stress

SOAPing up

Mental illness is hard.  Full stop.  It is hard and different for everyone.  Currently, my mental illness is harder than usual.  I have a foggy brain.   My heart pounds for no reason.  My anxiety is kicking my ass.  My depression makes me just want to stay in bed all the time.  Or maybe it’s fatigue. Or maybe it’s that I need more sleep.  Or maybe it’s my thyroid.  I’m cranky and bitchy and my tolerance for all the things is waaaaaaay down.  Maybe that’s my mental illness.  Or maybe it’s stress.  Or maybe it’s me starting menopause (even though I’m obviously much too young to consider that).

The problem with my current mental illness state is that I have too much other shit going on.  My depression and anxiety are getting pretty dramatic – is that because my medication isn’t working as well anymore?  I mean, I did go off of it to try other meds that weren’t as expensive (or, as it turns out, as effective for me) – thanks, Blue Cross/Blue Shield.  And now I’m not feeling nearly as much like myself as I was.  But, I’m also on thyroid supplementation.  Maybe my dose isn’t high enough and that’s what’s causing the brain fog.  Or maybe I have Bartonella and that’s causing the brain fog.

In my career as a veterinarian, I frequently have to figure out what is wrong with my patients that have many different factors and potential illnesses that could be contributing.  (Also, they can’t talk.)  (Also, also, the owners that come in with them sometimes talk too much about things that don’t help.  But I digress).  The way I try to figure that out is by using SOAP.  While sometimes I WOULD like to wash my eyes or brain or ears to get rid of some of the things I see or hear, that’s not what SOAP is.  SOAP stands for Subjective, Objective, Assessment, and Plan.  It’s a way to organize the information we have to try and figure all this shit out.  So, I’m going to SOAP myself.  When I type that, I feel like maybe I should set up a webcam and get some $$ for it…  Haha.  J/K  No one would pay to see that.  Also, J/K  it’s not that kind of SOAP, so get your mind out of the gutter.  And pull mine out too while you’re at it.

Here we go

(Edit: P = patient.  That’s me; hx = history; HR = heart rate; EENT = eyes, ears, nose, teeth; H/L = heart and lungs; PLN = peripheral lymph nodes; M/S = musculoskeletal; abd palp = abdominal palpation – which is weird to do on yourself, btw; Neuro = neurologic system; Integ = integument – aka skin; Ddx = differential diagnoses – aka things that could be the cause)

S: P experiencing “brain fog” and memory loss.  Has pounding heart unable to associate with any inciting factor.  Severe fatigue and lethargy.  Depressed.  Hx of anxiety and depression.  Medication previously effective but has changed recently – once changed back to original medication, it seems less effective.  Weight gain.  Not interested in exercise and has difficulty motivating herself to get up, much less exercise.  Losing interest in things she usually loves. Emotional lability, unpredictable.  Gets hot easily (this is new).  Occasional night sweats while husband keeps bedroom a balmy -10000000 degrees. Joint pain.  All of them.  Can’t hold onto thoughts – they slip away and it’s super frustrating.  Easily distracted.  May have ADD but has never been diagnosed, even though she fits the bill quite well.

O: Overweight/obese, sedentary (except at work when she stands all day, but then she sits all the rest of the time when she is not lying down in her bed which is pretty much any time she can get away with it; at least when she sits, she looks less lazy).  HR – usually 70bpm, but sometimes pounds (HARD) at 90 bpm.  Bounding pulse quality at that time.  Normal pulse quality otherwise.  12 breaths/min.  Can’t assess my lung sounds because it’s weird and I can’t seem to do it. But I don’t feel like I can get a good breath without coughing. EENT – no obvious dental disease except that one tooth that hurts all the time and the dentist thinks it might be fractured but p doesn’t want to spend the money to get it pulled and have an implant. Eyes are shitty and super nearsighted but now p can’t see to read very well either, so basically she’s old.  Pain on palpation of ethmoid sinuses, maxillary sinuses, and frontal sinuses.  Probably the sphenoid sinuses as well.  (ok just got back to this from learning/googling about all the sinuses in the human face and where they are located and what they are lined with and their purposes – to lighten our skulls and also to be torture devices – and where they drain. Where was I?) H/L – see above about pulse and not being able to auscult my own lungs. PLN – all seem normal size except that one lymph node on the right side of my neck that has always been big – no recent change; Abd palp – Fat.  Not painful.  Very jiggly.  M/S – see obesity above; see joint pain above; stifles make TERRIBLE creaking noises like small trees breaking in a storm when they are flexed.  Lower back pain from having weak core muscles; Joints may be hypermobile, although it hurts for them to bend as much as they used to, so p avoids it.  Neuro – holy hell who knows.  Integ – dry skin.  Chafing of thighs when wearing shorts and skirts.  Getting old lady skin – it’s looking thinner and less collagen-y.

A:  (DDx)

1) Sinus pain – allergies/chronic sinusitis; sinus infection; punishment from the gods

2) Obesity – inactivity and poor diet; hypothyroidism (supplementation too low or needs non-synthetic hormone because of course I fucking would.  Nothing normal works on this stupid — i mean unique- body); aging/slow metabolism; Cushing’s disease (I add this because of my patients, not because I really think I am Cushinoid, but who knows)

3) Brain fog –  hypothyroidism, Bartonella, brain tumor, this is just me now, allergies, immune mediated dz, ADD, stress, depression

4) Emotional lability – mental illness flaring up, Bartonella, brain tumor, menopause, stress, depression

5) Fatigue/Depression- SSNRI not working as well, stress, hypothyroidism, poor body condition/out of shape, Bartonella, immune mediated, viral infection, just luck

6) Irregular pulses/ runs of tachycardia- HYPERthyroidism (oversupplementation), stress, heart disease, menopause, anxiety

7) Joint pain – Bartonella, age, hypermobility catching up with me, immune mediated,  DJD, stress, viral infection

8) Night sweats/Day sweats – hyperthyroidism, hypothyroidism, diabetes, menopause, stress

9) Dry skin – hypothyroidism, heat on (does a thermostat set at 64 count as having the heat on, really?), menopause, allergies, old age/loss of youthful collagen

Aaaaand that’s where this fun exercise ends.  Because I’m not sure how to make a plan.  I am going to start with a visit to my doctor because she is smart and thorough and she listens.  But it’s an awfully big mess to sort out and I don’t like being a complainer.  Which is dumb and has put me in a lot of stupid situations (looking at you, Incident) when I don’t reach out and end up losing my mind completely or just suffering in silence when there is no reason for it.

I’m not really sure why I put this here.  Maybe just to help me sort it out like I would if I were assessing a patient?  Maybe to see if any of you have ideas?   Maybe to let you know that you’re not the only one who is a chewed up bubblegum sandwich?  Or maybe to let you think “Oh wow.  Yeah, she’s pretty messed up.  I don’t have it so bad.”?

Any of those things are ok I guess. So, if you were thinking that you were the only one out there confused and with all kinds of shit going on, don’t worry.  There’s lots of us out here.  I mean, I deal with the ones that have sweet eyes and (usually) 4 legs and (also usually) are covered in fur with pure hearts and souls.  But there are the other ones, like me, who have squinty eyes and damaged hearts and souls and may also be covered in fur when it’s winter time and I don’t really feel like shaving tyvm.  We’re out here too, just trying to figure things out.  The problem is, things KEEP CHANGING.  Like, our metabolisms, or our response to medications, or new stresses or just different stresses or hormones.  Things are always changing and we just have to try to keep up.  Sometimes it’s helpful to take a step back and SOAP ourselves to see what the possibilities are — and sometimes we just need to take a long bath and relax – which is where I am going right now.  Love you all.

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Right now

Well hello again! In case it wasn’t clear from my previous sporadic posts, I’m having a hard time doing anything on a regular basis. Except procrastinating. I’m pretty regular with that. Why do today what you can put off til tomorrow, amiright? Except that’s not right. I don’t know what tomorrow will bring or if it will come at all. We have right now and that’s really all we have. (Stick with me. It’s not all gloom and doom…)

On the one hand, that seems super depressing to me. I could die at any time. Anyone could. Ugh. Not really a cheerful thought. But it’s one that really hit me all at once when Daddy died. He kept thinking he would do more things once he retired. He was so close. Months from retirement. Once he found out about the cancer, he died within a week.

But on the other hand, it reminds me that we are here. Right now. And each moment is its own. It’s just there, perfectly being that moment. This is a really hard lesson that the universe is trying really hard to teach me. I’ve been trying to learn for a long time, and it is sloooooooowly, so slowly sinking in. (A lot like me when I’m supposed to swim laps but the water is just so damn cold and I just can’t quite deal with it reaching above my thighs. *shudder*)

Some examples of this simple, difficult lesson.

I went to another Michael Franti concert, this time with the loves of my life. (As far as Michael Franti, I just love him. Just really have always loved his music since high school. Which is TWENTY YEARS. Even though that’s impossible because surely it wasn’t 20 years ago that I was in high school. More like 5, right?) So, I was reminded once again, that THIS moment is the only moment. It’s the most important moment. I was so happy. I felt like I was floating. And smiling. I couldn’t help but smile and wipe happy tears out of my eyes. Music lifts me up and gives me this feeling of an eternal moment. An eternity in one moment. Obviously, it’s something I can’t even describe. I mean, read the previous sentences. Do they even make sense?!

But then it was time to go back to work and bills and messy house and drama from difficult people and the injustices of the world and a 24 hour news cycle and…

Back to worrying and not living up to my expectations and putting things off until a better time.

Then, something else happened. An amazing person who had fought cancer like a champ while being amazing (as only an amazing person can do), found out that the nasty cells weren’t gone. They were elsewhere. She’s going to fight again and this time, she’s going to put her foot down and tell cancer to “fuck off for good, you bastard.” But she’s going to do it every day, in each moment. And just like that, the lesson is slammed in your face. THIS moment. This is the most important moment ever. Because this moment is the only one you have. This lesson wasn’t as gentle as the lesson the concert taught. But it is the same lesson.

And just when I think I’ve learned the lesson, because my life is relatively simple with the not having cancer and not starving to death and not worrying that I might be shot down in the streets, I slip right back into worrying about everything else and putting off living and doing the things I love to do. Until one Thursday.

I decided to give a yoga class a try. I used to do yoga before school in high school. I followed my VHS yoga tape through poses and I loved it. I had never been to a class with real people I didn’t know.

A little insight into my psyche (because it is TOTALLY not obvious from my posts… <– sarcasm font): I am always comparing myself to others, or at least to my perception of others. And I am always falling short. I am constantly telling myself how badly I am failing compared to others. Then I tell myself that the only person I am trying to be better than is the person I was yesterday, which sounds like a totally legit and empowering thing to tell myself. Except it kind of isn’t.

So, I went to this class. By myself. Without knowing anything about yoga or yoga classes. I was completely prepared to be the least knowledgeable and least thin, lithe, yoga-body owning person in the room. But this class, you guys. It blew my mind. The instructor is amazing. She just embodies being positive. You can’t help but feel at peace and happy around her. The other ladies there were all unique. They all had different sizes and shapes and experience and backgrounds and reasons for being there. I was reminded, over and over, that this practice was my practice for my body on this day. It might be different than any other day and I might have a different intention for this practice than others.

Here’s the kicker: AND IT’S TOTALLY FINE.

What? No, no. I am supposed to try harder to be better than yesterday. That’s what I do. I’m a doctor and an Ironman and a perfectionist and that’s what we do. We strive to be better every day.

No, this class said. You don’t. That’s not something you have to do. You just have to be. Right here. Right now. Just be. That’s enough. You’re enough.

You guys, I almost happy cried at least 3 times during that class. I felt like I was floating again.

I’d like to say that I am now enlightened and I am above all the bullshit, but nah. I had a frustrating day today. I am exhausted. I am stressed out. I have bills and drama and unmet expectations.

But every now and then, I remember. I am enough. It is enough to just BE right here, right now. I am enough; and so are you. Just you. Not tomorrow you or 10 pounds lighter you or out of debt you. Just you. That’s enough.

Let’s enjoy this eternal moment. Because it’s all we’ve got and it turns out, it’s all we need.

 

 

Sometimes I need to hear my own voice

I’m having a hard time tonight. I feel like crying. I think it’s hormones. These days, the few days before my period, I am like a toddler. Uncontrollable mood swings from hell. And my tolerance for people is at -45.

Right now I’m sitting at work, even though I could have left 2.5 hours ago, because if I go to the old house, I will fall asleep as soon as I sit down. And I have some shit I need to get done.

My daughter is staying with her grandparents tonight, which is totally cool since she isn’t staying with them as often as she used to. I will have grand plans to write or read or clean or pack or even just paint my nails, but I will sit down and the next thing I know J will be calling to check on me and it will be 11:00. And I will have mush brain but won’t be able to fall back into as deep of a sleep again until 10 minutes before my alarm goes off in the morning. Then boom. Mush brain again.

Plus, I don’t have wi-fi at the old house and I wanted to download some updates for the ol’ electronic devices. And I don’t know what I want to eat. And I’m cranky. And I’m mad at myself for not being healthier or training or just getting my shit together. Right now, I don’t even know where my shit is, much less if it’s together!
————————————————————————————————————-

Whoa.

I was interrupted in my stream-of-consciousness rambling rant when J called to chat. We talked and he was going to get something to eat and play COD (that’s Call of Duty to you uninitiated folks.) That’s how exciting our phone conversations are. When we hung up, I decided to go through some voice memos on my phone. I’m not really sure why. I’m weird like that.

I just listened to a very frustrated, very unhappy, very lost little girl. She hated her job and she couldn’t think and she was feeling very overwhelmed and very much like a failure. She was thinking of writing a letter to a self-help person because she didn’t know what else to do. She cried when she talked about how lucky she was but how broken she felt. I have to admit, I teared up when I heard her. Okay. I ugly cried. I wanted to call her and hug her and tell her everything is ok. That she is ok. That she is depressed and she just needs a little help to get moving again. She needs to tell someone else all that stuff she just told the recorder on her phone. Because she doesn’t have to hide behind a façade of everything being just fine.

I wanted to give my 4 years younger self the gift of knowing she has the strength to get through this, but she can’t do it alone.

It has been a hard 4 years. Until I listened to that scared, broken woman, I didn’t realize how far I had come. I didn’t really realize how long I had been fighting my depression and then fighting even harder to hide it. I’ve survived a lot. My depression was brought out into the sunlight (and internet and tv and newspapers) for all to see and to make — usually erroneous– judgments about.

And here I am.

I am standing. I am smiling more than I am not. I have a happy, healthy, super smart and hilarious daughter and I have a husband who stood by my side through it all.

Oh younger me, I am so sorry I let you stay in that dark place for so long! And I am sorry to know what trauma you have to go through to get back into the sunlight. But I am not sorry to say that you are awesome. You are tough and you are loved and you are amazing. You still have bad days and you still are tired sometimes and you’re not as perfect as you would like. But you are standing tall and you will continue on in the sunlight with the help of all those people who love you, whether you’re perfect or not. (Mostly not. And that’s ok.)

By the way, “those people?” That’s you guys. Thank you for being cheerleaders and companions and spectators along this journey. I appreciate you more than you know. I love you and you are all tougher than you think.

Tired. Overwhelmed. Living.

So here I am. Finally getting to another blog post. And I am stressed. I know, that’s totally weird and out of character for me to be stressed. But I am more stressed than usual. And I am more stressed than I was expecting and stressing out about being when we were contemplating all the craziness that is currently stressing me out.

 

We are moving. Because small minded people tend to influence other small minded people, career prospects are limited for my awesome husband as a result of “The Incident” (see previous post for hints but not explanation….that comes later!) even though The Incident was my fault and not as simple as people would like for it to be.

 

But, I digress.

 

So, we are moving. Away. Not 1000s of miles away but about 1.5 hours away from our awesome home and even further away from my awesome family. I am thrilled that J has found a new position in an area that is excited to have him, and I am even more thrilled that he has found a new position that will allow him to continue to make the world a better place. He needed that. His heart was absolutely broken by the cruelty he saw following The Incident. He has always been such an honest person. He believes that everyone deserves the benefit of the doubt. He is who he says he is. He believes everyone else is the same way. Over the past 18 months, the world has broken his heart and he realized that not everyone is honest, not everyone is kind, and not everyone is as understanding as he is. On the flip side, we realized that we have some of the best, brightest, and most incredible friends anyone could ever have the honor of knowing. J will do amazing things in this next phase of our lives, just like he always has.

 

And there I go. Digressing again. Back to the stress.

 

Moving. Because I feel that 90 miles is too far to commute on a daily basis, I am looking for a new job. This is something I haven’t done for 8 years. It sucks. It’s hard and it’s time consuming. It’s like a part time job, and I am having a really hard time doing this part-time job of finding a new job while trying to do a good job at my current full-time job. Whew. And I tend to try to be whatever people need me to be, rather than just being honest about what I need, so that’s a scary thing when interviewing.

 

My partner is gone. Not gone, gone, but not currently present. The partner who could throw that load of laundry into the dryer since I forgot and left it in the washer or who could mow the yard this afternoon since it’s the only time in the next 10 days it’s not supposed to rain or the guy who could drop off a bill payment or stop and get some milk because I forgot to or pick up our daughter or meet me for lunch when I had a bad day or meet me to ride our bikes for an hour because I didn’t really want to train. That partner is 1.5 hours away. And it sucks. Waking up extra early to drop G off before I go to work or making plans to pick her up or trying to clean house while spending quality time with my sweet, wonderful daughter who will never be 4 (and a half!!! She always reminds me) ever again or trying to ride on the trainer while she wants me to put the diaper back on her baby over and over is really a bit of a stress I wasn’t expecting at this particular moment.

 

Riding the trainer. Yuck. Had I known that I would have a part-time job finding a new job and looking for a new home and (kind of, but not really) being a single mom for the 3 months prior to September 28, I wouldn’t have signed up for the damn Ironman. As you might have noticed from previous posts, my training isn’t going as well as I would like. This (as I knew prior to signing up) training is a part-time job. And it is not getting quality work from me. Today I got to do my hour ride with some of the best company out there (Love you, B!) but tomorrow I get to swim for 1:15 BEFORE WORK. Ugh. Then bike 3 HOURS after work. Then pick up G (after a shower, I hope) and drive to J where we will spend the weekend in the absolutely cutest little room ever where he is getting to live right now. I will, unfortunately, miss the Michael Franti concert in Nashville (He is amazing. Go see him. Listen to him. He is just… wow.) The next day we will get to hang out and have brunch at The River Café. And G and I will drive home so that I can get up early the next day and do a 2:30 run before work.

 

I’m already tired.

 

No real inspirational message here. No words of wisdom. No specific encouragement in this post. Just me being whiney and tired and stressed. Letting you guys know that we are all stressed sometimes. Some of you are dealing with problems much bigger than mine. But we are all dealing with something. The next time you see someone sigh or look tired, give them a smile. We all need it.

 

(I thought about editing this stream-of-consciousness post, but decided to leave it as is.  My mind can’t focus on anything long enough to organize thoughts, and a streamlined, edited post would never get done.  Better messy and coarse than never, right?!)