Feelings and Fentanyl

It’s been over a week since I was released from the hospital. Generally, I’m feeling much better. I’m still a little weaker than normal, a fact I was reminded of by a short hike yesterday.

While I was in the hospital I had some strong feelings. Feelings that I haven’t had in a long time. Old feelings that no longer serve me. And yet there they were. Gnawing at me from the inside.

I had a lot of support from friends and family during my hospital stay. I had text messages, phone calls, flowers from friends across the country, tweets, and in person visitors. I felt lifted up. Supported.

And I felt unworthy. I felt that I didn’t deserve the support that I was getting. I felt like I was too much of a burden for folks. Not because anyone made me feel that way — everyone attempted to make me feel the opposite actually — but my own self talk told me that I didn’t deserve the love and support I was receiving.

It’s been suggested to me that I wouldn’t stand for a stranger talking to me the way my internal speaker does.

It’s true. I’d tell anyone who told me the things my own mind says to me to fuck right off. And yet, when I’m in a foul mood, or when things aren’t going very well, my internal dialogue goes straight for the jugular.

I don’t think I’m alone in this. Some might call this “alcoholic thinking,” but my experience tells me that nearly everyone has these internal doubts. I believe it’s part of the human condition rather than a feature of my addiction.

The difference between me and someone who hasn’t suffered through an addiction is how we have addressed those thoughts. I used to cover them up with a heavy salve of alcohol. And it worked for a while, until it didn’t. And when it didn’t, it was terrible.

It was terrible because it just made the self doubt, the self hatred, worse. I knew that I was fucking up my life and the lives of the people who I loved the most, and I was powerless to stop it. Until I wasn’t.

When I made the decision to get sober and acknowledged that I was powerless over alcohol, I reclaimed some measure of power. I may be powerless over alcohol, but alcohol no longer holds power over me.

Some may argue that this is delusional thinking, that it’s is my disease talking, but I know it to be true. I know that I don’t ever want to be where I was again and that I’ll go to any lengths to avoid it. I also know that i can’t live my life in fear.

After I woke up from surgery in the post-anesthesia care unit (PACU), the nurse offered me pain medication. At first, before the anesthesia wore off, I said I was fine. But as the anesthesia left my body, the pain became real. It was a 10. I asked what they would give me.


I looked at the nurse and said, “I’m kinda scared of Fentanyl.”

Before I could go on she said, “that’s because of what you read.”

“No, it’s because of what I’ve seen. I’m in recovery. I don’t want to get addicted to Fentanyl.”

The nurse assured me that they would not let me get addicted to Fentanyl. She told me that they could give me micro-doses and that they would stop giving me any once I said the pain was better. And she told me that once I was out of the PACU I would not be given any more. They couldn’t give it to me in my room.

I was never into opioids or opiates. Frankly, they always just made me tired. I never enjoyed a high from an narcotic in my life. I knew this in my bones.

I had a decision to make. Agony or Fentanyl. Trust in modern medicine or not. Trust my own previous experiences with opioids and opiates or buy into the stories and fear that I’ve heard so many times in the rooms.

I chose Fentanyl.

They gave me three micro-doses and the pain subsided. I was in the hospital for another two nights and didn’t need any more narcotic pain killers. In fact, by the next morning I didn’t even need Toradol, a NSAID similar to Ibuprofen delivered intravenously.

I never had any cravings and don’t believe that I was negatively impacted by accepting the Fentanyl. It served an immediate medical need, and the dosage was supervised. I did not feel high — I just didn’t feel the pain. The drug did its job.

Would I do it again in a similar situation? Probably.

That said, I understand that others in recovery might choose differently. I also understand that for others it would have represented a huge challenge and possibly led to a relapse.

As for the thoughts of being unworthy, I’ve begun processing those in therapy. I don’t know that I’ll every rid myself if the negative self talk, but I do recognize it when it’s happening and can call bullshit on it in the moment. It’s progress.

I’m grateful that for me, my experience with Fentanyl was not a problem and didn’t lead me to a relapse.

I believe addiction and recovery exist on spectrums. That’s why no two stories are identical. There are many paths up the mountain.

Fragility, Acceptance, and Patience

We are fragile creatures. We like to think that we are at the top of the food chain, the apex predator, the all powerful human beings, but in reality we are sensitive little organisms going about our lives as this tiny planet spins around on its axis orbiting one of billions of stars in the expansive universe. And we can be conquered by organisms that we can’t even see with our naked eye.

I have been reminded of this over the past week as I’ve sat in a hospital bed, tethered to an IV drip of a cocktail of antibiotics, saline and non-narcotic pain medications.

About a week ago I did something that millions of people do every day — something that I’ve done hundreds of times before in my life without incident — and it landed me in the hospital.

I plucked a nose hair.

Yes, I plucked a nose hair and set off a series of events that I could not predict nor control. The small trauma inside my nose was invaded by a virulent microorganism that appeared to be resistant to antibiotics. I began to feel pain on Monday last week and thought I had a pimple on my nose, but there was no evidence of one. By evening, my nose was starting to swell and looked a bit pink. Tuesday morning, it was swollen and red and I went to urgent care. That afternoon I found myself leaving the ENTs office with instructions to head straight to the ER for a CT scan. I was admitted to the hospital that night.

After 48 hours of two of the strongest antibiotics we have available, I was still getting sicker and my nose had ballooned up to the size of a golf ball. I had cellulitis (an infection of the soft tissues) and an abscess forming. I had surgery on Thursday evening and felt relief from the pressure within a few hours.

I’ve had a lot of time to think about acceptance while was in the hospital.

We were supposed to leave for a vacation on Thursday. It was abundantly clear on Wednesday that we would not be able to go. In the past I would have felt that it was unfair. That I’d been wronged. That surely someone was responsible. And that I was owed something by the universe.

I’d be lying if I didn’t admit to having a little self-pity party on Wednesday. But it was clear that there was nothing I could do to change my circumstances. It was clear that I’d only create more misery for myself and others if I got angry and frustrated about it. So, I spent some time feeling the disappointment and practicing letting go.

On Friday, after surgery, when I was staring to feel better, I started to have the self pity again. My situation sucked. There was no way around it. I’d been stuck inside for days — hadn’t left the room in days — I felt trapped and annoyed about things. But I knew that I needed to accept the current situation and I needed to not judge it.

I got past my self pity when I found way to get connected to the program of recovery. On Wednesday I reached out to friends in recovery and this agnostic asked for, gasp, prayers. Yes, it’s true. As I mentioned in my post on the eleventh step, my understanding of what constitutes prayer has changed and I’m now comfortable asking for them, and accepting them when I need a little help.

On Thursday the program came to me. I got a lovely text from a gentleman who I’d told my story to a month ago — a friend of a friend whom I’ve never met in real life — with a picture of his 1 month chip and a note of thanks. This little message lifted me up and reminded me that small actions can have big impacts.

Friday afternoon, I worked from my hospital bed to connect a young man who I know in recovery with some resources in the city where he will be attending college. It turns out that one of my connections at my alma mater, Penn State, who is the faculty coordinator for the collegiate Recovery Center on campus knows the coordinator of a similar group at my friend’s school.

By getting out of myself, and finding ways to be of service to others, I was able to pass my time here in the hospital in a productive manner and make a difference for other people.

There have also been some lessens in patience for me here. As I mentioned I was admitted on Tuesday and had surgery on Thursday. I would have liked to have had surgery sooner, but it turned out that the abscess just wasn’t ready and surgical intervention prior to Thursday would have been pointless. And so we waited. And my nose got more swollen, and more painful.

After surgery, I had two full days of sitting in that small room, waiting to be released. Again an exercise in patience. I was physically healthy enough to leave on Friday but wasn’t released because cultures take time to grow. And my doctor wanted to ensure that we had the right treatment in place before sending me home. So I waited. My patience was thin, but I reminded myself that getting out of the hospital only to have the infection come back would be worse.

So I made some calls to friends in and out of the program. I texted with a friend new in recovery. I took laps around the floor. The decision was not mine to make and it would come when it came.

On Sunday morning I woke to the news that my cultures were done and they had a treatment plan. I was sent home at 10:00 AM, with a prescription for a ton of antibiotics over the next ten days.

This too shall pass.

Step 12: Give Others Hope

Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

Fundamentally, the 12 Steps are a roadmap for change as well as a guide for living a rich and full life. Whether one calls it a spiritual awakening or something else is immaterial. Some folks do feel that they have undergone a monumental psychic shift as the result of working through the steps. Others feel that the change is more subtle.

I personally suspect that the degree to which one feels a change is highly dependent upon how circumstances of their active addiction. For an addict who found himself or herself living on the street, steeling to survive, and living in constant fear, the shift is undoubtedly monumental. But for others who managed to keep their outward lives together while they suffered existential dread internally the shift may seem less dramatic, at least from outward appearances.

Personally, it took more than the 12 Steps for me to feel a fundamental shift in my outlook on life. Specifically it has taken the support of friends and family as well as trauma therapy. I began trauma therapy about nine months ago and as I’ve learned what triggers me, how to recognize with these triggers, and how to be with these triggers in the moment, I have felt a calmness that I’ve never known before in my life.

Many people do find this calmness through the 12 Steps. I didn’t. I felt just the opposite for a long time because the 12 Steps tripped my triggers. I am triggered by the word God. I am triggered by the the notion of an omniscient, omnipresent, and benevolent deity. The root of these triggers are in my life experience. I suffered spiritual trauma when I was told that my birth father could never go to heaven because he died of suicide. Additionally, my life experience is at odds with the idea that there is a benevolent deity directing the world — my direct experience is the opposite. The universe is chaos.

And yet, I’ve learned to accept this. I’ve learned that even if the universe is chaotic, it can still be a power greater than myself. I’ve learned that the mystery of the universe shows me that there is something more out there. Something that deeply connects us to all other things in the universe.

Recently, I was reminded of the scientific Law of Conservation of Mass, which states that matter can not be created or destroyed. When I consume food, that matter gets converted into either cells in my body or waste. For my rational brain, this is proof enough of the interconnectedness of everything in the universe.

For the past few months, I’ve been attending a Unitarian Universalist church and have found in this church a welcoming of my skepticism. It’s as if I suddenly found a bunch of people who think like me. Who suspect that there is something out there but who may not always be sure. The church is welcoming of theists, non-theists, atheists and agnostics. There is very little dogma. They don’t tell me how to believe. And that’s what I needed. This is my spiritual tribe, at least for now.

Importantly, I couldn’t have considered attending this church without going through the therapy process. I needed to deprogram old thinking and old patterns of behavior that no longer served me.

In the 12th step, we are asked to carry the message to other alcoholics. I believe the message is simple. There is a way out of the horrors of addiction and we can have a happy, healthy, and full life without the bondage of addiction. In short, it is a message of hope.

That is what I felt when I came into the rooms in 2015, a great sense of hope. Hope that I could turn things around. Hope that I could feel better. Hope that I could get the monkey off my back. Hope that I could be free. Hope that I might live past fifty years old.

Interestingly, when I was in high school I knew the importance of hope. In a very dark time I scrawled out a short poem that likened life to a matchstick. It shines bright and strong. Intense and dramatic after being lit. And then it’s over. The poem asked the question, if there’s nothing more than this life “why even spark the match?” Years later, one of my teachers found this poem tucked inside my old social studies book and got it to my mother.

And so, when I was confronted in therapy with the question, “what does a God provide to people who believe?” I knew the answer even if I wasn’t ready to accept it. The answer is hope and meaning.

And hope was vital. Without hope, my recovery would not have been possible. And so, even if I don’t like the words, I’ve had what one might call a spiritual awakening.

We need to be able to see that there is a way out of the things that we struggle with. We need to see that our struggles are part of the human condition. All humans struggle with “character defects.” All humans have problems with their egos. All humans have thoughts that if given voice might cause others to pause, to be taken aback. There is nothing unique or special about alcoholics and addicts that predisposes us to these things. The difference is how we have attempted to cope. Alcoholics and addicts have attempted to numb the pain of being human. But numbing the pain doesn’t make it go away.

What helps in times of struggle is the belief that the present reality won’t always be the reality. That things can and will get better. It doesn’t matter what the struggle is — it may be addiction but it may be something else — the message of hope is the answer.

I carry the message of hope with me in my daily life. Through my words and actions, I share it with others who are struggling. Sometimes in one on one conversations, sometimes in tweets with the RecoveryPosse on Twitter, and sometimes here on this blog.

Step 11: This Too Is Prayer

Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

“Seriously? We haven’t talked about God for a while so we better bring Him back into the picture.” This was how I felt when I looked at Step 11 for a long time. The only saving grace for me was that the payer recommended in the Twelve and Twelve was the Prayer of Saint Francis, which despite being a Catholic prayer, has always been a personal favorite and that peculiar word “meditation” in the step.

I really couldn’t imagine myself praying. Certainly not to an omniscient, interventionist deity who had fixed me and now had a plan for me. I struggled with this step. As a way to make this work, I tried to get comfortable with ignoring all the theistic overtones and focusing on meditation.

I’ll be honest, my success with meditation has been less than stellar. I have tried doing it in my own. I’ve tried to do it with the help of apps. I’ve read about it to the point of recognizing that reading about it isn’t actually doing it.

Where I struggle with meditation is making it a ritual. I’m just not a very ritualistic person. The only ritual that I adhere to is the ritual of making coffee in the morning. That happens every day, right after getting up.

But when I do make time to meditate, something happens to my monkey mind that is hard to explain. It never stops. The thoughts keep coming. But I’ve learned that this is not actually the point of meditation. By recognizing the thoughts, noting the thinking and not judging it, over and over and over again, I come to a more peaceful state of mind.

I do a fair amount of walking, running, and in the past cycling. I’ve always found that cycling by myself is meditative, and the same is true of walking and running. It’s time for me to slow down the thoughts, focus on one thing, get moving, and just be in a state of flow. Time passes effortlessly.

Still, I wondered if I was doin this step wrong since I was so adverse to praying. I worried that I needed to actually be praying — on my knees, hands folded, eyes closed, saying some rote words to a deity that I knew in my bones does not exist. And so I did a lot of reading. One book that really helped me is Waiting: A Nonbeliever’s Higher Power, by Marya Hornbacher.

In the chapter on Step 11, I came across some words that would totally change my perception of prayer on page 114:

“November morning. The sky turning from indigo to violet blue, the curly oak sketched in black on the sky. Steam rising off the lake. I sat in absolute stillness, absolute peace.

This, too, is prayer.”

These words encapsulate what I’d sensed all along in my life every time I’d stood in awe of the natural world. The sense of finiteness in the infinite that I feel when I’m alone on the beach looking at the ocean. The feeling that everything would be okay when I’d hike up to the top of the ridge at Shingletown Gap and look down in the campus of Penn State when things felt overwhelming. The sense of peace that comes when I can no longer hear the sounds of cars as I walk down a trail in the woods.

Those words also showed me that prayer need not be directed to a specific deity. That you could simply send prayers out to the great mysterious universe. My uncle gave us a small Buddhist prayer bowl for Christmas. The bowl came with the instructions to write our prayers on a small piece of paper, to put them in the bowl, and to set it near a window. When the suns rays hit the papers the prayers are carried out to the universe. This gift reinforced the notion that prayers need not be directed to a specific deity.

Today I think of many things as prayer. My silent walks in the woods can be prayerful. My time writing these words can be prayerful. Simply closing my eyes and noticing the breath is prayer. There is something centering about prayer. Something contemplative. Something quieting.

It all comes down to intentionally making time to refocus, to find a small amount of peace in an otherwise chaotic world.

That’s what prayer is for me.