No Thank You!

Hmm. Maybe I should wait to do that until after my surgery.

Hmm. Maybe I should wait to make those plans. My surgery is coming up.

You know what?

Fuck that. Absolutely, unabashedly, fuck that noise.

In other words, NO THANK YOU.

I'm not sure when I decided that I wouldn't wait on things. At first I hesitated because I didn't want to make the decision and then not be able to follow through. And then I hesitated because I had a temper tantrum about not being able to make plans for anything at all ever. And then at some point I just...decided to stop waiting.

This has been a long year and I was tired of waiting for my health to improve before I started working on my bigger goals. I just couldn't wait any longer.

And hoo boy, do I have some bigger goals.

I was talking to someone today about boundary setting and incorporating three words regularly into their vocabulary: No Thank You. In this particular instance, they were feeling parented by a peer, and I introduced them to the "no thank you" of it all. If this person decides that they want to give you advice when you didn't ask for it and didn't want it? No thank you. That literally needs to be your only response.

If someone tries to invade your boundaries? No thank you.

(It's not mean. We just think it is. And, if it feels like shit, then that means we're doing necessary boundary work. It's a good thing.)

I decided to try it with myself. Why do I really want to wait on these things? 

Maybe I should...

No thank you.

I'm not doing enough of...

No thank you.

I have to make sure that I don't forget this or that, or the Very Bad Consequence will be...

NOPE. NO THANK YOU.

I'm not doing as much as I should be and I'm going to be totally unprepared to not work for four weeks...

No thank you.

In other news, I think I'm going to have to wear a post-surgery turban. One of my friends suggested that there is funnier headwear, and I agree, so I'm going to try to make it hilarious.

Maybe I'll have people sign it like a cast.

My point? Shit's getting real, kids. On several fronts.

By activating my inner "No Thank You", I've found myself to be ready for every single bit of it.

Maybe I should make sure that all of my electronics are charged so I can bring them to the hospital and make sure that people can get in touch with me.

No thank you. Rob's going to do that and he has already volunteered to do that.

Maybe I should make myself a to-do list for when I get bored while I'm out.

No thank you. Napping will be just fine. You have a team of Very Capable People that can do all of these things, and if they can't, then they can wait. Seriously. THEY CAN WAIT.

Maybe I should make a plan for exercise so that I can start doing that as soon as possible. That marathon ain't going to run itself.

NO THANK YOU. You're getting a treadmill delivered after Christmas, and it will be walking only for at least three months. WALKING ONLY.

Maybe I need to eat better in this time so that I can prepare myself better for surgery.

No thank you. Use this panic time to eat whatever the heck you want. Eat healthy after, which is also what your doctor recommends. And yes, you may go home and make that second box of mac and cheese today. Do it up, friend.

It's amazing how much inviting in No Thank You has also invited in self-care. I'm kind of floored and in absolute love with this idea.

More to come. Stay tuned!

Adversity as an opportunity

Friends, my meningiomectomy is coming. (I'm not sure if that's what it's actually called, but that's what I'm calling it.)

Marvin is getting evicted, tentatively, December 15. I'm ready. This is the last thing in the unending tirade of medical bullshit that has come my way this year. And, if Marvin is benign, this surgery is curative. CURATIVE. After this is done, all that's left to do is recover and to heal. And to have a Ceremonial Burning of the Medical Paperwork of 2021. Let me tell you, I have A TON of it. Like, a ream and a half of paper. Of course, I have to have another colonoscopy in January, and then there are the every-three-months follow-ups for a few years with my endocrinologist, but I will not be in a doctor's office three times a week come this time in four months. If I am, I'm going to strongly consider quitting my job and being an arsonist as a next career move. (JUST KIDDING. I AM NOT A SAFETY RISK TO OTHERS, I ONLY MAKE VERY INAPPROPRIATE JOKES.)

Anywho, with, y'know, brain surgery coming, it's given me a fun opportunity to delve into the world of hairstyling. A fairly significant portion of the left side of my head is going to be shaved, and while Rob thinks that the best course of action is to shave my entire head, I'm not so sure. I don't want to freak out my clients, we'll be going directly into wintertime, and I don't want to wear a hat everywhere, so there's a lot to ponder. Pinterest has some very interesting wormholes in the world of hair, let me tell you. I so rarely take care of my hair - I go to the hairdresser maybe once every four to six months - and so I've got a lot of pondering to do about it. My hair is curly, which adds another dimension to it, but I think I'm finding some really, really fun stuff.

Of course, I say that I'm going to sit with it and figure out what I want and be methodical, but given that I have an impulse control problem, I'm likely going to the hairdresser tomorrow. Yeah, I'll be going into the office on Tuesday with all of my hair chopped off. I've wanted a new hairstyle for a while, and I'm super stoked to change it up a bit.

I've also decided that the thyroid cancer has not spread. I'm having a total body scan in a week and a half to see where the radioactive iodine is concentrating, and it will show no spread. It just won't. The surgeon took two lymph nodes and one of my parathyroids in the thyroid surgery just to make sure, and they were all negative for metastasis, so the chances of that being true are pretty good. My geiger counter came in the mail today, and I've been having a hilarious time holding it up to things and seeing if they emit radiation. I imagine I'll find it less entertaining when I have to hold it up to myself and it dictates whether or not I'm able to leave the house, but I digress.

Also, my hate amalgam is ruined. RUINED. KYLE IS A REALLY NICE DUDE WHO IS JUST TRYING TO DO HIS JOB. To add insult to injury of the death of this hate amalgam, my therapist was all "How about you just feel the anger that you feel, Ryan?" PFFT. WHAT DOES SHE KNOW OTHER THAN THE MOST INTIMATE DETAILS OF MY LIFE AND MY DEEPEST THOUGHTS AND FEELINGS THAT I WOULD NEVER SHARE WITH ANOTHER PERSON EVER. I mean, this is a great opportunity to be able to actually delve into my feelings about all that has happened over the past year, so there's that, but I'm just so MAD about it. Everything is annoying, and I am Most Definitely Not In A Place Where That Can Be True. I'm trying to run a business and bring on new clinicians and be supportive of my clients and navigate all of this medical stuff. My feelings can take a number. The reality is, my feelings are currently the Karen in the Deli Line that's all "I don't have time to wait for this! UGH" and has a temper tantrum and everyone just wants to shut her up and just lets her cut to the front of the line. There's a lesson to be learned there, which is that my feelings need their turn in the front seat for a little while so that they don't jump on the hood of the car, but I don't want to learn it. I just don't. There's a big part of it that's fear - if I open up that well of rage, will I ever be able to close it again? I was able to practically cement it shut in years and years of therapy and trauma work, and I didn't expect to have to let it out again, but here we are.

Who knows. Maybe I'll pick up boxing. Punching things feels like a good idea and a good way to get out some powerlessness and frustration and rage, and it's WAY more productive than what I'm doing currently, which is nothing.

A Rant About Ableism

Recently, one of my doctor's appointments was made without consulting with me. I was called by the nurse that made the appointment (and yes, it was the real-life Kyle) who just called and told me the appointment time. No negotiation, no "pick from a list of these times". It SUPER bothered me at the time. At first, I wrote it off as just being bothered by everything lately, because I am, and so just add this to the pile, but it continued to stick. I couldn't let it go. It was for my radiological oncology appointment - my first one. I called to change the appointment, but I couldn't without messing with the timeline for treatment, and the conversation yesterday (after trying three times unsuccessfully over the past week and a half to get this appointment changed, I finally got someone on the phone) went something like this:

Me: Hi! I'm scheduled for an appointment in early September, and I need to change it.

Scheduler: Ok! We can get you in for a consult in mid-October.

Me: I can't wait that long without messing with the timing of treatment, which has to be done within 3-6 months of my diagnosis, and I'm already 6 weeks post-surgery, so I'll figure it out and just keep that time. Also, can I ask? Why was this appointment made without consulting me in any way?

Scheduler: That's just how we do it.

Me: You should change that practice immediately. My very busy life does not center around this diagnosis and I'll have to change my whole schedule around to make it. Moreover, who says that's a good practice? Why is that policy in place?

Scheduler: Well when works better for you? (Do you see how she turned it around there and didn't answer my question? Her tone also suggested that I was being entitled about it. Nope!)

Me: I don't understand how that's relevant, but mornings work way better for me.

Scheduler: Ok. We'll remember that for the future. In the meantime, we'll see you on September 9 at 1:30.

I had a meltdown of nuclear proportions about this. I was so pissed that I didn't even know what to do with myself. Once I was done melting down about it, I sat with it. Why such a strong reaction?

What I realized is that the reason for this is because they have me by the balls, and they know it. I had another doctor's appointment at that time and had to cancel it, and I also had times that I needed to see my clients during that time and I had to shift it all around. 

The thing for me is this: they deal with cancer patients all day. There's a sense of powerlessness that I've felt about this that I've never felt before. I'm in the middle of a time in all of this medical stuff where I need to be able to have some semblance of control over what's happening to me and my schedule is where I find it in spades, and it was taken away from me in a blink. Is this objectively a big deal? No. To anyone who isn't going through this, of course it's not. But, I can imagine that for other people going through similar, or even more severe things like this, they may feel the same way as I do. The person on the other end of the phone doesn't know or realize that, and neither does Kyle. Neither does anyone who has never been through it. There's a privilege that comes with not having to grapple with something like this that I think a lot of people don't realize.

What I also realized was that this wasn't just about the appointment. It was about the powerlessness. I felt a big piece of grief yesterday that I've been pushing away for awhile, and it has to do with my utter powerlessness to stop what's happening except to accept it and go through the motions of being treated, and there are many things about which I don't have a say. It's so surprising how some of this stuff bubbles up, and what can push on that button unexpectedly.

There's also a piece of this that isn't about me at all. When you have multiple medical things that you're juggling, it's its own full-time job. For someone to just swoop in and assume that you can make it work and figure it out, it goes beyond rude. It goes beyond disrespectful. Due to the nature of my work, I know a lot of people who are managing multiple medical things; I've heard time and time again the frustration of trying to manage schedules and "Oops I have two doctor's appointments at the same time, I can't believe I did that, and so now I need to use my triage skills and figure out which one to keep and which one to reschedule", and from a patient care standpoint, the idea of just scheduling a time for someone without their input is so deeply ableist. It hits two ways: The first is that medical organizations, by doing this, show you that they operate under the assumption that you can't or won't do it yourself. The other is that if you can't make it work, that's just further proof that you can't manage it on your own. The power differential between doctor and patient is only further reinforced that their time is more important than yours, and they have you by the balls, so you are the one who has to make it work. Patients are screwed either way and are treated like they don't know what they need in terms of their own care.

This is changing how I practice clinically, without a doubt. My availability is drastically changing due to all of this medical stuff, and while I don't have control over that, I'm definitely putting more of a priority on letting my clients have more say over when we meet when I'm able to do that. I think that the more say we can give someone when they're going through something hard, the better. Also, the more we can give them the space to say "I need help with this" to the people who are there to help them, the better. Make it safe to ask for help and to change things up a bit in the most basic of ways, and I think people underestimate how much easier that will make people's lives.

I understand that doctors be doctoring. I understand that I'm not the only patient. I understand that they have schedules to keep and patients to treat, and there is a limited amount that I can do about that. All I want is a shred more of understanding that I need a say, too.

At least that's what I'll be telling the patient feedback department when I call them later to start the advocacy train rolling about this.

What a Difference a Year Makes.

I'm rounding out a year since my Lynch Syndrome diagnosis, which is the definite marker for all of this stuff starting. It's weird to think about so much happening within the past year for me health-wise, but I have to remember that this health stuff is not the only stuff. For instance:

1. We adopted a dog. Three months later, we lost our eldest dog in a way that ensured that he did not suffer and it was as quick as we wanted his end to be without too much suffering on his part, and for that I continue to be infinitely thankful, as hard as this grief has been. We still miss him every day.

2. I gained my confidence as an independent clinician and finally figured out what the hell I want to do with my life, and made active steps to go toward that.

3. I SURVIVED A DAMN PANDEMIC. (This still continues.)

4. I totally tweaked my working style and how I operate and I got used to doing telehealth 8-10 hours a day.

5. Once I had all of my ducks in a row logistically, I filed paperwork to start my own business in November 2020. I picked a logo. I started advertising.

6. I dipped my toe in starting said business in January and as quickly as I opened, my tiny caseload filled.

7. After my hysterectomy, I jumped in with both feet into the deepest possible end of the pool and gave my notice at the group practice at which I worked, and started making plans to hang a shingle in an actual office.

8. I surrounded myself with colleagues who are amazing and supportive and I'm creating the exact business I want, and it is booming.

9. I taught 6 classes! All while managing health stuff and starting a business and figuring out a pandemic and moving it abruptly online a year and a half ago!

10. Mostly, I realized that I can't wait on my health being better to be the point at which I start taking care of myself better and more intentionally.

The Universe is sending me a BIG sign. I was out for tea with one of my favorite humans the other day, and he was like "Um. Either the Universe needs to send you WAY less harsh signs, or you need to listen when there are less harsh signs being sent." (I have a hunch it's the latter.)

There are a lot of things over the past year that I've realized that I don't have time for. I don't have time for how other people's opinions if their intention isn't to be helpful. I don't have time for people who assume that just because I'm talking about something that it means that I want advice about it. I don't have time to waste on people who aren't as curious about me as I am about them (if they're not my clients). I don't have time for people who invalidate what I'm going through. I don't have time for other people's reactions about my incision scars or how I will look after said surgeries. I don't have time for other people's opinions about my body.

But you know what I unequivocally, without a doubt no longer have time for? I don't have time to not avidly and rabidly take care of myself anymore. I put it aside in all the wrong ways for so long at the expense of my health at every turn, and at the expense of so many other things. The past few weeks in particular have been an eye-opener. Self-care has become my foundation and it's the first question I ask myself before taking on something new - "Is this in the best interest of ensuring my mental and physical well-being?" If the answer is not an unequivocal yes, then I say no to it.

I've been openly avoiding using the c-word when it comes to my thyroid stuff, and I can't anymore. I'd been scared about this moment for literally decades, and here it is. When my biopsy came back as questionable back in November, I started having to put myself in the mental place that eventually, I'd get a thyroid cancer diagnosis. I envisioned what that might feel like, and how I might react. When the diagnosis actually came after my thyroid surgery, it was nothing like what I expected. I didn't feel as scared because I felt mentally prepared, I knew what the likely plan would be, and I had done so much digging and ruminating and spiraling that I'd already done the hard part emotionally. Also, the types (two) of cancer that were found have an astronomical cure rate - 90-95%! And, the first line of treatment had already been done - surgery - so, the rest of it will seem like a cakewalk compared to the recovery from the surgery, which has been hard and is not yet fully done. My numbers are currently so good that "they're what I'd expect to see from someone post-radioactive iodine," my doctor said to me. As of right now there is no spread, but I'll know more once the full body scan happens in a few months, and the radioactive iodine will get it no matter where it might be in my body. But for now, we adjust to the unabashed fuckery that comes with trying to get my hormones in balance after eliminating estrogen, progesterone, and thyroid hormone-producing organs and suppressing my pituitary gland so that it doesn't freak out and make my body start regrowing thyroid cells, which is a tall order. We caught it so, so, so early. I feel like a little bit of a fraud because I don't have a "hard" kind of cancer that's going to require chemo and months of pain and suffering to kill it. Will suffering happen? I won't be able to come in contact with my husband for five to seven days because I'll be radioactive, and there's all kinds of weird stuff that's going to have to happen from that, but by and large, easy peasy, but yeah, there will be. I have to internalize the idea that I have to be monitored for recurrence for the next 10 years. My chances are GREAT because it didn't spread anywhere and we got it all, but it's still a hard thing to sit with.

My point is that I have to make room for this stuff, all of it. I have to make physical room and logistical room in my schedule, and that means adjusting my caseload and taking enough time to do everything logistically, and making sure that I'm tending to my own physical needs at the same time, because all of this stuff is really physically taxing. I also have to make room emotionally. The amount of support I have gotten during this time from my family, my friends, and my colleagues has been nothing short of astounding, and I just feel really fortunate. At the same time, this is really hard. There's a lot to work through here, and it's just a matter of giving myself the space to do it.

I also have to recalibrate my definition of easy peasy. I talk about this medical stuff and I've been able to internalize it because it's literally three surgeries, with this thyroid stuff a couple of extra things, and then it's done. That feels easy to me, even though intellectually I know it's not. Recovery from these things has been hard. Coordinating this care has been hard. Having my literal life in the hands of a system that I don't inherently trust has been hard. Not being able to operate at full capacity has been really, really hard, especially since I have so many exciting things happening, and it feels like I can't be fully present for them.

These next few months are going to be a journey. I'm facing the hardest leg of this health journey yet, and that's not lost on me. I am facing treatment not just for the cancer, but also potentially brain surgery within the next few months if we don't take a wait and see approach (which is looking less and less likely judging by how my body is behaving since my hormonal system has totally changed).

That being said and weirdly enough, I feel physically better than I have in a really, really long time. Migraines have gone from weekly to rare, I sleep like a champ when I can get there, and my mental health is pretty great at the moment. As soon as I get over this hump, I'm training for a marathon. It's happening. My goal is to run one by 45, and I think I can do it. The beautiful thing about this health stuff is that it's all one-and-done - there's no prolonged treatment, there's no having to go through super long periods of recovery (though my thyroid surgery recovery has felt super long, I definitely know that it's only been six weeks, which is basically nothing) after really difficult treatment, and I'm going to bounce back from all of this and be better than before. I just know it. There's a ton of hope to be had, and I'm here for all of it, even when things get hard.

Calci-Yum

"It'll be a snap," I said to myself as the ramp-up to my thyroid surgery came and went. Monitor my calcium levels for a few weeks, get some rest for about a week, then have a few days off to myself where I won't have to worry about any of that shit.

The spot that my thyroid used to occupy is laughing the laugh of the righteous at this present moment.

My calcium levels aren't rebounding the way the doctor would like to see. (I have a hunch it’s because of low vitamin d.) I'm taking 4,000 mg a day of calcium (AND LET ME TELL YOU, THE SIZE OF THESE PILLS IS BONKERS.), and no change. What that means is that my parathyroids aren't working yet. It's fine! They get bruised, it takes some time for them to heal. No cause for alarm. There are four of them, and I actually technically only need one. So, three could totally dip out forever and I'd be fine.

You'd think this would be the stuff that dreams are made of, right? I can eat all of the cheese with reckless abandon! I can eat all of the ice cream! Just all of it! (And trust me, I certainly am.) Also, butter! Also, oreos and milk when my throat is up for it! Just, all of the dairy that I can handle!

I've had to get blood drawn every day since I left the hospital. Except Wednesday. Wednesday I was off the hook. 

(Can we also acknowledge that I've lost two full days of my life this week? I have no idea where they went. I literally went to sleep on Monday morning in the hospital and feel like I didn't wake up until Wednesday afternoon on my couch at home. I have some fuzzy memories, but overall, it's just...gone. I find that totally unnerving.)

ANYWAY. Because my calcium is still low, when my doctor called Thursday, they were all, "you have to go again tomorrow so we can make a plan of action over the weekend and also take three pills instead of 2 of the calcium for each dose and here's a prescription to help your body absorb it." It rebounded a little yesterday but it’s still low, so I shove even more calcium in my face and go get poked by medical vampires again on Monday. I’m sick of it already and still have to do this for like another month easily.

Other than occasional tingly feet and slight brain fog, I feel great! I'm clearly healing nicely, I still have a weird voice, but I'm hoping that as I continue to rest, it'll rebound more quickly. I can breathe better, and as soon as my epiglottis starts doing its thing again, I'll worry less about choking on things, which happens almost every time I put something in my damn mouth. I've sat down and gotten a shitload of work done, and while I know that mentally I'm ready to go back to work, I'm not physically ready yet. I have clients scheduled for next Friday, and I may not be physically ready by then, and I'm mentally preparing myself for that. But in the meantime, I have a bunch of things that don't require talking, and I'm staving off the boredom by doing those things. They're a bunch of tiny things that kind of always are there, and to check them off feels nice.

I’m also starting this really awesome grief class that’s running for the next few months, and it’s coming at the perfect time because I’m teaching a grief class in the fall. But, it’s causing me to examine my own, and while I’m generally pretty good at being able to recognize when it’s my grief talking, I could always be better about it. Why am I talking about this now? There’s a MOUNTAIN of grief work that I need to do around this past year or two, all around my health, that’s right in front of me and I have basically been pretending it’s not there. I am upset and very angry that I’m going through this health stuff, and I know that it’s normal to feel this way intellectually, but not acknowledging how painful this has been for me emotionally is going to keep kicking me in the pants until I address it. I’ve dipped into it a tiny bit in therapy, but it’s the softest spot I’ve had in a really long time. As in, I didn’t know I had emotional spots that soft anymore. I’ve also been trying so hard to triage and deal with this medical stuff as it comes I haven’t been able to unbury myself enough to look at the bigger picture of the grief that I’m feeling. It has affected literally every single facet of my life, and I think I’m finally at the point where I can take a good look at the mess and see where I want to start picking up the pieces. There is no grief like the failure of your own body, of that I’m intimately aware at this point. Denial has been powerful and incredibly effective for me, but I think I’m reaching the end of where it’s helpful and it’s time to address it. Now is timely as well because I only have one more medical hurdle, and so it is starting to feel like my brain finally has the capacity to do this work. Weird, I think, because what I have internalized as the scariest part hasn’t even happened yet, and I feel like I’m handling it better than any other part of these shenanigans so far.

In the meantime as I ponder that, I’ll go eat ice cream with cheese on it for breakfast. Just kidding.

Maybe.

Let's Get Weird.

I wish I didn't know this about myself, but two weeks pre-surgery, I go a little batshit, and it happened right on cue. It was almost comforting. It's endearing, I think, but it follows a pretty specific pattern: First, I start sleeping less. Then my anxiety goes up. I get a little impulsive. I have trouble focusing and remembering things. I have my own therapy sessions that I can't make it through because I literally cannot show up to do the emotional work. (That happened a couple of weeks ago and it was REALLY special. I've never had such a disaster of a therapy session ever.)

Back in March, I was working from home and so Rob was the only one who bore witness to it. It was a very interesting time. Now, I have two interns, an office manager, and a few colleagues who are going to bear witness to it. It's not so off the chain that I can't hide it, so my clients generally don't see it, or maybe they do. What the hell do I know.

What I do know is that there have been and will continue to be periods of time where I'm barely holding it together, and at the two-week mark is where that starts. I had my pre-surgery screening and asked a million questions to the nurse about food and what I'm supposed to do about it while staying overnight when I can barely eat anything at all. (I won't be hungry anyway, but it's nice to plan.) I panic shopped on Amazon and bought things that people on Reddit recommended for post-surgery. I did the same thing in March, and it legit saved me in certain ways. I asked about front-loading calcium to maybe help my parathyroid along. I wanted to ask if I really needed to spend the night if I'm going to have to go and get bloodwork every couple of days anyway and I'm allegedly going to have a drain that I'm going to have to go home with and why do I have to stay if I'm just going to have to do all the same stuff at home except in a hospital room where I'll be woken up every five seconds and can't I just come home and sleep in my own bed. (I knew the answer was going to be no, so I kept that one to myself.) 

I have so much shit to still do before Monday that it's bananas.

I'm generally able to tolerate all of this medical fuckery. The switch flipped the rest of the way on Monday, when I was a week out. Intellectually, I know that this surgery is likely going to drastically change my quality of life for the better. That doesn't change the fact that I might have paralyzed vocal cords for a little while. It also doesn't change the fact that my hormones are going to go ALL KINDS of bananas and there will be very little I can do except alternate frantic calls between my endocrinologist and my OB-GYN Oncologist so that I don't annoy the shit out of them both. They have both told me not to worry, but we all know how that advice lands with me. I've read the articles and the data. Thyroid hormones and estrogen mess with each other. There's no way around it. I just have to put my emotional helmet on and board this roller coaster that I'm about to take a ride on for several months and know that I just have to hang on tight and wait it out because every time my hormones are changed, I have to try it for 4-6 weeks before I make any other requests. Except when I was on Premarin. That one was almost an immediate difference by comparison, and so Dr. Awesome changed my estrogen prescription pretty quickly.

But I digress. Everything will be ok, and I will be through this and home resting and recovering before I even know it, and then it's on to addressing the meningioma.

Fun fact about Marvin the Maddening Meningioma (yes, I named it. Why not have a little fun?): It was found by accident. ACCIDENT. I don't know whether to be relieved that it was found in the first place or to totally and unabashedly flip my shit. The half-red-face thing? Nope. Not caused by it. The impulse control problems and the occasional aphasia and the personality changes? Yep. Do we know what's causing me to look like two-face every time I exercise? Nope. Might it be made worse or entirely go away because of the thyroid surgery? Maybe. Her theory is that it's possible that my thyroid is pressing on a nerve that's causing it. If not, I go for a chest and neck contrast CT, and we take a wait and see approach with the meningioma, which I am not at all here for, and I told her so. I go back in 3 months for another contrast MRI to see how it's behaving, and then it's likely going to be a surgical thing. Radiosurgery is not something I'm a candidate for because of the Lynch Syndrome. Regardless, I wanted a quick answer and I didn't get one, which kind of makes me want to go outside and throw a tree.

Also, if you have an MRI taken of your brain and you're tempted to look at it, REALLY check your tolerance for looking at freaky things. I mean, REALLY sit with it before you decide to take a look if you get a copy of your imaging. I did, and I didn't sit with it and just went for it, and that proved to not be the best idea. That thing is HUGE. AND, I saw an MRI image of my face, and that's just something you can't shake. I looked like a character from those books, Scary Stories to Tell in the Dark. But, for now we wait and see. Which I'm super good at and by that I mean I'd stage a sit-in at Dana Farber if it meant that I could have answers faster.

HRT Nonsense and the Rule of Three

Phew. Hormone replacement therapy is no joke. I started out on the Estradiol patch, which is the best way to get estrogen because it's bioidentical.

It turns out my body REALLY REALLY REALLY doesn't like estrogen replacement that isn't bioidentical. You see, I was on basically the lowest dose in the patch form right after my surgery, and it would work great for a few days and then just...wouldn't. I'd get hot flashes, but most of all, I'd get murdery. This would start every Friday, and then last through Sunday, and then I would change the patch on Mondays, and then the mood cycles would start all over again. I had to give it six weeks, and I gave it a bonus seventh week because I apparently can't quit my OBGYN-Oncologist.

ANYWAY. I called him and he was all, "We're going to switch your HRT to Premarin and it's a pill" to which I said to myself (and to him) that I'm terrible at taking pills and that I likely won't be able to take it consistently because of this fact, and he was all, "let's just give it a try."

Sigh. Fine.

I actually did pretty ok with it...for two weeks. Then I was pushed off of some kind of emotional cliff. I had some stressful stuff happen both professionally and medically within a couple of days of each other, and I just...suddenly could no longer handle it. Any of it. In short, I unabashedly lost my shit for about two weeks, and then I had a lightbulb moment one random Sunday. Maybe it's the estrogen. I was handling all of these transitions and this medical stuff like a champ until I VERY SUDDENLY wasn't. Something biological changed, and that was literally the only thing I could identify. I also got my first genuine migraine in two and a half months and I was PISSED about it.

So, because I apparently still can't quit my OBGYN-Oncologist, I called again a couple of weeks ago. I was all, "Please switch me back to Estradiol. I have become a murdery insane person who can't stop sweating." The nurse was all, "Are you sure it's not the hot weather?" and I was like "UM I WEAR SWEATERS WHEN IT'S 90 DEGREES OUTSIDE. It's not the hot weather." (Yes - if you saw me that day at my swanky new office, I was absolutely, without a doubt, wearing a sweater over my dress.)

I'm positive it's the placebo effect, because he both increased my dosage AND has me now change patches twice a week instead of just once. Bless this man and his very attentive ears and brain and face. I feel so good that I could kiss him on his married mouth. I'm also less overwhelmed, and I'm able to focus and I actually checked a bunch of lingering stuff off of my to-do list. It's super awesome. I'm also genuinely tired instead of hormone tired, and for once, I laughed. Like, genuinely laughed at something I found funny instead of feeling perpetually uncomfortable and omg is it going to show how awful I feel and everything sucks and I am back at pre-therapy-level Ryan with my moods and who's going to notice and UGH EVERYTHING IS TERRIBLE.

Speaking of everything being terrible, there's this thing about the rule of three that has stuck with me for a very long time. If one or two things happen, even if they're not for you, there's always a third thing. Pet loss? I hold my breath whenever two friends lose pets. Illness? Absolutely, you bet I'm stacking on the vitamins.

So OF COURSE there's a third medical thing, because of course there would be. I would never hope a medical thing on anyone else so I'm pretty happy it's happening to me instead of someone else, but still. There's a third thing.

About five years ago, I went out on a boat with some friends and got sunburned on exactly half of my face. Literally, you could draw a line down the middle of my face and the left half was sunburned and the right half was not so bad. I thought it was the direction that my face was in the sun (which makes no sense in hindsight whatsoever, because I was in the middle of a lake - so there was no way that my whole face was not toward the sun the whole day), it healed, and I moved on with my life.

Then about six months after that, I started running again and started noticing that that same half of my face would turn red! Did I get sun damage on half of my face, I wondered? I felt a little pressure on the left side of my head, but it was weird. I brought it up to my doctor and they were like, "Are you in any pain?" and when I said no but I felt a little pressure, they were like, "Then it's no big deal" and let it go. Yet it kept happening.

Then I switched PCPs, and they also dismissed it.

Then I switched PCPs to who I have now, and they are Colossally Not Dismissive, and so when I had a med check a few weeks ago (and a few days before it, I went for a run and it was worse than ever - I looked like Two Face - and so I snapped a selfie and sent it over the patient portal to them), they were like "Let's get you a brain MRI to make sure there's nothing weird going on."

Great! We can get a clean MRI back and I can move on with my life, right?

Nope.

When my doctor called me with the results, her first words were, "Before I tell you the results of your MRI, I need to tell you that 85-90% of these are benign, but even if they are, they need to be addressed."

Shit.

I have a meningioma above my left frontal lobe. From my copious amounts of digging, what I can gather is that it's caused by one of two things: Hormone imbalance or head trauma. Unless this has been growing since I was 12, the head trauma is out, which leaves hormone imbalance, which makes sense given how much better I continue to feel after the hysterectomy. Regardless, I've been trying to get in with a neurologist, which is the next step, but have struck out time and time again if I want to get in before September. So, I'm going to Massachusetts at Brigham & Women's, and I'll be able to get in hopefully in July. The next step could be one of two things: Either surgery, at which point they will break open my skull, remove it, and then stitch me back up, or radiosurgery, for which they'll use targeted radiation and both cut off the blood supply and shrink it. Surgery will leave me out of work for weeks, radiosurgery for a couple of days, so put me under that gamma knife, baby.

But for now, I wait while eating pasta salad, getting adjusted to my new office, and then getting my thyroid removed in three weeks.

But, as soon as I have a course of action, I'll know that this chapter will be closing. It has to at some point, right? (Yes. The answer is yes.)

Leap and the Net will Appear

 I've had a few times in my life where I've taken risks. More lately than before, but I digress.

Every time I've bumped up against a potentially big change in my life, at least in my adulthood, I find myself falling back on the phrase, "Leap and the net will appear". When I stopped being an Americorps member, when I decided to go back to grad school, when I became a supervisor, when I decided that I wanted to let that go in favor of seeing clients again, and now that I'm branching out on this new endeavor.

What's different about this time is how unbelievably sure I am that what I'm doing is the right move. I've told some colleagues about what I'm doing and they look at me like I have 10 heads. "Isn't this risky?" Yes. "Aren't you afraid that you're not going to make any money?" No. "How is this different from a group practice that takes X% of your income?" I'm not doing it to make money off of my colleagues who work hard enough and should keep every penny that they earn aside from sharing the cost of the space that we use and the resources we use to keep it running.

The thing is, once I stopped panicking about money and turned my attention to where it belonged, which was on building the field and serving clients well, all the rest of it fell into place. I've literally never had the stars align like this. Never. I've never been more sure about my career and what I want to do with my working life. I wake up every day excited to see my clients, excited to see how my business is going to develop today, and just...excited. There's lots of messy stuff coming for me over the coming weeks, and I'm ready for every single bit of it. All I have to do is keep putting one foot in front of the other, and I'll get there.

The biggest growing edge about self-care for me, I've realized, is that I don't listen to myself. I get internal feedback all the time and most of it just gets cast aside. The time off from work that I had when I had my hysterectomy really forced me into that place of listening - just listening. There wasn't much else I could do because I blew through Intervention and most of Hoarders in my first week between naps after showering, so I decided to tune into the demolition derby going on in my own brain for a change. I am still in disbelief about what came out and what continues to emerge. The lesson that I had to take from that time and still have to continue to learn is that I will do myself no good whatsoever if I don't tune into what I need. At what point did I start to think that my own needs weren't important, or that others' needs were more important than mine? It has gotten to the point where I struggle A LOT to ask for what I need. Even basic stuff! What's that about, and how can I fix it? And, if I don't state my needs, how do I expect them to get met? All of this work has opened up a huge Pandora's box for me, and it's one that has needed to be opened and rooted around in for, well, basically almost 41 years.

I have two weeks before I start on this next leg of my journey, and I couldn't be more excited. (Now if my internal feedback could just stop yelling so that I could hear what it's actually trying to say, that'd be fantastic.)

Best.Birthday.Gift.Ever.

I've been going back and forth with the surgeon I'm working with for a few weeks now trying to nail down a date to yeet my thyroid. I'd call, they'd call, no one would call anyone, and then finally I got two options: July 12 and July 19. July 12 is my 41st birthday.

In considering these two dates, I had a few things to think about:

1. Rob sometimes works during the summer and I didn't want to interfere too much with his schedule. It's fully a two to six-week recovery time, with the first two weeks just spent on my couch watching TV, as it was with the hysterectomy. 

2. I am opening the doors of my private practice hopefully in the next four weeks.

3. It's summer!

4. Perhaps the biggest, I don't want to bring this health stuff into 41. It started just a couple of months into me being 40, and I've been dealing with it literally since I was diagnosed with Lynch Syndrome in September. My goose is cooked. I don't even want to think about the amount that I've paid in copays this year, but it's several hundred dollars. I've visited doctors literally 1-3 times a week for the past eight months. I'm ready to not set foot in a doctor's office for a while (though I know that's not in my cards, because once the surgeries are done, it's time to mess with my hormones through medications and make sure that my levels stay stable, which is going to take some time, which also means visiting more medical vampires).

5. This is a riskier surgery than the hysterectomy, and until I can talk fully again (which I'm told takes some time), I don't necessarily want to be seeing clients. I caused enough of a ruckus with my clients in cancelling two full weeks of sessions and then appearing just fine afterward - I don't need to do that again with a side of "Oh also my voice may cut out from time to time. Pay no mind and also pay no mind to this incision on my neck that's going to be there for a while." (I'll be wearing lots of scarves, to be sure.) The best time for this surgery is when my caseload will be low, which is July.

So, my thyroid is coming out on my birthday. Rob thinks it's a little funny (not in a "ha ha" way, I can tell) that I'd do this on my birthday when I have the option to push it out a week. I am ready for this to be done, and I personally think that the best gift I can give myself for my birthday is the closure of this chapter. Will it entail a night in the hospital? Yes. Does that mean that I'll be spending my entire birthday in a hospital? Also yes. But, once this surgery is done, I'll finally be able to put all of this behind me - the fear, the physical stuff, the disruption in my life, and the general difficulties that I've had as a result of all of this stuff. It's worth spending my birthday in a hospital if that's what I get to leave there when I walk out post-surgery.

The page is turning, and I'm on the home stretch, friends. I can feel it coming.

The Miracle of Healing

First, I want to say that I have become this annoyingly and deliriously happy person over the past four weeks. It's weird how much my brain has cleared out all of the difficult stuff that I was wrestling with. It's literally just gone and I don't know what happened. Maybe it was being able to let go of anxiety around getting pregnant, maybe it was hormonal changes, who knows. I've tried to examine it a little, but I'm not entirely sure that I want to. I've been able to get out of my own way more than I ever have in the past, and it's making me much more effective as a human being.

That being said, I was sitting here drinking my morning coffee and I thought to myself what a gift it has been to bear witness, really bear witness, to how much I've healed over the past four weeks. My body has gone through some monumental changes and I know more are coming, but to watch the pain subside, to watch my body change shape as it heals, to watch in real time how my body is finding a sense of balance, finally, has been kind of unbelievable. My whole relationship with my body has changed over the past four weeks, and I did not expect that to happen. (I also came to the stark realization today that menopause kind of suits me. One person joked that I've been an old woman drinking tea and wearing slippers and a housecoat since I was 19, and I can't say I disagree with that.) I know that I have two more weeks until my body has fully healed from the surgery itself, but I'm here for it. I remember when I broke my arm, I didn't want to see the healing process. I was in this big splint after surgery and then when the doctor cut it away to reveal a pretty grotesque looking incision, I couldn't look at it. I tried and almost fainted. I'm not sure if this healing is more internal and so I don't have to see the changes, but I know healing is happening. While I'm not where I want to be yet, if this is how things continue to shift for me, bring it on.

I'm at this weird place where I feel so good and I want to exercise, but I can't. I'm seriously thinking of calling the nurse at the OB-GYN place and asking if there's any exercise I could be doing. This is crazy, because I'm back to work full-time this week and I've currently got 35 clinical hours scheduled (and trying to cram in others when I can), but I want to find a way to fit it in. I just want to. I'm ready mentally, and it's been a little tough to wait for my body to be there physically, but I'm trying to summon what little patience I have in the first place to just ride it out. Once I hit the three-week mark and was halfway through the recovery period, I said to myself, "yes, I can definitely do this one more time." I can, it's just a different kind of hard. I don't do so good with the patience with myself part.

Phew.

Ok.

Here comes what I've been sitting on for the past few months.

Deep breaths.

I'm starting a private practice. I started it back in January with the piddliest little caseload that you've ever seen and it's been stuck in that spot because of the group practice I'm in. I've made the decision that I'm going into it full time as of June 1. I'm also taking on 3 interns, and will be both operating a private practice and a supervision/training hub. I am so excited about it that I could literally pee my pants.

It's exactly, and I mean exactly what I want to do with my time as a professional. This business I'm creating, this is what I want to do to help my clients and make the field continue to be better.

The tides started turning for me a few months ago. I was sitting and thinking about my clients and the idea of this private practice, and I said to myself, "wouldn't it be neat for my practice to be a training ground for interns and other professionals." I didn't dare put it out into the Universe, but that's what my gut was telling me that I actually wanted. I love teaching. I love training. I love supervising and watching growth happen before my very eyes. I also love being a counselor, so that would have to be part of it too. The seedlings that had planted themselves in my brain were starting to grow.

Then I had the surgery, and I had lots of time to sit and think about just that. One of my friends made a joke a few months ago about being my assistant, but it stuck with me. Like, really stuck. So, I talked to him. He's one of the most sarcastic, hilarious, earnest, and hungry for knowledge people I know, and he wants to do good. He's got the gene. (I'm also pretty sure that he's 1000 times more diligent and smart than I am, so I'm pretty super excited about that because he's given me a fresh perspective on a few things lately that have been super helpful.) We're cut from the same cloth, is what I'm saying. Then another colleague approached me and said that she wanted to get into private practice, so she came over and we talked about it. Then I was approached by two of my students who were having trouble at their practicum sites asking if I knew anyone who would be willing to take on interns because they were looking to change sites. All of this happened over the span of two weeks. It was literally one of the most bonkers ways of the stars aligning that has ever happened to me, ever.

So, now I scout for an office. I am super excited and terrified and holy shit this is real now because I gave my notice today and this really has to work now. The next few weeks are going to be stormy and hard, for sure. But, the thing is that I feel equipped fully to deal with it as it comes. I just need to ride it out and know that on the other side is something so exciting that I can barely contain myself even thinking about it.

Also, I'm starting to become this unbelievably, unabashedly happy person. The tides are turning in such amazing ways that I can barely contain my joy. Look out, world.

Professional Self-Care and Fake Running

You know what's my favorite as a professional counselor?

Game-changing trainings.

I had one this morning. It was only like four hours long, and I went into it with a little bit of a pre-emptive eye-roll-but-I'll-try-to-have-an-open-mind attitude. It was about treating teens with anxiety and depression.

Snort. Listen to that hubris that I just put out there.

But, I signed up for this training because I could always use a refresher and new techniques or just affirmation that I'm doing right by the kids that I work with. I've also heard rave reviews about the trainer. 

I got all of the above and then some. This woman was SINGING MY SONG, let me tell you. I left there feeling validated (which can be hard sometimes - therapy isn't meant to be comfortable, and so sometimes I have people yell at me and slam the door on their way out while giving me the finger and I just have to take it - I'm happy to, but it wears on you after a while!), more competent, and with HUGELY IMPORTANT tools in my toolbox that I either sharpened or put newly in there. Moreover, it set my hair back on fire about working with teens. I wasn't beginning to hate it, but I was starting to feel complacent about it. 

I started using some of the techniques I learned this very afternoon and like three of my clients started bawling.

I went through a training a few years ago and the trainer said something to me that will stick with me until the day I stop doing clinical work: "If they're not crying, you're not trying." Every once in a while it smacks me like a 2x4 how right he was.

But, the most important part of this training was what it wholeheartedly affirmed for me: Professional self-care is equally as important to me as personal self-care. I need to feel competent at my job, which is a tall order on the best of days. Trainings are a hugely important part of that. I'm decent at my job, sure, but in order to stay competent, I have to keep training, and keep growing and changing. If I don't keep my finger on the pulse of my growth, I'm not taking care of myself professionally, which is a big problem. It's been hard this year because of COVID because I haven't attended any in-person trainings for almost two years - they've all been online - and so it feels to me like I'm not doing enough (though my grid of CEs and what they're for and how they meet the requirements would disagree with that. I'm up for licensure renewal in December and I already have nearly double the CEs I need, if I'm not already there. I had 155 when I was up for my first renewal. What can I say? I love to learn.).

In order to take care of myself professionally, I have to tap into my desire to learn, which is incredibly deep. I feel so good and energized after today's training that I want to go sign up for more of this woman's trainings. She's amazing. What an unexpected gift today was (and I almost skipped it because I've been up since 2:30am with a coughing dog - I'm so glad that I didn't!).

Let's also talk about how positively things have changed for me since my surgery. I haven't said much about it, but I feel like a totally different person. To figure out why this is, I did some digging and it was likely one of two things: I was either SUPER sensitive to progesterone, or I was estrogen dominant. Or maybe both. Let's talk about what's specifically different:

1. I want to be active. Yes, you heard that right (and in fact, I'll be taking a walk after this blog post is finished). I am itching to get back to yoga, I'm going to start training for a 5k as soon as humanly possible, please, and we have that spin bike that I'm absolutely itching to get on. This has never happened before. I've always taken a kind of "blah" attitude to exercise, but let me tell you that I get out walking every day and I am LOVING IT. What I've started to do is what I affectionately call Fake Running. I start my Couch to 5k program, and I do a whole workout, except I don't run. I deliberately try to walk slow, and then when the "run" comes, I speed up my walking. I'm being careful and I'm doing what I'm supposed to do by holding off on serious exercise until after my 6-week follow-up, even though it's hard. 

2. I can breathe. I did not expect my asthma symptoms to remit after the surgery, but that's exactly what happened. I would go through periods where I would struggle to take a deep breath in because it felt like someone was standing on my chest. That has not happened in four weeks. I also can't help but think this is also tied to anxiety, which is also now basically gone. I have been more emotionally even than I have been in in my life, ever, over the past four weeks. Even after I have a little caffeine.

3. I am pretty sure my migraines are gone. As in, completely gone. If there would have been any time for me to have a migraine, it would have been one of three times over the past month: 1. Right after the surgery; 2. When I would have gotten my period; or 3. The antibiotics that I've been on. I had a slight headache one day that I didn't need to take anything for - just drink some fluids because the antibiotics were drying me out BIG TIME. I drank a liter of water and it was gone a half hour later and never returned.

4. I require less sleep. I wake up at certain points of the night, which is not in and of itself fantastic, but I don't struggle to wake up anymore. It takes me a bit longer to get to sleep, but that's ok. I go to bed later and get up earlier and I'm totally, totally ok with it. I also have the most bonkers dreams ever, every single night. I wake up literally every morning being like "uh, what the eff just happened?" Because my dreams are so vivid and realistic that I sometimes have a hard time discerning if that really happened or not until I'm fully awake and realize it was a dream. No, I am in fact not pregnant with twins or triplets, my doctor is not a serial killer, and I did not spend an entire night just rolling around in the grass. (At least I don't think I did.) I also talk in my sleep a lot more, which Rob finds hilarious.

Things are changing for the infinitely better. Will I have bad days here and there? Sure. I'm able to allow for and accept that wholeheartedly. But, if things keep going this way (and I think they will - BIG blog post coming in a few days about more stuff), my life is about to get infinitely better, and it wasn't even half bad to begin with. :) I am more excited and inspired than I have been in a super long time, and I am SO SO SO grateful.

Three Weeks. WOO.

I'm not sure what happened.

I went to Easter dinner with my in-laws on Sunday, ate barely any dinner because I had no appetite (except for the chips and salsa that I was eating because I re-found my appetite after losing it again - I definitely ate too many), took a nap after dinner, and then came home and felt VERY full for the rest of the night. I'm supposed to take one of my antibiotics with food, and I really had to shove it down. It was unpleasant.

But then something magic happened while I was sleeping on Sunday.

My head screwed itself back on straight on Monday morning. I woke up feeling like I'd been hit by a truck, but after going through my morning routine, HOLY BALLS. You could peel me off the ceiling, basically. I saw five (!) clients in a row Monday after not being able to see more than two in a row without needing a nap last week, and I woke up today feeling more of the same. I had my follow-up with my doctor and the infection and the surgical stuff are all healing great, and I'm finally, finally turning a corner.

I'm just ready to get off of the antibiotics. The side effects are hard (but not as hard as they were when I had C. Diff, which is an unendingly pleasant surprise), and I've lost another ten pounds since starting them, and I know that's not a good thing. I'll gain it back and likely fairly quickly (or maybe not if I can keep eating well and being active!), but I just am ready to not have to take antibiotics anymore. I need to find my new sense of normal, and having to be smacked in my bladder by an infection at this juncture is making it harder.

I have to remember to continue to take it easy, but it's getting harder as I'm feeling better. I cleaned my kitchen this morning, I went on a Fake Couch to 5k Run yesterday (and by fake run, I mean that I walked slow during the walk parts and walked faster during the jog parts - I want to heal faster, but I'm no masochist and there's no changing the reality that I can't be super physically active for another three weeks, if not longer depending on what my doctor says), I was able to bring laundry downstairs in one trip instead of multiple, and I'm just feeling great. I'm at the stage where I'm ready to get fully back into everything, but I know intellectually that my desire far outpaces my capacity still. The reason that I know this is that I was trying to walk Ruby and it was...less than pleasant because she's an out of control puppy for whom Benadryl doesn't have the sedative property. How is that even possible? I am like five times her size and ONE knocks me out for 14 hours. No impact on her WHATSOEVER.

She's a mutant dog. I decided.

But, the healing continues.

I've also made more Big Life Decisions That Are Going to Result in Hard Conversations in the Very Near Future, but I'm so excited about what's coming that it's going to be easier for me than it would have been even a few weeks ago. Now that my brain has reconnected, I'm now able to figure out how to make things work. Once I've had the conversations that need to be had, I'll talk more about it. But for now, I continue to work and think and heal.

And be patient. Patience is the name of the game because if I'm not, I'm going to really severely hurt myself. I just have to keep reminding myself of that whenever I feel the urge to push farther than I can or should.

The Cure is Worse than the Disease

So, not surprisingly because it's super common, I have a post-surgery infection. It's a little bit in my bladder (also unsurprisingly because my bladder's default position is Low Key Mad, and then when you shove a catheter in there, even for a little while, and then it also has to move to take up space that wasn't there before, it's going to exact revenge) and other places, nothing major, and easily fixed with antibiotics. Two of them, in fact.

Right.

The good part is that I'm on day 2 and already starting to feel better. Let's just say that from the outset. I was feeling weird pains that I knew weren't normal (and also my doctor said they weren't normal) and those are gone, and it no longer takes multiple tries to pee, and I'm not as tired. All good things.

I spent a morning/early afternoon in the ER (not because it was super dire, but because my doctor told me to go there because my insurance was taking its sweet time approving a contrast CT scan and my symptoms started escalating in ways that were very, very uncomfortable) and I've also decided on a new career: ER eavesdropper. If I can make a career of that, that'd be awesome. Literally, I heard someone call their refrigerator a Grocery Hole and that is what I will refer to it as for the rest of my days. (Not a patient. It'd be markedly less funny and I wouldn't be joking about it at all if it was a patient.) Then, I left with one antibiotic, and then immediately got a call from my OB-GYN Oncologist dude that said "nope, don't take that one, take these two instead."

One of them is Flagyl. Awesome. Except not. It's already throwing me like it did last time.

You see, about seven years ago around this time, as a result of the antibiotics that I took after getting my wisdom teeth out, I got C. Diff. It was, to this day (inclusive of breaking my arm in three places and needing surgery, having a full hysterectomy, and two fine needle aspiration biopsies on my thyroid), the worst thing I've ever been through medically. Ever. It took a full year for me to recover from it, and it took even longer than that for my gut to recover.

Flagyl (and can we just say out loud that it sounds like some weird protozoa or amoeba or something?) was one of the antibiotics the doctor put me on back then. Right now it's not going so bad, but let me tell you: I remember. It takes a few days to get really bad. The weight loss, the digestive issues, the fatigue, the constantly terrible taste in my mouth, the brain fog, the joint pain (which was actually more likely caused by the other antibiotic I was on at that time), the inability to eat distilled foods and crying in the produce section of Hannaford, all of it. It's hard to take vinegar out of your diet. I dare you to try it. It will be much easier for me this time because I eat a lot better and I'm much healthier than I was back then. There's also the fact that the antibiotics are not treating a debilitating case of colitis this time, but still. I can't use things like hand sanitizer because if I slip up on ingesting anything distilled or alcohol based, I pay a pretty heavy price.

No joke, and not to put too fine a point on it, but I went to my follow-up with my PCP back during that time and she put me on another 7 days after an ER visit and I legit asked if I could just live with C. Diff, and burst into tears when she said no because it kills people if it goes untreated and it's super contagious. The side effects of the treatment were literally that bad.

I am also battling the fact that while my appetite is coming back little by little post-surgery, it's not fully back yet. So, I asked my doctor what to do about that because he was like "make sure you're eating enough and hydrate hydrate hydrate. And then when you think you've hydrated enough, hydrate some more," and then when I asked him how to figure out having to eat more when I literally can't, he was like "Shove it in if you have to." This man does not sugar coat anything, and if I could, I'd have him as my PCP. I was also talking to him after I got out of the ER and was like, "But, all things considered, I feel great!" and he was like "Um. You're a vivacious person, and I totally get that, but you just got out of the EMERGENCY ROOM, Ryan. It's ok if you're not doing so hot. Give yourself permission to not be doing so hot."

Great advice, I must say. But, I'm currently at the First Circle of Flagyl Hell: This Isn't Super Pleasant But Not Terrible Either. I'm also teetering on the Second Circle of Flagyl Hell: I'm Very Tired and My Gut is Very Very Angry and No I would Not Like to Eat That Very Pleasant Thing but Thanks Anyway. It's coming. I can feel it.

In the next day or two, I'll experience Circle Three: Fluids. Just, All of the Fluids, and Also I lost Ten Pounds. Because this course of antibiotics is mercifully short, I'll likely only make it to Circle Four: Dear God Make It Stop. 

If my doctor extends them (DEAR GOD I HOPE NOT), I'll likely have further circles, like Circle Five: I Can't Stop Sweating and None Of My Pants Fit, or Circle Six: I Can't Eat Anything and I'm Very Frustrated and I Don't Want to Eat Anything So I'm Going to Look at Watermelon in the Produce Aisle and Start Crying Uncontrollably In the Grocery Store and Leave Empty-Handed.

I just have to keep thinking to myself that I'm starting to feel better and repeating that to myself over the next five days.

Flexin' Those Muscles

 Or, you know, not.

This surgery fixed things that I didn't even know were wrong. In short, I feel amazing. My anxiety is drastically reduced, I have more energy, and I don't want to sleep all the time. It's been kind of an amazing turnaround, actually. Do I have weird pains? Yes. Do I have waves of fatigue? Yes. But it's all post-surgery stuff. I have my two-week follow up with my doctor this afternoon, and I couldn't be happier about how I'm feeling. Seriously.

The anesthesia has worn off at this point (it takes about two weeks) and so I'm clearer in my head, and I'm ready and raring to go to get back into everything. I'm not going to go full bore all at once (I'm going back half-time this week and next, and then back to full-time the week after)

I'm not sure if he's going to clear me for work that involves sitting 8-10 hours a day, but that's another conversation.

I also had a meeting with a surgeon for my thyroid, and I'm getting the whole thing out. My biggest nodule has grown by a half centimeter (which is a lot), and my right side has developed a nodule that wasn't there before, all within the past four months. So, out it comes. It looks like kind of a risky surgery, but he explained to me in detail how he does it and it doesn't look so bad. I was hoping to have all of my medical stuff squared away by June 1, but it's now looking like that's not going to happen, which is ok. The recovery from this surgery is pretty quick - I just need to make sure I can, you know, talk before I go back to work, which takes about a week. I found some relief in my anxiety about having two surgeries when this dude said to me that this surgery is not urgent - I don't have cancer, and so it's not something I even need to think about worrying about until I'm fully healed from the hysterectomy. Today is also going to be a great opportunity for me to ask some questions about how the two surgeries are going to affect each other (because that's A LOT of messing with my hormones in a matter of just a few months), and so that will be good to get figured out.

At this point, I want to get exercising. We have a new spin bike sitting in our three-season porch that's itching to be taken out and set up, and I have a hunch that Rob is hesitating to put it together because I'm going to want to use it, and I can't. I'm absolutely itching to get moving. I can understand not doing things like yoga to make sure I'm not putting any strain on my core, but come on. I can go for a little run, right? Or maybe a little bike ride?

The answer's going to be no. I know it. So walking it is.

This week has taught me a lot. The first thing that it taught me is that I do too much. Tooooooooo much. So, the next few months are going to be about paring down my responsibilities. I didn't realize how overwhelmed I was feeling until I stopped and couldn't do anything at all - there are things that are important to me, but I'm not operating at full capacity ever because my attention is in 10 different directions all the time. It's time for that to be 100% done. The reason that I know this is because I'm supposed to be doing work right now and I'm being totally resistant to just jumping back in. I'm sitting with this feeling and trying to figure out where it's coming from, and I'm coming up with nothing so far, so I have to continue to sit with it. How can I make this work? What will it be like for me to pare down and just be really, really good at a couple of things instead of trying to do it all and be it all? I did come up with some really good ways to start paring things down and put some of those things into action just this past week, and so I need to keep this train going. The good thing is that these things (which are big things, like I hired a person to help me with Big Important Things) will snowball. The relief I felt making these changes and offloading some of these things has helped me immensely already, and I want to chase that feeling. My priorities are changing, and I think it's been a long time coming.

The next thing that I was taught this past week was that it actually takes me quite a lot to get sick of knitting and watching TV day in and day out. I don't actually know where the end of that tolerance is, which is an interesting revelation. I knitted almost an entire sweater (I literally have half a sleeve and a hood left, and I need to put it together) and watched A LOT of television, and while I got stir crazy, it wasn't anything that a visit from a friend or a little walk couldn't fix. I'd be totally, totally ok being a hermit.

Also, the past couple of weeks have given me time to discover some pretty great stuff. I discovered a gluten-free bakery this weekend that was recommended to me by someone, and eating all of the things from there helped me find my appetite again after it was almost entirely missing for two full weeks. Now that my sleep and appetite have stabilized, I'm starting to feel much better and can focus on these new priorities and get things figured out. I feel amazingly hopeful about the rest of this year and what's coming - it's just a matter of being patient as I make my way to where I want to be.

But first, I have to get clearance to get my ass off of this couch.

Healing Well

"You really, truly only get one chance to heal well from this surgery," said my doctor.

"Yeah, I don't like that," I replied. (I was grumpy because of the argument I had just gotten into with a nurse about whether or not I had to pee, so that was not helping matters. WHO ARGUES ABOUT THAT, ANYWAY? It's going to stick with me that someone somewhere tells medical professionals that "no you don't" is ever a valid response to a patient telling you they have to pee.)

"Um. Well. I don't think your body actually cares how much you like it or not, and I know for sure that in the interest of your healing, I don't either. Your body is just trying to heal and if you don't give it time to do that, then you're going to pay for it for the rest of your life. Mark my words. I've watched it happen. There is no wiggle room here."

The man gets me. He knew exactly what I needed to hear, gave it to me unvarnished, and didn't allow for loopholes anywhere in any of our conversations, yet it also doesn't feel like I'm trapped. He made it clear that I have choices in my healing, but that I have to choose wisely.

My first surgery of two went off without a hitch on Monday - so much so, that I've overdone it a little bit over the past few days because I'm feeling so good. I got up and walked around several times that first day. I was home by 4pm the day of the surgery, and I got up and walked for five minutes several times, which was encouraged. I continued to feel great the next day, and continued walking. I walked the whole loop around my house (the shortest of several), and then came back and proceeded to sleep for six hours. That was my signal that my body isn't ready to do that yet, even if it's only a half mile, and so I have to keep being careful. I tried driving yesterday because my pain was low and I've been sans narcotics. It did not go as I had hoped so I'm going to give it another couple of days. But, this was a good turning point for me, because if there is one thing that has become alarmingly clear over the past few days, it's that I have to listen to my body.

Do I want to get back to work? Yes. Do I want to get back to doing yoga? Yes. Do I want to be active? Absolutely, yes. But what has to happen is that I have to listen to my body when it says that I'm not ready for any of those things yet. The thing is, rest like this is not in my DNA. It just isn't. I want to be back up and running as much as possible and as soon as possible. Yesterday would be ideal.

But, the other part of me, the more rational part of me, is continuing to repeat that I have been given this gift and if I don't give myself the opportunity to heal well, I'm 100% wasting it. I no longer have to worry about getting reproductive cancers. If I get colorectal cancer of any kind, it will be caught so fast because I have to get yearly colonoscopies. Soon, I will never have another thyroid cancer scare, ever. Two is enough, thank you. There's this weight that has been unbelievably lifting, and I have to just remember that as I move forward and let it drive my motivation to nap, or to rest, or to work on that puzzle instead of reconciling my billing or working on my schedule when I come back.

It also occurs to me that I haven't talked a whole lot about Lynch Syndrome and how I found out that I have it. A family member suffered a pregnancy loss, I'm assuming there were other factors at play as well, along with the fact that another family member in this same immediate genetic line had reproductive cancer. I have no family history of colon cancer, which is how Lynch is usually caught. With this family member that lost a pregnancy, their doctor did some genetic testing, and that's how Lynch was found. Then my family member that had cancer got tested (it was positive), my mom got tested (it was positive), and my sister and I got tested (I was positive). I think about this a lot, and instead of trying to sit there and be like, "This sucks, I can't believe I have to have all of these procedures, blah blah blah woof woof", I think about how the first family member to find that they had Lynch, through this really tragic loss, likely saved my life in the longer term. I'm also trying hard to let this drive my motivation to recover well. I don't know what it's like to want kids, but I would imagine that when someone gets that desire, losses of this kind are especially tragic. Do I have a responsibility to myself to heal well? Yes. Do I have a responsibility to also not take this chance for granted, not just for myself, but for others who paved the way for me to have this chance? Absolutely, yes.

This is the hardest time I've ever had prioritizing my self-care. Ever. I can usually fit it in in little ways, and it's been easy. This time, I'm incapacitated and there is nothing, literally nothing, that I can do to fight against it. There is no arguing my body into a quicker recovery from having four organs removed. So, today I made the call - I had some clients scheduled toward the end of the week next week, and I cancelled them. Even though I don't want to, I'm taking two full weeks off of work. It's happening. Will I be tearing my hair out from boredom by the end of that time? YES. I already am. But, I also know that it's for the greater good of my long-term health, and I just have to keep reminding myself both that this is only temporary and this time is worth taking. My long-term health is worth taking this time, even if I'm going to be grumpy about it. I've also realized that the grumpy isn't grumpy; it's the reality finally hitting - I am, in fact, not superhuman.

The Gift of Health and Radical Acceptance

"I want you to think back to seven years ago when you got your wisdom teeth out, Ryan," said my therapist. (Yes, I've been seeing her that long. And no, I will likely not stop seeing her until she retires. She's amazing and I'm going to hold onto that therapeutic goodness until I can't anymore.)

"I literally worried myself so sick I had to cancel the appointment and reschedule," I said. Next week will be 7 years ago that I got them out.

"Look at how different it is this time," she said. "You're literally about to get four organs taken out of your body next week and you are doing just fine with it - you're a little nervous, sure, but this is a major surgery. Look at how far you've come."

She had a point. It was nice to look at how far I've come in terms of my own anxiety around medical stuff in particular.

What I've also come to realize is that this time, this experience, it is a gift, and a big one. I'm getting the signal and I'm getting it right now - this is my chance to become healthier when this is all done. If I waste this opportunity, what in the actual eff am I doing with my life? If I don't have my health, I have nothing. Literally, nothing. I can push against it all I want. I can buck against how this is unfair, how I could have learned this lesson differently, how something different could have happened. I could have lamented that my body is failing me and wonder why this has happened and why now and spiral right along with all of these thoughts.

It couldn't have gone any differently. This is written into my genes. If it didn't happen now, it would have happened at another time and I would have gone through this all still, but later when I had less of a chance to recover well and make some use out of this lesson, or worse, if those thyroid nodules had turned into cancer, or I got some kind of reproductive cancer. I made the decision somewhere along the way that I wasn't going to worry about what this would look like. What's the point? There's no changing it! I had two choices - I could either let it stress me out, or I could roll with it. The thyroid stuff is written into my genes too, and I could have made the choice to get mad about it. I did, for a while - it's been a really hard few months. But, literally one morning, I woke up and said to myself that I needed to make a different choice in how I was handling this if I was going to get through this with my sanity intact. I could, again, buck against it, or I could roll with it and let myself learn the lesson that I was supposed to.

My health is precious. That's the lesson. Faced with the idea that I might lose it, it's time for me to continue to push it to the forefront.

That means exercise. That means eating better. That means leaning into my body's signals instead of ignoring them. That means trusting my doctors enough to be honest with them and let them help me.

So, at the same time as looking up what to expect after a hysterectomy and after thyroid surgery, I've been looking up ways to carefully exercise in ways that will both benefit my health and speed my recovery process. The hard stuff, the emotional work, is progressing and I'm over the biggest hump of it. The scary stuff is done now that I have the information that I need and can make educated choices. The only thing to do now is let the physical stuff run its course, recover, and then make different choices in how I treat my body. What I keep hearing from my doctors is that because I'm only 40, my body is much more resilient than it would be if I was even doing this a few years from now, so I'm in striking distance of something big and amazing health-wise. I'm solving a lot of potential problems down the road by getting these surgeries done now, and alleviating a lot of worry around what my health will look like if those thyroid nodules continue to grow (and they are - I got an ultrasound of my thyroid done yesterday, and the biggest nodule of the four grew a half a centimeter in three months. This is not a problem that is just going to go away.) or if I don't have the hysterectomy.

So, as I move into the healing phase physically, I'm starting to move into it emotionally too. I've got really good feelings about how the next few weeks and months are going to play out, and I'm going to continue to ride this wave. Am I nervous? Sure. Freaking out? Maybe sometimes, but not all the time anymore. These surgeries will solve a lot more problems than cause them, and I feel really good about that even if it's not something I asked for. And, even though none of this is in my control, I feel thankful for the lessons that this experience is teaching me.

Will it always be this way, especially through my recovery? Probably not, but I'll ride the good days as much as the bad ones, knowing that both are temporary. Pain only turns into suffering if we hold on to it.

(I also think it's no coincidence that Radical Acceptance has been a major theme in my clinical work this week. Thanks, Universe.)

Proud Moments at the Doctor

I had my first meeting with a new gastroenterologist today. We talked about all kinds of things - yearly colonoscopies, cancer risk, celiac, egg intolerances, red meat intolerances, intestinal inflammation and how stomach acid goes so far up my esophagus that it's going into my lungs and that's what's causing the chronic cough, you know, great stuff. She asked if I had anything unresolved from the medication that I was put on to control the inflammation in my stomach and I described a few symptoms to her. This was how the conversation went.

Doctor: It sounds like you might have lactose intol-

Me: No. Don't finish that sentence.

Doctor: I know. There's already a lot that you can't eat.

Me: That's correct. Also, cheese is what I would consider a staple food.

Doctor: It's so good, isn't it?

Me: I don't think you understand. If I could put cheese on my pancakes and not get funny looks, I would.

Doctor: Wow.

Me: Yes.

Doctor: Why don't we try lactaid enzymes then? That might help.

Me: That sounds like a good idea.

Doctor: Great!

Me: You can pry the cheese out of my COLD DEAD HANDS, doctor.

Doctor: (Trying desperately to change the subject) .....so do you also drink milk? What other dairy do you eat?

Me: I eat yogurt sometimes but I try to trend toward non-dairy because we like each other much better than dairy yogurt likes me. I haven't had dairy milk in easily over a decade because it bothers my stomach. I don't eat a whole lot of dairy-based ice cream because it doesn't like me and also because most of it has eggs in it. But yeah, I'll put a hurt on a bowl of coffee ice cream if the mood strikes me.

Doctor: ...and you don't want to acknowledge that you might have some kind of a lactose problem?

Me: DO.NOT.BURST.MY.BUBBLE.OF.DENIAL.

Doctor: It's only 10am and I've already probably had the most ridiculous conversation of the day.

Me: Well your receptionists have a Poo Award behind them that I was too weirded out to ask about, so there's that. I do have some tact. Somewhere. Also, I get that a lot.

She loves me already, I can tell. She laughed at me pretty hard a few times. She's going to love putting a scope up my colon once a year and a scope down my throat every two.

I've also decided that brutal, unvarnished honesty is what I'm going to bring to every doctor I meet. It works very well. Take the conversation that I had with my dermatologist a couple of weeks ago:

Me: I want to get rid of the red on my face.

Doctor: It's rosacea, so that's totally understandable. Do you moisturize?

Me: I'm just going to be straight with you. No.

Doctor: Ever?

Me: Ever. My showers are also a million degrees.

Doctor: So let me see if I have this right.

Me: Sure!

Doctor: You basically burn your face and scalp and skin every time you shower.

Me: Yes. Until my whole body is bright red.

Doctor: Which totally strips your skin of moisture.

Me: Yes.

Doctor: And you don't moisturize.

Me: I do not.

Doctor: Ever.

Me: Ever.

Doctor: Do you even own lotion?

Me: Oh, sure! I just never use it.

Doctor: Why?

Me: Ain't nobody got time for that. Also, I have yet to find one that doesn't make me break into an angry rash.

Doctor: Ah. Do you at least wash your face?

Me: In the shower!

Doctor: ....with steaming hot water running directly on it.

Me: Yup!

Doctor: And you don't moisturize afterward.

Me: Nope.

One or both of two things (likely both) are happening for me:

1. I'm burnt out on doctors. Just...stick a fork in my burned and dry skin. Done. I also have a thyroid doctor appointment next week and will likely be referred to a surgeon to get that whole mess figured out. I just want this all done already. (And no, it was not a funny funny joke when I talked about visiting 1-3 doctors per week. I literally see a doctor at least once a week.)

2. I've decided that brutal honesty is the way to go because if I'm not, no doctor will be able to adequately help me. I have to do my part if I want to get the treatment that I need. I can't just flail around and not tell any doctors anything and then be like "WHY AREN'T THEY HELPING MEEEEE?" Totally fair to exactly no one, least of all me.

Today's been a funny day, just in general. I'm just...I don't even know! I think this is the calm before the storm and I'm like those little kids who are so tired they can't stop laughing and is about to pass out and sleep through all of it in a matter of minutes. It's not a horrible place to be given my circumstances, but I know that I have to buckle down HARD on the self-care in the next week and a half to get through it.

And also start to put things I frequently use at hip height so that I don't have to bend down.

And also start buying chicken broth. And soup.

And relish the fact that two weeks from now, I'm going to be in the middle of my first of two weeks of blissful, blissful rest. I'm feeling like this whole situation is more manageable a little bit every day, which feels GREAT. I've got a plan for my clients, I ordered some loose-fitting pants, and I'm feeling almost ready. I just have to keep telling myself that I've got this, because I do.

Knitting it Out

Soooo, the two week mark. I'm having a full hysterectomy in two weeks.

It feels better to say it out loud.

We did some preparatory shopping yesterday (followed by more list making) and I started looking at message boards on Reddit from people who have been through it and also from people who've had Lynch Syndrome and been through it.

I'm not sure if it helped or not, but it definitely gave me more of an idea of what to expect. All I know for sure at this point is that the nerves are starting to set in. I know that's natural, as it would be with any major surgery. I've also already called the surgical nurse a couple of times with questions (which she wholeheartedly encourages, so I'm limiting myself to making a list and calling one more time per week before the surgery if I need it). I'm not freaking out, not yet, but I'm anticipating it. So, I did what I always do when I start to feel a surge in my anxiety about something big.

I went to Michael's.

I bought myself some rainbow yarn and some new knitting needles, and I'm going to knit it out. It always helps, without fail. Could I work on my star blanket? Yup, but crocheting doesn't help me like knitting does. I'm not sure why, but it does.

I think what happens is that knitting, because I don't have to count my stitches, helps me work stuff out. And, I've got a lot of stuff to work out. Like the fact that I'm going to be in there by myself and Rob isn't even allowed to go in with me, and how I'm actually kind of relieved about it because pre-op is a lengthy process. About what I should pack. About where I'm going to set myself up for a couple of weeks while I'm recovering. About what if they keep me overnight unexpectedly. About when I'm going to go back to work, and what that's going to look like. About what I'm going to do with all of that time where I won't be able to do anything except sit my ass on the couch. About what I'm going to watch/sleep through during that time. About when I can start walking around. About how I'm going to feed myself or what I'll need for that after the surgery, given that it's incredibly common to not want to eat for a couple of days afterward. About how my bodily functions are going to get back to normal and how long it will take. About whether or not I'll have to have a catheter and what that's going to be like. ABOUT WHAT I'M GOING TO DO ABOUT NEVER HAVING TO WALK DOWN THE FEMININE PRODUCTS AISLE EVER AGAIN IN MY WHOLE LIFE. (I may just dance down them one more time for shits and giggles once this is all done.) About what I'm going to eat after surgery because it's very likely that I won't be able to eat anything that they have to offer me, which is how it was after my endocolonoscopy as well (they said I could bring light snacks if I want). About what I'm going to bring with me for food so that I can eat if I need to. About what time I have to be there. About whether or not Rob is going to be able to work that day. About how I'm going to keep my 8-month-old-hell-on-wheels puppy from jumping all over me. About how I'm going to be able to sit up while my abdominal muscles are healing. About hormone therapy and what that's going to look like and whether my doctor is going to start me on it right away or if he's going to wait (from everything I've heard, I'm hoping he's going to start me on it right away).

That's just the stuff off the top of my head. There's more in there - I'm certainly counting on that.

But for now, I just knit.

At this rate, I'll have a whole hat done by tomorrow even though I'm using pretty small needles. :) I'll get this all figured out - the only trick is to not over-think it. I'll just be so relieved to have it finished.

The Miracle that is Prilosec

Friends, I've had a chronic cough since my teens, and on-and-off shortness of breath for almost as long. So, we're talking decades. A long time. I chalked it up to allergies, and so did my doctors without so much as a "let's see if this is something else" until I was 24 when I had a REALLY REALLY REALLY bad reaction to peanuts that landed me in the emergency room. It wasn't the throat-closing-omg-I'm-dying reaction - it was sharp pains in my stomach that were so bad I could barely even move enough to get myself to the emergency room. At that point, my PCP at the time ordered an Upper GI, which I did, and it indicated that I "might have some reflux", and nothing more was spoken of it other than "stay away from honey roasted peanuts."

Solid plan, doc.

I had my first colonoscopy a few weeks ago. They also wanted to do an endoscopy to "check for celiac" (spoiler alert: it was positive) because my blood tests a couple of years ago indicated that I had it. Through that endoscopy, they saw inflammation in my esophagus and my stomach. In other words: GERD. The doctor put me on Prilosec (and I promptly switched my gastrointestinal care over to her permanently since I'm going to have to go through this every 1-2 years and I loved her straightforwardness and the having of solid plans immediately that I can stick to. SHE IS AMAZING.).

Within three days, the cough that had plagued me for literally decades was gone. Just...vanished. Like, I didn't know what to do with all that time that was no longer spent coughing and clearing my throat. It was NOTICEABLE. People pointed it out, that kind of noticeable.

I haven't been so compliant with it over the past few days. Part of it was negligence, sure, but I was also curious about what would happen.

Shortness of breath and that cough returning full force is what effing happened. My esophagus is so inflamed that it's keeping me from drawing in a full breath.

I am floored. I took it this morning and the cough that kept me up half the night last night was gone within an hour. UNBELIEVABLE.

I also started seeing a dermatologist to finally get rid of this rosacea that has been plaguing me since, well, my 20s. (This is an ongoing pattern and why I make the sweeping generalization that doctors are human turds in coats.) 

I figure why not, since I'm getting a whole bunch of other medical stuff addressed, why not just go all the way and address it all, right? I reached the point where I'm finally tired of my medical needs not being met and I'm going to speak up for myself, and my goodness, it's working. FINALLY.

ANYWAY.

Again, I brought it up to my PCP at the time that it started happening, she threw me some face gel, and we never spoke of it again even when I tried to bring up that it wasn't working. I now have a special face wash, all of the face creams, and another one coming. My face is already starting to heal and it has only been four days.

Let me tell you, friends. I finally found a good PCP that actually listens. I didn't think that existed, but there she is.

I'm hoping that I'll have all of my medical stuff wrapped up and be on an even keel by June. I have my next thyroid appointment in March, as well as my first appointment with my new gastro, and then I am having the hysterectomy March 15. Even if I have to have thyroid surgery, it's going to be a cakewalk. I'm also choosing to look at the first half of 2021 as "that funny time where I visited doctors 1-3 times a week for a while" and let it be a Comical Thing that Happened on the road to being as healthy as I can be.

And let me tell you, as soon as I have this hysterectomy done, LOOK OUT WORLD. RYAN'S BECOMING AN ATHLETE. It's happening. It is decided.

Having Too Much Energy

This seems like a good problem to have, and it is, but I have too much energy.

It really started when I woke up the morning of my endocolonoscopy. I had little glimmers of it before that, and I think it was because I started taking Zoloft, but I'm not sure. It's not switching or anything, of that I'm sure, because I'm fully aware and in tune with what's happening. I'm sleeping like a rockstar (back to 9-10 hours a night for the first time in months!), while I'm more able to focus, I don't have any super goal-directed activity, and I'm not having any kinds of hallucinations or delusions, so I know it's not that I have some hidden bipolar disorder. I'm eating really well, and I just...feel awesome.

I think I've had low-grade depression for a really, really long time. I've kind of always been troubled by persistent negative thoughts - nothing major, just gloomy. A lot of people who don't know me well are always surprised to hear that, but the thing about it that I've learned both from my work and from my own personal experience is that people can become masterful at hiding that kind of thing. We don't know the thoughts other people have, so they're super easy to hide. When I'm having a tough day that gets harder to hide, but I've been able to keep it pretty well hidden since I was a teenager. Have there been some big bumps because of life happening? Yes. But, outside of that, I haven't really opened up about it to anyone but my therapist and my husband.

ANYWAY. I've tried some antidepressants in the past with no real change except for the side effects. Lexapro made me gain weight that took like six years to get back off, Effexor was just...no. So I gave up after that. Then my naturopath put me on Dopaboost, and my world started to change. All of these issues started to go away. Then a bunch of stuff happened, both good and bad, and I became less adherent to my supplements, and I took a BIG BIG dip recently, like within the last couple of months. So, I talked to my doctor when I went to my physical. There was a pretty clear line to chemical stuff happening in my brain.

I have also started eating better, which is not a small thing in the constellation of stuff I have going on right now. Do I hate that I have to take medications every day, now three (one for my thyroid, one for my stomach, and the Zoloft)? Yes. But, if it means that I am going to feel like this, I'm ok with it. I went from not being really able to do anything at all outside of work and teaching to feeling more motivated to get out of the house sometimes. I don't want to get out of the house all the time because pandemic, but I'm getting there, and I haven't been able to say that for a long time, if ever. But, if I decide to have a lazy weekend in which I don't leave the house or talk to anyone at all except for my husband and my dog, it feels more like a choice now, if that makes sense?

But, I'm doing things like keeping my house clean and doing laundry regularly and splitting up my workload into little bits so that it doesn't feel as overwhelming. What's funny is that no one ever talks about how depression and anxiety look a lot like ADHD because they affect our executive functioning in many similar ways, but it's true! I thought for a long time that that's what it was, but I'm finding that now that I'm clearer and my brain chemicals are doing what they're supposed to, it's easier for me to make a plan for myself in terms of life and work and teaching. Do a little bit here, a little bit there, and suddenly everything feels more manageable. I'm going to be having surgery sometime in the spring semester, I don't know when, and I went back and forth with myself about how I was going to handle it in terms of my classes. I literally couldn't figure it out. The answer was right in front of me, but I couldn't even come close to getting there. It was keeping me from being able to set up my classes and get them going, or to even finish the syllabi for the classes. The solution I came up with was so easy when I sat and actually gave myself a chance to think about it yesterday that I'm almost kicking myself. What's stopping me is that when I started to put together the syllabi for my classes, I was in a really overwhelmed state, and so there was no way that I was going to be able to think it through. (A side effect of the entire front of my brain just basically being like "Yup! I'm going on a vacation. See you in two months! Take it away, Fear Center!)

But for now, I'll just ride the wave and enjoy it, because I know it isn't going to last forever, so I may as well enjoy it while it's here and savor it - that's the whole point, right?

And also trying to get my dog to stop chewing the damn windowsills. And the curtains. And the couch. And my textbooks. And my crocheting. And also to stop barking at me whenever I don't immediately give her what she wants. Like my foot. Or my socks. Or the sleeves of my sweater.