On My Reorientation To "Growth Oriented" Mindsettedness

And yes, I do have a few of her books (albeit on CD, highly recommend, as she's got a great voice, and lovely sense of humor about things). Big help. 

Patience & consistency have been invaluable tools I've used on the path I've chosen to walk. Neither patience nor consistency are easy to come by, either. It takes fortitude and cultivation. It's not the destination, but a process. 

My husband's grandmother had a saying, paraphrased as "If you do nothing at all, 75% of your troubles/problems work themselves out." The hard part here is, knowing when to wait it out, and when to act; as well as knowing HOW to wait it out, and HOW to act. 

Triggers abound.

As I mentioned elsewhere regarding my over-clingy doorman at my office (forgive me, I truly have compartmentalized so much of my life, and by extension, my blogging habits), I've been actively avoiding him. I mentioned all this to my therapist this a.m.: The trigger, the constant neediness, my suspicions that I might have Oppositional Defiance Disorder (that the more someone demands or expects me to do something, the less inclined I am to do what is expected or demanded of me), and lastly how I've been avoiding him. 

I reiterated my personal mantra: "I say what I mean, mean what I say, and try not to be mean when I say it." While cutting him off cold turkey without discussion is harsh, I recognize he's a time stealer. If I give him 15 minutes of chit chat or an hour every now and again, he's not happy with that. He expects that to be the norm. And, well? Ain't nobody got time for that.  I've got shit to do, and to be honest, I'm at a different stage of my journey than he is, in dealing with an overly demanding mother with narcissistic and destructive tendencies. 

If he's not going to recognize HIS participation in his suffering and just disengage, it's somewhat toxic for me to subject myself to it. It's not rocket science. I'm not some super special FORTIFIED bitch warrior. But I made up my mind to no longer be consumed with it. I've somehow shifted it into neutral and have been able to keep my eye on my prize, keep my eyes open and be ever-vigilant regarding the things I will tolerate, things I will not, and things that I consider value-added. 

Bottom line is, I've given my time, and advice, both of which he surely must think I have an endless supply, and he doesn't take any of the advice. So, if you bitch to me, ask for advice, don't take the advice? You pretty much have lost the right to bitch to me about whatever it is. DO SOMETHING ABOUT IT. I don't have time for wallowers.

I said this to my therapist this a.m. "Everyone is neither entitled to nor needs to know every little detail in minutiae of what we think of them. Not everyone is ready to hear harsh realities. To tell them honestly what you think when they are not ready for that level of honesty, is nothing short of cruel. So, yes, my avoiding him is cruel, but it is the kindest option of the cruel things I can do at the moment."

I got some validation from my therapist as well, that all this is not my imagination. This is not all contrived. I *have* made progress towards my goal of shifting from a fixed mindset to a growth oriented mindset. Even if it's a lot of little things, rather than one or two major, VAST SWEEPING, life changing gestures. 

Talking to him is almost like a verbal to do list. Things I've done in the last two weeks which work towards my goals. What things worked, what things didn't work. Rumination on that for a bit. Musing openly about the futility of this or that, then progressing onto other things which might help work towards my goals.

I'm incredibly frustrated that my desire to find another job is so limited. I've quipped that my current salary is like the noose around my neck, keeping me tethered to this job, where I'm neither happy nor fulfilled. Not even the people with whom I work make it worthwhile. So this feeds my anxiety and my depression.

I'm incredibly frustrated by my inability to lose my Cymbalta weight. Next week is my 3.5 year weigh in with my bariatric surgeon. Full of anxiety. Wishing I could dump even a few pounds, so I'd feel less shitty about myself. Realizing that my insomnia is probably playing into that (if I stay awake 3-4 hours longer, that = additional food which then = additional calories which then = additional weight not coming off). So this feeds my anxiety and depression.

So at a minimum, I need to change my sleep. I need to get to sleep by any means necessary. I've been taking melatonin, but that's been leaving me feeling fuzzy headed and hung over for the first two hours of my day. So tonight I might switch to Zzquil just to get to sleep. I'm going to hydrate the hell out of me, and keep doing what I'm doing and hope for the best, and hope the scale doesn't depress me further next week.  

I'm still doing physical therapy, albeit once a week. As I said to my physical therapist, "I'd much rather under-commit than to over-regret." I'd rather do once a week and be conscientious about it, than over-commit to 2-3 x a week, lose interest or just cannot find the time to do it, and quit. Like so many other things in my life. QUIT. I was never taught fortitude. I was never taught (by example, that is) FOLLOW THROUGH.

Another thing hit upon in my therapy session this a.m. was about how damaged BOTH of my parents were. I know I put my father on a pedestal, and in many ways he deserves that pedestal, but the reality is, he abused us too. Sure. At least as far as I am concerned (I cannot speak to my siblings), he was pretty good about not continuing the cycle of brutal physical violence his dad did to him. But dad's inability to fight against the constant abuse and emasculation from mom? Well, if he couldn't help himself, it's no surprise he couldn't help or protect us kids. 

My sister and I both have anxiety and depression (or mood disorder) and zero coping skills because of our environment. Simply put, we were not taught how to be adults, because our parents were incapable of being adults. So here we are, well into our 40s, trying to teach ourselves that very thing. Trying to cope. Trying not to destroy or tear down those closest to us in the process. Trying to change our health and the direction our lives are going. Striving for something. Striving for a better quality of life and health. Striving for actual peace and happiness. Moving actively towards A GOAL. 

It's a process. Goals are grand, but the process is key. The striving and moving forward, even in the face of futility. Crossing things off my list. Noting the things that worked. Noting the things that didn't work. Reassessing. Redirecting. Adjusting. Tweaking. But always moving. Some days on a molecular level (like at the moment with my job thing, I realize on a very real level, that here I am, at work, blogging, where in most other jobs, I probably would not have the ability AND LUXURY to do so). So there are tiny things to be grateful for. It's not all horrid. It's a means to an end. It does not define me. So while it does frustrate me, that WANT, that need for fulfillment, the journey itself, in those in-between-moments of here-and-there, it is very fulfilling to know I am making progress.

I still have a lot of work to do. And I'm okay with that.

Dread

(Fill in all my usual rantings and drivelings herein.)

On top of my baseline of angst is the knowledge that 9 days from now I see my bariatric surgeon for my 3.5 yr check up (I'm six months past the 3 yr). I'm still not confident I've shed all my Cymbalta weight. Dread. Depressed. I think for this week I'm just going to take Zzzquil and go to bed in the spare room. Sleeping = weight loss. Sleeping also might = better frame of mind. So win-win.

Cycling Thru

Cycling through a rough patch/depression these days. Fatigued and depressed. Have absolutely no motivation, especially at work. I feel like I've truly run out of steam, run out of give-a-fuck, run out of usefulness. It also doesn't help matters that I feel invisible or marginalized. It also doesn't help that given the new office, I'm now sitting 18 inches from "TheWorkHorse," spinster-bitch extraordinaire, who personifies pettiness and hostility. Each day I catch myself ABOUT to say either "Shut the fuck up!" or "I quit!" Ideally, I'd love to say both of those sentences in quick succession, then grab my purse and valise and get the fuck out of Dodge. The dread and ennui are killing me.

Regarding Pain Management

For whatever reason, this neuron is firing:

Getting lip service or (possibly well-intentioned) promises of help is worse than getting no help at all. Doublely so, if I never asked for help in the first place.

Think or want to help? Then help. Otherwise, just STFU.

If folks aren't loving or supportive or even diplomatic with the things they say, I'd just assume they keep their yappers shut.

Hollow promises are like hollow chocolate Easter bunnies: on the outside they look appealing, it's only after sinking your teeth in do you realize it's a whole lotta nothing inside.

Opportunity knocked...

Was a strong candidate for a job. However, due to my current salary, no one can come close to making me an offer I can't refuse. My salary is like a noose around my neck, tethering me to my current job. But at a minimum, there is merit in knowing someone was interested in and thought I was a good candidate for a job. 

Resume is updated. But the realist in me realizes this is all an act of futility. I've been here 12 years, 7 years longer than my original 5 year plan. I live every day afraid that if I don't leave now, I never will. As I said to my therapist this a.m., "I realize the potential that I will encounter unpleasantness and assholes at every job; however, after 12 years, I'd really like to deal with some NEW assholes."

ETA: Turns out that particular workplace is dysfunctional and full of assholes, ranging from a chronic flatulator, to management that doesn't provide adequate support/help to new hires. Useful information. Glad to have dodged this bullet.

On Finding Happiness

A Guide to Finding Happiness by Bill Watterson

New Dx: Trochanteric Bursitis

Need to call insurance on a DME matter. After that will get scanned, and hopefully my chiropractor will make adjustments with a lift under my orthotics to lessen the hobble-wobble aspect of my walk.

Dear Uterus

What the ACTUAL fuck? Seriously. 25-almost-26 days? Can't me and my panties catch a break? Hell week is nearly here? I cycle in and out of this agonizing pain, and mess, and I'm losing between 12-24 days annually due to this, plus innumerable days of just recoiling from the horror show.

Here we go again. 

Vodka tonic, ahoy!

Giving the Status Quo a Kick in the Pants

So yes. I suck. I cancelled tonight's physical therapy session, though I have every intention of going to next week's. Sadly that appointment is not with my preferred physical therapist. Oh well. I needed more time go actually do my home work and apply myself. I've been tired and starting to slip a bit into depressed mode. So I need a bit more time to work on a few of the exercises, so when I have my next appointment, my slacking won't be so evident. At least I cancelled it yesterday and won't be hit with a $100 cancellation fee.

So one bad thing I did yesterday (cancel PT) is off-set by one good thing I did yesterday.

I got a message from a friend, "Quick, send me your resume. They're hiring admins at my job." Brilliant, no? :) Well I made a couple minor tweaks to my resume, and quickly zapped it off with the warning, "Hey, it's a three page antique. I haven't gotten around to having a professional resume writer have at it yet." That aside, within the hour, I got this message back:

“So just an FYI, they LOVE your resume! You will probably get a call in a week or so from a guy named Lee who will let you know a little more about the specific position and to ask if you'd like to come in for an interview.”

Looks promising, doesn't it? 

I do not know if this is my coping mechanism, by protecting myself, I talk myself out of HOPE. But I know the reality is, given the economy, they no doubt will not afford to hire me at my current rate of pay.  And that, at a minimum is what keeps me from hoping that it will self-manifest and blossom into the ideal job opportunity.

I am nothing, if not an unconventional person. And while, yes, I *am* hoping that Lee will call me, I am also hoping to have the audacity and opportunity to take the bull by the balls and invite Lee out for a lunch date, where we can discuss both abstracts, of what the job itself entails, as well as what direction I hope my life and career will take in the next (at current writing) 4 years, 2 months, and 27 days.  

Spoiler alert: I'd love more money, but will take a lateral move, salary wise if it means a shorter work week and opportunity for career growth. And of course, I'd want to become part of a team. I figure what's not to like about lunch, we both have to eat, and I'd gladly pay to discuss things, so then at the end of the "interview," neither of us feels like the time was wasted, because at a minimum our bellies were filled. And hopefully my suggestion of a lunch date might be either something memorable (for them) or something ultimately worthwhile (for me), and might actually work to my advantage.  I have found in the past that when I cared entirely too much about a particular outcome, I cannot contain my disappointment when a less than desired outcome happens. At this juncture, while I do CARE to a degree about changing jobs, I am a bit ambivalent about the outcome. Rather than worry if I will fit THEIR expectations, I worry if they will fit MINE.

Working Towards A New Normal

After last visit with the endocrinologist, he insisted I step down my calcium and perhaps change the formulation from the citrate to TCP. My norm was 1500-2000 mg cal citrate daily. Now I'm taking 1000 mg TCP. 

I might need to adjust other things (such as decreasing or eliminating my daily Colace) as a result, to keep things middle-of-the-road manageable. I don't want to go from one extreme (constipation/impaction) to the other (sudden onset liquefied shame). 

But so far, so good. I think.

The goal is to have me on the lowest amount of supplementation as necessary, as there's drawbacks to too much calcium (kidney stones, thyroid irregularities, bowel issues).

Riddle Me This

How or why is it...

I can consume 1-2 of these a day...

And eat a lunch like this... (in Paris) with 1-2 dinners nearly FULLY immersed in creamy Perogourdine type sauces, and still manage a TWO POUND WEIGHT LOSS? 

Baffles the mind! Note to self: Of the ten pounds gained while on Cymbalta, I am now 3 pounds away from my pre-Cymbalta weight! :) It's taken a while to shed it, but very glad.

And on another note, both post-vacation doctors visits (one with endocrinologist,

the other with the kidney doctor), all my numbers seem good-to-great.

Blood pressure is normalized for me (roughly 140/80), the proteinuria hasn't

relapsed, and my calcium levels are so good the endocrinologist wants me to

try dosing down from 1200 mg daily to 800.  

Pain is still kicking my ass. To be blunt, it was the perfect storm of combined

pain issues: headaches, migraines, knee pain, IT band pain, sciatica, adenomyosis, plus a bonus slight sprain in my ankle. No real relief in sight, other than the occasional, 

judicious vodka tonic. 

And the pesky-ness in my throat which I thought was related to my 

thyroid nodules? Nope. The prevailing suspicion is that it's reflux. Doc gets halfway

into telling me blah blah blah, and I said, "... and I took an omprezole, and VOILA. Gone." 

Momentary Niggling.

Nothing quite like gearing up for travel & exploits, only for my throat to be bothering me. If I tilt my head just a smidge too far back while swallowing... OUCH. Fortunately I have an appointment scheduled with my endocrinologist for when I return, and I've emailed him, so he'll be on the look out for my thyroid nodule ONCE MORE, when I return. 

In the meantime if I can wrangle it, I want to see my gastro guy and see about scheduling not just a colonoscopy as he wants, but also an endoscopy. So he'll get me comin' and goin' as it were.

It wouldn't be springtime if I didn't have something scoped, prodded or poked.

Better living thru diagnostics, people!

Sad State of Affairs

Still keeping up with the physical therapy, with the best possible intentions.

Last night, before I could even get around to doing my "home work," I had to add more air to my exercise ball. And well, fuck! I went into muscle fatigue just manually pumping air into the ball. 

My focus for now will be to continue to work on my low back and lower abdomen, hoping to strengthen myself, in preparation for a hysterectomy at some point in the not-too-distant future.  So, I'm using that to stay on track for goals. To make myself strong enough to join a pilates class without fear of injuring myself, and to physically prepare for surgery.  

There are worse goals to have, I think!

Maintaining

Nothing new to report. Or so I think.

The weight I gained while on the Cymbalta hasn't really seemed to come off, but no NEW weight gain, so I guess there's THAT. I just wish I could jump start the weight loss again. I'm trying to eat 1/2 a grapefruit a day, so hoping it helps burn fat, or boost metabolism or whatever.

I'm now about a month into the experiment known as physical therapy. I've been going once a week every week, though two weeks ago I had to skip a session and next week skip a session due to scheduling constraints. But for as little as I've done thus far, I feel different, physically. Perhaps in a few weeks I can explore a pilates class without harming myself in the process. 

Blood work drawn on Monday; accoutrements acquired for a 24 hour urine collection (good times). Perhaps sometime before my grand vacance I'll get around to doing the actual collection.

So, no new antidepressant or anti-anxiety medication. Been cold turkey off everything with the exception of an occasional cocktail for medicinal purposes.

And about that cocktail... 

Last Friday I hit my tipping point. I brought booze to my office, as I knew Friday would be a particularly horrible pain day (and it was, and it was also followed up by an even worse Saturday, which rendered me bed bound with a migraine). 

I think I'm ready to start thinking about a hysterectomy. According to my rough math, I'm losing 14-28 days a year due to the migraines, menses mess, and overall agonizing pain. Life is too short for this.

Of course, my mother is the poster child of ILL HEALTH, so I won't be using her as my case study for post-op hysterectomy progress. My mother-in-law, in stark contrast, is nothing short of awesome. Good overall health and lifestyle and mindset. So I'm hoping her recovery is a speedy one, and I hope she dispenses plenty of first hand knowledge of what her experience has been.

Bottom line is, pain sucks, life is short, and I don't want to be a burden to my husband or friends.

ETA: Six months later, and I am no closer to actually thinking about or considering a hysterectomy. And glad for it. I started taking B1 supplements, and it's helped quell some of the agonizing pain. Let's wait and see if it continues to diminish the pain over the long haul.

Tipping Point & Colonoscopies

(Cross posted from my dysfunction blog.)

Had a goodish session with the psychotherapist this a.m., talked about everything that's been cookin' the last two weeks: Physical therapy, work shit, Audrey, my sister's mass in her lung, pain, fear, depression, all my talking points.

It is hard work trying to go from a fixed mindset to a growth oriented mindset. By and large, at the moment, I find the hardest part just to be consistent. For me to consistently show up at my appointments, be focused, do my homework (for the physical therapy), keeping focus that this is a means to an end, working towards the goal of taking pilates (without seriously hurting myself in the process). 

My first instinct of course is to whine, "It's not fun. It is unpleasant. I hurt afterwards. I'm bored." My first instinct is just to recoil, or as Audrey would do, put the ol' head in the sand. And you'd think that with the seething disgust I have towards her and the train wreck her life has become, you'd THINK the last thing I'd want to do is the very same thing she did (or didn't do). It's easy to take the easy way out. 

As I said to my therapist, the hard part right now isn't the physical. It's the mental heavy lifting. Being present of mind, having some mental fortitude, working towards a goal, having a plan, starting something I finish. Trust me when I say, these are not qualities I inherited from either of my parents. My first impulse is to run away from conflict. Run away from things that are unpleasant. Run away from the possibility of failure. Right now, I'm trying to stay grounded, and take each session of PT on its own merit, on its own day. And as long as I can just SHOW UP, the rest will take care of itself. A good lot of life is just like that.

I make promises to people and work hard at keeping my word. It destroys me, in fact, when I fall short of my word. And yet, for myself, I think nothing of breaking promises I've made. How am I less important than others to whom I give my word? My mantra right now is JUST SHOW UP.

I made a promise to myself that I would go visit my mother tomorrow. She's been in the nursing home for 2.5 months, and I haven't laid eyes on her since before her surgery in January. Snow, sinus infections, adenomyosis pain, migraines, menses, you name it. The valid excuses kept creeping up and here we are, the weekend before Easter. And I need to go. No man's an island and all that crap. 

The older I get, the smaller my family becomes, and as less-than-ideal as my family IS, time is a bitch. Tomorrow isn't promised to any of us. Opportunities are finite. It'd be lovely to make a silk purse out of this sow's ear that my family has become. It simply is what it is, and that's just damaged. 

Mom's in the nursing home. Doubtful she'll come home at all at this point. Sis had a mass on her lung (which I believe was removed yesterday). Unsure if it's bronchial carcinoma or not. One aunt has stage four breast cancer with mets to the bone and liver. One aunt is so damaged from my grandfather's death, here it is nearly 2 years later, and she can't get her head out of her ass to just settle the estate (as if that will bring him back), and of course she's mentally checked out of the family and is uncharacteristically unreliable at this point. Brother still clueless and detached (said totally without judgment). His wife and my mother have made amends somewhat, yet my sis and brother's wife have not. So the whole thing is fractured into these little fragments. 

I told my therapist that I am mentally preparing to visit my mother as if I were mentally preparing to go for a colonoscopy--as both are a pain in the ass. It's a thankless thing. But as unpleasant as a colonoscopy is, there IS an endpoint. With my mother, that endpoint is not so clearly defined. 

So about that promise I made to myself, that THIS WEEKEND IS "THE" WEEKEND I'll go to Jersey to visit family, and get it over with. Of course, I'm about 12 hours out from menses and the distinct possibility of a migraine. Couple that up with just the overall crap at work, tipping point has been met. Today is the day I packed a travel flask of vodka with elderflower liquer in it and a can of sprite. I shall quaff it liberally before eating my lunch today... purely for medicinal purposes.

No New Reportables

Started physical therapy last week. Haven't built up to doing anything that actually works up a sweat. I've been given a small series of exercises to focus on at home in between sessions. Next session usually has expansions on those exercises. 

Been off the cymbalta for a few weeks now, and still too afraid to hop on the scale.

The Post-Meltdown Journaling

Perhaps it was a Perfect Storm of too much bullshit coinciding at the same time. Perhaps. I cannot blame it on just one thing, but an amalgamation of shit. The meltdown was spectacular and has been an act which had been brewing for quite some time.

Before I go into the breakdown, perhaps detailed in a subsequent blog post to this one. it's best to inventory what no doubt contributed to the breakdown. In no particular order, other than "stream of consciousness," which is pretty much word vomit as it courses its way from the frontal lobe, vomitting forth out my fingertips):

• Drama with my mother. Granted at the moment, we're coasting along as she's in a nursing facility--though doubtful she'll ever go home again. She's been there a full month and is still unable to stand or walk on her own. However, from January until current writing (close to three months) it's been a non-stop fuckfest of resentment, drama, anger, etc. She's barely civil when I call, and isn't interested in anything going on with me, and the nastiness makes me less inclined to make that thankless trip to Jersey to visit--which I was planning on doing this weekend, then started to feel shitty, back achey, and thought hey she wasn't even really pleasant to me on the phone, fuck it, maybe NEXT weekend, perhaps;
• The weather. It's been a particularly snowy winter, which has kept me indoors, I haven't done my daily constitutional as a result and have seen a 7 lb uptick in the last month alone--though a good lot of that is no doubt related to the Cymbalta I was on.
• I was on Cymbalta for about a month, and over the last two weeks had gradually weaned myself off it. Today is effectively day six of cold turkey, not even a single solitary pellet of the stuff is in my system.
• I've been under a lot of stress at work given our relocation to a new office. So there's been a nonstop flurry of activity preparing for the move. Friday was our last day in the office, and in keeping with the baseline of constantly being everyone's afterthought, not one single person let me know in a timely manner, "Hey, the phones and computers are down--go home." I sat around until someone from the relocation team came thru and they were the ones to tell me to scoot. I sat around for nearly an hour or two waiting, looking like a fool.
• I also managed to lose track of when my menses was due this month.
• I also may not have taken my blood pressure pills the night before.

Yesterday started out oddly enough. My ritual of sitting in my car, windows up, shrieking at the top of my lungs a Tourrettes like string of expletives peppered with sentiments of not wanting to go into the office, which I pretty much call a Primal Scream... sadly did not issue forth.  I sat in my car, mute.

I busied myself with some last minute details and running about. Even managed to growl at a co-worker again, as I said, "I'm issuing a pre-emptive GRRRR!" In person it's less cute than in the written form, trust me. I felt off and depressed and angry all morning.

Then the oversight of not being included in the conversation of "hey go home."

So I decided to head off and get a deep tissue massage. Surely THAT would be enough to set things right for me. And sadly, it didn't.

I then thought, perhaps I was still edgey because I hadn't eaten lunch. So I went for a sit down at a nice Chinese restaurant for salt and pepper pork chop (my fave) and some garlicky sauteed spinach. Then Kenny G came on, much to my chagrin (dad used to listen to this on an endless loop during his nap times as a white noise--and I was brought right back to the fact that there I was, on a Friday, yet another Friday since he died). Lunch did nothing to improve my mood.

I then decided to set about to scope out the two block radius of the new office for alternatives to the parking garage they have lined up for us, and allegedly scored a "limited time" fee of $75 a month for parking. I go to the garage. Park the car, and go inside the desolate mall to attempt to find the parking management office. The world's slowest elevator is in this mall, mind you. So I go up to 3, then get informed it might be back down on 1... and the elevator took so damned long, and I'm about to jump out of my skin with hostility, that I walk out into the garage on the third level and walk around and around until I get back down to one, get to the car, and as I approach the toll booth to pay my parking ticket, EXASPERATEDLY, I ask the attendant where the parking office is, and she gets her manager over to the booth, and he can pretty much tell just by looking at me that I am unhinged. He talks me down a bit, and I'll go on Monday to attempt, yet again, to get my parking permit, which I insist on renewing each month, in person, paying cash, because FUCK I don't want these people having my credit card info, drivers LICENSE info, etc. WTF?  HELLO? IDENTITY THEFT ANYONE?

I then decide to go to the grocery store to use the rest room and buy a replacement jar of peanut butter, as the husband absconded with the new jar I JUST BOUGHT, and as I was approaching the door, a taxi cab decided right then and there, without looking, they were going to put their car in reverse, without looking, narrowly avoiding hitting MY PERSON, which then of course, made me erupt a VOLCANIC SHIT TON OF EXPLETIVES for all to hear about what shit bags the taxicab drivers are in White Plains.

While inside, once I procured my items and sauntered up to the self check out aisle, a man standing there with 2 gift cards to buy, CHIVALROUSLY offered to let me go ahead of him. I even remarked to him directly (after thanking him), "I must have quite a facial expression right about now." He remained kind and helpful. I could tell he was having quite a day too.

At this point I decided to cut my losses, and head over to City Center, to both, inquire at the parking garage about parking permit costs, as well as head to Barnes and Noble for some crochet magazines, then off to Atlanta Bread Company for coffee, and wasting time crocheting while I waited for the husband to arrive at the train station.

I managed to keep my shit together until I picked up the husband, who had our household's traditional "Friday Night Take Out" in tow. And I know he's been having a hard time at work lately, so no, I couldn't unload on him. But by the time I picked him up, I was so upset I just go inwards, almost like a borderline fugue state. Where I hear people, but I'm locked in and locked up and just cannot respond. I drove in complete silence as the husband repeated several times about the turkish pizza he got for dinner, and I remained entirely mute, but tears still streamed down my cheeks in silence.

Once I got into our parking lot at home, I dropped him off at the ideal spot so he had less walking to do to our entrance, and I continued to drive in the lot to find a spot, and once in it, I broke down into sobs.

I ate some pizza and promptly fell asleep in front of the tube. I awoke about 11, and he was already in bed. I stayed up a bit and vegetated, then fell asleep on our lounge chair.

My back aches. My period is due any moment now (just in time for my first day in the new office on Monday).

I'm miserable, and feel helpless to change it.

Good News/Progress

I've been accused in the past (by a sociopath, no doubt), that all I do is bitch and whine about my lot in life, or all I do is post a never ending stream of disorder-after-disorder. What-evs. 

Stick this in your pipe and smoke it:

Kidney update: Apparently boosting my intake of alpha lipoic acid from 250 mg to 500 mg daily has positively impacted my proteinuria to the point where it's reversed itself. So no more kidney problem.

Blammo! Obstacle, overcome. 

Also, the last six months of 2013 really derailed my best intentions to get to my rainy day projects, and in a fit of serendipity, when researching physical medicine and rehab, I just-so-happened to make an appointment with a physiatrist, which was on my to do list last year. Appointment set for two days from now.

Onward, and upward!

An Experiment

So what am I to do about that 7-10 lb uptick?

Every once in a while, I revise my eating habits to keep things interesting for me mentally, and hopefully to tweak things back in the direction to re-ignite my weight loss, which has pretty much been stalled for two years (the bulk of my weight I lost post-op was within the first 11 months post-op).

Even after the pitiful bowel movement I had this a.m., I hopped on the scale hoping against hope that it would read what it did at the nephrologist's office last week. No such luck: 4 lb uptick since then (on a completely empty body!). 

Today's reading, ego and efforts be damned: 203. (This is also going to be my "starting weight" to monitor progress from/once I start physical therapy.)

So, between going off Cymbalta, I've decided to forego my usual a.m. "intake" of 2 low fat Baby Bells and about 1.5 oz of Cheez Its (approx: 320-350 calories),  in favor of a Jimmy Dean breakfast sandwich (english muffin, egg, cheese, w/turkey sausage, weighing in at 250 cal and 17 gm of protein). I toasted the English muffin, nuked the filling to the sandwich, reassembled, then reheated right before leaving the house. I ate it while I waited (in my car) for the clock to strike 9:30 as I don't enter my office until the very last possible moment. 

# Calories reduced by substituting breakfast sammie for the cheese/crackers: 100

Current typing: 10:53 a.m., and I'm  not peckish, actually I still feel full.

In the feedbag today and timings of intake:

11ish: Protein shake blended w/iced coffee 23 gm protein thereabouts
1 p.m.:  1 can Campbells low fat/low cal Light Chicken noodle soup (140 cal and 12 gm protein for the whole can)*
3 pm.:  Small salad of arugala, sliced beets, red onion, blue cheese, 1/2 HB egg, and a few oz of last night's steak (this will be tomorrow's 3 p..m., too)--to be drizzled at the last minute with some low fat/low cal dressing
5 p.m.: Baby carrots and low fat/low cal dressing (for something crunchy instead of my standby pork rinds)
Banana in case I need it while I wait for the husband this evening at the train station.  

# Calories reduced by substituting Campbells soup for the Chinese take out egg-drop/wonton hybrid (I'm rounding up to about 200 calories for a pint of this soup, entirely possible, the soup is more calories), approximately:  60

# Calories reduced by substituting  3-4 oz baby carrots + low cal dressing for the pork rinds, approximately:  140   

Note: It's entirely possible I won't even eat the carrots, there are some days I forego the snack. 

*Now back to the soup in question... Every work day, it is almost imperative I have soup for my 1 p.m. intake. Usually it's egg drop or egg drop wonton mixed. And SURELY, that's gotta weigh in at more calories than the 140 for the can of Campbells, with an undetermined amount of protein and nutrition, too. At least with the canned soup, I know exactly what I am consuming. Let's see if I can get into this habit, and save my egg drop/wonton hybrid for something like Fridays-Only, or if I can eliminate the egg drop entirely from my weekday repertoire, I could just relegate it to the days I pick up/drop off my laundry.  

If anyone reading this is interested in the exact soup I am eating and wants to try my experiment (of just purely cutting calories, that's it. Simple math, cutting down calories), here is the exact soup:

I'm just hoping dropping the Cymbalta will take the edge off my hunger.

7-10 lb Uptick

So, about the Cymbalta...

I have been taking about a half dose each day for the last almost two weeks, and I'm still seeing no real merit to staying on it. No diminishment of my pain, I'm still pretty blunted and ambivalent to the point of not wanting to do anything, bathroom habits are a bit better than they've been (though, still nothing to write home about), and I've noticed roughly a 7-10 lbs uptick in weight and an increase in appetite.

Today I've decided to forego my dose, and perhaps tomorrow take a dose with even more pellets knocked out of the capsule, to finish tapering off. 

If I weren't depressed and anxious enough, the thought of stalling and sabotaging my weight loss is enough to make me downright despondent.

In two days, I see a physiatrist, and I'm hoping that will help turn things around, mentally and physically.

I hope.... famous last words.

Appointment Made!

At the recommendation of a friend, I've decided to explore going to a doctor that specializes in physical medicine and rehab, to help battle my pain issues, and hopefully get me more active so I can lose some more weight.

Appointment set: 3/13 6:30 p.m.! 

I go for a consultation, and hopefully they can get me started on physical therapy. Granted it will be for a set period of time, but it will be supervised and hopefully I can get active enough where it will make an impact on my mental and physical health.

So About That Weaning...

Well, I made it through Friday all day without a dose, but the more I thought about it, the more I thought I should really try to lower the dose, stay on that until the neuro is back from vacation. He comes back on the 10th and my next appt with him is on the 25th, so I think I can tough it out in the meantime.

So I open the capsule and dump out an approximation of half the pellets. No. I don't count the pellets. It's imprecise, imperfect, but it's better than not taking any of the medication.

I seriously think that I'm suffering such strong side effects to the medication because my physiology has changed since my gastric bypass, and the Cymbalta formulation is a time release capsule. I'm just not managing well on it at all. The constipation issue was really a quality of life concern for me, uncomfortable, plus the epic ambivalence wasn't helping me do anything.  

Tomorrow I follow up with my kidney doctor, and later on in the afternoon I have an appointment with my therapist. Full day planned, assuming nothing gets cancelled due to snow.

Cymbalta: The Weaning Off

So far, one hour past my usual dose time. So far, so good.

Cymbalta: Day 9

It's not helping my pain, and it's blunted my anxiety to the point where I'm ambivalent to the point where I don't want to do anything, even things I enjoy. So while my pain and depression were limiting me, now the ambivalence is limiting me. Plus constipation (this is on top of the baseline of bathroom issues due to the bypass).

I can't tell. Is there merit in continuing to take it? I'm too ambivalent to tell. Perhaps that should tell me something right there, but still... ambivalent.

I am nauseated a good lot of my work day, and feel FULL (even when I'm hungry). Weird. Should I stop it? Should I wait until I see my neuro at the end of the month of March? IDK what to do, honestly.

Called the neuro, and he's on vacation until March 10th. My appt is March 25th. I can't go nearly a full month without stopping this.

Going to start weaning myself off it tomorrow. Going to step down dosing every other day, and just hope for the best. Going to take melatonin to help me sleep, get into better sleep hygeine as I do this, and hope for the best.

I'm convinced there is no medication that is going to help me, my pain, my anxiety. Convinced.

Cymbalta: Day 8

Perhaps it would have been useful for me to know up front, prior to taking the first dose, that Cymbalta would have constipating effects. Knowing I have had bathroom issues for three years since my gastric bypass, this would have been useful information.

So instead of having general anxiety and depression, I now have ambivalence (which just exacerbates my ennui) and a perpetual case of performance anxiety in the bathroom. Anxiety when I don't go, thinking I'm surely going to have an impaction issue eventually. Anxiety that since I'm not having (shall we say) "productive" activity, it will equate to an uptick in weight. And just a general sense of unwell "down there." 

Is it worth it? I mean. I'm not crippled by it. There *is* some activity each day (though Saturday was worrisome, as my poop was MIA). But it's not "satisfying." 

My colon is already "loaded for bear" each day (Colace, fiber, probiotics, magnesium supplements, hot coffee galore, and on Saturday it was all that PLUS Miralax--and still nothing). I'm adding prune juice to the mix, thinking I need to up the ante as it were. And of course, trying to keep myself adequately hydrated.

A normal person doesn't think about their poop this much. Do they?

Note to self: Milk Thistle

Day 1: Start taking.

Cymbalta:: Day 7

Cymbalta, day 7: 
Blunted. Ambivalent. Like so ambivalent I just sneezed so hard I had an eruption down below. Not sure which form of matter was involved. Is it time to go home yet? I need a nap.

Cymbalta: Day Four

Really no complaints, thus far.

Took my fourth dose this a.m., and so far I'm managing well enough, I think!

Positive observations:  

• It's blunted my anxiety considerably. Not sure if I'm any less depressed as a result. Color me: AMBIVALENT.
• Additionally, it's blunted my interest or passion for food. Everything tastes fine enough, though I do have a horrid after taste in my mouth. No excessive dry mouth either as I've experienced with other, similar meds. I'm just disinterested in it. I notice I'm not eating everything I pack for work, either.
• Also worth noting, I'm sleeping pretty soundly. To my knowledge, I'm experiencing neither night terrors nor sleep walking. 
• Weird note: Onset for menses was Tuesday, same day I started Cymbalta. Usually days 1-2 are heaviest,with about 4-5 days of it tapering off. Seems that it's tapered off in half the time. But then again, with the adenomyosis, I might burst a little pocket of whatever-it-is, and spot a few days from now--but such is life with this disorder:(

Negative observations:

• I feel I'm running a little on the warm side (I'm almost always too cold);
• I experience nausea within an hour of dosing and usually it lasts about 2-3 hours;
• I have a weird numb/tingle/twitchy thing happening, occasionally, from my knee to my ankle in the evenings.
• I don't notice any change in the overall pain issues: herniation in neck, diminished disk space/pinched nerve in low back, arthritis, adenomyosis, etc. 

Cymbalta: Day Three

Still muddling through. Still nauseated, though it is most intense about an hour after ingesting the capsule and lasts roughly 2-3 hours.

Sleeping pretty soundly, which is nice, and a rarity. Husband hasn't complained of my snoring, so who knows if he's sleeping sounder than I am. 

Later in the day I get a slight headache, though that could be from hunger, though I have noticed my hunger sensations have abated somewhat. My eating is "off," and I'm a bit indifferent to food.

Only negative thing I can say so far is this weird chill type tingle that runs down my right leg on the outside lateral, from the knee to the ankle. Not painful, it's just a very weird sensation. 

Beyond that, and the fact that it's done zilch for my adenomyosis or herniation pain, nothing else to report. Though, to be honest, it has blunted my anxiety a lot (which also might be feeding into the ability to get some sound sleep).

Stay tuned.

Cymbalta: Day Two

Took my second dose today. Still feel that foggy-headedness, and later on, the nausea presents itself. I'd say roughly 1-2 hours after taking it, the nausea kicks in.

I can't seem to locate my Zofran, which is possibly in my travel gear pain kit; so I've been sipping Coca Cola Zero to stave off the waves of unpleasantness. So far, I haven't heaved at work. SCORE.

Observations thus far:

1. It's curbed my interest in food. I don't know if I'm truly not hungry or if the nausea makes me indifferent to food or what, but I'm just "meh" about food right about now. 

2. I was starting to nod off a wee bit in front of the tube last night, so I got up around 11 to turn the lights out and head to bed. Before bed, I did manage to pop a melatonin (3 mg.) though I don't know if I should do that given the Cymbalta. I'll have to get a ruling on that. I just wanted to ensure I went to bed and stayed asleep. Which I did. And given the husband is away on business and not here to be my human alarm clock, when the alarm went off, I woke up, hit snooze, woke up and hit snooze, and woke up finally with no problem or any additional grogginess. 

3. While walking out to the car, and looking at all the snow that abounds, and I have been miserably depressed being indoors (I think I'm finally suffering from SAD from all this indoor nonsense), I actually said to myself, "Well, I guess this beats the alternative" (with the "alternative" I suppose being death).

I did have a chiropractic adjustment last night, and ate pretty light when I got home (I had crackers and cheese while I waited for my steak to cook, and once it was done cooking, I was indifferent to it). I slept pretty good. I think. Though without the husband here I have no knowledge if I woke up, if so, how many times, or if I had a night terror.

My adenomyosis pain is pretty sharp. Onset day was yesterday, and everything from my navel to my knees was nothing but a bundle of angry nerves. Can't tell if the Cymbalta is helping that at all. But the anxiety and anger and hostility seems a bit diminished today. Though, how much diminished? I don't know. I feel like the edge is blunted. Somewhat.

The chiro knows about the nonsense going on in Jersey with my family, and especially the negativity and the expectation that somehow I should be there more, despite the obviousness of snow storm after snow storm, and now with my assorted pain issues. Even the chiropractor said it's actually not helping my own pain issues. Again, obvious. But nice to get validation from someone else that insulating myself as much as I can from what I can is the only response I have at this point.

Side Note: The Closer

I've been bingeing on The Closer, as it's available on Amazon Prime videos. 

I found it fascinating they worked PCOS into her story line, despite the fact she doesn't appear to have any of the other symptoms of the disorder. No acanthiosis nigricans, no hair loss, no facial hair, no fat accumulating around her middle (despite the obviousness of this character's addiction to sugar). But fabulous to have a show that finally presents a character with this, as well as "premature menopause."

Though to be honest, and not to be hating (as I do love her as an actress) a more believable character with PCOS would be Melissa McCarthy's Molly from Mike and Molly. 

Cymbalta: Day One

Interesting choice of words in that warning.

"Fear?" Really?

FWIW, I'm taking this Rx for pretty much everything else listed,

save for the "fear."

Conversational Nugget

Endocrinologist to me: "You? Depressed? Srsly, I don't see it."
Me: "I'm high functioning and keep my shit to myself. I wish I were dead inside."

Frova Coupon

So I'll always be able to find it.

Post Therapist To Do List

Start Cymbalta.
Maintain boundaries with my family.
Consider finding a source for weed.

Medical Updates & Supplementation Tweaking

Two days ago I had appointments: First with my neuro who is local to me; and secondly with the endocrinologist who is in NYC. 

The appointment with the neuro was a bit more involved than it normally is. Normally, I just go for follow ups, he gives me my refills for my Frova for my migraines and we bid each other adieu for another six months. 

Thanks to the last six months of 2013 being so chock-a-block with unexpected medical wild goose chases (thyroid nodules, lung granuloma, etc etc), I hadn't had time to address all my "rainy day projects" (pain  management, follow up sleep study, colonoscopy, to name a few items), so I figured I'd start with the most pressing: PAIN.

Given I was going to explore pain management with a "pain specialist," and given that the particular specialist in question was a neuro, and given I ALREADY have a neuro, I figured I'd unload on him everything, to see if HE can address and treat those issues:

• Migraines
• Headache from herniation at my C4
• Adenomyosis/endometriosis pain
• Anxiety/Depression

I told him I was on Wellbutrin from November to the end of December, and it gave me horrid dry mouth, a persistent baseline headache, increased my predisposition to anxiety attacks, and brought me to a full on feral, frothing rage, and due to this, I stepped myself off it, as it truly wasn't value added. Also? Taking Frova (my migraine Rx) with Wellbutrin is contraindicated, so yeah, there's that.

He considered other things, the tramadol, my use of an occasional vodka tonic, and realizing nothing's really helping the pain, which is debilitating, and sometimes the migraines and adenomyosis pain are not running immediately in tandem with one another, so I'm losing between 2-4 days a month due to this, and really it's unacceptable.

In addition to the myriad of things going on with me, the latest Dx: Chronic Pain Syndrome.

His recommendation: Cymbalta. 

I'm pinning some hope on it that it will help me, even get my pain managed a smidge better, to allow me to be more predisposed to getting more active, which I am convinced will make me feel better for an assortment of reasons. I just hope it doesn't make me add weight.

Then it was off to the endocrinologist for my four month, standard appointment with him. Pretty standard fare. Nothing too alarming. A slight, 4 lb uptick in weight (perhaps due to an ineffective poop that a.m., and perhaps water weight due to my period due any moment now, or perhaps due to total inertia, thanks to the fucking weather we've been having (Mother Nature: A snow storm every week, really?).

We discussed my right lower quadrant pain and spitballed ideas about if it were related to the adenomyosis, or if it were related to something else. And he did a manual exam of the abdomen, and quipped about that pesky fatty liver syndrome, which I thought was managed or thwarted by the gastric bypass I had three years earlier. My triglycerides and overall cholesterol are great; however, either my good cholesterol is low or my bad cholesterol level is high (I don't know specifics at this very moment and I'm too lazy to pull out the blood work to verify, not that it matters herein, does it? really?) 

And again, the topic of my occasional cocktail came up. One a week (maybe one more if I'm at a function?) doesn't seem too outlandish, but given the concerns of fatty liver syndrome morphing its way into NASH (essentially non alcoholic cirrhosis of the liver), it IS a concern. Ideally I shouldn't drink, but if I want (because hey, life is meant to be lived), to try to limit it to one cocktail a week. So I guess moving forward, I should be very particular about the deliciousness of my weekly potable.

This is of particular interest to me, of which I find hilarious and ironic, given my mother's lecturing of me in December about my latent alcoholism, citing dad's family's predisposition to drink. One cocktail does not make one an alcholic. Funny thing here is, it's not dad's family's predisposition which is hindering me taking a nose dive into a vat of limoncello, but MOM's fucked up gene pool, given the fatty liver syndrome is from the obesity and insulin resistance issues on mom's side of the family. Hilarious, and of course, pointless to point that out to her, given she won't listen anyway.

Doc hooked me up with some samples of Lovaza, given that I am already on Omega 3 capsules. And lo-and-behold, my insurance will pick this up! So I'm happy about that, though I'm not sure of the merits this will have.

I had to laugh at the doc, as he told me some insurance doesn't pay for the Rx, but he's got a bunch of samples he can give me. I compared him to a heroin dealer, saying, "The first hit's always free." 

Part of my personal make up is that I like to try to find work arounds for life's problems. Kind of like puzzle solving. Well, I would like to keep having my weekly beverage. So, I have decided to dump off one supplement out of my daily routine (evening primrose oil) and bring a new player up at bat: a liver tonic with milk thistle.  Additionally,  I'd like to try to cut my carbs down, even though my intake is not carb-intensive, I need to try to find a way to wring out the fat out of my liver.

One more talking point was about calcium supplementation, and apparently there's a bit of conflict/controversy over how much is too much calcium. Doc suggested I read this article, and I found it interesting enough to warrant that I get a 24 hour urine collect done now, go 1-2 months taking a lower dose of calcium daily (dropping down to 1500 mg daily instead of 2000 mg which my bariatric surgeon recommends), then do another 24 hour urine collect right before my appointment in May. And at the May appointment, we will numbers crunch and see if by dropping my calcium intake if there's any negative impact. I don't want to overdo things, as too much calcium can mask other issues and adversely impact the thyroid.

So, the current supplement line up moving forward will be thus:
First thing in the a.m.:

Cymbalta 30 mg, 1x
2 Gummy VitaFusion Prenatal Multivitamins
2 Gummy VitaFusion Sugar Free Fiber Chews, 5 gm, 1x
Lovaza 1x
Colace 200 mg (1x)
Vitamin C, 400 mg
Feosol 325 (2 tablets)  *I boost to 3 tabs during menses
Alpha Lipoic Acid 250 mg
KAL Brand B12 spray (1-2 spritzes under the tongue)

Right before leaving the house, I take a zinc losenge, and then throughout the day I manage to get these in:

Standardized turmeric in capsule form
Boron, 3 mg, 1x daily 
Magnesium 400 mg, 1x daily *I boost to 2x daily during menses 
D3 2000 IU (1x) 
Calcium Citrate, 250 mg (3x) 
CoQ10 (50 mg, though I'm thinking of boosting this) 
Vitamin C, 400 mg

Then in the evening, I take:

Quinipril, 80 mg
Alpha Lipoic Acid 250 mg
Milk thistle 

Items highlighted in red are new additions to my line up. Note: The Lovaza was just an experiment, as my endo gave me some samples. I'm back to taking my regular Omega-3 fish oil supplement, as I did not see any marked change in my blood chemistry (and the doc never prescribed an Rx).

In the blink of an eye: Three Years

I awoke this morning with my husband nuzzling my neck and wishing me, "Happy Surgiversary, baby."

Ever the literalist, I bit my lip and kept myself from saying, "oh that was YESTERDAY, babe." But I held off on saying it. The sentiment is still true and still sweet, that he remembered. Such affection!

One of the many improvements in my life the surgery brought forth, I never thought in a million years that it would improve the state of my marriage. Turns out my recovery and life post-op has been a joint project for both of us to work on. 

There's no place I'd rather be.