Another Night in A&E


I am in the emergency ward of the St Joseph hospital. My face is swollen to twice its size from an abscess in a back tooth. Because of my rapid heartbeat, because I've taken over 30 ibuprofen capsules in the last eight hours, I have been warned that if I leave the hospital the police will be called. To show how ridiculous the situation is, to show how physically well I am, I begin jogging on the spot. The stony faced nurse on reception who legally took me hostage, seconds after my disclosure that I am a heroin addict, asks me to stop. I carry on. I'm in tremendous pain but not unwell. As I jog on the spot I tell her the problem is my swollen face not my heart. She says that the face is a matter for the dentist or the plastic surgeon and that they don't deal with either emergency here. What concerns her, she says, is my tachycardia, a potentially fatal side-effect from an overdose of ibuprofen. She says I will be legally detained until a doctor is satisfied I pose no danger of collapsing and dying somewhere. I tell her I always pose that threat. She isn't amused, and I wasn't trying to raise a smile. She points to a waiting bed and tells me to take it.

  – How long must I wait? I ask, still lightly bouncing from one foot to the other.
  – Could be 10 minutes... Could be 3 hours, she replies.

It's not me she's protecting, its her - the hospital. She's thinking professional liability and malpractice, well, that cocktailed with a spiteful sense of revenge for me having destroyed my own teeth before staggering into the hospital, a lifetime too late, smacked up and begging for help. It's a donkey court and it always is.

In addition she also finishes her shift soon, I heard her say so:
  – I'm off in half an hour, make sure that one (her eyes sliding across to me) doesn't leave!

She finished with a weird amphibious glee pealing out from the corners of her lips, delighted at the prospect that some other poor soul will be obliged to stay under the the sallow fluorescent lights of A&E, amongst the ragtag of the public with bloody-DIY-bandages, burst bowels, vertigo and short tempers, while she does not. She likes that idea: someone else occupying her vacant hell for a while. That's who she is right there. No need to horrify you with any tasteless physical details, turn your stomachs with a nauseous description of her large, padded-arse preordained for flatulence, or describe the comfy, squeakless shift-shoes she melts down into, the flesh around her ankles spilling out and moulded obediently over the sides. They're just physical accessories to the real deal. Her real personage, her dire essence, the consequence of her twenty years fast trading in the 'care' industry was that which oozed out in her spitefulness, her scepticism and hatred of the sick and dying, the delight she took condemning another person to experience the torture of her daily existence... Someone she had judged undeserving of her or the hospital's services (which would be just about anyone still breathing) and who then merited a hefty spanner in their day's works.

Not long after and she's back, asking me how I feel: nauseous? Light-headed? I slide off the bed and onto my feet and begin jogging again.

  – I'm fine, look...

The nurse marks something down on a clipboard of information she's already started collecting on me and returns to where she came from, looking back with raised eyebrows to confirm she's never seen anything like this before. It's an insane thing I'm doing, but it's an insane place I'm in. An old woman leans across and whispers:

  – Young man, they'll section you if you don't stop. They'll say you need psychiatric help and you'll be up in the hills for 7 days. They can do that!

And I know they can. They did it to Mary's mother on the third time that week she was driven into hospital claiming to have suffered a heart attack. She didn't return home for over a month and when she did she was dressed like a whore, with a wig of red hair and a lurid smile painted across her face in cheap pink lipstick. Cured!

I think of my methadone at home, of the 3 grams of smack wrapped up in foil and left on my keyboard and I stop jogging. From the disgusted look that crosses the nurses face I know I'm the last patient in a stressful day and I'll wait every minute of the three hours she said it could take for the doctor to see me.

* * *

Being a coward, with an innate fear of hospitals, disease and doctors, I sit on the emergency bed comforted by one of two friends who'd accompanied me to casualty. I can't get my mind of the swelling in my face and the more I try not to think about it the more aware I am of its presence. I have thought of everything from deep vein thrombosis to a ruptured aneurysm as being the cause. Thoughts of blood poisoning and jaw and brain infections are whirring through my mind. I feel sick. My heart starts the mad beating again. I come over all cold. Then sweat. It must be the fever from the septicaemia. It starts of like that and then you fall into a coma. I'm in the emergency ward thinking of comas. If I lose consciousness and am dope sick on top I'd never survive and I know it. My heart pounds right through my head and I flush pale. I need the toilet. I don't want to be alone. The nurse arrives with what looks like bottle of gas attached to a coat stand.

  – Roll your sleeve up, she demands, let's check your heart again.
It's jumping out my chest, and gets worse as an expression of grave concern comes across her face.

* * *

It's an hour and a half and I've not been seen. From one of the drawn off rooms an old man in groaning somewhere between panic, pain and fear. There will be no good news from that room. I think of my stepfather and an atmosphere of tragedy and loss seeps into the hospital. It's quiet, like a great storm is sat in the sky. My heart calms and goes again and a terrible feverish chill goes through to the bone.

***

  – So tell me, where did this fear of diseases come from? My friend asks.

  – I don't know, I say, without even having thought of it. It's always been there.

He pulls a face and we fall quiet. But now I am thinking. Of those young days, laying on my bed, with Parrots disease or breast cancer, my heart flipping out and desperately wanting some reassurance.

  – You know, I say, I think in a way it comes from wanting my mother to return home. In a way it was always and only that which I waited for... To be told everything was alright.

He doesn't understand.

  – Why, where was your mother?

The atmosphere in the hospital is dense, like it is when waiting for bad news to filter through, like it is after death has visited some place, and reality and life and nature suddenly become nostalgic and full of immense sadness, and human comfort and warmth becomes a real and needed commodity. I look at the floor.

  – She drank, I say, a lot. She'd leave for week's or months at a time with some man or other and only return when she was either half beaten to death or sober. But I waited for her... God, I waited like I'd wait for love all my life.

My friend had drifted on the emotion of my words. The French was bad but there was something in my throat, in the gloom and finality of the hospital which made my words work. I am pensive, maybe sad too, maybe pitying myself in this place and thinking of my cold empty room and not wanting to be there alone once this is over.

  – And when she returned, your mother, did she calm you? He asks.

  – Always, I say, nodding. Without ever really trying to. Then she'd go and I'd imagine I was dying again and be miserable until she returned.

  – And your father, couldn't he soothe you?

  – My step-father? No. He was an intelligent, knowledgeable man but I didn't trust him. Something about his knowledge seemed fraudulent. I'd never have believed him if he had tried to calm me. It's about my mother. My fear of hospitals too. Even sitting here, in this foreign place, the smell's the same. I can remember the overdoses and the hospital wards and not being allowed to see my mother because she was still unconscious but knowing she was laying half dead just in the room opposite. Those things burn images into the mind. Then on her waking, hearing her describe how the paramedics had bruised her breasts reviving her, speaking like each bruise was a token of honour. There was something about hospitals and doctors surgeries from those days on. Even though they saved her I associated them with death and they scared the hell outta me.

We fell quiet. The late spring evening was coming to a close outside and there was no doctor in sight.

***

I am looking at an old couple across from me. The man is thin but with a huge bloated chest – probably lung disease. He is laying out on a trolley bed, fully dressed but with his shoes off. He has cheap white socks, grubby on the soles, that make him look unkempt. His eyes are to the ceiling and his Adam's apple juts up sharp out his taut throat which in turn is covered with specks of dark grey and silver stubble. Resting down by his stomach is an oxygen mask. He looks like he's waiting for the white tunnel we've been told so often about. The woman is sitting tight alongside the bed holding his hand. She has tears in her eyes. Sometimes the man shrugs as if life was life and life is over now. The woman squeezes his hand and tears betray him. I know what it is, the tragic realisation that the years have really gone, that already you are here, and yet it seems you only crawled out from the cocoon of youth just yesterday. I watch his socks and then the two hands entwined. Wrinkles, veins, interlocking fingers, a gold wedding ring. The man closes his eyes gently and it reminds me of something I can't remember.

***

I'm starting to get dope sick. It puts the world in context, and if not context at least prioritizes what's important. Staying in the hospital is not important, and having the police call for me once I've stashed my crimes not so much either. If I leave I need to get a quick hit, pocket a bottle of methadone and then make good the apartment.

I roll a cigarette in the emergency ward. My friend tells me: they'll never let you out. I reply: they'll never keep me in!

As soon as I stand and pat my pockets down for my lighter the old grunt of a nurse is upon me, waving her clip board with some squiggles on it which is apparently my heartbeat. I tell her no living creature could possible make such a pattern. She doesn't understand, and it's not a language thing. She says there's no way I can leave to go for a smoke.
1) in case the doctor arrives; and 2) in the event that I lose consciousness out in the street.

I argue the toss, but as the door is securitized and needs to be released by a member of staff I cannot leave by it no matter how determined I am. The only way out would be to rush into the staff area and leap out over the reception desk. I think of it, imagine the shocked expressions such an act would encourage, but sit tight. Then I spot my chance, a member of staff entering with a swipe card. He hesitates while swapping a few pleasantries with the girls at the reception desk. As he holds the door open I dart out. There's a confused noise, a feminine screech of annoyance and then the same voice calling "Monsieur?.. Monsieur???" I hold my cigarette up above my head and make for the exit, purposely lighting up a few steps while still inside the hospital.

I am smoking calmly, though caught in thought, when my favourite nurse arrives and stands staring at me. She hasn't got her hands pressed into her sides and she doesn't tower over me in the shape of a capital 'A', it just appears like that.

  – Put the cigarette out and get back inside! She says.

I tell her I will smoke and I have the right to smoke and I will come in once I've finished.

She warns me that if I disappear she WILL phone the commissariat and I WILL be taken against my will and I WILL be returned to the hospital. I tell her my bag is inside and I have no intention of doing a runner but I WILL smoke my cigarette... maybe two or three. She pierces me with a chilling stare of hatred, leaves, and then does a Colombo, spinning around and coming back at me.

  – Oh, and if you collapse out here and we don't get to you in time it WILL NOT be the hospital's fault!

  – I understand, I assure her, and if I collapse I'll make sure to do it inside.

She leaves again but incredibly she cannot. The Colombo is an overwhelming force within her; she needs the last definitive word. So she's back, this time warning me that if the doctor calls me and I'm not there then the wait will begin anew. I'm sure this is now what will happen. I could annoy her further but decide to allow her the victory of last retort. I continue smoking, light a new one with the remains of my last, and watch as she re-enters the hospital all bosoms, ass and calves, and a face that speaks of another victory and serves as a warning that no one else should try fucking about on her shift.

My God, I think, who needs the love of a woman like that.

* * *

The mild spring evening has fallen, the stodgy-arsed receptionist has gone home, an air of tiredness and reflective calm is manifest in the corridors of casualty awaiting the night-shift and all the blood and street life that that will soon start dragging in. Now and again from one of the various screened-off wards someone is wheeled or stretchered out and past me, up into the main hospital where they've earned their place for the night and maybe much longer. In this securitized heartland of A&E I am the only person not in a bed, on a drip, or being treated by multiple doctors. My face is horrendously swollen and so may give a false sense of urgency concerning my presence here, and even though I've been told I will not be treated I have still been needlessly leapfrogged over the poor souls in free-town, that side of casualty which is drop in or drop out whether you can bear the wait or not. In fact the wait seems more like a surreptitious filtering system designed to clear-out the patients who aren't strictly emergencies, and acting as nothing more than a sobering room for others. Now and again the police lead someone in and sign them over, cast a look over the wounded for any known criminal faces, and then leave.

Taking me by total surprise a young nurse approaches me and asks if I'd like to see a female Welsh doctor who works there.

  – Only if she's younger than 35! I reply. The young nurse looks at me strangely, bemused. Not even I know what I meant.

  – Whoever's the quickest, I say. Apart from my tooth and the pain I'm not in need of any urgent treatment and just want to be home.

The young nurse understands I'm really not an emergency, and that if I am irritable it's due to having been kept here when if anything I should be at an emergency dentist having my tooth and swelling treated. She asks if she may take my blood pressure and heart rate one last time. I look at her long delicate fingers, her slender flat figure beneath her light uniform and nod my approval.

  – The thing is though, as soon as you pump up that pressure band my heart is gonna rocket... It's always like that. It's why I did so miserably earlier. It's why my doctor always takes my pressure twice.

  – And why's that? she asks softly. There's really nothing to fear. Even a high reading isn't the end of the world and in most cases not serious at all. But it's nothing to be scared of, really.

By the time she's said that, and asked me: – How long have you been in France? she has inflated and is now releasing the pressure band. She is tricking me and I let her trick me, and I need to be tricked.

  – 7 years, I reply, and the language is still a nightmare.

  – But you speak French well. I understand everything... except the 35 year thing??? Maybe an English joke?

  – Maybe? I say and smile, Or maybe it's just a Me joke... Which hasn't any meaning and isn't funny.

Her trick has worked. Her hands are warm and her fingers delicate and caring as she loosens the pressure band from my bicep.

  – That's fine, she says. A tiny bit higher than average but still within norms.

  – And the heart, I ask, feeling it rise in tension and begin pumping what feels like thick blood up into my head.

  – Normal, she says, nothing worrying there either.

  – So I can go?

  – No. You must still wait the doctor but he won't be long now.

Not 5 minutes later a bespectacled, middle-aged, fair-haired, balding doctor arrives and calls out my name. As I jump up he looks at me with an air of horror and surprise.

  – But you, are YOU an emergency?

  – No, I say, I feel fine. It's my face... A tooth, but the receptionist said...

He shakes his head and cuts me off, beckoning me to follow “This way” into a small curtained off surgery.

  – OK, so you're not ill but you're here as a potential fatality sat in one of our our few emergency beds alongside your own emergency buzzer? Please do explain?

I tell him about my face and the toothache and the nurse, then about my heroin addiction, methadone treatment and the ibuprofen I've taken. Of course the only detail he hears is that about addiction to heroin and methadone maintenance, and not even allowing for me to finish he is laying it down very firmly that the hospital, not this hospital or any other hospital in France, gives out methadone to addicts.

  – That's impossible, he says getting angry.

I tell him I'm not there for methadone, that I have plenty and better at home. I tell him I am there because some receptionist-cum-nurse threatened to have me arrested if I left, even after telling her I didn't want any treatment for the suspected ibuprofen overdose it was obvious I wasn't suffering from.
  - So if I'm here taking up valuable time it's not by choice and it's not to try and swindle a meagre dose of shitty methadone either!

Even after my words the doctor isn't having any of it. The way he speaks, the harsh fashion he tells me to strip to the waist and take the couch, the way he washes his hands and violently slings the water of his fingers into the metal sink, rubs a heap of tissues between his palms and let them fall free into the waste bin, and then the look of absolute vexation on his face when he turns to find me still standing there fully dressed.

  – Listen, I say, I just want to be outta this place. I don't want any more blood pressure checks, no more heart monitors, no more looking down my throat or peering in my eyes and you're certainly not doing a fucking liver damage test or whatever it is you want to do. That's my right and I don't want to be touched or prodded any more. I just want to be left to go home. I came here 3 hours ago for my face and tooth, I'm in tremendous pain, you tell me you can't help me but keep me here for a treatment I don't want or need but will have to pay for! Well I don't need treating and I refuse treatment... I just want to get the hell outta here.

The doctor looks at me and with all his intelligence, all his ten years of study and fifteen years of practice, he says: So you are here just to try and get methadone?

I feel sad and I don't reply. I have no words and I do not want words in the face of such disastrous care. Words and language are useless when you come up against someone so stupid as that. I let my head drop. The swelling in my jaw and cheek is pulled by gravity. My face feels like it is falling off from one side. The pressure and throbbing rise and pumps around my head. I close my eyes and let the pain take hold.

* * *

It is almost 8pm when I finally step out of A&E, hurting more than when I entered, too late to find an emergency dentist and holding a prescription for antibiotics I don't need and which is to be exchanged at a chemists which closed almost two hours ago. On top of that I am now snivelling and yawning hard from dope withdrawal and am the best part of sixty euros out of pocket for my treatment. The money doesn't matter. If I'd have been treated for my actual ailment I'd have paid sixty and a whole lot more besides. I'll get them back at death, I thought... I'll rack up such enormous medical costs then fail out on life and all due payments!

The sun was then almost gone from the sky. It lay half below the horizon, an orb of light through shutters of evening cloud. The city was a silhouette of buildings in front of it, under a mauve sky darkening off in one direction. It was that time, on such an evening, where a beauty descends far out over the city and the shapes of a few migrant birds swoon off alone. In that descending light, with the crisp sounds of evening ringing out, a faint chill having us tighten our coats, I walked from the hospital with my two friends and we made light fun about my visit and the nurse and that ultimately I was fine and that at least my swelling wasn't the onset of a painful death. It was affectionate humour, a means to balance my very real panic about health and death and being alone. And one friend said he was going one way, and the second said she was going another, and I said I was going straight on, into yonder, into pain, into the ever decreasing, darkening light home.

- - -

Thanks as ever for reading and a new text will follow soon... Shane. X

40 comments :

JoeM said...

She likes that idea: someone else occupying her vacant hell for a while. That's who she is right there.

There are so many angry petty people around. Just loving to take out their own failed lives on others. On the vulnerable.

I see it all the time at work. People making mountains out of molehills or deliberately being obstructionist. This doesn't matter too much in a library. But when you know that doctors nurses cops bankers politicians judges and so on are doing it then it's very scary.

I'm glad that finally civilians are realising that not all nurses are angels nor all cops Dixon of Dock Green.

How long before you saw a dentist? I think I'd have gone there first.

And see - I remembered that Heroin isn't a pain killer!

Memoirs of a Heroinhead said...

Hey Joe...

I never actually saw a dentist. This happened quite a while back, last year. I couldn't see a dentist as this was a sunday evening and the next was a bank holiday. I worked all day with the swollen face and by 6pm I was in so much pain I had to do something and so two colleagues (the coward I am) escorted me to casualty. There was one emergency dentist open that night (and then none before tuesday morning). And having read the post you'll know why I never made it to the emergency dentist that night - because I was detained at the hospital and by the time they let me out it was gone 8pm and the only emergency dentist was then closed! That's how crazy it was. They kept me 3hrs at the hospital for care I didn't need, and while doing that they ruined my only chance to get treated before tuesday!

The problem is recurring and happened again, just last month. It is a back tooth, broken, and occasionally it takes in liquid/food but doesn't let it out: like a one way valve. My face always swells when this happens, but normally it's not so bad or painful and goes down itself after 3 days. This time however the swelling got worse and worse until my left eye closed over and I got a little scared. Finally, as always, it healed without treatment... but it was painful and scary that time.

Obstructionist people... I've a history of working in the French public sector, I know only too well such people... one accompanied me to the hospital that night! X

Loquii Lokiss said...

Hi Shane,
Unfortuinately for many of us, that seems to be a very familiar tale all over the world.
This scenario has happened to me countless times upon visiting Australian hospital emergency depts, especially the part where the "knowlegeable medical practitioner" hones in on the insignificant detail of the heroin/methadone use & twists it to use as hard evidence of doctor shopping..(despite the nature of the complaint almost always referring to something completely different)

Last year a colleague of mine was in absolute agony from kidney pain (I cant recall the exact nature of it) & was rushed by his mother to the local emergency ward. They promptly looked up his details & saw that he had been a pharmacotherapy patient in recent years & thus refused him treatment. He went home & died 4 hrs later. The hospital has since been the subject of a large scale coroners court inquest, & has started the ball rolling concerning the stigma & discrimination faced by pharmocatherapy/opiate users by medical professionals across the country. New protocols/laws/procedures are supposedly being drafted due to this case, but you can guarantee that this will take years to finalise whilst many others befall the same fate.

Anyways, yours was a great article which shows that some things never change no matter where you are.

Loquii Lokiss

Calamity K said...

Another great post! Perfect way to start the day!

I used to fantasise about my death when I was a kid and my dad went away on business and left me with various strangers. I imagined a coffin like in my Lady Bird Snow White book (after she eats the poison apple), glass with flowers. I figured at least my dad would come back for my funeral.

Yes, docs to fixate on mention of addiction. I've usually listed my medications, and they always ask... buprenrophine? what's that for? And at that moment I know I'll be given the 'special' treatment. I've actually been surprised how little they know about opiates and opiate receptors etc.

Dentists are my biggest fear, but it's mainly been the bill they've presented me with after that's reduced me to tears. I did once try to be 'clever' before a dentist appointment and had a few toots. It backfired cos opiates reduce the effectiveness of the anaesthetic so I had to have even more of those horrible injections in my gum before anything went numb!

xCalamityK

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_Black_Acrylic said...

Always a huge pleasure to read your posts Shane, and I'm heartened by their regularity of late. Your description of the old fellow on his trolley bed was particularly moving, I thought.

fallen said...

Hi,your post reminds me of several visits to A&E .Mentioning a methadone script or heroin habit was never a good idea.They usually think that you're there for freebies & then you're lucky to get a paracetamol however much pain you're in.I used to get so ill that I couldn't keep my methadone down & then would get withdrawals on top of whatever was wrong in the first place.I didn't think they were that bad in France.I new a couple who had pneumonia while in France.They both had heroin habits & were given a double room & were allowed to use when they wanted.That was several years ago though.Thanks for your post.I'm sure there're many of us that don't comment but love everything that you write.

darren said...

i too loved the little vignette of the old couple having arrived already at death's door. very sad. it's that which makes your writing special, the profoundness of such observations coming from your unlikely source. daz

bonedust said...

Hey man, I'm a new reader. I forget where I got the link to your blog-- it was either from Opiophile or the opiates community on Reddit.
Anyways you mentioned your tooth that's been giving you trouble is broken. Have you thought about simply having it pulled. Mouth infections can be deadly. Please be careful.
I'm also an addict. Six years on methadone. I'm weaning myself off the methadone and I'm finally down to 10mg. I do use heroin every couple weeks.
I really enjoy your blog. You have a very unique writing style. Keep up the good writing.
--A USA fan, Christine

JoeM said...

I was thinking what bonedust said - why not just have it pulled? But I thought there might be some Heroin-related reason. Calamity K says opiates reduce the effectiveness of the anaesthetic.

Hi CK on here!

I've deja vu about this - I think you must have told me about it in email and that's when I learned H wasn't a pain killer. But I have no memories these days, except the false ones. So I hope I'm not asking the same stuff over and over.

bonedust said...

Heroin is a painkiller. But if you've been on it a while it can mask pain you have until you are off it. If someone needs to get dental work or surgery they need to tell the dentist or surgeon what they're on so their anesthesia and pain meds can be adjusted accordingly. If not you can risk waking up during surgery or dying. They need to know what to give you. One of my teeth is acting up and if worse comes to worst the cheapest option is just having it yanked out.

Memoirs of a Heroinhead said...

Hey Bonedust and welcome! X

"Mouth infections can be deadly. Please be careful".
I think you need to read this post:

A Modern History of Rotten Teeth

I got down to 5mg every three days a few years back but didn't come off as I was saving it up to use after my smack days (a two day binge every two weeks). Of course it went along fine for months and then I started taking too much of everything once again. I'm on 40ml a day now.

Thanks again for your words.. Shane. X

Memoirs of a Heroinhead said...

Hey Kelly, normally I just don't disclose I'm on any medication... it only ever causes problems. The cocktails of drugs I've taken for fun far exceeds the dangers or risks of any cocktail the doc or dentist is likely to give me and so I just cash the prescription and swallow. X

Memoirs of a Heroinhead said...

Hey Loquii... Yeah, hospitals are' in a terrible state worldwide... though gets better the more insurance you pay each month. We need a drastic rethinking of healthcare or we'll soon have average life-expectancy differing drastically between classes... and that'd be a real tragedy.

Hope you're well, man... Shane. X

Memoirs of a Heroinhead said...

Hey Doctor Abraham... Yeah, I'm a junkie who cares about his skin... and have the means to go to India... See ya there no doubt... X

Memoirs of a Heroinhead said...

Hey Ben... Has my frequency improved? I'll take your word on that. It will do though... I've been putting posts together for some months now and so have a little stock of almost complete texts in the bank. There's a nice one about electric cigarettes.

Hope you're well Ben... Love as Ever, Shane. X

Memoirs of a Heroinhead said...

Hey Fallen and welcome... X The quality of health care in France is actually generally pretty good. It beats the hell out of the NHS in the UK. My problem wasn't really with the care but the protocol.. and more the men and women you often come across who carry out that protocol and who take a sick delight in fucking up your day and causing you headache and trouble. X

Memoirs of a Heroinhead said...

Cheers Darren... sorry it's brief but am in a bit of a rush. X

Memoirs of a Heroinhead said...

Hey again Joe... No, heroin IS a painkiller but does not kill all types of pain. For example it will never relieve a headache (and often makes it worse). I can't recall what it was now but the body experiences two types of pain and heroin will only relieve pain associated with the central nervous system (or something). I'm not even gonna research it.

Heroin does work for toothache and works very well. But severe toothache gets to the point where NO painkiller can relieve the pain and at that point it needs treating. That's very rare, and has only happened three times in my life. It's why I mostly don't go for treatment as I've learnt that most toothache can be numbed until it passes (even if it sometimes takes weeks). So usually I bear it out and swallow fatal amounts of paracetamol or ibuprofen and only go for treatment when medication no longer works. Also dental care is enormously high over here and treatment isn't generally reimbursed at all. So proper dental care is a measure of last resort I'm afraid. X

bonedust said...

I read the rotten teeth post and the afterthoughts I came away with are:1. OUCH. 2.Thank gxd I have dental insurance through my husband's work.
After six years on methadone I still have all my chompers. The one that's acting up is from a filling that needs repair, I think. I will say this though, being and addict has put almost all hygiene on the back burner. I gotta start bathing and brushing my teeth a lot more. My hurts says I don't stink though, which is comforting.
My husband has super jacked-up teeth. The ones he has left are mostly broken and dark. Not from addiction really (he's on methadone as well), mostly from genetics and poverty.
I do admire the self-surgery though. I do what I can as well.

bonedust said...

* My husband I meant to say, not hurts. haha

My methadone taper is hurting me a bit so maybe that's on my mind.

Calamity K said...

Hey JoeM,

The dentist told me that ibuprofen (or any NSAIDs) interfere with the (speed/effectiveness of) local anesthetic. That dentist though, I have to say, was the best I've ever been to. Super fast and no pain after the anesthetic wore off. Unfortuntely he had to leave the UK, he was Polish and didn't officially have all his papers to work here.

I had the same problem when I had to have epidural injections (which I never want to go thru again!). They used the biggest needle I've ever seen (about 6 or 7 inches long as they have to go quite deep into the gaps between the vertebrae). They had to give me a few extra shots cause it wasn't taking effect and getting deep injections in your spine is extremely painful. One of them gave me her hand before they started and told me to squeeze it when it got painful. The poor woman had pianists hands, I have washer woman's hands (like the rest of me...made for grafting def not dainty). On pain scale out of 10, I'd give it 15. Weird being numb from the waist down, weirder watching your colostomy bag fill up and not feeling a thing.

But the pain didn't end there. After it wore off and I was discharged from the hospital, I had sharp nerve pains where at all the injection sites. It felt like I had a morbidly obese person (let's not be sexist), in sharp stilletos dancing flamenco down my spine. And had kind of 'phantom' pains (the same sensation, slightly less sharp) for about 6 months after.

Oh well. Pain is life

x CalamityK

JoeM said...

So Shane, I'm still not ready to do Heroin on Mastermind! It's all so complicated.

Wouldn't it be great if someone made Heroin their specialist subject on Mastermind?

CK - I've got the dentist next week.
Like so many other things that never used to bother me - big dogs, walking home at 3AM, long public transportation - I now get panic attack-y at the thought of it.

I used to take Paracetamol before the dentist. No more after what you said.

Calamity K said...

Oh God Joe, Don't let me influence how you cope with the dentists! If you've used paracetamol in the past and not had to have extra injections then carry on and do what's right for you. I used both ibuprofen and heroin prior so it might even be the combination of them and bear in mind at that time my tolerance to opiates was pretty high. Plus I think individual metabolism plays a part too. So, really my experience doesn't mean you'll have the same.

The way I've dealt with dentists is to dissociation* (http://en.wikipedia.org/wiki/Dissociation_%28psychology%29)i.e. this might be happening to my body but it's not happening to me. And breathing as slow and calmly as I can (opiates slow down your breathing so maybe that's why just doing that (and the fact it's a distraction from the pain) is quite effective if done right. If the only pain you're expecting is in the dentists chair (i.e. you're not in agony with an abscess) then know that the pain is temporary and just another sensation of life.

You'll be fine big man
x CalamityK

*dissociation, a shrink once told me (after I revealed that I looked at a lot of the worst things in a dis-embodied way, kind of like leaving your body and being a viewer rather than a player) that it's not a normal part of child development but is exclusive (as a coping mechanism) to kids brought up in traumatic situations. Great! Thanks for making me feel normal!

JoeM said...

I do the dissociation thing too.

I took advice from my favourite philosopher Andy Warhol:

When things are bad
Pretend it's all a movie

Memoirs of a Heroinhead said...

Joe, "take heroin on Mastermind"! I'm not sure Eamonn Holmes would stand for that! Though he may allow you take it is as your specialized subject... but I'm sure that's what you meant. Oh, that's what I'm gonna do right now:

YouTube - Blockbusters... and my evening will be so perfect! X

JoeM said...

I'm sure somebody's already taken Heroin on Mastermind.

And not just as a specialist subject...

seneca uk said...

Another great post mate. One thing I don't quite get though- why did you go to A and E? You mention the tooth, but also that you don't want treatment or drugs. So why did you actually go there? Sorry if I'm being slow!

Calamity K said...

Afternoon Shane,

I'm probably going to tell you about something you already know again but yesterday at the bus stop, I saw a product for tooth pain on the billboard that I'd not seen before. It's called 'Orajel Extra Strength Dental Gel'. The main ingredient of the gel (to rub on the affected area) is the anaesthetic Benzocaine to numb the nerve endings.

I'm gonna get one for my medicine cabinet as these things tend to strike suddenly.

Incidentally, if anyone here knows of a good cough supressant (other than heroin/opiates), then please let me know. I've been waking up in the middle of the night with a tickly persistent cough and badly blocked sinuses (that almost make me gag). And no, I don't want to give up smoking just yet, it's the last frontier of my addictions.
CalamityK

Gravediggin' Under the Mancy Way said...

Hey Shane,
The judgemental way heroin addicts are treated by medical so-called professionals is something that realy needs to change. Scripting doctors are just as judgemental in my experience, which buggers belief.
Your experience sums it up perfectly. Beautifully, captivatingly written as always.

After an operation a few years back, I was refused take home morphine amps (oral) and given ibuprofen and very short term cocodamol 30/500s, whilst someone I knew who wasn't an addict was given a huge supply of morphine amps: and my operation was more invasive, more painful and more major than the op they had...I was in AGONY for weeks afterwards.

A good friend of mine was in severe pain for years and doctors just put his pleas for diagnosis and treatment down as drug-seeking behaviour. Turns out he has cancer. If he'd never have used heroin, they'd have done tests from the beginning. What about the ehics of suing the NHS for negligence like that though? Is his life worth nothing? Someone commented "Sueing the NHS is wrong: they're underfunded as it is". He says they want him to die.

I'm looking forward to your next posts. The electronic cigarette. I tried refulling most non-refillable brands succesfuly until I tried it with E-Lites. The fluid killed my fuckin e cig.

Good luck with the tooth my dear. It sounds horrendous. Why do they think heroin addicts can't feel pain? Someone with long term exprience as an addict should write an educational manual for healthcare profesionals on the subject.

Much Love& Long Life,

Vee X

Gravediggin' Under the Mancy Way said...

wah, my typos are bad...sorry! x

Memoirs of a Heroinhead said...

Hey Seneca UK and welcome...

No, I wanted treatment... I needed treatment, but at A&E I was told they do not treat dental emergencies and my swollen face and pain was at its root a dental problem. Then they gave me the address for the only emergency dentist open, which would close in just over 90 mins at 8pm and would not then be open until tuesday as the following monday was a bank holiday. Before leaviung for the emergency dentist I had to fill in a form and on that form was a question asking me the level of pain I was in on a scale of 1 - 10. I marked an 8 but added that was even after taking heavy doses of painkiller/ibuprofen. The nurse asked how many ibuprofen, and when I told her she looked shocked and said it was a dangerous amount. I waved her off saying at other times I've taken twice that amount, sometimes daily over weeks. I also explained I needed elevated doses due to my immunity to painkillers due to my heroin and methadone addictions. So it was then that she officially detained me, not for treatment but because she said I had taken a potentially fatal dose of ibuprofen. It was because of that that the hospital then wasn't prepared to give me more, stronger painkillers. So I wanted treatment but the hospital didn't treat dental emergencies and by detaining me also ensured I couldn't get any help until tuesday morning at the earliest. X

Memoirs of a Heroinhead said...

Hey Kelly... thanks for the tip but one of the great myths of toothache is that it's nerve pain or an exposed nerve, etc. That is painful, but ALL nerve pain can be treated and completely calmed by paracetamol/aspirin/ibuprofen... or clove oil and even pure alcohol. So these things work for nerve pain. The dental pain which becomes untreatable by ANY painkiller (even heroin) is ALWAYS pressure pain. In a way it works on the nerve too as it is the nerve surrounded by pressure which cannot be released. It's why all severe toothache happens to full teeth not as we'd maybe imagine a half rotted tooth. Usually it's a hairline crack or small hole which lets liquid/food enter but doesn't let it out. The tooth becomes full of pressure and that pain requires dental surgery to relieve it. Actually you need to break the tooth to relieve the pressure. It's why in my other post I talk of cracking my own teeth open and self-surgery. It sounds brutal but the pain is relieved instantly and it's the only way to do it (or sitting the pain out for weeks until the hole decays further and allows the build-up to escape. But weeks is impossible to wait with severe toothache.) It's hard to break a tooth when you're suffering so much because your great fear is that you'll make what is all ready unbearable pain worse, but with a little practical experience and knowing cracking the tooth will end the pain, it becomes a very easy thing to do... and when you do the relief is IMMENSE! Seriously... pain relief is euphoric, it's why heroin is a huge disappointment for those who use it who aren't in pain. The high of heroin is actually in the relief of pain or suffering, not in the effects of the drug itself. It's why I say that this idea that addicts are always chasing the buzz of their first high is bollocks. The pleasure from heroin is relative to the pain/suffering you can be relieved of, and the more pain you're in the greater the hit will be. So actually, if a great tragedy coçmes your way, you can have your greatest heroin hit even 20 years into your addiction. I'll write a post about this. I keep meaning to but haven't got around to it. X

Memoirs of a Heroinhead said...

Hey Kelly... thanks for the tip but one of the great myths of toothache is that it's nerve pain or an exposed nerve, etc. That is painful, but ALL nerve pain can be treated and completely calmed by paracetamol/aspirin/ibuprofen... or clove oil and even pure alcohol. So these things work for nerve pain. The dental pain which becomes untreatable by ANY painkiller (even heroin) is ALWAYS pressure pain. In a way it works on the nerve too as it is the nerve surrounded by pressure which cannot be released. It's why all severe toothache happens to full teeth not as we'd maybe imagine a half rotted tooth. Usually it's a hairline crack or small hole which lets liquid/food enter but doesn't let it out. The tooth becomes full of pressure and that pain requires dental surgery to relieve it. Actually you need to break the tooth to relieve the pressure. It's why in my other post I talk of cracking my own teeth open and self-surgery. It sounds brutal but the pain is relieved instantly and it's the only way to do it (or sitting the pain out for weeks until the hole decays further and allows the build-up to escape. But weeks is impossible to wait with severe toothache.) It's hard to break a tooth when you're suffering so much because your great fear is that you'll make what is all ready unbearable pain worse, but with a little practical experience and knowing cracking the tooth will end the pain, it becomes a very easy thing to do... and when you do the relief is IMMENSE! Seriously... pain relief is euphoric, it's why heroin is a huge disappointment for those who use it who aren't in pain. The high of heroin is actually in the relief of pain or suffering, not in the effects of the drug itself. It's why I say that this idea that addicts are always chasing the buzz of their first high is bollocks. The pleasure from heroin is relative to the pain/suffering you can be relieved of, and the more pain you're in the greater the hit will be. So actually, if a great tragedy coçmes your way, you can have your greatest heroin hit even 20 years into your addiction. I'll write a post about this. I keep meaning to but haven't got around to it. X

Calamity K said...

Shalom Alaykhem Vee,

Was your typo 2nd to last word; "Scripting doctors are just as judgemental in my experience, which buggers belief."

If so, that wasn't a typo, that was inspired!

xCalamityK

Calamity K said...

Nerve pain! I had the nerves taken out of a few of my teeth so I'm blissfully unaware that they're probably rotting away, my breath probably smells like a corpse when I talk to people but...no pain, so I'm not complaining.

Anyway, halitosis that smells like a neglected morgue will just sort out the chaff from the wheat, as in who my real friends are.

My worst dental nightmare though is that the jawbone gets infected and they have to saw it off! That part of my face would collapse!

AND I wouldn't feel like half the person I once was!

xCK

Calamity K said...

I look forward to the post...

You know what you outta do as a sideline?... back street dentistry

When you're poor they take all your teeth out anyway cos they know you'll probably not be back again to replace those caps or veneers.

I'll design your business cards... I can feel the name 'Crack' coming on...wait a minute...then there's smack... I got it!
Crack your teeth and Smack your face up dentistry

Sorry Mr Levene, I had to indulge myself x

seneca uk said...

Thank you sir, much appreciated! Keep up the good work; I wrote the comment on your Afghanistan post about being a neoconservative addict. Great blog :) x

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