As the pain from the surgical procedure started to recede, I was able to gradually reduce the dose of Percocet (an opiate) until I’d completely transitioned back to Tylenol and Ibuprofen, and I was sure that that would lead to a big uptick in energy, because I was convinced that the Percocet was what was making me so sleepy, and dizzy, and nauseous. Come to discover, there’s such a thing as Percocet withdrawal, even when you’ve only been taking an opiate for a limited period of time. And Percocet withdrawal, it seems, can exist along a spectrum, from the version we’re familiar with from movies, where hard core addicts are locked in padded rooms, sweating and hallucinating for days until the drugs are finally out of their system, to something more like what I’ve been experiencing, which is extreme physical weakness, dizziness and depression.
“What makes this night different from all other nights?”
My current form of depression involves swirling fears around the death of critical thinking in the academic world, and the super-fast pace of everything, and how thoroughly unprepared we are as a society for most of the things we have to deal with on a regular basis. It’s not just the doctors who prescribe medications without explanation (leaving it to the pharmacist to report contraindications and side effects in the tiniest type possible), it’s the short bursts of news on social media that have replaced comprehensive and detailed storytelling, and the eye rolling and foot stomping that has replaced careful listening and thoughtful responses. It feels as if we’ve bought into an assembly line philosophy of life, where all of the pieces of are laid out from the start, with very little room for variation, and we’ve applied it to things like news and medicine and school and work without ever recognizing that it doesn’t actually work for more complex, human activities. I saw this in graduate school for social work, where so much of what we were taught was manualized, until each problem, no matter how long lasting or deeply ingrained, was seen as solvable in 4-16 weeks, as long as you adhered to the plan. This was, of course, nonsense. I learned, finally, that the system is set up for the sake of insurance companies and legalities and institutional survival, rather than for the healing of actual human beings. And now I am watching people in the world at large fight over who can be louder, stupider, meaner and more unrealistic, and I keep waiting for the world to right itself and return to the boring, pragmatic, long-term work of connecting people to the resources they actually need, and listening to the people who have been left unheard, and teaching all of us more effective ways to communicate and function in our changing world. And I’m exhausted with the waiting.
My hope is that as the Percocet leaves my system, my thoughts will shift from assembly lines and failed systems and the end of the world as we know it, to something more hopeful, but I worry that this might be more than just a symptom of a passing disorder. Nurse Tzippy has been keeping an eye on me while we wait.
If you haven’t had a chance yet, please check out my novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
I had another oral surgery a couple of weeks age, a second attempt at a skin graft to ameliorate recurring infections around one of the zygomatic implants, after last summer’s attempt failed. I scheduled the surgery for after school was over for the year, so I would have time to rest and recover before having to deal with actual people again. We had to take a car service to the doctor’s office because I was going to be on anesthesia for the procedure and therefore wouldn’t be allowed to drive myself home, but Mom came with me for uneventful-ride-with-a-stranger and when we arrived Mom set herself up in the waiting room with a book to read and a sewing project, and the staff took me over to an exam room to prepare for the procedure.
“I stayed home. Thank God.”
There were a lot of Elton John songs playing over the speakers that morning, for some reason. Usually there’s a mix of music from the seventies and eighties, and very rarely from the nineties, but there was something comforting about hearing Elton John’s voice over and over, as if he was hanging out in the room with me and keeping me calm as they put the mask over my nose and started the nitrous and then poked my arms, endlessly, in search of a good vein for the anesthesia. I think there were three needle sticks before they finally believed me that the good vein is in my right arm. The last thing I remembered was the doctor saying, “she’s a cheap date,” and I wanted to stand up and tell him that’s not funny, but I was out. I woke up to instructions about where to hold the gauze to staunch the blood, and how to put pressure on the gauze with my tongue, and then I was taken to the recovery room, given a few envelopes of gauze, and the same aftercare sheet I’ve gotten for every procedure in that office, and sent on my way.
Almost as soon as I got home, though, I realized that I was going through the gauze much faster than I was supposed to. I can’t remember if I’d ever used all of the gauze in the packet before, but this time my mouth was filling up with blood faster than I could change out the gauze, and blood kept pouring onto my shirt before I could fold up new pieces of paper towel to replace the gauze. I couldn’t speak through all of the blood and gauze and paper towel, so Mom called the doctor’s office for advice and they told us to come back in right away to get the wound cauterized. This day was getting expensive, with our third taxi ride in a row, but I had no choice, so I held a pile of paper towels to my face and stared out the window of the car, watching all the same houses pass by for the third time.
Then I was back in the exam room and they were syphoning away the blood, and rinsing my mouth with salt water, and the doctor was pressing on the wound so hard it felt like his fist was going to push into my brain. My face must have still been numb from the earlier procedure, though, because even though I was uncomfortable and confused, I wasn’t in a lot of pain, and then the bleeding finally stopped and they washed my face, and gave me another sleeve of gauze, and sent me on my way again. One of the nurses offered me apple juice as I was leaving, but I was afraid to dislodge the gauze and start the bleeding all over again, so I promised I would drink something once I got home.
Mom and I sat in the waiting room for the next ten or fifteen minutes, waiting for the notification that the car had arrived, and then we took the elevator down to the lobby to meet the driver in the parking lot. I felt sort of dizzy and clammy when I stepped out of the elevator, but I thought it was form getting back in touch with the heat of the day after living in the bliss of air-conditioning for hours (it was 80 degrees Fahrenheit in the real world), so I was sure I just needed to rest against the wall for a second and I’d be fine. I took a few breaths and stood back up and made it another few steps towards the glass doors of the vestibule, where I knew I would really start to feel the heat, but I had to find a wall to lean on again, and then I found myself sitting on the floor, which just seemed silly. I laughed at myself and pulled myself up again, feeling like I was getting a full day’s exercise in one go, but I felt really nauseous and found myself on the floor again. From far away, I could hear Mom asking me if I was able to move my arm, because it seemed that my arm was trapped in the doorway and sticking out into the vestibule, and she was worried I would get hurt, or that I would block someone from entering or exiting, I don’t know. I must have been able to move my arm out of the way, and I must have tried to get up again, but the next thing I remember is being flat on my back and hearing the sound of racing footsteps coming down the stairs. Mom had gone back up in the elevator to get the doctor, and it seemed like the whole team had come downstairs with him. I could hear Mom telling them that I’d fainted and hit my head, which was news to me, and I felt a cold compress on my forehead and an oxygen mask over my nose, and one nurse even had a little electric fan that she used to try and cool me off. They put my feet up on a chair at some point and I heard the doctor say that he’d called for an ambulance, and then there were even more people around me, lifting me onto a stretcher (it’s good that she’s wearing jeans, so we can lift her by her belt loops).
Then I was in the ambulance and they were checking my blood pressure and doing more needle sticks (at least three more tries before they found a vein they could use). Every once in a while, I was able to say something, like, that’s the bad arm, the good vein is on the other side, and I could hear the EMTs asking how old I was and saying, no way, she looks twenty-five (which lifted my spirits, I have to say). They put a neck brace on me, because of the fall I couldn’t remember, and I heard Mom tell them that I’d hit my butt first and then my head, so I was probably okay. They brought me to the nearest hospital, which was literally around the corner, and I remember being outside for a moment and then they pushed my stretcher into the emergency room and transferred me to one of the hospital stretchers, which were all sort of floating around the room, with some make-shift screens put up between them to allude to privacy. They checked all of my vitals again, and took the neck brace off, thank God (because at that moment the brace was causing the most pain), and I had to sign a bunch of digital forms, but I can’t tell you what they were, and then the doctor told me her plan: blood tests to see if I needed a transfusion and a CT scan to make sure I didn’t have a concussion.
The original procedure had been at 11:15 that morning and we’d returned to the doctor’s office around 3:30 in the afternoon, so we probably got to the hospital around 4:30 pm. There was a nice lady in the bed next to me with an amputated leg who seemed to think I was up to making conversation, and then they gave me saline in one of the many holes they’d made in my arms, and I just stayed flat on my back because even lifting my head felt impossible.
There was something about those few hours, where I could take in most of what was happening to me but couldn’t really make logical decisions, that felt revelatory. I’d forgotten that this state of being even existed, even though it was a very common state from my childhood, because, I realized, I’ve always read more consciousness and choice into my memories than was really there. I always thought I should have been able to understand things, and should have been able to make better choices, but lying there on the hospital stretcher, I realized how silly that was. The whole time I’d been in the lobby of the doctor’s building, falling and standing back up and falling again, I’d been so sure that I would be able to stand up and walk out to the car if I just tried a little bit harder, and each time I was wrong.
At some point, Mom got a text from the oral surgeon, who had seen some of my early test results and wanted us to know that the reason my blood sugar was slightly elevated was because he’d put a steroid into my anesthesia cocktail, along with the Propofol and Versed, to extend the length of time the pain relief would last. And that was the first time in hours that I even remembered that I’d had surgery that morning and that half my face was still numb. Eventually, the saline started to do its job and they brought me some apple juice to drink and some disgusting orange Jello to try to shovel into my mouth and they tilted the bed so I could sit up like a human again and see what was going on around me.
Next up, they took me for a CT scan on my own personal stretcher, because they didn’t trust me on my feet even long enough to transfer me to a wheelchair, and I found my sense of humor returning, which was good because I could see my reflection in the elevator door and it was a lot. And then I was back in the Emergency Room, waiting for results. I remember thinking about all of the people I should be calling or texting, and just having no energy to even look for my phone. There was a basketball game, or maybe hockey, on the TV screen in the distance, but mostly I just listened to the conversations around me: the woman with the amputated leg really didn’t like her sandwich, and a woman with cancer arrived in so much pain that her not quite adult daughter had to speak for her, and there was a man with back pain who kept trying to stand up against the nurse’s advice, and a woman I couldn’t see who was angry about something I couldn’t understand.
Once all of the test results finally came back, the doctor told me that the blood loss and the anesthesia, and having two serious procedures in one day, had caused a Vaso-vagal Syncope (AKA I fainted), and it wasn’t an uncommon response (which is what my brother had said a few hours earlier, when Mom texted him). I was discharged from the hospital after 11 PM, once the doctor was convinced that I could walk without falling down, and we called the car service yet again to take us home. I was starting to feel much better, and therefore much more aware that my poor mother had spent the whole day taking care of me, despite the fact that she was walking with a cane and sitting on a hard chair and really really really needed a nap. We both struggled with the walk from the parking lot when we got home, and I had to sit down twice to rest along the walkway. Our downstairs neighbor, a nurse, met us at the front door of our building and insisted on helping me up the stairs, and I don’t know why I kept arguing with her because I really needed the help. We’d called her earlier to ask her to check on Tzippy for us, and it turned out she’d been waiting up for hours just to see how I was doing.
The left side of my face was still numb, but I dutifully ate a few spoonfuls of chocolate pudding, because it was at the top of my soft foods diet list, and then I made my way to my bedroom and fell asleep.
“I did not sleep, ever.”
I hadn’t really believed in the fainting part of Mom’s story, to be honest, until I woke up the next morning and could feel the sore spot on the back of my head from where I’d hit the floor, and the pain from the actual surgery was starting to kick in as well. I looked over the aftercare sheet from the doctor’s office and took the recommended doses of Tylenol and Ibuprofen and made myself some very well smushed tuna with mayo. The pain in my mouth kept getting worse throughout the day, but I was sure the Tylenol and Ibuprofen should be enough to manage it, since the doctor hadn’t prescribed an opiate this time around, and I really didn’t want to bother anyone.
I was still very disoriented, and exhausted, so I had a lot of time to think over the next few days and I kept reliving those few moments in the lobby of the doctor’s building, and wondering what would have happened if Mom hadn’t been there with me. I would have been just as helpless, but no one would have been there to fill the gap between what I could do for myself and what needed to be done, and that gap was starting to look really vast. And now that I was remembering all of those times as a kid when I couldn’t help myself, and no one else was around to fill the gap, I realized that instead of feeling the grief and helplessness of those moments, I’d filled the space with self-loathing, as if yelling at myself to try harder would suddenly make me capable of doing the impossible. There’s something so terrifying about that space, where there’s nothing I can do and no one is coming to save me, and my mind chose to deal with it by pretending I was wrong, telling me that if I could just push myself a little bit harder, be smarter, older, stronger, taller, healthier, whatever else I was not, then I would be okay.
But now, seeing myself over and over on the floor in the lobby of the doctor’s building, and realizing there was nothing I could have done, was an incredible relief; as if I was patting my younger self on the head and saying, see, you didn’t do anything wrong, and here’s the proof: when people knew you were struggling and were able to be of help, they came running. I remember being told as a kid that life isn’t supposed to be fair, and thinking that that was just nonsense, because of course life is supposed to be fair, and therefore if I’m not getting the help I need then I must not deserve it. That makes the world make sense. That makes the math work. But maybe the math doesn’t add up in real life. Maybe, more often than not, the gap between what I need and what I get is left unfilled, not out of intentional malice or because it’s what I deserve, but just by chance. Which is terrifying.
Anyway, I spent the rest of the week resting and recovering, thinking deep thoughts, eating soft foods, and wondering why the Tylenol and Ibuprofen didn’t seem to be doing very much. And then, exactly a week after the initial surgery, I woke up at three thirty in the morning to the taste of blood in my mouth. I put pressure on the wound right away, just like they’d done in the doctor’s office, and I looked up excessive-bleeding-a-week-after-oral-surgery on my phone and tried to feel reassured when it said that if I kept pressing on the wound and stayed upright, the bleeding would eventually stop. Mom got up to sit with me and after forty-five minutes or so, the paper towels I kept stuffing into my mouth started to be less and less soaked in blood, and I was finally able to take some pain medication, and a few deep breaths. Mom went back to bed, but I stayed on the couch in the living room and kept pressure on the wound, just in case. And then, around six or seven o’clock in the morning the bleeding started again. I went through four rolls of paper towels trying to staunch the blood and I finally texted the doctor’s office and was told me to come in as soon as possible. I woke Mom up again and she called the car service, again, and we made it out to the parking lot somehow and arrived at the office sometime around 8:30 am. But, after getting myself out of the car and thanking the driver and closing the car door, I couldn’t take another step. The nausea and dizziness and this strange weakness in my legs were overwhelming. Mom went inside to get help and I sat down on the sidewalk, trying to scoot along the ground to get a few feet closer to the front door, and then the doctor’s assistant arrived with a tech and a wheelchair, and they brought me inside and up to the exam room.
“What the F&%# is going on, Mommy?!”
The syphoning began again, and it was as if the intervening week hadn’t happened. The doctor was probably in the middle of another surgery when I arrived, so his assistant was in charge of assessing the situation and she gave me fluids through an IV and put me on the nitrous again. Somewhere along the way I heard her telling the doctor, “she’s a faucet,” probably in response to his endless requests for updates while she was busy trying to keep me from drowning in my own blood. Eventually, the doctor decided to cauterize the wound without anesthesia, so he could see where the blood was coming from, he said, and the pain was extraordinary. I was screaming and crying openly and my hands and feet and bottom lip started to go numb, and the doctor said I was hyperventilating and needed to focus on breathing out through the mask more than breathing in and I would have slapped him if I’d had any strength at all. At some point the doctor was standing in front of me and asking if I wanted to go to the hospital and of course, I said no, and then, finally, the anesthesia must have kicked in. I don’t remember losing consciousness but everything became sort of fuzzy. A nurse and a tech stayed with me, changing the gauze religiously until the bleeding had completely stopped, massaging my hands when they went numb again, checking on mom and letting her know I was okay, even bringing her pretzels and coffee in the waiting room.
Before running to help with the next procedure, the doctor’s assistant told me to stick to a liquid diet for the next few weeks, drinking a lot of Ensure and smoothies to keep my calories up, and I wondered why she was telling me that now, instead of a week earlier. I made a point of asking when I should go back to rinsing with the medicated mouthwash in case the vigorous (recommended) rinsing was also part of the problem, and she said, definitely not today. They transferred me back to the wheel chair and then wheeled me to the waiting room to sit with Mom until the car service could arrive, and then the nurse took me downstairs in the wheelchair and made sure I was safe in the back seat of the taxi before walking away.
The lesson this time around seemed to be that both me and Mom needed to work on asking for help sooner, and not worrying so much about bothering people, so even before we arrived back home Mom had texted the maintenance man at our co-op to ask if he could bring her rollator down from our apartment (it was actually her sister’s rollator, offered just in case she might need it). I was barely able to stand up long enough to transfer from the car to the rollator, even with help, but it was an incredible relief to find myself sitting on the rollator seat while our maintenance man pushed me all the way around the parking lot and up the walkway (I tried my best to hold my feet up off the ground, so they wouldn’t act as brakes), and we even zoomed along for the last bit, reminding me of childhood visits with Grandpa, driving along in his convertible with the wind in my hair.
And then I was sitting in front of our building, unable to stand, let alone to climb the two steps up to the front door, and forget about the twenty steps up the stairs to the apartment. My downstairs neighbor, the nurse, was home in the middle of the day, fortuitously, and she looked at me and looked at Mom and offered to drive us to the hospital. But I didn’t want to go. I thought, maybe I could just sit there for a few hours until I felt stronger, but my neighbor was dubious and said I’d be safer in the hospital, where they would probably want to give me a transfusion. When I finally accepted that I had no choice – my feet were not walking themselves up those stairs – I also realized that I couldn’t even make my way back down to the parking lot and into my neighbor’s car, so we called for an ambulance.
The maintenance man went to meet the EMTs in the parking lot and brought them to the backyard, where I’d been resettled in the shade, with a bottle of water and a box of tissues (I can’t even tell you how lucky we are in our neighbor and our maintenance man). There were two or three EMTs and they transferred me onto a stretcher and rolled me down to the ambulance, and then the one who looked like a cross between Harry Styles and Harry Potter started the assessment. He couldn’t have been much older than my nephews, and he had tattoos down both arms like Harry Styles, but he had a reassuringly sweet smile and I was pretty sure the bangs on his forehead were covering a lightning shaped scar. He took my vitals, including an EKG, but he didn’t try to put in an IV for fluids this time. My arms were already black and blue from all of the needle sticks the week before, and then again from that morning, so he might just have left it for the nurses to manage later in the ER, when I wasn’t so much of a moving target.
We went to a different hospital this time, closer to home and with a much bigger emergency room, and the EMT parked me in the entrance hallway and reported my history and vitals to the nurse in charge, and she put two bracelets on my arm, one with my name and birthdate on it, and one in bright neon yellow that said “fall risk.” Pretty quickly they moved me from the assessment hallway to my new parking spot at the end of another hallway, and I started to meet a lot of nurses and techs and doctors. My sense of time was all over the place, but I remember a lot of blood being taken, and I remember drinking apple juice and worrying that the bleeding was going to start all over again.
The ER doctor asked a cardiologist to consult at some point, and he pulled the skin under my right eye (checking for hidden aliens?) and looked at my blood test results and said I’d probably lost half my blood volume and would need a transfusion. Which meant that the needle sticks had to start again. One nurse even got out the ultrasound wand to try and locate a vein before sticking me three more times, but the pain was excruciating and she still couldn’t find a good vein. Eventually the next nurse, or the one after her, found a usable vein on the back of my right hand, and then she taped the needle in place three times so it wouldn’t move even in an earthquake. By then they had decided to keep me overnight for observation and I sent Mom home to rest (one of the nurses had even brought her a tuna sandwich and some gingerale along the way). More blood was taken (no wonder I needed a transfusion!) and they checked my blood pressure a thousand more times and gave me more apple juice, and I spoke to my brother on the phone and he told me that when they gave me the transfusion, I would be able to hear the memories of the blood’s owner (he reads a lot of sci fi), so I was looking forward to that.
Mom had reached out to the executive director of our synagogue (one of her favorite people on the planet) so I got a call from one rabbi and texts from the other. I still couldn’t walk, or really stand on my own, but my sense of humor had returned somewhere along the way, and I was taking copious notes in my tiny notebook, and at some point they started the actual transfusion, and then at nine or ten o’clock they transferred me to a semi-private room deep in the ER, where I could watch TV and, to my surprise, was able to fall asleep.
They woke me up around five or six the next morning and the first thing I noticed was the pain. Whatever anesthesia the oral surgeon had given me in his office the day before was finally starting to wear off, but the nurse needed a doctor’s approval before she could even give me an Ensure, let alone a Tylenol, so it was a few more hours of sitting and waiting in pain while they gave me more fluids through the IV.
The older rabbi from my synagogue came to visit around ten or eleven that morning, and the younger rabbi texted to check up on me and asked if I’d like to be added to the Mishaberach list, so people could pray for my well-being at Friday night services this week, and I surprised myself by saying yes to that for the first time in my life.
The cardiologist came in to check on me at some point, and had my blood pressure checked in three positions, lying down, sitting and standing up, before ordering more fluids. And, finally, sometime after noon, the cardiologist cleared me to go home. It still took a while before they could remove the IV – which was really well taped in place and therefore hurt like hell when it came out – but Mom was able to get a lift from yet another generous neighbor, and the nurse walked me out of the emergency room for pick up. When I sat down on a bench by the front circle where patients were supposed to be picked up, I realized that I was finally walking on my own power for the first time in twenty-four hours, and then I saw the car and didn’t quite sprint across the parking lot to get into the backseat of the car, and finally, we went home.
I slept for a long time that afternoon, after filling up on Tylenol and Ibuprofen and Ensure, and when I woke up Mom told me she had called the doctor’s offices asking about pain management, so I guess I must have mentioned the pain to her, but she hadn’t heard back yet, so I took more Tylenol, drank another Ensure, mixed with Fairlife Chocolate Milk to make it more palatable, and went back to sleep.
The next morning, the pain was so bad that I couldn’t even drink the Ensure, so I texted the doctor’s assistant and she had the doctor call in a prescription for Percocet and Mom was able to get a lift to CVS to pick it up for me.
The Percocet did its job, so it was a few days before I realized that I didn’t have my hospital notebook anymore (I was sure it was sitting safely in my pocketbook waiting for me, but I must have lost it among the sheets of the hospital bed at some point), and I felt stupid, because the nurse had specifically asked me if I had left anything behind when I left the ER, and I didn’t think to check for the notebook. But I drank more Ensure and got to work reconstructing events to the best of my ability, though to be honest, everything from the midway point of this essay onward is just a guess.
As you can imagine, I have some notes for my doctor about what to do differently next time around (on someone else, because I can’t see going through this again, even if this procedure was as unsuccessful as the last one). I still worry that I’m going to wake up with a mouthful of blood in the middle of the night, but so far everything has remained intact.
I’m not sure what lesson to take from all of this, to be honest. I was hoping that writing it all out would give me some clues to bigger life lessons, but for now I’m just grateful that there are so many kind people in my immediate vicinity, willing to go out of their way to help me. Though, I think Tzippy has been taking her own notes on the whole ordeal, so she might be ready to share her life lessons any day now. Fingers crossed.
“I have absolutely nothing to say.”
If you haven’t had a chance yet, please check out my novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
Coming to the end of another school year means it’s time to reassess and plan for next year, but I’m not ready. My thoughts keep swirling and I can’t slow them down enough to make any decisions. I have yet another oral surgery coming up at the end of May (hopefully the last one, but I’m not holding my breath), and I’m exhausted from all of the effort that has gone into trying to get healthier when the only thing that improves, somewhat, are my numbers, rather than how I actually feel.
I have lost most of the weight I need to lose, overall, but there’s still too much fat at my belly, which is specifically dangerous cardiac-health-wise, so I have to keep going, but each time the doctor has raised the dose of Zepbound, my depression has gotten worse and I’ve had to ask the psychiatrist to raise the dose of my antidepressants in response. The GLP-1 drugs are relatively new, so it’s not surprising that some side effects were underreported, but depression seems like a big one to have overlooked. I was warned about the gut issues, but not the dizziness on standing and not the depression, but it feels like I have to keep going anyway.
I’ve been trying my best to look for other ways to raise my serotonin naturally, like singing more each day, or exercising more, but I’ve been so exhausted that even getting the laundry done feels like an insurmountable task. Whenever I get an idea, even a small spark, I write it down, somewhere, in the hopes that the small sparks will add up to something meaningful, someday. I’d love to spend more time singing with other people, and going to classes, and writing more, and spending more time with friends, but I don’t know how to get there. For now.
“Let’s just sit here and enjoy the beautiful weather, Mommy.”
If you haven’t had a chance yet, please check out my novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
I’ve been waiting for my appointment with the oral surgeon for most of the summer, ever since he decided that there was something he could do to deal with my recurring infections (caused by the original oral surgeries, two and three summers ago), other than more cycles of antibiotics. He’s come up with a few different explanations for the infections over time: that the screws they used for the implants way back when (three years ago) were too porous; that the original bone loss left pockets where food could get stuck; that it’s all my fault.
I was worried that this would turn out to be yet another involved, painful, expensive procedure, but instead the doctor told me it would just take an hour or so, while they took some skin from the roof of my mouth to fill in the vulnerable area, and there would be no extra cost. And, the doctor said, the pain wouldn’t be too bad, just like “a pizza burn.”
I haven’t had much pizza over the past eight months, since I’ve been on Zepbound and certain favorite foods have become unfriendly, but I vaguely remember burning the roof of my mouth a few times and not being traumatized by the experience.
Most of the anxiety came before the procedure itself, of course, because it was all unknown. I was relieved when I found out that I wouldn’t need to do all of the medical checks I went through before the two big procedures, because it would be a much shorter, less involved process, and only require twilight sleep instead of full anesthesia. But I still had two months to wait and worry before the appointment, and I’m very good at anxiety.
“Me too.”
Finally, on the day itself, we had to take a car service to the doctor’s office, because I wouldn’t be allowed to drive home, and even though Mom would be with me for moral support, she can no longer drive. And, of course, I was about as anxious about the car service as the procedure itself, because I’m not so good with strangers, in small spaces, early in the morning, or ever. But when I got to the office, the doctor’s assistant welcomed me, and she has been the reliable, friendly, down-to-earth face of the practice all along, so that helped calm me down. A little. She brought me into one of the regular exam rooms, where the light fixtures are covered with happy clouds in a blue sky, which also helped. And then I had time to get anxious again while they set up around me. My x-rays were loaded onto the screen in the front of the room, making me look like a very scary alien, and then my charts came up, saying that I had been told to “aggressively waterpik” (which was news to me, because I was sure “assertive waterpik-ing” should have been good enough). And then I saw the words “arm restraints” pass by quickly on the screen, and I, of course, had to ask what that was about. It turned out they were going to be restraining my arms during the procedure, to prevent me from, I don’t know, punching the doctor or trying to scratch my nose.
Then they took my glasses, so I couldn’t read anymore, which was a relief, and they put on the automatic blood pressure cuff, and the pulse/ox monitor, and then the oxygen mask, which made my nostrils feel cold and sore. And then came the needle. They had to use my left arm, for choreographic reasons, even though the good vein is clearly on my right arm (I get a lot of blood tests), which meant they couldn’t find a good vein in the usual places and ended up sticking the needle into the back of my left hand, which hurt more than pretty much anything else the whole day. And then there was nothing.
I came to while they were removing the different monitors and restraints, and telling me that everything had gone well. Then they walked me to the recovery room (pretty much a closet with two places to sit) where Mom was waiting for me, and then they gave me instructions for how and when to change the gauze pads, and ice the wounded area, and let me go home.
Half of my face was numb for the rest of the day, so I was only allowed to eat pudding (yay!) and cold soup (eh, not so much), but I wasn’t especially hungry anyway. On day two, I was allowed to rinse with medicated mouthwash and as much warm salt water as I could ever want, but no brushing or aggressive waterpik-ing, yet. And I could chew again, though I still wasn’t eating anything too complicated. By the end of day two, the pain was actually worse, and the swelling had started to kick in, but not so bad that I had to fill the prescription for opiates; I was able to make do with Ibuprofen and Acetaminophen.
Day three was a rest day. It was sort of a delayed reaction to the procedure, as if I’d been the one doing the surgery rather than the one sleeping through it. The doctor called to check on me towards the end of the day and seemed pleased with my report. I’ll see him next week so he can marvel in person over what a great job he did (he likes to marvel at his work like that, unironically), and hopefully, once this short recovery period is over, I will be done with the infections, and maybe that will mean that I’ll feel better overall (since cyclical infections can’t be helping my overall health), though there are no guarantees.
The thing is, I’ve been really, really tired this summer. I’m always tired, to be honest, but it has seemed worse lately, and I don’t know if reducing the frequency of infections will make much of a difference, or if whatever underlying disorder that has been causing all of my symptoms is ever going to resolve. No further diagnostic progress has been made in the past few years, despite visits to geneticists and neurologists and neuromuscular specialists and rheumatologists, etc., and all kinds of tests and treatments along the way.
At the very least, I’d like this one procedure to have been successful, and for that to mean a somewhat less crowded year of doctor appointments ahead. Though it would be really nice to feel like a healthy person for a little while. Weird, but nice.
“Weird, but nice? Welcome to my life.”
If you haven’t had a chance yet, please check out my novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
Every three months or so, I see my psychiatrist for a few minutes on zoom (or Doxy, actually, a platform specifically for medical appointments), because he decided not to go back to in-person visits after Covid. He asks me how I’m doing with my antidepressant medications, and I say “fine,” and he takes notes and refills my prescriptions and makes a new appointment for three months in the future, and then we’re done. Of course, there have been times when I didn’t say I was fine, and he raised the dose of one or the other of my medications, which led to a one month follow up instead of a three month follow up, but for the most part, everything has been stable for quite a while. To fill out the four- or five-minute appointment, we tend to chat about my teaching, or my other doctors and the new medications they’ve added to my regimen, but for the most part, he asks me if I think I need to raise the dose of my meds, and I say no, and we wish each other well. But at my latest appointment, when I said a variation of my usual “I’m fine,” he said, “but what does that mean?” and I didn’t know how to answer.
“Do you ever talk about me?”
In the end, I must have said something reassuring, because he kept everything the same and we made the usual appointment for three months in the future, but when I closed my laptop, I wasn’t sure if “I’m fine,” was really the truth, or just something I’ve gotten used to saying. I don’t remember if I was more willing to go into details back when I actually had to leave the house for those five-minute session every three months, but there’s definitely something about the virtual appointments that encourages me to keep it simple.
The fact is, I don’t really know if I’m on enough anti-depressant medication, or the right medication. I have no idea if this is the best my mental health can be, or if there are medications or other treatments that could make things better. The few times I’ve been willing to risk changing my medication were when I was feeling so awful that I wasn’t sure I’d be able to function otherwise.
Antidepressant medications are a mystery, and not just to me. Doctors still don’t really understand why they work, or why one medication works for one person and not for another. It’s a lot of trial and error and guesswork, and a little too much Russian roulette for my liking. When I was first trying medications, years ago, the doctors would try a few from each family of drugs, and I had to spend weeks, and even months, dealing with weird side effects while waiting to see if something positive would happen. There was one medication that the psychiatrist (a different one) insisted on trying even though it was meant for bipolar disorder, which I don’t have, and within 24 hours I felt like I was going to jump out of a window, or at least scream until my head exploded, and I refused to take another dose. The doctor didn’t seem to think my reaction to the meds was all that bad, and he wanted me to stick with it for a least a few more weeks to see what would happen, but I felt strongly that I shouldn’t be taking a medication that made me want to kill myself and he reluctantly moved on to another class of drugs.
Psychiatrists, and other doctors who prescribe these medications, also tend to be unusually terrible at diagnosis, because there is almost no consistency in how different doctors interpret the words of the DSM (Diagnostic and Statistical Manual of Mental Disorders), and the words used in the DSM are generally unrelated to the way patients actually experience and describe their own symptoms. Sometimes it feels like the doctors are waiting for certain magic words to be said, and don’t know what to make of the metaphors, sentence fragments, and shrugs that real people use to describe how they feel.
To be fair, medical doctors are just as terrible at diagnosis when they don’t have hard and fast results (from blood tests or scans) to determine what’s going on inside. The pain medication I’ve been on for maybe fifteen years now (after trying a lot of different drugs meant for any number of different diagnoses) has only ever reduced the pain by half, and usually less than that; and the same is true of the psych meds: if they reduce my symptoms by half, that’s a good day.
In an ideal world, I would sit down with each of my doctors and describe in detail how I feel (what hurts, how it hurts, what I’m struggling with, and what I’ve tried) and be answered with curiosity, understanding, respect and investigative questions to help me pinpoint and articulate my symptoms as clearly as possible. But, to be honest, that has never, ever happened. I have certainly attempted it, with dozens of doctors, but they tend not to hear what I’m saying over the noise of their own assumptions, and it ends up being easier to keep things short.
I’ve been on my current anti-depressant medications for more than ten years now, and while they have caused weight gain and nervous system disruptions and a bunch of other side effects, they allow me to function most days, and they give me the leeway to do the therapy work that helps me move forward. And for me, to be able to say on an average day that I am fine, that I am not in a panic spiral or falling into depression or obsessing over this or that awful thing coming up in my life, is huge. It allows me to live my life each day and accomplish some of the things that matter to me, and experience joy, and even do the laundry. It may not be miraculous, but, at the very least, it qualifies as fine.
“Have you tried chicken treats? They really work for me.”
If you haven’t had a chance yet, please check out my novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
Sometime over the winter, one of the rabbis at my synagogue announced that there would be a week-long volunteer trip to Israel in August, for teenagers and adults, and, oh yeah, they were applying for a grant to subsidize half the cost of the trip.
That was all the information available at the time, but I already knew I wanted to go, desperately. I fought against the loud voice in my head telling me that going to Israel during the hottest month of the year, and volunteering, most likely outdoors, would be impossible for me, because the idea of going to Israel with people I knew, and being able to learn more about the situation on the ground, and to be of use, at an affordable price, just seemed like the answer to a lot of my prayers.
So, I started to prepare myself. I wrote out a long list of what I’d need to bring with me (meds, sunblock, water bottle, adapters for the electricity, sim card for the phone, a week’s worth of clothes, Icy Hot patches, extra pain meds, etc.), and I wrote through all of the reasons not to go (fear of the effect of the heat on my autoimmune symptoms, fear of being lonely, fear of pain and exhaustion, fear that something would happen to Mom or Tzipporah while I was gone, fear that I would be too shy to use my Hebrew, fear of feeling bored, or trapped, or disappointed, or confused, etc.). And then I wrote out as many ideas as I could think of for how to deal with those fears.
“Wait, what’s going to happen to ME?!
But despite all of my efforts, I couldn’t plan for the trip until I knew exactly what the trip would entail. So, I reached out to the rabbi with my concerns (how much time would be spent outdoors, would the volunteering activities be things I could actually do, would there be rest periods for recovery, etc.), and she sent me the planned itinerary, with the proviso that, because all of the volunteering locations were small and relatively new, there wouldn’t be any room for adaptations.
And it looked amazing! They would barely be staying in one place for more than a day, traveling to the north and the south and in between, meeting people who were rebuilding in the north after a year of bombing from Hezbollah, and meeting Israelis of all religious backgrounds working to help each other, and meeting families of those who were killed on October seventh, and families of hostages, and Palestinian citizens of Israel, and helping rebuild the agriculture sector in the south that was impacted both by October seventh and by so many men being pulled into the army reserves and out of the fields. There was one afternoon set aside for potential beach time, but other than that, free time didn’t exist.
I was in awe of the opportunity to meet so many different people working in so many different parts of Israeli society, and the more I read, the more I wanted to go. But no matter how I tried to move things around in my mind, and research all of the sites and turn the pages this way and that, it became clear that I would barely survive day one, let alone a whole week. Except, a big part of me was still in denial, imagining that if I just spent the next few months in physical therapy, and had a miraculous recovery from all of my health issues before August, and maybe found myself a full-body airconditioned suit to wear, I’d be okay.
The tour guide who would be leading the trip (and who had been leading bi-weekly zooms for us since October seventh, to help us understand how Israelis were reacting to the Hamas attack and the ensuing war), came to the synagogue for an in-person visit leading up to registration for the trip. I sat in the sanctuary and listened to his impassioned thoughts on the current political turmoil in Israel, and the moral quandaries of the war, and the grief and anger around the hostages still trapped in Gaza, and the communal efforts to support those who were struggling, and I could envision myself in Israel, marching for the hostages, and marching for democracy. In my imagination I could walk for miles, in the heat, singing and calling out at the top of my lungs, even though I’ve never been able to do anything like that here at home.
At one point in the evening, when I was sitting next to the older rabbi from our congregation, who had either led or participated in every previous synagogue trip to Israel, and who had marched in many protests over the years, I told him how much I wanted to go on this trip, and he told me that he would not be going because it would be too much for him. “But, but doesn’t it look amazing?!” I asked, and he shrugged and said, “You can’t do what you can’t do. There will be other trips.”
And the bubble burst. I knew he was right, and that he was speaking as much to my situation as to his, whether he meant to or not. Of course I couldn’t go on this trip, and it felt awful to have to know that; just like it feels awful every time I have to accept a reality I don’t like. You would think I’d be more practiced at handling disappointment by now, but I suck at it every single time.
I still made a point of applying for a new passport though (after years of putting it off), just in case, and I kept my packing list and my research on the different volunteering sites, and I continued to add hundreds of Israel-related videos to my YouTube watchlist to fill out my understanding of the culture and the people. One day, hopefully not too far in the future, the right opportunity to go to Israel will come up, and in the meantime I will keep doing the work I am capable of doing so that I’m ready to go when the time comes.
“Puppy, cover my ears!”
If you haven’t had a chance yet, please check out my novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
We don’t know what set it off, but Tzipporah was sick for a week. One afternoon she had a loose poop, and the next poop was even more liquidy, and the next was all liquid, and then she was vomiting, in her bed. Right away, I was having flashbacks to the last few months of Cricket’s life, when she was suffering from kidney disease and we had to spread wee wee pads everywhere. But I tried to stay calm, and when I gave Tzipporah her first bath-at-home, and she hated it, the energy with which she fought off the washcloth and the water made me hopeful. And then we gave her some Pepto Bismol, enrobed in peanut butter, to see if we could stop the flow in its tracks, and she ate the newly crunchy peanut butter gleefully, and then threw it all up. The next morning, she didn’t eat her breakfast at all, so we called the animal shelter’s clinic and they gave us an emergency appointment. Tzipporah needed to have her butt washed one more time before her appointment, which she hated, again, and then we wrapped her in a towel and brought her to the car.
“I don’t feel so good.”
She sat shaking in my arms in the waiting room at the clinic, leaning her head under my chin to hide. When we were called into the examination room, she let me place her on the exam table, but she stayed as close to me as possible, and then, when the vet came in to examine her, she tried to climb me like a tree. But she survived, and even let me hand her off to the vet tech, who took her away for blood tests and an x-ray, and then brought her out to us in the waiting room wrapped in a wee wee pad, because she’d had another accident during the x-ray.
I held her close and whispered to her and scratched her ears, and she started to relax. And I realized that somewhere along the way Tzipporah has decided that I am her Mommy. There was no one moment that clinched it for her, as far as I could tell, it was just a gradual realization that I can be trusted to feed her, and wash her, and comb her hair, and to comfort her when things go wrong.
When we were called back into the exam room, the vet told us that there was nothing in the blood tests to worry about, except some small elevations caused by stress, but the x-ray showed that Tzipporah’s large intestine was swollen, which could be a sign of a blockage, or not. The vet wanted us to come back the next day for a follow up x-ray, hopefully to find that the swelling had reduced, but if not, she said, we might need to think about surgery. She sent us home with a few medications (all in liquid form, in case Tzipporah still wasn’t up to eating solid food), and a lot of anxiety.
When we got home, I gave Tzipporah yet another bath while Mom cooked up her newly prescribed bland diet (boiled chicken and rice), and then we gave her the prescribed appetite stimulant and she gobbled up her lunch and even let me give her the rest of her meds, sort of. And then she and Mom rested while I went out to teach.
Tzipporah happily ate her dinner later that night, and there was no more vomiting, but she did continue to have diarrhea overnight. The next morning, we were only allowed to give her a little bit of food to go with her meds, because the doctor wanted the second x-ray to be as clear as possible. And then I gave her yet another half-bath and we were off to the vet again.
These visits to the animal shelter clinic, the same one where we used to take Butterfly (our first puppy mill mama), were bringing up a lot of grief and fear, and it was hard to remember that this was probably just a blip, not an illness, yet, and not fatal. When Butterfly came to us, she was eight years old and had significant health issues, so we spent a lot of time in and out of that clinic, especially towards the end of her life, almost five years later. That clinic was a god-send, honestly, and helped us keep Butterfly for much longer than we’d ever have expected, but the grief has never really faded. And watching Tzipporah, another puppy mill mama, going into those same exam rooms, was a lot.
Miss Butterfly
Tzipporah’s second x-ray was better than the first one, with signs that the inflammation was passing, but the vet said to keep an eye out and if she vomited again, we should take her to the emergency vet for an ultra-sound, all of which sounded terrifying and expensive. Thank God, Mom had thought ahead and bought health insurance for Tzipporah the day we adopted her, which, after a deductible, would give us 80% of the cost back.
Before we left the clinic for the day, two vet techs gave Tzipporah subcutaneous fluids and a B12 shot (which also reminded me way too much of Cricket’s final months), and the doctor prescribed another medication to add to her cocktail, and we went home.
Miss Cricket
I spent the rest of that day doing laundry (both dog beds, a whole pile of towels and blankets and toys, and all of the clothes I’d worn to the vet and while giving Tzipporah her many baths), and Tzipporah spent the rest of the day eating and sleeping.
By the next day, there were no more signs of diarrhea or vomiting. It still took her a few more days for her to get back to normal (AKA running down the hall to beg Grandma for chicken treats), and even longer for us to stop watching her anxiously, but we eventually began to add some kibble back into her diet, and she had the energy and presence of mind to toss the kibble out of the bowl and focus in on the chicken and rice.
The whole experience was overwhelming, especially because of the memories it brought up, but something good came out of it too: when Tzipporah was sick and needed help, I had to help her, whether she liked it or not. I’d been so careful with her through her first few months with us, because I didn’t want to re-traumatize her, and I wanted to give her time to acclimate to life with people, and because I was afraid of making mistakes. But when she was sick, I stopped worrying about all of that and gave her the care she needed, and she responded by leaning on me, and asking to be picked up, and looking to me for reassurance. She’s still suspicious of me, of course, but she seems to understand that I can be trusted. I’m also realizing that I was probably too careful, worried that she would reject me or worried that I would love her and lose her too soon. Cricket and Ellie’s deaths last year, within months of each other, left a deep mark on me, and I think some part of me was holding Tzipporah at arm’s length, just like she was holding me at paw’s length for her own reasons.
Cricket and Ellie
But she looks at me now, and communicates in her own unique way, and even recognizes me as a particular person, who she might even like. We still don’t know what set all of this in motion, maybe a stray piece of chocolate or a dropped pill or something else she managed to find on the floor during her nightly wanderings. But whatever it was, it passed, and she seems more confident in the aftermath. And I think we’re more confident too, and willing to be more proactive with her, even when she looks at us with suspicion. It’s still a work in progress, and we still have a long way to go, but we’re finally getting somewhere, and she even seems to be a little bit happy to be here. Sometimes.
“But only sometimes, Mommy.”
If you haven’t had a chance yet, please check out my novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
At my most recent visit to the endocrinologist (thyroid issues, etc.), the doctor told me that Lilly has decided to offer Zepbound (a variation on Ozempic) for a discounted price to patients whose insurance companies won’t cover the GLP-1 weight loss medications. The average price for these medications, in the United States, is about $1,000 a month, though in other countries they can be bought for $100 or less, which has come up in contentious congressional hearings of late. My health insurance still refuses to cover these medications for anyone without type two diabetes or a severe heart condition, and I have been waiting impatiently for them to decide to cover GLP-1 medications for Non-alcoholic fatty liver disease, which I was diagnosed with last year, but who knows when that will happen.
Last year, the endocrinologist told me about a program that discounted Zepbound to half price, but only for people without any insurance coverage, which did not include me. But now, they are making it available to people like me who have health insurance that doesn’t cover the medications. The cost is $400 a month, which is a lot for me, but for the sake of my health I really can’t say no. My hope is that, if the Zepbound works for me, these medications will soon be covered under my health insurance and I won’t have to pay this much for long. Ideally, losing weight will improve the health of my liver and reduce the need for heart medications. I don’t think it will give me more energy, or reduce overall body pain, but you never know.
To be completely honest, though, what I really want from this medication is to lose enough weight to feel like a normal person. Yes, I want to reduce my risk of liver and heart disease. And yes, I would love to find out that losing weight could give me more energy and allow me to actually live more of my life, but, since childhood, I have been self-conscious about my weight, and I am so tired of feeling like a mutant. I know weight loss won’t change my life miraculously, because I’ve lost weight in the past, when I was able to exercise enough to lose weight on my own. And I’m sure I will still feel uncomfortable in my body, and struggle with pain and depression and anxiety and exhaustion. But it would be great to be able to go to my doctors and tell them my symptoms and NOT have them blame everything on my weight.
I was on a low dose of Ozempic last year, when my insurance was still allowing it, and I lost fifteen pounds. But as soon as the FDA cracked down on off label use of Ozempic, I was cut off, and within three months I’d gained the weight back. So, one, I know the meds can work, and two, I know I will have to be on them forever.
There’s a lot of fear for me around starting the Zepbound, actually. For some reason, the discounted Zepbound comes in a vial, with separate needles, instead of in pre-dosed pens, so I’m afraid it will hurt more and/or I will do it wrong. I’m afraid I won’t be able to lose enough weight to make a difference in my health, or I’ll get cut off again, because the price will go up or supplies will run out. I’m afraid I’ll be sick to my stomach for the rest of my life (though that’s not very different from how I feel now, to be honest), or that the Zepbound won’t work, or that I’ll lose the weight but I’ll look like a deflated balloon instead of looking, and feeling, healthy.
Maybe most of all, I’m afraid that having to spend $400 a month on this for the foreseeable future, on top of paying off my medical debt, will mean that I can’t really afford a new dog, with all of the vet bills and adoption fees and toys and treats involved. And going too much longer without a dog in the house feels like a risk to my mental health (and to Mom’s). It feels so unfair to have to choose between my physical health and my mental health, especially when they are so intertwined. But here’s hoping I won’t have to choose, and a little, hypoallergenic rescue dog will come along soon, and congress will decide to cover GLP-1 meds for Non-alcoholic fatty liver, and all medical debt will be wiped out, and we will all live in peace and harmony, forever and ever, amen.
A girl can dream. Right?
“I’ll eat whatever you’re not eating. You’re welcome.”
If you haven’t had a chance yet, please check out my novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
In a previous post I mentioned that I was putting the idea of what I want out into the universe, and ever since then I’ve been debating with myself over whether I really believe in this concept or not. I want to believe in it. I want to believe that by putting my dreams into words and speaking them outloud I can create some sort of alchemy that will bring these dreams to life. But then I worry that this is all “magical thinking,” which has always been a soft spot of mine, and something I’ve been told is somewhere in mental illness territory.
Logically, I can argue that you have to articulate your dreams in order to reach them, at least as a first step on the journey, because if you don’t know what you want you can’t work towards your goals. And I can also argue that telling other people what you hope for can be practical, both because they may have connections or advice to help you reach your goals, and because having friends remind you of your goals can keep you on track. And, if you strip away the wishful thinking part of the whole thing, it’s reasonable to assume that if you focus more on the things you really want in your life, you will start to notice the small opportunities you might have missed before, and therefore have more chances to reach your goals.
But, I don’t think that’s what I really mean when I think about the power of putting an idea out into the universe, or “manifesting” as it seems to be called today. What I’m really hoping for is that God, or the universe, will give me what I want without me having to do anything.
Early in life I learned about a version of God that actively does these kinds of things for us: pushing water out of the way so that my ancestors could cross the Sea of Reeds, or sending locusts to convince Pharaoh to let our people go. I loved this vision of God, but it was hard to hold onto it in the face of a much more disappointing version of reality. Then I was taught that even though God hears our prayers, and they are therefore never wasted, sometimes, for whatever reason, God’s answer is no; and we should trust that when God says no to our requests that means the best answer was no, even if we will never understand why. This has never been a satisfying idea for me, if only because I don’t really trust authority figures to judge what’s best for me. Even God.
And then, in college, I learned that it is reasonable to doubt that God has a plan as such and is choosing winners and losers, or even has a role in our everyday lives. Instead, I should see God in the Aristotelian way – as the unmoved mover, the one who got the ball rolling but then stepped back and left us to our own devices. And therefore we have to make our own fate, and fight and scrap for everything we want and never wait for luck to kick in.
So, I’m split. I believe, deep in my heart, that there are powers and connections at work in the universe that exist despite my inability to see them. But I also believe, almost as deeply, that believing in such things is ridiculous.
Recently, my mother underwent a heart procedure where they were supposed to insert clips on her mitral valve in order to mitigate the damage to the valve, which was causing fluid to regurgitate into the left ventricle. She has had mild to moderate damage to her mitral valve forever, but a recent test showed that the damage had reached the severe stage and therefore needed to be addressed surgically.
Except, the procedure was unsuccessful. It’s not that the clips were unable to adequately close the holes in the mitral valve but that the doctor was unable to even deploy the clips in the first place, because of changes in Mom’s anatomy caused by her scoliosis. The doctor also discovered two other important things during this failed procedure: one, because of these changes in her anatomy the open heart surgery that would have to be performed to fully replace her mitral valve would be contraindicated (aka too dangerous), and two, the damage to the mitral valve isn’t actually so severe and therefore can be managed with medication.
After reading up on “manifesting,” I started to worry that my fears about the open heart surgery had caused this procedure to fail. I was asking God to make sure we didn’t have to do the open heart surgery, or anything that could put my mother’s life at risk, and what if, in response, God said, Okay, we’ll just stop it all right here. The logical part of my brain says that God didn’t do any such thing, and that this was going to be the outcome no matter what I thought or prayed for. But if that’s true, doesn’t that mean that my prayers are a waste of time in every case?
In the research I did on “manifesting,” I came across different interpretations of the idea. One said that having any negative thoughts causes negative things to happen, so, it really is all my fault. Another said that if you do affirmations a thousand or so times a day, you will draw your goals closer to you, with your vibrations. The most practical interpretation I read, though, said that the point of all of the thinking and hoping and focusing on your goals is to get you to start thinking of actions you can take towards your goals, and to encourage you to notice more opportunities than you otherwise would. There is still some magic implied in this interpretation, along the lines of “God helps those who help themselves,” but it’s a kind of magic I can almost believe in.
The reality is, you can argue for almost any world view you want to, and find plenty of evidence for your choice, but there will always be loose threads left unexplained, because we don’t, and can’t, know the whole picture. We are all guessing, or at the very least, interpreting the data we ourselves have access to as if that’s all the data that exists.
So, do I believe that I can manifest my dreams by saying them out loud? Maybe. I don’t know.
For now, I’m going to hope that the doctors can find the right combination of medications to help Mom manage her mitral valve, and allow her to have the energy to do more of the things she loves, for many years to come. And I’m going to keep looking at the stuffed puppy dog sitting on top of my computer screen, and hope that the real life version of him will arrive someday soon. I don’t know if God listens to my hopes and prayers, but I know that it feels good to put it all into words, and saying my dreams outloud makes me feel like I’m taking steps to make the world into the kind of place I can live in, just by imagining that it already is that place. We’ll see where it takes me.
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
My allergies have kicked in big time, and the most likely culprit is all of the maple trees right outside my window and the thousands of seed pods they send raining down to the ground. The wheezing came out of nowhere one day last week: I heard this strange sound, like someone crying or screaming from a distance, and it took me a while to realize that the sound was coming from my own throat. Somehow all of the allergens have chosen to bypass my nose, and mostly my eyes, and lodge themselves in my throat where I inconveniently need oxygen to breathe. Sleep has been tough, and the allergy meds I take day and night are not helping much, but it is sort of fun to sound like Darth Vader every once in a while; it breaks up the monotony. Not that there’s been much monotony lately, to be honest.
I wonder if the mask would help me breathe better (not my picture)
This past week Mom and I went to see a cardiac surgeon to find out the next steps for dealing with her damaged mitral valve. I was very nervous about the appointment, we both were, in large part because there was so much we didn’t know. We spent about four hours at the hospital on Monday and met with the cardiac surgeon and then with his colleague who specializes in cardiac interventions other than surgery, and the plan going forward is to have a minimally invasive procedure (sort of a combination of an angiogram and an endoscopy with mitral valve clips thrown in), in the hope that clipping the mitral valve (rather than replacing it) will be enough to mitigate the damage. The doctor explained that at this point about fifty percent of the fluid leaving Mom’s heart through the mitral valve is going into the left ventricle, which is stretching it out of shape and wreaking havoc. The clips will close the holes in the mitral valve, at least partially, to redirect the fluid to where it belongs. This less invasive procedure will only require one overnight stay in the hospital (as opposed to a week in the hospital and then two weeks in a rehab facility after the full surgery), and recovery will be minor.
But there’s something so un-reassuring about the image I have in my mind of the mitral valve clips: I keep seeing tiny wooden clothespins, like the kind that hold laundry on the line so it won’t blow away in the wind, but the doctors say it’s worth a try and could reduce the symptoms of fatigue, shortness of breath and heart palpitations to a more manageable level. The problem is that Mom’s mitral valve isn’t just damaged in one place, it’s more like Swiss cheese, so there’s a fifty/fifty chance that the doctor will go in to do this procedure and on the spot decide it’s not working and we will have to go ahead and schedule the full heart surgery after all.
(not my picture)
I feel a little better knowing the steps involved in all of this, even if we end up having to go the full surgery route after all. The worst part was not knowing and leaving it all to my imagination, which is vivid. The doctor made sure to say that the chance of death from the minimally invasive procedure is about 1%, which is close to the risk from, say, going for a walk on a spring day. The full surgery’s risk is at about 5%, which is higher, but not high. I’d prefer zero risk and full recovery, but I understand that I’m being unreasonable.
The cardiac surgeon was pretty optimistic about the success of the full surgery, and said we could just go ahead and do that if we wanted, but as soon as he used the words “heart lung machine” in describing the surgery I came close to having a heart attack myself, so I’m happy that we’re starting small. The ultimate decision to try the less invasive procedure first, of course, was Mom’s, but I think a small part of her was disappointed that she wouldn’t get to stay in a hotel (pardon me, a hospital) for a few weeks, with room service and house cleaning and varied and interesting company.
I think this is more evidence that Mom has reached the second phase of retirement. The first ten years were about making up for lost time, doing all of the projects and trips and socializing she didn’t have time for while she was still working, and the next phase looks like it’s going to include more pampering and siestas. I guess I’ll need to look into getting the co-cop to agree to a pergola in the backyard, and maybe a hammock, so Mom can get her moments of nature and her rest at the same time. If all goes well this summer, this second phase of Mom’s retirement could be even longer than the first, and filled with good health and relaxation, and time to build more happy memories with her grandchildren. And a dog. There really needs to be a dog.
Not my dog, but just sending this image out into the universe
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
rachelmankowitz 