A little help for chronic pain; managing depression during cancer treatment
Q: I took a new job, and now my health insurance plan won't cover my old pain medication. (I deal with chronic pain after losing a vertebra in a car accident.) But long-acting morphine is covered. I don't know if I can do my job on that kind of medication, and I really don't want to face an opioid addiction. What can I do? - Jessica B., Kissimmee, Florida
A: Insurance companies are a bureaucratic nightmare these days, but usually in the end, if you jump through enough hoops and over enough hurdles, you'll get what you need. It looks like you have to start filing appeals for an exception. Your doctor(s) will have to get involved in the paperwork, too. If the insurance company denies your appeal, keep appealing away. It often takes more than two or three tries.
The New York Times and ProPublica recently did a piece on a situation that's similar to yours, showing how, in the middle of an opioid crisis, insurance companies are refusing to cover less-addictive pain meds that cost more and are doling out opioids, often with no co-pay. This will happen as long as insurance companies are short-sighted, for-profit entities. It would be cheaper in the long run to treat you with better, more-expensive drugs now, because that will help you avoid additional medical visits (even hospital time) and addiction services, which the insurance company will just have to pay for down the road. But no one ever accused insurance companies of being too smart.
That said, there's a new chronic pain remedy that was just approved by the Food and Drug Administration that might be a good choice for you. It's a spinal cord stimulator called Intellis (by Medtronic) that runs off a small implant that a clinician can control from a Samsung Galaxy Tab S2 tablet. It sends an electrical impulse from a lead implanted in the epidural space to block pain signals from going to the brain. So talk to your doc and go see a pain management specialist to check out it and other alternatives. Good luck!
Q: My husband has colon cancer and is doing chemo. I think he should get some mental health therapy because he's pretty depressed. What do you suggest? - Arlene, S., Boston
A: You're absolutely right, and there are many beneficial therapies. Talk therapy and cognitive behavioral therapy can make it easier to cope with fears, depression and anxiety. That promotes healing and improves everyone's quality of life enormously! You also can talk to a doctor about medications that ease depression and anxiety, and when your husband can take them.
In trial after trial, mindful meditation has been shown to reduce stress in cancer patients. It yields better survivor outcomes and also helps with chronic pain, insomnia, depression and anxiety. And it's cost-effective! Dr. Mike's Cleveland Clinic just opened the Taussig Cancer Center; one of its cornerstones is a wellness center for guided imagery and a spiritual area for prayer or meditation.
At Dr. Oz's New York-Presbyterian, home to the Herbert Irving Comprehensive Cancer Center of New York-Presbyterian/Columbia University Medical Center, mindful meditation plays a big part in the comprehensive support programs that address the emotional and physical challenges faced by cancer patients.
You have a lot of great cancer centers in the Boston area, so wherever your husband is being treated, ask about programs that help cancer patients and their families through the treatment process. You can combine meditation with other programs that dispel cancer-related stress. Find out what physical activity he can do - chair yoga, walking, swimming? Exercise builds confidence, improves body image and helps ease depression.
And, Arlene, don't forget to take care of yourself. Eat more healthfully and do more physical activity, too. Studies show that these activities benefit the partners of cancer patients as well as the patients. We think you'll both find a lot of great support if you just ask around.
Distributed by King Features Syndicate, Inc.
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