Brother-in-Log Day 9

After Brother went into liver failure and they sent him to Vanderbilt, he was put on a high protein low sodium diet. He is on a fluid restriction. He is on a handful of vitamins 3 times a day and that is just so he doesn’t die on our couch. In order to get on the liver transplant list, which is what Vanderbilt says he needs to do, he also has to be clean from drugs for at least 6 months and have gone to an intensive outpatient or inpatient program. He no longer qualifies for inpatient because he has dietary needs that most facilities can’t meet and because he has been off alcohol for over 20 days. I don’t understand why they don’t count the buprenorphine as a drug, but they don’t. So that leaves him having to go to an outpatient program. Outpatient programs are usually 3 or 4 days a week for 3 or 4 hours a day.

For the first week, like I said yesterday, he was foggy. Yesterday, I called the place we had reached out to when he was in Vanderbilt and they gave us an appointment after his GI appointment to come do an intake evaluation. It was him in a room saying God knows what to the counselor for 30 minutes. She, then, has to send his info to their medical doctor and their psychiatrist. She said their program would require him to eventually come off the buprenorphine because it is not meant to be a lifetime or long term solution. After making her repeat herself so brother could hear, he, of course starts making excuses about how it’s for pain management along with helping to curb his appetite for opioids. And it may have irritated me more because it irritated Flea Market Guy.

It is very hard for us to have a drug addict at our house, especially one who is still on drugs. The RouletteWeekend Flea Market Guy Recovery plan wants to see brother coming off his opioids completely, finishing an intensive outpatient program, learning how to recognize his triggers and work through them to a healthy outcome, learning how to take care of himself in a healthy way, learning how to eat right, exercise, go to meetings, seek out the help of a therapist. We want to fix him wholly, but he just wants to do the bare minimum required by Vandy to get on the transplant list. And I called bullshit.

It’s not the first time Brother and I have had words. He’s always very respectful and I’m always very brutally honest. He’s very much in denial about the fact that he could still die… at any moment. I’m very honest about the fact that if he doesn’t want to do what’s right, he can go live with his mother who gets mad every time we talk about tapering him off of his opioid. So after the appointment with the IOP counselor, she asked if he would be willing to switch doctors if that’s what had to happen to get him into the program. He said no. We said yes. Mom had gotten mad and left by that point so she didn’t get to pick a side even though it would have been his. So FMG was mad that brother wants to keep taking the drugs that make him high that his primary care doctor said he shouldn’t even be on right now because of his liver. And I got mad because brother always wants to take jabs about Flea Market Guy’s sobriety. Or his disbelief about his sobriety. He likes to say things like, “if he’s even sober, he could be drinking while he works and coming home and you wouldn’t know.” Today he said, “well, he should be going to a meeting every day still.” And the mama bear came out in me because I know how hard FMG has worked to stop drinking. I was there. Day in and day out. Through the hard truths and the long sleepless nights. And I feel like how dare he even think about being judgemental when we have literally put our whole lives on hold to make sure he lives. So I got offended and went straight for the gut.

I told him that FMG knows when he needs to go to a meeting and when he needs to he goes. And then I went on to tell him that he doesn’t have to comply with all the “rules” at our house like no sodas and no cigarettes. He doesn’t have to get off the buprenorphine. He doesn’t have to go out of his way and do whatever it takes to get into an intensive outpatient program. He can choose to do whatever he wants. He just has to make those choices if he wants to continue to stay with us. I was worried about changing things too fast when he first got to our house so we have handled him with kid gloves. His body has been through a lot. Emotionally he has been through a lot. And he is going to continue to go through a lot physically and emotionally over the next few months.  But the kid gloves are off. I told him every action he took from then until now were choices he got to make. And he made those choices and he lost the life he knew, the life he says he loved. And now, he gets to make the choice to get better. And I told him if he chooses to stay with us, then the rest of his choices will be taken away from him. He can’t stay with us unless he is getting tapered off the opioids. He can’t stay with us if he’s not willing to go above and beyond to get healthy. He can either choose to do the right thing our way or he can choose to go live somewhere else, but he has his best chance with us.

And he didn’t like it. And I didn’t care. So I gave him the task of calling his psychiatrist in the morning to get an appointment to talk about what tapering his drugs looks like and if that doesn’t happen tomorrow, he will be leaving. I want to help, but I do not want to help someone who doesn’t want to help himself. And maybe I’m a dick for that, but I guess I’ll just be a dick.

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