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Chapter 4: Fiorinal 2008

 Reading at Vitello's on Monday August 1st, 2016.

Reading at Vitello's on Monday August 1st, 2016.

Step 1: The Ordering of the Medication.

“Pharmacy,” the pharmacist repeated.

“Oh, hello. Good afternoon.” Light. Polite. I needed this call to go smoothly. “I was wondering if you could check and see if I have any refills?”

“Patient’s name?”

“Henriette Ivanans-McIntyre.”

“For what medication?” I could hear him typing in the background.

“Um, Fioricep?” I feigned. This was key. To never look too eager.

“Fioricet,” he corrected. “Yes, you do. Would you like me to fill it for you?”

“Yes. Thank you.”

“OK. Give me half an hour.”

In porn, this moment would be known as the money shot. Now that She was ordered, I was free to explode in ecstasy all over the car. Yet, I continued to pretend I was so not into this transaction. Although I wasn’t doing anything illegal in ordering Fioricet, I had no intention of taking Her according to directions. So whom was I manipulating the phone call for? Not the pharmacist. He didn’t appreciate my professionally trained voice inflections, or my genius pretense that I was so noncommittal about this drug I had forgotten its name. He wouldn’t care if I took my pills as prescribed or not. He wouldn’t think about me after I left the pharmacy any more than I would think about him.

“And how late are you open?”

I knew it was open 24/7. That’s why I had picked this CVS. I placed the question there with a quiet flourish, not to convince the pharmacist I wasn’t doing anything wrong, but myself.

“24 hours.”

“Thank you.” I replied, hanging up. My chest erupted with joy, hard and loud. As if a team of cheerleaders had stormed the field, screaming Her name. Gimme an F! F! Gimme an I! I! Gimme an O! O! Operation Refill complete, I maneuvered the car off the freeway, and onto the San Fernando Valley side streets, detouring south towards my Burbank CVS.

Timing is everything when you are having an affair. I didn’t want to call Kevin and let him know where I was just yet. It would be too hard to pretend I wasn’t on the freeway. If I got home much later than I told him, I would have to pick a reason why other than that perennially golden LA excuse: traffic. Maybe get a receipt to prove I had been running errands. Or straight up lie and say I had been to the chiropractor or even the gym, even as my gym clothes lay untouched in the back seat. 

Kevin ran his photography business from home, and we shared one car, so we were together a lot. Which is not a bad thing when you love your husband, but it is a tricky thing when you are also in love with something else.

It was hard to determine what Kevin knew about my increasing binging. He was starting to speak up, noting I can tell when you’re on them or Your personality changes. Or maybe I chose not to pay attention to what he said. It made the logistics so much easier. As long as he didn’t stand in Our way, I really didn’t care what Kevin thought, and as I pulled into the pharmacy’s parking lot, I was no longer thinking about my husband at all.

Flipping down the visor mirror, I slid on a generous layer of lip-gloss. I always made an effort to look nice before I saw Her. I knew my pupils were black, glinting with Her magnetic force, goading me towards a dark dance choreographed just for Us.

Clip, clip, clip. My heels echoed across the parking lot. Fiorinal empowered me. Around Her I soared, in spirit and stature, insecurities like my stunted growth from kidney disease dissolved. I had always felt awkward about my height, but in this moment, invincible—all legs and no regrets.

I had entered my church and would drink the holy water. The antiseptic smells of witch hazel, hemorrhoid cream and Epsom salts comforted me like Roman Catholic incense swirling around the sanctified on their knees. Here I would find a friend. Here I would be saved.

Fiorinal and I had discovered something that made our relationship even stronger. In Vino Veritas. This was how we would really bond. We did not care for the subtleties of pear notes or a blackcurrant after taste. We were fans of what was cheap and cold. My customized cocktail was simple: the coldest possible chardonnay and a fistful of blue plastic pills. No mixologist could ever trump this winning combination. Hold the fruit, straws and tiny umbrellas. I took my absolution straight up.

I grabbed a sale-priced Mondavi and pretended to peruse the label. Really I was just fondling the nape to see if it was cold enough. Almost perfect. Nothing that a few ice cubes couldn’t cure. Then I began my march towards the pharmacy.

Step 2: The Purchasing of the Medication.

A bottleneck of people jammed the analgesic aisle, diverging into two lines at the counter. I joined the crooked, toe-tapping line, slumping my shoulders along with the others: the plaid-clad, blue-collared workers, the disheveled, scrunchied housewives and the hopped-up hipsters. My greatest fear was to approach the counter only to have the pharmacist report they were out of stock, would have to reorder and She wouldn’t be available until tomorrow or the next day.

At the other register, an elderly man was rambling on about his medication regimen, then his insurance, then, could they just check one more time that the generic medication was indeed the same as the brand name? How could an old man talk so much? Shifting my weight from one foot to the next, I rested the bottle along the back of my neck. Nice and cool. I wanted to yank him by his shirt collar and hurl him into a display of One Direction singing toothbrushes. I tried to make eye contact with one of my fellow prisoners-of-wait, to commiserate in mutual irritation. Everyone was either dialed-out, heads up, scanning the water-stained ceiling tiles or dialed in, heads down, scrolling on their phones. We were nothing if not a motley crew of disconnected pill poppers.

“Next!”

I approached the counter. The backs of my knees quivered as the cashier retrieved Her from a hanging hook on the back wall. Thank God. She was so close now. Folding over the top of the bag, he stapled it shut. My mouth watered. It took everything in me to place the wine on the counter and hand over my debit card. I smiled brightly. He ignored me.

“Have you ever taken this medication before?” he asked. I wanted to laugh in his face.

“Yes. Thank you.” I replied. He lifted the bag. Our eyes met. I watched as it dangled from his arm over the DMZ of the pharmacy counter. No longer his, but not quite mine.  His eyes narrowed as my fingers hovered, curling around empty air. I grabbed the bag and pirouetted away, tucking the wine under my shoulder and busting through the front doors.

This was the feeling I wanted every moment of every day. Like fucking Christmas morning. Like fucking on Christmas morning. In this dance of anticipation, I was about to fall into my partner’s arms and succumb to every inch of Her charms; crossing over from “Hen” to “Her,” losing myself one delicious misstep at a time.

I slid into the car, adjusting my dress over the hot fabric of the front seat. Even in May, within a few short minutes, the interior of a California car stifles. Tucking a damp tendril of hair around my ear, I exhaled. Organizing my bags on the passenger seat, I glanced up to make sure no one was loitering beside me. Sometimes I wondered if anyone else was doing what I was doing. Taking their controlled medication before heading home, despite a prescription label that warned: Do not drive on this medication.

Mostly, I chose not to think moments like this through, never connecting the dots between my secretive adventures and how, a few days later, I would be dope sick and full of remorse. Just like alcoholics were men in trench coats who sat on park benches and drank from bottles concealed in paper bags, drug addicts were ne’er-do-wells who lived under bridges, jamming needles into their arms slamming heroin eight times a day. I did not know, that addicts, like pills, came in all shapes and sizes.

 

Chapter 9: Alcohol

 Reading at Book Show on April 9th, 2017.

Reading at Book Show on April 9th, 2017.

Saturday March 26th, 2011. 12 days pre-transplant.

Despite all of Cedars-Sinai’s bells and whistles, it turns out there’s just no way to dress up a dialysis unit. It was an almost mirror image of the Toronto unit I had spent six weeks on before my first transplant. The room held 20 dialysis machines and accompanying beds. The beds are a combination of a hospital bed and a dentist’s chair, although patients who are too sick to sit up receive treatment on gurneys. The machines’ repetitive churning had not changed, clanging the same ominous mechanical lullaby, hypnotizing patients into a sleep just one breath above death.

Length of dialysis sessions is calculated by: age, gender, weight, height and GFR. In March 2011, I was 42, 5’3” and 53 kg (115 lbs). My dialysis sessions calculated to three hours in length, with a half-hour prep time on either side. By comparison, a 6’, 200 lb man would dialyze for four and a half hours. Finally a reason to be grateful for my stunted growth!

On this particular Saturday, when other married couples might have been driving along the Malibu shoreline or relaxing at the movies, Kevin stood across from my machine, studying the nurse as he hooked me up for the sixth time. After just five sessions, my husband had turned pro, identifying what would make me more comfortable throughout my three-hour sentence.

Strategic dressing was key. Today, it was a scoop-neck blouse so the nurse could more easily access my PermCath without complication or increased chance of infection. Changing its dressing was time-consuming and painful—like someone taking half an hour to rip off a Band-Aid. The nurse flushed tubes, input information, and discarded what seemed like innumerable piles of packaging, gauze, needles and plastic. As the pile of hospital waste on the rolling table grew, I shrank into helplessness, unable to look down at the tube springing out of my chest like a giant plastic worm. The raw skin around it throbbed. I tried to ignore the tugging when the nurse connected the final tube, programmed the computer to remove several kg of fluid and then, anti-climatically, pressed, “Start.”

My shoulder-length hair was always pulled back: 1) I had no energy to wash it, and 2) so it wouldn’t get caught in the tubing. With my braids and swollen face, I didn’t look much older than I had at my first dialysis rodeo. I also dressed for the unit’s Siberian cold: Thick socks. Skullcap. Several cardigans. Even Kevin wore a sweater. My hands were clamped around a large cup of tea Kevin had purchased from The Ray Charles Cafeteria, but when there’s a dead organ inside of you, there’s just no way to warm up.

Dialysis units are kept at low temperatures for the active staff. Patients suffer the brutal cold for two additional reasons: 1) Another symptom of renal failure is anemia. My kidney was barely producing the protein EPO necessary to produce hemoglobin, which feeds red blood cells, which provide oxygen (which provides energy) and contain iron. Low iron = Shivering bones. 2) As my blood passed through the dialyzer (dialysis filter), waste was filtered out and clean blood sent back into my body. When my blood left my veins, it cooled. Before it was returned, a warmed dialysate solution was added to the filter, but sometimes this process was not controlled well and cool blood would slither back into my body an icy, alien creature.

“Are there any more blankets?” my teeth clattered against each other.

Kevin glanced at the three blankets and parka already piled on top of me. “No. That’s all we brought.”

I studied the machine to my right: its robot-like body, knobby eyes, and flat-screen computer face blinking information about me. It chortled away as my bright-red blood began to swirl through the serpentine tubing. Shivering, I pulled the blankets all the way up to my chin. Perhaps there was a fourth reason I was always so cold—the surreal knowledge that all of my polluted blood would now be removed from my body and returned to me clean. I couldn’t deny my resentful reverence for dialysis. I understood it was the thing keeping me alive, but I hated its emasculating power. I was its bitch.

Glassy-eyed, I stared at the overhead television. Carrie Bradshaw was silently oooh-ing and aaah-ing with erotic appreciation over a pair of Manolo Blahniks. I never wore earbuds as the intrusive sound scraped my ears. I never bothered to bring a book. Paragraphs spread out on the page like complex computer code I could no longer decipher. Instead, I dozed inside a toxic restlessness.

Suddenly, a blood-curdling electronic cry filled the unit. Kevin’s head whipped up from his iPhone. A swarm of nurses swooped in. An oxygen mask landed on my face. My eyes darted frantically trying to find my husband inside this sudden sea of scrubs. One nurse adjusted the tubing around my ear. Another pushed my table away. A red light flashed in inauspicious time with the feedback-like screech that filled the room. Coldness gripped the back of my neck. Kevin. Where was Kevin?

“Sit very still,” the nurse instructed. There he was. Right in front of me. My eyes bugged, imploring him for information.

“What’s going on?” His eyes cycled from me to the nurse, to the machine, back to me.

“Her pulse is 145. Her BP is 190/121. She needs to sit here for 15 minutes and not move.”

My palms sprung leaks. Chronic illness has overwhelmed, depressed and humbled me, but in 29 years as a patient, I had never been terrified. An ideal blood pressure is 118/72. Anything above 130/80 is considered hypertension. At 190/121, I had landed in stroke territory.

Blood pressure measures the force of blood against the walls of your blood vessels. When your kidneys fail, your tissue retains too much fluid, including your vessels, and the kidney’s ability to regulate blood pressure is compromised. Your heart pumps harder to compensate, which elevates your blood pressure. In ESRF, excessive fluid becomes life threatening to your other organs, so dialysis machines are programmed to remove fluid as well as clean your blood.

Kevin sent me a small smile. I closed my eyes and breathed in and out through my nose, trying not to picture a blood vessel bursting in my head.

My kidney could no longer clean my blood. My kidney could no longer regulate my blood pressure. My heart was pumping too hard, and I could not, for the next 15 minutes, breathe on my own.

Kevin sat next to me, stroking each finger for equal lengths of time in a kind of meditative trance. Slowly, I turned my head to look at him terrified the oxygen mask might slip off. What did he see? I knew what I saw when I looked in the mirror. My skin was now a chalky yellow. When loose, my hair hung in frayed strands, its strawberry-blond sheen tarnished by medications and stress. My eyes were dimmed by fear. The oxygen mask fogged and defogged with every shallow breath. With my eyes, I tried to communicate to my husband, what I dared not speak from behind the mask. Thank you. In that moment, I could see Kevin was a victim of illness too, unable to lay claim to being destroyed by it, but being destroyed by it just the same.

                                                                        *

Later that afternoon we arrived at Rite Aid. Legs still trembling from my session, all I wanted to do was go to bed, but Dr. D. had phoned in another prescription, another well-meaning, yet useless attempt to temper my nausea. To kill time at the pharmacy, we often snapped photos for my blog. My photo journalistic postings included all kinds of medical images: getting my blood drawn, posing with Dr. D. and Kevin and I recording our blood pressure with Rite Aid’s community machine. I would caption these photos Today my BP is lower than hubby’s! or  She gives good veins! Kevin might grab a metal cane and role-play as Martin Crane from Frasier. We craved these laughs created from the black comedy of our circumstances. But today, we were silent, spent from the afternoon’s close call.

It is sometimes difficult to spot Kevin’s faults. He is loving, but not gushy, loyal, but not demonstrative, and he is always, always on his phone. Upon awakening, he takes it with him to the toilet. Unlike me, he always had his ringer on, were Cedars to call.

We were loitering at the intersection of Energy Bars and Tampons when it rang. The conversation quickly devolved into a back-turning situation, and Kevin began gesticulating towards the maxi-pads. This couldn’t be good. In no uncertain terms this meant Kevin could not be distracted by my inquisitive squeaks.

“It’s just that Henriette is really sick right now.”

My stomach dropped. Oh, God. What now? Kevin had already registered a false positive for opiates back in February when he had been tissue tested. We had endured our own not-so-funny version of the classic Seinfeld  Poppy Seed episode—when Elaine tests positive for opiates because she has consumed a poppy seed bagel that morning—which, it turned out, was exactly what Kevin had done. (Kevin! Seriously?) His transplant evaluation had been postponed for another nightmare week until his blood panel could be cleared.

“So it’s not going to change again?”

I peeked at his profile. His already pinkish skin flared an angry red. Leaning against a wall of vitamins, my freshly cleaned blood drained into my stomach as I waited.

“Fine.” If he could have, Kevin would have slammed down the phone. Instead he delivered, what was for him, a furious goodbye. He turned around to face me. “They changed the date.”

“To when?” I held my breath.

Today was March 26th. April 5th was our scheduled surgery. All we had to do was hold out for twelve more days. I placed my hand on his taut arm.

“April 8th,” he rumbled. I laughed.

“Sweetheart. That’s only three more days.”

It was his clenched jaw, those arms tucked up into his armpits. I was not the only one hurting. Kevin was suffering renal failure right alongside me—from every painful twitch of my Permacath, to every crippling wave of nausea. Every miserable molecule shaking inside of me was shaking inside of him. This would not be over for my husband until his kidney was inside of me.

“I’d like to see one of those doctors wait three extra days for their paycheck, never mind a kidney.”

I laughed loudly and then soft-shoe shuffled around his rigid frame, poking at him until his arms gave way. His face relaxed into a reluctant smile, as he swept me up into a hug.

“Remember when your phone rang off the hook with auditions? Now we get excited about approval for surgery.” For a moment we did not speak.

“I have to stop at Ralph’s,” I confessed into his chest.

The misconception about dialysis is that it makes you feel “better.” Dialysis “replaced” my kidneys for as long as I was on the machine, but the second I was disconnected my veins began to fill with toxins. All night and into the next day I would shake, my bloodstream too quickly taken from poisoned to pure. This is the horrible irony of the dialysis experience—not unlike the novice alcohol drinker. One who has not built up a tolerance for alcohol will get sick. I had no tolerance for a clean bloodstream.

When your kidneys can no longer balance vitamins and minerals in the blood, they must be removed from your diet or it can be fatal. High levels of potassium can cause heart failure and spiking phosphorus leads to osteoporosis. My diet consisted of pretty much tomato and mayonnaise on white bread sandwiches. Celery sticks smeared with Philadelphia Cream cheese. Limes. And Corona.

Corona’s bubbles helped Alcohol hit my brand spanking clean bloodstream faster. With those first crisp sips, my nausea vanished. Anxiety softened into waves of calm. Corona transported me from the electrical shocks that shot through my heart all night long. It saved me from the startling drops in blood pressure that sent me falling through space even as I lay flat on my bed.

Kevin didn’t ask why we had to stop at the grocery store. He knew what was on my limited shopping list and no longer raised an eyebrow. We had gone to war over pills, but he had lost the desire to battle over booze. He kissed the top of my head.

“OK. Last stop Ralph’s.”

We were in this illness together. We had amended the abstinence form together. We endured my dialysis together. In twelve days, we would have a transplant.

My husband would give me his kidney, and everything would change.

 

Chapter 7: Fioricet 2012

 Reading at Side Door Salon on July 18, 2017.

Reading at Side Door Salon on July 18, 2017.

I will never be able to raise my head.

Sunlight scraped at my face with its prickly heat. I squirmed. My eyes flickered open, then shut against the bright light. My entire body ached with a flu-like fierceness. Kevin and I had slept together in truce through the eye of Her, but now the storm of dopesickness was rising inside of me.

Where was he? Even behind closed lids, I could feel he wasn’t lying next to me. Pushing the sheets away from my burning skin, I strained to remember where he was. Bracing myself, I cupped my hand across my eyes, and then opened them against a lightning strike of pain. Through spreading fingers came white light and then the hazy shapes of our bedroom, as if through a soft focus lens.

As I shifted, a whiff of Tiger Balm residue filled my nose. During the desperate night, I had slathered it beneath my nostrils, trying to clear the congestion that prevented me from sleeping with my mouth closed. Open–mouthed breathing was the only option when I gorged on Her. Rattling snores that made Kevin shake me awake. Not because he was a light sleeper, but because breathing like that—too deep and loud—means your central nervous system is shutting down.

I had also smeared it on my forehead, massaging it into the indents of my temples and jawbone. It was an obsessive distraction from the inevitable rebound headache. As I slept, Fioricet had withdrawn from my system. My euphoria had devolved past status quo down into bone-searing pain.

As slumber meshed with consciousness, my ears began to ring. Even over the A/C wall-unit, Her frequency grew increasingly shrill. I hated this side effect. As if She was screaming at me. I reached for the bedside table and then remembered.

Oh, my god. She’s all gone.

A skunky sweat pooled in my armpits. There was only one way to survive withdrawal from Her. More of Her.

My cracked lips smacked open in disbelief. The sour stink of dehydration wafted from my mouth. Oh, my god. I had to do it. I had to move.

Reaching over my head, my hand skillfully crawled through the obstacle course of half-finished glasses of juice and a crusted lump of washcloth. Her plastic side brushed my finger and I grabbed on. Lifting Her up, I read—1 refill—but there was one more thing to check. My eyes zipped across the label. Date filled: May 30th, 2010. What was today’s date? I wracked my brain, my blood vessels angrily surging with the effort.

The house was still. There were no photography clients walking around, chattering with Kevin. Even over the electronic rattling, I sensed I was alone. A wedding. Kevin was shooting a wedding today. Weddings were almost always on Saturday. Yes, it was Saturday. Kevin was definitely not here and it was Saturday. That meant it was Saturday June 5th, 2010. Kevin had mentioned something about staying overnight in a hotel. San Diego. The wedding was in San Diego. I exhaled. Thank God. I had no energy to deal with him.

That it was Saturday also meant in four days we would be attending my kidney transplant evaluation at Cedars. This half-day seminar includes a PowerPoint presentation on everything from types of dialysis to the projected wait list time for a kidney if you do not have a living donor. But I, of course, did. My husband.

Together, we would meet my transplant coordinator, who, much like a conductor, was responsible for syncing up all the instruments in my medical orchestra pit: Surgeon, urologist, social worker, financial counselor, dietitian and one of the four attending kidney transplant physicians. I would then be evaluated for heart disease, hypertension, and ulcers, undergo screening for blood and tissue type, and be psychologically evaluated.

I struggled to prop myself up on the bed, my head pulsating as I shifted. I punched in Rite Aid’s phone number, by heart.

Press 1 if you would like to refill a prescription.

Yes, yes, yes, I would like to refill a prescription. I pressed “1.”

If you know your prescription number please enter it now, followed by the pound sign.

I punched in the first five digits of the pharmacy code, also by heart. My finger throbbed with every jab. Ow. Ow. Ow. Ow. Ow. My hand shook as I squinted at the label. I couldn’t see the last portion of Her code. Tears collected in the far corners of my eyes. It was agony to focus on the tiny number. I blinked and the sticker came into glorious focus. 1-2-3-4-5-6. Each electronic cheep pecked away at my eardrum like a swallow I wanted to smash beak-first into the wall. Then the automated woman clicked away into silence.

 I knew this phone call would go one of two ways: 1) In a minor-chord tinged tone, she would sadly inform me: There are no refills left on your prescription. We will contact your doctor on their next business day with authorization to refill.  2) In a major-chord tinged tone, she would brightly declare: Your prescription will be refilled. After only a week since pick up, I knew the odds of a refill were slim to none. Insurance almost never approved the refill of a controlled substance like Fioricet until 30 days had passed.

There was a brief pause on the line, and then a series of clicks. I swiped at my armpits. My chest seized up as the electronic response began.

Your prescription will be refilled.

Fat tears of relief dribbled off my chin. Did she really say your prescription will be refilled?  How had this mini medicinal miracle occurred? This was clearly a computer glitch. Oh my god, oh my god, oh my god. Goosebumps of delight sheeted my skin.

A few minutes earlier, I had been loath to ever leave the uterine comfort of my bed—my cotton batten protection against a world in which I had no interest in participating. The idea of breathing without Her was unbearable. With five unexpected words, my body was shot through with adrenaline. I could sit up. I could button my jeans. I could trudge through this physical hell with the soul-stitching knowledge that I would soon be holding Her.

The harsh light streaming in through a crack in the curtains told me it had to be early afternoon. I squinted at the back lit face of my clock. Did it say 11:38 am or 1:38 pm? I squinted again. The “1” was a “3.” It was 3:38 pm. She would be ready at 4:08 pm. I could almost taste Her plastic shell melting on my tongue. Feel Her acidity scratch my throat and drip down into the anticipating bile below. I swung my legs over the side of the bed and hoisted myself to sitting. Nausea gripped as I eyeballed the jeans that lay at my feet. I could do this. I could slip them on, grab the car keys and…My heart stopped. Kevin had the car.

I would have to walk.

To get there, I would have to navigate the extreme driveway down from our cabin to the street, traverse two roads, a busy thoroughfare, and walk beneath a freeway overpass. Then continue on to the strip mall where my sanctuary would be waiting like a random crucifix in the desert, its neon-sign flashing its message of salvation.

I sat for a moment with my head in my hands, trying to still my uneven breath. Swinging my legs over the side of the bed had been a herculean accomplishment. The idea of using them felt impossible. In my dopesick haze, it never occurred to me to Uber my mission. I would have to walk for nearly two miles round trip in the blazing sun. I had no choice. I had to try.

Unwittingly, I had been entered into an extreme sports competition for which I was utterly unprepared—dehydrated, with no time to carb-load, and no sports therapist to help me visualize the finish line. I sighed. There was nothing a trainer could tell me that I didn’t already know. All I had to do was focus on Her beautiful blue-on-blue self, knowing She would be cheering for me at the end.

Also, I would make a mental “To Do” List! The obsessive lists I had been compelled to make throughout my life would help me now: 1) Slip on jeans. 2) Keep on Tiger Balm-stained t-shirt (this conserves energy.) 3) Skip brushing teeth (brushing motion too jarring, will trigger head pain.) 4) Skip brushing hair. (see: Reason #3.) 5) Place baseball cap on head (reason is twofold: cap hides unbrushed hair and protects head from sun.) 6) If possible, pee. (renal failure and dehydration an unexpected bonus!) 7) Slip on clogs (how serendipitous that clogs are shoe of choice—will expend no energy bending over to tie laces!) 8) Grab house keys (hide on property, do not waste energy carrying.) 9) Begin to walk.

Through the glass of the front door, it looked like your typical California day: 72 degrees and sunny. But when I opened it, I walked straight into a wall of heat. California summers are dry and intense. Not like East Coast heat, and its mummifying humidity. This heat is focused. It slices your skin with its hot-knifed edge.

I leaned against the door frame and steadied myself. My brain was spinning, my ears buzzing with those Barbiturate bugs. I had to rally. I plugged my nose and swallowed hard, attempting to clear a head so clogged with phlegm I could barely breathe. On your mark. Get set. Go. I closed the door behind me and began to shuffle across our cobblestone patio.

I slipped my keys behind one of Kevin’s lighting backdrops, and then walked across the flat patch of asphalt. When I reached the swinging metal gate that marks the top of our driveway, I unhinged the chain link ring that keeps it closed. Down the steep slope I scuffled, bracing my body against the ribbons of sand that threatened to take me down. I began to walk.

The afternoon sun pummeled the back of my neck. Stumbling over pebbles, sand filled my clogs, but I never stopped to empty them. Every time I raised my foot, I wondered if I would be able to complete the step, never mind form another one. I focused only on lifting my leg and placing it a few inches forward on the road below.

With my head tucked into my chest, I noticed things I didn’t see from the temperature-controlled comfort of our car: the glint of a flattened soda can or triumphant succulents sprouting from the cracks in the asphalt. Against all odds, life. No one passed me on this sidewalk-less stretch of road. For this I was grateful. I was conserving my energy for five words. Picking up for patient Ivanans. I dared not waste it on “How are you?” when I didn’t really care.

Our street ends in a fork, a chain link fence and the roaring freeway beyond. To the left, the road circles up a hill into a loop dotted with McMansions. I turned to the right, doddering down the slope of road. My t-shirt was drenched. The back of my neck throbbed. I swiped the salty beads from beneath my sunglasses, arriving at the busy thoroughfare that would take me to Rite Aid. If I had been protected by residential obscurity, my cover was about to be blown. The city was about to assault.

Around the corner, a freeway off ramp ended in a traffic light and three lanes. Occasionally, there would be a man begging at this intersection, replete with cardboard Armageddon signs and messiah beard, but on this day I was alone: the singular act in this urban freak show. Swaying in the heat, I pressed the Walk button and stepped back from the curb. The cars roared by, barely gearing down from their speedy flight off the freeway. Leaning against a cement post, I glared at the digital hand that had halted my momentum. Change. change. change. Willing the light to morph into the neon-white strides of the walking man. My stomach rumbled, hollow from days of not eating. Cramps seized my gut. I had to keep moving.

The light changed and the cars began to slow. Engines revved in angry protest, anxious to reignite their wild ride home. The drivers’ judgmental stares pierced my body as I passed. Why is this woman walking by an off ramp? I tightened the elastic band that held back my shoulder length hair, and then pushed my sunglasses up with my middle finger. Fuck You. I could have been anyone. A woman whose car had broken down. Looking for the bus stop. On a reality show. Why did they need to know I was en route to salvation?

Along the next stretch of road, there was no relief from the triple-digit sun. No buildings, just ribbons of cement tying into the freeway above. I must have stood out like a wild animal traversing a desert plain, limping along toward the underpass.

Shuffling into its shadowy relief, I sighed as the cooler air hit my skin. My nostrils twitched at the stench of piss. Someone squealed to a halt at the light up ahead. My heart leapt, already thudding a frantic beat. Someone else honked. I plugged my ears against the relentless noise, as the roaring freeway above echoed inside the graffiti-covered walls of the cement cavern. I wanted to collapse on the urine-kissed sidewalk, but even if I had, now that I knew She was waiting, I would have crawled every last foot.

At the final traffic light, I paused. On the other side of the intersection was a Sizzler restaurant, and beyond that, the strip mall.

Although Kevin and I had lived in Shadow Hills for four years, we had never eaten at Sizzler. Joints like Sizzler or Coco’s (which lay at the far end of the strip mall) just weren’t our bag. By no means foodies, Standard American Fare like iceberg lettuce and poor cuts of red meat held little interest. But the restaurant, or more specifically its sign, had long been a source of entertainment. Over the years, the lights of the Sizzler sign had been fading. We would mock the partially darkened sign, as we waited on the off ramp for the light to change. Hey, wife. Want to go to…ZLER for dinner? Hi. Yeah, I’m wondering if…ZLER has a take out menu? No, not SIZZLER, but…ZLER. Could we make a reservation for two at…ZLER, please?

From what marital adventure had we been returning while idling on that off ramp? A night at the movies? An uncomplicated day of errands? It didn’t matter. I reveled in my husband’s company for its own sake. Once Kevin got on a roll, I would double over with laughter, grab at his arm, and like a child, tell him to do it, Again! Again! until I was wiping away tears. As I shuffled by the restaurant, my eyes watered from the flecks of dirt kicked up from the cars whizzing by. I did not look up at the sign. There was nothing to see. Over time the letters had faded from “ZLER” to “LER” to “ER” to “R” to black.

Are you staying? I wondered if Kevin had responded to the text I’d sent before I left, praying he would crash overnight in San Diego. Having a husband was too painful when I was dopesick, and it was a nightmare to hide being high. Either way, I didn’t want him around.

I wobbled down the strip mall driveway into the parking lot. My stomach turned at the cars’ exhaust. I pulled the top of my t-shirt over my face, inhaling my sour brine instead. My mouth filled with bile. I stopped in the middle of the parking lot and spat. The pale yellow gob glistened. I shivered, disgusted. Spitting in public is one of my biggest pet peeves (along with deliberately misspelled signs and people sweeping trash underneath my table while I eat). Who had I become? I didn’t know and didn’t care. I just wanted to get inside, get my pills and leave me behind.

Rite Aid’s doors whooshed open with a welcoming sigh. The cool blasts of chemical air soothed my trembling skin. Breathing in the familiar antiseptic aroma, my shoulders softened. I removed my sunglasses and wiped at my face repeatedly. My hairline was soaked. As I secured my glasses, I could see my hand was shaking. I swallowed several times, my sandpaper throat catching on itself. I could do this. I was almost there.

I shuffled down the store’s main corridor, passing the laxatives, rubbing alcohol and analgesics aisles. There was only one item on my list today. At the back of the store, I spotted the gleaming white letters that spelled out deliverance from my purgatory. PHARMACY. I turned around the final corner and gasped.

The pharmacy area was deserted. The uncluttered tile floor gleamed. It was like the scene in The Shining when Jack Nicholson walks through an empty ballroom and up to a fully stocked bar with bartender ready to take his order. No one stood waiting in line, tapping her toes in the throes of detox. My heart soared. All I had to do was walk up to the counter and take Her home.

“Picking up for patient Ivanans,” my voice splintered. The pharmacist turned away and began to sift through the hanging bags.

I leaned against the counter, suddenly dizzy. The walk, the heat and the nausea were catching up with me. Rifling through the plastic bags, she came up empty-handed. My palms sprung leaks.

“When did you order this?” She stared at me.

What if the computer had caught the mistake? What if they were out of Fioricet? How would I walk back home? How would I survive this? I would not survive this.

I stared back from behind my sunglasses and baseball cap. Covering my face like this felt rude and only made it more obvious I was hiding something. The cap and glasses like the arrow of a roadside motel pointing towards my neon-bright desperation. This get-up was my poker face, and I wasn’t ready to fold.

“Uh, about an hour ago?” I guessed. I wasn’t fibbing. I really had no idea what time it was. I had left my cell phone and keys at home. My I.D. and ATM card were tucked into my jeans’ back pocket. My outfit streamlined like a spy’s for maximum efficiency in completing this mission.

She moved to the computer. Her eyes narrowed as she scrutinized the screen. I withered against the counter, my breath leaving my body. I wanted everything to disappear. The harsh lighting. Her exploratory pecking. The painful cramps in my gut. It was all too much. I had come so far. Why was this happening? JUST GIVE ME MY PILLS!  I would have done anything. Anything. I would have stripped naked. Bartered my wedding ring. I could not bear one second more.

“Oh!” she laughed, her eyes relaxing. “We haven’t filled it yet! Give me 15 minutes!”

Fifteen minutes! Was this a joke? Why would it take that long? There was no one else here! I grabbed at my chest, my breath coming back to me in choppy bursts. At least I knew She was back there. I could do this. Just fifteen more minutes. How would I kill fifteen minutes inside a Rite Aid? Peruse the Aisle of Random Items of turkey basters and Chia Pets? Lie down in the middle of the floor and die?

I turned away to survey my options, my torso rattling with every heartbeat. Despite the Freon breeze that swirled around the store, I couldn’t stop sweating. I tried to swallow. I had to get something to drink.

Rivulets of sweat streamed from my hairline as I scanned the coolers. Nothing appealed to me: from milk to juice to iced tea to soda to water. Especially water. The idea sent my stomach into violent waves. It was too pure and clear, too shocking for a system clogged with drugs. I needed something to soak up the bile. Tomato juice. Yes. This would hydrate me, fuel me with much-needed calories and settle my stomach.

Slumping into one of the chairs, I brought the tomato juice up to my cracked lips, daring a small sip. As the clumpy liquid moved down my throat, my stomach lurched in protest. Bracing the container against my mouth, I forced myself to take another couple of sips. I didn’t care that I hadn’t paid for it. Arms crossed, my Entitlement and I sat scowling in the waiting area as the pharmacists took their sweet, sweet time.

They were having way too much fun, laughing together the way friends do. Maybe they were friends. Why were they so happy? They were working on a sunny Saturday afternoon, surrounded by a bunch of pills they couldn’t have. Trapped. Yet I sat unencumbered by any responsibility, ostensibly free, and I was miserable. As I stared at the shelves of pills behind them, wondering what they were for and fantasizing about getting my hands on them, I didn’t realize that inside this prison thoughts, I was the one who was trapped.

I spotted a tiny clock on the pharmacy wall. It was approaching 6 pm, but I wasn’t worried about getting home to see if Kevin had responded. Wedding receptions were at night. His standard contract was for eight hours of shooting, usually beginning at 1 or 2 pm and ending at 11 pm. Kevin being Kevin, he would always stay longer than contracted. Above and beyond the call of duty was his MO and San Diego was over two hours away. Kevin wouldn’t be home for hours, and possibly not tonight.

But any thought of my husband was random and fleeting, like a rare cloud that might pass through on an otherwise clear summer’s day. My thoughts were focused on Our reunion. How hard the pharmacists should be working, not how hard I knew Kevin was working—running around in brutal heat, contorting his body into all kinds of crazy positions to get the perfect shot. Putting money in the bank, bread on our table, and pills in my pocket.

“Ivanans!” I walked up to the counter and plunked down my tomato juice. The pharmacist placed an extra-tall container beside it, slipping it into a white paper bag. They must have run out of short containers.

This pharmacy had made mistakes in the past. One time, they had doled out 90 Ambien instead of the 30 tablets Kevin had been prescribed. Another time I had been all the way home before realizing they had given me someone else’s antibiotic and not my Vicodin. Seething, I had raced back to the pharmacy terrified that although the antibiotic was untouched, I would be denied the 30 Vicodin tablets I would gobble in just over a day. I had learned to check my medications before leaving. Especially today. Today was a return trip I would not survive without Her.

I thanked the pharmacist and stepped away. Ripping open the bag’s stapled top, I plunged my hand inside and pulled Her out. Through the plastic I saw the familiar double-blue capsules heaped on top of one another in a playful mound. It was Her all right, but the pile looked enormous. I turned the bottle on its side and read the label: Henriette Ivanans-McIntyre. Fioricet (Acetaminophen/Butalbital/Caffeine). No Refills. 120 capsules. My breath caught. 120 capsules! My prescription was for 60. I glanced up at the pharmacists, but their heads were down, giggling. This was bad. Shockingly negligent on their part. I couldn’t even begin to imagine how this had happened.

My knees wobbled. I had hit the jackpot! I looked up and around. No one was watching me. I wanted to shout with melodic jubilation the way a slot machine jangles when it hits three 7s in a row. Blood rushed to my head as I fought the urge to charge for home before the pharmacists realized their horrendous mistake.

An agonizing tug-of-war pulled at my gut. I should be responsible, walk up to the counter, point out their mistake and hand Her over. I knew I should do this, but I could not make myself move. I could not return this Accidental Prescription. I wouldn’t be able to control how much I took or how often. I would take all of these pills in four or five days. I would become dopesick, but I could not let Her go. She rattled as I lifted Her up as if to say, You are mine.

Holding Her high beneath florescent lights that glowed with artificial warmth, I triple-checked the label. A halo flared around Her, spotlighting what would soon be my salvation, airlifting me out of my pharmaceutical purgatory, and then dropping me straight back down into hell. I would not return Her. I would consume Her, every last pill.

I walked back outside into the unforgiving heat, clutching the paper bag in one hand and the tomato juice in the other. Adjusting the lid of my baseball cap, I began the long walk home.

I did not take a pill right away. I knew She could alleviate my symptoms, but I was restored just walking with Her. Her power to transport me was something to be revered. I would honor Her in the cool and quiet isolation of our bedroom, cut off from the rest of the world. Far away from any sight or sound that might detract from those first blissful moments of relief. She would release me from nausea, ear ringing and throbbing temples. These moments were too profound to share with the dregs of Sunland Blvd. In a way, having Her dangle from my arm was like pharmaceutical foreplay. Now that I knew I would have Her, I could hold out. Euphoria would arrive at home.

I barely remember the trek home but for the final walk up our steep driveway. It was a hurdle I would have sprinted up four years earlier. Such exertion would have barely elevated my pulse even two years prior, even with my rejection diagnosis. Today, my heart was racing. Panting, I closed the metal gate in triumph, planting my feet on the asphalt plane the way a mountain climber must stake his claim atop Mount Everest: with exhilaration and pride. The walls of our cabin glowed with the shifting orange light of the evening sun. I had only been up for about four hours, but my day was already coming to an end. I had completed the mission. I was home.

I entered the cool of our living room, all four A/C wall-units blasting. I loved the clatter. It reminded me of sitting in a plane on the tarmac, all its engines whirring in anticipation. Ready for take off.

I swiped the dampness from my neck. My blood sugar was dropping the way it often did when I starved myself for days to feel Her effects more acutely. This insane deprivation was easy to justify. Fioricet’s instructions clearly stated She was more effective if taken on an empty stomach. Shaking, I stumbled into our bedroom, thinking I might faint. Still, I would not eat or drink anything.

With the curtains drawn, our bedroom was now dark. I switched on my lamp. Next to it, I placed the now warm tomato juice. Removing Her from the bag, I cracked open the lid and swallowed four capsules.

My stomach constricted in that instantly familiar way. My body jerked back on itself, but there was no time to run for the toilet. Red projectile spewed everywhere, splotching the walls, floor and my feet with a watery thud. Thick red liquid dripped down our pale green wall. The pills! The pills! I fell to the floor, scooping up the dissolving capsules from the puddle. I didn’t think there was anything odd about a 41-year old woman on her knees rescuing pills from a pool of bile, while 116 capsules of the same medication stood right above her head.

Popping the melting capsules back into my mouth, I knocked them back with another slug of the warm juice. Bringing my fist to my mouth, I suppressed the impending gag, and then swallowed. On the table, my cell phone was blinking. It was Kevin.

I don’t know if I am staying down here tonight.

An hour later.

Where are you?

I collapsed onto the bed, sinking into the mattress as cool currents of air soothed my aching body.

I was sleeping. I have a migraine. Stay. Treat yourself to a nice hotel room.

Everything would be so much easier if he stayed away.

I rolled over and put the phone on the table next to Her. Even as my head began to swirl with relief, I told myself they weren’t working fast enough and palmed three more. Seven in twenty minutes. Faster. Faster. It’s never fast enough. I wiped away the last of my sweat and reached for the remote.

Night was falling on Saturday June 5th. On Wednesday, I was to meet the professionals who would decide my transplant eligibility. I had to show up. I had to be sober. This meant at some point soon, I needed to stop taking pills. I could do it. I just needed a few more to get me over the hump.

My bones’ fierce flu-like ache had been tamed. My limbs were now marshmallow-soft. Euphoria had arrived. I was not worried about urine tests that might screen for drugs, or showing up dopesick. I had no worries at all. It was only Saturday. Wednesday was four long days away. I would stop. Now. Soon. Tomorrow. Yes. I could do this. I would be fine. I swallowed five more pills.

And then 111 more.

 

Chapter 16: Trazodone

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Reading for SHINE: Inspiring True Stories on March 19th, 2017.

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A wrinkled slice of lime lay in a pool of vodka water.

Already?

Pushing back my chair, I stumbled over to the refrigerator, trudging the way this Canadian child used to walk through mile-high piles of snow—laboriously, with joyful purpose. A whoosh of air hit my flushed cheeks as I yanked open the freezer door. Reaching down towards the bottom shelf, I started. Where was my vodka? I whipped around. Fuuuck. There it was, its empty neck sticking out from the recycling bin.

Stupid, stupid, stupid. What am I going to do? There was no way I could get into the car and drive to 7-11, not because it was 3 am and I had caught myself nodding off at my computer, but because the sound would wake my husband. Bracing myself with the fridge doors, I rocked back and forth on the balls of my feet, scanning its contents repeatedly, praying a bottle of wine would miraculously appear because I willed it to be so.

Is there any alcohol in the house? Maybe there was enough vodka in the empties to mix one more drink? Hmmm. Mouthwash? A shot of it had been fine to steady my nerves in the past, but I didn’t really want to savor a glass of it. Bathroom. Alcohol. It was clear like vodka. It was just a higher proof. Rubbing Alcohol.

Grabbing the bottle from underneath the sink, I slipped it beneath my t-shirt, slinking past our bedroom door. I never wondered if my party-for-one was keeping my husband awake. Or if he struggled to sleep, knowing I was marinating his precious gift in alcohol.

Hmmm. What can I mix this with? It’s a shame we don’t have any tomato juice. I could have made a Bloody Mary! Pineapple juice? How random. Meant to be!

My heart pattered as I watched the sunny liquid splash against the icy rock formation. Grabbing the rubbing alcohol, I poured once, then twice, completing my cocktail. It’s so pretty! What a shame I don’t have one of those teeny umbrellas!  Then I raised the glass, toasting my ingenuity. The cool of the ice brushed my lips as I tilted my head back. Then I took a giant sip of my rubbing alcohol cocktail.

Fire coursed down my throat. I slammed the glass down on the counter and grabbed at my neck. I gagged, doubling over. Tears filled my eyes. It felt like boiling water from a whistling kettle had been poured down my throat. Oh my God, it burned. Like drinking flames.

Then I inhaled and went in for another sip.

                                                                        *

On my bed at Klean, Debussy continued to swirl through the air. Something inside me was cracking, an entity that needed release. Hot tears dribbled down my cheeks and onto my chest for long minutes, soaking the sheets around me. I couldn’t breathe. A force pushed me onto the floor. My hands found each other in a desperate grip. Burying my face into the side of the bed, I began to scream.

How had I forgotten this? But I had. With but a few sober days, my longest probable run since age 19, my mind had defogged enough to recall this insanity. What had I done? I had consumed rubbing alcohol on the kidney Kevin had gifted me four months earlier.

But on that July night, it had made total sense. The bottle said 70% alcohol. I knew of 80% proof rums, recalled that the legally reinstated Absinthe hovered around the 100 proof mark. Drinking rubbing alcohol would be fine. But alcohol proof is different from alcohol content. Proof is an expression of the strength of alcoholic content, defined as twice the percentage of Alcohol By Volume (ABV). So what I did not understand was the rubbing alcohol’s 70% alcohol content was actually 140% alcohol proof.

More significantly, rubbing alcohol is not ethyl alcohol (beverage alcohol) but isopropyl alcohol, a totally different chemical than the alcohol of beer, wine, or liquor. The lethal dose of isopropyl alcohol in adults by mouth is about 8 ounces. I had poured 2 heavy shots into a glass and proceeded to drink.

On the floor I shifted, reaching for a deeper comfort than the endless stream of snot and tears. The Serenity Prayer drifted towards me like divine flotsam. I struggled, uncertain of the words, clinging to each syllable while every cell inside of me was breaking apart.

“God grant me the serenity / To accept the things I cannot change / The courage to change the things I can / And the wisdom to know the difference.”

I was an alcoholic and an addict. I was in rehab. And I didn’t know if I had lost Kevin forever.

Through the music and tears and prayer, I saw I had not just taken myself for a joyride down the winding roads of addiction, but that Kevin had been dragged along behind me for endless miles. Was it too late for us? I did not know. His sagging blue eyes floated before me and my anguish rose again, a wailing siren without end. Every time the idea to get up entered my mind, something kept me on the floor.

I remained there for two hours, unable to recall when I had ever felt so safe.