Tag psychiatry

Do I need to put on clothes today?

Angel Ackerman Leave a comment

Tonight I have a long-for-me shift at the fast food restaurant. 4 p.m. to 10 p.m.

Tomorrow I have a very busy day– gynecologist appointment at 7:30 a.m., helping Nan with her stuff around 9:15 a.m., teaching in the afternoon.

Thursday, we are recording our radio program at WDVR. Then, selling chicken from 4 p.m. to 9 p.m.

So, today I wanted to send out our acceptance letters for the Greater Lehigh Valley Writers Group The Write Stuff conference, March 11-13, 2027 at the Homewood Suites by Hilton in Center Valley, Pa. And I almost sent one so far. It’s ten minutes from noon.

Did I do things? Yes. Were they important? Yes.

Just not what I intended.

One of the items I have needed to do is grab a few groceries. I have been very careful with my diet lately (which has led to a new number today, one I haven’t seen in more than a year if not since the pandemic when I started rapidly gaining weight). And my daughter made me get dressed and go to Aldi.

Why Aldi? I wanted chicken salad and shelled endamame.

They didn’t have chicken salad and only had whole edamame. I didn’t want whole. I also wanted a salad and all their greens and pre-bagged salad mixes looked past their prime. So I came home with baby carrots (which I don’t eat, and I was hoping to make carrot pickles but I didn’t get the vinegar…), plain greek yogurt (because the flavors have too much sugar, but I probably won’t eat the plain), half and half (but I did not get coffee), crab cakes, and cheese. And bologna. Cheap cheap bologna because despite my primarily vegan tendencies I just really needed a bologna and cheese sandwich.

And two boxes of protein bars since I didn’t buy much food.

I did not want to get dressed. Until later.

Yesterday, I had my annual physical with my primary care physician. It was the first appointment of the day, and he spent 45 minutes with me. I had told myself that I did not intend to bring anything up. That I wanted to get in and out, continue my own experiments into diet, exercise and sleep, and ask for follow-up bloodwork.

He went through my late June bloodwork I did for him and the mid-August bloodwork I did for the life insurance company, with me, and requested I do another A1C and some vitamin D and some stored Ferritin… He was surprised to see– that as I told him– my “bad” cholesterol and my weight change very quickly according to what I eat. It’s how I gained almost 15 pounds this winter and lost it since July.

I still think I am among a rare amount of people who really pay attention to their bodies and try to understand and improve. He also asked how long I’ve been off my blood pressure meds– and I said– “about a year,” and then I reminded him that my cardiologist knows, or at least I told her I would probably stop taking them.

“Your blood pressure is great,” he said.

“The pills didn’t help,” I replied. I was prescribed the beta blocker because of my single incidence of afib. I stayed on it because I hoped it would help my anxiety– specifically the way my heart will sometimes race for hours for no reason. But the medicine never stopped that. If anything (and I have yet to prove this, my evidence so far is purely anecdotal, it’s food. I think the right blend of high sodium and refined white carbohydrates makes my heart want to explode.)

And my blood pressure has maintained itself in a healthy zone the entire time I have been unmedicated.

But then my doctor found out, I have been having stress dreams, disrupted sleep routines and general poor sleep since incorporating more “easy food” and less of my “outside aisles of the grocery store” home cooking. And now he’s worried about sleep apnea, my tendency to display symptoms of mild clinical depression, and my inability to relax (or have fun). He offered me a temporary antidepressant, and I declined.

And then today I remembered… I have been on the waitlist for a psychiatrist appointment for almost a year. During my routine physicals last fall I talked with my entire care team (primary care, cardiologist, mental health therapist, and neurologist) about the prospect of trying a low dose of valium as a breakthrough medication.

According to my research, doctors often give valium to children with cerebral palsy to calm spasticity and help them sleep. I asked my team about it. No one has experience with that sort of thing so they referred me to psych. So I reminded my doctor of this is an email. I told him that on bad days I often take 60 mg of baclofen– so could we try a small dose of valium in a small amount of pills to see if I took 2 mg of valium instead of all the baclofen if that would calm my muscles, alleviate my twitching hamstring, settle my heart, reduce my spasticity, and allow me to (1) stretch everything, (2) sleep better and therefore (3) recover better.

Remember– my leg muscles are unable to relax. I can’t even describe what it feels like. Sometimes it feels like my calves are so tight they burn. Sometimes my thighs feel like bricks. So if my doctor thinks I might benefit from a little something… this might be the something.

And on my one tangent for today: I have been binge-watching Nurse Jackie. I never liked Jackie, found her repulsive as a person but the older I get the more I recognize the accuracy of the depiction of people in addiction. And my daughter brought up something vital to consider:

Is Nurse Jackie an unreliable narrator?

My daughter votes yes, because there’s no way that an addict taking as much shit as she does (especially as a nurse) could appear to have her shit together as well as she does.

Interesting thought.

I have reached the midpoint in the series, and I’ve never watched this much before. And she has entered rehab and thrown her husband out of the house. And I’m thinking about it.

Meanwhile, my daughter has been tracing ADHD and autism in her family tree. My daughter– from a young age– has been super keyed in to people’s minds, patterns and habits. And just like she’s freakishly good at seeing every ripple in a dog’s body language, she’s damn accurate with her psychiatric diagnoses. And she’s finishing her bachelor’s in psych at Lafayette, she’s also developed some ideas about medication (so I asked her to do one of her recent psychopharmacology assignments on valium). She’s wondering if I might have ADHD.

My response is typically that it doesn’t matter.

I have a disability. One that stems from lack of oxygen at birth. One known to affect GABA in the body.

I score fairly high on the ACE scale for childhood trauma.

My parents were alcoholics.

Did I inherit generational trauma? Probably. Do I exhibit everything from OCD to depression to anxiety? Yes. Because my brain never learned how to feel safe and/or let its guard down. I never relax. The last time I felt truly relaxed was during some good adult physical activities that I don’t get nearly enough of. And do you know how much I need to trust my partner to let that happen?

My daughter believes something interesting about this whole ADHD hypothesis. She basically said I have not allowed myself to fail enough to recognize the truth it what she’s said. AND that because of that no clinician could ever diagnose me.

Strange food for thought.

Advocate: A Difficult Day on the Health Quest

Angel Ackerman Leave a comment

Well, if yesterday made one thing apparent… it’s that sometimes answers lead to bigger questions.

And questions often shake our foundations.

I have had an appointment every day this week before work. In the last ten days or so, I have seen my therapist, my personal trainer, my chiropractor (who has a background in physical therapy) and my primary care doctor and one of his new residents.

Yesterday was the latter.

This recounts why I was seeing my doctor. Later in this post, some of this info may be pertinent.

My heart was genuinely excited for the visit as I’ve made a lot of positive health habit changes and my primary care physician and I have a great relationship. Normally my care is a discussion and we work together to resolve my issues.

Since Covid, the practice has seemed much less organized and attentive as usual. They also recently took on some family practice medical residents. I waited in the exam room for 75 minutes.

I went into my phone to record my blood pressure on iHealth. And that’s when I noticed— iHealth has been recording my double support time and my walk asymmetry for a year. (This morning I compared my walking and balance statistics with my teenager’s and her walk is more screwed up that mine! My walk is consistent and consistently “off” but hers gets severely skewed every time she gets plantar warts. Turns out my neighbor has more issues in this area than I do, too.)

So, at 12:15 pm — as I am lusting for a glass of water and breakfast, I had nothing yet but a gargle of purple listerine— the resident enters the room and apologizes for the tardiness. I told her I was about to order GrubHub out of fear they forgot me.

I told her everything about me (as she had never met me before) and relayed that the doctor wanted to see me. I also mentioned that muscle relaxers might be a better fit to ease my periodic pain than ibuprofen or acetaminophen because it might be more due to the stress on my joints and the tightness of my muscles as a side effect of the cerebral palsy.

Now, remember, my anemia started more than 12 years ago with work stress, gaining weight and heavy menstrual bleeding. And I came to my current doctor because my former one refused to look into the source of my anemia. And that doctor made me cry. And I had started having panic attacks.

Now I am back in a similar symptom situation but I have better mental health and a way better doctor.

The resident goes and gets my doctor. I propose waiting several months to see if the anemia improves with the mesures I am pursuing now. He is worried about polyps in my colon. We agreed I will use some stool cards for a home test.

I didn’t feel heard about my request to find solutions for my body pain because then we discussed my mental health.

And he wanted me to visit their new staff psychiatrist to rule out any issues (like bipolar 2) that might require a mood stabilizer.

Now I complete understand why his said this: I had mentioned some dramatic temper incidents previous to some of my recent lifestyle changes, I had asked to restart the prescription for a very low dose of lexapro that had been prescribed for high blood pressure to see if it would even out some premenstrual mood swings, and I had mentioned some highs and lows in the past.

But I also said the isolation of the pandemic gave me the space I needed to deal with some heavy duty stress, and that good things were developing for me and I felt like this was one of the great years in my life. I talked about having rid myself of anxiety and being able to look back at that former period of my life with understanding of myself and pride. And that my therapist and I were finally looking at my childhood trauma as I scored 6/7 on the ACE test.

And he knows I have been in therapy for more than a decade. And that my therapist recommended him. Shouldn’t he let my therapist request that type of referral?

So I felt betrayed and it reintroduced feelings of anxiety and insecurity, not being sure if my medical professional was really paying attention to me and what I was saying. I had just mentioned delving into childhood trauma for the first time in my life. I am having other health issues that I need to address. So now, in my opinion, is not the time for questioning my brain chemistry.

So we agreed to discuss my anemia and my psychological state with my gynecologist (whom I see Monday) and my therapist and revisit the issue when I return in three months to discuss the follow up blood work.

This left me shaken and wanting to scream, “Stay in your lane.” I went to the doctor because he asked me to come discuss my anemia— how did a shrink come into play?

I often think this is how people get misdiagnosed, not by bad doctors, but by doctors trying to rule everything out and in the process convincing patients they need different help that they actually need. Like when people see a commercial for medicine and later “ask your doctor if (this expensive drug) is right for you.”

I emailed my therapist from my phone as soon as I got into my car. By 3:30 pm, he said he disagreed with this assessment— that I should be screened by a psychiatrist— but that we would discuss. Honestly, he is the only person I would trust with a decision like that. We all need to build teams we can trust. And this is how I advocate for myself.

When I got home, around 2 p.m., I finally had my morning coffee and made this— what I would call my “summer vegan sandwich,” courtesy of my stress shopping last week and a Hungryroot delivery. (See the teenager unboxing here.) Lightlife bacon tempeh, Hungryroot lemon tahini, romaine, deli pickle on 12-grain bread.

I didn’t take proper care of the animals (loosing almost four hours of my day to a doctor’s appointment that normally takes one hour).

I QCed 123 fixes, which is far better than the 116 the night prior. When my favorite Stitch Fix supervisor said hello, she asked how I was, I said okay. She looked at me askance and said, “only okay?”

She told me if I needed anything or if there was anything she could do to let her know. But she can’t fix the emotions in my head. So I thanked her and went back to some of my standbys— showtunes!

I listened to the soundtrack of Avenue Q as we used to in the makeshift temporary newsroom of Lehigh Valley News Group, and I can still remember one of my favorite young editors with her big headphones on, fighting her stress and her insecurities with a dose of “What do you do with a B.A. in English/It sucks to be me.”

Apparently this is the whole musical on YouTube. Check it out.

And if you just want the song… Here you go.

Speaking of the newspaper days, I’ve reached out to some Chronicle colleagues for help with promoting the FURR Pop Up Cat Café August 15. The man who hired me for that newspaper (the boss of my best boss ever) mentioned that my daughter has grown up in the blink of an eye (which he has seen thanks to Facebook).

And that brought back great memories as I think the teenager was the only baby born to a staff member during the run of those newspapers. I realized I was pregnant while planning a political debate sponsored by the newspaper in Phillipsburg, N.J.

So yesterday was hard, and I managed to avoid slipping into those old panic-prone mentalities. I am drained today but luckily only have a four hour shift.