Tapestry, coping and shame

Last Sunday afternoon, Thanksgiving weekend, I was out for a walk in Perth taking some of the photographs I collected over my five days there.  I was also slipping away from the family in order to listen to a radio program which included brief comments I had made by phone as invited by the producers.

CBC Radio’s Tapestry was airing the second part of a series called Coping and at about 15:49 into the program I am heard introducing myself, then speaking of how my bipolar II diagnosis was an “A ha!” moment for me in the context of living as a survivor of childhood trauma, addiction recovery, and living with HIV/AIDS since 1989.

I also said that the bipolar II diagnosis has allowed me “to have a little more compassion for myself” and, in turn, with others with mental health issues with whom I can more easily and comfortably empathize and suppress my self-criticism.

“I live on,” I said, “and live on in curiosity”.

The reason I felt I had to head off to my favourite café, rather than invite my family to listen to the program with me, is that they are not all up-to-speed on my bipolar II diagnosis nor, in some cases, the sexual abuse.  In the case of my mother, I have withheld these because I have judged that she has had more than enough to deal with.  Whether it is worth the secrecy may be another matter entirely.

Fast forward to my weekly group therapy yesterday, which I had missed due to travel last week and being ill the week before.  It followed on the heels of my check-in with my psychiatrist in the same hospital during which I confessed that, due to financial problems over the past little while, I had been unable to pay my quarterly prescription co-pay of about $100 and had, therefore tapered myself off my medications – re-starting at the end of September after more than a month when my finances were back in limited order.

He urged me to be in touch with him should I ever run into trouble again (I had even bluffed my way through an appointment with him during the crisis) and to keep in mind that relapses could be very serious.

Off to group therapy I went where I broke down crying as I reviewed the past couple of months and spoke of the shame I felt in being short of money.  It was of my own doing, I judge, because I had sought sexual release time and time again with the click of my TV remote at $9.99 plus tax per viewing.  (More shame.)  The financing – no worries until the bill arrives – was as seductive as any of the pay-per-view characters.  There were equal amounts of shame in having dug myself into a financial hole, putting my health at serious risk, and the mental condition which I dared not speak of with my loved ones – despite all of their support for me in every other area of my life which many other families might not be able to tolerate.

I did manage to tell my family, as we packed down a splendid turkey dinner, that I had lost ten pounds in the past little while.  What went left unsaid was how much less I had been eating and why.

What could I have done differently?

Certainly I could have flagged the financial problem with not only my psychiatrist but also my doctor and pharmacist.  Heaven and earth might have been moved to make sure I had my meds.  Instead I chose, in shame, to deal with it myself – the same faulty self-reliance that got me through the rough years as a kid.

I could have told friends what was going on.  It would not have been too tough to borrow a hundred bucks for my meds.

No doubt I could spend time, honestly, openly and,  more constructively, out of isolation with friends.

The circular isolation of self – my 1010th post

I have a small collection of turtle ornaments on a book-case. I relate to them, seeing myself personifying some of their characteristics – slow, steady and self-deprecating to a fault, able to withdraw, when threatened, to my own delusional safety.

Someone once told me that five bucks in your pocket often makes the difference between a good and a bad day. I would just add that it’s important to discern what’s best to do with it.

This is a good day. I refilled prescriptions, overdue by a month, the self-deprivation of which I know from experience may have already done me harm. Going without them, both mood and HIV-related, has been a strain, one which I have not shared. I find fault in myself without even trying.

My auto-correct will rightly call this “awkward phrasing”:

Had I not needed to pay off a pay-per-view bill (self-centered shame involved) that was through the roof, at least in part because of being without my bipolar II meds (self-centered stigma even mentioning that), I would have felt better. It is probably for this same reason, and a decrease in food intake (fitting the stereotype of those who make choices between medicine, food and, in my case, $9.99 pay-per-view movies), that I lost about twelve pounds since I was last weighed two months ago – still 6′ 3″” (1.9m) tall, of course, but now just 130 lbs. (58 kg) for a BMI of 16.2 (underweight being anything below 18.5). How my blood-work has been affected has yet to be revealed.

The first thing I did this morning, pay-day, was go out for a Subway breakfast sandwich (far too salty!) before picking up my prescriptions. (Nothing for breakfast was available at home.)

It’s a chicken-or-egg riddle – being without money which caused me to withdraw treatment of my mental and physical health or a lack of untreated mental health which caused me to be care-free about money. ‘Twas ever thus, except I have had enough repeat experience to know that one begets the other.

I have begun to track my every expense as a first step in budgeting.

Writing this has been a detached, left-brain exercise. Maybe if I read it enough I’ll begin to feel it.

Ending the week on a positive note

I checked in with my doctor today to get results from my latest blood tests and the news was all good!

CD-4: 310 (about the same as January)
viral load: undetectable
Hemoglobin A1c: .063 (down from .077)
Weight: 144 lbs.

So I’m good again until June, by which time I’ll have had some more routine, albeit neglected, age-related tests done.

Medical update: I could do better if ‘good enough’ wasn’t still good enough

It’s been quite some time since I had the run of tests for HIV and diabetes, in part because of my fear of the results, so today’s news was quite satisfactory with clear room for improvement.

My viral load, a test which measures the activity of HIV in my blood, is below levels of present-day detectability. That’s the goal of this test of primary importance.

The CD-4/T-4 count, a measure of the immune response to infections, is 350. It has been higher, and also much lower (10 back in the early 90s), so I’m hoping that I can see it go up again. (I think my personal best is in the 600s.)

On the diabetes front, my A1c hemoglobin test – ideally at 7% (0.070) came back at 0.077. I know there’s room for improvement and, frankly, was surprised I did that well.

All in all, while I had some apprehensions about getting the results today, I was pleasantly surprised. Oh and my “head meds” are at acceptable levels.

Bursa – and not the city in Turkey!

The ever-increasing pain I have experienced recently now has a name – bursitis.

I’ve narrowed down the cause to being on my feet or, alternatively, sitting on concrete, the weekend of Jack Layton’s funeral.

Yesterday I began physical therapy treatments and learned that we all have bursae, at which I inquired, “As in bursitis?”, not knowing what that is, having only ever associated it with people of a certain age.

I have been given a few simple exercises to do between visits and am continuing to use my cane and choosing my chairs carefully. Nice to know a little more about anatomy, even if it takes pain to educate me.

Aches and pains of fractures of old

This post serves as a reminder of what has ailed me in recent days.

On the day of Jack Layton’s funeral I spent an inordinate amount of time on my feet, standing in one place, taking pictures, standing in line, etc. A few days later I noticed some pain in my femur, which I could only visualize as the metal device in my femur driving into the lower half of the bone. The pain seemed to pass a few days later but returned last weekend.

My family physician is away but his receptionist recommended that I try the walk-in clinic on the main floor of their office building. “Walk-in”, I have discovered, is not synonymous with fast availability as people without family doctors were given priority having booked appointments with “walk-in” doctors. I took it in relative good humour, only once getting up to ask if I would be seen by closing time – which I was and with room to spare to have x-rays done upstairs. Now I wait to see my family doctor on the 16th’

Referring to a 2003 report from my orthopaedic surgeon, which I took with me, the “walk-in, sit down for an undetermined period” doctor reminded me of the technical terms that had been lost in my memory. “Displaced intertrochanteric fracture of the right femur and a displaced fracture dislocation of the right distal radius and wrist…The patient was taken to the operating room the following day where open reduction internal fication of the proximal right femur fracture was performed using a DHS plate and screw system. Under the same anaesthetic an open reduction internal fixation of the right distal radius was performed utilizing a plate and several screws.”

Although the prognosis back then pointed to me having troubles with my wrist, and a good recovery of the femur, the wrist and radius are fine.

In the meantime, I’m back using my cane which I had stopped doing several years ago – even around the apartment where short walks seem to be more difficult as I need a few steps to get my balance and confidence.

I’m not out of commission, but am taking things easier than I’m accustomed to (which was easy enough!). No long walks are being contemplated for now.

Observations from Buckstars Coffee Shop

I’m home from picking up prescription refills to paint a story-picture.  Note to self (the umpteenth): always, always carry a pen and paper!

Having dropped off written prescriptions for repeats of my head meds, I walk briskly in the fresh cold wind over to the Cabbagetown location of Buckstars to wait.  A grande Americano should fill the time nicely.

As I pull open the door my sense of smell is flooded, not with the many varieties of beans ground here, with the overpowering smell – scent would be too subtle a descriptor – of cologne.

There, seated at a wooden table and chairs set right inside the door, is a man whose description deserves at least a paragraph so I continue to the counter and order my drink.  Then I make a quick stop in the loo while the barista does his thing.

Soon, cup in hand, I return to the front of the shop where a cushy chair is, thankfully, available on which to seat my emaciated bum – but I have to whisk by the aforementioned man first, his cologne hitting me before, during and after my walk-past.

I carefully place my cup on the table in front of my chair, tuck my back-pack beside me, and shed first my toque, then my outer jacket, followed by the inner fleece.  (I’m going to be wearing Craig’s much warmer coat tonight – it is that cold in the wind.)

Again wishing I had a pen and paper or even a phone to text myself some notes, I carefully observe the subject in the window seat.

He presents shiny black hair, leather complexion either of southern European extraction or the product of a tanning bed’s fourth visit (think John Boehner).  The cologne continues to waft throughout the front of the shop as the door opens and closes.  Although he is seated the entire time I am there, I assess that he is not exceptionally tall as his feet tuck underneath his chair quite easily.  What he lacks in height he makes up for in girth.  He is quite rotund – not a Mayor Ford (sworn in today) overweight but large enough so as not to be able to see his black shoes which are so shiny that he might otherwise be able to examine his nose hairs without any eye strain.  He wears a black mock turtleneck shirt-sweater under a big-not-tall blazer, burnt gold in colour with a faint black check pattern throughout, with matching black slacks.  I did not take note of his right side, which faced the window, but on his left he wore a large gold watch and gold accordion-style wristband, and a gold pinkie ring that rode right up to his knuckle with a setting, which filled that entire space, of what looked more like shards of glass than diamonds in a flat bed of something resembling white marble.

Yet this is not Liberace reincarnated.

He looks quite gruff so, as he regularly checks his watch, fanning his scent like a disposable air changer, I guess that he might be a fight promoter or maybe a boxer’s manager – there being a youth boxing centre nearby if I’m not mistaken.

I hum along to an ambient recording of Ian and Sylvia singing “Four Strong Winds” before I assemble my outerwear and venture back over to the pharmacy, wishing it was Christmas cinnamon and not cologne I was smelling as I push the door open.  Less is more, Sir.  Less is more.

An early afternoon visit to my doctor (the g.p.) leaves me feeling buoyant enough to record this story in my head.  Blood pressure: 120 over 80.  Weight: up five pounds.  This is all good!

This evening I again head into the cold wind for a previously-booked appointment with a CT scanner.  I have no reason to believe it is anything serious. But a year-old sinus infection, lessened somewhat with two more rounds of antibiotics recently, bears further examination by the ear, nose and throat specialist I saw a few weeks ago.  It is, it seems to me, a luxury of living in the downtown core of a city that would allow me to walk over to the hospital for an 8:30 pm CT scan.  These are my kind of hours!