My Experience Only. YMMV.

Posts tagged ‘physical pain’

The Comfort That Remains

Here I am, caught between reactive depression and clinical depression.

If you’ve been reading my last several posts, you know that I’ve been having a rough month. Several months. It’s been a real challenge to my hard-won quasi-stability.

3ff82b43-7ccd-4bde-8219-be5598c73452Last week, my 20+ year old cat, Louise died. The week before that, my husband’s 17+ year old cat died. So now I am trying to deal with those reactive feelings of grief and loss, without losing myself in the eternally waiting Pit of Despair that is clinical depression.

In doing that, I am trying to find things that remain to take comfort in.

I take comfort that my husband was here with me, to help me through.

That Louise had a good, long life spent in our loving care since she was a tiny kitten.

That she died peacefully, at home, in my lap, with me petting her.

That I had a chance to say goodbye to her.

That I know she loved me as much as I loved her.

That her presence and her purr helped calm me and helped me when nothing else could.

That she gave me a constant presence through a third of my life, and all of hers.

We have two cats now – Dushenka and Toby. They are young and healthy, but of course our time with them is not guaranteed. I know that, just by having them and loving them, we are inviting future grief into our lives, along with the joy. That’s just how it is.

I’ve been reflecting a lot lately on animals, humans, and what we share with each other. I know this is likely to happen again, and soon, for our dog is also aged and nearly ready to go. It’s hard. Is it harder when your brain doesn’t work right and tries to tell you that sorrow doesn’t end?

I don’t know.There’s no scale by which to compare pain, and loss, and despair, and grief. We each go through it the only way we can.

I hope that soon, at least a few of the clouds will part and I can feel something besides sorrow, express something other than pain. Maybe next week’s blog will be about healing, or coping, or sharing strengths.

Those are all things I need to be doing – that we all need to be doing.

Someone remarked this week that a recent post (http://wp.me/p4e9Hv-k8) was not about healing. It reflected, the commenter said, all the privileges I have – money (or those who can lend it to me), drugs I can take to help me through a crisis (too many, according to the commenter), a supportive husband. And that’s all true. I have these privileges and more besides – a home, work that I can do without leaving the house, insurance, a psychiatrist and a psychotherapist. Some of these come to me because of circumstances I don’t control, and some I have had to work very hard for, as I have worked hard for the ability to heal, a little bit at a time.

There are still things I cannot do – leave the house more than twice a month or so, shop for groceries, see the dentist without massive panic, stop taking the psychotropic meds that allow me to think, have a healthy sexual relationship. I expect that some of these will get better and others won’t.

But, no matter our symptoms or their severity, we as people with bipolar disorder are all in this together – or as the Bloggess would say, alone together. Maybe I have an easier time of it, but that’s far from saying it’s easy for me.

I still experience grief and sorrow, depression and anxiety, irrationality and immobilization, pain and despair, relief and help, struggle and hard work, love and loneliness.

And always, I look for the comfort that comes when I need it most, or expect it least, or believe I’ll never feel again. We all do.

Forced to Face My Fear

A little while ago, I posted about my severe dental phobia (http://wp.me/p4e9Hv-cG). So of course fate pushed me to the wall and left me no choice but to confront it.

tooth fairy illustrationHere’s the backstory. My teeth are awful, and my dental phobia has a lot to do with it. Realizing this, we borrowed some money and put it aside for my dental work. The reason that we had to borrow that much money was not just because we’re broke (we are) or that our dental insurance is so crappy as to be nonexistent (it is), but the fact that the last time I got any dental work done (years ago), I was so terrified that I had to have a traveling anesthesiologist brought in to put me completely under. And that approximately doubles the cost of already-pricey, though necessary, procedures.

Then another disaster ate the money we had put aside. There was no choice in the matter. The dental money had to be sacrificed.

Then fate stepped in. Last Saturday I got a toothache. Of epic proportions. Not realizing that the dentist had a 24/7 emergency number, I toughed it out till Monday, when my face was hideously swollen and the combined powers of Anbesol and Tylenol were insufficient to let me sleep. I got in to see the dentist on Tuesday.

That one tooth was definitely going to have to come out and the abscess drained (did I mention there was an abscess?). And there were a few other highly recommended procedures that needed doing as well. None of which the crappy insurance would pay for.

But that wasn’t the real problem, or at least not the only problem. The traveling anesthesiologist was out. The dental slush fund no longer existed. Normally (that is, for normal patients) the dentist offers “oral sedation,” which turns out to be triazolam (Halcion). But since I already take lorazepam (Ativan), that wasn’t considered safe.Apparently the two don’t work and play nicely together.

“You’re going to do this without anesthesia AND without oral sedation?” the dentist said.

“I have no choice,” I replied. He had given me Vicodin for the pain (as well as an antibiotic for the abscess), but I couldn’t really take that long-term. And so I was cornered. I had to have the procedure, no matter what. (My husband offered to get a rubber mallet and knock me out, or knock the tooth out, or something. I politely declined.)

The plan we worked out was this: On Thursday, when they were to do the procedure, I would take two Vicodin and increase my lorazepam from .5 mg to 1.0 mg. (with my pcp’s permission). Then I would have nitrous oxide, which had never worked for me before, but hey, worth another try, right?

And I would have my husband there in the procedure room, as my comfort animal. He had to stay out of the way, but was able to reach over and pat me on the ankle. Which was comforting, actually.

Double Vicodin (I was permitted two but had been taking only one) and double Ativan (plus one prophylactic Immodium) left me suitably stoned. I was totally confused when the hygienist asked me, “Bubble gum or orange creamsicle?” I was stoned, but that made no sense. Turns out nowadays they have scented nose cones for the nitrous. (I chose mint.) I could barely feel the numbing shots, and the extraction went smoothly. I didn’t hear/feel the terrifying, sickening crunch that went from my jaw directly through my brain when I had my wisdom teeth out. My husband said I didn’t even flinch. He patted my ankle anyway.

Then we paid about the same as we recently had for two vet visits for our ancient cat, but nowhere near what we had borrowed, put aside, then spent.

I didn’t even disgrace myself, though I had spare underwear in my purse, just in case.

All in all, it went way better than I expected. Have I conquered my fear? I don’t honestly know, and probably won’t until the next time. (And there will be a next time.)

But at least I’ve proved that I can do it. I can have a dental procedure done without anesthesia and without oral sedation, if it’s really, really necessary. Pain is surely a great motivator. I am no longer a huge wuss, I guess – just a regular wuss. I do hope, however, that when the clot heals and the infection clears up, and the swelling has gone away, that I do not have to go through this again for a very, very long time.

(At least this time I did better than when I faced my apiphobia (http://wp.me/p4e9wS-7H).)

 

Who’s a Spoonie?

With all the talk about cultural appropriation lately, I’m hesitant to wear Kokopelli earrings or eat at the Chinese buffet. I understand that some people object to Canadians playing Englishmen who are pretending to be Japanese for a production of The Mikado is offensive or racist. I don’t always agree, but I understand the principle involved. Even I, a WASP, find Mickey Rooney’s character in Breakfast at Tiffany’s to be egregious, appalling, and insulting to everyone involved, including the audience.

Hand XrayBut recently there’s come the claim that those who are not entitled to it are appropriating Spoon Theory language. And in this case, “entitled to it” means someone with an “invisible illness” – chronic pain, chronic fatigue, and other conditions that do not announce themselves to the public with visible cues such as wheelchairs, crutches, missing limbs, or guide dogs.

If you don’t already know Spoon Theory, you should. You can find the explanation here: http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/. Basically, “spoonies” have only a limited amount of energy units per day, represented by spoons. Spoonies must use a ridiculous amount of spoons to get through tasks that others accomplish normally in the course of life – showering, driving to work, driving home, fixing dinner, et endless cetera.

In fact, on any given day a Spoonie may not have enough spoons to get out of bed and get showered and dressed. It’s not that Spoonies are lazy; they may have only three metaphoric spoons that day, compared to a non-Spoonie’s typical, oh, I don’t know, 20? 30?

A few weeks ago, I wrote about whether bipolar disorder and other mental disorders are invisible illnesses: https://bipolarjan.wordpress.com/2016/03/06/is-bipolar-disorder-an-invisible-illness/. (I said they mostly are.) As far as I’m concerned, we’re Spoonies and “entitled” to Spoonie language. Most of us have had the experience of not having enough spoons to spend on a morning shower, having to choose between hygiene and, say, eating breakfast.

So now, apparently, the general public is picking up Spoonie language – saying “I’m out of spoons” when they simply mean “I’m tired” or “That was an exhausting day. I’m done.” And some Spoonies resent that. See http://m.dailylife.com.au/news-and-views/dl-culture/stop-appropriating-the-language-that-explains-my-condition-20160113-gm4whc.html

I have two things to say about it. The first is that language is always growing and changing. But it does it on its own, without our control. (Unless we’re France. France at least tries.) We may wish to eradicate the “n-word,” but we can’t. It’s less socially acceptable to use in polite company, but you know people still use it. Read the comments section on any social media post about President Obama if you don’t believe me.

The second thing is that at least Spoon Theory and language are entering the mainstream. People without invisible illnesses are at least getting a clue of what it means. They may not have the details right, but at least now when we explain it to them, they won’t be starting from scratch.

And after all, isn’t that how Spoon language started – as a way to begin a conversation on what invisible illnesses are and how they affect our lives? Not a secret language that only those who know the password and handshake can use.

Dental Health and Mental Health

I still remember one of my earliest episodes of panic, which happened in a dentist’s waiting room. As I said in the uncomfortable chair, surrounded by Highlights for Children magazines that I had already read, I felt dread moving up my body from my toes. It crept up my legs into my hips and on into my abdomen. I was convinced that when the feeling of terror reached my heart, I would die. I was called into the doctor’s office before that happened.

This is a memory I have shared with only one other person before now. Just thinking about it still brings back a visceral body memory of fear.

It really bothers me that some people think that good teeth are a sign of moral superiority. Some other people, like me, are simply born with bad teeth, or at least weak, cavity-prone little tooth buds embedded in our infantile gums. Brush as diligently as we might, we are never going to have pristine white teeth like the people on TV.

While my dental phobia can possibly be attributed to the general pool of my anxiety triggers, there were also some outside factors that contributed to it.

My parents were never good role models for dental health, as my mother had gotten dentures at age 16 and my father chewed tobacco.

There were also bad experiences with blame-and-shame dentists and hygienists, one of whom scraped a bit of tartar off my teeth, stuck it in my face, and asked, “If I put that on a piece of bread, would you eat it?”

I used to loathe the public school practice of making us chew little purple tablets to see how clean our teeth really were. My teeth were – and still are – considerably crooked, so it was difficult for me to brush in a manner that wouldn’t leave glaring purple spots all over my mouth.

My teeth have only gotten crookeder, since my parents were not able to afford orthodontia for me. When and where they grew up, braces were a luxury for the well-to-do; rural children like they were simply did without. By the time my sister and I came along we lived in the suburbs, but braces had never become a priority for my parents compared, say, to eyeglasses, which were deemed essential.

My last and most recent experience with a dentist was a number of years ago. I don’t remember what prompted me to go, but I did tell the dentist about my phobia and he was very considerate. (I always look for a dentist whose advertising says, “We Cater to Cowards.”)

He did my exam and treatment in the kiddy room with the bright, nonthreatening murals of cowboys and western scenes on the walls. Just the x-rays and routine cleaning proved alarming enough to trigger one of my worst stress reactions – diarrhea. When it came time for the actual procedures the dentist brought in a traveling anesthesiologist so that I could be knocked out rather than conscious and terrified. My husband was there for driving, moral support, and decisions that needed to be made while I was out cold.

I have not been back to the dentist since. However, it’s becoming increasingly obvious that I need to. My teeth ache. My fillings have fallen out. One tooth is broken. Because of that, my teeth are moving in directions they were never supposed to. And that makes my dental bridge (acquired at the aforementioned last experience) fit poorly. I look like the stereotypical Willie Nelson fan. (I am a Willie Nelson fan, but I don’t care to reinforce the popular image.)

This week I was trying to convince myself to call a dentist just for a consultation. I still haven’t managed to do that. Just saying the word “dentist” gave me a spasm in my chest. Maybe I’ll be able to make the call during this coming week.

The only person in the world who is a worst dental-phobe than I am is my sister. She too had childhood dental issues. Once she even bit a dentist and he slapped her. Needless to say, that experience did not improve her attitude toward dental care.

She is also ultra sensitive to (or afraid of) pain and quite terrified of needles. Even as an adult, she has been known to scream so loudly and lengthily that she has cleared an entire dentist’s waiting room. (She then sent the dentist a Halloween card that screamed when you opened it.)

Still, I am a grown up. I need to do this. I cannot convincingly tell myself that waiting will improve the situation. I just have to pick a day for my appointment when my husband is available to take me and I have had my prescription for Ativan recently refilled. And some Immodium on hand.

Wish me luck.

 

ETA: I now have an appointment with a dentist for some serious work, and with a traveling anesthesiologist for IV sedation. I tried to get the doc to prescribe roofies, but some guys have no sense of humor…

Self-Harm Revisited

If that title isn’t enough of a TRIGGER WARNING for you, I don’t know what is.

Not long ago I saw on the web a video with the title “Is scratching self-harm?” Well, of course it is, I thought. The video agreed with me.

It seems like the low end of the spectrum, not as extreme as as what most people think of as self-harm, but a form of it nonetheless. Scratching, pinching, hair pulling, and the like are probably considered subclinical next to cutting and burning. But they are still problems. They can escalate into worse self-harm.

In another article (http://www.upworthy.com/this-researcher-who-studies-self-injury-explains-why-people-do-it-and-why-he-did-it?c=ufb1) I saw this definition for self-harm:

“Self-injury is intentional damage to body tissue (that doesn’t include body modifications like piercings, tattoos, and scarification) without suicidal intent.”

So, yes, scratching is self-harm. It is intentional. It is damage to body tissue. and it does not indicate suicidal intent.

Scratching sounds so minor. We scratch ourselves all the time when we have an itch or an insect bite. We scratch ourselves accidentally on protruding nails. Occasionally we draw blood. We wash it off, slap on a band-aid, and that’s that.

But when scratching escalates to self-harm, it can indeed be serious. For one thing, scratches have a tendency to become infected, infection of the sort can lead to further tissue damage – and if untreated, to more serious complications.

There is also the potential for further harm because the scratching will scab over. Then the desire to scratch off the scabs kicks in. When this happens, the scratches never heal. And yes, that’s both a fact and a metaphor.

My own experience with scratching came when I was working at a job that required me to monitor burglar alarms. The alarms tended to go off – whether there was a burglary or not – during thunderstorms. When a storm hit, a dozen or more alarms could go off simultaneously, or at least in rapid succession. I had to call the owners of the businesses, or emergency services as required.

One night during a particularly bad storm, I missed one of the alarms. I did not call the owners until I looked back at the record. When I called, it was 45 minutes since the alarm. I knew I had made a mistake, and a bad one. The owners of the business would not be happy. My boss would not be happy. I was not happy.

I sat alone by the monitors and imagined the trouble I was in. I started scratching my right arm – long slow strokes from nearly the wrist to nearly the elbow. Repetitively. Obsessively. Painfully. I believe I was punishing myself for making a bad mistake. Perhaps there was some thought that if I inflicted the pain, I would escape further consequences of my mistake.

Of course that makes no sense. It’s an example of the irrational thinking that goes with self-harm.

I don’t cut anymore, as I discussed in a previous post (http://wp.me/s4e9Hv-cutters). I also don’t scratch the way I did that night. I still have a tendency to pick scabs. Occasionally if I have an insect bite, I will scratch it to blood and then pick the scabs on that. I try not to. My husband helps me by reminding me not to pick at scabs or to put band-aids on them. I try to rub instead of scratch, or use lotion.

Jenny Lawson (aka the Bloggess) has admitted in her most recent book, Furiously Happy, that she scratches past the point of bleeding and pulls her hair enough to create bald spots. It’s clear that she considers this self-harm. Her husband tries to help her with it too.

But self-harm is basically a private thing – something we do and hide from the world. Some people are able to hide it even from their most intimate family and loved ones. I know I wore long sleeves to cover the dreadful scratch on my right arm. It healed from a scratch to a pink scar and then to a white scar. Now I can’t even see it anymore through the freckles.

But I don’t need the visible reminder. I remember how it felt to do it, how it felt after I did it, and how I felt as I watch the scars slowly fade. its nothing I’m proud of, except for the fact that I survived it and no longer do it.

As most cutters and other people who self-harm do, I feel shame in recalling the act, and almost never speak of it. The reason I’m sharing the story in such a public forum is to let people know that not all self-harm consists of big dramatic gestures. It can start with a tiny scratch. But it is not something to be ignored. We need to talk about self-harm, educate about it, bring it out in the open, and let others know that it doesn’t have to continue.

And that it can start with something as small as a scratch.

The Spike

It was The Year of Living With Rex, and for me that meant dangerously. I was undiagnosed and unmedicated, except for wine. I had already been through an episode of cutting. I was clueless and stubborn, isolated and emotionally abused. Tired to my soul and trying to claw my way through my last year of college and a relationship that has affected me to this day.

Then the pain started. Without warning, I would feel a railroad spike being driven through my right temple. It was blinding, all-consuming, and lasted for as much as 30 minutes straight, sometimes. If I was lucky, it was only a few seconds, but I was seldom lucky.

I didn’t know anything that would make it better. All I could do was lie down and weep until it went away.

As this continued, the fear grew in me that I had something dire, like a brain tumor. In addition to my major depressive episode, I was living with massive anxiety.

I don’t know how I made it through my senior year. I don’t know how I made it through the train wreck I was living.

But here’s how I made it through the railroad spike.

Actually, it was kind of amusing, if you weren’t me and it wasn’t happening to you. I went to a doctor, a neurologist, who took one look at me and said,”I can give you any test you want, but I’ll tell you what it is right now. Your jaw is crooked.”

It was Temporomandibular Joint (TMJ) syndrome. And this was before it got trendy and over-diagnosed, the way way gluten sensitivity is now.

My jaw was indeed as crooked as could be. When the doctor put his fingertips on my jaw and asked me to open my mouth, we could both feel it slipping sideways. I’ve been told it feels like my jaw is going to fall off in the doctor’s hands. It made clicking and cracking noises that I had somehow never noticed, and occasionally seemed to get stuck briefly.

How did this explain the railroad spike? When I was anxious, my jaw muscles would clench – and since my jaw was crooked, they would tighten up unevenly. Causing much pain.

“What can you do for it?” I asked.

“We could break your jaw and put it back together, but there’s no guarantee that would work,” he said. (This was in the ’70s. I believe treatments have improved since then.)

While I contemplated whether I really wanted to have a surgically broken jaw (I did not), he gave me a prescription to calm my anxiety so the muscles wouldn’t tighten up and trigger the pain spasms.

Good ol’ Valium.

Now I was officially medicated with benzos and self-medicated with wine. It did take down the anxiety, but plunged me even further into the depression. And I was still living with academic pressure, isolation, no psychiatric diagnosis. And Rex.

I finished up the year, grabbed my diploma, and lit out for my home state as fast as I possibly could. Rex threatened to send the police after me if I took my things while he wasn’t home to supervise and prevent theft of any of his goods. Fine, I thought. Just let him try. I was across two state lines before he got home from work. No, geographic cures don’t work, but sometimes retreating to a safer place can help.

So, all in all, a truly rotten experience. But did I have a psychiatric problem? After all, a crooked jaw is a decidedly, visibly, diagnosably physical ailment.

Of course I did. The crooked jaw was just one component of my condition. The anxiety was another –  a big, huge, whopping one. After all, I’d had a crooked jaw my entire life, and it never sent me railroad spikes until that year. And the depression made it all harder to see and to get away from.

If you ever needed proof the mind and the body are so intertwined that you can hardly tell one from the other, there it is. Physical problem + psychological problem = pain, of both sorts. Good luck trying to sort the two out. And medicating one without making the other worse.

Stress Plus

Mental stress plus physical stress = Stress Plus.

The mind and the body are part of the same system. What affects the one affects the other as well. When the body is stressed, the mind suffers. When the mind is stressed, the body suffers.

When both are stressed, you get Stress Plus.

Here’s how it works for people with mental disorders. You feel depressed or immobilized and you don’t get up and move around. Your body responds by becoming lethargic and flabby. Your mind responds to that by becoming discouraged and self-blaming. What you have there is a feedback loop.

My body and brain have been going different directions of late. My mood disorder has lessened and my brain doesn’t seem to be trying to kill me at the moment. This is good.

However, my body is experiencing all kinds of unpleasant disorders and sensations. Some – the thinning hair, the jowls, the weakened eyesight – are simply functions of aging. This does not make them any easier to deal with. They are wrapped up in my self-confidence, my sexuality, my identity, how others perceive me, and how congruent my self-image is with reality.

Stress symptoms have affected me at least since junior high. I developed a tic in which my chin would jerk up and to the left, making it hard for me (or anyone sitting behind me) to study. My doctor put me on Valium, which stopped the tic, but did no good, I’m sure, for my then-undiagnosed bipolar disorder.

Other physical ailments and disorders are the result of specific events or diseases. I have a bad back, which required two operations, the second because I irrationally thought it would be a good idea to ride an Arabian horse bareback. The experience has left me with nerve damage in my left toes – idiopathic radiculopathy, they call it – and an unsteady gait that sometimes necessitates the use of a cane for balance. It does not make me look or feel any younger.

Also, my hands shake. My neurologist called this an “essential tremor,” which means it’s caused by nothing in particular. He noticed that I often sit with my hands folded in my lap to call less attention to it. Between this and my balance issues, sometimes I stagger and shake like an old street rummy. A friend, God bless him, once told me I had a long way to go before looking like a street rummy. It was nice to hear, no matter what my brain tells me.

When my brain was acting up the worst, it also gave me the worst physical symptoms. My reflexes were hypersensitive and that included the reflex that empties my bowels. Just imagine the literal shitstorm I created in the bathroom of a bookstore one day. Then imagine how much of my self-esteem got flushed along with the rolls of toilet paper I used to try to clean it up. Imagine the humiliation of telling a store clerk, “Someone’s been very sick in the bathroom and you probably need to send a janitor.” I’m sure she knew it was me, because of how embarrassed and sickly I must have looked, but we both pretended that I was simply informing them that an accident had occurred.

Needless to say, all these conditions make me not want to go out amongst people, which adds to the isolation that my bipolar disorder already exacerbates. And when I don’t get out, my body doesn’t get moving, and I become even more immobilized – both physically and mentally.

Like I said, Stress Plus – a vicious circle.

Tag Cloud

%d bloggers like this: