Chronic pain sucks

Can’t think. Can’t read. Can’t write. My brain is focused entirely on not moving my leg, or sometimes on moving it to a more comfortable position — which doesn’t exist. My right ankle continues to swell, and my whole foot is turning pink, so everything is getting worse.

After praising the alacrity of my treatment yesterday, though, we have hit a snag. Everything has been held up because…further work has to be approved by the insurance company. I guess they have a lot of highly qualified orthopedic surgeons examining my case and going “hmmm”, and wondering whether I can handle more chronic pain before they approve treatment.

So I get to suffer for a few more days before we can take the next step.

I am not asking for sympathy, though. Don’t feel sorry for me! The health insurance demons have found me wanting and think I deserve a few more pokes from the pitchfork. Instead, I would appreciate your curses and imprecatory prayers directed at the health insurance industry and the whole damn American health care system. My situation is relatively minor compared to what others must suffer.


  1. says

    Dear PZ, I’m so sorry you have to be subjected to the ‘the whole damn American health care system’. It is a sadistic, barbaric nightmare. As we wrote ‘civilized nations don’t let for-profit corporations ru(i)n their healthcare systems’. Hope you get good treatment and recover soon.

  2. birgerjohansson says

    And this parasitic insurance system is why American healthcare is very much more expensive than for other industrialised nations.

  3. birgerjohansson says

    As for the lobbyists of the insurance companies, I think I have found out how to solve the shortage of transplant donors.

  4. Pierce R. Butler says

    birgerjohansson @ # 3: … I have found out how to solve the shortage of transplant donors.

    Except for those in need of functional hearts.

  5. robro says

    Yes, there’s no scam quite like the “insurance” scam in America. I can’t imagine a more corrupt system. Unfortunately getting Americans to recognize the fact and do something about it seems very unlikely. More likely is to finish off what little public healthcare cost support we have. That’s evil socialism. Insurance companies that use our money to own congress for their benefit…that’s the great American way.

  6. dschultz says

    “whole damn American health care system”

    It would have to be better organized to be considered a system.

  7. jacksprocket says

    Shout it loud- there are a lot of people here screeching that the NHS model is inefficient and outmoded, and we need to involve the private sector more. Tony F888ing Blair among them.

  8. robro says

    dschultz @#7 — I don’t know, seems like a pretty good system for sucking money out of our pockets, both public and private, to enrich a bunch of billionaires.

    jacksprocket @ #8 — Well, the result of that is what we have in the US. If you can’t pay, well, they’ll drag you through healthcare red tape hell but just remember, you were gonna die anyway sooner or later.

  9. says

    The American health care/insurance system shows one thing:
    If Star Trek was real, we’d be the Ferengi.

  10. stuffin says

    Professional Nurse for 40 years. As my career went along, I found myself giving advice to my patients about what words they should say to their providers. Taught them to use key words and key phrases that ring to a medical professional. Frequently would explain the obstacles they would face getting through the medical system. This on top of the care I was legally obligated to give them. Didn’t have much to advise about insurance, other than it sucked, but the medical system I could help them get through.

  11. moonslicer says

    Observation: until about a year ago my son was working down in Malta, where the company that employed him was paying his private health insurance. Then he came back home to Ireland, and his new employer didn’t cover his health insurance. So he was going to have to address that himself.

    We got to looking at the situation and decided that it didn’t actually make any sense to go private. You’re just paying some company a lot of money and at the end of the day, you have no idea what you’re going to get for it. Now the Irish public system is a shambles in a way, but if you need medical attention they do have to provide it. And if you have no insurance, they can only charge you up to €750 a year for all the medical care you get. That 750 figure was in effect a few years ago. It may have gone up a bit since then, but you get the idea.

    The practical effect? A few months ago my son came down with something or other. I forget the exact complaint, but he was feeling extremely unwell in his gut. So we phoned the number that allows you to talk to a doctor in the middle of the night, explain things and get his/her opinion on what needs to be done. This doctor decided my son needed to get to the hospital. Well, we don’t have a car, so he sent out an ambulance.

    Now we did have a wait of 3 hours or so, but my son saw a doctor and she decided that all he needed was a course of antibiotics. So he got his prescription and we went back home (and the antibiotics did fix him up). And we were dreading the bill–a trip in the ambulance, a consultation with the doctor. And when the bill came? €100. Yeah. My son was delighted. He’s never in his life been so happy to pay a bill.

    As for me, I’ve never had private insurance. And when it came time when perhaps it would have been useful, it was too late. No insurance company was going to take me on with my pre-existing condition. So I’m dealing with the public system, which for someone like me is free of charge, despite the enormous costs to them.

    My son and I were talking about it. If there was a public sort of insurance, we’d be happy to pay it. You’d pay according to your means, and you’d be paying doctors, nurses, hospitals, pharmacies, i.e, the people who are looking after you and need the money–instead of handing it all over to the privateers. But there is no such public insurance.

    I think we human beings fish around for the most absurd way of doing things, and that’s what we settle on–especially when there are huge profits to be made by big companies.

  12. seversky says

    The NHS has it’s fair share of problems, some of it caused by successive governments cutting its funding, but it’s still way better than private alternatives in terms of breadth and affordability of coverage. UK citizens do not go bankrupt in huge numbers because they can’t pay medical bills while insurance companies rake it in.

  13. rockwhisperer says

    USian here, I get it. I have nerve pain in my feet, that was originally diagnosed as type 2 diabetes related peripheral neuropathy. Except that I’ve never had diabetes. I had one wildly high A1C blood sugar test, got labeled as diabetic in my health care system’s electronic database, and that has caused me more trouble. My A1C, which was admittedly higher than normal (prediabetic) for a few years, is now normal. But damn, docs see that label, and it screws things up.

    So I was seeing my podiatrist for a routine check, and complained that the neuropathy was getting worse. “Which toes,” he asked. I told him. He turned to me and said, “That isn’t neuropathy, that’s the L5 nerve in your back. Go see a physiatrist immediately.” I did. Now I get an injection in my back every four months or so, and it greatly reduces the problem. But I suffered for YEARS, taking massive doses of a nerve drug, and nobody–not my primary doc, not the neurologist–connected it to my back. The thing is, the insurance system requires them to do only short appointments, back to back, all day, every day. They aren’t given time to think about anything other than the most obvious answers.

  14. weylguy says

    Hang in there, Dr. Myers. Donald Trump managed to survived bone spurs, which sadly prevented him from bravely and heroically serving in the military, and look where he is today!

  15. nomdeplume says

    Considerable sympathy and empathy PZ.

    It’s no help, really, but this pain episode will eventually be far in the back mirror.

  16. wsierichs says

    Never had bone spurs, but 2 kidney stones taught me what extreme pain really feels like, so I can empathize. I hope you get the relief you need asap. I hate both parties for our lack of good, universal health care. I tend to hate the Democrats even more than the Fascist Treason Party because the Dems/Obama had a clear mandate in 2008 to finally settle the whole problem. Instead, Obama and the Health Insurance Vampire employees in Congress gave us a Rube Goldberg contraption that had its primary purpose of feeding more blood money to the vampires. Obama had a huge mandate, something Supreme Court-appointed Bush never had, and he screwed all non-multi-millionaire Americans royally. So I hate him as much as Bush.

    By the way, you probably know who else had “bone spurs,” that kept him out of the military and possibly an Uncle Sam-funded vacation to South Vietnam in the 1960s. I’m sure that orange-hued person can really feel your pain. :)

  17. Tethys says

    Chronic pain does suck. It sucks up your energy, ability to function, and sometimes it sucks up your ability to sleep.

    Our healthcare system is run by for profit insurance hacks, so in addition to being in pain, you get to navigate various Drs and therapists who constantly imply that you’re seeking painkillers or possibly imagining the pain. (While being paid ridiculous sums of money for worthless tests and treatments.)

    I would suggest some topical salve that contains THC in addition to the oral anti- inflammatory. It actually works well on inflammation, and nerve pain caused by the inflammation.

  18. hemidactylus says

    @15- rockwhisperer
    I’ve had sciatica and nagging lower back issues for decades and resulting lower leg issues. I should get that checked. 30 minute 5am neighborhood walks usually keep it in check and I get to see my neighborhood cat buddies lying in the street. Weird cat thing. I would never own a cat (or be owned by one) again mostly due to mild allergies and litter box stinks aversion, but I enjoy seeing the neighborhood cats chilling in the street when I walk. My favorite thing about other peoples cats is they don’t bark at me. At worst they scurry off, but that rarely happens. I think they look at me and say “Oh that dude again. Yawn.” except for one who wants to be fed and I have to engage in avoidance maneuvers.

    Must be residual heat in the pavement that draws them out at that time in the early morning. Sometimes there’s a congregation of 5 or so cats within several meters of each other and a couple more far peripheral cats hesitant to get closer to that clique lacking invites or something. Might make an interesting ethological study.

  19. shelldigger says

    Chronic pain sufferer here too. Mostly it’s manageable with my meds, but there are days where there’s just nowhere to hide, and it’s a miserable existence. It can beat you down into a dark hole if you let it.

    I try not to go there.

    I sincerely wish you well. And hoping for a speedy system that gets you in soon.

  20. hemidactylus says

    I can’t imagine bone spurs, but I do fondly recall what happens when I stand from a sitting position and my back does that thing. It’s not often, but the aftermath etches itself in stone. I side sleep which doesn’t help. I cannot describe the fun getting out of bed trying to achieve the standing position. Excruciating. Good thing I didn’t go to a doctor and get conned into surgery and opiates. Saw that crapfest second hand.

    I did learn to do knee bends and extensions in bed and walk around the block to loosen up. The drive in the car for any long period would aggravate it.

    Bone spurs must suck. Lower back agony is special too. As my emphysemic dad often said “Getting old ain’t for wussies.”

    At least I got past my early onset cataracts.

  21. says

    “Insurance agent from hell” is redundant. But at least he doesn’t have to deal directly with claims adjusters… oh, wait…

    The fundamental problem with the “health insurance system” is that it does not meet the definition of “insurance” — the spreading of random, relatively catastrophic risks among a wide pool of those relatively equally subject to those risks. (As other commenters have pointed out, it’s not coherent enough to be a “system,” either.) The American “health insurance system” is actually an attempt to discern just how much energy Maxwell’s Demon can withdraw from the system — the Second Law says he is, even when it’s only an “informational” system, and this was proven nearly eight decades ago — without causing immediate system collapse. That’s one reason that “insurance agent from hell” is redundant: The insurers and their agents are all Maxwell’s Demon…

  22. Jazzlet says

    Yeah chronic pain sucks, time for me to take some more meds, then let them kick in before heading up to bed. I hope your foot stops getting worse, it’s not like you haven’t go the message.

  23. VolcanoMan says

    Yup. I’ve endured chronic pain since ~2005, and it hasn’t gotten any easier (I’m turning 42 in a couple of months, so I expect that it shall become quite a bit more difficult over the next few years). In 1998, as an idiotic 16 year-old, I careened down a Minnesota (HA! I knew Minnesota was bad for me) large hill/small mountain at like, half the speed of sound (hyperbole, obv.), downhill skiing (it was Giant’s Ridge, btw…I was on a school ski trip, venturing out from Winnipeg, which, for the uninitiated, is in Canada, and therefore has publicly-funded healthcare…no insurance company gatekeepers for me), and crashed (the injury was due to a twist fracture, not something impact-based), shattering my right femur (like, literally shattered – my proximal femoral shaft, distal to the neck thank goodness, endured a comminuted fracture of aroung 10-12 large pieces, and dozens of tiny ones, and orthopedic surgeons had to piece it back together in a complex surgery, like a jig-saw puzzle). Anyway, the pain from that never really went away, and became what one would call “chronic pain” a few years later. To this day I consume ungodly amounts of codeine (time-released, ~500 mg/day) and an anti-seizure med that has been discovered to be a great Ca-channel blocker, which is called gabapentin (2,700 mg/day), to manage my symptoms. I had a family doctor for 23 years post-accident, and he understood my issues fairly well. Since he retired (in Jan. 2022) I’ve had to find a new doctor who took a bit of convincing (I think it was me DECREASING my daily codeine allotment by 15%*, and accepting a certain amount of increased pain, that sold him on the legitimacy of my pain issue), but who has decided that I’m not a drug-seeking addict and provided me with analgesic relief.

    So don’t feel bad about accepting a drug-based intervention. We have these drugs, and they work. Just be careful with opioids, as they do have an addictive/dependence component to their profile…if you are careful, you should be fine.

    *I used to take 600 mg/day time released. People think that with opioids, you need more and more, but with respect to the legitimate use thereof, “need” is a bit of a weird concept, and decreasing the dose is actually possible. if you are willing to endure a bit more pain (not ideal, but with medication sometimes these things are for the best). Not to zero, obviously – my pain is still partly “real,” partly neurogenic (as in, my brain expects pain due to neuroplasticity, so it delivers). Nonetheless, it’s amazing what the human body can get used to.

  24. chrislawson says

    PZ, have you seen any doctors since your foot became swollen, pink, and even more painful? Because it sounds like it needs an urgent review.

  25. nomaduk says

    The NHS is another of Britain’s great contributions to Western civilisation. The utterly contemptible scumbag Tories and their neoliberal acolytes in New Labour (I’m looking right the fuck at you, Tony Blair and Keir Starmer) who are trying desperately to privatise it on the sly, ever so carefully so that nobody will notice, deserve — well, I know what they deserve, and if I could get away with it, I’d give it to them.

    After living in the UK for 10 years, I can no longer even comprehend the US medical system; my eyes glaze over and I have no idea how any of it works any longer. My wife has to deal with the paperwork for me. I can’t wait to go back.

  26. tacitus says

    One of the less talked about benefits of a strong National Health Service is how much more affordable it forces private medicine to be. There were two occasions — torn shoulder tendon and a pinched nerve in the spine — where my elderly mother was faced with a several month-long wait before she surgery could be scheduled. For the former, the sooner the shoulder repair was done, the more successful the outcome, for the latter, the pain was excruciating.

    So my parents — both retired teachers and not wealthy by any stretch of the imagination — investigated the possibility of going private instead. They didn’t have private health insurance, but what they found was a marketplace where the small private hospital sector offered their services with up-front all-inclusive prices (surgery, anesthetist, and hospital stay) ranging in the thousands of pounds (i.e. not tens of thousands) that actually allowed them to comparison shop before choosing the provider. They didn’t even have to call anyone, it was all accessible on the internet. Try doing that here in the US!

    Both surgeries went well, with the only caveat being that rehab services were only available through the NHS, but that turned out to be little problem. I should also point out that when my mother did need life-saving treatment for two bouts of cancer, the NHS was there for her, her surgeries conducted within three weeks of diagnosis, and she’s still soldiering on at the grand old age of 92.

    Would it be better if everything could be done through the NHS in a timely fashion? Of course, and I would support the level of funding that allowed it, but as a less than perfect alternative, it shows how a strong national health service is far better at keeping private sector medicine prices in check that any type of government regulation, though strict regulations on price transparency would be a good start, I guess.

  27. Snarki, child of Loki says

    Tacitus: this is why the USA is sorely lacking a “public option” to provide competition with private insurance. The possibility of which in Obamacare was killed off by ONE asshole in the Senate (Lieberman) who is continuing his asshole ways by pushing a No Labels campaign to benefit Trump.

    Note that state-funded colleges provide a “public option” for education, that the GOPers have been working hard to defund/kill/privatize.

  28. says

    I’m sitting here in a haze of aching. Tomorrow I go in for an MRI in the morning, which won’t do a thing for me, but will give the podiatrist more info to work with.

    I’ve had about enough of this nonsense, I tell you what.

  29. Jazzlet says

    This may not amuse anyone else, but – when Boris Johnson was prime mminister one of the excuses he gave for the Tories deplorable record on house buiding was the presence of so many rare newts on prosective building sites. After his ignomious departure he and Carrie bought a desirable mansion, that just lacked a swimming pool to make it perfection, but alas it is not to be, the newts is there are newts on the estate (of course it has an estate). Which is making me ridiculously happy, Go Newts Go!

    The odds are he will be able to have his pool, but he’ll have to have an expensive survey and if newts are found anywhere near the proosed pool site some even more expensive relocation work. Go Newts!

  30. hemidactylus says

    @32- PZ
    Hang in there. At least you can vent a bit here.

    It’s been a while since my back problems put me into a damning my life sort of state from long term frustration over pain and limited mobility. But even recently my back has tweaked a little, though knee bends in bed, stretching, and early morning neighborhood cat fanclub therapy helped.

    Walking itself is easy to take for granted. A sprained ankle, nail in my foot, and busted knee ligament (not all at the same time) come to mind. Also a busted pinky toe that swelled and bruised badly. Luckily my feet seem ok when sciatica isn’t radiating.

    Weren’t you in a boot a while back for some sort of malady?

  31. says

    I was in a boot for the same damn thing. It subsided and I went back to doing nothing about the problem. I think this time I’m going to have to go under the knife.
    I still have the boot, and will be wearing it this weekend when I fly off to visit family.

  32. hemidactylus says

    @37- PZ
    I had lived with profound vision issues way longer than I should have and decided to have it checked. Cataract surgery was a blessing in my case. I can’t imagine letting that get worse. My right eye was useless. Good thing the brain compensates with the better eye. Glad to be done with that now. Insurance helped, though not with the more advanced lenses I wanted and got. Not perfect but close enough. Still kinda expensive overall even with coverage.

    I’m sure you’ll weigh all the options and make an informed decision in your situation. Hopefully you can put an end to those foot troubles in the best way possible.

  33. Daniel Storms says

    I give way to no one in my hatred of insurance companies, and I’ve dealt with many of the big ones–UHC, Anthem, Cigna, Aetna, et al. I’ve had to literally beg them to make an exception to allow me to refill my insulin prescription because their policy was to insist that my doctor specify both number of injections and dosage per shot, and I had run out because I exceeded that amount. My logical response, that usage was dependent on blood sugar, which was variable and not a hard and fast number, didn’t impress them until I said, “I will die without it.” But in the criminally stupid system we call health care, let’s not leave out the increasingly consolidated provider behemoths. In my area it’s Hartford Health Care and Yale New Haven. The actual physicians/APRNs are generally good, but they’re under pressure to see as many patients per day as possible. For emergent but not critical complaints, it’s almost impossible to see the physician same day because they have so many patients booked. The choice then is to accept an appointment days away, by which time the complaint may have resolved itself; waste the time and resources of the ER; or spend interminable time in an Urgent Care waiting room, only to be told after a 10-minute look-see that you should use ice (generally not helpful) and Tylenol (the most useless drug, with the possible exception of laetrile, in the entire pharmacopeia) for the pain.

  34. birgerjohansson says

    You know, if I get Ebola, I will volunteer to come over and give senator Lieberman a hug before I die. Because as we all know, social distancing is a commie plot.

  35. StevoR says

    FWIW. Best wishes and sympathies and hope you get well as quickly and smooothy as possible from me and am seconding chigau (違う) here in urging you to get medical help if needed, sooner rather than later.

    Yeah, the USA’s healthcare system is so totally messed up.

  36. wsierichs says

    Here’s another best wishes for your recovery. May the God of Pain show you mercy.

  37. chesapeake says

    Agree on the opioids. Sounds like Pz is in need of them. He doesn’t need to suffer that much pain. I have had chronic pain for over 20 years in my back and life would not be worth living without opioids. Literally. While one can become physically dependent on them in time, that doesn’t mean you are an addict, which means someone who takes them to get high. I have never done that and don’t think I could. Whenever I’ve taken a bit extra to cope with the pain I get sleepy and dizzy not high. I’m on a pretty high dose of oxycodone ,which may have serious long term effects, but the alternative would be self-deliverance a la the plastic bag with nitrogen as described in the addendum to “Final Exit”. I’ve found that when I used codein short term-2-3 weeks there was no withdrawal on quitting. Also beware those combined with acetaminophen. lots of that for a long time will destroy your liver.

  38. Joel Anderson says

    Not sure if your pain-induced agony caused you to emit some cranial flatus,, but the actual diagnosis is “enthesopathy”… but you have my endlesssympathy

  39. hemidactylus says

    I had a friend who had severe back issues and got prescribed opiates, stuff for constipation, and other stuff for depression. Opiate side effects. Not that people cannot benefit from opiates, but I preferred my severe back pain. My only experience with opiates was with a severely injured finger in high school and taking one pill that made me feel so horrible the severe pain was preferable.

    I don’t buy into weed propaganda, but I would much prefer excessive weed and beer combined to that.

  40. chesapeake says

    Some can’t take opioids . My wife was given one while in hospital and it caused hallucinations. A previous try had some negative effects though she able to tolerate a morphine drip after surgery.

  41. says

    I offer both sympathy and the curses … but the latter are old hat.

    My situation is relatively minor compared to what others must suffer.

    Fallacy of relative privation.