Thursday, July 28, 2016

Sponge

"So, after all of that, my doctor decided to prescribe me some cholesterol medicine. My cholesterol was little high and I have a a family history AND she thought it would help counter act the side effect of the Sertraline."

Rose, my therapist, smiled. "That is good. So you no longer are experiencing...uhm...you no longer have your...issue."

"Nope. It is back to normal. My doctor is pretty smart."

"That's good. What brings you in today?" She flipped through my chart. "You have not been here for a few months."

My chart, which was a brown folder with about 8 pages of hand written notes jotted down by Rose after every session. She never wrote anything down during the sessions unless it was a drug dosage or some other medical changes I was having. I always compared the amount of pages in my folder against the other folders that were placed on Rose's desk. My folder was by far the one with the fewest pages. That made me happy.

I always started each session with what I would call my disclaimer. I know other people have it far worse than me. I know there are many bigger problems in the world. I know my issues are small in comparison. I know I should not worry about the little things. I have it good. 

Rose would always tell me that she understood but it was okay to talk to someone.

"I know I have not been coming in but I was having a good run for a bit." I said.

"That is good. I am glad to hear it. What has made it a good run?"

"Since I started on the meds and got some of the side effects under control I have been less worried."

Rose peered over her glasses."Less? Or No worries at all."

"Less."

"Are the worries you are experiencing real? I mean are they normal worries?"

I smiled. "Yes. At least I think they are normal. It is not the Sharks."

"Are they interfering with your life?"

" No. I have not had any kind of panic attack in a while. I just made this appointment because I thought I should get a mental health check up."

"Okay. Great." She smiled.

We talked for the rest of the session about what I would consider little things. A few issues I had with other parents, or some disagreements with my wife. We talked about the dish sponge. Every night I would do the dishes but I would not put the sponge in the sponge holder. Every night my wife would get mad at me for leaving the sponge in the sink. The sponge was a bone of contention between us.  I thought my wife should be happy with the fact that I did the dishes but she only focused on the sponge in the sink. Some days I would cook, do the dishes and then run the kids to basketball or something else. But if the sponge was in the sink nothing else mattered. The sponge took away any of her appreciation of all the other things.

 I left the session feeling great. My medicine seemed to be working. Life was good.

That's the funny thing about Anxiety and Depression, just as things are feeling good, Anxiety and Depression will leave sponge in your sink.


Thursday, July 21, 2016

Frank and Beans

I was sitting in another waiting room at the hospital. An attractive women in her late thirties, wearing some kind of Disney Character scrubs called my name directly to me. I was the only person in the waiting room holding a purple folder. Red meant CT scans. Green was X-Rays.

Purple was Ultrasounds.

I followed her back to the ultrasound room. She looked at my paper work and looked at me. Looked at my paper work and looked at me. I was sweating so bad I felt like I was in a sauna.

"I will need you to remove your pants and underwear." She handed me a paper gown. "I understand that we are doing an Ultrasound of the left side. What are we looking for? What are the symptoms?"

I was silent. I did not think she needed to know my predicament.

"I need to know what I am looking for." She said.

"I know. I just don't think you really need to know. My doctor, she just wants to make sure I do not have any physical issues."

"Well are you in pain? Is there a noticeable lump? Why did you see your doctor in the first place?" she asked in rapid succession.

Anxiety and embarrassment sometimes, physically,  feel very similar. I could not tell which I was experiencing.

"I would rather not say, if that is okay with you." I responded.

I removed my pants. She started instructing me on how I was supposed to positioned.I was laying on my back.  She was going to move the frank upward towards my belly and wrap a towel over it to keep it in place. The towel was slightly tucked under my back.  I was to place the beans on top of a rolled cloth to keep them easily accessible.

"This may be cold she said." She squirted lubricating jelly on the beans.

I was looking at the drop ceiling trying to count the holes in the tiles to keep myself distracted.  Now the whole reason I was at the hospital in the first place was that I was having issue keeping the frank in check. Now I was laying down while a woman is rubbing the beans with lubricant. In my head I knew it was not going to end well. I was doing my best to concentrate on anything else. I started to do some breathing exercises my therapist had taught me. I thought I was about to have a panic attack.  After a minute or two I found my mental zone and finally felt okay.

"Everything okay?" She asked. " I need to check the other side to make a comparison."

She squirted more jelly on the beans.

She totally took me out of my mental zone when she talked.  Then I felt the towel move. Then it moved some more. Then it moved a lot. The towel fell off.

She was very professional. She did not say anything. She finished the scan and told me that everything looked okay but was going to have to get a doctor to double check. She covered the frank and beans with the paper gown and she left.

Two minutes later a man in a white lab coat in his forties walked in followed by the ultrasound tech,

"Hi. I am the doctor. What seems to be the problem?"

"My doctor recommended I get the ultrasound to rule out a few things. She also said there was a slight bump on the left side." I said.

"But why would your doctor send you here.  Everything I can see on the pictures is that everything is normal. There is a slight varicocele but nothing to worry about. What were the symptoms to lead up to this?"  He crossed his arms and gave me a stern look.

"I...I... seem to, seem to have..." I stuttered and could not get the words out.

"It's okay. Let me take a look."

He removed the paper gown and the frank was staring right back at him not wanting to go camping but making sure the tent was ready. The doctor took a step back. The technician turned around.

I started crying. I was crying out of relief that I did not have cancer. I was crying because of how embarrassed I was. I was crying because at that time I felt crazy.

"I can't control this." I said through tears. "This happens all the time and I can't get rid of it."

"It's okay." the doctor said as he sat in the chair next to the exam table. "Let's talk about this from the beginning."

For the next ten minutes I poured my guts about about everything, the sharks, the meds, the side effects. When I was done talking I finally calmed down (frank did not).

The doctor stood up and said, "You are probably right, this is probably due to the medication. As far as I can see there is nothing physically wrong with you." He turned and left.

I did not like they way he stressed the word "physically".








Wednesday, July 20, 2016

What is the Code

"Do you have your I.D. and insurance card?" The elderly volunteer asked from behind a large, white Formica covered, desk.

I handed her my cards.

"Okay let's see what brings you in today."she said as she clicked on the computer keyboard. "Oh I see. OK, ultrasounds get the purple folder. " The last sentence was more to herself than to me.

She handed me a purple folder with some papers and my cards attached by a paperclip to the cover. She asked that I wait in a chair until some one could process me. A few minutes later a woman in the office marked with a number two called my name.

I handed her my papers and took a seat across from her. She was silent for a few minutes.  I stared at the various pictures of her dogs that plastered the wall next to her. "Ok" she finally spoke. "The paper says you need an ultrasound but it does not say where you need it."

"At the hospital." I joked, knowing that I was going to have to give some uncomfortable answers to questions.

She smirked. "I need to know so I can send you to the right area. There is no code on this paper to indicate the part of your body that needs an ultrasound."

I could feel my heart start to race. My palms became damp. I already had to have this conversation when I called for an appointment. This would be the fifth person I had to tell. I am used to saying inappropriate things to make people laugh. I have no problem sharing parts of my life in writing or telling stories around a fire or being the butt of jokes at parties. I really don't. But in the moments when these stories are  actually happening the Anxiety builds up. I start to worry. I start to think of the possible outcomes. I entered the hospital already thinking I had a potentially serious problem. I spent the past 4 days worried. My mind was racing in all kinds of directions.

This was all because of my last appointment with my Physician. Dr. Christina did a physical check of my problem area and she felt something that needed to be checked. She wanted to rule out any physical issues before changing my meds.

I took a deep breath and I let the air out slowly.

"My left testicle."

"Oh. Okay. Let me look up the code for that." She clicked on the keyboard. "Why are you getting that checked?"

"Because my doctor told me too."

"But why? I need to find the right code."

I was thinking of the tent issue I was still experiencing. My mind was thinking I had a serious health issue.  I was trying to control my mind and my body.

 "Believe me, I do not think there is a code for what I have."

Monday, July 18, 2016

Checking Myself

Due to the side effects of my anxiety medication I found myself getting more anxious. I started to become more withdrawn. I was still able to do normal day to day stuff like going to work and coaching kids sports but I was not able to enjoy anything. I was always looking forward to getting home so I could be away from the possibility of embarrassing myself.

 My bed became my favorite spot. I was becoming depressed. I was not sad. I was not down. I was suffering medical depression. Actually I was diagnosed with Dysthymia or PPD.

I used to be one of those people that when someone said they were depressed I would say "Suck it up." Or "Oh come one, you have so many reasons to be happy. You are just having a bad day."

I hate those people.

 I know they mean well. I used to mean well. But now that I understand the thick dull cloudy murkiness of a depressed mind.  I know that the person experiencing the depression cannot really out-think the situation. It is like asking someone with Hypertension to "just relax".

Most people do not want to talk about mental issues. It is too judgey. I do not mean that people without the mental sickness are judging those with it. It is actually the other way around. People that have mental illness judge other people as "They won't get it. They won't understand."

Every person experiences anxiety and depression in different ways. A lot of people say they "suffer" from anxiety/depression. I never really felt the suffering. I felt the lack of suffering. I felt the lack of almost all emotion except worry. Worry was always there.

I started keeping a journal during these early stages of diagnosis. Journal is just a masculine way of saying diary. I would also keep emails and read them the next day and the next day after just to make sure I was not missing anything or making anything up. Text messages became my main way of communication. I could always read the previous text thread and remember what was said to certain individuals. I kept checking myself because I started feeling like I did not know who I was.

I only knew WHAT I wasn't.

Wednesday, July 13, 2016

Dreaming

"How is the medicine working?" Rose asked as she peered over her reading glasses to get a better look at me.

 This over the glasses look made me feel like I could not lie. They probably teach this method in Therapist School. I bet those glasses are not even real.

"Good. Good. I feel much better." I said trying not to make eye contact.

I like Rose, She is a good therapist for me. I am not sure how she would be with other people but she worked for me. Rose would call "bullshit" when she needed too. But that was what was funny about me. In therapy I did not bullshit. I learned early in the process that I was paying her for her educated and experienced opinion. Me bullshitting was a waste of MY time and money.

"Are there any side effects?" she asked,

"Yes. A few. One of them we are looking into with my family doctor. But it could be something else." I said. "I have to take some tests. I am not ready to talk about that one just yet."

"Okay. What are the others?"

This is where it got tricky. I already kind of knew that I was an outlier with one of the side effects, the one I was not ready to discuss. But I was not sure where I was in the spectrum for the one I was ready to discuss with Rose.

"Rose, I do not know how to explain this except to say" I took a deep breath, "my dreams are real"

She crooked her neck in disbelief. "What do you mean?"

"Every night I have the most normal dreams. I dream about work, about coaching, about family, about anything. And when I wake up I cannot tell if it was a dream or if it really happened."

"So you are having very lucid dreams?"

"Yes. No. I thought a lucid dreaming meant you can kind of control your dreams. I do not control them. My dreams are so normal and vivid that I am not sure if the situations in the dreams are real or not."

I could tell from the look on her face I was confusing her. I was confusing myself.

"Rose," I said in a lower voice to convey the importance of what I was about to say, "I have dreams about me getting into arguments with friends. Then while I am awake and in real life I apologize to those friends and they look at me like I am a freak."

"What do you mean?" She asked.

"I apologized to a friend of mine about a disagreement we had only for my friend to tell me that we NEVER had that particular disagreement."

"Oh." Rose said looking down at her notes.

"I realized that the disagreement was in a dream. It never happened." I took another deep breath. "I also have good dreams that never really happened either. I had a dream where I found a bank mistake in my checking account in my favor for like 300 bucks. I was in the bank lobby ready to ask about it when I realized it was just part of a dream."

Rose sighed. "We may need to find a different medication for you."

"No." I said " This is working for me right now. I will figure it out."

I continued to take the medicine. They way I felt in real life out weighed the questions I had about what was true and not what was not. Some mornings during the early stages of me taking the meds, I would ask my wife if certain things happened. Did you and I fight last night? Did I call my mom and ask her to baby sit the kids? Did I go into the school and demand that my kids get A's.  These were all dreams but I needed clarification, just in case.

Due to this lapse of reality, I started to withdrawal from certain public situations. Volunteering at the kid's school, hanging at kids birthday parties, or even just attending certain functions. I did not want to feel embarrassed if I were to bring up something that never happened.

The social awkwardness is not listed as a side effect on the prescription bottle.

Friday, July 8, 2016

Camping

I was sitting on the exam table waiting for my doctor to do the polite knock and enter that they must teach in the first year of medical school. The large white sheet of paper that they could use as a table cover at a Maryland crab house was crinkling under my butt. I was wearing shorts.  My legs were dangling over the edge of the table,  the skin on the back of my thighs was sticking to the red vinyl table covering.  I was sweating. I was nervous.

Knock- Knock. The door swung open. Dr. Christina smiled as she entered the room.

Dr. Christina was by far the best medical professional I have ever met. She was my doctor for the past few years. She did everything right. She did not talk down to me. She did not judge me. She took her time explaining everything to me. You could tell that Dr. Christina loved what she did. And what she did was treat the patient and not the symptoms or the disease. She treated people.

Still smiling Dr. Christina said hello and placed her laptop on the counter, and turned to shake my hand. I felt like a little kid with my legs dangling off the table so I scooched off the exam table to shake her hand. My bare legs rubbed against the vinyl.

BRRRREEEEERRRRRRRPPP!

"Uh, Hi. That wasn't me. I mean it was me, but it was my legs rubbing the...not a..uhmm. You know..what I mean." I stuttered as I shook her hand.

"I know." She said. "So what brings you in today? How is the Sertraline working for you?"

Sertraline is a selective serotonin reuptake inhibitor. Basically it balances the chemicals in the brain.

"It seems to be working. I feel a lot better, less anxious." I said. "But that is one of the reasons why I am here. You know how I am allergic to all kinds of drugs? Well I do not think I am allergic but I need to ask about some possible side effects."

"Ok, like what?"

"For someone who is experiencing panic attacks and anxiety and some social anxiety I think my, uhh, issue is causing more anxiety. The Sertraline is definitely making me feel better but if the side effects out weigh the benefits then I need something else."

"Why you think it is due to the drug." she asked.

"It has only been happening since I started on the meds."I replied.

"Ok. What are your symptoms?" She reached for her laptop.

"Ok. I can feel my heart racing right now. I feel, this is difficult. I wouldn't really call it a symptom."

Some of the medical terms and explanations in the following paragraph have been changed to protect the innocent, those easily embarrassed and various word searches. This is what I explained to my doctor.

My body is constantly ready to go camping. My tent is ready almost all the time. Even if I go camping, and I really like camping, my wife does not like to camp that much, but even when I am done camping, my tent is ready. I could be sitting at my desk at work and all of the sudden I have an urge to go camping. My tent is ready. My tent is ready for a few hours at a time. And it is not like I am thinking about camping. I am not looking at camping websites. It just happens. It happened in the grocery store the other day. I started freaking out. I almost went into a full panic attack. My body just thought I was ready to go camping.  It is really embarrassing me and causing me all kinds of anxiety. I know this is not a bad problem to have because I sure there are people out there that cannot even get a tent. I just need to figure out why. Is it my brain? Is it my body? Is it the meds?

People who have chemical imbalances sometimes question what is real and what is just in their head. This is the worst part about about anxiety or mental issues. This is why people do not discuss it. It is tricky.

When I finished explaining my face was flush, my palms sweaty.

Dr. Christina smiled, "It's okay. The usual side effect is the opposite of what you are experiencing. But there are rare cases of this. But we need to rule out other possibilities. I need to take a look"

She snapped on a blue rubber glove.

Thank god I did not feel the need to go camping right then.






Thursday, July 7, 2016

Insulin

I came home from the shore (as we in the Philly area call the beach) knowing a few things about myself.

Number One-I needed help with my anxiety.

Number Two- People who do not have anxiety or depression do not "get" it at all. My wife and kids just thought I was crazy.

And number three -People who actually spell out numbers in writings instead of just using the actual number, are two thirds more likely to be an idiot than those who just use the numbers on the 1 keyboard they are typing on.

Oh and number IV--Things were not right in my world. I couldn't explain it. I couldn't figure it out. All I know is, at that time, I was feeling like I was water skiing in a leather Jacket.

I talked to Rose about the Sharks.

 Rose had been my part time therapist for the past year. I say "part time" because I only would go see her every so often to talk about the minor anxiety issues I was having. Rose, an attractive woman in her mid 50's, at the end of every appointment, would push her reading glasses down to the edge of her nose, read her chart look up at me and ask "Why are you not taking medication for anxiety?"

I always responded the same way.  "I am allergic to many different medicines. The side effects usually are too much to deal with versus the benefits of the drug."

This appointment, the appointment about the Sharks, was the first time I was able to explain in a way that Rose and I could understand what was going on in my head. She pushed her reading glasses to the end of her nose, looked at her chart, looked up at me and said, "You need to take medication for anxiety."

"Why?" I asked.

"Because the anxiety and depression are affecting your life. They are getting in the way of you being able to enjoy your life."

"Yeah, but..."

Rose cut me off. "Think of anxiety as a disease."  she said as she pushed her glasses back up her nose. "If you had diabetes would you take insulin?"

"Yes."

"Then think of the medicine as insulin for your brain."

I sighed. "Ok. Can you prescribe something for me?"

"No." Rose smiled. "You need to see your regular physician for that."

I had to call my doctor's office several times to make an appointments as well as getting referrals to make sure I would see the right kind of doctor. Each person I spoke to I had to explain the reason for my call. I had to tell them about the Sharks. I had to tell them about how I needed insulin for the brain. I had to tell them I was crazy.

HIPPA privacy laws are such bullshit.

Things were about to get hard.




Wednesday, July 6, 2016

The Sharks

I suffered through my first full blown panic attack in the summer of 2012. Although I have had minor panic attacks prior to this event (is "minor panic" an Oxymoron? ) they were more disguised as anxiety or trepidation, and not really an attack, but more of an incursion or encounter,  so I guess I previously had  "trepidation skirmishes".

 But that day in 2012, on the beach of Atlantic City, I had a full blown panic attack.  I could not move due to fear. I could not breath due to worry. I could not focus on what was in front of me due to the feelings that were inside of me.  I was being attacked by my own mind. In my mind there were sharks in the water right near where my kids were currently swimming. My kids, in reality, were swimming in the Atlantic Ocean, five feet in front of me, however there were NO sharks near them. Although sharks do live in the Atlantic Ocean they were no where near the beach that day.   MY brain put the sharks right near my kids. Sounds crazy I know, but that is what anxiety and depression can do.

I was unable to enjoy the afternoon and my family in the sun and surf because no matter what I tried I thought sharks. My wife at the time, told me I was acting crazy. That did not matter to me, because the sharks had already surrounded me and were closing in on me causing my chest to feel tight and my breath to shorten. The sharks were also making my eyes burn. Although there was a nice cool ocean breeze, the sweat was building in the creases of my forehead and along my hair line and slowly dripping into my eyes. The salt of the air combined with the salt of the perspiration made the whites of my eyes bloodshot with irritation. Wait, sharks can smell blood, can't they? Crap. I should get out of the water so I do not attract sharks. I backed out of the ocean.

Now, due to the burning irritation, my vision was blurry. I was further away from my kids.  How am I going to see the fins of the sharks that are about to attack my kids. My kids who are not paying attention to the dangers of the ocean because they are busy Karate chopping and  Kung Fu kicking waves. Maybe the kids will get lucky and actually land a kick on a shark's nose. But I would not be able to see if they made contact because of the sweat in my eyes.

I can't breathe, I am having chest tightness, I can't see. Why are my kids laughing? They are having a good time even though I am stressing out.  They must not love me.  Oh no, my kids do not love me. I am going to die alone. No. No.  I still have my wife. She will not let me die alone. Wait a minute she just said I was crazy. No, she said I was acting crazy. You know what, I will act brave. I will make sure that my kids and wife will see that I am a brave and a strong leader of the family.

"Everybody out of the water!" I yelled.

"But why dad?" the boys asked in unison.

"Because I need a break." was my response.

I needed a break from my own worries. I need a break from my own anxiety. I needed a break from the sharks that were in my head. I sat down on a flimsy low-to-the-ground beach chair trying to catch my breath. A frustrated expression was plastered on my wife's face. She did not understand.  My kids started playing in sand.

The panic slowly subsided as I inhaled deeply over and over again, counting every second of every exhale as I watched the foam of the waves retreat back into the ocean. I was looking for sharks. They were not out there.

The sharks were in my head. Like the Fonz in Happy Days I need to jump past these sharks. Wait a second, Jumping the Shark is a metaphor for the beginning of the end of the quality of something.

Crap.