#hit the curb twice but he said overall i went well and told me to book my official test

[mrvdocks]

Plus One Finale

Summary: You and Steve make up. Steve plans for the future ahead.

A/N: We finally made it to the end, thanks to everyone who read it and liked it and reblogged it. :))

@mochminnie​, @80strashbag​, @artsymaddie​, @har-rison-s​, @theblueslytherin​, @prettysbliss​, @deliberatequeen​, @fl0ating​, @crystalyn-aurelia​, @itsbabybat​, @bellasymph​, @hawishima​, @hvtelcalifornia​, @stevexharringtonx​, @fisherbrookphotos​, @revangeline​

He paced back and forth in the hallway of the animal clinic, somehow both muttering to himself and racking his head for some way to reply other than the incredulous reaction he just gave you.

You squeezed your eyes shut and shook your head. You knew it, you knew it was too soon to say. 

You cross your legs in an attempt to stop the distracting bouncing of your leg and ease your nerves. 

Sure he just confessed he loved you and apologized, but now that you could possibly be pregnant? What if that was the dealbreaker?

“Steve.” You call, attempting to break him from his trance.

He mutters more, going much too fast for you to understand. 

“Steve!” You exclaim, unable to take the suspense.

He stops and turns to face you, visibly shaken. You exhale shakily, trying to keep yourself steady emotionally.

“Listen, if what you said earlier is true, then this is nothing.”

“This is nothing? (Y/N) we’re bringing someone else into our messed up lives. What if we’re terrible parents?”

You stand and take his worrisome hand in yours, “So we don’t have the best model. That’s fine! They’re not the ones raising this kid, it’s us. It’s you and me.” 

He bites his lip in thought, eyes falling to his feet. You felt your heart race as you tried to decipher his emotions. You loved Steve, kid or no kid. But this was something you two needed to face. 

“I don’t know. I - ” he shrugs. 

You try not to remember the last time he shrugged and what followed. 

“You and I don’t need to make a decision so quickly. We can sleep on it. Alright?” You try to be comforting, smoothing out the lines on his disheveled shirt.

He seems to relax at this and nods. You nod in conclusion.

“I’ll be back.” He says, letting go of your hands and walking down the dimly lit corridor. 

“Where are you going?” 

He won’t leave you, right? 

“I have to do something. I’ll see you back home.” 

He leaves in a rush. It hit you then. Home. You were dreading returning to the apartment all this time because you were afraid of the confrontation. 

You had planned on coming back sure, maybe yell at him or take Mickey as you’d promised, but the thought of having to confront his issues and your own made your stomach do somersaults. And not in the good way. 

But it seemed to turn out fine. You sighed. 

You and Steve barely got by as it is. Robin’s leave put more strain on both of you to come up with rent money. Neither you nor Steve were too content in your career choices, and God knows the place would get cramped with a kid. 

It was hard to be an optimist in these trying times but you tried to hold out hope. Maybe things would get better. After all, you had new friends, you’d made new connections. Who knows where that would take you. 

You wondered what your sister would say. For once, you valued her input in this. 

Honestly, the thought of the future from this point on made your heart race. 

Steve was capable of growth…..right?

Once Mickey was cleared to go home, you let out a breath of relief you didn’t realize you were holding. Things felt a lot lighter, it was a weight off of your shoulders. Though a tiny pebble by the name of Steve remained. 

You carried your dozed pet out in your arms in the early hours of the morning, choosing to walk it home and avoid another Danny encounter. 

It was a chilly week in November. The crunch of the leaves under your feet wasn’t enough to rouse Mickey awake but you kept count of how many you stepped on.

You don’t recall how long it took you to get home. It was most likely the autopilot in you flipping on, your head just too worried about other things at the moment. 

You just know you’d made it home without a scratch. You kick away the pile of mail at the foot of your doorstep and take the extra key under the mat. Once you’re inside, the warmth of the radiator kicks in, letting your body relax after the tensing up of your muscles to keep warm outside. 

You lay Mickey down in his makeshift bed, the foot tub with a mix of yours and Steve’s old shirts. He grumbles in his sleep, his tiny tongue peaking out in lazy and unconscious movement. 

You shake off Jonathan’s coat and drape it over your body like a blanket and collapse onto the couch, too lazy to curl up into your own bed. 

You shiver as you run your hands over your arms and cup your hands together to blow air into them. The tiredness from walking and overall excitement of the day weighed over you from the way you felt your eyelids start to fall. 

You blink once, twice, and then fall asleep just in time to see Mickey kick and stretch his paws in his sleep.

Steve pants as he reaches the door of the room at the hotel his father’s staying at. He’d been too hasty to berate his future stepbrothers once he saw what they’d done to Mickey. 

He knocks rapidly on the door, seeming like a madman to the couple who’s just leaving their own room and staring at him. He composes himself, zips his jacket up, and gives a faint nod as they pass him.

His dad opens the door a second later. “Hey kiddo, what’s with the commotion?”

“She’s pregnant.” Steve regurgitates your confession to his father. Don’s mouth falls open slightly. 

He closes it and stammers. He turns to check on the kids in the room, seeing them preoccupied with the tv. When the coast is clear, he closes the door behind him and stays with Steve outside in the hallway. 

“I - that was fast.” Don chuckles, feeling flustered for his son. “What did you tell her?”

“I ran here to tell you!” 

Don’s hand comes up to pinch the bridge of his nose in disappointment.

“So you’re telling me, the girl of your dreams, the one you’ve been miserable over breaking her heart, just told you she’s pregnant and the first thing you do is leave her and run to me??” 

Steve understands the gravity of the situation but he is stuck on the thought that he needed all the advice he could squeeze out of his father.

“Basically.” He says simply.

Don sighs. “What’s the problem, then?”

Steve’s shoulders slump. “I don’t know how to be a dad. In case you haven’t noticed I didn’t have the best model.”

Don nearly rolls his eyes. 

“Is that really the reason, or is there another?”

Steve stays silent, contemplating while his eyes scan every inch of the hallway from the detail on the carpeting to the colors. 

“I guess….I’m not happy with where I am right now. I’m pushing thirty in two years, I’m a bartender, everyone I know got married and I just feel like I’m out of time. But Dad, this girl. She - she’s everything I’m not. She’s spontaneous and funny and sarcastic and - I don’t know, sometimes I just feel like she could be doing so much better than me.”

Don places a hand on Steve’s shoulder and gently shakes him. “Hey, don’t say that. You’re a Harrington, you’re a catch!” 

Steve half smiles at the encouragement. 

“Steve, everyone progresses through milestones differently. No one knows what they’re doing. And if we’re being honest, I think you just have to find what you like and hold onto it. Something that makes you want to get out of bed every day and just take all of the bull that life throws at you because, at the end of the day, that something is always going to be there. Have you found something to do that for you?”

Steve nearly dissociates altogether as he falls deep in thought as his father speaks. His mind reeling the montage of memories his brain concocts like film. 

He sees you the day you walked into the apartment and into his life, covered in dirty water from being sprayed by a taxi on the curb and taking it in stride and making jokes about it. He sees you dancing in the kitchen to god awful music he’d grown to love in a big shirt and long socks. He sees the way your eyes crinkle when you laugh hysterically at the prospect of trying to help him find dates. The image of you sitting near the radiator with a book in hand and your thinking face. 

He thinks these past few months might’ve just been the best ones he’s ever had. Before he went and ruined it. 

He didn’t think he would experience something like this after Nancy. He thought he could just run away from Hawkins and leave the bad memories there, but they crept up on him when he least expected it. His fear was not your fault. 

He was done running and he was ready to grow. 

“Yeah,” he nods. “I think I do.”

The phone ringing off the hook startled you awake. You sit upright, finding Jonathan’s coat at your feet and Mickey pawing at the phone cord. He wriggles his head side to side when he finally gets the cord in between his teeth. 

“I’m coming, I’m coming.” You mutter to yourself. You pick Mickey up with swift ease and pull the cord out of his mouth to pick up the phone.

“I’m up.” You announce somewhat sleepily into the phone.

“Good! I have news!” Nancy’s rapid-fire voice comes through and alerts you awake.

“Wait! I did it, Nance! I told him!”

“Oh, what did he say?”

“He….kind of took off.”

“He what?!” 

“Okay to be fair, a lot has happened in the past,” you glance at your wrist to see you’ve been asleep for a while. “Five hours? Geez.” 

“Okay, okay. Well, we don’t have to worry about this anymore.”

“What do you mean?”

“The tests! They’re faulty! They’re recalling them for false positives or something. I don’t know but Kali just called to tell me.”

“Oh….” You trail off. 

In a way, you're very relieved. And yet also a little disappointed. But very relieved.

“What’s wrong?” Nancy senses something’s off. “I figured you’d breathe a little better if you knew the truth.”

“No I am,” you say, cradling Mickey in your arm like a mom with a baby on her hip. “I don’t know, I guess I kind of made my peace with it.”

“Oh, well hey, maybe it’s a good conversation starter for both of you.”

You lean against the wall where the phone hangs, letting your furry son sit on the counter. “Yeah maybe. I mean, it was all too fast anyways.”

“Yeah! You have lots of time. Just take baby steps. I think slow and steady would put yours and his mind at ease.”

You had to agree. Time had to heal all wounds. You two had to start again, without interruptions. 

You finish talking to Nancy, reassuring her that you’d need to get over the first wave of shock and tell him when he turned up. She offered to go over but you’d declined. When everything’s over, you collapse onto the couch again, slumping as far as your back would let you. Your stomach protruding a little from under your tee. You roll up the lower half of your shirt and let it sit above your belly button. 

You prod your fingers at nothing, feeling odd and a little bit silly at the thought that there would be a little person in there. 

Mickey whimpers. 

“Looks like you’re the baby still.” You chuckle, scratching behind his ears.

The peace and silence are broken by the door swinging open to reveal an out of breath Steve. You straighten up immediately and pull your shirt down. 

“Are you okay?” You ask, making a pass to reach for him but he sticks a hand out for you to wait as he regains his composure. 

“I’m….fine…..just have to….talk...holdonaminute.”

He’s visibly sweating, beads of sweat on his forehead. He looks like he just ran track. His pants come to a slow until he’s back to normal. He puts his hands on his knees and it takes everything in you to not make an old joke for the sake of the seriousness of the situation.

He stands up straight, keeping his eyes trained on you, and with a softness in them, you feel at ease.

“I quit my job.” He says finally.

Your eyes widen. “You what?”

The confession hung in the air, settling in like the warmth of the radiator. He rushes to you and kneels before you can leap up off the couch and takes your hands in his. 

“Hear me out. Before you get mad, just hear me out.”

“Okay.” 

“I’ve done a lot and I mean a lot of reassessment about you, me, everything. If we’re going to do this, I want them to be proud of me. I want to be there for them as much as I can be. I’m starting over. At 28.” 

You stifle a laugh but release it when Steve takes the initiative to laugh at himself. 

“So….what are you going to be doing now?” You give his hands a squeeze, utterly terrified at the plunge he’s taking.

He looks as if he hasn’t planned that far ahead besides quitting. “I….don't know. But it’s, um, kind of cool. I get to see a bunch of different jobs. Find out what I really like.” 

“And, what’s that?”

“You.” He smiles, the sight of it sending butterflies free in your stomach. “I like you. So, so much. You’re not hard to get at all, you’re hard to earn. I’d take that over any messy, drunk bridesmaid.”

You tilt your head, feeling the corners of your lips lifting and before you know it, you’re grinning like an idiot.

“And that’s why,” he says, his right hand leaving yours and digging into his pocket to bring out a plastic ring from the bubble gum machines in the laundromat downstairs, “I’m jumping in, all the way.”

“Steve…” You’re nearly speechless. “Oh my god, what are you doing?”

“I know it’s not perfect or big or shiny. But this is just a placeholder for now. I’m all in if you are.” He holds the ring with the pink gem in his fingers, waiting for you.

Maybe it’s the fact that ever since you started to see him in a different light since the start of the year, you’d determined that you’d follow him anywhere. Whether he’d have you or not. Even with his moods and awkwardness and clumsiness. He’d been scored on your heart. You’d marry him with paper rings.

“I’m not pregnant.” You reveal.

His face softens. “What?”

“Nancy called earlier before you came. The tests were faulty. I just wanted you to know that so that wasn’t the only reason you decided to do this.”

It was and wasn’t the reason. But in all honesty, he didn’t think he could bear to stomach the idea of not being with you or the image of you with someone else. He also doesn’t think starting over with someone else was the best idea, you two had been through so much in two years. You shared a particular connection. One that he now realizes he had been looking through seas of beige and silvers and golds. 

“It’s not,” he titters, “I don’t care that we don’t have the meet-cutes or the chance run-ins. That’s not what love really is. I thought it was more complex but it’s so - simple. It’s about being comfortable with someone and wanting to hang out with them as long as it’s humanly possible….and just not trying to mess it up the way I did.”

Your heart swells. This is love for him. This is him planting his foot in the sand and not running away when the sea rushes for him. Anyone else would’ve ditched him the moment things got ugly. But you were nothing if devoted.

“Yes, Dingus. I’m in too.” You nod, overjoyed as you feel your eyes get watery. 

Don & Mary’s Wedding

December 25, 1994

Hawkins, Indiana

“Okay, okay, how does this look?” Steve asks, fixing his tux for the fifth time that day. 

You roll your eyes. “You look fine babe, honestly. We’ve ironed the jacket out twice. Any more and I think you’re going to set it on fire and then you’ll upstage the bride.”

Steve snorts, fixing the knot on his tie. “I’m sorry. I’m just so nervous. I can’t mess up the speech.”

You fix the starchy collar of his shirt. “I’ve heard it many times and I think you’ll do great. Just don’t think too much about it.”

“You don’t think it’s too late to back out?” 

“I think,” You pull him by his tie close to your face to tease him. “If you can get through this, you can either have the best after-party experience or you can get the new fridge.”

Steve purses his lips, conflicted. “We do need a new fridge.”

You playfully smack his arm as you feign offense. 

“I’m kidding, I’m kidding.” He repeats, enveloping you in a hug. 

“Whoa, whoa, easy on the goods.” You say, smoothing out the easily crinkled fabric of your dress. 

“I’m always easy on them.” He jests, slipping in innuendo that you still find yourself blushing to.

“Alright, alright. Let’s go before they start guessing why we’re late.” 

You climb onto his back and ride him piggyback all the way to the elevator. He goes over his speech one more time as you descend and tries to tell a joke at the end that doesn’t stick the landing. 

You arrive just in time, settling at the table next to the newlyweds. You pat Steve on the shoulder, give him a glass, and wish him good luck. “Go get ‘em.” 

He kisses you tenderly before he goes up on stage, feeling like a teen again the way his senses go crazy when he kisses you. He fumbles his way up the stairs to the microphone making you hold back a laugh. He composes himself a second later.

“Hey everyone! Thanks for coming. I’m Steve. Most of you know me as Don’s son. And if you’re wondering why I’m up here giving his best man speech, so am I.”

The crowd of family and friends laugh in unison.  

Steve fixes his footing and his grip on the champagne glass tightens. 

“The truth is, I put up a pretty big stink about all of this. I didn’t want to do it. To me, a second marriage was ill-advised. I mean, my parents’ divorce was pretty hard to swallow. But also, I just didn’t get it. I believed in things like fate and love at first sight, that once you found the one, that was the ballgame.”

He scans the crowd, passing familiar faces like Jonathan and Nancy, Dustin and Suzie, Robin and Kali, each one helping take the pressure off just a bit. He stops when he lands on you, your warm smile and thumbs up making him feel better.

“But the truth is, if you spend your whole life looking for something perfect, you wind up with nothing. See, there are many innings in this ball game and I don’t think it's about good timing or fate. It’s about trying not to mess up.”

He locks eyes with you for the last part.

“But you will mess up. No matter how hard you try, you’ll get in your own head. But if you can learn from your mistakes, you might just end up with something...even better.”

“I’d like to raise a glass,” He says, raising his cup along with everyone else. “Dad, Mary, congratulations.”

The guests applaud as Don is overcome with emotion and wipes at his happy tears and takes his son in a bear hug. Steve is taken aback by the sudden strength of his father and nearly drops his glass.

The party goes off without a hitch. Steve actually partakes in the festivities with pride and even makes an attempt to get to know his stepbrothers. He laughs at their awful attempts at jokes and bestows some girl advice when they ask him about you. Jonathan, Nancy, Robin, Kali, Dustin and Suzie all congratulate Steve when they find out what the pink stone on your finger means. You meet Steve’s mom for the first time, a charming and lovely woman who is eager to show you loose baby pictures in her clutch and embarrassing stories.

You wait on the sidelines watching as the new Harrington family take their family photos. Mary and Steve talk in what seems to be a sincere and sweet conversation. Don is trying to bribe the rambunctious kids with sweets if they can sit still for the photo. Jonathan glances from them to you.

“Hey,” He asks from behind the camera. “Why aren’t you in there?”

You open your mouth to justify it until Don speaks up.

“He’s right. What are you doing there? Come in! Come in!” He waves you over with encouragement until the entire Harrington gang begins to beg for you to jump in.

“Come in sweetie!” Mary cheers.

You’re about to make your way until Steve leaves the group and carries you over his shoulder. Jonathan smirks as he takes multiple photos, taking advantage of the candid moment. Steve’s stepbrothers singsong about you two kissing in a tree. The Harrington party make a mixture of sounds and cheers as Steve puts you down and wraps his arms around you in a prom pose. You go with it, feeling like you belonged in this crazy puzzle with other people. The little kids make a disgusted sound when you peck Steve on the cheek.

He kisses the top of your head in return and gives you a squeeze. 

For the first time in his life, Steve’s not afraid of the future. 

[vthiker09]

Taking Opioids During the Opioid Crisis

I’m fairly sure there isn’t a person in America who isn’t aware we have a big problem with opioids.  It feels like every day there are new reports about the dangers of opiate addiction, the increase in overdose rates, and major efforts by Congress to slow what feels like a pending train wreck.  Many states are actively suing Purdue Pharmaceuticals, saying they were well aware of the addictive properties of the drug they ruthlessly pushed doctors to overprescribe at unsafe dosages. Regulations are coming out in massive numbers both at the state and federal levels, all in an effort to decrease the number of people who end up addicted or dead.  At the same time, taskforces comprised of medical professionals, police, non-profits professionals, substance use treatment professionals, and concerned citizens sit in public forums trying to figure out how it got so bad and how we can fix it.

While all this is happening, doctors are still prescribing opioids.  At this time, there isn’t a viable alternative to acute and chronic pain management.  I’m sure many people would say the idea opioids are best at managing pain is wrong.  We’ll talk more about why I think is true in a little bit.  Recently, a panel of thirty doctors conducted a study at Johns Hopkins and released guidelines on how many opioids to give a patient post-op for 20 common procedures.  Long story short, orthopedic procedures routinely are listed as procedures which require the most, if not the maximum, number of pills perceived as safe while still effectively managing post-operative pain. In more basic terms - when people drill holes in your bones and put screws in them it will hurt.  During my two year stint in the orthopedics world, I’ve seen a drastic change in the way in which doctors address acute and chronic pain, how they treat opiate prescriptions, and if I am honest - it’s not great. 

During my very first pre-op visit, the surgeon told me “this is going to hurt” when he described the procedure I would undergo a few days later.  When a surgeon says this, I feel like you know it’s true.  The nature of their profession is they put people in uncomfortable situations in an effort to make the overall situation better.  After surgery number one I was given 30 2 MG Oxycodone tablets and was told to take 2 tablets along with 1,000 MG of Tylenol every 4 hours.  I’m good at taking things when I’m supposed to and not taking more than I need. At the same time, 30 pills don't last long when you are taking eight a day. A few days later, I called in a refill and had no problem getting more.  During the second bottle, my leg started to feel better, so I took fewer pills. This bottle probably lasted a few weeks. I called in a third refill and had no problem having this filled. I ended up finishing this bottle a few months later and never needed to have it refilled.  Overall I was prescribed 90 pills for my first surgery.  I was given some handouts about the potentially addictive qualities of the drug I was taking, but this was pretty much it.  I never felt like the nurses didn’t believe me when I said I needed them and I never felt like they were judging me when I called to ask for more.  I guess this makes sense when you had your bones rearranged with several clamps and a few screws thrown in there to hold it all together.

After surgery two I was given five 2 MG Oxycodone tablets to take as needed. My second surgery was hardware removal and on the pain scale was quite minor.  I believe I took two pills and the rest sat in my medicine cabinet for a long time.  Between my second and third surgeries, Vermont passed a new law about opioid prescriptions for acute pain management.  I’m not well versed in the details, but I did see the impact it had when it was first implemented.  My third surgery was only a few months after this new law became effective and there was a big change.  Before my surgery, more time was spent on lecturing me about the potential negative consequences of taking opioids than the actual details of the procedure.  I was given much more information about addiction, how to get help, and alternative pain management tactics.  I was asked to sign a consent acknowledging I knew and understood the dangers.  On the day of my surgery, the nurse couldn’t find the consent I had signed only a few weeks earlier and asked me to sign a new one.  She brought it into the OR and asked the surgeon to sign it.  He rightfully so became frustrated and said it was not important at the time.  I’m glad the surgeon acknowledged correctly fixing my ankle was more important than a piece of paper which said I knew the drug I was going to take might ruin my life. Post-surgery I was prescribed 30 5 MG Oxycodone tablets.  I was told to take 2 every 4 hours along with 1,000 MG of Tylenol.  Most of the time I only took one and when I ran out, I called in a refill with no problem.  The second bottle contained 28 pills and I never needed another refill.  Thus, for my third surgery, I was prescribed 58 pills.

My fourth surgery happened in New Hampshire.  Much like Vermont, New Hampshire has a big problem with opioids. Both states are routinely seen in the national news as states who are hit hard by the crisis.  Both states are routinely passing legislation to curb prescriptions and divert patients to alternative methods.   After my fourth surgery, I was given 30 5 MG Percocet tablets. Percocet tablets already contain Tylenol, so I only had to take these pills. I ended up calling in a refill and was given 21 more pills.  I didn’t need another refill after this.  I was given almost no information pre-opp about the medication I would be taking and no one talked to me about it.  I didn’t have any problems getting a refill and it felt like it was just part of the operative process.  

Over the course of my operative journey, I was prescribed opioids quite a few times.  In total, I was given 204 pills.  In these instances, the medication was prescribed for acute pain.  Between my fourth surgery and today, I found out I developed severe arthritis in my big toe.  Mainly a result of walking around without a functional ankle for a year and a half and what looks like a missed fracture of my first metatarsal, my big toe isn’t in good shape.  I first started to notice an issue after my third surgery.  My second surgeon thought it was a tendon issue and gave me some stretches to do.  After this didn’t work, my PT thought it was nerve pain caused by a pinched nerve in my back.  After a multi-month long process to learn I didn’t really have back issues and certainly didn’t have nerve damage, my third surgeon thought the disaster that was my ankle was the cause of my foot pain and when this was addressed my foot would be much happier.  When this proved to be untrue, an x-ray and MRI revealed my first metatarsal is severely elevated, I have a pile of bone spurs, my toe bones are warn, and I have cartilage damage.  This all boils down to arthritis, which is a very common chronic pain condition.  Having said this, I found this out because my foot hurts – a lot.  It hurts with every single step I take.  Certain activities hurt more (hiking and running) and some things I can’t do (planks and walking around without shoes on).   I’m limited to basically three pairs of sneakers and every single day ends with me on the couch with a pile of pillows.  Between my fourth surgery and now I have tried physical therapy, ice, heat, NSAIDS, Tylenol, a pile of creams and essential oils, stretching, massage, rest, elevation, custom orthotics, and a cortisone injection.  

I ran into some roadblocks with getting the cortisone injection on the schedule and learned it was going to take a few weeks.  At this point, I was done with being in pain 24/7.  After almost two years of varying degrees of constant pain, I threw in the preverbal towel.  Between the delay in scheduling the shot and waiting eight weeks for the orthotics, only to learn they weren’t going to fix my issues given the severity of my joint degeneration, I was basically desperate for another option.  My NH surgeon texts with his patients, which I wish every surgeon did.  Anyway, I sent him a text and explained I needed something to lessen the five to eight level pain I was constantly experiencing.  I explained I was looking for a temporary solution until I was able to get the cortisone injection or if that didn’t work until I could get on the surgical schedule.  

He sent me a text back saying he would call in Celebrex and Tramadol. Both medications are commonly used to treat arthritis and Tramadol is an opioid.  A few days later I went to pick up the prescriptions with no issues.  I was given 37 50 MG Tramadol pills.  I could take 4 a day, however, 2 does the trick. This lasted until I went on 10/4 to get the cortisone injection.  When I saw my surgeon on the same day I asked him if I would need the Tramadol anymore. He said ideally not, however, he wasn’t confident the shot would improve my situation. He asked if I needed a refill and I said “yes.”  He said he would call in a refill and ended up forgetting to do so.  In an effort to not nag him, I called the med refill line for his practice.  They sent 5 pills in.  When I went to pick these up the pharmacy didn’t treat me the same way. I sensed a judgmental vibe and was asked to provide them with my license.  They wrote down my address and license number.  I have no idea what this information is used for.  The five pills were a temporary prescription until my surgeon remembered to call in an actual refill.  A few days later I went to pick up 30 more pills as the cortisone injection made my foot feel worse for a few days and then it just returned to a slightly less puffy version of the same painful toe.  The pharmacy seemed less alarmed by this prescription and didn’t really blink twice about it.  At this point, I take opioids every single day to manage chronic pain while I wait for my surgery date on November 7th to fuse my big toe joint together and thus, relieve the moderate to severe pain I’ve felt daily for the last year and a half. 

With the exception of my third surgery, I never felt like my medical providers thought it was a bad idea to take opioids and it was clear to me they thought it was necessary given my medical condition or the procedure I had done. While I don’t feel any judgment from my surgeon around the medication he’s providing me with currently and I haven’t had any problems from his practice around getting a medication I clearly need, the rest of world is quite different.  Here’s how:

Social Media: I don’t know about everyone else’s accounts, but my social media is relentless when it comes to the opioid crisis.  It’s a compilation of people sharing new studies, reports of overdoses, stories of children in cars with parents who fall asleep while under the influence, debates over safe injection sites, and articles about laws and efforts by local authorities to address the crisis.  The worst part, however, is the comments people make. They vary from people who understand the complexity of the issue, particularly when it comes to chronic pain and people who very clearly don’t believe people who struggle with addiction should be allowed to live.

Friends: People have opinions.  It’s also really hard to hide that you’re taking a medication which prevents you from drinking when you live in a state which bleeds beer.  When people find out you are taking a narcotic, my experience has ranged from they totally understand because they have listened to you struggle for years and know you wouldn’t take something just for fun, to people who don’t believe in taking pills because they never really have been in pain and thus don’t understand what it means to feel like you don’t have another option.   They are there to tell you you’re making a bad choice or frown when you tell them your medication makes me you drowsy and it’s hard to focus sometimes.

Family: My parents have told me from day one to not take pain medication.  My Dad routinely lectures me about how awful they are and has told me the same story about my sister and how when she got into a major car accident, he told the doctors to not give her anything except Tylenol multiple times.  Even though the doctors said this was borderline insane, while my sister fought for her life, my Dad knew better.  He also likes to pair this story with his own story of how he had both of his hips replaced within a few days of one another and didn’t take anything other than Tylenol.  Both stories come with a tone of pride because he believes he beat the pain monster. My parents still don’t know I’ve taken opioids. Oddly, they were totally okay when I told them about the nerve meds I was taking which have since been proven to cause permeant brain damage and the muscle relaxers which run a similar risk of addiction.

Work: I happen to work for a company who offers an Electronic Health Record product to mainly non-profits.  Many of these non-profits are seeing the effects of the opioid crisis on the front lines and it impacts their work on a daily basis.  In addition to this, some members of my team are heavily involved in Congressional efforts to address the opioid crisis.  We routinely get updates on the progress of these efforts both via email and during team calls.  The messaging is mainly routed in prescribing fewer pills and suing the pants off the companies which created the problem, to begin with.

People have opinions when it comes to how to treat pain and their opinions become much stronger when your pain management entails taking opioids. Over the course of the last two years, I really never had a problem with my medical providers.  I always felt like we were on the same page.  I took what they gave me as directed, usually took less than I could have, and stopped taking them within a reasonable period of time. Although I don’t like taking opioids because they make me tired, dizzy, nauseous, and it’s hard to concentrate, these side effects are more desirable than the alternative, which is feeling awful all the time. Having said this, the pressure I feel from the above four places (Social Media, Friends, Family, and Work) make me feel really bad about taking something that I actually need.  

In the case of social media and work I know it’s not intentional.  I’m sure if I actually talked to them about my situation, they would say something like “oh no, Erin this isn’t about you, you actually need them.”  At the same time, so did the millions of other people who ended up addicted to them.   I can’t tell you the difference between those folks and myself.  I’m pretty sure no one really knows the difference between people who can take opioids and end up okay and those who end up injecting heroin multiple times a day – although there is a ton of theories out there which attempt to explain what makes people more or less likely to end up in camp addiction.   At the same time, those comments about how no one needs opioids and how the newest study says Tylenol will do the trick are frustrating.  It’s hard to hear those statements all the time and not take them personally and wonder if what you’re doing is a fast track to a life you really don’t want. At the same time, I don’t think crying yourself to sleep every day is a viable option either.   Personally, the worst part is the strong language around alternative pain management strategies.  Much of the current guidance says to use opioids as a last resort after PT and the other 20 or so things you can try fail.  Here’s the thing – do those people have any clue what it’s like to work through PT and those 20 other things and have them all fail?  Do they know what it’s like to hope the next thing will actually make you feel better and then realize it doesn’t and then end up taking a pile of pills just to make it through the day?  I bet if they did they would be a little softer in their messaging.  

When it comes to my friends and family I don’t think they have an excuse. We have differing opinions and I think they are wrong.  I’m pretty sure if any of them had to deal with what I’ve had to deal with, they would do the same thing.  I hope for their sake they never have to make these decisions and deal with being judged for doing so.

The opioid crisis is widely complicated and I’m not going to try to solve it.  At the same time, my intent is to show people these pills are not always prescribed for no reason, or in excess, and not everyone ends up at the methadone clinic. In my case, I was given low doses for short periods of time, I took them as prescribed, and their purpose was to make life doable.  When I could make it through the day without them, I stopped taking them and I didn’t have withdrawal symptoms.  I just stopped and life was fine.  I feel as though the social pendulum has swung too far into shaming those who take opioids and it’s not necessary. My hope it there would be some middle ground between appropriately treating patient’s pain and not fostering a new generation of addicts.  Having said this, I would particularly caution those on social media. You have no idea what your friends are taking and why and a lot of what’s out there is simply bullshit.  It fosters a culture of shaming people, which actually makes the situation worse.  It would be better to keep the lines of communication open between patients and providers.  People are going to do what it takes to manage pain and it seems like a much better idea to keep this within the confines of the medical world vs. people trying to do it on their own.  Perhaps we can all be a little kinder to those around us and at acknowledging the complexity of this issue.