Category: Wellbeing

Pick, pick, pick

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I’m back at work this week, a little reluctantly. I’m still expelling – those of you with respiratory issues feel me. I feel run over. Those of you who haven’t been run over – I don’t recommend it.

However, my thumb – the real reason I haven’t posted in a while – still throbs. You may not know this, but approximately three out of every four American adults suffer from some form of self-mutilation.

Actually, as far as I know that’s not true. I made it up – out of whole cloth, as they say. I have no idea how many of you pick pieces off. I’d like to think there are a lot of you out there. Then I wouldn’t feel so bad. Me? I’m not doing anything that would draw the attention of a mental health expert, if that’s what you’re thinking. I just pick the hell out of my fingernails. The only phrase heard more often in our house than “Adam, stop running,” or “what the heck is that and what is it doing there,” is “John, stop picking.” I don’t know what the big deal is. It’s not like I’m blowing my big chance as a male hand model. Here’s the thing: it drives Cheryl crazy. It’s like nails on a chalkboard. If I were a pet I’d be a peeve. It’s not entirely my fault though. I swear she has a supernatural sense of hearing. We can be watching a movie in a loud theater and she’ll grab my hands in frustration, trying in vain to squeeze the will to pick out of them. It’s times like these I’m thankful she doesn’t have a firm grip.

Anyway, those of you familiar with Olympic fingernail picking know there are risks involved, one of which is infection. If you pick too much off it grows back off track. That’s what happened to my thumb. On my right hand. On the outside edge.

I don’t know about the rest of you, but that part of my hand gets a lot of work: it’s my space thumb. Come on, admit it, you’ve all got a space thumb. You probably take it for granted too – pounding away at your keys without a thought for it’s needs, dreams, or desires.

I won’t. Not anymore. I thought office email was painful before. Try it with a bum space thumb.

Brain a buzz

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A friend of mine likes to talk about “the karma truck” and it’s chances of running you over. I’ve pointed out that talking about it probably doesn’t help his chances, but some people just can’t be helped.

I wrote the last entry two weeks ago but I wasn’t going to post it. I’d shared it with Cheryl though, and she thought it was amusing. (It’s fine to love and lose, but I’d just as soon not precipitate the loss). Still, I didn’t want to offend anyone… mothers making up a large percentage of the reading public, and a fair portion of my audience (such as it is). The equation changed somewhat on Monday when I got clipped by my friend’s karma truck. I figured I might as well post it – if for no other reason than to give this one a little context. Besides, I’ve really enjoyed writing these last two paragraphs. They’re begging me for a raison d’être.

—

I had my quarterly visit with my oncologist on Monday. Her people drew some blood and ran the numbers, per usual. One number is normally out of range (my lymphocytes), but a couple more numbers were slightly out of range too. Still, my Doctor’s first reaction was, “this looks good.” It’s happened before and it was no big deal then. However, this time she followed it up with the most thorough physical exam since my initial diagnosis; asking me about localized pain, unexplained fevers, and checking all the places blood cells can collect when things go wrong (thumping my spleen and massaging my lymph nodes). I haven’t had any pain or fevers, but my answers seemed to surprise her. It could have been my imagination or deficient social skills, but it seemed like she was expecting a yes or two.

Well, by now I’ve revealed enough of myself and this visit for you to recognize the makings of a panic attack – the paralyzing variety. I’d planned to go back to work afterwards, but it was enough to send me home, take a pill, and chill.

We now return you to my appointment, already in progress.

I can put up a pretty good front as long as speech isn’t required. Not talking is a pretty revealing tell though. She tried to reassure me. “You’re fine,” she said. “I want to do a blood smear just in case, but everything looks great. Oh, and if you do have any unexplained pain or fever, give us a call right away.”

Um… ok. We need to work on our focus when we’re reassuring.

The last time they wanted to check my blood under a microscope it was to check for cell abnormalities – which they found. Oh, and wasn’t there an old revision of an AMA medical dictionary (before they went soft on bedside manner) that defined “right away” as “you better do it right fucking now before you drop dead?”

If I was smart, or I could string two meaningful words together under pressure, I would have asked questions, like: “Why do you want to take a closer look at my blood? Does something concern you? Why are you concerned about these particular symptoms?”

This is the part of the post where I tell you the worst thing that came from my little dance with leukemia two years ago was fear. It’s a scary word and I’m easily frightened.

Even if it did return to active duty, the kind I have is easily treated (relative to other cancers)… and none of this means it’s back. One of my numbers: a type of white blood cell that’s about half of what it should be, could be explained by a simple infection. Plus, the prior fight with my little hairy mutants left me with fewer of those cells to start with. I’m also two years into my remission. The chance of a reoccurrence at this point is quite low. There’s a window between ten and fifteen years where younger people tend to have another go at it, but I’m not there.

Hairy cell leukemia is quite rare already, but it’s even rarer in young people. It’s mostly a senior’s disease. (I never thought I’d be ahead of my time.) Over all relapse rates may be artificially low because patients tend to die of other, natural causes (not precipitated by the leukemia) before it has a chance to come back. However, I’ve been told that since I was so young, there’s a good chance it will eventually come back (unless I pick a fight with a truck in the mean time) but probably not now.

I’ve also been told that even if it does come back, there’s no change in treatment, and no change of prognosis – which is really good. The treatment is easy as chemotherapy goes (though I was an exception, requiring hospitalization – sensing a trend?), and the prognosis is excellent.

I’ve tried to show everything in it’s naturally occurring, good light in this post. I just wish I could make myself believe it. If it makes you feel any better, writing it down helped.

Mid-morning man

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I’ve probably written this post before, but I don’t care. My editor is on vacation this week, so this one’s going straight out – repost, new ground, correct spelling, good English, or not.

The spell checker on my phone… is unreliable. I was going to use another word, one of a few colorful choices rhyming with duck, but I’m feeling polite.

I pride myself on self-awareness. I like to think it’s one of my strengths – the silver lining to low self-esteem. The monitor runs pretty close to 24/7, so I’m usually right on top of things. Whether I cope well is another matter, but I figure I’ve got half the battle licked.

Some people say they’re morning people. Others say they’re night folks. I think it’s one thing to be a night person but a little creepy to admit it. Maybe it’s the books I’ve been reading. Well, I’m here to tell you I’m neither. I’m more of a 9 to 11a.m. kind of guy.

What does any of this have to do with today, my status, or the relative humidity in Skokie? Not much really. I just felt like sharing a random quirk, wondering if I’m as strange as I think. No, I’m beyond wondering. I’m embracing the strange today. Sorry Cheryl. At least I warned you.

I wonder if I’d find a correlation if I plotted the caffeine levels in my bloodstream during the day. I wonder if I’d find proof of a coffee fulfilling prophecy. Maybe I need to drink bigger. Maybe a thermos just isn’t hacking it.

Carafe? Jug? Barrel?

“John’s Jiggy Java has a wonderful, balanced flavor, with a smooth finish, and a hint of oak that you won’t find anywhere else.“

A tale as old as fire

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We’ve been bad lately. Few of our meals have been home cooked the last few weeks. It begs the question: has my mood driven our dinner selection, was it the other way around, or were we involved in a tragic dinner-depression feedback loop?

Begging or not, that’s not really why I’m writing. I’m writing because we didn’t have salsa.

“Holy hot sauce Batman!”

The thing is, I was ready to bust out of my funk. I was ready to go toe to toe with the blue mood. I was going to make us some dinner, everyone was going to sit down around our new/old table, and they were going to love it – and me.

I oiled up my pan, got ready to chop an onion, and let my mouth water at the thought of the southwestern dish I was ready to whip up.

No salsa.

It’s the story of my life.

When people care

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My wife is worried about me. From a purely selfish standpoint, this is a good thing. The depression bug hasn’t run it’s course and the stay in bed headache is on day number three.

“Headaches don’t last this long.”

“They have before.”

To be honest, I’m fully reclined on the Lazy-boy in the living room right now (not in bed).

I know it’s not my fault, but it hurts when I hurt people. It means I have to work extra hard getting back to good working order.

My silence

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How would you feel if your spouse didn’t speak? What if it was a coworker or a friend? Would you impute something to their character or nature? Would you interpret it as arrogance, disdain, or indifference? Would you conclude something was wrong? Would you wonder if this person was burdened with a problem in their personal life? Would you ask this person if something was wrong? How would you feel if this person usually replied, “nothing,” though not convincingly?

I think about it quite a bit. When I’m depressed I spend a lot of time not talking, or saying as little as possible. It’s not because I’m angry, impatient, or think too highly of myself. Mostly, it’s because I don’t have anything to say, or the energy to say it if I do.

It’s possible some of you know exactly how I feel, if the statistics on depression are right. But I wonder if the popularity of a term has anything to do with real awareness. With all the ads for antidepressants flooding our lives, with actors pouting and wearing sad, puppy dog eyes, has depression become a throwaway word – something people use to describe any bout of blue? When folks ask me what’s wrong and I answer “nothing” it’s about as close to the truth I can get without borrowing a Vulcan. I could tell you I’m depressed but the word feels overused and under valued – like saying a blue whale is a mammal.

What’s wrong?

Depression isn’t enough and I don’t have the words in me to replace it. Maybe it’s fitting depression (the word) feels a bit empty. For me, depression is profound sorrow without cause.

What’s wrong?

I don’t know. There’s nothing I can point to. I can’t say the cat died or someone said something mean in study hall. It’s nothing, everything, and exhausting. I feel upset but nothing obvious is wrong. I feel preoccupied but I’m not doing anything (and I don’t have any plans or desire to do otherwise). Imagine how I might respond when someone comes to me with a question, asks for a favor, or invites me out for a little fun. I try to rise above the depression, to not let it define me, but it’s hard. Really hard. I try to be helpful, to be the person I want to be, but sometimes tone speaks louder than words.

I suffer in silence. I appear to be unwilling to tell you what is wrong, but I feel incapable. I appear reluctant to help, socialize, or join group activities, but I feel overwhelmed. I appear to be making excuses and I fear that I am.

Still, I’m determined not to let it be one.

In the mean time I want you to know one thing.

I’m sorry. It’s not you. It was never you (well almost never). It’s me.

—

People are capable of great strength, and sometimes I wonder how. Is it like asking a great writer how he/she writes so well, or a bird how it flies? Maybe some people just are, and the rest of us are not. Or, maybe I shouldn’t worry how others manage great strength and focus on the evidence it’s possible. Maybe I don’t have a gift for writing, but I could try to cut down on unneccessary punctuation. Maybe I can’t flap my wings to get off the ground, but I could work on my vertical leap.

Today is another day, another opportunity to step forward.

Love thy couch

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Pre-post warnings are not a good way to win over readers. I recognize this, yet I ignore it. If you’re here you’ve probably either learned to overlook my poor habits or you find them a little endearing.

Oh my! The headache meds are working just fine now!

All of my posts start with a single sentence. When you write you probably start with a single sentence too – unless you have a punctuation problem, but stay with me. My posts start with a single thought. When I sit down to type I’ve rarely thought things through or done research of any kind. Posts either flow from that single thought or they die from lack of inspiration. Lately my enthusiasm has been in arrears, so more often than not they die… as evidenced by my queue of “unpublished,” unfinished posts.

What I’m trying to say is I’m not entirely sure where I’ll end up going with this one.

But you’ve been here a while, right? All of this is probably obvious by now.

I left work this morning, the result of pain in my head – more than one kind. Taken by themselves, I’d probably still be there, but together they were too much. I’m a wimp when it comes to physical pain but it’s nothing compared to my emotional fragility, even at the best of times. I may sound flip when I say it, but my nonchalance masks years of hiding and denial.

So here I am, my eyes closed (most of the time) to deal with the physical, and my fingers poised above the keys to deal with the emotional.

What was this thought that started all of this rambling nonsense? Well as the title suggests, it was my couch. My mind has been on my couch a lot lately. That’s what happens when you lie down.

My mind was on my couch, half awake from the meds and fatigue, when a question formed – the illusive thought. Am I like my couch?

Some people don’t like my couch. They think it’s too soft. They think it’s lumpy. They think it’s not supportive. Sound like anyone you know? I don’t mind the soft or lumpy part, and I think it’s more supportive than some people say, but here’s where the comparison really breaks down: I like my couch.

So… why? Or more importantly, what do I do to fix this… to fix me?

I’ve tried counselors (though not recently), and they’ve been almost useless. Just talking can be therapeutic, but I know some of the playbook. I was on the path to being a counselor one day myself. Wouldn’t that have been a sight: the introvert making a living on communication. (Growing up, my pastor was really subtle about his thoughts on my future – providing me with plenty of literature on Lutheran seminaries in the US.)

I’ve tried making time for myself. I’ve tried to find and do things I enjoy. I’ve tried taking better care of myself: eating better and getting regular exercise. I’ve tried to get plenty of sleep. I’ve tried to spend quality time with the people I love. I’ve tried to be a good father and husband. I’ve tried to talk to people when I’m down, to open up rather than shut down. I’ve asked for help. Oh have I ever asked for help. God can’t come to the phone right now but if you leave your name and number he/she will get back to you as soon as possible. I’ve tried to let myself off the hook. As Freud might say/ask, I’ve talked about my mother. I’ve tried to look at my life objectively, to see how fortunate I am in many, many ways (like Cheryl, who has done her own trying)… but also to see if there were things I could do to make it better. I’ve tried exploring biological causes of depression and anxiety – though I haven’t exhausted this avenue yet (to be honest in many ways I’m really just getting started, even though I’ve been at it for a few years).

So where does this leave me now? Well, have you ever had that talk with one of your kids after a fight with your spouse about love… how you may be angry right now, and look like you don’t like each other very much, but you still love each other? I still love life. I’m still trying.

In the mean time, thanks for hanging in there with me while I talk about my stupid couch.

Some of you sent me your own comments, messages and suggestions. No matter what I said above, all of them were appreciated. Most helped, suggesting I should revisit my thoughts on counseling. A few friends and a couple good books have been as good a medicine as anything else.

The new doctor

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The effect was fleeting but appreciated. I finally made an appointment to see a new oncologist and she was really nice.

I’m always nervous about seeing a new doctor. They play an important role in life and I’m afraid of getting one I don’t like or trust. The logical thing to do when this happens is switch, but I usually don’t – not for a while anyway. In fact I’ve only switched doctors voluntarily once. Hate is a strong word, so I’ll say I REALLY didn’t like one guy… but I still stuck with him for several years. I’m sure it has something to do with the relative trust in the devil you know versus the one you don’t, not that all my doctors are Satan’s spawn, but my facility for logic is easily lost in the face of fear.

I should say that I really like most of my doctors, and not just because I trust their professional judgement. I like them on a personal level. They’re kind, patient, and caring.

sandspur_sm.jpgMy oncologist was an exception. On some level I liked the guy, but at times he fit my stereotype for the highly educated/paid professional: he was a bit of an arrogant prick. Mind you, I’ll take a competent doctor, even if they have the personality of a sand spur. If it starts to affect my trust then I’d have a problem, but that wasn’t an issue with my old oncologist. Quite the contrary, I trusted him implicitly. I think it’s part of the reason I put off scheduling an appointment with a different doctor when the insurance issues started.

All of these concerns were put to rest this afternoon. I found another kind doctor, someone who seemed to know her stuff – and care about the person behind the symptoms.

I left the office feeling pretty good.

It wasn’t enough to crack depression’s hold for long. I found myself back in the emotional valley soon enough. But, I’ll still take all the good I can get.

—

Just in case there’s any question, there’s still no sign of cancer in my blood. My doctor’s are confident it’ll be gone for years, and even when it does come back it’ll be easy to treat. It’s not something I was worried about going in, or going forward. I’m odd this way: all worked up over which doctor handles my routine check-ups.

Feeling sinking

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I’m feeling up and down right now, and that’s the problem. I’m up four hours before I’m supposed to wake up for work (it’s a little past 2am here as I write this), and I’ve yet to get a whiff of sleep. I’m up because I’m down, for reasons I can explain and others I can’t.

The last few weeks have been tough. The last few months have been tough, but for different reasons.

Cheryl finally convinced me to see our doctor, but the outcome was a little different than she was expecting. I’ve been treated for panic/anxiety disorder in the last few years, but I’ve had bouts with depression all of my life. Looking back, I can see signs of a few depression disorders (though that may just be my undergrad degree talking). Anyway, lately I’ve been wondering if my symptoms (fatigue, headaches) could be related to depression… so I told my doctor I was depressed. The headaches and fatigue have been holding steady, but the depression has been getting worse, even as some things in life are getting better. So rather than monkey around with the meds for my headaches, we’re monkeying around with the meds for depression/anxiety… slowly weaning off of one while slowly introducing another.

Plus, she threw in another visit to the phlebotomist for good measure. The weight loss tally since late November is approaching fifty pounds.

It’s not fun being in between medications… weaning off of one that kind of worked, waiting for the new one to slowly build up and kick in. I’ve been a wreck. It’s been hard to concentrate on the simplest tasks. It’s been hard to get out of bed in the morning, and hard to get back in come nightfall. Nothing gives pleasure. Stuff that was fun now feels like a chore. To top it off I hurt my back last week, forcing myself to stay active (knowing physical activity is one of the ways to fight depression). Between my aches, pains and emotional state I don’t know how anyone can live around me.

Cheryl insists she didn’t notice my mood was that bad. She’s either lying to make me feel better or I’m way better at masking my emotions than I thought. I always thought of myself as a whiner, but I suppose even that requires some minimal amount of speaking or communication.

I can tell you I’m depressed, which is sort of an explanation for why I’m up, but it feels lacking. Can two syllables ever truly explain how you feel, particularly when it casts such a shadow over so many aspects of life? I can tell you I’m depressed, but how do I begin to explain the sense of dread? The absence of energy or enthusiasm? How do I explain the frustration I feel, knowing it’s all in my head, unable to pinpoint a reason… an event or circumstance in my life as the cause? I wish I could. I live in fear my emotional state is interpreted as laziness.

Or worse, I’m using a family history of mental illness as an excuse to be lazy. I don’t really think it’s true, but some people who suffer from depression can be very creative coming up with reasons to hate themselves.

Now Cheryl’s on the verge of killing me herself. A combination of lethargy and insurance problems have put off my oncology follow-ups. I’m more than three months overdue for my checkup. If there’s one thing I’m good at, it’s rationalization. So good in fact, that I’ve placated Cheryl (who’s not easily placated when it comes to her family’s health) for a little over three months. Stupid? Monumentally. Will it amount to anything? Probably not. I should be good for another nine to ten years. It’s one more way depression has affected my life. It’s one more example of how depression can just as easily be written off as just another lazy whiner.

My real fear in all of this is that it’s more proof I’m my mother’s son… that I’m destined to follow in her footsteps… to gradually lose my mind entirely and end up in a state hospital. Seeing her there, seeing what she’s become and how she’s come to live… it’s more than mere fear. It’s damn scary.

Is it getting lighter in here?

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There’s a chance you won’t like me a few sentences from now.

I’ve lost almost 40 pounds this year, but I haven’t been trying.

Some of you know I have regular blood tests – and not because you’re my doctor. One day I may regret speaking so openly about myself. So much for my dream of one day being named ambassdor to Iceland. Although they’ve always given me a clean bill on the cancer front, they’re setting off klaxons on the metabolism front. Alright, it’s really not that bad, but I like the word klaxon.

Red meats are off the menu, as are many sugars and starches. I carefully track the foods I eat on a dandy little app on my phone. That’s how I know. Eight pm rolls around and I’m often WAY under my recommended calorie intake for the day. Many nights I’m breaking out the snacks just to get within a couple hundred calories of where I should be. And I’m not hungry.

I’m not starving myself. I eat little (healthy) snacks throughout the day. My doctor was surprised by my weight loss, but not alarmed, so maybe I shouldn’t worry. But 40 pounds? My weight got a little out of control after I got out of the hospital two years ago, but I wasn’t close to obese. Now twenty percent of my body is gone. What if there was something in that fifth I liked?

I’m going to need more reassurance from my doctor the next time I see her. Don’t get me started with the insurance problems I’m having with my oncologist. I’ve cancelled my last two appointments waiting for the contract to be finalized between my insurance company and his new practice. Cheryl’s gonna have a nervous breakdown and order me to pay the damn bill as a self-pay patient.

Oops! I guess I got started.

People who know my history come up to me with concern in their eyes. “Are you ok? You look like you’ve lost a lot of weight.” I’m not sure how to answer. Do I tell them the truth? “I think I’m ok, and I appretiate the concern and all, but you’re freaking me out a little.”