PHARMACIST STEVE

“We feel like we have to keep proving we are disabled just to get some level of care to keep making it day to day,” Janet Zureki says.

http://www.monroenews.com/news/20180319/opioid-epidemic-patients-who-are-caught-in-middle

As the country confronts an ongoing opioid epidemic, law enforcement officials are cracking down on healthcare providers they deem as overprescribing medicines — a practice many say contributes to an increase in drug abuse and overdose deaths.

It’s a problem that deeply affects Monroe County: 44 people died from drug-related overdoses in 2015, with 31 of those deaths tied to opioids. It’s a stark increase compared to earlier years — in 2010 there were 18 drug overdoses, with nine of those deaths caused by opioids.

While officials confront the health crisis, however, patients who suffer from chronic pain or have debilitating illnesses have found themselves caught in the middle.

They are patients who are prescribed opioids; they neither abuse their medications nor distribute them to others. Instead, they rely on them as part of their treatment plans.

Many of those patients feel like they’re the invisible victims in the response to the public health crisis.

LIVING WITH THE PAIN

Janet Zureki will never know a day without pain.

From the moment the 49-year-old Monroe resident wakes up, she grapples with managing pain stemming from a traumatic injury she endured after a botched operation.

Zureki had to have her tailbone surgically removed after it was broken. The injury also resulted in her spine leaking fluid and damaged muscle tissue in her lower back and hips, causing her severe pain.

“My kids would have to watch me crawl around the house,” she said. “There were times I couldn’t even crawl — I would have to stop and wait for it to subside.”

Zureki takes prescribed opioids throughout the day, combining it with physical therapy and exercise to address her pain. A patient of Dr. Lesly Pompy of Monroe, she worked with the doctor for several years to develop a treatment plan to give her “back a quality of life.”

But in 2016, Pompy’s offices were raided by local law officials after a year-long investigation levied accusations of illegal pill distribution and healthcare fraud. His license later was suspended and his case referred to a federal court.

The charges left several of his patients with chronic conditions and severe illnesses adrift, many scrambling to find new pain management specialists, she says.

An Air Force veteran, Zureki worked as an asset collector for the Internal Revenue Service before her injury prompted her to take an early retirement. A wife and mother of two, she says addressing her pain is a part of her daily life, often making it hard to take part in social and family events.

“It’s hard sitting at an event for your kids,” Zureki said. “You don’t get butterflies when your kids are doing good because you want to go home because of the pain.”

Lyn Herrmann, an auto factory worker who lives in Monroe, can relate.

Herrmann suffers from bulging discs and degenerative disc disease. She also has another serious disease that causes her pain. Her job, which she has had for 21 years, requires strenuous physical labor and has long hours, sometimes averaging 10 to 12 hour days.

Herrmann is not a viable candidate for corrective surgery. Instead, she has to rely on a treatment plan that addresses her condition, which includes opioid pain medicine. In addition to complicating her work life, her conditions impact life at home with her husband and 4-year-old daughter.

“Some days my daughter wants me to play with her on the floor and I don’t know if I’ll be able to get back up if I get down there,” she said. “I want to play with my kid, but sometimes I just can’t. It makes me feel like a bad mother.”

EFFECTS ON PATIENTS

A routine operation gone awry resulted in the injury to Zureki’s tailbone. For nine months, her pain grew until it became unbearable. At first, doctors were unable to identify the source of her discomfort.

But as her condition worsened, her primary physician referred her to Pompy, who specialized in pain management. He was the first doctor to find her broken tailbone and helped her come up with a plan on how to address it.

After the raid, Zureki was unable to receive her medications for several months. She tried to find another physician quickly, but many doctors who worked in pain management were leaving the field or weren’t accepting new patients.

Her own primary doctor refused to prescribe her pain medicines and others in the area were wary of taking Pompy’s patients, she said, adding that some doctors even had signs in their windows saying they wouldn’t prescribe opioids.

“We feel like we have to keep proving we are disabled just to get some level of care to keep making it day to day,” Zureki said. “We were treated like we did something wrong. No one would even see us.”

Zureki eventually experienced the effects of withdrawal and the return of her pain. The muscles in her back contracted again and she struggled to breathe while sitting up.

“The vomiting, the pain, the crying — you can’t feel like yourself. To be taken off medication you’ve been on for years isn’t safe,” she said. “Even when you’re back on the medicine, it’s like you have to start all over.”

Herrmann, also a former patient of Pompy, had similar experiences.

Her primary care physician refused to treat her pain and referred her to another doctor, a practice many pain patients face, she said, adding that doctors would rather transfer responsibility of their patients’ pain care to another physician than risk scrutiny.

“Family doctors in Monroe are all afraid to give anyone any pain medicine,” Herrmann said.

It took several months for Herrmann to find a new pain management doctor. During that time she lowered her dosages and rationed her medication as she looked to bridge the gap in care, an act that she says shows she doesn’t abuse her medication.

Even now doctors are reluctant to prescribe pain medicine, often reducing or adjusting her dosages.

“Every month it decreases like I’m magically going to get better,” she said. “I’m not going to get better. I’m going to get worse.”

FIGHTING A STIGMA

Zureki said pain management patients face stigmatization for taking medications, sometimes even from their own doctors. Pain patients will minimize the depth of their pain out of fear of being accused of drug seeking, she said.

“You tell your pain doctor about your pain, but you don’t want to tell them the worst of it because they may think you’re trying to get more drugs,” she said. “You’re always walking on egg shells. What if you lose this pain doctor? Where do you turn next?”

Herrmann said people make assumptions about pain patients and patients of Pompy without trying to understand the severity of patients’ pain or conditions.

“They think you’re a druggie or just making it up,” she said.

Zureki says it’s easy to became resentful of having to take medications. Her life is regimented around it, often having to plan days in advance what she will do so she can be prepared.

It also takes a mental toll, she said, adding that she sometimes battles depression and anxiety that stems from her condition.

“It’s a constant battle. If the pain would be better, the depression would be better. They feed off of each other,” she said. ” You end up in a vicious cycle.”

LOOKING TO THE FUTURE

Herrmann’s plant is slated to begin production on a new vehicle soon. She is worried about how she will manage her pain as the car parts she works with at the factory will be much heavier. Not working is not an option for her, she says, so she’ll have to work through the pain.

She said a lot of people aren’t abusing their medication and need it to function, which she hopes law enforcement and doctor will better understand in the future.

“Overdose death numbers seem to be rising even though prescriptions are more rare,” she said. “Who do they have to blame now?”

Zureki understands the need to address the opioid problem in Monroe. She supports stricter prescribing guidelines, but she also hopes law enforcement will work more closely with doctors to ensure patients with legitimate needs for medication don’t lose access to care.

“They’re creating a vacuum by just cutting off the doctors,” Zureki said. “They’re potentially making people go from getting the legal medication they need to turn to the streets.”

Zureki hopes to get her doctor back one day. She continues to work on retraining her muscles by going to the gym and hopes to resume the treatment plan she and Pompy created together.

Filed under: General Problems