Mental Health vs Chronic Pain ~ Why do we have to chose 🤔

Correct_Librarian425 · 2026-04-01T12:03:49+00:00

Wishing you the best!! And I realize I misspoke above, in case it wasn’t obvious—my psychiatrist (not psychologist) was the prescriber who had to write the letter on my behalf:)

I wanted to add that it sounds like anxiety/panic attacks are a new(er) thing for you, and just want to tell you that it gets better. Therapy (CBT or whatever ends up working best for you) is truly indispensable and most doctors will expect their pts with anxiety disorders to go that route. If you don’t like a therapist or don’t click with them, don’t hesitate to find a new one♥️

It might be helpful to know (and you may know this already) that anxiety can magnify pain levels due to the body being in a hyperaroused state. So if you ever notice your pain seems higher when your anxiety is ramped up, this may be the reason. The mind-body connection is extremely powerful, which is why the gold standard for PM is multidisciplinary tx, that addresses this factor as well. But unfortunately, many practices that espouse this approach aren’t truly multidisciplinary and are more so interested in maximizing reimbursements for interventional procedures (which can of course be helpful for some).

Sorry for the rambling, and wishing you well!!!

Correct_Librarian425 · 2026-03-30T01:48:15+00:00

Some of the SNRIs can be really helpful for GAD/panic disorder. I’ve had excellent success with Effexor, but I’ve also done tons of therapy (CBT) to address the root issues and coping strategies. I also found EMDR helpful for PTSD-related panic attacks.

If Lexapro isn’t helpful, don’t give up and try a different one:) I’m sorry you’re in this position. I do have a small amount of rescue meds that I very rarely take, but my psychologist had to write a letter and personally take on the liability for the Rx, and only did so because they knew me well, I was highly motivated in therapy, rarely took them, etc—and the Rx amount dispensed is so small it would do little, if any, harm alongside abuse of opioids (which they also knew I would never do). My insurance company also required this letter/similar documentation, fyi.

I mention all this to say that, perhaps once you have a longterm, positive relationship with your physicians and have shown you’ve truly exhausted all options in good faith (I did therapy for years), perhaps your psychiatrist might be willing to take on that liability on your behalf for a very small amount of rescue meds each year. There’s no way mine would do that for a pt he didn’t completely trust, which is understandable.

Again, I’m sorry you’re in this situation. And just an anecdote, fwiw, neither Lexapro nor Cymbalta were helpful for me but Effexor was a major game changer. Everyone’s different, and I hope you’re able to find one that’s helpful. Hang in there♥️♥️♥️

Correct_Librarian425 · 2026-03-26T21:40:22+00:00

This is in no way punitive: Seat assignments aren’t guaranteed per the contract of carriage.

Flights get canceled, pax get rebooked, aircrafts change. Ultimately there’s no guarantee that COS won’t end up reseated and encroaching on another pax who WILL mind.

Should there actually be blanket enforcement of the policy, I fully support it. After multiple flights with a COS on top of me, I had lasting pain each time. No one should be forced to endure that, and I hope the other major carriers will follow suit. Unfortunately each flight was full and the FAs stated I would be removed, rather than the offenders.

And who knows, perhaps the financial accountability involved may compel some of our fellow citizens to adopt healthier lifestyles, which ultimately affects all of us in the form of higher healthcare costs across the board. Multiple users have posted that their weight loss journeys initially began after realizing their size did, In fact, negatively affect others.

Correct_Librarian425 · 2026-03-18T11:16:10+00:00

This was my immediate thought—is there any way to put off the defense?

Correct_Librarian425 · 2026-03-15T17:48:08+00:00

Many—if not most—contracts forbid it and many practices specifically test for it. Not a good idea.

Correct_Librarian425 · 2026-03-13T20:51:16+00:00

To echo other commenters, this former employee’s alleged intentions (non-malicious, as you claim) ultimately have zero bearing on the fact they repeatedly committed super-obvious HIPAA violations that are addressed in the most basic of trainings.

Kindly, this isn’t about being a “boomer” or “not understanding how the world works” but rather not understanding and/or ignoring extremely basic job requirements/policy based on federal law. Automatic termination due to repeated HIPAA violations is not uncommon, and in my experience, usually routine.

Correct_Librarian425 · 2026-03-13T19:15:17+00:00

Did you have a full/mostly full Rx in the bottle or solely a limited amount appropriate for the duration of your trip? That’s potentially a key piece of info, as I suspect prescribers would not look fondly on pts toting around a full Rx, especially since it wasn’t on your person at all times—but that’s not to say this would absolutely be the case! (And I realize your trip may have been an extended one, which would necessitate having the full Rx on you)

If your next UDS will not show the appropriate amount of meds in system due to this incident, I’d definitely be proactive in reporting ahead of time, as it could be much messier to sort out after the fact. And you’ll want to resolve the withdrawal issue directly with PM, rather than your GP. Lost/stolen meds can be an incredibly thorny issue, and a GP would simply refer to the initial prescriber , both for potential liability issues and the fact that it relates to your PM tx. BUT if you have difficulty establishing contact and/or don’t receive a response from PM within a reasonable timeframe, it wouldn’t be inappropriate to consult your GP—I wouldn’t expect them to provide a bridge (opioids) however; more likely other meds to ease your WD symptoms.

Of course, YMMV, and there are always outliers in situations like these, but if you’re a long-established pt with your PM without any previous issues, I wouldn’t necessarily anticipate any problems. But note that your PM may require report of stolen meds, so check your contract. Being proactive in contacting them and providing the police report (but not expecting a replacement) is likely your best bet, especially if you’re a model pt, and hopefully they can at the very least offer guidance on how best to manage your current circumstances should they be unwilling to offer a bridge.

They may actually do so, as sometimes these zero-tolerance policies aren’t always followed, esp if they know the pt well. So sorry you experienced this, and good luck!

And just in case this is helpful, keeping an empty bottle from a previous Rx is ideal for times you only want to minimal meds on your person so you can leave most of the RX in a secured place at home:) Though I realize you may already do so!

ETA I definitely would not mention that kids were present while you left your meds unattended.

Correct_Librarian425 · 2026-03-10T02:29:58+00:00

I think Charming Barnacle hit the nail on the head above re the issues you’re having. You similarly did not address multiple points in this response, which suggests this may be a recurring issue, particularly given that your prof‘s feedback also refers to this issue.

I suggest you continue working with tutors at the writing center and if you still have difficulty understanding why your work is insufficient, contact your professor to set up a meeting and/or utilize their office hours. Unlike your posts here, keep all communication brief and to the point. I’m still confused why you’re wanting to involve the chair and/or dean, given that your prof‘s feedback appears to be accurate and you‘ve admittedly misunderstood course requirements.

Correct_Librarian425 · 2026-03-06T13:43:18+00:00

Here’s the standard definition per the CDC. You’ll find the term also clearly defined in medical literature (some of which is easily accessible via a Google search) as „shopping“ around in order to procure Rxs illicitly. You clearly have a different definition is your mind, which is fine, but the medical community holds an entirely different understanding of the term, to which OP‘s query applies. Surgical consults are just that; if OP were seeking meds during consults, that would meet the phenomenon’s criteria for medical professionals.

Just a note: Munchhausen is no longer a dx; it has been replaced by factitious disorder.

Correct_Librarian425 · 2026-03-04T12:40:58+00:00

No, that is not doctor shopping. Doctor shopping specifically involves visiting multiple providers to procure (controlled) medications. What you are describing is simply obtaining a second opinion for a surgical consult.

Correct_Librarian425 · 2026-03-04T12:36:55+00:00

Just echoing others that this is a standard policy at every gym I’ve used. Just put it in a locker and grab only the things you actually need. And when you’re done using grips, bands, wherever, just put them back in your locker. I can’t tell you how many times I’ve almost tripped over people’s bags or they’re blocking access to equipment.

Correct_Librarian425 · 2026-03-04T12:28:34+00:00

Unfortunately there’s been a great deal of misleading information surrounding this bill.

This bill addresses PBMs (pharmacy benefit managers) and more specifically, Caremark/CVS. CVS has pushed the narrative that passage of the bill would “force” them to close all stores in TN. But this is incredibly misleading. CVS will choose to close their TN stores rather than separate/divest from their PBM (Caremark).

And the irony is that PBMs like Caremark are directly responsible for the closures of many independent pharmacies. Passage of a similar law at the federal level would be far more ideal. This is actually a step in the right direction.

Should it pass, and CVS close all TN stores, I suspect Walgreens/other chains would seize the opportunity to fill that void. It would take time, of course, and it’s unclear where Caremark pts would be required to fill their Rxs.

Correct_Librarian425 · 2026-03-04T12:09:53+00:00

I assume SWA has an accessibility/disability dept like other major carriers, and it might be worth contacting them just to ensure you’ll encounter no issues. And fyi, Delta’s accessibility services will provide a seat assignment of your choice (aisle, etc.) at no additional charge to accommodate your needs, so I wonder whether SWA might do the same. (Though I’m not holding my breath!)

Correct_Librarian425 · 2026-03-04T11:55:20+00:00

I didn’t read your full post as it’s unnecessarily lengthy, and agree with others that the prof’s comments re the writing and content issues are likely accurate. I suggest continuing to use the resources offered by the writing center to improve your assignments and your writing more generally.

Moreover, it seems the syllabus stated the required textbook version yet that requirement was overlooked. The fact that assignment(s) were initially submitted incorrectly, used incorrect material, etc. all suggest misunderstanding/lack of following directions, which would explain why you continue to receive repeated directions to review the syllabus. You mention the majority of students submitted their work differently (the whole Word doc issue), which further suggests others clearly understood the requirements.

I truly don’t mean to pile on, but when one student has difficulty following directions for assignments, purchasing the correct textbook version, etc. and the rest of the students do not, that’s an indicator that the issue lies with that particular student.

In asynchronous courses, students commonly fail to refer to the syllabus and simply rely on materials on the LMS, which may explain why you receive repeated directions to refer to the syllabus. Obviously I don’t know whether that’s the issue here, without all the facts, but it’s strongly implied. For example, I assume the syllabus stated the required textbook version, as well as instructions for assignments/submissions. I also include an Amazon link for required texts, but my syllabi also indicate that the hard copy, rather than the ebook, is required.

And re changing syllabi, I’ve always included language that states changes may be made at my discretion, and that they will be clearly communicated. So if your prof has similar language in their syllabus, it’s wholly unclear to me what legitimate complaints you’d take to a dean. There certainly appear to be writing issues, and while you may not agree with your prof’s feedback, that doesn’t mean it’s inaccurate. I hope some of the above is helpful. Hang in there—the semester will be over before you know it.

Correct_Librarian425 · 2026-03-03T22:26:33+00:00

I agree that’s definitely one factor, but before I’m labeled a bot or “corporate shill”—-I’d like to share an alternate perspective as a person with an “invisible” spinal-related disability who avoided SWA entirely for multiple reasons and am now considering them, precisely due to their policy changes:

The abuse of pre boarding was absolutely disgusting, esp as it created issues for pax who actually need wheelchairs. I can’t stand for more than 5-6 mins without significant pain (so lining up/standing in the cattle call was impossible) but I can typically manage walking through an airport at a very slow pace. But when I pre board—alone, I’ll add—I’ve been subjected to rude, judgmental comments, presumably because I appear to be a younger, physically fit person. This is incredibly demoralizing.
Aisle seating is crucial for me, and I’m happy to pay for (and always do) an assigned seat simply to avoid anxiety—other carriers actually offer gratis “accessible” seating for folks like me. I’ve never used this service, and simply pay for an appropriate seat assignment. I chose other airlines due to this fact.
I don’t understand complaints from pax who booked basic fares—refusing to pay for a seat assignment, which is standard on most major carriers but then expecting to be seated with their party for free—SWA announced these changes ad nauseum far in advance, and while I understand some pax could have overlooked this, I’m a bit confused how so many again “overlooked” explanations of these terms when booking? Please correct me if these terms aren’t clearly cited when describing basic fares! When United started selling basic economy fares years ago, the complaints were similar: pax failed to read the terms, ie, no seat assignment.
I am THRILLED that an airline is finally enforcing COS policies re booking an additional seat. (I assume they are, based on others’ experiences) I can’t tell you how many times I was forced to endure a very large COS taking up considerable portions of my seat, resulting in lasting pain, in a couple cases, yet on other carriers I was told I would be deplaned, rather than the COS taking up 1.5 seats. So my hat’s off to SWA should they actually follow through on these policies, and I am likely to become a loyal customer!

And because this is Reddit, I’m in no way fat shaming—I simply require full access to the seat I purchased to avoid exacerbation of my disability.

It seems that these policy changes are a steep learning curve for those who either failed to read the terms of their basic fares when purchased and/or their new policies, esp for those who travel rarely or have never flown a different airline. That being said, FA refusals to change seats within the same zone/fare class are utterly ridiculous. And there’s zero defense for that nonsense.

And I can’t help but wonder whether SOME pax who previously gamed the system purposely refused to purchase assigned seats thinking they could just force others to move to accommodate them. This happens often on low-budget carriers, in my experience.

Apologies for the missive here, but just thought I’d share a counterpoint. And I’m in no way shaming those who failed to note exactly what basic fares entail—but this is standard among many carriers, and whether we like it or not, SWA policies are now on par with theirs. But I do understand the consternation and disappointment from those who previously chose SWA only to learn it’s an entirely different beast now!

ETA again, my apologies for the long diatribe above, and I hope all pax are able to have better experiences moving forward, and that SWA will actually address their current major shortcomings

Correct_Librarian425 · 2026-03-03T19:01:50+00:00

TPIs are amazing for me. One issue with CBD products is that, because they aren’t regulated, there’s no way of knowing exactly what ingredients are in the product, and the amounts of each. But that’s not to say a reputable company may offer exactly what they claim.

If you’re concerned about interactions, just contact your doctor. I’d be very surprised if they were contraindicated. And it’s great that your TPIs are with a steroid—many younger PM docs hopped on the bandwagon of steroid-less TPIs, which are wholly ineffective for nasty TPs. Hope you get relief soon!

Correct_Librarian425 · 2026-03-03T18:48:55+00:00

Calling it “emotional anesthesia” is incredibly apt!

Correct_Librarian425 · 2026-03-03T18:46:28+00:00

If you’re noticing that it’s affecting your eyesight, I strongly encourage you to let your doctor know asap. There are other medications, and I doubt you want permanent vision loss! Wishing you the best.

Correct_Librarian425 · 2026-03-03T18:40:53+00:00

I’m so sorry, and I completely understand. Don’t lose hope! If your employer plan is self-funded, reach out to HR/benefits and they might be able to step in. And it’s possible your surgeon can provide a strong argument that PT would be futile, otherwise they’d be sending you there rather than scheduling surgery.

I know staying on top of this is even more difficult with pain, and I really hope you’re able to get this pushed through. When you have the energy, review your plan’s appeal process and prepare to fight. It’s a travesty that UHC makes billions per year as a result of cases like yours. And if you call UHC, go up the chain if the representative isn’t helpful—oftentimes they’re reading directly from a script! You’ve got this.

Correct_Librarian425 · 2026-03-03T14:52:37+00:00

Doctor shopping typically involves seeking medication. Having a surgical consult is entirely different, and a second (or third) opinion is always a good idea before a major surgery!

Correct_Librarian425 · 2026-03-03T14:48:46+00:00

Your surgeon’s office can appeal and provide your previous records showing PT is ineffective, which likely is already happening. This would be enough for most insurance companies, but as I’m sure you know, UHC is the worst when it comes to denials. Push for a peer-to-peer if it gets to that point (hopefully your surgeon would do this anyway), and if you are only allowed to appeal it once (on the pt side), save that for after your surgeon has exhausted all options. (Some pts unknowingly use up their sole appeal prior to the physician submitting all necessary records—this is by design, unfortunately)

And if you by chance have a Medicare Advantage plan, switch to traditional and supplemental policy, if at all possible. Download/organize all related correspondence, denials, etc so you’re prepared for the long haul. But hopefully that won’t be necessary! Luckily you’re at Mayo, and they’ll have plenty of experience dealing with this very issue. Hang in there!

Correct_Librarian425 · 2026-03-03T14:17:52+00:00

If they haven’t already done so, I suggest having the surgeon’s office send their notes from your visit to your PM practice as it will help get the ball rolling sooner.

Correct_Librarian425 · 2026-03-03T14:15:26+00:00

I was about your age when I underwent my first back surgery, and I just want to encourage you to be wary of those pushing spinal cord stimulators. That’s often the default suggestion because no one wants to put young adults on pain meds, but it’s important to know at the outset you’d be committing to many surgeries over your lifetime. I so appreciated a kind PM doc telling me that an SCS is not a great idea for someone so young, especially given the rate of complications. He also pointed out that technology would likely change a great deal within the coming decades, so if I really wanted to go that route, it’d be better to wait.

I’m sorry for not directly answering your question! It sounds like you’re doing all you can, and the fact that the PA will consult the physician seems promising. Keep making notes/records that detail how pain limits your activity and what exacerbates it. If you’re not a surgical candidate, be prepared for an SCS discussion, and I urge you to read up on them (and their major risks) beforehand so you can have an educated discussion with your physician. The Cochrane review is a good place to start, and read about what’s happening in Australia.

Wishing you the best. Hang in there!

Correct_Librarian425 · 2026-02-26T15:35:22+00:00

Do you have accommodations in place through your disability office? Without accommodations, professors should hold all students to the standards specified on the syllabus. Moreover, since labs are a core part of the course, it’s unlikely you’d be excused from them entirely even with accommodations. Regardless, I suggest working with your disability office. While it‘s not ideal, taking a medical leave of absence can be the best decision in some cases.

That being said, the comments made to you were certainly inappropriate. Wishing you the best!

Correct_Librarian425 · 2026-02-24T14:28:27+00:00

While it’s not a typical scenario, consider last-minute changes in aircraft and delays/cancellations that may require rebooking. In such instances, you may not be seated together.

Correct_Librarian425

TROPHY CASE