Monday, July 30, 2012

On the Road Again

This is the fourth time I have moved in the last two years.  That's not counting the packing up and storing of all my stuff at the end of each academic year at Smith, and the subsequent unpacking into a different room the following fall.   I'm so unbelievably, down-to-my-bones tired of moving.  I'm tired of finding boxes, of cramming everything I own into them, of tape getting stuck, of losing my marbles over how to get everything done, of paying exorbitant amounts of money for moving help and U-Haul trucks, of signing new leases, of breaking old leases, and of never feeling at home.  I'm tired of it all.

I know that this is what being in your twenties is supposed to be about, on some level: being unmoored, portable, and (relatively) spontaneous, given that I am unattached, unmarried, childless.  I certainly wouldn't argue that moving a family of five is more difficult than moving myself, a friend, and two unruly cats, but I still crave stability.  I want to be able to attach things to the walls without Command strips because I don't have to worry about getting a security deposit back in six months or a year.  I want to actually unpack things, instead of just stowing overstuffed plastic totes under my bed or in a closet, because I'll just have to pack it up again, anyway.  I want to be able to give someone my address without the caveat that by the time they send something, most likely I won't be there anymore so they should probably send it to my parents' house instead.

All of which leaves me with a wary sense of excitement and tentative relief at the prospect of where I will land on this move.  After all, the first floor of a cute little Victorian house on the outskirts of New Haven will be home to me for at least the next three years.  I can settle in there, I hope.  I can set up my printer, I can find a place for my Crock-Pot, I can maybe even start going to the dentist twice a year, like you're supposed to do when you live in one place long enough to keep appointments like that.

And really, I know there are worse things.  I really do.  I know that even setting aside the horrendous troubles of the world at large and other people's pains that I'll never try to compete with, I myself have gone through a hell of a lot worse than moving.  I know that.  But when I stand in the kitchen, here, and remember how sad and desperate I was when I moved in, and I remember all the times I've cried on this here floor, and I take a bite of the lunch I just made out of things I'm trying to use up in the kitchen so I don't have to pack them (i.e., rice with eggs and Sriracha sauce) and the rice has the nerve to be undercooked because I can get into Yale and I can't cook rice, what the hell is wrong with me and I start to cry, again - it just seems like a bit much.

In a few days, this will all be over, I tell myself.  You just have to keep pushing to get through the next few days.  Put everything in a box.  Don't worry about it not being organized, just label it so you know.  (This is how you end up with boxes with labels like BEDSIDE LAMP, TUCKER TREATS, WEDDING DRESS, HUMIDIFIER, WAX PAPER.)  Keep taping up boxes until it's done.  Try to sleep a bit, then go pick up the moving truck.  Drive.  Don't think about how scary it is that you're driving a 20-foot long vehicle, alone.  Just drive.  Move things into house.  Hope the moving men speak English.  Return scary huge truck.  Go back to the yellow house that is now home.  Collapse.  Get up again.  Commence unpacking.  Find a place for everything.  Make your bed, and if necessary, bury your head in your pillow that smells like your shampoo and Tucker's sweet fur, and the old t-shirt you sleep in.  Cry again, if you must.  Then get up and keep going.  Because it will work out, I tell myself.  It has to.

Tuesday, July 24, 2012

Looking the Part

I feel like a fraud.

I stood in the dressing room at our local uniform store, awkwardly tugging on the navy blue scrubs that I was trying on, and cracked the door open.  "Mom?" I called, in a wavering voice.  "Do these look okay?"  I sounded like I was twelve.  Not twenty-four, and certainly not old enough to be entering nursing school, where I will all too soon be put in charge of something small and manageable, like someone's life, for instance.

I have the navy scrubs, two sets of them.  I have the sensible shoes, that will support my back and wipe clean with a towel.  I have those things, but I feel like I'm pretending.  Like I'm playing dress-up.  I'm terrified that on my way to my first clinical shift, someone is going to collapse on the sidewalk or in the coffee shop that I'm walking past and someone will stop me and say, "Please, can you help?!  You're a doctor/nurse/you know what you're doing, right?!"  No!  I don't!  I don't know a thing!  And yet, here I am, marching off into rooms filled with unsuspecting patients, asking them to proffer me their wrists, so I can search for a pulse, their upper arms so I can over inflate a blood pressure cuff on them, and their shivering backs, so I can listen for breath sounds that I can't interpret, anyway.

There are two things, however, that I am bringing with me, that I do think will help.  The first is my grandfather's Timex watch.  My grandfather wore this silver watch for as long as I can remember, and my mom held onto it for the past sixteen years since he died, tucked away in her drawers.  When I mentioned that I needed a watch with a second hand for school, she pulled it out.  A new battery and a new wrist band later, I am outfitted for pulse-taking and contraction-timing with the most perfect watch I could ever want.  I think of him when I look at its reassuring hands, and I remember how safe I felt in his lap.  Maybe I can bring a little of his calmness and steadiness to my work.

The second thing I am bringing is my mother's stethoscope.  My mother put herself through nursing school long before I was born.  She did it as a single mother, while raising two little boys (my older brothers), with no money and almost no help.  She fought an uphill battle in order to be able to provide for her family on her own, without depending on anybody else.  And through sleepless nights, and government checks, and the aftermath of divorce, she did it.  She did it, and she believes that I can do it too (though under considerably easier circumstances, I might add).  And I am so grateful that every day, as I struggle to learn and to measure up, and to prove to myself and my professors that I can do this - I will have her reassuring presence with me, hanging around my neck, or resting in my pocket.  The stethoscope that helped her realize her dream will now become a part of mine.

Thursday, July 19, 2012

Just Say No

I've been filling out more than my fair share of medical paperwork over the last few weeks, what with trying to get everything cleared for Yale and all.  It's all very standard stuff, but there is one question that continues to trip me up, every single time I see it: please list all medications you are currently taking.  Obediently, I put pen to paper and start to list the four or five prescriptions I have in my name.  Give or take a few seconds, and I'll pull up short and remember - I'm not taking any medications these days.  Not a one.  For someone who has been on one form of a psychopharmaceutical or another since I was nineteen, it's a little bit unsettling.  Also, given the manner in which I went off of my medications, I consider myself more than lucky to be doing as well as I am.  Suffice to say, it was not one of my more responsible moments.

Moving to another city presents many challenges, and finding psychiatric care - that I could afford - when I moved to Boston proved to be a challenge.  I halfheartedly started seeing a new therapist, but balked when she mentioned an every day intensive outpatient program for eating disorder treatment.  I had already had one job blow up in my face as a result of being honest with my employers about things I struggle with, there was no way I was about to come clean to my new bosses in order that I might leave work an hour early in order to make it to IOP in Harvard Square every single night.  Add to that, I was still speaking to my New York therapist on the phone every other week, and there was no way I could afford to keep paying two therapists.  So, I reasoned that doing phone therapy twice a month was sufficient, especially since I was seeing a new psychiatrist to manage my medications and my plummeting moods.  The first session I had with her was exhausting.  I left feeling like I had been poked with a sharp stick for an hour, never mind the fact that I had paid her $350 to do it.  With instructions to return in two weeks, I drove home in a driving snowstorm and promptly crawled into bed.  Two weeks later, I paced the floor of her waiting room with barely contained maniacal energy.  She ushered me in, took one look at me, and said, "This has got to stop."  I clamped my hands down on my thighs to stop their frantic twitching and asked her what she meant.

You're twenty pounds underweight, she told me.
You're headed for a manic break, she said.
Your medications can't work for you if you're not eating enough to metabolize them, she scolded.
We might have to put you on lithium.

I think my heart stopped.  I tightened my grip on my emaciated thighs as I started to shake uncontrollably.  Lithium.  It's not for the faint of heart.  Lithium is an excellent drug, one that entered the scene of psychiatric treatment in the 1950's and was found to be very effective at managing manic depressive illness, particularly in controlling manic episodes.  It comes at a cost though.  Lithium has a narrow therapeutic/toxic ratio, meaning I would need weekly blood draws to measure my plasma concentrations.  Side effects include a perpetual dazed feeling, hand tremors, dizziness, nausea, possible birth defects and permanent kidney damage.  A toxic dose is deadly.  The most common side effect, however, is weight gain.

I can't I won't I can't I won't, I chanted in my head, and the rest of our $300 session passed in a blur.

I never called her back.  I never returned her calls.  Two weeks later, my medications ran out and I didn't have any refills.  I went cold turkey off of five serious medications, each of which I should have been weaned off of over a period of weeks, and possibly months.  She left me angry (albeit, concerned) voicemails and I deleted them without even listening.  I won't pretend that any of this was a good idea.  My moods swung wildly.  Without sleeping pills, it was weeks before I slept through the night.  I had days of such paralyzing depression that they reminded me of how I had felt before I went into the hospital three and a half years ago.  I had nighttime anxiety attacks so bad that I would grip my headboard until my knuckles turned white, trying desperately to breathe, focusing in on Tucker's glowing eyes in the dark while he sat with me, never leaving my side.  Eventually though, the storms began to pass.  I could feel sad, and it wouldn't knock me to my knees.  I could feel happy, and it wouldn't lift me ten feet off the ground.  I could cry over Alix, and still get up for work the next day.  Even hearing about my dad's diagnosis only spurred me to try harder to pull myself out of the eating disorder's grip, until eventually, I resembled a healthy human being again.

Two weeks ago, I sat down once more in a psychiatrist's office (not the expensive lithium-suggesting doctor of this past January) and laid bare my history.  "I just want to see whether you think it's okay that I'm not taking anything," I told the nice, earnest-looking resident.  "I don't want to do anything irresponsible or stupid when I'm starting a new school year like this."  He listened closely to my colorful history, asked all the right questions, and finally told me that no, I didn't need to be on any medications right now.  He cautioned me, though, and made sure I understood that the very nature of bipolar disorder is that it is cyclical.  That there's a greater than ninety percent chance that I will need medications again at some point.  I already knew that, and I told him as much.  He told me to pay attention to my moods this fall, when the days begin to shorten and Seasonal Affective Disorder begins to set in.  He told me about exercise, and good sleep habits, and the benefits of surrounding myself with supportive people.  I stifled a yawn, and told myself he was trying to be helpful.  There was no way for him to know that I could have given that speech myself.

I don't know how I feel about the likelihood that I'll be popping handfuls of pills again at some point down the road.  Maybe he's right, and it will happen, or maybe he's wrong, and it never will.  Regardless, I am fully enjoying being unmedicated for the first time in five years.  And the last medical form I filled out, where it asked me to list all of the medications I am currently on?  I drew a smiley face on the lines instead.

Thursday, July 5, 2012

Tuesday, July 3, 2012

All of the Things

  • Everything really is bigger in Texas.  Like big oil, and how gas prices are at least fifty cents cheaper here than in Massachusetts because of it.  Also, the bananas.  Are huge.  Not kidding.  I carried three of them through the supermarket today and felt like I was gathering props for a low-budget porno.
  • Today was the first Monday that I haven't been at work with my girls since I started in January.  It's a bit surreal, to say the least.  Also weird: depositing my last ever paycheck on Friday, and knowing that the next time I'll be working full-time, it will be as a midwife (or nurse) - NOT as a nanny.
  • I've been reading up a storm in an effort to stockpile memories of pleasure reading before school starts and the only things I should be reading are textbooks.  Some recent favorites: NurtureShock: New Thinking About Children, by Po Bronson and Ashley Merryman; Wild, by Cheryl Strayed; and The Night Circus, by Erin Morgenstern.
  • The following articles/opinion pieces made me think:
    • The Busy Trap
    • This, about "having it all," but then (thank goodness), 
    • This, about taking the whole crazy thing less seriously sometimes.
  • I saw this movie last week, Your Sister's Sister, and it was the best movie I've seen in a long, long time.  Can we have a show of hands from all the little sisters in the world whose older sisters didn't teach them about ahem, the need for trimming?  Go watch the movie, you'll understand.
  • Fun things I am doing this week in Texas, to be included in an upcoming post:
    • Ze wedding! (technically, this already happened, but since it's the reason I'm here, it deserves some proper attention)
    • pie-making
    • hair-cutting
    • day trip to Austin (we're going to the bat bridge!)
    • Rangers game
    • Half-Price Books
    • good Southern food/real bbq
    • swimming
    • sleeeeep
And those are all of the things.  Please tip your waitresses, I'll be here all night.