Tag Archives: medicine

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

Perhaps That Was Too Brash?

 

First, off, I want to apologize for the bluntness of my previous post. I don’t often do this. But I didn’t think through the fact that the information I was sharing hadn’t actually been disseminated throughout my close friends and family yet, and that it might be not only shocking, but that it might feel like a betrayal to read something so important online rather than hear it from my own lips.

 

 

I guess the fact remains that I am braver in print than I am in person. I’m often willing to admit a lot of things here in my blog that are difficult for me to talk about in person, especially with family. You see, for them, it isn’t just an academic exercise, and I can’t pretend it to be. They care about me, and their emotions justifiably get entangled and so when I post something on my blog that is controversial or shows me in what they perceive to be a negative light or whatnot, it is easy for some people closest to me to take things personally.

 

 

I just want to apologize because I didn’t take that into consideration with my last post. I was attempting to be honest about my experience and I knew that if I just ignored the “green” elephant in the room I would end up just never talking about it in my posts.

 

 

But I am serious about wanting my blog to be an accurate and honest reflection of my experience. Of course, it will always be my experience, which means it may not always coincide with the experience of others, even when the same events are involved. I think there is some universal moral truth, but for the most part, I think that what is true often gets muddled in the eye of the beholder. I know that my perception of what other people say and do is always, ALWAYS colored by my prior experience of those people, of their actions, their relationship to me, the time of day, how I’m feeling, and a host of other things, up to and including things like the weather.

 

 

But I want to do my best to describe my experience accurately, and to tell the truth as best I can as I have experienced it. I am, of course, always open to comments. But if your experience and mine don’t match, there’s no need to get angry. We just have to find the commonalities in our mutual experiences – they are always there.

 

 

Anyway, I may have erred in posting about the medical marijuana issue so quickly after my return home from the hospital. It just seemed important, and I knew that if I made it OK to skirt around it, I might never actually post about it, and that would have felt like lying to all of you.

 

 

So, that’s the first part of my apology.

 

 

The second part is that I think I made the assumption that those who were reading my blog at this point either already knew about the medical marijuana or were a part of my generation who are more used to such things. But in my haste to be honest, I hurt some people’s feelings, and I think, gave them the wrong idea entirely about my desire to use/not use substances as a medication.

 

 

So to finish, I’d like to make a couple things abundantly clear:

 

 

First – I am NOT using marijuana recreationally. Not at all. I am not looking for a “high”, or to “get fucked up”, or whatever you want to call it. I don’t want to completely numb myself out, the way I used to while using opiates. I want a legitimate medical option to treat the chronic (but intermittent) joint pain and headaches caused by my CF while also helping to treat my anxiety/panic attacks and improving my appetite while decreasing my nausea. I obtained my medical card for exactly this condition and these symptoms. And I want to re-iterate something here: my pulmonologist, (I won’t name him here cause if I were him, I wouldn’t want these words online attached to my name if I was a physician) who actually recommended medical marijuana use to me as a viable option and signed all the paperwork allowing me to get the card, told me very clearly, “Nathan, I would rather have you smoke two whole joints a couple times a day, every single day, than to continue to do what you’ve been doing, constantly going on and off narcotics and taking anxiety meds that are also dependence forming. I think that possibly medical marijuana could be a really helpful option for you. I have had several patients in similar circumstances to yours who have tried it and who had a lot of good things to say.”

 

 

Now, this doctor is no yahoo. He’s in his sixties, he has numerous accolades, and published papers. He has practiced privately at the Oregon Clinic and publicly in the Providence Medical Group hospital system for years. And he has known me for years, and knows my history and my health condition intimately. He has shown me a lot of compassion over the last couple years. I haven’t been the best patient. So I was actually pretty shocked at his thought process when it came to cannabis.

 

 

Anyway, I have had the paperwork done and the medical card in my wallet since early November 2012. I tried it out a couple times back then, but it was very difficult to find a correct strain and dosage, and it cost money, and I was already getting sick, and didn’t want to make it worse, so I didn’t try it systematically the way I am doing this time. I also didn’t have any oversight or supervision.

 

 

This time, since I am still living with my parents, I’ve asked them to speak up right away if they find my behavior to be weird or if I seem “stoned”. Because I don’t want a medication with side effects that will make me unable to function. Opiates do that to me. So, to a certain extent, do benzodiazepines. But in correct dosage and when I use the proper strains for the proper effect, it seems possible that cannabis may provide some occasional relief with a lower side effect profile and no chance of physical dependence.

 

 

And yes, I’m aware psychological dependence is a real thing. I know what it is like to be addicted to something psychologically, to the point that I’ve done stupid things. That is why I am making sure to be open about what my experience with cannabis as a medicine is/was/will be. I also want to point out that this is one small part of my new Wellness Quest 2.0. But it is by NO means the focus.

 

 

I got some criticism last night which I felt was perhaps invalid, but regardless, it deserves mentioning. A close family member told me that in reading my last blog post he/she felt like I was just trying to find another substance to be addicted to and that nothing had changed and that I wasn’t going to follow through on any of my commitments because all I cared about was myself and getting drugs.

 

A couple of photos to illustrate my options:

Medicine Drug Pills on Plate

Medicine Drug Pills on Plate (Photo credit: epSos.de)

English: Organic cannabis Indica purchased fro...

English: Organic cannabis Indica purchased from a Medical Cannabis dispensary per California Proposition 215/Amendment #420/ Health and Safety code 11362.5 and 11362.7 (Photo credit: Wikipedia)

 

 

 

 

 

 

 

 

 

 

This?                                                                          Or This?

I can see how his/her opinion could be lead there, especially after the difficulty of the past couple months. I won’t make excuses, but it did feel like going back several steps. Taking narcotics (legitimately or not) messes with my motivation and with my brain and my ability to examine reality in a dispassionate way. Combine that with being sick and dealing with pain, anxiety and lack of sleep…It has been disappointing. November through January have shown me that I wasn’t perhaps as strong as I thought I was.

 

 

They have also shown me that even when I do everything in my power to maintain my health, it is still possible for me to get sick. That means I have to push myself, work myself back to “full strength”, in a timely manner, and that I must be extremely diligent about my CF treatments to make sure that when I DO get sick (because it is, in fact, a “when”, not an “if”) it doesn’t get as bad and if I keep up with it and monitor it, there’s a good chance I get get to any infection before it gets out of control and, for lack of a better phrase: “nip it in the bud”.

 

 

But still, after having reach such peak condition for myself near the end of September, it has been very disappointing to me to realize that even when I am in the absolute peak condition possible for my body, it can still betray me.

 

 

But I am trying to come to grips with that.

 

 

So please, if you can, take the cannabis factor into account as one single option. There are many others, including treatment that doesn’t include anything for pain or for my mental health issues. I have to talk to a professional about my mental health, because these last couple months have been painful, and the last five years have been devastating, and if I’m honest with myself I need a psychiatrist, sure, but I also really need a therapist who will just work with me on how to move past this history I have with drugs and help me understand my reaction to cannabis and advise me professionally as to whether or not it is possible for me to use any substance for pain/anxiety relief without becoming dependent.

 

 

But one thing is sure. For all of you out there questioning my decision here, I want you to know that I question it as much as you do. Even as I have gone about attempting to try it, I am constantly questioning: “is this the right thing? is this working? is this giving me a feeling I want, or is it just making me feel sluggish or out of it? is this going to make me want to use other drugs? how do I feel, right now, and why do I feel like I need to modify or change how I am feeling mentally/physically at the moment?” And those are just a few questions running through my head that I thought I’d share with you.

 

 

While I am pretty certain that while in and of itself, cannabis is not harmful to me, I am not yet certain about whether it can be used as a viable medical option for me.

 

 

Just like I wasn’t sure about Tai Chi at first, or about my diet affecting my health, or about many of the suggestions made by my aunt and uncle at the start of Wellness Quest 1.0. While I am making up some of the new experiments myself this time, the idea is the same: to promote Optimum Wellness – mind, body, and spirit, while using an absolute minimum of unnatural substances in my body.

 

 

One other option I want to mention right now as it may actually be more promising than the cannabis idea is the option of bio-feedback. A physical therapist came to visit me in the hospital this last time and gave me a huge packet of information on how pain works (not a revelation to me, but still, nice of her). If I enroll in a a two part workshop that helps education patients with chronic illnesses about pain and how to deal with it it sans pharmaceuticals, I will be able to make an appointment at their specialty rehab/physical therapy/pain management clinic where they have true bio-feedback machines.

 

 

Bio-feedback is simply a way of giving you a way of visually seeing the way your brain waves are reacting to stimulus and giving you the opportunity to learn to modulate them to do all kinds of things. Once really trained in biofeedback, a user should be able to calm his/her heartbeat, quiet pain throughout the body, focus and engage more effectively, and stop a panic attack in its tracks. It is being used experimentally to treat chronic pain, ADHD, Anxiety disorders, and even being used for athletes, to train them how to get their brain into that state we would call “The Zone” where the body and mind function as one unit. Because studies show that if an athlete can practice “The Zone” in a lab or even at home in bed, it is the same experience to his/her brain as experiencing “The Zone” in an actual competitive situation.

 

 

So needless to say, I am pretty excited to try this out. I know it will take quite a bit of work on my part, but if I can truly learn to train my brain, it should greatly enrich my life and allow me to take advantage of opportunities that have been out of my reach for a long time.

 

 

Thanks for reading this long post.

 

 

I don’t often refer to previous posts, nor do I usually offer apologies or disclaimers. But my blog isn’t about being inconsiderate or just writing whatever the hell I want. I can’t claim journalistic license. I simply didn’t think about the consequences of what I was writing – I didn’t consider how others might feel or react to an issue that could easily seem huge, when to me, it seems a piddly little thing. Perhaps that is denial on my part, or minimization. But I know that the less energy I put into it, the less I’ll be disappointed if it doesn’t work, and frankly I am skeptical. So I just haven’t given it a lot of attention aside from some research and some conversations with “experts”.

 

 

Anyhow.

 

 

If you have questions about this or the bio-feedback idea, email or leave me a comment.

 

 

But unless there is an important event or change, I probably won’t write another post about this for a while. As I said before, this is one small part of my revised quest for optimal wellness, and it may not even work out in the long run. I am just happy to be writing again, and grateful to be home and to have a vehicle and to have a supportive family and doctors who continue to encourage me to do what is best for my health.

 

 

Peace to you all,

 

 

-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

What I Need

Alright, so this is going to be another post that has some brutal honesty in it. I’m not going to like it, chances are if you know me, you might not like it much either. But really, if I let the image I want to create supersede truth, then I will lose all credibility with myself, and eventually, with you.

So here it goes:

As many of you know I’d been given a prescription for some benzodiazepines (clonazepam – brand name Klonopin) for the anxiety and muscle spasms caused by my withdrawal from the Subtuex.

I would like to divert here by talking about how often doctors prescribe a different drug to manage symptoms caused by another….but that’s not the focus of this post, so I’ll get to that another time.

What I want to talk about today is my “need” for pills. I’ve been curious for a long time what it actually is inside of me that makes me think I actually need some sort of pill to change the way my brain is working chemically. After all, I made it till 18 years old without ever drinking a drop of alcohol or smoking marijuana or doing any sort of drugs at all except my legitimate CF treatments. At one point (at 15) I did go on Ritalin for ADHD but I found that all it did was make me lethargic, and make it impossible for me to focus on more than one thing at a time. In short, I took it for about a month then stopped.

The point is, I know that although I may not have been totally healthy and I ignored quite a lot of mental health symptoms (e.g. depression, anxiety, etc) I was able to manage my life okay without the influence of a pill to take away pain or calm me down.

A lot of people may hate me for saying this, but I think I opened the door for myself with alcohol and marijuana.

I don’t see those substances as being “bad” in and of themselves. However, they, just like anything else, can be used and abused illicitly and end up turning into something they were never meant for. For example, marijuana was originally used by workers in the fields to calm their weary muscles and help them relax after a long day of hard physical labor. (Or at least, as far back as we really know – plants of the cannabis family have been cultivated for thousands of years, and their medicinal use has probably been understood and utilized at least as long)

Alcohol, too, arose from the general human need to deal with pain and to relax after labor.

However, that human desire can all to quickly turn a substance with a legitimate medical use into a drug of addiction and dependence.

Look at the opium poppy. From this innocent and very beautiful flower, some person lost in the mists of ancient history discovered that he could dull the pain of soldiers on the battlefield. Some of the earliest recorded usage of the gum harvested from poppies come from the annals of Alexander the Great. You see, he realized that the morale of his men was much improved when their injured comrades were not screaming all night long. And since someone had figured out that the poppy could induce sleep and pain relief, he began to have his battle surgeons administer it to the injured.

Even before that, the poppy was cultivated in ancient Egypt, used in ancient Ayurvedic practice in India, and grown in China. But it was used by medical professionals in isolated situations, and because the technology did not yet exist, it remained useful rather than harmful.

Then came the industrial age, modern chemistry, and morphine. Named for Morpheus, the god of dreams, morphine was much stronger than any previous tincture or distillation of opium. Although there were many opium addicts prior to the advent of morphine, morphine was different. It could be injected directly into the veins, in a way opium could not. It also “edited out” many of the chemical compounds in opium that caused numerous side effects. It was, by many medical professionals, considered to be a panacea.

But then C. R. Alder Wright had synthesized another compound in 1874 – diacetylmorphine – more commonly known as Heroin. And the world had a new cure-all. It went into everything from cough syrup to headache remedies to food and drink products.

In fact, they even thought at one point that heroin could be used to cure morphine addiction! What a thought. Instead they ended up with a bunch of people even MORE addicted to heroin than they had been to morphine.

And there ends my diversion into the history of man’s problematic relationship with poppy derivatives. Obviously there are many more types of what are now known as synthetic “opiods” meaning anything synthesized to mimic the way the natural opiate compounds (morphine, codeine and thebaine being the primary three natural substances found in the opiate poppy) work in the brain.

All of this research, chemical study, and clinical use has had one primary purpose: to help relieve pain.

And I don’t think a single one of us would argue that there is something wrong with that goal. The issue has consistently been that while these types of substances work incredibly well to deal with pain, they also cause a host of other effects that are not intended, including a level of dependence that is at least alarming, if not downright terrifying.

If you have ever had to take prescription pain medication for an extended period of time and then had to try to stop, addicted or not, your body does not like it. Your body, for lack of a better expression, gets angry. It tells you, “what the hell man! You’ve been putting this substance into me and so I’ve adjusted, and now you STOP?! Either you keep using that substance or I am going to flip your world upside down!”

But there is something deeper than mere physical dependence for those of us who truly become addicted.

I finished my prescription for the clonazepam yesterday. It would have run out much sooner, except that I kept myself to half of what the prescription actually said I could take.

But I probably would not have been able to do that without the help of my aunt and uncle who held onto the medication for me and just gave me the 3 pills a day that I had decided I “needed” to get through the last part of my withdrawal from subutex.

And yet here it is, I’ve stopped. The withdrawal process (at least the acute portion) is totally over. But something inside me still says, “you need to take a pill today. Right now, actually. You aren’t right without something to change what’s going on in your brain.”

It says: “You are too anxious, too active, you can’t focus, you are in pain…pill, pill, pill, pill, pill!!!”

But at the moment, as I sit here writing, I can analyze my body dispassionately (as much as that is possible for any human being). And I can see that the pain I feel is manageable. The anxiety I feel is manageable. The hyperactivity I feel is just causing me to write this faster. I am easily able to focus, and I don’t feel one bit depressed.

So what the hell do I want to take a pill for? This is why I know the motivation for altering my mental state is coming from somewhere other than just my body. Yeah, people talk a lot about “psychological dependence” but they don’t really make much effort to define or understand it, in my opinion.

While there are many therapy approaches to help deal with this issue, my approach, at the moment is to just continue on my journey and keep myself accountable to my friends and to all of you.

I’m done with pills to make me “feel better”. And yes, I recognize that in certain situations I may have no choice (if I was in a severe car accident or something crazy like that). But except for in some sort of dire emergency, I am choosing to use other methods to change how I feel, whether it be exercise, meditation, or even just getting on the web to interact with some of you about how I feel.

So yes. As I write this, I wish I had one of my “anxiety pills” to take to “calm me down”. But I don’t. And even if I did, the reality is that I don’t need one.

Remember one of my first posts: When Have I Done Enough? In it I examined that idea of “enough-ness”, and here it is again. What I know now is that what I have, who I am, and what I am doing, right now – in this moment – is enough.

And that, my friends and fellow wellness questers, will be my mantra for the next decade, probably:

“What I have is sufficient – I need nothing more than what I have”

-Nathan

Laughter – Yes, it’s Good for You

So the last few days…ok, in reality almost every post I’ve made so far has been pretty serious. Tonight I have a more lighthearted topic: laughter.

I think anyone who has struggled with illness, mental health issues, or addiction will remember pretty clearly the point in their recovery when they were first able to truly laugh again. One thing about being sick, depressed, or addicted (and many other things, or, as in my case, all of those together) is that it becomes very difficult to laugh. You may fake a laugh or give a little false chuckle. But a really deep, body shaking, soul lifting, cheek straining laugh….that just doesn’t happen.

You’ve all heard the saying, “laughter is the best medicine”. Whoever first spoke those words was more right than they knew. Because studies have shown that laughter really is medicine. It touches a part of our brains that is older and deeper than conscious thought. We don’t really know why laughter developed. But we know it is good for us. Here’s a quote from a Psychology Today article (Click here to link to the full article):

“Laughter, it’s said, is the best medicine. And there’s lots of evidence that laughter does lots of good things for us.

It reduces pain and allows us to tolerate discomfort.

It reduces blood sugar levels, increasing glucose tolerance in diabetics and non-diabetics alike.

It improves your job performance, especially if your work depends on creativity and solving complex problems. Its role in intimate relationships is vastly underestimated and it really is the glue of good marriages. It synchronizes the brains of speaker and listener so that they are emotionally attuned.

Laughter establishes — or restores — a positive emotional climate and a sense of connection between two people, In fact, some researchers believe that the major function of laughter is to bring people together. And all the health benefits of laughter may simply result from the social support that laughter stimulates.

New evidence shows that laughter helps your blood vessels function better. It acts on the inner lining of blood vessels, called the endothelium, causing vessels to relax and expand, increasing blood flow. In other words, it’s good for your heart and brain, two organs that require the steady flow of oxygen carried in the blood.”

Wow. If only coffee did all that for us! Coffee you can make with coffee beans and water. Laughter can’t be poured into your cup from a French Press. It can’t be grown on a tree and cultivated. In my opinion, laughter is one of the most purely spontaneous human experiences. You can’t force true laughter. No matter how “funny” something might be, it doesn’t always make you laugh. In addition to being spontaneous, laughter is also a communal experience. Think about it. When was the last time you were sitting by yourself, watching a silly movie, and you laughed out loud? Doesn’t happen too often does it? (this is one of the reasons the internet slang LOL irritates me…but don’t let me get off track..) On the other hand, watching that same movie three days later with your best friend, you both burst out laughing. Strange isn’t it? I don’t think so. I think that the nature of laughter is to produce and deepen the communal bond between members of our human species. Check out the quote from Psychology Today again. See where it talks about laughter being the “glue of successful marriages”? That is because it stimulates production of hormones and neurochemicals that promote bonding, trust, and pleasure.

In my own experience, I know that many of the women I have dated made me laugh early on in our relationship. Something they did or said made me burst out into the strange physical and vocal act we call laughter. And after that, I felt a greater connection to them.

Think about your best friends. They are your friends for a lot of reasons, I’m sure, but one thing that I am certain of (without knowing you or them) is that there have been times in your friendship, and probably more than a few, when you have laughed together. At a movie, at a comedy show, at a television show, at a joke you told or at something odd one of you did…it doesn’t matter why. What matters is that you laughed. And through that laughter your brain and body became more connected to that of your friend, and he/she to you.

Ok, enough science/philosophy stuff.

I was prompted to write about laughter tonight because my aunt, uncle and I were sitting watching a new ABC show called “Trust Us With Your Life”. The premise of the show is that improvisational comedians act out scenes from the lives of famous people who come on the show as guests. Tonight we had Serena Williams first, then Jack and Kelly Osborne. Several of the improv artists used to be on Whose Line Is It Anyway, including Wayne Brady (yeah, he’s taken a lot of flak lately, but I still think he’s a great improv comedian). What really cracked us up, however, was a bit where the actors are filmed from above, while doing the scene lying down on the ground. So the floor becomes the rear wall. It might not make sense with me explaining that way. So try and imagine this: you get up from wherever you are sitting and lay down on the ground. Lay on your side, with your feet straight and your arms out in front of you. Now, imagine that someone on the ceiling has a camera and is filming you straight down. Imagine there is a white line the runs beneath your feet that symbolizes the floor, and the floor on which you are lying is the wall. Let me just tell you, it is hysterical when you actually see it done. The actors were acting out a tennis game with Serena vs. some unknown Russian opponent with a grumpy umpire. They had tennis rackets and tennis balls. At the very beginning, the “Russian player” tossed the ball up to serve, but to do that he had to literally roll the ball across the floor in the direction that was now “up”. But he rolled it too hard so it disappeared off-screen. And the reaction and expression of the “tennis players” was so hilarious that my aunt, uncle and I could barely stop laughing through the rest of the skit.

I have read a lot about why we find things funny. Out of all the things I have read, the one that I think makes the most sense is the idea that it is the surprise, or the unexpected, that is funny to most people. Of course, different cultures and age groups and socioeconomic classes have different “senses of humor”. But one thing that seems to stay the same regardless of where you are or who you are is that a novel or unanticipated twist is funny. Sometimes, things are funny vicariously. For example, dramatic irony. When the audience knows something is going to happen to a character but the character doesn’t. The audience laughs because they are anticipating the surprise of the character onscreen. Inhabiting the surprise of someone else is apparently just as funny as being surprised yourself.

But the question I find myself asking tonight is this: what does this stuff about laughter say about the experience of being human? And furthermore, what does this information about laughter say about the experience of being me?

I don’t have a concrete answer for you (or for myself) yet. What I do know is that I love to laugh, and that I can feel the power of a really good laugh deep inside my body and my spirit. People tell jokes sometimes to “lighten the mood” or to “ease the tension” because true laughter does just that: it lightens the energy within us, it forces our bodies to tense, but to ultimately relax. It makes people feel more connected to one another. And that lightening, that relaxing, and that connecting…they are vital components of a healthy life.

I challenge you to a contest: post the funniest joke, video, link or whatever on the comment section of this post. The one that is the funniest (according to some relatively impartial judging method which I will develop later) will win a prize (which I will also decide on at a later date).

Thank you for reading, and thank you, in advance, for your funny comments. I’m sure they will provoke much laughter, and we will all be that much healthier because of it.

Goodnight, and happy laughing,

-Nathan

I Am the Perfect System

I had a great conversation with my uncle today while in the car on the way to my appointment at the social security office. He told me that most performance errors are not the fault of any individual; they are the fault of the system. He told me a story that he had heard: It seemed that a small post office was having a major problem with misfiled letters. They identified a single employee who appeared to be at fault. Almost all of the misfile mistakes happened during her shifts. So what was the post office to do? (this is where you chime in and say, “well fire the woman, duh!”) It seems logical that if this employee is the cause of the problem, you ought to fire her and be done with it, right…?

However, the people in this postal service were smart. They decided to investigate further. It was learned, after an inspection of the office, that the labels on the bins into which the mail was filed were the problem. The bins were labeled in such a way that the ones on the top level were completely readable….as long as you were over a certain height. However, anyone shorter than that would be completely unable to read any of the bins on the upper level. Guess who the only employee in the office shorter than that critical height was? Yeah, of course. The woman who was causing the problem.

She wasn’t failing the system. The system failed her. The post office re-labeled the bins and the problem went away. A much simpler, cheaper solution than firing an experienced employee and hiring someone else and training them to replace her.

My uncle brought this up in conversation about what I dealt with at the pharmacy yesterday. He thought there might be some sort of systemic failure in the pharmacy that was causing all the problems I’d been experiencing there. (if you haven’t read my last post How to Harmonize, take a look – I describe my pharmacy problems in detail there)

But his story got me thinking along a whole different track. If I think about myself: body, mind, and spirit – my whole being…. if I think about me as a system, how does this idea of systemic failure apply?

Because I am a system. I am a network of interlocking cells made up of molecules made up of atoms made up of subatomic particles made up of (theoretically) vibrating strings of energy. I am a system of firing neurons, chemical changes, hormonal balance and imbalance, spiritual light and darkness – I am energy in all its forms woven together to create a being that is much more than the mere fabric of my body. I am a system of grace and beauty. I am not cobbled together from spare parts that the universe has discarded – no, I am made of the same stuff that is all around me, yet the creative life force designed me with infinite care, giving me self-awareness, intelligence, and a small part of  itself: the ability to create and to destroy.

While systems created by us, by humans, who are, ourselves, a product of the universal creative life energy, are always destined to have failures from time to time, I think that nothing about me is a failure.

I am, always have been, and always will be a system of perfect design.

I’m not saying that I don’t make mistakes, cause I sure as hell make them all the time. But I don’t think I am a mistake. I firmly believe that I am here on this earth in this form at this time for a damn good reason. I don’t know what that is yet, but perhaps the more that I open myself and all parts of my “system” to the world around me…well, perhaps I will begin to learn what role I play in the enormous system of this fantastic universe.

What do you think? Who are you, what are you, and what part are you playing in our cosmic theater?

I’d love to hear some responses. It doesn’t matter if what you think is that I’m full of sh%&. I’m still interested to know what your story is.

 

-Nathan

How to Harmonize

Today was, quite frankly, exhausting. I woke early for an appointment with my Pulmonologist (for those of you unfamiliar with the medical lingo, that’s a lung doctor) and found myself having to rush, something that often throws my morning off. The appointment went well, but afterwards I found myself having to deal with a pharmacy fiasco (more about that later). Then, another appointment with a Naturopath, after  which I was planning on dinner with my aunt Sharon and uncle Chris, but after assessing my mood and energy levels I realized that I just wasn’t up to going out. We rescheduled. I could have dropped to sleep in my chair at 6pm.

All of you who have  been following along with  me regularly can tell that this day has had a much busier schedule than most of the past week. I had been wondering how I would deal with the increased stress that comes with a fuller schedule. Today I saw that I am woefully unprepared to deal with stress when it appears in my life.

The Naturopath said a lot of things that weren’t new to me in the least. However, he did have a couple “diamonds in the rough” so to speak. One of these insightful gems was his intent to “reduce stress on the body by whatever means possible”. He stated that our bodies have a default response to  stress: we reduce damaging and inflammatory hormones and chemicals. So while treating the symptom or even the cause of some diseases through  western medicine is important, treating  the whole body by reducing stress is even more important.

And I ran into a highly  stressful situation today that showed me just how unprepared I am, just how out of practice I have become at handling the little twists and turns that life throws my way. Yeah,  this is the “pharmacy fiasco” I mentioned earlier.

I won’t go into detail, because that could take me thousands of words just to explain a single phone conversation during this experience, and it took 3 phone calls and 3 in person visits to the pharmacy for me to get everything straightened out.

To simplify, lets just say there was a medication that I must take daily. It is critical to my success at this early stage of recovery and in this early phase of my wellness quest. My Pulmonologist was able to write a prescription for me today but  when I tried to fill it, the gremlins in the insurance system struck. I spent one phone call with a pharmacist who literally contradicted herself every 10 seconds, being told “we can only fill part of your prescription,” then “oh, actually we are out of that medication,” to finally, “well the computer says we have some, but I can’t find the bottle.” !!!!

You know what the response in my head was, right? It went something like this: Really?! You can’t find the effing bottle? Your other pharmacist special ordered it for me and told me this morning, four hours ago, that he had plenty to fill my full prescription and now you say you have none? Oh wait, not that you don’t have any, but that you just can’t find any…Well, miss lazy arse, why don’t you get off your butt and go figure out where it is at? Or is it an acceptable situation in your pharmacy for drugs to just go missing?

and on and on and on, ad infinitum. Fortunately for both her and I, my “try not to be mean to people” filter was still functioning, so my reply to her ridiculous waffling was to just say, “I’m sorry, I don’t understand.”

Again, fortunately for us all, my aunt suggested we just drop  by again. Once we were there, standing in front of her, the pharmacist searched again for the medication. Guess what? It was sitting in a tray on the counter directly in front of her face the whole time she was on the phone with me.

Here’s my dilemma. And I think this is relevant to everyone because god knows we all deal with ineptitude from time to time. Both with others and ourselves. So here it is: how do I deal with a situation that seems to need me to take control and push things if I want them to work out in my favor without going overboard and collapsing in a fit of panic when it seems like a situation is headed for disaster?

I want two things: to put in the effort needed to ensure that my immediate needs are taken care of, and to not try and force my way on the universe around me. Sometimes these two things seem absolutely irreconcilable. Today was one of those times.

I knew that I had no choice but to follow up, to keep calling,  to question, to insist, and essentially to  make a hassle of myself until they took action and did what needed to be done. However, doing all that was required made me want to cuss  out a generally well meaning pharmacist. I was so rattled by the end of it that I  could hardly sit still during my appointment with the Naturopath – I kept pacing,  I had to keep the door open because I felt a jolt of extreme claustrophobic panic (something I haven’t felt since I was released from the hospital), and I could barely listen to what the doctor was saying.

So I have got to find a way to do what needs to be done while still retaining some inner calm and  harmony. How do I stay harmonized when the world around me is NOT harmonious? How do I transfer the idea of flow that I am learning in my Tai Chi practice toward the rest of my life?

Would that I knew the answer.

I’ll leave you with one of my favorite phrases from the AA/NA program: “progress, not perfection.”

Although I don’t know quite how to achieve an inner calm when the world around  me is in turmoil, I suspect that by the end of this month I will have made some progress.

Goodnight,

-Nathan