I am traveling through each day at 1,000 miles an hour, unable to stop and take a breath, take a moment, take my time. In a paradox that seems unfair at the very least, my ability to accomplish anything has been greatly diminished. There is so much to do and I am doing so much, yet I haven't done anything. It is a maddening cycle of days, endlessly repeating and compounding.

My irritability finds new intensity with each 24-hour spin of the earth. There is no one particular source of this mood; there are, in fact, several.

My body has forgotten how to sleep properly. It was insomnia that first brought me to the point of seeking medical help for the storm in my head. I remember asking the doctor, "Does insomnia cause depression or does depression cause insomnia?" He never answered my question, but he wrote a prescription for Lunesta and sent me on my way. A month later, he added Lexapro, a move that only prompted my brain to induce its first full-blown hypomania. Years later, I find myself taking eight medications, six of which have or are intended to have drowsiness as a side-effect. Why, then, can't I sleep?

I am afraid that one day my brain will implode, leaving me without the ability to recover. In my fear-stoked version of saving for a rainy day, I have crammed every day full of work, work, and more work. My doctor, my husband, my therapist all warn me to slow down, take it easy, take some time and then get some sleep. They don't understand--my level of activity isn't causing my insomnia; it is a response to it.

I'm not having manic symptoms. I know this because I am only irritable and tired--I'm not talking too much, but more telling--I'm not funny. No, everything that comes out of my mouth is laced with the snap of impatience. The glass is very much half-empty and my brain seems to be capable of generating only complaints. I annoy myself, so I can't even imagine how everyone else is perceiving this mood.

And that's what it is--it's a mood. I'm tired, I'm in chronic pain, and my resources are so depleted that patience is not even in my repertoire. What is the answer to pain that doesn't respond to treatment and sleep that never comes? My time is coming out all wrong. It's all wrong.

Complain a little more, May. It's doing so much for your image...

Another day, another mood, and good meds

Yesterday was the Big Event at work. I survived! We all survived, but the biggest hazards turned out to be each other. Our entire department gets snarky with each other when this event rolls around. I cannot hold myself above the bitchy, for lo, I am the worst of them.

Here's the thing. I'm still in chronic pain from shingles. When I do too much physically or experience too much stress emotionally, the pain flares brutally. It's worse when I don't sleep. On Wednesday night, I barely slept. This means that when Thursday rolled around, I was one big batch of Bitch.

There is no reason to recount my bad behavior here, especially since I'm sure it will be told and retold among my coworkers until it becomes legend. The only part of the day that brought me any true satisfaction was when I got into it with the parking troll who "guards" the parking lot where I work. It was a telling-off that was ten years in coming, and it just means that I won't be able to illegally park in the alley anymore. Easy come, easy go.

Here is what I know for sure. My mood came from stress, unmitigated physical pain, lack of sleep, and resentment at having to participate in an event that requires an unreasonable amount of work but results in no benefit at all to me or my coworkers. This year was the year I stopped pretending that I was a team player, on board and happy about it. Instead, I was just exceptionally frank about what I thought and how I felt the whole damn day. What a refreshing change.

Last night my feet hurt so badly that I had trouble falling asleep. The incessant throbbing was relentless--and I wore running shoes under my floor-length dress throughout the entire day. We had off today, and that was a blessing. There was no improvement to my mood, though. I can dwell under the clouds of bitchiness, deep in the Dungeon of Resentment, indefinitely. When the conditions are right, my moods are no longer within my control.

All of those bipolar medications work, although it may not seem that way. Without them, this mood would have escalated into flat-out nastiness and rude behavior. Every thought coming into my head would have exited through my mouth, unchecked and unfiltered. Taking medication doesn't stop you from having moods; the medication stops the moods from turning into something unmanageable. Sometimes I miss that lack of a filter. I can insult people with exceptional skill and intensity, but my willingness to cross that line is greatly diminished by the medication. Ah, those were the days.

Have I mentioned that the entire right side of my body is on fire? It's getting old and I'm very ready for it to end.

Which reminds me of a conversation I had with myself. Every morning, as I drive to work, I play a question game with myself. There's a different game for the afternoon. The morning game is called, "If you could be anything in the world what would that be?" The answer is a litmus test for whether or not I am mentally healthy. These days, the answer is likely to be "free of pain," "lottery winner," "exceptionally thin," or an equally shallow option.

It wasn't always like that. For two years, my answer to the question was, "Dead." Every day, for more than 700 days, I asked and answered without deviation. That made me come up with another question game for the afternoon: "How would you kill yourself?" For a long time, the answer was really a list of things I wouldn't do. Then it became a list of things I would do. And then I finally got the answer, and until this moment, never revealed it to anyone.

Here's what I would do: I hate late fall, I detest winter, and I don't like spring very much because where I live, spring is often cold, wet, windy, and snowy. Summer is my haven, my salvation, the season I am awake. So, I would have to carry out my plan in the winter. On a frigid, sub-zero-temperature night, I would first sedate myself with a sufficient dose of the appropriate medications (which I have in abundance), knowing it would eventually send me into deep unconsciousness. Before that point, though, I would, quite simply, go outside and lie down in the bitter cold night, on the frozen ground of my front lawn, wearing nothing more than my pajamas and socks. Then, I would fall asleep and die--if not from the overdose, then definitely from hypothermia. It makes for an easy clean up, too, as well as being easy for the coroner to recover the body. No stairs, no walls, no furniture, no obstacles at all. No blood, no bodily fluids, no mess of any kind (with the exception of my office and basement which are beyond the scope of my organizational abilities at this point).

So, summer is on the way, and I feel cheerier at this time. The irritability will pass. The drugs will force me to feel OK, and lithium will protect me from killing myself. I will live to blog at least another 120 days. After that, it's really a matter of mood and weather. Nobody ever really knows how precarious my situation actually is, and that's probably best for my own autonomy.

The Bad Daughter

I didn't get my mother a Mother's Day gift. Her birthday is tomorrow. I didn't get her a gift for that, either.

I know this will be held against me. (You could have made a necklace for me. But I've been sick, I've been in terrible pain, and I barely made it through the Resentment necklace. That's no excuse. I'm your mother.). This conversation hasn't happened yet, but a similar version of it will.

I'm not sure what to do with that. Guilt seems so unproductive.

The bigger question might be, why didn't I buy a gift for either occasion? The truth is simple and I think I can actually admit this: I didn't get any gifts because I did not want to. Seriously.

Barriers to medication compliance

If you want to see a generally "normal" mentally ill person snap, ask this question: "Are you off your meds?"

It's the stuff that sitcom jokes are made of and the kind of thing that people say when they want to be particularly insulting. It's the kind of thing, that when said, reinforces our deepest cultural attitude about those who take medication for the mind: You are strange. You do not merit credibility or respect.

The reasons why lack of medication compliance is so widespread vary, but generally fall into two categories: Money and side-effects.

Many of the medications I take align my behavior more toward the center of the normal spectrum, but it's like cropping a photograph to get to the good part--No matter how good that picture looks when you've finished, you probably had to cut out some things you didn't want to in order to get a satisfactory result. My medications work well at making me socially acceptable. They also do a great job of dulling my sense of humor, slowing my thinking, drying out my mouth, and compromising my speech. I have learned to live with it.

More potent medications cause some truly terrible side-effects, many that I, if given the choice, would not accept. I've seen people with tics and shakes and stutters, and tongue-thrusting, and gut disturbances, blurred vision, hair loss, and worse. Still, patients are expected to adjust and accept these side-effects in the interest of social propriety. That's really what the meds are about--making people like me less distasteful to everyone else. My meds do stabilize my mood, but they still ain't all that.

I am currently reminded of my early struggles to succumb to the power of medication. It's all coming back to me now. The urologist prescribed three medications for me, and all three share one side-effect. All three medications make me drowsy and slow. It's like being on large doses of benadryl all the time. It's a little hard to take gracefully right now, since the drugs haven't yet started healing anything or diminishing any pain. That's how it is with the other meds--the side-effects are instant, but it takes a really long time before any benefits become evident.

I hate this feeling. It's like I'm seeing the world from somewhere much deeper inside of my head than my eyes can account for. Everything is in slow motion. I can't think of words or names. I want to sleep. Elmiron gives me terrible headaches. I'm so damn tired.

Only three months to go.

May is in a vile mood. Do not look at me wrong if you cross my path or I just might kick you. Of course, then I'll have fits of self-loathing because I don't really want anyone to feel bad because of me.

Could it be a result of mixing eight prescription medications?

I've been having suicide ideation since I woke up. I'm not sure why. I'm never sure why. Sometimes it just pops into my head like a bingo ball and rolls around all day. Again, I ask: Could it be a result of mixing eight prescription medications? Could it be depression? If I have to put up with this bipolar shit, then where is my occasional expansive mood and feelings of grandiosity? Huh? Why must it always be paranoia, insecurity, sadness, and irritability. Memo to brain...Variety is the spice of life.

There's nothing in particular that's setting me off, but it seems like everything imaginable is getting to me. I take things personally that can't even be personal. How sad is that??

Oh! Could it be from chronic pain??

Paranoia is definitely a bit of an issue today. Maybe it's not that serious and I'm just a garden-variety neurotic. I don't know. I feel distressed because I haven't been very productive lately. It makes me worry that I can't keep up with the rest of the world, everyone is onto me, and I am a total loser, loser, loser.

Every spring, my employer hosts a large cultural event for the community. It's A Big Deal. Over the years, I have designed invitations and posters, written press releases, created promotional materials, program brochures and a public-area display, and more. It occurred to me that this year, I seem to be in a weird position of being asked to give other people my files/samples/copies of these things because those other people have been assigned to do all of those tasks. Each department employee oversees an area of the building on event day, usually in teams of two. This year, a third person was added to my area. It occurred to me that the event is coming up very, very soon, but the other two people have "taken care of everything." I know I'm neurotic, paranoid, and insecure, but still, I'm starting to take this personally. I feel like I've been unceremoniously dumped from my previous roles, and it must be a reflection on me.

I can only conclude that my work on this project, although always prolific, has been deemed unacceptable. That makes me sad. It makes me sad because it just proves that all of my fears about my place in the world are absolutely valid. Tattoo that big L on my forehead, will you please?

Really, it makes me want to kill myself. God knows, I have enough pill-power on hand to knock out a small village, Or cure a smaller village of its mood problems, neuralgia, and pelvic pain.

I hate myself. Always have, always will. Why can't I think and process feelings like a rational, relatively normal person? Why can't my brain keep itself on track? WTF???

I decided that if and when I kill myself (probably to save my long-suffering husband from any more drama), I will post an ad on the Internet and possibly the newspaper before I go. Right before I go. People should know why other people die. My will clearly states there is to be no funeral, so this would be the means to providing closure for those nosey people who need to know what happened. those would be the out-of-touch people.

When I went to the urologist last week, I overheard an unsettling conversation. It was unsettling because it underscored the lack of understanding people have about suicide.

I was waiting for one of the two receptionists to set up a follow-up appointment for me. Next to me, another women was checking in. In a loud whisper, she asked the receptionist, "Is it true? Dr. Ruben died?" The receptionist nodded, and in a conspiratorial tone, the women leaned in a little closer and whispered, "Did he really kill himself? He committed suicide?" I wasn't about to turn and look at her or the receptionist, but they definitely had my attention. Again, the receptionist confirmed the news. The patient shook her head, put her hand on her breast, and said, "But he had everything to live for."

I know I was making that face. It's that face I make when I'm annoyed and trying not to say anything. I get that sort of closed mouth, crooked-jaw, Melanie Griffith thing going on. My first impulse was to blurt out, "How the hell do you know what he had or didn't have to live for? How do you know what he valued? What makes you think that you can even begin to understand--let alone judge--what he did?"

Of course I kept my mouth shut. I took my appointment card and barged out the door into the snowy, wet spring morning.

People just bug the shit out of me lately.

366 days

One more lap around the sun.
Made it through another one.

The female fire

There's a reason I won't see male doctors anymore. They don't get it. Even those who are by nature quite sympathetic, will only grasp women's health issues in the abstract. There's the biology--that's pretty straightforward--but they have no real understanding of what it means to be unable to function as a woman because your body seems to physically block out sexual contact. How our pain affects us in our day-to-day life is not taken all that seriously by those of the opposite sex. For them, it's just another icky thing somehow connected to that monthly inconvenience women are always bitching about.

Not all women doctors get it, either, but at least they're able to conceptualize the problem on a personal level. I said not all, though. Sometime in the 1990s, my mother sent me a book. The author was making the rounds on public television where she was espousing Women's Bodies, Women's Wisdom: Creating physical and emotional health and healing by Christiane Northrup, MD.

My mother sent me the book and said it was just what I needed. Two other people had recommended it as insightful and empowering. On a Saturday night in the summer, I sat on my back porch and started to read. I read Northrup's case studies of women who suffered with undiagnosable abdominal ailments, periods out of control, and recurring infections. We have the power to make it stop was her message. Oh, really? Obviously, I had been trying, so what was Northrup going to tell me that was new? What, indeed.

In the case studies, Northrup pointed out again and again that we just had to want to get better. Our maladies were really just the result of our own out-of-balance lives, our deepest intuition we were choosing to ignore. Break up with the boyfriend who doesn't support you and the menstrual pain will stop; bring your life back down to size and abdominal pain will follow suit; address your inner demons/trauma/career choices and your body will stop expressing its distress through your reproductive system.

The message was clear. Despite my lifestyle change, avowed singlehood, ambition, and attempts to get answers, Northrup was telling me that my pain was my fault. It was the result of my subconscious attempts to sabotage myself. My pain was there because I wasn't trying hard enough to address my deepest emotional pain.

Fuck that. Anecdotal case studies without solid science just pissed me off. It seemed like Northrup had found people whose situations proved her point instead of finding people and then finding out what the point was. I closed the book and threw it in a box, where it still sits today, more than a decade later. It is not my fault. I've been known to achieve some formidable accomplishments, but not even I can spontaneously conjure up parasites in my vagina. I wouldn't even know where to start.

Here is the first paragraph from Amazon.com's summary: Quite possibly every female over the age of 12 will find this huge book enlightening, pain saving, and perhaps even lifesaving. Think of it as a much more empowering and holistic Our Bodies, Ourselves...In Women's Bodies, Women's Wisdom, she covers the treatment of many physical concerns--among them PMS, menstrual cramps, breast cancer, fibroids, endometriosis, infertility, depression, childbirth, abortion, cystitis, and menopause--explaining how many of these physical problems have roots in emotional upsets. For example, a woman who is unhappy with her marriage may be infertile because deep down, she knows that her husband is not the right man to have children with; a teenager who has cramps may be having problems accepting society's expectations of her as a woman.

A woman with chronic pelvic pain may actually be of sound mind and have a medical condition, Christiane.

I can only imagine what she'd have to say about bipolar disorder. Maybe she's a Christian Scientist. Maybe she's a Scientologist. I wonder if she knows Tom Cruise?

I digress. All these years have passed, and my pelvic pain has never gone away. I don't remember what intimacy is, because my husband and I gave up on it quite some time ago. If you were counting in days, it would be in the many thousands.

To my benefit, I have a good gynecologist. Actually, she's nurse midwife, and I chose her for just that reason. Nurse midwives are excellent listeners who have a certain appreciation for a woman's pain. They have a refreshing philosophy about women's health, and they do not believe that any degree of pain is normal or should go unacknowledged.

Jessie the nurse midwife has been trying to get me to go to a urologist for years. I never went because I felt that after so may times being told there was nothing wrong with me, it wasn't worth the embarrassment or the money to see a specialist--especially a specialist whose specialty I didn't really understand.

Jessie and I talked a long time about my pain. She asked about my bipolar and inquired as to why I had decided to pursue treatment. I told her that I wanted to stop the pain, the discomfort, the arduous climb each day had become. I also said I wanted to stop being a burden to those I loved and a nuisance to everyone else. After my last heart-to-heart with Jessie, I made the appointment with the urologist.

The doctor is a woman and she is consistently voted by her peers as an outstanding practitioner--top three in the city--year after year. She is in her 50s, crisp, business-like, and full of information. She is a teacher and it shows. As she performed the most vigorous pelvic exam of my entire life, she talked nonstop about what she was poking around for. At one point, I cried out and said, "You know, that's gonna hurt for days." She told me that wasn't normal, but she knew why and what we were going to do about it.

"May, you have three things going on, and any one would have had most people in here a long time ago. You're right that when this started, docs didn't know what it was, and even if they did, there was no treatment. Most of what I know about this I've learned in the last 12 years."

"First, you have Interstitial Cystitis, what we now call Painful Bladder Syndrome. You very likely have a lot of scarring in your bladder wall, which causes pain and stops the wall from expanding properly. This is triggering another condition called Pelvic Muscle Floor Spasm. This condition is not widely understood, but we know it's painful and once it's been activated, it becomes easier and easier to trigger. Now, the third condition is actually quite rare, but you've done an excellent job of documenting your symptoms and the course of your disease. This is something that usually comes about as the result of a difficult childbirth, or injury to the lower back, pelvis, hips, or legs. I know you said you've never had an injury like that, but this condition is also seen in people who are or were high mileage cyclists. We do know for sure that you have to have a genetic predisposition for it. Do you have Irritable Bowel Syndrome?"
"Yes."
"Do you get migraines?"
"Yes."
"Hmmm. We know there is a connection. People with your condition almost always have migraines and IBS, but we don't know why. Nobody has figured out the link, only that there is one. It's all part of a big mystery wrapped up in the central nervous system. Even your shingles outbreak came from your central nervous system."

I was trying to follow along despite the now flaming pain in my female area. Damn that central nervous system. "Does my condition have a name?" I asked. "Yes. It's called pudendal neuralgia. It's going to take a while, but it can be treated." (Note: My brother also has this condition. He's a cyclist.)

So, here I am with three diagnoses and three more prescriptions to my name. First, Lyrica, an anticonvulsant used for neuralgia. It is advertised as a treatment for fibromyalgia, but it was actually developed to treat diabetic neuralgia and....tad dum! Shingles pain! I have nothing to lose by taking this one.

The second medication is called Elmiron, and its sole purpose is to recondition the bladder wall in patients who suffer from Interstitial Cystitis.

The third medication is hydroxyzine, an antihistamine that calms the bladder's reaction to irritation. Perhaps it will address my springtime allergies, too.

I also need to undergo physical therapy. This will be a type of trigger point therapy performed by a specialist. I looked it up and this therapy is...internal. For a moment, I envisioned a scene from the movie, The Road to Wellville, wherein women shed their malaise after "internal manipulation" at the hands (literally) of Dr. Spitzvogel. I can't explain more; you'd just have to see it.

The last thing I mentioned to the doctor was that I was going home to sit on an icepack. She handed me some photocopies and said, "There's a better way. Read this and take care of yourself."

One of the handouts included instructions for dealing with post-exam pain. Advil...blah, blah, blah...no caffeine...blah, blah, blah...condom, KY, freezer...What??? I went over that part again: Fill a condom with KY jelly, tie it off and freeze it. Insert the frozen condom into the vagina to ice and soothe the sore area. Oh. Oh.

Oh, it was brilliant. Of course. It would be much more effective to use this item than an external ice pack. But what was it called? Jelly ice? Cool condom? Crotch-cicle? Twatcicle? Somebody needs to perfect this and patent it. I wish I had thought of it--or at least heard of it much sooner.
This latest bout of health news has me dragging. More drugs. Therapy. More doctor appointments. No real immediate relief. Continued chronic pain. Drowsiness from medication side-effects. Enough already.

I have enough health messes going on iin my one body for an entire village to bear. I have far more illness and health-related quirks than one person should ever have to handle. There definitely needs to be a new policy, and I vote for a one-person-one-illness world. That seems fair to me.

Excuse me now while I fetch my very special frozen treat.