Another day, another group

There are few things I like less than talking about myself. I don't know why. That's just the way I've always been. I suppose it's very selfish of me, because I generally enjoy asking people about their own lives; there just doesn't seem to be much about me that I find interesting enough to share I guess.

Imagine then, if you can, a person such as myself spending 10 hours a week in one group therapy session or another. This is what I face for the next 9 weeks, not counting tomorrow. In addition to the brain-injury group I've been in for over a dozen years (1 hour a week), I am now committed to three more substance/alcohol rehab groups, at 3 hours a pop.

I have already been to two sessions of the new group. The people seem very nice, welcoming, supportive. The woman running the group, a matronly woman named Patricia, is likewise quite nice, but her method (and I was told of this ahead of time) is quite a change from what I'm used to. The brain-injury group is a pretty informal deal. Group members assemble in a neuropsychiatrist's office, which has a large sofa, a couple of soft leather chairs, and a few other fairly large chairs. One person strikes up a conversation -- it could be about brain injury or baseball or cars -- and after a while the neuropsych, Alec, picks up on a relevant point raised in the conversation.

In this new group, Patricia decides on the topic. For the two sessions I've attended, the topic has been "boundaries." Whenever the discussion has taken a detour (i.e. something we actually want to talk about) Patricia eventually brings it back to the main topic. I find it all a bit stilted. Maybe it's the fairly vague nature of this particular topic. Hopefully next week's topic will be more interesting.

Strange dream song

I rarely sleep, therefore rarely dream, but maybe this new drug (Seroquel) is helping because I had a weird dream in which a fellow played this song. Except he played it much better. I don't think I've touched a guitar in a year for reasons I can't explain, but the result is the terrible technique displayed here. I used to be a lot better, like in my teens and 20s when I played almost fanatically.
In the dream, this mysterious fellow also sang along with this tune, an Indian raga or maybe Hebrew deal. I don't remember. I'm lucky to have remembered this much.

Rehab Day 1: The Interview (cont.)

So Jennifer and I head to a small office more or less behind the receptionist area, where a copy machine is making an eerie wheezing sound each time it is used. I take one seat, Jennifer takes the other and proceeds to explain the purpose of the program and, wait for it, asks me another hundred questions I've already answered in part or in full somewhere else. She is pleasant about it, and even offers to turn out the brutal overhead lights in favor of a table lamp. But the questions are so tedious -- and frankly pointless -- that I feel myself on the verge of either bolting out the door or putting a nearby pencil through my eyeball. Do I own a gun? What if I did? Is there any family history of substance abuse? My mother had six brothers and two sisters; I have a dozen or more first cousins, many of whom I've never met, hardly any of whom I know well enough to answer such a question. Finally I tell her I've had it with the Q and A.

"Let's take a break," she says, sensing my discomfiture. I gratefully accept the invitation. Five minutes and a couple cups of water from the front cooler later we resume. I confront Jennifer about the state prescription database document that the receptionist told me I just had to sign in order to participate in the program. "Well," she says, haltingly, "it means that if you're seen by our doctor and he needs to see your records, he has permission to do so." The tone of Jennifer's voice tells me even she isn't sold herself. "I don't think that will apply in your case." I tell her that the thing is so badly written that there's no way a poor schlub like me would interpret the verbiage in that manner. Jennifer nods her head. "You're right. It's very poorly worded. If you're really uncomfortable with it, would you like me to shred it?" The thought had never occurred to me; but now I'm really curious. Why would she just fold like that? "How can I know if I want to shred it if I don't know, and you don't even know, what it is I'm signing?" I get up and walk over to her as she holds the now-discredited document and even try to suggest alternate language. In the end, we agree to leave the thing in. I've made my point.

Jennifer is finally done querying me at about 10:45. She hands me a packet of stuff about the program and her card, which has several hand-printed corrections. The phone system is being serviced somehow, she tells me, which is why she doesn't care how long this interview lasts, because as soon as I leave she will have to attend to her own voicemail or something. This is fine with me -- I have nowhere to be for several hours, and I have questions for her too.

First, I ask what the recidivism rate, or dropout rate, or failure rate, whatever they call it, is of the CATS program. Jennifer doesn't pussyfoot around: about 50 percent don't complete the 10-week program for one reason or another (relapse, successful legal appeal, insurance trouble, etc.) Do those who relapse get kicked out? Not necessarily, she says. The program has a more intensive one-month inpatient option, one I was presented with and rejected, and those who fall off the wagon may end up there. I ask about the groups, which last for 10 weeks and are held 3 times per week. They last 3 hours (!), but Jennifer quickly adds that there's always a half-hour break in the middle. Still, compared to the weekly brain-injury group I've attended for the last dozen years, which lasts just an hour, this seems like boot camp. On the other hand, I once had to ride a small bus with no suspension an hour each way to an outpatient brain-injury rehab program, and that was all day, 4 days a week. So everything is relative, I suppose.

Jennifer and I have talked ourselves out. It is 11:45. Nearly 3 hours I've spent, about as long as the group sessions. I'm hungry, tired and my head hurts, more than usual but less that I was expecting. I leave Jennifer to her voice-mail duties and agree to appear for the first group session tomorrow evening at 5:45.

Rehab Day 1: The Interview

It's cold and raining and Monday, and I have to get up early for my admittance interview at a local hospital "intensive outpatient program" for people with drug and/or alcohol issues. The hospital is only a few miles away, but it's rush hour and traffic on and around the DC Beltway is never pleasant. I have a 9 a.m. appointment, but have been told to arrive 20 minutes in advance to do the inevitable paperwork.

As usual, I can't sleep, so I wind up leaving home around 7:45, figuring I can stop at a McDonald's on the way  for coffee and a biscuit, and read the paper for a while, because I know this upcoming appointment is going to be a bitch. "Paperwork" always means filling out forms that ask questions you've already answered and given to somebody else, but their own system is too inefficient or their own personnel are too lazy or stupid to find the data, so it's just easier to make me provide it all over again. My labor is free after all.

So I get my coffee and biscuit and dawdle over the paper as long as I can stand the light and noise (I am sensitive to both due to my brain injury -- long story, another time) and head back to the car. Jesus, for late April it is downright chilly: my car dash reads 39 degrees. Traffic, however, is more forgiving, and I am nearing the hospital with time to burn. Which is good, because it just then hits me that the appointment is not at the hospital, but at an adjacent building. (Another common trait among TBI's.) Anticipating this brain fart, I entered the address in my phone, along with the time, so at the nearest opportunity I pull into an office building parking lot. I check the address, then the street sign, then the address again, because this never happens to me ...  I have quite by chance found my destination!

The euphoria was not to last. CATS, a cute euphemism for something rehab related, turns out to be located in a generic office suite, such as any dentist, lawyer or architect might lease, complete with oppressively bright fluorescent lights and six-month-old copies of People in the waiting area. I complete the paperwork with what I consider admirable dispatch, considering the conditions and circumstances. There is one piece of paper concerning a state database of drug prescriptions that requires my signature for some reason, but the verbiage is so inscrutable that I'm compelled to query the receptionist. Her only suggestion is to take it up with the social worker I'm about to see.

I finish the paperwork and wait. 9 am comes and goes. Meantime a stream of people enter, chatting amongst themselves. This would be one of the groups run by CATS, which I'll be added to once this obligatory process finally ends. About 9:40 a 30-ish brunette woman named Jennifer opens the door and calls my name.


to be continued...

Near Death Experience

I suppose I've come close to dying several times, mostly in auto accidents; the most recent of which is the source of the pain which in turn inspired this blog. But without a doubt, my closest encounter with the Reaper came just a couple of weeks ago. As I mentioned in a previous missive, I had over a number of years acquired a very unhealthy habit of mixing alcohol and prescription medications in order to sleep. (The list of medications is long, and has varied greatly over the years. I'll go into detail at some point.) I had to drive a long ways to a funeral, and my back was screaming the whole way. Evidently the combination and/or quantity of medications I was taking in the days leading up to the trip caused my kidneys to shut down.

I had passed out in a hotel bathroom. My wife and daughters found me and called for an ambulance. I remember none of this -- one minute I am at a post-funeral reception, the next I am in an emergency room, surrounded by doctors. I am asked the date. I don't know. I'm asked the month. I don't know. I'm asked what holiday we just celebrated. I don't know. (The answer was Easter, which I probably would have remembered if my kids were 15 years younger.) I'm asked who the president is. I'm not sure about this one so I guess, I don't remember who. Wrong. "He's out of it," one of the docs says, helpfully.

It should be noted that I am a lousy ER patient. I do not cotton to having tubes inserted into or wires affixed onto my person by total strangers, particularly when their purpose is not explained to me (or if I am incapable of understanding said purpose). So I will gleefully rip out any tubes and wires I find attached to me. Most likely the ER docs knock me out just to keep me from doing this, and I don't blame them. It's also worth pointing out that I'm of the red-headed variety which studies have shown is more resistant to emergency-room sedation. So I'm just a pain in the ass to doctors, nuff said.

Since I'm out of my mind at this point, what follows now is my own highly subjective account of events, interspersed with occasional facts as I subsequently learned them from sane human beings (e.g. doctors, family members). The latter will be indicated in italics to avoid unnecessary verbosity. Finally, I don't know in what order the following events occurred.

At some point I became aware of the TV in the room, which at first was just noise but gradually took on ominous overtones, as if the TV was some sort of portal into my subconscious. I tried redirecting the TV/portal toward something benign, like sports, but having no idea how to operate the remote in my hand it was futile.

It is some time after the 20-questions period. The docs are around me. I am saying something, answering a question perhaps, and time just slows down, then stops. Oh fuck, I think, I am "locked in," and will be like this the rest of my life! The docs scurry about, but I'm as helpless as a newborn. This was probably the effect of medication and/or withdrawal. 

I awaken to the sight of a familiar nurse, who is feeding me ice chips. "Where am I?" I say. She laughs. "That's better than 'Whaa guh huh?" I feel like half my brain is thawing out. "Those were some good drugs," I say. "Yep," she says, paging one of the docs. "Where are you?" "Hospital?" "What month is it?" "April?" "Good," and I get more ice chips. My brain is almost thawed out. I am certain that they have synthesized a brand-new drug to bring locked-in people like me out of their locked-inness. Actually it was probably just a jolt of   Narcan.

I again wake up. It's night. My bed inflates, and the cover of the mattress is red. I worry that I am bleeding. A doc, or maybe a male nurse, comes in. I can't recall what he says, but the message is that because I have combined drugs and alcohol, I will be in this bed the rest of my life. Obviously this is untrue, but the doctors did not know about my drinking early on. I went through alcohol withdrawal (DTs and all) which could account for any of the hallucinatory experiences.

There's more, but I'm tired. It happens a lot. 

Crash and Burn

Everyone has a limit to how much pain he or she can tolerate. I always considered mine higher than most, but when I was in an auto accident a decade ago I was left in a state of chronic, at times debilitating, pain. To combat this pain I have taken a whole smorgasbord of medications, including narcotics; some have worked better than others, but none have actually offered the kind of relief I would consider adequate to return to a "normal life."

Another very annoying problem resulting from the accident was insomnia. I get very little sleep at night, and what I do get is of such a poor nature it's like I haven't slept at all. At one point I went from Tuesday night to Friday morning without so much as a nod-off. Take my word for it, going three days without sleep is its own form of pain.

So after a few years I decided to ignore the warnings on the prescriptions and have a drink at night to help me sleep, since nothing else was helping. And in fact it did -- at first anyway -- but predictably there came a time when one drink sufficed no more. You know where this is going surely: crash and burn. In my case, kidney failure and near death experience. But I'll save that for next time.

This is about living with pain. Also living without pain. But mostly about living.