Fentanyl Appearing for Pain, Pills, and Policy

Within the depths of pain

In some ways, I probably have a very high pain threshold, but in late 2009, my pain tolerance was completely overwhelmed when I had cancer in my left foot, with fungating tumours and blackened skin lesions, both deadly and deathly.

Standard painkillers (paracetamol) and stronger medication (tramadol) failed to relieve the pain. It was so intense that I could not put my foot down without crying. In the hospital, I was given morphine, but that only lasted two days before I was vomiting everything.

The Search for Effective Pain Relief

Then came OxyContin, but I was not given enough of it. The nurses seemed to be rationing it even as I begged for relief. However, when I was discharged after 18 nights in the hospital, my pain medication was adjusted. Multiple types of pain relief were administered to target different aspects of the pain.

Paracetamol, oxycodone, and a fentanyl transdermal patch; all that, and pain still persisted, sometimes taking centre stage. I resorted to almost hysterical laughter to release endorphins as a form of palliative coping.

After another consultation, I told the doctor I was still experiencing pain. In his view, my medication should have been sufficient; it was not. He doubled the dose of the fentanyl patch, and only then did I achieve what might be called pain relief.

The Path to Recovery

I was on pain medication from late September 2009, and by the end of January 2010, the tumours were gone. I had fresh, pink skin on the soles of my feet, a miracle of medicine, but it involved gruelling treatment, including chemotherapy and its dreadful side effects.

The pain had gone by March, so I removed the fentanyl patch. Big mistake. I salivated excessively, spat out mouthfuls of saliva, and became severely diarrhoeic. I had to reapply the patch. From this, I learned I needed to wean myself off it gradually. I kept it on for twice as long while gradually reducing the dose by halving the patch at each change.

It took three months to fully stop using the patch, long after I no longer needed any sort of pain relief.

Understanding Fentanyl's Role

Without fentanyl for this level of pain, life would have been unbearable, almost not worth living. One day, the patch fell off. Not knowing you could cover it with a transdermal sticker or plaster to keep it in place until the new patch was ready, I was laughing deliriously. My friend thought I had lost my mind; it was a protective mechanism. If I hadn’t been laughing, I might have been dying from unbearable pain.

Today, fentanyl should only be taken under medical supervision. I also understand that not everyone has experienced the severe pain I did, nor have suffered the otherworldly pain others endure; my pain was eventually brought under control, subsided, and disappeared entirely. I consider myself extremely fortunate.

My body became so accustomed to fentanyl that I couldn’t simply stop using it. It took willpower and determination; perhaps a rare gift. We all have different physiological responses. I am not seeking praise for that.

A Broader Perspective

Beyond the need for medication for chronic pain, there are issues of susceptibility to addiction, both requiring a sensible, empathetic approach under medical guidance across a broad spectrum of related conditions.

Regarding fentanyl as a narcotic, I feel ambivalent. People don’t become addicts solely by enjoying sweets; there are complex circumstances that I believe cannot be addressed purely through criminal justice.

Labelling fentanyl as a weapon of mass destruction would be narrow-minded and lacking understanding of human suffering, especially in pain management.

Learning from Recent Experience

My perspective is personal. I am cautious with medications, aware of their addiction potential. Recently, I used codeine, which converts to morphine in the body, to manage penile and urethral pain during the fourth week of radiotherapy for prostate cancer.

Prescribed to be taken up to four times daily, I rarely exceeded two tablets a day. After three days, I only took one tablet at night. I still felt pain and discomfort, but consciously avoided the lengthy process of weaning off codeine once my body adjusted.

As long as those who truly need such pain management are not disadvantaged by misguided policies, I hope this decision by the White House does not, in pursuit of an ideal, create suffering for many who simply seek relief.

Pain in my blogs

Blog - In hospital to kill the pain

Blog - Getting off the pain train

Blog - Generally responsive and dealing with pain

Blog - Stronger medicine and another course of chemo

Blog - Boldly tell your doctor everything

Blog - Off and back on the pain patch

Blog - Opinion: Where addiction and tragedy can confuse issues

Blog - Knowing pain is personal

Cape Town: Is it time to lean on the fat?

How addiction hobbles our chances

Walking through a cancer hospital to the department where you are receiving treatment reveals a world of great suffering, the unerring will of humanity to survive, the purveyance of hope for which the only currency of purchase is faith that could waver depending on prognosis, pain, confidence, or despair; it is a teaching and humbling moment.

How I have wanted to walk out of that hospital and snatch a cigarette from the lips of a young smoker totally oblivious of what cancer does to the body and how the odds one faces with cancer depends of what it is, where is has been found, if it has spread and if there is a body of knowledge and expertise available to give you a chance to survive.

Then, I do not have to walk far to realise how much of a hold tobacco and nicotine has over people. As at a designated area near the entrance of the same cancer hospital, you will find patients undergoing cancer treatment huddling in corners for another drag of the poison already killing them. They give themselves no chances at all, and if they come through, good for them.

This is obese in plain sight

In Cape Town, there was something we could not unsee, when we stay in Cape Town, we try as much as possible to walk everywhere and everything is within walking distance. Even on days I did not seem to have the strength or the capacity, I made my daily 10,000 steps.

Walking alongside us or coming into view from our vantage point of observation was someone carrying just that extra extra bit of weight on their hips, their bellies, and usually both, then arms and thighs; sights to make you catch your breath.

What you cannot deny is there is an obesity problem which should be registering somewhere in the South African healthcare system. There cannot be any aesthetic value to wanting to tip the scales until the springs broke.

How you address this obvious health crisis will no doubt require tact, wisdom, and some innovative policy initiatives, it should not be ignored. You could see people who could barely move, some were panting every few steps and I cannot put a statistical value on those who might have already acquired diseases of the heart, the kidneys, the pancreas, the liver, and other related serious health problems because of this excess weight.

The fast in fast-food is weight

One other observation we made when we were in Muizenberg, some 25 kilometres from Cape Town, with long stretches of beautiful beaches that more deserted than walked, was the number of delivery bikes that attended our estate at all hours, as if most did no home cooking, but relied on fast food. We do most of our cooking, from quick preparations like stir fries to slow cooking activities, it is about the willingness and timing.

In town, the fast-food outlets are full, taking orders for tables and takeaways for patrons and the ubiquitous delivery bikers, God forfend we dignify those places with the moniker of restaurant. They offer you something to masticate and swallow, but none of it is of value to your body and if you do not work it off, it sits somewhere in your body and accumulates in fatty tissue.

Maybe the new miracle weight-loss drugs might bring respite to the South Africans we saw and give them a fighting chance, but it also must include some desire and the will to do something about it.

While everyone is free to celebrate their bodies and love who they are, while not being shamed for what they have become, we need to square the circle between feeling good and being healthy. That will not come by lying to be nice.

Pouring sugar into my ears

Mums in admonition

It is quite funny the kind of early Friday morning banter I have with my mum which after the greetings follows a range of questions, answers, prayers, advice, admonitions, and generalities.

At 57, I am both a child as much an adult, though, in the admonition department, it is like a tussle of wills and determination. Obviously, one of the sticking points is how to wean me off sugar and my apparent addiction to sweet and sweetened things. Much as I avoid artificial sweeteners of every sort, pure sugar that goes into confectionary and demerara sugar that I put into beverages, I cannot seem to avoid.

Then again, some years ago, I did take sugar out of my tea and as long as my latte was milky enough, I could have coffee without sugar, I have returned to my old ways, and the craving for sugar heightened by reduced sensitivity of olfactory receptors and taste buds.

Sweet to my hearing

Mother however would not hear my pleadings and even as I would hate to admit I am addicted to sugar; it is something I should work to reduce just for health’s sake. She seems to think she can apply and exert coercive pressure by twisting my ears so that they turn and burn bright red to which I retorted, sugar does not go in through the ears.

The impression I got was the flaring of my ears might well moderate my use of sugar and before I could say, Fat Chance! I could feel my ears warming up and I relented on the point of adjustment I was taking only to make coffee some two hours later with the same amount of sugar I put in the mug yesterday, which I ended up not drinking because I was invited for tea by my neighbour. It is muscle memory as it is taste bud memory.

As for my ears, spare the twisting, I can still remember the last time.

The Hillsong controversy and resignation

Conduct with consequence

I would hate to stand in judgement on the conduct or abilities of another person. Yet in the lives of others, there are lessons we learn by example or the absence of the same to become better people. A few weeks ago, the Global Senior Pastor of Hillsong Church resigned from the church hierarchy that the church alluded to be certain breaches of the pastoral code of conduct in the last decade.

The two issues investigated together from almost a decade ago and in 2019 were serious enough to require that the co-founder with his wife of Hillsong Church from 1983 resign his commission. Apparently, Pastor Brian Houston in the first instance sent inappropriate messages to a woman who was not his wife, in the second instance, he visited the room of another woman and spent some time in her company.

Medication taking the blame

One should not speculate on what might have happened, but it is obvious that there were lapses in the judgement and definitely questionable conduct on the part of a high-profile religious leader. However, what does not sit well with me are the reasons given for these lapses in judgement; a dependency on sleeping pills and apparent disorientation as a result of the consumption of antianxiety medication combined with alcohol.

Why a man of God cannot sleep or needs to be on anti-anxiety medication that he ingested beyond the prescribed dose along with alcohol during a major global church conference is one might have to ponder and is open to conjecture, much as it speaks to the inadequacies and frailty of our humanity, regardless of position or status.

Owning up to our actions

Yet, we should be honest and ready to own up to our indiscretions, mistakes, errors of judgement, or irresponsible actions, whether sober or inebriated. To absent ourselves from consequence for our actions by reason of diminished responsibility or mental incapacity brought on by what we have consciously done is at best cowardly, if not dishonest, but let us not jump to conclusions.

For a church leader in the evangelical and Pentecostal circles to vacillate and dissemble when much of their core teaching is on leadership is quite unfortunate. I have given up friendships for what ex-friends have said about or to me in their drunken state because that is how they felt about me all along, the alcohol removed their inhibitions and sense of judgement or restraint to reveal what was in their hearts. To separate the man from the bottle or their addictions to excuse and overlook their actions, is to suggest all agency is lost when under the influence.

Admitting to our own faults

We might well excuse drunk drivers who cause accidents by their carelessness, maybe even gun owners for shootings because it was the gun that killed rather than the person who pulled the trigger. No, we hold them responsible because as a society we expect people for face consequences for those actions.

Indeed, Pastor Brian Houston might well take the time to reflect on how his life’s work might court an ignominious exit and the far-reaching consequences of his actions. The loss of place or status is a great sanction, and there might be redemption with the passage of time, but a man, if he is to be called a man must stand up and face what they are responsible for whether under the influence or not.

The owning up to “I did this …” has not been fully admitted to, rather it is the sleeping pills, antianxiety medication, alcohol doing the heavy lifting, what we are hearing is a tendency to seek absolution by reason of rather than the clear admission of fault by the person. This is where we need to be, his actions might have been exacerbated by medication, but the real story is the action of the pastor, that is what he resigned for. It is a matter of character as much as it is of integrity.

References

Hillsong: An important message from the Hillsong Global Board

Blog: Hillsnog: How the scandals at Hillsong took root

My friend, the genius

Your boundaries are sacrosanct

I would hardly be the one to initiate an intervention because I respect boundaries to the extent that I might not have been as helpful a friend as I could be. Also, I am rarely confrontational, it is not my personality type, though, if I have to confront a situation, I will, usually as a last resort.

However, if I am specifically engaged on an issue, I will apply all my faculties as objectively as possible, but herein is my dilemma. I believe I am watching a friend go off the rails and I do not know how to address the matter. I provide nominal support, but this is hardly sufficient to the situation, and it thoroughly disturbs me.

Call me anytime

My inclination is always to have an open door against the buffeting a person may face from others, but what if I am the only one left as the voice of reason: the last bastion of hope. The thought I might lose my friend terrifies me.

Professional support offered does not seem to meet the underlying need that moralises addiction and its detriments when a person believes they gain benefits from substance abuse and usage, or so they aver.

What he could be

This is someone whose abilities, aptitude, and intellect, if harnessed can operate consistently at a genius level with prolific output, whereas now, we contend with torrents of sometimes incoherent but amazing ideas that might only be realised with some sobriety. I have a friend who is a lot more than he sees in himself and considerably a lot more than I know he is capable of.

Whether rehabilitation can begin to extricate him from this situation towards better outcomes and fulfilment, I cannot tell, but in my view, he is doing himself gradual and progressive harm without realising or acknowledging it, comfortable in the feeling that exacerbates his most creative self. It bothers me and I am somewhat crying for help and inspiration for what is possible and within the scope of arrest. My friend is a genius unrealised.

When the cult of mother becomes a curse

Speaking of the oracles

Òrìṣà bí ìyá ò sí. This is a saying in Yoruba that is not that easy to translate without losing the fundamentals of meaning and context.

Òrìṣà in Yoruba is the core of the indigenous animist culture representing the supernatural, elemental spirits that are varied depictions of polytheistic deities, powerful, revered, worshipped and honoured. In the main, they traverse the early plane in legend as human and the heavenly plane as spirits, they are the mainstay of the deepest cultural identity of the Yoruba.

Only, a decade ago, I had to reflect on who the Yoruba were when I met two Cuban professors whilst on holiday who appeared to have more insight and knowledge of Yoruba myths, mythologies and legend than I ever knew. Steeped in superstition in what Lord Lugard dismissed as a ‘vague dread of the supernatural’, you probably would never understand the Yoruba without being Yoruba.

Blog - Who are the Yoruba?

The enduring hold of our oracles

I might extend that to suggest the Yoruba influence that remains strong in the practices as varied as Santería, Candomblé, Trinidad Orisha, Umbanda, and Oyotunji suggests some fundamental underpinning of the mother culture has been lost to the influx of new religions that have in most cases branded these traditions as savage, uncivilised and inherently evil.

Yet, these beliefs have sustained people for centuries and endure in the spirituality of the peoples and their descendants of the new world who were trafficked in the malevolence of the trans-Atlantic slave trade.

Òrìṣà bí ìyá ò sí. Indicates that the mother or motherhood usually as seen from the perspective of the child is the genre of elemental spirits worthy and possibly demanding of worship, adoration and adulation.

In the cult of mother

Recently, in watching a film and a television dramatization, I was exposed to an interesting dynamic between mother and child, the blood relationship persisted to serve the purposeful hold of the Òrìṣà mother on the worshipper child, but it was progressively damaged through abuse brought on by drug addiction.

A child desires of a mother love, attention, care, protection, maybe encouragement and even guidance, but some children get little of that because the mother’s capacity to mother in a somewhat ideal mothering situation is impaired by personal struggles that distract the mother from that objective.

In the one case, as in the film, Moonlight, the mother only seemed to come to, late in life whilst in rehabilitation and she profusely apologised for being less of a mother than she could have been. It was a time of tears, of hugs and of healing.

Blog - My own #Moonlight story is not a movie

Breaking the cult of mother

In the television drama, it was the 6^th episode of the 5^th Series of Law and Order: UK, called Deal where a drug-addict mother could care less about her son, first blaming her 13-year old son who for years had been told he was responsible for her problems and then when she was owing money to her drug dealer, she sold her son to the drug dealer to abuse as he saw fit.

The Òrìṣà mother bond was kept strong with threats to kill the boy’s mother if he stepped out of line. It is not until he saw that his mother had indeed sold him that the wicked Òrìṣà mother – worshipper child hold and bond was broken.

The travails of mother and child

The Yoruba culture places great burdens of responsibility and duty on the worshipper child to serve and sacrifice to the Òrìṣà mother, which in many cases is a willing and honourable function in the life of a child who has had positive influences of the mother, mothering and motherhood.

We as child strive to do as much as we can to uphold that Òrìṣà – worshipper bond, yet, that bond can be broken, broken beyond repair by agency or acts of either or both mother and child. The addiction that belies incapacity does not have to be drugs, it could be any other activity that brings on the infirmity breaks that maternal bond.

At peace, away from mother

As I wrote in my blog on Moonlight, the case of my mother is an addiction to a syncretism that combines elements of Judaism and Christianity with African-initiated interpretations of scripture along with strange animist traditions enlivened by incantations of the Psalms, rituals and holy waters, the result of which has broken the Òrìṣà mother – worshipper child bond.

Whilst it pains me that there is no relationship of any note between us, I cannot help but see my mother through the prism of those other mother addicts with no prospect of a Moonlight ending, because somewhere down the line she sold that motherhood to her devotion, hoping my fear of it would bring me into line, like the drug dealer’s threat to the boy.

Coming to terms with this has meant that I have decided not to waste precious time trying to make peace, but as I learnt in a conversation with a dear friend, I must find ways to be at peace with myself. I write about these things because I believe I am not alone in this kind of experience, it is also my own personal therapy in resolving the deep conflicts of the heart.

Opinion: Where addiction and tragedy can confuse issues

It is a sad story

I just read an article posted on LinkedIn titled, Opioids, My Mom's Death, and Why People Trust Science Less and the human side of the story is very sad, however, the additional narrative is opinion, conjecture, suspect and unfortunate.

There is a conflation of issues along with unresolved conflicts that need to be separated before this article tagged as an Editor’s Pick, Healthcare and Pharmaceutical are taken in without questioning or review.

Separate the issues

Walking back the issues, there is grief at a mother’s death, addiction to pain-killers that came as a result of prophylaxis for osteoporosis, estrangement, and then the machinations of the pharmaceutical industrial complex, known as Big-Pharma.

There is no doubt that Big-Pharma, Big-Tobacco, Big-Oil, Big-Manufacturing, Big-Agriculture and Big-Anything have a lot to answer for about their products and the effects of the production and use of those products on people, on the environment, and everything that makes for the wellbeing of our common humanity, but that is addressing the symptom.

The fundamentals would always be down to the individual, their personality and their experiences in how persuadable they are and this is not to castigate the strength of character of anyone, but missing that point would allow for drawing the wrong conclusions.

Scientific advancement has done wonders

For instance, it is thanks to the contributions of scientific research and medicine that I am alive today, having at one time been at death’s door with a prognosis of 5 weeks to live if my physiology could not tolerate and respond to the regimen of therapy I was being prescribed.

At the lowest point, I was in such unbearable pain that if not for the need to monitor my vitals, I would have been anaesthetised to manage the stress of it. Before I was admitted to the hospital, I was on Tramadol, then on the day I was admitted, I was given a morphine skin patch that had to be taken off after two days because I could not keep my food down and from then on, I was put on Oxycontin and Paracetamol with Codeine.

Whilst it appeared to manage the pain, when a deep biopsy was done on the fungating tumours under the sole of my left foot, 7 shots of local anaesthetic did very little to deaden to the pain. I simply bit on a think piece of a folded napkin as they prodded the anger in my foot.

Managing pain alone

On leaving the hospital, I was prescribed a list of pain and nausea management drugs that I was concerned about the cumulative soporific effects of the drugs. In addition to the earlier prescribed drugs, I was given a Fentanyl patch and that dosage was doubled when I reported that I was still in very much pain. That was when the equilibrium for my pain management was reached, I was not as pre-occupied with the pain as I took in 7 sessions of chemotherapy and the cancer lesions healed.

Whilst the lesions had gone and all the necrotised skin had been removed to reveal fresh skin, I was still in pain into the 4^th month of my diagnosis, then the pain began to subside. One Sunday, the patch fell off my skin, I did not know until then that a patch retainer film could be worn to keep the patch in place. Until the effects of the new patch kicked in, I was in such pain I began to laugh almost into delirium, but that produced endorphins to ease the pain. My friend thought I was going crazy, but I knew what I was doing.

Coming off pain killers

The pain of cancer is in another realm, it cannot be explained, the therapy for chronic pain has addictive qualities too. When the pain had gone, I could not just take off the patch, I had to wean myself off it, this is where the mind and the will come to play. Addiction has much of its roots in the psyche first than in its palliative effects. The palliative which is in itself a kind of comfort has to be consciously managed.

In my case, it took another 2 months to come completely off the patch and other pain medication. With the patch, I cut it in half and left it on for longer, each patch dosage halved and left on for much longer until my body could do without the drug.

Then, we all have innate tendencies to addiction and some people might be able to avoid addiction. There was another instance where a change in drug regimen meant I could not sleep, the first suggestion was to put me on sleeping medication, however, I thought of working a plan to take my pills at a certain time and avoid completely drug-induced sleep. I could see the dangers of becoming dependent on sleeping pills.

Addiction is first personal

Going back to the purpose of writing this blog, addiction has social, emotional, economic, relationship and physical consequences. In my view, addiction is not just to drugs or the abuse of drugs, alcohol, it could be sex, it could be religion or any other activity. The person and people around that person suffer, and that is very sad.

Regardless of what brought on the addiction, it is always first a personal struggle, what other factors contribute to it does not take away from how the person might have succumbed to addiction. Whether we fail to be better informed of the debilitating side-effects of a drug does not take away from the balance between efficacy and damage.

Apportion rightly

The science would suggest a drug can do something, most drugs have to recoup research and development costs and it unfortunate that some people put the profit motive well and above the welfare of patients and customers – that is commerce, we cannot avoid it.

It is, however, a long stretch to conflate personal tragedy, addiction, the science and the commerce into one clickable title of Opioids, My Mom's Death, and Why People Trust Science Less and draw the conclusions in the piece without properly assuming personal responsibility on the one hand and understanding that every individual has a unique physiology that adapts to medication in different ways which could influence the mind too.

I recall my doctor saying they could treat my condition but it depended on my physiology to tolerate the medical regimen. I lost a friend to a similar condition because his physiology did not have the capacity to tolerate the regimen of chemotherapy.

The responsibility of addiction remains a personal thing, the responsibility for being properly informed lies within the person, their medical support, the pharmaceutical companies and the science that balances efficacy with possible side-effects, with the hope that efficacy outweighs side-effects.

I am sorry, the writer lost his mother to addiction, but if we are to trust science less because of the conflicts of interest between treatment and commerce, we would all die sooner in more misery and pain with respite or comfort. That is why these issues need to be treated completely separately even if they are linked in a personal tragedy.

My own #Moonlight story is not a movie

Why I write

I wrote the themes of this blog in my mind and my head as I walked back from the cinema after watching Moonlight, the 2017 Best Picture Academy Award winner.

Normally, I would write a review of the film and from it draw allusions and relationships that resonate with me. However, on this occasion, I would suggest everyone who has the opportunity go and watch the film.

What I have to write below touches on some very personal things that in my own coming of age I feel I must express and I am sorry if anyone after reading this is adversely affected. We bottle up too much of our experiences in silence and hurt, giving no option to expression and lessons to be learnt.

As a child

Moonlight comes to us in three chapters of life, of childhood, of adolescence and of adulthood, the story of understanding sexuality and the relationship between mother and child in the midst of addiction.

As a child, I first recognised issues with my sexuality that began to find expression originally in sexual abuse at seven, and more towards an affinity to people of the same sex from around that age. In the process, there were people who took advantage of me and took their sexual favours whilst I obliged like a catamite.

I was 3 when I noticed my mother’s own addiction, it was religion and the constant visits to prophets and soothsayers, the inclination towards syncretism and the rituals therein, the recitation of Psalms and the invocation of inscrutable angelic beings, none of which inspired confidence in me for what a useful religious devotion could be.

In my teens

As I moved into my teens, I grew rebellious and difficult, the relationship with my parents deteriorated and my mother’s addiction took its toll on her reasonableness, her marriage, our family and consequently her career. My baby sister’s medical condition sunk her under the mesmerising spell of a ‘prophet’ who I considered false, she lost her agency as my sister was shunted between hospital and grotto, my mother finding justification for her actions in such atrocious hair-raising conspiracy theories.

I sank into depression, failed at school, took religion and almost lost my bearings. Meanwhile, I found a different friendship, occasions for a sexual outlet, all guilt-ridden and self-loathing, yet taking a hold I could not deny. I, without a doubt, had same-sex attraction that I could not explain and understand other than beginning to come to terms with who I was and who I am.

I got older

As I entered adulthood, I found some stability and an accommodation for expressing both my religiosity and sexuality, a family that took me into their bosom and gave me a grounding that became the foundation of who I am today. My mother in her own way that done really terrible things to me, things she dismisses but no child can forget.

It irks me when people interfere thinking there are filial duties incumbent on me without any acknowledgement of the deeper issues that necessitate estrangement. My situation is not necessarily unique, but my experience is exclusively mine to understand and that hopefully would be respected by others.

Whilst I was bullied in secondary school, I was saved the physicality of beatings, people exercised power in other ways. In adulthood, before I left Nigeria, I was being blackmailed but I refused to pay up knowing it was the gateway to something beyond my control. I was ready to face the consequences, just as I had years before when I was caught in a sexual liaison with another man.

I accepted myself

On leaving Nigeria, I decided no more to live in the shadows, I reached a point of self-expression and acceptance of who I was and that freed me to enter relationships, find love and develop productive and useful friendships amongst people like me.

Beyond that, I was freer with information about my sexuality in my workplace and it meant I did not have to live a double life. It also meant my managers quickly nipped any homophobia in the bud. I was fortunate to be respected for who I was regardless of my sexuality.

Sex had its attractions, an outlet, a search of companionship, a kind of addiction and a self-destruct button that was pressed more times than I could reckon. In that scheme of things, I became HIV+, developed AIDS, had cancer, lost everything and rebuilt my life from scratch again.

Sadly for my father

My siblings probably do tolerate my mother, I cannot, she has no capacity to reflect and that is to reflect on anything she might have done wrong, she feels entitled and makes demands of entitlement to fealty from her children, failing which we are emotionally blackmailed. I stopped giving in to this kind of manipulation some time ago.

My father who by commission has done little wrong, but by omission failed to save me from the menace of my mother’s caprices sometimes finds himself on the cold shoulder that is given my mother. His ability to reflect and accept wrong is sometimes limited by his inability to empathise with settings in which he cannot find a frame of reference. I probably should be more forgiving of that inadequacy, but everything is quite emotionally draining, it is sometimes best to let sleeping dogs lie.

I don’t hate her

Invariably, I do not think I would ever get to wipe the tears from the eyes of my mother from her acknowledgement of the hurt that I have suffered at her own ‘motherly’ acts. I do not hate my mother, then I cannot convince myself that I love her either. We exist because of the accident of circumstance, not something I had the freedom or will to affect beyond the fact that I was born.

My moonlight is a story with parallels and analogies, it is not a movie, it is my life and the way I have been affected. In my moonlit night, I find the peace and tranquillity of accepting who I am, and in my coming of age, I cannot deny who I am. The pursuit of happiness endures and a better story will be written, either by me or by those who learn something from my life.

Thought Picnic: Try to make me go to rehab

Preoccupied with levity

Many days have passed that I would have loved to commemorate, as I pay almost too much significance to the passage of time.

Yet with the passing of time comes experience and more of a story to tell of a life lived within the widest spectrum of emotion from sadness to joy, from ignorance to knowledge and from stupidity to wisdom.

Preoccupied as I have been with things that I would not, yet addiction has its hold driving one as if possessed towards destruction, careering down a precipice just in a path of an avalanche and volcanic pyroclastic flow coming inescapably from behind.

Then a dawning and a realisation begins to take shape in the mind bringing one to a place where there is probably help and succour and hope.

Distracted to attraction

We struggle as the relentless hold of these things, fleeting in moments, pleasure soon dissipated, the pursuit of happiness turning into a race towards perdition, breaking free into suffocating guilt and unease for a while as the oscillation comes around to take you back to that wretched-richly place of bloom and gloom.

Is this why people go to rehab? To find cures for their ills? Having their activities patterned for distraction finding new hobbies for old habits, fighting inside and outside the battles of human frailty with the hope that the victory will be the defeat of the past?

It is unlikely much will be achieved with the dogged determination of self-help and asceticism, regimen is hardly the lot one has chosen for a standard, but we are at the beginning of something and surely, it should not be the death of me. I've done therapy, maybe it's time for rehab or at the very least, an intervention - now, I would really hate that.

Nigeria takes Big Tobacco to court about kids

Why kids smoke

Sometimes one can wonder how kids get into smoking and eventually get hooked on the thing for life.

Growing up in Nigeria, there was a bit of a rascal in me and I remember times with my cousins we had a puff at strips of matting (sleeping mats) which had the look and feel of real cigarettes but their potency and efficacy was not known apart from the fact that they were unsmokable.

I had a puff or two before I was a teen but only really started when I was 14, however, it was a secret act of rebellion and quest for adulthood – however, kids caught smoking exacted the highest penalties of corporal punishment and serious ostracism from older members of society along with status amongst peers.

Resisting peer pressure

I always drew the line about what I would try and I remember one episode when I was in company of people more wayward and off the rails than I was, who were smoking pot, I refused to participate whilst others did – a few days after, one of the tough girls in that group leapt out of a first-floor window to escape many things I cannot recount.

She spent a few weeks in hospital and returned to her ways and people usually do.

I did have an inclination to start smoking pipes, but never got that far with the threat that someone at polytechnic was going to inform my parents of my smoking; one had to be more discrete about these vices.

Quitting by religion

At 18, I got religion and it just stopped, the desire, the craving and wanting and I did not have another puff till 17 years later and none since.

Whilst religion seemed a good thing, one must say that there is nothing that preaches against smoking as one can find preaching against alcohol. Basically, smoking is just a “social vice” which has been promoted into a sin because basically, it is what adults do rather than kids.

If however, one sees smoking as an addiction and hence a type of bondage from which one would want to be delivered then there is scope for belief systems to help.

There is also the matter of stewardship of your body in such a way as not to bring it into harm’s way – though not many take the body as seriously as they show even though it is the only shell of representation we have to interact in this world.

Those rotten companies

I am quite interested in the move by Nigeria of suing international cigarette companies on the matter of childhood smoking. They probably have a cause, I am not sure if they have a case.

Indeed, there should be serious educational material that talks about the dangers of smoking and the consequences of the same beyond threats and housewife tales.

When I was a kid, the most glamorous adverts were the smoking ones which showcased Marlboro Man and made every kid want to live their lives like him.

Tobacco companies would want to present a responsible corporate image to the West whilst they aggressively ply their trade in developing and emerging economies because that is where the growth for their market is, until some smart head shows to replace fossil fuels with tobacco.

Intoxicating Africa for Western profits

These emerging economies would usually not have addiction mitigating services or disease amelioration systems to handle cancers and other smoking-related disorders such that once people are hooked, they are truly hooked as they dig their graves with each long draw of the puff.

It is a welcome move and if does not get the companies doing something positive about eliminating access to the toxic weed to children they would know that the times of dumping poisons in Africa to keep their profits in the West are coming to an end.

In general, smoking is becoming less a social statement with smoking bans in New York, London and many other cities, smokers are finding ways of a healthier outlook to life; there are some who see a human-rights element to the freedom to puff, hopefully the quest of a healthier life would outweigh any temporary benefits that lead to long-term terminal illness.

References

Illicit tobacco trade contributes to global disease burden

Smoking curbs: The Global Picture

The African tobacco conundrum

Taking the World Up in Smoke

Tips to stop smoking

AIDS cure or homosexual lure in Iran

Between herbs and chemicals

Any development in alternative or herbal medicine that offers to give palliative comfort, therapeutic cures or prophylactic remedy for the diseases that rage amongst mankind today is very welcome.

I have many a time refused synthetic medicaments that pump the body full of chemicals providing temporary respite to a point that the body can handle no more and the person expires not so much from the illness but from the treatment – but who would own up to that?

Cures for serious pain that then lead to heart attacks, treatments for cancer that leave the person hanging on to a thread of life, in fact, I am convinced that many have not died for the reason that they have a stronger will to live rather than them reacting to the effect of the toxins they have to ingest with side effects, if recounted, would make a Stephen King horror novel look like a kindergarten colouring book.

Herbal clams making me puke

Even so, the big healing, cure or remission people are looking for is one for HIV/AIDS, this has been hitting the headlines faster than I could raise commentary, only last week the President of Gambia suggested he had been curing AIDS with herbs, in people who have been invited to his harem, my views on this were not half derisive, I was enraged.

Now, I read that Iran has also laid claims that it also has a cure for AIDS, a claim that has been out since September 2006 and reported by the Science Daily – this has been further developed to a herbal cure for AIDS or in some cases used in some combination therapy with existing chemical compounds that make up current HIV/AIDS treatments.

Of nuclear herbalists

Iran being a closed country and one with which countries like America has not had any diplomatic relations for 37 years, it is unlikely that we might really get essential corroborative detail of this development just as we cannot ascertain if Iran’s nuclear programme is purely peaceful or has militaristic tendencies.

Now, I would hope that the quest to find a cure is altruistic and compassionate to a larger degree than commercially driven for the benefit of blockbuster inventions and profits that Big Pharma is too indulged in to offer benefit to mankind.

Institutions like the Bill & Melinda Gates Foundation are also spearheading research sponsorship to develop drugs that impoverished countries and their people need and this is laudable.

A cure or a lure

Concerning Iran, my concern is whether this cure for AIDS is really one that its people should flock to for treatment or it is a lure to encounter the wrath of Sharia Law in the administration of punishment to the extreme.

At least, up till last year a number of teenagers were executed for being homosexual and that raised hackles in the Netherlands when our matronly Minister of Integration had to be forcefully dissuaded from deporting homosexual asylum seekers back to Iran on the whim that she had been assured they would come to no harm.

Thankfully, the young men were saved from the ideology of rule-keeping to the exclusion of commonsense and compassion, we all did breathe a collective sigh of relief.

Numbers to numb some

However, Iranian statistics suggest that most HIV/AIDS sufferers 62.3% are drug addicts who inject drugs and would have been infected through needle sharing, 27.9% have acquired the disease through unknown causes and 7.4% by possible sexual contact.

It would be interesting if checks are first made for needle marks to determine the druggies, background checks to determine the heterosexuals and possibly what is left over might be fit for the mob and the gallows – it does not bear thinking about.

Believing the best

Again, I want to believe the best of this situation, if indeed the Iranians have had a breakthrough on something that has foxed the whole of Western civilization over the last 30 or so years, they have a gift for mankind that far outweighs a prissy little nuclear tiff that is getting America too hot under the collar.

My only other concern about these herbal remedies is after the Gambian President’s announcement, maybe one of the reasons President George W. Bush is against stem cell research funding is because the Crawford Shrub or the Prairie Chapel Flower is being tested as an efficacy against Alzheimer’s disease – you never know.