Oxymorphone Er Generic By Global Pharmacy (Page 4)

Hi,

Since I heard that Impax finally got the green light to distribute Oxymorphone ER (Opana ER) generic through Global Pharmacy. I didn't hesitate to rush to my PM doc and he instantly had me switch to this new drug. He prescribed me 40 mg twice per day to treat my busted back & fibromyalgia.

I noticed the pill is round in shape with G74 on one side with nothing on the other. The color for the 40 mg ER tablet is an orangy/gold color. Ever since Endo ruined their product with the new TRF formulation. I promised myself to jump back on the bandwagon as soon as the generics were released.

Today is a great day for all who suffer chronic pain. Yay! 8-)

Moon

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My advice would be if you want to remain a patient of this pharmacy pick a pharmacist you like and who doesn't give you any trouble. The week you drop off your script ask that pharmacist what days he/she works and go on that day. Otherwise switching pharmacies is your only safe bet. I normally fill at Kroger but once or twice I have needed to use walgreens when my pharmacy didn't have the drug, my script was 6 days early and they have no problem holding it that long. So whoever told you they cannot keep the script is lying. The pharmacist is trying to cover up the pharmacies incompetence. Basically they are saying things are such a disaster here we WILL lose your prescription if we keep it. There is no law or rule stating they can't keep it. Both my kroger and walgreens both hold mine all the time. If you have another choice I suggest trying somewhere else. That walgreens sounds like a hot mess. There is no advice for intolerance. If they give you any more trouble call them out on it. Let them know you feel they are treating you badly because you are a pain patient, and that you are not a fool. Little secret....most pharmacists assume patients are dumb or have no understanding of the medication or policies. That is why I let them know up front that I am a pharmacist and I fully understand what is happening. You sound intelligent use that to your advantage. Also there are no real red flags and even if they did come up with some stupid flag system that would have nothing to do with you and your doctor. As long as you follow the doctors rules that is all that matter. The pharmacist used the term red flag to scare you into doing what they wanted. From your post I didn't understand why they had to contact the doctor in the first place. Why? I know more than anyone the problems with filling pain medication and being on the other side. Most of the chronic pain patients came to me with their problems and questions and I loved helping them. Pharmacists take an oath as well to treat their patients with integrity without bias and of course do no harm. Well it is harmful for a pain patient to be out of medication. That is all the info I can think of right now but let me know why they needed to call the doctor and feel free to ask any questions you may have.

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So I thought I'd share this with you Curious 80 I went to my regular walgreens and of course there was a new women pharmacist. She looks at my scripts goes to the computer and comes over to me a couple mins later and say" Sorry but I don't feel comfortable filling this prescription" I said I don't understand I've been coming here for 7 months why all of a sudden can't you fill for me. ALL'S she said was I'm sorry and handed back my scripts. I asked to speak to a pharmacy manager and wouldn't you know they weren't there. So I asked for the store manager she gave me a number I could call and the name of the pharmacist that denied me. So I went to the other walgreens that filled for me once before they told me to come back in an hour. On my way back I get a phone call from walgreens and the lady says I see you tried to fill at the other store and she didn't feel comfortable filling so we can't fill for you either. So she said I was banned from ALL WALGREENS. I just don't get it how can one pharmacist ruin me for life. I haven't called the number the manager gave me yet and I thought about contacting a lawyer but I'm sure walgreens has their ass covered for stuff like this. So I had to go back to the mom and pop spot that is charging me 800 bucks to fill oxycodone 30's cause they don't take insurance. And they have no problems getting my oxymorphone either the next day.
So any advice on what I should do or just do and say nothing? I'm thinking of trying CVS next month but who's to say I won't run into the same problems there? And will they be able to find out what walgreens did to me??
Any and all help n suggestions are welcome

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CVS should not know what walgreens has done or said. The computer systems of different pharmacies are all different. If one chain store won't fill it usually you can't just go to a different store in thay chain because they can see what another store did. A pharmacist is 100 times more likely to call their other stores about a prescription for a class 2 medication. There are laws that protect pharmacists and it is pretty vague so it gives them a little more room to refuse patients. Basically it just states that if the pharmacist feels uncomfortable filling a prescription (and sometimes they don't even have to explain why) they don't have to fill it. The only instance where this has been successfully fought is the selling of the morning after pill. Many pharmacists wouldn't fill the scripts because they didn't believe in it. But most were forced in the end to fill the prescriptions because they were mixing their own moral values with the business of health care. Even with this though there is still a loop hole. A pharmacist can still refuse as long as they tell the patient where they can purchase the pill, but now you don't need a script for that anymore so problem solved except for the problems with us in the pain management community. I doubt you will get very far with an attorney. These companies have huge extremely large law firms protecting them and their pharmacists. If it was free I would say go for it. You may not win but it will annoy them. But lawyers and court costs are expensive. It is a hard thing to deal with for patients because there is rarely a chance of getting the medicine you need once they have decided you are some kind of addict. The can and will ban you from all stores and there is nothing you can do about it. I worked for CVS and if we put a note in someone's file every other CVS could see it as well. The only way you can remain unrestricted is to pay cash and not use insurance, but that isn't an option for most because as you have said these medicines can be very expensive. All you can do is find a chain that treats you right and stick with them and try never to give them any cause to doubt you. If this happens again I would definitely pin them down for a specific reason which might prove difficult but it is hard to fix what you don't know about. All I can think of is a couple possibilities, the pharmacist has reviewed your whole profile and found something they felt was a possible red flag for abuse behavior or the pharmacist does not personally want to fill medications that are so strong, or they have made a judgement they are technically not supposed to which is that you aren't in enough pain to need it (some pharmacists enjoy overriding doctors decisions), or the last possibility is that they have an issue with the doctor you see. They could have decided that the doctor is over prescribing high level narcotics and have decided to turn away all that doctors patients. Those are the only possibilities I can think of. And keep in mind I do not have their computer monitor in front of me. I can't see whatever it is they are seeing. Follow through with the best of your ability to get an answer on why they won't fill your prescriptions anymore. Heck call their corporate office and irritate them into checking into the answer for you. I am very sorry you are having to go through this. I have had a hiccup here and there but I have mainly had no problems with my prescriptions. I am under contract so I can only use one pharmacy so the pain clinic can always check on my scripts and how I am filling them. Please do report back on anything you may find out. It could potentially help someone else.

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RAWDOG, that is a bunch of Bulls***, i go to a pharmacy that is in a hospital, cos one month CVS would have it next month they didn't then few months in a row they have it so i got tired of that and i go to a hospital pharmacy and they have it every month. I called up a CVS in target to see one month if they had it and he told me your best bet is to go to a pharmacy around the hospital and i called them and the woman said yes we can fill it for you no problem...only bad thing is they are closed on weekends but i don't have any problems cos i still had 12 pills left even on my fill day so when i got it filled i still had 10 pills left...i love Oxymorphone ER 10MG cos i take it 1 every 8 hours which helps me for my back pain...The doctor where i go to for pain management told me they weren't going to give it to me anymore cos he thought when i got my cat scan for my back there wouldn't be anything wrong. To his surprise a doctor backed up my 2006 cat scan and said my back was worse than before...Good Luck RAWDOG! I hope it all works out for you..

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Thank you us in pain that don't abuse., really don't want to read that we are reading for help. I was taking the activis now finally seeing why I'm getting these other pills ecpains it,they give me migranes and I have not felt good in months doctor even done blood work I figured out it's the change in my pill.

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Bertman, I've been trying to get Activas. But pharmacy said it's a litagation problem and will be unavailable for a period of time. Have you been able to still get them? Thanks Widhearts

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Hey RAWDOG (REFERENCE 08/06/16 POST), so I was curious about something. I know this is from months ago, but I still think it could apply to others. In your situation, you were going in a few days to a week early in order to make sure they could order your script. Pretend your original fill date was January 1st, you adjusted to going early, but for easy understanding let's pretend you went 5 days early (December 26th) and planned to pick up when ready. That means that every month you dropped off your prescription on the 25th or so right? Then you went back on the first of every month to actually full the med? I had a friend with the same issue you are citing and he was going a few days earlier every month. Like the 25 of jan then the 22 of feb and then the 18 of March etc. I asked him why and he cited the issue you did about ordering the meds. It took him awhile to have his epiphany but you should only ever need to go in early once. Then when you go in to drop your script it should be exactly 1 month after the previous time and same goes for when you actually get the meds.

Some insurance will allow for prescriptions to be picked up 3 days early without an issue. However, if you do three days early then next month you should do 3 days late. If you are early every month you are just asking to get flagged as a trouble patient.

I have no reason to think you abuse your meds, I am sure you dont. When it comes to the current state of life for pharmacists and doctors, it is easy to see why a patient getting meds early could be a cause for concern. If they have months worth or records about you that wasn't ignored in choosing to no longer fill. That doesn't mean there wasn't good reason, like on your end, but new or unfamiliar pharmacists will have to make judgement calls.

Just fyi, I take 2x 40mg oxymorphone er and 6x 10mg oxymorphone ir everyday. I also take miralax, omneporazole, a fiber supplement, lyrica and daily vitamins. If a doctor or pharmacist ever asks me what I take I always say all of it. It is dumb but people who take opioids tend to have constipation and messed up bowels and usually having a nerve med also gives credence to your pain and attempt to fix it. Always be dressed well. Always speak with kindness and honesty. Ask for help even when you don't need it. Making someone feel special is a sure way to guarantee they will be on your side. You need them, you need their insights and knowledge.

Just some insights from a CPP of over 7 years.

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I'm curious if anyone else has had issues with the Impax generic, oxymorphone ER, not working well. For the past year I've been taking the Actavis generic and it worked the best, much better then the brand name or the Impax generic.

Endo Pharmaceuticals decided to be greedy and forced Actavis to quit making their generic, because supposedly their sales dropped for the name brand, by a whole 10%. Something like 100 million in sales to 90million. Greedy jerks! Why they aren't forcing Impax to quit, I'm not sure. Unless it's because they know the Impax brand doesn't work as well, and many of us will still have to go with the brand name from Endo.

Sad part is, that for some, the generic is the only way these meds can be affordable and approved by insurance, since generics on many plans are required, or the cost difference in which tier the medication on the insurance formulary is so large, you have to go generic to keep copays down.

So anyone else have these issues with the Impax version not working as well? I've seen a few comments that others have had issues, but many of those were also from people who are modifying the pill somehow before taking it. I would like to know if anyone is in the same situation I'm having, where we take the pills as prescribed.

For me, I would say the best was the Actavis generic, it worked the most often, and was the best for pain reduction. The Endo brand name comes in next and is maybe 60-65% as effective as the Actavis one. The Impax generic works closer to 30% (or less) as effective as the Actavis brand or half as well as the Endo brand name Opana ER.

It's so sad that a company as big as Endo Pharmaceuticals, is so greedy, that they pick and choose companies they allow to have generic substitutes. Why stop Actavis, but then allow Impax to make their generic? Unless they know it doesn't work as well, or they have some form of kickback deal happening.

Much of this could be fixed, if they got rid of that stupid 'Time Release Formulation' or 'abuse-resistant formulation', that they claim is an abuse deterrent. Many studies have happened that show that the TRF doesn't work like they expected and in reality just causes the medication to not work as well, so the patient has to up their doses in the hopes of receiving the same benefit. It's also not much of a deterrent for those that want to abuse the medication. I've read multiple threads on sites about people who have found ways around the coating by doing some bizarre chemical experimentation.

For those of us who take our meds as prescribed, the pharmaceutical companies and laws governing generics are hurting us considerably. I understand greed and they want to make their money on a product, but fighting over that 10% sales dip, when they've already had years of high dollar income, before generics are allowed to be made, just seems wrong.

Well thanks for letting me rant on here. I would really like to hear though if anyone else has had the same issues about the different brands not working as well, even if it's totally different then my experience. Maybe it will give me some ideas to how my doctor could change my medication dosages.

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I fully agree with you. The Actavis brand is far more superior than the Global brand. I too was in love with the Actavis. I was getting the 20mg ER's but got bumped up to the 30mg and ever since only got the Global's. And as I said before it's easily a 3 to 1 ratio. I have to take 3 30mg ER's to get the same effect as a 20mg ER from Actavis. Maybe they knew that Actavis was stronger and to cover it up they just stopped making them. Who knows? I really wish I could get my hands on the Actavis again but since that's not gonna happen... I would never go to the brand name made by Endo. I've tried them about 3-4 years ago and they were horrible. They were the 15mg ER's of a hexagon shape. I believe they were green in color (it's been 4yrs don't hold me to the color) but those sucked. So what's left to choose from? Nobody else makes generic oxymorphone and dilaudids suck. And the next step is Fentanyl and once you go there there's no going back and a lot of doctors won't even up you to it. Hope I've been some kind of assistance to you.

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I don't know if you already had this answered but yes it was discovered in Germany in 1955 and went onto the market in 1959. It had a different name back then it was called Numorphan so maybe the pharmacist would recognize that name. I learned about it in pharmacy school as Numorphan but the name Opana is new. It was reformulated and the name was changed. I don't think they prescribed Numorphan very much and then when the addiction resistant Opana name came out they started prescribing it again. So just for your knowledge and your pharmacist's knowedge here it is. But I went to pharmacy school in 2005 so your pharmacist should know.
Amy

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I had had problems with both the brand and the substitute. Opana technically doesn't have a generic so most pharmacies want it written as oxymorphone in order to fill it that way. I am in Tennessee and use Kroger and they don't even keep the brand name anymore. I have been on both Opana and oxymorphone, neither has done anything for my pain. I have trouble with these crazy formulations because my disability is pancreatic and so the metabolic process simply doesn't work in my body. I am running out of options. The fentanyl patch is ok but the dose that helps my pain overdoses my body and makes me fall into a deep depression. So I am forced to try these pills and their new tamper resist formulations. I don't mind because I don't abuse my medications but unfortunately they don't metabolize properly in my digestive tract. If anyone has any suggestions that would be great, but I fear I may be in terrible pain for the rest of my life if they keep messing with the pills and all this abuse resistant garbage. If it stopped addiction I wouldn't be so upset but people will always find a way. This new war on pain patients will only kill and destroy those of us who really need help.

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I moved to Texas several months ago from CA. Since I've been here they have been filling my Oxymorphone 40mg ER with Impax. I forget what brand I received before but they were tiny white pills. I have been in chronic pain since a horrific accident in 2005 where my left leg was smashed. These Impax pills seem to be highly effective compared to the old brand. I was however spoiled by the pharmacy that I had in CA. If I had my PM appt. on Monday, I would call or stop in the pharmacy on Friday and they would order my meds so I had them on Monday. Here I have a stuttering fool of a pharmacist who one week was a pharmacy "technician" and had graduated school and was a pharmacist the next time I went to fill my prescription. Every time I go to fill my scrip he has to order it which takes 3-5 business days. The guy is a horror show who gets extremely nervous filling controlled substances and won't refill until 30 days to the day although my insurance and doctor give a 3 day grace period for lack of a better term. While I am very happy with the pain relief that I get from the Impax, dealing with this pharmacist is a royal pain in the ass. The more I question or explain my experience with PM the worse his stutter gets. Unfortunately he is at Walgreens and other than other Walgreen stores, there is only a CVS who won't carry opioids. It also took me over a month to explain to the PM doctor's nurse and Walgreens that there is technically no generic for Opana and the prescription must be written as Oxymorphone. To fill the Opana name brand would cost over $500, the Oxymorphone with my insurance is $10 The Oxymorphone Impax 40mg ER without my insurance would be $1320.99

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Thanks for the reply. I went to pharmacy school on 2005 too and they did talk about Numorphan but we were taught it wasn't prescribed anymore. I don't think my pharmacy carries it because of the new Opana formulation. I won't go back to the fentanyl so I guess I will keep trying the different types of pills until one works for me. I appreciate you responding to me.

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i know some pharmacist act like they are God and they get smart and act like well you do like i say or you won't get it filled which in some cases is true, but i have 2 places usually i can get it filled, one place is at the hospital and the other is a regular pharmacy meaning its not affilliated or however its spelled with any pharmacy.. and i couldn't get mine til tuesday so this one pharmacist was really nice and gave me enough till mine came in, but i went there the next time and he was off so this woman was working there and she said of i have to call your doctor to see if i can fill this cos oxymorphone is different cos opana has no generic brand i told her look i been getting that filled for 5 years now written as opana 10mg er and was told they could fill it as oxymorphone and she said well the insurance said we can't we got to fill it as it is written cos there is no generic brand i said BullS**T, so my PM told her yes you can fill it as Oxymorphone, and i was told by several people including my PM Doctor that she can fill it as oxymorphone but some pharmacist like to cos waves.
so i went to my appointment and told my PM to write it as Oxymorphone 10mg er so there is no issues and she said yeah i agree, i am sorry you went thru that, but i told her its not your fault its just some pharmacist like to be God and give people a hard time. :-(

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I had major problems with the impact global brand. It didn't even seem like it was in my body at all. I spend months in pain trying to get someone to really listen to me but there is nothing I can do. That is the only generic brand I know of on the market so I am now having to switch medications again. I am getting tired of all this bureaucracy in medicine. What happened to doctor and patient not doctor patient FDA messing our lives up and the oh my gosh opioid epidemic. I am a pain patient not an addict. I am so tired of all this drama all the time. They fail to mention almost all those that died wither mixed their drug with alcohol or some other drug. This is not kindergarten where one person messes up and the rest of the class pays the price this is my life we are talking about. I used to be a pharmacist before I got sick and I met more than my fair share that did play God with opioid medication. They simply decided all those who needed it where addicts and made so many ridiculous excuses why they wouldn't fill the drug. Believe me they do exist. If you come into contact with one tell them what kind of ass they are being and let them know they couldn't survive a day in your body then go find another place to do your business. The poblem will not get better with that pharmacist it will only get worse I can promise you that. I treated people with kindess and respect by some don't take the oath to do no harm seriously it is a major paycheck for them that is the only reason they went into the business. At close to 60 dollars an hour that is just how it is. Sorry for the rant but I am fed up.

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Curious80, that's too bad that the Impax isn't working for you, I guess everyone has a different metabolism. I was in NY in 2010 for about 6 months to sell my house. That's when my original PM doctor since 2005 first prescribed me Opana. He had prescribed me 30mg ER tablets one pill twice a day. The Opana was $200 a month and there was no generic. I did some research and found Oxymorphone 15mg ER tablets and the pharmacy accepted the script written as Opana 15mg ER 2 pills twice a day. It was always a hassle and the PM doctor put me on Fentanyl patches which I thought worked well. I found a patch in a medical supply store that went over the fentanyl patch holding it in place extremely well. When I moved back to CA my PM doctor there insisted that in San Diego's climate that the patch would never remain in place so he switched me back to the Oxymorphone 15mg ER, 2 pills twice a day. Now in Texas, I can get the Oxymorphone and my PM doctor here just increased my dose to 40mg ER twice a day. These are the Impax brand and as I stated they work well for me. I'm also prescribed Oxymorphone 10mg IR 4 times a day for breakthrough pain that's from another company, not Impax. I think I'm going to ask this PM October to switch me back to the Fentanyl patch as they worked well for me and having a cognitive impairment I don't have to worry about missing a dose or taking an extra dose, I can put the patch on every three days and not worry about missed doses and still have the IR pills for breakthrough pain. As I had stated and most seem to have similar experiences are the issues with some of these pharmacists. Just because of the continuing opioid "epidemic" and the people who abuse the medication and the PM system, us folks who legitimately need the medication, go to a PM doctor and do all the things we are supposed to be doing have to suffer because of the people who abuse the system. I don't appreciate being thrown into the "drug seeker" category. Although I'm sure that there are exceptions, I didn't work a 23 year career in law enforcement, retire and then decide to take up drug abuse in retirement rather than golf, fishing, etc. I developed a rare disease from 5 months of daily exposure to the toxic cloud that hung over lower Manhattan after 9/11. Its cyclical and puts me in the hospital ER about every 3 months. Because of all of the blood work at the hospital and my doctors office, I have developed some scarring on my veins. Because of this I am almost always classified as a drug seeker especially since one of the meds needed to treat this excruciating condition is Dilaudid. Again, it's absurd being vilified for being on narcotic medication because of somebody else's issues. I've seen people on here that state that the tamper proof pills, whether they be OxyContin or Opana either don't work or aren't very effective. I only took the tamper proof Opana while in the hospital for about 7 days and didn't really notice their effectiveness, probably because of the myriad of other medications that they were giving me. Regardless of the tamper proof formula that these company's use, inevitably the people that want to abuse them are going to find a way to do it. I worked in narcotics back in 1994-1997 in Harlem. There was no opiate issue back then, just heroin which a lot of these opiate abusers are turning to in lieu of the tamper proof formulas and the prices the drug dealers are charging for the regular pills that they can still abuse. I still keep in touch with people still on the job and also through fraternal police organizations. Apparently there are ways to manipulate the tamper proof pills by use of acetone and other nasty, deadly chemicals. Once again, the people who are in chronic pain due to any number of legitimate medical conditions or accidents have to jump through all kinds of hoops to get the care and proper medications needed to try and live a somewhat normal and hopefully productive lifestyle. Dealing with these pharmacists who try to play doctor or interject their own personal views on whether or not someone should be prescribed narcotic medication is absurd. They should be professionals and do the job they are paid to do. All their unnecessary meddling does is cause undo stress for the patients just trying to get their meds and feel better.

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I know how it goes with pharmist playing God I posted on here plenty of times on my struggles trying to fill at a local Walgreens until I had enough and went to a different Walgreens even closer to my house. I got REALLY LUCKY and got a cool pharmist but then she went on leave for pregency. I thought not again but to my luck the other two (women) pharmists wound up being cool too!!! So I remembered their names and when I would go in to fill I would make it a point to say hello..(enter name) and smile and say hello and just let them see my face. I also go in dressed like I'm going to church. Dress shoes dress pants and a long sleeve colored shirt and say yes mam. So for the past 6 months I've had no problems THANK GOD. I get the 30 mg oxymorphone ER'S from Global they are just o.k. like I've said on here before it's definitely a 3 to 1 ratio from the Activis brand witch are far more superior in quality and strength. But since no of us are ever gonna see any more pills from Activis all we can is reminisce.
Now to the point of my entry, I just picked up my script they are Globals for some strange reason they are not working hardly half as good as last month the only thing I can think of is I got a bad batch has anyone out there ever experienced anything like this before or am I just growing tolerant to the 30mg and need to get bumped up to the 40mg?? Please help any and all suggestions are welcome. Now I will find out with time and I'll explain every other month they have to order them for me and this month they had to so I get two months from the same bottle. So next month when I fill I'm getting the same ones as this batch(the ones that feel like their not working as well) I'm gonna have to wait two months to see if my prediction is right but in the mean time I'd like some help from the community for some educated explanations. Thank you so much for your help to everyone out there who's helped me in the past Curious80 and others hope to hear from you guys soon

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Opana is a 2 times a day medication meant for round the clock pain just like the fentanyl except obviously it is a patch and you change it every 3 days. It is the highest you can go so moving down to Opana could cause some withdrawl symptoms if the right dse isn't given. I was on fentanyl for over a year and I hated it I felt depressed and it wouldn't stick to me either. Most people have to get tegaderm patches to put on top of them to keep them on. The withdrawl from fentanyl is way worse than any other narcotic I did it cold turkey once and thought I was going to die. I was then put on the Opana but for me the brand name new taper resistant pill didn't release properly so then I switched to the generic which didn't feel like I was taking anything at all. It had just been a mess trying to find something to deal with my chronic pancreatitis. I am now trying oxycontin with oxycodone ir for breakthrough. It has only been 4 days but I am so drowsy with this pill so far. I hope this is an effect that will go away. It is working but the dose has to he higher since it is less strong than the Opana. So far its taper proofing hadn't caused any releasing problems but I still have my fingers crossed. On the plus side I have needed less of my breakthrough medication but that could he more an effect of me being exhausted than the pain. I need these medications to live not to sleep. If I have to sleep all the time what is the point?

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To curious80 what Mg are the oxycontin I was on them a year ago DIDDENT do anything for my pain and yes they did make me drowsy I also was,on oxycodone 30mg IR for break through I hated it so bad and before the oxycotin it was the 30mg MS contin(morphine sulfate)WE witch REALLY SUCKED!!! Well I hope you find your right doseing formulation but why again did you not like the Oxymorphone? What Mg were you taking and what brand?

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There is a possible explanation for the globals not working as well in one fill than another. Generics are only required to be 25% as strong as the original product which can be found on the FDA sites but they don't really advertise it. Also the generic companies use substandard main ingredients sometimes to save money. So the brand will get premium say opium as it's base ingredient than manipulate it into the form they need like Opana, but a generic company will buy for lack of a better term crap opium to start with as a base. These are true facts that can be verified through the FDA but you have to do a little digging. I hope this maybe helps explain a possible reason. The globals didn't work on me at all. I had to switch drugs altogether since they are the only generic allowed to be made. It always felt like I was taking a placebo and I couldn't stand the pain anymore.

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