My Struggle

My apologies for not reading your blogs lately. I’ve not been feeling well. After my quit date for espresso drinking, I have been experiencing pain in my stomach, insomnia, and a generalized feeling of depression.  I felt a slight, pin-prickling sensation in my gut as I was riding my bike over to the Navigate Counseling Clinic the other day, and then, an hour before my counseling session, an excruciating pain erupted in my stomach, and I when I was in Dana’s office, this was all I could talk about. I told her that I was at the crossroads of my life.

When I confided with Dana my fears of relapse, she suggested writing a letter to myself, reminding me of the distress I was feeling at that very moment. She handed me a clipboard with a blank sheet of paper on it and a writing pen. I scribbled a few lines, but I rewrote and expanded upon them days later, when the inflammation in my insides had cleared up somewhat. This is the text of the letter:

Coffee is not for everyone, regardless of what the media may insinuate. You can look at black coffee sitting inside a coffee pot, and you can see for yourself how toxic this substance is. You know that if you keep drinking this stuff, indulging in your pathological espresso habit, it will lead to ferocious stomach pain, which will, in turn, lead to stomach ulcers and possibly your own death. Espresso is killing you. Think of the pain you are feeling right now. Your abdomen fells like it is in flames, and it hurts at the same time, as if you had swallowed a ball of molten lead. Whenever you fill your stomach with food, this same sensation — this gruesome pain radiating throughout your stomach onto other parts of your body — to your chest and to your guts — affects not only your stomach, but your esophagus and your small intestine as well.

Think of these things the next time you have the desire to purchase a cup of coffee — a substance so addictive that you lose control of your behavior, indulging in a few fleeting moments of pleasure, a hideous gratification which will lead you down a gilded pathway to bloodcurdling agony. You may feel good after you drink your first cup, but you know perfectly well that once you get started, you cannot stop. The next thing you realize is that you will have to undergo medical procedures, revealing the damage you have done to yourself. Relapsing is no longer acceptable. You must quit forever, starting now — right now! — you must not drink it ever again!

This is the only prescription for good health, the only way you’ll ever feel normal. What is the point of everything else if you lose your health? Nothing else seems to matter when you’re in pain. You can forget about doing the things which are important to you, because your mind will be consumed by suffering. Life will lose its luster, and lying in bed will be all that’s left for you. And this is not the way you want to live — you want to live the active life, a life filled with physical and intellectual activity.

The myth of the coffee achiever is a falsehood. Put it away, and live a better life.

When I returned to Dana’s office the following week, she had noticed that I was feeling better, and that I had a smile on my face. I replied that I didn’t have a pain in my gut that day, but if I thought about it, I could feel every contour within the inside of my stomach. I showed her the letter I had written and she spent some time reading it. I told her that I stayed sick for a whole week this time, and I had written the letter when the pain finally eased off some.

And I told Dana that I had entered a convenance store early one morning to buy a slushy, when I saw some men inside the store, who were preparing to go to work, drinking coffee, and just watching this made me want to throw up. Dana mentioned that in my letter I had written about a toxic substance, which looked like water mixed with tar, and I could imagine those men pouring this down their food pipes and into their stomachs. There was no chance I would relapse right now, but I was uncertain about the future. I asked Dana would the cravings eventually go away. She said that they come onto different people in different ways. I might never feel a real craving again, but then I may experience them like the waves upon a mighty ocean.

Dana had been searching the internet for resources I could use to assist me in quitting. She handed me a document that she printed out. Dana had found a website entitled Caffeine Addicts Anonymous, which provided a phone number to call on certain days of the week, and at certain times, which would ask for an access code (which Dana gave me), and this would make me a party in a conference call with other support group members. There would be readings from a book Confessions of a Caffeine Addict, by Marine Kushner, and a teleconference meeting for twelve step caffeine support, similar in nature to the program for Alcoholics Anonymous.

I mentioned to Dana my appointment with Dr. Ali, the gastroenterologist. I had seen him three years ago, and the next day I would be returning to his office again for the same reasons. I was hoping that he would think I was telling the truth when I would say to him that it was espresso which was hurting my stomach, and not alcohol. I told Dana the embarrassment I was going to feel, after having imposed self-inflicted harm upon myself, but, even though I would be standing before him once again, I was going to tell him the truth. I viewed this process as a form of punishment — having to confess and to be put under anesthesia, having to endure the anxiety of what they might find inside of me.

I told Dana that my other goals had been put on hold because of what I was struggling with now. I told her that I hadn’t forgotten about them, however. I brought up the stigma of having to ride my bike from place to place in Robersonville, not being able to afford a car and being the only person in town who rides a bike. I told Dana the story of what I witnessed the other day. While I was riding in Laura’s car, we passed through an intersection, and we saw a group of cyclists stopped at a stop sign. I noticed they were dressed differently from me. They looked as if they had bought their clothing from a sporting goods store, which made them appear that they were not riding their bikes in order to transport themselves, but were out riding for pleasure and for their health. I though it would help eliminate the stigma if I imitated them. When I had left the campus of the medical school after my previous therapy session, I stopped by the bike shop to get my tires inflated, and I bought a pair of designer biking shorts. When it was time for me to travel to the food bank, with my large hiking backpack strapped to my back, I wore those shorts, along with a pair of specially made protective gloves, designed to keep my hands from going numb on the handlebars, and when I arrived at the housing projects to stand in the bread line, I received a complement on my biking outfit from one of the people who were there to get food. They could see how independent I was, carrying my own food home on a bicycle, and I began to feel respected once again.

Dana and I discussed how the stigma isn’t there when I’m riding my bike through Greenville. Dana said that she often sees students and professors alike riding their bikes toward campus wearing street clothes, and no one thinks badly of them. I replied that in Robersonville, you see men in pickup trucks smoking cigarettes, getting off work after getting their hands dirty. They don’t respect a person on a bicycle. They view me as a bum living on welfare. In Greenville, everyone goes about their daily business without being curious about the people they see. In Robersonville, you keep bumping into the same people in different places, and everyone tends to be inquisitive and judgemental.

As Dana wrapped up the therapy session, she told me that she admired my resilience and my hard work in attaining my goals. I replied to her that when I come to the clinic, I don’t feel that people are judging me, condescending to me, or putting me down.

To disregard what the world thinks of us is not only arrogant but utterly shameless.

— Cicero

The following day, Laura took me to Vidant Gastroenterology to see Dr. Ali. I asked her to come into the examination room with me to offer moral support, which she did. When the doctor came in, he remembered me from last time I was in there, and I told him the truth. He didn’t seem critical, but he asked me how long had it been since I quit drinking espresso by the pot. I told him I had quit completely seven days ago. He asked me where the pain was located, and I placed my hand directly over my stomach. “Is there any blood in your stool?” he asked. I replied no. “Is you stool completely black?” I replied no. Dr. Ali asked me to lay back on the examination bed and I pulled my shirt up. He applied pressure to different sections of my stomach. “Do you feel pain in any of these places?” he asked. It was obvious that I didn’t, because I did not flinch. He told me not to drink things which irritate my stomach anymore. He gave me the option of skipping the procedure, since I wasn’t displaying any symptoms of an ulcer (it was just that the insides of my stomach felt like sandpaper, and on a scale of one to ten, my pain level at this time was a two or a three), but I told him we had better take a look inside anyhow just to make sure.

The doctor shook my hand and Laura’s, then left the room. Then a nurse came in, brightening up our day with banter and joking. “We’re going to have to put you in time-out!” she said to me. I replied that I had learned my lesson, and I wasn’t going to drink coffee anymore. The nurse typed in some information into the computer, then handed me a questionnaire to fill out and to bring back the day of my procedure. She told me not to drink water or eat any food after midnight on the big day. I would be under anaesthesia, and I would need a driver to take me back home. Laura said she would do this. The nurse handed me a purple sheet with some writing upon it. This is what it said:

To help determine your medical treatment, you have been asked to undergo a procedure called an upper endoscopy. This is an examination of your esophagus, food pipe, and stomach. The procedure is performed using an endoscope or gastrointestinal fiberscope. The endoscope is a narrow, flexible tube. It is passed through the mouth and the back of the throat into the stomach. It will not interfere with your breathing. Abnormalities seen by x-ray can be confirmed. Others that are too small to be seen on x-ray may also be able to be detected. If the doctor sees a suspicious area, he can pass an instrument through the endoscopy tube and take a small piece of tissue called a biopsy. You will be given medication through an IV to make you relaxed and sleepy. You will either gargle or have your throat sprayed with a local anesthetic. The procedure is well tolerated, with little or no discomfort. Following the exam, you recover for about an hour. A nurse will be checking your blood pressure and checking on you frequently. You may have a minor sore throat after the procedure and during the next day.

I was all set up and my procedure was scheduled for three weeks from now. When Laura and I left the doctor’s office, returning to Robersonville, there was a huge thunderstorm. The summer solstice was tomorrow.


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