Tuesday, March 24, 2015

So many things.

Let me start out by saying how grateful I am for having found an anti-anxiety drug that works for me. The absence of crippling anxiety that made me afraid to move is a huge relief. Unfortunately, if you peel back the anxiety, the depression is still there, and, while not as sickening as anxiety, it still slows me down and prevents me from doing things I want to do. I have been depressed for so long, at this point, that I don't really even know what it is I want to do. Every ounce of energy is spent just trying not to stay in bed all day. I have no means of relief from my physical pain except muscle relaxers, which knock me out cold. My TENS unit is useful only when I am actually wearing it, and the diclofenac I got at my last (and final) visit to my pain clinic is utterly useless.

I am living a largely sedentary existence, and it isn't because I want to. There are times that I don't eat, because it hurts too much to bend over to rifle through the contents of the refrigerator. There has got to be some other way to get around this pain and lead a more productive life. I made an appointment with a chiropractor. I am hoping that maybe he can help me out. I am hoping our insurance will pay for it. I'm also going to find out if my insurance would cover acupuncture.

I'm going to bitch about pain clinics, now, and explain why I've decided to go a different direction. I've been to three of these clinics, and it seems that they all operate the same way. They double- and triple-book appointment times, so that the waiting room is always jam-packed, and it is usually an hour or so after my appointment time that I am actually seen. They do three things: hand out prescriptions for opiates, perform injections, and refer patients for surgery if neither of those work.

When I finally get into an exam room, I get about five minutes with the doctor to tell him what's wrong. In the case of my last appointment, the doctor I saw wasn't even one I'd seen before, and he hadn't even looked at my MRIs. I told him upfront that I can't do steroid injections because of my mood disorder and high blood pressure, but he still tried to recommend a steroid injection. Then, he suggested an immediate injection of Toradol, which I know works, because I have gotten it in the ER for severe pain. "Thank the gods!" I thought. "They're going to actually do something!" Ten minutes later, the nurse practitioner came in and said, "Sorry, we're out of Toradol, here's a prescription for diclofenac. The doctor wants to schedule your injections for next week." And that was it.

I obviously did not schedule any injections. I think I have ample evidence that they simply do not work for me; I've tried them twice with no effect except to feel worse for two days following the procedure. I have a case manager through my insurance company. She called and asked if there was anything she could do. I told her I needed to find a pain doctor, so she mailed me a list of in-network pain clinics. But you know what? I've had it with pain clinics. I don't want to get hooked on opiates again, I don't want intervertebral injections, and, apparently, I don't qualify for surgery, and that is pretty much the extent of what pain clinics do. I'm done.

Next subject: breast reduction surgery. I went ahead and made an appointment for a consultation in April. On the paperwork I filled out, I had to tell them I am a smoker. They recommend three months being nicotine-free before they will do any surgery. That means no cigarettes, no vaping (unless it's nicotine-free), no patches, no gum, no nothing. Well, shit. I guess I need to figure out how badly I want this. I don't smoke nearly as much as I used to. I don't chain-smoke anymore, and a pack usually lasts me about three days. I need help with this, so I called my health insurance's quit smoking line. Well, that was fifteen minutes of my life I'll never get back. I got put on hold immediately. Then I was told that their quit-smoking program "doesn't have a contract with Ohio." I asked if it made any difference that my husband worked from home but that his employer was in Minnesota. She didn't seem to know. She put me on hold again. Then she came back and asked me a couple of more questions. Silence. I finally said, "Look, I've been on the phone 10 minutes with you and you haven't even asked me my name," and I hung up. So, next time I go to CVS to pick up one of my other scripts, I'm going to ask about their smoking cessation program and see how that goes.

As to the surgery, itself, it does scare me a little. Same as when I was facing back surgery, it would be my first surgery, and it would be a major one. Sucking enough tissue out of my saggy-ass H-cups to make them perky C-cups is a major undertaking. I kinda wonder what will happen to my tattoo. I'm grossed out by the fact that I'll have to have plastic drains put in. I'm worried about getting hooked on opiates again, because recovery from breast reduction is very painful.

But if it will help me in the long run, then it's worth it. If it reduces my back pain, makes me feel more comfortable in my own skin, and helps me find clothes that actually fit the right way, it'll be a big boost in confidence. Do I like smoking more than I hate my body? It's a tougher question than you'd think, and I'm still thinking on it. My consultation isn't until April 15, so I have some time.

Subject the Third: Fucking cancer, and the death of a Facebook friend. I only met her once in real life, briefly, at a science fiction convention. She and her husband really seemed like the kind of people I wanted to hang out with. I always enjoyed CJ's posts. She made a paper crane every day and posted a picture of it on her page. Seeing them made me happy. I wish I had made more of an effort to reach out and talk to her and talk with her online, but, you know, you never expect these things to happen. (I should know better, but I don't.) She died peacefully of an extremely aggressive form of brain cancer. They removed one tumor, and things were looking up for a bit, but then they found two more, which were inoperable. In a matter of weeks, she was gone. I've reached out to her husband, of course, checking on how he is through Facebook messages. I am one of just many voices.

Fucking cancer. There are so many people in Matt's and my circle of friends who have had to deal with it, or lost someone to it way too soon, that it seems like a statistical anomaly. How can I possibly know so many people who have, or have had, some form of cancer? Matt and I had lunch with another friend last week who has lung cancer (never smoked a day in her life). She doesn't talk about it. She lives an incredibly busy life and does all sorts of amazing things like drawing comic strips and self-publishing children's books and working on a Master's thesis. She made it clear that she doesn't want anyone to treat her any differently, and so, we don't. But the elephant is still in the room. Another close friend of mine is in remission right now, after going through hell traveling to Illinois every weekend for several months for a special, targeted radiation treatment only available there. And, of course, there was Matt's dad's cancer scare, and Matt's own cancer scare. My grandmother died of asbestos-related lung cancer, my grandfather and great-uncle died of prostate cancer. What the fuck?

It's made me very melancholy, thinking about mortality. Thinking about how it doesn't seem to matter how healthy and active a person is --death can strike at any moment. I am scared to die. I am more scared of losing loved ones. What if that lump in Matt's jaw hadn't been benign? What if Matt's dad ends up with a malignancy? Even my beloved cat died of cancer, and I miss him every day.

Subject Number Four: Cat-tastrophe. Around Yule time, we took in one of the neighbor's cats, because they didn't want him anymore. Apparently they didn't understand that kittens grow into cats, and cats need to be neutered or else males will spray and females will go into heat, and both those things rank among the most annoying things in the world ever. They kept leaving the cat outside all day with no food or water. We finally got sick of the poor thing mewing piteously at our door, so we took him inside one day. We asked if they wanted him back, and they said, "no." Well, all right then. Our Robin has recovered completely from the flea infestation and upper respiratory infection he had when we got him, and has become a part of the family, but I always worried about his sister.

Well, his sister ended up being neglected just as badly as Robin had been. Skinny, flea-bitten, bad upper respiratory infection. She came to our porch and meowed to be let in. Well, shit. What were we gonna do? We couldn't have five cats. We already have four, and that's two more than we're supposed to have in this apartment. It just so happened that some friends of ours had recently lost a furry member of their family, and were more than happy to take her in. So they came, and they and cat-burgled Robin's sister (now known as Ginger), and took her straight to the vet, and then to her new home.

Just like with Robin, right? Except we, uh, didn't exactly tell them we were taking her. I saw "Trish," the female half of the couple, while I was outside, a little while after the deed had been done. She hadn't even realized the cat was gone. Then she decided to open up to me about her troubles, about how she was on methadone because of a painkiller addiction, which hit really close to home. She'd had cancer, she said, and she showed me her scars. She asked how the other cat was doing. I told her he was doing great. Trish suggested we have "play dates" with the sibling cats. "Sure, that sounds fun," I said. Oh, gods, what have I done?

The next day, I saw Trish again, and she was completely distraught because she couldn't find her cat anywhere. I suggested she might have jumped to the ledge next to the balcony and gone around to the steps on the other side. I told her I'd look for her. She hugged me, and said "Thank you." But she will never find her cat.

I was torn up inside with guilt, not for stealing the cat, but for what I knew Trish was going to go through. Blaming herself for not paying attention. Wondering if her cat was okay, or if she had died somewhere. I wish I could give her closure. I wish I could tell her, "We did the right thing for the cat. We took her to a place where the people can give her proper care." But I couldn't say any of those things. Instead, I explained that when a cat goes into heat, she will try anything to get out of the house, and find the nearest tom. She seemed to accept that explanation. I just hope she doesn't run out and get another cat, because I'm not doing this again.

Loki tells me that sometimes, the sneaky, two-faced, underhanded thing is the best thing to do. It's how I feel, too. I just can't help but empathize with Trish, because I can tell the reason she couldn't take care of the cats is because she can't even take care of herself. The only reason I feel remorse is because of my empathy for Trish and her situation. There was a time when I had a cat, but I didn't have a stable place to live, myself, and I had to give her up. It broke my heart. Then again, I don't think everyone thinks of animals as true family members the way I do. Hello, repressed maternal instinct...

So, that's about it. I'll close by saying that I learned a lot about myself these past few days, and that I have a lot to think about for the near future.

Tuesday, March 3, 2015

I love you, Xanax.

For the last four days, I have been taking regular doses of Xanax. Gone are the heart palpitations that made me feel like I was going to drop dead at any moment. Gone is the constant fog of fear clouding my life and making it almost impossible to do the simplest things. Gone is the constant need to reassure myself that "I am safe, I am going to be okay." I haven't felt this normal since before I went off Percocet.

My psychiatrist prescribed 2 mg twice a day, which is a pretty high dose. I found that the full 2 mg zonked me out pretty rapidly, so I only take the whole pill (which is scored in four sections) before I go to bed. This has helped me sleep better, and, even more significantly, seems to have stopped me waking up every morning in a panic. I take 1 mg when I get up, and divide the other 1 mg up during the day, as needed.

The news isn't all good, however. Today, I saw my GP, and though my blood pressure was better than last time, it wasn't where he wanted it. So, he is putting me on Norvasc, a calcium channel blocker, in an effort to lower my blood pressure to an acceptable level. I'm worried, because the last time I tried a blood pressure medication that was not a diuretic, I had a paradoxical reaction and ended up with tachycardia and severe panic after just one pill. I am hoping this doesn't happen again. It works on a different set of chemicals than Propanolol did, so, hopefully, I'm safe.

Anyway, here I am, a 37-year-old woman, now ingesting a cocktail of 7 different medications every day. It doesn't make me feel good, and while Xanax has improved my anxiety, my depression is still there, dragging me down. I feel broken. Getting a lecture about how I probably have high blood pressure because I'm fat didn't help. Hello? I've lost 33 pounds since January 5, when I stopped taking Percocet, and my blood pressure has gone up, not down! Fat shaming aside, I don't think my GP is really seeing the big picture, no matter how clearly I try to paint it for him. So, do I take this new drug, or do I try other methods to lower my blood pressure, like meditation and exercise?  (For the record, pre-Xanax blood pressure was 157/108, and today it was 136/94.)

I'm just so sick of doctors and medications and fat shaming and health insurance. Blue Cross still haven't approved my TMS (transcranial magnetic stimulation) therapy, and given their track record, I'm bracing myself for a rejection.

So what do I do? I guess it's up to me and my gods. As I recover from the trauma that was withdrawal and the subsequent PTSD shit from staying at my mother's, as I begin to feel normal again, I need to take steps to heal on my own. I'm not going all crunchy-granola and stopping my meds, but I would like to start doing things I used to do, like going out on my own, and meditating, and becoming more active spiritually. But I have to take baby steps.

Meat suit.

This was originally a really long Facebook post. I decided to share it here, and edit/add a little more to it. This is what happens when the constant fight-or-flight shit goes away: I get thoughtful. I get existential. I get melancholy.

I often feel as though my spirit is separate from my body. That I am just piloting this broken-down meat suit through life, a suit I didn't choose, a suit that is cumbersome and doesn't fit who I really am. At least some of my depression and anxiety come from this singular perception. I don't feel whole. I feel like I am missing some vital component that would fix the disconnection between body and spirit, and I've been looking for it my whole life.

I woke up from a nightmare in which I was screaming at my mother that I wanted to transition. I guess the body dysmorphism crap is still an issue in my subconscious. In my dream, my mother was wearing a strange mask painted blue and white, so I couldn't see her face. Her eyes were covered, so she couldn't see me, either. Maybe it symbolizes that she will never see me as I truly am.

For those who don't know me as well, I have struggled with my gender identity for a long time. I don't fit into the gender-presenting stereotypes because I still like to wear pretty girl clothes, but only sometimes. I'm most comfortable in jeans and a T-shirt. I experimented several years ago when I was dating Joyce. I found that presenting as male, to the exclusion of anything feminine, was just as restrictive being trapped in a very feminine body (I have large hips and H-cup breasts.)

Deep down, I feel like a boy who just likes to cross-dress a lot. But, if I want to present as male, it takes a lot more effort than just wearing boy clothes and foregoing makeup. It's just the way my body is shaped. There are times when I enjoy my curves. I just wish I wasn't stuck with them. Just like I wish I wasn't stuck with painful joints, headaches, depression, and anxiety. Somehow, they all seem part of the same thing.

I have made progress since I first started to feel like this. I changed my name to Morgan about a decade ago because it is androgynous. I felt it fit more with who I really am. I still wish I had been born male. I'd still cross-dress. I'd be a fabulous boy who could pull off drag really well, and that would suit me fine. Gender expression and gender identity are different things. Sexual preference is independent of those things, too, and it's too easy to dismiss my gender dysphoria as some kind of manifestation of my bisexuality. It's too easy to try to fit me into some neat little category of "lipstick lesbian" or "butch lesbian". Those categories exist to make other people feel comfortable, but they don't do anything for me.

So let's get down to the potentially TMI nitty-gritty. I only like my breasts when they are giving my lovers pleasure. I don't like how they look. I have always had disproportionately large breasts, and on top of exacerbating my gender dysphoria, they hurt my back. I have often thought about a reduction, if not a total mastectomy. On "girl days" I could wear falsies, and that would be acceptable to me. As for my lower bits, I find it impossible to have an orgasm without imagining I have a penis. Yes, you read that right, and it's not something new. I've felt this way for most of my adult life, and even in my early teens, long before I had any concept of what "Trans" was.

So what has stopped me from transitioning? Back when I was presenting as a boy for a few months. I went to a psychologist. She gave me this ridiculous, antiquated test that was supposed to tell if I was trans. It asked shallow, stereotypical questions, like, "Would you rather be a car mechanic or a nurse?" I kid you not. This particular shrink dismissed my gender dysphoria as part of borderline personality disorder. (I'm bipolar, but she's the only shrink who ever diagnosed me as borderline.) I felt defeated, and not heard. So I gave up. I decided I would be okay with just being a really convincing "secret drag queen" for the rest of my life.

I think I thought that getting married to a straight man would somehow make the gender dysphoria go away. It hasn't. It's just curled up in a little ball, at the back of my mind. Sometimes it comes out in the form of a nightmare, or even a good dream in which my body looks- and works- the way I want it to.

I know I just mentioned this, but it's important to explain that gender identity and gender expression are two entirely different things. There are plenty of drag queens who still identify as men. Cross-dressing does not equal trans. Lack of cross-dressing does not equal not trans. Trans just means that you feel that you are a different gender than the one that was assigned to you at birth, and this definition describes me.

I'm probably going to continue doing exactly nothing about this. Science hasn't yet come up with a cost-effective way to give me truly functional penis and testicles. (Yes, I said testicles.) Nor do I want to flood my body with hormones that will probably turn me into She-Hulk.
I also wouldn't want to put Matt and his family through my transition. I don't want to have "the talk." I don't want to have to feel like I'm hiding when I visit his parents and grandparents. (But isn't that what I'm already doing?) Besides, fully transitioning to male wouldn't give me what I want. I'd just be stuck with another set of stereotypes. It's inescapable. And Matt loves me no matter what, and we've talked about this, but the fact is, he's straight. I don't know how that would work in the longrun, and I'm not willing to risk our relationship.

I've used the terms "genderqueer" and "bi-gender" and "gender-fluid" to describe myself. It feels mostly like my innate gender is masculine, but I enjoy presenting as female sometimes. (I'm sorry, but women get better clothes.) I am planning to buy a wig. That way, I can keep my hair short and androgynous and do fun things with it, like spike it up and color it crazy colors, but I can still have long, feminine locks on days when I feel like it. The wig/hair thing is about the only thing I can do to "transition" right now. Maybe, someday, I'll take other steps. One thing is for certain: this isn't going away. I can only ignore it for so long before it eats me up inside.

So, that's my rant for today