Opioid Insanity

Let me begin with several presumed facts:

1) There is an opioid problem, crisis, epidemic in the United States.

2) I personally use an opioid for a pain issue I have been treating for over fifty years.

3) I have at various times in the past 5+ decades had acupuncture, acupressure, chiropractic manipulation, cortisone injections, prolo-therapy, massage and literally scores of salves, balms, lotions, tinctures, pill, capsules, powders, back braces, straps, devices including electric stimulation, both light and laser therapy. Most of these interventions have been legal according to the FDA.

4) I hold a Ph.D. degree in psychology and as such claim to have a fairly well-rounded understanding of the roles of pain, pain management and the medical establishment.

Hence, begins my story.

Last week, I had my semi-annual appointment with the pain-management physician. After consultation, he renewed my medication. The new order was transmitted to my pharmacy and I shortly received the text notification that my prescription was delayed pending a insurance review. This was expected.

Within 48 hours a new message informed me my prescription was available. When I got to the pharmacy I was asked if my insurance company has informed me of the one week limit they were willing to pay for. I had not been thusly informed. The pharmacy technician said a lot of patients were running into this new insurance edict.

I was informed that I was considered "opioid naïve" and that the insurance would only pay for 14 pills for one week. Then I would be required to see my physician again (and pay the $40 co-pay again) for another prescription.

Here is the math. I currently get 30 capsules every 6 months. The insurance company wants to pay for 14 pills every 7 days. 

In the midst of an opioid crisis (see #1 above) the insurance company believes I and my physician are not intelligent enough (see #4 above) to correctly manage my pain. The insurance company wants me to take MORE drugs than I am taking by a factor of nearly twelve times more.

Crazy? Ridiculous? Counter-intuitive . . .

But wait there's more. My pain doc also requested that before I my next visit I should take one pill the night before and one the morning of my appointment, so that I will test positive for the opioid. It seems the government needs proof that I am taking my pain meds and not selling them on the street. So once every six months, whether I need them or not on my appointment day I have to take medication to satisfy big brother.

Not one but two instances where during this 'crisis" (#1 above) a well-managed pain patient (#2 above) is required to take pain medication to satisfy medical bureaucracy. Who might a rational person ask should be making such decisions? The patient (#3 & #4 above); the patient and their physician; the insurance company; the government?

Perhaps the problem is I am just too naïve.

Another Lap Around Sol

definitely chocolate on the inside

Images of Me

Me, Mira, Geri-Ann, Tina, Matthew

"Open that one," she said. While looking over my shoulder and spotting a folder labeled 'me.' Just a stash of photos from long ago, semi-recent, and middle not so long ago. "Those belong on your blog." So now, infrequently, I will share the past in pictures with you my friends.

This was and is Mira's home in San Francisco, circa 2010.

The Benefits of Writing

[first posted November 2015]

Write two paragraphs and call me in the morning.

"Science has good news for people who write: The consequences of putting pen to paper go beyond hand cramps and furrowed eyebrows. Study after study has linked the act of writing to myriad mental and physical health benefits, including elevated mood and emotional well-being, decreased stress, an improved ability to deal with trauma and even physical healing."

FULL ARTICLE from whence come these conclusions.

Manichean Worldview

This is an encore post from 2010. It has always been one of my personal favorites and the time seems right to consider dualism again.

Manichean (man-i-KEE-uhn)
1. pertaining to a strongly dualistic worldview.
2. An adherent of the dualistic religious system of Manes, a combination of gnostic Christianity, Buddhism, Zoroastrianism, and various other elements, with a basic doctrine of a conflict between light and dark.

I am by nature opposed to dualism. I don't believe in light versus dark or good versus evil. Yet, many of the world's great religions are founded on such beliefs, not to mention many more secular philosophies, dozens of national constitutions and nearly all wars.

On one hand I believe any thoughtful person will concede that nearly nothing can be framed in a purely good versus evil dichotomy. Even in the darkest of evils and the brightest of perfections there are elements of the other. But more importantly the human minds that are observing these clashes of opposites almost never agree on which side is light or evil or dark or good. Grey is the color of the day, all day, every day, until the final day.

Standing on the far side of the battlefield we invariably find other humans who feel as strongly about their position in the light of good and truth and right as those on our side. Yes, yes I know you want to bring up Hitler and the Nazis right about now. I concede there are historical aberrations to contradict any position. However....

As fairly evolved sentient beings we are or should be capable of using our ability to perceive subtle nuances to inform our worldview. We should be able to discount the jingoistic speeches of political leaders and make measured judgments about our side (light) and the other side (dark), because there are equally intelligent, evolved individuals on the other side who would reverse those dark & light flags.

Part of the problem is one position cannot grow to be better, more light or inherently correct unless the opposing philosophy becomes more dark, more evil and inherently wrong. Such dramatic opposition leads to conflict, battle and war. Where does it all end? I would suggest the more productive question is to ask: Where did it all begin?

Conflict usually begins when there exists one or more dualistic views. If you strongly believe your position to be right, then others must be wrong. Wrong equals opposition to your position, which is by self-definition -- right. I encourage examining where your beliefs are dualistic or oppositional to another and then perhaps -- listening to the other. Start small. Begin with a minor disagreement. Leave terrorism, abortion and whaling for later.

Ever wonder why the dominate color of this blog is grey.

A Personal Reaction to The Debate

I promised a few weeks back to not write about American politics again until after the November election. To be clear, this is not a post about any of the candidates. This is my personal experience of tonight's debate. First, I should say that I got up and left the television room at 9:42 PM EDT. I literally could take no more.

This realization came to me when I noticed I had not looked at the screen for over ten minutes. Just the voices of the candidates was an assault on my person. My psyche just was unable to continue with the sheer vanity and mendacity of the works being spew at us all. I could not longer face them or let them face me.

Assault is the only word I can find that fits my feelings. That a great or formerly great or going to be great again country finds itself glued to all forms of media to listen to those two shining examples of our best and brightest is sickening, depressing, bordering on existentially unforgivable.

I can vaguely hear the sounds of the debate from the other end of the house. Never thought I would be thankful for an ear infection. I'm not going back to hear another word, my soul won't take the abuse.

I'm going to do now, what my great friend Gary would recommended, I'm going to watch reruns of The Andy Griffith Show and try to figure out what Aunt Bea would do in this deplorable situation.

Playing the Cards You're Dealt

"We play the cards we're dealt."

"Just play the cards you're dealt."

"You can only play the cards you're dealt."

Interesting, yes I get the intent of the aphorism. No, not a metaphor, a simile or an analogy. Can you tell I've been immersed in editing the last few weeks?

Anyway, the meaning is simple. We get certain plusses and minuses in life and we make the best or the worst of them. Usually somewhere in between for most of us. But that's not how card games work. 

A single hand is not a lifetime, it's a moment, an opportunity, a chance. You play or not. Folding your hand is always an option. It isn't like life, you don't commit everything to a single deal of the cards, unless you choose to. 

In any card room or casino, these words are always spoken: 

"There's another hand just around the corner, 

you don't have to play this one."

That feels more like real life to me. We are presented with circumstances, sometimes of our own making, other times not. Free Will intervenes and allows us to play or pass. Yes, I know sometimes you feel like your choices are limited or non-existent, but so many of those situations are of our own making.

Most of the time, as adults, we have options. In this First World society, we have gobs and gobs of options. Sure, some things are fixed, even immutable but others not so much. Take your health for example. Can't change your DNA or not eat all those years of burgers and ice cream. But you can intervene now.

You may be holding a poor five card hand but the rules of this game allows you to discard and draw new cards. Your choice, play the hand you're dealt or step up and change the content of your hand and perhaps your life.

Voldemort Death Card image first found on Deviant Art

Where Are We Now - Oakland

I am now fully committed to my undomiciled lifestyle. Though I have briefly stayed here in Oakland once in the past, it was less than a week, just passing through. Now 'South Oakland near the Zoo' is a geographic description I give to friends and family.

My future plans are listed over there at the top of the right-hand column. That's my plan for the next twelve months, most likely there will be a few adjustments but the die is cast.

I'm working hard on my book: "Undomiciled: How to be the Perfect Long-Term Houseguest." Hopefully, by the time this year of wandering is complete, so shall the book be.

In the meantime, I would be interested in any tips or insights you may have on experiences as a home-interloper or host of same. You will remain anonymous if quoted in the book.

Happy Cooking Travels!

photo credit: Dennis Past

Boat of a Million Years

I had an unusual experience today while reading. 

But first some contextual history. I was not a big science fiction reader in my teenage years, the usual time for boys to have their sci-fi immersion. Oh sure, I read 1984 and Animal Farm but those are more dystopian political commentary. In college, I read Lord of the Rings but that was fantasy and in the 60s a right of passage. I think Brave New World was assigned in an English Lit. class but reading it did not set the sci-fi hook.

It was not until 1972, when I fell in with the McGovern crowed at the University of Michigan that I discovered science fiction. In truth, it found me or rather a good friend did. In the course of conversation a work of sci-fi came up and it was discovered that I had not only not read it but I had missed the mandatory sci-fi bibliography altogether.

I went home from his house that evening with a small stack of 'required reading.' I still remember the list:

Dune Frank Herbert

Stranger in a Strange Land Robert Heinlein

The Moon is a Harsh Mistress Robert Heinlein

The Foundation Trilogy Isaac Asimov

Childhood's End Arthur C Clarke

Hooked I was. I read the compendium of science fiction over the next several years. However, since the late-70s I have kept up only when 'must read' works of science fiction have appeared; with the exception of finding Kim Stanley Robinson in the early 1990s and reading everything he has written.

Here begins Part Two of my tediously long preface -- I am not much of a re-reader. Few works of fiction get a second pass from me. However, a few days before departing the Berkeley condo in March, someone left an old copy of The Foundation Trilogy on the recycling bench. On impulse I picked it up and got around to reading it while lingering up here in Lake Shastina. Seeing it on my night stand my host mentioned again that he had been trying to find The Boat of a Million Years on audio. 

Weeks later I was hunting for something or another and stumbled on the book cabinet in the garage. Sitting there on top of a row of old sci-fi novels was The Boat of a Million Years by Poul Anderson. The front cover was detached but it was the old oversized version I had read back in 1990.

The years 1989 & 1990 were a bit stressful for me, part of my coping strategy was fiction. Several sci-fi novels were included in my literary escapism, including Poul Anderson's novel about immortals.

I reattached the front cover and put The Boat of a Million Years on the nightstand . . . which leads us back to I had an unusual experience today while reading today.

I'm about 2/3 of the way through the novel and out of the blue I have a complete memory of a conversation with a young woman I was dating in 1989. It was our first date, I had picked her up at her apartment and we had gone to dinner. Afterwards she wanted to see my house in Hermosa Beach. As the home tour passed through the bedroom, she noticed The Boat of Million Years on a pillow. As a sci-fi fan she knew the author but not this, his latest novel.

We talked about science fiction for a few minutes before she abruptly changed the subject.

For over eight years I have kept this blog at least R rated usually PG, unless you are a sensitive conservative, however, the remainder of the story is absolutely X-rated. I apologize to readers who feel deprived by this abridged NSFW ending. Trust me, the memory came back most vividly.

 I wonder where she is today?

[Yes, you know who you are, I will send you the unabridged ending of the story, all you have to do is ask]

Antarctica (1981)

I don't think I've ever written about my trip to Antarctica 35 years ago. I was prompted to do so now because of the picture above. That photograph is an entry in the 2016 National Geographic photo contest.

I know this place, I recognize those mountains, this is the Bay of Isles on South Georgia. I was there December 19 1981.

The foothills are just under a mile from the beach. We landed in our zodiac down the beach to the far right. This is a king penguin rookery, on that day the only birds at the shore we either going or coming from the sea. We had to hike about half way to the mountains to be close of the clustering colony of adults and yearlings. The young chicks and parents were even farther away, I and my two companions did not venture near the rookery, best to stay far from the chicks.

So I walked to within twenty yards of the colony edge and stopped to watch and photograph. Slowly the adults returning from the sea would either push through the throng to get to their hungry chicks or, if they were not brooding parents, they would just stop at the edge of the colony. Over the course of an hour without moving I was subsumed into the colony.

The returning penguins eventually reached me and surrounded me as the colony edge expanded, I was one tall, red-jacketed bird.

Eventually, the ship whistle blew calling us back to the shore and our boat ride back to the safety and warmth of the Discovery Expedition. I edged my way out of the pack, to many squawks and a few beak pecks to my well-padded arctic coat. I worked my way towards the nearest open ground, which soon was to cause a problem.

I was headed back to the sea shore by the nearest route but not the one I had used to reach the penguin colony. My plan was to make it to the shore and then walk on the beach to the landing where the zodiac raft awaited.

Unfortunately, I had waded several small glacial streams deep inland on my way in but now near the shore, those streams had merged into a icy, eight foot wide flow of indeterminate depth. Looking back it was a big hike inland to where a crossing might be more sensible.

As I pondered my options, two penguins arrived on the opposite of the icy divide. I looked at them, they looked at me, they looked at the swiftly moving water, so did I. Then they looked at me again.

I took a single cautious step into the water with my water-tight, well-insulated booted feet. Six inches of water only. Another step and I was a foot deep. A quick calculation told me at this rate mid-stream might well be exerting enough pressure to knock me down, hypothermia was not a suggested course of action.

Just as I was about to step back on the bank and head back inland, one of the penguins stepped into the water on his side of the stream. With a knowing nod, he leaned forward and with his beak, tested the depth for his next step. Slowly he located a rocky ridge of stream bottom that meandered a bit upstream but stayed at the depth of less than a foot.

Once he was midstream, his buddy followed him and there they stood. If they fell in, they just swim out, being much better insulated than I was. I was pondering our situation when a loud squawk brought me back to my, I mean, our predicament.

I swear the penguin was suggesting I get with the program and do my part.

I backed out of the water where I had originally entered and moved upstream to where the two penguin buddies stood about three feet from my shore. There was clearly a deep, swiftly moving gully between them and dry land.

I noticed another shallow ridge just a bit upstream. I easily took two, three, then four steps on the ridge and found myself even with the penguins and just a few feet upstream. Taking the initiative, I hopped over to where the penguins stood. The buddy gave me one good, hard peck while his trailblazing friend duplicated my hop in the reverse direction. His buddy followed and now we were both within shallow sight of our goals.

If there had been an observer to our inter-species cooperation, they would have noted my three foot leap across the watery divide was much more elegant than the splash and dash approach taken by the penguins.

Then again, I was the one who had to be reminded that we were involved in a joint venture to ford the stream. The penguins had been there before, I was the rookie in the rookery.

Feedback?

Over the last decade I have written for a dozen or so websites. Most of the work is background or SEO content. Search Engine Optimization for those not into cyber jargon. During this time I have received a lot of feedback from editors, content managers, public relations specialists; you get the point.

Each website has a theme or a "voice" they wish to project and often times it takes some back-and-forth to get in synch with what they are looking for. More often than not the editorial suggestions are constructive. Writers tweak our work to fit the tone of the website.

It's often good work for decent pay until it isn't. The internet is ephemeral.

However, and I do mean however. This last week I got a one sentence rejection based on a spec article I wrote for a website I thought would be a good fit for my work. I offer you the befuddling feedback I received without further comment.

"Your approach to the topic and your research is simply too intelligent for our needs."

Long Ago But Not So Very Far Away

Forty-eight years ago this week, I had an Arlo Guthrie day at the old weathered Fort Wayne in Detroit. It was there I failed my draft physical and became ineligible to join the young men and women of my generation in Vietnam. To those who served, those who did not return and those who never were again. I offer these musical thoughts from John Prine.

You can listen along here.

Sam Stone came home,
To the wife and family
After serving in the conflict overseas.
And the time that he served,
Had shattered all his nerves,
And left a little shrapnel in his knees.
But the morphine eased the pain,
And the grass grew round his brain,
And gave him all the confidence he lacked,
With a purple heart and a monkey on his back.

There's a hole in daddy's arm where all the money goes,
Jesus Christ died for nothin I suppose.
Little pitchers have big ears,
Don't stop to count the years,
Sweet songs never last too long on broken radios.

Sam Stone's welcome home
Didn't last too long.
He went to work when he'd spent his last dime
And soon he took to stealing
When he got that empty feeling
For a hundred dollar habit without overtime.
And the gold roared through his veins
Like a thousand railroad trains,
And eased his mind in the hours that he chose,
While the kids ran around wearin' other peoples' clothes...

There's a hole in daddy's arm where all the money goes,
Jesus Christ died for nothin I suppose.
Little pitchers have big ears,
Don't stop to count the years,
Sweet songs never last too long on broken radios.

Sam Stone was alone
When he popped his last balloon,
Climbing walls while sitting in a chair.
Well, he played his last request,
While the room smelled just like death,
With an overdose hovering in the air.
But life had lost it's fun,
There was nothing to be done,
But trade his house that he bought on the GI bill,
For a flag-draped casket on a local hero's hill.

There's a hole in daddy's arm where all the money goes,
Jesus Christ died for nothin I suppose.
Little pitchers have big ears,
Don't stop to count the years,
Sweet songs never last too long on broken radios.

The Sunshine State

Part three of my 2015 wandering finds me in Florida. The Villages to be exact. Over the next several months, I'll be adding more reviews of this Boomer retirement mecca. Last year's commentaries can be found here, here (the book), here and a family update with pictures here.

This year I promise more pictures, more stories and more on my potential to become a complete nomad and go 100% undomiciled.

More soon.

Just a Thought and a Feeling

"Writing is a socially acceptable form of 

getting naked in public."

- Paul Coelho

". . . even more so these days is the act of blogging."

- me

Bucky Wisdom

Sorta, kinda how I've tried to live my life
or at least how I've chosen my various career paths.

This or That Old House

I was at a small gathering a few weeks back when the topic of residences came up. In particular - how many residences had we each had in our lifetime. We quickly determined that some rules had to be agreed upon accounting for various aspects of life and living. For instance, we decided that the minimum time of residence in order for an address to count would be six months.

Someone suggested that transient places of residence could be valid only if one received mail at the address. College and dormitories was an issue quickly settled by assigning each college and/or university a residential value of one. No matter how many dorms or apartments one occupied, each institution of higher learning counted as only one. Unless you had significant breaks in your attendance.

Military service had to qualify under the same six month rule but it was felt that unlike a college or university, Vandenberg Air Force base in California and Ramstein in Germany should count separately provided the six month limit was reached.

I finish a distant second with 21 legal residences. The winner was a true vagabond who may have some issues with law enforcement in several jurisdictions. The next day I wondered about how my 66 years divided up among those houses, homes, apartments and dormitories. As of today, I have:

32 years in Michigan (9 residences)*
 1 year in Massachusetts (1)
 3 years in Nevada (2)
30 years and counting in California (9)

*my parents home where they moved when I was a year old, accounts for a full sixteen of the thirty-two years I have accumulated in the Wolverine state.

I wonder how many of these Bob has penciled into his address book?

We're Back to Words Again

The wonderful camera that has entertained us all for the last few months has returned to its rightful owner. This means I must once again consider the continuing fate of this misty gray blog. For the moment there are a few stray thoughts to catch up on. Then, well who knows, I certainly don't.

Winter Fog

The Farmer's Almanac predicts a wetter than normal winter here in  the Bay Area. This is good news, we've had a couple of dry ones of late and the reservoirs could use a topping off. A wet winter means more fog and unlike some I really enjoy the gray atmosphere.

The picture above is a morning shot from the Marin Headlands through the Golden Gate and back towards San Francisco, not exactly my perspective but a nice shot. I live just about eight miles left of those two bridge towers, sort of out through the upper left hand corner of the picture. Each evening this week from my perspective the sun is setting directly behind the Golden Gate Bridge. There are times when the view out my window is a complete distraction from my writing but I find it impossible to complain.

I like the gray weather in all it's shades of grey.

My Feelings Exactly

Editing

Man Oh Man do I love to write. I enjoy it so much. When I was younger I didn't, not at all. But somewhere in the late 90's and early 00's I found my voice. Writing the Matusow book with Amy Calistri confirmed it, at least to me.

There are certain words I don't throw around very easily, love is one; home is another. I love to write. I am, however, not fond of editing. In fact, one of those others word I don't utter often is hate. I don't hate editing, I would prefer someone else do it and hopefully somewhere in the future there is an editor out there who will be taking a blue pencil to my words. But that will be after many months of editing done by yours truly just to get my current work into the condition that deserves a good editor.

It's a drag, it sucks; it's a dangerous job but somebody's got to do it. Expect periodic murmurings from this blog about this task as it shall be around for the near future. And let me just add grumble, snarl, hiss.