Or....not.

After about two solid weeks of the lower dose of anti-depressants, I'm ready to declare the experiment a failure. I'm overwhelmed, super-tired, and not particularly cheerful.

But this isn't supposed to be easy, and getting ON the meds was tough, too. They take about 6 weeks to work their way into your system, although I don't understand the whys of that, since you take them every damn day. So the "I'll show you" side of my personality wants to stick with it partly in the belief that it will get better and partly to prove to myself that I can. Lowering the dose is never going to be easier than in the summer; trying this in the depths of winter would be catastrophic. I can picture that resulting in getting back to the point where losing my car keys is major meltdown time.

If I give up on it now, therefore, I won't try again until next summer.

I keep saying that I'm OK with the fact that I might need the meds for the rest of my life, but maybe I'm not OK with that. Because I don't think it is all right to need the maximum daily dosage for the rest of my life, really. What would happen to me if I was living in the times before these drugs were so readily available? Would I have been one of those people that friends and family would natter to pull myself up by my own bootstraps? Or would I have been one of the millions that suffered in silence, quietly choosing a handful of sleeping pills over the stigma of admitting that I had a mental illness? Thank goodness for the modern age, and for the meds.

Stepping down the dose is at the suggestion of my doctor, although we did not discuss the ramifications of it. He told me to step it down by 150 mg, which means that I take one 300 mg pill a day instead of one 300 mg and one 150 mg daily. I didn't expect it to be difficult. I didn't expect it to be such a roller-coaster. If nothing worthwhile is easy, though, I don't know why I thought this would be simple.

I should, in the interest of science, give it the same 6 weeks I gave the meds to start working. Give my body that time to adjust to alteration (again) of my brain's chemistry. But I'm sticking with the adage of "If it ain't broke, don't fix it," and going back to the 450 mg dosage. The negative effects of lowering the amount that I take each day is not worth it to me right now.

One of my personality traits that I really don't like is that I'm indecisive. It is good to be able to look at a problem from many sides, to be able to see all the benefits of a particular decision, but not good to waffle between two or three options. I'm not fence-sitting on this one, and I'm going to try to stop fence-sitting in the rest of my life, too. June 1, 2010 seems like a good date to me to try again.

Down the steps

Not long after I wrote in a post about the Doc telling me to step-down my meds, I finally remembered to do it, and have been for about a week now.

It seems to be going OK.

I'm reminded of the book Is It Me Or Is It My Meds by David Karp when I tell you that one of the few effects I've noticed from taking less of my Wellbutrin is that I'm more apt to say something nasty or biting to someone. Not funny-sarcastic-snarky. Downright obnoxiously rude. My gut instinct is to just - bam - snit back at someone, instead of answering them nicely. DH, unfortunately, seems to bear the brunt of this.

So then the question seems to be: am I really and truly a total bitch, and the meds kept that in check? And I'm quite afraid that the answer is yes. And I don't like that answer very much. Which means I don't like me very much. Which starts the whole vicious downward-spiraling tornado of the mental imbalance that is depression, since the disease insists to you that you're worthless.

I'm not worthless. I won't listen to that particular demon. I can fight against that, and I can do it with less of the medication. It is time, ffs, to begin the path to cut down the dose. I freely admit that I may need the meds for the rest of my life. I'm OK with that. But I don't think that I need the maximum dose every day for the rest of my life. Nearly 2 years of the maximum dosage is enough time to turn it around, and my life is much better than it was 2 years ago. (At this time 2 years ago, for those of you just tuning in, I was unemployed and deeply unhappy.) So I'm comfortable with the decision to step it down, and I'll work on that snark response reaction. This time, "down" will not be equal to "out".

Down and out-ish

Facebook status today:

Lucy looked in the mirror this morning and saw a woman who looked like she'd been sick for a week.  Wonder why.

That would be - er - because I was sick for a week.  Ugh.  No one I know likes being sick, so I'm not going to state the obvious, that I hate being sick.  Of course I do; so does everyone else.  I don't often catch whatever bug is running about; chalk that up to my innate health, or the fact that I eat right and take decent care of myself, or the fact that I take a daily dose of Oregano Oil (sold under the brand name Oreganol).  It doesn't really matter why I don't often catch cold (although I do wish I could figure out exactly what the direct cause is!).  What matters is that I don't often get sick, and I often feel inordinately smug about my ability to resist the bug du jour.

So then it is a karmatic crunch when I do get sick; as if Mother Nature wants to remind me that I ought not be so smug and smarmy.

DH came down with something a few Saturdays ago, after a tame night out with a few of my friends.  He spent a weekend in bed, sleeping, awake for a grand total of about 6 hours out of 48.  I'm not good with the sympathy when someone else is sick; not that I lack empathy, but I lack the ability to DO anything about you being sick, so please don't whine incessantly to me about how miserable you feel, especially after turning down my offers of a blanket, water, chicken soup, analgesics, cold medicine, tissues, or any of the other things that I CAN do to help you.

Mostly, then, I let him sleep, although doing my utmost to be sympathetic and supportive whilst he was awake.  (Add that, please, to the list of reasons that motherhood is NOT for me.)

Monday morning, he and I both went off to work, did what we needed to do, met up at home, and went to bed at a reasonable hour, all per usual.

Tuesday morning, I woke with sinus pressure under my right eye, and a worldview made grumpier by the fact that I felt like someone had run me over with a Mac truck.  I went to work, did my best to keep to myself and stay productive.  I made it through about half a day, and went home ostensibly to sleep, although I ended up watching WALL-E on my computer in bed instead.  Wednesday, I worked a full day, but felt even crappier; everyone at work was irritated with me for coming in at all, as they didn't want me to share my germs.  All-righty then; Thursday and Friday I stayed home.

Late Thursday night, I woke with blurred and shaky vision, which scared the bejeebus out of me; it looked as if everything was both wobbly and out of focus, and mattered not if I had glasses on or didn't.  Friday, then, blurred vision abated for the moment, I took myself off to the doctor's, and armed myself with an antibiotic prescription.

It wasn't until late Sunday that I felt like myself again; I knew I was finally going to kick the cold when I woke up around 10.30 PM hungry.  I wasn't hungry at all while sick, in fact, in addition to the pain of the sinus pressure, achy joints, and general miserable-ness, I was nauseous for most of the time I was ill, and food?  Ugh, thanks, but no.  But as a thunderstorm raged outside, I ate two bowls of an organic granola cereal I had purchased (with two coupons, thankyouverymuch)  and all but licked the bowl clean.  It was goooood.  (I could go for more right now, in fact.)

It doesn't help matters much that I chose a poor time to be off sick; things are too busy at work for me to be away, and I'm leaving the country soon for an extended period of time (umm...I haven't told you about that yet, interweb, sorry) so I have lots to do, little time to do it in, and don't have my usual energy to get it done.  

I need both a nap, and a clone.  Anyone want to get to work on that for me?

Yarn-related ranting and some non-sequiturs.

I love knitting with big, bulky yarns.  Bulky yarns, according to standards provided by the Yarn Craft Council of America, are yarns that knit 6-11 stitches to 4 inches.  The smallest category, for those readers who are not fiber fanatics, lace weight, can be as many as 40 stitches to 4 inches.  Bulky yarn should be knit on big needles, size 11 (8 mm) and larger.  

I am not a fan of lace weight yarn and teeny-tiny needles.  I know knitters who think that my size 7 (4.5 mm) needles are "huge".  No, size 7s are small.  I knitted a shrug for my sister on size 7s; that sucker took me 5-1/2 MONTHS to knit.  Urgh.  I want to make things that are finished a little more quickly than 5 months.  And maybe next time I knit that same pattern (for ME!) it might go more quickly, because I'm familiar with the pattern.  But making things that take eons...just not my style.

Sadly, I realize that I am indeed part of the instant gratification everything-all-the-time set.  Wonder if my obsessive-compulsive disorder has anything to do with that.

Back in March when I visited my sister in New York City, she took me to a wooooonderful yarn store in Brooklyn on Atlantic Avenue, Knit-a-Way.  My sister is a great one for monopolizing my knitting time; she sends me patterns via e-mail or links via instant message, asking if I can make whatever it is for her.  She has 3 hats, a scarf, and a shrug of my making.  I'm not complaining, I'm usually thrilled to accommodate her, and she is always appropriately excited about the finished projects.  2009, however, will be the year of me knitting for ME.

At Knit-A-Way, sis picked out some very yellow yarn for me to use to make a hat for her.  Manufactured by an Italian company (di.Ve Fiamma) and imported by Cascade yarns, the 100% wool was surprisingly a delight to work with.  Surprisingly because 100% wool makes me itch like crazy.  I can not wear wool next to my skin in a sweater or trousers without at least one layer of cotton between me and the wool.  I think my skin is hypersensitive to wool.  I've worked with wool before that made my hands itch from holding it.  But this didn't make me itch.  The pattern I chose for my the hat was probably part of the reason that I enjoyed working with the yarn.  I like the pattern so well that I've made 2 more hats with the same pattern and have a third on needles, not done.

I've searched locally for more di.Ve, and while one local store does carry many of Cascade Yarn's products, di.Ve isn't one on their list.  They're quite happy to order it for me, with me paying the shipping, and a bit of an elevated price.  Thank you, but no.  Not that I don't want them to make money, I do.  I support local merchants whenever possible.  But this stuff is expensive at the MSRP.  Adding to the cost makes it worse, and paying shipping adds insult to injury if you ask me.  

So I've watched eBay and searched on Ravelry for people willing to part with di.Ve that they already own.  Found some, and the person was willing to part with it for a very reasonable price.  In our exchange of e-mails, I mentioned the trouble I have had trying to track this stuff down, and she informed me that many of the Fiamma colors are no longer manufactured.  What?!?  WTF?  Turns out that with the rising cost of, oh, EVERYTHING, bulky yarns are getting too expensive for local yarn stores (hereafter referred to as LYS) to buy and carry on inventory, and so buyers for the yarn stores are purchasing less, and money talks, people.  Bulky yarns tend to be expensive, and so to purchase enough of it to make, say, a sweater or a full-size afghan, you'd be breaking the bank.  The volume that your LYS sells, then, is much diminished from the volume of finer gauge yarns.  Result?  The LYS doesn't have a lot of bulky yarn.  Boooo!  Boooo!

On to the non-sequiturs, then.

I went to the doctor's office, my usual family doc, to get a flu shot.  Yes, yes, you're supposed to get that in October or November, but I didn't.  I plead laziness and lack of time.  I'm leaving for Florida in a week and the flu is making the rounds there, so I wanted to make sure I finally got one.  The entire collective office where I work has also been passing a viral infection around.  Fun.  Yeah.  Like a hole in the head.

I hate waiting in doctor's offices, but usually manage to stay calm by knitting or reading.  Several of the other folks waiting were really pissy about their wait, making lots of passive-aggressive remarks.  Equally as annoying as waiting, if you ask me.

When I finally got called back, the exam room where the nurse was waiting with the shot had a framed bit of advertising from a drug company advertising medication that treats an extreme form of sleep apnea.  Like many of these posters, there was a checklist of questions to ask yourself, and the oh-so-helpful tag line that if you answered yes to three or more of these questions, you should talk to your doctor about this apnea thing.  These kind of things are bad for me, because I am a major hypochondriac.  So I try to look at these posters with a humorous eye, not with an omigod I'm going to die eye.  That said, the list intrigued me.

Waking up with headaches.  Check.

Sleepiness during the day.  Check.  My caffeine consumption has gone up A LOT recently.

Chocking sensation while sleeping, waking up coughing.  Check.

Excessive or very loud snoring.  Check.  DH claims I snore.  I know he snores, lots.  Dunno if I do, really, but I believe him because my dad snores.  

Hmm.  Something to think about.  Maybe the headaches have more to do with something outside of my usual litany of suspects; hormones, weather, ciggy smoke, stress.

I Only Smile In The Dark

~stolen from a lyric, band: Garbage, song: I'm Only Happy When It Rains, Album: Garbage, Release date: 1995

Yeah, yeah, I've still got my head in the 90s for pop music.  Whatev.

I'm happy.  Nearly deliriously so.  Riding a euphoric high.  Which, ridiculously, scares the hell out of me.  I have no idea where this particular aspect of my personality comes from, but even though I'm extraordinarily happy, I'm waiting for the other shoe to drop.  That things can't possibly, seriously, really be this good.  Can they?  I've had a great success professionally (and, sorry, that's all I'm going to say about that) and personally I am on an even keel even despite the shorter, colder, and greyer days we're experiencing in Ohio.  We have snow in the forecast this week, FFS.  But the depression is currently manageable most days.

I went to see my family doc last week, because my 'scripts for my allergy medicine and anti-depressants all ran out at the same time.  Because the anti-depressants are a maintenance med, I'm supposed to have blood work done periodically, and I knew that if I just called and asked for refills, they'd say no.

He and I talked about my dosage, and I told him what I've been telling you people for quite a while now: I accept that I may need to take this medication for the rest of my life.  I'm in far better shape than I was a year ago this time...see this post and this post for backstory there, if you're just joining us...but I've learned the very hard way that I'm not ready to step down the dosage or discontinue them by any stretch of anyone's imagination, certainly not mine or the doc's.  He did suggest tapering them, but I related an incident that happened on a day where I managed to take just a partial dosage (here's a hint: it didn't end well) that I blew far out of porportion over the summer.  Given that, he agreed with me that we'd revisit the issue of tapering the dosage in 6 months.  Fine.

In the meantime, where the hell is the sudden onset of anxiety coming from?  Breathe, Luce, damn.  How is it that I'm fairly unable to live in the moment, appreciate what's here and now?  Enjoy the success, build on it, take the congratulatory flourish that goes along with it, and start working on the next event on the horizon.  

How hard is that?

Four-eyes

For a long time, I've been having some vision trouble.  Annoying?  Yes.  Life-threatening? No.  I got new glasses earlier this year, and from the moment I put them on, I told the eye doc that they weren't strong enough.  Did he listen?  No.  Did he agree with me?  No.  

His office people attempted to convince me that contacts were what I needed.  There's a racket, yeah?  They've got you for the contacts, then solution, and all of the other paraphernalia that goes with them.  Far more expensive, to my way of thinking, then just a simple pair of specs.  But I played along, and we tried several different brands of contacts, several different strengths...higher magnifications (or whatever the hell the +1 or +1.50 means) lower prescriptions, this strength in this eye, that strength in another.  Finally, after playing this game for about three weeks, I finally said enough.  Just give me a damn pair of glasses.

They did, but they weren't the right glasses.  Urgh!

I complained about the glasses, especially at the end of long days, because by then, they were totally useless.  Cute, yes, they were adorable.  But as far as helping me see?  Um, not so much.  On the advice of a co-worker, I went to see another eye doctor, one who spent more than ten minutes with me.  The prognosis?  I need progressive lenses.  Which is a very polite way of saying, "Sweetie, you need bifocals."  Thanks.  So much.  

The silly thing is that the first time I went to the eye doctor's as an adult, at 25 years old, they told me to get bifocals, and I, the smart-ass know-it-all, said, "You've got to be kidding me.  Bifocals?  I am 25 years old!!!  No way."

Last year, when I was unemployed, I spent a lot of time on the computer, job hunting, screwing around online, gabbing to friends in fandom, re-writing my resume, drafting innumerable cover letters, writing my book, blogging, and generally trying to figure out to do with my life.  It was then that I noticed my vision deteriorating, but as I was unemployed, there wasn't much I could do about it.  I bought drugstore glasses, getting stronger and stronger ones, and tried to make do.

The progressive lenses showed up on Friday last week, and I've spent the weekend trying to figure them out.  I am reminded strongly of when my dad first got glasses, and he would peer through the bottom of them, trying to read the newspaper.  The tops of my new glasses are for distance.  So I can read street signs, and recognize people I know at 20 feet away.  The middle section is supposedly for the computer, and the very bottom for reading books, magazines, the teeny-tiny ingredient lists on things in the supermarket.  So yes, not just bifocals, but TRI-focals.

They make me tad more clumsy then I already am, which is bad, because y'all: I don't need help being clumsy.  I manage that just fine on my own, really.  There's a slight curve in my peripheral vision that makes it look like you can see the curvature of the earth.  Freaky.

The tech at the eye doctor's recommended that I use extreme caution on stairs until I get used to them.  Fab, because I don't fall down enough staircases already, right?  I'm glad that she forewarned me, though, because taking a header down my own stairs at home is something I've managed to AVOID doing thus far, and I'd like to keep it that way.

I like 'em, though.  I'll get used to this whole tilt-your-head-to-see-up-close game soon enough.  (I hope!)

I was thinking about my school days, and I was enough of an outcast and social misfit through junior high (too smart by half) that I can only imagine what adding glasses to that would have done.  Now, I look geeky, studious, whatever you want to call it, and that's OK with me.  I like looking smart.

Now, where did that staircase go?

This is a fine stew.

I went to see the doctor yesterday, braving cold temperatures, bad roads, and heavy snow, because I think the depression is backsliding.

While I was there, of course, I took the opportunity to have him look in my aching ears to make sure that the creeping crud has not turned into an ear infection (thankfully, no) or strep throat (again, no) or something more than what I thought it was, a simple bacterial sinus infection.

Before I begin to ruminate on the disease of depression (yes, again) I want to share some more upbeat news; the only benefit, as I see it, to having a cold is this. According to the scale, in the last week I've lost 7 pounds. I'm not hungry, the only upside to not being able to breathe and being so dizzy from the congestion in my ears that elevation changes, going from sitting to standing, were a potential fainting spell. At the moment, I weigh less than when I got married, nearly eight years ago, at 25 years old. Woot!

As difficult and painful as it is, I am always truthful with my family doctor. I don't sugar-coat what I'm feeling, nor what I think is really going on, when I talk to him. Sitting in the exam room, waiting for him, always freezing my butt off, I'm usually so nervous that I'm nauseated. I feel that way at the shrink's sometimes, too. Spilling your guts to someone who isn't your closest friend, someone who isn't already inside your heart and head, is damn difficult.

The first thing he said when he walked in the room was, "Look at you!! You're looking fantastic!"

I cracked up. "I wish I felt as good as I look," I told him. "Between the cold and the depression, if I looked like I feel, children would run away from me crying."

The cold has just about killed my vocal cords, so even talking is tough. But I told him about the dark days I've been having. Why I think that's been happening. What I'm willing and not willing to do about it. How I remember he wanted to add Effexor to my regime of Wellbutrin.

He tends to pooh-pooh my worries over side effects of the meds and my fears of becoming psychologically dependent on them. He listens, but either tries to soothe my fears or brush them away. He always tells me the same thing that someone else said to me recently; just because a side effect is listed in the medication's literature, that does not mean that YOU are going to have that side effect. Those are potentials, not necessarily realities.

Wellbutrin XL is a SNRI; Serotonin-norepinephrine reuptake inhibitor. I'll allow you to google that one yourself, or click here for Wiki's definition. The drug blocks some of your brain's ability to absorb serotonin and norepinephrine. As I understand it, anyway. This is part of the chemical imbalance in your brain that I'm always talking about, which I firmly believe is the cause of depression.

It bears repeating: depression is NOT about being sad. Depression is about an inability to do things that you normally enjoy, a dimming of the lights in your life, making you feel like you're metaphorically stumbling around in the dark. Depression is about not having the will to do anything; it isn't that you can just 'pull yourself up by your bootstraps' or 'snap out of it'. You certainly don't want to feel this way, but not only can you not stop it, it is hard to see sometimes that it is even happening to you.

So the meds fix the chemical imbalance in your brain. Were it any other disease, diabetes, for example, no one would hesitate to take the meds. You'd die without the insulin used to treat diabetes. But it is perfectly acceptable to urge someone to not take anti-depressants.

I keep telling myself that taking the meds isn't a cop-out. It is a very difficult thing to reconcile. At the moment, I'm OK with the fact that a)I need them and b)I may need them for the rest of my life. But I go through stages with that, where sometimes it isn't OK that I need them, that I ought to be able to cope on my own. FFS, what does it say about me as a person that I can't cope on my own without a chemical crutch? That I'm weak? That I'm incapable of dealing with stress? That I'd be better off locked in a ward? Eeek.

So one med is bad enough, even when you believe that there is not much you can do on your own without some help for your body to process the excess stress hormones that you produce. But I knew going to the doc's this time would lead to a second med. And if all of the above is true of me with one medication, what does it say about me that I need two? Ouch.

He told me that he'd had a plan all along, that when the Wellbutrin didn't work for me at the smallest dose, that he'd had a contingency. That's great, wish he'd let me in on that one. Seriously. But he gave me samples of Lexapro, a selective serotonin reuptake inhibitor, or SSRI. This is a different type of anti-depressant; again, if you want the technical details, check Wiki. According to the doc, my depression is such that I need both; he claims that this will enable me to be the person I remember wistfully right now.

We'll see. I'm still working on what I believe with this disease.

Plexi

I was at the eye doctor's (yes, again) trying yet another pair of contacts out yesterday. The original contacts were grossly uncomfortable. In addition, annoyingly, they didn't enable me to really see any better than without them. We tried any number of combinations, switching strengths, switching which eye the stronger contact is worn in; none of it really seems to work for me. And driving in the dark? I couldn't see at all. Dangerous.

I asked for a different brand of contacts. Anything but what I'd been wearing. The new ones were instantly more comfortable, I noticed an immediate change. But something had been bothering me; what if it was the meds that was making my vision worse (some weird-ass voodoo side effect) or maybe they were more irritating to my eyes because of the meds. So I asked the eye doc; could any of my prescriptions be causing some of these problems?

He pulled a PDR off of a shelf, and thumbed through it while glancing at my chart. "hmmm, Singular," he mused.

"That's not the one that concerns me," I told him. "What about the Wellbutrin?"

He raised his eyebrows slightly, but didn't comment, flipping closer to the end of the book.

"You know what that's for, right?" I asked him. (Yeah, yeah, he's a doctor, but I'm thinking that eye doctors don't write so many prescriptions for anti-depressants.)

"Yes, an anti-depressant, right?" He asked.

"Yes; I'm on a fairly high dose of it," I told him.

450 mg/day of Wellbutrin XL is the maximum recommended dosage. My cute family doctor tells me that it would be OK to exceed that if the effectiveness wears off again as it did when I was taking 150 mg/day and then when we upped it to 300 mg/day. I disagree; but I digress. Back to the chat with the eye doctor.

He didn't ask me why such a high dose. But I'm decent at reading people sometimes, and I could tell he was curious. He did ask if it was working for me. Briefly, I explained that the 150 had helped, 300 was better, but that to come out of the dark, I'd needed the 450.

"It is hard to explain to someone who's never been there," I told him, "but depression is like this giant inertia that surrounds you, making it hard to breathe, hard to move. It isn't that you don't necessarily want to do something, it is that you almost can't. It is like sitting in a dark room; 150 made me feel like someone turned the lights on, but not up; at 300, it was like a dimmer switch being turned up, but it took the 450 to turn the lights on."

I told him if it bothered him for me to be so frank about it that he should tell me; but he said no, that he wanted to understand. The PDR tells us that blurred vision IS a side effect of Wellbutrin, but that it is a very rare one. And my vision started to get worse before I started taking the med. Days when I've forgotten to take it, I see no better than on days that I do take it, so I don't really think the med is causing the vision deterioration. We'll see what the new contacts bring.

Today, I was talking to a friend that I haven't seen since last spring; she knew that I started taking the med, but its been a long while since we had a chat. She too has lost a ton of weight, and she too has been battling depression. Sans medication. I was telling her about the eye doctor, and she told me about how she's been coping. She's doing well.

She described the way that she'd felt in a manner that I thought was both interesting and on point.

"I felt like I was behind a wall of Plexiglas," she told me, "and I was scratching at the glass, banging against it. I could see everyone else, but I felt like I couldn't be there."

What is interesting about that is one of my sisters had told me that she felt like I wasn't 'there' sometimes when she was talking to me when I was in worse shape.

Feelings of alienation are common in people suffering from depression. Trying to explain it to someone who has only been outside of that glass wall is nearly impossible.

My friend C said something else that stuck with me. She said as she's begun to feel better, she feels, "more like me. More like the C I used to be. I see her, and I recognize her. I've missed her."


Me too, honey. Me too.

There's Beauty In The Breakdown

Well, no, really there isn't, but the line above is from a song I like and it is too cool to not use it for this post's title.

I've been having a bit of a relapse with the depression in the past few weeks, regressing to a stage where it is hard to get out of bed, hard to breathe, hard to move. Yes, I'm still taking the meds, but it really seems like out of the blue one day they just stopped working, leaving me tail spinning.

I made an appointment to see Dr. H, my adorable family doctor, because it is he and not my therapist who prescribes them. I see a psychologist, not a psychiatrist. Anyway, I had a list of things I wanted to discuss with him; not just my anti-depressants, but my skin which is broken out like a teenager's, I wanted him to run blood work to see where my cholesterol et cetera is, and I needed a flu shot. When I was working I could get the flu shot for free from my employer, both the olde evile bank and the non-profit offered the flu shot gratis to employees. As an asthmatic, it is important for me to get a flu shot. Or so "they" say.

One thing above all else that I appreciate about my family doctor is that when you are with him, you've got his undivided attention. You may wait in his waiting room for-freaking-ever while he's with someone else, but I really feel that he LISTENS to me. He's also quick to admit when something is beyond his expertise and refer you to a specialist.

He listened to my concerns about still being on the med and how much it frustrates me that I still need them; even though I haven't been feeling that they've been very effective lately, miss just one day's dose and I'm am nearly paralyzed with misery. We discussed other options; neither of us is willing, just yet, to scrap the Wellbutrin XL that I've been on since April for another med; instead he upped the dosage again. I'm of mixed emotions about that; if it helps, then fine. But what if it stops working just like the last dosage did? That's a scary thought, isn't it? He claims that you can't develop a 'tolerance' for this med; the anecdotal stuff I've read suggests that yes, you can, but for once I'm letting HIM be the doctor and taking his advice.

He noted that if this dosage (the max recommended daily dose of this medication) does not seem to push me up over the edge to a more healthy frame of mind that he next wants to add another medication. I'm not crazy about that idea, actually I hate it, if I'm going to be fully honest. I have no desire to be on more than one medication for a mental illness. One is quite enough, thank you. He tried to ease my anxiety about that by telling me about other patients that are on shed-loads of meds, which was very sweet of him, but wasn't very helpful, frankly, when he told me that both patient examples that he gave me have had numerous hospitalizations for their mental troubles. Yikes.

Then he told me something that was helpful; apparently patients with major depressive disorder who are also OCD end up needing the max dosage of SSRIs. He paged through my chart and reminded himself of my family history; rather than giving away secrets that aren't mine to tell, let's just say that there are one or two of my family who have OCD a weee bit worse than I do.

He seems worried about my anxiety levels; I don't think that my anxiety level is high, but the therapist has also mentioned that she thinks I have a lot of anxiety and since they're the ones with the medical expertise....well, that doesn't mean that I agree with them or want to take their word for it, but for now I'm letting it stand. The therapist is vehemently opposed to anti-anxiety meds like Xanax and Klonopin; Dr. H thinks that they have their time and place. I side with the therapist on that one. Xanax especially has a pretty quick half-life and you can and do build a tolerance to it.

Dr. H says that as long as I am managing to sleep that he'll not insist on adding Xanax; I told him the only time I can sleep is when I take the sleeping pill, but he says for now that is all right.

When he upped my daily dosage of the Wellbutrin from 150 mg/day to 300 mg/day, the change and feeling "better" was nearly immediate. It took just a few days for it to kick in. So here's hoping that a daily dosage of 450 mg/day is the answer.

In other news, completely off topic, I've actually found a few jobs to apply for in the last week and have been sending out resumes like mad. Here's hoping one of them pans out.

Oh, and I've got some massive geeking out posted on MySpace about Supernatural's return to prime time last night.

Televisification

I hate the TV
I hate the TV
I hate the TV
I hate the TV
Y'know that its killing me
Y'know that its killing me
~The Violent Femmes, "I hate the TV," from the Add it Up album.

Yes, televisification is a made-up word. Just like Steven Colbert's "truthiness." I was thinking about that Tuesday while I sat in the doctor's office. By 'televisification' I mean the prevalence of televisions everywhere we go, from restaurants to bars to coffee shops to even the doctor's office.

This particular doc has moved offices since the last time I saw her, and her new office is nice and posh, with a fireplace in the waiting room, and a 45 inch plasma TV. I chose the only seat in the waiting room where you could not see the screen, but unfortunately, you could still hear it. A large sign on the mantle of the fireplace said, "Do Not Touch Controls (on/off/volume) for the Television." Well. Damn. That sucks.

This was my annual exam, so I'm not running in and out of this doctor's office all the time, but when I was annoyed at the noise, I realized that EVERY. SINGLE. DOCTOR. that I see has a TV in the waiting room.

The dentist? TV in the waiting room AND you can watch The View while they clean your teeth. Oh, the joy. I always make the hygienists shut the effing thing off, and they always think that I mean I want to watch another program, at first, until I clarify that no, I want the machine off, not turned to another station.

Dr. H, my family doctor? TV in the waiting room with a sign that says, "Can't hear me? Turn me up!" Arggh!!! They have it tuned to a doctor's office version of CNN Health, which repeats every 10 minutes, after a word from the drug-company-rep sponsors.

Even the shrink's office has a TV in the waiting room. Last time I was there, it was tuned to some Judge Judy-esque sort of program. Ick.

You wouldn't know it if you had started reading this blog in the dawn of 2007, but the truth is that with the sole exception of Supernatural, I despise television. With a passion. I always have. I wasn't allowed to watch much of it as a kid, and eventually, I stopped caring.

The national obsession with sitcoms, reality TV, the soaps, and talk shows makes me nuts. Read a book, FFS! Or a newspaper, or a magazine, or the comics, or.....

A friend told me about gadget that will allow you to turn TVs off surepticiously wherever you go. Called TV-B-Gone, it claims to work anywhere. Well worth the price tag, if you ask me! I've got mine on order.

Phobic

Spiders. Heights. Drowning. All things that terrify me. Fears that are not so far out of the ordinary, I share them with many others. And then there's this one; I'm terrified of the dentist. Not the actual dentist, the human being, all of them that I've seen over the years have been perfectly lovely people. It is the scraping of my teeth, the noise of the dentist drill, ugh.

I had a dentist appointment today, and the hygienist used a tool on my teeth that I've never seen before. Called a Cavitron, it was not among my favorite experiences at the dentist's office. It uses a high pressure jet of water to blast away plaque that has calcified. Yeah, that's fine, but add to it a metal hook that the hygienist also uses to scrape the teeth on top of that. The hygienist was very nice, and felt bad for me, but it wasn't about her. It is about trying to forget the way it felt when she slipped with the tool from the line of plaque to the back of my lower front tooth and I flinched. It didn't hurt; but it is worse than fingernails down a chalkboard and I can still feel it. It will take a couple of days for the sensation to fade.

As much as I hate having my teeth cleaned, I do like the end result. Human memory being what it is, by the time six months has gone by, I'll have forgotten today's trauma and will be glad to head there again. My dentist has retired and sold his practice to a younger doctor, who is nearly as easy on the eyes as my GP. I've been going to see the old dentist since I was 9 years old and had a high degree of comfort with him. But the fact that the new guy is adorable more than makes up for the loss of comfort.

I'm Entertained.

I went to the doctor's today. Dr. H, my family doctor. I made the appointment several weeks ago at his request when he upped the dosage on my anti-depressants.

Have I mentioned that I adore Dr. H? Yeah, once or twice, I think. Besides the fact that he actually listens to me, and he's easy on the eyes, when you're in his office you get his complete, undivided attention. Which is why I don't mind waiting in his office for sometimes an hour or more.

Today, after the nurse weighed me (woot, the Dr.'s office scale shows a number lower than the YMCA's!) I asked something I've been meaning to ask for several years now. "Can you measure me?" I asked her. "I have no idea how tall I am."

"Sure," she said, pointing out the heretofore unnoticed wall chart. I have been telling people for many, many years that I am 5'4", but the last time I know for certain that I was measured was when I was about 15. More years ago than I care to admit. So she had me remove my high heels, and stand up against the wall, urged me to press the small of my back more firmly into the wall, (twice) and announced that I am 5'6".

Really? I had no idea. But I am vastly entertained. My parents are tall people, Dad is 6', Mum is 5'8", the sibs are 5'8" and 5'9", and DH is 6'1". So I'm used to being the short one. Dad often teases me by encouraging me to "stand up" when we're taking group photos...when I am in fact already standing. (Either learn how to deal with the constant teasing in the household or learn how to STFU, them's the rules.)

My posture is really good, though, and people have been telling me for years that they thought I was taller than 5'4". My usual response to that is that I stand up straight, I carry myself well, and with my personality being as forceful as it is, people assume that I am taller. Plus I wear heels every single day.

Yoga and Pilate's have made my muscles longer, leaner, stronger, and made me think even more about standing up with my shoulders back. I can't slouch, it makes my shoulders sore. Sitting on the ground with no spinal support isn't painful anymore, and I can sit still longer without pain.

All of this makes me think about how far I've come in my quest to be in better shape, be thin like I once was, to avoid the familial legacy of hypertension, diabetes, and bad joints. And yet, how far I have to go. Thirty pounds lighter, in better shape than I've been perhaps since my early teens, and still, at least another thirty pounds to go. Discouraging.

The process of re-framing that the shrink was talking about last week means (looked it up, finally) that you turn things around, from negatives to positives, and so if I'm truly in that process, then I should be able to look at the additional 30-40 pounds that I need to lose as a challenge, as something that keeps me motivated. I'm not quite there yet, able to keep the motivation high by re-framing. But I am working on it.

In the news today, President Idiot commuted Scooter's sentence. This is something that DH and I actually agree on, wonder of wonders. Our political viewpoints are so diverse that we never talk politics. But when he noticed this news on Fox, he said, "You've GOT to be kidding me." I looked up from my MySpacing and read the ticker on the bottom of the screen and let out my own howl of frustration. I hate that I was right about what the Idiot Administration was going to do about this, although my timing was off. I thought W would do it right before he left office. But by doing it on July 3, he was clever, because the news cycle will move on to July 4th celebrations and fireworks, and Scooter will be forgotten.

Isn't that a damn shame? He should do the time. Herregud, if PARIS HILTON had to spend some time behind bars, then so should Scooter. God, I despise this administration.

If you're in the States, I wish you a wonderful 4th of July.

Törstig Tisdag

Thirsty Tuesday

I am indulging a bit in my neurotic tendency to be a hypochondriac. Here's a silly thing. I'm worried about the amount of water I drink every day, which has increased dramatically since I started running at least a mile six days a week.

I do know that the thirst and the exercise are directly related. When I was in California around Mother's Day, I was active, but not as much as I am at home. By the 3rd day away from my usual routine, I wasn't as desperately thirsty. But I wasn't not thirsty either.

I've always been a water drinker, rather than soda or other things. The first time I visited Europe, at 14 years old, I was appalled at how expensive a can of Coca-Cola was, and stuck with water in order to be able to buy other things. Very important things. Like Sangria.

With the rise in bottled water being sold in this country, and an increased awareness that not only is soda a diuretic, but also in the awareness that the sugar in soda contributes to our expanding national waistlines, I don't ever have trouble anymore when all I want is some water. Used to be I got odd looks in stores when I asked for bottled water. Every single gas station, convenience store, even sometimes upscale department stores, sells bottled water now. We have a water cooler at home, and go through about 8 of the 5 gallon bottles every month, but I also buy bottled water by the case from a warehouse club for when we want water that's more portable.

I suppose it is very silly to purchase water when it can be had from the tap for much cheaper, but the taste and lack of chemicals in bottled water appeal to me. You have to read the labels of bottled water carefully; I remember finding gallon jugs in the grocery store once which flatly stated in tiny print: Source: City of Columbus water supply. Yuk.

The cases of water that I buy have 32 bottles, each containing 16.9 ounces of water. I drink one at the gym every morning while walking/running. Another on my way home from the gym. A third when I get to my office. A fourth usually before 10 AM. A fifth, and sometimes a sixth, with my lunch. Sometimes even a seventh on the way home from work, and then at least two or three 16 ounce glasses of water from the water cooler with dinner and while I'm online. That's a grand total, every day, of a little more than a gallon. It seems like a lot to me. A whole lot. An excessive amount.

The last time I was in Dr. H's office, I complained to him about it, wondering if my allergy pill was contributing to that problem, making me thirsty. No, he didn't think so. Well, what about my family history of Type 2 diabetes? Excessive thirst can be a symptom of undiagnosed diabetes. If you read this blog all the time, you know that becoming an insulin-dependent diabetic is one of my greatest fears, second only to the fear that abortion could be outlawed.

Dr. H rolled his eyes when I asked about diabetes again.

To reassure me, he flipped open my chart and showed me the lab results from the last time I had blood work done. Normal range for my glucose levels. "You know you're paranoid about this, right?," he asked me, exasperated. "I mean, if you want, we can do a finger-stick test right now, but really, you're NOT diabetic. And I'm going to start charging you for those, because I think that's the only way you're going to stop requesting them every time you come in here."

"All right, I know I'm overly worried about diabetes." I responded. "But I'm thirsty ALL THE TIME, that's not really a good thing, is it?"

"Luce, if you're thirsty, drink more water. But for chrissakes, quit worrying about it." He rolled his eyes again.

His advice is seldom bad, so I've tried. Lest you think he was too abrupt with me in the above exchange, he's someone I've known for a very long time, I knew him before he was a doctor, so a bit of back and forth harassment goes on every time I see him. But when I say I'm thirsty all time, I mean ALL THE DAMN TIME. It is this odd little tickle in my throat, and when I drink water to get rid of it, it reminds me of when you water plants that you've neglected, where the soil soaks it in hungrily. For a short while, that parched feeling dissipates. But not for very long. I'm talking a space of a few minutes.

On the Sunday before Memorial Day, DH and I trekked part of the way across Oh-hi-ia for a family gathering. We stopped for gas just outside our city, and I got out of the car to get some water for the ride, having forgotten to grab a few bottles from home. DH said, "Hon, there's already a bottle in the car. I brought it for myself, but you can have it."

Um, thanks, but it wouldn't be enough. I bought two one litre bottles and drank one entire litre before we got to our destination, which took roughly an hour. While at our destination, I drank 2 more bottles provided by our hosts, which were 32 ounces each. We were there for about 5 hours, so I'm not guzzling the stuff, but still. Then I drank the second litre on the way home. Doesn't that seem like a lot of water?

Sure, being hydrated is a good thing. But there's also too much of a good thing; have you ever heard of water intoxication? First time I ever heard that phrase, I thought that it sounded like fun. Intoxicated on water. Turns out not so much, really. You can die. You would need to drink something like three gallons of water over a very short period of time, but it is worrisome.

I've been trying to dig up some research to see just how much water I really should be drinking every day and if I ought to be concerned about this thirst, and of course I'm not turning up things that are helpful. I could have psychogenic polydipsia, although I seriously doubt it. Yeah, I'm nuts, but psychogenic polydipsia is usually not seen outside the population of those with serious mental disorders says Wiki.

Then there's Diabetes Insipidus. (the diabetes that I'm worried about, type 2, is Diabetes mellitus.) DI is about loss of kidney function, also worrisome, but unlikely, because lemme tell ya, my kidneys? Working just fine. One of the symptoms of DI is craving icy cold water. I do like my water cold, but if it isn't, it don't matter. I just need to quench the thirst.

About the most useful thing I've come across so far, besides Dr. Hottie's advice to just roll with it, is this article from CoolRunning.com, which just about says the same thing as Dr. H, but with some scientific facts to back them up. One hour's run can cause you to sweat more than a quart, active people need more water, you should try to drink 4-6 ounces of water every hour you're awake, yadda yadda. All good to know.

The end of the article makes some good points about alcohol consumption and running. Since this thirsty all the time thing started, I've been very cautious about any alcohol-consuming, because we all know how boozin' it up can make you dehydrated. Since I don't need any of that (I think the thirst then would KILL me) I've been skipping the hard liquor mixed drinks that I'm fond of occasionally indulging in.

But if you're looking for who took that last bottle of water? That would be me.

Never Was A Cornflake Girl

This post has sat in my queue for a while, as I've spent some time contemplating if I am going to share it with teh internets. I've edited, edited, edited, revised, changed, and generally obsessed over it. This is perhaps the most honest thing I've ever penned, and is without a doubt the most difficult thing I've ever tried to commit to words. It may also take the prize for Longest. Blogpost. Ever.

The title refers to a Tori Amos song, with lyrics that have almost never made sense to me. I'm a big fan of Tori's music, but that doesn't mean that I always know what the heck she's talking about.

It seems an appropriate title to use when I'm going to talk about something else I barely understand.

Once upon a time, I had the blues. Summer, 2004. Not depressed, just down. The blahs, the out-of-sorts feeling. My sisters had moved far away, my job sucked, and I lived in an apartment that I despised. I put some effort into finding another job, and when I finally left the big ol' bank, I thought I'd left the blues behind too. For a while, things were great. My new job was infinitely more fulfilling, we moved, my sisters came back to Ohio.

Fast forward almost three years. Things are better. And worse. I have a beautiful home that I love, I've discovered that I am a writer, but my sisters are far away again, things on the job front have deteriorated, and I feel the weight of so many things on my shoulders that it is hard to move sometimes. Literally. I feel like I'm dragging myself around, every step a monumental effort. This isn't a case of the blues. This is clinical depression.

If I could pinpoint an instant when things changed, that would be lovely. But it isn't just one thing. In a way, it is a fairly standard issue mid-life crisis kind of thing, albeit about 20 years early. Because while I feel old, even ancient some days, I'm not really in the proper age bracket for a mid-life.

I'm wondering what the hell I'm doing here, that existential question of why we're all here on this earth. What's my purpose? I'm wondering what happened to that rebellious , spirited, loud, I'm-going-to-change-the-world 17 year old who I used to be, and why I can't go back to being her. Someone invent time travel, and I'll be happy. Riiight. But it is also part self-realization, that I don't like where I am. In my career, geographically, emotionally. I'm not sure if I like who I am at all. I'm having trouble envisioning a future when I don't feel this way. Hell, I'm having trouble envisioning a day when I'm not a complete train-wreck of a mess. Days have become something to be endured, a waiting time between when I can escape to sleep.

I was able to admit to myself that something was really wrong when I had a conversation with my mother while sitting in a busy restaurant, and I burst into tears at something she said. It isn't like me to burst into tears in public. It isn't like me to not have 36,000 things going at once. It isn't like me to not be reading 3 books, working on a myriad of projects. I'm not the lay in bed and do nada type. I can't focus at all on any one thing long enough to fix what the major problems are. I feel twitchy, like I need to jump out of my own skin. There are things spinning around and around in my head, endless loops of things that are far beyond my control, and yet I worry about them, worry at them like a dog with a big treat bone.

Back in 2004 when I had the blues, I was on a whole boatload of meds, including a very small daily dosage of a common anti-depressant called Elavil. I had extensive stomach problems at the time, acid reflux, esophageal damage, crippling heartburn. My gastroenterologist, aka the tummy doctor, had prescribed about 3 of the meds I was taking. I objected, strenuously, to 'an anti-psychotic' (my words) when he told me he was going to prescribe Elavil, but he convinced me to take it by explaining that it was an experimental off-label usage, trying to ease some of the pain I was having with the acid reflux. And it worked. Like a charm. Helped with the pain, which was a minor miracle. {It is sort of beside the point that what he should have done is told me to lose some weight and the heartburn would disappear.}

I had far too many prescriptions in my 20s. Besides the 3 from the tummy doctor, I had allergy meds, asthma meds, the Pill, more crap than most 70 year olds take every day. When I came to my current job, at about 29 years old, I trashed everything except the birth control pill, and that was it for meds in my 30s until recently, when I started taking Singulair for the allergy/asthma crap and Ambien for my sleeping trouble.

So I didn't want to go on an anti-depressant, because I thought it wouldn't really change anything. I don't particularly like the idea that there's a little pill to fix every single ill. I know I've got some problems. I know that I need some help. This time is much more than the blues that I had before. More intense, more debilitating, more suffocating. Sure, going on an anti-depressant will help the chemical imbalance in my brain that makes me depressed, but it won't change the rest of my issues. Which are myriad.

I spent some time talking to Dr. Hottie, (you remember Dr. Hottie, my family doctor, right?) who explained to me that within two weeks of beginning an anti-depressant, I'd feel 'better'. And that most people who take them end up being on them for six to nine months, that they're able to move off of them, get things back under control. He told me that the Elavil that I'd taken previously at the dosage I took it was not the same as taking an anti-depressant for depression. He told me that at the proper dosage, anti-depressants can change things. He also agreed with me that treating what's going on with me with medication alone is not the best answer. I love it when he agrees with me. Do it my way, doc, it is so much easier.

He gave me a prescription for an anti-depressant, at 150 mg/day. I agreed to give it a shot. I've been taking it for about ten days. It seems to be helping a little bit. I'm not sure that it will be the final med that I end up on, so I'm not going to mention it by name until I've been on it for a while longer. We're messing with brain chemistry here, scary stuff, kids. What works for me may not work for you, your mileage may vary, et cetera. It gives me a headache, every afternoon, like clockwork. I don't know how long I'll be able to handle a daily headache. I really dislike needing to take an over-the-counter pain reliever to counteract the side effects of a prescription.

I've always been a 'fixer', I want to 'fix' everything. So this bleak outlook I've developed requires some tinkering, some adjustment.

I have decided to get some therapy. No, seriously. To work with a psychotherapist, doing some talking about the things that are problems. And the reason that I'm posting this in my blog? I mean, seriously, girl, why would you want to share this with the whole wide world? There are a couple of reasons.

One, I'm not ashamed of having a mental illness. My maternal grandmother suffered from depression, suffered in silence, never getting any treatment for it. I wonder who she might have been if she had gotten some help. I wonder who I might be if this giant suck wasn't weighing me down. Gram suffered in silence because that's what you did in her day. You didn't talk about it, there was a huge stigma attached to any mental disorder which then reflected poorly back on the family, was a sign of weakness. I reject that.

Two, I'm hopeful that by adding my voice to the chorus of those sharing their struggles with mental illness (Dooce, among many others) that it will help with the destigmatization of all mental illnesses, not just depression. I am certainly not the first blogger to ever talk about depression. Far from it. I truly believe that this is a disease like any other chronic condition, and should be treated just as diabetes, or cancer is treated. Don't get me started on the insurance companies, and what they will or will not cover when it come to mental health issues, because that's a rant for another time and place. I'm talking about society in general, and things have come a very long way since my Gran's day, but we're not there yet.

So going forward, occasionally, I am going to post something that relates to what I'm working on in therapy, what I think about it, and if the meds are working. I'll stick the tags 'depression' and 'cornflake girl' on them for identification purposes, and because everything must be compartmentalized and organized. (hee! My inner geek is showing.) Having a label of 'cornflake girl' entertains me a whole lot. Don't ask me why. I just find it really funny.

This sharing of my depression and general miserable-ness isn't a desperate bid for attention, merely a simple statement of fact. I don't want pity. I'm having enough of a pity-party for one without help from anyone else, and feeling guilty for feeling sorry for myself. So spare me the sympathy. I'm only one of millions who is depressed in the US, and depression diagnoses are handed out every day, all over the world. While for me, this started as a deep sadness, and I think maybe partly stems from grief over a death in my family, true clinical depression rarely has anything to do with being sad or just having the blues. The clinical symptoms are more about that huge dragging suck I was talking about earlier, and not having enough energy to do things that normally give you pleasure.

I can't tell you when the last time was that I picked up my knitting needles. Or made up a recipe for something yummy to eat. Or worked for more than an hour or so on my novel writing. Daily posts here can sometimes take me as long as 3 days to write. Those are all things that I love to do, and can't focus on. I don't want to do anything, other than lay in bed, watch TV, and when I'm feeling really 'good', then I want to read or randomly surf the net. I don't want to do much else. I have to FORCE myself out of bed to the gym in the morning, force myself to get to work, and it is a major struggle to do things like laundry or errand running. Minor problems become major hurdles. "Catastrophes," like not being able to find something, become reasons to climb back into bed. Or sob, you know, whichever is more convenient. Unlike lethargy, where you just don't want to do something, depression kind of makes you unable. Makes you feel that nothing matters, so why bother.

The Swedes have a saying, Jag örkar inte. Like many things, something gets lost in the translation. Literally, it is "I go not". But it means both that you don't have the energy or the will to do something, anything. And that adequately sums up how I feel.

I'm hopeful that I'll be able to 'fix' my depression. I am a little frightened of what I'll discover about myself on this voyage. But I'm taking that vital first step, bravely, tentatively, even a little defiantly. I invite you to share the journey with me.

Monster. Asthma. Synonymous .

Tuesday, and time for another installment in my Brain Dump series.

I am an asthmatic. I was diagnosed with asthma at 19 years old, and it has always seemed odd to me that no one picked it up before then. The very first time I thought the asthma might be something other than a hyper-sensitivity to environmental irritants, I was out to dinner with my parents, and this was before Ohio passed the smoking ban. We were in a small, family-owned restaurant, and someone near us lit up a cigar. I hacked, and hacked, and hacked some more, and both parents insisted that I make an appointment to see our cute family doctor.

When I got in to see him, Dr. Hottie had me breathe into a tube (which tests lung capacity), gave me a breathing treatment, had me breathe into a tube again, and just like that, I was slapped with the label of asthmatic. I got a prescription for Proventil as an added bonus. Yay.

Through my 20s, I would sometimes control the asthma better than other times. At various junctures, I had prescriptions for: Advair, Allegra, Allegra D, Proventil, and another allergy med that starts with a P that I can't even remember. Proventil is a rescue inhaler, you are supposed to use it when an asthma attack overwhelms you. I despise the side effects of Proventil, so I've always been very stubborn about using it. Unless I cannot breathe at all, I refuse to use it. It makes my heart race, gives me the shakes and makes me more jittery than a 13-year-old on a sugar rush. It ain't pretty.

When I have an asthma attack, it sounds as if I'm dying. I've told close friends over and over that unless I actually fall over and start turning blue from lack of oxygen, they are to ignore the hacking cough and wheezing that accompanies an attack. They're pretty good about doing just that, much to my relief. I like the spotlight, yeah, but not when I am gasping for breath with tears streaming from my eyes and my nose running, from the sheer force of the coughing.

I'd like to be able to completely ignore the fact that I have this condition, but it has been very difficult to do that over about the past two weeks. Living in Ohio means that we have 4 distinct seasons, a very clear differentiation between winter, spring, summer and fall, and whenever the seasons change, the monster comes out to play. The worst transitional times are from winter to spring and summer to fall, as each time the pollen counts, mold counts, and other allergens are out in full force.

There are more than a few types of asthma, exercise-induced, environmentally-induced, et cetera, but mine seems to be mostly related to environmental factors, like allergens. Besides the blooming trees and flowers and mold and dust, cigarette smoke really bothers me and sets off the monster. Cigar smoke is worse. Makes you wonder how on earth I ever smoked, but I did, from about 16 until about 18. I am really glad that I no longer have that habit.

Big temperature changes, going from a well-heated building to outside in the cold, or walking into a really warm, damp room after being someplace cold and dry will also set it off.

The attacks start out as a little tickle in the back of my throat, as if I've swallowed a small bit of goose down. Sometimes, swallowing hard will get rid of it. Sometimes a sip of really cold or really hot water will soothe it. The urge to cough to get rid of whatever 'it' is becomes stronger if the water tricks don't work. Taking a deep breath becomes difficult, it catches in my throat and then I've got no choice but to cough, a ragged, deep, drawn out hacking bark of a cough, that sounds like perhaps a chunk of my lung might be expelled soon. I can exhale all I want, as I cough, but taking a breath in is like sipping air through a straw. After you've just finished running a marathon.

That's where the wheeze comes in. As my lungs scream for more air, the rest of my body is still being wracked by deep coughs, and a little, tiny sip of air is all I can get in. It makes a small noise, a wheeze that can sound like a death rattle. Which will further convince the uninformed observer that I'm about to die, because it can also sound like an injured animal's last cries.

Bad asthma attacks (as opposed to 'good' ones? No, as opposed to mild ones.) are painful, causing aching abdominal muscles from the coughing, and a tightness in the chest. An invisible giant's hand is squeezing your lungs for all he's worth, and then when he suddenly lets go, and you're able to breathe, the tightness relaxes after a few normal breaths. It only disappears after the attack is completely over, usually ten minutes or so later.

The last time the asthma was badly out of control for me was October of last year, when the last vestiges of Indian Summer finally died away and the leaves began to fall from the trees. The temperature changed from hot and humid to cool and then chilly. I'd have terrible attacks on the way to the gym every morning, after leaving my nice warm bed and heading out into the cool, pre-dawn chill.

Because I got really damn tired of starting my workouts short of breath, I called the doctor's office and requested an appointment with our family doctor. Dr. Hottie gave me Singulair, Xopenex, and Advair that time, and after using each for about a week as prescribed, I ditched the Xopenex (another rescue inhaler) and the Advair, and took the Singulair daily until the weather finally decided to just be fall, instead of jumping back and forth from summer to fall to summer to winter to fall again.

When the very first signs of spring began appearing, daffodils and other early spring flowers pushing themselves up through the snow, I began taking the Singulair again every day. That was about three weeks ago, and over the past week we've seen outdoor temperatures range from 13 to 70F, about -10 to 21C. Trees are blooming, flowers too, and my allergies are bad, making me want to scratch out my eyes and find some perfect cure for the raw skin around my poor nose. The monster is always just out of sight, hiding on my shoulder or behind my ear (he's little, you see, until a really severe attack, which makes him grow to gargantuan proportions) when he decides that he wants some attention, and then he harasses me.

My mind is seriously in the gutter, because re-reading that bit about the monster growing has me thinking about other things that start small and grow large quickly...uh. If I have to 'splain it to y'all, it loses some of the funny, so moving on....

When I'm working out each morning, the last thing I want is to have an attack happen on the treadmill. I could fall and hurt myself, yes, that's a concern, but more than that, it attracts unwanted attention from the other early-morning gym rats that make me feel like I've got a flashing neon "check out the freak" sign over my head.

Here's a cheerful thought about asthma. There is no cure. All I can do, besides taking medication daily when symptoms are bad, is increase my lung capacity through cardiovascular exercise, and perhaps move into the middle of the desert, where there's little or no pollen.

Most of the time, it doesn't bother me. I don't think about it every day, nor do I dwell on it when it isn't acting up. I refuse to carry around a rescue inhaler because it isn't that severe for me, and I'm too stubborn. I don't wander around wearing a badge that says, "I have asthma!!! Feel sorry for me!!!" And that's because until it rears its ugly little head, I mostly forget it is there.

Last Tuesday I wrote a post about OCD. Asthma today. Y'all are going to really think I'm falling apart, a mess, or truly in need of intense therapy, as my own mother suggested the other day. I simply prefer to think of myself as one of those eccentric geniuses. At least I entertain myself, cause it makes me giggle, describing myself as both eccentric and genius.
(Heavy on the sarcasm there, in case it doesn't translate to the written word.)

Personal Ick Factor: 7 out of 10.

Although I know that writing blog posts about dreams and medical problems isn't a great idea, I'm going to do it anyway. I wrote about some odd dreams a week or so ago and today I'm going to describe a medical thing that I went through.

Once upon a time, I was 15 and in my school's drama club. I had a small non-speaking role in our spring play, and while at play practice, was sitting on the scaffolding that was stored backstage. Hearing my cue, I jumped up and promptly missed a step off of the scaffolding, thereby giving myself a lovely wound on my shin, which besides hurting like the dickens, left a scar that I still have today. About a week later, near that same spot, I noticed a little brown bump, kind of like a mole, but not a mole, exactly. I thought that either I had a new bruise or a new mole and never really gave it much thought.

Fast-forward about 15 years, to last year, when my mother had a bout of skin cancer. Her skin cancer was a small bump on her nose that had changed color. They removed it, no worries, no chemo, and warned her to use lots of sunscreen and keep an eye on things like that should they change size, color, or do anything else weird. OK, duly noted, thanks! I thought about my leg bump at that time, but since it was still the same color and shape, and didn't hurt or anything like that, I left it alone. About 3 weeks ago, my bump started to itch. Lots. I actually broke through the skin by scratching at it in my sleep. And the color had changed from a brown very similar to Crayola's brown crayon to a sickly greenish with some brown bits. Not good. I called my family doc, someone I've known forever, since before he was a doctor, and explained all about my bump. Since it wasn't really raised up from the skin like a mole, I expected that he would refer me to a surgeon to dig it out. (First ick factor.) No, he thought he could get rid of it just fine in the office, which is A-OK with me. I'd MUCH rather deal with him and his office staff than have some outpatient surgery.

Today was my appointment, and ick-s number 2-7 are all about how he really dug this thing out of my leg. The easily grossed out should probably not read the rest. Fair warning has been given!!

First, the nurse had a look at the spot, and assured me that she though he could get it out without referring me to a specialist. Then he had a look at it while the nurse shuttled in and out of the room with all kinds of sterile supplies that I was very careful to not look at....scissors, some weird tweezers, two packets of sutures, a syringe (which is what I really ought to not look at, because I haaateee needles) a scalpel that he wouldn't let me see, and what seemed like a huge amount of sterile sheeting. Then there was also a specimen bottle, cause they need to ship this thing off to the lab after they remove it to make sure it isn't skin cancer. 2nd ick factor, the thought that I might end up having cancer. Fan-fucking-tastic. Oh, and the nurse brought in Novocain.

They covered my leg with the sterile sheeting, which had a hole in it just a wee bit bigger than my bump. They rubbed the spot with alcohol, then started giving me shots of Novocain. Damn, that shit burns. And the bump is right near my shinbone, so the skin's pretty thin there. I lost count of the number of shots. I had a knitting book in my hand and was determined to not look, but who was I kidding? I looked, and asked lots of questions. He made 4 straight cuts, all around the bump, boxing it in. At the tail end of the last one, I felt the knife and said, "OW!" and he said, "You can feel that?" Yup. So he gave me about another 4 shots of Novocain and then started to remove the bump. I stopped watching for a bit then, but he snipped the skin and used the weird tweezers to pick up what he cut out. 3rd ick factor, hearing the snipping and knowing it was my skin.

He explained that the two types of sutures were because he needed to build back up what he took out, and one type of stitch goes in the sub-cetaceous layer of skin and the other goes into the dermis. Maybe I'm crazy, but that kind of thing is interesting to me. I watched while he began the sub layer of stitches, then noticed how much the spot was bleeding and was freaked out (4th ick) and looked back at my book. When I looked again, he was working on the dermis layer of stitches, and was using the weird tweezers to hold the skin while he stitched. Ick, again. That's 5. He gave me about 11 stitches, all told. The little teeny tiny needle they used for the stitches was really cool. A curved tiny little thing, as long as I wasn't really paying attention to the fact that he was punching through a layer of skin for every stitch, it was really cool. He put 5 in the sub layer and 6 in the dermis. That’s another ick, because I’ve never had stitches before unless you count the self-dissolving kind I had when I had my wisdom teeth out in 1994. Which I don’t, because I never knew they were there. Stitches you are unaware of until after they’ve dissolved don’t count. The six have to be removed in a week or 10 days time, and they should have the lab results back by then. I’ll post whatever they tell me, but I asked the doc what chances he thought I had of having to have further surgery for skin cancer and he said, “almost none.” So that’s a good thing. I’m counting having to have the stitches removed as ick number 7.

When he was all done, he showed me where he thought the scar line would be, and how it should heal. I said, “I should worry if….” and he said, “If it bleeds profusely, gets red streaks around the wound or gets hot to the touch.” He showed me how the Novocain blanches the skin, which is really odd, and told me he had to give me lots more than he usually gives people because I felt the cutting. I asked if it would hurt when the numbing wore off, and he said not anymore than what acetaminophen or ibuprofen over the counter pain relievers could handle. He offered to give me samples of Darvocet, but I thought that was silly. (DUH! Always take the drugs! LOL)

I’m going to mix myself up a big Bloody Mary with some of the wasabi I got in the mail today for an article I’m working on for Fitfare. Who needs meds when you can have booze?

Soundtrack: O.A.R’s “Love and Memories”, please check them out if you’ve never heard of them, they rock!