Where the dogs of society howl

Lots going on.  Mainly feeling lost.  I’m still on FMLA per my psychiatrist.  I’ve been off all this month and won’t be going back until next month.  I’m having a hard time keeping my medications down and we’re not sure why.  My moods are cycling rapidly and I’m thinking it’s because they aren’t being absorbed properly since the surgery.  I’m worried about having all this time off, how it’s going to affect my job.  It gets more interesting: I have an interview for another job next week.

I reached out to a friend of mine regarding a possible job opportunity in a private practice setting.  I was doing some research and found that working midnights with bipolar disorder is a no-no.  Apparently most people working midnights – mainly those in the healthcare field like nurses – with bipolar disorder have circadian rhythm issues, leading to shift-work disorder (which I’ve been diagnosed with).  This triggers mania and many times, hospitalization.  Sound like anyone we know?!  

So I got freaked, reached out to a friend and asked if she knew of any job opportunities.  She reached out to her boss who reviewed my resume and offered me an interview.  I miss doing therapy.  I remember my old supervisor said to me ages ago while I was in training after graduate school and doing therapy in an underprivilaged area with substance abuse clients.  I was burning out hard, between the clients and the administration I couldn’t seem to meet anyone’s expectations of me and wanted to quit doing therapy altogether.  I told him that I wanted to work in a hospital doing intake assessments and case management to take a break.  I said that it would be “one and done” – I’d never see the people again after they left; no need to build rapport and no need to terminate; they couldn’t accuse me of abandoning them if I’ve known them for 20 minutes.  He told me that I was an excellent therapist and working in a hospital setting was “a waste of my talent.”

He burned out too and moved out of state.

I didn’t listen and got a job doing assessments.  The population I work with tend to abuse the system.  I often see the same faces – sometimes 3 times a week.  I’ve had some people discharge because they tell me they are not suicidal, turn around in the parking lot and walk directly back into the hospital stating they are suicidal and homicidal and want 3 sandwiches.  The record turnaround is 7 minutes – I actually counted.  It is rare that I assess someone that actually needs help.  I got into this profession to help people.  Will I have better luck doing so in private practice?  I think so.  I think I will because people are paying to be there.  Sounds messed up, but it’s true.  This is your “managed” care/health system at work, USA.  I have “managed” in quotes because there is nothing manageable about it and you, my dear reader, know it.  I’d be ignoring the system by leaving, but I’m not single-handedly going to overhaul the health care and mental health system – I know that.  Contrary to popular belief by many recent graduates in my field, you cannot change the world.  You can only make a dent.

Here’s where my trepidation lies.  I would have to file quarterly and withhold my own taxes.  What a pain in the ass.  I’d also have to go on the exchange for health insurance.  God please no.  Right now every doctor I work with is in network because they all work for my employer LOL.  If I go on the exchange, there’s no guarantee they take that insurance and I’d have to pay astronomical premiums.  It would take several weeks to build a caseload and get paneled with insurance companies, which means I would not be paid by the patients or insurances for those weeks.  Weeks.  Flipping WEEKS, man.  I’m torn.  Do I liquidate my house fund to pay my bills while I’m not paid for those few weeks – if I’m even offered the job?  Do I leave my awesome co-workers because I hate the population I work with?  The population, the crushing rules of administration and low wages are what keep me from wanting to stay are my job.  I know once I get a full caseload as a private practitioner I could rake in double what I’m making now, but I’m afraid.

I’m terrified.  What if I’m not good enough?  What if I fall on my face?  What if I messed up my taxes?  What if my clients don’t like me and I end up without anyone and I’m broke?  My psychiatrist told me it takes a while to build a caseload too.  How do I work both jobs to cover my butt?  Work midnights and days?  I freaking can’t.

And Mom’s going into surgery.  They said it’s going to last 8 hours and due to the definite blood loss, she had to sign a waiver permitting them to give her a blood transfusion.  So I’ve been scared about that.  Lately her voice has been irritating me for some reason and I’ve been blocking out most of what she says, but I think it’s me being irritable because of my mood cycling.  I apologized to her if I had been short or curt with her and explained I had been tuning her out.  I told her I’m scared shitless about her surgery next week.  I wish she didn’t need it.  She’s going to lose 20% functionality of her back in all directions.  She seems excited she’ll never have to load the dishwasher again.  Lucky.  Not the way I would want to avoid that chore, but still lucky.  I’m just scared – I keep telling myself not to tune her out.  Not to put this bed vibe out there in the Universe, but if her being annoying is the last thing you ever hear her say, hear it anyway.  I try to remember that and listen to her give me instructions about how to feed her fakakta fish.

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You got me wanting you

I. Fucked. Up. Royally. 

Waaaay royally. 

You always think as a kid, how fucking untouchable you are. Invincible. Magic as hell. I can do this – I got this. Y’all just don’t know me. Even in your 20s, there’s a certain smugness that comes with having survived your teens (somewhat) unscathed; now bold, fresh and ready for adulthood. 

Ohhh boy. Your 30s. They are sobering. You realize your body isn’t what it used to be, your parents aren’t what they used to be, your goals and expectations are miles apart because reality is a median that is difficult to cross. 

Fuck. Your 30s. Are goddamn depressing. My mother is getting older and I want to cry every time I see her; I want to steal back every time I was a bitch, called her names, hurt her feelings, treated her like less than – despite how she may have made me feel. Seeing my dad is just as bad. He’s losing his hair, hunching over, getting skinny – his mustache is white!  I remember when he looked just like Tom Sellack – no joke. 

I’m stalling. I don’t want to tell you what’s up. If I tell you what’s up then I have to admit the truth to myself. I don’t like this truth. No matter how much I don’t like it, doesn’t make it any less true. 

So I’m pre-diabetic now. So fucking kill me already. I haven’t eaten in 11 hours and my POC glucose is 82. Fuck me, that’s high. Had my doctor do an A1C test and BAM pre-diabetic. Oh and I have high cholesterol too – 200mg/dL. Great! Sign me up for the Fatty of the Month Club!  Do they give out pins? How about a luncheon? FUCK. So the words “gastric bypass” have been tossed around. 

Frequently. 

A lot. 

Like I’m probably gonna do it. 

Haven’t told my gastroenterologist yet so that’s good. I’m sure he’ll sign off on it, you know, because gastroparesis, IBS, and GERD. What the fuck. 

Release me from this curse I’m in

My meds are off. Like off

I’m laughing.
Crying.

At the same time.

Thinking about the election.
Thinking about work.
Thinking about nothing.
Thinking about suicide.
Thinking about my dog’s exercise plan.
And back to suicide.
And now on to my DVRed episodes of People’s Court.
I’m hungry.
Did you hear that?
I fucking heard something.
It’s dark over there, I’m not going over there. Fuck that. This house is full of stuff I don’t want to see at night. 

Why can’t I fucking sit still?  I want to throw myself against a wall. Maybe I’ll slow down. 

Nothing’s right. Nothing’s right. It’s all wrong. It’s all wrong. Everything is all wrong. I don’t understand why everything isn’t right. 

“Well isn’t this nice.”

I am struggling with something that I shouldn’t be. This should be easy. This shouldn’t be my problem. 

I have (unconsciously) made it my problem. And my grandmother can take some of the blame for this too, but I’ll get there in a second.

My mom, like most parents, gets on my last nerve at times.  I have often whispered under my breath or said to myself “you need a man,” “go out and get a life,” or said to her face things like “your identity isn’t just ‘mom;’ there’s more to you than that – go find her again.”

How I want to eat my goddamn words.
How I want to shove my foot down my throat and swallow.
How I wish I could just shut the fuck up for once and mind my own goddamn business.
My advice is bullshit and I take it all back. 

She found a man.
She went out and got a life.
She’s found her identity outside of being my mother.

…And I don’t fucking like it at all.
She can stop at any time now.
You proved your point.
Now, come home and watch TV all day with your hair all jacked up with the dogs in your lap.
Come on, quit fucking around. 

She’s been dating a guy for the past few months and she seems to really like him a lot and the feeling appears to be mutual. They’ve been spending at least four out of seven days of the week together, going to dinner, movies, sidewalk fairs – stuff like that. Last week she asked me how I’d feel if she spent the night at his place.  

OK, maybe I should explain.  My parents divorced when I was 5 years old.  I never really saw them together. I never really remember them kissing or hugging, being lovey-dovey or any of that shit. My mom didn’t seriously date when I was a kid because she didn’t want me exposed to “uncle” this and “uncle” that – too unstable for a kid.  And she watched too much Law and Order: SVU.

So this is all new to me. My mom being touchy-feely with someone, or talking about being touchy-feely, kinda freaks me out. It’s not that I want her to be that way towards my dad (wow yeah no thanks gross), but in general I think I’ve blocked that version of my mom out. 

I always joke that my parents are built like Barbie and Ken – not anatomically correct, just smooth plastic where their parts were supposed to be. I think by erasing any part of their being, I’ve been able to turn a blind eye to their humanity – their fallibility and imperfections.  I complain that my mother has these ridiculous standards for people but I hold her to this ideal that she should only be my mother and not have her own life. I thought she was the only one attached to our relationship. 

I was raised by my grandmother to take care of her and I see her growing, learning to trust again. I’m proud of her and scared – for her and for me. 

Devious stares in my direction

It’s been a minute, I know. I’m hanging in, but barely I feel. 

I’ve been struggling at work the past few weeks. I feel drained and overwhelmed. I often wear my bite guard to work to keep from grinding my teeth while I’m awake. The job is stressful while at work, but I don’t often take it home which is nice. When I do, it’s usually a personal problem, not a patient’s problem. 

For instance, the other day I had someone call me a fat bitch.  While normally I wouldn’t pay much mind to what others have to say to me, that stung for some reason.  Maybe because they hit that right on the head. Obviously the “fat” thing pissed me off more than anything. And it hurt. It cut really, really deep. Then I had a situation where I felt I did something right – I felt confident about my work and I was ripped apart.  Later that shift I assessed a situation and my disposition was not what anyone wanted to hear. I was ripped apart by family members, nurses – and I broke down. I was so frustrated and angry that I started tearing up and couldn’t stop them from falling.  It didn’t help that I’d had a UTI and hadn’t been able to pee all shift long.

What I’ve realized since then is I can’t allow people to dump on me. My supervisor said that’s what happened – everyone felt like crap and needed to release their frustration and crap and I happened to be the nearest one there. 

I am not a trash can. I am not a dumpster. I am not here for people to dump their crap onto. This was a step further than projection – this was blame, guilt, manipulation, and avoidance.  

See, when things don’t follow the natural order of things in my department, the staff gets freaked. It’s admission, assess, and either discharge or transfer.  Not to mention cleaning up the ancillary bullshit that no one else “knows” how to do. (They sometimes know, they choose to shove it into our laps).  That shift, things were so fucked up it didn’t go that way for several patients and each time I had a gaggle of nurses and 1:1 sitters in my office asking me the same questions: 

“What are we doing with them?” 
“Bed 58 wants to see you again.”
“So what’s the game plan?”
“I know you’re super super busy, but Bed 58 said they wanted to see you again.”
“What’s the ETA for transfer for Bed 13?”

When the staff gets freaked, I’m usually good at holding my own, but that day I couldn’t keep it together. I had 2 nurses, 1 security guard, and a 1:1 sitter standing there just pressing and pressing.  I answered the same question three times.  At what point should I stop talking? At what point did you stop listening – were you ever listening?

Every thrill is gone, wasn’t too much fun at all. 

It’s like a trapeze act around here. I get my bearings, holding on to one partner then I have to swing again – back and forth, until the jump – and into another partner’s palms I go.  From disease to disease, disorder to disorder, over and around. With all the switching back and forth between symptoms and doctor’s appointments, I get just a little heated when I see no movement on my pedometer – I could swear I’ve walked to hell and back. 

My stomach has gotten worse; every time I eat, no matter what I eat it feels like I’ve swallowed a bowling ball. 

So I stopped eating. In the past four or so days – not counting last night – I had two actual meals, the rest of the time I snacked here and there.  Is that good?  Of course not.  My gastroenterologist appointment isn’t for another three weeks and there’s no moving it up so I have to figure out a way to survive until then. I’ve tried soft foods, liquids, semi-liquids, small portions, and prayer. 

Nothing is working. It doesn’t help that when following my doctor’s orders and eating six small meals a day, one cup at a time, I started to become lightheaded, my glucose plummeted, and my blood pressure was kissing the floor. My sugar shouldn’t be 79 at fasting and my BP is normally low, but never 92/54.  That’s goddamned terrifying. I ran to my primary care doc who told me my psych and GI meds at their high doses are hypotensive – as my blood work came back normal, he said he’s going to discuss my issues with my psychiatrist first. I love my primary care doc – he seems to care. 

In the meanwhile, when at work I’ve been muddling through. I do my job and come home. It’s a 12 hour shift; if I’m lucky I get to use the bathroom – my desk is next door to the employee restroom.  I try to drink some water at least, but if I don’t eat it’s not the end of the world. 

Lately my stomach feels better completely empty than it does with even the tiniest morsel of food. While that’s great for my overeating disorder, it’s not great for me or my mindset.  I’m terrified I could swing to the other side of the spectrum of eating disorders.  Eating disorders run in my family – most famously in my mother who went so far as to staple her stomach to lose the weight, yet continues to suffer from body dysmorphia to this very day.  I don’t want to live that way.  But when the only things that I can stomach are hard candies and chewing gum, I feel trapped.