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Thread: Avoid opioids for chronic back/knee/hip pain

  1. #31
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    Quote Originally Posted by Pluripotent View Post
    I had some other thoughts on this issue. I think the use of opioids for chronic pain, which is a bigger problem for men than for women is a sign of nihilism. Nihilism is not just a philosophical idea, not even primarily a philosophical idea. How do you know if you are a nihilist? Are you participating in self sabotage? People who engage in nihilistic behavior are essentially destroying themselves. This includes all the drug and alcohol addictions, smoking and even less obvious behavior, such as fragility from the lack of physical training. Essentially, I think people engage in nihilist behavior when they lack clear goals for the future, either because they are unable to make goals, or because they have no hope that they could ever achieve goals even if they did make them. The problem affects men and women, but currently more men, because men are being inundated with the idea that masculinity is somehow "toxic" and they are being told that their contributions are not wanted. Most of the time this is implicit rather than explicit, although it is becoming increasingly explicit. And so men retreat into activities that can only be described as slow suicide (or they just do it outright). People need to make goals. The act of making goals for the future is the best antidote for nihilism because it is its opposite. And, assuming that those goals aren't also nihilistic (such as to shoot up a high school or concert), then the goals themselves are going to be incompatible with the self destructive behavior. You cannot get to a 315 lbs squat for 3 sets of 5 and smoke or do drugs (or at least it's very unlikely and it would be much better if you didn't). Making goals forces people to decide between self destruction and self improvement. So if we could just get people to lift...
    Quote Originally Posted by I_iz_a_fatass View Post
    Just... damn. New poster for when I rebuild the flooded-out gym.
    Double Damn. "Pluriposter", I think you nail a bunch of issues here. My humble nomination for post of the month. If just the readers of this thread contemplated this post, the world would be a better place.

  2. #32
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    Quote Originally Posted by David Kirkham View Post

    As a guy who has lived with chronic, serious pain,
    There is a certain reason why the name David Kirkham is spoken with an air of reverence within the SSC community.

  3. #33

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    The VA has made the full version available as a PDF, so there is more than just the abstract of the study to go by now: https://www.va.gov/PAINMANAGEMENT/do...oidtherapy.pdf

    As stated in the abstract, both groups seemed to be about as functional as each other at 12 months out, but the opioid group reported significantly higher perceived pain.

    It's too bad that we don't get to see a squat and deadlift column in the charts. (Cue McCoy asking "What is this, the Dark Ages?")

  4. #34

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    Quote Originally Posted by GammaFlat View Post
    Double Damn. "Pluriposter", I think you nail a bunch of issues here. My humble nomination for post of the month. If just the readers of this thread contemplated this post, the world would be a better place.
    Thanks. But I don't think I got it quite right. I think, to improve it, I would say that if you are able to accomplish your goals and you are also able to participate in self destructive behavior, then your goals are not nearly ambitious enough. Assuming that your goals are self directed and the definition of self destructive behavior is also defined by you, this this is a moral statement that I don't think anyone could find a problem with, and it works for every skill level.

  5. #35
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    Quote Originally Posted by Pluripotent View Post
    Thanks. But I don't think I got it quite right. I think, to improve it, I would say that if you are able to accomplish your goals and you are also able to participate in self destructive behavior, then your goals are not nearly ambitious enough. Assuming that your goals are self directed and the definition of self destructive behavior is also defined by you, this this is a moral statement that I don't think anyone could find a problem with, and it works for every skill level.
    There's also no nihilism in making self-destruction your one and only goal, nor is a tendency towards self-destruction symptomatic of a nihilistic "worldview" (in itself an ignorant phrase since you cannot turn nothing into a worldview). Actually having no values, goals, ambitions, interests, morals, or desires is quite simply impossible for any living human being. One has to wonder if the propagators of nihilism knew about how pointless an exercise they were undertaking, or maybe they meant something different altogether?

    Nihilism is like going back to the blue book after having watched all too many YouTube fitness videos. Now overburdened with clutter, other people's conclusions that only apply to themselves, and otherwise redundant information, one relinquishes the imposed responsibility to make all the puzzle pieces fit and instead reasserts the absolute minimum. This assertion is to follow a momentary state of nihilism by design as one cannot "live nothingness", only somethingness. The idea is to go back to nothing and then decide, for yourself, which values you truly espouse, not by picking and choosing your morality à la carte, but by trying your best (and inevitably failing, necessarily) to be honest with yourself. And we didn't even need an outside influence for it. Isn't that amazing?

    Do consider that maybe you're saying "no goals" when you mean "not the goals that I make for myself", and thus conclude that anyone who lacks your goals (e.g. of getting stronger) is necessarily a nihilist. Without conceit, I think you should consider that other people can make their own decisions in choosing to not be strong, not be smart, not be ambitious, not be "self-constructive". It's true that all of these words have dictionary definitions, but you're assuming everyone is using the same dictionary, or any dictionary at all.

    muh postmodernism, tho, amirite?

  6. #36

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    Quote Originally Posted by Pluripotent View Post
    I had a bad back spasm once in medical school and went to the ER because I couldn't get up off the floor, they gave me narcotics, but I didn't finish the bottle (although my anatomy professor called me into her office to quiz me about it, trying to determine if I was an addict or not). I had back pain most of my adult life and it didn't stop until I started doing Starting Strength. So far I have not met another back pain patient who is willing to do that to get rid of their back pain.
    Although we have not met in person, I have also used the strength exercises and the method for doing them as advocated in Starting Strength to ameliorate moderate to severe recurring back pain. As I have previously mentioned in this forum both a sports orthopedist and a chiropractor vehemently disagreed with my back pain solution.

  7. #37

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    Quote Originally Posted by Scaldrew View Post
    There's also no nihilism in making self-destruction your one and only goal, nor is a tendency towards self-destruction symptomatic of a nihilistic "worldview" (in itself an ignorant phrase since you cannot turn nothing into a worldview). Actually having no values, goals, ambitions, interests, morals, or desires is quite simply impossible for any living human being. One has to wonder if the propagators of nihilism knew about how pointless an exercise they were undertaking, or maybe they meant something different altogether?

    Nihilism is like going back to the blue book after having watched all too many YouTube fitness videos. Now overburdened with clutter, other people's conclusions that only apply to themselves, and otherwise redundant information, one relinquishes the imposed responsibility to make all the puzzle pieces fit and instead reasserts the absolute minimum. This assertion is to follow a momentary state of nihilism by design as one cannot "live nothingness", only somethingness. The idea is to go back to nothing and then decide, for yourself, which values you truly espouse, not by picking and choosing your morality à la carte, but by trying your best (and inevitably failing, necessarily) to be honest with yourself. And we didn't even need an outside influence for it. Isn't that amazing?

    Do consider that maybe you're saying "no goals" when you mean "not the goals that I make for myself", and thus conclude that anyone who lacks your goals (e.g. of getting stronger) is necessarily a nihilist. Without conceit, I think you should consider that other people can make their own decisions in choosing to not be strong, not be smart, not be ambitious, not be "self-constructive". It's true that all of these words have dictionary definitions, but you're assuming everyone is using the same dictionary, or any dictionary at all.

    muh postmodernism, tho, amirite?

    Like I said, by your own definition. Don't use my definition or goals. I did not tell you or anyone what goal to strive for. You decide. I might suggest that getting stronger is a good goal, and I have some reasoning to back that up, but ultimately it's your goal, not mine, that is important to you. But if you understand nihilism as there being no meaning to existence, then there is no reason to make goals, since everything is meaningless, therefore making goals is the opposite of nihilism. You can not make goals, but then you wither and suffer. Some people take it out on themselves, but others, like in Parkland et al, take it out on other people.

    You are defining nihilism as "nothingness" which apparently one can "go back to" and then fill up with something better than before. It's an interesting approach, I suppose, but then you have to decide on some values to know what to fill up with again that would be "better." You say not to "pick and choose your morality a la carte" but then you avoid saying how one actually would go about choosing. And what does it mean to "pick your morality?" Are we not talking about values? What a person values and thinks is better than something else? Like strength, for instance? or knowledge? Are these not goals to be achieved? Do we not decide that this value of "strength" is not better than "not strong" and then strive for that, for instance? (and the same for any other value). Personally, I think that you can decide that nothing is better than something and spend your life doing meaningless things, since nothing means anything anyway, perhaps convincing yourself that you are an Epicurean or Hedonist, but you wither as a result (and we all do this to some extent -- we all have some self destructive behavior lurking in there, and maybe even some plain old destructive behavior). But like I said, this is not meant to be judgemental. Go do that, if you think it's the best option. Maybe I'm wrong. As long as you're only hurting yourself, then there is little reason to condemn you for it. But when the suffering is too much, then you can always come back and lift a load. Well, maybe you can come back. Sometimes it's difficult or impossible. It depends on how far down that road you have gone. I spend a good portion of every day telling people that it's basically too late. I call this the "put your house in order" talk, which I got from that Michael Keaton movie My Life where he finds out he's dying of cancer and he makes a film for his kids to watch when they're older. In the film he goes to see an old Chinese guy who does some weird shit with his hands that weirds him out so he leaves (which in reality is probably what you should do when an old Chinese guy starts doing weird shit to you). But then he comes back and tries it again but this time the old Chinese guy just says there's nothing he can do, "put your house in order." I have that talk multiple times every day.

    Essentially these people are the Fisher King. When Perceval comes to the castle and finds that the king is castrated. You're the king of your story. In the myth, the king is castrated because he's dying and he has done nothing, he has no legacy, his life is wasted. And what often happens when you have the "put your house in order" talk with the Fisher King is that he kicks you the fuck out of his castle. Because here they are, having wasted their whole lives with absolutely nothing to show for it. Their relationships are in ruins (and believe me, they are), they have no legacy, they have no accomplishments, and here you are telling them that it's too late, put your house in order. They generally don't take it well.

  8. #38
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    Quote Originally Posted by Pluripotent View Post
    Thanks. But I don't think I got it quite right. I think, to improve it, I would say that if you are able to accomplish your goals and you are also able to participate in self destructive behavior, then your goals are not nearly ambitious enough. Assuming that your goals are self directed and the definition of self destructive behavior is also defined by you, this this is a moral statement that I don't think anyone could find a problem with, and it works for every skill level.
    Sorry - I think you did get it right. I'll agree with you that you're not always perfect or maybe you are moving further down the road.

    Whether one has goals or not is critical. Whether one accomplishes goals is actually considerably less important (unfortunately I suppose?!). ...It may eventually become a precedent to more goals if one never reaches them, however. Applying meaning to things (anti-nihilist) is a step toward goals. Nihilistic is begging for a terrible path.

    I watched a slow suicide in my family (more than once). They were victims of abuse at key moments in their lives which made them become "professional victims" with nothing being important in their lives because of miserable self worth - because after all, "I'm not worth anything if the most important "function" in my life is to be abused". Being convinced by your primary care-giver that you are worthless likely puts you in a spot of nihilism or worse. It takes an amazing person to pull out of that nose dive. Everyone knew they were on the grand swan dive of life face first into an empty pool.

    Alas, we're all human... full of surprises. I believe we've naturally got some neat stuff built in (we are all wired to survive) that usually requires careless, reckless, selfish or malevolent others to "break" us if we are to become nihilistic or very self-destructive. Some of us are so strong (in certain areas) that we can overcome the "baddies". In those cases, we see phenomenal things. I know a guy that literally moved out of his home (sort of ran away) when he was 14. He got his own apartment, continued school through undergrad, built his own businesses, etc. His mother would have "destroyed" a lesser guy and certainly worked very hard at destroying him. It was a horrifying event for her to lose her control over him. This guy became obsessed with succeeding in spite of his circumstances. He did amazing things. Many extremely successful people have similar stories.

    Doing Starting Strength is rife with (encouraged) anti-nihilistic behaviors. I find it interesting that getting stronger is only part of the benefits I've seen come out of participants of Starting Strength. (thank you Mark!)

  9. #39
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    Quote Originally Posted by Will Morris View Post
    There is a certain reason why the name David Kirkham is spoken with an air of reverence within the SSC community.
    LOL. Some of us are so smart we paid all our tuition at the school of hard knocks instead of listening to those who knew better...

    I have spoken with Rip on several occasions about how powerful the barbell is. Like Rip says, "The barbell has saved a lot of us many times." The bar controls my pain and distracts me from the pressures of life and work. You can't think of anything except squatting when 387.5 is on your back--I still can't get 400 grrrrr.

    If any other thoughts enter your mind, you will be pile driven in the hole. There is something very powerful about making your mind focus intensely on the moment. Once you forget about something that is bothering you--even for a moment--the spell is broken and the shit begins to fade.

    I am fortunate to lift with my wife, my sons, and Doug. I am extremely fortunate opioids hold no allure to me. Lortab doesn't work on me. Percocet works well, but it makes my brain foggy and my vision blurry and blue...no thanks.

    Advil controlled my pain quite well for years. Of course, 10 Advil on some days weighed heavily on me. There were many nights I seriously considered going to the ER because I thought I must have popped a vein. Recently, I found a plastic surgeon who does Botox for migraines. It has worked wonders on my headaches and my shoulder and now I can bench again. Of course, the surgeon shakes his head when I come in because I suck up 14 syringes of Botox...

  10. #40
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    Quote Originally Posted by Pluripotent View Post
    But if you understand nihilism as there being no meaning to existence
    If one understands nihilism to mean no meaning as opposed to no intrinsic or objective meaning, then one is sorely mistaken. Moreover, one such an interpretation would proceed from observing clichéd teenagers who enjoy wallowing in self-pity. The only nihilism present is the both parties (the teenagers and genuine nihilists) agreeing that there is no intrinsic value to life, no causal purpose (cf why is the sun-question), but then if you ask both why they believe so, you'll get different responses both corresponding to different ends of an intellectual spectrum. The teenager will blurt out something like "the government, everyone's a damn conformist, life has no point so why bother why live why not just kill myself", whereas the nihilist might reference Nietzsche's master-slave dialectic. The latter broadly entails the slave's self-assertion as no less relevant than the master who's been imposing his morality on the slave and calling it objective (i.e. intrinsic value). Anyone is free to disagree on the merits of this, but not to take these ideas out of context and pretend to be really really smart.

    To wit, nihilism posits that there is no such thing as a clear answer, as an immediate and apparent, objective, and always true and relevant morality. There is no "ought to" to the "is" of the universe. Human beings existing does not imply XYZ in terms of morality. The sun existing does not imply XYZ in terms of morality. Any existence of a god does not imply XYZ in terms of morality. That last one is especially important since nihilism as a philosophical problem did come about in a Western, pre-dominantly Christian context. For it to be reduced to "life has no meaning at all whatsoever" really takes quite a bit of neglect towards just about every single one of its theorisers and texts. And if you think "don't kill" is an objective moral value, do consider that self-defence can lead to killing, yet is never condemned in anything resembling the same manner of means as plain old killing. That is to say that the act of killing depends on who's doing it, why, the place and time, and something as fickle as the language of the community in which the killing is taking place. All of these are subjective things, own to the subject and disagreement will occur, not objective, own to the object where discussion about its existence can hardly (if at all) be disputed.

    I don't think I didn't offer the alternative, which was to honestly listen to your own feelings and exercise proper judgement. How do I think about self-determination? Why? Why don't I take the opposite view? I'm basing my arguments on empiricism. Why? Why aren't I basing them on cartesian rationalism? Etc ad nauseum. The feeling as an emerging sensation is more important, I'd argue, since just about anything can be argued or explained in a way that is logically sound. And faking your morality by pretending to care about things you don't care about is an unhealthy mentality to take, regardless of whether or not you or anyone else disagrees. People are mostly in agreeance on some relevant key topics such as don't kill and don't rape, anyway, so there's hardly a cause for alarm.

    No cause for alarm, I said. Stop it. Stop causing alarm! No!

    PS: you caring is sweet and all, but redundant. I've lived in nothingness long enough to be virtually indestructible, and I still have quite a few decades of strife left to go. I know that sounds really silly, but there really is no other way to talk about these sorts of things, hence I don't like to talk about these sorts of things.

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