That's what it is

I've been playing "name that feeling" for a while now about my unexpected positive feelings about my sister having my niece.  I finally just figured it out:  I feel this: "Thank God she has a chance to do this the right way".  Her right way may not be my right way in many regards.  But she will not ever abuse Miss Anne and that's huge.

Another strange thing?  I am terrified of men with beards in general.  It's an abuse thing.  Once Dr. Mind grew one briefly and I had a really hard time being with him.  In fact after Christmas he came in deathly ill to make sure I was ok and he hadn't shaved or anything else that day except try to stay alive.  He was so sick he came in just for me, cut that time short, and then didn't work for a week.  Even his one day not-shaven face was scary.  But my brother-in-law has grown a beard and while I'm not going to hug him, I am not afraid of him.  Apparently I have a lot of respect for my sister and her husband that I didn't see behind the jealousy.

Huh.

I don't know what this means and then a total change to Medusa meds.

So when you work as a traveler, as I have done for the last year, you have the right to convert to a permanent position with the contracted company if you complete 2 consecutive contracts (each contract is 13 weeks).  According to the handbook you are to tell them as soon as you have an offer to stay.

This week started my 2nd contract and I'm staying.  The last time I made noises about permanent placement my company talked me out of it, mainly with promises for things in the contract that only lasted one contract with my being under the clear impression it was for my time with the company.  That time though I wasn't 100% vested in staying.  This time I am.  I know this is the right place for me.  So, I sent an email about that and something else. Well, the response has been.......nothing.  So I emailed again this morning, because I kind of need a response about another question in the email and still.....nothing.

I cannot think that they did not expect this.  They've known how much I love where I am and how much my supervisors like me.  They also know that I've done what is unusual as a contracted person and that I've pretty much developed my program.  So I thought this would be no big surprise, just taken in stride.  After all I've been with them a year, will have been with them 15 months when I leave and considering that travelers have no paid vacation (I did negotiate a bit once), no sick days, no paid holidays, horrid health insurance ($3000 deductible.  I'll be paying medical bills from this last year for a very long time to come), constant fighting for mental health coverage (we're expecting to be denied here soon because I've improved, although am certainly not as well as I was in January before the PTSD and panic attacks got so bad).

So I'm stressed.  And stress makes me want to sleep a lot.  Which is too bad since I have 8 AM meetings tomorrow, Monday and Tuesday.  Tomorrow's meeting I found out about at 6 pm.  I have been so sleepy that even when I get up at 4 it takes a long time to get moving and so I really wish I'd known to stay down there.  Oh well.  Life goes on.  I just need to get to sleep fairly soon.

I learned something the hard way.  I've been so tired and really not anxious as much lately.  I'm not taken Klonopin during the day about 50% of the time where a month ago I was taking it twice during the day.  I also have not felt I needed it at night as i was so very tired I didn't want to increase my sedation.  So I stopped it and then wasn't sleeping very well.  I restarted it and am finding I sleep better and wake easier with it.  Good to know.

Saturday I pick up a prescription for a new med for constipation.  That will bring my meds to the following:

Psych meds:  Seroquel 2 tablets, lithium 1 tablet (may be 2 after Dr. Brain visit Saturday), Nuvigil 1 tablet, Klonopin 2- (probably still usually 3) tablets daily.  Also up to 4 PRN vistaril capsules that I don't need recently and 1 patch daily.

Meds to treat side effects:  2 doses of Miralax daily; 2 pills of this new med Amitza? something like that; 1 Nexium; Vit. D 2 pills to replace natural Vit. D because I can't be in the sun much and was severely deficient a year ago.

Meds to treat damaged systems thanks to psych meds:  amelioride 2 tablets for diabetes insipidus thanks to lithium; synthroid 1 tablet for the thyroid that lithium destroyed when I was toxic; 1 Vitamin B to prevent the recurrent sores on my mouth from too many years of vomiting affecting my nutrition.

Totals:  Psych meds (maximum excluding vistaril since I've not had any for 3 weeks):  7 pills and 1 patch
            Meds I take thanks to years of psych meds:  11 doses (2 are a powder I dissolve and drink)

This seems backwards....Not that I miss taking 32 pills/day most of them psych related (that was my high
and I did that for a long time) but still, the side effects are so varied and in several cases treatment isn't optional, so that turns into a lot of meds.  It's like every med you take begats another 3 meds.  Like a Medusa head......

Ouchy-and the world's most irritating phrase

Switching to home health combined with the ankle and foot pain I went through for so long/ recent stress/depression/carbohydrate pigging out has led to weight gain between being less active.  I refuse to gain weight.  It also is contributing my crazy constipation issues, which I'm about to start a new med for on top of my double dose of Miralax.  At least there is something new that will be better than huge doses of 2 stool softeners plus tons of Miralax.  So my Wii Fit has now become more than a balance activity.  This morning I did 20 minutes of aerobic exercise.  Frankly it nearly killed me.  I am sore in muscles I did not remember having.  This is a very good thing, and I love that I can do one thing for 5 minutes, another for 10 if I want, and keep changing as I get bored.  Plus it always includes at least one thing for my ankle, more if I add them.  My goal is to work up to 30 minutes at least 5 days a week, even if they are divided times.

I'm not exactly hurting, just aware of where a lot of muscles hang out.  But in the last year I have experienced quite a bit of actual pain.  My foot is hurting tonight, for example, and my ankle lets me know about it if it rains or I step funny.  That's just part of life for me.  Or last night, I had a migraine for a while.

So this patient who I really do enjoy seeing and find interesting has landed on something that makes my teeth grind, preventative device or not.  Pain is a vital sign and therefore must always be assessed.  Instead of saying no, this patient asserts that God won't allow this person to have pain.    Which just makes me grind my poor broken teeth every time I hear it.  It feels like being told that because I experience physical/psychological pain that God loves me less.

I'd forgotten this aspect of home care-you're in their home so they feel more open about pushing their beliefs at you.  I left one home last week with a paper about how to become a Christian and a lecture about not going to church.  Because someone who met me 45 minutes ago knows how to judge?  It's ridiculous.  I just smile and ignore it, glad they have faith to gain strength by, but why must they judge me?

Anyway, I think I'm getting sleepy so I should stop typing.

We'll see what is interesting tomorrow.

Telemarketers: Where the bipolar rage remains

Not so long ago I started talking about something making me angry with Dr. Mind.  He told me that he had never heard me say that before, that I have refused that word for years.  Further reflection revealed that I am terrified of anger because for so long it came out as rage.  Further discussion with my main victim and internal review revealed that I am actually not nearly so volatile and that I can probably handle anger now.

Well, I just found the one group of people I cannot abide.  I realized I yell at one group too frequently.  I'm trying to get to sleep early since I had a migraine earlier and am a bit drained from that.  Well, 30 minutes ago I got a call I could tell from caller-id was a sales call.  I ignored it.  5 minutes later another call from another state came, something about "do I have smoke detectors...?" then I interrupted.  "Take me off the list." Not 10 minutes later another call, again from a diferent state "This is not a sales call..  do you have smoke detec..." results in Jen yelling "I JUST TOLD YOU PEOPLE TO LEAVE ME ALONE" followed by "ok,ok ma'm, i'ts ok, I'll call back later.", resulting in "NO, NO, NO DO NOT CALL BACK EVER.  TAKE.ME.OFF.YOUR.LIST.OR.I.WILL.REPORT.YOU.  I AM TRYING TO SLEEP"  as she continued to argue.  I yelled.  Enough to make my cat come comfort me.  But really.....i'm on the do-not-call list.  And I have no interest in their whatever it is.  Nor do I want to talk about my home.

I swear, one more and I start reporting.  Especially it it comes when I want to sleep, which is all the time lately.

This shows why I chose my caregivers over all other, more convenient oness

Provider 1)
Last week, as you know, I talked to Dr. Body (my family doctor) about my abusive past and some of my issues identifying pain.  I felt much better after we talked and sent him an email thanking him and saying that he is the opposite of all my bad experiences.

This was his response:

You are more than welcome! It is disheartening to know that other physicians don't treat people with respect, but I try very hard. While we do have "problem" patients, you are certainly not one of them!
I'm glad that you feel comfortable, and while I might not always have an answer, I will at least listen and try.
Have a great evening!

And he does.  I used to really like one of the earlier places I saw him because the walls weren't very sturdy and if a patient was hard of hearing I could hear at least part of what was going on.  Because I've worked with the elderly for so long and know how confusing and demanding they can find some doctors I found his approach interesting, and well in tune with what can be complicated for an outsider:  Appalachian culture.  Because of poverty, tradition, etc. people here (especially those without much income) tend to eat what the land provides:  they get fresh stuff only in the summer, but while it is fresh they eat a ton of it; they get the things they can or freeze the rest of the year, and meat is either what you raise and butcher or what you hunt.  It's one of the things that makes me so grateful to have a decent income; I can buy fresh produce year round and we buy some portion of an organically free fed beef and share it every few years.  I still wish I had a way to get fresh fish, but that's dreaming; fish here is usually frozen, shipped, and thawed then presented as "fresh".  And they only get "fresh" 2-3 times per week. Anyway, I remember listening to him try to convince a diabetic patient to change his diet just a little "just have the slice of bread OR the potato, not both every day".  much more practical since those of us of the Applachian culture can be resistent to change, especially change from someone who is not local at all.  He told me another time that he had to learn that nearly everyone in this area would have elevated potassium in the summer because we eat tomatoes while the eating is good.  As a kid tomatoes every meal when in season was the norm.

But he has also tried to understand what it means to be me and what the parts of my childhood he has been told about mean.  Which takes more imagination as my childhood is so complex and the results are so mixed up in my illness that it is hard to sort that out.

Provider 2:
My dentist.  I went in because I broke a tooth.  Ultimately it will need a crown but for now we're just going to let it do it's thing and break because apparently when a camper smacked me in the face years ago the dentist who repaired it just cosmetically repaired it rather than dealing with the extensive fracturing.  Granted he probably assumed my father did it, but still.......This is not the first or 14th time that I have had a poor repair done on a tooth.  Anyway, he fixed it (no charge! which seems to be one of the things he does for severe tooth grinders who break teeth; I've had lots of no charge evening things out).  But he asked about my ankle and I told him it was anothe situation where I refused to listen to pain.  He just rolled his eyes.  Later, when I told Dr Mind about this Dr. Mind said "so he knows?" and I had to admit "he doesn't just know.  He has declared me an unreliable source and has told me that from here on out HE determines what hurts in my mouth and what doesn't, after I let an infection get way out of hand, and after I demonstrated repeatedly that I a unable to isolate pain anyway.  Dr. Mind has now declared that our goals may need to be getting me to react when things are not drastic.  No kidding.

Provider 3:
Dr. Mind.  I talked to him a bit about my fears of him leaving, as he has said this is possible in 4 years after his son graduates.  As proof that he's not going anywhere today he told me about being recruited somewhere else, then laughed and told me "actually you'd like that one; it's only 90 minutes from where you work and you'd just find a way to work that out."  Which is true, I would.  I have carefully considering the situation and I couldn't care less about being "over-dependent" on Dr. Brain/Dr. Mind or Dr. Body either.  Or really Dr. Teeth for what that is worth.

Provider 4:
Dr. Brain is trying to schedule the one weekend/month she sees pts. around when my insurance is going to lapse in November as I change jobs.  Think about that.  How many doctors?????

Decisions and Ramifications

I mentioned about 2 weeks ago that I was taking my cat to the vet, expecting to hear her thyroid wasn't working properly.  Instead I learned that her thyroid is ok but her kidneys may be failing.  They wanted me to bring her in for catheterization to determine the degree of kidney failure.  The problem with that approach is that it assumes I would treat kidney failure.

This cat is 15 years old, so not exactly a spring...kitten.  She loves food more than anything except MAYBE me, and I'm not sure about that.  I am not taking her food away from her.  When she had to be on a special diet for a few days a while back she gave up eating entirely until she got what she wanted.

I've been ok with that decision.  If I see changes like weight loss, not eating, etc. then she'll go back in.  But for now I'm fine with making her happy and feeding her more (which may kill her sooner but at least I won't have taken her favorite thing to keep her happy).  And right now she just doesn't appear sick.

Except that today she has.  She didn't pester me to feed her, and when I did she backed away.  She threw up a little earlier, which isn't that uncommon in this house.  When I did put food out she was interested, but not hungry.  She feels cool to the touch, but I think she was sleeping by the air conditioner vent.  She, initially cried when I picked her up (which she does; I assume she has arthritis) but she did purr.  She's ok but it is another clue that I am going to have to get used to the ultimate ending here:  Anna won't live forever.  I have had her in my life so long and through so many really hard years when she was one of the things that gave me strength or at the bare minimum drug me out of bed for 15 minutes a day; she also has let me hold her while crying and screaming and totally falling apart more times than I'll ever admit and she has been with me through years of my life I don't remember.  I can't imagine not having her to love.

Expectations

I was thinking a while ago about all the things I had expected to feel when my niece was born.  I thought that I was going to be so jealous as I watched all the things that I knew would never be part of my life unfold in my sister's life.  Growing up my mom and her sister had 5 daughters in a 42 month period.  I'm the oldest by 3 1/2 years.  We were also very close and had such fun together.  Spending time with our cousins was generally the best our childhood got.  It was one of the safest places, because my aunt wouldn't allow my father near her home.  So there was never danger like so much of our lives as children.  I had thought my sister and I would get to watch this with our own children someday.  And instead my sister and I had a messed up relationship and I certainly wasn't going to be bringing children into our midst.  I thought without that shared bonding there was no hope.

I thought that I could never understand the much more normal life my sister lives and that she could never understand the more challenging parts of my existence.  I thought things would automatically work out just as she wanted them to.  If she wanted a home birth and all sorts of restrictions on how she would raise her child then i was sure she'd have things just as she thought.  After all, from my perspective she bounced out of our past and landed on her feet.

I did not expect that my sister would have everything she had planned about her birth to not happen.  I did not expect that there would ever be signs that something isn't made the same way about my little niece that is there in  most babies, that my tiny, sweet, beautiful niece may have her own set of difficulties in this world.  If I did think about that I figured it would be the scary things our family already has:  frightening types of diabetes (3/4 of my mother's sons are now gone to early graves due to diabetes) and bipolar.

I may be wrong.  She may have not a single thing wrong except for a birthmark that will be so easily treatable.  Everything else that may be wrong (and I can't be more specific here right now because some of what I think is speculation based on clinical observations and I'm not qualified to diagnose, nor am I sure.  I just know I see things that worry me, and that there are things her pediatrician wants checked that may lead to other things) is speculative right now.

But even then, I have just learned that just because I got sick and she didn't and because I was more severely sexually abused than she was, that doesn't mean my sister has things easy.  Somehow I got so used fighting for everything and that not being true for her that I forgot she didn't have some magical protection from pain.  She's had to hear some scary things in the last days of her pregnancy and she's had to hear that her baby needs tested for some scary things in the next while.  If my suspicions are right she still will have to hear some frightening things.

When I am working with people who have had strokes who are feeling frustrated with life and afraid and frustrated by the "why me/why not me" conundrum that is life with an illness I very often share with them about my little brother's stroke at 8 hours old. Inevitably they are shocked, then amazed at his story of healing.  Generally they take away from that story that nothing is insurmountable and nobody is exempt from life.  Yet I had forgotten this myself.

The one thing I never dared to hope for seems to be coming true; my sister and I are at least talking like friends.  Everything I expected, once again, was wrong.

I can't stop smiling

I think I'm a bad, bad person.  I'm smiling at too much that is not funny. But it is happy.

1)  Last summer the people across the road had a graduation party with a live band.  Who kept the amps up high enough to entertain the entire town for 6.5 long hours.  I know this because I had bronchitis and had been given my only cough medication option--liquid vicodin.  The noise kept me awake and the vicodin kept me immobilized.    It was a very, very long night.  Well, tonight they set up for another "share with the neighbors who now hate you" thing. Except they got caught in a storm.  I was gleeful because I didn't WANT the same experience, but as I wrote this they started up.  However, my new windows make things so much quieter that I barely can hear and should be able to sleep.

2)  Yesterday I did an evaluation on a woman who has some dementia but not enough to keep her from being pretty sharp as long as she had written reminders of things.  She had been at the nursing home where I worked and was fired last year.  Her comment about OT?  "I don't mind you coming, but I do wish that if they thought I needed more therapy that they would have done more in the nursing home than just making me mess with that stupid putty."  I asked her about who her OTs were and they were the same 2 that I was complaining about ethrical issues with their lack of doing functional ativities a year ago.  She had all the signs of a patient of those two:  plenty of arm strength, no safety training, obviously no focus on self-care, the foundation of OT.  I haven't had very many patients who were in that particular place, so I've not heard much about their OT.  I love that the first thing I heard was a very articulate, precisely what I was saying a year go, complaint from someone who they'd consider too confused to understand they weren't giving proper treatment.

3)  A few days ago I checked my messages to find that I had a message from a company I left a few years ago pretty much begging me to rejoin their PRN (on-call) list, promising a substantial increase in pay.   Back when I worked for them they constantly griped that I was over-paid, despite evidence to the contrary.  They are considered the 2nd worst employer in northern Ohio by many people, second only to the company that fired me last year.  (Reason that company has a horrid reputation, so bad that my massive company won't staff for them?  They fire experienced therapist to replace them with inexperienced, cheap ones).  The next message was from the place that fired me a year ago, wanting PRN.  That means I didn't even wind up on their do not hire list, just their fired and therefore by the rules can't work for them/not ABOUT to work for them list.  I've smiled a lot about that message.

And comment moderation is off!

Blogger added a filter that if I understand correctly will keep the Chinese comments hidden away unless I approve them regardless of filtering.  I may be wrong on that, but I don't think so.  We'll try it anyway.

Briefly

It went well with Dr. Body yesterday. He was kind and patient and understanding and we spoke quite a bit about my history and it's landmines. I was glad I talked to him.  I also was glad that I was strong enough to do it.  I couldn't have just told someone some of that in the past.

He also said that I may have endometriosis.  Since I'm rather indifferent about pain it could easily have been something like that which caused the pain when I was sick and it could also explain my crazy recent period changes.  We'll see I guess.