Oxycodone and Me


David Ryan

David Ryan is a boat builder and USCG licensed master captain. He is the owner of Sailing Montauk and skipper of Montauk''s charter sailing catamaran MON TIKI You can follow him on Twitter @CaptDavidRyan

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18 Responses

  1. Avatar Oscar Gordon says:

    A co-worker and I both have damaged knees. I recently dislocated my knee, and my co-worker tore his meniscus and had surgery.

    We were talking about the constant low level pain we live with and how you just stop noticing it. It never goes away, but it simply drops below the level of consciousness. Until you dislocate, or tear something, and then you notice every little twinge again. And you have to work to push it back down below the level of noticing.

    Personally, opioids make me feel like crap (except morphine, that stuff is awesome), so I avoid them, but I can understand how, if they help a person drive the pain down, they get addicted.Report

    • For me pain occurs in three varieties: pain of effort, like from running or lifting, and which is pleasant to endure and transcend; pain of existence, like my scar and other lingering injuries, which can mostly be compensated for and/or ignored; and pain of injury and damage. Part of living well, I think, is being able to discriminate which is which, and then enjoy, ignore, or be moved to action as indicated.Report

      • Avatar Oscar Gordon in reply to David Ryan says:

        With the knee, it’s mostly pain of existence. Except when I dislocate it, then there is a lot of pain of injury (turns out knees don’t like being dislocated, who knew?) that is coupled with pain of existence, and for a few months the two are tightly co-mingled.

        What I’ve learned, over the years, is to distinguish the two, but that first month or so after a dislocation it’s damn hard to do that. On the bright side, if applying ice or heat, or popping a couple of Aleve, makes the pain fade, chances are I haven’t done any further injury and I just need to stretch things out and do my exercises again until everything fades into the background again.Report

  2. Avatar Jaybird says:

    Slate Star Codex has an essay about “pseudoaddiction“. He goes into a lot of words about what pseudoaddiction means but, in a nutshell, let’s say that your painkiller works for 3 hours. Let’s say your doctor says “no, that’s not right, your painkiller should work for 6 hours.” Now let’s return to the beginning assumption: the painkiller only works for 3 hours.

    Pseudoaddiction is when you want more painkillers because your painkiller only works for 3 hours but doctors think you’re addicted because they should work for 6 hours.

    All that to say: our attitudes toward pain are magnificently messed up in this country. I have no idea how we’d go about fixing it. Even in theory.Report

    • Avatar dragonfrog in reply to Jaybird says:

      Apparently that was a significant contributor to the OxyContin part of the opioid crisis – Perdue Pharma marketed OxyContin as being effective for 12 hours, so doctors could prescribe the patient’s required daily dosage in just two pills per day.

      For a large percentage of people, it’s effective nowhere near 12 hours. But that’s not Perdue’s doctrine. If it’s not working for the patient, it must be because the dose is too low, so you prescribe a higher dose; you don’t increase the number of pills and decrease the strength to keep the total dose the same, because *by doctrine* the effect can’t be wearing off before 12 hours if the daily dose is appropriate.

      So the result was that patients were cycling back and forth between being high and being in withdrawal, rather than maintaining a dosage that kept the pain at bay without creating much of a high.Report

    • Avatar David Ryan in reply to Jaybird says:

      The other scar in the picture is from an appendicitis attack and suffered when I was, and which capped off my one, miserable semester at art school.

      Post surgery I was in a lot of pain, as I lay in the bed I afraid to even move or breathe. The the nurse would come in with a pill. At first the pill made me feel pleasantly warm, then it felt like my body was starting to melt, and then finally my body would evaporate and I would lose consciousness.

      The problem was I was roomed with a non-compusmentus old man would would regularly get out of bed, tear out his IV, and go crashing around the room. This would wake me up, often after the effects of the drug I had been given had worn off. I’d push the call button, then lay in bed, very still, counting the minutes until my next dose.

      Two things I wish I had known:

      1) Apparently what they had done is SOP — put a good patient with a bad patient to help keep an eye on things

      2) I wish it had occurred to me to ask for more drugs. If it had, and I had understood their stratagem, I could have advocated for myself more effectively.Report

      • Avatar Jaybird in reply to David Ryan says:

        That sounds awful. On every level.Report

        • Avatar David Ryan in reply to Jaybird says:

          Eh? What are you going to do. What was worse was that because I had been feeling bad for a few days before I went in (finally I called my dad and he diagnosed me over the phone and I walked to the St. Vincent’s ER) I hadn’t eaten anything for about 3 days. And because I hadn’t eaten, my bowels showed no sign post-surgery that they were back to working order — i.e. I wasn’t shitting.

          So there I was, stuck in the hospital on a restricted diet of clear liquids, doing laps of the ward with my IV, hoping someone would notice that I was ok and ready to leave.My favorite neighborhood pizza joint was in plain view out the window of my room and I’d sit, nose against the glass, imagining how good a pepperoni slice would taste! Finally after about a week they gave me a real meal and voila.Report

  3. Avatar CJColucci says:

    I was also born (in 1953) with an undescended testicle, on the right side, which they didn’t do anything about until I was 5 or 6, clearing up both a hernia and the undescended testicle at the same time. (They reopened the same scar when they had to get my appendix out. It was only years later that I saw a normal appendectomy scar.) The scar was no big deal, but leaving the testicle up there for so long often results in infertility. I hope you were one of the lucky ones.Report

  4. I so appreciated this post. Having something in the range of 30 torso scars (add another 32 if you want to count the staple scars individually) I could relate to a lot of this. Especially pushing through and making it worse, since my health issues started while still active duty and I ignore them for the greater good to my own stupid detriment. Very glad to have you back and look forward to more writing from you.Report

    • A few weeks after 9/11 I went into the recruiting station on Times Square and tried to sign up. Was rejected for being too old. As the whole thing turned ran on, with stop-loss, raising the maximum age, and lowering criminal and drug record standards, I could have signed up, but I didn’t. The only service people I know first hand are my father, his brother and my mom’s brother’s long time companion. All three marines, all three admirable men. I know I missed out on something important. I also know, from the service people I’ve met and become online friends with that I’m glad I missed out. Life is complicated.Report

      • It is. My entire family is military on both sides, with the exception of my paternal grandfather (too old for WW2) and my father who volunteered 3 times, got drafted twice, and they still wouldnt let him go. We’ve had that conversation on how he always felt he missed out (his brother was career Army) but as he got older his opinion changed on it, especially with members being active duty and being on heavy rotation most of it. Report

  5. Avatar Michael Cain says:

    The summer I was 16 I had a bout of pleurisy. I could do anything I wanted to physically except breath, which felt like someone had a big nail started between two ribs and every time I inhaled or exhaled it felt like they gave it a good smack. My parents let me go to the doc when Mom finally noticed that I was serious about finding out how little I could inhale/exhale and stay conscious. The doc gave me a bazillion units of penicillin in the butt and prescribed more penicillin and a “don’t care” drug.

    I don’t know which one it was. A friend stopped by to see why I missed band practice. After I described it to him, he asked if it still hurt. “Yep, some, but I just don’t care.” I lost significant chunks of the next three days. It was those missing chunks that put me off anything stronger than mild intoxicants for recreation.

    Every chest x-ray comes with a reminder, since I have to explain the shadow on my left lung.Report

  6. Interesting piece, thanks for writing it.Report

  1. October 14, 2020

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