The Hero in the Little Bottle, or: Thank Goodness; or: That #!*@$&! Dog!!!

Here is a sample bottle of some hydrocodone medicine.  You can see by the beat-up label that it’s kind of old.  The expiration date is 1995.

It’s part of my emergency kit.  The last time I took one was in 2010, when I was in India and broke my wrist.

Yesterday I was walking on a State Park trail enjoying the late afternoon sun when a lady walked by with her Golden Retriever.

“Is your dog friendly?” She asks.

“Well….sometimes.  She plays really, really rough,” said I.

By this time I had moved off the trail into a little grassy area to give the lady and her dog room to pass.

Instead, she decided to bring her dog over to “make friends.”

Before you could say “Oh fuck!” Atina was in her dog’s face snarling and making that fearsome sound dogs make when they’re fighting.  She was so determined, I found myself helplessly dragged along at the end of the leash.

Then I myself roared into life and dragged her off the terrified retriever, whose owner was triple quadruple terrified.

Atina had not finished snarling when I got hold of her, but she shut her face once she saw mine.

God I just wanted to kick her ass around the block!

I waited for the poor terrified lady and her dog to get back down the trail before I started back myself.  It was getting toward “coyote time” of the evening and I was in no mood for another confrontation.

As I led the now-chastened Malligator down the path, I spied a rock sticking out.  Watch out for that rock, my brain said.  Fuck you, said my body, and demonstrated my foot-drop so that I could trip on that very rock….and fall into thin air.

I saw the whole thing in slow motion.  The hard ground coming closer and closer….I dropped the leash from my left hand and the baggie full of dog poop from my right, and broke my fall with both hands.

Jesus Christ on a bicycle, I have rarely felt such pain!  Now I know why beating people on the hands and feet is such a popular form of torture.  There’s really nowhere for swelling and blood from broken blood vessels to go.  The pressure is maddening.

I’m able to this only because the first-aid measures of last night have much improved the situation.

First I managed to get myself and the Malligator into the van.  This was no small feat, since both of my thumbs were so swollen they were pulling my hands into claws due to the spasms in my thumb muscles.

Once I got inside, the only thing I could do was to sit down and bawl uncontrollably for a long time.

Next I had to remember where I’d stashed my emergency pain pills.  Fortunately my mind’s eye is pretty good, and I located the plastic box where I keep seldom-used meds.  It was dicey getting the box out of the overhead compartment, between my bad shoulders and my completely fucked-up hands.

I took a pill, then sat down to cry some more.  Eventually I remembered the Traumeel, that wonderful arnica-based homeopathic ointment.  It’s great for bruises and any kind of trauma that doesn’t involve an open wound.

And ice!  It required some ingenuity to get the damn ice out of the ice tray, but I did it.

As I was icing, I remembered that I am an acupuncturist.  I got some needles and by pressing my teeth into service, extricated a few from their sterile packaging.  I did some emergency points for general trauma, then did some decompressing local points.  After an hour the spasms had gone from my thumbs and the swelling was subsiding.

This morning my hands are much better, although I fear I may have further injured my already-fucked-up left wrist.  I guess I should call my hand surgeon’s office and make an appointment for next week….

(The Golden Retriever was fine, by the way.  Just a lot of noise and display, apparently, but soooooo NOT okay.  I might get the electric collar out for our next walk.  When she has it on, I almost never have to use it because she KNOWS what it means….)

Patient Abandonment: Personal Experience of an Ethicist

http://m.content.healthaffairs.org/content/36/1/182.full

A patient receives prescription opioids after an accident—and no support from his physicians as he weans himself off.

…In Which I Try Something Altogether New And Different

My recent posts have been lame and few.

Depression is largely to blame.  So is pain.  I wouldn’t go so far as to chalk my depression up to pain, as I’ve been suffering from depression literally all my life; but it sure is hard to get un-depressed when struggling in the grasp of unremitting pain.

I went to see an orthopedist about my shoulder.  He seemed like a decent sort.  I was struck dizzy by the splendor of his haberdashery.  His colors were straight out of the last Laura Ashley paint swatch book I consulted for a vintage room re-do.  

I had to drag myself away from admiring the knife creases on his shirt sleeves and trousers, the precise correctness of the diagonal striped tie….

The shoulder.  Oh yes.

It feels like how your shoulder feels after a **really good** flu shot.  You know, the way you slink around trying real hard not to bump into anything, and of course you do, because you always do, except you don’t normally notice it because your deltoid muscle is normally not all hot and red and swollen and sore.

You try to move your sore shoulder around, because you’ve heard that moving it around helps…with, oh, something.  I can’t remember.  The only thing that helps is Time.  Tincture of Time, that great healer.

So it goes with my shoulder.  It’s been hurting for several months.  I’ve given it gallons of Tincture of Time, to no effect.  In fact, it’s getting worse.

So it was that I came to visit Dr. Haberdashery on Friday last.  He took no x-ray, but put me through a rigorous demonstration of my range of motion, marveling at my flexibility (quite!).  I yelped and complained of pain, but forced my upper extremities into all sorts of contortions–in order to prove, I suppose, that I’m not…something.  I have a morbid fear of being thought a fake.  I believe this comes from having been accused of faking various things like asthma, which I got from inhaling my mother’s cigarettes since before I was born.  So now I feel like I have to demonstrate how hard I’m trying, to show how rigorously I’m adhering to my physical therapy regimen…which, in truth, I’m not really, because I’m simply hyperflexible.  I have abnormal collagen.  I can pop my shoulder right out of its socket!  

The diagnosis (sans x-rays) is arthritis.  The treatment: increase my celecoxib for a couple of weeks; then if no improvement, consider steroid injection.  If no relief with that, consider surgery to “decompress” the joint by grinding off the bone spurs.  Dr. H quoted the numbers: 80% get relief from this surgery, 20% don’t.  Better than back surgery, but still more risk than I’m willing to take at this point.

After my bout of calisthenics in the way of physical examination, my shoulder started feeling like a tensely  swollen and exquisitely tender softball.  Getting dressed/undressed is a new kind of challenge.  I quickly learned that pullovers are not a good idea.  I got trapped with a sweatshirt over my head and no way to get further in or indeed further out!  

Just because I needed more pain, something in my thoracic spine went “pop”a couple of days ago, and now it hurts to cough, or breathe, or move, or do anything….

So now, if you include my wrist that needs surgery (I do), I have three active areas of acute pain on top of my entire spine and the rest of my joints, which provide a kind of basso continuo for the baroque dance that is my Pain Body.  

So, did Dr. Haberdashery send me away with any pharmacologic relief?  Aw, come on…you know the answer!  Of course not.  We’re in a national epidemic of…something.  No, pain medication is no longer a menu item–not that it has been, not for many years, for me anyway.  Maybe it’s the brain diagnoses.  My experience has been that I’ve had to beg for pain meds, even tramadol.  This guy had “Please don’t even ask” written large all over his vintage green shirt.  I didn’t ask.

Up in a high cabinet, in a box with teas that I use infrequently, are a couple of packets of Mitrogyna Speciosa, also known as Kratom or Ketem.  It’s an herb that teeters on the brink of making the DEA Schedule I list. In fact, it was scheduled to be scheduled this past December.  In an unprecedented move, tens of thousands of people wrote to the DEA requesting that Kratom be saved from the list, that it not be torn away from law-abiding Americans who want to stay law-abiding and not have to scramble around in the darkness of the black market to get their medicine.  Sound familiar?   

Why does the DEA want to sequester Kratom?  Is it really as bad as heroin or (gasp!) cannabis? 

Well, not really.  In fact, Kratom simulates mu receptors, which is what opioid medicines do.  It’s a mild pain medicine, rarely results in addiction, and is extremely useful in helping opioid addicts to detox with hardly any withdrawal symptoms.  

We can conjecture why Big Pharma wants Kratom off the market.  With such valuable properties, people might not need a whole subset of expensive pharmaceuticals–anything from naloxone, which has risen in price some 1,000% (yes, that’s right) since the CDC’s initial report and the subsequent media blast about opioid epidemic, and the very real heroin epidemic that spits out scores of overdose victims daily–to fentanyl patches, to the drugs used by the “recovery” industry: buprenorphine and Suboxone being the contenders here.

Kratom can contend with the contenders in a number of contexts.  I’m not an expert–the opposite–so please fill me in, in the comments.  I’m just here to report my personal experience.

Which is: I was going mad with pain.  I had bought some sample-size packets of Kratom powder.  I took some.  I felt better.  Much, much better.  Still painful, but bearable.  Liveable.  Much better.

I’ve been afraid to try the Kratom because of fear of side effects.  The chief side effect is nausea and vomiting.  This is hailed by Kratom users as a built-in overdose preventer:  If you take too much, you puke and that’s that.  I’m not 100% convinced of that, but I have a lot of research to do, now that I’ve dipped my toes in the green waters of Kratom and lived to feel better.

And what about my legal medical cannabis?  Isn’t that supposed to be a panacea?  Why do I need something else?

Let me tell you, if I were to take cannabis sufficient to blot out this pain, I would be blotted out myself!  I do medicate at night very heavily, using a powerful coconut oil infusion that I’ve baked up into brownies…and what brownies they are!!!  Knockout drops.  If I got that medicated in the daytime I wouldn’t be able to stand up.

Which brings me to another Kratom advantage.  In low doses it’s a stimulant.  In high doses it’s a sedative.  Now, I haven’t found any definition as to what constitutes a “low” or a “high” dose.  I suppose it’s individual.  I started out with a gram yesterday, got some pain relief with that, and increased my dose to 1.5 grams today.  Better pain relief, felt a little bit high but clear and alert.  Decent!  Tomorrow I might try 2 grams.  

Have you tried Kratom?  What was your experience?

Why Did Fentanyl Maker Insys Give $500K to Defeat Legalization? | Leafly

https://www.leafly.com/news/politics/fentanyl-maker-insys-give-500k-defeat-legalization/?utm_medium=email&utm_campaign=B2C%20News%20-%20Week%2035%20-%20Eng&utm_source=Sailthru&utm_term=Master%20-%20Engaged%2C%20Active%2C%20Passive%2C%20or%20New

How Do I Advocate for Chronic Pain? – National Pain Report

Is the current “Opium War” hurting you or someone you know?  Here are some good tips for how to get involved.  Don’t let them kill us with “kindness!”

http://nationalpainreport.com/how-do-i-advocate-for-chronic-pain-8831046.html