Tag Archives: ER

Coping with Distress

Today has already been what some might call distressing.

I spent my morning in the ER. Again. I thought, perhaps, it was a continuation of one of the two problems I’ve had within the past two weeks: either another kidney stone or another small-bowel obstruction. Fortunately (or unfortunately, depending on how one looks at it) it was neither of those things. Instead, it was a condition called inflammatory colitis – in other words, an infection inside or outside the small bowel causing inflammation, pain, nausea, etc. To me, the symptoms were very difficult to distinguish from the feel  caused by a kidney stone or a bowel obstruction. There was a slight variance in severity and location of the pain, and the level of physiological distress (I separate this from pain because for me, it is a separate issue) which is a term I have invented for that feeling of intense frustration and anxiety that occurs when one has a medical condition or illness (or even a psychiatric or psychosocial issue) that is continuing to reoccur or worsen despite your best efforts. It is that feeling inside your head that makes you crazy: you start to wonder if perhaps there is no cure, no treatment, no solution that will be effective for you. It starts to seem like no matter what you do, you will always have pain, always be depressed, always have difficulty meeting people or with the opposite sex, or perhaps that you will always be estranged from a friend or family member whom you love.

I may have invented the term “physiological distress”, but I’m betting I’m not the only one to have experienced it. Like pain, or anxiety, this type of distress defies external measurement. It is subjective. In fact, in my experience, it is so subjective as to be unpredictable even to one who has experienced it multiple times in multiple situations. For example, I have had abdominal pain and nausea more times than I can count in my short life. And yet, there is no predictability in the way each iteration of these symptoms will cause physiological distress. Last Thursday I was feeling possibly the worst pain and worst nausea out of the last two weeks. Yet I proceeded to drive myself to the hospital and wait in the ER and explain everything to the nurse who commented: “you seem incredibly calm for someone experiencing the symptoms you are experiencing”. And yet, when went to the ER this morning, I was so anxious and upset that I took the wrong freeway exit, then misspelled my name, then nearly missed the gurney as I tried to sit down. I could barely get the gown on, and for those who have ever put one of them on, they are about the simplest garment one could imagine: there are two holes for your arms in the upper portion of the gown. That is it. Sure, it has a place to tie in the back, but no one expects you to tie it yourself.

I guess this post is really about this idea that the frustration in dealing with chronic or reoccurring problems in my life can actually become a significant, separate issue that may not really coincide with the severity of the inciting incident.

That is really easy to demonstrate, given that today, I was not actively passing a kidney stone, nor had I passed one (at least to my knowledge) in the past several days. A kidney stone SHOULD produce a significantly higher level of distress than a simple inflammation of the intestinal tract. And yet, possibly because it seemed to be a reoccurrence of an incurable and unpredictable problem, today’s pain and nausea (most likely lower in severity than that of a few days ago) produced a much higher distress level.

I honestly don’t know what the application would be. Perhaps all of this just means I need some more psychiatric and psychological help. (that is probably a fact rather than a supposition, whether for this type of distress or for one of the other myriad of mental absurdities my brain and body put me through on a daily basis) Perhaps it just means I am spending more time than I should using my brain to watch my body and using my brain to watch itself – we typically call this “introspection” or something like that, but I find that term to be rather one dimensional as it primarily refers to using one’s brain to ruminate on past actions, behavior, thoughts, and responses rather than focusing one’s attention on what one is thinking NOW, or a combination of those things, or even what one is feeling emotionally and physically combined with what one is thinking at any given point in time.

Enough with the terminology.

My question to myself and to all of you, in light of the distress I was feeling this morning, is this: if and when you are feeling physiological distress, what methods are available to deal with it, and which ones are the most effective? Which ones are healthiest? Which ones support your personal wellness and lifestyle goals?

For example, one way many of use deal with our distress is to eat. Yet for many, that is a destructive way of dealing with distress, and might even wind up causing distress in the future. Another method for dealing with distress is recreational drug use. But if you don’t know from personal experience, then take a leaf out of my book: this is NOT the way to deal with your distress. It ultimately causes a significantly higher level of distress in all areas of life, rather than a single source of distress that may have triggered the drug use originally.

But there are healthy ways to deal with what distresses you. One thing I can almost always count on to alleviate my distress is to act. To DO something that addresses whatever is causing me to feel the way I do. So today, that action was to go to the hospital. Something that, even as frustrating and anxiety producing as it was, was actually less frustrating than sitting at home hurting and anxious.

I wish I could tell you that because I am aware of this dynamic in my life I always choose the healthy ways to combat my distress. In fact, it is probably the opposite: even though I am aware of this dynamic, I still often choose unhealthy coping methods.

I’d love to hear from you about your experiences. Have you felt “physiological distress”? If so, what does it feel like to you, personally? What methods, healthy or not, have you employed to cope? What works best, and what just doesn’t work at all?

Thank you for reading. I wish you a distress-free Sunday!

Peace to you,

-Nathan

A Rolling Stone Gathers No…?

Kidney stone with a maximum dimension of 5mm.

Kidney stone with a maximum dimension of 5mm. (Photo credit: Wikipedia)

***Disclaimer: This is an absurdly long post. Read at your own risk.***

This post is officially for yesterday. I’ll be posting again this evening for today. For once, however, I actually had a pretty good reason for not writing yesterday. What is that reason, you ask? It is the simple matter of me passing a kidney stone, without any pain killers. Yep, you read that correctly. About 24 hours ago I passed a kidney stone and it was, to say the least, quite uncomfortable.

I knew something was wrong yesterday morning. When I awoke from the couple of hours I was able to sleep, I felt like someone was squeezing my lower abdomen in a vice. The pain got so bad that I began to vomit, and was unable to keep liquids down, rendering the pills I took for the nausea totally useless as twice I tried to take them and twice the just came back up again along with whatever was left of my stomach contents at that point.

But I suspected another bowel obstruction, so fortunately I decided I needed to get things checked out at the hospital. By 1pm I was at Legacy Emmanuel Hospital. I would have gone back to Legacy Meridian Park, where I was seen for the previous obstructions, but when I called, the guy at the ER admitting desk told me that the wait was over four hours long! So since all records are shared between Legacy hospitals, it made sense for me to go to Emmanuel, where the wait was only about an hour long, and where they would have all the records, lab tests, and scans from my previous visits to Meridian Park. Had I gone to Providence (where I would rather have gone, despite the fact that it is further away from my house than either of the Legacy hospitals), they would have had to start from scratch and re-do all the x-rays, CT scans, blood, urine and stool tests that were done originally at Meridian Park. And of course my experience is that sometimes two different doctors will read the same scans or the result of a blood test in two completely different ways.

So it made sense for me to go to Emmanuel rather than Providence.

I made sure I was able to drive; I had nothing left in my stomach, so vomiting wouldn’t be a problem. I was in pain, yes, but although it wasn’t getting any better, it also wasn’t getting worse. I was exhausted, yes, but I certainly was in no danger of falling asleep – there was far too much going on inside my body for me to be able to rest.

Once there, the wait seemed interminable. All I wanted was to lie down – the only position that seemed even remotely comfortable was lying on my left side with my knees curled nearly up to my chest. And there was no place in the ER waiting room for me to lie down like that. Instead I was forced to sit in a chair, hunched over so that my back wasn’t pressed against the chair. Not very comfortable in and of itself, and less comfortable for someone who has (albeit unknowingly) passed a kidney stone just an hour or two earlier.

Fortunately, the wait wasn’t much longer than an hour. By 2:30pm I was back in a room, lying on my side. The nurse placed an IV and drew blood for labs. Finally the doctor came in. He was a kind, partially balding man, probably in his mid-forties. His name was Dr. Gillette, which of course made me wonder if he was possibly related to either the family whose manual razors I have often used for shaving, or to my sister’s junior high basketball coach.

He asked me the obligatory questions, listened intently, then did his standard physical exam. Nothing was out of the ordinary, except that I nearly screamed and simultaneously jumped off the gurney when he pressed on my lower abdomen. I told him that it felt sort of similar to the way I’d felt with the bowel obstruction, but not exactly the same. And then, he asked me to lean forward and pressed on my lower back. I felt nothing when he pressed on the left side, but when he pressed on the right, I nearly vomited it was so painful.

He ordered x-rays to see if the obstruction had reoccurred, and ordered a urine test. Fortunately, I had just enough liquid in my body to be able to pee right away. He also ordered a bunch of IV fluids and some nausea medication through the IV as well. We were very clear that any sort of narcotic pain relievers were not an option.

The x-rays came back completely normal. But when he came back he told me that the urine had a lot of blood in it, which usually indicates either an infection somewhere in the urinary tract, bladder, or kidneys, or else a kidney stone, which he thought most likely. He ordered a CT scan to confirm.

Laying on my back in the CT was excruciating. But one of the great things about CT’s is that they take less than ten minutes. Before long I was back in my room, waiting. I didn’t have long to wait, however, because the doctor came back in to tell me that I had definitively passed a stone sometime in the past 12 hours. The CT scan I had taken at Meridian Park just days earlier had shown two medium sized stones in the right kidney. The scan he had just take showed only one. In addition, the scan showed significant inflammation throughout the urinary tract as well, which solidly proved his suspicion that the stone no longer appearing in the kidney had decided to take a painful tour of my ureter before exiting my body.

It was a bit of a relief, really, knowing that the stone had passed and therefore the worst was over, however, it didn’t change the fact that I was still in a substantial amount of pain. And it was at this point that the line became a bit hazy, for the doctor, if not for me. It was at this point, having satisfied himself that I was really in pain and not just there to try and scam drugs, he asked me if I wanted him to treat the pain or not. I’m not sure why I had the self-control to turn him down at that point, but I did.

I asked him if there was anything else, non-narcotic, that he could use to treat the pain. He said, actually, there was. Unfortunately, the particular drug he wanted to use was in my medical records in the list of drugs to which I am allergic. But it had been listed as an allergy since 2009 when the doctors at Serenity Lane (the first inpatient alcohol and drug treatment center I attended) in Eugene gave me an intramuscular injection of it, which caused an enormous rash, made me short of breath, as well as causing lightheadedness, dizziness, and a whopper of a migraine.

When faced with those two choices, however, I decided that perhaps taking a chance might be a good idea in this situation. I told the doctor that although the medication (a powerful anti-inflammatory called Toradol, also known as Ketorolac) was listed as an allergy, I would rather chance an allergic reaction than either have zero relief from the pain or take narcotics, which, although they may have helped in the short run, will always make me miserable later. He agreed, and ordered the Toradol, but made sure the nurse stayed with me for 10 minutes or so after she administered the medication, to make sure I didn’t have a severe reaction to it.

Fortunately, I had no negative reaction at all this time. It just goes to show you how complex our bodies are, that once I had a major issue with a medication, and several years later I had no problems with it at all. My suspicion is that the batch of medication given to me back at Serenity Lane was either old, or possibly just bad. Plus, the route of administration was different. An intramuscular (or IM) injection involves the medication being injected into muscle (usually shoulder, buttocks or thigh) and absorbing into the bloodstream from that tissue. It takes longer to be effective, and can sometimes cause a range of side effects that are unassociated with intravenous (or IV) injection. So perhaps that was the major difference. Or perhaps my body’s tolerance to the drug had just changed over the last four years. Who knows, really? The important thing is that the medication worked. I finally felt some relief, and was able to drive myself home, with the doctors instructions being to make sure I kept myself hydrated (as dehydration is the main cause of kidney stones) and to rest and take ibuprofen for the pain.

I could tell that the doctor was surprised that I didn’t accept his offer of opiate pain medication and that I didn’t ask for any to take home with me. Now, 24 hours later, I’m quite glad that I declined. If I had not, I surely would have run out of whatever medication he gave me (if I have access to a bottle of opiate medication, it is typically gone as quickly as I am capable of ingesting it) and would most likely be facing several days of misery. For most people, taking narcotics even round the clock for a day or two would not produce withdrawal effects. But for someone whose brain is still out of whack from years of opiate addiction, it can only take a day (for some people even just a few doses) and the withdrawal symptoms kick in.

Instead, although I feel sore, the pain is easing, and I don’t have to fight through three days of nausea, muscle aches and cramps, fatigue, dizziness, anxiety, insomnia and depression.

Right now, I’m just sore and tired – I didn’t sleep very well last night, because of the pain. But that is altogether preferable than the alternative.

I apologize to anyone who has kept reading this far. I know this post is immensely long compared to my usual. But it was a story I needed to tell. Not for bragging rights, but to remind myself that yes, I can make it through pain without having to take narcotics, and that I am capable or refusing them, even when they are offered by a sincerely compassionate doctor.

It is the reality that comes with being an addict – sometimes you need to chalk up the wins to remind yourself that you may be powerless over your drug of choice once you have made the decision to put that drug into your system, but that you have the power to choose not to use that drug in the first place.

Thank you all for reading, it is days like today where I am reminded how powerful it is to share your experience with others, even you may not know the majority of those with whom you share.

Peace to you,

-Nathan

Takin’ Care of Business

English: Emergency room after the treatement o...

English: Emergency room Photo credit: Wikipedia)

I wish I could predict things before they happen. Well, perhaps not. But it would sure be nice to know in advance when I’m going to get sick. I know that when I listen to my body I can notice those signs that precede a major illness, but some of the smaller, more complicated problems that can be caused by my CF are harder for me to predict, and I can sometimes confuse them with normal CF symptoms I feel every day.

Anyway, I started this entry last night, so I’ll be writing you another for today later on.

But here’s the crux of yesterday for me: I had some pretty serious pain in my flank and in my lower abdomen again and when I called my doctor he was concerned and once again directed me to go to an ER asap. So I did, not having a clue what they were going to be able to do.

It’s tough for me when I am in the hospital and I am experiencing real pain to not give in when offered narcotics and if they aren’t offered, it can sometimes be really hard for me to not ask for them. Despite the fact that I know where that leads, part of my brain always tries to rationalize it: “Hey, it’s ok,” it says, “you’re sick, in the hospital, the doctors are monitoring all your medications, they know your history, they won’t give you anything too strong and they won’t send you home with anything so it’s not like you’ll have to go through withdrawal again, you’ll just be more comfortable here, right now, in the hospital, and then they’ll figure out the problem, treat it, and you can go home and the pain will be less and you can handle it.”

But all that boils down to is that the part of my brain that still wants to numb out the rest of the world wants to take drugs now, for immediate relief, and not worry about potential consequences in the future, and in fact, not even think about consequences as a possibility. My logical brain knows that consequences are inevitable for me if I even take one dose, even if it is supervised and in the hospital. And yeah, there are exceptions. If I got into a car wreck or broke my arm or had any other obvious, serious, pain causing injury that can be objectively observed, then yeah, they can give me narcotics. I’d probably need to stay an extra week in the hospital so they could supervise me tapering off of the drugs, but obviously if I have a real injury or illness that they know causes pain, the rules change. But barring that, I need to always remember that I can handle pain. I just have to commit to not letting myself go down that path again despite how much something might hurt.

It is tough though, because I feel sometimes that when I get sick I might as well have a couple doses of pain medication while in the hospital. Because it won’t be long enough to cause dependence, it would be supervised by medical professionals, and it would make being in the hospital so much easier.

But on the flip-side, even a dose or two of those medicines get my head spinning, and I always want more. Even if I tell myself and tell the doctor I only want one dose, I inevitably ask for more, and inevitably try and convince the doctor to give me something to go home with.

So I know that I really can’t do that. I made that mistake back in August, allowing myself a single dose while in the hospital, and it sure did make me want more.

Here’s where I tie in the title: my health is just one more aspect of my life where I just need to take care of business. Sometimes that means going to the ER. Sometimes it means just staying home and resting instead of going out. Sometimes it means doing an extra nebulizer treatment during the day, or changing my exercise routine based on what my body is telling me.

But the point is, I have to take care of business when it comes to my health. It really is not negotiable. There have been a couple days where I’ve let things slide, and there have been a couple days when I really didn’t feel well but I forced myself to do things anyway, which is fine, but there’s a fine line between working through something difficult and not taking care of myself.

I just have to keep in mind that I will suffer the consequences should I be lax on my meds or forget to take my digestive enzymes, or just stay up too late and get up too early. I am coming to learn that almost everything I do has an effect on my body, and it is all I can do to make sense of those many influences (both major, obvious ones and smaller, less noticeable ones) and try to respond accordingly.

What my body tells me right now is that I probably need to eat and take a quick nap before finishing my work.

I can tell my body and my brain are tired, and that is usually the perfect time for me to take a break.

Thanks for reading,

Peace to you,

-Nathan

When The Medical System Really Can’t Fix It….

Tonight’s post is simple. Sometimes western medicine doesn’t have all the answers. My symptoms got worse today and on the advice of my primary pulmonologist and all around good guy, Dr Libby, I went back in to Meridian Park Hospital.

Of course, it being an ER, I had to re-tell the entire story to them, even though Dr Libby went through the hassle of faxing them records (though he was out of the clinic and on rounds at a DIFFERENT hospital at the time).

They always have a hard time treating me, because it is difficult to tell what symptoms relate to what. Whether a cough is just a cough or whether it is something more serious.

Whether stomach pain is just diet/enzyme related or whether it is something more serious.

Whether an infection is just a local one or whether it is systemic.

And most of all, how to effectively treat pain without triggering an addictive response for me.

That frustrates the doctors as much as it frustrates me because when I refuse their pain medication, I take away their front line of defense for making me comfortable. And when I refuse, they usually (at least at this point in my life when I am doing well) argue with me.

These past two times in the ER, I happened to have good ER docs who understood and helped find workarounds for pain that were non-addictive and non-opiates. But it sort of is the “luck of the draw”.

Anyway, I am determined to do the right thing, eat the bland, boring diet I’ve been told to eat, take OTC cold medication as needed, as well as my other meds, and rest. That was basically the conclusion that both ER docs came to. But it wasn’t a waste for me to go in.

I learned a lot about ways I can manage pain, particularly stomach pain, without opiates. There are some anti-seizure drugs that will stop the cramping if there is a blockage. There are, of course, drugs to stop you from going, if that’s what you need. And since really the biggest thing they did for me each day was give me IV fluids, I learned that if I want to feel better I need to hydrate better. Because I did feel better on leaving the hospital both nights. I felt exhausted, but better. I felt much worse when I woke up this morning, but I just let myself work it out, until I was awake and alert enough to drive home.

Now I have about 6 hours to rest before I go to Karate class. And I may end up having to sit out half the class or just sit and watch. But I miss not being there, and, to tell the truth, I just want my effing belt!

I earned it, and because I’ve been sick I haven’t been able to go, and that frustrates me. So a little motivation can be a good thing, I guess. Get me out of bed, off my butt and out doing something even when I don’t feel good. Because I know if I keep that up, I will feel better as long as I keep taking care of myself.

Sorry for the sort of rambling post.

I’m going to nap now.

Thanks for reading, and peace to you,

-Nathan

Exposing “Mr Q”

Well last night my mother and I slept at my Aunt Laura’s. We were a bit worried that we might be imposing because Laura leaves on a trip tomorrow, but she was happy to have us here. We brought over some Thai Food, sat and chatted, watched some of the end of the Olympics, and played a few rounds of Boggle, which looks suspiciously like “Scramble with Friends”.

I had an okay day thanks to the support of my family and my commitment to continue moving forward. But it also helped to have some meds to make my symptoms a little more bearable.

What I am contemplating now is this:

Throughout this process I have been able to draw upon an inner strength that I didn’t even really know existed. Imagine hauling up water out of a previously dry well, and you get some sense of what it has felt like to dredge deep within my soul and pull out resistance and strength I didn’t know I had.

Always, in the past, every single time, when things got tough and the symptoms got worse, I let the addict part of my brain run the show. I delivered myself into his hands begging “please, oh please get us out of this pain!”

This time, however, due to the help of my family and the doctor I saw in the Emmanuel ER, I was able to say, “no”, you can not control me, you can’t make me go back on drugs just because that will temporarily relieve the pain. It is hard, denying myself something I feel I need, that sometimes I even feel like I deserve. The worst part is when your brain decides to get all clever and come up with a really pretty and logical sounding rational for why getting immediate relief from pain while sabatoging progress is not just okay, but is the right thing to do.

All along, my brain has been feeding me lines like

“you shouldn’t be doing this, you did the taper wrong, the withdrawals are worse than they should be, you won’t be able to deal with them, if you want to stay on track, you need to get back on the subutex, cause after all, it was what made your progress possible, not you. No, not you, never you. You could NEVER have done all this stuff without subutex. So obviously you should get back on it so that you can keep moving forward…right? So just call your doctor, tell him you made a mistake, he will work it out with you, you know he will. And your friends and family might not approve but if the understood how much easier this will be for all of them…..

Uh…Wow. My uncle named that voice inside me “Mr Q”. Because it is always questioning, always looking for a loophole, or a way out. Clever as clever can be, but without a shred of dignity or honesty. Mr Q will accept any means to his ends, even if it means hurting those he loves or endangering himself.

Mostly though, when Mr Q talks, what comes out are lies. He is the part of me that lies to myself, that I use to manipulate others…he is the kingpin of all the addictive voices in my head.

And the reality is not that I will ever truly try to be rid  of Mr Q, per se. More that I will be able to hear him, listen, and just observe his voice without getting sucked into it and embodying it. Q’s energy is fearful, distrusting, scheming, conniving, manipulating, lying, hating, angry, and in pain. He curls up in a corner so that no one will see him, and when someone does happen to notice him, he becomes standoffish: “whatchu lookin at? Mind yer own damn business” he snarls. Mr Q doesn’t care about anyone or anything except protecting himself and keeping himself pain free.

So my goal for the next five days: observe my Mr Q, but keep him in check, and mostly, to embody him as little as possible. He must remain in the background for me to do my work.

Thank you to everyone who has been reading this and following my struggle through the past few days. Things are hopefully on the upswing now, and I look forward to posting more tomorrow,

 

Goodnight, and Peace to you,

-Nathan

 

Don’t worry, more about “Mr Q” in the next few posts

Midnight Meltdown and Subsequent Fallout

Yesterday was absolute hell. I was sitting in a tiny ER room from about 2:30am to around 10pm or so. My aunt and uncle were there till the doctor saw me at 6am, and then they went home and eventually my parents came instead.

I didn’t take any opiates, and all they really did was give me some IV fluids and some ativan to settle me down. And it helped a bit.

The problem was that when I started talking to my parents, they both told me that the contract I have had with Richard and Kate for the last several months was now null and void because of my actions. You see, part of the contract said that I, Nathan, will not cheat, steal, or lie. And unfortunately, during the past couple days of weakness, I lied to my aunt and uncle, I stole some of their wine and drank it (which didn’t make me feel any better, by the way) and I also had told them that I had done more work on a set of forms for SSDI than I actually had done. In this way, and because of my hysterical desire to go to the ER last night and keeping them up the entire night, I had voided the contract, which meant when I left that little ER room, I now had no place to go.

Fucking scary right? Right in the middle of detox and all of a sudden someone tells you that you’re homeless.. All I could think of was that I was going to die. I know there is no way I can make it on the street. I have tried that, and I got so sick I had to spend three weeks hardly moving from a hospital bed.

I am blessed to have a family that is firm but not cruel. My parents, aunt and uncle, and my sister and soon to be brother-in-law helped me talk through the whole thing, and then I went upstairs with my sister and they decided what was to be done with me.

It was as nerve wracking as the only time I have been in court. I felt like I was being given a guilty verdict and a sentence without any type of appeal or defense.

But it turned out there were really just trying to figure out how they could best support me over the next few days so that I can make it through this detox process safely (both for me and them).

So after the conversation it was decided that since Richard and Kate had hardly gotten to sleep the day before, someone needed to come over here with me to just be with me and to help distribute meds if needed and just generally stay with me to help me make it through the night.

So my loving mother came and slept in the guest room next to mine, and she put up with the half dozen times that I actually had to come in to her room tell her how crappy I felt, and she let me just sit in the chair by her bedside and talked to me a bit, she even offered to come lay with me in my room and just hold me so that maybe I could settle down and sleep. I can’t believe how blessed I am to have the family that I do. Even Luke, the “newest” member of the family told me yesterday to call him for any reason and he would do whatever he could to help me.

There were still times throughout last night where my body and mind wholly wanted me to believe that I couldn’t do this. But I just kept asking for my mom’s support when I needed it, and as a last resort I took an ativan to help call down my raging muscles and my spinning mind. With all of that assistance I made it through the night.

Now, the challenge is to make it through today.

It is nine am right now. So right now my goal is to make it till noon. If I can do that, then I am on my way. After noon, my goal might just be to get to 1pm. So much of this process is just being able to rethink what is happening. If the thought in your mind is that, “oh god I might feel this way for 5 more days and I can’t sleep and I can’t eat, and I can’t relax and I just can’t even do this for five more minutes, much less 5 days…”  well, of course you won’t be able to handle it.

So now after hours having past  – it is 10:30pm at this moment – I can see that despite all the doubtful moments I had today, I made it through. Even though I was still having thoughts all day long telling me that I can’t do this, trying to get me to scheme to get drugs, I did m best to just notice them, not judge them, and let them go. Ok, so this voice in my head says, “you can’t take this, go get drugs”, and I respond, “oh I hear you, but that isn’t the direction we are going right now.

As I explained in this meeting with my family today: the question I need to ask myself for the next few days is this: am I the King or am I the King’s Horse? In other words, who is riding whom? When I start to freak out and lose control, and when I fully believe I will fail and there is no chance for me to succeed, then the horse is riding me. I think this horse that has been riding me for the last few years has left me not feeling much a king at all. He has left me feeling like the lowest of the low. But I am fighting back against him. And I am not doing it alone. My family and friends are there to say, “hey Nathan, watch out, who is riding how at this moment?”

I want to take a quote from

Florence + The Machine (a lovely British band) from her song “Shake it Out:”

“I keep dragging that horse around

Our love is pastured

Such a mournful sound

Tonight I’m gonna bury that horse in the ground”

I feel like I have been this horse around on my back for five years, listening to it, and doing what it told me, so that it truly became the king and I became the horse. But now, I’ve thrown him off, and I am dragging him around by his ankles and he is moaning, quite loudly the he needs help and the I can’t do without him. But tonight, I will bury him so far down out of reach that he won’t ever ride me again.

That may be an ambitions statement, but I find that sometimes the more ambitious a statement I make (therefore the less likely others will take it seriously) the more often I want to stick to it, sometimes just to spite all the doubters, sometimes merely to prove to myself that I can.

Thank you for all bearing with me throught these last few days of sporadic posting.

Things should level back out again in a few days once my system is back to normal and I am no longer bouncing around from house to house.

Peace to you,

Nathan Howells