I just discovered this in a random file I call “stuff.” I wrote it in 2008, a year after my hip resurfacing surgery which followed three years of escalating pain, misdiagnosis and medication.
I recently had lunch with a very interesting, very bright man. He told me that he had suffered a freak illness that resulted in his needing an artificial heart valve. He said something I’ve thought about my hip, something to the effect of, “I wonder how I will have been changed by it.” I’ve wondered the same thing about the effect of my experiences in the process of losing my hip joint and having it resurfaced with titanium steel.
Sometimes in conversation bits of the change, of the experiences, come out even when I think I’ve moved on. I realize that, in the interest of living in the future rather than the past, I close things away. Still, they happened and they have words and seek voice. In early January I talked with a man who’s recovered from a couple of serious addictions, one of them to painkillers he had been on for a back injury. He mentioned it, and my mouth opened, and out of some deep place came, “I hate that shit. That shit is evil.” We burst into in a passionate brief explosion on the subject of Vicodin, basically a talk between a couple of junkies.
I went back and read about the drugs now that I don’t need them. A description of Norco, a Vicodin sister, with a smaller percentage of acetaminophen, reads: “Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Keep the medication in a secure place where others cannot get to it. Norco can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.”
First, with extreme pain, you don’t WANT to be awake and alert. One excruciating August afternoon I realized that it is IMPOSSIBLE to feel pleasure when you feel real, honest-to-god inescapable pain. Opposites (that term was clarified for me, too) opposites are not two sides of the same coin. They exist in separate worlds. But in the world of narcotics, NOTHING exists.
Second, “It may be habit forming” – it IS habit forming, even when you might hate, as I hated, the non-pain killing side effects of the drug. It destroys the ability to think; you cannot feel like yourself and if you LIKE yourself, as I do like myself, it’s horrible to be compelled to shove the self aside for the sake of slaking pain. An addict – even a reluctant addict, as I was – is a lost soul. The Vicodin/Norco time would come and I would “jones”. I hated the drug, I hated every single thing about it, but without sleep, the pain was worse.
I did a bit of research and discovered that (hope you’re sitting down for this news flash!) pain causes depression. I went to my (horrible) doctor to get a prescription for an anti-depressant. He was angry with me because I had not taken his instructions to my hip replaced; I knew there was a better option for me than that, and I was determined to have my hip resurfaced so I would not lose my range of motion or the chance to run again. I was waiting for my HMO year to end so I could choose my doctor and choose my treatment. My doctor had no sympathy or interest, was rude and possibly even mean. But he did suddenly remember having read an article about a newer drug called Cymbalta developed to help people with depression caused by chronic pain. I started on the drug and I’m sure it helped me get by with fewer narcotics, but it had its own beautiful garden of sinister effects. The most common side effect of Cymbalta is rapid weight gain; I got off easy – I “only” gained 25 pounds (bad joints don’t need more weight to tote around, grrrrr)
Cymbalta acts on the serotonin and norepinephrine uptake receptors, i.e. the little brain fingers responsible for pleasure and for pain. It helped. I would have taken more narcotics without it. It was fun in the beginning, with the constant nausea, vomiting, throat swelling. Tonight I see that Cymbalta has the same warnings as the narcotics: “Cymbalta can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.” I quit cold turkey (the only way I can quit anything) and the result was painful flashes of electricity crashing from side-to-side inside my brain for more than a month.
So it was not just the hip, the degeneration of the joint due to injuries incurred riding, hiking, climbing, blading, there were the drugs, the brain numbing, a narcotic addiction and withdrawal from an antidepressant. I don’t think of this, but I should in determining the “changes”. I had the game pulled out from under me at a moment when I was playing harder, faster and better than ever. I fought hard to get my game back and I want it. Waking up from all the numbing, I’m finding myself again, but yeah, I seem to be transformed somehow, maybe more awake.
Lawrence Durrell, in the Alexandrian Quartet, the fourth book, Clea, wrote about an artist who was not able to express herself as she wanted to, with the skill, freedom and authenticity she dreamed of. Even as a human being, she was inhibited somehow, unable to break free from an inscrutable inner bondage. In a freak diving accident in the gulf of Alexandria, she lost her hand and it was replaced with a mechanical hand. That mechanical hand set her free, as a person, as an artist. I’m hoping for that.