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Monthly Archives: September 2018

Physical Therapy, Again

 

Once my internship ended in August, I started scheduling doctors’ appointments right and left, to make up for two years of putting off everything but the most essential (which still turned out to be a lot). One result of all of these doctors’ visits is that I’m back in physical therapy, again.

I’ve had this pain in my neck and shoulder for three or four months now, and driving, sitting at the computer, and walking all made it worse. I could barely turn my head, but I kept putting off a doctor visit because I knew I wouldn’t have time to do all of the testing and drug taking and exercising she’d expect me to do. And then, just before my internship ended, this strange buzzing started in my left shoulder.

I went for x-rays, I tried Tramadol and a muscle relaxant, which wiped me out and did nothing for the pain, and then I got an appointment with a new physical therapist who came highly recommended. I’ve been through physical therapy so many times before: for my lower back, neck and shoulders, balance, gait, etc. I’ve also gone for acupuncture and chiropractic, cranial sacral, massage, and on and on, so I wasn’t sure how hopeful to be.

The new physical therapist did a long evaluation, with lots of questions, and muscle testing, and range of motion testing. When she had me turn my head to the left I became so nauseous that I had to sit down. She also said that the buzzing in my left shoulder could be coming from pressure on nerve bundles in my neck, because my upper body is so rigid. And she asked if I’ve seen an ENT (ear, nose, and throat doctor) recently. Three years ago seemed pretty recent to me, but she looked skeptical. She gave me three exercises to start with, and a print out in case I forgot the exercises immediately (which I did).

I’m actually fascinated by the weird glitches in my body: the way the nausea kicks in if I move my head too far to the left, or if the physical therapist presses on a certain spot in my upper back; and then the dizziness can be triggered just by a movement of my shoulder!

But I’d like to be able to turn my head while I’m driving, without feeling like I’m going to vomit all over the car. I’d like to be able to do Tai Chi again, or yoga, or just exercise regularly without feeling like my limbs are going to disarticulate. I’d really like to be able to run with the dogs at the dog park without needing a heating pad and a three hour nap in the aftermath.

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“Not that the dogs mind napping.”

So, for now, I go to my physical therapy appointments twice a week, and do my at-home exercises, and I worry that I’m going to have to add an appointment with the ENT to my long list of doctor visits coming up, just to be told, one more time, that I’m fine and no one knows why I have all of these symptoms, so it must be in my head.

I’m trying to watch Ellie for inspiration, because she does something new every day, not because she thinks she has to, but just because she discovers new things she can do. She didn’t know these things were possible before, and she didn’t know she would enjoy them so much! She didn’t know how much she’d like massages, and spending time with her humans, and smelling everything in the backyard, and checking in with Cricket. She even tried pickles, because Cricket likes them so much, but she hasn’t discovered a great love there. She’s also discovered that she hates having her hair combed and her teeth brushed, but I think that’s because Cricket has been whispering in her ear.

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“They tell you they’re going to comb your hair, but really they’re scooping out your brain. It’s true.”

Miss Ellie has also been creating her own physical therapy plan. She went from needing to be picked up every time she wanted to come up on the couch or the bed, to jumping up (and down and up again) at will. She can stand up on her back legs, for long periods, begging for treats. She even figured out how to jump into the back seat of the car, which she was sure was impossible. And then she does all kinds of stretches, swishing her neck and back every which way to work out the kinks. I’m pretty sure my physical therapist would not approve if I tried to follow Ellie’s plan, especially the swishing around part, but it looks like so much more fun than mine!

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“Hi, Mommy!”

Cricket has taken to watching Ellie’s antics with a big sister’s eye roll, as in, Oh my gawd, she is so weird! But I think, secretly, Cricket is getting inspired too.

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” No, I’m not.”

 

 

Personality Disorders

 

In my Assessment and Diagnosis class last semester (for graduate school in Social Work), I had to spend a week studying the personality disorders. These are, at least for now, seen as the enduring pathological character traits people live with in their daily lives. The personality disorders are separated out from other mental health disorders because of their lifelong nature, and because, usually, the patient doesn’t see his or her behavior as problematic, which makes them very hard to treat. But more often than not, the personality disorders are used as epithets, by lay people and clinicians, to describe people who resist therapeutic help. The current list of personality disorders is broken into three clusters: the not-quite-schizophrenia-but-still-odd-and-occasionally-psychotic personality disorders; the criminal-manipulative-lacking empathy-selfish personality disorders; and the fearful-avoidant-dependent-obsessive-compulsive personality disorders.

 

 

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“Are you diagnosing me, Mommy?”

This small strip of the DSM (The Diagnostic and Statistical Manual of Mental Disorders) has come up recently, in our public dialogue, as people struggle to explain the president’s behavior. We don’t know if he has dementia, or some other mental illness or medical diagnosis, but we can certainly see traits that fit Narcissistic (grandiose and exploiting of others), Histrionic (melodramatic and attention seeking), Paranoid (preoccupied with doubts of loyalty in others), and Antisocial (lying, intentionally harming others, and lacking empathy) Personality Disorders.

The value of the personality disorders is that they give us categories to put people into when they consistently behave in abnormal ways, and categories can help us feel like we have some control, and some understanding, about what’s going on around us. But, are personality disorders actually mental illnesses, or something else? The personality disorders attempt to describe the perpetrator of domestic violence (Antisocial personality disorder), and the victim (Dependent personality disorder), as equally ill, and/or equally character disordered. Meaning that as a society we have as little compassion for victims as for perpetrators, something that is objectively true, but still horrifying. Other personality disorders are just lower level, and more persistent, versions of mental illnesses we already have in the book, like Obsessive Compulsive Personality Disorder, which is seen as different from Obsessive Compulsive Disorder (and, yes, that’s weird).

The personality disorders are the most extreme example of what’s wrong with the DSM: it focuses only on the negatives, the weaknesses, and the disorders of human beings, and never on the strengths that mitigate illness. The same person who has Major Depressive Disorder may also have a great support system that keeps her going. The same person who obsessively washes his hands or checks the lock on his door, maybe also obsessively study or work or create and accomplish great things. The same person who lives daily with Social Anxiety Disorder may have an even stronger need and desire to connect with other people, which allows her to reach out despite her fear.

Miss Cricket has her own reason for thinking that the personality disorders are unnecessary: she knows, in her gut, who to spend time with and who to avoid, and she doesn’t think she needs a diagnostic manual to help her. For her, it’s all about a complicated internal set of calculations, based on how much you smell like someone who gives out chicken treats (she is doing her best to teach Miss Ellie this wisdom as well). I have seen no mention of generosity with chicken treats, or any other positive character traits, in DSM 5. Clearly they have more work to do for the next edition.

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(Cricket transmits a lot of information through her butt. Who am I to judge?)

 

Longing

 

I live in a constant state of longing, for safety and comfort, for love, for excitement, for satisfaction, for a lot of things. Longing is both the engine that keeps me going, and the pain that keeps me stuck. There are some things that help for a little while, like: chocolate frosting, puppy kisses, therapy. I keep thinking that a publishing contract would help a lot, because I want to know for sure that my books will be published, not to make a million dollars, just to be sure that people will get the chance to read my work. Because one of my biggest longings is to be heard, and understood.

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“What is Mommy doing here? Why isn’t she scratching me?”

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“You’ll get used to it.”

I think that I use the word longing, rather than anticipation, though, because I don’t really believe these needs will ever be filled. I am afraid that I will never get what I want; but I’m also afraid that I will get what I want, and it will disappoint me, or overwhelm me. I’m often longing for things I’ve never had, rather than things I’ve had in the past, and maybe that’s why it feels like the longing is hopeless.

Longing for things is an intense feeling, it’s not like wanting, or appreciating, or expecting; it’s painful and has a doomed, melodramatic feel to it. There’s a push pull in longing, a sense of opposites fighting it out; I long for food and weight loss, companionship and time alone, work and rest. Longing feels like keening sounds, as if there’s a wounded animal trapped in my chest. Which, I guess, there is.

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Miss Butterfly

Longing isn’t like liking. I like Caesar salad, or PB&J sandwiches, or lentil soup, but I long for a chocolate sundae with whipped cream and chocolate fudge. Longing has a level of guilt to it as well, and density, and overwhelming-ness. Longing doesn’t really lend itself to a happy-go-lucky life where you can take or leave things and just accept your lot in life.

Longing implies that there is something so much better out there, so much more satisfying, and that it is worth trekking through mountains, and ice, and fire to get to it. It implies desperation. I feel like that describes me too well, because I don’t know how to seek and accept the B+ version of my life. I’d almost rather suffer, and fail to reach my goals, than accept a life I haven’t been longing for.

I’ve worked hard to change this; to accept that most experiences will be mixed, and that very few will feel wholly satisfying. But, sometimes, I think my longing acts as a safeguard, a way to keep me from accepting things that I won’t be able to live with long term. A voice in my head is always looking around and saying, I don’t know what I do want, but I know I don’t want that.

When I watch Cricket and Ellie’s excitement – at going out for a walk, eating chicken, playing with a toy – I want to feel like that. I like spending time with the dogs, I even love it, but I long to have Butterfly back. I like doing jigsaw puzzles, and eating cherries (though the season is clearly over and the crispy, sweet, juicy cherries have been replaced with zombie cherries, and the thrill is gone), but I long for the chance to feel healthy enough to go for a run, and actually run full out.

Maybe I just long to be Cricket, instead of just being around her. I long to feel joy with the intensity that she feels it: ears flying in the wind, every thought absent except, “I’m flying!!!!!”

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(I wouldn’t want to eat chicken treats, though. They seem like they’d be very hard to chew.)

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“I’ll take the chicken treats, if you really don’t want them.”