Filed under: Uncategorized
Have you ever wondered about where that little voice comes from? It is your conscience? Is it some higher spiritual being speaking to you? Is it your subconscious mind playing tricks on you?
I have pondered this question many times. Going through many years of chronic narcotic use, I found that at several junctures I began to hear this voice. At first it was easy to ignore. But as time went by, it became louder, more distinct. The message became clearer and clearer. “Stop the insanity, or else”. Well, I didn’t listen. And the harbinger of bad news became my best friend.
Now that I have been drug-free for 17 months, and after much thought and rumination, I finally think I have an answer to the question I posed in the first sentence. In my case, I believe the voice in my head was death. I have read a book that was recommended by my son and his girlfriend called “The Book Thief”. This book is unique in that the narrator throughout is Death, personified. It is set in the late 1930’s in Germany which was a very busy time for Death. And it would only get worse. I would recommend this book not only for it’s rather unique perspective but also for it’s heart and soul.
So, anyhow, why do I feel like the voice speaking to me was Death?? In my experience, Death had a grip on me. I skated at least twice in relation to drugs and couple of more times for other reasons. He doesn’t miss an opportunity, normally. So after several near-misses, he began giving me hints that if I didn’t get my act together, the next time it might be our “final dance”. And still I didn’t listen. I continued with my nonsense until the point where he was screaming in my ear!!
When do you start listening to Death when you are addicted? Is it the first time you O.D or nearly so? Is it the second? Is it the time you wind-up in the E.R. because you have chosen poorly, and quite cold-turkey, psychotic as shit? I guess for me it took really about 4 times. Maybe 5. I never said that I was the sharpest tool in the shed. When I worked for Jerry Coulson in high school, there was a young boy who lived in the neighborhood of the service station. It was apparent that he did not have an easy life. He would walk into the office, dirty, disheveled, looking as though he had not eaten in a month. He talked incessantly. Jerry would get a bit exasperated with him at first as he would be trying to balance the books and this kid would not stop talking. So he would feed him and give him a soft drink in the hope of shutting him up! Well, after a while, Jerry decided that it might be better to put this boy to work. So he would give him odd jobs, (he was maybe 8 or 9 years old) and then payed him at the end of each day. Often, the kid would do something fairly simple-minded and Jerry, who could never pass the chance to make a joke, would call him “hammer-head”. The first time he did it, the boy looked at him and asked, “what’s a hammer-head”? Jerry said, well son, you are not quite sharp enough to be a hatchet-head. Then he would laugh! I figured out one day that death was this boys companion. After nearly 4 years working for Jerry, through rain, snow, sleet, hail, no matter how long this kid was a the station, no one ever came looking for him. About a year after I graduated high school, I stopped back at Jerry’s to buy gas and he was working there, not as a kid any more, but as a young man. Jerry, instead of just doling out charity to this unfortunate lad, taught him to work, and taught him a skill.
Was talking today to Jonathan, who related a message from one of our old neighbors in Lee’s Summit, MO. In 1998 when we left there, a young boy who lived across the street from us, was diagnosed with some form of Leukemia, the type escapes me now. He had been in remission for several years but this past Christmas, contracted a staph infection and quickly died from sepsis. He was about Jonathan’s age. Death had been his companion as well I guess. He just didn’t know it.
Anyhow, back to my story. So after 4 or 5 brushes with Death, I finally began to see that I was cheating him and that in the end, the only one to win is Death. You can’t beat the odds. No matter what, he wins, eventually. I have read how others have made a similar journey with pain and with drugs. How they fought and fight addiction. I wonder though, if they realize how close they are to meeting Death? I would love to have some comments on this subject from you, the readers.
I have talked about how at one time several years ago, I was “the sickest person in the hospital” according to my surgeon. Lying there with this horrible infected abdominal wound, a raging fever, my gut twisted, I had a lot of free time to think. I was so weak that making laps of the nursing unit I was on was all I could hope to do. And some days it took every ounce of strength I had to rise from the bed and walk the 60 steps it took to make a “lap”. I know how many steps it took because I counted them Then I would add a step or two each time in a attempt to regain my strength. But it wasn’t happening. Nothing in, nothing out. Just like your car!
One day I actually had a talk with death. I was sick and tired of being sick and tired. So I talked back to the voice in my head. I was hurting, pissed-off and in the foulest of moods. And you know, he listened. And I don’t think that at the time I was aware of with whom I was speaking, but I had this abiding sense of peace come over me, like something had been accomplished in this 5 minute conversation. And what I had said was simply this: ” I am done. Do with me what you will. Take your best shot. But you had better be prepared, because you won’t take me without a fight. I have too much left I wish to do in this life.” And I guess that has been my mantra of sorts ever since that day. That the day may come, will come, when it is time to reconcile many things. But being off of narcotics has given me a renewed sense of purpose. I see things more clearly, feel things more acutely, and love, truly, like there is no tomorrow. And I am no sage, no font of wisdom. But I have watched Death waltz into the E.R., the O.R. the back of the ambulance in which I was riding, dozens of patient rooms, a few roadside encounters, a restaurant, and the room where my mother died. He is smug. He is cold and calculating. He takes those we care the most for with no regard for feelings. I guess the one consolation is that we shall all shake his hand.
One day, I saw Death come into the ICU. He was dressed as family. The hospital where I was working was fairly small so everyone basically knew everyone, particularly on the shift you most commonly worked. On the Med-Surg floor there was an older nurse who had been on the same unit for nearly 30 years. She had a reputation for being a bit gruff, even mean at times. But she was always an advocate for her patients. The only times I ever saw her get really angry where when things were not happening in favor of her patients.One night during her shift, she began having chest pain. She had been a lifelong smoker and was well known to me for her exacerbations of COPD. She worked too much and slept too little. Ultimately, she her lungs had de-compensated, and her heart couldn’t take the strain. She had a cardiac event and wound-up in the ICU on a ventilator, critical but stable. She was awake and alert. The morning after this happened, her daughters blew into the ICU filled with anger and harsh words for anyone in earshot. They screeched at the doc for having their mother on a ventilator, she would have never wanted that, didn’t want any kind of heroic measures done to save her life. Well, no one bothered to ask this woman. The daughters demanded that she be removed from the vent so that ” nature could take it’s course”, it was what she wanted they insisted. After several hours of posturing and discussion, I got a call from the ICU. When I arrived, I was told that I was to disconnect her from the ventilator. Now this was nothing new to me. I had done it many times, but never with a patient who was awake and alert. I grabbed the nurse for this patient and the doc and walked them into the break room across the hall. I asked, “WTF??” This woman had a chance, a real chance for recovery. But the daughters had insisted that their mother wanted none of this. So I walked back to the ICU and did a quick assessment of her. BP was good, stable, breath sounds were fair, no major arrhythmias. I told both the nurse and the doc that they would have to find someone else to unhook this woman. That I was fundamentally opposed to doing this. So the nurse disconnected her and switched off the vent. Honest to God I stood there and watched this woman gasp for air and beg for help. It was the most horrific scene I had ever experienced. She was mouthing the words, “Please help me” I finally left the room, no longer able to watch this. That day, Death strode into the ICU dressed as her daughters. And she died. And what had happened in my mind was criminal at best. Indeed!
Filed under: Health
I was thinking the other day, dear readers, what it take in life to find serenity. To find a place where everything in your life starts to come together and the emotional constraints of youth begin to fall away. Where do you find a place where you can meet this kind of mind, body, spirit, enlightenment? I have read a fair amount about the Eastern religions, have read most of Deepak Chopra’s books, even attended one of his weekend seminars in rural NY at the Omega Institute. Not that any of this makes me any better to comment on this subject than the person next to me. But after spending many years wrestling with chronic narcotic use and chronic pain, I do think that anything I can share might be at least interesting.
One of the things that happens to people who live with chronic pain/and or chronic narcotic use is that you tend to be somewhat stunted emotionally. Either the pain forces you to move within yourself, mostly as a coping mechanism, or the drugs blunt your sensorium, physically and emotionally , leaving you unable to truly “feel” and experience the emotions, healthy or not, that someone else might.
I personally spent a number of years walled-off from those around me. I pushed my emotions deep inside as I tried to cope with the increasing pain, and the need to keep it from the surface of my existence. I think that it is impossible to embrace the increased physical stimuli on a daily basis and not lose part of yourself in the coping. As humans we tend to move things around, particularly emotionally, in our attempt to cope with adversity, and in the process, something gets lost. It certainly did for me.
And now that I find that I can “feel” again, it is the oddest of sensations. It is as though my body is not my own. That the part of me I need to rely on to keep things real is running on “hyper-drive”. It is like the governor on my emotional flow is stuck wide open. Everything flows so quickly and with such a roar, that it is easy to miss something along the way. But by the same token, being drug free has it’s disadvantages. Since the drugs are no longer present, but the pain is, then something has to give. There has to be a new set of skills to deal with the pain. Not that they probably were not present all along, but weren’t engaged in a way that was particularly meaningful.
So what does all of this really mean?? Well, for me, it means that many old feelings come creeping back in . Particularly when it comes do dealing with the GI issues. There is so much fear, so many negative feelings and emotions tied to the exacerbations of my GI symptoms, that I find myself hiding out more and more. This has been a particularly long exacerbation, and it is becoming more and more frustrating. I find that I wake every day dreading food. Dreading the realization that it might not be better today. Then hoping that it is. And in the back of my mind are the trips to the ER in the middle of the night in a blizzard, completely obstructed, vomiting , in incredible pain. The surgery, the recovery, the complications, and last but not least, the alteration in body image that each new surgery brings. My wife asked me why I don’t take my shirt off when we are at the beach or on a cruise. It is because I don’t want to scare the little one’s around. I don’t want people to stare and question what has happened to me. This horrendous scar down my midsection sometimes alternately feels like a badge of courage and a brand. And along with everything else about my body that I dislike, makes me feel like I am sometimes untouchable. I guess we should all be proud of who we are, of how we look. And as a society we certainly put way too much emphasis on physical appearance. But I also know that physical appearance goes a long way in our whole “first impression” of people. It shouldn’t but it does. So if you meet someone new, you are forced to work harder than a person who is physically impressive, no matter how terrific you are on the inside. The preconceived notions of people stand strong against the tide.
So if you find yourself in a position similar to mine, remember one thing. It is truly our hearts that make us who we are. Our bodies are simply the vessel by which our heart and soul is conveyed. Remember that the next time you meet someone who might otherwise be “untouchable”. Put yourself in their shoes and try to imagine how you would feel if you were that person. And remember: Kindness goes a very long way. Reach out to someone in need. It serves not only to make them feel better, but in the end, is so good for you as well.
So what dose this have to do with seeking and finding serenity?? I believe serenity comes out of love. Alone, the sense of being in a better place is tempered somewhat if we find ourselves alone. Being able to share our good fortune, our life filled with peace and happiness, is so important to finding serenity. Being able to share ourselves and allow for an exchange of emotional energy is so fundamentally important. Being alive is so much more than just breathing. Being alive is so much more than taking up space on this planet. John Lennon wrote a lot about love, as a means to finding a better place in ourselves. “Love is all you need” Goes a long way to filing the void, doesn’t it?
Find it, grasp it, hold on for dear life!
Filed under: Health
Weird title, huh?? Well sometimes I feel like that is what I am doing on a daily basis. Long division in my head, trying to keep what’s in there from coalescing into something unusable. A mind is a terrible thing to waste, right? Being subjected to the rigors of chronic pain is something that most don’t understand, unless they have been there themselves. A tooth ache, a back ache, a broken toe, all examples of pain. But when the insult is fixed the pain goes away. Imagine have this sensation today and every day for the rest of your life! Then add that to the rest of the stuff and you get a picture of what life is like.
But one point I wish to make very strongly. I would so much rather “feel” on a day to day basis, even if it is pain or discomfort than the alternative. I spent too many years denying any feelings to keep the bad ones at bay. Not a pretty place to be. For me or for those around me. The feelings of loneliness and isolation in me had to be compounded in those around me. When someone won’t let you in, the frustration can be overwhelming, very painful. Sharing is always preferable to not sharing.
Unfortunately, it took me 30 years to realize this point. And managing your life in chronic pain is a delicate balancing act. It can be a simple task one day when you are feeling well and the pain is minimal, and others, it is all you can do to get out of bed! The trick is to minimize the days when you really feel badly.
I have learned to use a variety of techniques to balance things out. Biofeedback, relaxation (which I use every day, some more successfully than others) rest (which can not be over emphasized) and exercise, which I do better with some days than others. Rest is one of those things, for the many of you who have been through a multidisciplinary pain management program will tell you, that is imperative to success in coping with pain. When you are exhausted, not sleeping for one reason or the other, and pushing yourself to do more than you know you should, it will catch up with you. I am the king of driving myself to finish what I start, and keep moving. I know there are days when I should stop and rest in the middle of the day but don’t because I am trying to get something off of my plate. It is dumb, it is foolish, but I do and you so do the rest of you. And yes, you know who you are!!
Pain control without narcotics was something I thought would be nearly impossible to deal with. I was both right and wrong. There are days, I have to admit, that it would be nice to be able to kill the pain, regardless!! But it is those same days that remind me of all of the wasted days when I did just that and was still in pain. Now that I am left to my own devices, I manage to get through with a dose of Advil or whatever, and nothing stronger. And I am ultimately thankful for that!! And without the support of my wife and son’s I would never have been able to make it to this point.
And I am not sure about others out there, but for me, when I thought I was managing my medication use, feeling like it was the only thing in my life that I had control over, I was deluding myself. I was not managing anything but to escalate the doses, shorten the time between them, and push myself toward an early grave! And even after I got to the point where I wanted to stop, the spectre of “withdrawal” was always lurking not far away. And as I have said before, it is a powerful deterrent to quitting. Even in the best of rehab programs, withdrawal is going to happen. It will be managed to a point, but it will come and take you places you don’t wish to go.
So what does the future hold?? My crystal ball is murky tonight. What I do know is that more than likely, I will have more surgery, knee, hip, back, etc. And with that comes the whole re-introduction of narcotics into my system. But now, I have been down the dark path enough times to know that I can’t do it again. I won’t do it again. I feel stronger, wiser, than I have ever felt in my life. I see things through new eyes! And I hope and trust that it will be enough.
This is somewhat a rhetorical question. And the answer on both counts is yes! But only if you embrace your faith. I did. but now don’t. I have mentioned before that being a cradle-Catholic served me well for a period of time. Now I feel like god is a mean kid with a sharp stick. That he has this perverse sense of humor when it comes to us humans. If he were truly a benevolent god, why is there so much suffering in the world?? Why do children die of horrible illnesses? Why is there crime and mayhem? Why is the sky blue? Why do they put mayonnaise on hamburgers??
In my journey, I have more or less lost my faith. Not so much in the fact that there is likely some sort of being pulling the strings, someone bigger and more inspired than we humans. But my thoughts on a benevolent god are not for the faint of heart, so if you are believer, if you embrace this whole concept that everything happens because it is “god’s will” then you had better look elsewhere for substantiation. You won’t find it here.
My religious upbringing has been discussed previously so I won’t bore you with a further dissertation of it here. What I will do is tell you where god comes in in this whole addiction/ chronic pain scene. The only time I have seen god is in active withdrawal. At those times I have begged him to kill me. To take me right there and then so as to not have to endure the absolute suffering. Guess what?? He didn’t listen. I guess he thought that it was “good for my character” to experience this once again. It is also at these times when I curse him the most for not being a kind and benevolent god. For sparing us weak, puny humans from the this plight.
As someone who has had an abiding faith, it may seem odd to forsake it all only because of one issue in my life. That statement is so far from the truth. If you have been reading this all along, you know by now that it is a combination of things, the physical problems being only one color of the spectrum. I think the biggest issue for me is the hypocritical way the Catholic Church dealt with the whole crisis involving pedophile priests. What they did was so wrong, so twisted. A typical bureaucracy, trying to tap dance it’s way back to credibility. To save it’s ass really!
I was so centered in my faith for so long, the priesthood even sounded plausible. But after coming through what I have, that seems like the most remote possibility on earth. My own mother would probably be gravely offended by my opinions and my lack of faith. She was one who walked blindly after hers. And she spoon-fed the tenants of it to me as a child.
One of the things that bothers me today is that as I get older, I do find god, or whatever your idea of god is, in strange places. Sometimes in music. Others, in nature. But of all the places I have encountered anything I felt could be evidence of some “supreme being” I find in the concept of love. Love can be this elusive notion that we chase our entire lives. But when it is right, it is like nothing else on earth, or presumably in heaven. Wasn’t it love that inspired god to create the earth?? Or was it loneliness? I guess it depends on which account of creation you embrace, or what day of the week you catch me. But it is certainly undeniable that love is a force to be reckoned with. Another question to ponder: Can love cure an addict? There’s one for the sages of the world to mull over?
You know, I really don’t mean to sound so bitchy and awful. But I have come down this road for what is approaching 30 years. 30 years of pain. I see that on the page and have trouble wrapping my head around it. 30 years! That is longer than many who grace these pages have been alive. And we go on from year to year along this merry path, and every day is a new challenge. Every day is something new to overcome, and to be honest, I am tired. I am tired of the fight some days. I am tired of using the energy I have for useless endeavors. I am tired of just being. It is not that I don’t love life. The psychologists in the crowd, take heed! If you were to dissect this, you might come to the conclusion that I was suicidal. That couldn’t be further from the truth. I truly do love life. I love it in spite of the warts and all that come with it. What I find distasteful as I get older is the mundane. There was a time when I could be happy doing the simplest task for hours or days on end. But now, I find that I struggle to focus. I struggle to complete simple things because the energy to accomplish the task is so all consuming. I would rather use the energy I have for something amazing. (Tell me what that is and I will hand you the keys to the kingdom).
I once read that by declaring that you are NOT Suicidal, you are actually affirming that you ARE. How messed-up is that?? I will be the first to admit that over this journey there have been times when the idea has flown through my head. But this is one issue where I have extremely strong opinions. To me, suicide is the ultimate in selfishness. Period. It totally ignores anyone who cares for you or loves you and diminishes that love and respect. My uncle, my dad’s brother committed suicide. He walked outside their house in California on a blissful northern California day, and used a deer rifle to ventilate his cranial vault. Now that sounds cold and cruel, but it is intended to. He was a selfish prick! His poor wife inside had to come out and see his dumb ass lying in the yard with virtually no head. How do you think that colored the rest of her life?? And what about anyone else who cared about him?? My father never has said much about this issue. We talked about it some when it first happened, but not in any real manner to try and analyze it or understand it. The police were so understanding. They called dad and offered him the weapon used in this senseless act. He in turn offered it to my brother. Now what red-blooded American wouldn’t want a gun in the house, a gun that was used to kill a loved-one?? Silly people!!
Ok, I am done with this!! Please feel free to sound off on this topic. But in closing I will say that I have known many people with more of a reason to end their lives. And they didn’t. They didn’t even consider it. And I don’t know if god, or love or addiction had anything to do with it. But I do know that they made the right choice. They chose life! Now I must make one other point. I am not one of those who thinks that you should choose life over all else. I have stated before that in the end, life is not always the best choice to make, when the body is done, and the end if inevitable, then why choose to use any means to prolong the end. I watched a man die from an awful disease many years ago. The disease was Wegner’s Granulomatosis.
Please read this before you come back to what I have to say:
Wegener’s granulomatosis is an uncommon disease that begins as an inflamed mass in the mucous linings of the nose, throat or lungs. The condition can get worse and affect the blood vessels such as the small capillaries of the kidneys. Eventually, the inflammation can cause the tissues to begin to die.
Wegener’s granulomatosis may either begin suddenly and severely or come on more mildly and gradually. It can take years for the full range of the disease to develop.
A person usually goes to the doctor with symptoms of a chest condition, including:
- A general feeling of not being well
- Fever
- Joint pain that comes and goes
- Loss of appetite
- Congestion of the nose and sinuses
- Sores on the lining of the nose
- Bloody runny nose
- Cough, which causes blood to come up
- Inflammation of the linings of the lungs which causes difficulty and pain when breathing
- Inflammation of the middle ear, which is painful, can cause hearing loss or potential rupture the eardrum
- Weight loss
Inflammation of the nose is what usually brings patients to a doctor first. At this stage, Wegener’s granulomatosis can often be mistaken for chronic sinusitis. The mucous membrane that lines the nose looks red, has a raised grainy appearance and bleeds easily. Other symptoms may also appear including rough, bumpy skin rashes, eye problems including redness of the eye and blockages of the ducts between the eyes and the nose and inflammation of the cartilage of the outer ear.
Serious complications may also develop as a result of Wegener’s granulomatosis, including heart attack, meningitis or inflamed masses of the central nervous system that don’t heal. Eventually, the condition spreads to the blood vessels and causes complications such as fluid leaking into the lungs and inflammation of the tiny capillaries of the kidneys. This latter condition can cause rising blood pressure and blood leaking into the urine.
Now doesn’t this sound like a wonderful way to die?? I swore right then that I would never forget the name of this disease. This man was beset by chronic and horrendous nose bleeds, chronic sinus infections, renal failure, near total deafness, and huge pulmonary insufficiency. He was the kindest and gentlest man in spite of this awful disease. When the time to die came, the doctors, along with his family decided to intubate him, place him on a ventilator and to NOT make him a DNR! This man was ready to go. He had made his peace with the world, his family and God! But it wasn’t to be. Before he finally died, the medical community flogged his poor body for all it was worth. In the end, he still died. End of story. I attended the postmortem on this man, which was somewhat difficult as I had grown rather close to him. But it was truly amazing. His organs were so involved that his liver was the size of a Volkswagen. His lungs actually were removed in pieces. His brain was horribly swollen. And his kidneys were the size of show boxes, my shoe boxes.
So the good old college try didn’t make any difference in the end! Sleep well Mr. L .
Those of you closest to me may wonder about my preoccupation if you will, with death. I think it part it is being driven in part by my reading of “The Book Thief”. Reading a book narrated by “death” is a sobering thing, particularly in light of when the book is set, Germany, 1939! Great time in German history, huh? Death was only beginning to become a way of life for the German people and for the scores of “undesirables” who would succumb to the German “solution”.
The book is a very interesting read!
Now that you have watched a big chunk of my story unfold, there is so much more to share. There are certainly huge gaps in my story that are in need of plugging. There are inevitable questions, comments, rude remarks that you all should feel free to share. The one thing I wish to say at this point is that I am far from exceptional. In fact I am quite ordinary. My journey could be any one of a thousands who have traveled this path parallel to mine. Some have better outcomes, others, well, I am sure they have much worse. I have observed a few that were much worse!
I have taken a recommendation from Robin with regard to a book she and Grant enjoyed called, “The Book Thief”. It is quite appropriate actually and tantalizingly good. The narrator is Death. And instead of this being a totally dark, rather macabre story, it is filled with humor. The book is recommended as a young adult’s book, but I think, along with many critics, that it should not be missed, regardless of the reader’s age.
Thanks Robin and Grant!
I am now going to tackle a subject that will make some of you squirm, others relish in the irony. That topic is religion, and more, faith. Read on fair followers!
There is one thing about addiction that is universal. It too will pass. One way or another, you have to break the cycle, you have to stop, either willingly, unwillingly, or through death. I don’t see many other choices. Having now made it through several health crises, the continued use of chronic narcotics was beginning to take it’s toll, physically, emotionally, spiritually. Having “been through the fire” so to speak with all of the GI issues, surgeries, etc, as a rational person you would think that maybe I would have learned something. You would think that maybe I was smarter, faster, more ready to meet the world on it’s terms. You would be right on some level, but on another, I mostly wanted to escape. Wanted to rid myself of the pain that dogged my every move. There is nowhere to run from it, nowhere to hide, no vacations from it. It is a part of your existence and no one can possibly know what you are feeling. Unless they have walked this path, it is impossible to know.
One of the challenges in beating addiction is knowing when to quit. For some, the issue is simple, quit or die. For other’s it is much more complex. Opportunities present themselves from time-to-time for an escape but are often ignored. By this I mean hospitalizations, surgeries, etc. Times when it would be relatively easy to taper off of the drugs and be done with it. But few embrace those opportunities because of one simple thing: active withdrawal. No matter how long it takes to wean yourself off of chronic narcotics, there will most likely be some active withdrawal. I can’t remember if I have described my experience with this up to this point in time so I will touch on it once again. It is a subject that should not be taken lightly if you have not experienced it yourself.
The first time I experienced active withdrawal was in 1979. I had been hospitalized for 6 + weeks following my right knee fusion. Up to the point of the surgery I had taken some narcotics but once the surgery was over and the protracted recovery ensued, they became my best friend. Lying in bed for 6 weeks flat on your back is a challenge for the best of us. The narcotics helped ease the considerable pain and soothed some of psychological pain of being incarcerated for an extended period.
Once I was well along on my recovery, it was time to stop the meds. This came in the form of basically a cold-turkey approach. The first night I thought I was going to die!! For me, active withdrawal was/is the worst experience I can remember. Screw the pain. I can take a shit-ton of that. But withdrawal feels like every molecule in your body is flying apart at the speed of light, cubed! It feels like your arms are being ripped from the sockets, your guts ripped out, and your body drenched in alternating stream of boiling, then frigid water. Other than that, it’s not so bad. This goes on for several nights. Now I say nights because daytime is manageable. If you keep yourself busy, it’s easy enough to pass through it. But when you try and sleep, your brain starts screaming for drugs. It’s the whole frog on a hotplate thing that I have described previously.
On a couple of occasions, I made the choice to quit cold-turkey. Now I have to say that this was an extremely BAD idea. And anyone reading this should know that if you are considering this method of breaking the cycle, freakin’ forget it!! It is the most ignorant, stupid thing I have ever done. It is also very dangerous, not only to yourself, but to those around you.
My problem was that when I chose the cold-turkey method, and I suspect that this is true with most, I became psychotic. Totally so! The first time was not terrible. We wound-up going to the ER in the middle of the night because I was talking out of my head. I went back on the meds in an attempt to wean myself off of them slowly. The second time was really ugly. This time it involved the Sheriff’s department, the paramedics, and me sitting in a landscaping bed throwing rocks at all of them. I am not relating a first person account of this, rather the account my wife shared with me. I awoke in the ER, groggy and disoriented but alive. And by virtue of the fact that it was a Saturday, they couldn’t send me to a rehab facility because there was no way to get approval from the insurance company. So I went home with instructions to contact my PCP on Monday. This I did! And he saw me that day, at which time we talked at length about my issues, the happenings of the weekend, and what the future looked like. He spoke of an addiction counselor of which Iw as already familiar through the ER doc. The place was Conifer Park, a dedicated rehab hospital, and no not that kind of rehab, but drug and alcohol rehab. He spoke with the physician in charge of the program and the counselor, laying out my entire history up to present. The concensus, right or wrong, was that I didn’t need an inpatient stay to beat this. That with my history, I would certainly need narcotics from time to time in order to survive. And that rapid weaning and detox was not necessary. Instead, the plan was set to implement a longterm plan to wean me from the chronic meds. So over the course of the next year, well, at least until I moved here in late 2006, the plan was perfect. Each month the dose of drugs was decreased. I had regular session with an addiction counselor and was even subjected to weekly drug tests (which was a requirement of Conifer Park and not the physician nor counselor). I believe I have stated this before, but one year and 3 months of being drug free.
The truly odd thing is this: It took nearly 6 months of being drug-free to finally truly feel that way. The issues with sleep finally disappeared. The minor tremor (which I am sure was a function of a bit of prolonged withdrawal) finally subsided. I finally began to feel like a human being again. And have never looked back. I have to say that I can’t ever go back to that place. I can never go back to living a life where I am numb from the neck up. To denying who I was and what I wanted and needed out of life. To being this robot who kept his emotions at bay so that no one could get too close and see the chinks in his armor. ]
I am human. I am frail. I am stronger than I ever imagined. And once again, I see life through open eyes. I see people with a new light. And I feel.
If I had to sum up the experience I had with chronic drug use, I could do it in a sentence or two. First of all, don’t! Unless there is no other way, and there nearly always is another way, don’t go down that path. Unless I was told that I had a terminal disease, I would never go down this path again. The pain is much too exquisite. And also, never give up. Never give yourself over to a substance that is so cruel, so heartless. Fight the temptation to color your world with anything, drugs alcohol, whatever. Life is too short to let it pass you by. Life is too fragile to disregard the beauty you see each day. Hold onto those you love with both hands and never let them go.
I am going to revisit some topics to try and flesh out my story, my odyssey. Please join me in my experience.
Filed under: The past!
Surviving a horrendous illness is a funny thing. It makes you examine your life and think about the what if’s and the wherefore’s. I don’t mean to sound obtuse here but this whole ordeal put me through some serious changes, some of which I am not going to address here for privacy reasons.
One thing it did do is push me toward having a life outside of home for the first time in many years. I decided that I would like to go back to R. T. in some fashion so I took the steps necessary to obtain a license to practice in the wonderful state of NY! Now when I started in R.T. as I have mentioned previously, formal training existed, but so did a method in call, On The Job Training. Once you were hired, you were placed with a credentialed therapist or technician and you learned what you needed by immersion. After several years of working as an OJT and making no money, I decided in the late 70’s that getting registered was the only way to advance and be able to support a family. At the time there were no training programs in Kirksville, MO where we were living. So I began to explore some of the “non-traditional” programs around the country. The closest was at Creighton University in Omaha, NE. It was a 6 week, intensive study program that covered the equivalent of an associates degree worth of material in 6 weeks of 8+ hour days. We had 40 people in my class who completed the course which had a prerequisite of either an AAS or 64 hours of college credit to include all of the basic sciences, Anatomy and Physiology, etc. The other prerequisite was a minimum of 2 years work experience which by this time I had well exceeded by more than double.
It was an amazing experience. There was not much clinical time spent, rather concentration on the basics of RT and advanced courses in pharmacology, critical care, etc.
The first day of the course was a Monday. We met with the two instructors, S. Lee King who was an old-school therapist with a doctorate and Don Barlow, who was younger, more hip, and just the coolest guy. At the end of the day they invited the entire class to a place called ” Grandmother’s” Telling us that Monday is 2 for 1 Margarita night and that it would likely be the only time in the next 6 weeks we would have time or presence of mind to let our hair down a bit.
One of the guys who attended the course from Kirksville was named Doug. He was a sweet kid, married with a kid or two, and just very kind, humble person. He and I had become fast friends since we both had a fairly similar temperament. We arrived at the restaurant which was mostly Mexican in theme and execution and started ordering pitchers of Margaritas. Two one liter pitchers for $ 4.00!! Doug had never found any kind of alcohol that suited him from the perspective of taste. He had tried most everything but nothing met with his fancy. That is until he was introduced to the Strawberry Margarita!! Oh did he fall in love with them!! An hour or so later, he was becoming a bit glassy-eyed and we started collectively asking him if he was ok? His only response was, “I can’t feel my face!” The entire table just roared!! We took good care of him that night, making sure he got back to our lodging safely.
We were staying in a very old fraternity house on campus which offered us rooms to the tune of $100/ month. This was a huge bargain in our minds over the guys who were living at the YMCA!! Very different clientele, by comparison. I had a room that was rather unusual. It was part of a two room suite with a common entrance door then separated from the second room by a privacy door. The first or second day there I saw who I thought was my “roommate”. He was a very muscular, very long haired young man, maybe a year or two older than I. Sort of a hippie looking dude, actually. I was a bit put off mostly by his appearance. I learned quickly that appearances could be deceiving. His name was Russ and he was a medical student at Creighton. Uber-bright!! My lord was he smart and not just about all things medical. I also learned that he and his brother we nearly deafened in the explosion of a homemade bomb when they were a bit younger, part of an anti-war protest that went awry!! We spent many nights talking into the wee hours of the morning!
At the time of my completion of this program, the pass rate on the NBRC written exam was below 40%. Dismal at best. Of the 40 people in my class, 95% passed the written exams on the first try, some thing to be said for the caliber of the program. In the years that followed, I found some prejudice toward those of us who had completed ” nontraditional” programs. In fact during one job interview the therapist who was questioning me referred to “us” as “6 week wonders”. So I asked him what the pass rate on his written boards was. He sheepishly admitted that in spite of having a bachelor’s degree, he had not passed on his first try. Case closed. And I have to admit that there is more than passing an exam to speak for the quality of an education program. Full length programs had the advantage of offering clinical time, but the majority of student who enlisted in this programs did not have the benefit of any real world experience. Which was something we all had, for better or for worse.
So to make a long story, a bit shorter, in 2001 I decided to obtain a NYS license to practice RT, however, in 1999, the state had implemented a statute requiring an AAS degree in order to obtain a license. Even though I had obtained my National Registry through the NBRC, and had completed an JRCRTE approved course of study, I could not get a license in NY!! My only option was to attend an approved program and complete the required course work to satisfy the requirements for an AAS degree!
This would mean two semesters in an AAS program which in my area in NY meant HVCC (Hudson Valley Community College). I set up an appointment with the program director and clinical coordinator in mid-summer. It was nearly July by the time I had an answer from the licensing board in NY so I had to move quickly if I was to get started in the fall! The start of the term was not much more than a month away and I was faced with a daunting task. In order to start clinical rotations in the fall, I had to have passed the Mechanical Ventilation Critical Care Course, which wasn’t offered until spring. So this meant that I would have to basically self teach the course and then be tested over all of the available types and brands of mechanical ventilators in a lab setting, and pass the final exam for the course. And during the summer this meant only having access to the lab 3 days per week. So I bought the textbooks and started reading! It had been 18 years since I had touched a mechanical ventilator. I spent every possible minute in the lab playing with the “toys”. The only real help I had was being able to ask questions of the instructors or program director if and when they were available, as the summer is rather hit or miss. Just short of a month into it all, the date for the testing rolled around. The start of school was looming on the horizon and it was time to fish or cut bait! I guess I wasn’t as rusty as I thought. I breezed through the equipment check-offs with 95% or better on each machine, and scored better than 95% on the written final. I was not poised to begin classes and clinical come mid August!
The first day of school was surreal. Here I was, 45 years old, a student once again. My peers were a mix of ages but the average was somewhere in the 20’s. Some were even younger!! Most had come from high school or were second year students in the program. But as time went on I found that it was difficult, but not impossible. Getting back into the routine was not impossible. Learning was fun, the students were a blast, and I was this sort of “object of interest” to most of them, if nothing else someone with a bit of seasoning, a resource person who could help those struggling, although most were much brighter than I. It was truly amazing being involved in something that I had loved so much and that had largely forsaken me, and I it. Health issues had been de rigeur for me for so many years, now here I was “back in the saddle” as if nothing had ever happened.
Classes began, clinical began, and I feel like I was doing something important. Doing something that was going to make a difference at some point. The routine was different. Three days a week I had to be at Albany Medical Center well before 7 AM. Report started at 7 followed by a trip to the respective clinical areas and patient assignments. We then had approximately 45 mins to fully work up our patients for the day, review the charts, be familiar with all of their medications, treatment, history, etc. It was a lot to do in a short period of time. Then we had to present our patients to the instructor and field any and all questions. It was challenging but also fun. And every day it got easier. The days we were not in clinical, we were at school either in class or in lab. And this was usually a full day, depending upon our course work. Mine was a bit different as I only had a handful of classes required to fulfill the requirement for graduation. The bulk of what I needed were clinical hours.
An Aside: Like most of us old enough to remember where we were the day JFK was assassinated, I was eight years old, most anyone who had a pulse will remember where they were and what they were doing on 9-11-2001. I happened to be at Albany Med doing a clinical rotation in the SICU. Before any of the reports started coming through, a nurse whose boyfriend lived in Manhattan, got a phone call. Her boyfriend called to tell her that a plane had hit one of the towers of the World Trade Center. She came into the room where I was doing an assessment and told everyone what he had said. We all just kind of shook our heads and didn’t think much about it, to tell you the truth. Then someone turned on the T.V. in the patients room and the very first news items were beginning to come through. Being only 3 hours from NYC was kind of surreal. As the morning unfolded, we all were in shock, transfixed on the unfolding story. In a matter of less than an hour, an announcement came on the overhead that all staff would be on call for the possible transport of injured to our facility. Honestly, my first words came chillingly true. I told everyone in the room that there would be very few injured. That anyone in those building was dead! How prophetic those words were, unfortunately. In a matter of weeks, our entire class was asked to go to NYC to test workers for lung injuries. That was one trip I was unable to make.
Not long into the second semester, I began having abdominal pain and and colic. It was very reminiscent of what had happened the previous year. It was a Monday. I got up feeling terrible but had to go to class. We were preparing to do our certification for ACLS, PALS, NRP, and NALS. This semester marked the beginning of my peds and NICU rotations. I was also taking Pulmonary Anatomy and Physiology. Well that Monday morning, I continued to feel worse. I called Jeanell and then called my primary care doc. He had worked me in that afternoon. So I left school a bit early and drove the 45 minutes to his office. He took one look at me and sent me directly to St. Clare’s for a CT of my belly. It was now nearly5pm. It was a case of do not pass go, do not collect $200 ! He called me in almost before I had a chance to get my clothes back on in the Radiology Department with the good news. Bowel obstruction, big time. So I drove home, grabbed some things, and we went right back to the hospital. The requisite NG tube was placed, the Morphine started, and 24 hours to see if things would clear. Not a chance. I was taken to the OR once again to clear an obstruction, which is a problem in itself that I haven’t mentioned previously. Every time you open the abdominal cavity for any reason, you are causing more scarring. Handling the gut causes more adhesions, which in turn make way for more possible obstructions. It is certainly a vicious cycle. The clinical course this time was a bit easier than the previous and I was out of the hospital in about 10 days. Still partly obstructed, I was relegated once again to mostly liquids for a time, but after 21 days off, made the decision to return to class.
I will never forget my first day back to class. It was a Thursday. I had Pulmonary A and P lab on Thursday and not much else, so I thought it would be a good day to test the waters. I was so freakin’ weak!! I remember that it was very cold and snowy. I arrived way early as it took me some time to walk to the classroom. By the time I got there I was sweating profusely and felt like I was going to pass out! But I made it and Dr. Mastrangelo, who was a true gem in the community college circles, made me feel right at home. I had missed a lot but it was not insurmountable. I took it one day at a time and in reality only wound up missing one course that semester, a PICU/NICU rotation which was well underway by the time I was back to school. The only issue was that it wasn’t offered until the following spring, so I was stuck here for an entire additional year.
I spent the summer tutoring and staying fresh for fall, and in reality, had decided to take advantage of the extended time at school to spread out the course work a bit. Rather than completing everything in the compressed time slot I had chosen, I was now able to breathe a bit.
The rest of the program was fairly uneventful. The course work was challenging but I learned so much. I will say that there are truthfully, not many RT programs in the country that are more comprehensive or tougher than this one.
One game the instructors liked to play with the students in the critical care areas, in those quiet times, waiting for patients, etc. was something I have always called “stump the dummy”. Essentially what would happen is this: the student would set up and pressure test a mechanical ventilator. He or she would then leave the room, and the instructor had the province of doing anything he please to make it malfunction. Once the student returned, he would have 2 minutes to troubleshoot the ventilator and fix the problem. Now, I loved playing this game. In my previous life, have worked as clinical coordinator at Children’s Mercy, this is what I did morning, noon, and night. Whenever a therapist could not find or fix an equipment problem, it was my place to step in and do so. Well, one of the instructors at HVCC did not appreciate this ability in me. While many times the students would take the entire 2 minutes to find and repair the problem, I could normally find the problem in 10 seconds and have the settings restored in under 30! It literally drove him crazy. No matter what he did to the machine, he never once stumped me. I guess it was a battle of egos of sort. He was determined to fool me or make a fool of me is probably a better thought, while I never really bought into the whole thing and just did what came naturally, stayed focused, stayed calm and just did the deed!
So nearly 2 years from the time I started out to finish two semesters, I finished. My GPA was so-so, but mostly I had my AAS degree and could go on to get my NYS license. The program had served it’s purpose. I had gotten out of it what I needed and was now giving back by working as a tutor in the program. The opportunity also presented itself for me to take courses toward my BS degree through an evening program at SUNY Upstate Medical. The program was based in Syracuse, but the courses were offered via video link on the HVCC campus. Two of the instructors who were not BS prepared and I started doing the course work. In compensation for my time as a tutor, they paid my tuition and fees for the courses. Over the course of the next couple of years, I took one course a semester which was plenty! !They were challenging, fun and I was learning, a nice place to be. But trouble was looming. I was becoming more and more deeply mired in my use of chronic pain meds. It was making it more difficult to concentrate, more difficult to spend the amount of time I needed to at school, and mostly wearing on my body.
The one thing that is so true is that I wouldn’t trade the time I spent at HVCC for anything. Either the time as a student or otherwise. It was an amazing experience that made me so appreciate my profession and helped me to get in touch with a part of my life I had largely given up.
Filed under: Uncategorized
Sometimes when you have a chronic illness, you can go weeks, months, even years without an exacerbation of the disease. Today was a day that I would rather forget. Brings back way too many bad memories, having a flair of my gut issues. I always wonder when this starts where it will end. Having been down this road with bowel obstructions, when the pain and the cramping and the horrendous gas starts I always fear that it won’t subside. That it will lead to more of what I have been through in the past, more surgery, more pain, and ultimately something much worse. And sometimes it takes days to know if the quick fix is going to work. It takes days of a liquid diet, anti-spasmodics, which make your mouth so dry all you want to do is drink 24/7. And in my experience, when my gut is hurting, I just feel like hell overall.
Along the same lines as chronic illness, I would like to recommend a book to anyone who is struggling with cancer, or any terminal illness as far as that goes. Or if you know someone who has cancer, this book is a chronicle of a couples journey through their relationship, falling in love, marriage, and then very early diagnosis of cancer on the part of the wife, very shortly after they are married . I will say that the outcome is not a good one only so you can be prepared for that. The title is: “Grace and Grit”. It is authored by Ken Wilber, who is an Integrative Psychologist. If you are not familiar with the discipline, it is an extension of psychology that integrates the spiritual journey with the exploration of mental health issues and more so, provides a holistic, inclusive approach to psychology. He is an amazing writer. And the story will grab you by the shorts and not let go. I truly couldn’t put it down once I had started it. There are a few chapters that are quite technical, but as the author states, can be skipped without disrupting the flow of the book. Anyhow, if for some reason you can’t find it and would be interested, let me know and I will gladly hook you up with the publisher. And I actually just checked and it is available through amazon.com . So you have no excuse!!
Maybe I am weird, but in some ways I don’t look at cancer as all that different from any other chronic illness. Other than the potential for lethality, the process one goes through dealing with any sort of chronic condition is virtually the same. And the mental process is totally similar. We all go through the stages of grieving that Elizabeth Kubler Ross wrote of. The process of reconciling that our lives will never be the same even though we many not succumb to our illness. Denial, Anger, Bargaining, Depression, Acceptance. I guess maybe I have a fascination with death on one level or another, having danced with him a time or two. You can’t have made the journey without being touched in some way, for better or worse by the experience. And although I don’t wish to hurry things along, I really have little fear of dying. As a society, we are taught that the only normal outcome is life. Even when you are 95 and have been there, done that to the max. We train our physicians that death is an unacceptable outcome. That we should only strive for the continuation of life. Not a smart thing in my book. Why subject an old person to the rigors of chemotherapy, resuscitation, invasive medicine at the end of life. Nature has a way of evening the playing field when it comes to death. We can’t escape it no matter how hard we try, no matter how much money we spend. I have truly sworn to come back and haunt anyone who subjects me to unnecessary pain and suffering at the end in the hope of prolonging my life. I truly will and it won’t be pretty, so pay attention!!
The best college course I ever had was one titled “Death and Dying”. It was my Sociology requirement and I could not have chosen a better course for that endeavour. It was taught by a professor named Harold Eastman who had been instrumental in helping to establish the hospice movement in the US in the 70’s and 80’s. He had worked at St. Christopher’s Hopice in London in the 70’s. In the course we studied both Kubler-Ross and Raymond Moody who were contemporaries of one another.
Anyhow, death is such a natural part of nature. Whether you are human or another of god’s creatures, you must face it one way or another. Why not do so with some sense of dignity. I won’t cower in the corner, waiting for the Grim Reaper to take my hand. Screw that! I will go out the same way I came in, kicking and screaming. A party to end all parties! And when I am gone, for those of you who are reading this who know me, pay attention, no wailing and gnashing of teeth. Got that?? Celebrate my life! Remember who I am. No traditional funeral, no graves, no funeral crap whatsoever. I won’t pay the assholes who run the funeral industry one cent toward my ultimate demise! They can kiss my ass!! My body is going to a medical school, the city dump, it really doesn’t matter. Cremation is fine! But that is the extent of their involvement. I don’t need it any more at that point. I guess I have adopted my sense of what I want at life’s end from my dad and his family. No muss, no fuss. A simple memorial service, period! Some great music, some laughs and inevitably some tears, but more of the previous for sure.
Ok, enough of that!! Now I am depressing even myself!!
