Opioid Use Increases

Sadly, due to COVID, public health and those handling treatment programs seen an increase in opioid use and overdoses. During quarantine help was hard to get to and the help was working from home. Slowing public health and treatment programs opened back up but not after hundreds and thousands have died.

I've written before about the elderly and opioid use. When the shut down happened things switched over to a technology based system for meetings, appointments, delivery of healthcare, etc. Many elderly don't have the technology abilities. Not only are the elderly faced with COVID death possibilities but now with medication issues. 

As time goes on I think we'll see a spike in drug overdoses not only due to illegal opioids but due to prescribed medications in elderly who are not being managed during the pandemic. Keep an eye on your elderly population and offer help. Reach out with support in anyway possible. 

Weighing in on dementia...

Opiate abuse in elderly can also react and be diagnosed by emergency room physicians as dementia. Elderly have a tendency to have problems properly taking life sustaining medications but often abuse PRN medications such as pain killers. Elderly are often over medicated with pain killers that provides a sleep aid. Other elderly abuse their pain killer because some are good sleep aids. Many elderly then forget what they have taken.  Normal pain becomes pain they believe can be rid of through more pills. When they run out of pain killers they tend to take OTC pain killers and sleep aids. This combination then can provide an overdose of medications. Overdose symptoms are confusion, hostility, aggression, and fantom pain to name a few. ER physicians diagnose symptoms as dementia. Law enforcement chaulk up the actions of elderly to "old age" when actually the elder may have caused an accident or broke a traffic law under the influence of a substance.  Families must get beyond the age appropriate addiction thinking; believe and understand that addictions can happen to anyone, any age.

A romantic encounter

            Dina shut off the light to the exam room leaving just the faint light of her eye chart glowing.  Craig was sitting in the exam chair as asked upon entering the room.  ‘Darn was he gorgeous’, Dina thought to herself.  Dina noticed his eyes, of course, when she first glanced at him in the waiting room earlier.  She noticed how very green and sensual his eyes were.

            Dina went through the normal exam of determining Craig’s ability to see near and far.  She knew the best was yet to come.  The process of looking deep into one’s eye was her favorite.  She could tell so much from this part of the exam.

            Dina guided Craig’s chin firmly up against the tonometer, a machine to check for glaucoma, briefly touching his cheek with her finger tips.  She felt him shiver.  Deep into his eye Dina noticed a very unusual pattern, a pattern similar to a spider web.  She was fascinated.  Dina’s knee bumped Craig’s by accident as she adjusted her equipment.  She noticed that her handheld magnifying piece dropped and landed in Craig’s lap at his crotch.  They both suddenly looked at each other, Craig appearing embarrassed.  Thank goodness he couldn’t see the color of Dina’s face clearly in the dim light or the excitement her body displayed.

            She didn’t know what was happening but Dina wanted this man.  She had never felt this way before, especially about a patient.  ‘Snap out of it,’ Dina told herself.  She could smell Craig’s aftershave, or maybe it was his cologne.  It didn’t matter.  Whatever it was Dina would love to drop him here and now to do unmentionables.

            There it was; the disease starring her in the eye.  Craig’s ophthalmologist was spot on.  There was definitely a change in the pressure within Craig’s eye; a clear sign of something more serious. 

            “More testing is needed Craig in order to further understand what is going on with your eyesight.  I’ll set you up with a dye injection at Boston Regional.  This test will allow us to further access what’s going on,” Dina explained.

            “I’m leaving tomorrow,” Craig replied.

            “Well, I’ll do my best to get something scheduled later this afternoon or first thing in the morning if that will work.”  Dina hoped it wouldn’t so Craig would have to stay in town longer.

A Willing Prey: Chapter 1

            She found herself again in stirrups, naked and sure this time Dr. Rachel Johnson would find something wrong.  Why else can she not find the right man as a partner and best friend?

            “Nope,” said Rachel.  “There still is nothing wrong with you Dina”.

            “Are you sure?  I’ve been feeling different.”  She had felt cramping, spotting and heavy menstrual cycles.  She was sure that she was projecting off some sort of scent or something that was keeping that right man away from her.

            “Dina, you need to stop convincing yourself there is something wrong.  Next time I’m going to charge you double.  I love you but seriously I have other patients who have real problems.”  She could tell her long-term friend from college was getting fed up with the more frequent visits in Rachel’s very busy OB/GYN office.

            “Okay, okay.  I swear not to be back until at least my next annual exam.”

            “I think you’ve had more than enough exams this year Dina.  Give yourself and me a break.  No offense but I’ve seen enough of you and your vagina.”

            Rachel Johnson and Dina Montgomery had been best friends since medical school.  Rachel always knew she would be working with babies.  Dina was late in deciding her medical career but once she selected her specialty in ophthalmology it only made sense.  She had a knack for seeing into the being of a person and knowing exactly who they were.  Or at least she thought she did.  She still hadn’t mastered that talent with her men.

            “Okay Dina, I will see you Friday at the spa.”  Rachel pushed back her stool from the exam table peeling her gloves off and depositing them into the biohazard container.

            “I won’t be late, promise.”  Dina had been late the last couple of times.  Rachel usually is the one who has the emergencies with early arrivals from eager babies entering the world but lately Dina had been the one late.  Her practice was keeping her busy for some reason with unexpected orbital fractures out of the local county jail.  She was almost convinced those prisoners did nothing but knock each other out for the hell of it.

            “I think we should catch lunch at Little Italy on Beacon Street after the spa.  What do you think?”  Little Italy was her favorite ever since she met her most recent on-line date there, which turned out to be a tragedy except for the food.

            “Can’t.  I have a c-section at two that day.  Maybe next week.”  Rachel was entering her busier season.  It amazed Dina that there was actually a busy season for gynecologists.  She guessed the old wise tale of cold weather creating babies holds true because summers kept her best friend Rachel extremely busy from August until October.

            Rachel walked Dina out of the exam room and to the front desk.   She knew the drill; hand the charge form to the receptionist, pay the co-pay and schedule her follow-up appointment.  Today she knew better than to reschedule.

            “I will see you Friday girlie.  Enjoy your week and try to stop worrying.”  Rachel gave Dina a quick hug and turned to go to her next patient.  Dina knew Rachel was right.  Dina had nothing to worry about.  She totally trusted Rachel.  Rachel was the best doctor and friend anyone could have. 

Dina smiled sheepishly at the receptionist who returned the smile as to say she knew that Rachel was tired of seeing Dina in the office.  The receptionist took Dina’s credit card, ran it through for the usual co-pay and returned it with her receipt.  Dina gathered up her belongings and headed out the door back into the heat of the day.

Chance encounter

     Separated by mere chairs along the wall outside the lone courtroom in the very small town courthouse we are both here today researching our ancestry.  Spider tells me he is from here; I on the other hand have traveled from the east coast to find myself and my past.  I have no interest in small talk.  I have a lot of ground to cover and things to do during my trip in a small amount of time.

     Suddenly a small stout man quickly emerges from the lone courtroom.  He told Spider and I to "come with him" and wisked us off to a small wood paneled room next to the courtroom.  The next thing I know the judge introduces himself as the appointed clergyman who is going to marry us today and where were our witnesses.  Spider looks at me at the same time as I quickly look him up and down.  We both stammer at the judge boisterously and simultaneously, "we're not getting married".  The judge jerked his head up from his paperwork with a questioning look upon his face, "then why are you here together?"

     We cleared up the misunderstanding with the judge, walked out of the look alike chapel and sat back down outside the courtroom where our documents were still sitting incomplete and some untouched.  For a moment we both sat there taking it all in when finally Spider turns to me and says "do you want to go to dinner?"  "Sure," I replied still stunned by what happened and how quickly things could have turned very weird, very fast.

Ana Bell Johnston

            I’ve had enough.  I leave in a hurry from our run down farmhouse that I’m constantly reminded is not mine.  I don’t want it to be mine.  Who would?  The porch is falling down and the carpet needs replaced, where we have carpet.  The basement is actually a crawl space with a dirt floor that you can’t do nothing with.  Larry hoards everything he finds and thinks he’s gonna make a fortune out of it but will never part with anything.  I think just about every car and truck he’s owned sits in our backyard.

            But I’ve had enough.  His drinking tonight is more than I can handle.  I walk up the road knowing I’ll come to The Rebel first before I head out of town to the hollars.  It’s a hot night, very muggy.  Luckily it ain’t any earlier.  I hate walking when the mosquitoes are out.  I stumble a little because I’ve been having those pains again.  The kind I get when I can’t breath.  Doctor says it’s from my up-bringing.  I am traumatized or something and I have breathing attacks remembering it.  Whatever, I just take them pills because it goes great with tequila chasers.  They take the pain away.

There isn’t much traffic out this time of night on a weekday.  I didn’t think about what I was wearing when I left.  I just walked out with my shorts and t-shirt grabbing my purse on the way.  Little does Larry know I still have his paycheck with me.  He’ll be pissed in the morning but what else is new.  I think that man wakes up pissed and goes to bed even more pissed.  Today is no exception.  I’ve spent all day being yelled at for one thing or another.  I’ve had enough.   It’s about time I left his ass for good.  I know, I’ve said it before but this time I mean it.  I’ve had enough.

There ain’t too many cars out front of The Rebel.  I’m grateful for that.  I don’t want to be seen by too many people with the shiner Larry gave me on my birthday.  When I asked him what he got me for my birthday, he punched me and said “this is what I got you bitch”.  My eye still ain’t healed all the way.  Nothing a little make-up can’t take care of.  But that’s been a few days and Larry totally denies it ever happened.  He said “you fell walking up on that rickety porch out front woman and don’t you go round telling lies otherwise”. 

I walk through the door of The Rebel allowing a few seconds to pass so my eyes can get adjusted to the dimness of the room before I venture any further.  I pretty much know my way around.  I use to work here.  This is where I met Larry one drunkin day long ago.  It should have been a sign, meeting in a bar.  I’m learning from every bruise and attack on my body that alcohol and Larry don’t mix. 

Prologue

Dear Kaylie Mae,

If you are reading this you have found my voice put on paper over many years.  You have only started to know me, your Mama, as an adult; the friend I could have been if only I were given the chance.  The life I wanted and the life I lived were two different worlds intertwined beginning many years ago. I witnessed and learned things that no one should have to see or know. I protected those I love in different ways. I protected one for life and protected another from death.

I don’t expect you to understand why I did the things I did. I did what I did out of love, deep love and protection for you and your Daddy.  I truly don’t understand how it all started myself. To look back on my decisions that I made I know that my actions had to be the way they were. I had no choice. I value life, I value family more. I did what I had to do to survive in the only way I knew how.

Please understand as you read my journey, my life, that I love you and I will always love you and your Daddy. I’m sorry if my actions to protect those I love have caused you heart ache, shame or discontent. One day when you have a family of your own you will feel the joy I felt with the family I created, the family I had to protect from despair and destruction.

Love always,

Mama