Not this shit again

Something about me and hospitals. A week ago I'm in one again, for the same reason as last time -- renal failure. Except I'm not drinking, not taking opiates of any kind, not even taking naproxen, which is what landed me in a hospital in Richmond for five days last April. No, this time it was the combination of aspirin (generic from CVS, extra strength) and the lack of central air conditioning, resulting in me becoming severely dehydrated.

What is pain?

Given the title of this here blog, I reckon I've been remiss in failing to explore this topic in much detail. The reason, I suppose, is that by the time I created this blog I had been in more or less constant pain for 13 years. Constant pain, in my experience at least, entails a complete alteration of reality, to the point where pain becomes something like a fifth limb: it's always there, you can't do anything about it, and if it weren't there you don't know exactly what you'd do.

That's right -- I honestly don't know what I'd do with myself if I woke up one day without pain. One possibility is I would assume I was dead and had gone to heaven, or whatever place you go when you die. Or I'd gone to hell, and this was some dirty trick, and the pain would return at any time. But the hope that I will ever be without pain again has long since passed. I've tried every drug there is, several times in fact. My first encounter with serious opiates began about 12 years ago, under what turned out to be the reckless auspices of a Dr. Stein.

He started me out on Oxycontin, a drug I'd never heard of at the time (this was 2001), but which would soon become vilified in the press as "hillbilly heroin" after a number of Appalachian addicts overdosed on the stuff. To that he added Dilaudid, a short-acting form of morphine. This combination proved only moderately effective, and had several decidedly unpleasant side effects. One, which is universal among opiate users, is constipation. This may strike the reader as a minor, even amusing, inconvenience; let me assure you that when you haven't moved your bowels in a week, all humor gives way to discomfort, then concern, and finally outright desperation. The other side effect was far worse, however. I awoke in the middle of the night gasping for air. It's impossible to know for certain, but I believe I had been in respiratory arrest for a significant duration. (This is another classic effect of narcotic use, and in fact respiratory arrest is the definition of overdosing.) It took me a long while to fully catch my breath and walk around rubber-legged. I was afraid to fall back asleep for fear of ever waking up again.

Not long after this episode I resolved to tell Dr. Stein that I wanted off the narcotics altogether. At one point I was taking 240mg of Oxycontin and 48mg Dilaudid per day, and the pain still was winning. Worse, the side effects were not only affecting my life, they were threatening to end it. My wife, curiously, was adamantly opposed. She said that I was a mean bastard before I went on the pain meds. On them, I was at least under control. I could see her point -- my behavior following the accident was nothing to be proud of -- but I couldn't see living the rest of my life under these conditions. So we all (including my wife and two daughters) went in to see Dr. Stein. He informed us that he had become involved in a federal investigation involving Oxycontin and was closing his practice. So my decision was moot, I was off the narcotics whether I liked it or not. Six months later Dr. Stein was on the front page of the Washington Post. Several former clients had died from Oxycontin use, among other lurid charges. He was a nice guy to me, but you never know about people.

Because of my association with Stein, I would be many years before a doctor would prescribe anything stronger than Percoset for me. But that's another story for another day, because I'm getting tired now.

Well whatddya know?

Two days in a row I'm posting on this here blog. Going back over the earliest entries, I can see why I started this thing: fear, mostly, combined with uncertainty about the rehab stint I was facing. I don't think I was afraid of rehab -- I was looking forward to it as much as dreading it -- but the fear was how I would cope with the pain without morphine and the sleep without alcohol.

A year later I can report that the pain is still bad, as is the sleep. But the morphine wasn't helping that much anyway, and the alcohol was doing such damage to my body that it was no solution at all, as I learned the hard way. I still think about the folks I met at that rehab place from time to time Chris, the lacrosse coach at Lake Braddock who needed a liver transplant, I sure hope he turned out okay. Greg, the oxy addict who was trying a new line of work, seemed well on his way. Eric, the alcoholic back from Iraq who doubled up on rehab both in Fairfax and down in Fredericksburg, I don't know about him: he seemed way too cocky to me, and I can easily see him thinking he has it all under control. But I can say the same about me. I thought I had it under control when I started up with the drinking, rationalizing it as a sleep aid until I was guzzling a fifth a night without realizing it.

Unlike just about everyone else at rehab, I could honestly say my addiction(s) had little or no affect on my personal or professional life. That's partly because I have none of either, but also because I rarely drank during the day, and in any case rarely felt intoxicated no matter how much I drank. As for the morphine, like the other opiates I've taken (and I've taken them all) they never made me "high", just fractionally less miserable. But the side effects of opiates, principally constipation, were such that I never wanted to take them to excess. So when others in rehab told their remorseful tales of career-ending debauches and shameful displays in front of their spouses and/or children, all I could do was shake my head in sympathy and think "you poor bastard." And when, in the case of at least three group members during my tenure, said it was their second go-round of AA after falling off the wagon, all I could think was "you poor stupid bastard."

I know, I know. Not very sympathetic, there but for the grace of God, etc. Still, I can't imagine how someone who has lost all he values in this world -- his family, his career -- can still go back to the same vice that brought him to this pit of despair in the first place. A disease? There is a medication for that now, I believe, called antibuse or something. Makes you physically ill if you drink. If I ever found myself tempted to drink again, I believe I would seek out this medication.

My head started aching this afternoon, and despite a nap it is still killing me. So we shall see what tomorrow brings.

The biennial blog post

Well. It's been six months since I last did anything here. How's it going blog? Slow I see. Don't take it personally -- it's not you, it's me.

I've been a good boy. No booze, no pills (other than what I'm supposed to take), no temptations of any kind. Just the usual pain and sleeplessness, which I'm more or less used to. I've thought about attending another AA session, for the hell of it, but it hasn't been that high on my list of priorities. The other day I took Marielle to Falls Church and showed her the Unity Club, where the meetings are held. It must have been around the top of the hour, because a gaggle of folks were coming out, talking, smoking cigarettes. If I actually thought I'd start drinking again I would definitely go, but the thought hasn't crossed my mind really.

Robin's "anniversary" was a couple days ago, which means my own is right about now. I don't have a lot of feelings about that. I'm not sure I want to. Not an experience I like to reflect on. I guess I'm not a dweller. Learn your lesson and move on, that's my modus operandi. It's served me pretty well so far.

So that's the update. I need to pick up Marielle from the library. Maybe I'll be more conscientious about this blog. No promises.