Thursday, January 28, 2010

Well, I'm not changing my blog's name

Patient: May Voirrey

Final report

Brain MRI W/WO contrast

Findings: There is no infarct, hemmorhage, brain lesion, mass, extra-axial collection, vessel occlusion, or abnormal enhancement.

There is no structural abnormality. Orbits and pituitary look normal. Foramen magnum is patent.

No intracranial abnormality. Brain volume is normal.

Which begs the question: Then why the hell doesn't it work right?

Thursday, January 21, 2010

Daring to see

Are self-awareness and personal knowledge helpful? How much do we need to know about ourselves as seen through others' eyes? Do I want to know the conclusions that have been drawn about me? What do I gain by facing someone else's interpretation of me and my circumstances?

In late 2006, I was hauled off to the ER for an unnecessary psychiatric evaluation. The incident was humiliating from start to finish, and it left me so traumatized that I have been unable to look at a cop or even to eat in the fabulous Thai restaurant across the street from the hospital. Some nausea-and anxiety-producing form of PTSD still has me in its grip three years after the fact.

When memories of that night begin to slide into my conscious thought, I immediately snap to attention and force myself to think of something--anything--else. For months after the event, however, it was the only thing I could think of. It consumed me in my waking hours, and I spent hours going over it in my mind, working out more assertive dialogues and alternate endings. It didn't really help--I just felt more frustrated and overwhelmed with bitter anger.

The last year has been an improvement. My palms don't sweat quite as much if I see a cop car when I'm driving. The dialogues in my head were nearly put to a stop. The entire memory is allowed to surface only in generalized terms, and only when absolutely necessary.

Until last week.

Because I've spent such a tremendous amount of time in doctors' offices in the last 18 months, it is necessary for me to assemble a comprehensive file of my medical records. When I set out to do this, I was thinking only of the most relevant care I have received: for pain, for pelvic syndromes, gynecological issues, GI issues, neurolgical problems, orthopedic care, physical therapy, and the long, long list of labs and imaging procedures I have been put through.

While looking online for the forms and instructions to get copies of my X-rays, CT scans, and the brain MRI, something in the instructions caught my eye. The hospital where I endured the ER visit is owned by the same organization as the hospital where all of my current medical care takes place. It hadn't occurred to me until right then, but I could request my medical records from that night. Free of charge.

I checked off the appropriate box, filled in the date, and submitted the form.

The other day, a reasonably thick envelope arrived in the mail from the hospital. I slid it out of the pile and dropped it into the tote bag I take to work. It stayed there for a few days, until I moved it to the dining room table. It's still sitting there. I can't bear to look. I want to know, but I'm afraid to see how I was actually judged among the harsh realities of a forced psychiatric evaluation.

I felt so small, worthless, invisible, and dismissed at the time. No one involved had any interest in anything I had to say, although I was lucid, rational, and very much in control of myself. No matter what I said or how articulately I said it, the people who had put themselves in charge of me reacted as if any utterance from me was going to be a lie.

I was appalled to be unnecessarily put in an embarrassing situation that was initiated by someone I had never met. Any stranger (any stranger) can call the police and accuse you of being suicidal, and from that point on, you have no right to control your destiny. You are considered to be not dangerous, exactly, but too brain damaged to have anything meaningful to contribute to any conversation concerning you or your welfare at that point. I was a non-person reduced to the status of a housepet. I could say I had no credibility, but that would imply that at some point someone was aware that I was producing intelligent speech or even speaking at all. I was nothing. I was nobody. I had no rights. I was the defective thing put in the corner for a time out.

Even Frank let me down when he made it clear he would not be accompanying me to the hospital--I was on my own. So on my own.

It took five hours of sitting in a room by myself under the watchful eye of an armed guard, but someone eventually showed up to do the actual evaluation. I thought he was running late, but it later became evident that making the patient just sit and wait is actually part of the overall humiliating punishment meted out to a potentially suicidal person. I'm pretty sure the idea is to demean you so severely, you make sure you never again even breathe the word "depressed" to anyone within hearing distance.

The evaluation was anti-climactic, and I passed it with no problem. It took another hour to get discharge papers, but I was eventually allowed to go home and think about how I was going to come up with the thousand dollars I would be forced to pay for my hospital-based incarceration. I use the word incarceration because I was there very much against my will, I wasn't allowed to wear my own clothes, I wasn't allowed to use the phone, I certainly wasn't allowed to leave, and I had to submit to a drug test (at my own expense, of course).

I learned a lot that night. I learned that I can still remain calm in the face of a personal crisis; I can hold my temper when I'm being subjected to intensely unfair treatment; it doesn't matter how pleasant and cooperative you are--you're screwed; I know that we are all, ultimately, on our own and when you most need those you love, they'll bail out on you--not that it matters because if you get into this particular situation, you're considered to be so toxic, protocol dictates that you sit alone, isolated from everyone, even those who would give you comfort, so, I assume, you have the opportunity to think about the behavioral gaffe led you to be experiencing such punitive measures in the first place.

I developed such a deep fear and mistrust of the police that I think I can say I will likely always loathe them--collectively--and because my trust was so callously betrayed, I will never voluntarily speak to one ever again (if you want to know the definition of patronizing, go through a similar experience--the cops talk to you like you're mentally retarded or a very small child incapable of intelligent thought--and they will not answer your questions or help you understand your rights or even what to expect in the next few hours--oh, no--can't divulge that to one of "those people.") There will be no neighborhood-watch-good-citizen calls coming from me, no accident reports, nothing. If I witness a murder, I will not admit it. It is highly unlikely I would report my own assault. I realize that were a cop to take the report and run my name through the computer, I would likely be dismissed or blamed for my own rape. I now have very, very clear insight into how police think, and as a result, I understand that I will never have any credibility with them. Once you have a psych evaluation, that is the only thing the police will ever care to know about you. Nothing else about you can override that, and it is this truth that makes me want to lie down and quit. It has been three years, and yet, when I see a cop in near proximity, my heart races hard, my mouth goes dry, my throat feels like it's closing, and I struggle to breathe.

The envelope containing my medical record is still sitting here, unopened. When I can tell this story without feeling oppressive sadness and defeat, when I can look back on that night without feeling humiliated, and when I can see a cop and not have to avert my eyes to avoid a rush of painful nausea, then maybe I'll be ready to open the envelope and see the details of my judgment.

It seems I'm not there yet.

Thursday, January 14, 2010

Status update

It's been 20 days since Christmas, but still no call from Joanna.

A rose by any other name

A series of PSAs is currently running on network television. One of the spots features Glenn Close and her sister, who suffers from bipolar disorder.

This campaign makes me cringe. At first, I couldn't articulate what my objection was, but in the last few days, a complete thought formed before the 30 seconds had elapsed. Here's the thing: If you have to run commercials telling people not to be prejudiced and not to stigmatize the crazy people, you'll just make people more aware that the differently-brained are not in your league.

The people in the PSAs are all wearing T-shirts that label them with their respective illnesses. Labels are bad--I get that, but why not make the point that's attempting to be made by instead having the shirts dissolve into regular, generic shirts at the end of the spot? Isn't the point also supposed to be that people who are ill are really just like everyone else?

I wondered about what would happen if I walked around wearing a t-shirt with the word "BIPOLAR" emblazoned across the front. Would people laugh? Avert their eyes? Smirk? Cut a wide berth?

For a while, I seriously considered getting the word BIPOLAR put on my license plates. My state has front and back plates, so anyone around me would have to take a moment to think about just how badly they wanted to rush me through the intersection or give me the finger for driving the speed limit.Most people have absolutely no accurate idea of what the illness really is.

While doing some research recently, I came across the following list of symptoms:
  • tiredness,
  • decreased mental work capacity,
  • weakened concentration,
  • sleep disturbances
  • sensory disturbances
  • mania,
  • psychosis,
  • fatigue,
  • memory impairment,
  • depression,
  • irritability,
  • personality changes.
I have every one of these symptoms, but this list is not describing bipolar disorder. These are the symptoms of B12 deficiency, a condition I am currently being treated for.

Now, if I walked around in a plain white shirt with the words "PERNICIOUS ANEMIA" across the chest, what reaction would await me? Would they be the same as those associated with the BIPOLAR shirt?

If so, why does it matter what the etiology of the illness is, when the resulting symptoms are essentially the same? Why isn't the AdCouncil running spots to stop the stigma surrounding vitamin deficiency?

Why, indeed. Because we live in a world that segregates illnesses into categories. There are those that it's OK to have, and others that invite suspicion and disdain.

After I read up on B12 deficiency, I once again wondered if, in fact, my bipolar diagnosis was accurate. Once again, a flash of rage passed through me as I realized that it just shouldn't matter. Symptoms are symptoms and illness is just illness.

Just I was wrapping up my self-education, I read this line:
Bipolar disorder appears to genetically co-segregate with the hereditary B12-deficiency disorder pernicious anemia.

In order to get pernicious anemia, you have to already have the genetics built in, but the onset may be faster in people who don't eat meat. I had to look up the word co-segregate; it means the two conditions are inherited together. In other words, the redundancy meant I was screwed either way.

Quoting Frank

"Gosh, the government and private agencies are falling all over each other trying to get aid to Haiti--you know, just like they did for the people of New Orleans."

Tuesday, January 12, 2010

A random thought

I haven't been to a movie in about three years. I haven't even watched one at home--without commercials and all in one sitting--in at least as long.

Maybe my memory is failing me on this one.

I'd like to see a movie that isn't tragic, where the dog doesn't die, and that maybe is funny without being juvenile, formulaic, or blatantly moronic.

Oddly, I do remember the last movie I found to be essentially unwatchable. I rented it on Netflix two years ago and after starting the DVD, quit half-way through: "Lost in Translation."

OK, that random thought is over.

Monday, January 11, 2010

I miss my blog

Today's weight: 191.4, up 1.2 lbs since last week.

I've been spending too much time on Facebook, hanging out with people that I don't really like all that much and who certainly only brush the surface of me. They know nothing.

Did I mention that I sent Joanna a 500-minute phone card for Christmas? Self-serving, yes, but it was the most meaningful thing I could say.

Operation med-down is going well. I lowered lithium to 600mg, halved whatever I was taking of lamictal, 50mg of Lyrica (half), but staying at the 9mg of EMSAM. So far, so good. I knocked out seven other medications entirely.

My brain seems a little better in terms of cognitive function.

During these winter nights and weekends, I've been trying to get my piles and piles of clothes out of the basement. Since most things will be donated to people I know, I've been trying to iron everything. The sorting alone has been taking hours. And yet, I see no tangible progress. It's a metaphor for my life.

Ironing in the basement gives me a lot of time to think. What I think about usually leaves a melancholy trail of memories I'd prefer to forget. Mostly, I think about me. I suck.

the piles of clothes, the unconquerable massive clutter, the mystery "illnesses," the lack of friends, the bailing out on a lucrative career for one that has left me a person of painfully modest means, the being sucked into my mother's financial disaster when I was only trying to do something good, the lack of car maintenance, the lack of a sex life, the weight, the goddamned weight, the fucking, goddamned, disgusting, revolting weight that has made me into a pig person, the supposed mood disorder (or inability to manage stress and emotions), the oversleeping, the forgetting, the lack of exercise, the inability to maintain relationships, the short temper, the lack of attention span, the chronic misplacing and losing of items, the inability to cook, the abject lack of financial management, the inability to experience happiness or to feel love...

I am incapable of effectively managing myself or my life or even an adult life. When I reflect on who I am and what I bring to the world, I can only see a long, long string of personal failures. I am proud of nothing. I'm fat, I'm broke, and my house is tattered, half-assed, and so messy even I can't stand it.

I think of sense of self-worth has to come from succeeding at things that hold personal significance. Plenty of people will tell me that I'm a valuable asset and I've accomplished a lot. Maybe so, but that's a value I hold for them, not me. At 48 years old, I think I've shown my true colors, my abilities, and my failings. It seems doubtful I'm going to change, even as much as I want to.

I'm unable to entertain myself. I'm jealous of all of the people who travel and go to movies and lead interesting lives. I am dying from the prolonged effects related to an unbearably mundane life. Of course, there's plenty I could go off an do on my own, but that's not the point. I've done alone, and in the end, it just makes me sad.

Some pictures of what surrounds me. My office is just the work version of what you see here. I do not deserve to live. Someone else could use this life and actually do something worthwhile with it for themselves.








And, the home office...






Tuesday, January 5, 2010

New year, new tactics.

Quiero dormir pero no puedo. Parte del problema es que los dos gatos y un perro también insisten en dormir en la cama, así que hay poco espacio para mí.

Ha sido un mes desde que empecé a reducir mis medicamentos. Mi cerebro no ha explotado, y mi estado de ánimo no ha cambiado mucho. Algunos de los síntomas de dolor pélvico han regresado, sin embargo.

Mi meta es detener todos los medicamentos con el tiempo. Estoy haciendo esto en la forma más segura posible. No quiero hacer nada de peligroso, ¿no?

Creo que el tratamiento para el trastorno bipolar me ha beneficiado tanto como sea posible en este momento. Tal vez mi hipocampo ha sido restaurada a su tamaño normal y la función prevista. Sólo espero que mi hipocampo no se atrofia una vez que los medicamentos han estado fuera de mi sistema por un tiempo.

Le prometí que en 2010 yo no iría de hablar sobre mis problemas de salud. Al escribir esto en español, no he hablado de nada porque creo que ningunos de mis lectores tienen ninguna idea de lo que acabo de decir. Jajajajaja!

Bueno, entonces. A dormir. I hope.

Sunday, January 3, 2010

I can enjoy

Last night I hosted a dinner party. People came. I was shocked.

There were only eight of us, but that was enough to tell stories and laugh quite a bit. The food was secondary to the company. I did a vegetable tray, but forgot to make dip. Anna picked up some onion dip on her way to the party, but Frank and I still forgot to put the celery on the tray. For the main course, I ordered an array of entrees from the Indian restaurant down the street. I forgot to make coffee after dinner, even though I bought espresso, half-and-half, and skim milk (it was going to be a coffee/tea bar kind of thing). I am a forgetful hostess and that is why I buy my dinner party meals from restaurants.

It took me days to get the house ready for company. It was never really "ready," just "ready enough." Still, the place looked cozy and cute. We are probably the only people who put up their holiday decorations on New Year's Day.

Two weeks ago, I set out to bring order to the basement of my house. The biggest chore among the many on my list is to sort all of the clothes that have ended up in piles, bags, and laundry baskets in the basement. Hundreds of pieces of clothing, all the wrong size. I'm going to iron all of it and then I'm going to give it away. Most will go to the refugees, some has already gone to Goodwill, but eventually, it will all be out of my house. Perhaps not having these reminders of the much smaller sizes I have worn in the recent past will help to stop hoping for something that is never going to be a reality for me again.

I haven't even gotten through a third of what I had scheduled out for myself by now. Ironing is boring and I had other things to do, as well. I am limited by my attention span, to a great degree, but more so by my poor physical condition. I may not be sick, but every part of my body seems to be in pain--terrible pain--most of the time. I can only iron through that for so long and then I sort of crash. It's much like running myself into the ground with productivity so not even I will believe that my issues inside m head can hold me back from anything I wish to accomplish.

Feelings are not an illness. It's my new operating philosophy.

Friday, January 1, 2010

Trying again in 2010

New Year's resolutions. I accomplished ZERO of my 2009 list. Cut it in half for 2010, renamed it "goals," and am hoping for a more successful outcome of self-improvement.

1. Try not to be so sad.

2. Talk less. A lot less. STFU, May.

3. Be more compassionate and tolerant.

4. Lower my expectations about others and try not to lose hope that others will, mercifully, finally, lower theirs about me.

5. Maintain my car.

6. Work on making my home a more hospitable space for Frank.

7. Be more mindful to stand up straight more often.

8. Work harder and do more in every context you lazy piece of crap. I am capable of more but I excel at wasting my potential. The parents were right all along.

9. Burden Frank less.

10. Remember that nobody cares about my health issues, so deal with them privately and quietly. STFU, May, STFU.

Wednesday, December 23, 2009

It's like Santa or God...

A reworking of previous posts regarding my leaning toward eschewing belief in the unseeable, unknowable.

I was diagnosed with bipolar disorder (Type II) five years ago. I thought it was odd to suddenly be diagnosed with something of this nature at such an advanced age, although I had experienced several serious bouts of depression throughout my life.
The more I read and learn about this condition, the more convinced I am that it is just that--a condition, not an illness. I was diagnosed based entirely on my own reporting of symptoms, just as I was when I had depression.

I was raised in a family where we were told depression and bipolar disorder were not illnesses at all but manifestations of immaturity, emotional weakness, and poorly managed stress. This is why meditation, yoga, adequate sleep, and diet are recommended as helpful treatments.

Isn't most mental health knowledge really just conjecture? Nobody even knows why lithium is prescribed for bipolar disorder--is it just a placebo? Does anyone know for sure why it works? Has anyone actually seen a neurotransmitter? How are neurotransmitter levels measured? How are they tracked and observed within a bipolar or depressed person's brain? If emotional problems like depression and bipolar disorder can't be identified through any tangible means such as a blood test or imaging, then who can say that they even exist?

Isn't depression an emotion? How did it evolve into an illness? Isn't bipolar disorder an emotional issue and not a physical/medical condtition? I'm skeptical about remaining labeled with a highly stigmatized condition that has no tangible means of proving its existence.

Despite trying to live a healthy lifestyle, I have gained 60 pounds from taking medications for an illness I'm not convinced I have. I am sluggish and cognitively dulled. I plan to wean myself off of medication and I'll try to do a better job of managing my emotions and stress without pharmaceutical treatment.

Frankly, I don't see any reason to take medications for illnesses that nobody can prove I have--or that even exist. I made this decision a couple of months ago, pending the outcome of the MRI. The neurologist said that my brain looks, "really good." No bipolar on film.

How many people are sent to therapy following a bipolar diagnosis? Is it because the medications aren't what's really providing therapeutic value? I refuse to go back into therapy. My life is pretty clear to me. I can't think of anything in my mind that needs to be healed other than the humiliation of knowing I totally bought into having nonexistent illnesses. Am I sad? Yes, definitely. The thing that makes me sad so often is that I have significant cognitive difficulties. Being stupid is devastating. I cover up pretty well, but honestly, I think medications are making me worse, not better. I'm living a fraction of my life. As I've said before, I'd rather be dead at 53 having lived my life fully than make it to 73 because I sat on the sidelines sucking down pharmaceuticals that didn't even make me feel better or cure any condition I was told I had.

I'll still have to see Dr. G and Dr. B a couple more times so they can prescribe doses that titrate down appropriately. I need to talk to Dr. B about how much of my diagnosis is fact and how much came about because I was prescribed an SSRI that spun me into a hypomanic mixed state--a condition I never had before. Or since.

How many books and psychology experts are out there saying that to be healthy, de-stressed, and well-adjusted, we simply need to make up our minds to feel that way and it will be so? I tried mainstream health care; now I'll see how the opposite school of thought works for me. Benign neglect certainly can't be any less effective than anything else I've tried.

From now on, I'm only going treat illnesses that have tangible symptoms. I'm all about proof and the concrete. How do you think I became an atheist?

You know it's almost here

It's not Christmas until this lady sings: Darlene Love performs on Letterman every year on the last new show before Christmas. That's tonight!!!

This is a Christmas tradition I've only missed maybe twice in 20 years (including the writers' strike in 2007). I've written about this every year since I started this blog. It's a weird holiday tradition, but Dave Letterman and I both appreciate it.

Crank up the volume!