Rays of sunshine

This has been one doozy of a year. It’s been stressful, expensive, and has triggered my anxiety big time. But, I feel like at this back-end of the year I’m experiencing some good things.

Pets

Hannah dog is recuperating from her health crisis. I had to stop all of the supplements and herbs that had been helping her arthritis pain, and that is apparent. However, she is eating and drinking again and keeping it all down, her potty habits are normal again, and after several trips to the vet for fluid therapy, she no longer shows signs of elevated bilirubin in her urine. She even shows interest in play, and still gets excited when I bring out the leash. I’m relieved and thankful that my online and IRL friends were so supportive to us during a difficult time.

Money

Oh my has this been an expensive year! I had to pay for my first eye surgery out-of-pocket in full, install a system of french drains and a sump pump around my foundation, and pay a lot in vet bills this year. There were also a few more typical home repair expenses/glitches that needed to be addressed, and I bought new tires for my car. My savings account is depleted, and it was hard to watch all that money fly out of it.

But some of that money is starting to wing its way back to me. After submitting the claim for the July eye surgery to the insurance company again, they actually paid for it! The eye surgery center sent the claim, so I will have to talk to them about getting a reimbursement for the money I already paid them. (And I still got to keep the cash rewards from the credit card company!) I’m also submitting the receipts for the post-op medications, since they had initially refused to cover it. I’m hoping to get a check for that before the end of the year.

Also, I will be getting some additional money from the IRS and State of California. Way back in the spring when I was doing a final review of my tax forms, I realized that I had forgotten to include my 2016 property taxes on the forms I sent to my tax preparer. When I contacted him about needing to correct this, he suggested that we file anyway since we were close to the deadline, and then do an amended return later in the year. I tried to get the amended return prepared as early as June, but he wasn’t responding to me. It took a lot of persistent follow-up, but I finally got the amended return a few weeks ago and mailed it off. (Yes, I will be looking for a new tax person to work with; that I had to follow-up at least 6 times via email and phone to get this addressed is unacceptable.)

This month I will get three paychecks instead of two. This happens at least once, and sometimes twice a year because I’m paid every two weeks. Since my budget is based on two paychecks a month, that third one is a welcome “bonus.” I could have used it to replenish my savings account, but instead I decided to use most of it to pay my future self and withheld about 35% to my standard 401(k) as a catch up contribution. I’m making a note to adjust my withholding again in a couple of weeks, because I want that large amount to be a one-time thing. Going forward, I’ll drop that amount to the single digits.

The balance of that paycheck can then be used to pay back savings account, and also to make some charitable contributions. I try to be generous with my contributions, but this year has been tough. Right now I’m mostly giving via auto-billing to a few charities, but not nearly as much as I have in past years.

Relationships

There has been a huge positive development in my relationship with my sister. She had surgery last week, and I was helping her out in various ways. Her husband had to be out-of-town for business during this time, so I stepped in to take her to the surgery center and pick her up. I’ve stopped by the house to help with a few chores, checked on her throughout the days, and run a few errands for her, too. Her recuperation period has led her to a new understanding of what I’ve had to go through with my various surgeries. Yesterday, as I dropped off some groceries at her house she got tearful and thanked me for helping her so much. She said she didn’t think she had been very kind to me after my surgeries and she apologized. Wow. That felt really good. I was gracious in accepting her apology and thanked her for it. There’s still hope for a better relationship here.

 

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Staring down the inevitable?

For the past week my beloved dog, Hannah, has been very ill. The onset was sudden. Last Monday she had her acupuncture treatment and all seemed well. Very early Tuesday morning, I was awakened by the sound of her vomiting in the corner of the bedroom. From there, we have had trips to veterinarians nearly every day.

Her usual vet didn’t seem too concerned when I brought Hannah in on Tuesday afternoon. Hannah had been refusing food all day, yet took the small treat the vet gave her. “Let’s wait and see how she is tomorrow,” the vet suggested. That night, when Hannah started shivering, I couldn’t rest easy. I knew there was something going on with her, so I bundled her up and took her to the emergency clinic.

At the animal ER, her exam was unremarkable, but they did offer to take blood and run some tests, and I agreed. The results showed all her liver health values were much too high. Her ALT level, which we’ve been monitoring for about two years now, was over 4,000. (A normal level is under 100, and at her last check the previous week the value was 280). The ER vet told me that Hannah needed an ultrasound, and that I should check in with the regular vet the next day.

As soon as the clinic opened on Wednesday, I called and was connected with the vet right away. She told me that they did not have the correct personnel to do the ultrasound that day, and that it sounded like Hannah needed hospitalization with round the clock observation. I had two options to consider: taking her to UC Davis, or taking her to a pet emergency and acute care center in the opposite direction. The vet recommended the Pet Emergency & Specialty Center of Marin in San Rafael, so that’s where we went.

Traffic was light, so it only took 40 minutes to get to San Rafael from Napa. When we arrived they were ready for us, as my vet had phoned ahead and provided all the necessary information. I had to leave Hannah there so they could run new blood work, do the ultrasound, and give her IV fluids and antibiotics. The vet thought it safest to assume Hannah had an infection, and the hope was that she could be released the next day, on Thanksgiving.

I should have been working that Wednesday and preparing dessert for the Thanksgiving feast I was invited to the next day. But I couldn’t do either of those things. I stopped to talk and cry with a friend on my way back from San Rafael, I texted others, and I asked friends on social media for their good wishes.

Thanksgiving morning I got a call from PESCM that she was doing well. She had eaten some food, and they were going to try giving her antibiotics orally. They thought she could go home later that morning. It seemed fitting that on Thanksgiving — a day set aside for celebrating our blessings and bounty — I got to pick up my precious dog, my boon companion. Hannah was eager to be out of that place, too!

We had a pleasant ride home, and after we got inside the house she headed straight for her water bowl and drank quite a bit of it. I headed for the bathroom, and when I came out I saw that she had not held down much of the water she drank. I called PESCM back to report the problem, and the vet said that her nausea meds had probably worn off. She said that if I brought Hannah back she could get an injection of the nausea med, and they would give me some tablets to give her at home. I decided to wait a few more hours to see if the problem passed, and prepared to go to the Thanksgiving dinner with friends.

In the late afternoon, when Hannah was still refusing to eat or drink anything, I put her back in the car and made the round trip to San Rafael and back. She was given her nausea med via injection, and I also got the tablets to take home and give her orally.

We managed to get through Friday without a trip to the vet, even though it was clear that the nausea med wasn’t helping as long as it was supposed to. The med is supposed to work for 24 hours, but she was showing signs that all was not well after only 14 hours. I needed to give her antibiotics with food, so this was a problem. I gave her the nausea med early a few times so I could get her to keep some fluids and food in her system and give her the antibiotics. Then, first thing Saturday morning when her regular vet was open I called for a same day appointment.

Yesterday the vet we saw (not her regular one) prescribed yet another nausea med for her to take in addition to the other one. She loaded Hannah up with fluids, and told me to bring her back this morning (Sunday) for more fluids and an injection of nausea meds.

Today I’m cautiously optimistic that Hannah is on the mend. She managed to keep water and some food down over night and again this morning. She acted more normally last night by spending the night in her own bed instead of velcroing herself to me all night. (Not that I mind her being close to me; it’s just not her normal routine.) And while she has still been sleeping a lot and generally low energy, she doesn’t seem quite as lethargic as she was.

Throughout this entire experience, I’ve been worried that this is it: the end of our time together. She is nearly 15, which is more than 80 years old in human years. When I start thinking/saying, “I’m not ready to let her go,” I quickly correct myself because this decision shouldn’t be about *my* needs, but instead her comfort and quality of life.

I’m not sure if she will fully recover from this or not. For now, she seems comfortable enough and ready to keep chugging along. So despite how horribly expensive this has been (we’re roughly up to $2,300 in vet bills from the past week alone), I’m not going to give up yet. But I have to get myself comfortable with the fact that she is likely nearing the end of her time.

My toddler brain

I’ve started to think of that part of my mind that stubbornly wants to make life according to my plans and desires as my “toddler brain.” Time and time again I’ve had to push past the “toddler brain” stage, to accept my life as it is and learn to deal with it from a place of reality.

When I went back for another glaucoma surgery in late September I had planned for my recovery stage to progress like the it did for the July procedure. That was not to be. The day after surgery when my bandage was removed I was horrified and shocked to see myself in the mirror. I looked like I had been beaten up. There was a lot of bruising, and my right eye was basically useless. There was only light and blurriness visible from it.

The pressure was non-existent, and that was a problem. There was a leak, which didn’t help the situation, either. The doctor prescribed eye drops that dilated the pupil in an attempt to force the pressure up and told me to return the next day. And the following business day, as well, because the situation required close monitoring.

The doctor also told me that I should plan to be out of work for a month. It’s a testament to my employer that there were no issues starting me on an unplanned medical leave of absence.

For the next few weeks I got very good at managing the public transit schedules between my home in Napa and the doctor’s office in San Francisco. Except for my unplanned drive into San Francisco to escape the wildfires in the area, I minimized my driving as much as possible because my vision was so poor.

It took about two weeks for the leak to heal and the pressure in my eye to elevate enough that the doctor told me I could stop the drops to dilate my pupil. He said it should take two more weeks for the affect to wear off and for my pupil to react normally. After three weeks, we gave up waiting.

So, here I am again at a point where I need to decide if I should have yet another procedure to try to fix my pupil. I’m now using drops to contract the pupil. That makes the vision better, but it’s still not that great.

I have a bunch of questions for the doctor, but I just couldn’t ask them during that visit. I was upset and crying. I told the doctor how I frustrated I was, though. That I had agreed to the surgeries to preserve my vision, but that it seemed worse now than before the surgery. He pointed out that my eye pressure was stabilized within the normal range without the help of any eye drops. I guess that’s supposed to be the mark of success.

The doctor told me that it should be OK for me to get new corrective lenses, so I made an appointment at the optometrist and started that process. The optometrist tried to find something that would work for my right eye, but he noted that with my pupil being distorted from the surgery, it was very challenging to correct. At least I’ll be getting a correction for my left lens, which will help me with my driving.

I started back to work last week. My anxiety meds are helping me deal with this potent combination of anger, grief, disappointment, and frustration, but it’s still been a challenge. That toddler brain starts kicking and screaming, insisting that this isn’t fair, and that somehow it should be made better. I wonder when it will stop.

Smoke and ashes

I’m OK. My house is OK. My dog is OK.

The wildfires that blazed through Napa County didn’t destroy any property within the city limits, although we had horrible air quality for many days. The smoke was so thick in the air at times that it was hard to see houses a block away. Schools closed. People were urged to stay indoors and to don N-97 masks when they absolutely must go out. On local social media sites like Nextdoor.com people provided updates on where one could buy masks and listen to the scanners to get real-time updates on the fire-fighting activity.

Cell towers were knocked out for most major carriers, and coverage was spotty or non-existent. With power out in some parts of the city of Napa, the only way people could get updates was to tune into the local radio station.

I never lost power, but I had no mobile coverage for several days. Since I stayed in the house, I was able to use wi-fi to make calls to worried friends and check on neighbors. Days and nights were punctuated by Nixle text alerts about road closures, mandatory and advisory evacuations, power outages, and the location of emergency shelters.

My car and everything in my yard was covered in ash. My little house is located at a low point, but friends with two-story houses or those at just on slight rises posted photos of the fires burning in the mountains at night.

Neighbors and strangers were helpful and kind to each other. When I asked about getting an N-97 mask on Nextdoor.com, a guy I had never met dropped two off for me for free. People volunteered at the shelters for people and pets. The local hotels offered stripped down prices to local residents who had to evacuate, yet had the means to pay something for a place to stay.

I was lucky to have friends in San Francisco and other areas outside the fire zone. When I found myself coughing even inside my closed up house, I took up a friend on his offer to stay at his house in San Francisco. I quickly packed Hannah dog and some necessities in the car and set off through the burned landscape. I returned home a few days later, after the winds had shifted to blow some smoke out of the valley.

The fires are mostly contained now, and there are signs all over town thanking the first responders. People see fire-fighters at local restaurants and stop to thank them personally. Many times the tab is paid, too. The fair grounds are still full of tents, trailers, and off duty fire trucks from other counties and states.

Schools are starting again on Monday, and the local visitors associations are urging tourists to come back. Locals are getting back to work, if they can.

The landscape will be very different for years to come. A favorite local hiking place only a few minutes from my house will be closed for months.

But so many people are not OK, and I’m grateful that I am.

 

 

Chasing the white rabbit

About two months ago I started seeing a therapist. I found her through the in-network directory of my insurance company, and there frankly weren’t a lot of choices. While I didn’t exactly dislike her, it seemed that often our sessions were more like sitting around and shooting the breeze like you do with an acquaintance. I wasn’t feeling that she was helping me move through the funk into which I had fallen.

So, just before the Labor Day holiday I showed up at our scheduled session ready to “fire” her, but also wanting her help to move on, too. In thinking about how I wanted to end the therapeutic relationship with her, I had decided to say “This isn’t working and I need to do something else.” Then I thought the conversation would be productive and business-like as we worked out how to close things, while also getting some recommendations on who I could see to get some medication.

It didn’t exactly go that way. Instead she stepped up and helped me more than I expected.

I delivered my planned line right away, but when she asked what I thought I needed I just dissolved into weeping. When I was able to talk again I told her that I thought I needed some medication at this point. I felt I had gone past my limits of resilience with everything I’ve had to deal with in the past 2 1/2 years:

  • moving across the country and setting up a new life;
  • being transferred to a new team at work, with a new boss and leadership, and an entirely different work culture;
  • multiple bouts of diverticulitis;
  • getting diagnosed with an incurable eye disease;
  • a cancer scare and subsequent hysterectomy and oophorectomy;
  • surgical menopause;
  • another bout of diverticulitis;
  • a lower anterior bowel resection surgery;
  • long periods of exercise restrictions and gaining over 40 pounds;
  • an eye surgery that cost me nearly $6,000 out-of-pocket and failed to treat my condition;
  • and, finally, another eye surgery scheduled for the end of the month.

Of these major life changes, the only one I had chosen to make was the first one. Yet all of these things rank pretty high on the stress scale. I was done in. I recognized that I was pretty much at bottom and had been having trouble with daily obligations: personal care-taking, and being productive and reasonably successful at work.

I shared with her my aversion to antidepressants. I had used two different kinds in the past — Paxil for treating panic attacks 20 years ago, and Lexapro for depression about 11 years ago — and the side effects I had experienced were a big concern for me. She offered some hope by mentioning other antidepressants that may help instead of those. Then we talked about how I could get a prescription.

The therapist is a LCSW and couldn’t write prescriptions herself. She first recommended I go to my primary care physician for a script and offered to call him, if needed. But I really wanted to see a psychiatrist. In my experience, they’re the experts when it comes to understanding which medications to use for mental health issues. Luckily, she knew one (the only one in town, apparently) and made a call as soon as I left her office. Within two hours I had an appointment with the psychiatrist the next evening.

The psychiatrist listened to me relate my medical history — including a run down all of the above issues — as well as my experiences with antidepressants and anti-anxiety meds. (Xanax and Klonopin are old, dear friends.) She made me feel comfortable with my discomfort, if that makes sense. She reassured me that I have been strong and brave, and that it is OK that I feel I have had enough at this point. But she surprised me by recommending that rather than an antidepressant, I should try an anti-anxiety medication: Buspar.

I started the Buspar just before Labor Day weekend. It was fortunate that I had the extended holiday, as it allowed me to work through the kinks of starting a new medication. My first week back at work was challenged first by extreme sleepiness, then by insomnia, but I feel that the Buspar is helping. I feel more focused; more on an even keel, and able to deal with the minor slings and arrows of a normal work day without getting distressed.

I had a follow-up visit with the psychiatrist this week and reported the side effects I’ve had and how I’ve been trying to cope with them. I had been resorting to taking Benadryl at night to sleep, which she said wasn’t good to do for very long. We both wanted me to be able to continue on the Buspar for now, so she gave me a prescription for Trazodone to use at night before bedtime.

I’ve been using the Trazodone for three nights now. The morning after I first used it I found it challenging to get up the next morning because I still felt sleepy, but it was also an extra early morning for me. When I took the first dose of Buspar that morning I also felt sort of dizzy, but that passed after about an hour and it hasn’t returned since. I’m still working out the best time to take the afternoon Buspar and how early I should take the Trazadone before going to bed so I can feel less dopey in the morning.

While I usually try not to rely on pharmaceuticals in my life, I feel like doing so now is the right choice for me. There are other ways I can address the anxiety and issues that I’ve been facing, and I intend to use them. But I was finding myself nearly non-functional. I was mentally dithering most of the time which wasn’t allowing me to do any personal work, much less professional work. Now I’m more focused and less reactionary to minor upsets. I’m starting to find the positives in my daily life and thinking about goals I can set for myself to increase my motivation. My sleep is still choppy and I’m restless through the night, but when I rouse I can go back to sleep quickly, at least.

I’ll still keep seeing the talk therapist and hopefully have more success now that I feel like I can focus and set goals. I can’t help this song playing through my head, though.

Dreams of my youth

My subconscious is so mysterious to me. I know there’s a lot of processing going on in it all the time. A few times a year, a rare gem emerges from it: insights into one of my behaviors/actions or that of a family member or close friend, for example. I find this both marvelous and frustrating, because I wish it didn’t take me so long to figure stuff out. It seems most other people are better at reading these tea leaves than me.

In the past few months I’ve had several nights full of vivid and highly memorable dreams featuring an old boyfriend. This was my first serious boyfriend and he entered my life at a time when I was still quite young (late teens). We kept up an on again/off again relationship over a long distance for many years.

I have regrets about how our relationship stopped being an exclusive one and became what it did instead. For many years, I felt that this change was all my fault for being so needy and fragile. (Of course I realize that narrative is wrong now.) I thought I wanted to marry him, and he didn’t seem keen on it. So I shut him out for a while and pursued another relationship that ended up being very bad.

When we reconnected years later a lot was different, but we were still attracted to each other and that there was a comfortable familiarity, too. He was going through a tough time. His mother was dying and he wanted me to visit him so badly that he paid for my plane ticket since I didn’t have the money to do it.

And so our odd long-distance relationship truly began. It was a FWB arrangement, at a time when that phrase hadn’t yet entered the general lexicon. We enjoyed each other’s company, felt comfort with each other, yet didn’t have to put in the real work of a relationship. He had moved since our exclusive days and now lived in a popular tourist destination, so there was always something fun to do during those long weekend visits.

For me, there was still the tug and desire for a more traditional LTR, though. Once or twice I’d get wrapped up with someone and wouldn’t see him for many months, or even a year or two. But when the relationship didn’t work out, I would get in touch and a visit would be arranged. To me and probably most people he seemed to be a dedicated bachelor.

Once he paid for another very expensive plane ticket to fly me halfway around the world with him to visit his father. We were together day and night for more than two weeks, and I realized how much of a challenge it would be for me to live with him every day. When I returned from that trip I started dating the man who I would marry just over a year later (and divorce 11 years after that). I recall talking to him about my choice to marry and receiving his best wishes.

After my divorce, I reached out to him again and arranged a visit with him. We had both changed a lot over the years, but he was still a bachelor. In just those few days it was clear we still hadn’t changed so much that our habits wouldn’t rub against each other in uncomfortable ways, though.

 

When I next contacted him a few months later he told me he was seeing someone and was thinking that they may get married. It was my turn to pass on best wishes to him and we haven’t interacted since then.

But in the past few months I’ve had these vivid dreams about him. In these dreams, he is usually in bed with me, mostly as a comforting presence, but sometimes there is physical contact. I wake from these dreams full of longing and wanting to sink back into that dream state where I have him next to me. Recalling our times together I remember how much he made me laugh, the meals we enjoyed, and conversations and adventures we had.

Years ago, I visited the city where we had lived together with a friend. After a few days of my nostalgic comments of how much I missed living there my friend questioned me “Do you really miss the city or do you miss being that young?”

I think that is what is going on in my head when I sleep. He has become a symbol of my youth and of simpler times. Of how connecting with another person could be fun and not require examination or emotional labor. I miss the time when my body seemed less of a burden and more of a joy, and when I had someone who I could turn to for physical, animal comfort: a cuddle, a kiss, a fuck.

Now that I’ve puzzled this out and written it down, I wonder if the dreams will stop. I’m not sure I want them to.

On to Plan B

I’ve been spending a lot of time hiding inside my house lately. I still get out for knitting group once a week, and I’ve had some local excursions with friends here and there, but mostly I’ve been rationing my energy for the big eye surgery late last month.

Everything happened as planned and/or advised. My insurance company rejected the claim for the surgery, so I paid all the fees out-of-pocket. The costs I had to pick up not only included the surgeon’s fee, anesthesiologist’s fee, and the cost of the device, but also the post-op eye drops at the pharmacy. Thanks for really sticking it to me, healthcare plan! I hold out hope that with the device manufacturer and surgeon’s office continuing to pursue this I will eventually get reimbursed. In the meantime, my savings account is nearly $6,000 lower, BUT I will get cash rewards on the costs ’cause I used a credit card with a 1.5% reward on all purchases. #silverlining

Sadly (the crying and sobbing type of sadly), the procedure did not work for me. There were promising signs at first. The initial post-op visit the day after was good. The doctor was pleased with the pressure drop and he thought everything looked great. One week later I returned for another check. Again, we were really happy with the progress. The pressure had gone up to 16, which is in the desired range, and seems pretty normal for me. (My left eye — the unaffected one — usually has a pressure around there.)

But…but…this week I returned for another post op check and the news was not so good. The pressure was back up to 36, which is way above my target of 20 or less, and about where it was when I was initially diagnosed two years ago. The doctor did something very uncomfortable to my eye with a needle right there in the office (the eye was numbed, but I was still freaked out and required some literal hand-holding by staff), but that didn’t help one bit.

Now I am back on the glaucoma eye drops to bring the pressure down as much as possible. The doc says that I’ve formed a cyst that is preventing the current device from working properly. I’m just too “young and healthy,” as he says.

What’s next? Plan B is to have another surgery so the surgeon can implant yet another drainage device in my eye and remove as much scar tissue as possible.

There are some small mercies this time around. 1) The insurance company should not put up a fuss about paying for this device since it is older tech that’s been around for several years. 2) The surgeon had a cancellation on his calendar, so I won’t have to wait quite as long as he projected. Instead of a surgery date in October or November, I snagged a spot at the end of September.

What if this doesn’t work? I don’t know. There is nothing that can be done about the ICE Syndrome that caused the glaucoma. I don’t think there is any way of predicting how long it will take the glaucoma to progress to the extent I lose all vision in that eye, but that is the inevitable outcome of the disease.

I had all these thoughts that once I had my eye issue taken care of I could focus on getting rid of all the weight I’ve gained from forced inactivity the past couple years. There are no physical reasons I can’t go the gym and start making my body smaller and stronger. But there are other reasons why this isn’t happening for me right now. I’m sad and depressed. I need gentle encouragement, and a partner/friend who is similarly matched would help a lot. I simply don’t have anyone like that in my life right now, and I just can’t muster much energy to tackle that issue.

I can manage to keep most of my work commitments, feed myself and my dog, keep the house clean, and take care of my personal hygiene. Those are the only expectations I can place on myself right now.

So for now, my restorative self-care is mainly allowing myself plenty of naps, short walks with my dog, playing games with my dog at home, knitting and watching streaming entertainment, and reading when it doesn’t tire my eyes too much.