Panic attack

I didn't get enough sleep last night.  I guessed wrong about how much valium I needed and the puppy woke me up early and I wasn't in my own bed (I was at my mom's) and it added up to a bad time.

This evening I was thinking about some of what has happened in the last year and about how glad I will be when all of this is over.  It's not just my brother's arrest, it has been the scary diagnosis and surgery for my niece and even though she is thriving now there is always the potential that the tumor will come back and if it does it is likely to be malignant.  There has just been a lot of truly huge, potentially life changing stress in the last year.  Then there is this upcoming ankle surgery and now is not the best time for it but I can't walk without hurting myself so I have to do it.  And I'm worried about money and vacation (I can't afford it) and on and on and so I was in the shower and suddenly was so panicked I couldn't breathe.  I took half of a valium and it is not helping me settle, even though I had my bedtime klonopin not long ago too.

This is the really bad kind of panic attack where it is hard to not just go and run up and down the road or something, anything to move but I know that I need to be still and focus on breathing and slowing down.  But that is so hard physically because my body thinks it needs to get away from my own mind.

I hate these.  They don't happen very often but when they do they are awful.  Usually I do a lot of crying and this time that hasn't happened although it would probably help.

Maybe hot tea.  Maybe some more klonopin.  I'll wind up knocking myself out through tomorrow.  But I have to make this stop.......

Hate this part of this disease.....

Surgery

I'm scared.  It's still a month away and I am more scared than I was a day before my hysterectomy.  The simple reason is that I need information and I'm not getting it.  Also nothing is working out with scheduling.

I had asked to not have pre-op on June 4 as I have a dental appointment scheduled.  I was originally going to have the hole in my tooth fixed (laptop smacked me in the mouth as I caught it falling down the stairs) then but it hurts so much it is getting fixed Tuesday.  So I can re-arrange my cleaning again, I guess.  But anyway, they scheduled pre-op for the week before that so that it is when I'm on vacation.  I found this out on the online site and so I called and left a message asking to change that.  5 minutes later I called and asked them to change my first post-op appointments because I was supposed to be in the cast room at 8:30 AM, 5 days post-op.  Given the pain level at that point, the 2.5 hour drive to get there and my slowness is getting anywhere I was concerned we'd have to leave at 5:30 to ensure lots of time to let me out to get a wheelchair and then wait for my mom to park a long way off and then come back to get me.  So I called again and left a message asking if a later time was possible and if not we'd make it work.

But the thing is that I have no idea what the timeline is.  There isn't a lot on the internet about the 3 procedures I'm having but the standard generally is 2 weeks in a surgical splint, 4-6 (sometimes 8) weeks in a fiberglass cast, transition to cam walker and then about 6 weeks in that and then gradually re-learning to walk in a shoe.  The nurse (who changes her story often) told me the first day that I wouldn't be weight-bearing for about 6 weeks.  I assumed that would me the typical process.  But instead I'm going 5 days post-op to get a cast.  I don't know if they'll take the sutures out then; it seems pretty early.  Someone responded on a message board that she was casted on day 5 and then that was removed at 2.5 weeks and stitches were removed and she talked her doctor into a cam walker instead of the cast he usually used.  I'm the oppposite; I hated the boot when I wore it before I until I'm allowed to do ROM I want a cast.  Her surgery wasn't the same as mine and mine requires no movement to allow excess scarring to form so that it can later be broken down. I assume that this means I'll either stay casted from day 5 or be re-casted after sutures are removed at a later date.  I just don't know.

The nurse who is the contact person tends to tell me one thing and then change drastically a day later.  She also doesn't easily give out information.  The surgeon gave less information about what he was doing than my cat could give.  If I weren't a therapist I couldn't have followed what he said before having me sign consent.  So instead of going into this with a good understanding of exactly what is happening I know nothing. 

I have told the nurse in an email that I need information to help me feel in control and less anxious.  I sent her another email asking for the breakdown of the casting process.  I hope she answers it tomorrow and is clear and accurate instead of her usual answer that changes the next day.  I more or less know what the surgeon will do.  It's the afterward part that worries me.

The surgeon and his nurse also have the attitude that my MAOI is only anesthesia's problem.  It isn't.  They rely on nerve blocks.  Anesthesia has to decide if I can have one.  The ortho has to decide what pain med to send me home on.  There are a number I can't take and the rest the Emsam increases their effectiveness so they need to be sure I can tolerate it before they release me.  Anesthesia has to decide if they require admission; Dr. Brain doesn't know and I can't remember but think they do.  However I mostly remember the last surgery when I just wasn't going to be released until my pain was controlled because it was so bad the prior time when they refused to treat it since I couldn't take ibuproferon when the vicodin wore off.  Giving steroids would be bad since my body hates them.  There's all this stuff the ortho needs to know and which Dr Brain has now sent him.  Whether he pays attention is another story.

I truly am not that impressed by him.  I think he knows the ankle stuff and will do the surgery fine.  But as far as making his patients comfortable with what is happening he sucks.  And his nurse sucks.  I need to try hard to not answer the phone in my sleep if she calls in the morning.  I want her to answer in writing and I've expressed that; writing is easier for me than talking.

I just want to know what to expect.  I know already that this is fairly painful surgery.  Part of my dread of the day 5 visit is the 5 hours in the car unable to elevate the ankle well while sitting awkwardly.  I can handle the pain if I never have to feel things tearing in my ankle. The day 5 casting is going to hurt terribly. The cast puts your ankle in a pretty precise position and my ankle is not going to want to go to that position.  I'm not worried about pain though; as long as they figure out the pain meds before sending me home I'll be ok.  I just want to know what is happening, more than the total information the dr gave me which was "scope of ankle, modified Brostrom, peroneal tendon repair, about 4 inch incision plus scope holes, please sign here".  Glad I knew what he meant.....

I am really hoping his resident is the one who does the surgery.  I felt much more confident with him. 

I just want to have this done.  Or to be told what is happening.  That seems so minor and it has been so hard.....

Big decision

 I am going to see my brother.  It will probably be next week or in a few weeks after vacation.  I'm not sure where and how it will work out but I decided I needed to do it.  The reason seems so simple but it has been a very hard decision.

Last week Dr. Mind told me "he's still your brother".  I came home and did a lot of crying and a lot of writing about who my brother is and how this person is not my brother.  But it did make me realize that he is still a person, just one who made terrible mistakes and I need to see him as a person.  And then I realized that it is entirely possible that he'll be in prison by the time I can get around well.  I don't know if I can go to prison to visit or not and I don't want to leave myself wondering about what he is like and what I should think or feel about him (or even if he is really a person; in my mind he had become a monster, and as Dr. Mind told me, monsters are green with scary eyes).  I do not want to be left with regrets through his entire prison term or questions about how I should see him.  He did awful things if what is alleged is real.  But one of the things I've noticed myself struggling with is that like it or not he IS part of my past.  Soon after he was arrested I took down 2 pictures of him that my mom had hanging on the wall outside the room I was staying in at her house because it was too upsetting to leave them there.  But even then I had trouble.  I kept wanting to go through all of the thousands of photos I've taken on family occasions and isolate the ones of him to a "Steven" file.  But that didn't work because that did not change that he was there on those occasions and the "Steve" file would still exist. 

So my mom is to work out a time to see him, somewhere neutral.  The rules are that he is not to touch me and is not to call me by the nickname he has used as long as I can remember.  And Dr. Brain was very careful to insist that wherever we meet that I have an out if I need one.  If I walk into the room and can't do it that's the way it is.  If I manage a few minutes and that's it, that's the way it is.  The goal is not to traumatize myself but to do what I need to do.

It feels weird.  But it would feel a lot weirder if he is plea bargained while I'm not able to get around this summer and my last interaction with him in person would be yelling at each other. 

And I truly need to see that he is human.  It has been so much easier to see all child offenders as monsters because my grandfather was one.  And that makes it hard to believe that my brother isn't just like my grandfather.  My grandfather though was a sadist.  I don't know if my brother has that kind of trait but I don't have anything that says he does.  And that's important.

I never thought that this would be something I could grow accustomed to.  But I have and while whenever the next step comes new things will come up right now I know pretty much where things stand and that this is how it will be until the indictment.  The lawyer says 3-9 months for that usually and it has only bee one month and 5 days.  It seems impossible that it has been such a short time but it has.  So it is probably still a while off.

So, big step is coming sometime.  I'm really kind of busy right now which makes this harder but when I get back from vacation I'll have 2 weeks before surgery. 

I've got to get to bed.  My nieces are here visiting and I want to enjoy every second I can with them before I will be unable to play very easily.

Not yet

I thought I was starting to get used to the situation with my brother.  It will be a month tomorrow morning that the middle of the night phone call came.  Since not a lot has happened in that time while we wait for the grand jury to indict I really thought I was getting used to it, while knowing that it would get very hard again when he was indicted and then again when the trial comes.  I dread the trial.  I suspect that my own secrets will be brought forth (not by me, from the psychologist) and I hate that thought. 

Then the last few nights have been tough. And today I had a minor meltdown.  It is just so hard to feel so torn.  I feel like I am a barrier to my mom helping him in the way she wants to.  And that is not a good feeling.  Yet I also know that the support she gives him is probably not good either.  It is so confusing and I cried long and hard this afternoon.

I'm finding this surgery stressful to prepare for.  My surgeon was not very detailed in what is going to happen.  His nurse, who I am supposed to use for questions and the like is not very helpful.  Thus far she told me on the day we spoke to schedule and go through pre-op requirements that since I forgot to have him look at a nodule on my Achilles that I needed to make an appointment to do so because I'd need to sign another consent document to have that surgically repaired.  Fine, I did that and she called at 7:30 that morning wanting to know why I was on the schedule.  I told her it was because she'd said I needed to and she said she'd take care of it and call me that evening.  Two days later I called her and she hadn't talked to the surgeon but decided it wasn't necessary and I could bring it up in the OR.  She explained that this is scar tissue from tearing my Achilles (I can't believe I was weightbearing on this ankle a week after I hurt it 4.5 years ago given the damage).  Which is good to know, but I don't think I can sign a consent in the actual OR.  I am worrying excessively about this because I don't want another surgery and this lump can be the most painful part of the injury when nothing is acute.  So I used a new feature in the patient chart feature and sent a note to the Dr.  I seriously doubt it really goes to the dr, I think it will probably go to that same nurse, but I just said I was not trying to be argumentative but I didn't want to not be able to have something done if it could be and that I was happy to come up to see the surgeon to sign consent if needed but that I wanted to be sure this wasn't missed, leaving me to face more surgery in a year.  Not telling him was a mistake but I did tell the resident who forgot also so it wasn't just my error and when the dr only spends 5 minutes with you it's hard to remember everything.  He is nice but his bedside manner leaves a bit to be desired.  He has explained almost nothing about the procedure or post op and I won't see him or anyone from the office again until surgery unless they decide to have me sign a consent to shut me u.

  He is going to be about a cm away from the nodule anyway, so he might as well keep cutting and get it out if that is possible.

I think the nurse has classified me as annoying anyway.  She didn't know what at MAOI was and keeps forgetting about it and what it is and she doesn't really care  and thinks they don't need to know because it is an anesthesia problem while it is really a anyone-who-treats-me-problem.  It's frustrating.  But if they don't want people asking questions they should give more information and if they don't like non-traditional medical situations they should quit medicine.  Plus, call back when you say you will, consult with the dr when you say you will or I quit trusting you.  This will improve with Dr. Brain gets involved but right now I'm stressed that they will not pay attention and give me something I can't have or do something dumb like not removing the nodule and then going back in next year to get it ou

Anyway, I took a full dose of valium last night that really knocked me out and then I got really upset and took klonopin a while ago.  I'm feeling kind of sleepy so I think I'll head for bed early.  Maybe it will help me to relax a bit.''

I will end with this thought:  Crime hurts your life, your family and your friends far beyond what you think it will.  Don't do it.

Oh so anxious

Anxiety is beating me up today. There are any number of reasons. The ortho nurse was supposed to call me back yesterday about whether a scar tissue nodule in my heel can be removed. She told me last week I had to see the surgeon about this and I was going yesterday but she woke me at 7:30 wanting to know why I was coming. When I told her she said I did not need to come in and she would call me at the end of the day after she talked to the dr. She still has not called. So I wirry that I am having this huge surgery and may still have pain or need another procedure.

Then I spent time this morning working on my hospital bill, a monthly, useless occurrence that stresses me out terribly.

I saw Dr. Mind for an easier visit but what I am worrying most about right now with my brother is not something he knew the answer to. That is hard because I don't know who to ask.

My mom and I packed up most if the rest if what was at her house. I have a lot of organizing to do tomorrow.

And then our internet went out. This is from my phone. I have stuff to read but wanted to work on some stuff tonight.

So nit my easiest day. There is so much going on. And that won't change for a ling time. At least surgery has a date to dread and then it starts to improve. 6 weeks frim tomorrow.

Anyway time to work on settling in for the night.
Sent from my Samsung Mobile

Maybe a little angry

There is some stuff going on outside my own life (but potentially deeply affecting me) that has added to the stress I already am feeling about my brother and moving and my surgery in 6 weeks (and vacation in just a few weeks; it is going to be kind of difficult without my brother).  Yesterday I snapped just a bit.....

I had gone to Kohl's to return some things and pick up replacements in colors/sizes that made sense and had a very bad time finding anything that I wanted.  I just wanted plain t-shirts but they had only 2 colors in my size, one of which was white (I'm too clumsy) and one of which I already owned but bought anyway.  Then I had to limp up to the front to the kiosk so I could order more, then limp back to look for a few other things, none of which I found.  So I wasn't in the best mood when I went to check out.  While I was waiting a new register was opened and the woman said "next in line, please".  While I gathered up my stuff and limped over an older woman jumped ahead of me.  I ran totally out of patience for the day and told her she was NOT next in line.  She came back with some line about "just being efficient".  The words popped out of my mouth and I said "well, I'm sorry about limping.  It slows me down." and then turned my back.  I know it was rude and unnecessary and ridiculous and not even like me to do that but I just had hit way too much stress.  I have a feeling those moments will come from time to time now....

Today though was good.  I was wakened by a call from my orthopedist's nurse. When I talked to her last week I had told her that I had a nodule on my achilles that I showed the resident but not the dr and that I wanted it to come off if possible because it really hurts.  She told me I had to make another appointment so I did, for today.  When she called today and I explained this she told me that I didn't have to drive so far for just that, that the dr had examined the ankle and she'd talk to him and call me after clinic hours were over.  (She's come across as a little flaky several times now, this being one of the bigger examples, while very nice).  So I'm waiting for that call and praying that this isn't translated into something that makes the surgeon not want to do anything because the stupid thing hurts more than anything else unless I've acutely injured something else (which is most of the time now).  I don't even know if surgery is possible but if it is I want this thing off and I do not want to go back to surgery in a year to do it.  I am praying that my not being there to present the facts that way doesn't mean that I don't get this thing taken care of.  Originally she said I'd have to come today to sign a surgical consent.  So either she decided I won't be having that operated on or she decided I can sign consent another time.  I guess I'll find out in a few hours.  It's making me anxious and I don't want to take any medication and fall asleep before she calls.  I am so cold that I could easily drift off.  It's very cold and rainy and damp here today and nothing I do gets me warm. 

Anyway, don't cross me this week and I'll share the results of my conversation with her later.

Moved

I am moved in to my apartment.  This is my 2nd night here.  My cats are thrilled and have already learned to use the cat door (although we taped the door part up so they really are using the hole in the door right now.  I feel like every time i get something unpacked and put away 25 new objects appear.  I cannot possibly own very much more stuff.  But I'm pleased.  It is beautiful, quiet, my own, and I woke this morning to very loud birdsong because my house is in a little thicket and there are apparently lots of birds nesting here.  I am so glad to have reached this point finally.  And Ikea is the best.  My whole home is full of Ikea and it is working wonderfully.  We need to make one more trip for another set of shelving but that's it.

I'll be all settled by my surgery. June 13 (which is Friday the 13th.  Doesn't bother me but I know it might bother some people).  I actually may be having a 4th procedure.  When I was there last time I told the resident about a nodule on my Achilles tendon that is often the most painful part (unless I have an acute sprain).  I did not, however, tell the actual dr and apparently the resident didn't either.  So I have to go back this week so that he can look and if it is surgically correctable add that in to the procedures.  I don't know that it can be done together.  I do know that it is another sign of how badly my ankle was hurt in 2009.  Dr. Body was concerned because I had bruising under the Achilles.  From what I've read this nodule is scarring from that beng torn a bit.  But removing it is very different than my other procedures so it may be something I have to live with or have more surgery on later.  I'm trying to get as much fun as I can before surgery as it is going to be a rather boring summer.  I will probably be in the hospital overnight because of the MAOI.  They put in a nerve block that prevents much pain for 24-36 hours.  I'm going to ask if they can do a 2nd block before discharge so that the trip home is less painful if the original is wearing off.  I have no idea if they can but there's no reason to not ask.  I'll be on very strong meds (oxycontin I'm reading online) for 2 weeks during which time I am to be on my back with my foot elevated high.  Then I'll get a cast for 4-6 weeks and no weight-bearing for all that time.  I'll get a cam walker and start putting weight down when the cast comes off and I'll start PT then.  The nurse told me by 6 months I'll be starting to walk normally and by a year I'll be 100% healed.  This seems unbelievably long but it is for a good reason and if at 4 months I'm not spraining my ankle ever 3 days I will feel that it's a victory.

No other big news.  I'm waiting as patiently as I can to see Dr. Mind Monday when I think he'll know more about the job thing.  My brother is holding steady.  My mom is now not telling me much about him because I won't fully support him.  I'm not sure she realizes she adds to the division when she starts not telling us things because we don't fully agree with her.  I can't do more than I can do and neither can my sister.

One of the things that seems bigger than it probably really is is that Dr. Mind and my brother have the same first name.  So I may be losing both the "Steves" in my life for vastly different reasons and yet losing either is a huge grieving process to go through.

Anyway, I am getting sleepy and still need to finish something before I fall asleep.

Summer plans

Tomorrow I will be booking my entire summer.  I saw the orthopedist yesterday and he gave me the choice of bracing my ankle in a custom brace long term (which as a therapist I could never do; it would just get weaker and weaker and less and less functional) or do surgery.  It is quite extensive surgery and will take all summer to be back to just walking wearing 2 shoes and without crutches.

I overheard the dr and resident discussing something that sounded like they think I ruptured the most frequently injured ligament in one of my recent falls.  There also is a set of tendons on the outside of your leg that they must feel are no longer in the track they should be in because the surgery will tack those down.  In total I'll have 3 surgeries in one:  arthroscopy to be sure there aren't bone fragments or ligaments torn that we don't know about now (there is concern I tore another one on the inside with my fall down the stairs), they will shorten the overly stretched ligaments, remove scar tissue and tack that down with part of a tendon (?) and then tack down those tendons. 

I'll know more specifics tomorrow but I will be non-weightbearing for 6 weeks.  Most surgeons do 2 weeks in a half-cast splint until sutures are out then 4-6 weeks in a cast, then a cam walker with really gradual increases in weightbearing.  I won't even start therapy until I'm out of a cast.  I'm hoping to do this the 2nd week of June which means that I'll be getting out of the cast around Anne's birthday, off crutches around Geraldine's birthday and walking a little in 2 shoes by
early September.  I'll know an actual date tomorrow and I think more about the surgery.  At this point I know major surgery, about a 3 inch incision plus 2 1-inch incisions, long recovery, I need a walker and crutches, I have a script for a year long handicap parking pass and I'll spend a huge amount of time sitting on the couch or bed with my foot elevated in the first month of recovery.

I'll be glad to be done with this.  However, it may not happen on this schedule at all because Dr. Mind is looking at an unexpected potential job offer and if he leaves I'll delay surgery.  I can deal with 2 of these huge things at once.  I can't handle new therapist, brother in trouble, summer of sitting around all at once.  I honestly can't imagine going through my brother's trial and sequelae without Dr. Mind but I can't go there right now.  The job doesn't sound like what he wanted.  It is not a sure thing.  At least one thing he did not want. I know he has turned down things that haven't been what he wanted. But at the same time this is his chance to follow a dream.  I selfishly want him to stay but I also know that if he goes it is the right thing for him.  I absolutely cannot imagine life without him but if he has to do this then I want to find a way to be happy for him. 

My feelings with him are so complicated.  He has been a big part of my life for so long and we have a comfortable relationship.  I feel completely safe with him which is really rare for me.  He knows enough that he can pick up on my concerns without my having to word them sometimes and at times like now that is a very good thing.  He is someone that I can  feel sure is on my side and really cares about me.  Those things matter.  So much.

I know if he is leaving he'll help me as much as he can.  That's the only reason I know about it at all; he knows time to adjust to ideas really matters for me and I know that my knowing has made this harder on him.  He has told me that he's never treated anyone as long as he has treated me and so he doesn't really know how you stop a relationship that has lasted so long. 

Nonetheless it is really hard to know that I'm waiting on yet another thing.  Moving is getting really close; maybe tomorrow.  I think tomorrow will work; we have things relatively under control and so I think we can move without it taking hours of heavy work prior to moving the cats and helping them adjust.  They'll be thrilled to leave this tiny space but it will be a big change for them.  They have to learn to use a cat door for one thing.

The big thing today is that there are no more unpacked boxes except photos that go straight into a drawer that isn't in place yet.  There are things all over to be put away but the stack of boxes is gone.  Thank God!  I am so tired of seeing cardboard.  It is looking really nice over there.

So I need to get some rest.  This week has involved so much driving and I'm completely worn out physically and emotionally.

More to come.

Redacted

I went through recent posts and deleted specific references to what Steve has been accused of.  I would really hate for my blog to somehow hurt him.  I think it probably is possible to follow through this and figure it out and I think most readers have read it, but I also think to some extent at least it doesn't matter what he is accused of.  (Remember right now he isn't even charged with anything.  He is as free and you and me).

 So if you happen to look back and see changes that is why. I'll figure out how to handle it as we go through this.

Copyright 2006 www.masterofirony.blogspot.com

Not Me

I have a few good things going on.  I will be moving into my apartment Thursday.  It's not all done but it is close enough.  I fell down stairs last week holding my laptop and smacked myself in the mouth.  It broke a tooth by hitting it exactly at the right angle to hit a weaker spot.  But it only needs a filling, not a root canal.  Dr. Mind released me from medication supervision because we agreed that I am handling so much medication right now that there just isn't any point.  It's been 2 1/2 years since I just got the vials out and filled the pill box. 

I sent a card to my brother last week.  This week I was thinking about sending him some information about a way to earn some money online, until I realized it could be a temptation for alcohol.  It's part of the rapid changes that I'm going through with being furious with him and not wanting anything to change.  Sometimes I get it in my head that if I pretend nothing has changed that maybe this will be a nightmare.  Dr. Mind asked why I am wanting to reach out when I've clearly said numerous times that isn't what I want.  I have a whole thing about knowing that just because you disconnect from family doesn't mean you don't hurt.  But the truth is that I  don't want to be part of his punishment.

I never thought about that before, that when someone commits a crime and especially if they go to jail (which may or may not happen; innocent until proven guilty) part of the societal punishment is that they are separated from the people they care about.  I guess that sounds simple enough, but I didn't think of how much it would change a family.  And as I bounce between different emotions about my brother I either am glad that this is the way it is or I am hurt that the legal system hurts me even though I didn't do anything wrong or I am afraid that if I don't try to stay connected that I will lose all connection forever and I don't know if that is what I want.  Mostly though I don't want to be a pawn in the process of punishment.  I want to decide for myself what relationship there is and if he is incarcerated a lot of that is otu of my control.  Not just because of my fear of visiting jail, but because I'm only allowed for so many minutes on 2 days per week, I can only bring white socks or white underwear, etc.And letting them decide this is what the relationship amounts to means that I AM a pawn and I'm not ready for that.

I don't know what to do with this.  It's another place that I feel shattered and have no idea how I will feel tomorrow.  But I need at some point to figure this out and it is so hard.

I wish I'd never had a chance to find out how hard this is.  When it happened before and my uncle was arrested I was only 9 or 10 and I didn't understand.  This time I understand a lot more, especially because I know what happened with my favorite uncle; he lost all of his family and ties to home because it wasn't safe. 

So hard.