Virtually Perfect

“What can I do for you?.” said the voice on the other end of the phone. I was talking to one of the nurses at the VA medical center oncology department, inquiring about why my pain meds were two weeks late. She said she could help me.

“I’m glad to hear it.” I said back, “But the lack of pain pills prevents me from gushing enthusiasm.” It was true. I’d run out of the sustained action morphine pills around the 5th of the month which left me only the remnant contents of my short acting pills. Since I have to take them every three hours to get a similar benefit to the time release version, I was a bit testy from a lack of sleep. It’s hard to get the full benefit of resting when you wake up every two and a half to three hours to take a few pills. I’ve tried to go back to sleep and ignore my scheduled dose, but abandoned that quickly. There’s nothing like being roused by serious pain. It also prompts one to have some very icky dreams involving pleasant subjects like being eaten by crocodiles and sharks. Look, I know that crocks and sharks don’t fraternize, but these are dreams and anything can happen and seem quite realistic.  I spoke again: “Could you see what the problem is and get it fixed for me?” The nurse said she would.

“While I have you on the phone, Mr. Kirkpatrick, I really should schedule you for a visit with the doctor. It’s been six months since you’ve been in.”

“I had a good summer. Okay, I guess I do have a few things I’d like to talk to him about.” I did. The nurse asked me what it was I wanted to discuss. “I have a bunch of new pain locations.” I left it at that.

“That doesn’t sound good,” she said. “Where are they and how would you describe them?”

“They’re in my body and they hurt a lot.”

“No, I meant where in your body are they?”

“Um, my back, legs, arms, shoulders, feet, ribs, hips and my head.”  There was silence for a few beats.

“How would you rate the pain?” she asked. “On a scale of one to ten where zero is no pain and 10 means you cannot function because of the pain.”

I thought about it. “Well, I guess that depends on the moment. I always feel it so there’s no zero involved. I think you should give me a scale that starts at about 4 and goes to ten. Or maybe a scale that goes from four to ten with occasional peaks of 20.”

“Can you describe the pain?”

“Yeah, it’s a sensation of varying discomfort that makes me say things like ‘ow’ and goes up to me shooting spittle as I scream and swear a lot.”

“No, I meant is the pain sharp or dull, like an ache, and does it move about or stay in particular locations?”

“Well, that’s a problem. They don’t all hurt at once, and it seems like there’s no place sacred from it. And it can be both an ache and a sharp pain.”

“Oh, I’m sorry to hear that.” She actually didn’t sound all that contrite. “I can get you an appointment at the end of January, would that be alright?”  I allowed as it would be just fine, but told her that I was hoping she could fix the pain prescription thing a bit sooner. She said she would take care of it right away. I thanked her and we hung up after the expected wishes for happy holidays.

Fifteen minutes later my phone rang and it was the nurse from my primary care doctor. “I see you have an appointment with oncology at the end of January.” I agreed that I did. “Well, doctor would like to see you here too. It’s time for your annual checkup.”

“You’re just saying that,” I said. “Because you’re jealous of oncology.”

She giggled. “You caught me.” Actually, the VA requires that we vets go see our doctor every year, specifically to monitor for any changes in health status, good or bad. I don’t see this as bad policy. “We should set you up for a number of tests as well, but I will let doctor decide about those after he’s seen you.” It always bugs me that nurses say “doctor” instead of “the doctor,” as if doctor was a name rather than profession.

“Vet agrees.” I said. I love to be facetious, especially when I’m in a pain induced bad mood. But she was cheerful and she’s a really good nurse who’s helped me a lot over the years and it’s hard to be mean to her, so I settled for just being slightly wise-ass. We made arrangements for my primary to see me right after my oncologist. No sense in making me come out there on different days.  She admonished me to stop by the lab for a blood draw an hour before my appointment time. I told her that would be fine, I had to see the vampires for my oncologist too. Again Christmas wishes were exchanged and we hung up.

I set my phone down and it rang again so I picked it back up. It was my oncology nurse again. She called to reassure that she found the delay and had fixed it. My medications were being handed to the postal system as we spoke. I was reassured. Apparently the pharmacy thought I would pick it up at the counter and so my medication had been languishing on a shelf waiting for me to fetch it. Problem solved.

When the VA mails my medications, they invariably show up the following day, what with the medical center and I in the same city. But I wondered about whether that would continue to be a reliable schedule, what with the announced changes to the postal system on the way. When Congress, in its infinite wisdom saw that the postal system was a solvent agency, they immediately began to siphon money from it. Our sitting government is equal opportinity and hates it when any of its agencies functions properly. It makes the bad management of the rest of the government stand out too much, and not in a good way. The Constitution just says that a post office has to exist, it never said it had to work.

I thanked her and once again we shared good holiday wishes and we hung up. I sat there looking at my phone and thinking about the upcoming appointments. I actually have a little trepidation about going in. Things have changed for me of late, and not for the better. I’m a bit afraid I’m going to get some bad news. I went through the summer feeling almost normal, save the occasional breakthrough pain –that’s discomfort that spears through the daily morphine dosing that raises my pain threshold and turns level five pain into level one. For the most of the summer I felt good considering my situation. But as August gave way to September, and it to October, my breakthrough pain was happening more and more often, raising the dosage I needed to maintain a comfort status quo. Now here in December, my usual dosage isn’t hacking it, and that’s why I was shaking the VA tree to get my medication snafu resolved. It’s been, to be honest, a pretty crappy December.

However, I have been cheering myself up playing virtual Santa Claus for my family and close friends. I spend hours online looking at all of the wares and products up for sale and selecting the many gifts I would be handing out had I actually purchased them. Since I have the budget of your average tree stump I’m not in the position to buy any of this crap, and so I make myself feel better pretending to satisfy the wildest dreams of my circles. If I could only get them all to pretend that they got something, I might have myself a workable system in the making. It’s actually a lot like me pretending to buy tickets for the Washington State Lottery and them pretending to let me win. It passes the time.

I play a lot of imaginary games, especially with the VA. For instance, they sent me a notice that I was given a specially adapted vehicle grant so I could get myself transportation that would carry my mobility scooter. I filled out the requisite forms and turned them in. Now they’re pretending they will process them eventually. They also qualified me for a specially adapted housing grant which would cough up to remodel a home or help me build a home that accomodated my disability. They’re pretending that the mortgage loan system will give me a mortgage, which they’re resistant to do what with me not working, and my disability income immune to garnisheement should I have difficulty meeting my mortgage payments. I’m pretending that I actually trust the mortgage loan system enough to risk buying a home with their “assistance.” There’s a lot of pretending going on in my life. I live a very virtual existence.

Things virtually couldn’t be any better. I should be thrilled to live such a virtually perfect life. But as I indicated earlier, my pain medications are working so virtually well that I’m virtually as comfortabe as a chipmunk in torpor. With things as they are, I could virtually live forever.