had a female friend or rape crisis volunteer with me.   It was not easy to talk about what happened.  My fervent belief that reporting rape is necessary isn’t in any way to say that it’s easy.   But for the type of justice I wanted  (lengthy imprisonment), it was what I had to do.  I had to know that I’d done all I could to prevent him from hurting someone else- and to keep him locked up for what he did to me.  He’d been on parole when he raped me, after being in prison for attacking someone at a bus stop with a screwdriver.  His violence was escalating.

As I’ve said in other blogs, it’s not a bad idea to have a mental plan of what you will do in the event you are attacked.  Survival is the first priority, and sometimes that means dealing with being violated.  I made it clear that I wasn’t consenting to anything, but complied purely to avoid physical injury.  I had to make a calculated decision when I escaped.  It took 6 hours for him to not have the knife at my neck or my body.  Even when he peed, he had me on all fours, tracing the blade on my spine.  You have to stay alive in order to survive.  Do whatever it takes to stay alive.

After an attack, the priority shifts to getting medical attention, and hopefully, reporting the rape, and participating in the legal process.  Have a mental list of who you would call in such a situation.  DO NOT wash or shower after the attack.  Save clothing and anything the attacker touched or left saliva on (even your face or other parts of your body).  If you are bleeding, take off the underwear you were wearing during the attack, and put it in a bag to take to the police/hospital. Put on clean underwear without washing/wiping your vulva/anus/ perineum (area between the anus and vulva), and a pad- not a tampon.  Do not brush your teeth.  If he kissed you, make sure you don’t wash those areas of your body.  They will be swabbed.  In short, don’t do anything that could remove body fluids before getting help.  You will have a chance to shower- as long as you want- after the exam.   It’s a small price to pay for increasing the odds of catching the jerk.  If a lot of things happened in your home, there is a chance that it will be sealed as a crime scene- so know where or who  you can stay with for a few days.  (I ended up with a friend/co-worker I trusted for a week).

Reporting rape can sound overwhelmingly frightening.  There have been stories of victims not being believed, stupid and hurtful things being said to them, and other dismissive and inappropriate actions.  That isn’t everywhere.  More education about sexual assault has been done in police departments for years.  I’m an example of someone who was treated very well, nearly 30 years ago.  Nobody deserves to be raped.  Everybody deserves justice- but that involves coming forward and reporting the assault.  It’s not easy, but in the end, there is such a sense of getting some sort of justice, and relief.   For those who choose not to report, for whatever reasons, please reconsider (for some, that means when it’s safe to do so).  If you don’t report, don’t complain about the way rape victims are treated, or ‘the system’.  Even if someone you know was treated badly, everyone is different- and every case is different (not to excuse being treated poorly at all- but it’s not a sure thing that it will be the same for you).  The only rape that applies to you is the one that happened to you. 

Rape victims stay stuck in the past in a self-defeating way.  Rape survivors work to put the rape in perspective, and don’t let the rape define who they are.

 

 

I Just Need To Write…

It’s been a weird few weeks in a lot of ways, and I’ve been exhausted.  Today when I woke up, I got the message from one of my cousins that her dad (my late mother’s brother) had passed away.  He’d been sick for a relatively short period of time (well, that we know of- he hadn’t been to a doctor in almost 60 years), and was diagnosed with end stage esophageal cancer.  He was getting it treated, and long story short, they found him very early this morning just before his heart stopped.

I have so many emotions going through my mind.  First, I feel for my cousins, their spouses, and assorted grandkids and great-grandkids.  Their dad had never been easy to deal with, but he was the only dad/in-law/grandfather on that side that they’d known.  It’s a loss, regardless of how close they’d been, or what he’d been like to them over the years.  There is no chance for  additional healing at this point, with him directly.  They can only fish through their own memories and pain, and figure out how to remember him over the long run.  It might be easier to deal with anger now, but there will still be some degree of the type of pain that comes from a little kid who lost their daddy- even if it comes out sideways. The only dad they knew is gone.

I feel sad for my uncle, that he created his world in the way that he did.  He and my mom were siblings.  My mom also had multiple sites of cancer, and while she beat it, the radiation to her brain left her demented for the last 10 years of her life.  She wasn’t mean or unkind (most of the time), but before her cancer, when I was a kid, she  was hard to ‘read’ – and that was very hard as a kid to figure out. I didn’t know if she liked me, and sometimes she was unkind (though I don’t think she always meant it to be that way), and it took until my 30s to figure out that it had nothing to do with me… she was wounded in some ways that I knew about, and undoubtedly in ways I had no clue about.  Their mom was orphaned at age 6, and she had her issues with attachment (that she talked to me about- not just me speculating), which didn’t help with being a mom to her four kids- though her issues were more with ‘omission’ than ‘commission’…she was afraid to lose more people, and didn’t want to get too close.  She turned 100 years old two days ago… and today she will find out that she’s outlived a second ‘child’.

It’s sad that my uncle  pushed people away by bullying them (that was when he was being kind).  And at other times, he was very generous in hosting family reunions that were no easy or inexpensive tasks.  There were a lot of us roaming, eating, and talking through a full weekend.  Sure, some of it was to show off his home (which is very nice), but he didn’t have to do it.   I ended contact with him when he lied about a conversation that was deeply hurtful, and he called me ‘human debris’, and said he was ashamed to be my uncle.  Fine.  No more relationship.  End of story; I won’t stay through that sort of thing  (and that was a drop in the bucket compared to being raised by him),  though I did e-mail him when I found out about his illness to let him know I’d be praying for him, and if he had any questions I could help with as an RN, I was available.  I’m not sure if he answered back, or someone else did, but I got a reply.   I know I can feel OK in that I reached out.  But I’m still really sad that he died.  Mostly because he left so much unfinished business with his kids and surviving siblings.  I feel so badly for them.  None of them ever did anything to warrant the way he treated them.

In general, to folks who have pushed people away by being abusive jerks, fix it before your time is up (which could be anytime, we are never guaranteed a tomorrow).  Understand that your interactions mean something, and leave lasting impressions and scars.  The world isn’t all about you, but how you either add to it, or make things worse for others.  For those who are afraid to lose someone, so you keep people at an arm’s distance, know that you also have an impact on those around you, especially if you have kids.

For those who have been hurt by someone close, especially as a kid, know that it wasn’t about you.  It was the one who caused pain who had the problem.  You may have gotten the brunt of their character defects, but it  shows that they are damaged- it would have been anyone there at the same time if it wasn’t you.  Yeah, it hurts, is maddening, and feels very personal… but for someone who is incapable of functional, healthy relationships, it’s all they can pull off in life, and that is pathetic.  I’m not saying to not feel what you feel… I’m saying it’s not about you.   I had to figure that out before I moved back to my home town to help take care of my mom.  IF I hadn’t figured that out, I’d still be living 1250 miles away (where I’d been for 17 years).  In the years I’ve been an RN (since 1985, though disabled in the last several years), I’ve seen a lot of families’ pain that really stemmed from the hurtful one not being able to give what the others needed.  There were some who were outright sociopaths, but most were situations where the damaged ones didn’t know any other ways to interact.  It was the best they could do, and/or had no clue on how they were hurting people.  Absolutely no insight about their impact on others. It was their normal.

My uncle is dead.  My cousins are having to deal with whatever ways they grieve.  My grandmother lost another child.  My surviving aunt and uncle lost a brother- another sibling.  But, I think saddest of all, the chance for reconciliation and building good memories is gone for all of them.  I’m still reeling from three very significant deaths this year in my family (on the other side), and while my relationship with this uncle was purposely estranged to not get any more of his crap, I still feel badly.  I remember him  when I was a kid, when we got together (and I’m guessing he was on his best behavior), and it was good.   His wife/my aunt (who passed away several years ago) was  a bright part of my life.  It’s hard to explain, but it’s kind of like him dying takes away more of her.

I’m rambling… just be decent to each other, and don’t let relationships erode because of ego or general apathy about how interactions can be so deeply scaring.  Reach out, and try to make things right.  Don’t be someone who others want to stay away from.  Know that at the end of the day, you didn’t do anything to hurt another person.  Especially family.  Truly be able to rest in peace whenever your time is up.

If my uncle were here, I’d say “I wish we’d had a better relationship during these last several years, but I’d never wish anything bad on you.  Nobody deserves to have a painful death, or to have to deal with cancer.  I just wish I knew what made you OK with treating people how you did.  I have a feeling I’d be more sympathetic than angry, since you and my mom came from the same family.  Regardless of anything else, you were still my uncle.” 

To my cousins, aunt, and uncle (grandma isn’t online)…. I’m SO sorry.  I’m sure his death hurts in a lot of ways.

Pain Management for the Non-addicted

Hydrocodone (Norco, Lortab, and Vicodin’s main ingredient) has been in the news a lot in the last few months.  People are dying from overdoses.  While that is very sad, it has created mayhem for those who take meds as directed.  Those who follow the rules are being ‘punished’ because of the actions of those who don’t (yes, I believe addiction is a disease, but there is a point in the beginning where using chemicals is a choice; genetics is said to load the gun, circumstance pulls the trigger, and the addict *at first* has their finger on the trigger… addiction doesn’t happen at literal gunpoint).

Hydrocodone has been moved from a schedule III to a schedule II.  That means that any refills must have a paper prescription- no getting phoned in refills.  Those with chronic pain must now go to the MD office and get the piece of paper to take to the pharmacy, then wait for the prescription to be filled, and then go back home.  That is ludicrous when someone hurts so much that leaving home for anything is painful.  My spine is collapsing, my discs are degrading, my thighs are shrinking from neuropathy, and I’ve got fibromyalgia.  I also have chronic headaches.  I’m in a lot of pain, more days than not. I don’t remember ‘pain-free’.   And now, I have to deal with the actions of people I have never met who have emotional issues that they use drugs I need to squelch.  Those people are now dictating my medical care.

Less than %6 of those who are prescribed opiates who TAKE THEM AS PRESCRIBED ever become addicted (Google it).  So, %94+ of those who need pain meds for chronic conditions are now subject to stricter rules because of those who use them for psychological reasons/pain.  I’ve had a prescription for one form of narcotic or another for almost 20 years.  I might take the meds for a few days and then take none for a couple of weeks.   I might take one pill on those days, or I might take two or three across the 24-hour period.  Depending on the type of pain I’m having, an extra gabapentin (seizure med also used in pain control) or even Excedrin will work better than the opiate.  Depending on the headache type, a triptan works much better than an opiate.  But on those days when narcotics are the only thing that will make it worth taking another breath so I can remind myself that it will ease up at some point, I shouldn’t have to pay for what an addict is doing.

Addicts are going to get their opiates (if that’s their drug of choice) no matter what.  I see this change in ‘rules’ driving more people to use herion or other illegally obtained drugs, and anticipate notable jumps in heroin deaths and overdoses over the next few years.  I already know of an entire medical group’s practice (for one entire hospital system here) that no longer allows primary care docs to prescribe pain meds because of this new change in the law (doctors already are monitored for how many prescriptions they write for narcotics, how many pills they give at a time, etc).  So the doc who knows the patient the best isn’t allowed to determine what is best for him/her.

My primary care doc  initially wasn’t comfortable in prescribing stronger  opiates when regular Vicodin (hydrocodone 5mg w/ acetaminophen 500mg) wasn’t working (after the discontinuation of Darvocet, which was effective), so I went to see a board certified pain management doctor.  Once I had a ‘system’ of what med to use when, she was then OK with prescribing, so I could have one doctor prescribing the vast majority of my prescriptions (my neurologist is the only other one), using one local pharmacy, and one mail-order pharmacy.

I have worked as a detox RN in a treatment center.  I ‘get’ that drug addiction is a disease.  I have a great deal of empathy for those who are in treatment and making positive changes in their lives.  But their inability to handle meds should not determine my medical care.  What someone else can’t control shouldn’t create issues for MY doctor when I am able to take meds as prescribed, and have for two decades (for chronic pain).  Acetaminophen (Tylenol) is the leading cause of liver failure in this country…. why isn’t that scheduled (or withdrawn from the market)?  Alcohol-related deaths can take out entire families at a time w/drunk driving- should we have licenses for buying booze?  Why are those with legitimate, documented medical disorders that cause pain made to ‘pay’ for those who don’t use the meds as directed?

My primary care doc and pain management doc (who I only see sporadically at this point) know me better than the DEA does.  My pharmacist can vouch for no hinky requests for refills.  I’ve never shown up in an ER asking for pain meds.  I don’t crave narcotics.  I don’t take larger doses, or more frequent doses than are prescribed.  I follow the rules.  And now, especially with winter approaching, I will have to go pick up a piece of paper (getting in and out of the car is painful in the summer, let alone the cold) which, until October 6,2014, was done by phone between pharmacy and the doc’s office.  I had to go every three months to be re-evaluated (which still stands), which isn’t a bad thing.  I don’t think pain meds should be thrown around as if they are insignificant… but  addiction isn’t my problem.  Pain is.  There is a huge difference.  I don’t even let myself get to the point of physical tolerance (when someone takes something as prescribed, and the body becomes used to it being there… withdrawal symptoms can happen if the med is abruptly stopped- and that is not the same as addiction).  There is a gross lack of awareness between addiction, dependence, abuse, and tolerance- and I think that applies to policy-makers as well.

No law is going to save people from themselves if they either don’t want to be saved, or don’t see that they have a problem.  They might not ‘get it’ on the first run through rehab or 12-step meetings… but those who keep at recovery will eventually get there, and be clean.

 

For those who are now in a position of not having a physician who will prescribe pain meds (whether from fear, ignorance, or restrictions from his/her employer- you may not know why they have changed their policies), here are some tips from an RN of nearly 30 years, who has taken care of addicts, chronic pain patients, and lives with chronic pain:

1.  See ONLY a board certified pain management doctor for pain control.  They often have ‘rules’ such as random drug screens, no dosage change over the phone, limits as to how many months before actually making an in-person appointment (vs. picking up the prescription from the desk), etc. Do NOT see a doc who asks how you will pay, writes a prescription, and has a line around the block…. Do. Not. Go. There.   :o

2.  Use only one pharmacy (two ONLY if you also get meds from a mail-order pharmacy for other chronic conditions).  Let your doctors know which pharmacy you use, and offer to get copies of records if they want them.  Pharmacies are bound by HIPAA (privacy laws), and might not be able to tell the doc asking what other docs have prescribed (if someone from the same practice is on call, they probably can, since they are acting on your regular doc’s behalf for you).

3.  Don’t dramatize pain.  Tell the doctor where the pain is, how bad it is, when it is better, when it is worse, what helps, and what makes it escalate.  You may have pain for the rest of your life- don’t wear out the extreme descriptions when you have 30-65 or more years to describe it.  Sometimes letting your doctor know what the pain keeps you from doing is helpful…. those pain scales are kind of useless for chronic pain.  But, if you tell your doctor that when it’s moderate, you have to postpone laundry, or if it’s moderately severe, you have to cancel appointments, that can give better information for chronic pain.  It’s way different than acute pain.

4.  Agree to get tests done to more clearly identify what is causing pain.  If you refuse to get diagnostic tests done, that can indicate that you know that nothing is going to show up.  Not all disorders show up on tests, but working with your doctor when they want more information via testing will go a long way.

5.  NEVER change doses or frequency without talking to the doctor who prescribed the pain meds (or any meds, for that matter), unless you have been given specific instructions.   There are some pain meds that have a very narrow window between effective dose and the dose that will cause you to stop breathing.

6.   Don’t ever forget the good parts of your life.  You are not defined by your pain or any other medical conditions.  You decide if you are happy or not.  You decide if you focus on nothing else.  I know that there are days (and sometimes weeks) when you really can’t focus on anything else for much of the time… but when you can, take advantage of those days and be thankful for your pets, family, friends, the ability  to still work (I’d give just about anything to still be working as an RN), your interests, etc.  Your attitude is completely in your control, even if nothing else seems to be.   ;)  <3

Triggered ER Memories…

I got a canned e-mail from my dad’s medical provider, asking for one of those Press-Ganey surveys to be filled out.   I don’t do those.   They’re a colossal waste of time, and the results are used ‘against’ nurses in ways that are demeaning of the job. They’re a popularity contest for healthcare. Nurses aren’t concierge staff… they’re there primarily to give medical care.  Not have to be subjected to some very fortunate person complaining about not getting coffee ‘sooner’, totally oblivious to the reason it was ‘late’ was that the nurse was doing CPR on someone two doors down.   Anyway, it got me all stirred up, and I wrote the following before seeing that it was a ‘no-reply’ e-mail.  Sneaky them :p

–I’m xxxxx’s DPOAH, and deal with all of his e-mail (I’m his daughter- and a disabled RN). He is pleased with his care w/Dr. Kxxx- no issues whatsoever. I go to some appointments with dad, and also have Dr. Kxxx as an oncologist- great folks in the office area, lab draw folks, and Dr. Kxxx himself. Couldn’t get much better.

As an RN (I still keep my license), I have a general loathing for Press-Ganey, since it doesn’t consider all factors in someone’s care (especially inpatient- like if someone complains about their coffee request being slow to be delivered, while the nurse is tending to someone who is either trying to die, or has coded somewhere down the hall). Totally bogus complaint in the GRAND SCHEME of things… our society is too much about “me”, and not about the entire picture.

IF there are issues, I have no problem contacting the hospital directly. It’s really none of Press-Ganey’s business in my opinion. If you can tell me why their butting in is so important, I’m teachable !

I do have some compliments regarding a couple of tests I had a week or two ago. I had a abdominal and pelvic CT w/contrast and a CXR. The nurse and techs in both departments were outstanding. Lisa and Shannon were in the CT department- both very personable, friendly, and gave great instructions. They had the perfect balance between respecting my knowledge as an RN since 1985, as well as informing me of what was going on (and what needed to happen since I’m on metformin- and getting a follow-up creatinine done 2 days later). Lynette was in x-ray, and came SO quickly to get me for the CXR- very professional as well, and also kind. They made the inconvenience of having to drag my ratty body away from home much less unpleasant. My overall experiences in the outpatient/testing departments have always been good- every last person has been pleasant and professional. I didn’t feel like they were trying to suck up, so that Press-Ganey would be happy… they were genuinely doing a nice job.

I have had my share of nightmares in the ER there…

I haven’t been to that ER in a several years- so this might be outdated (wanna be fair). My experiences there in the early to mid-2000s were horrific. I was considered a ‘frequent flyer’, though many times, someone else called 911 because I’d lost consciousness (I have dysautonomia and documented epilepsy among other things). I could give you a laundry list of abuses and negligence in that place. Maybe it’s better now- I hope so. When I got there because I had actually been awake enough to call for help, I was following my MD’s instructions for when to get help (my blood pressure would drop into the 50s systolically- and it wasn’t safe to NOT get help when just lying down wouldn’t do anything). I still was verbally demeaned- for following my doctor’s instructions.  It’s so important for those in the ER to know that just because THEY aren’t familiar with a diagnosis doesn’t mean that it’s automatically some psych disorder, and they don’t know everything about the person, just because they have some vague medical info on them.  I never asked for pain meds, never had a squadron of unruly family around (never had ANYONE around), never even asked for help to the bathroom- which was partly because the call-light was nowhere to be seen, etc. I was told I was a “wasted bed”, and that “seizure patients never follow up”; (I actually had monthly appointments with my doctor at that time because things were so unstable). It got so bad that I learned to put in my own small gauge NG tube and put in 1/2 strength Gatorade by gravity, to increase my fluids- and take my chances at home. My doc  wasn’t thrilled with that (but I know how to manage an NG safely)- yet she knew what had gone on in the ER from what another doc had told her (he was one of the few nice docs). It’s amazing what medical equipment was available on eBay back then.

On April 1, 2007, I was brought in (BP dropped again), and by the time I got there, with the jostling around, it was better, but I still didn’t feel right… I had had a few weeks of weird symptoms that weren’t quite my ‘normal’ weird. The doc on that night actually refused to examine me. He wouldn’t repeat the BP (meant pushing a button- and he didn’t even have to do that; a nurse was near the monitor). I continued to have odd symptoms after being sent home, and eventually had substernal chest pain radiating into my neck. On April 11, I called my doc’s office and was told to go to a different hospital,  and tell them about the chest pain; THEY would take care of me. Tests showed that  I had multiple chronic, sub-acute, and acute PEs in all three lobes of my right lung and R PA (pulmonary artery). I spent 17 days in the hospital getting regulated on warfarin. The chest pain was from my lung pushing into the apex of my heart. That ER doc’s personal ASSUMPTIONS  at St. Xxxx’s could have cost me my life. As it turned out, it was ‘just’ another blow to my feelings as a sub-human. I didn’t have the typical PE symptoms until the 11th (actually the night before- but I wanted to talk to my doc about what to do since going to St. Xxxx’s ER was just a set-up to be blown off and humiliated).  And the doc didn’t bother to see WHY I’d been there “too much” (his words) in the prior couple of weeks.

Being considered a psych case, I was sent home unable to walk one time- crawled into the cab, then crawled to my front door. Another time, I was put in a wheelchair van, and sent home- if I needed a wheelchair to go home, how was I supposed to manage at home. Alone. ?  One doc began to intubate me without checking to see if I was even awake (I was- I’d just regained consciousness, and saw him walk in the room- alone, no help for suctioning, no meds for a genuine intubation, no indication of what he was going to do)…. he knicked a tonsil going in, cutting it, and setting off my gag reflex- so then I was vomiting blood. A nurse came in, and he eventually pulled the laryngoscope out. He asked me if I’d OD’d (a common assumption- though no drug tests were ever positive), and I said no. He told me that’s all I had to say… he never asked me anything!  I didn’t know what he was going to do (he was behind my head- my eyes back there don’t work well). Then left the room. I was so embarrassed to have vomited- but I guess they call it a gag reflex for a reason.  That nurse was very kind as she helped me get cleaned up… she must have been new.

A nurse put a Foley in one time (I’d lost consciousness at a neighbor’s home, and she’d called 911… I’d had no presyncopal feeling -which I generally did- just awake one minute, and about 3 hours later waking up in the ER). The nurse blew up the catheter balloon up ON my internal sphincter. I said it hurt, and was trying to tell her it hurt WAY more than it should- and she turned around and walked out of the room. She just left.  Absolutely no acknowledgment of what I was saying, yet she was looking at me; she heard me, and saw me trying to move the catheter.  I managed to push it in far enough to actually be in my bladder.  It took 4 liters of fluid to get my systolic BP to hit 80…. I was sent to ICU, and just managed to avoid dopamine (which could have been a disaster for someone with dysautonomia).  I was admitted as an OD– yet NO drug screens  EVER showed any type of drugs.  Really?  Even with evidence, I was still some loathed OD patient?  My doc came to see me the next morning, and told me she’d see if she could enter a note to negate the OD diagnosis.

These are a few things that I will probably never forget… and the ER at St. Xxxx’s still scares me. I sent a few letters to the customer service person (whatever they’re called) at the time, and got the canned letter of ‘we strive for excellence in patient care’, blah, blah, blah. Nothing ever changed, because I was seen as a nut job. NO psych history, no drug abuse, no ODs, nothing psych related at all. Just judgmental nurses and docs who saw me too often for their liking. I (me, myself- no doctor) eventually figured out a medication interaction that was contributing to some of the BP issues (the dysautonomia won’t ever go away- but it helps to not have interactions messing with it). I also started going to another ER if I had stuff going on that required an ER (after the PEs, there were some other incidents of chest discomfort/SOB, as well as hematuria one time, requiring some IM vitamin K, and an overnight stay for a couple of tests and IV antibiotics for a UTI). I’m lucky I went there when I was having symptoms that were eventually diagnosed as AML- subtype M3 (APL). I was there for 6 weeks in isolation, induction chemo, and started 19 months of daily chemo of some type (except for ‘scheduled breaks’ and when I had shingles on my butt). I don’t have confidence that St. Xxxx ER docs would have bothered to check things out. And, I could have ended up like Jeannie Hayes- the WREX anchor who died 2 days after officially being diagnosed, after a brain bleed.

As an RN, I know that some patients are annoying, but that doesn’t mean that there isn’t some genuine medical issue going on as well. I did my best to not bother the ER staff. I did anything they asked of me while I was there. Most of the time, I didn’t make the call to be sent there, and when I did, it was because of my personal doc’s parameters. Nobody deserves to be treated like they’re a crazy HUMAN being, and waste of time. I think some of it is the age of many of the newer nurses, and the overall mentality that ‘work’ is a destination, not a verb. I don’t remember a single nasty tech, lab person, etc… it was always the docs and nurses…. very sad.  And even if I HAD been someone with some psychiatric issues, does that mean that subhuman care is justified?   People ask why those who do have mental health issues don’t get help… I can guess part of the reason.  The humiliation isn’t worth it. 

Anyway, I’m sure this is more than you wanted to hear. I don’t do Press-Ganey, since they don’t address issues I’ve had. They run a popularity contest, and I’m not interested in those.

Have an enjoyable week, and maybe remind the ER staff that they know nothing of the patients’ entire lives… they see a snapshot of a bad time. And regardless, they still don’t deserve to be belittled, or even physically injured because of their prejudice and assumptions.—-  (end of ‘note’)

ER staff gets very little information about a patient’s entire life- or even enough to make a true assessment (or judgement) about the person.  They see symptoms and test results, and whether or not they like the ‘diagnosis’ of patient who is before them.  It’s unprofessional and abusive to not treat someone with compassion.  If it was their family member being talked to in the same manner, they’d be outraged- yet they feel it’s OK to do it to strangers.   I realize that there are some amazing, compassionate emergency rooms out there, with incredibly kind and patient staff nurses and doctors.  I commend them.  They have to deal with whatever walks in the door- and that has to be difficult.

IF it becomes so easy to judge an entire person on a diagnosis (and be less than humane), it’s time to find a new job, or another area of medicine to work in… maybe the morgue.   ;)