“Big Pharma” & Privilege: Or Why I Wish Allies Would Stop Using This Phrase

This is the single best article on chronic illness I’ve ever come across.

Yes, drug companies are greedy. They overcharge. They hire lobbyists to subvert legal protections through large scale bribery. They fail to produce many medications that would transform people’s lives, either through lack of research and testing (research into rare diseases is expensive, and natural chemicals like cannabis aren’t profitable for various reasons) or through inadequate production of existing drugs. And they promote the use of drugs which are unnecessary or harmful (statins in people with high cholesterol but no history of heart attack, gastric acid inhibitors before the discovery of H. Pylori). But they do create much needed treatments and cures – I’d be long dead if they didn’t. And the natural lobby is no better – remember Ephedra?

Foxglove & Firmitas

A friend posts an article on Facebook about how the United States’ medical system does not meet the needs of those with chronic pain. This is a reality that I have experienced. This is a reality that I regularly speak to others who experience chronic pain have also experienced. About a month ago when I was at the doctor’s office for my annual exam, I overheard 2 medical workers talking about how they hate when patients say they’re in pain, because they know they’re over-reacting. I was horrified, but it wasn’t the first time I’d heard someone in the medical field say something like this.

When we talk about chronic pain, and disability in general, inevitably someone pops up to say something like the following:

I think chronic pain (and other illnesses for that matter) should be tackled with a holistic approach. Putting our faith completely in the medical system…

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On trigger warnings for medical content

This post explains in graphic detail why trigger warnings are so very essential for people with a traumatic medical history. TW medical triggers (yes, this is a TW for the content warning).
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MASSIVE content warning for medical triggers: blood, needles, hospitals, IVs, injections, surgery, blood draws, etc.
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My history with needles is not a good one. It started with me being a very sensitive kid (Autistic, and therefore vulnerable even compared to other children) and associating injections with authority figures forcing me to endure pain. When I was seven I fell and gashed my head; I was in a great deal of pain, stressed and crying. My mother rushed me to the emergency department of the local children’s hospital, and minutes after arriving they injected anesthetic directly into my forehead, then stitched me up with nothing but the local and maybe some nitrous. (I don’t remember the incident with great clarity, as your might imagine.)

When I was 18 my appendix sprung a leak. I spent four and a half days in recovery following an emergency appendectomy as they treated the sepsis. I woke up after surgery in indescribable pain, with a catheter, a plastic tube down one nostril (an NG tube to empty my stomach), and three IVs, two active, one spare. At some point one of the active IVs was removed and the spare activated due to irritation at the entry site.

In my early-mid twenties I developed a blood disorder called immune thrombocytopenia, or ITP. People with ITP lose the ability to clot at semi-random intervals, as our bodies go haywire and start confusing our platelets (the part of blood that makes clotting happen) with foreign bodies (infection). This necessitates semi-frequent blood draws to check platelet levels and the occasional hospital (emergency department) visit. I was diagnosed in the hospital after two or three days of tests, including five separate blood draws and talk of a bone marrow biopsy. This turned out to be unnecessary, but I knew it was a possibility and prepared myself emotionally to endure it.

Those are just the highlights. I associate needles with hospital visits, near death experiences, and incompetent IV techs. I have at least half a dozen scars from badly done IVs and botched blood draws. (You do NOT want to know what a blown vein looks like. You especially don’t want to find out in a high stress environment and knowing they’ll have to try again.) I have endured needles again and again and again, despite a panic reaction that makes my legs weak. When necessary I have gotten regular STI tests, even when I could easily have skipped them with no repercussions, because I value the health of my partners above my own comfort.

When I ask for a heads up before an image of a hypodermic or a graphic description of an injection, this is why. I am not weak. I am a chronic pain warrior. And I deserve your respect.

Driving forces: Medications and driving under the influence

Most DUI/DWI laws (driving under the influence / driving while intoxicated) are based on the effects of alcohol. This is a major problem for people who take strong medications for pain, nausea, or other medical conditions which are known for their intoxicating effects.

Unlike recreational users, patients taking drugs like morphine, cannabis, or amphetamines under a doctor’s supervision tend to use the smallest effective dose, balancing impairment from the symptoms of illness with impairment from the drugs we take to treat those issues. People who take these medications long term also develop tolerance to the side effects (don’t get as high as recreational users, and many of us don’t get high at all). In the long term those of us who don’t develop immunity to the perception altering effects of our medications learn to adapt to our medicated state, as long term use of medications makes that state our new normal. Many of us are very safe drivers on our meds and would be UNsafe without the symptom management they provide, but the law rarely takes that into account.

Exacerbating the issue still further is the issue of testing. Blood alcohol content can be quickly, easily, and reliably measured with a breath test, and confirmed with a more accurate blood test in cases where people end up in the hospital. Its effects on driving have been studied more than any other drug. Unfortunately, law enforcement agencies the world over tend to assume this holds true for other drugs as well.

That assumption is inaccurate, and the consequences of its wide acceptance by lawmakers and police is a major stumbling block for sick people who wish to maintain some level of independence. The only way to get an accurate picture of a driver’s chemical state is through an invasive and somewhat painful blood test, which then must be taken to a lab for analysis. The specific chemical processes are not well understood in many cases, and even with those test results having exact knowledge the presence, absence, or amount of specific metabolites in the body is a rough guideline at best, and utterly useless in many cases.

What constitutes a therapeutic level of a drug (and what amount makes a given person unsafe to drive) varies a great deal based on a number of factors. These include such variables as weight and body fat percentage, liver and kidney function, the specific combination of drugs in their system, diet, blood sugar, specific medical conditions, hormone balance, overall state of mental health, sleep issues, and many more.

Someone with low blood sugar, who hasn’t slept well, who is going through a bad breakup and just lost their job is an accident risk of the highest order even if they’re stone cold sober. Testing for impairment should mean actually testing a person’s impairment, not auditing their internal chemistry and making a rough guess based on rough guidelines and ill-understood science.

Further reading:
Driving Under the Influence of Drugs (FindLaw – US specific)
DUIs involving prescription drugs difficult to prove (USA Today – US specific)
Drugs and driving: the law (gov.uk – UK specific)
Warning over drug-driving law and prescribed medication (BBC – UK specific)

Religious arrogance

Most liberals will agree that accepting a wide variety of belief systems is a good thing. Less common is critical thinking about what exactly that means in practice. Here’s a few common behaviors you might want to nix:

*Telling someone “bless you” when you don’t know they’re okay with it (and especially if they’ve asked you not to!). Although it’s common speech in many places and people might not think of the religious implications, that’s because religion and religious (usually Christian) privilege is so entrenched in that place that people typically aren’t aware of it unless they aren’t religious themselves.

*Offering to pray for people (or worse, simply informing them you’re going to). This makes many people EXTREMELY uncomfortable, especially if they subscribe to a belief system which teaches that prayers have power. Imagine a Wiccan doing spells to convert you and your family, your children to witchcraft. Praying that someone will “see the light” and come to Jesus is no different. Even if you pray for something benign, some believe it to be an attempt to abridge their free will. When in doubt, ask, politely and without assuming an affirmative answer. And please don’t press the issue. No means no.

*Inviting strangers to church when they haven’t expressed interest in your religion. This is a common form of micro-aggression with a host of implied subtext regarding your opinion of their beliefs, the state of their soul, etc.

*Attempting to force others to behave in ways mandated by your belief system (including things that are part of religious culture but not explicitly part of your religion’s sacred texts). This one’s the worst on the list, as it includes legislative restrictions on freedom (passing laws to force people to act the way you want them to). Don’t like gay marriage? Don’t get gay married. Don’t want Satanic statues on public land? Stop erecting monuments to your own beliefs.

This all boils down to respect. Even if you think everyone agrees, even if nobody complains, I *guarantee* you’re offending people too polite or too scared to speak up. By insisting on special treatment for those who share your beliefs, you’re telling everyone else that they’re second class.

The best solution by far is a secular public sphere with protections for private beliefs. Feel free to do what you want on your own time, so long as you don’t force it on others. If you provide a public service, know that your license to do business is a privilege, and with that privilege comes an obligation to serve the public without oppressing disadvantaged groups.

If you don’t like that, well, consider the alternative. If you get to discriminate, so does everyone else. That means no service from the many people you’ve disrespected – and if the people you’ve oppressed acted with the same arrogance common to the followers of dominant religions, you wouldn’t last a week.

The Myth of Obesity

A PSA regarding obesity, fat shaming, diet culture

Obesity is a complex issue with many potential causes. It can be a symptom of poor diet or stress, a medication side effect, a genetic predisposition. Junk food is a common cause, since its low cost per calorie is often the only way economically disadvantaged people can get enough to eat. Junk food isn't as filling, so you eat more – and that's by design. It's addictive on purpose, because addicts are a very lucrative market.

Furthermore, obesity as it's defined in certain Western cultures (especially the United States and Britain) is a largely manufactured "crisis". It's typically measured using BMI, a system originally designed in the late 1800s to assess large populations which is utterly unsuitable for diagnosing individual patients. Many if not most people who are "obese" according to the BMI charts are perfectly healthy – the tables in question are tabulated for averages, and body types vary a great deal. Incidentally, this goes both ways – many underweight people aren't diagnosed as such due to doctors' mistaken faith in BMI.

This is not an unimportant issue. It affects social stigma (and therefore stress, ironically leading many people to overeat to compensate). Many people with serious eating disorders go undiagnosed, misdiagnosed, and mistreated thanks to the conventional wisdom on the subject: heavy people with anorexia told to eat less, skinny people told they're perfectly healthy.

The issue at hand is a large and complex one, affecting dietary guidelines, exercise regimens, medication prescriptions, social taboos, and other important components of people's lifestyles. Misinformation on this scale has extremely nasty consequences, such as the low-fat craze of the 90s leading to massive amounts of added sugar triggering diabetes in many people (which is NOT caused by excess sugar in the diet, but rather by elevated blood sugar in people with the genetic marker. If you don't have the genetic predisposition, you cannot develop diabetes, period.) We need to educate our governments, our doctors, and the general public in order to combat these pernicious beliefs.

For more on this subject I recommend the Everyday Feminusm article, 6 Must-Read Expert Perspectives That Destroy the War on Obesity

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