THE LYRICA CANTOS IV-VII
Another major complaint is fatigue. Some patients report that fatigue is more unbearable than their pain. Sleep disturbances, particularly restless leg syndrome, are also very common. Fatigue and sleep disturbances are almost universal in patients with fibromyalgia.
Look at the loose skin on Lyrica Lady’s long neck, the ambiguous pall in her expression. Her Botox-inflected smile hangs, restrained at the corners, too shiny. For a fleeting second I notice her sunken cheeks and a hint of sadness in the eyes—the sort of wisdom that comes from hard experience and can never be set aside. The kind of pain that locks a person in bed or on the couch for days and nights of listless, sleep deprived, confused demoralizing exhaustion. Not even dressing most of the time, turning off the phone, avoiding everyone. Hypersensitivity. Even the faint sound of her husband opening a beer in the next room rips like a thunder clap in her buzzing ears. The stifling smell of dusty carpet hangs in her nose, insidious as an overfull vacuum bag. Pain on top of pain, TV, Ambien, an aching inertia. This is what sucked the flesh from the Lyrica Lady’s face—for a flash I see naked mortality, a skull draped in pampered skin.
Available by prescription only.
Eeent, eeent, eeent.
Le Paradis n’est pas artificial
But spezzato apparently.
YouTube Kat is real. When she rolls her eyes and talks about how vitamins stink, how they would smell up her pill sorter case if she were to put them in there, you know she’s real. When she bats away tiny fruit flies while she’s testifying about muscle relaxants, you know she’s real. When she congratulates herself on catching a dropped pill before it falls to the floor, you know she’s real. Kat says “You can probably tell by looking at my eyes that I’m tired and hurting.”
Have I been fooled? As my advertisement gaze moves around I realize the Lyrica Lady is not speaking to me from her dining room. She never was. Beyond the potted plants and another red curtain I see black wrought iron chairs and tables, a narrow street meeting another at a charming intersection of street cafes. She is not in her well appointed home at all, rather the Lyrica Lady is in a neo-quaint gas lamp district where hanging plants and sunny skies are framed by two-story wrap-around terraces. A black-tie waiter walks by in the background carrying a menu, but Lyrica Lady has already ordered. Lying before her on the patio table I see a tall glass of lemonade, a sandwich paper, open, and a thick slice of bread, uneaten.
I have no will to try proof-bringing.
His fibromyalgia fixation had become an unhealthy habit, Sonny realized, instinctually closing his browser when his wife Janis entered the room.
“Lyrica again?” she asked.
A bit ashamed, Sonny answered, “I found another YouTube testifier—this one’s a real heartbreaker. She can’t even get out of bed.” He tried to emphasize his compassion, thinking it would put a better light on how he’d been spending his time. He said, “Her teenage daughter filmed it on her cell phone. It’s chilling.”
Janis set down the bag of groceries she’d brought in and she looked at him with tired disappointment. She said, “Well, do you think you could hose down the dog run? It smells awful out there and, if we’re not careful, Jack Porter will write another of his letters.” As she spoke, Sonny’s wife left the kitchen and headed for the bedroom to change before going out to pick up the girls.
He knew she was right to be disgusted. It was a filthy habit, his ghoulish hunt for YouTube testimonies of suffering, of medical humiliation. His tracking of Lyrica ads as if they held a secret code to survival. But there were, in fact, secrets. Every day Sonny found something new online, some nuance, some revelatory new swath of suffering he had never known about, subcutaneous treasures. Lyrica got people high, and so those subject to addiction should take care when using it. Lyrica was developed as a seizure control medication for epileptics, but it worked even better on fibromyalgia except sometimes there are seizures as a side effect.
Sonny opened his browser and returned to YouTube to see if there were any new postings before he stopped for the day. Just one more fast check, he told himself, then he would do something else, maybe even clean up after the dogs.
Five years. The average time required for fibromyalgia sufferers to get an accurate diagnosis is five years.
Doctor Marty is a serious man and his bearded face, his measured tone, reveal something of his compassion even as he explains himself in the cold clinical language of his specialty. Do the lines around his eyes convey his tenderness? Is it his sloppily knotted necktie? On some level, I think Doctor Marty must realize how rare his patient is, how rare the fibromyalgia sufferer who presents with visually discernable symptoms. He explains his findings to his colleagues sitting businesslike around the wedge shaped table, laptops open. “This is a 39 year-old white female who six years ago presented to me with a history of chronic back pain and longstanding fatigue which was recently getting worse. She associated this with an all-over body ache which she stated felt like being bruised all over.” He fades to a pre-recorded interview with the cheerful patient. She has blonde bangs and wears a hospital smock.
Amid her pills and bottled water, YouTube Kat keeps a special teddy bear, dressed in fatigues. It was a gift from Tom. She calls it her Tommy bear. I assume he gave it to her way back when her hair was long, when they used to sing and dance and make love like crazy. Or, maybe he gave it to her just before he shipped off for pre-deployment training camp—Tom is headed to Iraq. Since he left, Kat’s been needing to take her anti-anxiety medication daily, just to get by. She keeps her Tommy bear nearby, but not directly in her line of sight. Within arm’s reach but a little out of the way. Next to the two large bottles of B complex vitamins and ginseng.
Any beneficial effect that one might see from guaifenesin would create a high amount of optimism, since it would mean the drug is working, and that you are on your way to a recovery. Additionally, any worsening of fibromyalgia symptoms during the treatment is also a good sign, since these symptoms are attributed to guaifenesin’s reversal process that rids the body of “metabolic debris.” Thus, even feeling worse could make a person feel more optimistic.
great works by oppression
by splendid oppression
Doctor Marty’s cheerful patient with blonde bangs says “The biggest part of the pain is a burning pain. And, ah, that’s throughout my entire body, inside and out. Ah, it feels like, ah, as if you touched, ah, maybe a hot grid on a stove and peeled your skin off, with the exposed skin, um, that’s the type of burning pain it is. And then you’ve got aching on top of that.” As she speaks I notice her hair is beautiful, she has had it professionally styled for this interview, and it is an odd combination to see her with her hair made up as if for a prom or wedding, but dressed in a hospital gown. And as she speaks, I see just the tip of Doctor Marty’s nose on the edge of the shot, sometimes nodding up and down in agreement with her description. Is this amateur medical filmmaking or is his nose there intentionally, reminding me that this unnamed woman’s suffering is being managed, being documented, being treated? Before I can ponder this question too deeply, the film jump cuts from the earnest face of this gentle woman with blonde hair to a full screen close-up of her arm and hand, folded in, atrophied and deformed. A claw with fingers held stiffly apart from each other, curled in the shape of a wince.
Sonny knew he needed to break the cycle, get out of the house, get some exercise. Yet, even as he thought about bringing his bike out of the basement, he checked the clock and calculated that he’d have about a half hour to himself before Janis would get home with the girls. Time enough for a click on his YouTube fibromyalgia channels. And sure enough, once he had his bike tires pumped, and had changed out of his work clothes into shorts and sandals, he took a “fast ten minutes” to sneak a peak at the fibro blogs before heading out. When his computer hung on the Internet connection, though, Sonny took it as a sign, closed his laptop, and left on his bike.
Overhead were dark clouds with broken sunshine shouting through in patches. Remembering how to use his biking muscles, Sonny got an awkward rhythm going as he tucked into a mild uphill section of the bike path—pulling with his left leg, arms pushing down the left handle bar, pulling with the right leg, pushing down the handlebar, up with the left leg, down on the handlebar. Here and there he felt a spit of rain hit his face and arms, but Sonny didn’t mind. He was committed to the ride now, and should he return home soaked through, well at least that would give Janis something to laugh about. She would bring him a towel and tell him to get out of the wet clothes. She would actually take care of him instead of ignoring him or being disgusted by his YouTube fixation. For all of it, he felt incredibly grateful, comforted to know he had Janis to think about him when he acted foolishly, or needed a towel. Up with the left leg, down on the handlebar. Take pleasure in the small triumphs, Sonny told himself. He steered his bike off the paved path and detoured onto the riverbank trail connector. His mind wandered to thoughts of his two lovely daughters and their certain mirth were he to come home soaked through from a rainstorm—“Daddy took a shower with his clothes on!” they would say, giggling. And though the rain had stopped and he was biking in a sun patch now, Sonny still enjoyed fantasizing about how they would see him if it really happened, if he did get soaked. Up with the right. His muscles had warmed up and he was breathing regularly now, breathing hard, going quickly on the deserted trail. The only sounds were the roll of his tires on the damp grass, his steady breath, and then a magnificent flutter of swallows, barely audible, flushing from the riverbank as Sonny zipped past. Swooping and arcing in flight. Small triumphs, he told himself. Push down with the left. Savor the small triumphs.
From a different angle I see the Lyrica Lady, still sitting at the uncrowded sidewalk café, her table cleared and reset now, but up walks her man. He has Bill Clinton hair and an honest face, a small paunch shows beneath his blue dress shirt, casually untucked and unbuttoned at the top. His body language says vacation, says the bill has been paid, says full days and nights of togetherness and shopping. The woman rises from her chair as he approaches, and though I look on from a distance there is no evidence of pain. She neither winces nor clutches the table for support. It’s because she’s comfortable that she’s smiling.
yr/ humanity counterfeit
yr/ liberty cankered with simulation
Various vegetative and functional disorders, nonrestorative sleep, depression and anxiety. Etiology and pathogenesis of fibromyalgia still remain unclear. Current pathogenetic theories conceptualize a combination of biological and psychic, social and mental factors. Diagnosis is based on the characteristic clinical presentation, the presence of multiple tender points and the exclusion of certain disorders with similar symptoms. Laboratory examinations and imaging only provide nonconclusive results. Medication and physical therapies only accomplish some temporary symptomatic relief (30-50%). Psychosomatic rehabilitation should not focus on reduction of pain, but rather on physical reconditioning and development of an active coping style.
You should not drive or operate machinery until you know how Lyrica affects you. Mens sine affectu.
YouTube Kat has been posting her life online for some time, a few years. I see her in earlier days looking cute with long light brown hair, posting videos about all sorts of subjects, lots of performances by her and Tommy’s band. In more recent posts she sports her new short haircut, dyed black, a bad choice to go with Lyrica’s weight-gain side effect. She is not fat, but her face looks puffy today even if she has only been taking Lyrica for a month. Seeing the demise of Kat, her developing fixation on her meds and fibromyalgia is something that resonates for me. I expect spectacle on YouTube, yes, but a real person going through real transformation, visible weight changes, giving me a tour of her outsized medicine cabinet? Sharing with me the details of her digestion, her sleep, her worries, her nasal congestion, her pain, her invisible pain? It’s a riveting and guilty spectacle. In a world of virtual suffering, the YouTube fibro testomonials, these amateur digital scenes, these are the low-fi readymades of the Internet. Authentic suffering without the reality show host, without the theme songs, without knee sprains of the stars, without the judges and call-in votes.
Some of the most common side effects of Lyrica are dizziness, sleepiness, weight gain, and swelling of hands and feet. By splendid oppression.
Sonny reached a state of relaxed thoughtlessness, noticing things outside his body as he huffed along the path. The electric green fields in early spring, popping with bright clover, crisp dark edges of clouds against patches of brilliant blue sunshine. A cottontail scampered across the path and then darted into the bushes. For some blissful minutes on his bike ride, Sonny forgot about his body, his thoughts, his fixations. He forgot everything he knew about medical experimentation and cash cow surgeries, he forgot about ADD hyper-activity, bipolar disorder, generalized anxiety, and sleep disorders. Then Sonny reached a place on the trail where the center was chained off to keep cars out. To keep going he’d have to get off his bike or go around on the shoulder. Sonny really didn’t want to get off his bike and lift it over the chain, so he rode around. But the shoulder was too narrow and as Sonny lost his balance he fell in the worst direction, down the side of the riverbank, his bike flipping over him as he tumbled with one foot stuck in the pedal toe strap. It hurt when his shoulder blade thudded against a thick stump and his forearm cracked against the ground. When his tumble was over Sonny got disentangled from his bike, shuffled for stable footing, and stood up.
He was dizzy but except for some road rash on his leg and lower back, and a torn sandal, Sonny had survived the fall without visible damage, especially without a cracked head. Janis would kill him, he thought, were he to get a head injury while his helmet hung unused in the basement. The likely bruises on his back and limbs would be pretty telling as it was, he thought. Who knew if his flaming shoulder blade, and the ache in his lumbar vertebrae would hobble him tomorrow.
He mounted his bike to start the slow ride home but then discovered his rear tire had been flattened in the fall. Without a patch or a pump on hand, Sonny began the long push home. He walked wearing one sandal, with the broken one sticking out his back pocket, dangling the torn strap. The unevenness put a mild limp in his gait as he pushed his bike along. And when the clouds slipped from in front of the sun, Sonny saw for a fleeting few minutes a scrap of rainbow above the small wood. He turned away from the river and pushed back towards the paved path. Soon the sky got darker, and rain began again spitting down in heavy irregular drops.
With her face very close to her webcam, and her eyes looking drowsy but her lips decked out in fresh red lipstick, Rachel Russell says, “It feels like I’ve been beaten from the inside a lot of times. My medications do help numb the pain. It’s difficult to continue to get them—a lot of times the doctors are afraid they will cause me to be drowsy, but honestly I’d rather kill myself than be in the pain of my fibromyalgia because it is, it feels like you have done, bench-pressed a thousand pounds and you’ve pulled every muscle in your body. Especially your hamstrings, your biceps ugh, your calves, it hurts. Fibromyalgia day is coming up, it’s Saturday, May 12, the day before Mothers Day. I encourage you to wear purple.”
that you might understand it
that it be brought to consideration with certain details
discussed first orally and then put into writing
(See our ad in Redbook.)
Fibromyalgia may be impossible to detect in laboratories or on radiology film, but Doctor Marty’s blonde patient’s deformed limb, disfigured by pain, tells the story in terms that cannot be ignored. Her whole forearm, wrist and hand have atrophied into a curled claw, her pinky finger errantly crooked away from the rest of the hand, the index finger limp but not curled, the middle finger bent in. Each digit held in an unnatural position so as to avoid rubbing against the digit next to it. The cheerful blonde woman with bangs explains, “Anytime you touch it, it increases the pain. And, ah, the only thing I usually rest it on is I have satin pillowcases. When I put my hand down I rest it on my fingernails so that virtually none of my skin usually touches anything.”
If we never write anything save what is already understood
Quel che voglio io, tu vuoi?
I walked right in and asked my doctor about Lyrica. Lyrica is the number one prescribed treatment for fibromyalgia pain. (Individual results may vary.) And it’s not an antidepressant. Studies show Lyrica provides significant muscle pain relief in as early as one week for some patients. And with less pain, I know today’s going to be a better day.
(Including swelling of the face, mouth, lips, gums, tongue or neck.)
hast thou respite for a little,
By Molü art thou freed from the one bed
that thou may’st return to another.
Sonny lay prone on the bedsheet while Janis changed the dressing on his back, and rubbed arnica on his bruises. “I’m really serious,” she said, “You’ll keep your word, and start wearing your helmet?” She patted his butt to signify she was done covering his wounds.
Sonny rolled over and tried not to grimace in pain. He wanted Janice to see his face, to see how desperately he needed her, how grateful he was for her care and love. “It’s gonna be awhile before I can ride anything, and my bike’s got a flat, but, yes, when I ride again I will wear the helmet,” he said, making a small bow of defeat with his head, and feeling a little embarrassed at having gotten so thrashed. “Thank you for taking care of me, Jan,” he added.
It wasn’t until now, lying here in steady pain, that Sonny realized just how much he had withdrawn from Janis and she from him, how their flat romance had become the status quo. How that flatness oozed from the bedroom and infected the rest of their home. Meals were perfunctory. Expedient. Cleaning and bill-paying and other chores were divided but the two of them rarely even sat together in the same room anymore, except to focus on the girls. Full of Tylenol and with a heating pad on his pulled shoulder, an ice pack on his leg, Sonny understood now that his biking accident had brought him back to Janis in a physical way. There was affection in the way she was taking care of him. And later when she brought him some tea, she kissed his head. She didn’t have to do that. It wasn’t romantic or sexual, but it was warm. In his bedridden soreness and stiffness, Sonny felt better than he had in a long time.
Notes for Canto IV
stanza 1: quoted from A.D.A.M. Inc. “Fibromyalgia In-Depth Report.” New York Times. 2008. Web. 9 March 2009.
stanza 2: based on Pfizer. “Product Centers: LYRICA Fibromyalgia TV Commercial.” Advertisement. Pfizer for Professionals. Web. 10 Feb. 2009. https://www.pfizerpro.com/patient_education/lyrica_tv_ad.jsp.
stanza 3: “Available by prescription only.” quoted from Pfizer. Lyrica. Advertisement. CBS, WSHM, Springfield. 10 Feb. 2009. Television; and Pfizer’s Web ad for Lyrica. Ibid.
stanza 4: “Eeent, eeent, eeent.” Quoted from Wolf, Diana C. “Fibromyalgia Coffee Break- Early Mornings, Cymbalta Withdrawal, Ugggh!” Videos from Diana, Jovani and Alex. YouTube. 8 June 2007. Web. 24 Feb. 2009.
stanza 5: “Le Paradis . . . apparently.” quoted from Pound, Ezra. Canto LXXIV. The Cantos of Ezra Pound. New York: New Directions, 1993. Translations: Le Paradis n’est pas artificial [French, “Paradise is not artificial”]; spezzato [Italian, “broken”]. Translation references 1. Terrell, Carroll F. A Companion to the Cantos of Ezra Pound. Vol. I & II. Berkeley: California, 1980; 2. Edwards, John Hamilton, and Willliam W. Vasse. Annotated Index to the Cantos of Ezra Pound. Berkeley: California, 1957.
stanza 6: based on based on Katatawnic. “(2/3) More Drugs; Intro to How Lyrica Has Changed My Life.” Katatawnic’s Kraziness. YouTube. 23 July 2008. Web. 19 Feb 2009; and direct quote from Katatawnic. “Why Some Labels are Necessary.” Katatawnic’s Kraziness. YouTube. 22 April 2008. Web. 31 May 2011.
stanza 7: based on Pfizer (Web). Ibid.
stanza 8: quoted from Pound, Canto XXXVI. Ibid.
Notes for Canto V
stanza 1: quoted from Daniel Clauw, MD in UCSD/CMA Pain Management Program. “Fibromyalgia.” YouTube. 13 July 2004. Web. 25 Feb. 2009.
stanza 2: based on UCSD. Ibid., and including a direct quote from Martin Shullman, MD.
stanza 3: based on Katatonic. “(2/3) More Drugs.” Ibid.
stanza 4: quoted from Mark London. The Truths and Myths of the Use of Guaifenesin for Fibromyalgia, or, Guaifenesin: One Medicine, Several Effects. 23 Oct. 2008. Web. 9 March 2009. <http://stuff.mit.edu/people/london/guai.html>.
stanza 5: quoted from Pound, Canto LIV. Ibid.
stanza 6: based on UCSD. Ibid., and including a direct quote from Dr. Shullman’s Anonymous Patient with Blonde Bangs.
stanza 7: quoted from Diana C. Wolf. ibid.
Notes for Canto VI
stanza 1: based on Pfizer (Web). Ibid.
stanza 2: quoted from Pound, Canto LXVI. Ibid.
stanza 3: quoted from Fürst, Gerard. “Fibromyalgia—A Challenge For Interdisciplinary Management.” Abstract. PubMed. 2007. Web. 11 March 2009.
stanza 4: “You should not […] Lyrica affects you.” quoted from Pfizer (Web and CBS). Ibid.; “mens sine affectu.” quoted from Pound, Canto LXII. Ibid. Translation: [Latin, “a mind without feeling [passion]”]. References: Terrell, Edwards and Vasse. Ibid.
stanza 5: based on Katatawnic. “(2/3) More Drugs.” Ibid.
stanza 6: “Some of the most common side effects […] swelling of hands and feet.“ quoted from Pfizer (Web and CBS). Ibid; “By splendid oppression.” Pound, Canto LIV. Ibid.
Notes for Canto VII
stanza 1: quoted from Russell, Rachel. Fibromyalgia and Disability Awareness. YouTube. 11 May 2007. Web. 12 March 2009.
stanza 2: “That you might understand it […] put into writing.” quoted from Pound, Canto XLII. Ibid.; “(See our ad in Redbook).” Quoted from Pfizer ads (both) for Lyrica. Ibid.
stanza 3: based on and quoted from Martin Shullman, MD’s Anonymous Patient with Blonde Bangs (UCSD). Ibid.
stanza 4: “If we never […] what is understood.” quoted from Pound, Canto XCVI. “Quel che voglio […] Tu vuoi.” Pound, Canto XCVII. Translation: Quel che voglio io, tu vuoi? / Tu vuoi. [Italian, “What I want, do you want too? / You want it.”]. References: Terrell, Edwards and Vasse. Ibid.
stanza 5: quoted from Pfizer (CBS). Ibid.
stanza 6: quoted from Pfizer ads (both) for Lyrica. Ibid.
stanza 7: quoted from Pound, Canto XLVII. Ibid.
Michael Filas teaches fiction writing and literature at Westfield State University in Massachusetts. He has published fiction and criticism in journals such as Fiction International, Paradoxa, Review of Experimental Fiction, and Left Curve, among others. He currently serves as Review Editor for the journal The Information Society.