What Depression Looks Like

Earlier this year a friend of mine asked if she could take my picture.  She's spending the year focusing on the importance of the people in her life, A Year of Faces.  I was one of many she'd asked and declined at first.  It was a very dark time in my life.  Not a time I would look my best.  I explained to her where I was emotionally and asked if I could participate later, when I felt better.

She said she understood and, of course, we could wait if I wanted to.  But if I was willing, she'd like to capture where I was right then.  The darkness.

And I knew it was right.  I needed this to happen.  Even though it wouldn't be pretty and even though it was difficult, it was also so important.  I agreed to do it.

She sent me some pictures she'd found on the internet of depression.  Some were very stylized, very artsy.  Some were blank stares.  Some were silhouettes.  I understood why people associated these with depression.  And these might represent depression for some people, or even me at some times.

But not this time.  None of these came close this time.

This was my darkest time, at least the darkest I can remember.  This was the most painful depression I've ever had.  And the most unrelenting.  Months and months of pain and numbness and isolation and fear and loneliness and sadness and confusion and anxiety and guilt and exhaustion.

The day she came I was wearing the same pajamas I'd been wearing for three or four days straight.  My hair was dirty because I just didn't have the energy or will to shower.  She was the first person I'd invited into my home in weeks.

She asked me to tell her about my current struggle as she took photos.  She was gentle and kind.  She listened and asked questions.  It was an important moment.

She used one photo for her project.  I've been saving the others for the right time.  Today is the right time.

These photos are difficult for me to look at.  They hurt.  But people need to understand what depression is and I believe these will help.

Thank you, Karen, for capturing a hidden moment that needs to be seen.

My fingertips are pressing on the spot where I've had a headache for nine years.  When I cry, I tend to furrow my brow; this makes my head hurt worse.  I press on that spot to try to get the muscles to release and relieve the pain.  It helps a little.

Depression makes me feel incredibly vulnerable.  I have no emotional energy to protect myself.  That's part of why I isolate.  So often, when I am with other people, I feel the need to defend or explain myself.  When I am in a depression I just have nothing in me to do that.  I have no strength or will to draw boundaries and defend them.  It's easier to just be alone than to feel like a rag doll at the whim of those around me.  I often find myself in the fetal position in an attempt to seal myself off from the world and keep myself safe.

Sometimes my depressions are emotionless.  I feel nothing.  Most of the time it was like that.  Dull.  Blank.  Empty.  Nothing.  Other moments were like this.  Gut-wrenching.  Crying from the deepest parts of myself.  Falling to the ground sobbing.  Unable to stop shaking from the shredding of my soul. 

And this is how I felt so much of the time.  For months and months and months.  Like an empty shell.  Depleted.  Like everything that made me who I was had been taken away.  Worthless.  Like I had nothing to offer the world.  Without hope.  Without purpose.  Gone.  Lost.  Alone.

This is what depression looks like.  It's not a bad day.  It's not when things go wrong.  It's when the world is pulled out from under me and I am plunging to my death and I just don't even care.

My Hysterectomy

I will be using proper names for female body parts and bodily functions in this post.  There will also be pictures of my belly after surgery.  It's going to be long because I want to get the whole story out in one post.  If any of these bother you, please skip this post.

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So, twelve days ago I had my surgery (to read why, go here).  A total hysterectomy and oophorectomy.  He removed my uterus, cervix, ovaries, and fallopian tubes.  He cut the parts away laparoscopically using a DaVinci robot and delivered them vaginally.  He then sewed up the top of my vagina to keep everything inside from falling out.  I think that's the gist of it.

This is a picture from the internet of the DaVinci robot:

DaVinci Robot - cool looking, huh?

And this is what it looks like in action:

DaVinci robot in actual surgery, but not my surgery

The surgeon is that guy over on the left with his head in a box who looks like a ref watching instant replays in a football game (I'm pretty sure that's not what he's really doing).  That piece is separate from the robot.  Some of the internet pictures have it up close to the robot, some have it across the room.  No idea how close it was during my surgery, obviously.  The surgeon uses controls to maneuver the robot and do the laparoscopic part of the surgery (kind of like the crane game).  The advantage to using the robot instead of traditional laparoscopic surgery (according to my surgeon) is that with the robot he has full 360 degree rotation and with traditional he only has 180 degree rotation.  My feeling was this -- if he's the one doing the surgery I'd like him to use the method he is most comfortable with and has the most faith in.  I trust that he knows better than I do.

And this is how it all went down.

I went in the Friday before my surgery for a blood and urine test.  They look for anything that could be a reason not to do surgery or a situation to monitor.  They do a pregnancy test -- because, duh, taking my uterus.  At this time a nurse also reviewed my health and medication history.  I signed several forms, including one that said I understood that after my surgery I wouldn't be able to give birth anymore.  Apparently, some women haven't understood this in the past.  Oops.

I got a call later that night telling me there was a questionable result on my urine test.  It was possible that I had an infection, but not definite.  The nurse asked if I had any of the symptoms of a urinary tract infection, as she named them.  I didn't.  She said they were incubating a sample and would let me know if there was a problem, but it was probably just a contaminated sample.  Like maybe I touched something I shouldn't have in the collection process.  Anyway, I never got a call back on that so I guess it turned out okay.

My surgery was on Monday, June 30.  I was to be at the hospital at 11:00am to begin the whole process.  Shortly after we arrived (my husband and I) they took us back to pre-op.  The nurse came in and went over the flow of the process with us.  Pre-op, holding, operating room, post-op, room.  They had a board with the estimated time of things and I was instructed to let them know if the time passed and things hadn't happened as she explained them.  I think that was an important thing for me.  I tend to be extra patient and would probably just wait.  The surgery did start later than expected, but she had come in and told us it would and gave us a revised time, which was accurate.

She then reviewed the pain scale.  It looked something like this:

Pain Scale

She asked me where on this pain scale I would normally take something for the pain.  I said probably around a 6 or 7.  She said that wouldn't work in the hospital.  They want to know when my pain is about a 4 or 5.  I'm pretty sure I looked quite incredulous.  I said I would do my best to pay close attention and tell them at that point, but I sometimes don't notice it at that level (due to my chronic pain, I've had to learn to ignore most pain).  They took more blood and urine to test.  She hooked up my IV.  She hung an antibiotic on the IV post and said they would start that when they started my surgery.  And we waited.  How long did we wait?  I'm not sure.  We got there at eleven.  My surgery was scheduled to start at twelve thirty.  It was pushed back to one forty-five because the one before me went a little long.  I don't know how long the nurse's stuff took.  They took me back to holding at about twenty after one (if I'm remembering correctly, which no one should really count on).  My husband gave me a kiss and we went our separate ways.

In holding it was just a nurse working at a computer and me.  The room looked like it could hold several beds, I'm guessing six or so, but there weren't any others in there for most of the time.  This is where my surgeon and anesthesiologist met with me prior to surgery.  It's also where I presented this picture to my surgeon, who left it with my chart so the anesthesiologist and nurses could see it:

The creature

I explained to my doctor that I was pretty sure this was the creature that was chewing and clawing it's way from my body.  I wanted to make sure he recognized it when he found it.  He, the anesthesiologist, and the nurse each got a chuckle out of it.

Both doctors explained (in their separate visits) what they were going to be doing.  They asked if I had any questions.  They were both very kind.  They both seemed sincere in their concern for me.  My heart felt calm in their presence.  I felt safe in their hands, which was very important to me.

I spent about fifteen minutes in holding, give or take a few minutes (there were clocks visible everywhere so I could keep track).  Then they wheeled me to the operating room.

I don't remember a ton about the operating room.  I remember thinking it had a lot of equipment in it.  It also seemed like there were a lot of people in there.  They put my bed up next to a narrower bed and had me skootch (totally a real word) over to the smaller one.  There were no rails on this one like there had been on the other one.  I had a slight feeling that I could fall off.  But not for long because then they put a strap over my hips and secured me to the table.  The anesthesiologist told me he was giving me something in my IV to relax me (although I was amazingly calm, much more so than I expected to be).  Then someone, I'm guessing it was the anesthesiologist, told me they were going to give me oxygen and put a mask on me.

The next thing I was aware of was a man trying to wake me up in post-op.  I was very nauseous and worried that I would throw up, which was a concern I had prior to surgery.  I told whoever the man was waking me up that I felt like I was going to throw up and could he give me something.  He told me he'd already given me three things for nausea (if I remember correctly) but would give me something else.  He also handed me a cool blue bag with a round plastic neck in case I did throw up.  I kept this bag with me throughout that first day.

Through my still sedated haze I could see that there was a clock on the wall.  I fought through the medication to clear my vision enough to read it.  My daughter is on a mission and only gets to communicate home through email once a week.  I knew she would be doing so some time between 4:00pm and 5:00pm.  My other daughter was supposed to email her info on how the surgery went as soon as my husband got word and called her.  I wanted to make sure we hit that window.  I knew the surgery was supposed to take a couple hours so we might be cutting it close.

When my vision cleared enough to see the clock I saw that is was about four fifteen.  I asked the man if my husband had been given an update and explained to him why it mattered how quickly it was done.  He said my husband had been told and he would go find him to see if my missionary daughter had been told.  He came back shortly to report that communication had gone back and forth with my missionary daughter and she had the info.  Then I relaxed a bit.

I was moved to my room shortly after that.  We passed my husband in the hall, who joined us.  I think he waited in the hallway while they got me situated in my room.

He stayed with me until about eight that night, when I sent him home to sleep.  I wanted him to be rested when he took me home the next day.  My three younger kids (15, 17, 19) and a friend who's like our kid visited.  My parents visited (after receiving permission).  They can sometimes be stressful for me, but I understood that they needed to see that I was doing okay.  Their visit was short and nice.  And I was doing fabulously!  Every nurse commented that they just don't usually have people who are that happy on their floor.  I guess I threw off the anesthesia quicker than most.  And because all the anxiety I'd had before surgery was gone, I was very happy.  I had pain, but that I can handle.

I pretty much asked for the meds on schedule.  They gave me morphine to begin with.  I think that was every two hours.  Then they added something else; I want to say Tramadol, but I'm not sure.  Whatever that second one was, it was longer between doses.  Six hours maybe.  I was on a clear liquids diet, which was fine because I was still nauseous.  I got strawberry jello and a couple things of grape juice.  And water.  The nurse warned me to sip, no matter how hungry/thirsty I was.  Good advice!  I didn't want anything coming back up.

After my husband left I played hand solitaire and tried to find something to watch on TV.  I don't generally watch commercial TV, so it was tough.  I found a channel with old shows and watched some Murder She Wrote and later watched O, Brother, Where Art Thou?  I also went for four laps around the nurses station.  The nurse walked next to me, but I was stable enough on my feet to do fine just holding the IV stand.  The nurse was thrilled with my efforts; she said usually she can't convince people to even get out of bed and try walking.

I barely slept, which I knew would happen.  I listened to an audio book of Harry Potter on my mp3 player (I always listen to Harry Potter when I sleep because I am such a light sleeper; it's my white noise).  The nurses did their best to keep the interruptions to a minimum and keep the lights off to help me sleep.  It just wasn't happening.  When the phlebotomist came in at 3:00am to draw my blood I was awake.  (I guess my hematocrit had been low prior to surgery and they wanted to check that).

I had a little trouble with my catheter.  I still felt like I needed to go to the bathroom, which is a sign that it's not in right or is kinked or something.  And there wasn't as much output as would be expected from what I was drinking.  The nurse worked with it a couple of times.  It worked okay for a bit and then struggled again.  The other nurse had told me that since I was doing so well she would take the catheter out at six if I wanted her to.  Otherwise, they'd wait until I woke up.  I said six would be great.  It ended up that the nurse was in my room around five for something else, medication or IV or something.  I asked when she could take the catheter out.  She thought for a second and then said she could do it right then if I wanted.  I definitely wanted!  So she took it out and told me I had seven hours to pee on my own.  If I couldn't by then they would do a scan and see if they could figure out what was wrong.

On the information board in the room they write what the goals are for the patient.  The main goal was pain management.  Then she added "urinate by noon."  I can honestly say I don't think I've ever had peeing as a goal.  I had no problem meeting that goal.  I was able to pee all by myself within an hour or so of her removing the catheter. 

She switched me to a soft solids diet some time during the night.  After the catheter was removed I was finally able to get a few hours of sleep.  When I woke up I ordered breakfast.  I was so excited to be on a soft solids diet because it meant I could have milk!  Milk is what I usually use to soothe my nausea at home, so I was glad to have it.  I had pancakes, hashbrowns, two cartons of milk, and some tapioca pudding.  I wasn't a fan of the tapioca, but I ate everything because it had been so long since I'd had real food (fasting for surgery, of course).  I showered and put on a clean gown and underthings.  I went for another walk, without an escort.  Five laps this time.  I also asked for something other than morphine, since it was making me itch.  They added Percocet in its place (every four hours).  And the nurse applied an estrogen patch to my abdomen, to wear for seven days before switching to pills.

My husband and oldest daughter (23) came over around nine.  My 19-year old daughter is a nanny and brought the kids she cares for to visit. 

My doctor had told me I would get to go home after one night in the hospital.  Since I've taken care of many family members and a few friends while they were in the hospital I knew it wouldn't be until after the doctor made his rounds, which are usually done in the morning.  We hadn't heard anything by about noon so we asked our nurse to check on it.  He said he'd seen my doctor on the floor so he didn't know why he hadn't come to see me.  My nurse came back shortly and said the doctor had started his rounds but was interrupted by an emergency.  He would return when that was taken care of.

He came around one.  As he washed his hands I asked, "Did you get him?" (meaning the creature).  After only a slight pause he said, "Yeah, I ran him out of there."  He said he'd been getting a report from the nurse and been told I was hopping all over the place.  A wonderful report.  He asked how I was doing (fabulous!) and gave me instructions.  He asked if I had any questions.  I had typed my questions into a text message to myself in my phone so I wouldn't forget.

I asked how much it mattered if the pain meds made me itch (Percocet does a little).  He said as long as I could breathe okay, he wasn't worried about it.  And he said I could take Meclizine (which I had at home) with the Percocet for the itching if I wanted to.

I asked about yoga.  I have been wanting to start, but was waiting until after my surgery because I'd been hurting so much.  He said he didn't want me doing anything straining.  Yoga is out for a while.

Then I told him I have a high tolerance for pain and since I have chronic pain I just usually ignore it.  I asked him how much I needed to respect this pain.  He said my toughest struggle would probably be wanting to do more than I should because I felt so good.  We agreed that I would take the pain meds on schedule for 72 hours rather than according to my pain.  I agreed to not do dishes or laundry for two weeks.  I agreed to not lift anything over 15 pounds or spend too much time on my feet.

The nurse asked the doctor if he could take my IV out then, if he was done with it.  The doctor said yes.  But I'd been watching the clock and I know how things go as someone leaves the hospital.  It was almost time for my next dose of IV pain meds.  I asked if we could wait fifteen minutes and give me that last dose before removing it.  The doctor said that would be a good idea.

He left.  I got packed up.  The nurse gave me my last dose and removed the IV.  I got dressed.  The nurse came back with discharge papers.  He said someone had to accompany me out but I didn't have to ride in the wheelchair if I didn't want to.  That made me very happy.  I hate being pushed in a wheelchair, especially when I feel fine.  I signed all the papers and got the ones he was sending home with me.  The nurse shook my hand and thanked me for making his day fun.

Soon a lady came with a wheelchair.  I told her the nurse had said I didn't have to ride in one.  She said I could just put my stuff in it then, which is what I did.  As we walked to the elevator she asked what I'd had done.  I said, kind of embarrassed because of how well I was doing, that I'd had a hysterectomy the day before.  She said, "Wow.  You're doing great!"

The valet brought us our car and we were on our way.

I had amazing nurses the whole time.  In fact, everyone I interacted with was awesome, right from the first phone call.  Seriously, I couldn't have asked for kinder people.

I was sent home with a prescription for Percocet, prescription Ibuprofen, estrogen pills, and a stool softener (which was actually over the counter).  I took them on schedule for three days.  I took my last Percocet Friday morning, four days after my surgery.  I took the Ibuprofen (one at night and one in the morning) through Sunday. 

Monday afternoon I got a call from the surgeon's office checking on me.  How are you doing?  Great!  Any trouble urinating?  Nope.  Doing great.  Any trouble with bowel movements?  Nope.  You're able to go okay and without straining?  Yep.  We don't want any straining because you could pull your stitches.  Nope, no problem.  And how's your pain management?  Great.  What are you taking for the pain?  Nothing.  Really?!  You're not taking anything?  Nope.  And you're great?  Yep.  Well, okay.  I see you're already scheduled for your follow up and you say you're great so I guess we're done.

I've really been so much better than I expected to be.  My friends and family have been amazed at how well I am.  One friend said I seem so much better, they must have gotten something that was making me sick.

And I do feel so much better than I did before surgery.  Did it cure the problem?  It's hard to know for sure because there is still some pain in the same area that was hurting before because that's where they cut parts of my body out.  But I think so.

And this is what it looks like after:

July 2, two days after surgery

They make four incisions for the robot, including one in my belly button.  The incisions have surgical glue on them.  I think the doctor said the glue was over stitches, but I could be wrong.  It might have been in place of stitches entirely.  I never saw any stitches.  That white thing on the lower right is the estrogen patch.  To do the laparoscopic surgery they inflate your abdomen so they can see everything and maneuver.  I have no idea how long it takes for all of that air to leave, but my belly definitely still felt swollen for several days.

July 3, three days after surgery

That bruise on my belly button got bigger and darker for a few days.  The surgical glue started pulling up around the edges by this time.

July 9, nine days after surgery

The bruises are mostly gone by this point.  I took the estrogen patch off that morning, but the skin there was a little sensitive so I decided not to worry about the glue left behind from the patch until the skin there healed a bit.  The surgical glue is gone from everywhere except my navel.  It didn't rub enough to loosen it and that area was a bit tender so I left it alone.  You probably can't tell, but the incision on the left isn't healing quite as quickly as the two on the right.  It's possible that I might have encouraged that glue off a little sooner than it was ready.  Don't do that!  If you do, it's possible that the wound will weep a little and glue itself to your clothes and then when you move quickly you will tear off the scab and start bleeding and it will hurt.  Don't ask me how I know this is a possibility.

July 11, eleven days after surgery

Bruises almost completely gone.  Surgical glue gone.  Skin under patch healed enough to scrub clean.

Oh!  I forgot to mention vaginal bleeding.  I expected to bleed more.  I wore a pad for a few days (no tampons allowed because of the danger of infection).  The day of surgery I had some bleeding.  Not much though, like a light to moderate day of period bleeding.  The second day it was less.  By the third day I wasn't really bleeding anymore, just had some pink when wiping.  By the fourth day I was done.  It's kind of crazy that there wasn't more blood.  I bled a lot after having babies; I kind of thought it would be like that as things healed.  I guess it makes sense that things would heal much faster when they do it surgically and sew things up and cauterize them.

I am still on the same restrictions I was given when I left the hospital.  I see my surgeon Monday for my two week follow up.  At this visit he will check my abdomen to make sure that's all healing well.  We will also discuss which restrictions I still need to live by and which can be lifted.  I see him again around six weeks post-op.  At this visit he will do a vaginal exam to make sure everything is healing properly there, that I haven't pulled any stitches, and that nothing is falling out.  He expects that all restrictions will be lifted at this appointment except for one.  No vaginal penetration until eight weeks post-op.

I'm really feeling great.  I'm so glad to have it over with.  Everyone who took care of me was fabulous.  I even received a thank you card from the nurses who took care of me thanking me for letting them care for me and wishing me swift healing.

I can't imagine anything in the whole process going any better.  And I'm so grateful!

Health Update -- Not for the Faint of Heart

I will try to keep this clean, but my story may still make some a bit squeamish.

First, the basics.  I had my annual physical a few weeks ago.  Everything seems okay.  We didn't do blood work yet because I've switched thyroid meds and we'll need to do blood work for that in a couple of months anyway.  In order to spare me a poke, we're doing it all then.

I wanted his feedback on my thoughts about how to proceed regarding my prolapsed uterus.  I wanted to give him my full medical history (since this is my first full physical with this new doctor).  I wanted to give him an overview of my current symptoms, not looking to fix anything but just to give him a whole picture and see if anything worried him.  And I wanted to switch thyroid meds from a synthetic to a natural.

Doctors prefer the synthetic for more accurate dosing control, so it's not always easy to get one to switch you when your numbers are good.  My thyroid numbers have been good for a couple of years, but I still feel horrible.  My gut told me I needed to try something new.  He was a bit reluctant but said if I felt really strongly about it he would be willing to give it a try.  I've been on the new medication for about two and a half weeks.  I don't want to jinx anything, but I have been feeling a bit better on the energy front.  Not great.  And no where near how I used to feel.  But I have been able to do a bunch of work around the house - spring cleaning - that I had wanted to do for a long time but just couldn't make myself do because I was so exhausted.  Any improvement on the energy front is wonderful, so I'll gladly take these baby steps with joy.

After hearing my full medical history (including a headache for eight and a half years) and seeing my list of symptoms he suggested another MRI.  It's been about eight years since I had one and my symptoms certainly warrant it.  I told him I want to wait until we try the new meds for a while and after I have surgery and let my body adjust a bit.  If things are still the same I'll have the MRI then.  Besides, we have a one year waiting period for pre-existing conditions that will end in September.  Perfect timing.

I told him about my uterine prolapse diagnosis from the gynecologist and said that after all my research I wanted to have a complete hysterectomy, including ovaries.  He understood my reasoning and said he would back that decision.  He said I wouldn't have trouble convincing the surgeon to do the hysterectomy but might have trouble with the ovaries. But he also said when I mention two second-degree relatives with cancer (my grandma died of ovarian cancer and my aunt died of breast cancer) he was pretty sure I could persuade him.

I go back in two months for those blood tests.  I promised to have a mammogram at the end of the year.  We're good to go there.  That part was easy.  But then I had my surgical consult.  Ugh.  That wasn't so easy.

Sorry to make this so long, but I want to keep this all one post.

My husband came with me.  I told him he didn't have to, but he wanted to.  In the end I was very glad he did.

We start with the basic preliminary stuff, weight, blood pressure, etc.  The doctor comes in and asks lots of questions about my discomfort and pain.  Does this activity hurt?  Does this one?  What about when you do this?  So many questions about things I hadn't ever thought of.  So far so good.

Now, I'll step out, you take off everything from the waist down, cover with the drape, and we'll do an exam.

I'm sure there are women who don't hate pelvic exams.  I'm even sure there are some who get off on it.  But for most women a pelvic exam is something we know we have to do and we just try to endure.  Just get it done quick.  Honestly, trying to be elsewhere mentally as it's happening.

A regular pelvic exam isn't usually painful.  At least for me it isn't.  Uncomfortable, to be sure.  But not painful.  This wasn't a regular pelvic exam.

This exam was more extensive (my husband later said something to the effect of the doctor being in up to his elbows).  Instead of the typical two or three minutes of poking and swabbing, it was ten or fifteen minutes of pushing and reaching and pressing internally and externally.  (There was a nurse in the room that I paid no attention to.  My husband said he looked over at her during the exam and she was squirming and looked uncomfortable and pained just watching it.)  It hurt.  A lot.  And everyone in that room knew it was hurting me a lot, even if I tried to be still and wait it out.  The doctor even apologized a couple of times when I jumped.  It wasn't too long after it started that my pain became evident and my husband came and stood beside me and held my hand.  I'm so grateful for that; it helped get me through.

Eventually the doctor had all the information he needed from the exam.  He said he would step out, I could get dressed, and then he'd come back and talk to me.

He left.  I got dressed while standing on very weakened legs.  And I cried.  It hurt so much.  More than anything but labor.  It just hurt so much.

He came in.  We talked.  He did quickly agree to the hysterectomy and balk at the ovaries.  He told me all the reasons the medical community would suggest I keep them.  I told him I'd done my research and gave him my reasons for getting rid of them.  He said he would back that decision.  He said he couldn't guarantee that the surgery would relieve my pain.  Even after all the exams it's possible my pain isn't coming from my uterus and ovaries.  But he also said women tend to have a very good sense about this and it's best to trust them on it.  (That earned him a lot of points with me.)  He said my uterine prolapse isn't as bad as the lady who examined me before had said, but it can vary from day to day depending on how much I've been on my feet.  But he also said that with the amount of pain I've had and since I'd tried pain medications and hormone treatments already with no success, even without the uterine prolapse a hysterectomy might be advised.

I need to have a bladder test to see if I am a candidate for a bladder sling (you'll have to look that up; this is too long already).  Then we will schedule my surgery.  I will have a complete hysterectomy including ovaries.  It will be performed laparoscopically (with robot assistance) and delivered vaginally.  The recovery is two to six weeks (small stuff at two weeks, full activity at six).  I will stay one night in the hospital.

The day of and day after the exam, my pain was excruciating.  So bad I had trouble walking and was brought to tears more than once.  My pain used to come and go, but I am hurting all the time now.  I am cancelling a lot of plans because I hurt too much.  I am taking pain pills to get through the most important things (like my daughter's college graduation, yay!), but then I pay a price the next day.  Rebound headache from over-the-counter pain meds is tough.  Rebound headache from prescription pain meds is awful.  So I have to be very selective about what I take and when. 

I've missed most of my son's track season.  I missed the big party for the neighborhood's seventieth birthday that I'd been anticipating for months.  I missed my friend's fiftieth birthday party.  And so many other things I wanted to attend.  I'm just so ready for this to be over.

I understand things could be tough after surgery.  I know my body will go through a shock and might not adjust well to the lack of hormones.  I know I will hurt a lot as I recover from the surgery.  But I am so ready to trade the pain and problems I have now for the ones I may have in the future.  I'm just so ready to feel like I'm on the road to recovery.

Uterine Prolapse -- I'm a Little Obsessed

Last week I wrote about how much I've been hurting, that I was going to see the doctor, and that I was afraid I'd need surgery or they'd find nothing wrong and I'd get no answers.

Well, I did get an answer and I do need surgery.

I have uterine prolapse.  Prolapse means to fall out of place.  Basically, my uterus is falling out.

Take a minute to wrap your brain around that.  An internal part of my body is no longer where it's supposed to be and is on a path that will eventually take it outside of me.  Yeah, kind of funny and creepy at the same time.

And I'm having difficulty thinking about anything else.

I meet with the surgeon on April 23.  We'll discuss my options then.  But, of course, I've already researched it a ton online.

It used to be that the standard answer to this problem was a hysterectomy.  Now there is an option for reparative surgery, much like a hernia repair.  There are pros and cons to both options and several types of hysterectomies possible.  My brain is swimming with possibilities and trying to anticipate the negatives of every choice possible.

But I can't decide anything until I get more specifics on my case when I meet with the surgeon.  In six and a half weeks.  Doesn't that seem like a long time?

It does to me, too.  But that was his first opening for a consult and I've heard good things about him and my life doesn't facilitate surgery any time in the next month anyway, so I'm sticking with that plan.

But I have to find a way to pay attention to other things.

Okay, so I only found out four days ago.  I guess it's okay to take some time to adjust.  At least I've noticed that I'm not attending to anything else.  Maybe that's the first step.

So tomorrow I'll start making a list of the things I think of that I need to pay attention to.  And I'll try to pay attention to at least one thing a day that doesn't involve my uterus.  But I think it's unrealistic to expect that I can just move on with life and forget about it.

Because it still hurts.  And it's not where it's supposed to be.  And that kind of freaks me out.

What's Got Me Scared

I hate to use the word scared.  I hate admitting something frightens me.  It means a level of vulnerability that I try to deny I have.  I can admit when things make me nervous.  I can admit when I'm anxious.  But scared.  Scared is bigger.  Scared makes me feel like a little girl again.  A little girl in a big, mean world.

But I am scared.  I'm going to tell you why and it probably won't make sense to most of you.  But there will be a few who will totally get it.

I'm having intense pelvic pain again.  Last time it lasted almost two months.  So far this time, it's been a couple of weeks.  And it's been off and on in between those two major episodes.

Here's what I'm not afraid of.  I'm not afraid it's cancer.  It could be, but for some reason that's not really a fear I have.  I'm not afraid I'm going to die or anything.

I went to my doctor with this problem in October.  That's when I'd already been hurting for a month.  He did an exam, a pap smear, and ordered an ultrasound.  When nothing showed he suggested that I see a gynecologist.

I know it's possible that it's something non-female-problem related.  It could be intestinal.  Let me tell you why I don't think it is.  It feels like I have a rock in place of my uterus.

As a woman, I went years and years without being aware of my uterus or being able to feel it inside me unless I was cramping during my period.  I mean, how often are you aware of your pancreas or your liver?  Can you feel them?  Would you know if they hurt?  So I understand when my husband says, "How do you know it's your uterus?"  And, seriously, sometimes intestinal cramping and uterine cramping feel a lot alike.

But after going through labor, my awareness of my uterus increased quite a bit.  I remember when it tightened and felt like a boulder inside me.  And this feels kind of like that.  On a much smaller scale, of course.

And then there are the twinges in my ovaries.  Again, how can I know that's what's twinging?  Well, let me tell you.  If you've ever been to the doctor and said you think your ovaries are hurting this is what he/she will do.  He (because my doctor is a he) will have you lie down and will palpate (which means push around on) your abdomen.  And when he pushes in a certain spot and you practically jump off the table and he says, "Yep.  It's your ovary." then you remember that.  From then on, when it hurts, you know what's hurting.

And, yes, at my exam he palpated my abdomen and confirmed that it was my uterus and ovaries that were hurting.  (And let me just tell you, they hurt a lot worse for a while after someone pushes on them repeatedly.)

So I'm not completely ruling out something else, but I'm pretty sure it's my internal girl parts that are causing me so much pain.

My primary care physician thinks it's probably endometriosis.

Well, you know what happens when a doctor tells you they think you have such and such.  You start researching such and such until you see the specialist.

Endometriosis isn't something incredibly dangerous.  It won't kill me.  The worst side effects are pain and infertility.  And since I'm done using my fertility I don't mind if that goes away.  And I already have the pain.

So why am I scared?

I am scared because I read up on how they treat and diagnose it.  Often they use hormones to reduce the symptoms.  Well, I am incredibly sensitive to hormonal changes of any kind.  I've had PMS since my first menstrual cycle at fourteen.  I've been on birth control pills a few times in my life and had horrible results.  They either make me homicidal or suicidal or a bit of both.  Having just come through a nasty mental prison, I'm not anxious to go back there.  One of the treatments if they do find endometriosis and it's severe is a complete hysterectomy. 

Again, I'm done with those parts so I wouldn't mind giving them up.  Except for the whole hormone thing.  It's called surgical menopause because the surgery instantly does what is supposed to take a woman's body years to complete.  If small hormonal changes like my natural cycle and birth control pills can send me out of whack, just think about what surgical menopause could do.  And it's not like we can change our minds afterward and say, "This isn't working.  Let's put it all back."

So there are those issues.  But still those aren't my biggest fears.

My biggest fears are these:  sedation and no answers. 

The only way to confirm endometriosis is through surgery.  Laparoscopic these days, but still full sedation.  The surgery doesn't scare me.  Being put under terrifies me.  Not for the typical, "What if I don't wake up?" reason.  Sedation terrifies me because I will have no control over what is done to my body.  I have a history of sexual assault.  Things were done to my body without my permission.  At least once it happened when I was asleep.  This is when I became a light sleeper.  Being aware of and in control of what happens to my body is very important to me.  It's not that I don't trust the medical personnel.  They have no reason to hurt me.  But giving up that control just doesn't feel safe to me at all.  It terrifies me.

And I fear that after all of the tests and possible surgery, they won't find evidence of anything wrong with me.  It will be another time that we've spent lots of money and caused lots of worry for nothing.  Another time that the people around me wonder if I'm faking it.  If I'm just a big baby.  Another time when I doubt myself and wonder if everything really is all in my head.  Another time I hurt so badly but can't say why.  Another time of feeling embarrassed because I'm such an idiot who can't handle a few of the twinges that are normal in life.

But I can't just not get it checked.  Because it could be something else.  It could be something serious.  I can't take that chance.

I see the gynecologist on Monday.  Your prayers and happy thoughts are welcome.  Again.

The Silent Storm

A continuation from my last post, What a Bad Mental Illness Day is Like.

**********

For the most part, when I am struggling, I am not obvious about it.  I get very quiet and avoid people and activities when I can.  Because I have to for self-preservation.

Do I hide it on purpose?  Sometimes.  When I cry and cry all day long at every little thing, I fight those tears around my kids.  And around most other people.  I don't want my kids to worry.  I don't want to have to explain myself to others.  And seeing the pain in others' eyes because I am hurting is hard.

But sometimes I have to explain.  And then I cry and pace and shake my arms to try to make the feelings go away.  It's so exhausting and it hurts!  After an hour of trying to explain and process, I feel like I've done the hardest workout of my life.  I have to change my clothes because I sweat so much.

This last week I had to do this twice.

First with my bishop (pastor).  I snapped at him at church.  Later I apologized and told him I was not in a good place.  He asked if I needed to talk.  I try to keep my life off his plate because I know his plate is full.  But this time I absolutely needed him.  I needed a priesthood blessing.  And he needed to understand how bad it was.

We visited for an hour.  He listened well and asked good questions, but not too many.  And he gave me a blessing.

But I scared him.  Enough that he asked about hospitalization.  It's not the worst I've ever been, but it's the worst he's seen me.

He asked me to promise to communicate with him more often when I'm struggling and let him worry about how much is on his plate.  I promised to try.  It's very difficult.  I also promised to talk to my therapist about hospitalization and medication.  That was Sunday.

Yesterday, I met with my therapist and had to do the whole thing again.  So exhausting.

We did an EMDR scan to see if this was connected to some trauma we haven't worked on yet.  Nothing came up.  We did a couple of EMDR tracers to see if it was connected to either of the two traumas we've recently worked on.  Again, nothing.  My symptoms have been a lot like PTSD, but it doesn't seem like that's what this is.

When my PTSD gets triggered, I usually have at least an inkling of what it's connected to, even if I don't want to talk about it.  This time there is nothing.  I have no idea where any of this is coming from.  I don't know what's causing it.

My therapist said we treat it like an anomaly and treat the symptoms the best we can until it passes (unless it doesn't).  He suggested it might be SAD (seasonal affective disorder).  He offered to put my name on the list for the DBT group (dialectical behavior therapy -- mood regulation training).  We established a medication plan.  He gave me permission to isolate myself therapeutically (you wouldn't think that permission matters, but it does).

He asked what one symptom was the worst.  I thought for a minute and answered, "The way the emotions of others overwhelm me."

You see, right now I feel everything those around me feel.  It's like I am permeable and can't keep their emotions out.  They saturate me and drown me.  It feels like everything is a crisis.  When my daughter complains about someone she works with it feels the same as someone talking to me about the death of their child.  Everything is a ten on the pain scale and it all comes through into me.  Like they are drowning and clinging to me to save them, drowning me in the process.  It hurts.  The emotional pain is so intense that it becomes physical.

So I have to protect myself from it.  I have friends who have been going through a tough time and I haven't been able to reach out to them because it's too much for me.

Even when I'm not with people I hurt.  I feel like all my nerves are on fire.  It's like I'm wearing a coat lined with little needles and they are all pressing into my skin.  And it feels like if anyone bumps me they will press those needles deeper.  Plus, people give off their own electrical field.  When anyone is closer to me than about three feet, it feels like their electrical field is being conducted through those little needles into my body.  Having people near me hurts.  It just hurts so bad.

I cry a lot, over anything.  My heart races.  I feel like I am shaking (although I am only occasionally actually physically shaking).  And I am so sensitive to everything.  Today, even the shower hurt.

But this doesn't show.  There's no visible sign that I'm not okay.  Except for my red eyes when I'm crying.  Or when I cringe away from people when they get too close (which so often hurts their feelings).

I still can't connect to myself.  I've tried.  And I can't connect to God.  I keep trying.  I don't think he's pulled away, but I just can't seem to connect.  It's incredibly painful to not be able to connect to myself and to God.  I feel so lost.

I've had similar symptoms in the past, but I've always been able to figure out why.  I can't this time.  And it's usually been of short duration, but this time it's been a month with almost no break.  I know my behavior doesn't make sense.  I know my reactions are completely out of proportion.  I know I am angry way more than I should be, but I can't stop it.

So if you see me, please be kind.  I may look okay, but inside there is a storm raging that threatens to submerge me.

What a Bad Mental Illness Day is Like

It's so difficult to explain how it feels when you struggle with mental health issues.  How do you explain emotional pain in a way that others can understand?  How do you say how hard everything has become, things that shouldn't be hard at all?  Especially to people who don't struggle.

I've been on the other side.  I've been the one whose life was turned upside down on a regular basis because I lived with someone with mental illness.  I've been the one who got angry because my life couldn't be what I wanted it to be.  I've been the one who resented the person struggling.  I've been the one who thought they were making up excuses for things they didn't want that I did.  I've been the one who felt like I was being manipulated.  And I've been the one who felt guilty because I couldn't find empathy in my heart for them because I was too close to the situation.

But this time it's me.  This time I'm the one whose mental illness is affecting the lives of those around me.  I'm the one who's messing up the plans.  I'm the one who's dropping the ball.  And I feel guilty about it and try to hide it and try not to let it affect those around me.  But it does.

When you have a physical illness, it's not tough to explain why you can't follow through on a commitment or why you don't want to go out with friends.  "I think I'm getting the flu."  "I did too much last night and am just too worn out."  People might not be happy about it, but they get it. 

It doesn't work that way when it's mental illness.  "I'm having an emotional breakdown."  "Leaving my house is impossible."  "I can't be around people."  People don't get that.  And if it happens over and over, they think they are excuses and you don't really want to be with them at all and they just leave you.

Or they want to fix it.  They ask so many questions (which are exhausting for me when I'm struggling).  Then they tell you what to do to fix it so you can be with them again.  Like somehow they know what you need.  Let me just tell you right now, I've been under the care of lots of doctors and therapists over my lifetime and even they don't know what will make it better.  Luckily, they all knew enough to say so.  "Try this or that," but not "This is the answer for sure."  Because mental illness doesn't work that way.  (Heck, physical illness doesn't even work that way.)

I've been in a very bad place for about a month now.  Really dark days and just cloudy days but no bright days.  And I am trying.  I have done all the things every doctor and therapist and spiritual leader has suggested and I'm still there.  In the darkness.

Usually, I can't write when it's a really bad day.  But a couple of weeks ago I was able to.  I share it with you now knowing it might make me look more crazy than anyone thought.  I share it knowing there will be some who still think I'm making excuses.  But I share it because I am able.  Mental illness is difficult to communicate.  So difficult.  But I am a communicator, so I share this for all those who can't put it into words.

**********

January 13, 2014

I've been hurting a lot the last week or so.  Headache that just won't break.  I have a few hours that aren't so bad, but then it overwhelms me again.  Nothing I've taken will take it away.

But that's not the bad part.  The anxiety is the bad part.  For a couple of weeks now.  Moments of okay and then hours of worry and fear.

And I worry that whatever I've taken for my head is making the anxiety worse.  But if I don't take anything, the pain and anxiety stop me cold.

Still, neither of those is why I'm writing.

Today I feel like I'm slipping away.  Like my mind is going.  I have visions of myself in the psychiatric ward, no longer myself.  No longer able to care for my family or even for myself.

This thought was followed by the thought I often have that I need to get my life in order.  I need to get things running smoothly enough and processes in place so my family can run things without me.

For the longest time I've thought this was because I will continue to deteriorate physically.  To the point that I can't get out of bed and do things.

But today I found myself thinking, feeling, it might be something else.

What if I'm not just going to deteriorate?  What if I'm going to be gone?  What if I need to get things in order because I am going to die young?

It feels like a very real possibility in my heart.  I feel like I need to get my life in order so my family can get on without me.

And today, I just feel like I am slipping away.  Like there's less and less me inside this shell of my body.

And I thought I should write these feelings down while I can.  Before I'm too far gone.

It scares me and I don't know what to do.

***later***

I took a shower and brushed my teeth in case I need to go to the hospital.

Writing calmed me some.  But the feeling isn't gone.  It's like I've resigned myself to the situation.

It's like reality is just a step away from me.  I could reach out and grab it, but I don't.  I don't want to.  I'm not sure why.

My body is present; I am just slightly out of phase with my body.  Just connected enough to go through the motions.  I can put on a show.  Make people think I'm here.

They see my body so they think I'm here.  But I'm not.  I just left a tiny piece of myself in my body like a tether.  I am still connected to my body but not present with it.

I wonder if I will come back.  I wonder how long I'll be gone.  I wonder why I left and why I don't want to go back.

***later***

I interact with my family.  They can't tell anything is wrong.  I'm just more quiet than usual, until someone stresses me out with questions.  Then I snap and yell and leave.

But mostly I'm just quiet.  On the outside.  Inside there is a storm raging.  I want to peel my skin off.  Inside I feel like I am banging around on the walls.  Pounding.  Trying to get out.  Like I am trapped in an asylum.  Inside I am pounding and screaming.  But on the outside I'm just quiet.  And trying so hard not to be touched.

**********

I need to say more, but this is already too long.  For the rest of the story, see The Silent Storm.

Keep a Happy Thought for Me?

I am still hurting.  A lot.  The depression and anxiety are still bad.  My patience is almost non-existent.

I am going to the doctor on Monday and the therapist on Thursday.  I'm really hoping for some relief and/or direction by the end of the week.  I'm kind of at the edge of what I can take.

Keep a happy thought for me?

Still Not Good, But a Different Kind of Bad

Funny thing about PTSD.  It tends to make everything else in my life seem unimportant.  That's a good thing when the problems I was having with my therapist no longer matter and I'm ready to get back to work.  It's not such a good thing when I forget about the house payment.

The PTSD is not quite as bad.  I am still cramping a lot.  I am still touch-averse.  The nerves in my system are still on hyper-alert.  But I am able to think a little more clearly.  And, as of now, it doesn't look like he will become a bigger part of my life after all.  There is less fear.

But when the PTSD lets up, all those other things start to be problems again.

The depression is still in full force.  I'm having to force myself to eat and sleep.  It takes a monumental effort to leave the house.  But I was able to perform a couple acts of service this last week.  I've been able to play my flute a bit.  And I even went to book club.  Small victories.

My body seems to be in rebellion as well.  Whatever virus it is that causes my fatigue has flared.  I could easily sleep twenty hours a day (it's a different tired than the depression tired).  Accomplishing any one thing, even just writing a blog post, saps me of all energy and sends me back to bed.  I do a load of dishes; I have to lie down.  I straighten the living room; I have to lie down.  I practice my flute; I have to lie down.  Not being able to do anything doesn't particularly help with the depression.

My headache has been awful, too.  Severe pain.  Blurry vision.  Dizziness.  Nausea.  And an inability to process thoughts or find the words (simple words) to communicate.

I haven't gone back to therapy yet.  I'm still figuring out our insurance options.  But I will soon.

I'm worried about everything:  money, each individual aspect of each of my children's futures, all the ways I've failed to prepare them, everything that needs to be done today, everything that needs to be done tomorrow, everything that should have been done yesterday, everything that should have been done last week, everything that should have been done years ago, my daughter's health, my husband's health, my health, the safety of each family member every second that they aren't with me, my friends' difficulties, my parents' difficulties, all the ways I'm failing my parents, all the ways I'm failing my friends, what I should be doing right now, how much to stay on top of my kids' school work and how much to let life teach them, and any other little thing that crosses my path.

I'm still avoiding people.  I don't want to do anything.  It's even tough for me to make myself go to my son's football games (which are my favorite things in the whole world).  Octoboween doesn't even have the same appeal as usual.

I'm trying to do things anyway.  I do enjoy the football games once I get there.  I am doing an Octoboween count down on facebook to try to psych myself up for it because I believe it can bring me joy -- eventually.  I'm trying to fake it 'til I make it.  I'm trying to convince my body and mind to get back to work.

But I just want to crawl into bed and cry and let the world go on without me.  Is that really too much to ask?

Mother's Day Sucks!

It's that dreaded time of year again.  Mother's Day.  Those two words strike fear in the hearts of men everywhere.  (Is it everywhere?  Is Mother's Day recognized in other countries?)  And so many men think they are the only ones who dread this day, but they are wrong.  So many women dread this day, too.

I know there are women and men and children out there who are looking forward to this day.  I'm happy for you.  I would wish you a happy Mother's Day, but you don't need that.  You will have a great day full of love.  Because somehow you've found the magic tunnel that leads to a world of joy and celebration and giving and love.

The rest of us live in a fallen world full of heartache and unmet expectations.  I rejoice in the fact that some of my friends will have a wonderful day this Sunday.  I ask that you try to understand why so many others don't.  Please don't judge.  Please don't tell us to make it a great day.  Please don't throw sunshine and Disney songs at us and tell us to cheer up.  For so many women (and many men) today is a day of pain and mourning.  That should be respected.  It should be honored.

I expect Sunday to be a good day for me.  A couple of years ago I was able to redefine Mother's Day for me in a way that's really helped break through that dark cloud.  Even still, there are treacherous areas for me on that day.  I have to be careful.  And my associations with Mother's Day aren't nearly as tough as so many of my friends.  They are the ones I'm thinking about at this time.  They are the ones I am worried about.  They are the ones my heart is aching for.

There is my friend whose mom knowingly allowed her to be sexually abused for years.  Who barely noticed her daughter.  This friend is a wonderful mother and I hope the day is about her.  I hope she is able to celebrate her own motherhood.  But I can't imagine there isn't a twinge of pain for that mother she doesn't have.  Whether we like it or not, whether we fight it our whole lives or not, there is something in us that longs for loving parents.  It's part of our make up.  I know she is strong and loving and does her best not to let that part of her past control her, but I know there's still pain there.

There is my friend who has never been able to have a child.  She and her husband are good people.  They would make wonderful parents.  But for whatever reason, that blessing has been withheld from them.  I have watched them reach out and touch the lives of others' children, but I know their hearts have ached for that child of their own.

There is my friend who has experienced multiple miscarriages.  She has children.  But her heart longs for more.  Her heart aches for more.  But her body seems unwilling to cooperate.  I know her heart aches.  I know she feels an absence.

• There is my friend who lost a grandchild she never got to know.
• There is my friend who has been disowned by her mother.
• There is my friend who has been disowned by her children.
• There is my friend whose mother was taken from her while she was still in grade school.
• There is my friend who has been told over and over by her husband what an awful mother she is.
• There is my friend who's children won't allow her to see her grandchildren or be a part of their lives.
• There is my friend who lost a child to cancer.
• There is my friend whose mother killed her father and then herself.
• There is my friend whose mother beat him.
• There is my friend who's husband and children will forget Mother's Day because they don't think it matters and she will feel as if they are saying she doesn't matter.
• There is my elderly friend who has outlived all her children.
• There is my friend who grew up knowing her mom never wanted to have children -- never wanted her.
• There is my friend whose mother abandoned him and his siblings.
• There are my friends who are single mothers, doing the work of both parents, who would love to have a loving husband tell them how grateful they are for these wonderful women who are raising their children.
• There is my friend who feels so inadequate as a mother and sees Mother's Day as a reminder of all her failings.
• There is my friend who is caring for her mother with dementia and mourns the mother she doesn't have anymore.
• There is my friend who is watching her drug-addicted mother ruin her life and can't do anything about it.
• There is my husband who will be reminded that his mom is gone.
• There are all the women who will feel guilty for having a good Mother's Day when they know their friends are hurting.

 

There are so many people around us who will be hurting this Sunday.  And whoever thinks one day a year is enough to recognize and value all the work mothers do is crazy.  One day a year doesn't begin to cover the sacrifice and heartache it means to be a mother.  One day a year has turned it into a marketing ploy.  A way to make money off the guilt of people who should be more appreciative more often.

 

But for those of us who hurt so deeply on Mother's Day, one day a year is more than enough.

The Blessings of Chronic Illness

Last night I had a conversation with someone who knew nothing of my chronic illness.  This is someone I only run into occasionally, who has only seen me when I'm doing well.  Which makes sense because when I'm not well I generally don't leave my house.

I don't remember what brought us to the topic of my health, but there we were.  I was explaining to her that I've fought debilitating fatigue for twelve years and a chronic headache for nearly eight.  With no answers as to why.  And I watched her face change.  There was concern and sadness.  And she expressed as much.  As she said what kind of specialists have you seen and doesn't anyone have any answers and oh, how hard that must be, I realized I don't see it that way.

And I told her of the blessings I've received because of my chronic illness.  (Some of which I've written about here.)

As a society, we tend to celebrate busyness.  Go, go, go.  That's how to be a good person.  Do, do, do.  There's never enough time in the day.  We have too much to do.  Why can't we do and have it all?  Chronic illness has taught me that this is foolish. 

Doing just to be busy is worthless.  Even damaging.  When we do and have more and more, it is usually worth less and less.  There is such value in choosing how we live our lives, every moment of our lives, instead of getting caught in the rushing flow of life as it happens around us.  And sometimes choosing to do nothing.  Choosing to be still and quiet.  Choosing to do only one thing at a time instead of always multitasking.  Teaching our minds to be at peace.

There are people who can learn this without chronic illness.  I am not one of them.  If I felt better, even now after all I've learned, I would be running around like a chicken with my head cut off -- just like I used to.  Bragging (without realizing it) in a martyr-like way about how busy I was.  Holding my exhaustion up as a badge of honor for the war of busy I fought.  Busy because I couldn't bring myself to give anything up.  Because I didn't have the willpower to choose what was important and get rid of what wasn't.  Because I didn't understand that empty spaces in my schedule were worth choosing. 

I needed chronic illness.  I needed the smack in the head that said, "Sit down and be quiet!"  I needed to be forced to pay attention to other things.  I needed to question the desires of my heart and decide what was important enough to me to spend the tiny bit of energy I have on it.  And it can be summed up in one word.  People.

The things I was doing before were good things.  But most of them were not of eternal significance.  People are of eternal significance.

I'm still working toward the ideal for me.  For now, I have structured my life in such a way that I am able to take the time to be with people when I need to.  I'm blessed that my husband makes enough money that I don't have to work (which I couldn't do anyway because of my health).  I'm blessed that the days of small children needing all my time are behind me.  As I create my new life, which is constantly in flux, the one thing that must remain true is my ability to be with people.  I need this.  To set other things aside and just visit.

Maybe it's an hour chatting on my porch.  Maybe it's a trip out for ice cream.  Maybe it's lunch.  Whatever it is, it will involve intimate conversation about things that matter.  Things no one else has the time to listen to.  I have the time.  I protect the time so that I can offer it to others.

I still have to take care of myself.  I have to remember that I am important, too.  I have to remember that if I don't take care of myself I will have nothing left to offer others.

It is the desire of my heart to connect with people.  To lift and strengthen them.  And in so doing I am lifted.  I am strengthened.  Instead of draining my tiny bit of energy, it increases.  It feeds my soul.

My illnesses and life struggles have taught me empathy and an understanding of a great many things.  Between physical health problems and mental health issues, and the diagnosis and treatment of both, I've waded through many dark waters.  Certainly not all of them, but many of them.  Sometimes I am miserable and hurting.  But I would not trade it for the world.  Because it has blessed me with an understanding heart.

If I could go back in time and do something different that prevented me from getting ill, I wouldn't.  I am so grateful for what I've learned and how I've grown.  I am so blessed to be able to offer what I can.  And none of this would have been possible without my chronic illness.

I watched her face change again as I told her these things.  I watched it soften.  I watched her smile.

If I don't learn from these experiences and bless the lives of others through what I've learned, then it was just a lot of ugliness and unhappiness and pain.  But if I use it to reach out, it meant something.  It has value.  It has eternal significance.

Why I Go to Therapy (and write about it)

Sometimes I get the perfect question at the perfect time.  This is one of those times.

Today I received an anonymous comment with a question.  I wanted to reply immediately with a long, detailed email; but since it was anonymous I couldn't.  I thought about responding via the comment section, but that didn't feel right either.

Normally, I would ask someone's permission before ever using their words.  In this case, I hope it's okay that I forgo that.  The question was structured beautifully and I don't think it contains any information that would reveal who the questioner is.  But the question is important.

"Miss Robin,

My partner and I are struggling with the realization that there may be a hidden traumatic event in my partner's past.  We hope not, but we both agree that there is anger, which comes from hurt that is being directed at the opposite sex in general and at me most in particular.

My partner is very afraid of the possibility that something very bad is there, but is probably more afraid to find out that there is nothing other than verbal and emotional abuse.  That would maybe be worse because then why so much negative energy attached to it.

The biggest concern is that my partner doesn't believe that anyone he/she knows has been helped in any lasting way by therapy, in fact it usually seems to only get worse by opening those deep wounds.

This session of yours makes one wonder.  Can you help by offering your best reasons as to why a person should be willing to subject themselves to such intensive introspection and the resultant pain?"

I can't begin to express how honored I am to receive this question.  Any time someone is willing to open their heart and share their fears, I am in awe.  It is such a difficult thing.  This question moved me to tears.

First, let me say emotional and verbal abuse are very serious things.  They are incredibly damaging to the soul, often more so than being hit.  If you are anywhere near my age or older, you were probably raised with the "sticks and stones" mentality.  Generation after generation perpetuated this lie.  Words can hurt you.  We are finally getting to a point as a society that we recognize this.  This is why things like online bullying can now be prosecuted.  But if you are like me, no one in your life ever tried to help you heal from verbal assaults.  In fact, you may have even been told by your abuser (as I was), "There's no such thing as emotional abuse."  This is a lie.  The sticks and stones mentality is another way to punish the victim for being hurt, as if it's their fault.

I'm so sorry you and your partner are struggling (because we struggle together).  I don't know if there's a traumatic event buried.  I don't know how to tell you to find out.  I'm not a therapist or trained in any of this.  But I do consider myself somewhat of an expert at going to therapy, so I'll answer that.

Traumatic events are like slivers.  We can try to pretend they aren't there, they may or may not work themselves out, but usually we have to remove them in order to heal.  We can ignore them for a while, but something will happen that causes us to bump one and it will hurt.  Especially if it was serious and it's now infected.  We knew it should be taken care of but thought we could tough it out.  Or we didn't want to make a big deal out of it.  Or we didn't want to seem weak.

The only thing I regret about therapy is not starting sooner.

I was scared.  I was fairly certain after one session the therapist would tell me I was making a big deal out of nothing and didn't need to come back.  I was embarrassed.  I felt like a failure.  And I was terrified that if I opened up and let go of the white knuckle hold I had on things I would fall apart.  I'd accidentally opened things up once or twice before and it was horrific.  I couldn't shut it down and it controlled me for days, weeks, or longer.  I was afraid I'd find some horrible memory and I'd have to confront someone about it and it would get ugly.  I was afraid of being weak.  I was afraid of needing someone else.  I was afraid of trusting someone else.  I was afraid of feeling again, because then I'd be vulnerable.

But that's not what happened.  The therapist listened and validated me.  I felt safe in a way I hadn't ever felt before.  My feelings were honored. 

Working with a trained therapist is different than talking with a friend about a problem.  When I start to get to an unsafe place, a friend will hug me and cry with me but doesn't know how to stop the avalanche of emotions that's pulling me under.  A therapist does.  He can talk me through it.  He can teach me how to find my own way through it.  It's kind of like walking through a dark house when you're scared but having a cop with a gun and night-vision goggles as your guide. 

It is hard to open up.  And it's still scary for me sometimes.  But I have never regretted it.  Not once.  I have regretted telling someone else in my life, someone I thought was safe who turned out not to be.  But never have I regretted sharing anything with my therapist.

Traumatic experiences mess us up because our brains don't know how to process awful things that happen, especially if we were children when they happened.  Through therapy a memory can be brought out, looked at, re-framed, and put away neatly.  I know it doesn't make sense that just talking to someone can make things better, but when it's the right someone who knows what they're doing it works.  I promise.

Does your partner need therapy?  Do you?  I don't know.  What I do know is that it's been wonderful for me.  Without therapy I would no longer be married.  Without therapy my husband could very well be in jail due to ramifications of his rage.  And without therapy I would live in constant fear and stress.

I am stronger.  I am gentler.  And I have much more peace in my soul.  I feel more complete.  I feel more content.  I believe in myself.  My heart is lighter and more open.  My life is easier because I went to therapy.

Even after my last session, when things went badly, I highly recommend therapy.  My therapist is just a person.  And as with any relationship, sometimes there are communication problems that cause pain.  The key is whether or not you can work through it.  We are.  The amount of calm I felt after his phone call amazed me.  No matter how often I am healed through a therapy session it still amazes me.

Listen to your heart.  If you are religious, pray.  And listen.  You will know if therapy is a good choice for you (your partner must decide for him/herself).  Chances are life has caused you to doubt your own intuition, but your heart knows.

If you go and don't connect well with your therapist, I suggest trying someone else.  One bad experience doesn't mean therapy won't work.  It might just mean you didn't fit with that person.  There are lots of therapists out there.  You need one you feel comfortable with, because therapy is an emotionally intimate thing.  Don't think one session will fix it all.  It takes time. 

And if it doesn't feel right, you don't need to continue.  I have a friend who says therapy didn't work for her.  She had to work it all out with God.  I think of myself as a pretty spiritual person with a good relationship with God and I couldn't do it that way.  I needed therapy.

I hope this answers your question satisfactorily.  Please feel free to ask more.  And thank you so much for being brave enough to offer the question.  I am honored.

A Bad Therapy Session

It happens.  Sometimes a therapy session is just a waste of time.  Sometimes this is my fault.  Sometimes it's my therapist's fault.  Sometimes it's a mix.

But this time it was bad.  This time it was wounding.

I usually see him every two weeks.  This time, due to a scheduling problem, it was a month between visits.  I'm sure this contributed.

My last visit was rough.  My PTSD had been triggered.  I finally revealed to him an incredibly difficult memory from my past -- the memory that's held more power over me than anything else.  Ever.  One I only have vague images of.  One that's left painful muscle memories.  One I've been cautioned not to share openly because it could be dangerous for me.  One that causes me to feel like a small child and to cramp terribly.

It was a very intense session for me.  He listened and validated me.  He helped get me through the worst of the PTSD.  We formed a plan for working through it.  He assured me that I could heal from this even without the entire memory.  I left that session hopeful.

Over the course of the next month my PTSD was triggered two more times; my husband went through two anger cycles; I went through a deep, week-long depression; and I had a two-hour conversation with my mom which triggered that memory again.  That dark and painful and frightening memory.

I spent a few days cramping badly, my uterus and my back, almost like labor.  Constant.  No relief from anything I took.  And I knew it was directly related to this memory.

I knew I had a session coming up.  I knew we were going to work on it and I would feel better afterward.  I held on.

But the session didn't help.  I gave him a quick recap of the month and told him I was ready to work.  I needed to work so the pain would go away.  And he went a different direction.  He wanted to focus on something else.  It's not that he was trying to avoid what I wanted to talk about.  It's that he didn't remember.  I tried to redirect it a couple of times, but since he didn't remember that memory I had revealed last time, he thought he knew best what we should work on.

Sometimes I am strong and when he goes off on a tangent or chit chats too much I can pull it back where I need it to be.  This time I couldn't.  Like I said, this memory makes me feel like a little girl.  I am hesitant and scared and timid.  All I can do is politely go along.

When we had about ten minutes left, he asked what direction we should go next.  I reminded him of what had happened last time.  And I could tell he immediately realized his mistake.   And it was too late to do any work on it.  In reminding him about it, I had reopened it.  I was raw and crying.  He tried to salvage things.  He tried to give me something to work on before our next session.  And I did my best to reign in my emotions.  Our time was up.  I had to leave the office.  And I was trying not to make him feel bad.

But I was not okay.  I made it out of the office and twenty yards down the hall to the bathroom before I crumpled to the floor sobbing.  I got it under control enough to leave the bathroom and practically ran to my car, hoping no one would notice my red eyes and shaky breathing and ask if I was okay.  Once in my car the sobbing returned, stronger.  I sobbed in a way I have only done once or twice since I was a child.  Gut wrenching sobs.  Devastated cries from deep within me.

Over the next few days there was a lot of crying.  And there was still the intense physical pain.  But worse than that all my old, unhealthy coping mechanisms reasserted themselves.  Things I thought were in my past.  Things I thought I'd overcome.  Things I thought no longer had any power over me.  They suddenly slammed me to the ground and repeatedly kicked me.

My husband and I went out a few days later.  As we drove I told him about the session.  After approximately 10 minutes of yelling and swearing, I had to admit I was angry.  And it wasn't getting any better.  So when I got home I wrote my therapist a letter. 

I told him what the experience was like from my side.  I told him how difficult it is to know I only have one hour every two weeks.  I told him how hard I prepare for that hour so I can use it wisely.  I told him it costs me $100 every session because our insurance doesn't pay for it.  I told him it's a real sacrifice to pay that, but when it's necessary and helpful I am okay with it.  I told him I felt like he'd stolen from my family that day.  I told him that session wounded me because at such a vulnerable time he didn't listen to me.  And I wasn't strong enough to fight him if he wouldn't listen to me.  I told him I wasn't sure if I'd be able to come back.  I wasn't sure I'd be able to work on this with him after all.  I'm not sure he's a safe person for me anymore.

And then I took the letter to his office and gave it to the lady at the front desk.

I have not heard from him.

I have a little over a week until my next appointment.  I'm examining my options.  I've spent a lot of time trying to decide if I will go back.  I know he sees lots of patients.  I know it was a month in between visits.  I know he's human and makes mistakes, like we all do.  And I can forgive those things. 

But forgiving them doesn't take away the wound.  If you hit me with a rock and then apologize, I will forgive you.  But the bruise will remain.  It will take time to heal.  And any time I see you with a rock in the future I will worry about whether or not you're going to hurt me.

Unfortunately, our session was the rock.

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If you read this post, please read A Possibility of Healing for the resolution.