About 15 years ago, we were told that American medicine was making a bold new effort in the reduction of typical pain. An indigent friend in her mid-40's died of cancer seven years ago, and they were all over that woman making sure she didn't suffer needlessly. It was tremendously impressive.

Short years later, I watched a family senior fall into severe dementia, and over the course of about three years, die in a residential care facility. Again, a seemingly unremarkable set of caretakers —including an elderly MD who'd turned his practice into nothing but the care of the extremely elderly and demented— gave remarkable care, extinguishing pain without skimping on care that would responsibly extend life.

It's a real surprise to see workaday muckraking like this from Reason. (And I don't see what the celebrity angle means to this at all: Of course Michael Jackson's relationship to medication was atypical.) This seems like the kind of TV news report that you could issue at any time in human history, including many decades into the future, without changing the essentials.

And it's the kind of rhetoric I object to most in people who support universal health care: "Without it, some people will have no care at all!" (Perhaps, but with universal health care, abject suffering will certainly increase.)

The sad truth is that many of us are going see painful times. Fast policy changes are not going to make this go away.

If you really hate this truth, don't have kids.

_____

PS- And meanwhile, if you happen to hit the lottery before I do, please cut an anonymous, six-figure check to this hospital. They've earned it.

There is another side to this issue: addiction. If you know anyone who works in an urban emergency room, ask them about the people who fake chronic pain, attempting to get free narcotics. This is a chronic problem.

It's not only a problem of the unemployed - there are plenty of middle-class addicts. In some cases, they may even be sincere, having convinced themselves that they really are sick. Hypochondria can be very real, especially when supported by very real withdrawal symptoms.

Doctors have a responsibility to their patients' health that includes preventing drug abuse. It can be very difficult to tell the difference between hypochondria/addiction and genuine pain. It frankly doesn't help that doctors have put names like "fibromyalgia" to undiagnosable conditions - this gives legitimacy to drug seekers, making it even more difficult to treat the genuine cases.

Regardless, current drug laws are entirely unhelpful.

I have a very good friend who lives on pain management and I've seen how necessary it is. Sure there are people who abuse drugs but there are lots of people who actually need pain management. Personally, I live on Advil and Celebrex but once I get new hips I shouldn't need the pills nearly as much. But my friend has a condition (it involves the knees just as to be specific) that *can not be fixed* so to keep living, he needs almost startling amounts of pain meds.
To see doctors who are actually trying to help their patients getting mashed under the thumb of uncaring Feds revolts me. Reason is right.

Bradley's right. As one who works in a multi-disciplinary clinic and as one who has a sister who is an RN in charge of clinics, you'd be amazed at the things a druggie will do to get their fix. They also cause considerable damage and loss.

I'd like to know what you think of this idea, though. If you need pain medication, fine. You'll get it. You abuse it, even once, your home gets a new appliance. A dispenser. It will dispense your needed dosages at the appropriate intervals. Monitored via GPS. You so much as think about tampering with it or breaking into it, the police are on their way to confiscate the device and place you in jail.

Need to take an extended trip away from home? Fine. Bring it with you. No problem. It's on GPS. Inconvenient? Tough shit. You should have thought about that before you abused your pain medications.

As a sidebar, I very recently had cancer surgery and the doctors gave me Vicodin to ease the pain while my incision heals. They resorted to extreme overkill. I'm sensitive to these things. I took one half of a pill after the surgery and another half before bed. And I didn't need any more. So, I now have a bottle of 39 Vicodin tablets that I don't need.

If they do this much all the time, it's no wonder people become addicts.

It's so easy to scam pills, at least for awhile. My brother spent years going from doctor to doctor for what probably started as legitimate neck pain before they figured him out. Now, at least, he's too broke to buy prescription narcotics, so I wouldn't be surprised if he's back on the street stuff.

"If you know anyone who works in an urban emergency room, ask them about the people who fake chronic pain, attempting to get free narcotics"

How about, we let adults decide what meds they need when for pain? They want to be addicts, so what? Punishing those who need them because of the "oh how horrible" thought that someone might take them just to feel relaxed is fucking absurd. I appreciate having Mexico's pharmacies available to me, as a texan. If I need a med, I can always just go drive and get it.

If people misuse a medicine and cause themselves health issues, that's their problem. SHouldn't be covered by insurance. That'd thin the gene pool pretty quick.

I was in the Er for severe abdominal pain not long ago. They had no problem hooking me up to a morphine IV, but looked at me like a heroin junky when I asked about something to go home with. Asshats.

I've had 3 c-sections. It took a hell of a lot more than 1 vicodin to get me healed and ok. If you don't need pain meds, great, don't take them. Don't expect others with more pain or a lower threshhold for suffering to do as you do. And sure as hell don't try to legislate that they do!

What is illegitimate about being addicted to painkillers? Why shouldn't we just sell Vicodin or whatever to whoever wants to buy it?

Instead of hanging around emergency rooms, addicts would buy it at their corner drug store.

How about, we let adults decide what meds they need when for pain? They want to be addicts, so what?

The only problem I see with this is that ERs may become even more of junkie Nirvana than they already are, wasting time and resources that should be going to sick people.

We don't need to be dealing with more addicts. And making this stuff readily available will create more problems. So unless your idea of a good time is bleeding to death in a ditch by the side of the road because some junkie decided that he needed your money to pay for his fix more than you did, I really don't think you want more narcotics in circulation.

"I took one half of a pill after the surgery and another half before bed. And I didn't need any more. So, I now have a bottle of 39 Vicodin tablets that I don't need."

From the reading I've done, one of the problems with pain management is that there is no good way to tell how a pain med will effect someone who hasn't taken that particular med before. Body-mass guidelines aren't much help; some people are far more sensitive to a given med than others. I had surgery in 1985 where my nose was broken and reset (to correct deviated septum, an old basketball injury). After I woke up, they gave me a shot of Demerol. It did nothing. They gave me a larger dose. Still nothing. I made them stop at that point: "all those shots are doing is making my butt sore!" So they gave me codeine pills. That worked really well. A little too well, if you get my drift. After four days I realized what was starting to happen and I made myself stop taking them. Fortunately by then it was healed enough that Tylenol got the remaining pain down to an ignorable level.

I talked to my mom afterwards and I mentioned the Demerol thing. She said the same -- it has no effect on her either.

And actually I kind of like the sealed dispenser idea because it solves one problem that Patrick mentions: what to do with unused pills. I've been reading some about the environmental effects that flushed leftover meds are having. If you had a two-week dose in a sealed dispenser such that it was proof from tampering, and then you decided after a few days that you didnt't need the rest of them, you could return the dispenser to the pharmacy. They could restock the unused pills and credit them back to you.

I disagree with Bradley-

> Doctors have a responsibility to their
> patients' health that includes preventing
> drug abuse.

Well, I don't disagree with that precisely, but I think doctor's concern for individual health should outway wispy concerns about poorly-tended individuals who are outside the lawful stream of distribution for these medicines.

People who need drugs should be able to get them. It's like you're punishing law-abiding drinkers because some people get carried.

Patrick,

Judging by my local newspaper, there is no problem buying narcotics illegally, at least in my area. I don't think supply is a problem. There are plenty of robberies and burglaries as well to finance them.

So what is the government doing? Going after doctors who give people what they consider to be too much pain medication.

Being one who believes everyone should eat his own dog food, I hope they all experience the effects of their own policy. I think a few months of watching Teddy Kennedy in agony might be an overdue lesson for our political elite. Perhaps Senator Byrd might volunteer to be the next lesson.

Some people only learn the hard way.

Something must be wrong with me. I have no desire to run anybody else's life.

The idea of just letting people buy the meds they need is a nice idea, except for the fact that different addictions tend to prompt people to do different things.

Potheads are no big deal, generally. They go home, smoke their weed, eat voraciously and fall asleep.

By contrast, Oxycontin addicts are dangerous. They're worse than crackheads. If the problem was simply a matter of them sitting around getting high, no biggie. But there aren't too many places of employment that's going to keep an Oxycontin addict on the payroll, since someone who's hopped up on Oxy isn't likely to be a solid producer. So, they better have an inexhaustible supply of income...or they're going to be coming after yours. Whether it's by aggressive panhandling, or outright breaking into your house, they're going to do what it takes to get their fix. At least potheads can grow their own, and they're generally pretty mellow, even without their fix.

If Oxy becomes OTC, then you better get used to carrying and gun and have some good burglar alarms in place.

"unless your idea of a good time is bleeding to death in a ditch by the side of the road because some junkie decided that he needed your money"

Because it couldn't possibly be the War on Drugs rather than the drugs and the marginalized druggies that's causing this behavior, could it? Zealous LEOs depend on this hermetically sealed belief system to justify the devastation they spread. Its quasi-religious nature is shown by its absolute immunity to contrary evidence.

Consider for example the near-total absence of drug driven crimes in places such as Spain and Switzerland where prohibition has been abandoned. Bah.

--
phunctor

It frankly doesn't help that doctors have put names like "fibromyalgia" to undiagnosable conditions - this gives legitimacy to drug seekers, making it even more difficult to treat the genuine cases.

First allow me to address this fallacy. Fibromyalgia is a real illness. It is called a 'syndrome' because medical science has yet to determine what causes it, much like Multiple Sclerosis or ALS. Fibromyalgia patients have significantly higher substance P levels in their spinal fluid and consistently have the same series of symptoms, including sleep disorders (over 90% many with Alpha Delta sleep disturbance) and a genetic problems with hormonal function (http://www.ncbi.nlm.nih.gov/pubmed/17187510) It is real, it has been studied, and telling people that it is hypochondria is a disservice to people who are genuinely ill. Do some research before you flap your gums with no knowledge.

Let me give y'all a tour in the life of a person on long term pain management. I have fibromyalgia and have had it for many years although I was diagnosed with it about 9 years ago.

When I am off pain medication I have pain so bad that I can not stand completely upright and can rarely get out of bed. I take over 20 pills a day to manage various aspects of my pain, including extended release morphine. These pills do not completely get eliminate my pain...several times a week I am still in pain to the point of nausea and tears, however I am able to FUNCTION. I can hold down a job, work on my book, have sex with my husband. These are all things that I cannot do without the pain management.

I follow doctor's orders to the letter. I never take more than prescribed, I always bring my pill bottles in so that the doctors can count my pills if desired, and I submit to every drug test and medical procedure joyfully. I go to the doctor's appointments each month and follow all of the rules in my narcotics contracts to the letter.

However recently the DEA moved into Houston to get rid of pain doctors that they felt were over prescribing medications. They recently charged a doctor with drug trafficking for prescribing a patient an average of 3 Vicodin a day. That is actually well below the maximum dosage for long term patients considering that it is usually recommended to take one every 4 to 6 hours. This action by the DEA and additional actions forced my pain management doctor to close his doors in Houston. That has left me with 30 days to find a new doctor. I am an ill person with long term medical records documenting my illnesses and my consistent following of the rules of medication management.

I have gone to several doctors appointments where they refused to treat me because my pain is not from cancer. Others are insisting like our ill-informed associate, bradley13, that FMS pain shouldn't be treated on the long term. Most (and I've spoken with or seen 20 or more) just tell me that they are no longer doing medication management. They are scared to death that they will be the next to be arrested. I can't say I blame them, but as I face the possibility of going through morphine withdrawal in my living room and the thought of the agonizing pain I had before pain management, I don't know what I will do if I cannot find someone to assist me in managing my pain. I won't do anything illegal, and I certainly won't steal, but I am not going to face the next 60 years of my life in agonizing pain with no relief possible.

I live in a city with the largest medical center in the world. I am a good patient with a solid long term history of illness and appropriate pain medication use. I'm well educated about my illness, my limitations, and I am fighting tooth and nail to continue working. If this is effecting me negatively, what is it doing for everyone else? Millions of people are unable to function due to long term pain. Why are we attempting to deny palliative treatment to the ill and dying? Isn't it better to increase their function than to force them on the dole?

Amy, thank you for taking on this cause!

http://allnurses.com/pain-management-nursing/drawing-line-between-58993.html

-Julie

Julie: That sounds horrific. You've actually motivated me to write to my congressmen about this. Good luck.

MonicaP, thank you for the support. I truly believe that any visibility we can give this issue will be helpful. I'm formulating a plan to increase the visibility of this issue on a national scope. Maybe start a fund for the legal support of pain doctors, I dunno. If I'm going to hurt like hell, a mission might be the thing I need to crawl out of bed each day.

I also want to make another point. I am one of the lucky ones. I am intelligent, well educated, able to work a job where I sit on my ass most of the time. I have 'state job' benefits. I am able to get medical care more easily that probably most of the people in this country. All of that and I am having difficulties. It truly scares me to think of what someone without all of those advantages has to do in order to live with pain.

-Julie

By contrast, Oxycontin addicts are dangerous. They're worse than crackheads. If the problem was simply a matter of them sitting around getting high, no biggie. But there aren't too many places of employment that's going to keep an Oxycontin addict on the payroll, since someone who's hopped up on Oxy isn't likely to be a solid producer. So, they better have an inexhaustible supply of income...or they're going to be coming after yours. Whether it's by aggressive panhandling, or outright breaking into your house, they're going to do what it takes to get their fix.

I'm skeptical. There are millions of Oxycontin users in the United States now, yet we're not being overwhelmed by addicts who are breaking into our homes to feed their craving. Countries that have decriminalized drugs have not seen a crime rate increase. Why would we?

Even if legalization did temporarily increase the crime rate, there is a better way to deal with an increase in burglaries: imprison those who do it. To help we'd have the massive amounts of law enforcement and prison system resources that would be freed up by ending the war on drugs.

Outweigh.

Sorry.

The humiliation burns... Sumbuddy medicate me.

I'd like to know what you think of this idea, though. If you need pain medication, fine. You'll get it. You abuse it, even once, your home gets a new appliance. A dispenser. It will dispense your needed dosages at the appropriate intervals. Monitored via GPS. You so much as think about tampering with it or breaking into it, the police are on their way to confiscate the device and place you in jail.

Patrick, I would volunteer for the appliance now, despite the fact that I've never abused my medication. I suspect most people with pain issues would. The problem is that most addicts didn't become that way through long term pain management.

http://www.kap.samhsa.gov/products/brochures/text/saib_0401.htm#painmanagementwithopioidmedications

The hoops you have to jump through are too great. It is the pill mills and people who rob pharmacies and sell the pills on the street that feed addicts.

-Julie

Oh I dunno, Crid, I kind of liked the wave-of-drug-crazed-zombies imagery.
--
phunctor

i work as an rn in a specialty hospital, and the problem i run into most often is patients who are actually in a lot of pain (pain impedes the healing process, did you know that, it's been documented) refusing pain meds because they're terrified of becoming addicted. what people don't generally understand is that there is a REALLY BIG DIFFERENCE between addiction and physical dependency. addiction means you take stuff you don't actually need to get high. physical dependence is what julie has. will she go through withdrawal without her morphine? yeah. does that mean she doesn't need it? hell no. she's taking it for an actual medical need. which still exists. and always will exist. cancer patients have pain. they're not the only ones. good luck julie. that particular problem hasn't hit wisconsin yet, we still consider pain to be a medical emergency. i am actually expected - and do - call the doctor at 2 am if the patient's pain med isn't working. and he doesn't even yell at me, he just gives me something else to try, because he wants to know these things. other things he does not want to know at 2 am.....

oh, and to answer the question, would i go to jail to treat my patients' pain? yeah. that's my job.

what people don't generally understand is that there is a REALLY BIG DIFFERENCE between addiction and physical dependency. addiction means you take stuff you don't actually need to get high. physical dependence is what julie has. will she go through withdrawal without her morphine? yeah. does that mean she doesn't need it? hell no

I explain it to people by referencing my diabetic medications. If I don't take them, I will suffer the original physical problem, and sometimes might suffer additional problems for stopping them quickly. Would anyone really say that I am addicted to Metformin? I get no more of a high from my Metformin than I do from my Morphine. Both alleviate the symptoms of problems that I cannot solve.

Thanks for the good description Whatever.

-Julie

oh, and to answer the question, would i go to jail to treat my patients' pain? yeah. that's my job.

Please forgive me for being so naive, but why should you have to? I appreciate you (and all of the other medical professionals) being willing to put yourselves on the line to ensure that I don't have to live in agony, but it is stupid that the government is forcing your hand, and I cannot blame anyone who looked at spending the rest of their life in prison and said, "Ya know what...I don't think so".

I need to do something...I'm going to figure this out.

-Julie

i don't think i should have to go to jail either, obviously, and i really really really hope i don't have to, but i will. that doesn't mean i'll think less of someone else with my license who chooses not to. but i do take it seriously to keep my patients as pain-free as possible, i have two rules that i tell my new patients - 1, they have to tell me if they have pain because i'm not telepathic, and 2, if they've waited more than 5 minutes for me to show up with their medication i'm either performing cpr on someone else or i didn't get the message from my nursing assistant (that second part doesn't happen often, they take patients' pain more seriously than i do where i work!). they like me because of that.:)

Hey, momof4. My apologies if I gave you the wrong impression. I didn't mean to imply that you could have or should have gotten by with only one Vicodin, or that your greater need is to your discredit or my credit. Your C-sections sounded like a much taller order than my 2-inch incision on the back of my neck. If I had had something similar (obviously, I will never have a C-section), I'm sure that I would have needed more than a single Vicodin.

I only meant that it's unfortunate that they felt I should have forty Vicodin pills, when I barely needed one. (I'm not even sure I needed the one. My sister, an RN, drove me home after my surgery and suggested I take half a one before the anesthetic wore off so I could "stay ahead of the pain," and then the other half before bed. She had to open the pills for me, by the way. One of those medicated patient proof bottles. I struggled with it for about five minutes before she opened it for me.)

I'm only regretting the fact that there isn't some way to determine who needs what, so that my 39 extra vicodin pills don't get wasted. You'd go home with all the ones you need, and I would just get my single pill.

But I guess that's hard, if not impossible, to determine.

Julie, I commend you on your heroic struggle. I know that there are some doctors, even today, who will insist there's no such thing as fibromyalgia. Personally, I think that's a little arrogant. Just because they don't know what causes it, and what physiological changes to look for when they diagnose, it doesn't follow that it doesn't exist.

As a massage therapist, I treat fibromyalgia, with quite a bit of success. I hope if massage can help you, you avail yourself of it. In some cases, insurance will cover it. Just make sure you find someone who actually has the training to deal with this particular condition. Ask to see the certification and course description. Because fibromyalgia is a specialty. It's not something massage therapists are typically taught how to do in massage school. It's a CEU type deal.

useless information for you. have you ever noticed that a lot of the illnesses that doctors think are not real have a tendency to be more predominantly "female" diseases? the medical basis for determining "normal" is based on men. because our hormones make everything fucked up. not that long ago being female was in and of itself classified as "abnormal". so there you go. they thought lots of diseases were not real before they figured out what caused them, by the way, not all of them "female" diseases. just fyi. because i'm bored.

Whatever, women are also especially vulnerable to autoimmune disorders, although no one seems to know why. A doctor in my clinic thinks that it's due to stress. I wonder if fibromyalgia's an autoimmune disorder, too.

Lest whatever's good name be besmirched, I'd to be clear that the whatever posting here is not the Whatever who gets into pissing contests with Brian, Conan and others. Right on, though, whatever. It sounds like you really take good care of your patients.

My personal experience is that my physician is petrified to prescribe anything that might be addictive. It sucks to be an insomniac and in his care because he refuses to prescibe what actually solves the problem because Ambien can be addictive.

We have overreacted to a legitimate fear of addiction and consequently created a litany of problems worse than that which we feared in the first place.

actually patrick a lot of people think fibromyalgia is some kind of autoimmune disease. i have a personal and completely unsubstantiated (i.e. no actual evidence, just my random guess) idea of why women might be more susceptible to autoimmune studies.....i've read studies that say that the immune system is like any other, use or lose it. you know, the basic concept behind vaccines - if your body never recognizes it, it can't fight it, and then it never learns to differentiate between "self" and "other". one of the best ways for people to develop a good immune system is to play in the dirt. you get exposed to small amounts of a very wide variety of bugs that way. girls don't do that as much as boys.
and Whatwver (methinks it was a typo, but we'll go with it) is right, i'm not the one tht gets into pissing matches with the three musketeers, although i could if i thought there would be any chance of being beneficial. i'd just piss myself off. better to try to ignore their blathering. and now they will proceed to jump down my throat. oh well.

Better nicknames. Small price to pay for Amy's hospitality.

"oh, and to answer the question, would i go to jail to treat my patients' pain? yeah. that's my job."

The sentiment is appreciated, Whatever, but you can't do your patients any good if you're in jail. Be careful out there. And thanks for fighting the good fight.

(obviously, I will never have a C-section)

Well, you never know :) i think it's admirable your Dr didn't want you to have to deal with pain, and good for you for taking what you needed only.

I had a dr that wouldn't prescribe ambien, or for that matter just about anything else. He said I needed to learn to live with my natural sleep cycle. Uh, no, I have 4 little kids, I need sleep. I switched Drs to one not afraid of her prescription pad.

Interesting theory on the immune disorders and women. I'm glad my girls play in the dirt :)

have you ever noticed that a lot of the illnesses that doctors think are not real have a tendency to be more predominantly "female" diseases?

I have noticed that. I like to think that it is because most physicians are men and women communicate illness differently. I've never seen a comprehensive study looking at that phenomenon. I can tell you that it takes the average woman 7 years to be diagnosed with FMS. The few men that get it are usually diagnosed in less than a year.

Patrick, I have pursued massage to help with my pain, but I also have hundreds of myofacial trigger points. (Claire Davies is a God!) The combination requires a level of education that I haven't been able to find yet. When I go to an inexperienced person, it makes things worse for weeks after, so I kinda gave up looking. I do TRP release on my own at home when a few get out of hand, but it is impossible to resolve they all without misery, so I gave up the cause.

The most interesting conversation I had with a researcher was about another illness I have Chronic Fatigue Immune Deficiency Syndrome. He determined that the genetic markers for CFIDS and autism are the same. His hypothesis (that he was attempting to test when we communicated) was that in little boys (more boys than girls are autistic) had a greater genetic sensitivity to the inoculations they got as babies causing Autism. Something in girl babies kept that problem from happening, but the genes manifested later as CFIDS, usually after a large illness or childbirth. The solution was never to avoid inoculations (1 in 300 kids will die just from the measles) but to figure out what component was causing the problem and find a replacement for it.

I also have other autoimmune illnesses (psoriasis for one), so I wouldn't be surprised if FMS is autoimmune. The only way medicine treats autoimmune illnesses is by reducing the immune systems reaction. Not a good solution IMHO, but it is what we have currently.

The most recent theory is that FMS has much to do with disordered sleep. They've done multiple studies where they deprived healthy young people of sleep and after a couple of days of significantly reduced sleep, they start to manifest symptoms of FMS. Once the sleep returns, healthy people loose their symptoms. Interesting idea, right?

-Julie

Interesting aside - My mother has fibromyalgia. I thought it was yet another "made up" disease, but it ain't.

Seems that it's caused by a melatonin shortage in the brain.

And in favor of the autoimmune theory - if she doesn't eat anything with gluten in it, she rarely has any attacks. No, she doesn't have Celiac's disease - the gluten doesn't kill her intestines.

good point cousin dave, but at the same time, if i'm not able to treat my patients' pain while i'm not in jail, i'm not helping them anyway, so i might as well put that effort into trying to change the system too, don't you think? i don't know. like i said, i'm not saying someone who chooses to stay out of jail is a bad nurse or anything, just sayin what i would be willing to do. also i'm just a stubborn bitch, and i don't want some freak telling me what i can and can't do to take care of my patients, unless that freak is the doctor or my boss who has the right to tell me. it's not all about principle, it's a little about having authority issues. :)

I understand that. It's a fine line, and ultimately you have to judge for yourself. And you might think this is strange coming from me, but I don't think there's anything wrong with having a few authority issues.

And in favor of the autoimmune theory - if she doesn't eat anything with gluten in it, she rarely has any attacks. No, she doesn't have Celiac's disease - the gluten doesn't kill her intestines.

I've heard the gluten theory myself. I've also heard the theory that FMS and CFIDS are the same thing. Living on the inside of both of them, I can make the distinction, but since CFIDS is primarily caused but ATP deficiency, it is possible that the muscle pain/spasm, etc. could have the same root.

Starting Oct 1 I am going to go on an extremely low cab/low calorie diet and see if I can elevate my ATP levels again. I've tried supplementation and shots, but stress reduction and pacing have always helped my numbers more. I also noticed when I lost 100 lbs (that I've kept off) using low carb/low calorie, that I felt much better and had more energy. Anecdotal, but it might lend toward the no gluten thing as reducing carbs naturally reduces gluten.

-Julie

gluten intolerance isn't as common as we tend to think it is. people stop eating it because it's the trend. they notice then, that if they do eat it, they get uncomfortable. they then deduce that they have an intolerance. not true - guess what? your body only produces the enzymes to digest what you're actually eating. if you haven't eaten something in awhile, you won't have those enzymes, which will make it more difficult to digest at first, but if you continue to eat it you will start producing those enzymes again - rather quickly - and be fine. it's the same reason why a long-time vegetarian gets indigestion if they eat meat once. they're not allergic or intolerant of it, they just don't have those enzymes in ready supply. just fyi. i'm full of useless facts.

if you haven't eaten something in awhile, you won't have those enzymes, which will make it more difficult to digest at first, but if you continue to eat it you will start producing those enzymes again - rather quickly - and be fine.

This is where I show how anal I really am...

I keep a journal of daily activities, sleep, food eaten, as well as symptoms experienced and pain level, and an over all 1-10 rating of how I feel that day so that I can track cause and effect over the long term. With that I have found a series of cause/effect associations as well as being able to track the time of year I will feel the worst (Don't expect me to do much during the month of March).

I never make a major change to anything without a few relatively clear weeks behind me (don't try to change during a flair, sometimes you will just 'bounce out' of it, and then make an incorrect assumption about what caused it). I can tell with certainty that I felt better during the low carb/low calorie diet, but I fell into the depths of hell in 2007 health wise and kinda fell off the wagon (That is when I learned the lesson of stress reduction. I won't even watch a TV show that gets me excited now...it isn't worth the consequences. My doctor once told me that CFIDS is a pathological inability to deal with stress). I've made a series of changes and crawled my way back up since then, I'm ready to make this additional change to attempt to further increase my functionality and reduce my symptoms. It is a question of maintaining it through the initial few weeks of misery.

This is a very long winded way of saying that I tracked how I felt before the diet, and continued tracking through the diet, so I know a 'before and after' not just 'I feel bad when I start eating again'.

-Julie

i didn't mean that you specifically didn't feel better off the gluten, i was only saying for people to be careful with generalizations that it's necessarily bad for "normal" people... there seems to be a craze right now for people without food allergies - like an actual gluten intolerance - to decide that they shouldn't eat them either, and then using bad logic to decide they were right. and it may also be the carbs themselves that make you individually feel worse, and not have anything to do with specifically gluten, either. i don't know. i just find false logic and information annoying.

i just find false logic and information annoying.

I know, and I wasn't trying to be shitty to you, only to explain that in this case I'm following science (or as much of science as I can with a sample group of one). I agree that too many people read something stupid online and freak out when a little bit of logic and research would serve them well.

-Julie