From Axe to Anxious or the Story of Two Pills and $12

9 04 2009

A few years ago…well almost a decade ago now

I was stuck…in a tiny little tube…I was having trouble breathing, sweaty, struggling to move, on my side, bogged down and completely unable to even wriggle forward or backwards…again, I was stuck.

Lt. Green, the salt-fried truck officer yanked me out of the 6 foot long, 13″ square “confined space” tube and quietly shamed me for not being able to overcome such a tiny little obstacle…literally.

He intimated that men whose gut formed pannuses (what is the plural of pannus anways?) that overlapped their thighs could make it through that tube. He marveled – if the fat-bodies could hump their way through it, but I couldn’t – I bristled. I put my mask back on and I flew through that damned tube – I wormed through like a champ.

Fast forward nine years.

My back, which has hurt for the better part of a half-decade, is starting to hurt for more than just a day at a time. I’m always aware of it, the pain much worse now, is at times barely manageable. It’s likely soft-tissue damage and so the obvious thing to do in order to look at the soft-tissues – is to do an MRI.

An MRI is a test where the area to be imaged, in placed in the center of a huge magnet – basically you find yourself in the middle of a tube, while what sounds like a jackhammer thumps and tumbles all around your body. There is about 2″ of clearance all the way around you. It’s a tight fit – at least for me it was…

And it’s been a terrifying fit too. For some reason being on the table on my back, being in the magnet – unable to put my hands up to my eyes or anywhere near my face, over my chest, nothing – is unabashedly terrifying. It conjures up images of some of my most incredible fears – being buried alive. For that reason I’d rather be cremated than anything else – I have no desires to be buried.

I had gone from axe-swinging to anxious. I’d lost the fire in my belly. At least that’s how it’s seemed. I’d love to be able to tell you I finished the test – completely under my own willpower – but in a shockingly powerful way, my brain told ME ,that I wasn’t getting in that tube. At least not headfirst. I wondered if I could jump in the tube feet first. I wondered if I could be knocked out cold with a horse-dose of sedatives.

I’ve thought about losing weight – even going as far as making a bet with a fellow classmate who is entirely too skinny to want to lose weight – to make the tube a less claustrophobic and intimidating place to spend an hour of my time.

I’ve thought about zoning out – pretending I’m in outer space, and that I have to lie perfectly still in order to stay in my oxygen bubble – but that there was ultimately nothing that would keep me calmly lodged in the narrow little tube.

Damn. My doctor prescribed me some sedatives.

The tranquilizers by the way – two pills total, cost me and my insurance company $11.99. They were almost wholly ineffective to boot. I couldn’t help but think that it was why people didn’t go to their doctor – so that he could tell them to buy two expensive ass pills that gave them funky side effects and didn’t really do much to help them feel any better.

So now tangentially, as I’m getting my medication filled – I’m wondering if the exorbitant prices of drugs is one of the driving reasons behind the health disparities that we see in America. I’m wondering if it’s one of the driving reasons behind the amount of chronic disease we see in America – and I’m wondering if it’s the reason that we see people end up completely noncompliant with the regimens that doctors prescribe their patients.

The two pills never even touched the anxiety, the crushing feeling that prompted me to feel like I was suffocating even though I had just drawn in a deep breath of “fresh” air. My stomach tightened and I was having crushing palpitations. Physiologically, I was fighting for my life – my heart fluttering wildly, pupils dilating, and me shaking uncontrollably. I belched and passed gas for a solid ten minutes after the attempt. I walked out in the cool night angry, frustrated with myself and more importantly my head for fearing death in a way I’d always hoped I was immune to.

On tranquilizers, 20 minutes after the procedure had short-circuited a second time due to my overactive limbic system – my pulse was a solid twenty beats a minute above its’ normal. I still felt nauseous. The fight or flight response was still kicked into gear. I wondered what it might be like for those who had random panic attacks when they went about their daily life – doing things like going to the doctor, dentist, post-office. Going to school or the aquarium. At home with relatives, out at a grocery store. On an airplane.

I reflected on the last flight I was on – with a woman who seemed a little edgy and as it turned out she was – fairly afraid of flying – especially through turbulence. Her body language betrayed the shitstorm of fear that was flying through her mind. Her hands clutched out in vain for some sort of safety bar – but then she realized it would’ve been attached to the very airplane she thought was crashing.

A friend of mine summed it up quite succinctly and nicely – “when you are starting to panic, there is a duality in the logic you use to attempt to calm yourself down – you are able to tell yourself that nothing is wrong, and that you are perfectly safe, because there is nothing threatening or harmful happening…but then you realize that even if nothing threatening or harmful is going on – and you feel the way you do, something MUST be wrong, and now you don’t know WHAT it is.”

His understanding made me both laugh, and comforted me.

Now I’m confronting my own mortality. I’ve put on some years, and I’ve begun to learn about all of the myriad ways people can not only die – but degrade and die. I’ve also become much more aware of my place in the world and the world itself. This world is a terrifying and sickening place.

And so naturally, I’ve become more fearful, more anxious in general – and I’m wondering if its’ natural manifestation is via my irrational expression of fears. I’m wondering if I’m doomed to a semi-decrepit body that hurts but isn’t diseased enough to warrant much treatment.

I fear that inattention and slow decline exquisitely. More than ever before I realize the potency and happiness of youth. And I’m very glad I blew all of my money and did as much as I could when I was young. I’m glad I was mostly single – I’m glad I came out of my early twenties and late teens without children or hard committments to anyone other than myself.

But now I have to make sure that in this next few decades, I can learn to live in a fearless manner. They are there – I just need to ignore them. That’s a strength that I’m going to have to develop. As you grow older – the monsters under your bed don’t go away – they just change clothes and get jobs as attorneys or politicians. Or creditors. Or police.

I can’t help but wonder how people feel when they go to the doctor. Do they think they have a crushing super-debilitating illness? Do they feel like its’ going to be a pop-fly illness? Or is it going to be a chronic slog through misery?

Are their physicians going to make it any better? Can their physicians make it any better? How are they going to deal with it? Are their physicians going to even attempt to protect them from their own vulnerabilities and insecurities? Their unique neuroses?

My doctor did. A healthy dose of razzing followed. But he went on and sent me to a physiatrist even though he knows they are going to look at him like he’s not doing his best for not getting me into an MRI. But he did his best – both for the specialist I’m going to see, but also – and ultimately more importantly – for me.





Addictions

9 03 2008

Addiction is one of the most costly diseases in America right now,  filling our prisons, and killing our children and parents slowly.  A generation of parentless children, and drifting, seemingly heartless walking dead has descended upon America.  From the opening paragraph you would think I would be vigorously anti-drug.  You would think I agree with America’s War on Drugs.  Well, maybe not.  The War on Drugs is the other Vietnam.  The other Iraq.  The other ill-advised “war”.  It serves only to justify the massive prison budget we maintain.  It serves only to justify the massive prison-industrial complex we allow – something that is tantamount to legalized slavery.  It is unfortuate our companies have tapped this unfortunate and disenfranchised labor pool.  I’m definitely a fan of mass murderers, rapists, armed robbers, embezzlers, arsonists, and drug dealers going straight to prison.  I’m also a fan of them working their asses off while in prison.  Just not answering calls for a major telecommunications company.  I’m in favor of them doing something a little more productive, engaging in some type of societal “investment” such as building parks, bridges, schools, maintaining jails, etc.  What I’m not in favor of is drug users going to prison.  The sad state of our decades long drug interdiction campaign is that of broken people, families, homes, and communities.  Today I walked through a small area of Brooklyn.  Brooklyn is an area that despite its’ recent fashionable resurgence is one that looks like a bomb hit it…the bomb in this case was crack.  Introduced by the CIA to fund another pointless war, crack spread through Brooklyn, Queens, really any place with a poor to middle class populace, and it just destroyed the collective consciousness that had managed to build itself.  Unfortunately it was also a brilliant economic boost for those on the other side of the epidemic.  Jails, prisons, police precincts exist because of the scourge of crack cocaine, methamphetamines, ecstasy, and other drugs that are smoked, injected, snorted, and sold routinely.  The economic toll this has on our country is absolutely staggering, and the strategy to reduce this toll is absolutely correct – reduce the market for it.  A drastically reduced market will serve to drive thousands of dealers out of business, one way or another.  Making penalties for dealing all drugs commensurate to the amount of drugs found regardless of the drug would do much to reduce the inequities of the current drug enforcement system.  Unfortunately, putting sick people behind bars will do nothing to curb their illness.  Their illness in this case is addiction.  Addictions are a serious psychiatric problem – NOT a personal choice.  We allow people who are addicted to cigarettes, alcohol, prescription painkillers multiple attempts to get clean without prescribed jail time – why aren’t we doing the same for people who are caught possessing harder illicit drugs?  Why aren’t we pouring money into non-criminalizing medical treatment programs that don’t destroy families indiscriminately?  These are some of my motivations for pursuing research that could help treat addictions.  There is a legion of people who, shaped by both their past experiences – social and pharmacologic – are completely unable to participate in society in a productive manner.  We owe it to them to lift them back onto their feet.  Otherwise we lose the right to refer to ourselves as a “society”