Chronic pain: Honor above comfort
MONTE VISTA — Laura Armstrong has one more battle to fight.
Laura Armstrong, Ph.D., was involved in the civil rights movements in the 1960’s and 1970’s. She protested social injustice and war.
Now, having just turned 80 years old, she is taking on one more fight.
It will likely be her last.
Believing it is unconstitutional and goes against her principles of integrity, Armstrong is refusing to sign the “consent for chronic medication and paint management” form now required by medical providers in the San Luis Valley.
Armstrong had not encountered the form until February when her provider told her she would have to sign it to continue receiving her oxycodone prescription for chronic pain. Due to extreme chronic pain, the oxycodone is the only thing that has made it possible for Armstrong to function, she said.
She had previously received her oxycodone prescription through a physician’s assistant, but his boss put a stop to that unless the form was signed, she said.
She said so far she has not found anyone in the Valley who does not require the form.
Of the 17-18 items on the form, there were seven Armstrong said she would not sign off on, but to continue receiving her medication she would have to sign off on all of them, she said.
Some of the requirements with which she has concerns include prohibitions of receiving medication on evenings or through the ER (she said sometimes she has had to do that to get her through until she could get into the doctor’s office); medications would not be replaced if they were stolen; and she might be asked to bring in her medication for a pill count at any time.
“That violates the Fourth Amendment, illegal search and seizure,” Armstrong said.
“Your ‘consent’ form asserts your intention of violating your privacy without a legal warrant or having to show a court probable cause.”
To sign off on the form would be giving her rights away as an American citizen, she said, something she was not about to do.
She said it might cost her life, because if the agony becomes too unbearable, she will not want to go on. She added she believed the medical providers who refused to prescribe her medication would then be complicit in her death.
“If I sign that form I will lose integrity. That’s more important than my life,” she said.
Armstrong said illegal drugs coming in from Mexico and Debra Rice overprescribing medications have nothing to do with people like her who have legitimate prescriptions for chronic pain.
“I have tried to tell them the solution you have proposed has nothing to do with the problem,” she said.
Armstrong met with San Luis Valley Health Chief Medical Officer Dr. Gregory McAuliffe and several others about her reasons for not signing the form, but she said she felt like her words fell on deaf ears.
“I am coming from a moral framework, and they are coming from a bureaucratic framework,” she said. “For me, it’s a matter of integrity I won’t sign this form … They are refusing to budge, and I won’t capitulate … I am not going to be intimidated.”
She said it is like people who need ongoing pain medication are being treated like they are guilty of something.
She said she did not understand how people could be allowed to serve in the military but not required to carry a gun because it violated their conscience, but she would have to sign a form that went against her conscience if she wished to continue receiving her pain medications.
“This is morally wrong and it’s also not legal and I think it’s a violation of the Hippocratic Oath.”
Dr. Armstrong has a BA in literature, a Ph.D. in education policy, has been a teacher and has worked for the federal government as a policy analyst in Washington D.C. She moved to Monte Vista in 2004.
Since 1981 Armstrong has suffered chronic pain, which was later diagnosed as fibromyalgia. She now suffers from multiple chronic conditions including osteoporosis. Having experimented with “any and all treatments,” she has taken oxycodone or Percocet since 2007.
“The oxycodone gave me a life with some good quality,” she said.
This spring she lost that quality of life when her medical providers in the Valley would no longer prescribe pain medication for her without her signature on a pain management contract.
Armstrong said without her medication she is suffering terribly. She said she qualified for medical marijuana but is not allowed to consume it where she lives, which is government housing.
Armstrong said she received a letter from Kelly Gallegos, the administrator of the Conejos County Hospital where her current doctor is located. Gallegos stated in the letter that the staff had had multiple contacts with Armstrong in attempts to establish health care for her, and staff leadership met with her to discuss the pain management agreement and her decision not to sign it.
Gallegos stated that the staff apologized that their agreement insulted Armstrong, as it was developed in good faith with all San Luis Valley health care organizations. Those who met with Armstrong also affirmed her right not to sign the agreement, Gallegos stated.
Gallegos added that the staff encouraged Armstrong to share specific language in the agreement that might not be as offensive.
“We remain open to your suggestions,” Gallegos wrote.
Armstrong responded to Gallegos, also in writing, that the two of them had opposing views on the purpose of the meeting. Armstrong said that she was repeatedly told nothing was going to change as a result of the meeting, so her purpose for meeting with staff was to let them know why she was not going to sign the form. She wanted them to understand that she had lived in a world of moral imperatives, and “that some people have always, and still do, put their integrity over everything else and will make sacrifices to do so.”
Armstrong concluded, “Apparently it was your expectation that after you insisted on ruining my health and life, I would in return provide you with more elegant language for your cruel and unconstitutional intentions.”
Because she is now suffering so much now, some of her medical providers believe she is more likely to have a stroke or heart attack. She has less appetite because of the pain, and it is becoming more difficult to move around the apartment.
She said she thought doctors were trained to put patients first and see them as individuals. She could not understand why medical providers would sentence her to horrible pain for the remainder of her life — when there was relief for it — because she would not sign the pain management form.
“It’s not a statement I make lightly when I say I will endure or I will die, but I will not capitulate.”
This is part one in a series called "Chronic pain: Solutions and concerns." Click here for part two and here for part three.