Cyclothymia

Of Mothers And Daughters

My time away from civilization last weekend was so critical for my mental health. It was a great chance to take a step back from the mindless cycles I go through in my everyday life and get some perspective.

As my good friends know, my relationship with my mother has been a source of endless pain for me. I'm an only child and she's a single mother, which would breed an intense relationship anyway, but ours is probably at the extreme. I tend to think about it every day, even though she lives on the opposite side of the country and I have only seen her once in the last five years - and spoken to her only a handful of times.

Last year I finally went so far as to set up an email filter to forward her emails to a friend (in case there was something that actually needed addressing), and delete them from my box so that I wouldn't see them and get sucked in. Unfortunately she sent one to an email address not set up that way, so I saw it, and despite my best efforts couldn't stop myself from responding; the urge to defend myself from her manipulation is reflexive. Her answer came on the way back from Katahdin, and I'm so thankful it came then because I not only had the clarity from the trip, but was with one of my best friends who seems to have a high-tolerance for me sobbing and/or displaying some other crappy emotion. (He somehow walks that fine line between giving you room to feel what you need to feel and helping you to move past it. The ability to just be quietly present with someone who is crying is very underrated, especially amongst guys.)

I've always resisted the idea that she was an abusive person - that she had abused me. Even if I nodded when other people suggested it, or mused about it myself, there was always doubt.

In this one email she simultaneously described herself as a noble protector, blamed me for bringing physical abuse upon myself as a child, and played semantic games to avoid addressing the truth. When I was 9 she beat me with a hairbrush all over my body badly enough that I was taken away the next day, but according to her: "you got spanked, and you fought that - as most any child would." According to her I wasn't in foster care when I was 13, I was in "a temporary 'holding' facility that was a communal house for several kids and one counselor." She says she has nothing but love for me with one hand, and slaps me with the other.

I work with women in relationships with domestic violence, physical or verbal; I help them to try to see that they do not deserve what is happening to them, that they are strong, they can choose to leave, and now I have a true understanding of the leap I am asking them to make. I am angry, and I feel sadness for my younger self and my current self for the pain I still struggle with, and all the lost years. I am the closest I have ever been to being able to say THIS IS WRONG AND IT'S NOT MY FAULT. I'm not sure exactly what was different about this communication, as she has certainly said similar things all along, but maybe it was just a textbook case of what an abusive person does to maintain control in the aftermath that I was able to recognize.

I don't claim to be completely done with this, but I'm hopeful these flashes of confidence will get more frequent and last longer. I'm realizing that if she were anyone other than my mother I would not hesitate to say that she is a bad person, and that the reason for my pain is that I crave validation from someone who will never give it. I hope that someday that little voice that says "maybe she's right" will go away for good, and I can safely let it go. In the meantime I'll be setting up that filter again, and working to really believe that there are people out there that I can trust to truly love me.

I know this is a downer post, but it is cathartic for me to put it out there. Also, on another topic, Sarah Palin is the devil.

No Thanks, Send It Back

Pogo spent the night outside last night. The cat is obsessed with getting outside, despite the fact that he has NO SURVIVAL SKILLS and is SCARED OF EVERYTHING. Nevertheless, he clearly sees every open door as an opportunity to escape the brutal regime he's being forced to endure inside my warm, dry, food-filled house. I try not to take it personally, but last night I'd had enough, so I chucked him out the window, yelled some epithets at him, and locked up for the night. Or maybe I forgot the big window doesn't have a screen.

Why was the window open in February you ask? Because my shrew's tit of an apartment has two temperatures: boiling or freezing. The colder it is, the LESS LIKELY THE HEAT IS TO COME ON. I'm not shitting you. I have radiators that apparently are controlled by the building thermostat, which is ridiculous in a building with 30 units, and I'm getting screwed by it. Actually, I'm more worried about my aquarium, I'm pretty sure my fish aren't down with 90 degree water, although they haven't verbalized it BY DYING yet.

I know I'm USING A LOT OF CAPS TODAY, and if you're interpreting that as yelling, GO RIGHT AHEAD, because THAT'S WHAT I'M DOING. Aside from hunting for Pogo at 6am, and then crawling out the wet, thorn-covered window to retrieve him, this day can go suck itself because:

1) On the walk to work I walked straight into a low hanging branch covered in yet more thorns (wtf is up with the thorns everywhere today? Am I missing some metaphorical message the universe needs to get across to me?)*, which caught on my hood and ripped the gortex. The hood of my coat has a visor, which is awesome since it really keeps rain and snow out (or at least it did before I WALKED INTO THE DAMN BRANCH), but it limits the overhead visibility, especially when I'm walking hunkered down staring at the sidewalk in a puddle of self-pity and world-loathing. Thankfully I bet the 5 people around me and the nasty little tree were cheered up by my misfortune.

2) I'm the only one in the office today and I don't have much to do. I should have stayed home.

Note to self: do not drink a lot of sake and get to bed @ 1am on a Monday night, it makes you a bitter girl. Absolutely kick-ass date** though, so I've got that to cuddle with in my misery.

*Can someone with some rudimentary skillz in punctuation please tell me how the hell that sentence should have been handled?

** This "date" thing is new to me. The ex did not take me on dates, except for maybe valentines or my birthday. That should have been yet another clue that I was wasting four years of my life.

And I Broke My Espresso Carafe Too

Work this week has been really shitty. I was hired as a UX person, and I made it very clear that the testing aspect of my role should be kept to a minimum or I would not be happy, and they said it would be, and yet here I am wrapping up my second week of full-time testing. I know we have a build coming out today theoretically, so my hope is that my boss isn't completely addicted to having an extra tester available, so that next week I can back to doing what I was actually hired to do.

Another totally depressing aspect of life right now is hunting for new homes for two of my cats. In some ways all three adjusted to the move quite well, in the sense that no one refused to eat or drink, no one started spraying, and no one hid under the bed for days at a time. In the sense that they aren't trying to slaughter each other 24 hours a day, not so much. There is blood involved, and it's only a matter of time until someone loses an eye. It would be funny if it wasn't a) so concerning, and b) frankly as annoying as being trapped in a cage full of monkeys flinging shit at one another.

Aside from the ongoing ultimate fighting championship, my allergies are going batshit (yes, I'm going to see if I can use shit, or some variation thereof, in every paragraph of this post because cursing makes baby jesus cry, and that makes me feel better). My allergist told me this week that I'm starting to show signs of persistent asthma, and for whatever wacky reason he thinks it might have to do with my having 32 pounds of cat in 400 square feet.

I am broken-hearted that I have to do this. I've had all three of my cats for at least 8 years, and love them all as unique individuals. I'm a little more closely bonded to Preggers, but as far as my responsibility for them goes, they are equal. I was really, REALLY hoping to find a home for them with someone that either I knew or that a friend knew, so that I'd still be able to visit or at least get real updates, and not worry that their new people were going to neglect regular vet care, or give them up to a shelter at some point, or feed them shitty food, or let them wander the streets without a coat on, etc. But, that isn't happening. I had two leads, and both of them fizzled without really getting anywhere, so now I've got the cats listed with various cat rescue groups. After the struggle of finding the right home for them is over I'll never see my babies again.

So, yeah, life sucks, and I'm whining about it. Shit.

Medicine Needs Me

I had my endocrinology appointment this afternoon. I've basically been a wreck while waiting for it, because, you know, only my sanity and life rested on it. My body and I have reached our breaking point. I can't live with it for one more second. Freezing cold limbs, socks everywhere, toothpaste squeezed from the middle; I'm looking into legal emancipation from the damn thing.

The doc started off by asking why I was there. In a nutshell, don't feel like I've ever gotten respite from hypothyroid symptoms, even when labs are "normal", sez I. She responds by saying that if the labs were normal, then my symptoms were not due to hypothyroidism. Just exactly what I dreaded hearing. Hmm. So you are saying that the symptoms which were the basis of my initial hypothyroidism diagnosis, a diagnosis backed up by abnormal labs...you are saying these same symptoms in the same body are NOT due to hypothyroidism if the labs aren't abnormal? She said, "yes, that's what I'm saying, but your labs WERE abnormal, so this is a moot discussion."

No, no it's not, because for years I've been a good little patient, eating up the party line that my labs are normal, it can't be hypothyroidism causing my problems. For years I let them tell me the labs were normal, when what they called normal was just barely over the lip of normal. A stiff breeze would have blown my normal results back into wackyland. Except that getting the symptoms treated one by one didn't work AT ALL.

So we have a major pink elephant in the room, hypothyroidism, and the doctor is like "Don't look at the elephant, you have normal labs." Well, frankly, doctor, that's just bad science. It seems more likely to me that there is something you and your labs don't understand about treating hypothyroidism, than that I have just randomly developed seven ailments that happen to match the symptoms of hypothyroidism, but, oh yes, aren't hypothyroidism. But where are my manners - you just said my labs are currently abnormal, so lets get back to that. Please, don't mind the tears running down my face, carry on.

So you are willing to agree that my current symptoms are probably hypothyroid related. My weight gain, fatigue, muscle pain, tendinitis, depression, headaches, low blood pressure, low body temp, low sex drive, currently these are all acceptable hypothyroidism symptoms because my labs agree that I'm actively hypothyroid. And yet, I had all of these symptoms last year too when my labs were normal. They were all moderately better then, but still there. So back then they weren't hypothyroidism, but now they are. And now that my hypothyroidism is actually registering as worse in the labs, the symptoms are all worse too. But that must be a coincidence...perfect symptom overlap.

She asks if can tell her why I'm so upset (apparently the unabated tears were unnerving her). I asked if she wouldn't be upset if she felt like her symptoms were slowly ruining her life,  but she wasn't able to get them treated because they were tricky or fell outside of some arbitrary parameters for being taken seriously. I said I didn't understand how she could look at someone with all the symptoms of hypothyroidism clinically, and ethically/morally refuse treatment based on the labs. She said, "Well, how do you know I'm not hypothyroid?" And I said, "I know because you would have so much more sympathy and be willing to look outside the box, to do anything really, to try and solve an awful problem." She sighed, and said "I'm not hypothyroid, but I've treated thousands of cases". Mentally I put air quotes around treated, and thought, well, you asked.

We talked some more during the exam. She zeroed right in on the fact that I'd been treated for depression and see a therapist, it was obvious she thought depression was my main problem, hypothyroidism secondary, and I can see how a patient weeping in your office might be construed that way. But on the other hand, the more compassionate hand, it could also be construed for what it was - the sadness of a drowning patient who is having her hope and lifeline ripped away from her.

I defended myself by pointing out that psychiatrists are now treating refractory depression with thyroid medications, and seeing major success, even though the patients show normal thyroid function. Is it not possible that some functions are particularly sensitive to thyroid levels, and given that "normal" TSH values range from .3 to 3, a full order of magnitude difference across the range, that one person might do better at some point in the normal range, and another person do better at another point etc.

If a person has the symptoms, why not explain the risks in going with a higher dose of T4, or going with T3 supplementation, and give it a shot? If it doesn't help, it doesn't help. The risks of the treatment are not that high, but the risks of remaining untreated are getting pretty close to unbearable to me. It strikes me as so callous and cowardly to huddle behind the lab results and say go elsewhere, rather than accepting that perhaps there are things they don't understand about the system, and working to treat the patient. But like I told her, that's how I know she doesn't have the disease, anyone with the disease would feel differently.

She did eventually agree to give me a minuscule dose of cytomel, a T3 replacement, under the conditions that I come back every month for blood tests and every 6 weeks for appointments. I just don't know if I can consider her a partner in my care when her philosophy is so obviously not patient care based. I don't think trying a new therapy will work if I have an antagonistic relationship with the doctor, so I might be better off going with the other doctor I found who sounds very open and who I talked to in person. He didn't have appts till late Dec. though.

One good thing though, Justin has been helping me keep my spirits up and think about the options positively. I just wish he didn't have to go to work in the morning, it's not the same snuggling his pillow.

I'm Not Normal, Damn You!

When I was twelve I had a botched appendectomy. The fact that you could fry an egg on my forehead, and that my vomit put Linda Blair to shame, was apparently unconvincing as to my sickness; the folks in charge figured I was just nervous to be starting a new boarding school. Eventually they decided I was actually sick, but not sick enough to, you know, do anything. I was bumped for surgery several times, so when they finally went in they discovered that my appendix was not as patient as they were, and had spewed it's bacteria-laden insides all over my insides, which is not a good situation. I was flown to another hospital, one in which the medical staff did not diagnose the patient from within the confines of their rectums. I almost died, was in the hospital for a while, but beat the odds and recovered. Despite multiple organ failures, I have no lasting effects, except for one: I'm hypothyroid. Well, that and  my rather obvious inability to stop whining about the whole experience.

I'm not going to bother explaining hypothyroidism, because at this point pretty much everyone knows that it's the excuse fat girls use for being fat. Haha. I'm so funny. Anyway, I've had it for a long time, and I'm still alive, but that was pretty much the extent of my self-management. I went in to get the standard test (TSH), they told me what dose I needed, and I took it two out of three days, or thereabouts. At some point in college I started remembering to take my meds consistently, but I think to a certain extent youth was able to hide my misdeeds. I suffered from some symptoms, but not enough to get additional treatment.

As I've gotten older, I've gotten more consistent and more educated. Even so, it wasn't until I was 25 that I asked what my specific test numbers were, and pushed my opinion that being medicated adequately to be in the very tippy-top of normal wasn't good enough (the tippy-top, in this case, being right on the edge of still hypothyroid). However, as anyone who has a chronic non-lethal condition can tell you, dealing with it gets tiring.

Every so often I would get a spurt of energy and would do some research, run around going to multiple appointments, follow up with the nurses in person, deal with new medication levels or schedules, and try to self-monitor for any changes accurately. It is not easy to refuse to be dismissed by doctors who tend to just look at the lab sheets, rather than listen to the patient directly. Let's see, if Sally has most of the symptoms of being hypothyroid, but her lab results are "within normal", do you really think Sally gives a flying fuck what the labs say?

I came across this quote in my latest round of research, and I think it sums up my situation perfectly:

"The reality is that despite treatment for hypothyroidism, many patients -- some even say the majority of you receiving thyroid treatment-- continue to have symptoms that may be related to your thyroid. Even after you've been diagnosed and are on thyroid hormone replacement drugs, you may have persistent symptoms such as continued weight gain or difficulty losing weight, depression, brain fog or difficulty concentrating, hair loss, hand/feet/facial swelling, intolerance to heat and cold, muscle aches and joint pains, constipation, carpal tunnel or tendonitis, high cholesterol levels, low sex drive, and difficulty getting pregnant, among others."

Now really - which do you think is more likely:

1. The patient simulaneously is eating too much/exercising too little, and needs SSRIs, ritalin, propecia, a good winter coat, an ergonomic workstation, and MDMA.
2. The patient is hypothyroid and needs a different medication plan for that.

However, the cost of not being treated with the most up-to-date info or drugs is not death, so when the energy burst runs out, you are back to being busy getting on with life - it's easy to shrug off symptoms and just stay on the current course. Yeah, life isn't great, but you're alive and mostly functioning.

I wrote part of this post before my most recent appointment with my doctor (last last week). I have heard over and over again in the past couple of years that my labs were normal, labs were normal, LABS WERE FUCKING NORMAL. So, you see, I was a little tired of hearing that. When I went in to talk with the doctor I told her that I was at the end of my rope with my body. I work out hard five or six days a week and I have tried every eating plan in the book, and the weight has just crept on and on and on. It doesn't matter what I do, I can eat perfectly for weeks on end and lose maybe a pound. I don't want to go back to another carpal tunnel specialist, they couldn't help last time. I tried effexor and lamictal, and all that happened was my asshole shrink left for a month long vacation without refilling my prescriptions. My boyfriend is a very good looking guy, and doesn't get the attention he deserves. So really, doctor, let's talk about what we're going to do when the labs are fucking normal, ok? Because what we're NOT going to do is wait another year while my body simultaneously disintegrates and explodes.

She ordered a full panel on thyroid function, rather than the standard simple yardstick. As it turns out, all my fight or flight preparations for more "normal labs" was wasted, because my labs came back very abnormal. On the one hand I'm glad, it's numeric proof that the doctors have to accept that my symptoms are real. On the other hand, I've been through this before, and I'm a little afraid to hope.

It probably sounds like I'm blaming the doctors, and I suppose part of me is, but mostly it's just that I'm frustrated and worn out on this issue, psychologically and physically.

What A Beaut

I'm watching a special Steve Irwin tribute on animal planet right now, and I cannot stop the tears. I'm not sure what to think of the fact that the first person whose death has really required grieving from me is someone I've only known through television, but I feel like I knew him better than that, that he was a friend. My grandparents died and I was a little sad, but I didn't keep thinking that it can't be true, that it shouldn't be true, like I am now with Steve.

It seems so ridiculously unfair that someone who had that much passion for life and had such a palpable love - for his family, for creatures everywhere, and for his chosen calling - could be gone. He inspired, educated, and entertained people around the world. He was a warrior for all creatures. Absolutely everything he did, he did with wit and joy. Given how I, just a viewer, feel about this, I can't imagine what those who knew him personally are experiencing. I wouldn't call it praying, but I am thinking of his family quite a bit. There will never be another one like Steve, and the legacy he left will never be forgotten. Steve, I already miss you so much mate.

Sometimes You're the Bug

After getting to bed late because open office corrupted all of the equations in my lab report, and getting very little uninterrupted sleep last night, thanks to the endless aggressive snuggling and group gymnastics the cats subjected us to (they actually

a) woke J up and
b) drove him to the couch,

which tells you exactly how bad they were), I woke up feeling like a used diaper. My day proceeded to get better when I went outside and discovered that my car window was smashed and the radio was gone - and yes, it's raining, did you really need to ask? And finally, after getting to work and being insanely busy, I finally get a chance to run out to grab some takeout, only to discover that the fuckers gave me PORK kung pao lettuce wraps instead of TOFU lettuce wraps, a discovery I made after swallowing a bite of course, so now I feel sick and can't get it out of my head. And I don't have time to run them back. All of this seems entirely insurmountable, though a small part of me knows it's the fatigue talking, so...what I'd really like is a rationality pill that would remind me that the world is not ending, and at least keep me from breaking into tears in the bathroom when the toilet has been left clogged up. PEOPLE, ARE YOU FAMILIAR WITH THE CONCEPT OF A PLUNGER?! LEARN IT. KNOW IT. LOVE IT.

However, I'd like to note that J is the bestest ever for taking me to drop off my lab report before work, so that I didn't have to leave work early to drop it off after work, which would be a problem since I was getting to work late because of the busted window. Plus he didn't laugh at me when I started crying over-dramatically on the street. XOXO