Are Pharmaceuticals Evil or Godly?
This shouldn't be a black-or-white thing!
5 months ago I wrote about getting ill with a “long cough” that was going around the local community. I usually bounce back from illnesses like the cold well, or don’t get sick to begin with. This was different. I wasn’t able to heal without medication. A few months later, for a different reason I had a sleep study done. I found out I have hypopnea (shallow breathing). It can cause a person to have micro-wake-ups in the night. Those micro-awakenings don’t always cause you to be conscious of them. My best guess is that was why I wasn’t able to heal well during that time. When I got put on medication strong enough to knock me out (sleep-wise) my body finally healed itself.
Although I often reference the Greek word (used in the book of Revelation1 of the bible) for sorcery is pharmakeia, I don’t turn all pharma products into a persecutor. Sometimes you just need a little help. I view pharma products as good and bad and it depends on the dosage. But other people view them as saintly (pharma could have no problems whatsoever) or as the devil (never trust pharma and always suffer if you can’t find a better alternative).
I’ve been meaning to write this article for a long time but a few other things have come up and so now it seems like the perfect time.
First, this might be a fake rage-bait story, but supposedly a pregnant woman took an overdose of Tylenol because Trump warned pregnant women to not take it while pregnant unless absolutely necessary. I would not share that story as if it is absolutely true, but it proves my point. The story has been shared because it’s believable today due to some people thinking there’s nothing wrong with pharmaceutical products if they’re approved. It’s like they’re actually blind to side effects being an issue.
One-Dimensional Thinkers
I’ve discussed this before, but people in the drama triangle have the cognitive distortion of black-or-white thinking (aka splitting). People have TDS see Trump as “all bad” which means everything he is for, they’re against, and vice versa. So if Trump is against Tylenol for pregnant ladies, and these people are anti-Trump, they’re pro-Tylenol.
When I wrote about the “long cough” I had a comment from someone who thought my use of pharmaceutical products was going to make things worse rather than better. She believed that pharmaceuticals were all evil and you should never resort to using them. However in my case, it was the best thing I could do. It allowed my body the ability to repair itself so that I could get back to work, get paid, and not starve.
It’s Not All Bad…or all Good.
Pharmaceuticals are not all evil or all good. There is nuance and the dose matters. I am very wary of pharmaceuticals, and I don’t take more than I feel is needed, but I won’t allow myself to suffer if they’re going to help. Now that I know that I have hypopnea, I am using a CPAP as well, which leads us to the next part of the article…
Medical Folks — Condescending AF
I live in a small town, and I see a local Physician Assistant (PA) who can prescribe drugs (and a CPAP script). He’s been great, doing everything to help me figure out what will work for me. When I realized I could use an SD card in the machine and track my stats, I asked him if I could play with the settings on the CPAP and he said sure. So I did.
They started me on a pressure prescription of 4 to 20 cmH₂O. I found out that when my CPAP regularly puts out pressure above 7 it wakes me up. Here is one of my most recent nights with the too big (up to 20) range. At about 4:12 am it hit almost 8 and I woke up and took the mask off because of the annoyance. I wanted more sleep because I’m always exhausted. So I fell asleep without the mask that morning.
When the max was 7, my AHI was still below 5 which is considered normal (not apnea/hypopnea). It was actually really close to 1/hr. which is low. I used the mask for over nine hours that night. (Daily Usage is in pink on the middle right of these pictures)
So in the range that I have spent plenty of time and effort figuring out (4 to 7), I use my CPAP more often (than when the range is up to 20) and still get a good AHI for the whole night.
A couple of days ago I got a call from the people who I am rent-to-owning the CPAP machine and she told me that I can’t play around with the prescription (pressure range). They can see that I edited it. They won’t allow it. I need a prescription for that if I want it changed.
I told her, “I wake up if it goes above 7,” while she was trying to say, “It’s supposed to do that.” I asked, “It’s supposed to wake me up?” She said, “The pressure goes up if they detect that you are not breathing well enough.” So I said, “But it’s waking me up. What good is that?”
The Dose is Wrong
I understand why the pressure is going up. I think it’s going up too much unnecessarily. If it works at a lower pressure, like a constant 7, and it has been working well enough, then why do I need to let it go so high that it wakes me up and I stop using it? Because I will stop using it if it wakes me up. I’ll just go back to sleep without it on for a few more hours. And if I was in a different situation and couldn’t get a new prescription, I might just stop using it altogether.
If I didn’t get this machine through my insurance, and I just bought it from some website or second-hand marketplace, I could change the pressure range with no issues whatsoever. But, because insurance is paying for it, now I have to try to get my PA to change the prescription, because no matter what I do to this machine at my house, they keep turning it back to the prescription they want me on from their location.
Now, I’m willing to do the work that I need to do to fix this, even if it came to having to buy my own machine. But it’s beyond frustrating. And a large portion of it is because these people think they know better than I do what works and what doesn’t. People in the medical field, especially larger companies / cities tend to fit themselves into the “savior” mode of the Drama Triangle and they look at their patients as idiots (“victims”).
I do understand that they may be concerned about me changing the prescription and having something happen to me while on their machine (they don’t want to get sued). I have mild hypopnea when untreated. It’s not happening. I haven’t had an AHI over 5 (which is the threshold for getting called “mild” from normal) since I’ve been using the machine for the past month.
I hate that I have to deal with this crap when I’m an intelligent person way more concerned with my well-being than they are. They seemingly couldn’t care less if it wakes me up multiple times at night if it covers their ass.
This won’t last forever. But, yeah, if people in the medical community ever want to improve their reputation it’s going to have to come with a little humility.
They’re far too prideful right now.
EDIT 9/26/25
Last night I had an AHI of 0! But, then, why was the CPAP going crazy with pressure up to almost 9 waking me up at 2 am? I am okay with a small reasonable amount of AHI if I can sleep through the night.
Revelation 18:21 Then a mighty angel picked up a stone the size of a great millstone and cast it into the sea, saying: “With such violence the great city of Babylon will be cast down, never to be seen again. 22 And the sound of harpists and musicians, of flute players and trumpeters, will never ring out in you again. Nor will any craftsmen of any trade be found in you again, nor the sound of a millstone be heard in you again. 23 The light of a lamp will never shine in you again, and the voices of a bride and bridegroom will never call out in you again. For your merchants were the great ones of the earth, because all the nations were deceived by your sorcery (pharmakeia).”
That seems like much more detail than is available from the ResMed site. How do you get that detail?
There are two related things going on here that have converged to result in you having to do this runaround with the DME provider and your insurance company.
One is the fact that the person calling you has no authority to make decisions and is just running a script. The script says you're not allowed to muck about with your CPAP settings, so they're going to give you crap about that. This is basically the same phenomena you see everywhere there are bureaucratic systems, i.e., systems designed to produce desirable outcomes by rote, such that any literate person capable of following basic instructions can achieve said outcomes. Frustration occurs in edge cases, where the facts don't entirely fit the script and some divergence is needed. Because the person running the script has no authority to make such divergences, you get stupid, obviously idiotic outcomes with depressing frequency.
The second is the reason the script is written to prohibit patients from messing about with their own CPAP settings. The concern isn't really liability, though that's probably in the mix somewhere. It's that insurance companies don't like paying for expensive medical equipment that patients either don't use, or don't use correctly. CPAPs in particular take some getting used to. I know; I've used one for over a decade now. And there are a lot of people who don't stick with it long enough to really get the benefits the devices can and do provide. Something about the settings wakes them up, or the style of mask they start with is uncomfortable, or the mask leaks, or whatever, and they just quit using it. CPAPs aren't cheap, and insurers don't like paying for them if patients aren't benefiting from them.
Thing is, when people mess with their CPAP settings, it's even odds that they'll mess with them in a way that provides clinical benefits. They'll definitely change the settings to a point where they think they're sleeping well, or at least not waking up all the time, but the whole problem with sleep apnea is that you don't realize you're not sleeping. So what happens is that people adjust the settings so as to ensure they don't regain consciousness, but in doing so they eliminate the benefit of using the CPAP in the first place. The default script is thus to prohibit patients from doing this.
Now, an intelligent system would permit the person presented with an instance of a patient changing their own settings to evaluate the usage data/stats to see whether the new settings were working properly. But that would 1) require low-end bureaucratic drones to be authorized to make real decisions, and 2) require low-end bureaucratic drones to properly interpret and understand CPAP data. Neither of those are consistent with the ideal of a bureaucratic script: bone-headed to the point that it does not require any actual judgment on the part of the person running it.
All of which to say that yeah, you're clearly dealing with a sub-optimal situation. It seems like you're using your CPAP correctly. But changing the system to allow for an optimal outcome in your situation is just not going to happen. Which is bad, but nobody has any viable better ideas.