The Further Adventures of Deluzy

Auld Lang Syne

What a satisfying way to spend the last day of December 2007 -- with my old, dear friend B and, for a time, her sweet 4-year old daughter, in San Francisco.  We hadn't seen each other in a year, despite less than an hour's distance between our homes, and we were able to begin catching up.

Here's to the end of 2007 -- and the beginning of 2008. May everyone have a safe and happy New Year's Eve.

Time to turn the page

Okay, I'm ready for this month and this holiday season to be over. 

It's not that it's been awful -- but for a variety of reasons it's been a little bumpy, and so I'm ready for it to end.  In fact, until we do move into January, I don't think I'm going to be able to figure out how much of my emotional malaise is due to the need to tweak meds, or to the holiday season, or to all the work I had this semester and from which I'm still recovering, or to some nutritional oddity that may show up in my second-year DS labs, or what.  There have been just too  many factors occurring simultaneously for me to be able to sort through them all with certainty.

But with the holidays beginning to recede and 2008 only a few days away, I think the sorting will become easier. In fact, I'm counting on it.

Now, here's a question: am I making New Year's Resolutions this year?  Are you?  I haven't decided yet for myself.

Note: I guess I've decided.  Click on the list of resolutions under More (and Less) About Me at the top of the right-hand sidebar.

Body by Deluzy

I'm at 155.2 today (which is a weight I feel comfortable with in my head and provides  a safe, almost-4-pound margin between me and my top goal weight) -- and it's mostly a function of my normal monthly fluctuation (I'm at my lowest monthly weight just before my period).

However,  another factor is that I spent a lot of yesterday in the bathroom (warning: TMI is about to happen) shitting out the carbs of the day before (that'll teach me -- sort of) and, later upchucking the contents of my protein-rich dinner.

WTF?

Unlike many DSers, I spent the first 6 months or so after surgery tossing my cookies in a very untraumatic kind of way: it wasn't that deep, from-your-guts hurling but more like the overflow of carbonation from a soda when you crack it open.  I simply had to get used to a) eating much more slowly than I'd done for most of my life; b) eating smaller portions; c) stopping as soon as I felt full.  That took a while to learn.

I think last night's episode was probably due to the fact that, because it is almost TOM and part of my usual pattern, I'm eating less than I usually do -- but I was trying to be very vigilant about the protein after a day of too many carbs and overcompensated by eating too much of the good stuff.  (I remember this is something I used to do in the early days when I was so worried about getting in enough protein).

Sigh.

Never let anyone tell you that life as a WLS patient means you're not going to have to think about how and what you eat again.  I think about it as least as much as I ever did before surgery, only now I'm better equipped to keep my weight where I want it.

But at just over two years out? I'm still adjusting, one way or another.  It's a good thing, but it requires work and self-awareness. (Er, duh.)

Official assessment of Bhutto's injuries

Link: Bhutto Buried as Government Orders Virtual Lockdown - New York Times.

Ordinarily I'm no conspiracy theorist, but I'll believe the Musharraf government's account of Bhutto's death when real evidence is proffered -- or when pigs fly:

Saying he wanted to dispel first erroneous reports that Ms. Bhutto had died from gunfire, Brigadier Cheema gave an exhaustive description of the incident and showed a video on which Ms. Bhutto could be seen waving at the crowd from the sunroof of her car after the rally in Rawalpindi. But the camera lost focus in the pandemonium after it recorded the sound of three gunshots.

He said that Ms. Bhutto tried to duck down into the car just as the suicide bomber detonated his explosives, and the force of the blast caused her to strike her head.

“One of the levers of the sun roof hit her on the right side, which caused a fracture, and that is what caused her death,” Brigadier Cheema said. He said shrapnel from the blast hit the left side of the car, but her injury was on the right side of her head. The lever on the car showed traces of blood, he said. “There was no bullet that hit Mohtarma Bhutto, there was no splinter that hit Mohtarma Bhutto, and there was no pellet that hit her,” he said. It remained unclear if the suicide bomber had fired the shots or if a second person had, he said.

She was almost unconscious when brought to the hospital, he added. He said that Ms. Bhutto’s husband had not allowed an autopsy but that doctors conducted an external post-mortem and took X-rays.

Not that it makes much difference in the end.  Dead is dead.

Meds adjustment?

Hmm.  I'm thinking that it may be time to do something about my anti-depressant.  As in, change or augment it.

I have a 12-year history of success with the SSRI family of ADs, but after a few years on one, it ceases to be effective, and I have to switch to another.  This transition is usually a little bumpy, and  it occurs only after we try maxing out the dosage of the one I'm already on. Usually the increased dose helps -- but I'm currently at the highest dose of my present AD, so the next step is to try another med.

Except that, as an interim step, I'm considering investigating a course of Vitamin B. Vitamins A, D, E, and K are the usual culprits when it comes to vitamin deficiencies in DS patients -- not B, as is more typical of RNY patients -- but of course it's possible for anyone to develop issues with B.

Here's a rundown of About.com's take on  the relationship between B-complex vitamins and depression. Remember, though, that this is general information,  and thus not necessarily a medically reliable source, even if the site is vetted by an M.D.:

The B-Complex Vitamins

The B-complex vitamins are essential to mental and emotional well-being. They cannot be stored in our bodies, so we depend entirely on our daily diet to supply them. B vitamins are destroyed by alcohol, refined sugars, nicotine, and caffeine so it is no surprise that many people may be deficient in these.

• Vitamin B1 (thiamine): The brain uses this vitamin to help convert glucose, or blood sugar, into fuel, and without it the brain rapidly runs out of energy. This can lead to fatigue, depression, irritability, anxiety, and even thoughts of suicide. Deficiencies can also cause memory problems, loss of appetite, insomnia, and gastrointestinal disorders. The consumption of refined carbohydrates, such as simple sugars, drains the body's B1 supply.
• Vitamin B3 (niacin): Pellagra-which produces psychosis and dementia, among other symptoms-was eventually found to be caused by niacin deficiency. Many commercial food products now contain niacin, and pellagra has virtually disappeared. However, subclinical deficiencies of vitamin B3 can produce agitation and anxiety, as well as mental and physical slowness.
• Vitamin B5 (pantothenic acid): Symptoms of deficiency are fatigue, chronic stress, and depression. Vitamin B5 is needed for hormone formation and the uptake of amino acids and the brain chemical acetylcholine, which combine to prevent certain types of depression.
• Vitamin B6 (pyridoxine): This vitamin aids in the processing of amino acids, which are the building blocks of all proteins and some hormones. It is needed in the manufacture of serotonin, melatonin and dopamine. Vitamin B6 deficiencies, although very rare, cause impaired immunity, skin lesions, and mental confusion. A marginal deficiency sometimes occurs in alcoholics, patients with kidney failure, and women using oral contraceptives. MAOIs, ironically, may also lead to a shortage of this vitamin. Many nutritionally oriented doctors believe that most diets do not provide optimal amounts of this vitamin.
• Vitamin B12: Because vitamin B12 is important to red blood cell formation, deficiency leads to an oxygen-transport problem known as pernicious anemia. This disorder can cause mood swings, paranoia, irritability, confusion, dementia, hallucinations, or mania, eventually followed by appetite loss, dizziness, weakness, shortage of breath, heart palpitations, diarrhea, and tingling sensations in the extremities. Deficiencies take a long time to develop, since the body stores a three- to five-year supply in the liver. When shortages do occur, they are often due to a lack of intrinsic factor, an enzyme that allows vitamin B12 to be absorbed in the intestinal tract. Since intrinsic factor diminishes with age, older people are more prone to B12 deficiencies.
• Folic acid: This B vitamin is needed for DNA synthesis. It is also necessary for the production of SAM (S-adenosyl methionine). Poor dietary habits contribute to folic acid deficiencies, as do illness, alcoholism, and various drugs, including aspirin, birth control pills, barbiturates, and anticonvulsants. It is usually administered along with vitamin B12, since a B12 deficiency can mask a folic acid deficiency. Pregnant women are often advised to take this vitamin to prevent neural tube defects in the developing fetus.

Not that About.com is the received wisdom on Vitamin B -- but it was an interesting point of departure for some insomniac research I did online in the middle of the night last night as an alternative to lying awake and staring at the ceiling.

The results of that research and some chats with friends incline me to try augmenting my current medication (Lexapro) with Vitamin B in the form of something called Max Stress B Nano-Plex. (Keep in mind that the text that accompanies this product at the link I've provided is an advertisement and none of its claims can or have been proven.) This, after talking with my friend C, who's had trouble in the last year finding an AD that works well for her and who's finally resorted to working with a western-trained M.D. who uses both prescription ad homeopathic remedies in her practice.  C swears by this particular formula.

Now, I tend to view anecdotal "evidence" askance (e.g. "I have a friend who has a sister who knows a nurse, and she says  it's wonderful!"), but I'm thinking it won't hurt to try it.  I have to schedule my two-year labs and follow-up visit soon anyway, and it's certainly an issue I'll take up with both my PCP and Dr. K.

(I'm reminding myself that chronic clinical depression is like any other ongoing health condition -- e.g., diabetes, being a WLS patient, whatever -- and has to be managed every now and then.  That's just life -- and what I need to focus on is how fortunate I am to live in an era when many options are available and to have been so successfully treated for the past 12 years.  In other words, in the midst of not feeling quite right, I'm trying to cultivate a Pollyanna attitude because I think it's what will see me through most efficiently to a workable solution.)

Ghostbusters

First, thanks to all who have read and sent good thoughts and comments my way.  I'm genuinely touched.

Second, today is a substantially better day than yesterday, and yesterday was a much better day than the one before.  I'm chalking up my plunge into depression and anxiety on Christmas Day to any number of factors that are gradually dissipating in the way that things just sort of do (thankfully), and I'd say I'm back to 80% of my usual self. (Uh, well, of my now-usual, happily medicated, this-is-my-brain-on-effective-drugs self, that is.)

Now, 80 is a B- (says the college professor) which, technically, is "good, but leaves something to be desired."  It's not an A, which is always what I shot for as a student so it's not up to par, but realistically, I probably operate mostly anywhere from a B+ to an A on any given day in my life, so I'm not that far away from my own personal range of okay-ness. (Hey, there were years when I lived at a D level -- no joke, no exaggeration -- so this is a range I can deal with.)

(Perhaps the fact that I'm plotting my mental health along some kind of grade point average means I really need to get a life.  Or keep taking a break from my life, or at least, my work!  Fortunately, I don't go back to teaching until late January, and between January 2 and then, I'm genuinely looking forward to doing the research and writing I have planned for my break [and yes, I enjoy those things, as long as I have time enough in which to do them].  Until then, it's just me and those romance novels, my friends -- okay, and the occasional piece of respectable literary fiction as well. And a film now and then.)

Today I met a dear friend who lives in the east but is out on the west coast for the holidays for a delicious light lunch, latte, and bakery treats at Gayle's Bakery and Rosticceria in Capitola, just by Santa Cruz. I had a really wonderful pecan chicken salad and a slice of a four-cheese rosti, followed a little later by an almond croissant.  Carb central on the latter two items, and I shall pay for that tomorrow in the bathroom, but the protein count was also quite high, at least for the first two selections. I also bought some treats to take home, consciously deluding myself (is that an oxymoron?) that they were for both my husband and myself, when I know perfectly well that I shall be the one to eat most of them over the next few days.  If there's anything left on January 1, it's going directly into the garbage.

(And speaking of excessive consumption, for some unfathomable reason I'm below goal weight at 156.6 this week. Actually, that's not unfathomable --  it's purely because I'm at my lowest monthly weight just before my period, which is due next week.  For all I know, I may see a post-holiday, post-period bounce upward with the power to terrify, at which point I'll have to remember that yes, I now have the tools, the power, and the community to reverse any such bounce.  It's rather unnerving living at goal, I have to say, because it so often feels as if it could be snatched away -- but those very feelings are also the ways in which I give away the power I've fought hard to win, so the challenge is to feel them without getting lost and drowning in them. Hell, that's nothing new: one way or another, when I look back, that's always been my challenge!)

E and I wandered around a little after that, window-shopped, tried to catch up to the extent that we could, and then went our separate ways. It wasn't enough time, but we'll see each other again and share a hotel room at a conference in March, so that's something to look forward to.

All in all, a pretty good day. Maybe even a B, up from a B-.  I'll take it.

Old ghosts

Yesterday was oddly difficult, thanks mostly to a (now thankfully rare) attack of depression and panic that, at one point, had me swallowing Ativan and going back to bed for a couple of hours after my husband and I had opened gifts. It snuck up on me unexpectedly and I only realized that, in fact, I was having a full-blown anxiety attack once I was under the covers once more and gasping for breath. Horrible feeling at any time, particularly on Christmas Day.

But looking back across the past several weeks I can sort of see how the groundwork was laid for it. Old baggage in and around Christmas that dates way, way back to my family of origin had been accumulating in various mental chambers for weeks now. Then gifts received and not received, symbolism intended and unintended, were the triggers. And stretched beneath it all, as always, is my wonky brain biochemistry which needs its daily care and feeding.

All in all, the mind can be a dangerous, dark place, and unhappily it was thus for me for most of Christmas Day.  I laid low, turned off my phone, tried not to spread the non-cheer about to my husband  (who couldn't help but notice that something was off), and tried to sort myself out. I isolate when I get in this place, kind of like an injured or sick cat, and that behavior was itself an old trigger ("Uh-oh, am I going to find myself huddled in a fetal position on the floor of my closet in the next few hours?  Am I going Back There?"  More anxiety, more panic.)

It's impossible to describe the condition to anyone who hasn't been in the grips of clinical depression, clinical anxiety (something which is true but which I also realize I use as truth  to isolate myself further from others, thinking you can't possibly understand). Part of me still wants to numb out with additional meds, or with food; part of me wants to run run run to where no one can find me.

Sigh.  None of this -- none of these feelings, none of my past -- relieves me of the obligation of taking care of myelf, being an adult, and dealing like a grown-up in the present. So I won't numb out with meds or food; I won't run away; and I suspect that this, too, shall pass -- sooner rather than later.

Merry Christmas 2007

To those who celebrate and those who don't ...

 

Michael Kidd, Choreographer, Dies

Link: Michael Kidd, Choreographer, Dies - New York Times.

He had a long and creative life, that man.  He choreographed the truly odd-but-kind-of-wonderful trash can dance in It's Always Fair Weather (kind of like a less happy version of On the Town).

'Twas the night before Christmas

Okay, not quite yet, judging by the clock. It's just past noon. Moreover, there are plenty of creatures stirring in the house -- most of them cats.   

I'm dressed, after a fashion (in schlubbies, as I'm not going outside today). I've filled the bird feeders outside, neatened the living room, even taken care of my husband's stocking (I still have the kitties' stocking to do, though -- they share one). It's a bit early but we can't hang up stockings once they're filled anyway because they topple over (okay, so I bought defective stocking hangers at Target one year -- they look pretty on the mantel!). Moreover, this evening we're having a fire in the fireplace and would have to remove the stockings first [Santa will figure out how to come and go without sustaining third-degree burns, folks] so I thought "Fill the stocking now!").  Even all gifts are wrapped and under the tree (I really hate wrapping presents because I'm so bad at it -- shhh, don't tell:  I think it's supposed to be a part of Christmas one really enjoys).

My husband is spending the morning with a friend doing Manly Things with a Chain Saw (they're cutting up some wood on his friend's property -- he was looking forward to it, too ... men are really spectacularly weird sometimes), and in the time that remains before he returns, I'm actually going to do some baking. This, despite the fact that am Domestically Challenged in the kitchen.  Our house is homey enough in terms of decor, but I'm not a whiz when it comes to preparing food (I am what's referred to as an Adequate Cook and that's it -- furthermore, I don't enjoy preparing food, probably because I was raised by my mother who also disliked cooking, and because my oldest sister is so good at it that I never even tried, growing up. I know:  defeatist attitude).

But this afternoon, yes, I shall bake, and tomorrow we'll have a simple meal of pork roast, gravy, potatoes, and salad.  Not exactly traditional, but it is still Roast Beast of a sort.  I may have to make popovers as well (for those of you not familiar with 1930s-50s American staples, think Yorkshire pudding in a muffin tin, only a little lighter) -- but maybe not. We shall see what Christmas brings.

I expect there will be a high volume of phone calls later this evening and tomorrow from friends and family, as is usual for us on Christmas Even and Christmas Day. 

I'm looking forward to it all.