Many Standardized Tests do not Measure What they Should

Reason 2/5: Why Making the Atlanta Public School Teachers Felons Won’t Make a Difference:

Ever looked at a high school’s English curriculum? The objective strands look like a list of “shoulds”: Child will be able to synthesize primary and secondary documents. Child will be able to recognize post-war poetry elements. Child will be able to use punctuation properly. Child will be able to properly conjugate helping verbs. There are scores of these objective strands.  And on a standardized post-test, because there are so many strands, and they all need to be represented, each one of those elements gets usually just one question. So apparently using proper verbs is equal to recognizing Post-War poetry elements; worse, if the child misses the single question about verbs, then apparently he knows nothing about verbs, and I’ve taught him nothing about verbs.

A strand that says the child can develop a thesis and defend it with strong writing cannot be accurately tested on a multiple choice exam. So wrongly, in order to assess that strand, the child is asked to find the thesis statement in an offered essay. Test writers often do not spend enough time writing these questions well, and honestly, there really might be two or three sentences that could work as a thesis statement. As any good writer knows, essays don’t really have just one sentence that guides the whole flipping essay. (Tell that to the testing boards.) So, based on these standardized tests, a kid who can select a thesis out of a choice of four answer options, but not ever write an essay is deemed just as educated as the kid who writes well.

One year a major writing test that our county system gives to tenth graders had a major flaw. Over forty-five percent of the kids went down the rabbit hole created by this flaw and failed. Instead of retesting the whole population with a valid test, because there were already scheduled retests in place for kids who fail, the board did nothing about this flaw; they let the failures go on the children’s records and simply retested those students. The next year a new question was developed and applied. 85 percent of the kids passed on the first attempt. Suddenly, our county was bragging about how much better we were all doing as educators. LOOK how high this year’s scores trump last year’s! Aren’t we grand?   These scores didn’t represent what they are supposed to, at all.

So not only are objectives unbalanced in terms of importance, not only is success defined inaccurately, but we misuse the data collected.

How does the APS judge expect teachers and children to take any of these tests seriously when we know we are all being misrepresented?

Next up: Reason 3/5 Why Making the Atlanta Public School Teachers Felons Won’t Make a Difference:

The Tests Dumb down the System in General

Why Making the Atlanta Public School Teachers Felons Won’t Make a Difference

Good teachers don’t worry about being measured and evaluated. But I have to clarify, we don’t worry about valid, worthy testing, testing that actually measures what it says it will, and measures knowledge that is relevant. Right now those sorts of measurements don’t exist

The teachers from the Atlanta Public Schools system deserve what is coming their way. . .To a degree. Did they know at the time they were committing something immoral and unethical? Did they know they could lose their jobs and careers? Yes. They had to. Did they know they were committing a racketeering felony? Probably not.

Elementary school teachers are not famous for being overly educated. Yes, I know plenty who are sharp and brilliant. But too many of them graduate from local paper mills with low entry and exit standards,; they earn what many college students know is the least intellectually challenging degree offered (if not the most tedious):a Bachelor of Education. (Face it: a course called The Theory of Education is never going to be as challenging as Thermodynamic Chemistry, nor Math for Children as deep as Legal Statistics.) So more than likely, those fraudulent APS teachers didn’t think clearly enough to wonder if they could be arrested.

What law did they think they were breaking? None. I’d bet they believed fraud laws were all about money and theft. Silly them. But then when they were arrested, they didn’t believe they’d go to jail, be convicted. 21 of 36 defendants admitted they were guilty before trial. Of the eleven remaining, only one of the accused took the D.A.’s bait to plea bargain down his sentence. The other defendants took their chances and went to trial. AND then, after being convicted and called Felons, when offered a chance to bargain again for their punishments, no one took that offer either. They believed perhaps they could go win an appeal? On what grounds?

I understand that sometimes when one feels righteous, one doesn’t want to knuckle under. I also get that sometimes the plea bargainer affects the outcome of those who choose to go to trial. But ultimately, these folks did commit fraud. They did racketeer. And they did so for financial gain (their incomes.)

And my bet is that they did this with impunity because this sort of illegal manipulation is overly common. It’s the “everyone is doing it” defense.

Here is my beef:

The judge thinks he is helping the children of our future with his severe reaction of long jail times. Perhaps. But the system of testing, and performance-for-pay is so broken, has so many flaws and loop holes, that his ruling barely makes a ripple in improving the structure. Yes, it might stop a group of teachers and administration from sitting around a table and openly defying the rules in the future. But that doesn’t mean the testing currently in place is now going to help the children at all anyway.

Five Serious Reasons why:

  1. There are still plenty of ways to cheat.
  2. Many Tests do not Measure What they Should
  3. The tests dumb down the system, in general.
  4. The children rarely fail anyway nor get remediation even if they fail the test.
  5. The tests can be manipulated to fire or secure workers who don’t deserve it (see number 1)

Teachers know this, so it is hard for them to feel supportive, patriotic, even ethical when it comes to testing. It’s like being asked to take the gossip on FB or Nightline as serious.

Let me break this down in a series of Four separate posts, if you care. This knowledge is important for anyone who can affect the political machine called education.

Reason 1/5: There are still plenty of ways to cheat.

These Atlanta folks got caught because an AJC reporter who was paying attention began to wonder what this one elementary school, a school that had for several years in a row gained in their scores by leaps and bounds over its comparable sister schools; if the gains were real, why wasn’t APS requiring the sister schools to do whatever it was that the “successful school” was doing, the reporter asked. But there was no difference in anything they did. And from there the story began.

Someone at these sister schools blabbed. See, teachers shift schools, though they are still employees of the same system. They develop allegiances and conflicts with former bosses. Someone who used to be in the law-breaking circle ratted them out. But even if the tattler hadn’t come clean, there is an independent group that can take the scantrons from the tests and do a comparative match. Too many erasures in the same places? Too many kids getting number 36 right, when number 36 is predicted to be the question that only half the kids will know? Hmmm.

So cheat method one is to literally change the answers. APS did this as a group. But there can be one principal who does this him/herself in the wee hours of the night. Who would know if no one is auditing the scantrons?

When I have had to proctor high stakes tests, here is how it has often worked. I go collect my testing materials. I sign them out. I get a box with a particular number of scantrons, pencils, test directions, test booklets. I sign something that says I won’t even look at the test. I administer the test. And at the end of the testing period, sometimes at the end of the day, I return all materials.

BUT imagine Student Bobby is the first to realize there is an odd typo in test question 32. Then Suzy. I’m not supposed to look at it. Do I go ahead and try and help them decipher the question? George shouts out the answer anyway. I have to report this “aberration in the testing environment.” Glancing at the questions to see if it is ethical to help overcome the typo, I realize George is wrong. He might be shouting out the wrong answer on purpose because he is a brat. Who knows? Do I help? I don’t know. But either way, I could easily tell everyone the answers.

I’m supposed to proctor everyone else’s students, not my own, in order to “maintain the integrity of the testing environment.” In otherwords no favorites. But I’ve been around the school and community for a long time. The kids all know me. I’ve taught some before. I taught their siblings. I hate this test. I go ahead and answer their question when they get stuck and try to get them to “figure it out” with hints. They are so stressed out. . .am I less or more ethical than the convicts from APS? This method of cheating could show up on an audit, but probably won’t because it is one class set of tests.

I return my boxed set to the administrative helpers (teachers who are not supposed to be teaching any of the test takers currently, so they won’t be tempted to cheat.) They pass it along to the testing administrative secretary, who supposedly locks it up for lunch until the testing administrator comes back, and they count all the booklets triple times, sign a bunch of documents, and lock them up for the night; someone from the county delivers them to a central location later when absentee kids get a chance to take their test.. At this point, three separate people besides me at the least have touched my tests, and each has had the chance to change answers without me knowing. (Did this happen to any of the APS crew?) An audit might be able to catch this one too, though it cannot tell anyone who was responsible.

Or kids themselves, knowing the proctor doesn’t know who they are can send in another kid to take their tests. One kid takes the math tests, the other the LA tests. We don’t check IDs and you’d be surprised how few students will rat on each other.

Plus, every now and then, we get to proctor our own kids, especially if the tests are given online. These labs get used over and over for tests through the day, and kids will literally write the answers on the desks for the next incoming group. Kids have pens with cameras in them now, too, and can sometimes pass along whole test pages. I’ve heard of teachers who will write certain answers on the board without drawing attention just to see if the kids will notice. And some do. “Hey, look. . .24. A.” Of course, these accusations can never be proven after the fact except through an audit, or a confession, which a school system never asks for.

But here’s another way many teachers can cheat. At my school, teachers are assessed by the jump from a pretest score to a post test score of a set of kids. The system decides what this group of kids should be able to score once they have learned. The closer I can get them to that score, the better. BUT it is even more rewarding for me as a teacher to have a huge jump. So if my illiterate kids score a 12 on the pretest and a 70 on the post test, this is better for me than my gifted kids who score a 91 on the pretest and then a 98 on the post test. And guess what, since the pretest is not “secure” I get to give it to my own students.

I’ve known of teachers who literally tell their kids to “Christmas tree” the pretest. It takes two days to give. I’ve also known of teachers who give it one day, and if the kids don’t finish, oh well. SO those cheating teachers look like they are masters when the post test comes around, because obviously, the kids will do better on the post test which gets averaged into their grades than the pretest they were told to Christmas tree. And guess what? Noone wants to dig into my accusations of this unethical behavior, though auditing pretest scores , might easily show what I am describing.. I cannot prove it after the fact myself if the accused won’t confess.

Again, the “everyone is doing it” defense makes it hard for teachers to put any serious belief behind testing. The judge’s harsh punishment of these teachers, though warranted, as affected this beliefminimally.

Next up: ”Reason 2/5 Why Making the Atlanta Public School Teachers Felons Won’t Make a Difference: Many Tests do not Measure What they Should.’”

On Being Licked to Death

A few years ago, I admitted to my husband that had I known we’d have to spend this much time with his Mom, I would never have married him. I think he loved me a little less after that, but I don’t care; I still mean what I said.

My Mom says my irritation is just an in-law dynamic. Should your Mother-in-law or daughter-in-law be perfect you still would find her irritating. I mean Mom can reorganize my spice cupboard without permission, send me sixteen articles about how to parent, nag me about haircuts, and all just washes right off me. I love her that much. But should my MIL bake me a batch of macaroons. . .try to give me a magazine subscription? I’m rubbed raw.

My mother-in-law is sweet, generous, outgoing. . .a woman who gathers friends like lint. She’s NICE, GODDAMNIT. However, also needy, passive-aggressive, and dishonest, she is a stress-inducing conundrum I can’t solve. To make matters worse, she wants to be around me All. The. Time. If it were just that she wanted to spend more time with her son, fine. I’d be happy to send him over every so often. But no, she has to win me over, and no matter how nice I am to her, she knows she hasn’t.

My husband? He doesn’t fully understand my annoyance because their relationship is so profoundly different from mine with her. When he visits her or she visits us, he quickly disengages in some manly way, getting involved in a handyman project, or disappearing into a sports broadcast. She is sensible enough not to bother him then. So she turns to me. . .

Let me begin with an analogy. We recently got a puppy, a sweet submissive female. We already have a grand Alpha Male, a Picardy Shepherd who struts around the house showing off his regal mane. Well, the puppy , being submissive, wants to lick his face. He can’t stand it for more than a second or two. He growls at her, sometimes nips her. This only makes her want to “submit” even more. Now she’s jumping, and licking, pawing and licking, grabbing his face with her paws and licking. He’d probably have to kill her to stop her.

My Mother-in-law is licking me to her death.

My birthday was earlier last month. A few weeks before, my MIL called me late one afternoon. I was napping and didn’t catch the call. Tony came home from work. HIS cellphone rang.  His sister was calling to confront him about how their Mom had been trying to call me, and why haven’t I called her back. See. . . MIL called only once, waited less than an hour and then drew my sister-in-law and husband into a triangle to discuss not only why I am avoiding her callS, but what they are planning to do to me on MY birthday.

MIL wanted to drive over and get me, take me to SIL, and then to Tony’s job site to lunch, a thirty mile tour. SIL thought it would be better to come to me, leave my husband at work, and do lunch from my house. At no time did any of them ask and include me in the plan. I was just the bad guy in the back ground avoiding (supposedly multiple) phone calls.

I handled it by letting them know that I had other plans.   His family thinks birthdays are national holidays. Should we need to do anything else on “their day”, we are committing a family crime, even if it is OUR birthday. His mother pressed on, so Tony decided I was going to her house later in the week for dinner. (We’ll address his decision making issues at another post.) So to make them all happy, I complied.

She wasn’t going to relent.

Driving home after my birthdaty meal, Tony said, “Well. . .don’t you think that was a nice visit? I think it’s more relaxing when it’s just us and her.”

I wish I could blow steam out of my ears for real. I finally said, “I really think you don’t get it. She simply doesn’t treat you the way she treats me.” (His sisters once told me that my MIL had issues with the fact that my husband looks so much like his Dad, my MIL’s long gone ex-husband. Maybe this is why she handles him with more distance.)

“She pretty much leaves you alone or you disappear.” (This time he found that her new satellite radio system needed tweaking.)

“Me, she just can’t fucking leave me be. Everything is complicated. Everything is a push to hear praise or to insert herself. . .” He seems to only know I’m serious when I trot out the F word.

I go on to describe this: Upon arriving she always, ALWAYS tries to kiss me on the lips. I’m fine with the hug. But even the kiss on the cheek seems pushy to me. When did Americans get all lippy? Some men can get away with it. But my MOUTH? That’s reserved for my husband and, for a time, my sons when they were young. Once the boys were uncomfortable, they stopped. But no matter what sort of deflecting I do, head ducking, arm blocking, my MIL is going to land that kiss on my mouth or at least near it if she can. I am not exaggerating. And not a quick peck. A full, lingering smooch.

Why don’t I tell her to stop? Because I once told her something along those lines years ago, and at the next gathering all I heard whenever someone else arrived was a loud repeat of my “directions.” The passive aggressive wench. I don’t need her to yell out to everyone who meets me: Don’t kiss her on the mouth, she hates that. So instead I deflect and hope she will catch on. Eventually.

After arriving, I find a spot on the sofa that is comfortable for me. With my disability, I cannot sit just anywhere. I’m happy where I am. MIL pushed me to try this pillow, that pillow, this chair, that chair. No matter how many times I said that I am fine, she found something else to suggest. Finally, she asked Tony to go upstairs and bring down the chair that. . .Tony told her no. She shut up.

She served Tony some iced tea as I poured myself some water, which is what I always drink. Tap water and ice cubes, perfect. She jokingly asked if I had something against her special water that she filtered and refrigerated just for me so it would be cold. (That’s fine.) I dump out the tap water and reach for the filtered. She then stopped me. . . “Or did you want bottled water?” (No, whatever). “You do. You want the bottled.”  I told her to just give me whatever she wanted to give me. (Jesus! I think in my head.) I finally received a glass of water and returned to my spot on the sofa. Again I get a push to at least use this special pillow that she retrieved from her bedroom. Then when I said,  “No, no, that hurts,” as she was shoving it behind my back against my will, she asked if, maybe, I wouldn’t be able to use that pillow at home. I told her no, but maybe Tony could, throwing her a bone. She set it aside for later.

She began her typical peppering of questions for which she rarely waits any answer before the next query. And her questions always go toward the negative. WHY? Not because she is negative, but because if you answer the personal negative things, then well, she must be close to you; she is in “the know.”

Did my son finally get a job, did my Dad let my Mom come over alone like Mom wants, or did he have to accompany her, is our friend still dating THAT woman?   Tony puttered away in the back ground while I was on the hot seat, not wanting to share any of the answers with her. The information was not her business, and it makes her feel unnecessarily close. If you ever mention a struggle with your boss, it will be a question she asks you forever. . .and she will repeat and twist what you have said. Silence is the best option, but an impossible option.

She served us an appetizer of exactly seven wings to share. . . From this new place she discovered. She went there earlier today to pick them out just for us. Just a little something. . .How are they? (Good.) Really? It wasn’t a lot of trouble, she admitted. She just thought it would be a nice change. What did we think? (Yummy.) Are you sure? Mom did a good thing? (She talks about herself in the third person.) There are some spicy teriyaki, a few lemon pepper, some garlic basil. . .what do you think, a good selection? (Oh, yes. You done good. Really.) A friend of hers suggested the place, and MIL just thought perhaps a quick run over there that afternoon was a good idea. We were worth it. Yummy? Yes, yummy? (Sigh).

I kid you not. Every kindness she performs is met with a neediness that no amount of compliments can fill. I once thanked her eight separates times because she bought me a taco at Taco Bell. Tony has tried to teach me to say thank-you once, and let her just hang there when she asks for more. That’s tough when someone asks you a direct question. I’m still learning.

The worst part was that we all knew that these were probably wings that some neighbor had brought over the night before. She and her local retirees like to gather for drinks, lots of drinks, and a little food. These were some leftovers she served rather than thinking about an hors d’oeuvres, which is fine by me; I don’t care if you serve me peanuts or nothing. My complaint is the lie she tells so she can seek the praise without the work.  I mean: who goes across town to select seven wings for three people?  But we all have to act as if this is exactly what she did just for us.

She realized suddenly that she has some sparkling water. She pushed this on me, though I verbally doubt that what she is showing me is water, and I remind her how satisfied I am with simple water.. The bottle she found looked like artificially sweetened, flavored soda water. And after she happily served me some, that is exactly what it was. Some sort of diet soda, which I hate and she knows this. I try to drink it. (Sigh.)

When she wanted to make “whatever you want” on my birthday, I relented and suggested Linguini with clam sauce. She had made it for me before. I love it, I knew hers was good, and I thought it was cheap and easy. I was wrong.

When I make it, I use two cans of chopped clams, Olive oil, a few cloves of chopped garlic, the juice from the cans, and if I need, milk. I might add lime, or parsley or basil, or parmesan, should I have some on hand. She however met me at the door already telling me that she had been prepping this since yesterday. She bought a special kind of clam (still canned, just much more expensive), bottles of clam juice, the expensive kind of linguini (?), fresh this, fresh that, cream, and, as she explained, “hand shredded artisanal parmesan”. What should have cost her 7 bucks for an entire meal, probably was forty bucks, and I better know it and acknowledge it, by God. She pressed me to follow her, and notice all the stuff she is “trying” this time. Her meal was tasty, but I would have been just as happy with something less complicated and costly.

But My MIL has a reputation for making things so much more complicated than they need to be. Of course, she then offended me by serving me about a half cup, and my husband a mounded 3 or 4 cups. Did I mention how passive aggressive she is? Then later, when my sister-in-law called, MIL again detailed the meal she cooked and asked SIL if she can bring some of “Mama’s special homemade linguini with clam sauce” over to my SIL’s husband. No. “ReallY?” she said, “Well, I guess I can send it home with Tony for his lunch tomorrow. How disappointing.” See, she had already scored with us. She was hoping to score with the other in-law, too, off the same meal. And of course, she did not send any leftovers home with us.

I noticed several books, each with book marks on her coffee table. (She has a tendency to purchase the recommended things, place book marks in them as if she is currently reading all of them, and then never break the spine open, ever.) There was one I was interested in. Here’s how the conversation would go with my Mom or any of my friends.

Me: Are you reading this? Do you like it?

Someone else: Yes. When I finish do you want it?


Someone else: Yes. I’m finished.

Me: Do you mind if I borrow it?

Someone else: no problem.

Then It would go into my purse  to be returned later with a warm thank-you. Instead this is how it goes with my MIL:

Me: Are you reading this? Do you like it?”

MIL: What? That? Oh, are you interested in it? I thought it would be really good too.

Me: Can I borrow it when you finish?

MIL: Um, do you want to read it?

Me: Yes. Are you finished (I mean there is a bookmark half way in it.)

MIL: Do you want the other one, too, look at this one? (Holds up another)

Me: No, no, just this one, I’ll take it when you are finished if you don’t mind.

MIL: I just had heard such good things about it.

Me: Yes, have you started it? Do you want to finish? (I really don’t want her to give it to me if she is actually still reading it.)

MIL: Oh, take it now. Take them all. Here. . .(and then led me to review the books lined on her table and then in the guestroom. I’m encouraged to take any of them.)

MIL: I’m so glad that we can now exchange reading material, that I can give back to you, too. It’s nice that I have some books that you want to read instead of the other way around.

Me: (Thinking) huh? (Awkward).

I guess I have given her books. From the looks of it, my Mom has also given her books. But really, what is going on in my MIL’s mind isn’t about reading. It’s about sharing. It’s about having one more thing inserted in my life where I am obliged to thank her and lean on her. And I still don’t know if she started reading that book or not.

She remembered to ask about my painting, as she always does. Oil painting is something I do to relax, to feel productive and creative. It is personal. But she tries to save jars for me, and then constantly asks me how “her jars” are doing, like they are former pets. Has she been Helping? She demands to know. Uh, sure, I guess.

She found a used canvas for me. I think she did. For all I know she bought it to put up in her house and then suddenly thought, hey, she could give it to me. She buys framed artwork (prints or old office décor) with a compulsion, so it is hard to know. But that’s fine. Free canvases are good. But they aren’t really free. They come with the price that she can now tell everyone how she helps me with my art. She has inserted herself here.

Meanwhile, Tony was still puttering with the radio.

I glanced in a House Beautiful magazine while MIL was in the restroom. I found a roasted carrot recipe I’d like to try. Anyone else, I’d say, “Can I copy this? Or can I tear it out?” End of story.   I told Tony later that I actually considered ripping it out when she wasn’t looking and stashing it quickly in my purse, so I wouldn’t have to go through the inevitable push and pull.

When I asked, she joked about how the recipe was too important, she just had to keep it because of the Tide detergent ad on the back. Haha. Then she ripped it out, placing it in front of Tony’s eyes. “See? This Ad. I have to keep it. Haha.” Then she agreed that I could have it if I invited her over when I cook it, “Promise? Promise?” She wouldn’t hand it to me until I promised.. Then she begged to give me a subscription to that magazine, which I don’t want. I’m not an interior decorator. At all. She dragged out old copies for me to take home, and tried to push ANOTHER subscription on me. . .for a completely different magazine.

Aren’t you tired for me, yet, Readers?

I’m exhausted by now and just want to leave. And on top of all of that, she is always very handsy, especially if she has had cocktails, which she was enjoying that night, hiding in her “tea.” She will rub my shoulders, caress my arm hair. Kiss my cheek again (only because I won’t give her my mouth) or the top of my head when she walks by. Hug me spontaneously with a full bodied approach that is too familiar and sexual for me. Again, she barely touches Tony.

Tony finally stopped puttering. She pushed coffee on us. Dessert. We go through the same complicated dance. Rejecting the cup of coffee is as difficult as getting one.  Tony finally said, “Mom, forget it. We don’t need any coffee.” She then made a big production of giving me my birthday present, a gift card to a store where I like to shop. She spent waaay too much money on me, more than she can afford, denting her limited savings for retirement. I worry. Then she flourishes dramatically when adding a bag of macaroons on top of my present. (They aren’t my favorite, but somewhere she got it in her head that I like them and thus, she bakes them all the time in huge batches. ) I was happy, but again, I had to acknowledge all the hardwork she put into them first, before she actually let go of them.

She gripped them firmly, asking, “Isn’t it nice that I can do this for you now and then?” And though she made it sound like they just came from the oven, there was a freezer burn to them that lingered. I don’t mind that at all. I do mind pretending that they were just made. For me.

Finally, we prepare to leave, and Tony and she did a dance over the weird pillow she wanted me to take. Tony finally realized it was one she currently uses and said, “No. No, you use it, you keep it.” She shut up.

She made a big production of enumerating all the things we are taking with us. Thank-you. Thank-you. Thank-you.

So when driving home, Tony said, “That was relaxing”, I nearly punched him.

Mom tells me it drove her crazy when her own mother-in-law-my Nana- would stand waiting for a pot of water to boil when Mom made spaghetti. “Like I might miss it or something. . .” says, Mom. Or when Nana, while eating a piece of mom’s cooking, would tell Mom how she would teach her to make a pie crust “right” one day, a crust you could chip a tooth on. Maybe Mom is right. In-laws are naturally grating.

I wish, like my shepherd, I was allowed to bite my mother-in-law on the nose.

The Bastardization of Beauty: Sick or Sexy?

Several years ago, my sister-in-law died of a rare form of cancer.  She was strangled from the inside out by something called pseudo-myxoma peritonei, or jellybelly.  A gelatinous cancer grows and cuts off inner organs, in her case, her digestive system.  Every few years, over a decade, she would have surgery to scrape out the substance, until there was just too much to remove.  Then, she quite literally starved to death.  Horrifying and sad. I wouldn’t wish this on anyone, ever.

However, being a woman who could go up and down in her weight range, especially as she aged,  Lori could enjoy at least one thing during the final years when she was sickly thin: the compliments, the size zero bragging rights.  “You look so Fabulous!”. And she almost seemed to forget that this had nothing to do with her choice. She was proud.  But then the end came near, and she was thinner, then even thinner, too tired to enjoy her model-like figure.

Yet the compliments continued.  She could only eat certain foods pureed, which would then mostly be emptied through a thick tube surgically attached to her belly.  Chew, swallow, remove. Not everyone knew that.  So you’d think that the people who asked, “What’s your secret?” could be forgiven.  However, our attachment to the svelte image is so powerful, that no, even those who knew Lori was dying, were an eesny bit envious of the fact that she was wearing  a teenager’s leggings.

This five foot seven woman who wasted away in front of our eyes was America’s standard of beauty. The constant imagery of The Thin has really screwed up our value system.

A year after she died, her sister, another of my dear SILs,  (which we affectionately address one another as Sissel) began having health problems of a different sort.  She has always had food issues, one week allergic to something, the next not.  Can’t eat chicken, can eat chicken.  Avoided sugar, yet jammed anything sweet into her mouth before she could stop herself. She, like the majority of women, began to battle her growing weight as she moved closer to middle age.

About six years ago, she was diagnosed with IGG deficiency. an autoimmune disease.  This helps explain her fluctuating food reactions.  Then last year, her Celiac artery was semi-blocked. Surgery successfully opened it.  Though no tests can show that her system has shut down, no test can illustrate a blockage anywhere, she is certain that she has gastroparesis or an intestinal blockage; she is able to eat hardly anything.  Gastroparesis is when the duodenum, the sphincter at the bottom of the stomach is paralyzed.

Her doctor goes along with it and uses the term gastroparesis loosely, believing my Sissel when she says she is full, nauseated, unable to eat another bite. My  SIL will swing between a diet of certain extremely bland (and fat-free) foods, a total liquid diet and nothing, stating that she just cannot eat another bite. The other day, my mother-in-law threw her annual corned beef and cabbage party, complete with Shamrocks and Irish Ditties.  When the rest of us, who ate like kings complained about “tickin'”, my SIL chimed in about how huge and uncomfortable she was, complaining about how hard it is to eat and nourish herself.

She had indulged in a calorie free bottle of Sobe, a soft cooked baby carrot, and half a water cracker (and those last two only because she just couldn’t resist.).  Her brother, my husband, asked her why she was drinking calorie free drinks if even water fills her up?  Good point.  If one supposedly cannot get sufficient calories without pain and effort, shouldn’t every sip have a calorie if possible? Well, she answered, she just doesn’t want sugar to be her calorie load.  She reports that her body can only digest about 800 calories a day and then seems to shut down, get backed up, become painful, nauseated. She wants her drinks to be for hydration only.  Yet even the calorie free drinks fill and block her.


Though the only evidence of a medical issue at this point is anecdotal, though we get conflicting illogical info from her all the time, we are all expected to play along, and feel sympathetic to this gastroparesis.  And we do.  The woman weighs herself every morning and evening.  This supposedly tells her if she is facing a few days of severe indigestion as her food just sits in her bowels, unmoving.  This weight change of a pound or two upward, lets her know she is about to be backed up.  Who cares that. EVERYone weighs more at the end of the day; she sees this as a sign and stops eating anything but a low calorie liquid diet.

I know that she might be right. She might really have a true medical event going on; she and her sister have had the rarest of conditions.  But then again, she might have an eating disorder.  Or she very well might be reliving her sister’s experience, sort of like men who suffer phantom pregnancies.  The two were very close, and Lori’s loss was painful for everyone.

Sissel has dropped 45 lbs. She hovers just beneath 100 lbs. Five foot 5..  If she drops below that, she will be forced on a feeding tube. Her legs look like a child’s, her ribs pronounced.  I feel sympathetic pain believing they might break just looking at them. She sleeps too much now, struggles to work because she lacks energy, literally.  800 calories ain’t much.

But again, everyone thinks SIL looks great!  (And they aren’t being kind and mannerly. They mean it. They wish. They envy. . . They joke about how to catch her “disease.”) SIL has been happily posting fresh pictures of her newly slender frame on FB.  Before that, she never bothered with Selfies. She has taken to wearing clinging clothes.  Her husband says how bitter sweet it is to see her wear things she hasn’t been able to fit in for over twenty-five years. Her mother’s friends compliment her on looking like a teenager.  My SIL loves this attention.  So do they.

Another close friend of ours spent last summer with a fever,  vomiting everything. Doctors finally found a perforation in her bowels. A possibly deadly diagnosis. They saved her, but not before she lost fifty lbs. Again, the compliments rolled in. She felt like hell for months as she healed, but even her mother began sniping about how beautiful she was now; don’t regain the weight. (Her mother has actually been hospitalized for an eating disorder.)

My husband and I discussed how insidious this imagery-this thinking- is. When we reverse the gender, the underweight physique is so obvious, even deplorable.  If my husband weighed 120 lbs., or even 140 lbs, comparably adjusted for his height and gender to match my sisters’ puny sizes, would anyone ogle him with delight?  Would any woman admit that this man would then be her sexual ideal the way some men can only be sexually attracted to emaciated women?  Tony loses three pounds, and the whole family thinks he is sick or working too hard.  But folks everywhere find malnourishment in women intoxicating.

I can’t. Not anymore. Take the show Modern Family: I see voluptuous Sophia Vergaro as a beauty; I now watch Julie Bowen uncomfortably, who if you review her career, is a skeleton of her former self. She didn’t get that way as she aged, naturally.

I know there are certain people who are genetically thin-ectomorphs make up a small portion of the American population.  But my two sisters and my friend, even Julie Bowen, aren’t those people.   My Sissel says she is already looking at a menu that will help her keep her new figure should she ever eat normally again. . .How does she not see the flaw in her design? To remain that small demands she doesn’t eat normally.

I’m also aware now of how few calories someone must choose to eat if they are middle aged and want to be as thin as my sister. Way too few.  Undernourishingly few.  To do so, those dieters are denying themselves not only the pleasure of food, but health.

I know that culture often defines what we perceive.  But seriously, has culture gone so far down the skinny path that we no longer recognize illness, physical (or even mental).  We now think, oh, such beauty, when we are actually seeing self-denial, self-punishment, anorexia, even death?

I know this is not an original complaint.  But really, just like we had to push to change the habit of getting a dark tan to remembering to wear sun screen, can we change the image of sexy back to something safer in women?  Can we look at a woman who weighs 142 lbs. and think, lovely, healthy, centered, sexy, ever again? I’ll bet Sophia Vergaro isn’t 100 lbs.

Thinking of Love: Nonverbally

I recently had an epiphany about romantic, expressive men.  And for a bonus, I also got the elusive relationship closure that so many of us seek.  It was a surprise gift from the universe. . .and my unsuspecting husband, Tony.

On New Year’s Day, I ran into a lover from my deep, dark past.  He, his grown daughter, my husband and I sat for about thirty minutes socializing, very quickly catching up. Meanwhile, Former Lover kept, as they say, making eyes at me.

This was not an affair that had ended well.  But it had ended so long ago, I no longer hurt to see him or speak with him.  We are both plumper, a tad greyer, and definitely more lined, but it felt like we had just seen each other the last week.  We chatted and joked briefly, and then my husband and I climbed into our minivan and sped away.

That was not the closure.  Former Lover had been a man who, met years after I lost my virginity, had actually woken my sex drive.  Our connection, though doomed, was immediate and ridiculously hard to define.

He was a musician and an artist.  No matter what time of day or night, he had some instrument of creation in his hands, a drum stick, a worn nub of charcoal, a guitar, maybe even a teapot.  It was not the Art or the Music that seduced me as is cliche; instead, his sheer joy while lost in his work and play was impossibly attractive. Oh, and he was.  . .is British, for all you Anglophiles out there.  I know, a sexual awakening, creative Brit?  Aren’t they supposed to be uptight and cold?  He wasn’t. Former Lover was prone to saying things about his heart beating faster or not being able to think straight when I was near.  And when words failed him, his body never did.

Much later, a short year into my relationship with my husband,  I was uncomfortable and feeling insecure.  I knew he loved me; he tells me so every day, in those exact words..  But. . .something was missing.  We had more than a few conflicts over the fact that he doesn’t give physical compliments very often.  And if he does, they come across as forced or awkward.  “Uh, well, don’t you look cute. . .”  At first, I just thought he was not verbal.  But, no, he was voted most talkative in his high school.  He can articulate. In fact, he fully compliments my cooking or my intelligence all the time. And one of his greatest assets his how much we talk, late into the night.

I then suspected that maybe, though attached to me, he didn’t really find me sexy or even pretty.  I figured, he was a practical man who had made a practical choice and had married the smart, talkative, nurturer, instead of the empty, distant model.  He would get perturbed, annoyed and then angry with me for voicing these thoughts.  But I periodically have had trouble shaking this sinking feeling.

I said to him, “There have been men in love with me before, a number of them who wanted to marry me. I KNOW what it feels like to have a man want me.”  And this wasn’t it.

I reflected back on the men who had loved me, some of whom I had loved in return.  All of them had been expressive about their love and their desire.  They would tell me how gorgeous my eyes were when they gazed longingly into them.  One man used to sigh into my then long, curly hair and go on and on about how he wanted to one day die in it.  (Not as creepy as it sounds when you are in the middle of being loved.)   One used to tell me I had the most delightful ass on the planet. Another, as I mentioned, described how pit-pattery he felt.  I believed every single word from these men. It was the passion they exuded, the eyes that seemed only for me, that made their musings true.  They openly and verbally reacted to my attempts to look nice when I dressed up, to my natural appearance, and my very smell.

NO, I am not a raving beauty.  But these were men who knew how to make me feel like I was.

And my husband isn’t one of those men.  Yet, that expressive passion I enjoyed from former beaus, even my ex-husband and Former Lover, is how I have always felt about my man. Tony.  He drives me insane with desire: His smarts, his goodness, his love making, his very being.  (To gain a picture, he somewhat resembles Clint Eastwood from the early Dirty Harry days. In fact, I had never found Clint a sex symbol until I fell in love with my husband.)  Whatever this former lover awakened in me, my husband puts to bed in the very best way.  He is the sort of lover every woman wants-gentle at times, considerate, but with just the right amount of manhandling to get his way.  I compliment him all the time.  I’d finally come to believe that inside, My husband feels the same way, when once, frustrated at my insecurities, he shouted, “You are the best thing that has ever happened to me.” Enough Said.

So. . .a few weeks after this reunion, you might suspect how I’d react to receiving an effusive email from Former Lover.  (He knows people who know me.)   In it, he expressed how much he was still feeling toward me, and easily tossed out these words:  “My relationship with you was the most honest, intelligent, intuitive, erotic, and fulfilling of my life.  You got into my psyche more deeply than anyone ever did.”  He went on to express how he wished we had married all those years ago, issues be damned, and gone and lived the last two decades together.  In less than so many words, he was secretly seeing if I was “available.”

Nice to hear 20 years later, eh?  Do you wonder if I was tempted?  He was off to Central America in a few weeks.  I could easily jump on a plane and restart my life all over again.

I was stunned.  Angry a little at the tardy sentiment.  Envious of once again hearing such fine words. Irritated that he thought it appropriate to interfere in my love cocoon.  But also tickled pink. Tickled, tickled, tickled.

Though Former Lover hoped I’d keep all this hush-hush, I immediately told my husband, full transparency.  I was uncertain how he’d take it.

In stride. His first comment: “See, you still got it, Baby.”  Well, hmmm. Okay, yes. After how many gained lines and pounds?  “This guy sees you after 20 years and thinks to himself, ‘I want some more of her. I made a grave mistake all those years ago.’”

I also told my husband how sometime earlier last year I had written an amends to this Former Lover-we both owed one to the other for blowing up quite a lot of our world when we imploded as lovers.  I had tried writing before years before, but now, in Al-Anon and working a 12 step program, I felt the need to do so, with full responsibility. I’d written a heartfelt note, but suddenly my computer frizzed as it can do.  My words of contrition all disappeared.  I saw this as a sign to keep my mouth shut and mind my business.

Tony tells me this:  “Making an amends is for you.  God knows you did so with good intent, and cleared your mind. It doesn’t matter that the guy didn’t receive it. That this guy surfaces only months later, we run into him accidently, and now he is ‘resmitten’ with you, gives you a sense that what had happened years ago was real, true emotions on both sides.  Doesn’t that feel good to know now?”

There’s the closure, especially since I can respond with an amends now.

Here’s the epiphany:  All the men who have loved me in the past have been EXPRESSERS in various ways, artists, writers, musicians, even a stand-up comic.  They dealt daily in the world of sharing what was inside their hearts and souls.  I had veered away from men like Tony-business and math-minded, practical, relatively conservative.  In college, those practical guys had been the ones who seemed too preppy, they peed in the ice machines, and date-raped women in their fraternity houses. (How’s that for a childish generalization.) I stayed away from them.  But somewhere in my middle age, I got sick of the liberally slanted men.  Getting a divorce from my son’s Dad, an artist who had taken over a decade to figure out a career where he could actually contribute money to the household had left me cold.  And all my other boyfriends-even this Former Lover in question- had spent their lives stumbling  along, too, leaving all the heavy lifting to their wives or girlfriends.

Opening my mind, once I was single again, I found this trustworthy, practical, dependable Man, Tony,( . . .and yes, a former frat boy,) who has trouble verbalizing his attraction and his love for me in more words than “I love you, Baby.”

I had sacrificed the oh, so easy sway of big, fat words, for the strength of a solid man’s man.  And I’ve only benefited.

Those loving words in the former lover’s email were very pretty.  But also extremely simple to say, and not do for that guy.  My husband finds it much easier to do than say.  He understands commitment in a way no one else in my world ever has- takes care of his part of our world and then spoons me to sleep.  He also stands in the greeting card aisle for hours, reading all the cards to find one that says what he cannot.

The other night, my oldest son met his Dad for a movie.  After the film, en-route to somewhere else, he had a crappy flat tire on a major highway, and couldn’t get the spare loose.  Whom did he call?  Not his artsy-emotional Dad whom he had just left, but his step-Dad, Tony who quickly gave him directions to wait in the car safely till he got there.

This stoic man is the love of my life; I’m his, and we both know it.

The Pain in Pain Management: Oxycontin + Stigma

A.K.A Me and Oxycontin.. . .The untidy world of pain killers and those people who need them is a bear to navigate. Doctor incompetence, stigma, recreational drug addicts, government pressure, and even pharmaceutical companies all take part in creating an uneasy, often unsuccessful route to ease a patient’s pain, namely mine.

I have never been a drug user or abuser, but now, Oxycontin is part of my daily living. Last Fall, I had an extensive injury and resulting surgery, the sort that any internet search will prove, leaves plenty of patients with chronic, debilitating pain. I am no miracle unfortunately, and I suffer from a spinal fusion from T-4-T11, 14 pins, three rods, and four laminectomies, missing bone. If you know someone who suffered a back fusion, they probably had 1-2 levels fused; I bet even so, they suffer. The hardiest of people might be perfectly fine and pain free within the next year, but apparently I am not one of those lucky people.

However, I am a good and honest patient.

My neurosurgeon and the doctor who ran the physical rehab center I entered right after the procedure came up with a mixture of pain meds. Prior to surgery, I was on a morphine drip and Neurontin. After the surgery for the first week I was on a combination of morphine, Dilaudid, and oxys in relatively high degrees compared to my current usage. I did not tolerate the dilaudid-waking nightmares. . .the sort that would make me try to climb out of bed to run down the hall. Since I could not even sit up without help, this was frightening. They took me off the dilaudid and started a combination of Oxycontin-which is a time released opiate, and oxycodone (aka Roxy), which is a quick acting form of the same medicine, Robaxin-a muscle relaxer, Neurontin-a nerve pain killer, and anti-vert-an anti vertigo medicine.

I left the hospital on all five medicines and could very well still be on all five in large doses. I am the one-not the doctors-who asked to wean down, partly because I didn’t like the side effects of my combo-drowsiness, absent mindedness, severe constipation-and partly because I was in denial and believed I could be back to work as soon as I was off of the drugs. I ignored the idea that maybe I would heal faster if I remained on the drugs. And I definitely seemed to think maybe I wouldn’t be in any pain. See. . . the pain killers work so well, I started to believe I was fine, sort of like people who think they don’t need antidepressants once their drugs start working.

Coming off the Neurontin wasn’t difficult. It is a drug that has to be weaned and cannot be stopped cold turkey. I followed my doctor’s advice. I also got myself down to taking the Robaxin only at night. It is still an effective medicine for me, but I don’t like its drowsy effects in the daytime.

With the doctor’s plan, I weaned myself down on the Oxycontin as well. However, once I got myself down to just 20 mgs of Oxycontin a day, with the oxycodone as my breakthrough medicine, I noticed I was in too much pain, and relying too often on the oxycodone. My doctor advised me to go back up to the time released amount of two 20mg pills a day of the oxycontin 5-6 months ago. And there I have remained.

I rarely ever have to take my break through meds, not because I am pain free, but because I actively try to suffer through medium pain simply because I do not want to raise my tolerance level. Plus, the side effects are almost negligible. Any chronic pain sufferer will tell you that their pain meds. allow them to feel normal, not high. When there is a real need, the brain adjusts. So I feel like myself most of the time now.

Which is where the incompetency of the medical world begins.

Oxycontin is one of the most highly controlled substances in America. Many legitimate pain clinics in the U.S. require patients to sign a contract when they receive oxycontin. Patients have to come in for blood tests periodically to make sure they are taking the correct dosage each day. They also have to appear with their remaining medicine on hand. If they are “over medicated” of course they are dropped from the practice. If they are UNDER, and they didn’t have the assumed correct remaining pills, they are dropped from the plan. The remaining pills that the patient carries are often dumped down the drain in front of the patient. The assumption is that over medication could mean the patient is using street drugs, too. Under medication could allow the patient wiggle room to sell his prescription drugs on the street for more than he or his insurance paid.

Makes sense. Apparently I am one of those under-medicators since I receive enough of my break through medicine- the oxycodone-better known as Roxy-to take 6 pills a day each month. If I did so, I would be on approximately 100 mgs of oxy a day, counting my Oxycontin. I don’t need that. I now probably take 1-3 a week on top of my time released medicines, so I have plenty lying around (locked safely away from teenagers). Which is a Doctor mistake. . .in my naïveté, it never occurred to me that real pain patients would suffer their pain just to sell their “extras.” I had a partying buddy once joke a few months ago that she could get me thousands of dollars for my left over Roxy. (Reread the word JOKE. I mean that, you government lurkers.)

I have always done what I am supposed to do (I follow my dosage of the time released pills though I use far less of the Roxy than I could): Only my doctor prescribes my meds.; I do what he thinks is right; I use the same pharmacist in his building each month. I create no red flags at all. What do I mean by red flags?

Well, like I said this is a highly controlled substance. Although it must be prescribed only monthly, on paper, not by email/fax, Abusers simply go to multiple pain clinics and pretend they have this or that ailment. They hit up multiple pharmacists. They create one person accidents just to go to the ER. They lay a serpentine trail that takes drug investigators too much time to trace. And of course, there are corrupt pain clinics, too. Just as marijuana shops in California have doctors on hand to pass out prescriptions to anyone who complains of a low appetite or eye pain, pain clinics across the country have former gynecologists or dermatologists ready to make quick money handing out scripts for bogus complaints. I do not fit anywhere into that picture.

When I first was released from the hospital/physical rehabilitation center, we had great difficulty finding a pharmacist who even had the medicines in large enough amounts to fill my prescription. They had to confirm this was a legitimate prescription, and then called around to sister locations to find enough to meet my needs. Apparently most of the locations keep very small amounts, sort of like Gas Stations that post they only have $100 on hand. This slows the Oxy thieves from robbing the place. Once the pharmacist found a place that had enough, we overheard him confirming that yes, he had actually seen the patient and was certain I needed the medicine (being in a wheel chair and with my armband still intact.)

We shifted after that first prescription fill to my doctor’s pharmacist, so we wouldn’t go through that every month (which is the broadest time frame this can be prescribed.). We have also hit the problem of our pharmacist sometimes not having enough, or my insurance company setting a weekly limit. We have literally walked away with 6 pills for the weekend because the pharmacist is not allowed to give me more until Monday. Some of this is caused by the FDA or insurance company restrictions. Some of this is caused by my surgeon. Because he is always in surgery, we have learned to ask for the refill a week before we need it, because sometimes it literally takes a week for his staff to get him seated with a pen in hand. And since this is a medicine that should not be stopped cold turkey, I cannot run the risk of waiting till the last second only to find they cannot reach him.

Busy as ever, he just auto-fills all my current prescriptions, So I always get just enough Oxycontin, way too many Oxycodones and Robaxin tablets. The last several times I picked up my medicine I just told the pharmacist not to fill the Robaxin and the Oxycodone, I didn’t need them. In my husband’s innocence, he joked with her that if she needed any-since they have so much trouble with supply-give us a call, we have plenty.

Har har. You should have seen the look on her face. This was before my friend who once managed a pain clinic told me about how closely doctors are monitored themselves, about how they make their patients throw out their extras. Most surgeons will send their patients to a pain clinic because they themselves do not want the FDA monitoring that goes with prescribing narcotics. But I did not go to a pain clinic. . .My neurosurgeon has always trusted me. I have never asked him for extra, Never asked him to move upwards in mgs. Never run out too soon from over use. Maybe it is trust. Maybe it is simply inexperience or inattentiveness on his part?

Enter the Devil in the Details.

Each year 15,000 people die from overuse or overdose of Oxy.. To put this in perspective, between 75,000 to 3.3 million alcohol-related deaths occur in the U.S. each year (depending on how the data fall and who reports in.) This is a huge difference. While no death is acceptable, there is a hysteria about Oxy that is ignored in much of the bigger picture of substance abuse. One Public Safety Commision report states that approximately 78, 000 people go to the ER annually for Acetaminophen overdose. Really? I am fascinated by how we pick and choose our battles.

The people I meet who swoon and tut-tut when they have learned of my medicine, never have any real-life experience to share. No legitimate patients who suffered or died. They’ve just “heard bad things. . .”

We vilify Oxycontin’s effectiveness by focusing on its overuse and overdose. But because alcohol (or even OTC painkillers) are so socially accepted, and because a ban on alcohol in the last century ended in the development of major crime families, no one is interested in this disparity. Maybe I should just drink my self stupid everyday. I’d be more socially accepted. In fact, we don’t even use the words overdose with Alcohol.

The danger in Oxycontin, as in alcohol or any drug, is exactly that: overuse and overdose.

Is there a difference? Yes. When I was in my Physical Rehab Center, the night nurses who are often second string staff had the right to give me a certain number of roxys (oxycodone) within a certain number of hours. I noticed they liked to give me extra pills, extra close, right before bedtime. Keeps me down for a while-no bed pan help-no roll over helps. . .one night a nurse I had not had before gave me that amount and tucked me in with a blanket. I woke a few hours later having sweated the bed to a pool. She had to change the sheets and my clothes and then promptly gave me an extra dose “to help me get back to sleep”. Within the hour, I was dozing and struggling to breathe. Have you ever had one of those dreams where you feel like you are awake but cannot move? This was very similar, but it was my lungs that wouldn’t move. This is how oxy kills. It depresses the respiratory system.

This is why people freak out about this medicine. But was that the med or the nurse?

No, this was an example of an overdose, and the nurse was reprimanded.

Overuse is when patients are like me, but they do not pay attention to their own body and push too fast to go up in dosages. Irresponsible doctors don’t slow them down
, so they quickly end up on 400mgs of oxy that no longer kills their pain. This is why I do not always give in to my own pain by hitting it with Roxy at every turn, and why some responsible doctors and clinics have some of their patients spend several weeks on methadone allowing their brains to see a lower amount of Oxy as effective. These are doctors who understand how to avoid overuse.

Sadly, some people, their pain is so severe that even this doesn’t work. When my sister-in-law was at the end of her decades long battle with cancer, she could walk around on enough morphine to kill a whale, yet she was still in pain. She was always tempted to do more and more, which is why the rest of us had the keys to her meds, and she did not. And of course, this is why Hospice played an important role at the end of her life.

Overuse is when people buy and use oxycontin recreationally. I personally have never felt any sort of high on my medicines since coming home from the hospital. Yes, in the hospital the Dilaudid and Morphine gave me some funky awake nightmares. Apparently I also liked to sing aloud in that first week. But now on my effective regulated amount, I do not feel any sort of altered brain state other than the inability to recall some words at the tip of my tongue. However, I did have a former student about five years ago OD and die on his pleasure of Oxycontin. I understand its a quick high and an awful death. Since then the pharmaceutical companies have been able to adjust the time released version so that when chewed, the tablets do not have the same effect they used to have. But people still overuse and abuse this drug.

There is so much negative stigma attached to this medication that true pain patients have to deal not only with their pain, but also the judgment of anyone who might find out they are “on Oxy.” And because of this, people make some pretty horrible assumptions about me. My own mother likes to call me periodically creeped out by what she reads on the internet.

“I am worried you’ll become an addict.”

“Mom, I am already an addict.”

“Whaaaat? What do you mean.”

I have to try and explain the difference between a patient who becomes medically chemically dependent and what she pictures in her mind: the gutter dwelling, hand shaking, drug fiend.

“I was dependent on this drug before I even left the hospital. It simply means that if I stop taking it, it will cause me to go into withdrawals. My body has to have it now. Sort of like you and coffee. . .”

Then she worries I will die of withdrawal. Or die in an overdose. You know how Moms are.

Some of my work pals crack jokes about it. (My real friends know better.) They seem uncomfortable knowing that I am on Oxycontin. After all, isn’t that the thing that kid was using that killed him. . .isn’t that the current “fun drug” all the kids are using?? They seem to think I am not “better” yet because I like my medicine.

They lack compassion for my dilemma: incapacitating pain or medication. Tough, limited choice, I have there, the woman who shifts from 3-8 on a ten point pain scale throughout the day

Even my former physical therapist seemed very uncomfortable that I was still on Oxy and seemed to be prying into why I was really taking it, as if the grimace on my face every time she wanted me to put my hands over my head isn’t enough. (Did you notice the word “former?” My surgeon helped me find a new, more educated PT). Chronic pain is so foreign and rare to most people, even in physical therapy centers, people do not really have proper sympathy for it, and pass judgment.

Given the recent revelation that the government is listening in to our phone calls and perusing our internet histories, I am even uncomfortable searching the phrase: “Weaning off of oxycontin.” That is how diligently it is protected. The other day, we got an unsolicited sales call from a company pushing a new pain product for chronic pain sufferers. Hmmm. Makes you wonder. So now, am I “THAT household with an Oxycontin user” to the unknown internet peeping toms?

I have simply learned not to discuss it. “Why don’t you drive?” Uh, cause I can’t turn my head. Notice how responsible I am even about driving. But that doesn’t matter. . .people equate Oxy users to heroin addicts. I mean do I have to carry around a little copy of my MRIs and show my surgery off like a baby sonogram? People do have botched knee replacements, they do have rare physical disorders, extensive back hardware like mine. There are people for whom Oxycontin is a God send that allows them to have a modicum of normalcy in their lives again.

Even some surgeons avoid prescribing Oxy. Giving him all that extra time he has historically needed, we called my doctor’s office one week early to get my prescription refilled earlier this summer. Low and behold, he was on vacation for two weeks. Uh-oh. Ignore how irresponsible it was of him to leave a narcotic patient without any notice. What’s worse, his partners, who were supposed to take his calls, never prescribe oxycontin (their poor patients-geez). I know now that they don’t feel any negativity about Oxy; they just don’t want to be watched by the government. My doctor is the youngest in the practice and the only one who does prescribe it. Unfortunately for me, because my doctor was not there, and his partners couldn’t care less about me, (or a lawsuit toward him), they were only willing to supply me with Lortab.

My pharmacist told me this was not enough of the opiate my brain needs, and I would be forced into withdrawal, which means anything from the sweats, creepy crawly skin, to pounding headaches, deep depression, vomiting, diarrhea and on and on.

How could they be so careless? They had my records. They could see I am not an abuser. . .but since it was not their responsibility. . . Since they care more about some FDA assessment than my well-being. . .nada.

Yet. . .Other doctors have done this to their own patients, dropping them from the drugs cold turkey. The patient is then forced into an expensive ER trip. How can an oath to “First, do no harm” equate into ignoring OPIATE PROTOCOL of weaning a patient? I believe this is what also causes overdoses. Patients, instead of being on a monitored weaning schedule, end up suffering withdrawal so badly, they get enamored by and then hooked into an illegal situation in order to alleviate their suffering. Suddenly they have a money grubbing pusher.

Luckily, my pharmacist knows me now and trusts me. She gave me a schedule to use my left over Roxy that fit with my original prescription to help me hang on until my doctor returned. But this was not the same as the time released Oxycontin and I did suffer through a mini-withdrawal, though nothing like what I would have gone through had I had nothing at all.

My doctor returned and was as frustrated as I with his partners: “You, I do not worry about. You have a major trauma. You’ve always been responsible.”. Thanks, Doc. I asked him if we should try going down again in mgs. Nope. “We tried that already. It didn’t work, remember?”

I get such mixed messages. I cut my finger badly this summer and declined extra pain meds from the ER doctor. He was impressed I was on such a low dose after such a major back injury, and ogled my scar. “Wow!” My dentist is concerned I’m still on Oxy. My old PT thought I was an addict. My new one thinks I am UNDERmedicating. . .Sigh!

Even one pharmacist my husband spoke to (not my own) said, “Ah, she has been on this way too long.”

Really? By whose/what standards? I read again and again of people being on this for years, on higher amounts. . .One case study I read in the NEJM, the patient has been on dosages for a decade. She is one who enters a methadone clinic periodically to bring her back off of it, and then restarts on a lower amount. Bless her doctors for understanding that some physical conditions are life long intolerable situations. She is a true pain management success.

However, this last month was my last visit with my neurosurgeon. Being a surgeon, and on call, he doesn’t have the time to monitor post surgical patients longer than a year past surgery if all is going well. My pins are solidly placed; my fusion is “taking”; my myelopathy is permanent. Other than my pain, my therapy, and my fluctuating numbness, there isn’t much to monitor. So I have been released to a reputable rehabilitative physiatrist.

We worried about what this would mean in terms of my pain management.

We worried for nothing. My new Doc was surprised I was managing on such a low dose, but he listened to me closely. “Yes,” he said, “Too many neighbors think they know best. You have to accept; this is your life. You are on one of the most effective pain killers available. I’m concerned you are too worried about what people think. . .”

We explored options. I will get a TENS unit soon to try. He considered epidural shots, but since I have a lot of what is called “light touch” pain, he nixed those. I’m far enough in the fusion to try NSAIDs again. I have now been taking Cymbalta which some research indicates is effective with the sort of pain I suffer. I can already, in just a few weeks, feel a huge difference. I am not pain free, but I feel less constricted in my movement, and “brighter in spirit,” more myself. Plus, my husband and I have figured how to navigate successfully the sexual side effects of Cymbalta. Maybe soon, I can begin weaning off the Oxy. . .?

Of course, after reading all the websites and chat threads about Cymbalta, I see that I’m just swapping one stigma-saturated drug for another. I’m still going to face opposition, maybe even suspicion and fear.

But this is my point in the first place. Chronic pain can be managed safely. Yes, there are foolish people who will misuse Oxy (or bath beads or Robitussin for that matter). Unfortunately, we live in a country where everyone wants to protect us from ourselves, and judge us harshly in such trendy ways, just so Society can feel better about itself.

And that can leave too many people with unnecessary pain. Quality of life really isn’t a relative term to people in chronic pain.

Beholders for Sale

Absolute Beauty?

To say that beauty is in the eye of the beholder, gives the beholder waaay too much credit.

Remember the girl you envied in high school for her awesome “claw”-the towering, teased out bangs that hung somehow both above and over her forehead like a bear’s paw waiting to open up her scalp? Still like that look? What about the mullet? Was it really EVER a party in the back? How about super heavy eyebrows? If this could just return, not only could salons glue on expensive lashes as they do today, but costly fur-extensions above your eyes! But we decided somewhere in the 90s that, No, that’s just hideous. What about parachute pants, orange tans, or monochromatic suits and matching makeup?

Obviously, we cannot be trusted to judge what’s beautiful, because our own tastes not only shift, but can be shaped by a constant barrage of media images. Kate Moss’s body would not have ever been seen as lovely three hundred, maybe even a hundred-fifty years ago. Ditto for a young Arnold Scwarzenegger’s, believe it or not. Rubens’ chicks anyone? Those sexy dumplings. . .Want one now?

Not only that, our own emotions make us ripe for ignorance. A guy whom I had long thought was modelesque, once I figured out after a few dates how utterly dull he was, suddenly all I could see was that crusty yuck that always seemed to be collected on the edge of his pink-rimmed eyes. And don’t tell me that’s never happened to you, where how you felt shaped what you saw, (more so when you were young.) Luckily, for me, my husband loves me in a way that his desire overlooks my own crusty eyes, and Rubenesque tummy.

When I was young, I could NOT see what the rest of womankind saw in George Clooney; his acting on ER annoyed me so much, those times when he’d tilt his head down at an angle, so he could look at a woman through his lashes, with a mild sneer on his lips, the way he tossed his gelled hair (hat was actually untossable.) So. Heavy. Handed. Uggh. But. . .as his acting improved, and he stopped vamping, his beauty came into focus. I still prefer Benicio Del Toro, but again, can you really trust my fickle taste?

The scientists can do all the studies they want about the power of facial symmetry, but I’d say our tastes are so subjective to things beyond arithmetic, whom/what we call beautiful/attractive is a powerful commodity that plenty of industries (make-up, celebrities, art, fashion, home decor, cars, etc. ) want to control, and then own. That alone proves that beauty is not in the eye of the beholder, but in the hands of whatever industry wants a piece of our “taste.” So let’s not call our view subjective; let’s call it producjective.