I hate doctors - really, hate them. Now, there are some tolerable ones, but I have never met one who has known enough to treat me properly. A hell of a lot of docs will get very judgmental, when they hear the rx's I am scripted. I mean - the rx's are legitimate from a legal standpoint. I am not even on a real opioid - yes, tramadol is an opioid, but it has been years since I felt the opioid warmth. So, yeah - I mean, I am on stimulants (alternating between methylphenidate and d-amphetamine) - I actually rather like Ritalin. It doesn't fry me like an amphetamine, and amphetamine dependence was modest for some time, but I will tell you that for fatigue or for kicks or for whatever, if you take an amphetamine habitually and nearly every day, that honeymoon period is VERY nice, indeed, what you don't know what amphetamine can do - it worsens fatigue, causes anxiety and paranoia, loss of appetite, makes hot flashes so much worse, really seems to fuck my memory, too, and I am not taking really high doses. I usually take 20 mg to 30 mg at least three times a day, sometimes four, maybe five. See the morning dose - the first dose - is initially nice, for the most part, but fuck - in 2.5 to 3.5 hrs. I am fixing to re-dose. I haven't touched amphetamine for about a week, now, and switched with my doc to methylphenidate very recently. I don't worry about the neurotoxic effects of methylphenidate much at all - it is so like cocaine; no real tolerance builds physiologically, it doesn't have the physiological dependence I once thought amphetamine didn't really have. Methylphenidate is also nicely balanced in a way - you feel it in your body, in your mind, but you can rest rather comfortably on it - it is quite short acting, but I have accounted for that - I don't see this drug as one which I will need for school or school work; it really has all the marks of a euphoriant - so I am going to treat it like a fun thing or thing to do when bored. I will reiterate that with amphetamine, you become exhausted after some time, and it is really toxic to the entire organism.
BUT, BACK TO DOCS - Okay, so they are bizarre creatures; some of the things that have come out of their mouths nearly put me into a state of shock. Let see - some memorable quotes and little anecdotes:
One psych doc (residency, but had a lot of a charge in the ward): "Xanax has a half-life of about an hour."
My psych doc: "Well, Dexedrine is about half as potent, mg for mg, than Adderall." - That one worked out well for me.
ER doc: "So do you do any drugs?" ME: "Well, I use cannabis here and there." ER doc: "Oh, no that is fine; I mean like coke or heroin." ME: "No." So, then she berates me for being on so many meds, all legally scripted, mind you. She tells me I look like a drug seeker. I talk to her a bit, nicely, informing her that I know what it looks like. So, she goes from "I am not pushing any controlled substances into your body." Then, 10 minutes later, 10 mg morphine is shot up in my IV cath. For such a woman, flipping back and forth so much, I get 10 mg morphine IV push? This was somewhere else, but where I am from, acute pain crisis = 4 mg morphine, 6 mg morphine if the doctor is understanding. I mean, I can tolerate opiates well, but those 10 mg really got me comfy. Then, I was I given my discharge papers, almost immediately - no record of her name, no record of what she gave me - just 'acute non-traumatic pain in a, b, c, d, e, etc. - I told her my whole fucking body was in pain - neuralgias/neuropathies, myalgia all over, and migraine headache. They didn't even consider Benadryl! She also thought butalbital was a narcotic, and I think she said all controlled substances are narcotics; that is not right in medicine, law, or anything else! But, she was a fucking nut - all over the place, and likely recovering from addiction, herself - or in the throws of it, still.
Older GP (In his early 70's or so, now, and ill): So, the first time I was scripted Fiorinal (ASA/butalbital/caffeine), he told me not to worry about it and that it was harmless - Jesus! He also had someone I know on 2 mg Xanax QID for some time, along with plenty of Fiorinal - I mean, that is just not how it works, really.
Neurosurgeon: So, I went to him for a consultation of sorts. We went into his office after the basic neurological exam, and said he really cannot prescribe any painkillers for my headache. When I mentioned Fiorinal, he said he hadn't written for that in 5 years or so, and said he was completely fine with scripting me 60 with a refill. When Fiorinal W/ Codeine was brought up, he just said "no you don't want that - that will just make you sick" - Yeah, 30 mg or 60 mg of codeine is going to get me really sick. Fuck, I have taken 200-odd a couple of times, and it just felt like an opiate - nice.
Rheumatologist: Initially, she was the one scripting me the Adderall, as it was back then, and praising how it can help so very much with fatigue and fibro-fog; this was right after she said she is not going any higher than tramadol! Present day, she scripts me Lyrica, Soma, Fiorinal, & Tramadol!
Speaking of present day, my psych has me scripted for 3 mg Klonopin/day, 30 mg Restoril/bedtime, and 20 mg Dexedrine/day. I asked for a calmative agent due to temporary stress; he wanted to go neuroleptic, and I wasn't buying that, so I got him to write for 10 mg to 20 mg Pamelor at bedtime; truth be told, I have really cut down on tramadol (not much else, but tramadol, yes) and haven't been experiencing physiological discomfort or anything; I went from 400 mg to 500 mg daily to, now, 100 mg to 200 mg. I am not sure why or how; it wasn't consciously intentional, but I am glad I am down. So, any way I figure a brief regimen of fairly low-dose Pamelor (probably 20 mg to 30/40 mg daily - maybe a bit more) and just slide off the tramadol track; that is not good for me either. I suppose I just know some drugs are toxic for me, at this point, considering everything, and the less toxic drugs seem more valuable for all purposes. A long story is attached to my relationship with cannabis - I love it, and never thought I would at one point, like I do now. BUT, I cannot use it without putting myself in a lot of jeopardy, as of now. So fucked up - I need a dispensary to open, because I know I could get an MMJ card in a second by showing them my records. Really, though, cannabis seems to keep me at lower doses of the pharmaceuticals, without a doubt, AND it works wonders for my pain, fatigue, anxiety, insomnia, etc. It REALLY helps with every thing under the sun. Weed needs to get legalized for everyone, really, though - I think it stands a good chance to do as much in maybe a dozen states in the next five years - I am just worried about the federal law being enforced to a really severe extent. We need to repeal so many goddamn federal and state drug laws; I mean very harsh mandatory minimums for possession of a little coke or dope? What the fuck?
Back to docs: One doc told me I would benefit from a stimulant, knowing that my history was squeaky clean with drug use and that. But, he thought since I'd be continuing classes in high school, it would help. Initially it was the baby dose of 5 mg Adderall XR, but that gave me some really notable euphoria and sped me up real smoothly. The beginning is usually nice; it gets nasty if you take it every day, or even a couple days a week. Amphetamine is something that you have to be healthy enough to take, find your sweet spot dose, and use it a couple times a month or even less - it can be great, if you've never done it, but it wrecks your body pretty easily and pretty quickly.
BUT, DO DOCTORS JUDGE ME? - OF FUCKING COURSE, THEY DO. THOSE WHO DON'T KNOW EVERYTHING CAN BE MORE AMIABLE AND OPEN. BUT, ALL DOCTORS VARY SO MUCH; IT IS SCARY, REALLY.
Sorry...Rant over for now.