Clean

I had to have a stress echocardiogram yesterday. I’ve been having chest pains, and my primary doctor wanted me to see a cardiologist to rule out anything heart-related (my lung issues put me at a higher risk for certain heart conditions). My PCP is aware of my PTSD and my issues with medical stuff and warned me that it wasn’t going to be easy for me to do. She even said that I may have to be sedated to get through it. I thought she was joking. Now I don’t think she was joking at all.

When I went to my cardiology appointment a few weeks ago, I wasn’t expecting anything major to happen. I thought the cardiologist was going to tell me I was okay and send me on my way. I think he may have thought that, too, when he looked at my record. A 30 year-old with no high blood pressure, no diabetes, and no high cholesterol. No risks. But then he started asking me questions, and by the end of the medical interrogation, he told me I had a lot working against me. Smoking, drug use, medications, family history, and past overdoses were all fucking me over in that moment. There was enough concern to schedule more testing.

I didn’t really know what was going to happen aside from getting hooked up to wires and running on a treadmill. It didn’t seem like much, so I tried not to stress about it. I didn’t even bring it up in therapy the day before because I wasn’t expecting anything bad to happen. I thought I had it all under control.

I didn’t even make it to the first part of the test before breaking down and crying.

A nurse took me to the room and gave me a gown to change into. I knew I had to do it, but it was difficult. My layers of clothes help me feel safe, and now I had to let them go. I stood there, completely naked from the waist up, trying to wrap myself in the gown and holding it closed. But the nurse had to get in. She had to put patches on my skin so I had to uncover.

I stood there, completely vulnerable, trying to hold myself together. I felt the skin of her hands touching the skin on my chest. I wanted to tell her to stop but I couldn’t. I couldn’t move. I couldn’t speak. I froze. Then she reached her arms around me. I felt her against my body just like I had felt my mother just years ago. And I lost it.

I felt so sick. I couldn’t say a word. I just cried. All I could think about was my mother. All those times I would stand there and let her touch me and I never said a word. I never told her to stop. I never made her stop. I must have wanted it. 

How sick am I to have let this happen. Does she think I wanted this? I wonder if she know. Does she see how disgusting I am? Does she know what I’ve done? 

I don’t even really know all that went on during the test. I was so lost in my mind that my body became automatic. I know I stopped crying after a while. I finished the test. My heart was okay. My cardiologist was happy. I remember him asking me if I was excited to have a perfectly healthy heart, and I couldn’t answer. All I wanted to do was run to the nearest bathroom to throw up. And I did.

I needed to wash the filth off. All I wanted to do was scald my skin in the hottest water. But I was afraid to go home, because I knew I wouldn’t be safe being alone with my memories. So I took the bus to clear my mind. I fiddled around on my phone. I went to the movie theater to distract myself, only to end up crying in the bathroom stall for half an hour instead.

I wandered and cried for hours until I finally ended up at home before dark. I got in the shower and cried even more. I washed myself a dozen times but it wasn’t enough. I wanted to rip off all of my skin and scrub away all of the filth hidden underneath. I felt it everywhere. I just wanted it to go away. But it wasn’t going away.

I couldn’t eat. I couldn’t sleep. I needed clean. I couldn’t clean my body anymore, so I started cleaning my surroundings. I washed everything down with vinegar. I scrubbed the baseboard. I spent hours wiping every surface. I got a garbage bag and threw away everything that was dirty. Dirty clothes. Dirty shoes. Dirty knick-knacks. I needed everything to be clean. I rid myself of everything dirty because I couldn’t get rid of the dirtiest thing of all: me.

I can’t sleep because I can’t stop thinking. I can’t eat because my stomach feels so sick. I’ve taken four showers today and I still feel so disgusting.

I don’t think any amount of showers in the world would make me feel clean right now. I just want to feel clean.

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Pardon the mess

I am at a functioning level right now.

When I say functioning, I mean I am able to get out of bed and go about my life in the most minimal ways.

I’m back in graduate school. It’s been a little hectic. With a professor missing in action for two weeks (due to a death in the family), it’s now a rush to get three weeks of work done in the next week. I was a little overwhelmed at first, having never used SPSS analytical software at all before, but I am getting the hang of it.

I’ve also been co-authoring a book on DID. The rough draft will be finished in just a couple of weeks, so it’s crunch time to make sure everything I want to say is included. Some of the chapters are intense. While writing about my abuse and struggles is tolerable in small doses, writing with deadlines on specific topics that I can’t avoid has sucked some of the energy right out of me. I’m well passed the halfway point now, so I’m not giving up.

I am going through some physical health issues. I should be used to it by now, but I am not. It’s anxiety-provoking. I have been fortunate enough to find a primary doctor that understands my PTSD and anxieties. Even though it takes me hours in travel just to get back and forth to her, no other doctor was willing to work with me, so I endure the trouble. I’ve got a lot of specialist appointments in my near future, and that scares me. We are taking it one step at a time, but even that one step seems like a leap across two mountains.

My mental health is shit. I’ve been managing to stay out of the hospital, but it’s been difficult. The only thing keeping me in check is all of the other shit I have going on that I won’t be able to complete if I’m in the hospital. That’s probably not the best motivator, but it’s working for the moment.

I have a lot to write about, a lot that’s on my mind. I just wish I had the energy right now to do it.

There’s no need for any doctors

I’ve been dealing with a significant medical issue for the last ten days.

And when I say dealing with, I mean actively avoiding, pretending it’s not happening, and keeping my mouth shut about it, hoping it will resolve on its own. Because you know, that’s how I handle most things in my life. That’s how I was taught to handle most things in my life.

Medical avoidance is my norm. That is one thing I have carried on from my mother. She only took us to the doctor when it was required (because of school forms) or when I was near death. And even then, I was made to feel like it was some kind of burden on her for me to be sick.

Well before I was diagnosed with asthma at age 14, I kept telling my parents that something was wrong. I had to struggle to catch my breath. I felt like I was suffocating.

“It’s just allergies.”

Except it wasn’t just allergies. I suffered for a long time until my lungs filled up with so much fluid that I could no longer breathe. It wasn’t until then that my mother finally took me to the doctor. I probably would have died if she had waited any longer.

By then, the damage was already done. I spent the next 14 years in and out of hospitals, battling pneumonia and lung infections, living off of oral steroids and liquid Albuterol just to stay alive (and for those that may not know, oral steroids are simultaneously the best and the worst drugs ever).

I always waited until the very last minute to seek medical treatment. Concerned friends would tell me I was turning blue. “I’m alright, just cold,”I’d tell them. Then within the week, I’d be in the ER on oxygen. I wasn’t cold, I knew what was coming. I just was taught to think that I didn’t need medical care. I grew up believing that I didn’t deserve medical care.

And I’m still practicing that belief. I went to the doctor back in March, with my therapist, after her consistent prodding and encouragement. It was at that appointment that I was diagnosed with COPD. I haven’t been back to the doctor since. My prescription ran out, and I’ve been living unmedicated for months now.

I think I’m doing just fine, considering. My therapist is not as inclined to think so. We were discussing the impending hospitalization, and her reasons for wanting me to go. She mentioned me not receiving medical care.

“I don’t need medical care, I’m fine.”

“You have COPD, and you’re not getting treatment for that.”

“Yea but I don’t need it, I’ve been okay.”

“For now. But that’s not just something that can be put to the side.”

On a deeper level, I still feel undeserving of care. That ties into my even deeper belief that I am undeserving of love, and undeserving of life. Maybe I have COPD because I am undeserving of oxygen. Who knows.

I wasn’t even going to tell my therapist about my current issue. I had already endured enough of her semi-lecturing this session. But I found myself immensely tired during session. My therapist assumed it was related to not wanting to talk about the difficult stuff (which I admit, in the past, it has been). I kept telling her this was different, and she asked how I knew it was.

I finally told her what’s been going on. I knew it was just going to further prove her point about me needing to go to the doctor. Luckily for me, I squeezed in my admission right at the end of session, so I didn’t have to talk about it all that much. I’m sure I will hear about it on Thursday. Hopefully by then, the issue will be resolved and I can just say “see, I told you I was going to be fine.”

Or, it won’t. Either way, I’ll sit there and say everything is okay. I could be bleeding to death, and I’ll still tell you I’m okay.

That’s what I did in childhood. That’s what I do today.

Spurs, spurs, everywhere

I went to the podiatrist today.

It’s very hard for me to actively seek medical care. I think there are a lot of factors involved in that. I don’t have normal pain experiences. There are times when I am able to block out the pain completely, which does no good because the damage is still being done regardless of whether or not I can feel it. When I do feel pain, I have trouble admitting it. Pain usually leads to more pain.

My mother was never big on doctors, and I think some of her attitudes have carried on in me. There is also an underlying connection between doctors and the abuse my mother inflicted on me. She would use doctors and my illnesses as a cover for abusing me. Because of that, I did (and sometimes still do) associate doctors directly with the abuse. It’s a hard connection to deconstruct, but we’ve been working on it for a while now.

Regardless, I made the appointment and went.

The appointment wasn’t without problems. When I got there, I learned that my PCP never sent the referral. I called three times last week. I called Tuesday and left a message on the referral line. I checked with the podiatrist on Wednesday and they hadn’t received anything, so I called my PCP again and left another message. Still nothing. I called Friday and waited to speak to an actual person. I told them that I already called twice and they hadn’t done anything. The office person took all of the information again and insisted that she was sending it right out.

It turns out she didn’t send anything out. It was ten or so minutes before my appointment, I had taken two buses just to get there, and now I didn’t know if I would even be able to be seen. I had to sit there and seethe a little. The podiatrist’s office was able to get through to my PCP and was told they would fax over the referral right away. Like I haven’t heard that before.

The fax came through as I was being prepped to be seen, thankfully. I was still a little angry but I was able to keep myself calm. The doctor seemed really nice, and I felt comfortable right away. He asked about my pain concerns, and about my previous surgery. I had also noted on my forms about my foot fracture last summer, and he asked about that. He asked how I managed to fracture my cuneiform, as it’s a rare bone to break. Story of my life. Rare, weird shit always happens to me.

The range of motion in my left foot is considerably minimized. It is extremely painful for me to pull my foot forward towards my leg, enough so that I can’t even put my foot in a normal regular 90 degree angle position. The doctor pressed on some different areas of my foot; most were okay except for the spot on the bottom of my heel.

He didn’t want to address my right foot just yet. He acknowledged the visible growth on the top of my foot, but said a lot of the pain I am experiencing in that foot may be because I am compensating for the debilitating pain in my left foot. So we are going to focus treating the left and see if there is any improvement in the right.

I had a few x-rays taken of my left foot, each taken in a different position. I waited as the doctor pulled the images up on the screen. I noticed something off right away. I had so many x-rays and MRIs done on my feet in prior years that I knew what to look for. As clear as day was a large bone spur, resembling a claw, growing out from the back of my lower ankle. As he scrolled further down, there was another spur, growing out from the bottom of the heel of my foot. It’s not nearly as large as the one on my ankle, but the location of it makes it all the more painful. There is also regrowth on the top of my foot, where two of the spurs were removed just over two years ago.

If you’re taking count, that’s four spurs. On one foot. I’m sort of thankful the doctor didn’t really look at my right foot. I don’t know if I could have handled knowing anything more.

The first goal of treatment is pain relief. The doctor gave me a shot of cortisone into my heel. He also wrote me a prescription for an anti-inflammatory and pain reliever. I go back in two weeks for another injection. There is not much the doctor can do right now in terms of physical therapy and other treatments until he can determine how bad it is. Right now, the pain and inflammation is too great for me to even move my foot properly. Once some of that is relieved, I will have to do some physical therapy, stretching, etc. and wear a boot (for those that missed out on the early posts of my blog, I hate boots. I ended up taking my knee-level boot off one day out of frustration and throwing it in a dumpster, just one month after I had fractured my foot). So yea, I’m not thrilled about that at all. At least I have two weeks before I have to deal with that shit. Oh, and the doctor is also going to set me up with orthotics. Yay.

I made it through the entire appointment. I’m not sure that it was all me, but I’ll explain that later in another post. For now, I’m just exhausted and need to sleep. Hopefully the cortisone will kick in soon and I can walk on my feel again.

Doctors

I haven’t been to the doctor at all since I’ve moved here.

I’ve been avoiding doctors like the plague. I was always like that, though. I never really liked doctors. I felt like I needed to protect myself from them, and my way of protecting myself was to avoid them any way that I could.

It probably wouldn’t be that bad if I was a person in generally good health. But I’m not. I have asthma, arthritis, anemia, and malnutrition – all conditions that should be monitored regularly by a doctor. I know I need to see a doctor. I made a few half-hearted attempts to find one nearby, but the places I called were not accepting new patients, so I quickly gave up the search.

Then I received a notice from my college that my account was blocked due to missing health records. I’m not sure if I had mentioned it before, but I have no medical records, no immunization records, nothing. My mother switched doctors so much that my medical records were never complete, and I eventually lost track of them altogether. The only required vaccination to get into graduate school was the MMR, so I found a Walgreens clinic last month and paid for the vaccine with my credit card.

I didn’t realize, however, that a second MMR vaccine was required. I got so frustrated and angry because I know I had to have had these vaccinations as an infant, but because of my mother’s foolery, it is impossible for me to prove it. I looked into paying for a titer test, which would cover all vaccinations, but that cost way more than getting a second vaccine would. If I would just find a doctor, this would all be no problem. I have insurance that covers everything. But doctors. No doctors, please.

Perhaps it was because doctors and medical issues had been on my mind more than usual, I don’t know…but last week, I had a memory that eventually put things into perspective for me.

I was very sick. I had been sick for awhile, but my mother didn’t like doctors very much so I only went when required. By the time I got in to see the doctor, I was sick enough that he wanted me to be hospitalized. My mother talked with the doctor, right outside the exam room, insisting that she could take care of me at home. After enough back and forth, my mother somehow convinced the doctor to not hospitalize me. I was stabilized with breathing treatments and sent home with a bunch of supplies and medications.

And just as my mother had often done, she saw opportunity in my illness. I was a perfect target now, sick enough that I could not fight back. She abused me. Under the guise of a concerned, caring mother, she took advantage of me. And she got away with it, because she continued to do it every time I was sick, throughout my adolescence and adulthood.

At first, I didn’t really think much of this memory. I didn’t think it had a purpose. But I thought about it for a couple of days, and then I realized something. In some twisted way, I associated doctors directly with the abuse my mother inflicted on me. Doctors were not there to care for my health; doctors helped my mother hurt me. As an adult, intellectually, I know that those doctors had no idea what my mother was doing. They didn’t help her perpetrate; she did that all on her own. And as I’ve mentioned before, my mother had the amazing ability to sway people on to her side. Those doctors didn’t know what hit them.

As a child, I wouldn’t have known any better. I didn’t know the extent of my mother’s powers over people at that time. I just knew that the doctor sent me home with my mother so she could hurt me. So I associated all doctors in the same way: as my mother’s helpers.

My feelings towards doctors became less muddled as I thought more about this. This whole time, I have been unconsciously blaming doctors for my mother’s abuse. I can’t do that now. My mother has no access to my doctors anymore. I can go to a doctor without fear that I will be hurt. This was a huge realization for me.

Acting on this new insight, I gathered some more phone numbers from my insurance website and made a few calls. I found a doctor who was accepting new patients, and scheduled an appointment for the end of the month.

I told my therapist in the beginning of our session Monday about the big news. My medical issues and my hesitance to go to the doctor have been an ongoing discussion over the last several weeks, and I had regularly shot down her subtle insistence that I see a doctor. She smiled as soon as I told her I finally made an appointment. I could see that she was genuinely happy for me taking this step. I gave her my usual weird look and told her that this wasn’t that serious.

I could tell that she was holding back excitement. “I really want to celebrate, but I don’t want you to be all uncomfortable and tell me I’m weird,” she said. I told her to just let it all out. So she did. She did some version of a sitting dance in her chair and threw her arms up in celebration. All I could do was laugh.

My therapist then asked what prompted the sudden change. So I told her about the memory, and my subsequent insight and connecting of the dots. She agreed that it made sense, and was not surprised at all that I would have formed that association in the first place.

We started talking about the possible complications of seeing a new doctor. She had e-mailed me a packet of information for trauma survivors on how to handle medical situations a few weeks earlier. During today’s session, my therapist asked if it would be better if I called the doctor ahead of time to explain my trauma history and some of the things I may need. I gave her a look, and she already knew my answer. Using the phone gives me horrible anxiety, and needing to engage in a regular conversation, especially about those topics, is still not doable for me.

Then my therapist suggested a second option. She offered to call the doctor for me, to vet her and her experience with trauma patients, and find out if the doctor would be a good fit for me. If she was, then my therapist would talk to her about some of my issues -my diagnoses (physical and psychological), my triggers, things I would not want to talk about, etc. I was all on board for this. My therapist and I came up with a list of what I wanted to be included in the discussion – she would not talk about anything that I didn’t want to be disclosed.

I agreed to have the PTSD diagnosis disclosed, but not the DID; I don’t feel like most medical doctors have enough of a grasp on DID to handle that information adequately. My therapist asked if I wanted her to address my issues with eating. Since I am overweight, doctors automatically assume I need to diet and associate all of my health issues with weight. The reality is that I have lost a significant amount of weight in the last two years and I struggle with an eating disorder that often causes me to not eat enough. I know that my eating habits will need to be addressed because I have chronic malnutrition, but it would be helpful if my doctor knew my specific issues ahead of time so she doesn’t end up triggering me into starvation.

We talked about what procedures I wouldn’t be comfortable with, and what the doctor could do in case I am triggered during the appointment. It was a lot to discuss, and I ended up getting a headache halfway through our session today just thinking about it. I still have a few weeks to prepare. My therapist is going to call the doctor in the next few days, and I guess we’ll go from there. Until then, I’ll just try to deal with my anxiety about it as best I can.