missoula notebook
Sweet Mother Lortab
By Sutton Stokes, 7-23-08
| Ahhh... I can feel it working... | |
Judging by the mental feebleness of some of the regular commenters here at New West, I’m guessing that a few of you are believers in so-called “intelligent design,” so can one of you please explain to me what is so intelligent about the human neck? I ask because I’ve apparently caused grievous injury to mine with nothing more than pillows, which seems indicative of the kind of bug that never should have made it past beta testing.
It all started last week when I was down in Flagstaff visiting my wife, the Bird Woman of the Coconino. We stayed on San Francisco Street in the hotel Monte Vista, where parts of Casablanca were supposedly filmed and the rooms are named after celebrities who once passed through. In the past, Amy and I have had the Robert Englund and Michael Stipe rooms (yeah — disappointing!), but this time our room’s namesake had a more satisfying nostalgia quotient: Alan Ladd. (Think “Shane, come back!”)
Our first night there, we noticed that the pillows were exceptionally thick.
“Ooh, luxurious,” I thought, before turning in.
“Ooh, ouch!” I thought upon waking. I had a crick in my neck and, in certain positions, a pain that shot down under my right shoulder blade. There was plenty to distract me all week, though, and the pain was never that pronounced, so I was able to ignore it.
Until this morning.
I was lying in bed, trying to decide whether it was more important to sleep for another hour or get the trash out in time for pickup, when I made the mistake of commencing a langorous stretching of my lithe, catlike muscles. Suddenly I was shrieking with pain and twitching like an electrocution victim as I desperately tried to find a position in which I could escape the sensation of someone carving out my cervical spine with a filet knife while sliding red-hot knitting needles up under my shoulder blade. I finally found a somewhat neutral position and lay there gasping, thinking profound thoughts like “what the fuck was that” and “guess I should probably go to the doctor.”
I dressed and dragged myself out to the car for the drive to Northgate Medical Center, where the staff is friendly and helpful, but — it has to be said — the waiting-room-magazine selection is just about the worst I’ve ever encountered: three copies of Model Aviation (for a second, you let yourself hope that one of these will include photos from a party on Ron Burkle’s private jet, but, alas, not that kind of model, apparently) and a two year old Kiplinger’s Personal Finance.
The doctor wondered if I’d been in an accident or maybe fallen down, but when I explained the pillow theory she thought it sounded plausible. “The neck is really easy to injure,” she said. “If you end up needing physical therapy, the therapist can show you all kinds of exercises and how to improve your posture. It’s all about prevention,” she finished, cheerfully, apparently not having considered that — if it really were all about prevention — our doctors would have us all in for some posture analysis and medicine-ball work before the debilitating spasms commence.
She started explaining what the course of treatment would be. Waiting to hear what kind of painkillers I’d won been prescribed, I tried not to look shifty. I’ve been reading the fascinating Missoulian series on painkiller addiction all week, full of harrowing tales that almost make you never want to grind up and snort an OxyContin ever again, and I worried my treatment would suffer if they thought I was faking my pain, “doctor shopping,” another junkie just looking to score.
I was half expecting her to hand me a writ for “Coast Guard penicillin,” i.e., the 800-milligram Motrin pills the military doctors gave out for everything from sprained ankles to leprosy. But no: Flexeril for the spasms, and good old Lortab for pain as needed, and when isn’t it? They also gave me a “c-collar,” one of those foam neck braces you wear to court after you’ve been in a car accident.
I wracked my brain trying to remember if I’d seen mention of Lortab in the Missoulian series, but I didn’t think I had. I forgot to ask the doctor if that means it’s safe to snort it, although a quick Google search for “Lortab abuse” just now found that it is supposed to be “slightly less” addictive than OxyContin, which — I guess — makes it slightly safer to snort. (Disclaimer: The preceding statement is for entertainment purposes only.)
I left the clinic wearing the collar but took it off in the car so as not to frighten my fellow drivers as I made my cautious, pain-brightened way across Reserve Street to the Wal-Mart pharmacy. (Hey, did you hear that Wal-Marts don’t hurt small businesses after all — depending, as always, on just where you draw your regression line.) I turned in my paperwork and was told the prescription would take about 25 minutes to fill, which seemed like a long time for scooping some pills into a bottle, but at least the wait gave me the opportunity to slump on a bench by the checkout lanes and scribble most of this account in my notebook.
Now I’m finally home, after swinging by the video store for some horror movies (the only truly relaxing form of cinematic fare, I find, much to my psychologist’s concern, although he says he’s almost certain I’m not going to have any more “episodes") and the grocery store for some frozen pizzas. I popped a Lortab about a half hour ago, and I can feel it starting to spread its soothing warm tendrils down along my veins. The Missoulian isn’t the only publication with good drug stories this week: David Carr, the New York Times columnist who has just released a fascinating-sounding memoir of his own crackhead past, wrote in an excerpt on Sunday that “drugs… do not conjure demons; they reveal them.”
I’ll let you know if Lortab reveals anything to me. See you in rehab!
For more like this, read the rest of the Missoula Notebook.
Like this story? Get more! Sign up for our free newsletters.




Comments
A chiropractor will allow you to live pain free most of the time. The MD with surgery on his mind, and you willing, will almost guarantee you a lifetime of pain and pills. Go to the chiropractor.
My wife spent 25 years as a senior adjuster for workers comp accounts, and professionally found that chiros were slime. Then she hurt her neck. For two months she was in pain. She was beside herself. Then she did remember one chiro who seemed to not have people on comp for the rest of their lives, had been honest in all their dealings, and in desperation, went to him. And now swears by his manipulations. Recommends him. She figured it out. Go to the chiropractor.
twitching like an electrocution victim as I desperately tried to find a position in which I could escape the sensation of someone carving out my cervical spine with a filet knife while sliding red-hot knitting needles up under my shoulder blade.
Giggle.
And this:
I tried not to look shifty.
What I don't get is, how are y'all getting your drugs? Because I hadn't had or wanted prescription painkillers in twenty-some years until I got adult braces on a few years ago. I was in excruciating pain for 11 solid days, and neither my orthodontist nor my doctor would prescribe anything for me.
I'm still traumatized.
Willy: Your comment is a waste of "spqce."
I was raised to believe chiropractors were quacks, but once I found a good one who told me that chiros who keep you coming back forever are the quacks, I was willing to try. I had pain in my hip joints that made me cry out loud, but x-rays showed nothing. After a year of misery, this chiropractor cured me in one $35 visit. That was five years ago. Not a twinge of pain since. Ask around for recommendations, and when one name keeps coming up, try her/him.
I've had the same neck affliction you describe, and it reminds me of the George Carlin (or was it Steven Wright?) observation: "Did you sleep well?" "No, I think I made a couple of mistakes."
I got through the neck episodes (attributed to Getting Old) without seeing a doc, but as it happens I'm currently in possession of a shiny green bottle of Lortab 7.5's, which were prescribed by my orthopaedist to facilitate sleep with the pain of what is probably a torn rotator cuff in my left shoulder.
It's been a love/hate relationship with Mother Lortab over the last ten years for me (ever try to rub one out while on Lorab? Talk about hand to hand combat!), but somehow avoided addiction beyond the prescribed period.
The comments on seeking chiropractic are on the money, and for that type of neck pain, I think you could get some relief without the codeine or surgery. Good luck, and keep your chin up.
It is ultimately the patient's responsibility to use narcotics responsibly.
A few years ago, narcotics were only prescribed after surgery, severe trauma, or for terminal cancer because of a concern over the possibility of addiction. Recently, they have been cautiously prescribed to treat moderate to severe non-malignant chronic pain in conjunction with other modalities such as physical therapy, cortisone and trigger point injections, muscle stretching, meditation, or aqua therapy. Unfortunately, the upsurge of narcotics as medical treatment also increased associated cases of abuse and addiction.
Derived from either opium (made from poppy plants) or similar synthetic compounds, narcotics not only block pain signals and reduce pain, but they affect other neurotransmitters, which can cause addiction. When taken for short periods, only minor side effects such as nausea, constipation, sedation and unclear thinking are noted.
However, when narcotics are taken for several weeks to months, these side effects can become more challenging: loss of effectiveness due to built-up tolerance, possible addiction, or overuse for a temporary "high," not for pain. Because of the potential for addiction, whether physical (anxiety, irritability, nausea, vomiting, abdominal cramps and insomnia) or psychological (compulsive use, craving the drug and needing it to "feel good," narcotics are considered controlled substances findrxonline indicated in their medical articles, which means that the FDA and DEA govern their distribution, prescription, and use and classify them into different schedules as per the Controlled Substances Act of 1970.
While weak narcotics such as Tramadol (Ultram) and Schedule IV opioids analgesics such as Darvon or Darvocet N 100 have a low risk for physical dependency and addiction with mild side effects such as dizziness, sedation, headache, nausea and constipation, Schedule III opioids analgesics such as Lortab, Tylenol #3, Vicodin and Vicoprofen have a low to moderate potential of physical or psychological dependence. Demerol, Dilaudid, Duragesic, Oxycontin and Percocet, which cannot be automatically refilled, fall under Schedule II because of their high abuse potential, and possible severe physical or psychological dependency.
In view of the fact that narcotics can be addictive, they should only be prescribed when no other alternative is available and should only be taken as directed by your doctor. Most often, patients are required to consent to adhere to certain rules regarding the use of their prescription listed in a "Narcotic Agreement" between the patient and physician. Often, violation of this contract, especially selling, sharing, or trading the medication, attempting to obtain duplicate pain medication prescriptions from different physicians, and attempting to have the medication refilled early, at night, or on the weekend, to mention a few, would result in the patient's discharge from the practice.
So, take responsibility for your actions and know all your treatment options. Narcotics are rarely your sole savior.