Profusion

It feels as if spring was slow in coming, and even then it hasn't been entirely sure about staying. A long succession of chilly, wet, windy and gray days took over most of April, and snow was still coming in fits and starts until nearly May.

Small clusters of sunny days wove themselves between the dreary days, offering just enough of a hint of better weather that I did not give up hope that something better was coming--eventually.

When April rolled into May, the lilacs finally, slowly started to reveal themselves. They were two weeks late, but much anticipated because the week the lilacs are in bloom is one of the prettiest of the year. Had they shown up on time, the wonder of it would have been lost on me, because it was too cold to stand outside and enjoy the scent.

There is an enormous, bushy lilac outside of my bedroom window. I had been checking it every morning when I raised the shade, looking for any progress in the formation of flower spikes or the likelihood of opening buds. Just after May 5, the bushes leafed out and bore flowers simultaneously. The blooms were spectacular.

My neighborhood is a square mile of neat 1955 tract homes, nearly identical except for the landscaping. Lilacs are not particularly in fashion now, but when this neighborhood was first constructed, every home had to have at least one. Standing atop the hill a block away, I could see that there were lilac bushes everywhere, and they were heavy with huge clusters of flowers. Some are purple, some are white, but what is most obvious is that this year, the lilacs are intensely fragrant.

The spicy sweet perfume being put out by thousands of lilacs stopped me mid-step as I left the house a few days before Mother's Day. It floats through the neighborhood, a gentle scent that seems fit well as it wraps around tidy mid-century ranch homes.

The abundance of lilac blossoms and the pleasantly pervasive smell are special surprises unto themselves, but it is the fact this has continued steadily for three weeks that has been the true marvel. It's as if the lilacs have taken it upon themselves to apologize and make amends for a painfully dreary winter by providing an unusually robust output of flowers and fragrance.

A few days ago, this area got ransacked by 40-mile-per-hour winds that were unrelenting for almost three days. This only served to heighten the scent of lilacs in the air. Driving down the hill toward my house that first windy day, I saw dozens of lilac bushes shaking in the wind, waves of purple and white undulating along property lines like an animated Impressionist painting.

Today I noticed that the flowers are starting to fade and fall a bit. This means there's still a week left of lilac loveliness. A week. This will be the spring I remember as the year the lilacs were everywhere and they bloomed for a month--just when I needed proof that winter was most assuredly behind us.

Don't look down

I am walking on a wire, unsure of how to get where I'm going because I've never dared myself to do this until now.

It is not exhilarating. It is not frightening. It may be risky, but I won't know for sure until I do it awhile longer.

I need to try this, and so far, I am steady on.

There is a net, but I have no guarantee it will catch and hold me if I fall. The goal at this moment, then, is not so much to know how to walk the wire, but just to inch ahead so I don't fall.

Oh, that feeling again

Anxiety. Not a big favorite. It triggers all of the slime I call "lack of self-confidence" that begins oozing in every direction.

I can't say why, but for some reason, I feel as if my job is in trouble. That's unfortunate, because I only have one year to go until I'm essentially out of debt. That doesn't include the mortgage, of course.

Just one more year. That's it. After that I can lose my job, jump off a cliff, and go out knowing I've fulfilled my obligations. I don't want to leave Frank with any of my financial problems.

It would help if I could get a better idea of what's driving the anxiety. It would help if I could talk about it. Alas, I don't have friends; I have associates. There's a big difference in what you can tell the latter.

Jolie is a friend, but she's working through her own issues right now. I wish I could help her. I wish she could help me. It's possible we're both far too complex to be helped by any external influence.

Getting there

Haven't lost any more weight, but...I am down to 300mg of lithium and no other psychiatry-related drugs.

So far, sanity appears to be intact--or as intact as it was before, at least.

Please rephrase that

The cosmic forces of the universe are trying to tell me something today. I get that. I can hear it and sense it.

Unfortunately, I don't understand the message. You are showing me a picture and gesturing emphatically. I can grasp the subject matter, but not the main idea.

Stop sending me clues. They're twisting my heart.

Say it so I can understand. What is it I'm supposed to see?

Maybe I'm questioning psychiatry in general

I posted something on Psych Central's Q&A site. So far, everyone thinks I'm engaged in risky behavior.
http://answers.psychcentral.com/Bipolar/i-dont-want-to-take-medication-anymore/

The laws of physics elude me.

In mid-December, I weighed 199 pounds. that's a lot of bad self-esteem packed onto a 61.75-inch frame.

Yesterday I weighed 182.4 pounds. That's a difference of about 18 pounds. I can't take much credit for it--most of that change was due to adding more protein to my diet and stopping medications.

Still, it begs the question: After an 18-lb. difference, why hasn't my clothing size changed? When will I be able to wear pants that aren't a 16W? I'm not even close to a size change. All of my 1X tops fit the same. My pants are still snug in the thighs. Woud it kill my ass to rearrange itself to fit into a pair of 14W jeans?

I understand that I may never fit into clothes that aren't plus sizes. In fact, I suspect I'll still take this size when I weigh 104. It seems to be my body's own interpretation of the rules of matter and how it occupies space.

The other pain in my heart

There is a Post-It note affixed to the lid of my laptop. It reads, simply, December 10, 2004.

Five years of my life continue to be such a blurred memory that I had to look through old planner books to find out when, exactly, I was diagnosed as having bipolar disorder. From that point, I've been able to put some events on a timeline and bring mental order to a prolonged and profound cognitive fog.

This has been on my mind because of my conversation last week with the cardiologist. I told him that I did not believe my diagnosis of BP was one-hundred percent correct. At least, I had lived for 43 years without medication and without major problems, and I believed that the meltdown was the result of poor prescribing practices on the part of my primary care physician. "Of course," I continued, "I understand that I probably had some sort of genetic predisposition, but I don't believe this condition would have become manifest without the perfect storm of elements coming together at once."

Dr. C waved this off saying that probably I just hadn't realized I had the condition. He implied that it didn't matter what I thought, I had BP and I needed to accept that.

Now that more than a week has passed, I am troubled by this prejudice. A doctor who had known me for all of 15 minutes was quick to tell me that I had no nervous system malfunction, no chronic health problem, no pain disorder at all. He shot down the possibility of my having anything I thought I had (or that other doctors suspected), yet eagerly latched onto the validity of a BP diagnosis. Why are you so willing to choose this one as likely but not that one when you don't know much about me either way?

Earlier this week I had a regular scheduled visit with the doctor who tends to patients with chronic inflammation, hormonal or chemical issues or malabsorption problems that lead to or complicate chronic health problems. She assured me that she would not have continued to keep me on as a patient if she didn't believe there were a legitimate, physical etiology for my condition.

I told the doc that I felt my medical history was robbing me of credibility. If what the cardiologist said was true, then most doctors stopped considering my health issues as legitimate as soon as they got to the BP/lithium notes on my chart. "It seems to me," I said, "that from now on I would be better served by just leaving that information off of any paperwork I fill out and never making any mention of past depression or the BP diagnosis."

Dr. S nodded slowly and said, "You're probably right. You are right. If I were you, that's what I would do. I don't think that would hurt you."

Well, OK then.

It still troubles me, though. Why was the cardiologist so much more willing to believe I had a mental problem than he was to consider the possibility of a physical illness? What does that say about his attitudes about patients in general? Would he have held the same prejudices if I were a man?

How frightening to know that our medical care can be derailed so easily by one person's hubris.

I don't know what came over me...

A very prickly 64-year-old Karen woman from Burma recently thanked me for my kindness by giving me a traditional sarong for my birthday. I happen to know that this style is expensive and it takes three weeks for a highly skilled artisan to make.

Normally, I put these things away, but I went to a baby shower today and I boldly wore the sarong, along with my red Born maryjanes and a beaded necklace that a woman from Bhutan made for me.

I certainly stood out in the group of jeans-wearing party guests. WTF--why keep beautiful things tucked away? Someone liked me enough to give me her own very special, handmade textile piece. The least I can do is show my respect for the gesture by wearing the skirt to a special event.

For those who raised their eyebrows at me, fuck you.

Detail of embroidered 14" bottom border section of sarong

icing on the cake

When I told the cardiologist that I was working to eliminate lithium, lamictal, and EMSAM from my life, he asked why. I said that I don't think I need it and that the original issue was transient. Then I reminded him that I had gained 50 pounds from taking lithium.

The doctor told me that the lithium weight is going to be a bitch to lose, though. "Yeah, I know," I said, "but if I'm off of lithium, at least I have a chance of losing weight. There is no hope at all of that happening while I'm still on it."

My new weightloss goals are clear:

• 104 pounds



• A BMI of 19
  
  
• A body fat percentage of 18

I'm not sure how, but I will get there before 2010 is over. If my life is going to be mind over matter, I'm addressing what matters to me.

Meditation

Yet another doctor has told me to meditate. Meditation blahblahblah ohmohm.

I think a suggestion of meditation is doctor speak for, "I have no idea what's wrong with you, nor do I care to figure it out you hysterical freak. Oh--Have you tried acupuncture yet?

What I hear: "Go to the corner, sit down, and shut up. Then, think about how you're causing your own problems. Just go and busy yourself counting your breaths."

Frankly, I don't think the recommendation has anything at all to do with my health as much as it does with distracting me with a ridiculous task to get me the fuck out of the way.

Why did you send me to this arrogant asshole?

Dr. S:

I need some advice. Per your recommendation, I went to see a cardiologist regarding my occasional episodes of crushing chest pain and possible Prinzmetal’s angina.

Yesterday I saw Dr. C.

Upon reviewing my medical history, Dr. C stated that he felt he had to be honest in saying that a patient with my health issues— paresthesias, IBS, pelvic pain syndrome, pain with menstruation and/or heavy periods, previous depression, post-herpetic neuralgia, and other difficult-to-verify conditions—most likely has no actual illness other than mental illness. He said that it would be my task to demonstrate that his “doctor’s bias,” as he called it, was wrong. He also stated that any American doctor probably stopped listening to anything I was saying once he or she got half-way through my medical history. I am sure that my (dubious) diagnosis of bipolar disorder also greatly damaged my credibility as a patient not only yesterday, but with all doctors I've seen in the past few years. I am keenly aware of the stigma associated with it.

Dr. C said that regardless of his bias, he would still perform due diligence and send me for blood work, a stress test and echocardiogram. Angiograms are no longer used to diagnose angina.

I am not sure what to do. Part of me is overwhelmed with dismay at the thought that all this time I have been referred from doctor to doctor because nobody wants to deal with a patient like me. Dr. C strongly implied that this is what doctors do when they are too polite to tell a patient they think she’s nuts.

I’ve spent a tremendous amount of time and money trying to address what I perceive as very real discomfort (all of the conditions mentioned above). It’s emotionally distressing to have a doctor tell me that what I am actually dealing with is rampant mental illness and attention-seeking, and all I really need is to pursue meditation (and the reason that hasn’t worked for me thus far is that I just haven’t tried hard enough).

My understanding of Prinzmental’s is that half the people who have it don’t have atherosclerosis, high blood pressure, or high cholesterol—the things Dr. C will measure and conditions I’ve never been known to have previously. At this point, I need some guidance. If the tests don't show a blockage, then I assume this means I wasted everyone's time with my (I will assume) imaginary chest pain.

Is it even worth me emptying my vacation savings account for these tests? If I've never had the precipitating factors for heart disease that are going to be tested, does this mean that Dr. C is right and the episodes of non-stress-related chest pain are nothing more than a manifestation of mental illness?

Should I just stop worrying about the chest pain and all of the other things that make my life difficult and ignore them from now on?

I’m having trouble accepting the time and expense of Dr. C’s tests if, in fact, he has already concluded that he’s only doing it to indulge me.

My thought is that if he is right and all of the doctors I’ve seen in the last couple of years have been surreptitiously treating me as a hypochondriac, then maybe I should stop now with being concerned about things like transient chest pain and the rest of it. I don’t feel that I need to have tests just to satisfy my curiosity, especially if there’s no valid medical reason for it. However, I'm just the mentally ill patient, so what do I know?

I’m just not sure how to proceed. Are the tests worth the time and expense given my apparently spurious medical history?

I will articulate my concerns to Dr. C, as well, but I would appreciate knowing your thoughts.

Thank you.

May Voirrey