Zero Summing Concern

On December 19th, I had a pelvic ultrasound (regarding the adenomyosis and my PCOS), and I had an abdominal ultrasound to follow up on my NAFLD.

Sharing a crop of the report of findings:

So while, YAY! I did have that fleeting moment of relief to know that there is no "fatty infiltration" of my liver and quite possibly have reversed the NSFLD due to the weight loss, that moment of YAY then morphed into concern about my kidneys, as the multiple cysts coupled up with my hypertension (and headaches, and intermittent flank pain) might be harbingers of ADPKD.

While I have been accused by some to be a hypochondriac, I view myself as a stoic and a pragmatist, and I like to "Prepare for the worst, but hope for the best," with more emphasis on the former than the latter, to be honest. I have been reading up on ADPKD to familiarize myself with this, and here's a crop from the Mayo Clinic's site, which was kind of sobering, regarding possible complications:

And on PubMed, I found this information (and I fit the profile of a PKD1, given my bouts with proteinuria & hypertension):

So, *IF* I am ultimately diagnosed with this, I can still anticipate growths in my liver, among other things. And given my Factor Five Leiden Mutation (plus the additional, possible diagnosis of ADPKD), it looks like it puts me at an even higher risk for a stroke or aneurysm. But the most upsetting thing for me to think about is that mitral valve issue (well that, plus enormous, non-functioning kidneys, and possibility of dialysis etc).

While I do not believe my dad was ever officially diagnosed as having it, I believe he fit the profile. I believe his mom had it (and died from it) and his mom's younger sister (who passed away one year ago from TODAY) no doubt had it. 

In 2008, dad had his mitral valve replaced (and subsequently died, due to his overall health being so poor--and I believe his official cause of death was cardio-pulmonary, and renal failure). Last year, his aunt had her mitral valve replaced (though at close to 82 vs my dad's 67).  

There is no cure for this, if they do diagnose me as ADPKD. There are no supplements for me to take to "hack" or slow the progression. The only thing I can do is try to better manage my hypertension, try to balance out my diet a bit more (even though post op WLS, the focus is protein), try to cut down my caffeine intake, and possibly try to get more active (the latter of which has been something I've been working on for a while now, as I've been focused on better managing my pain issues).

Death awaits us all. No one gets out of life alive. But I would like to have some measure of control over the length and quality of my life, and try to minimize whatever suffering awaits me further down the road.

My endocrinologist was the one who ordered the ultrasounds to be done. And is on vacation until after the first of the New Year. I had my internist CC'd on the ultrasounds, and he provided me a copy of the reports, which I promptly scanned and sent along to my renal guy, and to my gynecologist. And I have made a hard copy for my cardiologist who I will be seeing in February. 

Perhaps I should mention this to my neurologist as well, since I've been under his care for migraines, which run in tandem with my menses, however, I'd feel more comfortable if we ruled out cerebral aneurysm. 

In the interim, I will probably contact my dad's former cardiologist to find out if dad was ever diagnosed as ADPKD (which would be useful information on the differential). And perhaps I will try to reach out to my aunt's son (perhaps sometime NEXT week, not today--I'm sure today's date is still raw for him, as it's the first anniversary of her passing), to find out if she was ever diagnosed with ADPKD.

And other than that, hurry up and wait.

Endocrinologist Appointment: An Update

Worried about my liver. It's tender when the doc palpated it.

AST/ALT, plus lipid panel and iron/ferritin etc are all perfect. 

Endocrinologist told me I haven't reversed my NAFLD, despite weight loss and cutting my risk factors for diabetes etc. 

Now wondering if my (non-symptomatic) factor five leiden mutation (heterogenous) might be influencing/impacting the NAFLD, as well as my hypertension. To add to that constellation of fuckeduppedness, even despite my weight loss, I still have Syndrome X. 

As is my nature, my mind goes to the things I can control, like how to combat oxidative stress on my liver; yet, in conflict with that, I still want what I want. I want to be able to drink a glass of wine or cocktail a week or so. 

In the meantime, I am trying to hydrate more. Going to up my omega-3 to 2x a day. I'm already on alpha lipoic acid and milk thistle both 2x a day. Was investigating SAM-e, but endo said NO. So not sure what else I can do to hack this. 

I'll be scheduling an abdominal sonogram for the liver, and a pelvic U/S for the adenomyosis and PCOS sometime soon. So I guess I should anticipate being referred out to a liver specialist in 2015.

Kenalog: An Update

Had the shot, then two weeks later, a follow up appointment to assess. 

I am neither overjoyed nor non-plussed by the effects of the shot. Do I feel any marked improvement? Depends on the day when you ask. We're now into rainy-snow almost wintery mix weather out there, and the pain is still there, though the intensity varies from day to day.

Some days it feels 20% better. Some days more. But I would not say on a good day that my pain is 50% diminished. Not going back for another shot at this time, or at least not in my spine. Though I am considering a shot for my trochanteric bursitis in my hip.

Results: Neither here nor there. Glad to check it off my to do list.

Yesterday: Kenalog Injection

Yesterday I had kenalog injections/facet joint injections. Too soon to tell if it's working. Though I'm clearly HOPING there is some merit in it!

Have to follow up with the physiatrist in two weeks to assess any improvement.

Pain Chronicles: Facet Joint Injections (Kenalog)

Appointment scheduled for next week. 

Mood: Hopeful.

Pain Chronicles: Persistent RLQ Pain

Going on for probably a year now.

Gastroenterologist has suggested colonoscopy--and really, I'm just too lazy to go thru all that trouble, plus the indignity of the diagnostic scoping itself. Plus: the inevitable "HANGRY!" of being on clear liquids (and no dairy--UGH).

Appendicitis ruled out, given no fever, no hershey squirts. Just intermittent, acute, sharp pain.

We speculated a while ago it could possibly be an ovarian cyst, since, HELLO! I have PCOS. But this pain is much different than the searing, TAKE MY BREATH AWAY PAIN that comes from a cyst bursting. 

Reading a bit today about the possibility that this might actually be lactose intolerance brought on by my gastric bypass. I'm nearing four years post-op, and only in the last year or so has this pain presented itself.

This a.m., while eating my usual "first intake" which consists of pretzel thins and two Baby Bells, the pain kind of amped up a wee bit. Granted, I woke up with it. As of late, I've taken to eating cheese as a late night protein dense snack. I suspect I might have to curtail this, or cut myself down to one serving of cheese a day. Despite the fact that yogurt and aged cheeses have a much lower volume of lactose in it (due to the bacteria cultures involved), it does not 100% eliminate lactose.

So, doing a differential diagnosis on myself, my first diagnosis will be a mild case of lactose intolerance. My second diagnosis would be something unusual like an adhesion resulting from my adenomyosis. And my third diagnosis would be intermittent appendicitis (not all appendicitis results in an exploding appendix). 

Going to discuss this perhaps at the next visit to the doctor, as I have to follow up about my vaccinations given our plans for a trip abroad in 2015, and I want to make sure I'm up to date on all my shots.

Pain Chronicles: Facet Joint Injections

As per the consultation with the physiatrist, I have an appointment set up with one of their associates, for a consultation to discuss facet joint injections. I'm hoping it will help. Anything to keep me moving, or moving MORE than I am, I am supportive of at the moment.

Appointment is two weeks from now. 

Hurry up and wait.

MRI of Thoracic Spine

Verbatim from report dtd 9/27/14:

Impression:
Diffuse spondylitic changes. Bulging T1-2. Left paracentral disc herniation T2-3 and posterocentral disc herniation T3-4. 
###

Tomorrow I see my neurologist for a follow up regarding my migraines and to get a refill on my Frova. I also will be taking along hard copies of all three reports from all three MRIs, and I'm hoping that my neuro and chiro can work in tandem with one another regarding possible plans to address/treat my pain issues.  I'm also going to back burner my query about testing neuro-chemistry re: my depression, as my B1 seems to be helping. For the moment.

In December, I will be seeing my gyno for my annual exam, and I'll take along a hard copy of the lumbar MRI report and disc, and hopefully he can find out more information from the imaging center, if possible, regarding the uterine involvement.

Unrelated/related note:

Someone with whom I've been cultivating a friendship with, who was a social worker in the past, has been jokingly accusing me of being a hypochondriac. Couple this up with other shit, like asking leading questions, then when I answer, he drones on about being a narcissist and a hypochondriac. It's happening with more regularity, and isn't something I can ignore. I find it appalling actually.

I've been avoiding him for several days now, and he keeps calling my desk (and hanging up). I really have nothing more to say. But I fear/feel it's going to get confrontational. So it's with this in mind that I decided to (I hope, succinctly) peck out my thoughts, print it  up, and folded it up tightly. I plan on having it in my pocket so if running into him is inescapable, I can pull this out and say something glib like, "Have a good night," or whatever. It's essentially a "FUCK YOU BOMB," because I've been too damned Churchill-ian* in my responses in person, thus far. It simply says: Since you are not reading the cues on my face or my body language, perhaps reading words on a page will articulate this best:

When you call me a hypochondriac, I do not find this funny. I find it damaging and insulting.

When you say I am not depressed, I find it damaging and presumptuous.

When you laugh about this, I find it damaging and mocking.

I need my space.

My normal route is to do what I call a "slow fade to black," where I limit my contact and put the person on the periphery to such an extent they eventually fall off my radar entirely.  Given I have not determined if I want to cut him off entirely, I figure this might be useful to inform him what's going on, and depending on his response (if any), might determine whether I move forward or not. All I know is, it's not funny. And no, I do not reciprocate in kind.

*Re: Churchill-ian-- There is a quote that is attributed to Churchill:

"The height of diplomacy is telling someone to go to hell in such a way where they actually look forward to the trip." 

I suspect I've either been too nice, or perhaps my look of shock is being misconstrued as laughter. This is not laugh-worthy.

I further rebutt: Being more aware of my body on a bio-mechanical and/or bio-chemical level than an average person does not make me a hypochondriac. However, someone who laughs at my pain & depression makes them a sociopath in my book.

To B(1) or Not To B(1)... That is the question!

Good to know I'm on track with my thinking and research regarding possibly including a B1 supplement in my line up.

Endocrinologist just informed me I could go up to 100 mg 2x a day. Here I am, thinking I should have reduced the dose, and I could have remained at the 100 mg without any deleterious effects.

Still no word from the bariatric surgeon's office regarding their thoughts on the matter. I cannot help but think of the surgeon being so quick to write a Rx for phentermine (given my hypertension), yet didn't think to run blood tests to see if there were any other B vitamins I might have a potential deficiency. His NP agreed with my desire not to take the phentermine. I don't want a happy pill, and certainly am agitated enough AS IS without taking something that could potentially stimulate me more and make me more susceptible to rage. 

Been on it roughly a week, and I feel different. Almost more rested (if that's even possible) and the "rough edges" seem to be blunted, even if a small amount thus far. 

Feels promising.

Pain Chronicles: The Litany (2)

Head: Migraines suffering from them since the early 1990s. Actually been hospitalized thrice for them.  Treatment: Frova.
Head: Depression & anxiety with bonus rage & insomnia issues.
Head: Low level TMJ. Treatment: Night time bite guard.

Neck: Right paracentral disc herniation C2-3, Posterocentral disc herniation C4-5, posterocentral disc herniation C5-6, sustained when I was rear-ended by an 18 wheeler in 1999. Treatment: Regular chiropractic adjustments.

Shoulders: "Rib head" pops out of place. REGULARLY.  Treatment: Regular chiropractic adjustments.
Shoulders: Disc bulging T1-2 and posterior disc hernations T2-3 and T3-4, sustained when I was rear-ended by an 18 wheeler in 1999. Treatment: Regular chiropractic adjustments.


Left hand: Dominant hand. Carpal tunnel. Mild-to-moderate case. Some days my hand is so spastic I cannot sign my own name without stopping three times because the way I write my name pinches the nerves in the wrist and elbow. Problematic since doing excessive, now-needlessly obsolete stenography drills in secretarial school in the mid-1990s. Treatment: (When having a flare up), Night time use of wrist immobilizer.

Low abdomen: A "mild" case of adenomyosis, which is kind of like garden variety endometriosis... IF IT WERE ON METH, CRACK, AND ACID. Diagnosed officially in February of 2012, and it's getting progressively more painful and uncontainable each successive month. Searing, agonizing pain that is isolated in the region between  my navel and my kneecaps, ranging from a dull throb, to a persistent agonizing pulsation of hot lava like HURT deep in my marrow.  Treatment: Uterine ablation (which did nothing for the pain and voluminous flow).
Low abdomen: "Impactions." OCCASIONAL. Treatment: Remain compliant with use of fiber and probiotic supplements, magnesium, and Colace, and ensure adequate hydration.

Low spine: Grade 1 Spondylolisthesis L4-5.  Treatment: Regular chiropractic adjustments.  Rest, heat, TENS/EMS, and ultrasound, maintaining good workplace ergonomics/hygeine, and consistent wearing of customized orthodics.

Right Hip: Trochanteric bursitis. Treatment: Rest, ice.
Right Hip:  "Hip Pointer." WTF Been problematic since a forced road march with a 40 lb pack in basic training.

Knees (both): Both knees have been compromised in two falls, one in winter 2009, one in spring 2010. Though to be honest, the pain is deep in there where most anatomical charts would indicate the meniscus. BONUS BAKERS CYST.  Treatment: Rest, heat, TENS/EMS, and ultrasound, maintaining good workplace ergonomics/hygeine, and consistent wearing of customized orthodics.

Feet (both): Heel spurs, plantar fasciitis, corns, and the newest addition to the Pain Chronicles Litany: My big toes are not level with the rest of the bones/toes (actually is lower than the rest), thus causing my feet to cantilever like a see-saw in my shoes (thus causing the corns; and is contributing to my overall balance issues).
Treatment: During flare ups, use of plantars fasciitis splint at night. Consistent wearing of customized orthodics.

Tweaking the Supplement List

In order to "wake up" my colon before the rest of my body is out of bed, the husband now brings me a cup of hot coffee, along with the following supplements:

2 Gummy VitaFusion Sugar Free Fiber Chews
Colace 200 mg (1x) 
Omega-3 

The object here is to start the trigger with my colon before I am out of bed, so once I finally do get out of bed, I can *ahem* "evacuate my fundament" in a more expedient fashion. We have one bathroom, and invariably I need to use the toilet as the husband is mid-way thru his shower. We're trying this change up to the routine, to help get or keep me (or specifically, my "fundament") on a schedule.  So, I drink my coffee with those supplements, and languish in bed for another 15 minutes.

Once I'm up, I set about either finishing that cup of coffee and finish what is my first wave of supplements:

2 Gummy VitaFusion Prenatal Multivitamins
2 Gummy VitaFusion Vitamin C
Feosol 325 (1 tablet)  
Alpha Lipoic Acid 250 mg 
Milk Thistle 300 mg
CoQ10 50 mg

Right before leaving the house, I blast 1-2 KAL Brand B12 spray.

Then during the day I take these, though not necessarily in this order: 

1 Cherry Rich brand Cherry Extract, 500 mg
Nature Made VitaMelt Zinc, 15 mg, 1x
Boron, 3 mg, 1x daily 
Magnesium 400 mg, 1x daily *I boost to 2x daily during menses, helps w/muscle cramps
2 Gummy VitaFusion Calcium chews (500 mg total) (Or, I might take 600 mg of Citrical Petites, in a 400 mg dose, then a 200 mg dose later)

Vitamin B1 (Thiamine), 100 mg, 1x (which I make sure not to take at same time as coffee) Note: Endocrinologist says that I could go up to 200 mg daily if I wanted to do so.

Then in the evening, I take:

2 Gummy VitaFusion Calcium chews (500 mg total)
2 Gummy VitaFusion Sugar Free Fiber chews

After dinner, I take a Now Brand "Berrydophilis" probiotic chew.

At some point between dinner and bed, I then take:
 
Alpha Lipoic Acid 250 mg
Milk thistle 300 mg
CoQ10 50 mg


Quinipril, 80 mg
Aldactazide, 25 mg

Items highlighted in red are new additions to my line up.

MRI of Cervical Spine

IMPRESSION:
Spondylitic changes. Right paracentral disc herniation C2-3. Postercentral disc herniation C4-5 with right-sided foraminal stenosis. Postercentral disc herniation C5-6, impinging the anterior margin of the cervical spinal cord. Spondylitic change with right paracentral disc herniation C6-7 Spondylitic changes with bulging noted T1-2 and posterior disc herniations T2-3 and T3-4.

MRI of Lumbar Spine

(Verbatim from MRI report of findings.)

IMPRESSION:
Disc dessication and facet joint hypertrophy from L3 through S1, with left posterlateral disc herniation at the L3-4 level. Disc bulging with peripheral annular tearing L4-5. Asymmetric disc bulging with right foraminal stenosis L5-S1. Left renal cyst. Prominence of the junctional zone of the visualized uterus. Magnetic resonance imaging of the pelvis is suggested for further evaluation. 

TECHNIQUE:
Sagittal flexion and extension imaging was performed.

INTERPRETATION:
Flexion and extension imaging demonstrates a Grade 1 anterior spondylolisthesis at the L4-5 level. This reduces on extension imaging.

IMPRESSION:
Grade 1 spondylolisthesis L4-5, noted on flexion imaging. 
******************************************************

The day after I received this report of findings, which my chiropractor provided me, I then scanned it, and forwarded it onto my endocrinologist, my nephrologist, and my gynecologist.

The nephrologist was the first to respond, as my email inquired about the possibility of an ultrasound prior to my next visit, to which he replied that it was not indicated or necessary at this time.

Uncharacteristically, my endocrinologist replied back that he'd view it the next day, but hasn't gotten back to me, and my gynecologist hasn't acknowledged receiving the email at all.  I will provide a hard copy when I see him in December. No doubt, the back pain is referring to the front of my body, adversely impacting the pain from the adenomyosis; and my adenomyosis is referring pain to my low back.

I have a third MRI scheduled for 9/27. I have an appointment scheduled for 9/30 with my chiropractor (who will provide the report of findings on the thoracic spinal MRI), and the following day, 10/1, I have an appointment with my neurologist, who I will provide hard copies of all three MRIs, and hope to discuss a pain management plan between my neuro and chiropractor, and hopefully not add a third doctor (orthopedist, orthopedic surgeon, or neuro surgeon) to the mix.  I have a "less is more" and "too many chefs ruin the soup" philosophy of having too many physicians involved in my care. I want things nice and organized. But really, I'm tired of being in pain, and beyond that, I'm tired of it impacting my ability to do the things I love doing.

I really know how to party: Unabridged

Yesterday was the day of three appointments: 10 a.m. endocrinologist, 11:45 nephrologist, and a 3 p.m. psychiatrist (for a consult). 

Yesterday was also my 46th birthday.

Sunny and pleasant, not too hot, not too humid. Ideal walking weather. Plenty of opportunity for me to boost my seratonin!

First appointment of the day was with my beloved endocrinologist, of whom I see every three months. These appointments are about as thorough as thorough gets. He quipped to me, "Look, your glands belong to me, and the rest of you? Yeah, that also belongs to me, too." He takes comprehensive notes about everything, not just glandular. Mood, migraines, pain, everything is taken into consideration and discussed.

He provided me with my copy of my most-recent blood tests, and we discussed anything/everything that was flagged. Despite some things being high, they were inconsequential, and all things look good. There were a few things I need to follow up on, and one of which would be addressed at the nephrologist an hour later.

He gave me the good news that the fatty liver syndrome no doubt has reversed itself given my weight loss, and that I shouldn't be so worried about having a cocktail, especially given I use it for pain management, as nothing else really helps as effectively.

What I appreciate most about my endocrinologist is that he treats me as a whole person, not just from a glandular standpoint, and also doesn't treat me like a number. I am not a sheep. I am not one of a herd. And I guess it also helps that I read up on whatever syndromes/issues I have, to become more educated, to ask more questions, and help my doctor give me the best care I need.

He gave me high praise. "You're bright. You've got it all together. You would have made a great doctor. You should give some thought about becoming a patient advocate." Now if only he could help me realize that goal! 

Going to this office is like visiting family. I see him more regularly than I see my mom. I get a hug and a kiss from him and everyone wished me a happy birthday and I was off to my next appointment.

Next appointment was the nephrologist, who I originally sought out consultation over a year ago for that pesky proteinuria problem (which resolved itself with an adjustment in the amount of alpha lipoic acid I take). Even after doubling my ACE inhibitor, my bp is still a bit on the high side (high side of normal, but not HIGH HIGH), and I wanted to discuss the possibility of a diuretic. I mentioned aldactone, and he wanted to know why that one in particular. My reasons were it's a potassium sparing diuretic and also has magical anti-androgenic properties, but given the ACE is potassium sparing, perhaps another option? He thought the discussion was well thought out and VALID, and split the difference and wrote up an Rx for an aldactone/HCTZ hybrid. I should come back in a month to see how I'm responding to it. I'll be glad to get my bp better managed, as it will no doubt help with my headaches and moods, and the water pill will probably shed a few pesky pounds that have been resistant to drop. Again, I love my nephrologist. He comes into the exam room, is friendly, engaging, and receptive to my concerns. What else could one want from a doc?

The first two appointments were on the upper east side 92/Park, and my third appointment was several hours later on the west side, near Columbus Circle. So there's that big ol' pesky park standing between me and where I need to be. I don't recall which bus I took, first one I saw, and all I really needed to do was traverse the park. I got off at the first stop (perhaps Central Park West?) and took on foot.

I walked south a few blocks, then made a right. Go one block, make a left. Walk south a few blocks, thinking about where I might want to go to lunch, as I knew there were PLENTY of truly great places to eat on the way. I was thinking of Thai, or French, and when I happened to notice HSB has an outlet there, I looked no further. I walked in. Without looking at the menu, I ordered a molagai podi and onion dosa. I washed up while I waited for my food, which of course, was delicious. And this was the first solid food I had all day, given I try to get weighed at the endocrinologist on an empty stomach.

From lunch, I continued on my path,walking a few blocks south, making a right, going one block, making a left, etc, until I found myself at Broadway and 60th, arriving 20 minutes early for my 3 p.m. I freshened up, hydrated, and sat peacefully crocheting until my time came.

I went to this appointment with the psychiatrist with the hopes that I could get tested for a chemical imbalance or find out if there's something wrong with my amygdala, which might be driving the melancholy. Sadly, they do not test for stuff like that. He asked every thorough and specific questions about my relationships with my parents, my siblings, what was it like growing up. I added in about how it took me until I was 40 to fully individuate, and how I feel I self-sabotage with my negative self-talk, and I feel all of this is interfering with the progress I've made so far.

Not to leave empty handed, the psychiatrist gave me this book and is going to discuss my situation with my psychotherapist, and see if we can change the direction of my therapy to include more cognitive stuff.  Nothing more specific to add, and doubtful I'll be making a follow up visit, given I do not want meds, I just want to know WHAT THIS IS in specific terms, and I mean beyond the new diagnosis: MDD.

Once I finished up at the last appointment, I pinged the husband and let him know I was on foot, headed to Ippudo, a wee bit earlier than our plan. But I figured I'd be able to stop at a pub for a drink or a coffee shop for coffee while I waited for my husband to arrive. Only problem is, most of the bars on that block don't open until 5 p.m.

So I walked out to 9th, and found a place where I could sit inside, where I pretty much inhaled a vodka tonic, while watching Dr. Oz on the bar t.v., reading the subtitles, and thinking exactly how full of shit that quack is. Looking at the time, I still had about a half hour before the husband arrived, so I ordered up what the lady next to me was having: a watermelon margarita, and didn't even consider whether or not the vodka and tequila would play nice in my belly. I was about halfway through my margarita and thought I'd have some time to enjoy the buzz (and enjoy my inability to feel my feet or my face) for a little while, when I got a text that the husband was at Ippudo waiting for me.

I am not sure how I made it to the restaurant, but I did, without falling, without being mugged, attacked, etc. So I guess I did not appear like a wounded gazelle on the Serengheti Plains. Ippudo was lovely, and everything I anticipated it to be. We ordered their most popular bowl of ramen, and we both ordered cocktails (more booze!). Husband got something lovely with lychee in it (a fave of mine), and I opted for something they have never encountered before: A plum wine spritzer. But to them, it amounted to plum wine over rocks with a splash of soda water. It surprised me in that it tasted like bourbon. Tasty. Good meal. The place was chock full of cacaphony. Blissed out on food, booze, and being with my husband. 

And in the blink of a bleary eye, one cab ride to Grand Central, and it was, just about, all over.

When we arrived back at our home train station, and headed to the parking lot, there was a guy who appeared either stoned or drunk, or perhaps just weary from work, leaning on his beat up hooptie, saw us walking into the lot. I guess both of us looked truly at ease with each other, and our arms were linked. As we approached him and were passing him on our way to our own car, the guy remarked, "That's just beautiful. What you have together is beautiful. I hope to one day have that." I smiled and thanked him, and didn't have any reason to think the guy was anything other than sincere. My husband, however, thought we were about to be mugged. The guy wasn't aggressive or even approaching us. I just thought he was being nice, and still do think that. Sometimes people have a way of surprising you, if you let them.

Shit-tastic Week, Event #3: Neuro No No, Pain Status-Quo

Today was supposed to be a day where I was working towards addressing and possibly coming up with solutions for my assortment of pain issues. Sadly, that was not to be. In all actuality, it would have been a better use of my time to have not gotten out of bed at all today.

1. Upon arriving, I was not given the COURTESY to be informed that the doctor was running late. 
2. After waiting a half hour, I got up to ask, and I was informed he was running late. No indication on HOW LATE.
3. At the 1 hour 41 minute mark, as I got up to leave, of course, THEY CALL MY NAME.
4. Against my better judgement, I go into exam room.
5. Get trifled with by the aide taking my stats.
6. YES YES, by all means! NOW IS THE BEST TIME EVER TO TAKE MY BLOOD PRESSURE, ASSHAT! SURPRISE SURPRISE, IT IS JACKED UP! GEE HOW DID THAT HAPPEN?
7. I am then asked to fill out new patient forms (despite that I am not a new patient at this office, nor am I a new patient at Mt. Sinai where this doctor is affiliated). It would have been just GRAND if I could have filled these out at a leisurely pace, WHILE WAITING AN HOUR AND 40 MINUTES!!!
8. NP comes in to assess me. Neurologist is no where's to be found.
9. Halfway thru the assessment NP lets me know they only do assessments for surgery in this office. Why in the name of the blue blazes of hell did my (otherwise sterling) internist recommend I see this fuckface?
10. Wrapping up assessment, neuro calls, says he was called away for an emergency.  WHATEVS.
11. As NP is writing up an Rx for me to go for an MRI (which I'll have my chiropractor read, or perhaps ANYONE ELSE ON PLANET EARTH before I give one more moment of my time to this time suck.
12. As I'm about ready to leave, one of the admins have the neuro on the phone and they ask if I want to talk to the neurosurgeon, to which I replied, "Fuck no. I've wasted enough time here."

End note: Total time invested in this shitscapade? 3 Hours. I was mugged. No, not at gun point, and no they didn't steal money or jewelery. What they stole from me was far more valuable, precious time I will never get back. Plus? It left me in such an effing foul mood. I've tweeted extensively about this, and left a Yelp review, but I am sure not one bit of this will be resolved.

Shit-tastic Week: Event #2: Road Rage Recipient

(Cross-posted at another of my blogs...)

As if it were not bad enough to be in PHYSICAL pain from the shoe-wear debacle from Monday's job interview, Wednesday, I found myself at an intersection. Middle lane of three. Left lane would have been optimal, as I was going to make a right then a quick left onto the side street. At the light, I put my blinker on, and as soon as it turned green, I gunned the motor, as the car to my left was lagging a smidge.

In my attempt to get over to the left lane, that driver finally woke up or dislodged his thumb from his rectum and decided he, too, was going to gun it into my blind spot, attempting to bully his way, and afford me zero courtesy to make my left.

Quickly as this is all unfolding, as I approach the side street, it APPEARS as if I can make a left in that lane, too. And I continue with my plan. Meanwhile he's in my blind spot, making his left, only once on the side street, there are cars parked on the street in metered spots, so he quickly made that left, only for it to fuck him up that I made mine.

I come to the traffic light which is red, but my mistake was I did not pull all the way up to the stop line. Sir Asshole sidles up next to me and motions to me to roll my window down. I shake my head no. He's aghast. And angry. Obviously I'm impeding his ability to tell me off.

I roll my window down and say, "I had my blinker on, and thought both lanes were left turn lanes." Of course, he launches into his tirade, and I promptly roll up my window.

Of course, he will not abide this aggression! Oh no! He has to nudge his car up and askew, and PARKS HIS CAR IN MY LANE THUS IMPEDING TRAFFIC, all to come over to my driver's window, which is rolled up and the car locked down tighter than a duck's ass, all to berate me and my driving.

Me and my bitchy resting face are in full effect, full on cool as a cuke mode. Honestly, I don't know how! IS THIS WHAT BEING A GROWN UP IS?

I mean, I could totally predict all the events happening. I could see it happening in my head, and VOILA! HAPPENING!

And, again, cool as a cuke, I roll my window down about 2 inches, and say loud enough for him to hear, "Yes, yes, and arguing about this is ACCOMPLISHING SO MUCH!" and I promptly roll the window up.

He blurts out an impotent,"Bitch!"  And I smile, and nod in agreement!

It was so awesome, but I think I'm going to investigate carrying mace, because "what if" he actually broke my window and tried to assault me, or somehow gained access to my car and tried to assault me?

Man, Oh Mangina!

(Cross-posted over at my dysfunction blog...)

It's been about two weeks since the apex of this story, and I know I've been a bit remiss in detailing this tale involving my brother; however, I figure I should share (or document herein, as I feel a lot of folks reading this already know what's going on) for continuity.

Brother is three years my junior. He's 6'2" or 6'4" (thereabouts) and at the apex of this story, he tipped in at "four and a half bucks," or as I like to say, he's built like a Berlin Butcher. 

He inherited either/or/both, the RA from mom's side of the family and the psoriatic arthritis from dad's side of the family. 

On or about (BEFORE) Father's Day, he was put on Embrel. We are not sure if this was the tipping point, trigger or what, but he started to withhold/gain a lot of water weight, an alarming amount at an alarming rate. I started getting second hand reports from Audrey and my sister about it. It got to the point where his legs were so swollen, he couldn't bend them, and it was almost to the point where he could not wear long pants.

The fluid started working its way upward around the midsection, and he has had a weird, wet sounding "lungular" type cough. 

All this alone would have been enough for ME to take my ass to the doctor. Not him. Hell. He retained so much fluid, his testicles were the size of grapefruits and his penis had fully retracted inwards, forming a "mangina" (man + vagina = you guessed it). THAT alone should have been the tipping point to get his ass into the hospital.

But, no.

I believe he wanted to keep his perfect attendance at work, and was holding out until Friday, so as to keep his perfect attendance. Things kept escalating. Thursday he went into work, only to have his shop foreman tell him "get your ass to the ER." Despite weeks of all of us telling my brother to go, it took someone with a penis to tell him to go and whaddayaknow? He went.

Each day brought with it increasingly worrisome news. (And mind you, I get it all distilled thru my sister or my mother, and what news I get from my brother is so nebulous, I really don't know what to think.)

At first, allegedly, congestive heart failure was ruled out, and he was waiting to get cleared by a pulmonologist. At this point, he told me he has had his "Come to Jesus" moment and was ready to start the process to get the gastric bypass.

Next day, scratch that! He's got congestive heart failure (at age 43!).

Next day, he's got congestive heart failure and has a paltry 25% heart function left (at age 43!!). I warned him that he should let his nurses know his past history of blood clotting problems. They don't have the compression thingies on his legs and to my knowledge had not put him on blood thinners. He of course, neglected to mention this (sister is convinced he is in full on denial about that time when he was very little and almost died).

Next day (or perhaps the day after), BADABING! BLOOD CLOTS IN THE LEGS!

Next day he gets cleared (allegedly) by the pulmonologist, and no clots in the lungs, but still, what's up with the cough? (Ever since dad's passing nearly six years ago, my brother has had this weird cough, which has been misdiagnosed as pneumonia--it could very easily have been CHF masquerading all those years. The medical "care" where my family lives leaves a LOT to be desired. Again, you can lead a horse to water...)

All the while this is going on, there's a parallel storyline going on, involving the YentaBeast, who was in Florida visiting her mom, and her resistance/reluctance to come home, despite the fact that he was in the hospital, in crisis. We can only deduce it was out of spite, given that my brother refused to pay for her to visit her mom, her mother paid, and the delay of about five to six days before she finally came home just further cements in all our minds (even his) that YentaBeast is pretty much garbage wrapped in skin.

Next day, he gets transferred to a different hospital, and is on deck for a cardiac catheterization. All his focus was on was seeing his daughter, as clearly, he was convinced he was dying. YentaBeast finally shows up with my niece in tow, just in time before he has his procedure.

Next day, he has the cardiac cath, survives it. And as he told me, he didn't have any blockages. Sure, good news, but fuck it! 25% heart function? I guess he'll look for any bright spot he can at this point? 

Next day he gets the news that he is not a good candidate for a heart transplant due to all his other co-morbidities; and the flip side to this coin is, he cannot go in for the gastric bypass which could turn some of this shit around, because his heart is so weak.

Next day, he gets fitted with a "life vest," an external defibrillator he will have to wear for the rest of his life. The subtext of him wearing an external one vs having a surgically implanted one is pretty much he's a lost cause. Not sure why they did not put an internal one in, given that it's no more invasive of a procedure than the catheterization.

Next day, as weak as he was/is, they release him home.

Next day, I get a frantic voicemail at work from Audrey, "Your brother is being rushed back to the hospital. The defib is zapping him."  I text him calmly, "Everything okay?" He says "The alarm won't stop." I said, "Does it hurt, yanno, as it's zapping your heart?" He replies back, "It's just the alarm. It's not zapping me." In keeping with my boundaries regarding the phone as it pertains to Audrey, I don't bother to call her back. This is just her way of  drumming up drama to get a telephone call out of me.  I let a week slide before I called her for my usual call I make every 7-10 days.

It's been two weeks now, and despite my suggestion that he gets a second opinion, and all he has to do is say the word, and I"ll make arrangements with my cardiologist in NYC. Apparently he's lulled into some false sense of security or is in active denial or what, but has not taken me up on the suggestion. Doesn't matter that dad was 20 years older before he was battling congestive heart failure in his 60s, while my brother is enduring this in his 40s. And despite the obviousness that dad's dad died at age 50 from a heart attack (but by all accounts had drank himself to death), and dad had his first heart attack at age 50, my brother doesn't realize the severity of the situation and might not live to see 50 himself.

As I said to Audrey last night, you cannot live other people's lives for them. Dad delayed getting a second opinion until it was too late. My brother is going through this EARLIER than dad, is much worse off than dad right off the bat, and refuses to do anything (beyond getting a hospital bed for the house, and set himself up for a sleep study to get a CPAP finally). I refuse to let this tear me up inside for however long it takes him to die. I was continually destroyed for the final 17 years of dad's life. I don't have it in me to do this again.

As Yoda says,"Do or not do. There is no try." Well, he's not even really trying or doing, and yet in the not-doing? That still is an action. 

All I can focus in on or control is ME. And I am in the full on assessment stage, worrying and wondering if in having my bypass and losing what weight I have managed to lose, was enough to prevent this from being part of my own life narrative.

Two aphorisms/quotes apply herein: "Man makes plans, and God says HA!" and "God helps those who help themselves." I've planned... I just hope it HELPED my own health.

Shit-tastic Week: Event #1: Feets They Failed Me Now

I am all about Newtonian physics, especially the law involving things in motion tend to stay in motion. I wonder how heat and moisture factor into Newtonian physics, well, how they factor in beyond BLISTERS.

Monday, I had a job interview. It was technically the second interview, as they had a telephone interview the week before. Wanting to make a good first impression, visually, I wore nice shoes. High heels. Not too high. Otherwise comfy. But I went barefoot. I did manage to wear a toe cup thing to help cushion my little piggies, but in the course of walking, it shifted, and started to chap my toes.

Once I arrived at City Hall station, first opportunity I could, I removed the toe cups, thinking the ten minute walk to the rendez-vous point would be quick. Hopstop said it was 12-14 minutes, and my shoes were good quality (or so I thought), and didn't think much of it. But each step of the way, was with increasing pain. Soon,  my whole body ached, and I knew things were going to shit... FAST.

I went to a drug store and got a box of water proof bandaids and a box of J&J brand "blister' bandaids (which, to be blunt, are TINY, they really should come larger). I put the blister bandages on the blisters, then regular bandages on top of them, and continued on my way.

I had to triage my feet a second time before arriving at the meeting spot, and to add to my pain and anxiety, I received a text from the ladies who were going to be interviewing me. While the interview was arranged for 3:30, the text came through at 3, so I knew that once I arrive, there would be no time for me to freshen up, relax a bit, perhaps crochet, and regroup. Once I got to the corner, I had to do all my last minute hair brushing, lip stick applying, perfume spritzing out in the open, and continue hobbling until I got to the entrance, and somehow or another "get it together" enough to walk to the table without appearing as if I were in the physical agony I was. 

I believe it went well. Who knows for sure? Looks promising, and if it weren't for my poor choice of shoes, I probably would have had a very good ending to my day. I intended on going to the Raging Bull on Wall Street and cup its balls for good luck, and planned on going to a yarn store which has escaped a visit from me thus far, as well as stop someplace for a drink or lunch. 

Instead, my focus was on my increasing agony and worrying and wondering how the hell was I going to get back up to midtown to catch the train home. I caught a cab, and while it probably was taking the longer way back up to midtown by way of the FDR Drive, we were free moving, wind in my hair, me with my shitty cell phone connection, with an ever-dwindling battery, trying to text to the husband saying where I was, an ETA for GCT, as well as BEGGING him to get me a pair of flip flops. IMPERATIVE!

So I get myself to GCT, and I get a hot dog and an ice tea and try to make the best of it. And I find a seat near an electrical outlet, and the husband arrived. And finally, I could take my shoes off without worry. And once on the train my feet were triaged yet again...

Horror of horrors, in the course of removing the bandages, we ripped the skin clear off one of the two big blisters (one on each pinky toe). It was gross and painful, but the husband truly was mission oriented and got my feet properly bandaged up.

Blisters to the top of me, blisters to the bottom of me (try to ignore the callouses, but at the same time behold that I have blisters UNDER my callouses!)...

Yes, there's nearly a string of pearls of blisters all across the ball of my foot under where the toes attach to the foot! BRILLIANT!

We get home, and I promptly pour a vodka tonic for pain, and gradually top it off with sparkling wine, just for good measure. Apparently, I got a wee bit drunker than usual, and went from a happy floaty feeling to outright sobs. I laid down for several hours, woke up, chewed an ibuprofen, had a yogurt, then a frozen klondike bar, and faded in and out of consciousness while watching Conan. At 1, I got myself back to bed, and finally drifted off.

Tuesday at the office was a whole OTHER problem. I was able to walk from my car to the office (roughly 400 paces), and once I got to the office, the bandage on the epic wound fell off, and it was gross looking, glistening wet and plenty of angry looking capillaries looking back at me.

I spent the day alternating between nausea and agony. No first aid kit to speak of here, not even a tube of neosporin to be found. My co-irker provided me with some foaming wound cleanser and I spritzed that liberally, but still worried about wearing flip flops in a carpeted environment with an open wound on my foot. By 4 p.m., I hobbled my way to urgent care, and an hour later, I returned to finish out my shift.

I will say that if I don't get an offer (whether I take it or not, is another matter entirely), I will be (wait for it.....) SORELY disappointed!

End note: My feet are different sizes. Left is an 11, right is a 10.5. No pair of shoes fit me perfectly. Hence the chapping. Problem also was I was barefoot. And I miscalculated exactly how much walking was involved. Like I said, amateur move. I traverse NYC all the time, and am always prepared and wear appropriate footwear. There were just so many elements of Monday which went wrong on a very fundamental level. I just hope they liked me. The interview was roughly an hour, and very casual. Stay tuned! I'm hoping there will be a positive conclusion to this, and hope to have a blog post wherein I am finally cupping the Raging Bull's balls for good luck. My office won't be far from Bowling Green, so it's entirely possible. 

As scary as it is to leave and start someplace else, it's scarier to think of spending another year or five or TEN here and be no better off, and if anything, perhaps even be MORE MISERABLE. And yet? I'm leaving myself open to the POSSIBILITY of growth, happiness, fulfillment. High risks sometimes equates to high rewards. Isn't it time I reaped some rewards?

ETA: Here it is, 10/23/14. Interview was 8/4/14. Not even the courtesy of a text or email to say "Thanks, but no thanks. We went with someone else." Horrible follow up skills for sure, but useful information no doubt. I imagine working with people with such poor communication skills would be downright hellish. 

Meet My Pelvis: A Picture is Worth a Thousand Words

Behold the sizeable GAP in the hip socket on the left in the image vs the hip socket on the right. Plus? I'm sure the fact that it's not smooth probably has a lot to do with my pain and instability in my hips/low back. 

More on this as it develops. 

End note: Chiro did comment upon possible start of osteopenia, and was interested in my ischial tubes.

Because I really know how to party

(Either that, or I am subconsciously a masochist...)

I have set up three appointments for my birthday: endocrinologist and nephrologist (both, for my three month check ups), and a BONUS! consultation session with a (new to me) psychiatrist, who, I hope, will help figure out if there is something chemically or physiologically wrong with my brain which causes me to be melancholy nearly all the time, and have the exquisite bonus of negative self-talk which is sabotaging me and my happiness, mostly manifesting itself in poor self esteem in my professional "self."

In the meantime (it IS, afterall, almost a full month until my birthday and my appointments), I'm trying to work on attaining more sleep, and perhaps diminishing anxiety or stress or depression, so I am trying out an aryuvedic herb, ashwagandha. Took one pill Saturday night, and Sunday I woke up feeling very fuzzy and hung over, not wanting to get out of bed. I didn't take it last night, and I woke up this a.m. not wanting to get out of bed at all.

I am sure my anxiety and depression are having some spill over effect with the husband, and again, I don't want to become a burden to him. And at the same time, I want to somehow or another get a handle on this, see myself thru the fog and negative self-talk and try to just get the fuck out of this negative workplace. But the money. What a trap. I'm not rich by any stretch of the imagination, but I'm not willing to take a 33% pay cut with zero guarantees that I'd be any happier. I see such a thing as a fool's venture. FOLLY, even.

I cannot wait for the day I leave here. Perhaps I'd take one final lunch with the two gents I used to eat lunch with regularly (up until our relocation to the new office roughly four months ago), or perhaps take in lunch with JabippyLoo (she, who shall go down in infamy for emailing me a picture of her shit, to my workplace email in box). Or perhaps I'll just gather up my things, go on vacation, and while on vacation just give notice. I have overstayed my usefulness here by seven years.

3.5 Years Out

Technically, it was three years in January, but I prefer to put off this appointment until spring or summer, because it’s nicer for me. It’s not a life-or-death type appointment, something perfunctory that needs doing, and well, rather than NOT DO IT AT ALL, I do it on my own terms, and this year it was June.

All things considered (the Wellbutrin experiment + Cymbalta experiment + PMS + I didn’t do my “primary poop” of the day—yes, there’s a preliminary, primary, and secondary poop of my day!), all in all, weight gain is roughly four pounds, negligible from their point of view.

Between me maintaining my weight and the numbers on all my blood work, all fingers point in the direction of me remaining on point, compliant as a WLS post op patient. Now if only, I could get a handle on my depression, anxiety and pain, which I feel is hindering my goals for a wee bit more weight loss as well as my goal of becoming more active.

Mind you, my blood pressure is high normally and I’m on an ACE inhibitor for that, which is normally controlled. I arrived at the appointment early and sat and crocheted while I waited. So I was about as peaceful as could be, before they called my name. They weighed me, then took my pressure with one of those automated BP cuffs, and I was appalled at the numbers: 165/120, which, no doubt were not accurate. My norm runs about 138/80 or 138/90. This surely was a mistake. Regardless, on paper, that’s the bp on record for yesterday’s appointment.

The elevated bp is distressing enough as it is, but when coupled up with what evolved next, I really have a wave of conflicting emotions and thoughts swirling through my head.

I mentioned in passing about my pain, depression, and anxiety hindering my goals, as well as messing with my overall sense of well being. The doctor spit-balled a few ideas:

Him: Wellbutrin?

Me: Tried it in November, and it made me very ragey, and not in a productive way.

Him: Cymbalta?

Me: Tried it at the beginning of this year. I gained weight, it caused horrid painful constipation and did nothing for my overall pain or anxiety.

Him: Topamax?

Me: I tried that YEARS ago for my migraines, plus, my endocrinologist assured me I’d lose weight on it. And much like with the Metformin which everyone promised I’d lose weight on, I never did.

Him: Perhaps lamictal? What about lyrica for the pain?

Me: I remain unconvinced that the side effects are a value added trade off for the symptoms.

And then with that, he did the most outlandish thing. Perhaps it was his sign that I was fishing around for an Rx, ANY Rx? I want the RIGHT Dx and the OPTIMAL Rx is what I want.  I don’t need a bariatric surgeon going on fishing expedition regarding my psychopharmacological needs. All that said, I found it more than a bit disconcerting as well as irresponsible that he wrote me an Rx for Phentermine.  Between the elevated BP plus the fact that I don’t want things to AGITATE me, I see this move as thoroughly confusing.

First order of business today was to drop an email to my ReproEndoGuy, whose only response back to me, all in caps was:  DO NOT TAKE PHENTERMINE!!! I guess I’ll have to wait on his recommendation for a psychiatrist or a psychopharmacologist. Perhaps my psychotherapist might be able to recommend a guy? One more thing for the TO DO list this year.

The appointment up until that point was decent enough, and actually was much better than I anticipated it to be (which I guess also is part of the dysthymic nature of my depression—that negative inward talk, sense of dread and failure that invades everything. And despite it, I power through the best I can. Most days I can fake it to make it, and other days I just need to curl up in a ball and be left alone, as I’m no good for polite civilization.

As is my norm after the visit with the surgeon, I usually plan a pop in at Murray’s Sturgeon for a celebratory tuna sandwich and stock up on other delicacies. But yesterday was warm and I didn’t have an insulated bag with me, and didn’t think that everything would “keep” in a plain sack. So, in lieu of my traditional tuna on rye, I got their smoked whitefish salad on rye, with onions, and a pickled herring filet. Traditional place to eat, is at the bench at the traffic median on the corner. And as I sat there, and unwrapped my sandwich, I had the conscious awareness and even looked upward at the sun, then back at the pristine whiteness of the whitefish salad tucked between two pieces of rye and said to myself, “It doesn’t get any better than this.”

Little did I realize, instinctively, all along, every single trek into NYC for medical appointments, every single trek I have planned a meal or planned stops throughout the day. Little did I realize this “reward system” of sorts I’ve structured for my days in NYC actually help stimulate my dopamine.

In keeping with my new way of being, this “growth orientedness” as I am calling it, I am going to try to focus on stimulating or elevating my dopamine, or my serotonin, or my oxytocin levels in small, but hopefully productive ways.

Dopamine: Just keep doing the things that bring me joy. If I do set a goal and follow through, enjoy the reward! And sometimes just doing good (for others, or even strangers) is its own reward. So I’ve got a few parcels to be mailed out soon.

Seratonin: Well, I guess I should revamp my protein shake regimen, and not mix it with coffee. I think I’ll start doing my banana-peanut butter shake again, as the power-punch of flavor is a boost. And also? Try to spend more time outdoors.

Oxytocin: More hugs and more orgasms from/with the husband, as well as more massages, and more regular pedicures/manicures. There is no disputing the benefit of just simple human, skin on skin contact.

Endorphin: Let’s not get ahead of ourselves! That will require physical exertion! Pain pain pain. So no. Also? I do not like to sweat.

So yes. With the depression, and the pain, I am fighting the Blerch. Even though I recognize I’ve been half assing the physical therapy since May by “under-committing to avoid over-regretting,” I feel it hasn’t made all that much of a difference, overall in the pain issues. I am more aware of my abdominal muscles and do try to hoist them up and suck it in while walking, but nothing else has changed. Yet, one good thing did come out of it: the physical therapist spit-balling a diagnosis of trochanteric bursitis. My chiropractor is confident he can make adjustments with my orthotics to compensate and hopefully remedy this. And in the meantime I’ve been doing ultrasound on the hip and avoiding taking the stairs any more than is necessary. 

It is all a lot to process. The anxiety and pain and depression feeds into every aspect of my life. I would like to “feel better,” not just pain wise, but also this cloudy, heavy, dark feeling of dread and melancholy that follows me most days. I feel this is a physical defect with the wiring of my amygdala, it’s not just MERELY a matter of changing my thoughts. I try to control what I can, and insulate myself from futile and stressful situations where I have zero control or cannot affect any productive change. But that aside, I still feel like a failure.

I view my problem as a snake with two heads: Physical and Intellectual:

Intellectually, I recognize all the good things in my life. I feel I’ve accomplished some good things in my life, and I’m contented in my marriage and my home.

Physically, I cannot shake this dread and depression, this melancholy feeling, on top of the anxiety, and on top of the pain. 

I power through as best as I can. Life is short. Life is meant to be enjoyed. I try to get out there and do things, have experiences, have friends and good food, and vacations to look forward to, and crochet projects and new recipes to create. And yet, this dread, this albatross around my neck from which I cannot extricate myself.

I know everyone has their ups and their downs, it’s part of the cycle of life. But when one is having good things happen, it’s not healthy or “normal” to be full of dread. It makes me feel like a cynic, and yet I’m not. I’m an idealist, who just is anxious and depressed and in pain.

I’m just trying to enjoy what time I have left on Planet Earth, and yet this nebulous force in my head is interfering with my goals and intentions nearly at every turn.