Sugar sugar/honey honey

Updates or rant? Updates or rant? Which shall I choose…?

Updates. I’ll rant another time.

It’s less than 2 weeks until I go under the knife. I’m not cutting myself – scout’s honor! I decided it’s time to take some accountability for my wicked ways and have gastric bypass surgery. I’ve gotten mixed reviews from my friends and colleagues – even my therapist, which was the most disconcerting.

The main problem has always been my psychological attachment to food. Food was a reward, my shoulder to cry on, my close friend in good times and in bad. Food never abandoned me or made me feel worthless – until one day I looked in the mirror and saw what food did to my body. A hundred pounds too late, I realized that food wasn’t a friend; it was a crutch. I needed food to comfort me, I needed it to celebrate and I needed it to mourn. Without it, I felt incomplete.

Well, I’ve since learned that I can have a good time in life without being food-focused. The problem is the habit is so difficult to break. I snack here, gulp there and — boom! I’m back up, 100 pounds over again.

My back aches constantly, I get winded brushing my fucking hair, elevators creak when I get on (don’t bullshit me – I know it’s me), and I have a fupa (for all you n00bs out there, it actually stands for “front upper pu**y area”). I swore to myself I’d stop eating when I saw the beginning of a fupa. Guess what? Little bastard snuck up on me. Nothing like putting powder under your fupa to prevent chafing and sweating. Goddamit – not cool.

Anyway. Ahem. I view this surgery as my Antabuse. For those not familiar with Antabuse, it’s a medication prescribed for people with a severe alcohol addiction. The medication blocks the absorption of alcohol in the liver, causing it to free-float in the blood in a higher concentration than if it was metabolized by the liver. This causes some really bad side effects like nausea, vomiting, headache – your worse hangover, basically. The point of the medication is to deter people with alcoholism to not drink, thus avoiding those shitty side effects.

Gastric bypass is to me as Antabuse is to an alcoholic. My stomach will go from being the size of a football to that of a EGG. I will be forced to take small sips of water, small bites of food – the right food – for the rest of my days. I will lose these 100 pounds, yes, but I will be forced to view food as a tool of survival, not as a coping skill. Eating sugar will likely cause me great distress due to dumping syndrome*. I’m okay with that. Something has to give, y’all because I’m tired of feeling like this. My back aches. My feet hurt. My A1C is not good – I’m pre-diabetic now. My cholesterol is high. My waistline is higher. It hurts to move (what was that about exercise?). I clearly don’t know how to eat sugar in small amounts and I don’t know how to control myself despite years of trying. I will make myself do it through biological means to save my life.

My mom’s mom? Died from atherosclerosis officially, but went through 4 years of ESRD* on dialysis before the dementia hit. You know what causes the renal failure? Diabetes from obesity later in life.

My mom’s dad? Died from a sudden heart attack. Had to buy an extra-large casket. He almost didn’t fit in the crypt. He was known for eating wild game. His typical breakfast consisted of scrambled eggs (cooked in bacon grease), grits, biscuits and gravy, sausage and bacon. On the fucking daily. Oh, and he was an insulin-dependent diabetic.

My dad’s mom? Fucking anomaly. She’s had 5 heart attacks, 3 stents in her heart, is morbidly obese and is diabetic.

My mom had the gastric bypass after a lifetime of morbid obesity and watching her parents die from obesity-related deaths. As much shit as I talk about her a lot of the time, she has been my rock in this. She’s been with me to all of my appointments and has talked to me about her struggles with her weight and her reasoning behind her final decision to have such an extreme surgery. She said she’d support me no matter what decision I made.

I was so unsupportive when she had her surgery – she didn’t tell me until she’d already scheduled it. I felt betrayed and angry. I didn’t get to go on this journey with her and she never explained all her reasons why. I didn’t understand then that it wasn’t for me to understand her reasons. They were hers and hers alone. She never lashed back at me for the nasty things I said. She just kept her head up. If she cried I never knew. That’s a mother; that’s a testament to real strength. Cause I would have slapped the shit out of me and told me all about myself.

Anyway. My family is riddled with obesity and disease; I won’t let their past dictate my future.

*ESRD – End Stage Renal Disease
Dumping syndrome – when food/sugar moves too quickly from the stomach to the small bowel, causing cramping, diarrhea.

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Angels lie to keep control

Hopefully this is the darkest I’ll ever get on here, folks. 

Hopefully this is the darkest corner in which you’ll have found me and the deepest within the forest of depression I’ll ever hide. 

Before I finished my last post was the first time in a very long time I had come to suicide.  The sheer amount of stress and depression was all consuming and swallowed me whole. 

I’m still fighting my way out, but at least I’m able to function right now. Over the weekend I wasn’t taking care of my hygiene, wouldn’t get out of bed, ate my husband’s entire birthday cake, 2.5 pints of ice cream, and wouldn’t engage in day to day human activities like talking. I blew up on my mother for asking me to pick up something off the floor. 

My husband says I don’t treat him like he matters when I’m this depressed. He says I don’t treat him like a husband but like a buddy or a friend. It comes from years of pushing people away. Every time someone gets close to me, I step back. It’s so strange to never live in the same household as my father and pick up his traits.  

I have 2 friends – Alissa and Elizabeth – who are both very close to me. I’ve known Elizabeth for over 20 years. We reconnected a few years back and have grown closer since. She’s truly a good friend. She tries to psychoanalyze me at times which I’m not the biggest fan of (not qualified to do!), but I know she means well.  Here’s the deal: for every inch she scooches closer, I pull back six. It’s not something I do consciously, it’s just done. Moving closer would make me too vulnerable and I’m in no position for that.  

My other friend, Alissa is also a counselor. She suffers with depression (I personally think she’s got more than depression, but I’m not in the business of diagnosing my friends) like I do so we commiserate together. We both work in the same area with the same population so, again, we commiserate about work stress and drama. She and I have grown very close. As she grows closer or needs more support, I fucking run – I don’t understand why.  When I need support, I hide from her until I feel well enough to express my feelings without being under suspicion of being suicidal. I’m always afraid she’ll petition me or send the police to my house to check on me because she’s a counselor. I refuse to go into a hospital involuntarily – I know what they’re like and I’m not ruining my career by sitting next to a patient in a group session. Fuck that shit. I’ve always gone voluntarily. 

Back to the husband thing, I always back away. I told him I distance myself from everyone because it’s habit at this point and – as much sense as this doesn’t make – if I did commit suicide, I will have put so much distance between me and everyone else, it’s like it wouldn’t have mattered much if I was gone. Just a buddy, not a wife. 

H: “That doesn’t make any sense.”
Me: “Depression doesn’t make any sense. What kind of disease has you thinking that in order to survive you have to die?  Our purpose as humans is to propagate the species. We can’t do that if we’re dead.  Depression isn’t based in any reality; my thinking isn’t real.  It makes you focus on what it wants you to focus on – which is mainly your depression, nothing else.  But you always matter; you’ve always mattered.”

I explained that it’s difficult talking to him about my deepest and darkest thoughts and feelings because he’s never been there. While I’m delighted he hasn’t, explaining what Hell looks like and how it felt versus describing how it feels to someone who’s already been there are 2 separate things. (I can’t go to support groups – I may run into patients there.). So I keep to myself. I understand my Hell and I know my pain. I’ll get through this if it kills me – whether by my hand or G-d’s. 

I can’t destroy what isn’t there

TRIGGER WARNING – RAPE

I met with my psychologist this past Monday. Aside from reminiscing about all my psychiatrists of the past (and their behind-the-scene proclivities), we talked about the moment I went nuts …no I was right. Went nuts is totally appropriate here.

She said that age five, I tried to kill myself. I know; I was there. I don’t remember the circumstances, only the where, the when and how. I remember my disappointment in it not working and my becoming even more depressed. I tried a few times. As a child that size, your resources and vocabulary are limited. I felt this deep overwhelming panic, anxiety, sadness, loneliness, hopelessness, anger, fear and helplessness and felt I had nowhere to turn and didn’t have the right words to express any of it.  So it appears, according to my psychologist’s theory, that my brain’s chemistry changed the first time. My body’s arousal system and my neurotransmitters went nuts.

I was majorly depressed and disordered by age 6 with at least 2 suicide attempts under my belt.  By age 16 I was full-scale self-injuring on the daily; it looked my dermatologist was Edward Scissorhands.  My mood was all over the place due to my hormones and my outright refusal to take medication until the next year when I was almost hospitalized for suicidal threats and increasingly intensive self-injury of which I still carry the scars.

I went to college at age 17, fully medicated for my safety and for those around me but it had little effect.  I went to a very large, very competitive, pseudo-Ivy League school.  I had very little social support and many of those I met didn’t fail to remind me of my social and racial status.  Yes, I was a part of the 49% of the students receiving financial aid and yes, I’m black.  (No, asshole – I got here on merit, not affirmative action.  In between slicing and dicing I managed to pull a 3.9 GPA out of my ass in high school.  I actually had people make comments in class about this shit to my face.  Unbelievable.)

Anyway, let me back up a bit.  Welcome Week, freshman year.  Exciting for kid fresh out of high school – getting to party in college!  I had arrived.  I was grown as far as I was concerned.  I could stay out late, meet guys, new people – have a blast!  My best friends from high school, now attending the rival college, were coming down for the weekend and we were going partying together so I was excited.  The four of us get some food at a local hangout near my dorm and start walking around campus to find a party that looks cool.  One of my friends, Tom, was a sophomore so he knew everything about frat parties since he was a frat member at Alpha Chi What-The-Fuck-Ever so we followed his lead.  We walk into this relatively jumping party – just wall to wall people, a DJ, jungle juice, the whole shebang.  Jim and Raquel start dancing (they were dating) and vanish into the mist of the crowd.  Maya, a sophomore at our school, fucks off somewhere, probably trying to find a rich white guy (she has a type – has since high school) and leaves me dancing by my lonesome.

At a frat party.
My first night on campus.
Awesome.
Well, this is the start of a Lifetime movie.

Boy did I call it.  This fucking guy comes up to me, introduces himself as “[inaudible due to the loud music played by the DJ]” and points toward the center of the dance floor.  I nod “okay.”  There’s 60 goddamn people on this dance floor.  I can’t be abducted in the middle of a crowd of 60 people.  It’ll be fine.  So we start dancing; no big deal.  He then moves behind me and puts his hands around my waist.  I can tell he’s drunk; I’m not having a good time anymore.  I need to find my crew and get the fuck out of here.  I’m looking for my crew so we can di di mao.  Before I get a chance to break away, he puts his hands down my underwear and ::ding-dong:: WELCOME TO COLLEGE.  Unwanted sexual contact.  I grab his hand and pull it out of my pants and walk away.  Of course NOW my friends are ready to leave and find another party.

Right before we go, this asshole gives me his number.  He wouldn’t leave me alone until he could put it in my phone.  He was too drunk to spell his name right.  Unless he was actually named after a tennis shoe.  I never told my friends – he was drunk, right?  No one’s fault – blame it on the alcohol…  I never told anyone.  Just buried it along with everything else.

Ah sophomore year.  This one’s gonna be tougher to talk about.  I met this gem on the back stoop of my dorm at the beginning of the school year.  We went on 1 or 2 dates.  He dropped me off at my dorm room and when he hinted that he wanted to take things further than a kiss goodnight, I told him I had a rule: 6 months of monogamy before sex.  He seemed outraged.  I made it clear I didn’t care – those are my rules.  Next date, we decided to stay in, were watching “Law and Order” when he said he had to tell me something: he was on parole for armed robbery.

Uhhh.  He knows where I live.  He knows where my family lives.  He’s 6’2”, 245 lbs – all muscle.  I was 5’4”, 145 lbs.  I was fucking terrified.

Someone tell me please: When an armed robber comes to your living quarters every few nights for several MONTHS, what do you do?  When you feel like you’re not given many options considering their size and tendencies to be ARMED?  Fucking terrified.  This went on for 3 months.  During that time, I isolated from my friends and family, I was “stealthed” countless times which resulted in a case of (CURED!) chlamydia.

When I finally broke down and spoke to the only person who I thought would listen, my ex-boyfriend Anthony, he helped give me the strength to leave.  I left and the man stalked me in my dorm room for a few months.  It took a key card to get into the building but somehow he would get in and leave messages on my door calling me “bitch,” “slut,” and “fuck you.”  I reported it to campus security but it was useless.  I moved out of the dorms into an apartment with Anthony the next year; we got back together after this.

Anthony is a story for another time.

So the intimidation-rape is trauma #2.  Trauma #1 was whatever happened at age 5 that triggered my suicide attempt – that is a mystery to me as of yet.  I’ve told my psychologist I’m considering going to a hypnotist because I’m tired of this Swiss cheese stuff – this holey memory of mine is ridiculous.  We either figure this out or we don’t.  My psychologist said something that has been weighing heavy on my mind all week.  She said that her theory is the chemical imbalances that have been caused by trauma can be reversed by re-training the brain.

…Excuse me?  If I’m understanding this correctly, bipolar disorder can be reversed through behavioral or cognitive behavioral therapy.  Are you shitting me?  

I’ve just been in limbo all fucking week, letting that sink in.  Think about it: if that is true, I’ve been able to fix myself this whole time.  I’m like Dorothy at the end of Wizard of Oz.  She had the shoes throughout her whole walk through Oz — the bullshit with the Witch, the Monkeys, the talking head of the Wizard, all of it — and she could have gone right home.  Unreal!  While I understand in Wizard it’s a little different – she needed to understand how good she had it in Kansas.  Someone tell me the point of walking this shit-brick road?  Where’s the fun in french kissing death?  There is none!

If this is true – what if I don’t get better?  It’ll be just something else I’ve failed at.  Can’t kill myself right* and can’t heal myself, so I’m stuck in the middle.  Fucking perfect.

*Ok, I may have lost a few of you there.  As a mental health professional, that’s a horrible thing to say and hear.  However, as a someone with a mental health disorder I can say that I may speak for a few people out there who have felt this way. when they wake up in the hospital, alive.  I did – I was pissed off.  You feel like a failure because you didn’t complete a “goal,” however this isn’t a goal – long term – you want, even if your depression says otherwise.  When I say I didn’t do it right, I mean that I failed and there’s no escape from this disease on either end – through death or living.  It’s fucking maddening and it makes me feel hopeless for a painless life.  While I appreciate the empathy I have gained for others like me, I wish for a life like anyone else’s.  I wish for happiness.  I’ve never known what that’s like because even what I’m happy I’m always wondering when the feeling is going to end.

But the levee was dry

So many changes, so little patience to write about it all.  I guess I’ll start with my latest. 

Decision to leave my job. 

I’m still 70/30 on the whole thing, but that’s still enough for me to cut ties and go. There is so much wrong with what I’ve seen and sometimes been a party of that I cannot take it anymore. I’m going into private practice where I belong. Where I’m my own boss, I make my own decisions and my own hours and I only answer to (technically) the insurance carriers during an audit of my files. I’m fucking done, y’all. 

This hospital work is draining. I thought it would be easier because you don’t form attachments to people; they’re in and out – goodbye!  Nope. Not this population. I see the same people week after month, month after year. Each time, coming into the ER with the same problem, same story:

Suicidal without a plan.
Withdrawal from drugs.
Chronic back pain that’s causing some suicidal thoughts – but they’re allergic to all pain medications except for Dilaudid.
Suicidal with a plan to OD on heroin; is an IV heroin user up to 1 gram per day usage – no history of attempts. 

Now, when I say the same people, I don’t mean the same backstory. I mean the same fucking people. Joe Blow and Heywood Jablowme come in two, maybe three times a month. I’ve had patients discharged at 10AM denying suicidal or homicidal thoughts and come back at 2PM, saying they are suicidal and now, homicidal with no defined target or plan.  And can they have something to eat?  Because, well what the fuck else is this place for?  I’ll go in to talk with them and ask how I can help them, what has helped in the past and some will turn me away. Because, you know – they really need some rest. Nevermind this is an ER and 5 beds away we have people having heart attacks and dying. People treat this place as a drunk tank or a free bed and breakfast. It drives me up the wall. 

What makes things worse is policy. In the ER, it’s liability and licensing. Patients who even breathe the words suicide or harm are begging to be petitioned. (A petition is a legal document that allows hospital staff to hold a person involuntarily until they can be examined by a psychiatrist or psychologist to determine if inpatient psychiatric hospitalization is necessary).  Patients don’t need to be petitioned because they have had thoughts of suicide.  People with major depression have thoughts of suicide regularly and have no intentions of committing suicide. Petitioning them could prevent them from being honest with mental health personnel in the future when they actually do have the desire to act on those thoughts.  

But lo and behold, they get petitioned and held for hours until they are evaluated by social work.  Here’s the fun part. Depending on which social worker/counselor one gets, one’s outcome for getting placed inpatient or discharged home differ.  It’s fucking subjective. I spent most of my first year trying to avoid putting people inpatient if they didn’t need it – and was fought by other social workers who would change my disposition after I left for the day (which would set me off), physician assistants, nurse practitioners and doctors.  

I realized at year two, I was fighting a losing battle. It was even more of a loss when the “frequent flyers” became more aware of what was needed for hospitalization.  Patients who we know have a very, very low likelihood of harming themselves or others, yet report otherwise with plans?  No doctor would take the liability; they go inpatient despite all of us gritting our teeth, knowing full well they are malingering. 

There are 2 sides to malingering, as far as I’m concerned. One is that the resources being used to care for the malingerer could be used for someone in a real crisis and that really chaps my ass.  Two is that someone who takes to malingering needs some type of help.  To feign illness for any type of secondary gain (e.g. Financial resources, medical care, etc.) takes a lot. The dedication used to feign illness could have been used to obtaining whatever the secondary gain was. 

Anyway. Yes. The ridiculousness. 

There is no upward mobility in the hospital unless you’re a nurse and I will be goddamned. 

I miss doing therapy. I miss actually helping people that want to be helped. Every now and again, maybe once every 2-3 months, I run across someone who is legitimately looking for help and legitimately sick. That is awful considering how many people I’ll see in a night. Many of the people I see want pain meds or a bed to sleep in and food because they’re homeless. Some people just love the attention they get in an inpatient facility because it’s more than they get at home. None of these reasons are good enough to go to an inpatient psychiatric facility – NONE – yet these are the only reasons lately that I’ve been seeing people going. I get defeated seeing it. What good am I if this is all I’m doing? Filling beds with people that don’t need the help?  

We’ve tried countless times to help the homeless people who come in, but most don’t want the help. They dismiss the shelter referrals we give out and have burned all their bridges at local transitional homes. It burns you out when you’re doing all the legwork, people do nothing and expect the world. The expectations along with the entitlement when one is not putting any effort is beyond irritating and exhausting. 

I’ve got more but I’m tired of writing. 

message from a.c. lerock

They fucked up and let me see some of my  chart. Lordy lord… this is what I bug the husband with in the middle of the day. 

And he stays. 

And I misspoke. There’s a space under the diagnosis that allows for clarification, as being depressed all the time negates a bipolar diagnosis but what people fail to realize is depression is my baseline.  

Sorry. My lack of chemicals, since a very young age, is all I’ve come to know. I’ve started back in therapy and I went back to the source: my childhood therapist. I worked with her from age 5 until my sophomore year in college, when I was raped. She said that I disappeared too soon – I had only scratched the surface in dealing with the rape and given my presentation, it seems that my mind hasn’t recovered. 

My body is now paying the price. 

So I spent a week between that session and the next thinking about everything: the rape, the aftermath, my life since then – my progress, my failures, my detours – everything – and it all made sense. My therapist was right: I stopped taking care of myself long ago.  I can’t do that anymore. I have a family, I have a husband. I have a life. I have a life I don’t want to lose. 

I told her that I have frequent suicidal thoughts with plans and access and means. But I have a huge protective factor: my husband. I told her that my husband lost his mother when he was 22 and he crawled inside a bottle to numb the pain. A year later, we started dating – he had one foot out of said bottle. I told him he’d have to stop drinking for us to date (at the time, I was a tee-totaler) and he quit. I will never send him back to that life. I will never leave him destroyed like that. He told me once that the only reason he attempts to get better paying employment is because of me, otherwise he would just live at home working a dead end job with no purpose. That leaves me to believe that I give him purpose. He gives me purpose and hope. 

I was hospitalized so many times during the first 2 years of our relationship that my own family stopped visiting. My (now) husband visited everyday, without fail. He never missed a day. Even when I didn’t want him there, he came. He’d sit through my nasty attitude and come the next day.  I finally thought to myself: Stop. Just fucking stop. This guy sees something in you. Something that’s good; something worth saving. Isn’t it worth it, perhaps, to stick around and find out what it is?  Otherwise you may never know. 

I still want to know. But if I keep hiding behind this trauma, I’ll never know. So it’s time to process it and move from victim to survivor. 

The only way around in this life is through. 

From my head to my feet

So that’s it – it’s final. I’m killing myself. I’m done. I’ve used up all 9 of my lives and it’s over. I’ve cheated death so many times; I can’t escape it anymore. My Higher Power has told me my number is almost up. 

I just get to do it slowly. Others get to watch; I get to watch. I’ll be slowly devoured by a disease that claimed the life of my grandparents in the most horrifying of ways. I watched my grandmother lose all her kidney function until she was on dialysis 3 times a week for 4 years. Over that time she developed dementia and became extremely labile: violent and hateful then minutes later, childlike, happy followed by apologetic and tearful for her violent behavior until it began again. This continued until she could no longer speak and began retaining water, slipped into a coma and died. 

So that sounds like a great future. I’m excited about it – truly. Considering I’ve gotten the disease 30 years earlier than she did, I’m on the track to die sooner. Splendid!  Just when I found the will and desire to live. 

Life always throws you a curve ball. 

The only way to reverse this is gastric bypass. Guess I’ve made my decision. I have no other choice. I made poor decisions that led me to this point. As much as food is addictive, I was never force fed. I chose what food to put into my body and I’m now paying a heavy price; I can’t get my glucose below 100 anymore. The only way I’ve gotten it to maybe 95 is to not eat for 8 hours – this is getting perpetually worse. I’ve been walking around my house complaining that I have no choice when I’ve been making choices that force me into a corner. I’m stuck choosing between body parts: my stomach or my pancreas and liver?  Do I sacrifice one for the whole?  Do I try to keep doing this on my own when I clearly cannot do it?  

Sorry stomach. It’s been fun over these years, but you’ve become a liability and we need to go our own ways. We just don’t work well together – it’s not you, it’s me. 

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.