from '100,000 Years in Detention'
I have a friend and his name is Jeff Bowman. The following is the culmination of hours of research by and recorded interviews with Jeff detailing his experiences with the world of pharmaceuticals and their by-products, side effects and consequences. It is compiled, written and edited by myself.
When I was growing up, learning my times tables and watching the dated video about sex education, you had to fight me to take a children’s chewable Acetaminophen. They were purple and tasted like purple – not grape, like the bottle said – and I reached the point of needing eight or 10 before I learned how to swallow pills.
It’s easy, my mother said, to take the pills. Just stick your tongue out, Jeffrey. Just place the pill on the center of your tongue. Just retract your tongue and take a sip or two of water until you felt the little medicinal cylindrical magical Acetaminophen slide past your throat and down your esophagus. Then, she said, your headache will go away.
It’s that simple.
It’s 500 miligrams of Acetaminophen per pill and just one will cure a headache when you’re 13 years old. Just two will cure a headache when you’re 17 years old, and just four will cure a headache before you’re 30.
Acetaminophen is used to treat aches and pains and to break fevers. Side effects include mild fever (I had to read it a second time myself), dark urine, clay-colored stools and jaundice.
It was my first step into the larger world of little oblong pills and might as well have had training wheels on it.
I suffered an ungodly sunburn after a short beach vacation with the family. Once the smelly-but-relieving aloe vera had been rubbed all over my body and the burning was disappearing, once the skin faded from crimson to pink, the nerve endings, deadened from their overexposure to Sol, began to awake.
By this time, in which they awaken, we have already seen the disgusting yellow the shoulders and upper back turn as they are filled with aqueous blisters, and I can think of nothing more vile than backpacking postules of unwanted skin and skin-healing-whatever around on one’s shoulders throughout the path that leads back to normality. The pain and itching were so unbearable I had to chew an antihistamine tablet so as to break through the outer coating of the pill and release its active ingredients to my body faster lest I scream or go insane from the sensation.
Antihistamines generally treat allergy symptoms by blocking the H1 Histamine receptor throughout the body. Its neighbor, the H2 Histamine receptor would, in years to come, cause me a significant amount of trouble in its relation to peptic ulcers and stomach acids.
The antihistamine I took to help with my sunburn was diphenhydramine. Side effects include sleepiness, fatigue, dizziness, headache, dry mouth and difficulty urinating.
One morning in high school, I collapsed on the concrete, clutching my stomach and screaming at the top of my lungs. I thought I’d been shot. I buried my face against the cold cement and soaked it with my tears, immobile, until two of my friends picked me up and carried me to the nurse’s office.
After an upper GI and a couple endoscopies I was diagnosed with my first peptic ulcer and prescribed Cimetidine, a third antihistamine. It blocks the H2 Histamine receptor to slow the production of acids in the body and over the course of its 30-day prescription, its bottle fades from smelling like a vanilla milkshake to an old corpse.
So I finished high school and returned to the South. Not the landmark South, of Atlanta or Birmingham or Memphis, but the forgotten South, the anonymous small towns and villages three hours from anywhere you’ve ever heard of, and it was there I was introduced to my new friend: Loratadine, another antihistamine meant to relieve sneezy or running noses, itching, watery eyes and itchy noses and throats. Loratadine remains a staple in my diet alongside fruits and veggies, pasta and meat.
Its major side effects include a fast or uneven heart rate, lightheadedness, jaundice or seizures. Its minor side effects are headache, nervousness, fatigue, stomach pain, diarrhea, dry mouth, sore throat, eye redness, blurred vision, nosebleed and skin rash.
So I suppose whenever I have allergies, I take Loratadine to relieve their symptoms, which in turn occasionally gives me stomach pain and headache which I nullify with Cimetidine and Acetaminophen.
Next in line in the Bowman Family Pharmacy is Isotretinoin. We were sitting around one night my first year of college and I confided in someone that I was sick to death of my acne. I’d had it since I was 10 or 11 and my face and I both felt like shit. He told me he’d had horrible acne on his back and had to go on medication to take it off. Given my luck with antacids and antihistamines, I decided one more trip to the doctor wouldn’t hurt.
The doctor I went to was near my parents’ house, as I was home for a visit from college. She asked me about eight times if I were suicidal. I said no each time and she gave me the slip with the signature and explained the new pill.
Isotretinoin is a vitamin A derivative and works by reducing the size of the body’s oil glands by over 50%. It also slows skin cell production, preventing clogged pores, has anti-inflammatory properties and slows the body’s natural oil production by almost 90%.
Most interesting side effects include permanent thin skin, hair thinning and cheilitis. Cheilitis is what it’s called when your lips get inflamed from a vitamin B deficiency.
“Cheilitis?” I asked her. “What’s that?”
“Just call it ‘Nigger Lip Syndrome,’” she said.
“Can I call it Cheilitis instead?”
Also, while you’re on Isotretinoin, you get depressed and see an increase in suicidal thoughts and tendencies. And your lips dry out like beef jerky and you have to apply industrial-strength lip balm every hour or two to keep them nice and lubricated. If you, hypothetically, forget it and go to class in college all day, you’ll look like you’re wearing lipstick and crimson lip-liner by the time you get back to your dorm to apply it.
So after a month or two my acne cleared up. For the first time in 10 years I saw my face again and it brought me to tears. I went back for my monthly appointment with the local dermatologist by my school and he noticed my improvement.
“Hey! Lookin’ good, sonny!”
“Thanks doc. Just here for my check-up and refill.” I always sound phony when I’m going through the motions of a conversation, but he didn’t mind.
“Sounds good to me!
So…gettin’ any pussy yet? Y’know…that young college stuff?”
Maybe it’s just part of the MCATs. Question 148 is “Are you planning on going into dermatology?” Question 149 is “Are you a vulgar bastard?”
Shortly thereafter, after suffering a long bout with the common cold, I reached my wits’ end with sickness. I’d been sick for over a week and, afraid of overdosing, cautiously took one type of pill a day to cure what ailed me most on that particular day.
Day 1: Acetaminophen.
Day 2: Loratadine.
Day 3: ______ (a multi-symptom cold medication)
This last resort, ______, was supposed to be the combo hoagie of cold and flu pills. Its active ingredients are Acetaminophen (the common headache/pain/fever alleviator), Dextromethorphan and Doxylamine Succinate.
Dextromethorphan, or Dex as the kids call it, is also found in cough syrup, which these same kids drink like beer to get high, producing a euphoric feeling. Unfortunately for Dex, and its addicts, by taking it one can come down with body rash, itching, vomiting, hypertension, nausea, blurred vision, shallow breathing, drowsiness, dilated pupils, diarrhea (AGAIN?!), dizziness, sweating, urinary retention and fever.
Doxylamine Succinate is a sedative that simply causes drowsiness.
I repeated this systematic self-medicating for the better part of a week, throwing in cough syrup (active ingredients Dex and Pseudoephedrine, same side effects as ______) on occasion for a sore throat I had as well.
By day eight I’d lost all patience and my temper went to shit, so I figured fuck it and took three Acetaminophen, two Loratadine, two ______, double the recommended dosage of cough syrup, my Cimetidine and washed them down with a screwdriver, heavy on the Grey Goose.
It may not have been my best idea.
It was Tuesday. Then suddenly it was Friday and I walked around my apartment like a detective trying to piece together a crime scene. My roommates said I held better conversation than I ever had in my life and apparently had downloaded instrumental tracks by Raekwon the Chef from Wu-Tang Clan and a cappella tracks from Gorillaz and mixed together the better part of a mash-up album similar to Danger Mouse’s mash-up of The Beatles and Jay-Z. I still have it; it sounds great.
When I got my wisdom teeth taken out, they prescribed me that extra-strength-industrial-grade Acetaminophen and a corticosteroid, Prednisone, used for anti-inflammation. The idea was that my cheeks wouldn’t swell up like a chipmunk’s post-surgery since they were going to saw bone out of my mouth and stitch it up.
The first side effect listed for Prednisone is facial swelling. Not even buried in the back, it’s right on top, as though the pharmacist has the same sense of humor I do. The rest read like a recipe for an elderly serial killer: increased blood sugar, weight gain, infections, mental confusion, blurred vision, peptic ulcer, painful hips, osteoporosis, joint pain, cataracts, mouth sores, avascular necrosis, depression, mania, anxiety, insomnia and long-term migraines.
My father drove me to the operation. I inhaled the gas and went under and woke up six hours later on my bed and ran to the sink and spat a mouthful of blood and cotton balls. Dad heard me moaning and came downstairs with water and my Prednisone and super-Acetaminophen. Unable to use mouthwash, or even the mouthwash motion of swishing water around and sucking my cheeks in and out, I resorted to tilting my head back, filling it like a cup with water, rolling my neck around and tilting forward, spilling pink out of it and down the drain. Once I regained my senses I looked at dad and he was shaking his head and said he couldn’t believe my post-op bedside manner. He regaled the story with equal joy and terror.
Dad told me that while he was waiting for me to be done with the operation, he read a magazine and helped a woman comfort her teenage daughter, who was the appointment following mine.
“It’s ok Nicole; everybody gets their wisdom teeth out! You’ll be just fine, sweetie!”
“Yeah, my kid’s in there gettin’ his done now and you’ll see when he comes out, they give you a bunch of painkillers so it doesn’t hurt at all. You’re just really sleepy; thank God you didn’t do it when I was your age and they kept you awake through the whole thing.”
Dad and Mrs. Nicole’s Mom spent the better part of an hour calming her down before the nurse called dad and said I was finished.
So I was so doped up they rolled me out in a god-damn wheelchair. I kept scratching my cheeks where, inside, the stitches itched like ants were crawling in my jaw. The nurse was afraid by scratching my cheeks, the inside of my cheeks would rub a stitch loose and they’d have to start over, so she kept pulling my hands away from my face. In turn, I tried to say to her “I understand your concern, ma’am, but my face is itching like crazy and when I got my tattoo I found that by scratching the itchy skin with the BACK of my fingernail instead of the cuticle, I could relieve the itching without causing any problems. Shouldn’t a similar principle apply here? Please, leave me be.”
What came out was me slapping her hands and saying “Qu-fugn-touch-me-fuckin bitch! Goddam face!”
By the time I got to dad, he tried introducing me to Nicole. She squeaked out a nervous, awkward hello and I lifted up my head and smiled, at which point a couple ounces of blood came pouring out my mouth, down my face and onto my shirt. She screamed and we left.
I tried to talk to dad on the way home and he held me up and walked me to bed. I insisted on going down the stairs backwards, and when we got to my room I told him I had to pee by grabbing my crotch and going “Fsssssshhhh.” He was peeling back the covers on my bed and told me to go ahead and try to walk to the bathroom.
So I guess I pulled it out and tried to go on the floor, but before I could he again came to my rescue and walked me to the toilet. I couldn’t go, thank you Diphenhydramine and Dextromethorphan, and we walked to my computer next to my bed so I could start a playlist of music to listen to when I woke up stuck in bed. I couldn’t click the “Play” button to save my life, so dad took care of it but I kept trying to click things anyway. Eventually he lost his patience and gently pushed me backwards and I fell into bed and passed out, not before asking why my shirt was covered in blood.
The night of the operation I was on a strict tomato soup diet and by the morning after I knew something was wrong. I’d taken my Prednisone and hyper-Acetaminophen and I felt like every time I ate, I was swallowing hot coals. By the third day, a Friday, I couldn’t get through a meal without crying and we called the doctor. He said to come in Monday and he’d take a look.
The first thing he noticed was that my holes hadn’t healed correctly. They were four giant open wounds like craters in my jaw that kept bleeding and so he took a sharp metal rod with a hole at the end, put a pea-sized gob of what looked like fish paste on it and crammed it into one of the holes. It was one of the most excruciating feelings of my life.
Then he did it to the other three holes and agreed to look at my throat.
Apparently the steroids were causing an extreme acid reflux reaction. One week and another bottle of vanilla milkshake-smelling antacids later, I could eat again.
As I got older, my medicine cabinet filled out. What once contained only a toothbrush and a shaver was, by college, home to those and four over-the-counter medications and growing. As I look at it now, it’s doubled again and I see all my new little orange bottles standing like soldiers in a row.
The label cuddling the orange plastic of the first little orange bottle says “JEFFREY BOWMAN.” Underneath that it says “Famotodine,” followed by its dosage (20mg) and its instructions: TAKE 1 TABLET BY MOUTH TWICE A DAY. It treats my peptic ulcer disease, since my H2 Histamine receptor built up a resistance to Cimetidine, which was a predecessor to Famotodine. As it turns out, one or both can cause gynecomastia in men. Gynecomastia is generally referred to as “man boobs.” I do like breasts on women, but I’m not sure I’m ready to have a pair of my own.
These antihistamines can also cause headache, dizziness, constipation or diarrhea (again).
The next bottle says “Hydrochlorothiazide.” Underneath that it describes its dosage (50 mg) and its instructions follow (Take 1 Tablet Every Day). Hydrochlorothiazide is used to treat high blood pressure (150/90). Adverse effects felt subsequently are more complicated than others.
First is that it inhibits the kidneys’ ability to retain water. It is a diuretic, which is like a sponge but instead of staying in the sponge, water just gets pissed out all the time. Finally, some entrapment: I’ve got antihistamines that cause difficulty urinating and one pill to make it fly out of me like a broken fire hydrant.
Next is a wild rollercoaster thrill ride of levels of various elements in my body: Hypokalmeia, Hypomagnesemia, Hyperuricemia, Hyperlipidemia and Hypercalcaemia; which are low potassium, low magnesium, high uric acid, high lipids and high calcium.
That last one, Hypercalcaemia, is detected by doctors from the groans, moans, bones and stones. Groans are from constipation, meaning you sit on the toilet and groan all day. The moans are psychotic noise you make from MORE side effects (including depression, confusion and anorexia)…I think that means they’re side effects of a side effect of a side effect. Bone pain and kidney stones round out the list of hypercalcaemic adverse effects.
From that point, Hydrochlorothiazide’s side effects diminish in interest, providing us only with photosensitivity to keep us from getting bored and skimming the rest of the package. So if you see me in the streets and I’ve got a bad case of borderline-vampirism and I’m shouting insane gibberish and I look like my body is low on potassium, we all know who to blame. Blood pressure meds, I’m looking in your direction…
Hydrochlorothiazide is the second soldier in line.
The third bottle says “Sertraline.” Underneath that it describes its dosage (50mg) and its instructions follow (Take 1 Tablet Every Day). These are my little blue ovular friends who help with my depression and anxiety.
Though it may be hard to stay chipper and calm as Sertraline may cause nausea, ejaculation failure, insomnia, diarrhea (and again) and decreased libido. Apparently it’s up to you whether potentially losing the ability to chase women and ejaculate will make you less depressed than whatever was bothering you with a healthily-operating sex drive.
Finally in my platoon of little orange sense-makers is Alprazolam, bringing in the rear at 0.50mg apiece to be taken in doses of 1 or 2 pills every day (“You can do 3 or 4 if you want though,” the doctor told me) as needed for panic attacks and anxiety.
Alprazolam may cause me to feel euphoric and disinhibited accompanied with hallucinations. At long last, side effects I can live with. Sadly, this peak may be watered down by suicidal ideation, urinary retention (son of a bitch, will I ever crack the porcelain again?), decreased libido, increase in appetite and anterograde amnesia. That last one is what the guy in Christopher Nolan’s breakthough film Memento had where he couldn’t remember anything after contracting it. Alprazolam is the final soldier on the frontlines between who I am off medication who I am on medication.
The ultimate irony, then, is how healthy I was as a child and how sick I felt, as opposed to how sick I could make myself now just to feel better from other sicknesses I already have. I used to jump out of bed and go outside and play all day, and now it takes 12 pills a morning to cure a hangover, make my heart stop beating like a drum, kill my panic attacks and make my hands stop shaking.
But at least I have insurance.
