Cancer testing, the tale continues

Peggy had a migraine and was exhausted when we left the urologist's office (see photo), so when we got home, I rubbed her back until she went to sleep, but as I was tiptoeing from the room, I broke a piece of pottery and had to rub her back a second time. She couldn’t return to sleep, so we talked about her fears of me having cancer—if I have cancer—and possibly dying. I like it when Peggy shares her fears, but she worries that they will scare me, although I don’t remember a time when this was soI can anticipate problems as well as she can. I tend to focus on percentages, so the better they are, the less scared I am. Peggy is so afraid of cancer that this doesn’t work for her. Some other disease might be easier.

I’ve had two previous cancer scares, but Peggy is more afraid this time, maybe because it’s the first time that I too thought I might have cancer. In fact, I wouldn’t have had my last two biopsies if she hadn’t insisted. They were both big deal biopsies that just scared the shit out of me—especially the one where the neurologist cut through the front of my throat to get a piece of bone from the back of my neck. Those two times, I just knew I didn’t have cancer. Feelings don’t constitute proof, so I recognized that I still might have it, but my natural confidence was such that I couldn’t get beyond seeing cancer as a remote possibility not worth the risk of a biopsy.

The more I learn about doctors and hospitals and the bad things they can do to a person, the more I try to make sure their proposals are necessary. Of course, when a book, the Internet, or a government panel’s report (like the one this week), tells you that a PSA-based biopsy (a PSA is a blood test) puts you at greater risk of harm than of good, and your doctor (along with two different urological organizations) tells you the opposite, whom do you believe? I should think the government panel would at least be objective in interpreting the data, whereas the urologists have a financial incentive to be biased--note that I said "biased," not dishonest. It’s also true that a person just naturally tends to believe in what he does all day. For example, Peggy is a nurse, and if the government had also announced that some standard nursing procedure did more harm than good, I’ve no doubt but what the nurses would be as enraged as the urologists. It’s hard to admit to yourself that you’ve been hurting people for years while trying to help them. Yet, none of this necessarily means that the government is right and the urologists wrong, nor does it take away my own doctor's power to influence my decision making. If I trust a doctor, I will generally do what he saysI just might not do it right away.

I’ve grown accustomed to orthopedists and neurologists, but this was my first urologist. Peggy went with me to the doctor as she always does (I do the same for her). She usually sits in the corner and says little, but today she sat between the doctor and me and read from a list of questions she had prepared and had me type. My first observation was that the waiting room was filled with old men, some with their wives, and I felt like I had walked into my next new club—Old Fuckers Who Dribble. I had known for some time that age would bring increased pain (even children know that it brings increased disability), but I hadn’t considered the indignities of aging. Old people have the kind of problems that gross out young people who are themselves certain that they will never have them. I reflect upon the fact that these indignities come to everyone if they live long enough, and this enables me to better accept them. Then too, death seems so near at times that nothing much matters to me anymore other than the fact that I have to fight to stay alive because I don’t want to leave Peggy alone.

I was prepared to mistrust Doug because statistics go against me trusting any new doctor (which is why I cling to the ones I do trust). He also works in a clinic with lots of other urologists, and I expect large clinics to be impersonal, rigid, and take a one-size-fits-all approach. As it turned out, I’ve never had a better first impression of a doctor. Changing doctors is a pain in the butt, so this meant a lot to me. He said that my odds of having cancer are 25-35% and suggested that I either go ahead and have a biopsy or, if I’m on the fence about the biopsy (prostate biopsies are another big deal kind of biopsy), that I have a blood test called a “free PSA” and base my decision upon the results. I jumped at the PSA. I don’t need government reports to tell me that I live in a test-happy/surgery-happy society in which I don’t dare subject myself to risk without doing what I can to avoid it or at least mitigate it.

Peggy and I have long agreed that it would be better for me to have cancer than for her to have it because she's so terribly afraid of it. She also fears death more than I. Yet as I see it, the one who dies has things relatively easy because the survivor will have suffered with him or her until the end at which time the survivor will embark upon an an even worse period of suffering while alone. I’ve always had doubts that I would survive without Peggy, but I always thought she would pull it together without me. To my surprise, things right now are so hard for her that I’m unable to console her. Yet, I’ve seen her handle loss before, and she always pulled herself together, so I think it likely that she will get her sea legs under her this time too.

It’s interesting how unpredictable Peggy is to me even after 41 years. Of course, none of us really know how strong we will be until we’ve been tested, and that’s mostly hindsight. Each new bad situation is never quite what I expected. There’s always fear, pain, anger, despair, and so forth, but it’s never the same fear, pain, anger, and despair because no two situations are ever the same. I’m not the same either, but at least I’m tougher than I used to be. Now, I just try to sit quietly and watch it all go by. 33,000 Americans die of prostate cancer each year, and another one is diagnosed every two minutes. I think of each of those men as being all alone in his own movie theater, just as I am all alone in mine. It’s the human condition. We can never feel another person’s life from the inside, so we are forever separate.

I’ve already gone through so much that a little more isn’t likely to hurt me unless there’s some unfortunate medical outcome. With every new ailment, there are new and interesting things to learn, and the tests and surgeries are often quite interesting too once you get past the fact that you might bleed a lot, will probably be in pain, will be exposed to noxious substances, and might very well die. I have grown increasingly able to make the best decision I can and to let it go at that, although I’ve lost faith that everything will go right because it's usually the case that so many things can go wrong, that there’s a pretty good chance that one or more of them will go wrong.

I panicked when I realized what a crapshoot modern medicine is even when everyone performs at their peak, but I’ve gradually grown fatalistic. The worst part is when I’m having trouble deciding what to do. For now, I know. If the free PSA test comes back bad, I’ll have the biopsy. That’s as far as it makes sense to plan right now. Yet, it’s emotionally hard to stop studying, and the subject is interesting if wearisome. 

You're not likely to see me buying any lattes

I was born frugal. I was also born clean and orderly. My dedication to the last two items has sometimes left people speechless because, as I suppose, they consider me neurotic and don’t want to risk setting off a crazy man. But have people ever given me hell about my frugality! Some of my happiest childhood memories are of taking my 25-cent allowance down to the polished marble of State Bank where hot-looking tellers treated me like a man. What do my detractors remember? Throwing away money on crap they didn’t need and didn’t even want a week after they got it, and that's assuming they didn’t break it on the way home?

My father-in-law, Earl, overlooked my drinking, my atheism, and my hippie fro. Likewise, he said nary a word about my screwing around; was silent regarding my inability to hold a job; didn’t flinch when I put my marijuana pipe in the sink for his wife to wash (although he flinched a little when I played Back in the USSR just for him); and never complained about me being kicked out of the Air Force after he had pulled strings to get me the assignment I wanted; but he has harangued me for 42 years because I save money. He had another son-in-law who declared bankruptcy, and I sometimes wonder if Earl ever bitched at him. The last time he was on my case was the last time I saw him, naturally, when he looked at me quite somberly in the presence of four other people and suggested that a lead coffin wouldn’t protect my money from the fires of hell. Okaaay! He’s a Baptist deacon, and I’m pretty convinced that heaven isn’t where most of them are going, so I’ll just have to bow to his expertise.

Given her father’s attitude, you’re probably wondering how Peggy feels about my frugality. Well, she’s frugal too, which makes it a little odd that Earl never criticizes her. She makes noises every now and then about splurging on something, but she doesn’t have it in her to truly go overboard—knock on wood. Like me, if there’s something she really wants, she gets it. Also, like me, she buys better than average quality (it’s seldom sensible to buy the very best), but we’re people with simple tastes. We’re also people who tend to anticipate bad things happening and to prepare for them. Money is a great protector from much that can go wrong in life—it’s literally a lifesaver in America where the government and insurance companies have no problem with allowing people to die by the thousands in what politicians call, “the most generous nation on earth.” If Peggy and I weren’t frugal, she couldn’t have cut back to working part-time several years ago, and she sure couldn’t be planning to retire in two years.

The biggest difference between us regarding money is that Peggy is more likely to buy something on the spur of the moment (“I’m going to treat myself,” as she puts it), whereas I usually think about a purchase for anywhere from a few days to a few months. The usual result is that I lose interest in buying it. When I do buy something on the spur of the moment, I regret it more often than not. For example, I bought a scented oil diffuser last month. If I had thought the purchase over for a few days, I would have remembered that Peggy and I often have opposing scent preferences, but as I stood there in that shop, I made a decision to allow myself to ride a wave of emotion. I justified this by telling myself that I was being childlike when what I was really being was childish. Now, I’m sorry I abandoned my usual prudence, and I regret owning something I don’t want but don’t have a great way to get rid of. My country is facing bankruptcy and my species is burning through the earth’s resources like there’s no tomorrow (which might be true given how we behave) because most people are improvident, and my purchase, small though it was, exemplified that.

I suppose Earl must think I'm denying myself too much, but I actually have no desire to spend money on anything I don’t already own except for a few items that cost so much they’re no brainers. For instance, I wouldn’t mind having a new van to camp in and a new car for Peggy to go to work in simply because I would anticipate them being more dependable than our old ones, but our ’93 Chevy and’98 Camry look good, run fine, and have less than a hundred thousand miles on them. I would also like to build an addition onto the house so I could maintain a resident masseuse to massage me in the middle of the night when the pain wakes me up. Travel? No, it’s too much work; there's no place I want to go that I haven't already been to; and I would miss my house, my cat, and my dog. I wouldn’t mind an occasional train trip maybe, but there’s no place in the world I had rather be than the Oregon coast, mountains, and deserts, and each of those is within a two hour drive....

I just thought of someplace I would like to go. I would like to have a private pilot fly me to cities with world-class gardens, museums, and plant conservatories. A chauffeur would pick me up, take me to an elegant hotel, and then drive me back and forth until I had seen everything. Too bad I can’t afford a live-in a masseuse or luxurious trips to art museums. As for new cars, I wouldn’t pay what they cost. Other people do, and if they think a new car is worth a year’s labor not counting interest, that’s fine with me, but to put it out there in all its bluntness, I would feel like an idiot.

Something else that strikes me as so outrageous that I can’t imagine doing it is gambling. I drove through Vegas once and stopped long enough to take a look at the inside of a casino. While there, I thought, what the hell, I might as well gamble, so I put a quarter into a slot machine, cranked the handle, and lost my quarter. I grieved for that quarter all the way to Fresno because I violated my integrity by gambling with it. Of course, I’ve known quite a few responsible people (hi, KJ) who liked casinos, but they seriously weird me out. Gambling is sort of like paying someone to hit you over the head and then feeling like a winner whenever they happen to miss. That’s what happens in casinos; you lose, lose, lose; then you win a little; and then you brag about your winnings to all your friends as if to suggest that you outsmarted the bastards. Yeah, sure you did.

When I started taking money out of banks and putting it into mutual funds, Peggy, remembering how bummed I was over that quarter, worried that I would freak-out completely if we should lose thousands. Well, we’ve lost entire years of income a few times by now, but it wasn’t me who freaked out. I handled it better than Peggy simply because I’m less of a pessimist than she, which is really saying something. Anytime we lose money, I try to hold onto the thought that it’s a temporary glitch, whereas Peggy concludes that it’s the first day of The Great Depression II. Now that she’s planning to retire in 25 months—right when the nation, if not the world, seems poised to go down the drain financially—I must admit that losing money hurts more than it used to.

There’s no getting away from the fact that you can do the very best you know how and still get screwed simply because life isn’t fair. Like turtles crossing a road, some of us come to a much worse end than others, and it’s not always because we behaved worse. The advantage of frugality is simply that you better your odds (sort of like a turtle who crosses the road quickly versus one who takes his time). I’ve often been told that I can’t take it with me when I die, as if a person’s goal should be to spend his last dollar on the day he stops breathing. No thanks; I had rather leave a little to charity. I donate some money already to civil liberties, animal welfare, public broadcasting, and environmental groups, but hardly enough to hurt. Since it looks like charities will still be needing money when I’m gone, that’s when they’ll get the bulk of mine. Until then, I might need it myself.

I guess I've made it clear that Earl isn’t the only one who’s judgmental regarding money. It’s just too bad that the only thing he and I agree on is that it’s better not to gamble, although he would argue that the stock market IS gambling. Now that I've become convinced that this country is racing out of control atop a highway paved with greed and stupidity, it is starting to feel that way.

The photo is of me with my fourth most expensive possession (after the house and vehicles). It cost $1,900 several years ago, and that was money well spent.

“Cowardly little atheist finds God 20 minutes after being told he’s dying”

I know. You saw it coming, but you haven't heard the details, so here goes. I made the following to-do list when my second PSA came back:

1) Run in circles while screaming and flailing my chest with my fists.
2) Find God so I check item number one off the list.

While I was still on number one, Peggy said, “You’ve done this same stupid running amuck display for years now, but am I imagining it, or is this the enhanced version? Also, did it ever occur to you that the reason your shoulders hurt all the time is that you’re forever swinging your arms?”

So it was that with my dear wife's gentle encouragement, I moved on to item two—I found God. I found two gods in fact, one male and one female (the Wiccans taught me that deities come in the same genders as people). Their names are Aphelandra (top) and Aglaonema (bottom), and I can’t tell for sure, but I think Aphelandra is the goddess because she’s shorter and because Aglaonema's stem is big and erect.

My first houseplant was a Spathiphyllum (peace lily) that my father left when he died in 1994. I didn’t want a houseplant, but it was a living celebration of him, and it was also evidence of a love for beauty that he seldom displayed. I saw caring for it as an extension of caring for him. Besides, I asked myself, how long could a houseplant live anyway. It’s now 19, and I wouldn't be surprised but what it survives me--after which Peggy will probably kill it with love, aka too much water. 

My Aglaonema is simply too beautiful for words, and despite its look of fragility, we get along famously (I don't do high-maintenance plants). I’ve even been looking for another Aglaonema (one called Silver Queen) for a year now and am starting to think I might have to drive to Portland for it… 

If I were rich, I would live in a conservatory. The beauty of plants inspires in me the desire to make my own life beautiful, and their presence fills me with joy. 

Maybe cancer; maybe not

My prostate antigen level in April of 2011 was two. This April, it was 4.5. This week, it’s 4.9. I’ve had a few biopsies over the years—including one of my lower abdomen and another of a neck vertebrae for which the surgeon had to go through the front of my throat—but I never believed I had cancer. This time, I think I do.

I would hate like hell to leave Peggy alone. I would also hate to leave my "bloggy friends" as Nollyposh used to call them (she was one of four bloggy friends I lost to cancer). A lot of people will find out that they're dying just in the time it takes to write this post, and that won't be long because I'm still doing my experiment with minimal editing.

A few years ago my 56-year-old neighbor, John, drove three hours, climbed a 10,358-foot peak (3,157 meters), and drove home. I saw him that evening, and he complained of fatigue. I laughed, but he said that, no, this fatigue was different. He died a year later of prostate cancer. (I can hardly hold out to clean house anymore, which is one of the reasons I think I have cancer). John died next door, but I never went to see him because I didn’t really know him, and I wasn’t sure I would be welcome. He was also a lawyer, and I hate lawyers. I now wish I had gone because it would have been the right thing to do. I also like being around people who are dying.

Doc Martin is phobic of blood; Nurse Peggy is phobic of cancer. She's so scared that she’s been having to struggle to keep from hyperventilating. 

I've often wondered whether it would be easier to have a terminal illness than to live in pain. One advantage of living in pain is that I have a sense of time stretching before me, and that gives me reason to hope that I will either beat the pain eventually or at least learn to tolerate it better.

My odds of survival are probably good even if I have cancer, but there’s still that 3% chance that I’ll be dead within five years. After ten years, the chance is 30%, and it keeps going downhill from there. As cancer goes, only lung cancer kills more Americans than prostate cancer.

I won’t be getting any more teeth crowned until I have a prognosis. The damn dentist crowned one in January, and that alone drained my insurance for the rest of the year. He wanted to crown another one in April, but I said no, so he squirted some gook into the hole in the hope that it will last until January 2013.

Helter Skelter captures my mood today just as it captured the mood of America in the late ‘60s. To represent the early ‘60s, I chose Johnny Angel. How, in a single decade, do you go from songs about cars and teenage romance to songs about drugs, death, defeat, confusion, alienation, insanity, and injustice?

I like things that mess with my head, so I like Helter Skelter. The good thing about music is that I can turn it off if it gets too intense. With real life, I have to divide myself into two parts. One part thinks, feels, and acts; the other part dispassionately observes the part that thinks, feels, and acts. Pain can become so consuming that it draws my observer part into it, and that's when I go to pieces. I assume that this can also be true of cancer. I really must learn to do better, and I think I'm succeeding. I've felt stronger than ever since my meltdown on Sunday.

P.S. Shelley Fabares is a goddess.

Today's barely edited

I didn’t feel old until a year or two ago. I attribute this sudden oncoming of antiquity to the pain. Except for misdiagnosed sleep apnea (which cost me two needless surgeries) and the pain of the last six years, I’ve been healthy as an adult. In fact, I used to marvel at my good health because I would — sometimes for months—feel such sadness that I was just sure it would eventually eat its way from my heart and into my flesh, causing me to sicken and die. The fact that I stayed in such good shape was curious to me.

Then came the sleep apnea, and I grew increasingly desperate over a period of five years until it was diagnosed and treated. Three years later came the pain. For the longest, I thought I would beat it. I told myself that my species, despite its many faults, is very clever in various ways, and that medicine has been one of the major benefactors of the explosion of knowledge that has occurred during my lifetime alone (I would have died had the sleep apnea hit 15 years earlier). How hard, therefore, could it be to eliminate my little old pain? It might be impossible as it turns out.

For much of my life, I held doctors on such an intellectual pedestal that if a doctor couldn’t cure me of something, I would assume that he wasn't trying hard enough—maybe he hadn’t run the right test or asked the right question. I later met doctors whom I trusted as good men as well as good doctors, and when they told me there was nothing they could do, I believed them. Even with this recent pain and the urging of one reader to see a pain specialist, I have no thought of seeing a doctor. For what? Pills? I’ve got pills, and if there were other pills, I would know about them. Dosages? If I want to dicker with those, I have more confidence in the Internet than I do in any given doctor (I've discovered two serious errors in my prescriptions by looking them up on the Internet). Tests? Diagnoses? Surgeries? I could probably get several more of each if I wanted to start from scratch with new doctors, but I don't.

Maybe my "barely edited" experiment is connected with my need to transcend the pain because while I've lost all hope of escaping it completely, I haven't lost faith in my ability to someday live well despite it. I think at least one of you might have worried about me euthanizing myself after my last post, but I wouldn’t do that. I thought a lot about it for a long time, and I must have decided against it because I don’t dwell on it much. Not that I was ever really close to suicide; it’s just that I considered it a reasonable and reassuring option. If you hurt as I do, and you killed yourself, I could respect you for it if you only had yourself to think of (If you were married, I would consider it necessary for you to get your spouse's blessing to kill yourself it unless your spouse opposed suicide on principal). But even if you were alone or had your family’s blessing, I would suggest that you hang in there. You’ll be dead-meat in a few years anyway and you'll stay dead for all eternity, so why not stick around? You might do some good, you might have a few laughs, and you can always decide to off yourself later.  

The photo is of me, from yesterday. It did me good to go to the woods.

A second experiment with posting in the moment

Given how much I bitch and whine, Peggy might not realize that I try to spare her from the worst of what I feel, but I can’t do it today. I had a horrendous night last night that followed a day spent trying to recover from another bad night. Dilaudid didn’t help, so I lay awake for hours and I am just about through the roof right now. I smoked some pot an hour ago hoping it would help, but unlike yesterday, I’m experiencing something similar to a bad acid trip. I feel like I’m caught in a nightmare, and I don’t have the strength to find peace in the storm. I work everyday to stay calm and hopeful, but when I’m really hurting, really exhausted, and really without any means to control the pain without knocking myself out, I just can’t find it in me. I’m unfit for anything but to shake and cry, yet, there’s something here for me. I know it, but I can't find it even after years of looking.... I've heard enough Mary Wells and going to listen to some Goulet. Before marijuana, I didn't care about music. Now, it's one of my main comforts, it and plants.

An experiment in not editing—much anyway

I’ve been thinking about posting more and editing less because it’s making me crazy that I can’t stop editing. Even after I post something, I continue editing for days. So, here goes.

It’s a good day to live in Eugene (the photo is one that I took of some area scenery). The six months of drizzle are at an end, and the drought hasn’t arrived. It’s our second 80-degree day (27 C), 80 being 15 degrees above my ideal, but still pleasant enough.

I did yard work yesterday and suffered a lot for it last night. In fact, I’m such a wreck today that I’m avoiding unnecessary chores. I had intended to at least march in a pro-marijuana parade, but my knees were hurting too bad. I did bike to the library and got some books about war (I just finished—and can recommend—American Sniper, The Autobiography of the Most Lethal Sniper in U.S. Military History). I also bought some eucalyptus incense—which I’m now enjoying—and biked around the downtown area looking at the freaks. I like freaks—if they’re pleasant freaks. I also enjoy homeless men. Years ago, I considered them disgusting, so one day I passed a panhandler without speaking to him although he said something to me. He got up and followed me, demanding in a loud voice that I at least show him the respect of acknowledging his existence. I walked on in silence. I now shed tears when I remember that man. I could have done good, and I chose evil.

My right shoulder is hurting me a lot today, but I do my damnedest to avoid drugs in the daytime with the exception of marijuana, and I’m already so strung-out from the drugs that I took last night that I don’t dare use that. I literally feel like I’m losing my mind, and marijuana could make it worse. I’m also so tired that I'm sick, and marijuana could make that worse too. Then again, it could make me hyper. It's not a predictable drug, at least in my case.

Kurt and Jackie are coming for supper. Their cat was killed the day before yesterday, and although we rarely see them more than a few times a year, I thought it good to invite them to supper for the second week in a row. They accepted with an enthusiasm that made me sad for them.

I have two other recommendations for you. The first is an interview entitled A Portrait of Maurice Sendak. It's the heaviest thing I've ever seen on film, yet it's only 39 minutes long. He died a few days after I watched it, and I've seen it a few more times since then. My last recommendation is Memoirs of an Addicted Brain: a Neuroscientist Examines His Former Life on Drugs. The author reminded me a friend from 30 years ago named Larry. One day Larry and were smoking pot with another man when the other man handed Larry a handful of pills and asked if Larry knew what any of them were. Larry had no idea, but he swallowed them down without even asking. After that, I thought of him as a starving dog.

So, I took a hit, and I'm happy to report that I feel a little better. The pain is still with me, but it doesn't hurt like it did.

Drugs and addiction

It’s a rare night that I can sleep without drugs. For pain, I take Cymbalta, Dilaudid, oxycodone, and Neurontin. For sleep, I have Ambien, Dalmane, Restoril, and marijuana. All of these drugs have overlapping benefits and they work best in combination, but with the exception of marijuana I seldom mix them because of the increased risk of side effects. Also, except for marijuana, I never take any of them during the daytime. The one exception was when I took oxycodone two weeks ago for that anxiety attack caused by the Cipro.

My most effective painkiller/sleep aide, is Neurontin. Oddly enough, considering how strong it is, Neurontin doesn’t make me high unless missing doorways and bouncing off walls counts as being high. To avoid tolerance problems, I save it for when I’m desperate. For example, I hardly slept three nights ago, and when that happens, I go for broke the next night, so I took three doses (900 mgs) of Neurontin at once and spent the next several hours flat on my back. One of the ways I minimize pain is by turning over a lot, so when the pain finally awakened me, I was hurting pretty bad, but the drug still had enough kick (about 16 hours worth altogether) that I was eventually able to get back to sleep. 

Last night, I was so tired that I did my best to sleep without drugs, but that only lasted for five hours before I took a 10 mg Ambien, which is my short-acting favorite. Taking so many drugs means that I'm pretty much permanently snookered. I'll give some examples of the annoyances this causes. One. When I got up this morning, I couldn’t find my sunglasses, so I finally left the house without them. When I got home, there they were, right where they were supposed to be, which was the one place I didn’t look. Two. I’ve already looked once today, and I still can't remember if this is 2011 or 2012.

I’m going to address addiction since some of you expressed concern about it following my last post. I was surprised that one person was especially worried about marijuana because I consider marijuana to be the least harmful drug I take in terms of tolerance, dependency, side-effects, or—in the case of narcotics—addictiveness. It strikes me as exceedingly odd that the least scary drug I use is the only one that's illegal. Marijuana can be habituating, of course, but then so can jogging or eating ice cream. Narcotics are a whole other animal because they bring about permanent changes in the brain and hellacious withdrawal symptoms. As I write, I haven’t used marijuana for five days (I sometimes get tired of being high) without the least problem. If I used narcotics as often as I normally use marijuana, I would be under medical care for withdrawal.

To further compare narcotics and marijuana; I prefer marijuana because it causes me to think about the world in deeper and more interesting ways, ways that are so profoundly true for me that they seem to be coming from the core of my being. The drug rarely leads me to euphoria while it not uncommonly makes me anxious, dysphoric, and sometimes downright miserable. I often go for months during which I start most days with marijuana and coffee and then continue to use marijuana until bedtime. I do this because I like the mental stimulation but also because pot works far better as a sleep aide if I use it all day. Sleep is my major challenge not just because of the pain but because I have four separate sleep disorders—insomnia, sleep apnea, nocturnal myoclonus, and nocturnal bruxism.

Narcotics differ from marijuana in that they do induce euphoria, although I find them boring in terms of thought stimulation (who needs to think when he’s euphoric?). I’ll use an analogy to describe how I envision narcotic addiction. Imagine that you’re rafting down a slow and muddy river. The hot air is stifling and the scenery boring. You too are stifled and bored, and you wish with all your heart that you could feel like you were getting somewhere, but your entire life has come to seem like a failure no matter what you do. Then you come to a whirlpool (narcotics), but you don’t realize it's a whirlpool because it's so wide. You’re just pleased to find that you’re moving, although you can’t really remember why you ever wanted to be someplace else. The breeze in your face is cooling, and the same scenery that bored you a few minutes ago is now fascinatingly beautiful. Happiness seems so simple and natural, and sadness so twisted and complex that it's hard to imagine that you were ever unhappy. By the time you see Death at your side, you might be too far gone to turn back. I’m not talking about me, but neither do I remain cocksure that addiction only happens to other people, people inferior to myself. When you're desperate for a way out, even a bad option can look better than no option.

My narcotic mainstay is oxycodone (when it comes combined with acetaminophen, it’s called Percocet) because I’ve been approved for a years’ worth without even having to go back to my internist. I limit myself to 30 mgs at a time (the starting dose is 5-10) three or four times a week. Unfortunately, I feel less euphoric and get less pain relief from thirty than I once got from ten, but I'm afraid that if I take a higher dosage even once, I’ll be tempted to do it again. Why did I set 30 as my limit when my prescription calls for 10-20? Because I was taking 30 when I got scared, and since I was handling that okay—except for the hellacious constipation—I stayed with it. Narcotics are so insidious that even though 30 no longer gets me high for more than a half hour, I crave it on my narcotic-free nights. On the nights I do take it, I have trouble waiting until bedtime to do so because the rush initially makes me too happy to fall asleep, so I want to be up doing fun things. There's nothing like high on narcotics and marijuana and then baking crackers while watching a movie. Yep, that's right, I can carry on real well even while real high, so well in fact that even Peggy can't even tell if I've had anything.

I sometimes imagine that narcotics are talking to me. They say they’re my friends, and that there’s really no reason for me to be in pain when all I have to do to feel better is to take a few milligrams extra. They assure me that, just as most people can safely relax in the evening with a few drinks, so can I relax with a few narcotics. Besides, don’t I deserve a little euphoria? Hell, I’m in pain; my brain—the one I once took pride in—is a turnip; I can’t do many of the things that I used to find meaning in; I look like shit, having gone from 180 pounds of muscle to 160 pounds of skin, bones, and a little round belly; and, worse yet, I have no hope of ever escaping the pain or ever regaining my strength and intelligence. As a matter of fact, the whole goddamn rest of my goddamn life looks pretty fucking bleak, and even after years of pain, I still don’t have a clue how to handle that. Narcotics tell me that they’ll handle it for me and make me deliriously happy.

The words that I say to myself are a bit different… "Why can’t I handle this better? I know people who are worse off but appear to be doing fine. Why can’t I be like them and cut through adversity like a knife through warm butter? And why, when I spent years trying to stay healthy and more years trying to regain my health, am I like this while people who are older than I and never gave a thought to diet and exercise are doing fine?"

So far, I haven’t been tempted to take a higher dose of narcotics or to take them during the daytime (except for two weeks ago when Cipro took me to the doorstep of panic). I’m helped in this by reminding myself of what George Peppard (see photo) said about drinking: “You have problems, you think drink helps, then you have two problems.” I never knew him, and he has been in his grave for years, but I sometimes imagine him beside me, looking the way he looked toward the end of his life when his arrogance was gone. I don't only want to be strong for myself and for Peggy; I also want to be strong to honor his memory because every little bit of inspiration helps, and George Peppard's tortured existence and eventual triumph has certainly inspired me.

The bareass truth is that I need drugs to sleep, mostly because I’m in too much pain to sleep without them, but also because I’ve taken them for so many years that normal sleep is all but impossible. Yet, drugs are robbing me of myself almost as much as the pain is, not because I’m addicted but because when you take mind-altering drugs everyday, you start to lose sight of who you are. I’m desperate to give up drugs as a way of life, but I’m desperate for sleep too, and I can’t have it both ways. You might look at my situation and think you could do better, and I hope you could because you might have to someday, but where I am is where I am despite the years I’ve put into trying to either get well or get strong. 

I just came off a five-month break from even trying to help myself—well, except for diet, drugs, writing, physical therapy exercises, and buying potted plants. When I started getting scared about how much I was looking forward to narcotics, which wasn't too long ago, I signed up for a Qigong class. My classmates are mostly old ladies, and I'm having trouble keeping up with them. I would have already quit the class, but where do you go after Qigong? It would be like dropping out of kindergarten. 

As the saying goes, “You either get tough or die.” I’m not all that tough, but then I’m not dead or on a psych ward either... I grieve my life. Although, for years now, my experience of it has hardly been in the league of a walking death, it seriously sucks. My chief support has come from Peggy, my doctors, and you. Two bloggers who were dying (Renee and Nollyposh) gave me a generous portion of their time and compassion, and that still helps even though they're gone. I wouldn't be surprised but what many a life has been saved by a single act of kindness on the part of someone who had no idea of the significance of what they were doing.