Ten Days Later (Viibryd)

After such a long wait & genetic testing to figure out which Rx to try, ten days into viibryd and I don’t know what to say. 

On one hand, I am no longer sobbing every day; however, my stomach hurts, and the last couple days I have developed a bad headache. This morning I decided to check my bp, and it was crazy high for me, 177/97 (when my norm usually is 117/70). I checked it a couple times in a row and the numbers kept going up. 

I texted the assistant for the NP who prescribed the Rx to me, to see if I could get a video appt for tomorrow, and as of yet (9 pm), still no reply. So I am popping magnesium & taurine and hoping it will bring my numbers down enough to keep me out of the danger zone. 

In the interim, I am left with the worry that I might have to sacrifice my mental health for my blood pressure, or visa versa. Quite the dilemma. 

The Journey Continues—Or Begins AGAIN

Finally, seven months after requesting a neuropsychological eval, getting a couple official diagnoses, and finally getting a psychiatric NP, and finally getting the results back from genetic testing to determine the best choice of Rx, after 11 years being off antidepressants, I am back on them.

I don’t count the Wellbutrin I started (and stopped) earlier this year as anything other than yet another failure—and technically, the 11 year statement still applies. 

So far I have 2 doses in, and too early to tell. Plenty of abdominal discomfort and gastric distress, but that should pass in a week or two—and if it doesn’t, hey, maybe I might lose some weight. Who knows. Pigs can fly too, right? 

Today I’m heading into NYC for my regular cardiologist appt. It is almost like old times—just with an N95. 

As always, now-a-days, I just hope I don’t catch COVID or something worse by going to the doctor’s office. 

Day 124

It’s wild to consider I am now 124 days post op from my hip replacement. All things considered, I’m pretty amazed at the whole process. Although I am not 100% better, I have managed to get back roughly 85% of my range of motion, and hope as time goes by and I continue to heal, that eventually I’ll be able to put my socks and pants on without having to put my leg in place with my hands. 

Pain has diminished, save for the incision hyper-sensitivity, and my inability to roll over on my left side. Yet. hopefully in time that will change too. 

These days I limp because of my problems with my feet, and this week I found (yet another) specialist who has a real plan (or “recipe” as he calls it), and today I start therapy with him for my feet and get cast for yet another pair of orthotics. 

Hopefully this will be enough to diminish my agonizing foot pain enough where I won’t be entertaining surgery on my ankle. The ankle has some soft tissue damage from my Mexican Adventure in 2019, but right now besides an occasional uncomfortable POP!, and instability, I don’t have pain. My pain issues are all on the bottom of the feet, bi lateral  heel spurs and plantars fasciitis. 

As I told the doc, I had the hip replaced to diminish pain and increase mobility, yet because of my feet, I can’t walk more than 3000 footsteps a day without losing countless days after, due to the resulting pain. 

So yet again, I start yet another journey of a thousand miles with a new specialist, and today I take those precious first steps. 

Day 112 Post-Op

Not much to report here, as things continue to trundle along on its own trajectory. I was discharged from PT on 10/25/2022, with glowing details of "excellent" compliance post-op. I'm still struggling a bit to cross the leg and do the external rotation necessary to put on my socks, but I guess that will all come back to me in due time. Follow-up with ortho is set for January 2023.

10/10/2022 was a duo of appointments, nephrologist and a neurologist. Nephrologist was usual six month check up for my blood pressure and I'm being monitored for CKD. Neurologist was a long-awaited EMG which didn't bear much fruit beyond median neuropathy of both wrists, mild to moderate neuropraxia (mild left, moderate right) on both sides, as well as left ulnar neuropathy at the elbow/cubital tunnel syndrome. 

Physiatrist is on maternity leave until January, so I guess at this rate I won't know what the next course of action will be. Maybe I can schedule my follow up with the ortho and my follow up with the physiatrist on the same day?

The only appointments in December are my annual appointments with both, my cardiologist, as well as the neuro-ophthalmologist. 

Still masking and COVID negative, and anxious as hell about both.

Started speaking with a trauma therapist/clinician three weeks ago, and had 2 appointments with a psychiatric NP to help navigate and identify an Rx to help support me while I "right my sails." Still waiting on authorization from insurance regarding genetic testing to find the optimal Rx--however, it's been 3 weeks, and I wish we just settled on Prozac so I would be on SOMETHING in the interim, as I'm still sobbing daily, and having anxiety attacks.

Still avoiding people--which is easy because at this point most people are avoiding me. 

New Normal

I don’t know about anyone else, but the “new normal” looks just like the old normal. Or “new normal” clearly means different things to different people, as clearly a lot of us are living entirely different realities. 

One reality is science based & cautious, masking & vaxxing and trying to ride out this mess. Another reality can be summed up thusly: “what mess?” As if 1.2Million+ US Americans haven’t died because of COVID. 

“The fish stinks from the head” as the old saying goes, and in this situation, the head is the WH & the CDC, both of which are misleading us into thinking we are post-pandemic, which clearly we are not. 

“It’s the new flu.” From Jan-Aug of this year (2022), 225K US Americans died of COVID—that figure is FIVE TIMES more deaths in any given year for flu deaths. 

I admit to not being a “math person”; however, I understand how it should work, and in this case, the numbers should be going DOWN markedly in order to justify removing all the mitigation efforts to beat COVID into submission. 

Instead, we are told lie after lie, meanwhile kids in school, people in nursing homes, as well as disabled & immunocompromised people all are being sacrificed to The New Big Lie (that the pandemic is over), all to keep the economy churning along, yet the powers that be fail to realize there are still supply chain interruptions and interruptions of service DUE TO COVID MAKING PEOPLE SICK AND MAKING THEM DIE. 

Instead of the pandemic ending because it has actually become managed and endemic like the flu, the powers that be have eliminated mitigations & discontinued testing & contact tracing & reporting—simply put IGNORING & DENYING this issue still exists. 

Meanwhile people continue to get infected & re-infected with (what I predict will be called respiratory HIV) COVID, get sick and either get Long COVID/disabled by it or die from it, which benefits no one. It doesn’t benefit us the people, it doesn’t benefit the economy, either. 100% it benefits people who have a vested interest in the companies that make the anti-viral meds etc. 

In 2020, I was one of the first people I knew who started masking & I will no doubt be one of the last to discontinue doing so. 

In “The Beforetimes” I was neurotic, risk averse, and distrustful of others, and in the 948 days since the beginning, I have become even more so. 

Survey finds more than 40% of Americans have misled others about having COVID19 and use of precautions

This article only confirms what I have *witnessed* with my own eyes with people I KNOW, and further drives home so many things: I can’t trust anyone anymore, and how radically different I assess my risks than most people. 

My sister (who should know better) claims she has been careful yet goes unmasked—and has caught COVID multiple times. “I guess I should’ve masked up” yet continues not to mask. 

One friend has traveled internationally to developing countries that lack vaccines for their citizens. She does stand up in small venues and doesn’t mask up. She goes to super spreader events & is the only one wearing (a poorly fitting fabric mask). “I gotta live my life.”

My office manager has done air travel this year & came to the office coughing & visibly sick 10 days before my surgery, yet never considered testing herself & staying home. 

 My life for the last 948 days has been work, medical appointments & judicious grocery shopping (off peak days/hours in store shopping, curbside pick up where available, and delivery for as much as possible). I get the rare pedicure during off peak early time of the day with an empty salon, and controlled road trips with my UV HEPA air purifier in tow. 

I am doing more than other immunocompromised people, and doing substantially less than COVID deniers. 

All this cognitive dissonance is reckless & devastating to witness, and only fills me with despair & feel even more isolated. It also fills me to the brim with rage & disgust.

I think to myself “how am I to manage being around these people once all this is really a thing of the past?” And then I laugh at myself and remind myself, “don’t worry, they never gave a shit about you, and they have already forgotten about you.”

Day 91 Making Microscopic Adjustments

Three days ago was my regular six month check up with my kidney specialist. All looks as good as possible. My kidney function has maintained and in some regards improved, though there is still damage to my kidneys from all those years before my PCOS diagnosis and the related obesity. 

Some days I start to get down on myself that I haven’t lost as much weight as I had hoped, but i look at my markets for fatty liver and how that improved, and I think of how my bypass has helped stop the kidney damage from progressing, and that is more than enough to keep me from spiraling further into ruminating on what a failure I am. 

Things I hope to improve are:

Glucose: 105

EGFR: 76

HDL: 56

LDL: 134

TRI: 140

I am hoping the combination of walking more now that my hip was replaced, and I am starting yerba mate supplementation today might help those numbers improve. 

Yerba mate is just a tool in the tool box and not a magic wand to make everything perfect, and I know ultimately a lot of my improvements (as always, with other issues) hinges on a commitment to change and consistency. 

Since I’ll be tracking those other numbers, I am putting my current LFTs herein as a baseline, to see if there is any negative impact to the liver function:

ALP: 92

AST: 27

ALT: 21

It took well over a year before my LFTs returned to normal after that unexpected turn/crisis after my first shot of Pfizer triggering a bout of acute hepatitis. 

Who knows? Maybe the yerba mate might be a mood booster too. It is worth trying, plus Maharajah had a bottle of it on hand. At the very least it is a choice to make, an item to check off on my “things I tried” list. Only time will tell if it will help me achieve my goals. 

Next time I see the kidney guy, will be in April. Six months is more than enough time to see if the numbers budge. 

To be continued! 

Day 88

Yesterday was day 88, but was too pooped to peck out the journal entry. 

Several years before my hip replacement, there was a day I spent in NYC where my footsteps were well over 10k. I remember it vividly today. VIVIDLY because my foot is killing me. 

I have plantars fasciitis & a heel spur & some soft tissue damage from what I call a catastrophic sprained ankle I endured in May 2019 when I tagged along on a business trip to Mexico. I am just thankful I didn’t snap my neck as the resort did nothing to make things right for me at that time; and here it is 3 years & 5 months later, and I am still hobbled by that accident. PS: Fuck the management at Nizuc! 

Anyway, yesterday was my regular six month appointment with my kidney doc—always a delight to see him. What a wild ride it has been the last 945 days. 

2020 I saw him in video appointments only. 

2021 I saw him in person, but no hand shaking. 

2022 I saw him in April and no hand shaking. I saw him yesterday (6 months later), and we shook hands. It was startling to me, and it seemed like such an intimate gesture after all we have been through. Part of my brain was saying “FUCK FOMITES!” and the other part of my brain ensured I sprayed hand sanitizer on my hands the first chance I got. 

So yesterday was like any other Columbus Day in the beforetimes: I had a double header of appointments scheduled, and even managed to go to the Neue Gallerie to visit the Klimt exhibits between my two appointments. 

I neglected to consider difficulties getting a cab due to traffic disruptions due to the parade. Maharajah kept suggesting getting an Uber and tbh my experience with Uber in NYC sucks, as they rarely pick me up at the door or location where I am, and I have to endure a game of “Where’s Waldo” trying to find the car. 

Time was of the essence and I just kept goofing it until I just gave up hope of hailing a cab at all—and in doing so, I hobbled myself like I did that last time. 

Every time I took a step with my right foot, it was as if I were driving a firey hot ten penny nail right into my heel. 

I had one more thing on my to do list, to visit one of the secret gardens in NYC (this one, at the Ford Foundation not far from the UN), but Maharajah but his foot down and made the executive decision to save it for another day. He got us an Uber, and I bruised my hip getting into it, and the driver drove us right past the building where I wanted to go. Perhaps another day. 

So good news is, my hip held up great during the 9K+ footsteps, but bad news, my foot really is demanding some relief. And I am reluctant to have surgery on it because the recovery time is much longer than for my hip, and it is my right foot which means  won’t be able to drive and do things independently. 

Today was a follow up with the surgeon as well as a PT appointment, and in both cases I had to emphasize my limping was due to my foot. Hip replacement was the project for 2022. I guess my project for 2023 will be my foot, though I am not sure how I will make that happen. 

Day 87

This week I had appts with/for trauma therapy, physical therapy, and a consultation with a psychiatric NP to evaluate possible meds to support me. 

Not much to report beyond the trauma therapist seems like a good fit & was a good listener & validating; and the consultation with the NP didn’t hear fruit yet. No meds yet. She is starting the process to get genetic testing pre-authorized to see which Rx might be best, though we did discuss possibilities, and I won’t be surprised if I end up on prozac. 

So in the meantime, I am still struggling with sadness, grief, rage, resentment, and panic attacks and dissociating—and just feeling profoundly alone and exhausted, and exasperated that no one seems capable to help me. And at the same time, I bristle at shreds of caring from others, and just want to push everyone away. I don’t want to grab their hands to help myself, as I am convinced I will only drown both of us as my emotional rip tide pulls us both under water and away from shore. 

Day 79

I am anxious and on the verge of tears pretty much all the time. I feel as if I were waiting for death. I wonder if this is what people who are terminal feel like, anxious, knowing the end is near, and feeling so alone in that discomfort, and knowing none of their loved ones can lighten that burden of foreboding. 

Day 78

I’ve been an insomniac my entire life, and have battled with night terrors since my teen years, so I can’t blame the pandemic for this; however, surely the pandemic isn’t helping things. 

I nodded off while watching tv last night, only to wake up to take my meds & use the toilet then be unable to drift off to sleep again. 

I nodded off briefly, only to wake up in tears saying to my mother, “if you have the ability to be anywhere, why haven’t you visited me even once? Why can’t we say we are sorry NOW? Sorry that we wasted our precious time together being angry or jealous or resentful? Why won’t you give me in death what you were unable to give me while you were alive?” 

My eyes are tearing up as I type this. What is it going to take to make me whole again? What is it going to take to make me stop sobbing each day?

Day 77 Slogging Away At Self Care

This past weekend I went for my first pedicure since my surgery. My feet were pretty messed up, and I wanted my feet in better shape because I had a Reiki session the next day, after which, I came home and dropped off into a 3 hour nap. 

All things regarding the hip are moving along. Still can’t cross my leg & externally rotate my knee to put on socks yet. Yesterday my PT ran me through my paces. 

So far I have lined up a therapist who allegedly has a focus in trauma based therapy. And a couple days ago I found a psychiatric NP who I hope will be able to find a Rx that might help me manage my C-PTSD. Therapy is scheduled for Monday 10/3/22 and the NP is 10/7/22. A plan will be devised to help me manage my symptoms. 

Plenty more to transpire before I return to the office on 10/17/22, more PT, a visit with my kidney doc, an EMG/nerve root conduction test on my shoulder & elbow, and yet another follow up with my surgeon to see how I am doing. 

I am still anxious, angry, and sobbing every day, and I am acutely aware how unprepared my husband and friends are, and how unable they are to help me. I feel like I am sinking further into the abyss, and all I am getting is “I’m sorry,” or “don’t say that” or worse, toxic positivity. Trauma doesn’t respond to any of this. 

Two things can exist simultaneously. I miss my mom, and my mom was the source of a lot of my trauma. 

Her death & the isolation I still am doing (within reason, after all I did say I went for a pedicure—just me and the shop owners and we were all wearing masks) makes me feel more alone than I am, and it is breaking my spirit. Pretty much my siblings have forsaken me, and mom’s sister too. I CBT the hell out of this and remind myself it is just as well as they all are continuing to catch and transmit this virus that killed mom. And I wonder if I am already a ghost. How easy it is for my family to continue on, and I am barely even an after thought. 

I am sobbing again. 

Day 71 & “Summer of Self Care”

I’m wondering what kind of timeline I should keep regarding my hip replacement—100 days? 365? 

Physical therapy went well yesterday. Only a couple more sessions, and then I’ll be on my own. 

Yesterday I broke down & revisited the neuropsychology group from which I was seeing one of their therapists from February until April before I decided to discontinue as the therapist I had settled on/for was only reinforcing toxic positivity and was doing nothing for my trauma. 

I called yesterday, again, out of a sense of futility & desperation, hoping they had someone on staff who has a focus in trauma based therapy—and they do—and I set up my initial appointment. This was also convenient as I didn’t have to register again, and they participate in my insurance. So here we go again—hopefully this therapist has the chops to help me. 

Meanwhile, I am still waiting on a call back from the behavioral health group at a hospital near me, as I would like a consultation with a psychiatrist to find out what my options are regarding medication that might help me in this process. 

This week I received an email regarding a “mandatory training” session which is scheduled for the day after I return to the office. The training will have everyone crammed into a conference room—which, coupled up with the lack of masking or improvements in air quality in our office, just is a formula for disaster. 

I have been ruminating on this all week, getting anxious and tense, about something that hasn’t even happened yet. 

I don’t like to share too much personal shit with my boss, however, I eventually relented and replied to the email and merely asked if I would be able to sit in on the training at my desk, and that I’ve been diagnosed with c-ptsd and being in an enclosed space with others is going to be a challenge for me. My boss replied, “Absolutely.” 

She further suggested I reach out to HR regarding special accommodations, and that will be my next step once I have set up an appointment with a psychiatrist.

Day 69

Just filled with despair. Again. Hip is fine but the c-ptsd is kicking my ass as always. 

The process starts all over again, to find the “pink unicorn,” in this case a psychiatrist and a therapist who are taking new patients, accept my insurance, and either are local to me or offer zoom sessions. 

The never ending calling, then waiting for return calls which go no where. The constant seeking out new names. Wasting more time. 

I have been over-stimmed and distressed recently as the 38 year old husband of my cousin died suddenly. I woke up this morning in tears, after having a nightmare where I watched a boat my husband was on capsize. I woke up in tears, and in the nightmare I was convinced he died. 

I wish it were ME who died. I don’t want to exist anymore.  

Day 64

Wow! 64 days since my surgery, and it has been a while since my last update. 

I’m still working from home & doing two  PT appointments per week. I am managing 2000-3000 foot steps each day. 

“Neuro-muscular re-education” is the goal. As many foot steps as I am doing, I am still unable to lift and cross my leg to put my socks on. 

Had my follow up with the neuropsychologist regarding my psych eval. Finally got a diagnosis. Unsurprisingly, it is C-PTSD (complex ptsd). PTSD is often only a singular event (like 9/11 for example), whereas complex ptsd is a steady diet of trauma.  

Apparently my cognitive abilities & language aptitude was classified as superior.

Surprisingly, I wasn’t diagnosed as autistic. Apparently the uncertainty & worry I have regarding “how long is too long to have a conversation,” and my belief that most people just are too polite to stop me, actually is not autism, but self awareness. And given how self-aware I am, that also ruled out narcissistic personality disorders. 

My problem is I have a great capacity for language. I don’t engage in small talk—which actually bores me. Too many people operate on the surface, whereas I operate from a place of depth. I overwhelm people. 

So next step for me will be a consult with a psychiatrist to explore medication options, and line up a therapist who specializes in trauma based therapy. 

Day 48

Today’s achievement unlocked: I put my pants on by myself. Maharajah didn’t help & I didn’t use an assistive device. It took some finessing, but I was able to do it. 

Today during PT, I mentioned my goal to put my socks on, and also for help stretching my quadriceps especially in the leg impacted by the surgery, so we focused on that today. She put me on the leg press & increased the weights without telling me (I knew immediately). Then 5 minutes on the exercise bike, which sadly only burned 20 calories!

Fridge was feeling a bit light today so I stopped for groceries & walked a bit more to find everything on the list in my head. By the time I got home I already accumulated 2336 footsteps. 

Day 44

Still waiting for the call from the neuropsychology group for a follow up appointment. 

Everything is otherwise good, except I started sobbing today. I miss both of my parents. And as fucked up as it truly is, I miss the idea of having family. 

Day 43

To expand on what I shared with the neuropsychologist during that four hour psych eval: 

Between 50+ years of emotionally destructive narcissistic abuse on top of a foundation of adverse childhood experiences, feeling unsafe, feeling like a failure, a burden or a problem, being hyper sensitive because of all that, coupled up with pain, anxiety & a baseline of dysthymia, the pandemic & unaddressed or processed grief over my mom dying, this all is negatively impacting my perception & performance at my job where I feel like a failure, a burden and a problem. 

My mom might have set this dynamic in motion; however, she is physically gone now, and I am the common denominator now in my problems, and I need professional help to try and untangle this mess because it impacts everything, and is holding me back, as well as it is impacting my ability to experience & cultivate joy. 

Day 42: The Six Week Mark

Still going to PT 2x a week, banging out close to 2,000 footsteps daily. By 1 pm today I achieved 1,771 footsteps—the day is still young. 

After PT, I went to Wegmans (which no doubt added to my step count), and then to the post office to drop off a letter. Then back home.

Today I am off medical leave and technically working. Basically today will be email inbox housekeeping, setting up new agency laptop & packaging the old one to be sent back to IT. Hard to believe it is nearly 900 days since the shut down in 2020. In some respects ties sure flies, but for me, for the most part, time has stood still. I struggle remembering what day of the week it is, and an always ama ed it is now 2022. 

I am still waiting on the results of my psych eval; however, I am reminded that at the end of 2018 I had a meltdown at work due to a debacle someone else created—and I was the one who was lectured on my attitude, which then had whatever hope I had just plummet—hope that my (then new) boss would usher in a breath of fresh air in my office, and instead, left me with the oh so familiar message that I am a problem. The same message that was conveyed to me by my mom for five decades of my life. 

At the end of 2018 when faced with this mess, it not only fill me with despair, but had me re-evaluate everything and I came to the conclusion to discontinue talk therapy sessions with my therapist after nine years of just stagnating.

My annual eval was the week before I went out on medical leave, and suddenly after 20 years of being in my job, suddenly there is some respect or regard given to my capacity for institutional knowledge—and after 20 years of basically having my arms tied behind my back, suddenly my input is wanted—YET! at the end of 2018, I learned first hand no one wants my input because it doesn’t align with what they want to expect to hear. 

So, I can’t help but see my seeking out a psych evaluation as just an extension of the 2018 bullshit messaging, that I’m a problem. 

My mom is no doubt to blame for this as well as my problem with most older women and women in positions of authority over me. But right now? I am the common denominator. 

I was hoping to use these past six weeks to start devising a plan of escape from this job. I started (and stopped!) reading What Color Is My Parachute. I lack the focus to sit and read and do the exercises in the book Maharajah found so useful last year during his career crisis. 

Periodically, the agency I work for runs retirement workshops at certain times during the year. I got an email this week about the next workshops & I let HR know I was interested. So that is a step in the right direction, I hope. By the time I am literally back in the office, it will be 11 more months until I am able to (I hope) retire from this job. 

Waiting for the results of the psych eval is like waiting for a baby to be born. So much anticipation and uncertainty, but I hope my life will be positively changed as a result.

Day 34

After a lifetime of feeling like I were a problem, and at a minimum the last four years (out of a total of 20 at my job) feeling like a problem at my job, I sought out, planned for, and finally had my four hour psych evaluation. 

In some ways the feedback I got during the process was very validating, especially in regards to my unaddressed grief over mom’s death & the precarious COVID hellscape we are all trying to navigate. 

Afterwards, I sat in my car and completed a 375 question survey as all part of the process. So now I wait for them to call & arrange my follow up visit where we go over the results.

The eval delved into all manner of things. Visual memory stuff, remembering weird geometric shapes, putting blocks in order to duplicate images, remembering long lists of words, having me pronounce a long list of words, and pressing me for not just definitions of words (two of which pavid and another words I cannot remember right now but I didn’t know the definition of them), but also couplets of words & have me say what they had in common—some, such as time and progress, for me were difficult to discern. 

She really appreciated how thoroughly I answered the intake form, and I even provided a power point presentation I created to hopefully cut through a lot of time. 

Day 32

I saw surgeon on Friday. He gave me the green light to shower today. 

I’m doing a little better each day. Today was the first day since 7/14 I was able to take a complete shower (without wrapping my ass in saran wrap) rather than bird baths & sink shampoos. 

I showered up before heading out for my first out patient PT session, run two errands, then visit my chiropractor. And yes, I showed him the shark bite. 

Tomorrow is a do nothing day, so I’ll rest up. Then Thursday is my psych eval, I can’t wait.