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I really like my therapist.  She is kind of flaky , and the first time I saw her, at a postpartum depression group, I thought she was a patient.  And she never cross-examines me about being late or about tearing up sometimes.  And she is, for the most part, really good about drug issues despite (because of ) it not being her specialty.

But then I started talking about the time that I almost ODed in New York, and how scary it was in retrospect that I didn’t even know how close I was to ODing.  And nobody had Narcan back then, and nobody knew rescue breathing.  And my therapist misinterpreted what I was saying and started talking about denial or something, and I had to cut her off.  Because, yeah, I had that too, after Michael died, and I got a lot more freaked out about ODing, but I would push it out of my head until I had actually pushed down the plunger so it wouldn’t get in the way of getting high.  But when I think about that time in New York, I’m mostly just angry.  Narcan existed; they just wouldn’t give it to us.  We were left with cold baths and walking someone around outside.  No one at a needle exchange ever said anything about rescue breathing or how to recognize the early symptoms of OD (e.g. weird snoring sounds).  And all the information about where it was safe to call an ambulance and where it wasn’t was strictly word of mouth.
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howtospotahorse:

You can learn a lot about people from what tattoos they have. Inside the hospital, a patient’s tattoos can give you some valuable insight into their social history. IV drug users often get tattoos with some feature that identifies which vein they prefer to inject into. A common form of this is a scorpion with a tail that points to the vein. Check out this tattoo of a sun on the arm of one of our patients.

The longest ray on the sun points to his vein of choice.

This seems like terrible advice.  The last thing we need is to have half-trained med students over-analyzing people’s tattoos.  We need better, more compassionate, more humane treatment of drug users.  And a lot of infections and tissue damage that land people in the emergency room could be prevented by supervised injection spaces and access to targeted safer injection related medical information.

When I was in the SFGH emergency room after an OD (and was propped up in a chair because they didn’t have enough beds) a whole group of trainees (I think med students and residents) came up to me to talk about injection drug use, overdose, and narcan.  They hadn’t learned about any of this stuff in school, and I was sharing what I knew with them.  Which seemed kind of ironic, since I was going to be paying for the privilege of an ambulance ride I hadn’t wanted followed by sitting in a chair for four hours with no real contact with medical staff except being told by a doctor at the end of the night not to do drugs.  Maybe things have gotten better (that was in 1997) but I kind of doubt it.

Also, the injection site tattoo.  I mean, if someone only has one vein they use, it’s probably the one in the elbow of their non-dominant hand. And tattoos can make it harder to find the injection site, if you’re used to using visual cues.  And some people use tattoos to cover scars.  So I don’t see the point of medical tattoo analysis.

But, yeah, Michael had a target on his left elbow, because, you know, subtlety is over-rated.  And I was going to get a black widow on my arm after seeing Killing Zoe, but didn’t really have the money, and then Michael died, and I was going to get it on my stomach as a memorial piece, but could never settle on the design.

OD

Apr. 4th, 2012 03:03 pm
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Just read this great article on Narcan and OD, and realized that I was much closer to ODing that night in Washington Heights than I’d realized (I’d never seen strange snoring listed as a OD symptom, but it makes sense). I had gotten high a couple times since I got to New York, but this was the strongest dope I’d ever done. I was hallucinating shabby old men (maybe Burroughs?) and couldn’t keep ginger ale down. We ended up hanging out in the utility room of one girl’s building, and I was nodding out hard and I guess snoring weirdly. Everyone I was with was younger than me – one was a friend, another I had just met and the other two were just bad and stupid – and people were more concerned that I would wake up the super than that there might be something wrong. At the time, it seemed like a great adventure, but in retrospect, it seems like a ridiculous multiplying of the risk that we were all so ignorant. No one except EMTs had Narcan then, none of us had learned rescue breathing. The best we could do was walk someone around, get them outside for some cold air, or try to get them into a cold bath.

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