Confessions of a Dopehead

Of cups half full and opioid top-ups

18 milligrams of Hydromorphone twice daily. What does that get you? In my case, in the middle of the night when I wake to take it and lie down again, drawing my writing and reading materials to me, it gets me a moment, eyes closed, of trying to take bites of imaginary food. A cheeseburger occupies the air immediately before my mouth, I’m sure of it. It pops into mind. I am instantly hungry. Before I know it I am straining forward, neck, mouth, and lips extended, to get a bite. And then it disappears, poof, and only then do I know that it isn’t and never was there, my hydromorphoned brain playing a trick on me: no cheeseburger for you.

Because my drug intake is not recreational I think of myself as an effect-free zone, unstoned, all the buzz that might otherwise lift a non-health-compromised body high instead steering me toward a bearable, breathable pain-free place. It’s heavy lifting to keep my radiated back and nerve-damaged upper leg in line. But even with that it seems there’s still a little something left over, a small portion: I am elevated even when not chasing cheeseburgers.

I’m a cup-half-full person as a matter of course, always have been, but I suppose I thought my half-fullness would take a beating living with cancer. Overtaxed. Unrewarded. I thought my half-fullness would be revealed to be conditional: a fair-weather state of mind. But not so far. It’s serving me well. I’ve got no complaints. I now acquire unhelpful cells at an accelerated rate, my body swapping the good for the misshapen, the latter outdistancing the former, I think that’s how it works, and still I feel fortunate. My kids have come home to take care of me. My body mostly feels fine. My love of everything is intact to the point of possibly making me insufferable. And, credit where credit is due, I can’t help but wonder what part of that owes to a hydromorphone assist. 

The only way to find out would be to stop taking it and at the moment that’s not on the table. I’ve got it managed just so, my drugs like dials on an analog radio: knobs I turn this way and that. I know I’m chattier than usual. I’ve gone from budgeting speech, exercising a modicum of care and self-censorship, to letting it rip: if I think it I say it. In the meantime, I make of point of experiencing just enough pain to remind me that there’s trouble bubbling just beneath the surface. That’s as close as I care to get. I don’t want it to break through. I don’t want to be a drugged and senseless mess.

On the ambulance ride to the hospital following a recent fall at the vet’s, the vet having thoughtfully shared the sum total of his knowledge on the subject of falls and humans, “Don’t move,” the attendants set up an IV and filled me with their own variety of opioid, the fall and the pain necessitating it. I’d already topped myself up from my own collection but it was insufficient to the purpose. At the hospital they gave me still more, a different flavour, and I became well and truly high. So be it. In the ambulance I’d seen a small animal coming from the ceiling of the truck: pointy-nosed, reindeer-like, timid, friendly. It couldn’t have weighed more than five pounds but still, impossible. Say more, said the EMT when I told her about it. In Emergency it was my speech that led me astray. My daughter held my hand through the rails of the gurney. I slipped in and out of midnight and early a.m. consciousness. Words formed in my head, I offered them to her. No sooner were they out of my mouth than I lifted my head from the pillow, lifted it above a teasing, mischievous, shallow in which it happily paddled, and said to her, I’m sorry, Please ignore me. 

My mother’s mother was a recreational prescription drug user. Opioids. The times, mid-20th C, were such that she could collect a variety of prescriptions from different doctors and have them filled at different pharmacies without detection. They were delivered to the house. And perhaps that’s why my mother would come home from school to find her mother sprawled naked on the floor inside the front door. My mother herself stuck to drugs meant to fix her, her clothes remaining firmly on.

My pain has nothing to do with the cancer, at least not half of it. Have you shaved your legs, my friend asks, catching me in mid-rub ritual, noticing the hairlessness of one leg. I’ve rubbed it so hard and for so long now that the hair’s come right off. Fuck off, says the pain, I’m not going anywhere. It will not be rubbed away. When surgeons removed my kidney six months ago they apparently nicked a nerve in my abdomen, the price for which is paid at the end of that extremity. It’s like someone’s running a butcher knife up and down its length, the pain out of all proportion to anything I’ve experienced before. I had four kids without pain relief, it wasn’t an option, and I never got used to it. I thought I’d die each time. But I didn’t and then it was over and I was still here. But this pain doesn’t go away.  

But neither pain nor native good health nor the residual effects of hydromorphone are on my mind right now. I’m happy to report that Health Canada has just approved an immunotherapy treatment aimed at extending life for people like me. It’s designed to slow down a cancer that, clever as it is, has created outposts in my lungs and spine. I will be Patient No. 1 to receive the drug, EP+V, in this part of the world. And since it’s all too new for the health care system to wrap its formulary around it in time, the therapy itself will be subsidized by a drug company for use by me on compassionate grounds. I will not need to leave the province, I will not need to pay, I will not need to work with a less effective treatment. The cancer remains incurable. It’s still Stage 4, still tearing a strip off me, but this new treatment stands a very good chance, better than chemo, of slowing things down and I’ll take that. Me and the mini-reindeer, the nonsense, the hairless leg: we’re raring to go.

Photo by James Yarema on Unsplash