Recovery Trek

The Virginia Health Practitioner's Monitoring Program (VA HPMP) switched to Recovery Trek at the beginning of November. Recovery Trek is supposed to be less expensive and make it easier to send in the various forms that have to be submitted on a monthly basis. Since there was no formal orientation to Recovery Trek for participants that had been in the VA HPMP already; it has been a learning experience. I will share what I know about Recovery Trek at this moment and will add to this post as I learn more.

First, Recovery Trek is a monitoring company based out of Virginia Beach, Virginia; which I was slightly excited to know that they are in the same state (Affinity seemed to have been based out of Canada, which the people who work there had no knowledge of anything in Virginia).

                                                                    Check Ins

The check-ins are some what the same as Affinity, a person can call in or check in online. In order to check in online, you need the program ID; username; and password. Once logged in, the participant clicks the test status button. The result is a clear 'Yes, selected for a test' or 'No, not selected for a test' with the 'yes' result in red and 'no' in green. The only down side I have found is that if you are a person that will not remember if you checked in that day, you will definitely have to write down the confirmation number they give to confirm check in. The reason is because the result does not remain on the screen like when a person checked in with Affinity (i.e. I could log out with Affinity and log back in and I could not check in again; with Recovery Trek, I can.)

If you choose to check in by phone, the number to call to check in is (757) 414-6039. It will ask for a ten digit number, which is birth date and last four of social security number. After, it asks for a pin number. At this point, I have no idea where the pin number comes from. I am going to call Recovery Trek next week and find out.

If a person is selected for testing, it will give the panel letter/number for test and the cost of the test. In Recovery Trek, the participant does not have to select a site before hand. They just look at the list of sites/type in the city and show up at the site with the chain of custody (COC). The cost of the test is not taken out until the result of the test is sent/received by the monitoring program. For me, the cost of the tests have been between $35-$49 per test. It does not seem that there are collection site fees as there are with Affinity.

                                                                Chain of Custody

The chain of custody is the drug test form that the participant takes with them to the site. The COC has the participant information, panel ID that is selected, and the stickers to seal the bottles. The participant must have the chain of custody with them when they go to the site, including Lab Corp locations.

On the COC, the participant fills out their social security number (Affinity used to give an authorization number to use in lieu of social security number. Recovery Trek uses the participant's social security number); name; telephone number; the panel selected for; date of birth; and date of test.

                                                                 VA HPMP Forms 

As of right now, the monthly forms are still mailed or faxed in to Virginia HPMP by the 10th of the following month (i.e. October 2016 forms are due November 10, 2016). Once it is set up on the Recovery Trek site, the forms will be submitted online and there will be the ability to contact a participant's assigned case manager through email. The participant will save money on faxing/mailing the forms, if they are not employed; if they are employed, it will save the headache of having to repeatedly fax the forms. Sometimes, it takes a while to get them to go through from the massive amount of faxes the VA HPMP receives.


Overall, I think once everything is available to VA HPMP participants, I think Recovery Trek will be a better monitoring company than Affinity. Again, as I learn more about Recovery Trek, I will update this post.

Hookah Smoking

I can honestly say that I did not find smoking cigarettes that addicting at all. I have friends that are hooked on smoking cigarettes but I did not find it addicting. I could go days and weeks easily without nicotine. That all changed when a friend of mine turned me on to smoking shi-sha through a hookah.

I live adjacent to a college town of a well known university in Virginia. I decided I wanted to go to the hookah lounge in this college town. I had never been, nor had I ever smoked shi-sha, so I begged my friends, especially my brother, to accompany me there. My friends had other plans and my brother is against smoking and thinks I need to quit. I still really wanted to go--I asked people in the college PRIDE group of this university that I am part of if anyone would like to go with me. I had a few people interested but two people couldn't go that night and one was broke. I offered to buy the shi-sha and the one that was broke took me up on the offer.

I met this girl, Liz, in front of the hookah lounge and we decided it would be better if we bought the shi-sha and went back to her place to smoke as she owns a hookah. Liz taught me all I needed to know about hookahs, heating the coals, and changing them. I got a light headed, dizzy; yet pleasurable high that I had not had since I drank alcohol. We spent over 3 hours just smoking shi-sha, talking, and listening to music. It was amazing and we both agreed that it was one of those connections that we had felt like we had known each other for a long time as opposed to have just meeting.

It was getting late. I had to work the next day and Liz had class; so, we hugged, made plans to meet again, and told each other bye.

We met up at her apartment within the following week and watched a movie, cuddled, talked, and smoked again.  I started to have feelings for this girl and I think maybe she felt the same. As I was getting ready to leave, I told her when I got back from Richmond, she could come by my house.

As I promised her, I took her by my house and asked her if she wanted to spend the night. She agreed as her roommate was having a significant other over and there was a chance of more than just a date that was going to happen. We talked for a bit as I do not have internet or cable at my house and she did not bring her hookah. Talking turned into intimacy.

The following day, we had a conversation through text. She decided that we were looking for different things and she did not want to pursue a relationship. I was okay with that as I agree that we are at different points in our lives and I am looking for a longer term relationship and she is not.

We went our separate ways. I was thankful for what I learned from her--I am a firm believer that a person learns something from every relationship whether good or bad, informational/superficial or a lesson that has a deep impact. I learned how to smoke shi-sha. At that point, I still did not consider myself addicted to nicotine; I had even changed my mind from wanting to buy my own to just occasionally going to a hookah lounge.

The next time I was in Richmond, I decided to visit the Mona Lounge as I wanted to check it out even before I smoked shi-sha but did not really have a reason to go there. Once I found out that they had hookahs, I decided to stop by on Ladies Night. I tried a couple different flavors-- Sex on the Beach and Mint-- and then, Mint with Red Bull (which the added Red Bull did nothing for me). I found myself getting that same pleasurable high that I had gotten when I smoked with Liz. It helped me relax and I slept well that night. Over the next couple of weeks, I found myself going back to the Mona Lounge twice a week and spending 3-4 hours there. Smoking cigarettes anymore do not do anything for me, even smoking a pack in one sitting. I guess at this point, it is safe to say that maybe I am addicted to nicotine...in very high amounts.

The Visit to St. Stephen's Episcopal Church

As I have gotten older, I have found myself less religious, more spiritual, and judge people based on their character. However, I must say that I miss the fellowship and beautiful services of mass. I was raised Roman Catholic and while living in Roanoke, I found companionship in a group known as the Roanoke Valley Catholic Young Adults. These fellow young adults amazed me--outgoing, nice, service oriented, and very devout in their faith. It was in their devotion to their faith that created two internal dilemmas for me.

The first one is that I personally am not incredibly devout and sure of myself when it comes to my faith. I will say that I absolutely believe in Heaven (I could not fathom not ever being with my earthly father again and I believe he is in Heaven); however, after that things get unclear. I want to believe I am monotheistic; however, having the belief that God is love and love can be found in many things that bring internal happiness and peace. I have been enlightened through reading that that belief is considered polytheistic. Aside from that, I believe Hell is a state of mind that one is unhappy and not in a peaceful state of mind; one can be in Hell while on Earth. Again, I do not believe that coincides with what the Catholic Church believes.

The second one is that they are so devout in their faith and the Catholic Church does not believe homosexuality is okay. Again, this group is amazing and I have never felt anything other than a welcome to the group but internally it feels awkward being the only member of the LGBT community (that I know of) in the group. I want to be able to find a same sex partner and come to church functions together and I believe that would be awkward with the Catholic Church.

I did a bit of searching on the internet and found that the Episcopal Church is very LGBT friendly. I decided to check out a church service within the Episcopal Church to see if it would be something I would be interested in joining. I selected a Celtic service at St. Stephen's Episcopal Church in Richmond. It was a beautiful service and reminded me a lot of the Catholic Church but very welcoming of many faiths and walks of life. The beauty of the church itself was breathtaking. The music during the service was Celtic and the environment was dimly lit with many candles. It is definitely a service that I will be attending again. Once I can get into the habit of going to church service again, I am going to try and make time to get involved in other events and with groups within the church.

Intensive Outpatient Program (IOP)

As mentioned in previous posts, I have been struggling lately with the possibility of relapse. I have done counseling for quite a while and as nice as my therapists are/were, it just was not helping like I thought it would. I decided to try difference options that I have not tried before--Dialectical Behavioral Therapy, Intensive Outpatient Program, and medication specifically for alcohol cravings. I have not even found a group for the former and the latter option, I am still looking for a psychiatrist. The middle option, however, is one that I am getting ready to start. I had an appointment  for an intake evaluation for Intensive Outpatient Program (IOP). IOP is a program that usually requires going to group 3 times a week for about 3 hours each meeting. It goes over various topics that can cause potential relapse and how to deal with it and general health. There is usually individual counseling sessions involved, too.
 
I am doing IOP through my local community service board. I was not sure how it would go; but, at my intake assessment, everyone was incredibly nice. I have another appointment in September to follow up and discuss treatment plan and to make sure IOP is right for me. My coordinator was not crazy about the idea of getting HPMP involved in going through IOP. Even though IOP was my idea, I explained that HPMP already knows I am going to go through IOP. He still wants to wait for first sessions before agreeing to provide information to HPMP as some people do not complete IOP and IOP may not be right for others. I understand his reservation and called my case manager at HPMP and let her know that he was open to discussing my case with HPMP down the line; however, not right now. I have not heard back from my case manager at HPMP.

I am kind of excited about starting IOP. I am hoping to learn some skills on how to cope and deal when I start feeling like I want to drink again. 

The Monster of Addiction (and the Frustration of the Mental Health System)

This has been the day from Hell. I have written about my alcohol abuse and potential for relapse. I have been dry for 4 years and 4 months, tomorrow. I continue to have cravings and my cravings have really come to a head recently.

I had mentally relapsed already--fantasizing about drinking and even going as far as trying to figure out how to beat the system with my drug screens. This weekend I had taken it a step further and went to the ABC store. It was almost a dissociative state move and it felt as though my body was on auto pilot and I was checked out. It was Thursday night and I was off the next few days; so, the plan was to wake up at 4 am and check in to see if I was to be drug tested on Friday; if not, have a drink of vodka and tea. I normally like a drink called a Sea Breeze, which has grapefruit juice; cranberry juice; and vodka. I did not have cranberry and grapefruit juice on hand, so a favorite tea would have to do. I woke up a little late at closer to 5:30 am and checked in. No test. Perfect. I was rather sleepy yet still wanted a drink; I knew if I did not drink then, there would be no way to beat the test as an ethyl G urine drug screen can detect alcohol up to 80 hours, sometimes even 5 days in rare cases.

I did not want to relapse, but I wanted a drink. I have not drank in almost 4 years and 4 months and it is an accomplishment for me; but the cravings and desire are still there. I just laid there thinking of what I had accomplished both personally and professionally--I had a great job that I love; I had my own house; and I was satisfied with life. I also reminded myself that I had an appointment with a psychiatrist for medications to help my cravings in a few days and if I could just hold on a little longer, everything would be okay. I was so close.

In addition, I was tired and I was reminded of time back during my drinking days when I waited until my parents were asleep; went downstairs, and poured me a red solo cup full of whiskey and drank it straight. I was sleepy after and went back to bed. I woke up laying in vomit. I have been sleeping in my guest bedroom, which my mom had bought the bedroom set for me as a housewarming gift. I could not imagine destroying it with vomit.

I decided to go back to sleep and to just smoke when I woke up in place of the drinking. Smoking does not alleviate my cravings for alcohol by any means; however, it has helped my anxiety dramatically.

When I woke up, I felt proud of myself that I was able to work through my near relapse and even shared my victory with a close co-worker of mine. My co-worker sent me back a 'good girl'. It helps to have a support system and I have a few co-workers in recovery that their support has been priceless.

I ended up going through this whole staving off relapse on Saturday, as well.

Flash forward to today. I had an appointment with a psychiatrist this morning. I showed up only to find out the appointment was cancelled due to insurance reasons.  This office is within network and there should not have been a problem. The receptionist seems to have no understanding the difference between insurance and a health savings account or understanding of being within network, a co-pay and submitting the claim to insurance. I was supposed to come back at the end of the day; and between the morning and end of the day, get everything sorted out with insurance. My insurance re-affirmed what my understanding of everything is and I tried to explain that to the receptionist. The receptionist told me I was getting irritated and that she did not think I would be a good fit for their business and to go elsewhere.

Here I am back at square one with alcohol cravings, no medication for the cravings, and no appointment to get medication lined up. Unfortunately, I have moments where I almost think relapsing/letting go and taking my chances with HPMP and the Virginia Board of Nursing may be easier than to keep fighting/hanging on. What happens next, I have no idea.

Deja Vu: Another Meeting with the Medical Director (and Staff)

A few months ago, I posted about meeting with the medical director of HPMP. Well, since then, HPMP has a new medical director. For a different reason, I found myself meeting with my case manager and new medical director along with a few other staff members. I also have to add that I also have a new case manager--her name is Dawn.

My new case manager is the reason I had another meeting with the medical director and staff. I just don't get along with her. We have since worked through a few of the problems; but, I just can't stop worrying about things with HPMP. I am a tense person to begin with and when any issues arise in HPMP, it throws me into an almost panic state. I get so worried about them taking my job away from me. Every time I am either late in getting something to them or not being able to accomplish a task on time, it is always my job on the line. I don't do well with threats--it just causes more stress and worry; then, I get incredibly agitated and go off on people.

I am having to do weekly counseling appointments and I have an appointment with a psychiatrist in August. I am hoping to get on medication for both the alcohol cravings and depression among other symptoms I am having. I have not been sleeping very good lately due to it being so hot outside and that has not helped the situation.

I keep telling myself that even though I have resentment with the Board and I hate HPMP, I am slowly making it through. Counting from my entrance date into HPMP, I have a year and a week left in HPMP; however, when I got a warning from HPMP for working too much, my date to completion is scheduled for July of next year. 

Sitting In On A Board Hearing

Colleen, a co-worker of mine, and I decided we wanted to sit in on a hearing at the Virginia Board of Nursing as both of us are in HPMP. I was completely nervous about possibly one day having to go before the Board and wanted to in a round about way face that fear. I contacted the Virginia Board of Nursing and set up a date to go observe a hearing.

We ended up sitting in on a narcotic diversion case. Occasionally, Colleen and I would whisper to each other about what we thought would be the outcome of the case. Initially, we thought this was going to be a cut and dry case and the woman was going to lose her license. Plus, it did not help that the woman showed up to the hearing in blue jeans and sneakers. As the case progressed, I changed my mind. The case against this woman was weak. She specifically got accused of being the one diverting due to her hand writing, her poor documentation, and the fact that she had a past with a different Board of Nursing. I am not saying she didn't divert; however, the evidence against her was weak. This woman also was shot in the leg about 5-6 years ago and is on opiates for pain relief. It was mentioned that her pre employment drug screen was clean and the drug screen performed after the diversion accusation was positive for opiates. She explained that she stopped taking her pain medication days before to prevent a positive for opiates so she would get hired. To me, that is definitely a possibility as if you need a job bad enough you would probably do anything. The poor documentation part I completely understand as nurses get busy-including myself- and may not always document as they should. Anyone who has not worked the floor probably would not understand.

Anyway, the outcome of the case is Reprimand and Indefinite Suspension of her nursing license Stayed with Entrance into HPMP. This poor woman has no idea what she is about to get herself into.