It's been four days since I took my last chip of Percoset. It was roughly 1/16th of a pill. I was tired of the whole business and it seemed likely my symptoms wouldn't be a lot worse than they already were. It was pretty intense for the next 24 hours. Since then it has been slowly getting better. I think I've got another two or three days of discomfort to go. Mostly the stomach thing. But the great news is I slept all night last night! That was a first since breaking my arm 3 months ago.
I had a follow-up appointment with my surgeon yesterday. I could see on the x-rays where my humerus had healed. I have a lot of work to do for the next year but the doctor thinks I could regain close to 100% of my range of motion. It is moving better and hurting less. I'm on the mend.
I've written a letter to the folks at my HMO. The first sentence reads, "[My HMO] gatekeepers were unresponsive, unsympathetic, and inappropriate when I asked for help withdrawing from Percoset." It goes on to describe how my HMO failed to offer assistance when I realized I was hooked on my pain killers and hadn't a clue how to stop taking them. It's a really ripping read, let me tell you!
I took a copy of the letter to the follow-up appointment with my surgeon. It was 2 PM so I was right in the middle of the worst withdrawal of the day. It always gets pretty yucky in the middle of the day. So there I was all edgey and extra-sensitive while trying to relate a rather emotion-laden series of events. I think I'm pretty expansive in my communication style under normal circumstance. This was not normal. So I probably appeared a bit unglued. I certainly felt that way.
Oh, well, as my dear friend Dawn might say. I have a strong opinion about being left on my own to deal with narcotic withdrawal and I wasn't going to sugarcoat it.
Despite my exuberant and impassioned presentation the doctor encouraged me to send the letter. So I'm sending it. Then we'll see if anything happens.
Meantime, I still have some detoxing to do.
Wednesday, August 27, 2008
Friday, August 15, 2008
SRD 30: It's All About the Smack
I'm still withdrawing from Percoset and it sucks. Imagine waking up everyday knowing you will feel like a piece of old cheese for anywhere from an hour to all afternoon. I say "like a piece of old cheese" because I really don't know how to describe the physical and mental intrusions caused by withdrawal. This is one of those things you cannot know unless you've experienced it. All those years working with social model recovery folks I had to just believe what they said--it takes a drunk/junkie/addict to help a drunk/junkie/addict. Now I know why.
When I came home from family camp I could see I'd be tapering, and withdrawing, for at least another couple weeks. The person I needed to talk to was Wendy. The ONLY person I'd met who has actually gotten off prescription pain pills. The only person I trust to get it. She delivered the bad news without exerting any energy to soften the blow. Withdrawal symptoms are more likely to worsen than improve as the dose is tapered. This can be mitigated a bit by taking the process real slow. But, basically, it's going to get worse.
How do people do this? I have an ideal situation: comfortable and stable home; reliable spouse/partner; grown, relatively self-sufficient children; access to acupuncture; and financial security. And yet this is really, really difficult. How do women with small children, no partner, no roof, or unpaid bills do this?
I would just take the damn pills. I wouldn't be able to do any of it while having withdrawal symptoms--drag myself through a day at work, attend to the needs of a dependent child, or plan, shop for and prepare meals. I can barely manage this WITH the hot tub in the backyard. And I've got another two weeks to go.
Here's the plan; I started out at one pill every 4 - 6 hours. I knocked my dose to 1/2 pill every 4 hours to start tapering. Ten days later I reduced to 3/8 of a pill every 4 hours. Now I'm taking 1/4 of a pill. Soon I'll drop to 1/8 of a pill. Wendy says it will be bad again for several days, maybe a week. But after that I plan to start dropping doses. The 3 AM will be the first to go. Then maybe the 3 PM.
I'll let you know how it goes.
When I came home from family camp I could see I'd be tapering, and withdrawing, for at least another couple weeks. The person I needed to talk to was Wendy. The ONLY person I'd met who has actually gotten off prescription pain pills. The only person I trust to get it. She delivered the bad news without exerting any energy to soften the blow. Withdrawal symptoms are more likely to worsen than improve as the dose is tapered. This can be mitigated a bit by taking the process real slow. But, basically, it's going to get worse.
How do people do this? I have an ideal situation: comfortable and stable home; reliable spouse/partner; grown, relatively self-sufficient children; access to acupuncture; and financial security. And yet this is really, really difficult. How do women with small children, no partner, no roof, or unpaid bills do this?
I would just take the damn pills. I wouldn't be able to do any of it while having withdrawal symptoms--drag myself through a day at work, attend to the needs of a dependent child, or plan, shop for and prepare meals. I can barely manage this WITH the hot tub in the backyard. And I've got another two weeks to go.
Here's the plan; I started out at one pill every 4 - 6 hours. I knocked my dose to 1/2 pill every 4 hours to start tapering. Ten days later I reduced to 3/8 of a pill every 4 hours. Now I'm taking 1/4 of a pill. Soon I'll drop to 1/8 of a pill. Wendy says it will be bad again for several days, maybe a week. But after that I plan to start dropping doses. The 3 AM will be the first to go. Then maybe the 3 PM.
I'll let you know how it goes.
Friday, August 1, 2008
SRD16 Resuming this blog
Let's see, I think the topic was P.G. Wodehouse.
My husband started reading aloud to me many years ago, I don't remember exactly when. I do remember we were on vacation, we were in bed, and the book was The Heart of a Goof. I was laughing so hard I had to sit up and will myself to stop so I could catch a breath. It was several years before reading aloud at bedtime became a near-nightly ritual. I think it evolved after our son no longer required my husband to read to him at night. Over the years, we have tried other authors--the names of which I do not recall--but no one else works as well as Wodehouse.
The world occupied by Wodehouse characters is entirely free of serious hardship of any kind. Young people are temporarily thwarted in their efforts to marry the girl/boy of their dreams. Practical jokes go terribly wrong, threatening to cast nephews into ill favor with their aunts. Feuds between elderly country squires cause friends and relations to conspire for their reconciliation. Golf is a religion of sorts. In short, nothing that might lead to nightmares ever happens in a Wodehouse story. You can safely drift off in mid chapter without fear of introducing strife or conflict into your dreams.
And that is exactly what I do every single night. My husband reads from whatever book we are working on , stopping periodically to ask, "Shall I continue?" I follow the tale for anywhere from 30 seconds to 20 minutes. If I fail to answer his query, my husband repeats the question. If I fail to respond the third time, he places the bookmark in the book and puts it away for the night. If I answer, he continues reading for another few minutes before asking the question yet again.
I was recently informed, since breaking my shoulder two months ago, the rules have changed a bit. He quits the moment he hears me snore. If I answer, "Shall I continue?" in the affirmative, he is not above quizzing me to see if I'm really awake. I can often repeat the last word but have no idea what else he has just read. That gets me cut off too.
I know what you are thinking. Why does he put up with me falling asleep every night while he is trying to read to me? I can only answer that the ritual seems to work for him as well as it works for me. If it ain't broke you really don't need to fix it.
These days I need P. G. Wodehouse as much as I need my little 1/2 pill of Percoset every four hours. It is, fortunately, a much more benign addiction.
Hiatus: I'll be away for a week. Look for new posts starting around August 11
My husband started reading aloud to me many years ago, I don't remember exactly when. I do remember we were on vacation, we were in bed, and the book was The Heart of a Goof. I was laughing so hard I had to sit up and will myself to stop so I could catch a breath. It was several years before reading aloud at bedtime became a near-nightly ritual. I think it evolved after our son no longer required my husband to read to him at night. Over the years, we have tried other authors--the names of which I do not recall--but no one else works as well as Wodehouse.
The world occupied by Wodehouse characters is entirely free of serious hardship of any kind. Young people are temporarily thwarted in their efforts to marry the girl/boy of their dreams. Practical jokes go terribly wrong, threatening to cast nephews into ill favor with their aunts. Feuds between elderly country squires cause friends and relations to conspire for their reconciliation. Golf is a religion of sorts. In short, nothing that might lead to nightmares ever happens in a Wodehouse story. You can safely drift off in mid chapter without fear of introducing strife or conflict into your dreams.
And that is exactly what I do every single night. My husband reads from whatever book we are working on , stopping periodically to ask, "Shall I continue?" I follow the tale for anywhere from 30 seconds to 20 minutes. If I fail to answer his query, my husband repeats the question. If I fail to respond the third time, he places the bookmark in the book and puts it away for the night. If I answer, he continues reading for another few minutes before asking the question yet again.
I was recently informed, since breaking my shoulder two months ago, the rules have changed a bit. He quits the moment he hears me snore. If I answer, "Shall I continue?" in the affirmative, he is not above quizzing me to see if I'm really awake. I can often repeat the last word but have no idea what else he has just read. That gets me cut off too.
I know what you are thinking. Why does he put up with me falling asleep every night while he is trying to read to me? I can only answer that the ritual seems to work for him as well as it works for me. If it ain't broke you really don't need to fix it.
These days I need P. G. Wodehouse as much as I need my little 1/2 pill of Percoset every four hours. It is, fortunately, a much more benign addiction.
Hiatus: I'll be away for a week. Look for new posts starting around August 11
SRD14 - We interrupt this blog
After whining in my last post about finding a comfortable position in which to sleep, I had to report this breaking news.
Yesterday, my PT, let's call him Wayne, showed me how to get a better night's sleep. It involves wearing my sling, lying on my back and placing a pillow on my stomach. I rest my arm on the pillow and viola! I can relax and go to sleep just like a normal person.
Now, you may be asking yourself why I didn't figure this out by myself. Good question. But I do not care. I'm just happy to be able to settle down without twitching around like a manic cat.
Yesterday, my PT, let's call him Wayne, showed me how to get a better night's sleep. It involves wearing my sling, lying on my back and placing a pillow on my stomach. I rest my arm on the pillow and viola! I can relax and go to sleep just like a normal person.
Now, you may be asking yourself why I didn't figure this out by myself. Good question. But I do not care. I'm just happy to be able to settle down without twitching around like a manic cat.
Wednesday, July 30, 2008
SRD 14 Better
Now that I've been detoxing for a few days I've had a chance to notice a pattern. I feel mildly crappy in the morning. I wake up with a sore arm and remember that I'm going to be managing withdrawal symptoms for the next 24 hours--not the best way to start the day. But the afternoons are always the worst.
I think it's partly a function of fatigue. As the day wears on I become more aware of the pain in my arm as I have less reserves to call on. The withdrawal symptoms seem to magnify at exactly the same time. I reach a point where I can't read or write or talk on the phone. I certainly can't pay bills, answer emails, cook or tidy-up the kitchen. I eventually find myself on the couch with the remote control in my hand. Thank God for Oprah and DVDs!
My son and I watched eight episodes of "How I Met Your Mother" yesterday. It's so much easier to just let Ted and Lily and Marshall and Barney and Robin deal with their lives while mine remains on hold. Some form of video crack gets me through the couple of hours it takes for the worst of the symptoms to pass. Then I'm mainly tired. But I'm usually too stubborn to just go to bed. Instead I soldier on until my 10:30 PM dose.
By the time I've taken my half-pill of Percoset, choked down a teaspoon of dry herbs (Did I forget to mention constipation? It isn't bad enough narcotics cause major plugging of the plumbing while still helping with the pain, they continue to slow digestion to a painful crawl even when you are getting nothing but withdrawal symptom relief.), washed my face, and changed into my nightgown, I'm so exhausted I feel like crying.
I finally get in bed and spend several minutes--no exaggeration--finding a comfortable position for my arm. This is complicated by the fact that my right humerus has migrated far forward in the shoulder joint due to a very tight pec muscle. Simply lying on my back creates a gravitational pull on the joint that feels simply awful--think weight-bearing on a very tight, sore muscle. I have to shift around until I find the one position in which I can relax into the mattress without encountering that icky sensation.
But it is all worth it because this is when P. G. Wodehouse takes over.
Coming up: the ultimate soporific
I think it's partly a function of fatigue. As the day wears on I become more aware of the pain in my arm as I have less reserves to call on. The withdrawal symptoms seem to magnify at exactly the same time. I reach a point where I can't read or write or talk on the phone. I certainly can't pay bills, answer emails, cook or tidy-up the kitchen. I eventually find myself on the couch with the remote control in my hand. Thank God for Oprah and DVDs!
My son and I watched eight episodes of "How I Met Your Mother" yesterday. It's so much easier to just let Ted and Lily and Marshall and Barney and Robin deal with their lives while mine remains on hold. Some form of video crack gets me through the couple of hours it takes for the worst of the symptoms to pass. Then I'm mainly tired. But I'm usually too stubborn to just go to bed. Instead I soldier on until my 10:30 PM dose.
By the time I've taken my half-pill of Percoset, choked down a teaspoon of dry herbs (Did I forget to mention constipation? It isn't bad enough narcotics cause major plugging of the plumbing while still helping with the pain, they continue to slow digestion to a painful crawl even when you are getting nothing but withdrawal symptom relief.), washed my face, and changed into my nightgown, I'm so exhausted I feel like crying.
I finally get in bed and spend several minutes--no exaggeration--finding a comfortable position for my arm. This is complicated by the fact that my right humerus has migrated far forward in the shoulder joint due to a very tight pec muscle. Simply lying on my back creates a gravitational pull on the joint that feels simply awful--think weight-bearing on a very tight, sore muscle. I have to shift around until I find the one position in which I can relax into the mattress without encountering that icky sensation.
But it is all worth it because this is when P. G. Wodehouse takes over.
Coming up: the ultimate soporific
Tuesday, July 29, 2008
SRD12 & 13 The Clinic
A/N: Life as a detoxing, shoulder rehabbing, therapeutic cooking, non-teaching Pilates instructor is so busy I'm falling behind on my blog! If you're reading this I'm pleased. If you would care to comment I would be even more pleased.
I arrived at the acupuncture clinic a little before 9 to fill out my paperwork. While I checked the appropriate boxes and signed the various consent forms required for free acupuncture, I noticed a little table near the door was slowly being covered with baskets of fresh fruit and vegetables, tubs of chunky peanut butter, and plates piled high with whole grain rolls. A large metal bowl filled with freshly picked spring mix sat next to two small jars of salad dressing. Smaller bowls held two different types of roasted vegetable salad. The food smelled fantastic even though I was too full to eat any of it.
The acupuncture clinic flyer had promised breakfast, but when I read "breakfast" I visualized cheap, store bought danish and weak coffee. So I still made a point of getting up early enough to eat my own home cooked steel cut oats with goat yogurt, walnuts, fresh blueberries, and maple syrup. As other participants filled their plates with wholesome goodies, I had to admit I hadn't expected the people taking advantage of free acupuncture for withdrawal symptoms would partake of such excellent fare. I guess I'm a food snob.
Because it was my first time there, I had to speak with a counselor before I could have a treatment. Amanda led me down a long hall to her office. She asked me very little about why I was there and seemed most concerned that I consider the psychological impact of being disabled and unable to work. I considered both and admitted that they suck.
Having met all the requirements for treatment, I followed Hope, the clinic's acupuncturist, to the treatment room. I soaked a cotton ball with alcohol, as previously instructed, and rubbed both ears clean. Hope handed me a piece of paper with the number "7" written on it and a clean cotton ball. I sat on a stool while she inserted seven needles; two in my right hand (for the pain in my shoulder), two in my right ear, and three in my left ear. Then I moved to one of the large, comfy chairs lining three sides of the room and sat in near silence just like the other 10 or 12 people with needles stuck in their ears.
Talking is actively discouraged in the treatment room. Most people seem to just close their eyes and chill. I took their suggestion and did the same. I've had acupuncture many times before so I wasn't surprised by the sudden calm. It was extremely refreshing to feel like I could relax in my own skin for a change. Next to nausea, feeling irritable and jumpy is the worst of the withdrawal symptoms. I sat back and enjoyed a vacation from those unpleasant feelings for about 40 minutes.
When I felt finished, I pulled the needles out of my hand and used a mirror at the front of the room to remove the needles from my ears. I stuck the needles into the cotton ball and showed them to Hope before dropping the whole thing into a container hanging on the wall.
I stopped by the reception office to say goodbye and made a little peanut butter on whole grain roll for the road. I still wasn't hungry but it seemed such a shame not to enjoy some of the bounty.
I had decided to try walking home. I stopped about halfway to take my 10:30 AM dose of Percoset, pleased I hadn't been looking at my watch for the past 15 minutes willing the time to pass.
Next up: afternoon is always the worst
I arrived at the acupuncture clinic a little before 9 to fill out my paperwork. While I checked the appropriate boxes and signed the various consent forms required for free acupuncture, I noticed a little table near the door was slowly being covered with baskets of fresh fruit and vegetables, tubs of chunky peanut butter, and plates piled high with whole grain rolls. A large metal bowl filled with freshly picked spring mix sat next to two small jars of salad dressing. Smaller bowls held two different types of roasted vegetable salad. The food smelled fantastic even though I was too full to eat any of it.
The acupuncture clinic flyer had promised breakfast, but when I read "breakfast" I visualized cheap, store bought danish and weak coffee. So I still made a point of getting up early enough to eat my own home cooked steel cut oats with goat yogurt, walnuts, fresh blueberries, and maple syrup. As other participants filled their plates with wholesome goodies, I had to admit I hadn't expected the people taking advantage of free acupuncture for withdrawal symptoms would partake of such excellent fare. I guess I'm a food snob.
Because it was my first time there, I had to speak with a counselor before I could have a treatment. Amanda led me down a long hall to her office. She asked me very little about why I was there and seemed most concerned that I consider the psychological impact of being disabled and unable to work. I considered both and admitted that they suck.
Having met all the requirements for treatment, I followed Hope, the clinic's acupuncturist, to the treatment room. I soaked a cotton ball with alcohol, as previously instructed, and rubbed both ears clean. Hope handed me a piece of paper with the number "7" written on it and a clean cotton ball. I sat on a stool while she inserted seven needles; two in my right hand (for the pain in my shoulder), two in my right ear, and three in my left ear. Then I moved to one of the large, comfy chairs lining three sides of the room and sat in near silence just like the other 10 or 12 people with needles stuck in their ears.
Talking is actively discouraged in the treatment room. Most people seem to just close their eyes and chill. I took their suggestion and did the same. I've had acupuncture many times before so I wasn't surprised by the sudden calm. It was extremely refreshing to feel like I could relax in my own skin for a change. Next to nausea, feeling irritable and jumpy is the worst of the withdrawal symptoms. I sat back and enjoyed a vacation from those unpleasant feelings for about 40 minutes.
When I felt finished, I pulled the needles out of my hand and used a mirror at the front of the room to remove the needles from my ears. I stuck the needles into the cotton ball and showed them to Hope before dropping the whole thing into a container hanging on the wall.
I stopped by the reception office to say goodbye and made a little peanut butter on whole grain roll for the road. I still wasn't hungry but it seemed such a shame not to enjoy some of the bounty.
I had decided to try walking home. I stopped about halfway to take my 10:30 AM dose of Percoset, pleased I hadn't been looking at my watch for the past 15 minutes willing the time to pass.
Next up: afternoon is always the worst
Monday, July 28, 2008
SRD11 Hitting bottom
Everybody is familiar with the concept of "hitting bottom". I feel compelled to acknowledge my "bottom" was roughly the depth of a kiddie wading pool.
Wendy, my drug dependence counselor, buzzed the CDRP doctor to ask for help figuring out what to do with me; the problem client who wasn't messed-up enough for the clinic. When the doctor joined us in Wendy's office I recognized her immediately as a fellow family camper. We'd been in a play together.
It was surprisingly not awkward to encounter someone I knew in a completely different context while being counseled for drug dependence. In fact, it was kind of great.
The doctor confirmed what Wendy had already said and then proceeded to tell me what I needed to do to get off Percoset. In about 5 minutes, I learned enough to leave the CDRP confident I could detox safely on my own. It's not rocket science, it's actually quite straight-forward, but I didn't know several things that made a big difference. For example; I had been trying to wean myself by increasing the amount if time between pills. The doctor said they recommend reducing the dose but keeping the time interval constant. I also learned that narcotic withdrawal is not life-threatening. Unlike kicking Valium or alcohol--which can cause serous problems like seizures--people withdrawing from narcotics may feel like dying, but it won't kill them. Good to know.
After fleshing out my self-guided detox program, the doctor wished me the best of luck and departed--no doubt to help someone who was in vastly worse shape than I. As soon as the door closed Wendy took me into her confidence.
"I didn't want to say anything while the doctor was here," she said. "But I don't think the doctor has actually experienced narcotics withdrawal, and I have."
With that, Wendy pulled a sheet of paper out of a file folder and laid it on my lap. "That's my back," she said.
It was an x-ray showing two rods and four bolts installed in the lumbar region of Wendy's spine. "That's how I got hooked on narcotics," she said. "I was never addicted either. But I can tell you from personal experience that it's going to take more than a week to wean yourself."
Wendy proceeded to amend the time-table I had discussed with the doctor. Rather than 3 days, she suggested I spend 5 to 7 days at each dose level, moving on only when I felt ready. If the symptoms get too intense, she explained, I could always go back to the previous dose. But the whole process would be much easier if I take it very slow.
Here's the plan:
Take one-half of a pill every 4 hours.
Drink detox tea (chamomile, mint, licorice, skullcap, and hops) all day long.
Get daily acupuncture treatments for free at a local public clinic.
Reduce the dose to one-quarter of a pill after 5 - 7 days.
Repeat.
Coming up: the acupuncture clinic
Wendy, my drug dependence counselor, buzzed the CDRP doctor to ask for help figuring out what to do with me; the problem client who wasn't messed-up enough for the clinic. When the doctor joined us in Wendy's office I recognized her immediately as a fellow family camper. We'd been in a play together.
It was surprisingly not awkward to encounter someone I knew in a completely different context while being counseled for drug dependence. In fact, it was kind of great.
The doctor confirmed what Wendy had already said and then proceeded to tell me what I needed to do to get off Percoset. In about 5 minutes, I learned enough to leave the CDRP confident I could detox safely on my own. It's not rocket science, it's actually quite straight-forward, but I didn't know several things that made a big difference. For example; I had been trying to wean myself by increasing the amount if time between pills. The doctor said they recommend reducing the dose but keeping the time interval constant. I also learned that narcotic withdrawal is not life-threatening. Unlike kicking Valium or alcohol--which can cause serous problems like seizures--people withdrawing from narcotics may feel like dying, but it won't kill them. Good to know.
After fleshing out my self-guided detox program, the doctor wished me the best of luck and departed--no doubt to help someone who was in vastly worse shape than I. As soon as the door closed Wendy took me into her confidence.
"I didn't want to say anything while the doctor was here," she said. "But I don't think the doctor has actually experienced narcotics withdrawal, and I have."
With that, Wendy pulled a sheet of paper out of a file folder and laid it on my lap. "That's my back," she said.
It was an x-ray showing two rods and four bolts installed in the lumbar region of Wendy's spine. "That's how I got hooked on narcotics," she said. "I was never addicted either. But I can tell you from personal experience that it's going to take more than a week to wean yourself."
Wendy proceeded to amend the time-table I had discussed with the doctor. Rather than 3 days, she suggested I spend 5 to 7 days at each dose level, moving on only when I felt ready. If the symptoms get too intense, she explained, I could always go back to the previous dose. But the whole process would be much easier if I take it very slow.
Here's the plan:
Take one-half of a pill every 4 hours.
Drink detox tea (chamomile, mint, licorice, skullcap, and hops) all day long.
Get daily acupuncture treatments for free at a local public clinic.
Reduce the dose to one-quarter of a pill after 5 - 7 days.
Repeat.
Coming up: the acupuncture clinic
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