Things just keep getting stranger and stranger

Russell—my habitually jobless brother-in-law—lived by the motto: “Dope will get you through times of no money better than money will get you through times of no dope.” If Russell was out of marijuana, he would drive as far as it took and spend as much as necessary to get some, and he would smoke it all day everyday until he ran out. Then he divorced my sister, married a woman with three children who vehemently opposed drugs, and took a sixty-hour job at an egg factory (picture a filthy, smelly, ear-shattering, disease ridden, standing-room-only hell for a million defenseless creatures, and that’s an egg factory). Go figure.

I never wanted to smoke dope all day long, but I’ve been high to some extent for weeks now, and I can’t say that I oppose staying that way. Pot lessens my pain, lightens my mood, helps me sleep, decreases my stress, renews my sense of wonder, heightens my appreciation of music, helps me get along better with Peggy, makes me tolerant of—and interested in—other people, and enables me to be more honest yet more tactful. On the downside, it shreds my memory, makes me accident-prone, messes with my coordination, decreases my ability to judge time and speed, and probably has long-term consequences that I don’t even know about. This leads me to ask which are more important to me, the good things that pot gives or the good things that pot takes away. Right now, my vote is with number one. Sometimes, you don’t know how bad things have been until they get a little better, and pot has made things a great deal better. Fuck having brains; I just want to feel good.

As I see it, pot is different from narcotics, anti-depressants, and sleeping pills (all of which I’ve relied on heavily at one time or another) primarily in that it does a better job with less risk. I’ve taken a lot of powerful drugs, but they all scared me so much that I never had the balls to take as many as I actually needed, and my fear increased dramatically as I built up a tolerance to every one of them. One virtue of pot is that you’re not going to wake up with yellow eyes or failed kidneys, and I would sacrifice quite a few brains cells to avoid either of those. Brains are good, obviously, but you have to ask yourself after a certain point how many are strictly necessary. Of course, I’m assuming here that marijuana-related memory loss is long-term, and I don’t know that to be true… Now what was I saying?

The photo is of a psychedelic frogfish and was made by David Hall at seaphotos.com

Update

I am now living a life in which I am desperate for sleep. I don’t know why I’m in such pain, but since I felt similarly after my previous surgeries, only to eventually reach the point where I could sleep for up to four hours at a time, I can but hope that this time will be that way also. After all, I only had my third surgery nine weeks ago today.

Before my final awakening this morning, I dreamed that I flew bodily to the home of my friends—long since dead—Jim and Doris Bateman. I was so happy to have surrogate grandparents whom I could drop in on at any time that I cried, partly out of gratitude and partly because I couldn’t allow myself to believe that I was really welcome. When I awoke, I was desperate (it seems that I’m desperate about everything anymore) to have such people in my life again. I then realized that I do, really. I have Bella, and I also have a couple of elderly neighors who would love to have me visit. It’s not the same though now that I’m 62. Sadly, the time for grandparents is past.

I’m taking fewer narcotics because they don’t work well enough (outside of elevating my mood) to risk liver damage. Double doses of sleeping pills still deaden the pain enough for me to at least rest a little, although I worry far more about becoming dependent upon them than I ever worried about Demerol or Dilaudid. I’m still pursuing marijuana, and, because of my desperation, I have placed what is surely an inordinate amount of hope in it. Meanwhile, Obama just reversed his promise to not bust medical marijuana users, doctors, growers, and everyone else affiliated with the drug. Because Peggy is a nurse, I worry that she might lose her license simply by being married to me—sort of a collateral damage scenario. The waste, bigotry, and short-sightedness that is America leaves me aghast. I violate my conscience everytime I pay taxes. I mustn’t dwell on that though…. I see that the mailman just delivered my seventh medical bill of the week.

When I go to a doctor, I take along a summary of my problems so that I can express myself succinctly and not forget anything. The rest of this post consists of my summary from last week.

Treatments that have been of little or no benefit in relieving my bilateral shoulder pain:

Three shoulder surgeries in two years
Numerous steroid shots
Several courses of physical therapy
Dalmane, Restoril, Ambien, Lunesta, Hydrocodone, Oxycodone, Ultram, Demerol, Dilaudid, Naproxen, Piroxicam, Celebrex, Neurontin, Elavil, Tofranil, DMSO, Ginger, Turmeric, SAM-e, Habanero Peppers, Topical Anesthetics
Ice packs
Massage, Yoga, Acupuncture
Sleeping in a recliner

It is a good night when I am able to sleep two hours in a row before the pain awakens me, at which time I have to take more pills, get a fresh ice pack, or stay up for awhile. The pain makes it necessary for me to sleep entirely on my back, but my middle back hurts so much in that position that it combines with the shoulder pain to keep me awake.

Before the onset of shoulder pain, I enjoyed yardwork and handyman projects; but I have to be very cautious about such things lest the nighttime pain becomes so bad that I am challenged to sleep at all. I also enjoyed camping, but the pain now prevents me from doing that as well. Life as I had lived it for decades ended in 2006.

I’ve spent 4 ½ months out of the past two years in a sling, and 4 ½ additional months during which I couldn’t lift anything heavier than a cup of coffee. Now, I’m facing at least one more surgery. As with other treatments, I will submit to it simply because I am desperate for relief and don’t know what else to do.

Other complaints:

Burning pains in both shins was diagnosed by one doctor as complex regional pain syndrome and by another as syringomyelia. A third doctor disagreed with both diagnoses but didn’t have one of her own.

Raynaud’s Disease in both hands.

Advanced osteoarthritis in my left knee accompanied by a Baker’s Cyst and chondromalacia (a 2006 knee debridement failed to help).

An osteonecrotic C-5 vertebra that was initially thought to contribute to my shoulder pain, although a vertebral biopsy and a series of steroid shots to my neck failed to reduce the pain.

Sleep apnea for which I use a CPAP.

*Photo by O'Dea

The state of my health

I’ll be lying awake in pain from osteoarthritis, syringomyelia, chondromalacia, a Baker’s Cyst, and an aching back, but I’ll be high at the same time because I will have taken a few Percocets or a couple of Demerols. Anyway, I’ll be lying there unable to sleep—partly because of the pain, and partly because being high makes my mind bounce all over the place—and I’ll think to myself: “Snow, you really could put yourself to sleep, you know. All you would have to do would be to take a maximum dose of one narcotic or another and a maximum dose of one sleeping pill or another plus three Neurontins, two Tofranils, and one Requip, and wash it all down with a shot of vodka… Okay, forget the vodka, at least until I build up such a tolerance to the pills that they stop working.” Well, it’s tempting sometimes because I’ve been lying awake most nights for years. Of course, the downside would be that I might die, or the house might burn down around me without me waking up until the roof fell on my chest.

I take a fair amount of scary drugs, and sometimes I enjoy them, but I never take more than I need, and rarely as much as I need. I sometimes wonder which would actually be worse for my body, taking enough pills to make me sleep, or the exhaustion I experience from never getting enough sleep. I just know that I take more pills than I ever imagined I would, and, as a consequence of the pills and the pain, I never feel really good anymore, and I never feel really intelligent anymore either. In fact, I worry about how much more I can handle before my organs start to fail.

I got another referral to a neurologist (the same neurologist who did my vertebral biopsy when my C5 turned up osteonecrotic—aka dead), but she won’t see me until I get another MRI, but I can’t get another MRI until insurance okays it, but insurance can’t okay it until my orthopedist submits the proper form. Insurance denied the Synvisc injections, so I have that on appeal, only I have no idea how speedily the orthopedist’s staff is moving on it. I just know that medical staff people tend to thwart a patient at every turn if he becomes impatient. I think this is because overpaid doctors, who are mostly male, treat underpaid staff people, who are mostly female, disrespectfully, so staff people take it out on the only people who are lower on the totem pole than they are, the patients—especially the male patients, although I am not too sure about this part of my theory. But anyway…

The steroid shot I got earlier this month has already stopped working, so I’m positively screwed, pain-wise, until I either get the Synvisc, or the surgical neurologist cuts me open again, or the orthopedist cuts me open again. I’ve been waiting for one thing or another to happen for years, and the glacial slowness of the process really makes me envy people who are so rich that they can get on their Lear Jets, fly to the top specialists, and plop a hundred thousand dollars on the counter and not miss it. They can no doubt get themselves moved to the head of every line too, but I wouldn’t do that, and I wouldn’t mind even a little bit shooting any rich person who did. Of course, that's a politically incorrect thing to say just as saying that I sometimes enjoy being high on narcotics is a politically incorrect thing to say. But, you know, my fondest dream is that I would never need another pill for as long as I live. As for shooting rich people, I think we could do with a few less of those bloodsuckers.

Baxter's not the only one with problems

Peggy had an ovarian cancer scare last month after her yearly physical, but blood tests, two ultrasounds, and a visit to a surgical gynecologist made it seem unlikely. The only way to rule cancer out completely would be an ovariectomy, but her surgeon recommended against it. Peggy had initially said, “Get this thing out of me!” but she trusted her doctor enough to leave it in.

Yesterday, I went to my orthopedist, Mark (see photo), because my own pain has been through the roof lately. Of the many narcotics I’ve tried, I still have a good supply of Vicodin, Norco, Percocet, and Demerol, but none of them help much, and they sometimes make me very ill. I also have the sleeping pills Ambien, Lunesta, Restoril, and Dalmane, all of which work better than the narcotics.

When I go to a doctor, I usually give him a written overview of why I am there, and what I want done. Mark usually does everything I ask. Yesterday, he gave me a steroid shot in my left shoulder, a prescription for Tramadol (a painkiller), and a humongous prescription for the sleeping pill Dalmane (Dalmane is so good that I call it "The Great God Dalmane.") He also agreed to hyaluronate injections (a joint lubricant).

I love Mark. If there were only one thing that I could counsel you to do if you should need surgery, it would be to find a surgeon whom you trust technically and as a caring human being. I’ve had the uncaring kind twice, and I promise you, if you don’t like your surgeon before surgery (no matter how good everyone says he is), you will want to murder him after surgery when you are overwhelmed with pain and despair, and he doesn’t give a rip. I can’t overemphasize the importance of having a good rapport with your doctor. The following is what I wrote for Mark yesterday.

“Pain in my left shoulder still awakens me many times each night and requires ice. Pain in my right shoulder also continues to be a problem. At times, it bothers me almost as much as the left. Bilateral shoulder pain in combination with bilateral knee pain has made both hiking and handyman projects disagreeable if not impossible.

“I saw a pain specialist in April due to shoulder pain and to sunburn-like pain in both shins. My internist said I had Chronic Regional Pain Syndrome, but the pain specialist suspected syringomyelia, and prescribed Neurontin and Tofranil. They helped the shin pain but did nothing for the shoulder or knee pain.

“I am here to get your thoughts about the continued left shoulder pain in particular, and a recent and severe increase in pain in both knees and both shoulders.

“I would also like to discuss alternatives for pain relief. The narcotics I’ve tried don’t help much, and they make me itch too much to sleep. Sleeping pills continue to be my best option—especially Dalmane—but the pain still awakens me ten times or more times each night.

“I read that Tramadol is sometimes used for moderate to severe arthritic pain, and would like to try it. Ultrasound is another option, but I haven’t found anyone who uses it, and my PT said the home units are a waste of money. I would also like to talk about hyaluronate injections—read the enclosed info at your convenience.

“I’m wondering if steroid shots might also help, although I’ve had mixed results from them in the past. I’m especially concerned about any harm they might do to joints.

“I’m now more open to the possibility of partial shoulder replacements, although I had rather pursue any reasonable option before agreeing to a joint replacement.

“In the last nine days, I’ve intentionally lost four pounds to make things easier on my knees, and I’m experimenting with a gluten-free diet. Other ideas would be appreciated.”