Just desserts

 Day 7 of Wellbuterin, and I wish I'd done this sooner.

I have avoided "drugs" all my life, because of the bogeyman they represented; my mother's fears about loss of self made manifest in her children. I remember my first time "driving" for a significant other on MDMA, and when he told me he loved me, I asked the next day if that was him talking, or the drugs? Who am I without tinkering with myself? Am I still me? It's an Odysseus' Ship problem, except on a more abstract scale: you could argue that the animating intelligence is what makes a person, no matter if their appearance, limbs, even organs, change. It's much less clear when you're tinkering with that intelligence, when what you're changing could materially affect how one thinks and perceives the world. If you are behind the wheel, but the drugs are driving, are you really behind the wheel?

So as I sat listening to music on the beach and Incubus came on, song that I rolled my eyes at in high school because it was "too popular", the line "let the fear take the wheel and steer" hit me like a poleaxe. I have been so afraid of letting the drugs steer, that now I find that, somewhere between 12 and 20 years later, that it hasn't been me per se driving, but my fear and anxiety.

It has been like realizing that you've been putting up with intense, grinding tinnitus for years and years without realizing it. It's like finding that you'd been carrying around a leaden weight for all these years, and like in a dream-state, been unable to look at it, put it down, or speak of it to other people. Suddenly, thinking about my relationship doesn't fill me with dread and terror. 

TikTok in loco parentis, TikTok in lieu of therapy; there are so many genres of self-help on the app that it's always amazing to me when I find something that makes me sob. And so I've been thinking about what happened to me around 2008, and I've been thinking about worthiness. I sobbed over a DnD NPC video where the barkeeper hands me the key to the tower room because I look like the kind of person who's not very good at letting themselves rest and I scribbled onto a post it note:

Why do I feel like I don't deserve:

• rest
• care
• to say no
• to ask for more
• to feel better

Sometimes catching the fleeting thought is an important part of acknowledging what hurts. I was in the middle of unloading groceries, thinking about the last time I felt like I could be sexually free, when it struck me: The last time I felt free was followed by horrible horrible times, and I felt I was being punished for something. An unjust breakup, a divorce, a housing situation falling apart, a job loss. Over the next year I rebuilt my life entirely, and closed myself off to many things. And while some of those things crept back into my world, I never fully uncircled the wagons, so to speak.

It's pretty shit, you know, when you're raised with these ideals of Karma, and how they're supposed to release you from a Judeo-Christian god-guilt. And yet, and yet, I felt like I had taken too much, and much must be taken from me in order to balance the scales. What rubbish. And yet here I am unable to truly fathom that things might go well for me without them also having to go poorly.

New starts

Appropriately, I started Wellbutrin today, on Ostara. 

I was not prepared for the emotional overwhelm of getting the vaccine on Monday. I was not prepared for the intense feelings of guilt about getting it while Martin couldn't. I was also 100% unprepared for the sudden burst of "omg pandemic is almost over, time to get the meatsuit in shape".

On Monday night I sent a flurry of emails, to my PCP, to my gastroenterologist, to my chiropractor, to a dentist. On Tuesday I scheduled a bunch of appointments. On Wednesday I cleaned frantically in prep for cleaners the next day, and my mood dropped. I started thinking about knives, and guns, and car exhaust while making dinner. I actually scared myself. At midnight, I wrote a short and slightly flippant note to the psychiatrist who I'd connected with in the weeks after my surgery. I considered using the "send later" feature, but figured that if nothing else could convey a sense of urgency, the timestamp would. She responded with an offer of a date in April, but also that we could work something out "if I needed to be seen sooner". 

Readers, I have never been so relieved, and felt so guilty, to see those words. I struggled to just *take the offered help*, but in the end we had a consultation on Friday during her lunch break. Filling out the family history forms was hard, and gave me a lot more fear. There's a lot to cover; anxiety, BPD, schizophrenia, manic depression, bipolar, avoidant depression, and that's not even touching the ADD/ADHD symptoms that are still lingering. (Even if the neurocognitive stuff is decreasing, the inability to focus isn't.) We didn't get through everything, but we ruled out a few things much to my relief. I was absolutely shocked (relieved-shocked) at how quickly we went from "nice to meet you" to "here's a prescription". Wilder still, after avoiding these things all my life, of struggling with everything related to getting mental health care covered, to have insurance cover my prescription with no questions asked, with a copay of $15. Trepidatious but relieved. 

We talked a bit about sleep, and how it's one of the things I've struggled with - and how that's ticked up in difficulty recently, and how incredibly important it is that I get back to having long, restful, non-apneatic sleep. So now I'm also scheduling and ENT appointment. 

I spent a lot of time last night thinking through it all. There's the family history of hating and fearing western medicine. There's the family fear of spending money on doctors. It's a potent combo of scarcity mindset and naturalistic fallacy. There's this idea that if I was a good person, this body would be just fine for the duration of my stay on this earth with no medical intervention necessary, but boy howdy, with a history of chronic sinus issues, an UID, two dental crowns and fucking plate in my neck, that ship has absolutely sailed.

What would I change with this vessel, if I could? There are some [embarrassing items redacted], I'd get my knee and feet looked at by an orthopedist, maybe get Lasik? On a super long shot, I'd consider getting something done to stop my inner thighs chafing. (I don't need or want a thigh gap but I'd like to be able to wear a skirt without shorts and not make my tender thigh skin bleed. And yes I've tried body-glide et al, and I just sweat them all off.)

I've been thinking a lot in the last week about transhumanism - the idea of hacking your body to make it work better for yourself, and I think I'm going to lean into it. The idea that maybe I don't deserve to suffer for all the fun things I did (all those ballroom dance injuries), and that maybe I DO deserve care (what?!) is really hard to process. But I'm getting there.

So this morning I took my vitamins, took my allergy pill, and before I could think too hard about it and psyche myself out about it, my first Wellbutrin. 

Here's to fresh starts.

The Ides of March

 ...or, how I got unexpectedly stabbed.

On Friday I got a text from the state saying to review the current guidelines about vaccination eligibility. And to my surprise, I found out that anyone with a BMI of 30 or above was eligible here in San Francisco. So many feelings. My BMI has prevented me from getting care for my pain and suffering for years, so to find it suddenly is getting me preferential treatment is both humiliating and... feels a little like reparations.

I made an appointment for Monday afternoon, and the followup for April 5th. I didn't know what to expect and my cuticles are a mess from anxiety. In the end I convinced Martin to come with me; I was hoping they'd just give him a shot, but honesty won out in the end. But I'm glad I had him there. 

I didn't expect the massive emotional... thrum - there's no real way to describe it - when she lined up the needle. I closed my eyes and thought about all the fear, and the pain, all the uncertainty and the loss. Of people suffering and dying in the hospitals alone; of medical workers forced to do their best over and over in the face of mounting losses and public indifference; of mothers laboring and delivering alone; of my own terrifying solo walk towards major surgery and possible death. I thought about the trips we'd planned; Melbourne, Burning Man; Costume College and Carnevale, Hawaii, London, all the good things we'd had to let slip through our fingers, then further and further away. 

I was in so much emotional pain I didn't even feel the needle, only the hard plastic seat, the hot wetness at the edge of my mask, and Martin's hand in mine. I can't believe that this is almost over.

And then I looked up at my partner, who is not labeled obese, who is not eligible, and who I am now terrified for. I didn't expect the shot to come for me before July and I didn't expect that we wouldn't get it together and now I feel like a horrible person for taking it and not waiting. 

I got stabbed on the Ides of March, and I will be fully vaccinated by May Day. It's a lot to take in right now.

One year gone

 In two days, I will have been working from home for a full year.

It's strange to think of all the things that I've grown accustomed to, in that year. No N Judah trains rumbling by, no lunches at work, no commute, making my own coffee, doing nothing, seeing nobody. I can't make myself participate in any of the online versions of the things I love, because... well, I don't know why. Honestly, staying home seems preferable to the disappointment of the pale shadow of what it was.

The question I posed in my second pandemic blog post was - what will be left when this is all over? So many of our favorite things have opened again only to re-close, and each time they do it wastes precious resources. How many times will they open and close, and will they ever open as they were, again?

And what am I going to be like? I feel like some sort of slug, like a potato. I can't get up the enthusiasm to get out of the house or go anywhere. Martin wants to make plans and I just can't get excited about anything. 

Part of this is that I'm still healing, I'm sure. I'm not back to 100% and I don't know when I will be. I honestly feel like I've been chasing 80% for weeks now, and not quite making it, but trying to get back to "normal" life again, whatever the hell that means, despite the pain and stiffness. My 3-month check in is on Monday and I'm terrified that they're going to tell me that the fusion isn't working, or that the third level we were supposed to do as an artificial disk has now failed and that's what's causing the pain. I don't know. I don't know. I'm scared. And I want so desperately to get back to "normal" even though there is no normal to get back to.

Some part of me has been observing with wry detachment as my brain... recovers... from all this pain. The silence that's rung in my head since May of 2017 (interspersed with gratingly loud loops of gratingly repetitive snippets of music) has been fading away. I thought it could've been that the breakup damaged my brain, because the rest of me felt weirdly physically fine but - what if it was the car crash? What if this degeneration started with whiplash in May of 2017 and took nearly two years to blossom into the first spasm (March 2019), and another 18 months to cause the second? I oscillate between dubious and angry that it could be true.

I'm angry at a lot of things right now. The housing market, politics that pits humans against their own interest, the pandemic, climate change. 

I would just like to go somewhere for awhile where I can make things and not be angry anymore, and not have to worry about how I'm going to get money or food or shelter or healthcare. I just want some sort of rest.

Get to work

Day two back to work and I'm exhausted already. I'm remembering how tired, burnt out, and discouraged I'd been at work before the Shoulder Thing and the Going Public Thing and the Neck Thing and the Acquisition. I realized that there's probably no future for me at this company because of a couple of people who've been quietly undermining me since I got there - and, hilariously, they picked today to show themselves. (But hey, at least I get a reasonable payout if I exercise my remaining options and GTFO?)

It's sort of a grim parallel with what's going on in politics now too. Biden is in, and has been working his ass off to start undoing the damage of the previous four years. And of course, the opposition is doing all the same dirty awful shit as they always have. We're right back to the stonewalling that they gave Obama, except now the economy is a farce and we're in the middle of a recession and a public health disaster while they're very suddenly concerned about the deficit. For fuck's sake. The Democratic Party needs to take no fucking prisoners.

The good news from today is that I'm feeling better, and better, and starting to really see the end of the tunnel with surgical recovery. Today, for the first time, the scar looked shorter, and less puffy. I can see the edges of the incision and see them starting to diminish. And I feel like my range of motion is starting to get better, bit by bit, even though the rest of me hurts like hell. I'm hoping to get back to yoga next week, even if it's modified.

And we're keeping up with the steady flow of houses on our radar, though none have been worth a look just yet, alas. And I apparently have good taste in condos, because the ones I favorite seem to flip to pending within 24 hours of my interest, siiiiiigh.

So, back to work.

Gratitude

 Wow, so, first week of 2021, really packing it in, huh? Only six days in and our first Doomscroll day of the year. I'm extremely thankful for a lot of things right now, and one of them is that I was still unambiguously on medical LOA while an armed mob signaled the end of our track record of "peaceful transfer of power" Democracy. 

I'm also grateful that, if it taught business people anything, when these doomscroll days happen there's no point in expecting anything to get fucking done; almost everyone I know who was trapped in view of screens reported that their bosses had given everyone a Mulligan for the day. Nobody can be expected to focus on work when History is happening - it's just been happening more and more frequently in the last year or so.

I'm grateful for the rain we've been having - mostly overnight, mostly in long slow downpours, mostly with sun breaking through in the afternoons. I have my fingers crossed that our aquifers recharge and the snowpack is deep and wet, and that the fire season gives us a bit of a reprieve in 2021. And I'm enjoying walking along the beach in the thin afternoon sunlight.

On Thursday, I logged in to work email for the first time since before my surgery, to request that we extend my LOA from the "best case" 4 week duration, to the full 6 weeks. It was *so* needed, and, looking back at my cuticles (which are picked and bloody) it was giving me a lot of anxiety apparently.

So I'm officially off work until January 26th, and friends, oh my god I need it so badly. I'm so grateful to have it and so grateful that I'm in a place in my life where it's available. 

And while I'm at it, let me say how grateful/angry I am about my health care coverage? As I'm tallying up the charges for medical services leading up to this, it's approaching $400k of billing. I hit my out-of-pocket maximum right before surgery so theoretically I'm not on the hook for any of that, but it's not clear that the individual providers won't come after me for the shortfall, which the imaging companies are already doing. I've been keeping all those charges on a single card since last year, just for tracking purposes, and it's already over $600 in post-insurance-settlement charges. Fuck those vultures. I'm scared.

Today was my one month check in, and now I get to track down and schedule the PT. The xray shows that my fusion is going well, and my doctor was shocked that I was still wearing the hard collar the whole time, and said to stop wearing it unless my neck feels tired or sore. I was worried about how puffy and lumpy the incision site is still, but I'm told that it actually looks great, and the level of puff I have is totally normal. 

My biggest question that I kept worrying about - what happened during the surgery that took an extra three hours has been answered. Apparently they didn't start the procedure until about 4, and I was held up an hour in the OR because there was no room in post-op yet. (The ICU bed shortage, and the extra-thorough cleaning of the rooms between patients has some knock-on effects.) Let me tell you folks, looking at the bill, that's like another $10k in anaesthesia drugs alone. The doctor also amusedly told me that it explains why Martin got an incredibly drugged out Laura call several hours earlier than expected; apparently the anaesthesia people get the task of monitoring/hanging out with the patient while the rest of the surgical team is dismissed, and they'll do puzzles and have whole conversations with you and put you on the phone with people if they're bored. 

And now... I want a nap.

Hello, 2021

It feels really surreal. Maybe that's the drugs?

Readers, I am here now to tell you that it was, in fact, the drugs. They are in fact both the solution and additional problems. This procedure has made what's already a rough and emotional time of year well-nigh unbearable. I've been see-sawing between totally fine and burn-your-life-down sobbingly depressed.

It turns out that tramadol has an SNRI in it, which is like an SSRI except that it also treats nerve pain apparently (which is good to do if you're treating chronic pain). I've struggled with, and mostly beaten, depression all my life. I've been passively suicidal on and off since I was 14 or so. My care team asked if I was currently on an SSRI but they did not ask about my mental health in any other way. Each time I've tried to taper off the tramadol, I've apparently been doing it wrong because I've had zero guidance from the team, and with zero guidance from the internet/community, because googling for this just nets you page after page of ads for rehab clinics. And each time I tried to taper, it's been like kicking the kid on the bike who's just taken off the training wheels. I felt like I've been barely staying astride.

And also the rest of the time, I feel entirely fine. Good, even.  We take nice long walks. We've cooked and built things and enjoyed the pleasant weather.

This is not to say I'm feeling totally great. I mean, I have intense and layered Strong Feelings about the state of my meat suit and how it's failing me, how ugly and lumpy and just overall gory the surgical site looks right now. But that's nothing next to the feeling like I've just come out from some sort of trance and found that I've been walking on knives for three weeks, and then effortlessly falling back into that trance. I cannot tell what's the drugs, and what's the continued conflicts in my relationship bubbling over; I can't tell what is forgivable and what's inevitable. 

And, for what it's worth, at least I can walk just fine, swallow fine, take all my vitamins again, shower, brush my hair and do a bunch of stuff okay again. I'm not off painkillers and not back to 100% yet and I don't know when I will be, but I'm no longer prevented from doing everyday tasks because of pain or stiffness, or lets be real here, fear. Though I'm also not yet off the opiods and thus not permitted to drive (which makes me feel surprisingly trapped), or alas, to drink. That latter has been a surprising ache for me, not because I particularly care about being drunk, but because I enjoy the sensory experience and traditions of cocktails so much. The fact that I feel sad about it makes me question if I have a problem? I don't think I do, or else I wouldn't have gone this long without any alcohol, right? 

I cannot wait to be out of this collar, to be able to drive myself places, and to have a nice nightcap before bed.

We dressed up for New Years Eve, because that's what you're supposed to do, even if you're just cooking and spending the evening at home on multiple Zoom calls with friends. And we took off my neck brace for a photo, so I could feel just the slightest bit normal for the first time in 17 days. 

So here I am. Don't tell my orthopedist.