Oxycodone and Me
When I was born (1966) I only had one testicle. Well strictly speaking I had two, but only one of them was in my scrotum. The other, my left testicle, had failed to descent and remained nestled in my lower abdomen. I did not give this much (any) thought until I was five (1971), when my parents told me I was going to have surgery to move my left testicle to its proper position in my scrotum.
The surgery went without a hitch, but left me with a ragged scar running from about my hipbone to my pubic bone. It’s a large scar for an adult. It must have looked ghastly as a fresh wound on a five year old boy.
(Sidebar: Only a week or two after I was clear for play I crashed my bike going over the sort of improvised jumps boys from the Evel Knievel era were obliged to set up. I suffered a concussion and fractured skull. I have no memory of any of this, but have a vivid image in my mind of what it must of looked like when my mom answered the door to find the older boys in the neighborhood bearing my limp body. My penchant for head trauma may be a subject of future posts.)
When I was 16 (1982) my family moved from San Diego to rural Oregon. In San Diego my father worked in a federal public health clinic that served merchant mariners (mostly fisherman), plus overflow from the VA. When that clinic was closed as a part of the Reagan Era cuts to social welfare programs, we moved to the Rogue Valley in Southern Oregon, and my father went into private practice.
It was during this time that I learned about prescription drug addiction. I learned about it because my father would get called into the hospital to do emergency x-rays on people complaining they were in severe pain. My father was annoyed by these calls, and disgusted by the addicts that caused them. (I credit my father’s clearly voiced disgust at drug use and drug addiction as the largest factor for why I never dabbled with drugs.)
When I was 23 (1989) I kayaked over a waterfall on an obscure tributary of the North Umpqua River in Oregon. My line was bad, and the nose of my kayak hit the rock wall on the right side of the descent. It was a glancing blow, but the impact was hard enough to painfully hyperextend my back, so I decided to call it a day, and hiked out to the logging road about 500 feet up the canyon wall from the creek. Naturally I dragged my kayak up with me. My back has never been the same.
When I was 45 (2011) I was invited to guest blog for James Fallows at The Atlantic. For the previous 10 years I had been pursuing a doomed vision of getting rich and famous (or at least be able to take care of my family) by making documentary films about real life couples’ sex lives and the joy their sexual connection brought to them. But in those ten years I ended up spending more time developing a critical frame work, and a historical and legal context for my films than I spent actually making the films themselves. Deeply aggrieved and deeply versed in the subject matter, I spend a week in bed writing non-stop, and by the end of the week my blog postings at The Atlantic totaled about 16,000 words and my back was locked up. (Ironically, my wife and were watching the TV show Southland at the time, and we were at the part where the avuncular and crusty training sergeant is getting into more and more trouble feeding his oxy addiction, precipitated by, you guessed it, back problems.)
On the day that my last post went live on The Atlantic I found myself driving to the Greenport public health clinic. I was in so much pain I could barely walk. I had also gotten into an e-mail argument with then intern Justin Miller about the fact-checking on one of my posts. Accustomed to fighting tooth-and-nail for everything related to my films I spent the two-hour drive from Montauk to Greenport on the phone with a researcher from Neilson gathering information for my rebuttal to Miller, plus e-mailing Fallows as he was enroute to the airport for his flight to China. By the time I arrived at the clinic I was hyper-adrenalized and in blistering pain, and oh, I had my five year old daughter with me.
Also I looked like a bum. The past few years had not been kind to us, and since I didn’t really have to dress for anything but the beach, yard work, or fishing, my clothes had become rather disreputable. I’m not in the habit of keeping my hair well-managed either, which added to the effect.
The reason I was there was because I needed a physical to complete my Merchant Mariners Credential application the Coast Guard. I walked in, stiff. Presented my paperwork and insurance card. Insurance card? Yes, despite our financial hardship I had managed to maintain our family’s health insurance, but over time all the local healthcare providers had peeled off, leaving our only option the public health clinic in Greenport, a hundred miles away. (Greenport was notorious for it’s opioid problem long before this issue rose to nation prominence.)
Sitting in the examination room the physician’s assistant got out the blood pressure cuff.
“Um, I just go some upsetting news,” I said, meaning my pissing contest with Justin at The Atlantic, “My blood pressure my might be a little elevated.”
“Oh I’m sure it will be fine,” he answered as he inflated the cuff, then I watched as his eyes widened at the reading. “Okay, maybe we’ll try this again at the end of the exam…”
Then it was on to see the doctor. He was from central casting for do-gooding-idealistic-young-jewish-doctor. He had a thick head of dark curly hair, a gentle but sturdy masculine affect including a knife on his belt, and solid jewish last name like Goldburg, or Finkelstein. He looked at me — ill-dressed, ill-groomed, eyes dilated from the adrenilyn still pumping through my veins, and my perfect little blonde-haired, blue-eyed child. I watched him regard her. “Sweet innocent thing,” I could see him thinking, “we don’t get to pick our parents.”
I guess what I did next is called “code switching”.
The first bit is easy to explain; I let a few yiddish words find their way into our conversation. The second bit is harder to explain, but simply put, my father taught me how to talk to doctors and other medical professionals — little things I know to drop into the conversation to signal “I’m one of you.”
Between the two of these gambits I struck an easy rapport with Dr. Goldberg. He worked his way through the form, and by the time he got to the end he knew that my mom was jewish, I was moving on from being a filmmaker to a second career as a sailing charter captain, and that I was recently published in The Atlantic!
Then it happened.
The drug-testing part of the application is not a part of the physical. It’s not. They are two separate parts of the form, and I had already done my drug testing through school where I did my course-work. I did not bring my drug test with me because why would I? But the way Dr. Finkelstein was reading the form, it appeared to him that he was signing off on the drug test.
“Oh that? I already did that,” I said, “left it at home.” I know what this sounds like and I can feel the good doctor’s affect become guarded. I’m going to have to make another 200 mile roundtrip from Montauk to Greenport to finish this up. I do not want to spend the time and we are dead-ass broke, so I sure don’t want to spend the gas money! I decide to rope-a-dope.
“Yes, I can see that,” I say, agreeing with why he’s reading form the way he’s reading it. “I’ll bring it back tomorrow,” I said, pantomiming defeat.
We’re already half way down the hallway to the exit. He studies me. He looks at my daughter.
“Fine!” he says, taking out a pen and using the wall as a desk. “I’m signing this, but if it turns out you’re lying to me I’m going to be really mad…!”
A few years later the sailing business is a success. We’re going into our third year (2015), with a good number of private charters already lined up for our opening week. I’m on the deck of Mon Tiki making preparations for her launch and I get careless lifting a start battery. I can feel something go “ping” in my back like a guitar string snapping. The pain drops me. I can’t stand. In fact, I can barely move. I call my wife to come get me. Somehow I slither over to the ladder and get myself off the boat and into the car. When we get home she drives across the grass to our front door. I ooze out of the car and into bed. Two days later, after liberal application of ibuprofen (pain, inflammation) and alcohol (relaxation) Mon Tiki launches with me at the helm. By the end of this season we will have resolved to build Mon Tiki Largo.
Winter 2017. I’ve become enamored of the idea of picking up cobbles off the beach, weighing them, carving their weight into them with hammer and chisel, then using them to work out. My largest is a grey-green 71 pounder I brought home from Turtle Cove near the Montauk Lighthouse. I’m doing squats. Enthusiasm gets the better of me and I feel a twinge in my back.
I should have stopped right there, but sometimes I’m stupid with the push through the pain thing. I finish the set. The next day I run a fast Valentines Day 5K with my wife. Then I get in my car and do the five hour drive to where Mon Tiki Largo sleeps for the winter. When I get out of the car in Maryland I’m pretty stiff. By halfway through the drive back home, I have to stop in New York because I’m locking up.
I spend the next two weeks trying to work through it, but it’s one step forward, two steps back. Finally, I’m in so much pain I can’t walk or stand. I make an appointment for a walk-in clinic in Amaganset. My wife drives me. I can barely get from the car to the front desk. I am, per usual, dressed like a homeless person and my hair is a mess. My breathing is shallow and guarded, trying to avoid anything that might make my back clench and spasm. I speak in a whisper.
Mercifully I’m ushered to an examination room without much delay. The doctor comes in. I relate my medical history regarding my back as above. He tries to examine me, but every manipulation he subjects me to causes excruciating pain, accompanied by shouts of agony that are heard throughout the clinic. The opioid crisis is on everyone’s radar now, especially in Suffolk County. I am concerned this may be interpreted as an addict over-selling it.
I try to establish rapport. He’s African-American. I consciously think “don’t say anything that makes you seem like you’re trying to be ‘down'”. I work the “my dad the doctor” angle as cannily as I can, but I am in so much pain it’s hard to be cunning. He seems genuinely concerned, but I’m afraid this is going to spiral into a hospital visit, imaging and who knows what else. All I need is drugs.
“When this has happened before I’ve able to work it out with ibuprofen and alcohol, but this time I can’t get ahead of it,” I say, trying to play this off as no big deal.
Oops, bad move. He doesn’t like my play.
“I can’t recommend that approach.” I think I just inadvertently suggested I’m an alcoholic.
In the end I leave with three prescriptions. Prescription-strength Naproxen (inflammation), a muscle relaxant, and Oxycodone, and instructions that I’ll have to come back in if I need to refill the Oxy.
I stopped taking the Oxy when there were still seven pills in the bottle. I once got a script for Vicodin when I had dental surgery, and I remember feeling the urge to take the Vicodin even after the pain was gone. Not so with the Oxy. I saved the remaining pills against future need. Last year I felt my back half-go on a sloppy lift. I took it easy for a couple of days, ate the remaining Oxy, and the pain receded without my back ever locking up in spasms. We didn’t miss a trip or lose a dollar.
I told you about my testicle surgery because I used to believe that my back problems were related to my kayaking accident, but actually the place that hurts is a different place from where my back sometimes goes ping and puts me down.
What I now believe is that they are related to the surgery I had when I was five. What I’ve come to realize is that the scar from that surgery hurts all the time, it’s just that most of the time I don’t notice it. The pain is just a part of who I am; just like the compensation for that pain in my hip and pelvic muscles that sometimes gets thrown out of balance is a part of who I am; just like the fact that my left testicle can only feel pain is a part of who I am. I have compensating strategies that mostly work most of the time. I am thankful to be able to be vigorously physical.
I decide to write this today after reading a fellow Leaguer’s memorial to her friend lost to heroin and fentanyl. Addiction runs in my father’s family. I’ve fired people for showing up high, or drunk. Addiction is a terrible, terrible thing, both for those who suffer from it, and the people close to them.
I mentioned in my (re)introductory post that I’m presently re-rehabbing my shoulder. That’s a more recent injury, that, in hindsight, I barely managed to rescue myself from. In my dotage I’ve come to think of a tree as being the best metaphor for how to get on with the business of living and thriving with whatever damage fate inflicts. I’ll be posting about that in due time.