Jeanne Hyatt is 56-years old and lives in Florida. On the outside, she looks like any other normal, healthy person. She could be your aunt, your next door neighbor or one of the ladies in the garden club.
Things are not always what they seem however; Jeanne is not healthy. She has an extensive medical history which includes fibromyalgia, chronic fatigue syndrome and chronic bursitis in both of her hips, which requires the use of a cane when she walks. Jeanne also suffered a severe case of endometriosis, which resulted in infertility and four laparoscopy surgeries. She was hospitalized with her neck in traction for a week due to an automobile accident, and was stung on her left foot by a sting ray two years ago and still experiences pain in that foot.
Jeanne also has a condition called neurally mediated hypotension, which is known as “the fainting reflex.” It occurs when there is a miscommunication between the heart and the brain that causes an abnormally low blood volume in the heart’s ventricle. This causes a sudden drop in blood pressure which drains the body and the brain of energy. Because of this, Jeanne suffers with frequent dizziness, sometimes passing out, and this condition affects her vision and causes extreme fatigue. She has severe insomnia too.
“I wake up every morning in pain. It feels like I was just run over by a steam roller or like someone beat me up,” Jeanne told me. “It’s not in any one area, but over my entire body. Everything hurts.
“It’s mostly muscle-type aches but it is also joint aches and sharp pains over my whole body; like little lasers are attacking me, sometimes in my shoulders, sometimes in my hands, my legs, my arms, neck, every place imaginable on the body, constantly throughout the day. It never stops or goes away. It’s relentless.”
Even menial tasks such as folding a load of laundry or going to the grocery store leaves Jeanne’s muscles aching and forces her to be bedridden, sometimes for several days. She has to do simple things like bathing and getting dressed in increments, resting after each task is complete before attempting another one. Vacuuming her small apartment puts her in bed for a week. Everyday things that most take for granted are torturous for her.
Florida’s Pharmacy Crawl
Some would say Jeanne has endured a long streak of bad luck. Since the state of Florida initiated a war on drugs, that streak continues to plague her every single month.
Earlier this year the pain management and internal medicine doctor Jeanne had been seeing for six years sent her a letter stating that he had decided to stop seeing all chronic pain patients and would no longer be prescribing pain relievers because of increased pressure on doctors in the state.
Jeanne started going into withdrawal and had to quickly find another physician willing to treat her. One doctor gave her a 7-day supply of medication to buy her some time. She had to go back for an additional 3-day supply in order to make it to her appointment with a new pain management doctor.
A few months ago, the local CVS that she had used for two years stopped stocking her medication, forcing her to do the “pharmacy crawl” each month. Some CVS stores in Florida have gone so far as to blacklist certain doctors, making it against company policy to fill any prescription for pain medications from these doctors, although the criteria they are using to determine which doctors to include is not clear.
Every month Jeanne has to travel to five or more pharmacies to find one willing to fill her prescription. She says she gets conflicting information, strange and disparaging looks from pharmacy staff, and feels like she’s being looked at as a drug abuser.
Legitimate Prescriptions Not Being Filled
There is no doubt that pharmacies have to be more cautious than ever before, because of the way things have escalated, and they now feel they have to police every prescription that comes through the door. What they don’t take into consideration however, is that while they are stopping addicts from obtaining these medications, the pendulum has swung too far and they are now preventing legitimate patients from receiving the medications too.
Many patients are being forced into withdrawal, having to endure brutal symptoms, sometimes for months at a time. There is no balance.
I was led to a website recently, where pharmacists discuss the “proper verbiage when refusing to fill a C2 (Schedule II narcotic) medication.” On this website, it is clear that some pharmacists are uncomfortable with the situation they’ve been put in, and seem to be concerned about the patients’ well-being. Others seem to have an antagonistic attitude toward patients, based solely on what medication is written on their prescription and nothing else. Several of them admit to lying to patients to avoid having to fill their prescriptions.
While pharmacists do have the right, and a duty to refuse to fill any prescription they deem questionable, one has to wonder how they can justify the number of prescriptions they are refusing to fill on a daily basis as ethical.
The state of Florida started a program in 2009 called the Florida Online Reporting of Controlled Substances Evaluation program or E-FORCSE. The purpose of the program is to prevent doctor and pharmacy shopping. What is happening instead, just as Jeanne Hyatt explained, is that pharmacies are causing pharmacy shopping by refusing to fill legitimate prescriptions. In some cases, pharmacists aren’t even checking the database. I’ve seen it firsthand. I’ve had several pharmacists look at what is written on my prescription and hand it back to me, saying they can’t fill it, without going anywhere near a computer. Other patients report the same kind of treatment.
Jeanne expressed her frustration recently when she was interviewed by the ABC affiliate in Tampa and asked, “What state, what country do I need to move to in order to have pain relief?”
That is a question that many Floridians are asking.
Editor’s Note: Mary Maston suffers from a rare, congenital kidney disease called Medullary Sponge Kidney or MSK. She is an advocate for other MSK patients and others in chronic pain.
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