heroin chic

The movie of Trainspotting came out the year I turned sixteen, and my friend Jamie was extra-cool because she'd seen it months earlier while living in Scotland as an exchange student. Heroin was fascinating. I read Trainspotting and several other Irvine Welsh novels, as well as Poppies: Odyssey of an Opium Eater, and found them interesting, funny and dark.

It's very different, now, to be learning about opiate analgesics in my pharmacology class. Since then I've known and cared for some opiate addicts and users, and it all seems far less glamorous and much more sad. And it's strange to have those old aches of lost friends and teenaged angst mingling with the aseptic simplicity of new drugs and practices of nursing school.

So it caught my attention when a little box in my textbook informed me that heroin is "biologically inactive" until the body degrades it into morphine. Huh? So why is heroin illegal, and why is it the drug of choice for opiate addicts?

Apparently heroin, which is a generic name for diacetylmorphine (morphine with two little acetyl molecules attached) is much more fat-soluble, and since the blood-brain barrier is a membrane made of lipids (fats), heroin passes across the barrier and into the brain much more easily than morphine. Once there it sheds its sheep costume, smiles a wolfish grin, and gets to work making the user bliss out. Clever, dangerous creature, that heroin.

p.s. heroin is illegal in the U.S. (of course) but is used legally in Europe in palliative care (usually in patients who are dying, as a comfort measure).

working hard, or hardly working?

photo by Damien

Just in case anyone got the impression that my life has been all work and no play, (which wouldn't be very much fun, or very healthy) I thought I'd tell you about my Critical-versary.

I spent last weekend "camping" (if you can call it camping when there's a microwave, hotpot and ice-maker involved) near Mount Vernon at an event called Critical Massive. Critical (for short) is the regional Burning Man event, and although many there are many shared elements, Critical is MUCH mellower - mainly because it's around 500 people instead of 50,000.

At any rate, this was my fourth year of going to Critical (and will be my fourth year going to Burning Man at the end of August) and this year I was constantly reminded of what an important personal holiday it has become. Many of my relationships have begun or deepened at Critical, including meeting my sweetheart two years ago, and being there I am very aware of a feeling of connectedness. The word for it is somewhere in between family and community, and means a group of people who hold space for each other that is sacred, safe, and very, very silly.

I did some crying and a huge amount of laughing, and came home feeling utterly relaxed and surrounded by love. And ready to return to my new nursing school family-community, which I am still settling into with enthusiasm :)

catching up

Wow - starting school has been even more intensely busy than I imagined. I apologize for the total abandonment of the blog - most of my life just got moved to the back burner.

That said, here's a wee bit of what I've been up to in the last month and a half:

More awesome Deep Tissue Massage classes from Brian Utting

One on QL (quadratus lumborum), psoas and the diaphragm and one on chest and shoulders (subscapularis, pec minor, and all manner of connective tissue around the sternum). Both were cozy little classes in his living room in Ballard and left me feeling relaxed and excited to be doing massage. It really was amazing to see how much easier it was to breathe afterward, especially with all the work around the sternum.

Needles, old folks and early mornings

Some of the things that have scared me most about this program - nasogastric tubes and catheters (yep, tubes going through nostrils and into stomachs or up ureters to bladders) we fortunately got to practice on eerily life-like mannequins instead of on each other. We did, however, get to poke each other with needles in several places. I was amazed to discover that the injections didn't hurt at all, but the pokes for a simple glucose test sure did! (At least to my massage-therapist fingertips - we ended up poking my earlobe, which was not bad at all.)

Perhaps the hardest part has been the idea of not just getting up, but actually being AT my clinical site at 6:15 am on Tuesdays. Yikes - I haven't been up before 8am on a regular basis in years! I've spent two days with my first resident, "B," and just briefly met my second - "A."
"B" is the sweetest little old lady, and still quite lucid and capable. She's made me think about how very little time I've spent with actually old people in my life, and how sad that is.

More updates to come!