Friday morning. I woke up on the floor again. I remember at some point in the night moving there because the pain was keeping me awake. The hardness of the floor is a relief. Camping pad and blankets, cold floor and plenty of space to sprawl and roll. I wake up better from the floor, the lower back is better from it. Neutralized. I like picking the blankets up and putting them away. No one slept here.
I made the ultrablackcoffee and sipped it on the balcony. It’s a sharp wakeup, standing out there in underwear and a t-shirt. The warmth of sleep gets blasted off. It’s like an acid bath. Rust removal chamber. If a person wonders how small his penis can get, winter balcony is the right way.
I teach today. I’ll look them in the eyes. Then I have PT. I’m giving a talk at an open mic on campus at 11, my subject is Shitty Music and the Ruination of the Cool. It’ll be a real rant.
My walk to work is about 20 minutes, up one street and through 3 distinct neighborhoods. In most ways it’s a perfect place to walk because there are always things to see that inspire new thinking and feeling before my day really even begins. The walk helps me wake up since I sleep until the last possible minute. Sometimes I leave without even having looked at myself in the mirror. The only real danger there is toothpaste lips and eye guck.
I see these little black kids waiting for the school bus in front of the housing projects they live in. They have brightly colored backpacks and are loud and happy. They’re jumping and spinning, pushing and laughing. To them the world must be one big joke.
The injury is now a matter of proportion, the ratio of pain-free minutes to painful hours. It’s changing in a positive direction, but can still be bad. The sensation has changed. It’s sharp and localized, still sometimes in the left buttock, but primarily right above the rupture itself.
PT lasts about 30 minutes and gets me relatively free of pain for about an hour afterwards. And slowly it returns. The goal is for that hour to continually lengthen. Sometimes it feels like it is, and other times it’s definitely not.
I built a standing desk for the living room and painted it white. That led to the realization that all of my furniture should be white… so I started with the tall stools that used to belong to a minibar I inherited in my last apartment. Nice. Next will be shelves.
The truth is that if I update daily I’m not sure how helpful it would be to anyone trying to keep up with me. I spend a lot of days just keeping myself focused. Describing this isn’t a habit I’m in and I’m not sure who I’d even be having that conversation with. Recording any of it makes no sense at all. It would contain too much of what you wouldn’t normally see, and wouldn’t want to see.
There are things I want to get done. I have four or five things underway almost all the time. It’s been the line since I can remember, since deciding it was all up to me. That’s probably about age 15 or 16, half of my living time ago, the year I made a run for it. If someone asks what I do I don’t even know how to answer. I usually just say I’m a student but that copout won’t be truthful much longer. What do I do for money? Or what do I do for having been born?
My line wouldn’t look straight to someone else. I understand that and it’s fine. It doesn’t look straight because they’re not on the course. Some people’s lines are circles, soft and rounded. I choose not to come back to the place I started. I move forward.
I’ll be moving on soon. This is the longest amount of time I’ve lived in one place since before the dash. The longest I’ve been around the same people. Hell I’ve even collected objects. I have a dresser. Can you believe that shit? I have a table with folding leaves. Just two or three years ago if someone had told me this would happen I would have laughed in their face before punching it square for lying.
It’s been an OK experiment. I’ve created some comforts for others in case they might fill in one of my missing pieces. This is what happens to people who don’t keep it going. People get tired or distracted from the line. It’s less foreign to me than before. Besides, a girl likes it when you have a pot to cook in, when you have more than one ratty towel, when your bed “matters”. I see the domestic stuff around me these days and shrug rather than shudder. It doesn’t anger me. I know what it’s for and it’s been worth it so far. But it’s not me, not at all. I wake up almost every day thinking about what order I’ll clear stuff out again. I spent almost a year in this place with almost no furniture at all, still basically living out of a backpack despite having three empty bedrooms, an empty living room, an empty kitchen. It was a great year. I had a ground pad and a tent footprint under a blanket I’ve had since high school. I’d rotate the camp around: the small room, the medium room, the living room corner, the master bedroom. It was great. There was an echo.
It’s important to know that when you leave, you’re not leaving anything behind.
See, I told you it wouldn’t make any sense. But you asked for it.
A couple people have asked about oxycodone given a few mixups over the last couple of weeks. I’ll share.
opium poppy
Firstly, Oxycodone is a Schedule II drug, the same category as opium and morphine. The difference between Schedule I and Schedule II drugs is just that the latter have known medical uses and the former do not. (source)
The name Oxycodone consists of three references to its chemical design (it is designed rather than harvested, unlike codeine). The cod is from “codeine” which is almost chemically identical and able to be harvested directly from poppy. The only difference is that oxycodone has a hydroxyl group instead of just a hydrogen at carbon-14. This is where the “oxy~” comes from. The the “~one” is from ketone which is another organic compound which codeine lacks.
Oxycodone was originally made by the Germans back when their pharmaceuticals were nearly supernatural back in the early 20th century. I’m always surprised that more people don’t know that this is where modern chemical medicine really came from.
The German chemical engineers were godly. We see the residues of that era today. Bayer, for instance, invented heroin. The name “Heroin” was a brand, trademarked by the company. It was intended to be a safer substitute for morphine and sold mostly as a cough syrup. The trademark was trashed during WWI (the US confiscated all of Bayer’s US assets), along with the trademark of their other important invention that was derived from the bark of the willow tree. At the end of the war, the US and other allied countries began to use the name of this other branded drug generically.
But at one point Aspirin was trademarked to Bayer, and that trademark is actually still recognized by many countries, including Canada, but only if the word is spelled with a capital “A”.
The name “aspirin” comes from the German word for salicylic acid, acetyl spirsäure, which was derived from the botanical name for meadowsweet, Spiraea ulmaria.
Anyway, oxycodone was also first created by the Germans out of the University of Frankfurt a couple years after Bayer discontinued selling Heroin because of the side effects we know so well today, particularly overuse and fast addiction. Oxycodone was basically created with the intention of being a safer alternative to medicinally intended heroin, and in many ways it is. It acts more slowly and is less addictive when taken as prescribed.
It is one of the most abused prescribed drugs in the world because of how similar its effects are to heroin. With the right dosage, a heroin-like high is possible, and even more possible if rendered to be pure and free of additives, such as the acetominaphen they add to oxycodone in the branded drug Percocet. The high comes from the same effect– it’s a central nervous system depressant that stimulates opioid receptors in the brain and body and produces analgesia and euphoria when the dose is adequate. Part of the reason it’s so addictive is because the opioid receptors get used to it right away, and after a just a couple doses the effect lessons considerably unless the dosage is increased. If you’ve ever wondered why/how people accidentally overdose on recreational drugs, it’s frequently for this reason. As the body gets used to certain narcotics the amount required to feel anything increases. This can get to the point where even taking very heavy doses has minimal effects, so the doses for getting high can get extreme, eventually crossing the line of what the body can handle without shutting down completely. Shutting down here means unconsciousness at best, and sometimes death.
So here’s my experience so far. A 10mg dose of oxycodone relieves the pain associated with lumbar nerve impingement in about 10 minutes. I’ve never used non-drip painkillers before and after the week of Vicodin failed completely, using oxycodone has been a great relief when needed. Feeling pain actually disappear in realtime has been pretty mystical. I’ve started concentrating on it.
A dose situation will begin with entering into a feeling of maddening helplessness. My pain, from nerve impingement, is categorized as Peripheral Neuropathic Pain. The effects of this are still being studied, but I can say with assurance that it’s detrimental. For me, the discomfort is one thing but the effects on thinking and mental performance is wherein lies the true agony. Studies show that certain kinds of ongoing pain have very clear negative impacts on how well the brain works:
Most chronic pain patients complain of cognitive impairment, such as forgetfulness, difficulty with attention, and difficulty completing tasks. Objective testing has found that people in chronic pain tend to experience impairment in attention, memory, mental flexibility, verbal ability, speed of response in a cognitive task, and speed in executing structured tasks. (source)
Occasionally the injured area will throb and my body will react automatically by continually adjusting to find a position of relief. Sometimes that position will just not exist: no matter how much I turn and arch and squirm and stretch and recline and bend, the pain will continue, sometimes worsening. It’s exhausting, distracting and frustrating.
Being able to “turn it off” for a break has been really nice– contending with extreme pain for extended periods of time (hours and days) really taxes the entire body with stress hormones and adrenal overstimulation and causes all kinds of other harmful effects. So when it gets tiring enough, I’ll dose. I stay standing up, and I wait. A few minutes will pass and I’ll continue to wait, trying to sense any changes, trying to stay aware. If I stay focused long enough I can actually feel the start, saying to myself: “There it goes…” And the pain completely disappears.
The side effect for me is that my brain slows down. My thoughts stay pretty quick, but externalizing them is slowed and I get extremely attention deficit. Writing while dosing takes serious work and therefore being on painkillers at work is just pointless. I wrote and rewrote one email for almost an hour last week, concluding it just wasn’t worth it to try.
OK, so if you take 20-40mg of oxycodone (about 3-4x a regular dose) and drink 5-6 beers and a couple shots, you will be high off your ass for about 8 hours. This is not recommended because it wrecks your liver and is extremely harmful to other parts of your body.
You will probably be extremely friendly and social for hours and feel intensely good, as if was the way things should be. Unfortunately, you will probably almost get arrested after deciding to lie down in the middle of a dangerous park at 3am next to your friend who’s equally wasted. You will probably be taken to the police station and held for a while for goofing off while the officer requested seriousness. You might get charged with failure to comply or resisting arrest depending on how you handle the confrontation. You might be able to get a clear head while in the holding pen and talk your way out of the mess. You might wake up at home at 5p the next day and wonder if it was all a dream until you see handcuff bruises on your wrists.
You might then decide it wasn’t worth it, especially as your injury seems to have worsened considerably, rendering you in agony for two straight days before starting to return to a healing state.
The thing about an internal injury is that it can only be felt. This leaves the imagination free to do the unavoidable work of producing visuals. For my injury, there are two. At times the feeling has a pressure quality, as if there’s an expanding bike wheel inner tube embedded deep in my left gluteal, extending linearly down through my hip and into my left leg, and it’s over-pumped, causing pain along the tissues it’s splitting open or compressing. But the pain is also a numbing, tingling pain. Throbbing. So the inner-tube is being filled with freezing cold air, giving my left butt and upper leg a giant ice cream headache.
The second pain is sharp, occurring in the morning or during PT, or when I do back-bridge type stretches. It’s in one place, a defined and localized rip, rough and clear, right where the rupture occurred. It’s a rusty screwdriver being slowly turned into my lower back about an inch deep.
But there’s major progress. PT has been fantastic. I feel better after every session, but I can tell it’s going to take a while.
The best part is when they plug me into the Dynatron 950.
electrical massage
It connects to soft tissue and sends electrical pulses between electrodes taped onto your body. It has a number of settings on it. Taken from their web page:
“This device allows full independent treatment setups. Treatment options include interferential, premodulated, biphasic, high voltage pulsed stimulation, Russian and microcurrent stimulation.”
Obviously I use the Russian setting.
I’ve been to 5 PT sessions and they really help. My PT has a doctorate from Columbia and is an ex varsity volleyball player so she gets me pretty well. She undertands how depressing an injury is for an athelete– everything changes. The usual hormones change, the brain chemistry changes, the body shifts into healing mode instead of growing mode. The appetite diminishes. Weight is lost. Spirits sink. Life begins to suck. She knows. So she talks about it with me and helps me keep perspective while taking me through the therapy she’s learned to conduct for my kind of injury.
It’s nice and I look forward to them. 3x wk x 10 weeks. Two weeks done.
Everyone, hi there. Just a quick update to let you know that updates are to return extremely soon, probably later today and then very regularly from then on, hopefully daily. Thank you all for the letters of concern. It’s been a strange, adventurous couple of weeks and I have lots of good stories so come back soon for the skinny, the fat and the injured. — OD
Posted inUncategorized|Comments Off on not abandoned!
It’s an odd feeling when everyone thinks you’re broken, especially if you’re partially known for being the least breakable.
“Obsidian! I heard you’re seriously injuried! OMG! Is there anything I can do? Can I bring you soup?”
It’s such a normal offering for wellness, soup. More attitudinal or associative I guess since on its own it doesn’t seem particularly useful for injuries. There’s a chance it’s residual– maybe the association is “healing potion,” the kind shamans used to rub on the injuries of their tribesmen like a lotion or salve. And then Marco Polo walked through and, misunderstanding, drank the stuff, and that’s that story of minestrone for colds. But backs?
<Bing bong >
“Yes?”
“Hey Obsidian, it’s me.”
“Sure, hey, what are you doing here?”
“I heard about your injury. SOUP!”
And just like that my back was healed in full (belly).
(OK it was mac and cheese and I reheated it from months ago.)
I do have two soup offers, some grocery offers… and then the occasional late-comer to the situation offering panic and dismay:
“I noticed you weren’t around lately and I thought you were on vacation, but I was just told me you’re bed-ridden! Broken! What on earth! What’s happened? Oh my gosh!! It must be really serious!
Nah, not really.
The MRI results are positive, but there was a surprise…
MRI textual report
Of the 5 disks (the spaces between the vertebrae of the lower lumbar spine), this report was supposed to list all as normal except for one, the one causing excruciating, radiating, appetite-and-mobility-ruining pain. But as you can see, it lists two of that variety: L4-5 and L5-S1.
So finally an explanation for the severity of the last twelve days: I have two extruded lumbar discs at once. Double the pain, but I’ve been told this does not necessarily double the recovery time.
OB's Disc Lameness
One is much worse than the other.
Every disc is supposed to appear white, and darker or fully black discs are damaged, usually drier and weaker. As you can see, both the L4-5 and L5-S1 (the lower of the two annotated discs) are pretty dark. The extrusion of the L5-S1 is very clear, pushing deep outside of the disc edge and out into the nerve roots connected to the spine. As the diagnostic report text mentioned, the pain from my injury is mostly from that disc pressing into and actually displacing the S1 nerve root. That’s why the pain runs down my leg.
This is a self-healing injury and I will be completely recovered if I do things smartly. The nuclear material from the disc will dissolve away off of the nerve root, the inflammation will then diminish and uncompress, and the disc wall will scar over and I’ll be back to kicking ass.
PT will help this all happen a bit faster, so I have 30 sessions prescribed. First session is Monday evening, not soon enough. Dying for activity besides walking.
I feel disgust at the imperfection of the human form. Look at how completely ridiculous the structure of the lower back is. There’s a load-bearing structure that at its center of gravity has a curve in it. The form, when being used normally, causes disc lesions, nerve impingement and crush fractures. The most common way to bust a disc? Pick something off the ground and as you come up with it, turn to one side or another. Wammo.
"About 80 percent of the adults in the U.S. have been bothered by back pain at some point. The Consumer Reports Health Ratings Center recently surveyed more than 14,000 subscribers who experienced lower-back pain in the past year but never had back surgery. More than half said the pain severely limited their daily routine for a week or longer, and 88 percent said it recurred throughout the year."
(Source)
I know, “lift with your legs, not your back.”
I squat 315lbs X 20, 405lbs X 6-8, and I deadlift 500lb X 4-6 X 3. Weekly. The problem isn’t me, I know how to move heavy things around. The problem is the design.
But don’t worry. I’m going to fix this. I’m going to build up an invincible shield of mass and strength around my core over the next few months, so even if I get dropped back-first directly on a rusty dock railing I’ll bounce off… especially if it isn’t covered in giant spikess. But come spring I should be spike-proof, too. No fucking around. This has really frustrated me and has gotten in the way of some important things, so never again.
There was an October snow storm over the weekend and it took everyone in the city by surprise. Saturday morning I was awakened by the sound of snow plows.
I have a very strong association with the sound. When I was in middle school, snowplows at night meant bedtime smiles of hope for snow days. Plows in the morning provided the best chance of all, and in early 90’s NH, it wasn’t uncommon.
There was one winter in particular when I hated school so much that snow days felt like gifts from god. I had a Sony alarm clock radio that was tuned to a local station that announced school closures between songs. The hit song of the season, the song that would play every morning on repeat, the song that bookended the list of school cancelations and became the song of hope and happiness:
I’m forever doomed to respond to the beginning— “tick tick tick tick” — with embarrassing joy. Don’t judge. It’s the sound of freedom.
In the city, plows have a similar effect on me– smiling at night, excited in the morning–which is surprising because of how different everything else is here. Though real “snow days” are rare, the muffled scraping noises that backdrop a white wall of falling sky is just as calming. A major enhancement to the experience now is a giant cup of stiff, black coffee to sip as the city whitens.
Snow in NYC is often temporary, and by the time I went into work on Monday, Halloween Day, it was gone. No complaints.
—————————–
Being in the office felt strange after missing last week with the back injury, and I didn’t last long before needing to recline and continue healing up at home. I got the MRI as prescribed, and was home by 2p– perfect timing…
…because just as I got home, a streetfight broke out in front of my building. It started with yelling. I grabbed my camera and jumped to the balcony– no time for setting up properly, but the D7000 performed well. Ah Harlem!
MRI results tomorrow, I should be figured out shortly thereafter. Very ready for the nanobots.
The least interesting thing a person can say about themselves is that they have a bad back.
“I have a bad back, did you know that?”
Everyone has a bad back. We’re still evolving, supposedly. Though this is less true now– medicine is starting to get so advanced that we’re freezing our current state. Instead of dying when a faulty gene wrecks our body, we just replace whatever organ it affects with plastic and metal versions. This lets us procreate, pass our faulty gene along, and basically weaken the gene pool. Eventually, newborns will have to have all kinds of procedures done at birth, including acquiring new and artificial genes, just to stay alive. I’m not for or against, just observing what’s happening. At the moment, I’m interested in full back replacement surgery. I’ll take the Indestructible Viking Spine model, please. In chrome if you have it.
I had my nearly obligatory “back thing” two months ago. It was stiff for weeks. It has happened in the past. I’d kick too high without having warmed up enough, or I’d pull too much weight off the ground without stretching enough. Stupid things. And I can always feel it happen, it’s never a next-day surprise. A little electric shock at the base of my spine. A tweak. A little zap of unfamiliar warmth. It’ll feel weird for the rest of that day, and manifest fully after a good sleep, always expected.
But this last one, from two months ago, was different. The stiffness didn’t diminish over weeks, and eventually I started training again, trying to train through it. I woke up last weekend feeling pain radiating down my leg.
It took 20 minutes at the doctor’s office. Vicodin for pain, Flexiril to get the supportive muscle tissue to unclench, my first time having either. Follow-up 4 days later. That was today.
Over the week there has been no improvement and I’m dropping weight like ballast. No appetite. Vicodin has had no effect, despite how prepared I was to become fully addicted to it. I was disppointed that I didn’t experience euphoria, and the doctor was disappointed I hadn’t improved. It took 15 minutes the second time: Percocet for pain, a steroid called Prednisone for inflammation of the tissue surrounding the nerve that’s being pressed, more Flexiril, and an order for X-ray and MRI. The MRI required approval from my insurance company, forcing me to wait until Monday. The X-Rays, however, happened. She put the images up on the lightboard:
“Mr. Duck, are you in here for lumbar pain?”
“Yes, exactly. Can you see something wrong on my X-Ray?”
“Well, if you look here, this disc is completely compressed. I mean, it’s practically destroyed. I’m surprised you could even walk in here… how long have you had this, I’m confused.”
The pain has been ceaseless and exhausting. When lying down, standing, walking. Sitting is actually impossible, the lower back muscles won’t allow my hips to flex. Last Sunday was the first hard day, and it’s gotten worse, progressively.
But right at this moment it seems that Percocet does help. Or maybe it’s the steroids. Or the second cycle of Flexiril. Or maybe I’m just too tired to hurt any more. My adrenal gland must be empty now. My nerves must be worn out, short circuited.
I once prided myself on hardly ever self-medicating. And now this…
It’s going to be tough for a while. Some are twice a day, one is 3 pills twice a day for 3 days, then 2 pills twice a day for 3 days. One of them is 1-2 every 6 hours as needed, not to exceed 8 in a day. That’s the most serious one– oxycodone:
"Oxycodone is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain."
I’m worried. I need to train or I get down. If I’m not releasing energy, if I don’t drain off testosterone, I start to hate everything I see, everything I hear. I go too far inside myself and think too much about everything. I remember things I’ve tried to forget. I confront things I had previously stepped around. I bury myself in obsessive thoughts about problems everywhere. I start to lose the ability to ignore the things I can’t help fix, and helplessness is my greatest torturer. I experience inner-world violence. Sometimes I want to die.
I don’t know how long this will take to recover from, but I’m worried about a lot of things now. One thing I know for sure: the worry will stop when the hatred takes over, and I don’t know which is worse for me to have inside.
Think about experience; how we understand the acting self; how we represent life in time and space; how we judge value in material, political, and cultural life; what we choose as our controlling purposes; and how we shape and situate our efforts in life and for what aim.
