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Monthly Archives: September 2018

The World is Spinning

 

So, as I was reading well wishes on the blog about my attempt to go back to physical therapy, I discovered why the physical therapist was so insistent on my seeing an ENT (Ear, nose, and throat doctor). Vertigo. Or at least that’s what they called it in the emergency room, after my second attack of the day refused to recede.

I’d woken up that Monday morning feeling like the world was spinning. No, not just feeling it, but seeing it spin. Every slight movement of my head made me feel like molten lava was about to pour out of my chest. It took a long time to inch into a sitting position, and even longer to stand and then to walk. I called my doctor’s office, and the secretary told me to go to the emergency room. When I told her that even walking to the front door was impossible, she said that she would have the nurse call me back.

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The girls watched me with concern, and/or suspicion.

After about forty minutes of sitting and waiting to hear back, I attempted to stand up, thinking I’d have to get to the emergency room, but I discovered that the severity of the symptoms had lessened by then. The nurse never actually called me back, but I was able to move around, slowly and carefully, and I decided not to set off to the ER and instead to go ahead with my pre-scheduled visit to the Endocrinologist, in the hopes that a doctor, of any kind, might be able to tell me what to do with what had just happened to me, or even give me an idea of what to call it.

The endocrinologist, after addressing my thyroid, which was the reason I was seeing her in the first place, listened to the symptoms I’d experienced that morning and said “it sounds vestibular.” She agreed with the physical therapist that I should see an ENT, preferably one who specialized in the middle ear, and gave me a recommendation. As soon as I got home I called for an appointment, and since the worst of the symptoms had passed, I accepted the earliest appointment available, the following week. By then I was exhausted from all of the drama, and the nausea, and the doctor visit, and trying to concentrate on homework while my head was still not quite right, so I took a nap.

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Ellie helped.

When I woke up a couple of hours later, the world was spinning again. It took ten minutes to sit up this time, and even the idea of standing made me feel wretched, so I called the doctor’s office again. The office was closed, but there was an emergency number and I called it. One of the doctors called me back immediately and he said to go to the ER. I’d been hoping he could suggest some kind of medication I could take, to lessen the symptoms, but he didn’t want to diagnose me over the phone and he was worried that my symptoms could represent any number of different things. It took me about fifteen minutes to walk from my apartment to the car (and no, I did not try to drive myself, Mom drove).

I felt silly for making such a fuss, because I figured, hey, if I can walk, I must be fine. There were so many more serious cases around me at the ER, too, like suspected heart attacks and serious diabetic wounds and dementia.

I was given a bed in the hallway, because all of the rooms in the ER were filled. There was even a number to mark out my parking spot in the hallway. I’d already had an EKG and a finger stick (to check my sugar, both fine), and once I was in my parking spot they attached me to a heart monitor and put in an IV. The girl who put the IV in was either nervous, or unwell, because her hands were shaking the whole time and she had to wipe up a lot of blood off my arm in the aftermath. When I asked the purpose of the IV she said it would be to give me medication. And then the waiting started. I was in a prime location to overhear all of the latest gossip from the doctors and nurses and Physician’s Assistants and nurse’s aides, because their desks were two feet away from my head. Confidentiality is not really a thing in the Emergency Room.

There were so many people on staff and each wearing different colored scrubs to attempt to tell you what their jobs were: navy blue, and black, and royal blue, and grey, and green, and bluish green, though no one actually explained what the colors referred to (I really could have used a chart on the wall, like a McDonald’s menu). And there were different patterns of beeps to denote different patient needs, but I couldn’t figure out which ones were serious and which ones were mundane, and I didn’t see anyone in a real rush to respond.

Oh, and they all walked around with rolling computer workstations, for when they were away from the stationary computers, but there wasn’t actually room for all of these little vehicles in the hallway, on top of patient beds and staff and wheelchairs, so it was a bit like bumper cars out there.

Time passed. The Physician’s Assistant came by to do a quick neurological exam and said I would be getting medication soon. Eventually, someone came by and gave me a Valium (a pill, not through the IV), and when I asked why I needed a Valium for dizziness they said it was the best choice for the ER (they were wrong, it did nothing for the dizziness or nausea, just made me tired). And they still hadn’t given me the anti-emetic (for nausea) or the Anti-vert (for dizziness) for my actual symptoms.

I finally went for a CT scan at around 10:30 pm (that’s three and a half hours after I’d arrived), even though by then the PA, a nurse, and a doctor had all told me that the CT scan wouldn’t show anything. Then they gave me two bags of fluids through the IV (finally, some reason for the IV!).

Mom was getting tired, and frustrated, so she started to stalk my nurse (one of three or four male nurses on the floor), while I watched cute animal videos on my phone. We were told that there was only one doctor on duty for the whole ER and he had to check on every case and that was why things were going so slowly. More blood was taken, from my non-IV arm, though no one could explain why more blood was being taken. And then the doctor’s shift ended and the new doctor had to be updated on all of the cases before he could make any decisions (like prescribing medication for me, though I’d thought that had been done much earlier in the evening. And, he had to wait for the results of the second set of blood tests.

I was finally medicated and discharged at four AM, in pretty much the same shape I’d been in when I’d gotten there nine hours earlier. They gave me Zofran for nausea and anti-vert for the dizziness. When I looked those up, and the Vertigo they had, by then, diagnosed me with, one of the first things mentioned was ear infections, but no one, the whole night, had even looked at my ears, let alone in them.

When we got home, Mom walked ahead of me to get the dogs, and they came out to greet me as I slowly made my way up the walk to our building. They were subdued but gave me lots of kisses and when we got inside we all collapsed from the exhaustion.

I was afraid I would wake up in the morning and the whole thing would start again, but, luckily, the symptoms were more muted the next day. I was still dizzy and nauseous, but at least not having the I-am-going-to-die level of intensity. The world was still spinning, and I couldn’t quite predict which direction my feet were going to go in, but I could, slowly, sit up and move from one room to another, so I had to cancel my physical therapy appointment, and email my rabbi to let him know I wouldn’t be able to do my public reading for Yom Kippur services (some part of my brain wondered if I’d gotten sick at this particular time just to get out of dealing with Yom Kippur, but I tried to ignore that though; missing Yom Kippur was just a perk).

Mom was exhausted. She’d survived on granola bars and Cheetos and caffeine in the hospital the night before, and got as little sleep as I did, so we were both a little bit worried that we’d end up back at the ER, for her this time. While Mom napped, I made the herculean effort to walk the dogs in the pouring rain, and they were wonderful! They didn’t pull or bark or complain at the incredibly slow speed of their walk, and when we got back inside, Cricket went back on duty, watching Grandma sleep and Ellie came back to nap with me, so we were both in good hands.

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Don’t be fooled; Cricket is on duty.

The symptoms receded a little bit each day, with the help of medication and rest. And when I went to the ENT the following Monday, he diagnosed me with Benign Positional Vertigo, even though I wasn’t showing symptoms anymore. He said I should come back if the symptoms returned and then he could do a maneuver that would shake my ear crystals back into the right place, but other than that, Shoo. No cause, no cure, you’re fine.

The physical therapist was relieved at the news and started me back on track with my exercise plan the next day, and so far, the world isn’t spinning, much. Just a bit blurry, at times, with some double vision, but, that’s normal. Right?

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“I’m supposed to be blurry, Mommy. I’m moving.”

My Apartment is Springing Leaks

 

First it was the drip drip from the bathtub faucet. No, wait, months ago there was the drip from the kitchen sink, which required a very expensive repair. Then last week, or two weeks ago, there was the bathtub leak. And then an attempted repair, which led to a lake on the kitchen floor (on the opposite side of the wall from the bathroom). At first we thought the kitchen lake was coming from the dishwasher, and called the dishwasher repair guy, but then realized that the leak only happened when we took showers. Oh, and then the toilet started to screech each time it flushed, with the water pipe connected to the wall doing a little drip drip of its own.

I was pretty sure we were going to drown.

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“Hey! Don’t joke about drowning!”

The leaks also seemed to coincide with the constant rain, which caused the bathroom door to swell and have its own panic attack where it tried to jump out of its skin. Really, we kept having to jiggle the door back into its skin in order to close it. Mom took on the project and took the door off its hinges, glued it back together, and put it back in place. I am not handy in that way. I can put together any kind of IKEA furniture, but the door didn’t come with a handy dandy diagram for me to follow, so I was at a loss.

So, the door was fixed, but not the leaks, which only got worse.

I may have written about this before, but I have a phobia of strange men coming into my apartment. Phobia is too light of a word. I would be hiding under my bed, if there weren’t containers of old clothes stored under there, leaving only enough room for Cricket to squeeze in. So, when the maintenance guys came to check on the leaks, I pulled the dogs into my room and shut the door. I’m supposed to be an adult who can manage basic household responsibilities, but in this case, I can’t. The dogs begged to be let out so that they could bark at the invaders in person and tell them what for. But I just stayed in my room, shaking, and waiting for it to be over.

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“Bark! Bark bark bark!!!!”

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“Should I be barking?”

But it wasn’t over, and we had to call the plumber, and then the maintenance guys came back. We have two maintenance men at our co-op, one is quiet and unassuming, and the other is very very loud, smokes cigars, and likes to blame everything on anyone else. It was the loud one who came over to argue with the plumber about what needed to be done. I couldn’t quite make out what anyone was saying from my hiding place, but I could hear the shouting, and it made me regress even further. I don’t do well with shouting.

I really should move the plastic containers out from under my bed, in case this comes up again.

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“You can’t come in.”

After an hour or two of shouting and futzing around, it was decided that we just had the wrong faucet in the bathtub, and Mom was sent out to get a new one, which, fingers crossed, seems to have solved the problem. For now. The squeaking toilet is going to stay as it is, because the plumber said that repairing it would be prohibitively expensive and we’d be better off waiting for it to die and then replacing it.

The dogs had a great time barking at all of the foot traffic in and out of the apartment, and received an inordinate number of chicken treats in a failed attempt to pacify them. My only consolation is that now I can go back to showering without worrying that I’m creating the next great flood. I was really worried, because I don’t have an ark, and I have no idea how to make one. I’ve never even seen an ark in the IKEA catalog.

 

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So we hired an architect.

 

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.”