Desperately Seeking The Elusive Dopamine Blast

I never thought of my zigging and zagging as my attempts to break free of this "learned helplessness" which I developed as a trauma response from the emotional and verbal abuse from mom (as well as HER father), but perhaps that's what this is. 

Sadly, the learned helplessness also is a big hurdle at work. I got my annual evaluation last week, and I got a 3 (out of 5), which is "adequate" but the negative narrative in my head tells me it's "mediocre." 

God damn it, if volunteering to come into the office as part of a skeleton crew during the shut down due to the global fucking pandemic is not enough to warrant a 4, then nothing I will ever do will warrant a 4.  OOH, and I was told I need to collaborate more. 

Obviously, the person rating me doesn't give two fucks that I'm an introvert--ALSO it's a pretty big insult to suggest I don't know how to collaborate after I've been here 19 years. As if the entirety of my tenure has been some act of charity. Anyway. Yeah. Learned helplessness is a thing I've been struggling with all my life, and only in the last few years have I come to discover IT IS A THING that exists, and I'm not a weirdo. 

Maybe I need to revisit CBT for this. And yet part of me (here's the learned helplessness kicks in again) doesn't want to start ALL OVER AGAIN with a new therapist. Why bother? I'm over a half century old and these neural pathways are deeply entrenched, and I don't know if I have the fortitude anymore to fight it anymore. This is where I worry that this is the start of the "slide into oblivion" path mom took.

All my life, to include the 19 years I have been in this dead-end job, I have been made to feel as an outsider looking in, as well as feeling as if I were a fish who is told they are a failure because they can't climb a tree. 

As of today, it's 445 days until I hit my 20 year mark. I need to contact the pension office to find out how much longer I need to continue working to make up for a voluntary furlough I took 10 years ago to tend to medical issues.

Regarding the DOPAMINE in the title:

Back in the "Beforetimes," when I'd have to go to NYC for medical appointments (thereby necessitating taking a day off from work), I'd bang out 2-3 appointments (December 2019, I even managed FOUR appointments), and to sweeten the pot, I'd plan little rewards during the day to reward me (i.e. Dopamine blast) for being an adult and getting shit done.

To say I am depressed right now is an enormous understatement.

Monday's Dopamine Hit: I ran to Shop Rite to pick up some pork roll (aka The State Meat of New Jersey), as no other stores seemed to carry it. I have been dying for a "taste from home" and for me, pork roll is one of those things of which I am nostalgic. I also bought a box of ice cream pops to put in the freezer at work. I even shared the pops with a new co-worker here (whose name is ANN, btw). We both enjoyed the ice cream.

Tuesday's Dopamine Hit: I ate a pork roll, egg, and cheese sammy made with a toasted day old croissant. This was to be my 2 p.m. food intake. I ate it at 11 a.m., thereby getting my dopamine blast up front and the rest of the day just dragged.

Today's Dopamine Hit: I went to the farmer's market here in the city where my office is (farmer's market is only on Wednesdays). I bought some nectarines, grape tomatoes, an enormous multigrain baguette, smaller onion roll type bread for a sub style sammy for tomorrow, and a cup of iced coffee.

I am seeing a trend for this week that I am so depressed, I am gobbling up the dopamine hits early in the day, I guess as an attempt at propelling me forward to get through the day.

I'm sitting at my desk here, 10:11 a.m. I arrived at 9:30 a.m., and I'm stifling the overwhelming urge to just sob, yet again.

The Upper Endoscopy & Limbo

June 14th, I underwent an upper endoscopy to inspect my gastric pouch/stomach for any changes or damages after my gastric bypass from 10 years ago.

I am glad to report, the entire endoscopy went without any negative comment (other than being made to wait an hour beyond my scheduled appointment). The anesthesiologist was able to get the IV in my arm on the first try, no difficulty. I'm tired of mediocre phlebotomists leading me to believe there's something defective with my veins because they fail to get the IV in my arm. I made a point of thanking the anesthesiologist after the fact.

The biopsy from the endoscopy was delightfully boring. Nothing to see here (for once!).

The gastro recommended I schedule an appointment with a liver specialist at Columbia (as he, too, is with Columbia); however, I refuse to go into NYC any time soon (as I don't think it's necessarily safe), and the specialist has an office near me; however, the next appointment is for 8/28. 

Not wanting to wait until 8/28, I took it upon myself to find a liver specialist at a local hospital where I'm an established patient, and made an appointment with the Director of Clinical Hepatology for a consultation regarding the biopsy. That appt is set for 7/2. 

In the meantime, I've pared back my supplements, and have discontinued my alpha lipoic acid, zinc, and CoQ10, as they all might have been playing a part in the liver issue. 

In the meantime, I have to continue taking my two Rxs as my kidney guy says the hepatologist will be the one to determine whether I need to discontinue/change my two meds. 

In the meantime, I am anxious, depressed, full of rage, and tossing around the idea of finding a therapist to help me work through all the learned helplessness I developed as a trauma response with my mom (and others), as I have also identified I have issues with learned helplessness at work. And yet, the thought of starting over again with yet another therapist makes me recoil at the thought.

The Biopsy: The Procedure Itself

To preface everything I'm about to share, we found out six days ago that my husband needs to find another job. He has a grace period, but the writing isn't on the wall, he got the news direct from his boss' mouth. 

Nothing quite like a new crisis to take your mind off a not-so-new crisis, eh?

My biopsy was at Columbia, which has an interventional radiology department nearby, so at least I didn't have to stress about going into NYC for this.

Everyone was pleasant, professional, helpful, and even compassionate, with one exception. Although, in hindsight, I have very critical thoughts about the RN. He had pretty much two jobs: get an IV in my arm so I can be sedated, and monitor my blood pressure. 

Not only did he fail to get the IV in my arm, thereby damning me to endure a very painful liver biopsy without sedation; he also let it slip in conversation that he has not been vaccinated against COVID. The more I think of this in hindsight, the angrier this makes me as despite being fully vaccinated myself, I had to endure a painful COVID swab before the biopsy. I am a huge proponent of informed consent, and I should have been informed in advance if anyone involved in my biopsy was vaccinated or not.

I woke up with an allergy attack and considered taking a benedryl, but didn't because I had to be NPO since midnight. I should have taken the Benedryl. It might have helped calm my nerves a little bit. I was already terrified of the procedure--and even more terrified of whatever the results would be, as a liver biopsy isn't like an FNA, it's more involved than an FNA, and has a lot of risks too. 

The xray tech had nothing to do as the doc was using an ultrasound to guide the biopsy needle, and he certainly distracted me the entire time with talk about food in the area. 

I anticipated that I'd feel nothing more than pressure; however, I *did* feel the painful jab each of the three times the needle punched down into my liver to grab a sample. It was far more painful than I anticipated.

By the time the radiologist said he was done, I laid there on the table having a panic attack in the form of silently weeping into my mask. My glasses fogged up. I was in pain, and anxiety, and worry for my husband, and it all became so much for me. Perhaps some relief that it was over was mixed in there, but that little micron of relief was washed out by the fear and worry. 

As my glasses fogged up, the nurse noticed, and he took my glasses off, as the xray tech dabbed away my tears.

There are little side stories, sweet stories, I could share about everyone involved--even the receptionist at the front desk came back to me when I was in recovery to see how I made out. Everyone at this facility truly exude caring. They all knew how anxious I was. And as unpleasant as the procedure was, they all did their level best (well maybe NOT the nurse--he should have been able to get an IV in my arm!), to make the process as pleasant as possible.

Results could come in about 3-5 days. Three days brings us to Friday--and that might be over optimistic to expect. Five days is Sunday. And Monday I go to the gastroenterologist for an upper endoscopy--and yet another IV sedation. Given I had a colonoscopy by this doctor 3 years ago and did not have an issue with either an IV or sedation, I am hoping for the same result--I don't know how much more jabbing my arms can withstand at this point.

So what will the results be? NAFLD? NASH? AIH? Honestly, I don't know what to hope for. I did have hopes that the liver fibrosity test was a false negative, or perhaps I have scar tissue from my gall bladder removal. I honestly don't know what to expect.

And just like she did 10 years ago when I went through my bypass, my sister proved to me that she just doesn't have enough give-a-fuck to offer anything in the way of substantive emotional support while I go through all this. She made some comment two weeks ago via text how she thinks I am driving myself crazy with this. Needless to say, I never let her know about having to go in for a liver biopsy. And I sure-as-shit am not telling her about the precariousness of the husband's job situation at the moment.

I am emotional "just enough" at the moment to allow myself to believe all this shit has manifested because of jealousy--the evil eye. Mom was jealous of me most of my life, her sister was jealous of me too. Same thing goes for my sister, as well as my now-former friend, JabippyLoo. Truly, it takes a village to cast an evil eye on me and the husband. 

I am used to shitty things happening to me; however, it's another thing entirely to see the husband get the wind knocked out of his sails. I remember all too well what it was like going through perhaps the worst time in my life 23 years ago--and do it relatively alone. Sure, my parents were alive then, but offered little in the way of help, other than mom basically selling me into indentured servitude to convince her cousin to let me live in her house FOR RENT by the way.

I am providing the husband as best of advice as I can, to help him navigate himself away from this. To see his confidence take such a brutal hit, it's been difficult for me to watch. Helping him navigate things also takes my mind off my own situation, albeit temporarily. 

Anyway. Yeah. It's been a rough couple of days. And tomorrow I am going to be subjected to the always-ego-crushing annual evaluation at work. 

To be direct, I just don't know how much longer I can keep "doing this," with "this" being work, or deal with the never-ending-stream of doctors. 

Whatever the results from the biopsy, one thing is very clear: the next doctor I see will be a liver specialist.

I just don't have it in me.

Prepping for the Biopsy

Things feel so grim right now. I admit I require a lot more certainty than most people. I freely admit I feel ill-equipped to handle whatever the next week or two holds for me. 

This morning (while working from home) I finally used the bottle of hair dye I bought at the start of the pandemic. A year ago I stocked up on all the obvious essentials, plus a 10 pack of sympathy cards and a bottle of hair dye. The sympathy cards were all long gone by year end. And today I finally used the hair dye. 

I have felt overwhelmed by the pandemic, and of course mom dying, and barely had a chance to fully process the gravity of it all, before I learned at the end of April the name of the kidney disease I have been monitored for by my nephrologist. And before I can process THAT, I am now in the midst of a medical mystery, trying to find out what has caused my liver fibrosis. 

My sister, I have come to discover, yet again (first time was after my bypass 10 years ago) that she is incapable of empathy or give-a-fuck, so as unpleasant as that is, it is useful to me to know from where to expect my support. 

So, today is the day I go for a COVID test, which is required in preparation for my liver biopsy, which is 5 days away. 

Usually I reward myself after doing something I really don’t want to do; however, I dyed my hair before showering, and I HAD to shower because the last time I showered was Monday, and I am a depressed weirdo who believes showering is part of the social contract if you are going to be up close and personal with anyone. 

24 more minutes until I check in. I guess I better get dressed and out the door.