Roger Johnson Weblog

It is a beautiful morning in Chicago: the sky is clear blue, the temperature is approaching 70 and predicted to hit 78, the humidity is 45% which for us is reasonable; thunderstorms are coming into the area this afternoon. It is a morning that I am doing my best to appreciate; Bach’s French Suites are being played on the harpsichord in my front room; there is a pot of Peet’s Aged Sumatra at my elbow; I am sucking the fibers from a pretty good orange out of my teeth; and will be getting dressed shortly. And I have no pain worth mentioning.

To celebrate this late spring morning I think I may commit an extravagance, I may never do the act but I am thinking about it. I own two short-sleeve sport shirts, one is a kind of Madras pattern on a fabric that wouldn’t fade if you soaked it in pure Clorox, the other shirt is a dark gray pattern with large white squares, also made out of indestructible cloth ; I have had these two shirts for at least four years, they have been all that one needs, one to wear, one to wash; it is like having two pair of shoes, one brown, one black–what civilized person needs more?

But I am considering the purchase of another shirt, a third shirt that will have no reason to be; the previous two have been working with satisfaction, can be washed in the evening, hung in the shower and be fresh and wrinkle free by breakfast. It is a mystery to myself why I would think of laying out another $5 or even more for a new shirt. I did something similar last month, I bought a third pair of jeans; usually I have two pair, one on the edge of being worn out, the other being broken in; now I own a third pair that causes confusion in the morning, a time when I am more easily confused than ordinarily.

Jeans come in blue, black or some shade of tan; mostly blue. Shirts come in uncounted colors, the colors are arranged in patterns that are beyond counting; so why would I venture into this maze of decision making? It would be a re-enactment of my visit to Bed Bath and Beyond, an adventure that took a week of recovery with the help of beer.

I now realize that there is a benefit to being married: spouse decides you need a shirt, the kids ask what to get dad for his birthday—and shirt appears, without angst or distraction from the important stuff of life. This operation is not available to the older unmarried guy; and only newly-engaged men ever go into Bed Bath and Beyond with a woman, veterans soon figure out escape mechanisms for when that subject comes up, as it does with regularity.

As the level of coffee in the pot approaches the bottom I approach a realization; perhaps I don’t really need to have a third summer sport shirt, I do have tee shirts, many of which are not yet frayed. Instead of going to the Target and seeing the selection they have purchased by the millions I could stop by the used book store down the street, have an espresso, find something good to read while sitting out in the garden. Isn’t that really a more civilized way to spend an early summer Sunday afternoon? One of my shirts is clean I think, I forget which one is in the laundry and which is hanging and waiting for me, there will be no question of choosing and re-choosing, I can leave all of that energy to looking into books that I haven’t read, or not recently. If both are in the laundry there is a tee shirt with just the right amount of fray.

One of the purposes of writing is to untangle human problems, I believe I have just accomplished that objective.

I have just returned from doing my cardio-fitness exercise, which for me is fast walking with a heart rate between 90 and 120 for 20+ minutes; I became a believer in this type of exercise when they reminded me that it produced endorphins and my pharmacist reminded me that endorphins hit the same nerve mechanisms as the juice of the poppy. It feels good and lasts for about 8 hours.

I have nothing much to report on Cymbalta, because the side effects are absent with the exception of the sexual business, no dizziness, no exhaustion; it does produce a bit of a high, but not too much of one. Having given the Lyrica about an 8 months try I feel that I was right in dismissing it for this stuff. Again, I have no idea how it affects anyone else, whether it is better for rheumatism/fibromyalgia for anyone else, I am just putting it down here for those who are following my journey.

Another aspect of pain management is what they call bio-feedback, what some might call mindfulness exercises involving breath control and the monitoring of pain and tension changes from the exercise. I have been doing this kind of thing for about a year and a half so didn’t need to be sold on its benefits.

Other specialized exercises and occupational therapy just make my body work in a more natural way, one that doesn’t hurt so much.

As for the psychology: reducing stress reduces pain, accepting what can’t be changed is a good habit, etc., etc.

My mechanic suffers from chronic leg pain from an old injury; I have been nagging, coaxing, showing him my progress, and I think he may actually try to do something. It is liking moving a house from its foundation.

As I wrote a few days ago, being open and looking beyond is the key to a great big future, but no one can do it for me except me.

There isn’t anything else to write than what I have put down so far, there is a smörgåsbord, so don’t be so picky, try a little of each.

Yesterday was my fifth and last session at the Chronic Pain Clinic; everyone I met with asked the same question–if I had met my goals for the program? To each one I answered the same: I had no goals, I could have no goals because I was ignorant of what the program had to offer, what my body could accomplish, I can’t foresee the future. This didn’t sit easily with any of the therapists, as I well knew from previous discussions; they have forms to complete, statistics to be calculated, and they are trained to having goals in what they do. What I answered each of them was whether I was happy with what had happened at the Clinic, was I discontented over any part of the program?

I am pleased with every part of the program: with the attention and focus of the physicians, the alternate medication they offered; with the attitude and professional nature of the nurses; with the insights and understanding of the psychologists; with the advice and attention of the O. T. staff; with the exercises and rehabilitation offered by P. T.; with the increased management offered by the bio-feedback portion. All areas offered benefits that I attempted to absorb to the fullest. But I had no goals, I had only attitude, to get all that I could out of what this clinic was offering, to do whatever I could to minimize my pain and discomfort, to be open to whatever benefit might come along.

This is of course an attitude towards the spiritual or Spiritual life; I can’t say that I am in full communion with the Divine, who could know that? I cannot say what my Spiritual quest will give me, if I could then it wouldn’t be a quest for what is unknown to me now. This is an attitude that often results in anxiety of the unknown, it would be comfortable to know that if I prayed a certain number of times, if I did so many good works, if I followed a particular method I would gain enlightenment. That’d be a great thing if it was so, but it is not, it has never been the path to enlightenment, never will be; it may be the reason that the organized church is on the edge of irrelevancy, except for the lack of alternative. To be catholic is to be a good follower, it has never been anything else.

I received far more from the Pain Management Program than I could have predicted, and I am pleased that I did not have quantitative or qualitative goals that may have given me temporary pleasure but would have restricted my growth. The same can be said of my spiritual journey; I don’t know where it will lead, I have faith that good will result, but I have no knowledge of the future or of the infinity of the Spiritual. And that’s the way I have always been.

And that would be a difference between being a conservative and what I am.

I feel the need to write because I want to break through, to discover something that is just about here and needs a bit of a push.

That’s what I thought until I put those words down here; for weeks now I have been banging and crashing around in a search for the idea that is about to break out, the idea that needs release, I need to proclaim some kind of discovery. That’s what I though until I wrote that first paragraph, and until I looked at it long enough to realize that there is no great idea ready for hatching, that I have been planning a coming-out party when there is nothing new about to emerge. I was planning the party in order to have a party, nothing more than that ego trip of self-proclamation. I don’t have anything new to say, nothing new to address, nothing new to conquer; but I like the idea of thinking that I do.

Here is the background for what I am trying to say: I enjoyed writing a few satisfying posts during the winter, when they came out well I felt good, when a few people read them and commented I felt better; they were early morning discoveries that added meaning to my day, and then the well went dry. I had nothing to say other than the few things I had done, I have no new way of saying the old ideas, I have no message that can’t be found many other places. I missed that writing.

And then I began to make explanations for my frustration, some discovery was about to burst forth with my help; I felt that I now had a serious chore to find a new idea and share it with everyone—-but I don’t, it was a fool’s errand, and here is why.

The idea that tomorrow will be as today, that the continuum has no breaks or quantum jumps was depressing. I want the excitement of a brand new idea or challenge, and so I manufactured one, a Potemkin’s village made out of the following:

I am about to turn seventy this Halloween, a significant number, no longer will I be anything other than seventy and counting. The second thing is that the work I have been doing at the Chronic Pain Clinic is making me healthier than I have been in decades, a most unexpected result. The third thing is that I have been put back on anti-depressant medication for the pain, but it is also doing things for my mood, I had thought that anti-depressants were something that I had long got past, that my brain was making its own feel-good molecules and needed no assistance; this is known as denial. I am going backwards and forwards at the same time; healthier in body; and yet needing medication to alter my mood, just as I had used them years before.

I walked past a senior-center that the City of Chicago runs just around the corner from me, I was out doing my cardio-vascular exercises when I looked in through their window, saw the umpteen individuals sitting and doing what appeared to be board games. There was something important for me to see here; the Pain Clinic doesn’t care about my age other than for calculating my target heart beat, the subject doesn’t really come up over there; and yet here were people of age similar to mine hunched over boards, moving their markers, killing time and chatting. I couldn’t get that image out of my mind.

There are dozens of platitudes about age and aging that are as helpful as breasts on a boar; this is a complicated business that has no role models that fit me exactly; I don’t know if they fit anyone exactly, or do people fit themselves into the model of the geezer that is put before them. A good friend asked me recently what role model I was using for this next chapter of my adventure?, I have none.

John McCain is an active older guy, but his mind was frozen into the patterns of long ago, he is just a champion for what he thinks was right back then. There are older businessmen, but life has shown that I am no businessman, they take that stuff seriously, they really believe that acquisition and control are important. I have never written anything for publication, so don’t know that road enough to find my way very far down it. I never earned a college degree, could never figure out which direction to go there nor reason to expend all of that energy; I was too young and unformed. I can’t find a future down any of those paths.

What I am trying to say is that I had erected a monument to being a person of a certain age who should be acting and feeling a certain age—-and the monument was made of cardboard. The new idea that I have been incubating is that there is no new idea, no roadside marker telling me to change my ways to those of someone who should be getting ready to shut down, preparing to wrap it up, or in love with the past. There may have been a valid sign years ago when bodies wore out quicker, minds could be in love with the past; but I don’t find that to be so now.

I don’t know if and what changes I will find in life as I go on, but I am beginning to think that there will be less than I thought, that the jokes of old age may be becoming passé.

I do feel better, clearer for having written this; but it isn’t over, this is the first draft of an attitude that I need to install in my soul, I hope to refine it.

I have not felt the urge to put anything down here recently, for no reason in particular except that I have been focusing on the pain clinic and the variety of homework required. It is easy to be diverted from writing, there are always more reasons not to write than to sit here and figure out what the next word ought to be; there are hundreds of quotes from writers on just that, in the end there is the simple rule that writers write .

Taking medicine is the easiest part of handling pain and discomfort, to change the behaviors that have either caused the pain or have grown up to protect it is difficult. I haven’t done any exercise for my heart and vessels in a long long time, since I injured my knee; as a result I don’t have a lot of endurance, I become fatigued quickly. It was easy to blame the fatigue on Lyrica, but when Cymbalta caused the same problem I began to wonder. Reading the list of side effects for almost anything it is easy to find what I am looking for, someone has reported fatigue somewhere the line, and I seconded that effect.

There is a growing list and daily log of stretching and strengthening exercises that will protect me from injury and discomfort, these are new to me, and none of them is easy if I am doing them correctly. But I can feel the improvement, it feels pretty good.

The reason I was not writing was not the time that I devote to exercise, it is that I have to think in different ways, additional ways. I feel natural when thinking and writing about philosophy or theology, the nature of the religious experience, the agonies of existential being and becoming; all that stuff fits well into who I am. The business of taking care of this body has been neglected, and I paid the price of neglect; perhaps I can incorporate these two areas of who I am together. Writing this helps that happen.

I feel that there are a few items that I might comment upon that I have left hanging:

The first has to be the continuing comments about MagicJack; there have been a few complaints that were similar to my own, more about the way that these people conduct business than the nature of the product; then there have been a couple of really funny comments by people who work for the company, I hesitate to call them lackeys or lickspittles because I don’t know them other than through their abject admiration for the guy who is steamrolling the company. I wonder if they realize that anyone in the world can read their devotional messages to The Great Chief? I was hoping that the whole issue was behind me, but perhaps it has a ways to go yet.

On a positive note: For those who have been following my fibromyalgia (now re-labeled rheumatism by me) the decision to go and see my internist, to tell him that I wanted alternatives to what was not working, was a good one. He wrote the order that I have a consultation at the Chronic Pain Clinic as I have written previously; the first visit was an evaluation, the second was a series of meetings with the different specialties involved in pain management. I will be visiting the clinic once a week for up to five weeks.

The change in medicine to Cymbalta continues to give me back the energy and stability that I had lost when taking Lyrica; the side effects seem to be some acne and a definite absence of activity between my legs. That last thing would be of greater interest a decade or two or three previously, but I turn seventy this fall. I have had little or no knee and leg pain, my rheumatism has been at level 2 or less since beginning this stuff.

There will always be some degrees of pain and discomfort, no one is arguing that that will be the case; this management is to minimize what can be reduced, and to stop the remaining pain from being such a big part of my life. The biofeedback part is new to me although I have been doing breathing exercises as part of yoga, the feedback takes it a step or two beyond those simple exercises. There are a group of physical exercises which have made an improvement in how I feel in general, pain reduction in particular. So that’s pretty much how that is going.

Again, the big point was that I decided to request alternatives to what had stopped working; that is always the case, I hear too many bitching stories from people who are waiting for the people in the white coats to open the magic box and release the instant cure. There ain’t no instant cures except in children’s story books, the people in the white coats wait to hear when the patient wants something.

I write this in the midst of doing three loads of laundry, something I would have not had the energy to do at one time just a few weeks ago. A thunderstorm is roaring through, dropping a lot of water and thunderbolts; Bach’s piano and cello concertos are going on in the other room.

That’s it from Chicago this Friday morning.

I don’t have the urge to write about anything momentous or heavy, as much as I enjoy doing that kind of thing; all I have today are comments about the new medication from the Chronic Pain Clinic.

This is the seventh day that I have been on Cymbalta, I took my last Lyrica on Friday evening; the doctor wants me to take 60 mg. each morning to see how it handles the rheumatism pain. Tomorrow I begin the half-day pain clinic sessions that may go on for up to five weeks; I don’t know what will go on there other than they told me to bring shorts and running shoes.

The Cymbalta seems to be handling the rheumatism pretty well, I don’t feel as creaky and tight as I had, the severe pain in my right knee and thigh is decreasing because I am exercising more, and better.

I drove a pain doctor, as passenger on Friday, who agreed that I should be calling whatever it is I have “rheumatism”, he said that I don’t fit the fibromyalgia profile which he described in sexist terms, he agreed that it was sexist but insisted that it was accurate; it confirmed my decision to have “rheumatism”. My pharmacist has been watching the “John Adams” series on HBO, he informed me that Adams also had rheumatism, for whatever that comparison is worth.

To be rid of the dizziness and fatigue is great, really great; I have yet to find out how much of this Medicare and Blue Cross will pay, so there may be a hammer ready to drop. This stuff ain’t approved across the board yet, so the insurance people are being reluctant.

As I said I don’t have much else going on today, just resting up after a long and tiring order on Saturday, but not a painful one as in the past; just charging my batteries on a cold and blustery spring day in Chicago.

It looks as if I am approaching the end of my adventure with Lyrica, it is to be replaced by Cymbalta. I gave it a good try from early August of last year until now, it was effective at times, ineffective at others; but it is the side effects that make me happy to say goodbye to Lyrica. I have had several hundred people read of my experiences with Lyrica, a number of them have sent me messages; my overall impression is that it is the dizziness and fatigue that keep people away from this drug.

Cymbalta works differently than the Lyrica, it combines the effects of boosting two neurotransmitters, giving some kind of synergistic effect that relieves rheumatism/fibromyalgia pain. Anyone who is interested can find more information on the web. The side effects of Cymbalta may be minor nausea I am told, there may also be some dry mouth effect. I think it acts as two anti-depressants in one, although I don’t need anything for depression, that is how I remember their explanation, I really don’t care too much how, just if.

This is the first time I have been to a pain clinic; I was interviewed by a nurse, a physician and a shrink over a period of about three hours. Besides changing medication I will begin attending a pain clinic weekly; the clinic advises on how to handle pain, a cognitive approach. One thing that struck me about this morning is that all three people asked about abuse, had I been abused, have I ever abused another; I had some things from my childhood that they found noteworthy, what will become of that I don’t know right now.

It is good to feel the support of a team that treats only pain; I have made a more detailed description of my situation than I could ever have imagined, and they understood my nuances.

I gave Lyrica a good try, I will give Cymbalta an equally good try, I will attend these clinics and get out of them what I can. I certainly am not going to miss being dizzy and tired, perhaps my half a dozen naps a day will diminish. For those fibromyalgia sufferers who have read my stuff I will try to keep you up to date on what is happening with this new approach; it is about time that we have have several alternatives, that we have professionals who now understand and focus on what is going on. I always have hope, perhaps a little optimism is in order here as well.

Half an hour ago I received a call from the Chronic Pain Care Center , they just had a cancellation and would I like to come in tomorrow at 8 a. m.? My answer was an immediate yes, the two month wait to see them has now become little more than half a day.

They had sent me a series of questionnaires about my pain, my health, my attitude that I was going to answer in June; so I had to do them this afternoon. To question closely the specifics of pain is unsettling, like most people I had made a mental accommodation, a day to day way of handling this thing, my special way; now I have described it by questionnaires for medical and psychological doctors. All my previous accommodations are upset and would like to be back to their almost once comfortable positions.

This is my first professional visit to pain specialists; not only do I expect that they have all the possible modes of handling whatever it is that I have, there is the thought that if they don’t have an answer, the answer, then I am in trouble. I have been avoiding, denying that my pain may be impossible to relieve, the rheumatism or fibromyalgia pain; in the back of my mind there was the belief that there is a cure, but if I don’t search for it I can maintain that belief, that fiction. That notion is about to be tested.

Now that I have put the idea down here, that there is or is not an answer I can see that there will probably be a complex answer, things that will relieve the pain and things that will assist me living with whatever pain is left over. This is not an uncomfortable afternoon.

A series of questions has to do with my significant other , they are insistent that I list someone in my life to whom I turn, this isn’t an easy question. I saw in the paper that a recent survey found just over half of all women are single, from that I assume that a fair number live alone, are divorced. For every divorced woman there has to have been a divorced man: that means there are is a big bunch of divorced guys out here, and many of them are not living with someone else, many of us have parents who are dead, more than a few are alienated from their children, or never had any, perhaps don’t have a close friend, haven’t had a close friend since they growing up. I don’t think that I am alone in having trouble naming this significant other person. I mention only men because that is what I happen to be part of, if someone wrote that there are a large number of women who would have trouble with that question I wouldn’t be surprised.

About a decade ago I had to go to an Emergency Room at 3 a. m. I had thought that there is nothing lonelier than going to the E. R. alone at 3 in the morning. Even when I had a wife who didn’t like me she would have felt it her duty to go with me; I think that there are a number of situations where an unhappy spouse gives in to duty, I remember when I did it for her, she for me. Now I sit alone.

I volunteer to sit with people who are about to die, I have yet to have a situation where there is a spouse present; children often are in denial about the situation, are present physically but not fully. There can be nothing fucking lonelier than sitting someplace and waiting to die; yet it is a necessary, the necessary, act of our life. It can be described as the second most common act, the first being when we become alive. I sit with these people in order that their loneliness is lessened.

Several people have commented that I have been writing about weird stuff, that I have difficulty writing about everyday things. Yes, that’s the truth. Is there anything more everyday than the knowledge that I am alive but someday will not be? I guess that I am writing weird stuff, and so what?

It is a beautiful spring afternoon in Chicago, daffodils and tulips are spots of strong color after months of gray and brown smudges. Almost everyone I have talked with in the last few days has mentioned how much they are enjoying our spring; it doesn’t last for long, but that makes it even more precious.

That is all I have time for now, it is time to open a beer and cook some orange roughy fillets, fingerling potatoes, green pepper, broccoli, a fair amount of olive oil and garlic are about to be ingested by this occasionally weird guy; there may be a third beer tonight.

I wasn’t going to write anything this morning, didn’t have anything to say; just as I was about to get up from sitting here I reached to the bookshelf and took down a book I bought in 1980, haven’t looked into in years; The Viking Book of APHORISMS by Auden and Kronenberger: The first place I opened it had the following quotation by Melbourne:

“Neither man nor woman can be worth anything until they have discovered that they are fools. This is the first step toward becoming either estimable or agreeable; and until it is taken there is no hope.”

And with that I am going to take a nap.