The Province of Misfit Doctors

Do you remember the animated special that plays every Christmas Rudolph the Red Nosed Reindeer? And if you do do you remember the land of misfit toys?  Well my husband and I have come to call Manitoba the province of misfit doctors, which would be funny if it wasn't such a sad statement.  We are talking about peoples lives at stake not a game or toy you get tired of playing with  and cast aside or pass onto another person over and over again.  Because you just don't want to do you job or in my case play the game of let's learn and educate yourself like I have done.  I am here to help you try and lead as comfortable and normal life as possible.  

Don't get me wrong I in my journey have had one out of the countless doctors I have seen being one I can say had the expectation any patient goes to a specialist/doctor to one who is doing their job out of concern for the patient and not for the money or to boost one's ego.  As for the rest I cannot say the same.  Unfortunately he passed me onto another doctor whom he thought could be more beneficial then himself.  I wish I could go back to him but once you have been passed on you cannot go back, I have learned.  Since then that doctor past me onto another one, who then passed me onto another doctor who has since passed me back. Like a toy no one wants to have anything to do with.

For any one who finds themselves living in this province I wish you well and hope that you hit upon a doctor that does know what they are doing and are willing to listen to you.  I'm not only speaking because of my situation but also for my sister who the doctors here took years to diagnose with Scleroderma. She passed away but with my recent experiences I am sure because of how long it took them to diagnose her, her life was shortened because again they would not listen nor did they know that with Scleroderma the disease can manifest itself internally, before showing on the outside.  For most diagnosed with Scleroderma it attacks the outside before moving internally and attacking your vital organs.

Our aunt who had a brain tumor/cancer who was told for a year she had vertigo and tinnitus which was causing her balance and dizziness.  The day she was taken to the hospital thinking she had, had a stoke. By the luck of the draw of the doctor on call, they knew it something serious .   Lucky for her they were able to treat her and remove the cancer but had she had waited even a few more days we were told she more then likely would not have survived.

We also have a cousin who kept saying she was having mini stokes after going to a chiropractor and the doctors here kept telling her she was not.  She finally found a doctor in Alberta who did confirm that she was indeed suffering from mini stokes.  Again why did she have to go out of province to find a doctor who could help her and actually listen to her.

I also as some know am currently in a study for a new drug with Health Canada for another medical issue I have.  Part of the study requires a full exam every few months which does include a very basic neurological exam.  Last week I went for my appointment which required a full exam.  Now granted the doctor who does the exam is a cardiologist not a neurologist however if you are part of the doctors in this study you should know how to perform the very basic tests requested in this study. Heck there are countless videos on You Tube with step by step instructions.  I as a non medical person should not have to tell the doctor how to perform these tests but I had to.  If that doesn't scare someone it should.  Lucky for me I knew what and how these tests are done because of how many I have taken but what if I had never been or had these tests?  And the best part is even though I was having trouble with all of them because he did not know what he was looking for he marked them all as normal!

Because of the stress/anger I was feeling about this situation and how my body was moved in directions that anyone who knows anything about Stiff Person Syndrome should not move I started having spasms.  The sad part of all of this is as I walked to the parking lot stopping and doubling over in pain I had medical personal walk past me not one asked if I needed help or was okay.  I finally made it to my car and sat for half an hour screaming in pain watching again medical personal averting their eyes as they walked past my vehicle.  I was within a 5 minutes walk away from the emergency room and could not get myself there.  And could I have would any of them besides myself know what needed to be done?  I wish I could say yes but sadly I know as we have made that trip many times to emergency that the answer was no.  So I sat crying and screaming in pain until they subsided enough for me to take as many back roads as possible to get myself home and to the medication that I knew could help me.  I do carry extra but when you are in that much pain the brain shuts down and too I know I have a short window to drive myself home safely on those meds that even if I could I would not have taken the chance.

That my friends is a small glimpse of life living in the city of misfit doctors.  And if any doctors would like to get a job here the last time I looked on the government job bank site there are taking applications.  As far as I know we are the only province who advertises on the job bank for specialists!   So if you are one that just made the passing grade in medical school not to worry Manitoba is desperate to hire you, just go to their website and apply.  Yay lucky citizens of Manitoba we will always be the province of misfit and uncaring doctors taking care of us!  One more thing to be proud of in Manitoba!

*Since writing this article in Oct. the study with Health Canada has been cancelled. I am publishing this as everything else is still relevant to the healthcare in our province.*

    

Thanksgiving

Tomorrow is Thanksgiving Day in Canada it is a national holiday celebrated in Canada and the United States (they celebrate in November). It was originally celebrated as a day of giving thanks for the blessing of the harvest and of the preceding year.  In current times it is more of a celbration to join together with family for a feast and to be thankful for all one has in life.  As in the richness of family.

For our family it is a bittersweet day this year October 10 as it also marks the day the day we burred one of my sister who passed away in 1999. But it does give me time on this weekend to reflect and be blessed with comfort to have had one of the most caring and thoughtful family members in my life, even though she was taken far too soon from our lives at the age of 42.

When she was ill I would spend as much time with her, going over cooking meals. Taking care of her boys to give her a break and to keep their lives as normal as possible. They have forgotten or were too young to remember all the time I spent with them and that is okay with me too.  I have not forgotten and that is what keeps me happy knowing I helped my sister in her time of need.   She unfortunately had a husband whom was absent most of the time especially once she was ill. That happens much more then people realize when someone they love is sick and especially when you have a terminal illness. Many people would see that as heartless but living now myself with a chronic incurable illness (unless you are lucky enough to be able to try a stem cell transplant) I see the toll it take and how strong a person has to be to take care of the person that they had vowed to love both in sickness and in health. Those are just words one utters when getting married but the true test comes when illness hits. For me I am lucky to have a husband who truly does take care of me, and took those vows and all they meant to heart.

Thanksgiving Day is also a time where most families get together mine no longer talks much to my husband and I.  They don't fully care to understand my illness and how a normal life is out of my reach these days no matter how hard I try.  Although some of them joined together yesterday to enjoy the usual holiday feast we were not invited.  You may think I am bitter or am writing this because I am but you would be surprised to know I am not.  I actually feel grateful for them showing me the type of people I am happy to know we are not.

I am also grateful that on this day I am able to write as it has been a long time since I have felt well enough to sit long enough to do so.  I read so often that in order to keep an audience engaged in your blog you should post often.  My condition or anyone who has Stiff Person Syndrome will tell you that that is an impossible request.  Unlike most conditions we don't have the luxury of having "good days".  That is the cruelness of this condition that so few understand including doctors.  We have a few good hours if we are lucky but days?  I could not tell you the last time I had a good day as it is so far out of my memory I can not pull it from the corners of my mind. 

I will try and write more often but I cannot make any promises, but to those who do engage and read I wish to thank you.  And if you are in Canada may you be blessed with wonderful friends and family who stick by your side, and have a wonderful Thanksgiving Weekend.  

And on this holiday weekend and in memory of a beautiful soul thank you for being a part of my life for the short time we had together.

 
 

Disability Parking Is Not A Privilege, It Is A Necessary To Try And Take Part In Society

This is my first video blog post as it is getting harder to type for any length of time.  My first video blog is on using handicap parking.   The first video was made by Ken Mckim and the next two are my personal experiences on this topic.

I wish to give thanks and gratitude to Ken McKim for allowing me to share his wisdom and passion for the chronically ill. You can follow Ken on his You Tube channel, You can also following him on his website www.dontpunishpain.com and please be sure to follow him on twitter and Facebook @dontpunishpain.

The link for his talk on disabled parking can be found here:

Ken Questions The Chronically Ill and Disabled Parking

*please note my first video I say my second video.  However I re-taped after calming down regarding my family members comment video.  My video's are also taped raw not prewitten they are open and honest how I feel as I am doing them *

My personal experience of being confronted by The Behavioral Police; Strangers and their right of being justified on confronting a person with an invisible illness:

Handicap Parking and Being Confronted By Strangers

Sadly some of us get horrible comments from our own family as this video talks about:
Disability Parking & Empathy

Isolation and Solitude

Again it has been a while since I have written anything. At the beginning of this month  yet another medication was added to the ones I already take and besides knocking me out for 17 - 18 hours a day it was not doing any good so I have told them I will not take it. And began my search for another GP, putting me in a zombie state is not of help to an already desperate situation. Nor was it a medication that offers any benefit to this condition.  

Most days I did not have the ability to do what everyone semi-healthy or healthy takes for granted in their daily life. Prior to stating this latest medication, I at least was able to be awake and enjoy reading people posts, be it on FB or Twitter. Throwing in my two cents for what it was worth here and there. Reading a good book or watching the occasional show I enjoyed. All of that in the span of starting this new medication made even that impossible within the first two days. I was unable to stay semi-conscious for any length of time. But at least I can control that part at least by going off this medication.

I too have not shared but am now letting you know I suffer from short term memory loss or as those with Fibro call it "brain fog" which has made my house full of sticky notes and calendar reminders all over! Many times I have the thought to call. message or email someone and then forget, it's nothing personal. That is just my reality, and I am trying really hard so don't think I am shutting you out. (I had a friend who thought I was ignoring them which rather than assume please ask I won't take offence. You should remember that I was not like that before, so why now that I am sick that thought process has crept into your mind?)  I know I have changed but not my care and compassion for my friends and family. If you feel it has please let me know so we can work it out.   

I also suffer from very jumbled thoughts. What I write is not as clear as it once was more then likely the medications and is part of this condition, I think.  I have read many people asking those of us in our support groups the same questions over and over so I know I am not alone.  Too bad no money is made in really studying this condition, someone could put two and two together.  

Which brings me to the topic of isolation and solitude. Last month I had my flurry of visitors...friends that I had not seen in a while. It seemed at least for a few weeks we were having non-stop visits which now again have ceased. Which is okay it's a pattern which only those who are chronically ill and especially those that are mostly house-bound know and can understand all too well. I say mostly because I am one of the lucky ones who still has some good days up until three weeks ago was able to get out occasionally on my own. I would not dare at this time until my sleepiness and nodding off without warning has diminished.  

See I/we can no longer participate in activities which in our or at least in my case have to weigh the pros and cons of doing so. My healthy friends and family I am sure you think I am ignoring you which is the farthest thing I am doing. But how do you participate in a world from which you no longer have much in common with? It's finding that fine balance which unfortunately until you are forced into the situation cannot fully understand. I struggle with this balance every day.

I would do anything to wake up tomorrow and call someone and say hey let's go out but I don't have the luxury of being able to do so. I no longer know what is happening in your life. Nor can I predict from one minute to the next how my body is going to react, so staying home is safer for me. But that does not mean I never want to hear from you. Or be invited somewhere. I leave you alone waiting for the phone to ring or for you to show up at our door, because I honestly don't know if you are busy, I have been away from your world too long to know. 

And in turn I have had friends say call me and let me know when is a good time to visit you. In all honesty I can't predict when that will be, but one thing I can say is show up I am use to being in pain and would still love your company. (I have become a master at masking the pain I am in, you would think nothing was wrong, unless my lovely muscles decide to put a show on for you. The one thing I have no control over but once over at least you can witness an incredible feat I do for kicks! Just ask any medical profession I've seen they will gladly tell you I have the power to put myself through the pain of having my muscles twist on their own!  Too bad side shows were no longer popular I would have a job again!)

I had a call with a friend not long ago who was starting to tell me of her troubles with a co-worker and stopped in mid-sentence and said "oh, this is so trivial compared to what you are going through". But what a healthy person fails to realize is we need or seek the mundane to remain part of the world. 

 

Just like I/we don't want to always bore you with my/our health but when you shut down the conversation it actually makes us feel worse or at least that is how I feel. Because it is one more reminder that I/we are not part of that world anymore. For a moment put yourself in that place of someone shutting you out. I'm sure it has happened to you before and the feeling was not a good one. I/we face that on a regular bases. Don't forget that we are still humans and need contact. Talking to you what is trivial and mundane gives us reason to feel like a part of the world that we to use to take for granted. Please don't shut us out; talk to us as you use to I guess is all I am trying to get across. We/I have mastered the art and have learned even though I/we are in pain we still want to know how you are too.

My illness should never make you feel like I care less about you or what is going on in your life. It matters to me because you mean that much to me. 

Remember we are still here and although  you may not be comfortable remember those of us who suffer from chronic illness are still trying to finding our comfort zone too. Embrace us and let us still feel like we are still a part of the mundane world.

We all know the saying laugh and the world laughs with you...Weep and you weep alone...well for those that don't know here is the rest of that poem. Both healthy and the sick should take note and help each other to the best of our ability, until we all have to take that final journey alone.

Solitude

BY ELLA WHEELER WILCOX

Laugh, and the world laughs with you;

Weep, and you weep alone;

For the sad old earth must borrow its mirth,

But has trouble enough of its own.

Sing, and the hills will answer;

Sigh, it is lost on the air;

The echoes bound to a joyful sound,

But shrink from voicing care.


Rejoice, and men will seek you;

Grieve, and they turn and go;

They want full measure of all your pleasure,

But they do not need your woe.

Be glad, and your friends are many;

Be sad, and you lose them all,—

There are none to decline your nectar wine,

But alone you must drink life’s gall.


Feast, and your halls are crowded;

Fast, and the world goes by.

Succeed and give, and it helps you live,

But no man can help you die.

There is room in the halls of pleasure

For a large and lordly train,

But one by one we must all file on

Through the narrow aisles of pain.

Giving Hope With Haematopoietic Stem Cell Transplant

Acknowledgement of the content of this post is given with gratitude to Bill Cole, Sam Baar and Anne (last name withheld) who reside in the USA.

There are many people in the world with devastating autoimmune diseases, including Multiple Sclerosis (MS); Stiff Person Syndrome, the extraordinarily rare (1:1,000,000 people) disease that I have; Scleroderma; Lupus; Type One Diabetes; CIDP, and other blood-borne autoimmune diseases.

The most common autoimmune disease is MS. Many people with MS become disabled and wheelchair bound.

Over the past approximately 15 years HSCT (Haematopoietic Stem Cell Transplant) has been proven to be a very effective treatment for MS (and other blood-borne autoimmune diseases). It stops disease progression in approximately 80-90% of MS cases & it can improve prior damage for many people, especially if they receive the transplant early in the course of their disease. Several thousand people with MS have had stem cell transplants over the past 15 years, and based upon the published results, stem cell transplant appears to be the most effective treatment currently available for MS.

Based upon the success of patients with MS (and a few other autoimmune diseases) that have received a stem cell transplant, three hospitals in the United States (the Fred Hutchinson Cancer Center in Seattle, the Colorado Blood Cancer Institute in Denver, and Northwestern University in Chicago), and The Ottawa General Hospital in Canada, have implemented clinical trials to use stem cell transplants to treat people with Stiff Person Syndrome. Approximately 23 people with Stiff Person Syndrome have received stem cell transplants over approximately four years. So far, the preliminary results look very promising, at least for those that received the treatment over 18 months ago. Generally speaking, the results for most patients with blood-borne autoimmune diseases that have been treated with a stem cell transplant are very good.

One of the problems in receiving this cutting edge treatment, is that many neurologists (the type of doctor that typically treats neurological autoimmune diseases) will not support stem cell transplants as a treatment for MS and other autoimmune diseases. (Fortunately, for those that have gone through the trails they were able to find neurologists who were both very supportive of their decision and encouraged them to pursue a stem cell transplant).

Speaking for my situation when I asked about this treatment was told and I quote "you are not seriously thinking about going to a third world, snake oil charming selling clinic who will cause more damage and upon your return I will be left to try and repair the damage they will cause you." I personally am in Canada so am trying to get to the Ottawa General Hospital last time I checked Canada was not a third world country and the team of specialist in Ottawa from what I have read and been told are not snake oil sales people left over from the turn of the century.

And to help clear up misconceptions many here have regarding what it means to have Universal Health Care in Canada we are require to have a referral to another province from both a medical doctor treating you and by your provincial health care provided e.g. MB Health needs to approve the cost to send me. Without both I can go but would risk having to pay for everything out of pocket. Not to mention that in Canada we do not have the freedom to see a specialist without being referred to by a GP (general practitioner doctor) first. So should I take this route on my own initiative I would also be required to move to Ontario find a GP then try and be referred to a specialist. Without following this protocol and going on my own MB Health has the right to refuse my claim sent back to them by another province's doctor who bills them. Not much different than a resident of the USA trying to deal with their insurance companies they are covered under.

Patients with such auto immune diseases can only speculate as to why their neurologists will not support stem cell transplants as a treatment option. Some of the theories that have been postulated are that their neurologists: (1) are uniformed or misinformed about the phenomenal success rates for stem cell transplant, (2) are relying on outdated clinical trial data, and/or (3) perhaps are financially influenced by the big pharmaceutical companies that make billions of dollars each year selling these extraordinarily expensive disease modifying drugs, & it is not in their best interest for people to go into remission from their MS (or other autoimmune diseases) as they will no longer require the services of a neurologist, and so they continue to provide their patients nasty and extraordinarily expensive disease modifying drugs, which might slow the disease progress a little, but will do nothing to halt the progression to disability, and also very often have very severe side effects. (Ps -- many neurologists also receive material amounts of money from these pharmaceutical companies that provide these disease modifying drugs for "speaking fees").

Unfortunately Stem Cell Transplants for MS & other autoimmune disorders remain only in clinical trials in Australia, UK, US & Canada. Unfortunately, it is also very difficult to meet the criteria inclusion for these trials, so many people are not able to receive treatment through these trials. Furthermore, it will also take many years until these trials are complete and stem cell transplants can be performed as a routine procedure that is covered by health insurance.

Stem cell transplants have been available as a treatment for MS and just a few other autoimmune diseases outside of a clinical trial setting in many other countries in the world (such as Germany, Israel, Russia, Mexico and other countries) with less restrictive inclusion criteria. Unfortunately, private health insurance will not cover stem cell transplants in these other countries.

Furthermore, here is a great description written by Sam Baar regarding the recent BBC program on stem cell transplant as a treatment for MS in the link below:

"This is a new 30 minute documentary from the BBC about Stem Cell Transplants for MS. This trial is going on in Chicago, the UK, and other locations. This is slightly different procedure than the Stem Cell Transplant I received in Denver for Stiff Person Syndrome a year and a half ago.

This is well worth watching if you have or know someone with MS or other autoimmune diseases. I expect that it will become FDA approved in the US as a procedure for MS rather than a trial in coming years.

MS is not the only autoimmune disease they are trying to cure using HSTC. Over 10 people have now received this for Stiff Person Syndrome like me and I hope more will! Autoimmune Neuropathy and Scleroderma are a few other autoimmune diseases they have done.

For many people that have become disabled from MS and other autoimmune diseases this is looking like a cure. It can stop the progress of the disease but some damage caused before may not reverse, some will!

This is a long procedure and is almost the same procedure you would have for blood cancers like leukemia.

Please do not confuse these academic FDA approved trials from the endless scams I see out there involving outpatient clinics that offer stem cell injections. These places are scamming people with little hope."

The same can be said for the trials that are being held in Canada

Here is the link to the BBC program:
Can You Stop My Multiple Sclerosis?http://www.dailymotion.com/video/x3n5jjl_can-you-st0p-my-mutiple-sclerosis-bbc-panorama-14th-dec-2015-720p_school

What Do I Want From My Doctor?

A few weeks ago I had an appointment with my neurologist, who was rather rude and short with me and my husband asking what is it I want from him.

 For starters and every time I am pass on from one neurologist to another I want a quality of life back.  That I will hit upon the doctor who went into medicine to help people, not to inflate ones ego.  Who listens to patients like me and does not talk over us, we can't have a patient knowing more about a condition when they did not go to medical school now can we!  Drop the ego down to a human level you are not God! That is what I really want to say.

My last appointment with him was in November when he took me off of my medication, he also reprimanded us like children because I changed my appointment date even though I showed him my email from my physiotherapist which in part read he would gladly see me in January instead of the end of February if I was doing as poorly as I was doing when J.F. saw me.

 Within a week of taking the last of my medications yet again my spasms came back full force and I went from having one to two a day, to having five on good days up to as many as twenty in day.  I know this because for the month of December we recorded them (check marked on a calendar) only the ones that last longer then a minute (128 not including the shorter ones) and the reason I bring this up to those who know or can image what a person who has these muscle contraction (and here is where I am going to switch the word spasm which sounds minor to contractions) feels like a life time, that honestly death would be kinder and easier to endure then the pain I'm going through and for my poor loving husband who has to stand and watch me go through or worry about me as I am alone all day when he is at work.

I and my husband also tried to have a conversation with him as to why he yet again thinks I would want to do this to myself or how a person has the will power to make themselves do this to themselves.  It's like a bad nightmare that I cannot wake up from, nor would I wish this nightmare on another person who has compassion for mankind.

I spend two days prior to my appointment typing notes, documenting what a week in my body is like, to be told he does not have the time to spend 24 -7 worry about one patient when he has many others he needs to tend to who have real medical conditions. He would not take my notes as it is too much of a time waster for him to spend 15 minutes tops before our next appointment in 4 months to read what I had prepared for him.  Really?  Am I sounding bitter yes.  Have I lost my faith in our health care system that I thought one got into because they wanted to help people, yes.  Is my will almost broken...sadly yes.

So to answer the question what do I want here is my list NOT that you have the time to care or want to hear:

Respect me as a fellow human being...the posters in all doctors office's these days say patients have the right to ask questions and has the right to care.  Why do you and all the others I've seen not see the hypocrisy of those posters as I sit and wait to see you, knowing the outcome of our 1/2 hour appointment?  It  also states that the staff will not tolerate abusive behavior yet it doesn't seem to work the other way,  you are being abusive to a patient allow someone to suffer.

I want to be able to walk longer then 10 minutes before my muscles start to give out on me and I look like a runner who has pushed their body pass the point at the end of a marathon.  Why do you think my physiotherapist contacted you,  I was in such bad shape even he could not believe how downhill I was going when he saw me, so much so that he said there was no point in seeing him until I am in better shape to work with without causing me more harm. Do you think I slipped him an extra  $20 on top of my payment for my session so he would contact you?  And yes I do pay for physiotherapy as the public system would not even work with me once they witnessed what my body was doing so I went private. Would a person who is trying to keep moving really pay out of pocket for help if they were doing this to themselves? And would my physiotherapist not have seen through my make believe condition a year ago when I first saw him and pushed me harder then he does?  I picked him because his objective is to help people return to work...which was my goal and still is.
 
I want to be able to prepare meals, chopping, stirring etc again a person should not feel like they just finished a 2 hour intense workout with a professional boxer doing something so simple.  I break down in tears trying,  that is not normal especially if you could have seen the entertaining I use to do for my friends and family.

I want to be able to dress myself without needing help. Why again would anyone do that to themselves reminder I am 50 not 2? If I go and visit my mother who is 86 she has to help me put my boots on, that works wonders for my self-esteem. You should try it some time, I'm sure you'd feel great about asking someone so old to help you parent or not.

I want to be able to go out to a mall, restaurant, anywhere but being a prisoner in my home.  I cannot do any of those things anymore especially on my own, yet I keep trying because you are making me have doubts am I doing this to myself but then reality hits and  I pay for doing any of these simple activities for days afterwards.  Even with my husbands help I last for a short of time before my body starts to go so rigid and the muscles start to contract so painfully I can barely move and we need to leave.  It has gotten to the point where he goes out and I stay home most times now.

I want to feel well enough to go visit my mom on a more regular bases,  although I sit at home most days (except for appointment days and the odd time when I will myself to get my mom out for her appointments) I don't have the ability or healthiness to get showered, dressed, drive and go visit her (if I am lucky I can once in a while but not as much as a person my age should be able) you are robbing me of time spent with someone who I love and the days are getting fewer and fewer in our lives.

Thanks to you I even missed Christmas with my family because I was in so much pain and woke up having non stop contractions that day we didn't dare leave home.  Chris and I spent the day debating whether I should go to the hospital or not because I was doing so poorly. Hospital or time with family which would you have preferred if you were not already a doctor?

I want to be able to enjoy a laugh even laughing can cause me to go into painful contractions again is that normal...if it is please show me how this happens to you.  You can ask my friends and family who have witnessed this happening.  Do you fear laughing? again if this is normal show me you having the same contractions as I do, if ones mind is so powerful.

I want to be able to stretch without starting to scream in pain and going into spasms/contractions. Can you last a day without stretching, people like me have to be aware and conscious of not doing even this normal function.  Unfortunately we are programmed to do so without thinking and when I do this it causes some of the worse and longest lasting contractions. Even my sleep gets disturbed because we do this function unconsciously in our sleep and I will wake up screaming...again please do this for me so I can see it happening to you. Heck I'll even take the time to watch your video, sadly I can't say you will reciprocate the gesture because we have tried, and again you don't have time to watch a less then 5 minute video. 

There is my partial list to you which was not as detailed as the one I tried to give you, but even that was too much for you.  I guess I should be grateful you have given me back some relief  by giving me back small dosages of some of my medications.  Not to worry I won't abuse them like you and others doctors before are so worried will happen.  This is where my ignorance comes in I don't even understand how one does abuse these medications that help them, that is where my ignorance lies.  But then again I am not an addict but a sick person needing help.    

Oh and as for our next appointment I still have not made it, by the time I left your office that day that you turned your head away as my husband helped me leave your office.  I was in such bad shape that my husband had to fight to help me get to the car and home to bed.  But not to worry my mind was still well aware that you  ego is intact for you and it means more to you then helping a person like myself who enjoys torturing  herself and yes she is grateful she is on disability as that is really all I wanted instead of relief from a make believe condition she has decided to give herself.