Monthly Archives: February 2014

Weighed in the Balance

I do not like standing on a scale. I don’t like that getting on that scale, and making note of the number it shows, is something I now do every day. I can’t stand those horrible commercials that show a skinny woman prancing in self-confident joy because the Scale God has given her permission to feel good about herself that day.

I do not like it…but I choose to do it because what I am trying to do now requires that data. I need to know how hormones, exercise, food intake, specific types of food and other factors affect my weight. I need to know the patterns of normal fluctuations, and I need to be able to spot trends that are not normal before they go too far.

I need the data because I’m attempting to do something that statistics aren’t too encouraging about: maintain a nonsurgical weight loss of 120 pounds. Past posts such as When Life Decides and Chicken Day talk about why this weight loss was necessary, and the health benefits I am receiving from being lighter. But keeping it off requires that I eat in a fashion many would find unnatural; I stick to very plain foods for the most part and there isn’t much I can order in a restaurant.

So, I’m just going to check in about how the maintenance thing is going. When I started the transition back to food, I weighed about 164 pounds. I dipped another 4 pounds to about 160 during the next few weeks, then began to experience some gain. I was told some gain is quite normal, since the body had undigested food in it again as well as a higher sodium intake. The metabolic rate is also slowed from the low calorie diet, and the body is kind of trying to put on weight at any opportunity, especially during this first six months.

This morning, I weighed 170 pounds. During the first 3 months of maintenance, my weight slowly crept up to the high 160s, and in the last three months it has ranged from 166 to 174. My ego takes a hit from this, because I’d like to get back into the low 160s and stay there. But if I can stay in this range, I will keep the health benefits I have received. My doctors reassure me that it’s still within acceptable parameters and I’m not doing badly at all–many patients get off the fast, go back to their old habits and put on 50 or 60 pounds in this same six months.

But I fear a creeping, continuing gain that will get out of control because that is my past pattern. That’s why I get on the scale every morning, even if I’m pretty sure I won’t like what I see. To be a witness. To avoid the disconnect many compulsive eaters like me can develop; that obliviousness to what my body is doing or how it connects to what I am putting in my mouth. To avoid the damn-the-dryer-is-shrinking-my-clothes syndrome. I have experience with all of these things, and I don’t want more of it.

That scale brings up many feelings for me. It’s hard for me to admit that I do get gratification when the number is down. It’s hard for me to acknowledge that I feel a jolt of fear or resentment when the number is up. It’s hard for me to admit how complicated my feelings are about what “should” be a relatively straightforward mathematical equation: Hmmm, my weight is exhibiting an upward trend. I wish to halt or reverse this process. I’d better lower my caloric intake and/or increase my activity. That this sort of logical conclusion is usually met with a wave of reactive hunger at the thought of having to restrict more.

In short, it’s hard for me to admit that I am, and always will be, a compulsive eater. That this particular manifestation of my addictive self requires this kind of day-to-day management, and that it’s not easy. Even right now, writing this, a part of my mind is complaining that this post is way lower on the coolness meter than the ones about drugs or suicide.

Oh, well. It’s not the first time, or the last, that I have to get over myself. My recovery’s not all spiritual insights and poetry and drama; it’s also taking the stupid vitamins and measuring the stupid oatmeal and going to the stupid appointments. It’s taking care of all levels of myself, including the mundane creature that eats and shits and navigates the physical world. It’s life.

Newbie

Well, I missed pretty much the entire Dr. Who convention this year because of coming down with appendicitis in LA. I didn’t get to mingle with the people dressed as the various Doctors, or Daleks or Cybermen or Weeping Angels. I didn’t get to help my daughter obtain autographs from actors. I didn’t get to collect ribbons and trade away the ones we brought. I missed the Masquerade, and the trivia contests, and the karaoke. I’m disappointed, and I hope we can find some kind of sci-fi convention to go to between now and next year.

When my family goes to the Dr. Who convention, we are amateurs. Yokels come to town. Why? Because we just love the current show and enjoy talking about it. We aren’t conversant with all nuances of the old series that ran several decades ago. We haven’t been following the various podcasts, web series and panels either analyzing the show or creating independent serials. We know little about the underworld of sci-fi television production, and the only people associated with the show we recognize on sight are the actors.

The convention is a microcosm of the larger world to me, because it makes me think about how I feel when going into any new environment, hobby or field of interest. There seems to be an expectation that I acquire a great deal of knowledge before I hang out with a group of aficionados, lest I be labeled–gasp–a newbie.

Video gamers coined the term “n00b” from this, a term that has many negative connotations. It’s used as an insult, basically, not just for the new but for anyone who is acting lame. So “new” is associated with “lame” and vice versa. Since it’s impossible to start a new game without being new, people must either endure ridicule or desperately try to carry off posing as an experienced player.

When did this happen? When did being new at something and/or not knowing much about it go from being an occasion for gentle condescension at worst to an occasion for contempt and rejection? And what does it do to a young person to receive a message of “keep your mouth shut unless you’re sure you know what you’re talking about and have searched the Internet to double-check.”

Our culture’s perception of expertise is changing. It used to be that there were a few experts in a given field: very few, if it was an obscure one. Now, because of the rate and extent to which we share information, even an obscure field has an amazing amount of information easily available. There seems to be an expectation that we not ignore any of it.

The trouble is that we’re not computers. We have individual learning styles and individual parameters for data storage, not to mention differing priorities. Take me and poetry…my love for it isn’t new, but my deeper involvement with it is. If you compare me to long-standing members of the literary community, my ignorance is no doubt abysmal. Yet, no matter how excited I am, I can’t read and assimilate new poets at more than a certain rate or the power is lost. This means I must be at peace with the fact that I can, for now and the indefinite future, be called ignorant.

Does this mean I shouldn’t try to be involved with this community at all until I have achieved some specific level of non-ignorance? Hell, no. I must be willing to present myself in any new field, if I love it, and own the role of the neophyte. Yes, use good manners and respect my elders, but don’t pretend to be something I am not.

Neophyte. I like that word. It was often used for new converts to religious orders, and comes from Greek roots meaning “newly planted.” Another good word is novice, which has also been used in religious contexts but simply means one who is new. Then, of course, there’s the word amateur, which comes from the word for love and was meant to denote someone who engages in an activity purely out of pleasure or devotion.

I hope my daughter’s generation will reclaim the words neophyte, novice and amateur. I hope they can embrace the idea that there is a difference between the discourtesy of willfully continuing ignorance and the innocence of the true neophyte. I hope they can learn to face the colossus of information peacefully, knowing that they cannot and need not absorb it all to enjoy and benefit from something. For they will need to be neophytes thousands of times, for all of their lives, unless they choose to hide in a fearfully and narrowly constructed barracks of knowledge.

At the Mousehole

It’s been six days since my surgery. I’m healing well, and I managed to get to a meeting last night. I’ve been very open with everyone about all that happened, and with input from my sponsor and others I’ve decided that I am going to keep my clean date the same. I’m pleased–I would miss celebrating my current date and all of the memories that come with it.

Two days ago, I told my husband to dispose of the medication they gave him when we left the hospital. I’d managed a day without any, and I didn’t want it around potentially calling to me. Even though none of it felt really good at the time, I will set myself up for trouble if I don’t admit the potential for temptation. Admit that there were a couple of things about it that triggered memories: the way it relaxed all my muscles; the sense of an “off” switch.

Now, as I try to find my center and begin to deal with everything that stacked up while I was ill, I admit that the addict in me always craves that idea of an “off” switch. The idea of a button I can push to stop the world, a sign I can wear that says “not here.” Escapism is so deeply ingrained in the psyche of an addict that it’s natural behavior.

Just as the drugs began to flush out of my system, I came down with a nasty head cold. “Unfair!” said my inner escape artist. “I just had surgery. I should be exempt from this kind of thing.” I got on the scale, and found that despite eating nearly nothing I’d gained four pounds in LA. “Are you kidding me? I don’t deserve this!” Yesterday, I spent the day at a clinic getting ultrasounds because of an inflamed vein from the IV site. “Oh, come on!”

I’ve been looking around bleakly at the stacked mail, the calendar full of my daughter’s appointments, and the general mess, wondering what malign quirk of fate caused my hospital-issued personal assistant to go astray. “What do you mean, I was never assigned one?”

I’ve been staring into space, feeling the disorientation from the inevitable disruption in the absorption of my psych meds, and wondering if I can do all this. “How, when I was barely (if that) balancing everything before, am I going to make up this shortfall and get back on track?”

These are all understandable feelings! But I have to name them, and talk back to them, so that self-pity doesn’t get to creep in. I have to get reconnected with the values of recovery; those values that can fade into dimness under the onslaught of fear and stress.

Bring out the Zen Master of Borg: Fairness is irrelevant.
Bring out acceptance of what is.
Bring out gratitude; the awareness of my good fortune in avoiding a ruptured appendix (imagine this happening to me a few years ago…I’d probably have just thrown down a few extra pills and knocked myself unconscious instead of going to the hospital. Hello, peritonitis!)
Bring out willingness and obedience.
Bring out the maturity to tackle one task at a time.
Bring out patience and humility. Bring out faith.
Bring out surrender. Bring out the qualities that will keep me from overeating out of rebellion, or over-restricting out of fear.
Bring out perspective and the awareness of what others are going through.

Good idea. Bring ’em all out. Line ’em up right over there.
Um…how?

I know they’re all still there. They’ve just scuttled out of sight, like mice down a hole. Now I’m trying to lure them out…one thought, one action at a time. A meeting. A shower. A joke. A prayer. A fragment of poetry. Tiny thoughts, tiny actions like crumbs. If I think of it that way, it feels less overwhelming. It’s not my job to fix or accomplish everything right now: it’s my job to recruit the ones who can. Just scatter a crumb. Another. Watch for the sight of timid whiskers.

Didn’t See That Coming

I have to share something I hoped I would never have to share on this site: I have narcotics in my system. Not from a relapse per se, but I did at some point make the choice to accept them. I will also need to make the choice–an individual and deeply personal one to each addict–of whether to change my clean date as a result of this.

I was down in LA with my family, attending the Dr. Who convention. My happy geekdom was disrupted by severe abdominal pain, which was joined by vomiting 5 or 6 hours later. I thought it was a GI bug and was determined to get through it. Through most of a very long night, I processed the pain as well as I could, until at about 6 am I woke my family and told them I needed to go to an ER. Sick at the thought of what this was going to cost, we looked up the nearest hospital and headed out.

I never wanted a medical issue to be the cause of a relapse for me, so it was always important to let medical personnel know that I’m in recovery. My medical ID bracelet even says Addiction on it, in case I get brought in unconscious.

The triage nurse was the first person we told. Then we repeated it to everyone else we met, whether they seemed interested or not. I’m really glad my spouse and daughter were with me, because it’s hard to be taken seriously when you’re rocking back and forth like a Weeble and you’ve also  identified yourself as having a mental health diagnosis. But the doctor was nice, and he agreed to hold off on morphine and give me a powerful anti-inflammatory instead.

So far, so good…I was doing everything recommended in this situation. I dictated texts for my husband to send to my sponsor, so she would be in the loop. She sent back supportive messages, and I tried to reassure myself that all would be well.

But I was frightened. What if they couldn’t find out what was causing the pain? I’d been processing it for 24 hours now, unable to eat or rest, and I was losing my strength. The anti-inflammatory they gave me took a bit of the edge off, enough to help me keep still for short periods so they could do the X-rays and the CT, but things were getting worse.

I’ve dealt with a lot of pain in recovery, but this acute pain was in a different league. My mind kept flashing on a scene from 1984, where Winston, arrested and knowing he will be tortured, thinks about how he wants to be steadfast and not betray the woman he loves–until the first blow lands. Writhing on the ground in the agony of a smashed joint, he feels his entire awareness subsumed by the drive to end this pain. In the face of pain there are no heroes, he thinks.

As I continued my psychotic Weeble impression, I knew that I was no exception, especially as prolonged pain and sleeplessness took away my ability to use my mental and spiritual tools. What was I going to do if things got worse, or continued like this indefinitely? Would I have to change my clean date if I accepted pain relief? What circumstances would justify not changing it, and as an addict, how could I ever be sure that I wasn’t being too quick to give in because a part of me wanted it?

My musings were interrupted by the doctor arriving with the results of my latest scan. He laid some questions to rest, and opened up new ones, with one simple word: Appendicitis. Now I knew why the pain was happening, and what to do about it. But it meant I was facing surgery.

In response to my queries about pain management for the surgery, the doctor recommended that I speak with the surgeon. When I met the surgeon, he thanked me for my honesty and said that the procedure itself would be under general, but he did recommend pain relief for the post-op. Looking wryly at my Weebling self, he said it was important to avoid putting stress on the body and the incisions. He promised that if he gave me anything at discharge, he’d give it to my husband and not to me.

So, my friends, that’s when I caved. Minutes from surgery, I decided, with my husband’s agreement, that we’d let the surgeon be in charge while I was in the hospital and my husband would take over, if necessary, when we left. I can’t honestly say what percentage of the decision was driven by practicality, or by fear of the impending procedure, or by sheer fatigue. Nor, as an addict, can I ever swear with 100% certainty that there was no part of my brain that didn’t welcome an excuse to have the sensation of narcotics again.

So, I had my appendix removed (just in time, apparently…there was gangrene involved. Yuck.) And I had morphine, given on the doctor’s schedule, during the recovery time. And my husband received some pills when we left, and I chose to accept the ones he gave me during our 8-hour postsurgical car trip. And I was relieved that none of it felt good.

I’ll write more about this when I regain more of my strength, and about how I feel and what I’ve learned. I’ll get out my trusty metaphor mill and wax philosophical in due time. But right now I just want to tell the truth about what happened, so my readers don’t worry about me. I am still here. I’m not going anywhere. However I choose to integrate this experience into my recovery, I will balance it with kindness and gratitude. Things could have been so, so much worse.

A Trip To Town

Yesterday afternoon, I realized it had begun. That I hadn’t drawn a full breath in a while. That I was compulsively keeping my head buried in reading material; compulsively nibbling on snack after snack and trying to convince myself it was okay because they were healthful foods. That my feet were twitching rhythmically and I was rocking back and forth on the sofa.

Today, I really want to stay away from the nibbling part, since my need to maintain my weight makes it a coping mechanism that carries a high price. That means finding something else to do with my hands, so here we are. This is one of those times when I need to let go of my ego, and my desire to write things that reach people, and just tell the truth.

The truth is, at this moment, I’m not dealing well. At this moment, all the Steps and insight and archetypal tools in the world aren’t making me any more capable of calming this anxiety. Something pushed my limbic system  over the edge and a switch clicked for me. The real circumstances contributing to it don’t matter right now, and at this moment they are as far away from my control as the moon.

I’ve done a lot of work about being more present and acting out less, and it’s hard for me to admit that I have absolutely no desire to be present with this feeling. Maybe if I were really enlightened, I’d be ready to sink into it and find some sort of useful experience, but I’m not there yet. When I start to sink into it, it’s just too much. When I start to sink into it, I’m seized with the desire to use something. NOW. Five minutes ago. Anything. A drug, a food binge, a blade.

I know when I am out of my depth. I know when it’s time to admit that I have entered the town of “Just Don’t Make It Worse.” It’s not my first visit, and it won’t be the last. And, like so many things in life, being here will be a lot less unpleasant if I can accept it instead of loading the experience with judgments and berating myself for needing to be here.

In this town, the rules are simple. It’s not about whether I will act out, because I will. It’s about how I am going to do it. It’s about picking the most harmless ways to do it. The most benign, least expensive, least disruptive ways to keep myself reasonably centered and occupied until this phase begins to pass. The nibbling I did last night, while it could have been worse, need not have happened if I had accepted where I am and given myself permission to be here.

Permission matters, because most of the harmless things that buy time are also things that are or seem of little practical value. It’s not easy, when there are so many more practical things that need to be done. Many are things that resemble “grounding” exercises or occupational therapy. Doing things with my hands helps a lot, as do different textures. Words are important, but I have to stay non-intellectual around them. Playing games with others helps, but I have to be humble enough to ask.

Shall I string tiny glass beads onto a thin wire, one by one, each bead giving form and control to that instant of time? I’ve got about ten feet of this from old attacks.

Shall I go and handwrite copies of my favorite poems onto linen paper, the smooth stroke of the pen drawing protective lines between my soul and the encroaching chaos?

Shall I read out loud? Shall I use someone else’s dramatic words and emotions to help me keep the panic at bay? I’ll never forget (nor, I am sure, will the staff) the time I wound up in the ER and had brought along my copy of Poe. For the love of God, Montresor!

Shall I go a less artsy route and challenge my daughter to some video games? And how do I silence the guilty voice telling me I should try to appear normal and not let her see me acting any other way?

How, also, do I reply to the voice trying to tell me that if I were connected enough to my higher power, I’d be able to shut off an episode like this without any interruption in functioning? That voice that sees any manifestation of my bipolar disorder as a failure? That voice that demands perfection and sneers at anything less?

Oh, wait. I know how to reply to that one. Perhaps some of the local townsfolk will join me!

Anhedonia

Addiction is hell. That’s a given. Hell, however, can have many forms. Although I feel a kinship with all addicts, my heart sometimes goes out with a special intensity toward those who shared my main drug of choice: opiates. Opiates and opioids, if you want to get technical. I have no illusions that our suffering is any worse than others, mind you, and there are some drugs I am really grateful never to have tried. But it’s the flavor of suffering I know most intimately.

So when I meet a newcomer withdrawing from these types of drugs, I always have the urge to let them know I have been where they are. That I know what it feels like. When I do, they tend to have two questions for me: How long have you been clean? And does it get better?

When someone’s in early recovery, the “it” can refer to many things. Inability to sleep. Anxiety, depression, despair. Fatigue, confusion, extreme mood swings, memory trouble, digestive problems, aches and pains…let alone trying to deal with the chaos of external life and the wreckage that probably exists there. But when I hear the “it” from someone who has a few days or weeks off of opiates, they are usually referring to the anhedonia.

Anhedonia is the medical term for the lack of ability to feel pleasure. It’s often a symptom of depression, so anyone can experience it in recovery. Recovery from opiates, though, brings it with a special certainty and intensity. There are biological reasons for this: these drugs affected our brain’s mechanisms for producing pleasure-giving and pain-relieving chemicals like endorphins, pushing them to produce more and more. Our brains became used to this artificial stimulation and have “forgotten” how to do it the natural way.

I tried to explain it to a non-addicted friend once, and found myself floundering for words. I said it was like having a big gray hole in my brain. It’s hard to describe because it’s just nothing, just dead, and the thought of being alive again seems like a theoretical musing at best. With it comes the trademark flat expression.

Anhedonia sucks for many reasons, but it poses a special danger in recovery. Complete lack of pleasure or satisfaction in life might convince us that it’s not worthwhile to keep trying; that this deadness we feel indicates that life without our substance is inherently boring and without pleasure. Complete lack of passion or excitement about anything makes us forget why we are doing all this. We become unable to care about the reasons, and if the thought of using comes into our head there isn’t much happening to stand in its way.

Anhedonia is one of many brain chemistry issues that can sabotage our recovery, and I always try to share my own experience of it with people. I want them to know that it’s a real, physical thing they are experiencing, and that it will improve with time. It did for me, and it has for other addicts I know. Some addicts need treatment for depression in early recovery, and then their treatment needs diminish with time. Some dually diagnosed addicts will need ongoing treatment, although their specific needs might change as they get healthier. But the sheer intensity of early-recovery anhedonia should not be taken as a sign of how the future will go.

There are recurring waves of debate about the use of “maintenance” opiates and opioids such as methadone and the newer Suboxone to prevent relapse. Anhedonia is one of the symptoms these are designed to treat. In treatment, I knew addicts who were given Suboxone and slowly weaned off of it during their inpatient time, making their detox phase a bit less painful and drastic. But I also know addicts who were still on it when they left, and I have heard some professionals speak of “lifetime maintenance.”

The controversies about this aren’t going away soon, and I don’t have an answer to them. I know that I’m grateful to have entered recovery without them because my brain chemistry got a chance to heal, and because I would hate to be paying for expensive medicine indefinitely, and because I think I’d have a lot of trouble with feeling compulsive about it. But that’s me. My experience. My particular level, and flavor, of mental and physical suffering. Someone else’s might be a lot worse, in ways that I can’t possibly understand. It is, to put it mildly, not a good idea for me to judge.

So, if you face choices related to this issue, please don’t think I am trying to tell you what to do. Experience, strength and hope is all I have to offer, and only my own. All I really wanted to do when I sat down to write this was give an encouraging nod to that addict struggling through a gray fog of anhedonia and say: I’ve been where you are, and there is a world beyond it. There’s a sun that shines, and food that tastes good, and a world of things that could begin to feel relevant again.

Goodbye Again

Every time I hear that a brother or sister addict has died from this disease, I feel the same combination of sadness, regret and resignation. When the brother addict in question is a famous person, the only real difference is that I get to hear the general public react as well.

Goodbye, Philip Seymour Hoffman. Many people have been writing about you during the last three days. They’ve been writing about how sad it is that you have died, and how sad it is that addiction led to your death. They’ve tried to analyze what made you relapse and what inner demons might have made you an addict in the first place. Some of them have then written extensive commentary on the nature of addiction in general, and what they think does and doesn’t work in fighting it.

I don’t know all the details of your story, Phil. All I really know is that we had one thing in common. We were both addicts. Now we stand on opposite sides of that dividing line between the living addict and the dead one. In the three days since you crossed over that line, hundreds of lesser-known addicts have followed you.

So many are shocked by your death, Phil, but I’m not. Really, people are overthinking things. It’s not necessary to analyze your childhood or every interaction you had in the last six months of your life. Nor does the fact that you were brilliant, articulate and many other admirable things make your death shocking. You used and died because that’s what we addicts do. Jails, institutions and death are the default path; they’re where we end up in the absence of extraordinary measures.

Your death isn’t a failure, either, Phil, although it’s certainly a source of regret. If you’d survived your relapse long enough to be ready to seek help again, you would probably have ended up taking a look at where your recovery had wandered off of the track that worked for you. Wearily, you might have taken up the burden of recovery again and hoped it would get lighter with time. Many have had to do this multiple times, and living long enough to do it each time is a matter of luck. You got unlucky this time.

Your fight with addiction and your other demons was a long one, Phil, and I hope you are proud of how long–and how well–you fought. Not only by resisting the darkness within you, but also by channeling it and transforming it into art. Your many years clean were a victory that is not negated by what has happened now. The art you created, the friendships you had, and every experience of your life exist in the time stream; untarnished, undiminished.

I will not forget you, or any of your new companions, and I won’t forget what a thin and often arbitrary line separates us. I’ll leave you with the words of an old warrior’s song:

My shame ye count and know,
ye think my quest was vain,
but ye did not see my foe:
ye did not count his slain.

Surely he fights again,
but when ye breach his line,
there will come to your aid my broken blade
in this last, lost fight of mine.

So here is my lance to mend,
and here is my horse to be shot.
Aye, they were strong, and the fight was long
but I paid as good as I got.