I spoke to a patient yesterday and was just blown away by some of the history we have in our facility. My PT told me how Z. had been a POW in Germany and then queried me as to how I thought Z.'s legs got messed up. I had no idea, but then was informed that the Nazis flooded the mining camp and broke Z.'s leg. It was never fixed, because Nazis have no hearts. Z. was set to be hanged on Easter Sunday, but was able to escape and made way for Canada.
It's incredible that I can be privy to this kind of thing. Z.'s really an easygoing person, which is amazing after going through so much. Z. answers everything with, "Yes, thank you very much!", and only complains of shoulder pain every so often, but otherwise is just an incredible individual.
It's nice to know that even after pain and suffering there is solace in a positive attitude and an embracing of life.
Showing posts with label physiotherapy. Show all posts
Showing posts with label physiotherapy. Show all posts
5.05.2010
4.28.2010
physio pt. I
Last Friday I was involved in a fender bender in which I was sandwiched between two cars. As a result, I've been feeling some lumbar and cervical spine stiffness, and booked in for physiotherapy today.
I have to say it's weird being on the other side. I had remembered how annoying MVAs were what with all the paperwork, so I made sure to fill out my AB-1 and AB-2 forms as best as I could. When I got there, the receptionists were confused: "You're literally the first person I've seen that's filled everything out." I told them I used to work behind the desk. It's weird and almost a little bit ironic - I never thought I'd need physio or be filling out my own informed consent form, but there I was doing what I'd told so many other people to do.
My physiotherapist, K. actually graduated last year from the U of A program, so we had a chat about all the profs and their approaches to therapy. It was kind of refreshing to speak to someone who had already finished the program and was practicing - it was kind of the light at the end of this endless scholastic tunnel, that there really is a career waiting for us. We discussed the merits of challenging Level 1s quickly and obtaining acupuncture in second year - apparently the benefits of knowing trigger points and basic techniques facilitates the education process greatly. Tips and tricks and words of wisdom from the ex-student.
Physios hate it when physios are their patients because it becomes immediately obvious when they're doing something wrong. It becomes quickly apparent that in the real world, we are forced to skip many steps - whether it's out of time constraints or just because they're more focused and know what they're looking for is beyond me (likely a bit of both). K. was extremely nervous throughout the entire process, giving the disclaimer "I should probably do it this way..." the entire time. Regardless, it was interesting to see how proficient you get at the whole process, even though some things get left out.
During the observation, K. noted bilateral muscle wasting in my lumbar spine, which took me by surprise. Atrophy happens pretty quickly after injury (case in point) but I didn't think it would be so obvious in me. Unfortunately, I can't really see my back on a regular basis so it never became apparent to me. During the scan she found right-sided C5 myotome weakness, but I'm not sure what she recorded with regards to AROM/PROM/RI. I received the straight leg raise for the special test, and the majority of the time was spent on joint play in both C-spine and L-spine as well as with palpation for trigger points. In the end, I was diagnosed with L1/2 hypomobility and L3/4/5 hypermobility, likely due to ligamentous strain, with quadratus lumborum tightness due to overcompensation. I also had unilateral levator scapula tightness trying to stabilize for upper C-spine hypomobility.
I was placed on heat and given TENS, but for some reason - my guess is nerve irritability - the TENS would cause tingling down my L4/L5 dermatomal distribution. During this period K. performed myofascial release at different trigger points to loosen up some of the suboccipital muscles preventing me from full side flexion and rotation, the actions that were most limited for me during AROM. I was prescribed with stretches for lev. scap and upper trapezius (side flexion, side flexion /w flexion), as well as stretches for my paraspinal muscles (tucking knees into chest in full hip flexion) and my quadratus lumborum (L-spine rotation essentially). We remarked that the levator scapula and the quadratus lumborum have a tendency to be extremely tight following injury, but that we never learn much about them in class, which makes treating it kind of a guessing game. At the end, I was given a hot pack to take home and throw in the microwave, but I don't really believe in superficial heating so I just warmed it up for Mag's feet which are perpetually cold.
I think it's really interesting to receive physio. Everything seems so simple in classroom, but in application to injury everything is surprisingly helpful. My neck is incredibly limber, and even that little bit of release makes a crazy difference. Even though my back hasn't changed much, I greatly look forward to the next few weeks of treatment. I think it changes your perspective on your profession when you actually experience what you do, and despite having a mangled car and some soft tissue injuries, I'm really glad for this opportunity. I don't like how I got there, but I'll take it for what it is - an exercise (pun!) in enlightenment.
I have to say it's weird being on the other side. I had remembered how annoying MVAs were what with all the paperwork, so I made sure to fill out my AB-1 and AB-2 forms as best as I could. When I got there, the receptionists were confused: "You're literally the first person I've seen that's filled everything out." I told them I used to work behind the desk. It's weird and almost a little bit ironic - I never thought I'd need physio or be filling out my own informed consent form, but there I was doing what I'd told so many other people to do.
My physiotherapist, K. actually graduated last year from the U of A program, so we had a chat about all the profs and their approaches to therapy. It was kind of refreshing to speak to someone who had already finished the program and was practicing - it was kind of the light at the end of this endless scholastic tunnel, that there really is a career waiting for us. We discussed the merits of challenging Level 1s quickly and obtaining acupuncture in second year - apparently the benefits of knowing trigger points and basic techniques facilitates the education process greatly. Tips and tricks and words of wisdom from the ex-student.
Physios hate it when physios are their patients because it becomes immediately obvious when they're doing something wrong. It becomes quickly apparent that in the real world, we are forced to skip many steps - whether it's out of time constraints or just because they're more focused and know what they're looking for is beyond me (likely a bit of both). K. was extremely nervous throughout the entire process, giving the disclaimer "I should probably do it this way..." the entire time. Regardless, it was interesting to see how proficient you get at the whole process, even though some things get left out.
During the observation, K. noted bilateral muscle wasting in my lumbar spine, which took me by surprise. Atrophy happens pretty quickly after injury (case in point) but I didn't think it would be so obvious in me. Unfortunately, I can't really see my back on a regular basis so it never became apparent to me. During the scan she found right-sided C5 myotome weakness, but I'm not sure what she recorded with regards to AROM/PROM/RI. I received the straight leg raise for the special test, and the majority of the time was spent on joint play in both C-spine and L-spine as well as with palpation for trigger points. In the end, I was diagnosed with L1/2 hypomobility and L3/4/5 hypermobility, likely due to ligamentous strain, with quadratus lumborum tightness due to overcompensation. I also had unilateral levator scapula tightness trying to stabilize for upper C-spine hypomobility.
I was placed on heat and given TENS, but for some reason - my guess is nerve irritability - the TENS would cause tingling down my L4/L5 dermatomal distribution. During this period K. performed myofascial release at different trigger points to loosen up some of the suboccipital muscles preventing me from full side flexion and rotation, the actions that were most limited for me during AROM. I was prescribed with stretches for lev. scap and upper trapezius (side flexion, side flexion /w flexion), as well as stretches for my paraspinal muscles (tucking knees into chest in full hip flexion) and my quadratus lumborum (L-spine rotation essentially). We remarked that the levator scapula and the quadratus lumborum have a tendency to be extremely tight following injury, but that we never learn much about them in class, which makes treating it kind of a guessing game. At the end, I was given a hot pack to take home and throw in the microwave, but I don't really believe in superficial heating so I just warmed it up for Mag's feet which are perpetually cold.
I think it's really interesting to receive physio. Everything seems so simple in classroom, but in application to injury everything is surprisingly helpful. My neck is incredibly limber, and even that little bit of release makes a crazy difference. Even though my back hasn't changed much, I greatly look forward to the next few weeks of treatment. I think it changes your perspective on your profession when you actually experience what you do, and despite having a mangled car and some soft tissue injuries, I'm really glad for this opportunity. I don't like how I got there, but I'll take it for what it is - an exercise (pun!) in enlightenment.
3.07.2010
dx/impressions
Two weeks ago in seminar, we were presented with a case about a patient who had fallen from his ladder while doing some roofing. We were given all the information about him: His objective history, observation, examination results, etc. We were told to, as a group, come up with a single diagnosis and be prepared to present it to the class.
While each group came up with their own suspicion as to what it was, we decided on a secondary supraspinatus strain/tear (semantics) with an underlying supraspinatus tendinopathy. We went back to class and convened for what we thought was large group discussion.
Little did we know, our prof had organized a debate - each two teams would select a representative to speak on behalf of their group and present their case as to why they thought their dx was correct. Our chosen member was Stephen, who bravely went in the hot seat and debated his case according to the findings outlined in the case. He then had to brave the heated questioning of the judges, which included, "If the supraspinatus is your tissue injured, why then is external rotation and internal rotation limited if it only does abduction?" He courageously answered, "Because as the supraspinatus lifts the arm, it also acts to stabilize the humeral head from riding up into the acromion. When the stabilizer fails to act, the entire rotator cuff will behave abnormally and cause an impingement syndrome for which he was already susceptible for with his poor posture and underlying supraspinatus tendinopathy." The entire class whistled - what an answer!
After the entire class had gone through their respective rounds, our instructor Judy gathered us together to give us that one last pep talk. She wanted us to do this exercise because diagnosis is incredibly important - this is what we are doing. She made the distinction that what we did before this program was make impressions - based on our knowledge of physiology, microbiology, anatomy, etc., all we knew how to do was form an idea of what was wrong based on what we were presented with. To make a diagnosis is to make a decision. Here we stand by what we believe is the pathology, and we must be ready to debate our case with client, colleague, lawyer. Diagnosis is the starting point for treatment.
It was at that moment that I felt that what we were doing in this program was no longer trivial manual muscle testing out of a workbook, but that this was real. We will have real patients with real issues, and we will have to take our impressions and form real diagnoses for treatment. People's lives are in our hands.
While each group came up with their own suspicion as to what it was, we decided on a secondary supraspinatus strain/tear (semantics) with an underlying supraspinatus tendinopathy. We went back to class and convened for what we thought was large group discussion.
Little did we know, our prof had organized a debate - each two teams would select a representative to speak on behalf of their group and present their case as to why they thought their dx was correct. Our chosen member was Stephen, who bravely went in the hot seat and debated his case according to the findings outlined in the case. He then had to brave the heated questioning of the judges, which included, "If the supraspinatus is your tissue injured, why then is external rotation and internal rotation limited if it only does abduction?" He courageously answered, "Because as the supraspinatus lifts the arm, it also acts to stabilize the humeral head from riding up into the acromion. When the stabilizer fails to act, the entire rotator cuff will behave abnormally and cause an impingement syndrome for which he was already susceptible for with his poor posture and underlying supraspinatus tendinopathy." The entire class whistled - what an answer!
After the entire class had gone through their respective rounds, our instructor Judy gathered us together to give us that one last pep talk. She wanted us to do this exercise because diagnosis is incredibly important - this is what we are doing. She made the distinction that what we did before this program was make impressions - based on our knowledge of physiology, microbiology, anatomy, etc., all we knew how to do was form an idea of what was wrong based on what we were presented with. To make a diagnosis is to make a decision. Here we stand by what we believe is the pathology, and we must be ready to debate our case with client, colleague, lawyer. Diagnosis is the starting point for treatment.
It was at that moment that I felt that what we were doing in this program was no longer trivial manual muscle testing out of a workbook, but that this was real. We will have real patients with real issues, and we will have to take our impressions and form real diagnoses for treatment. People's lives are in our hands.
12.11.2009
dreams
I am in danger when I begin dreaming physio. Last night went as follows:
I was driving in traffic when in front of me this tow truck gets T-boned turning left at an intersection and it catches on fire. I hear the driver yelling, "Move away move away it's going to explode!" and yet I still drive on through. The tow truck explodes and I have lacerations and burns to my hands that are just starting to sting really bad - I actually felt sharp pain in my dream so I was convinced this was real! Paramedics cleaned my wounds up and then some sort of physician said he was going to cast me up.
I turned to him and said, "Please leave room for my fingers to move so that I can keep the range in my hand."
It's like I'm at work when I'm sleeping. This is brutal.
I was driving in traffic when in front of me this tow truck gets T-boned turning left at an intersection and it catches on fire. I hear the driver yelling, "Move away move away it's going to explode!" and yet I still drive on through. The tow truck explodes and I have lacerations and burns to my hands that are just starting to sting really bad - I actually felt sharp pain in my dream so I was convinced this was real! Paramedics cleaned my wounds up and then some sort of physician said he was going to cast me up.
I turned to him and said, "Please leave room for my fingers to move so that I can keep the range in my hand."
It's like I'm at work when I'm sleeping. This is brutal.
12.10.2009
day last
Sorry I've been so busy. I've been posting on the PT discussion board rather than on here. I'll have something up real soon.
12.07.2009
day one
palpate ventriculoperitoneal shunt. inhibit student reflexes. score BERG in <8 min. ambulate patients alone. observe student doctors cower in fear from their supervising physicians in rounds. paraphasia. patient describes leg as a 'peg' due to impaired sensation and proprioception. donepezil. BAKING COOKIES TOMORROW WITH OT. presence of neuropsychologist and recreation therapist. resident failing miserably at social skills with patient and staff. how different OT and PT goals are. GOING SWIMMING WITH PATIENT TOMORROW. neuroplasticity - temperature sensations to the hand would also be felt in his lips (think: homunculus). how PTs are known to be hardasses. Takayasu's Arteritis. how Dutch people love to talk, even with aphasia.
HOW AWESOME PLACEMENT IS.
HOW AWESOME PLACEMENT IS.
11.05.2009
ortho
Performed my first pseudo ortho/sports injury case today - haha actually more like an impromptu therapeutic session. I doubt I'll end up in ortho, but it's interesting to diversify from the neuro I am so used to loving. It's fun because friends now go, "Can you help me with _____?" and I respond, "Not really, but I'll take a look at it." It's exciting to have the added responsibility of going through a differential diagnosis like Gregory House does. It's also nice to do the practical application of classroom to the real world.
My friend experienced an anterior shoulder subluxation in May, which means his arm bone popped out of the shoulder socket and then back in. P. went to see a doctor, who said he most likely had a shoulder dislocation, which helped in my diagnosis (history!). I assessed his range of motion (ROM) in shoulder flexion, shoulder abduction, and shoulder extension, noting that he liked to cheat with his shoulder extension and abduct his arm slightly (limited shoulder extension). I also tested his horizontal external rotation and external shoulder rotation in the scapular plane and found ROM to be extremely limited for both.
I got empty end feels for external rotation and shoulder extension. Anterior subluxes are one of the most common types of shoulder injuries and typically impinge on the two ligaments that cross the joint anteriorly. Ligaments heal slowly so stretching the capsule gently and letting it heal naturally were both on my mind. Additionally, P. had difficulties resisting movements when I was doing some improvised manual muscle tests, I'd grade him probably a 4. Based on what I found, I figured the best course of treatment would be to strengthen the muscles performing external rotation and extension about the shoulder - infraspinatus and teres minor (not supraspinatus since his abduction was absolutely normal).
I proposed simple Therex:
"1. Apply heat to warm the infraspinatus and teres minor (back of scapula).
2. Perform shoulder shrugs just to loosen the muscles.
3. Find a door frame. Keeping your arms at your sides, bend the elbow to 90 degrees - you should look like you're trying to shake someone's hand but your arm is bent. Using the door frame to stop your hand, turn your body so that your arm rotates out, like the resistance I was applying to you today. Don't stress it too hard.
4. Lie down on your back on a bed or couch with your elbow hanging off the edge of the bed/couch. You want to start in a position like you're sitting in an armchair but on your back. Let gravity drop your arm backward, think of the motion you need to pull back your arm to spike a volleyball and that's the direction you want your arm to fall in. When that's too easy, put an object in your hand and repeat the exercise, increasing the weight of the object to your preference.
5. Lie on your front with your whole arm hanging off the edge of the couch/bed. Hold a light object in your hand and keeping your arm absolutely straight, extend your arm backwards - the action you want to do is like if you were starting to scratch the center of your back without bending at the elbow - arm extension and adduction. You like to cheat and abduct your arm away from your body when you perform shoulder extension so try to really bring your arm into midline when you do it.
I think those will address your primary concerns, remember to not stress it too hard and give it time to heal. Anterior subluxes commonly lead to dislocations."
I think P. is going to see an actual physiotherapist, and I'll check up with him to see if our answers correlate. This is really exciting that I'm already starting to be able to apply what I'm learning, even if I'm grossly untrained and underqualified to be doing this. I'm actually having fun in my program for once.
My friend experienced an anterior shoulder subluxation in May, which means his arm bone popped out of the shoulder socket and then back in. P. went to see a doctor, who said he most likely had a shoulder dislocation, which helped in my diagnosis (history!). I assessed his range of motion (ROM) in shoulder flexion, shoulder abduction, and shoulder extension, noting that he liked to cheat with his shoulder extension and abduct his arm slightly (limited shoulder extension). I also tested his horizontal external rotation and external shoulder rotation in the scapular plane and found ROM to be extremely limited for both.
I got empty end feels for external rotation and shoulder extension. Anterior subluxes are one of the most common types of shoulder injuries and typically impinge on the two ligaments that cross the joint anteriorly. Ligaments heal slowly so stretching the capsule gently and letting it heal naturally were both on my mind. Additionally, P. had difficulties resisting movements when I was doing some improvised manual muscle tests, I'd grade him probably a 4. Based on what I found, I figured the best course of treatment would be to strengthen the muscles performing external rotation and extension about the shoulder - infraspinatus and teres minor (not supraspinatus since his abduction was absolutely normal).
I proposed simple Therex:
"1. Apply heat to warm the infraspinatus and teres minor (back of scapula).
2. Perform shoulder shrugs just to loosen the muscles.
3. Find a door frame. Keeping your arms at your sides, bend the elbow to 90 degrees - you should look like you're trying to shake someone's hand but your arm is bent. Using the door frame to stop your hand, turn your body so that your arm rotates out, like the resistance I was applying to you today. Don't stress it too hard.
4. Lie down on your back on a bed or couch with your elbow hanging off the edge of the bed/couch. You want to start in a position like you're sitting in an armchair but on your back. Let gravity drop your arm backward, think of the motion you need to pull back your arm to spike a volleyball and that's the direction you want your arm to fall in. When that's too easy, put an object in your hand and repeat the exercise, increasing the weight of the object to your preference.
5. Lie on your front with your whole arm hanging off the edge of the couch/bed. Hold a light object in your hand and keeping your arm absolutely straight, extend your arm backwards - the action you want to do is like if you were starting to scratch the center of your back without bending at the elbow - arm extension and adduction. You like to cheat and abduct your arm away from your body when you perform shoulder extension so try to really bring your arm into midline when you do it.
I think those will address your primary concerns, remember to not stress it too hard and give it time to heal. Anterior subluxes commonly lead to dislocations."
I think P. is going to see an actual physiotherapist, and I'll check up with him to see if our answers correlate. This is really exciting that I'm already starting to be able to apply what I'm learning, even if I'm grossly untrained and underqualified to be doing this. I'm actually having fun in my program for once.
10.27.2009
sigh
The world falls apart, slowly but surely. I know it's really lame, emo and cliché to blog about how depressed you are, but it's a little hard not to be down. I cursed PT today and really reflected hard about why the heck I was in this program. It took every ounce of will I had in my tired, tired body to come to school for 8 AM this morning. Why should I be up till 2 AM working on a 20% project that's due in the next day when it is supposed to be an "in-class assignment"? I stormed out of anatomy lab today because I knew nothing, picked up a soy caramel macchiato and felt a little bit better.
On another note, the CBC Literary Awards deadline is coming up, and I still have nothing left to submit. Last year I put through a short story about an obese girl with a ventromedial hypothalamic lesion but didn't make the short list. I was hoping to enter something this year but nothing I write is within the 2000-2500 word range...more like the 100-200 word range. I mean first prize is $6000, and that money could be going towards my wedding...
I wish I had more time.
This really sucks.
At least the good thing about being down is that you resort to the habits that pick you up. I did a project last year on music and motor control (sensorimotor integration) but one thing I read about a lot in the literature was sensoriaffective integration, that is that music is able to easily influence your emotional centers. Whether or not there is an auditory cortex connection with the amygdala and other limbic structures matters not (there are...) - it's the phenotype that I really care about on a day-to-day basis, because the moment you get sad you look for a pick me up.
When I feel stupid I listen to Regina Spektor and Sarah Slean. When I feel cool I listen to Cool Calm Pete, Lupe Fiasco, and The Cool Kids. When I feel hipster I listen to Emily Haines, Metric, Kate Havenevik, Priscilla Ahn. When I feel old school I always listen to Nas' Illmatic. When I study I listen to Imogen Heap. Today, I listened to Radiohead and Metallica because I was angry and needed motivation to not be down.
So in the words of James Hetfield:
These days drift on
Inside a fog
It's thick and suffocating
His sinking life
Outside it's hell
Inside, intoxicating
He's run aground
Like his life
Water much too shallow
Slipping fast
Down with his ship
Fading in the shadows
-Metallica(The Unforgiven III)
On another note, the CBC Literary Awards deadline is coming up, and I still have nothing left to submit. Last year I put through a short story about an obese girl with a ventromedial hypothalamic lesion but didn't make the short list. I was hoping to enter something this year but nothing I write is within the 2000-2500 word range...more like the 100-200 word range. I mean first prize is $6000, and that money could be going towards my wedding...
I wish I had more time.
This really sucks.
At least the good thing about being down is that you resort to the habits that pick you up. I did a project last year on music and motor control (sensorimotor integration) but one thing I read about a lot in the literature was sensoriaffective integration, that is that music is able to easily influence your emotional centers. Whether or not there is an auditory cortex connection with the amygdala and other limbic structures matters not (there are...) - it's the phenotype that I really care about on a day-to-day basis, because the moment you get sad you look for a pick me up.
When I feel stupid I listen to Regina Spektor and Sarah Slean. When I feel cool I listen to Cool Calm Pete, Lupe Fiasco, and The Cool Kids. When I feel hipster I listen to Emily Haines, Metric, Kate Havenevik, Priscilla Ahn. When I feel old school I always listen to Nas' Illmatic. When I study I listen to Imogen Heap. Today, I listened to Radiohead and Metallica because I was angry and needed motivation to not be down.
So in the words of James Hetfield:
These days drift on
Inside a fog
It's thick and suffocating
His sinking life
Outside it's hell
Inside, intoxicating
He's run aground
Like his life
Water much too shallow
Slipping fast
Down with his ship
Fading in the shadows
-Metallica(The Unforgiven III)
9.11.2009
sharpie
I love the many ways you can easily identify PT students. A good sign is a green Rehab Med lanyard hanging out of their back pocket just waiting to be commented on. Another one is that PT students are always carrying around a box of bones for at least the next two weeks. We have open bone labs, so you'll see us lugging around either a rectangular clear plastic bin with a number written on top or a rectangular ghetto cardboard box with a number on top. It's quite easy to spot actually. More signs include that PT students palpate themselves on the bus 95% more often than the general public, especially if they're reviewing lecture notes. Then might even lift their arm up randomly and poke at their armpit, but don't worry they're not looking to surface palpate the inferior aspect of the head of the humerus, their armpit is just itchy. This one's time limited, but PT students just recently had a biomechanics lab, and as such, were required to identify some structures and draw the axes of rotation of major joints with a permanent marker. If you were looking at a student and you see a dot right in the center between their collarbones, that's a PT student. If you're like my doctor who was examining three blue moles on my left hand, don't worry it's not melanoma, you just have to finish my health assessment because I'm a PT student.
So on the topic of permanent markers, Cool Calm Pete has this epic line in his song Lost which goes: "It's like you write with a Sharpie / you made a fine point". I'm not sure why that line is so etched into my mind right now, but every time I hear it I get excited. I just think it's really clever, that's all.
Tangential offshoot of our discussion together: I think that if there was a drug category I could get addicted to real easily, it would be opiates. I find my mood of the day is largely dependent on whether or not I get an endorphin rush from my run, and I'm wondering if this is an addiction type thing to the feel-good ways of endogenous opiates. They probably don't act in the exact same manner, but I'm speculating that there'd be some transferability in the results and their addictive potential.
I hate to say something really lame like this, but I feel more and more like Henry as the days go by. I run every morning, I feel older than everyone else, and as he says to Ben, "I like opiates." I often think Henry is my escape when I'm not interested in being myself, just because he's so darn complex and so incredibly cool.
Food for thought: When I'm chasing Henry, am I running towards a tangible goal or am I running away from myself?
So on the topic of permanent markers, Cool Calm Pete has this epic line in his song Lost which goes: "It's like you write with a Sharpie / you made a fine point". I'm not sure why that line is so etched into my mind right now, but every time I hear it I get excited. I just think it's really clever, that's all.
Tangential offshoot of our discussion together: I think that if there was a drug category I could get addicted to real easily, it would be opiates. I find my mood of the day is largely dependent on whether or not I get an endorphin rush from my run, and I'm wondering if this is an addiction type thing to the feel-good ways of endogenous opiates. They probably don't act in the exact same manner, but I'm speculating that there'd be some transferability in the results and their addictive potential.
I hate to say something really lame like this, but I feel more and more like Henry as the days go by. I run every morning, I feel older than everyone else, and as he says to Ben, "I like opiates." I often think Henry is my escape when I'm not interested in being myself, just because he's so darn complex and so incredibly cool.
Food for thought: When I'm chasing Henry, am I running towards a tangible goal or am I running away from myself?
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