The Last Addictions Memoir (Hopefully): An Evidence-Based Recovery Story Pt. 4

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The Last Addictions Memoir (Hopefully): An Evidence-Based Recovery Story Pt. 4

By Anne Giles 04/14/17

What does a broken foot have to do with addiction? A lot more than my doctor thought it would.

Image: 
Person with a foot in a cast laying on couch with cat.

On the day between receiving a token for four years of abstinence from alcohol and my 58th birthday, I fell down the stairs on my way to a support group meeting. Concerned about my limp, members urged me to go to the after-hours clinic for an X-ray.

The doctor showed me the X-ray of my right foot and its fractured fifth metatarsal.

He said, "Stay off your foot for six weeks."

Many people might react with a "Well, shucks! How inconvenient!" I, however, froze. As in "fight, flight or freeze" froze. I didn't feel inconvenienced. I felt endangered.

And then I uttered the sentence that makes other people freeze.

"But I have alcoholism," I said to the doctor.

"What does that have to do with a broken foot?" he asked.

Not feeling understood backhands me. When I try to explain to people who don't have this what it's like, the most sympathetic listeners can transform into thugs. I couldn't face another hit. I don't remember what I said. Something obedient. The nurse strapped me into a walking boot.

I hobbled to my car. I slung my newly broken, booted right foot into the passenger seat, then clumsily alternated between accelerator and brake with my left foot, jolting and jerking ahead. As I drove up quiet, dark Main Street in my small town, I envisioned the grocery store parking lot. I wondered if my favorite space near the left-hand entrance would be free so I could park there and stagger to the wine aisle in my walking boot.

I am not a poster child for addictions recovery. I would prefer to be drinking wine again with my friends and colleagues. Although I do anything and everything I can learn of, and a few things I've heard of, not to take a drink, I cannot definitively explain how I stopped drinking or how I stay stopped. If I return to drinking today, the brain science of addiction would explain it. If I don't, researchers can't explain it any more than I can.

If the end in mind is a nail driven into a board, there's the nail head, here's the hammer, pound away. If the end in mind is abstinence? Lots of people think their individual stories of achieved abstinence can be universally applied. "If you want what I have, you have to do what I do," they say. For some people, some of the time, that may well be true. But addiction puts people at risk of premature death. We need what we do to work for most people most of the time. And the data on relapse rates and death rates reports that what we do doesn't work and we don't know exactly what does.

However, we know much more in 2017 than we did in 2012 when I declared myself "an alcoholic." I imagined myself, today, following the advice from the Surgeon General's report on addiction to start with our primary care physicians if we think we have an addiction. My doctor would assess me for medication, the first-order standard of care for treating addiction, then present me with a little starter packet of information, just a few pages, synthesizing and distilling evidence-based self-care for addiction into a gentle and supportive to-do list. I studied the research literature and wrote that imaginary packet. Handout 1 is here, Handout 2 is here, and Handout 3 is here.

The research is mixed on the effectiveness of exercise for assisting with abstinence. But for my particular case study, my anecdotal data is this: on days when I exercise, I feel less like drinking. On days when I don't exercise, no matter what abstinence-supporting methods I might try, I feel a lot like drinking.

When the doctor said, "Stay off your foot for six weeks," I heard, "Lose your sobriety, yourself, and everyone and everything you love."

For six weeks, I stayed off the foot. I went from daily, intense motion - running, lifting, swimming - to motionlessness. As do many people with addiction, I have co-occurring mental and physical illnesses - for me, trauma symptoms and chronic back pain. I gripped my chair's armrests as these conditions began to rattle, then writhe. I have learned and ruthlessly practiced a billion ways to become aware enough of feelings and thoughts to manage them, to refute cognitive distortions, and to ease the volume down on my inner experience. I envision an ever-present, egg-shaped space of calm awareness in my brain. When I had endured six weeks of meticulously wrestling my inner experience without the help of exercise, I learned from the check-up X-ray that the broken foot wasn't healing.

Depleted from four years of hard abstinence, overwrought from six weeks without what helped me most to maintain it, confronted - again - with the hopelessness of having a condition where nothing I did seemed to help, and deeply unsettled by political events, I had exhausted my skills and abilities, tools and tricks. I had nothing left with which to protect myself. Distress burst through the membrane of my awareness with what felt like a horror of splintered bone, muscle and gore.

The Surgeon General's report recommends help for addiction in this order of priority: medication, counseling, support. I receive counseling and I attend support groups. I remembered Maia Szalavitz's candor about needing antidepressants. Using our health system's online software, I contacted my psychiatrist. (Scheduling an in-person appointment would have been impossible. I was on an eight-month wait list just to get the first appointment.) She prescribed. The gore retreated. I wish I could have used my own mind and heart to manage this inner state of affairs on my own. But I could not.

I wish people without addiction could understand the alarming agony of the inner experience of needing to do and not doing. I was afraid to look at my arms for fear I would see the skin buckling and roiling as waves of anguish coursed up and down my body. As the antidepressant eased my distress, I realized I would have to do for my broken foot what I did for alcoholism: piece together some kind of explanation of what went wrong and do something about it.

My toes began to itch in the boot and I thought I had developed athlete's foot from wearing it so long. One of the precursors to addiction is trauma - which I had experienced - and one of the symptoms of trauma is terror-based thinking. I feared gangrene and amputation and stumped into my doctor's office. I had chilblains, a pre-frostbite condition. But I had barely been outside! Googling why metatarsal fractures don't heal, I learned about low blood flow to that area of the foot. I tucked a heating pad at the foot of my bed, on the footstool in my office, and next to my grandmother's hand-knitted afghan in the TV room. I warmed my foot like an egg in an incubator.

I have to wear laced up, steel-toed boots to support my sore but healing foot, topped with its floppy calf muscle, atrophied from so much time in the walking boot, but I can now totter-jog around the elevated track at my gym. People who don't have what I have ask why I don't wait for my foot to heal completely before I start exercising again. How to explain? I can't risk waiting even one more second.

The opinions expressed here are mine alone and do not necessarily reflect the positions of my employers, co-workers, family members or friends.  This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Anne Giles, M.A., M.S., is a counselor, writer and business owner. She writes about addictions treatment, recovery and policy at annegiles.com. As of this writing, she has been abstinent from alcohol since December 28, 2012, and is in remission from alcohol use disorder.

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Anne Giles, M.A., M.S., is a counselor, writer and business owner. As of this writing, she has been abstinent from alcohol since December 28, 2012, and is in remission from alcohol use disorder. You can find Anne on Linkedin and Twitter.

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