I was sober until the age of 34. Yep, I said 34. My father was an alcoholic who made alcohol appear so unsophisticated that it never became even a curiosity. I disliked the taste completely whether that was a matter of taste or a coping mechanism. My first exposure to drugs was when I was a 2nd year medical student at The University of Texas Medical Branch, at Galveston. I was older than most of the other students and already wondered when they were going to realize I wasn't really smart enough to be a doctor. Anyway, in my second year while battling subjects like biochem, pharmacology, and others I developed a headache. I came on incidiously but would never relent. It was as if a vice were squeezing my temples and forehead and then ramming a flaming stick down my neck. I could not concentrate. I could not study. I could not think. At UTMB we have what we call "Black Mondays". Every five weeks we are tested on a monday on all subjects. Now imagine trying to study with that skull-crushing pain. Tylenol or motrin did nothing for it. My grades began to fall and my anxiety level raised. It did not help that my girlfriend was ranked #1 in our medical school class all four years.

I had to do something. I got a card for uninsured patients and made an appointment to see one of the faculty in the ENT Dept. Nothing moves quickly (or at least it didn't then) in the uninsured patients clinics. Finally I got to see her and you can imagine my letdown when after taking a careful history and physical, shooting a sinus xray, and using the other ENT instruments left over from the surplus of the inquistion she said that she didn't think I had a sinus problem, she thought I should see a neurologist. Argggghhh! A consult was requested in the neurology clinic and I was again interviewed and examined and told, "I don't think it is neurological, I think you have a sinus headache with secondary muscle contration headache superimposed. He sent me back to ENT.

Three weeks later I was again in the ENT office with a headache I had had for four months. She told me that the only thing she could do was a cat scan to see if it showed anything. That was requested, scheduled, and done in 3 more weeks. Two weeks later I was back in her office and she told me I had two posterior sinuses that showed chronic sinusitis and that I needed to have an endoscopic surgical procedure. But since I actually did have a medical problem and maybe not just drug seeking, she wrote me a proscription for Fioricet #3 which is a barbituate in combination with codiene, a narcotic. I went home took two tablets and within 30 minutes my headache that had been there for the last six months had nearly left. It was incredible. If there is a strong psychological reinforcer of addiction, I think this is the part that grabbed hold of my so tightly. I once again saw my ability to concentrate improve. I was less iritable for which I'm sure my girlfriend was appreciative. My grades began to improve and no longer did everything I had worked so hard for seem at risk. I also felt like doing things again.......Until the medicine wore off. Then the vice was reapplied. Two more tablets and sweet relief. I started squeezing the doses more closely together and then taking more that prescribed at one time.

I had an fiberoptic endoscopic sinus surgery. While in recovery the nurse brought me something for the pain of having bent left with a nasal splint the size of a Cadillac quarterpanel.
She brought me demerol and injected it into my hip. Nirvana. Bring on all of GM. The first surgery did not stop the headaches so she scheduled me to remove my middle turbinates. Still, my pain relented except by taking the fiorinal with codiene or just regular fiorinal. It was easy to get. Ask a friend to write you a script or get it out of the sample closets. What I would not realize for a very long time is that my headaches were now caused by a rebound effect to the pain medicine and the treament was to stop taking it.

More Later,
Phildoc