Running, or walking, or crawling on empty

Car with hood open getting tune up, hands visible working on car

I didn’t manage to publish a post last Friday, despite my best intentions. I was caught up at the doctor’s office for longer than I had expected. No, nothing was wrong, I had been recalled for regularly scheduled maintenance with Dr. Family. Even we sick people need to ensure we’re not going to get a flat tire on long, hot summer drives.

More often than not, when I go to see my master mechanic, I am seen by one of the many apprentices training under her expert wing. This time, my apprentice was a week from graduating with her ticket, so she handled my tune up with the expertise of a seasoned professional. Still, any apprentice takes longer to get the job done, and has to run everything by the boss before the car is allowed back on the road.

After a thorough review of my hefty file, Dr. Apprentice completed the routine checks from top to bottom. She ensured all my fluids were filled to appropriate levels, that my spark plugs were firing and my motor was functioning, and that my tire pressure was adequate. Then she inspected me all over for any unusual dents or markings.

Before we were done, we discussed the issue of my gas tank, which seems to have shrunk, along with the rest of my body, in recent weeks. If this lower gas consumption continues much longer, I’ll be reclassified from sedan to compact for the first time in years. I confessed I’d been having trouble filling’er up past the half-way mark, which is highly unusual for this Little Miss Piggy. Dr. Apprentice looked at my current weight, which had eked its way into the healthy range, and showed little concern. I imagine I’d have garnered more reaction from her had I stopped filling my tank altogether, or if I’d confessed that parts (or is that “pants”) had started falling off while driving, but since I still seemed to be running fine on half a tank, she barely raised her eyebrows.

I was sent off with the usual blood and body work, and told that the office would contact me with any recall notices. Sounds good to me.

Stalled car with hood up by side of roadThen the weekend came and, for the first time since this lowered gas consumption started, I tanked. I could barely turn over my engine. I virtually stalled by the side of the road. That’s when J. decided to start the force feeding.

In case you were wondering, I haven’t voluntarily adopted a calorie-restriction diet in order to live longer. You’ve heard of those, haven’t you? Crazy people are actually choosing to go hungry in order to extend their lives. Doesn’t sound like much fun to me. I am not them, I can assure you.

This Friday, I will be seeing Dr. Joint, or Dr. Goutfire, or Dr. Uri–so many options, so little time to decide!–and we will discuss the gout-busting pills that seem to be making it hard for me to fill my tank. Hopefully Dr. No Name Yet will support a medication adjustment so I can resume eating again, assuming my gas tank has not shrunk permanently. That leaves me four more days to fit into those favourite jeans….

Lest she forget

Where oh where has my appetite gone? Who cares? I’m on the easiest diet ever, one that doesn’t involve any planning or effort. Let me revel in it while I can. Don’t be jealous; losing an interest in food isn’t much fun. I don’t recommend it. I’m headed out for lunch today with friends and wondering what I’ll not eat.

Today I can assure you that my appetite loss is not a sign that my health is in peril. Yesterday Dr. Blood confirmed that my blood test results were a-okay. I’m fine.

Enough about that; we had many other more important things than my health to discuss. Dr. Blood is leaving for her overseas adventure at the end of July, so this was my last appointment with her, for now.

I’m going to miss her. We discussed the young hematologist assuming her practice in her absence–I’ll need yet another new name, folks–whom she’s no doubt chosen very carefully. Dr. Blood would not leave her patients with someone she did not trust. She assured us that she’d be back, and I believe her. She told us she rented out her home here for a year; she didn’t sell it. That’s a good sign, isn’t it?

I promised myself I wouldn’t cry and I didn’t, or at least not once I’d arrived at the Cancer Centre. (The drive there is another story.) J. and I asked Dr. Blood about her plans because we’re genuinely interested and we wished her well because that was the appropriate thing to do. I did not plead with her to stay, not even for a nanosecond.

Then I gave her the thank you card I should have written years ago telling her how grateful I’ve been for her diligent care. I reminded her of when we first met and how she saved my life. It’s a great story, and one she should never forget.

I’m an awkward hugger at best, but I was planning to ask if I might hug her at the end of the appointment. She preempted my awkwardness altogether. As we were parting, she asked if she could give me a hug. It was a significant gesture from someone who has been such an important part of my life for the past five years.

Changing of the guards

Just imagine these are doctors.

I am genuinely excited for her, and I hope she has a wonderful year. At the same time, I feel sad that she will not be here to care for me. Am I a bad person for thinking of myself and my needs in this situation? No, I don’t think so. Still, I’m glad I refrained from bringing Sadness into the room. I will miss Dr. Blood, but I will welcome her replacement and put my trust in him. I’ll adapt to someone new because I’ve been through the changing-of-the-doctors drill many times now.

Dr. Blood has also left me with a new goal to strive for. (We cancerous folks like setting goals for our futures.) The new goal? I now have to stay alive until she gets back. Dr. Blood seems convinced that I will still be here, and since her judgement has been 100% thus far, why start doubting her now?

Introducing the incredible shrinking woman!

Shot from the movie The incredible shrinking woman, tiny actress on big armchair

Thanks to all of my witty and creative readers who forwarded inspired names for my new doctor-to-be. (Take a look at last post’s comments if you haven’t already. I guarantee you will laugh out loud.) I may call a vote to decide the winner. Don’t worry, contributors, you’ll be able to vote anonymously for your own brilliant submission.

Today we have something even more remarkable to discuss, if that is possible, since I try to intrigue and delight with every post.

My weight has always been the bane of my existence. I insist I’m large boned, but that excuse will only go so far. I have likened myself to a pufferfish, and have spoken of my 75th trimester pregnancy (“trimester” may not be the appropriate word here). I generally watch my weight, but do not do anything about it, i.e., I am not a dieter. I may try to modify my eating if I fall off my Great Sugar Revolution wagon, for example, but I do not deprive myself of anything. Deprivation leads to bingeing, folks, remember?

For the past few years, my weight has been largely unchanged. I am overweight, but not excessively so.

But no more. My appetite has been MIA for two weeks now. I ate very little breakfast this morning, and now, at 1:20 p.m., I must have missed the lunch bell. I’m making myself consume small portions to keep myself going–I’d hate for my large bones to start protruding–but I have not experienced a hunger pang in some time. This is odd. My large pants are loose, and I even look a little less pregnant (which can happen if you’re not pregnant). I have re-entered the healthy-weight range for the first time in two years.

Normally I love food and I love eating, so why are the pounds are falling off me? I am not intentionally restricting my intake. I can assure you I don’t have an eating disorder. I’d eat if I felt like it. I don’t feel like it.

Of course this change of events could mean that my health is amiss, but there’s no sign of that. I feel absolutely fine, although I’m not sure how I’m functioning on so little food. Rather, I’m wondering if my latest combination of medications is to blame.

Many of my medications list loss of appetite as a possible side effect, but I never have the pleasure of experiencing that. I gravitate toward the tired side effect instead. Whatever combination of pharmaceuticals I’m consuming, I’m always famished. In fact, when I was speaking to Dr. Family the other day about my many medications, I told her I was hoping for the possible nausea from one, since I’d like to lose a few lbs. She looked at me quizzically, and then, despite herself, she laughed.

Perhaps the answer to this mystery is in my blood work, which Dr. Blood will review with me tomorrow. Whatever the reason for my incredible vanishing appetite, I’m hoping to extend my disinterest in food for a few more weeks. By then I should fit into my favourite jeans again.

 

Musings on avocado toast

Avocados have gotten a bum rap of late on two fronts. In case you missed it, an Australian real-estate mogul had the gall to assert that the younger generations cannot afford to buy their own homes because they are wasting their money on frivolous items like $19 avocado toast. Needless to say, the social-media backlash was fierce.

Don’t tell me you’ve missed the trendy toast movement altogether. FYI, it’s not all melted margarine slathered on highly processed white bread anymore. The toast I’m speaking of has fancy toppings, including but not limited to avocados, smushed on thick slices of organic sourdough toast. You can order it in restaurants with a variety of additional toppings, at unfathomable prices.

I’ve read about the toast movement but I’ve never gone out to a restaurant in search of avocado toast because I don’t eat out, remember? Since I was placed on a sodium-restricted diet in 2004, I have largely been restricted to reading about the hot new restaurants in town on the internet. Sometimes I salivate at the pictures, but God would punish me if I deigned to consume their wares. Did I mention how much weight I gained on my last vacation, despite my only eating only one pain au chocolate over two weeks? No? Well, let’s keep it that way.

The mogul’s lame argument was countered by a respected business writer at the Globe and Mail. Said writer noted that young people would need to consume over 33 slices of overpriced avocado toast daily to spend the $180,000+ dollars Toronto house prices have risen over the past year alone. Anyone consuming that much avocado toast has a bigger problem than covering her house payments. I suspect a binge eating disorder, but I’d need more information to make a definitive diagnosis.

If these house-less restaurant-going kids decide, instead, to make avocado toast at home in order to save a few dollars, they need to be aware of the second strike against the poor avocado: the potential dangers of avocado-pit removal. According to recent medical reports, a phenomenon dubbed avocado hand is showing up increasingly in ERs everywhere. The injury results from a missed stab at the avocado pit, where the knife slips off and pierces the palm of the hand. These cuts can be deep, and may therefore result in serious infection. A local emerg doc noted that his hospital sees approximately one case of avocado hand weekly.

Thankfully we have socialized medicine in Canada, so that your ER visit will not cost the you anything except your pride. Rest assured the ER docs will view you as one of those earthy millennial types who needed a healthy snack following hot yoga to sustain you through the afternoon.

I’m not that person–I prefer to keep my yoga sweat to myself–yet I confess that I too like avocado toast. I often slather half an avocado on my morning toast, sometimes topping it with an also-trendy poached egg. It’s a surprisingly filling meal. But I’m too cheap to pay $15 for all this rigamarole at a restaurant. I’ll pit my own avocado, thank you very much, very carefully, and pray for no deep-tissue injury since I’m infection prone. Already I’ve cost the health system much more than my share.

Picture of avocado on toast topped with poached egg and herbs

The dangers of dependence: a tale of two doctors

A tree that is unbending is easily broken

Did I happen to mention that my beloved Dr. Family will be heading off on maternity leave in August? The gall of that fantastic physician to place her family ahead of her patients, placing her family ahead of her patients. I was diagnosed with leukemia during her first maternity leave. Who knows what will happen this time she leaves?

I don’t talk about Dr. Family much because she is, in some ways, a peripheral member of my care team. By necessity, I spend more time with my specialists than with her. She has always diligently reviewed my file before I do visit, though. She is an astute diagnostician and has cared for me well over the years I have known her. She has arranged for excellent coverage during her two prior leaves.

Her upcoming departure for baby #3 happens to coincide with Dr. Blood’s leaving for her year-long sabbatical. That’s a lot of change at one time for a change-averse gal like me. Thus I considered becoming completely overwhelmed when I first saw Dr. Family’s baby bump, but I’d recently reached my fretting threshold over Dr. Blood.

That’s how I decided to approach to Dr. Family’s leave differently. I recalled my shutting my practice temporarily–unlike me, my clients had no opportunity to ready themselves for my departure–and how, unsurprisingly, my clients survived without me. I’d expect no less of them.

As a clinician, I am always walking a tightrope between assuring my clients they can rely on me when they are distressed and encouraging them not to become overly reliant on my support. From the outset, we discuss those supports available to clients outside the occasional hour that we meet. I’d never want a client to think he needed to talk to me and only me in a crisis because that would set him up to be overly dependent on my care.

I’ve always known I’m not the only psychologist in town. Other highly competent clinicians jumped in when I got sick because they had to. I redirected clients that asked; others muddled through in their own way. Some clients may have ditched therapy altogether to see how they’d do without a therapist’s support. I trust they managed well.

Those who transferred to someone new may have had to share their story from the beginning, which is certainly harder than returning to someone who knows them. Nonetheless, unexpected change like this can be good for clients. I may have missed something or focussed excessively on one domain when they could have used a different kind of support. I realize my former clients may have found a therapist who was better suited to care for them. Sometimes a client reaches an endpoint with a psychologist and a new perspective is beneficial.

If my clients can survive or even thrive without me, maybe I can do the same with my new physicians. I’d hate to become a needy patient, and I trust both my physicians will find solid interim replacements. Who knows? Maybe the change will give my flexibility muscle a good workout. I may even learn that there’s more than one doctor in the world who can keep me alive. That would be reassuring.

Two women walk into a home improvement store….

Picture of yellow and black drill

Sounds like the first line of a joke, doesn’t it? Well, it isn’t. Or maybe it is, if you’re thinking of klutzy me. J. is less injury prone and better with a drill. I am wisely relegated to a supporting role on home improvement tasks, e.g., “Honey, a beer/iced tea/lunch would be nice.”

We went to the store to buy planks for raised garden beds. According to J.’s careful calculations, we had room for two 12 x 3 foot beds. What we hadn’t considered was how we’d get those 12-foot planks home my little black car. Remember the car I said I’d never eat in and forever park at the far end of every parking lot to prevent door dents? I know, sounds a touch unrealistic.

The helpful and eager young employee–let’s call him McDreamer–believed we could somehow get those long planks home in my teeny car, so he and J. attempted to manoeuvre them while I watched in fascination. (I bruise easily, remember?) All was going well until McDreamer decided to move the planks a bit farther up the dashboard, at the expense of the windshield. Once he realized what had happened, McDreamer was so upset he bolted off in tears to seek help.

How would a normal person respond in this situation? J., ever the normal one, uttered the F-word several times. I am not normal, however, so my instantaneous response was to flash back through my many job disasters over the years and feel McDreamer’s pain.

I clearly recall the first time I really messed up at a so-called job. Early in my babysitting career, which was quite busy and lucrative, I somehow forgot a booking altogether. I remember feeling so ashamed by my error, and my shame was compounded by the parents’ rage. Needless to say, this family never asked me back.

Since then, I can think of critical moments with clients that I haven’t handled well and wished I could revisit. I addressed these mishaps with the client if I had the opportunity, but sometimes, because of circumstances, I did not. Unfinished business is unsettling.

In case you’re wondering, no, I did not immediately put on my psychologist hat and offer McDreamer my services. We’ve recently reviewed the prohibitions against ambulance chasing, and, in this case, I was the one in the ambulance. Rather, McDreamer appropriately sought help from an older and wiser employee, who explained that 12-foot planks could not safely be transported by a 6-foot-long vehicle. The store manager then magically appeared and offered to pay to replace the windshield. She was lovely and gracious, including with McDreamer, so everyone breathed a sigh of relief.

J. returned to the store the next day with a revised plan. If we built 6-foot rather than 12-foot boxes, the shorter planks would fit easily in our friend’s van. Since McDreamer had not been fired, he gladly helped us out. Even without my professional help, he seemed to have fully overcome the prior day’s trauma. The shorter planks were loaded in and nobody got hurt.

Even my car has learned an important lesson about knowing her limits. I doubt she’ll ever try that again. Or at least not under my watch.

Increasing my blog’s readership, one visitor at a time

It was a record week with two real live clients. For whatever reason, my second client found the session helpful and decided to rebook. At this rate, I may actually have a bit of income to declare at year end. Do you think her rebooking had anything to do with the despairing look on my face as the session neared its end? Or my begging? I thought so too.

I commended this client for making contact since we hadn’t seen each other for some time. I can’t imagine calling my therapist not knowing if she’d died since we’d last met. Kudos to her for taking the risk. I believe she could see, once she arrived, that my death is not imminent, or at least doesn’t seem to be so.

On a much triter note, I’d love my writing to find a larger audience. All writers would, wouldn’t they? Sometimes my narcissistic side wonders why my blog hasn’t garnered more attention over time. Is it my abrasively opinionated stance? My biting humour? How about my many random syntax errors? You’re probably wondering whether I’ll ever learn to stop my participles from dangling.

Despite my ongoing efforts to keep you entertained–“Enough already,” you say, “I wouldn’t have committed to this blog if I knew we’d be forging a long-term relationship”–I haven’t yet garnered any publishing contracts, I’ve had no requests for guest articles in esteemed newspapers, no talk-show appearances, not even any invitations to relocate to L.A. Perhaps my fame will follow my death, just like that of Bach or van Gogh.

It would probably help if I used social media to broaden my reading audience, but, because I don’t live with a teenager, I’m at a loss. I’ve taken a more primitive approach to expanding readership instead: I awkwardly tell people about the blog and ask them to take a look.

Sadness doll

Can you see the resemblance?

Take, for example, Mr. Platelet at the Calgary Blood Services clinic, the regular platelet donor who likened me to Little Miss Sunshine a few weeks back rather than my soulmate, Sadness, from Inside Out. You know Sadness, who’s forever trying to bring Joy down. (As a side note, notwithstanding the pale blue facial tone, I bear a striking resemblance to Sadness, even when I’m happy. The higher-than-average BMI, the frumpy sweater, the glasses, and the eyes that are always wide open. Hey, maybe that’s why Sadness is always sad. She’s tired all the time!)

I caught up with Mr. Platelet–would “Little Mr. Sunshine” be a better moniker?–this past Monday when I was volunteering and, while he was quietly eating his soup, I told him how touched I was by his kind words last time he was in. And then I clumsily directed him to the recent blog post where he’d played a starring role. In yet another act of kindness, he gamely read the post while consuming his soup. And just like that, I increased my readership that day. Poor fellow probably didn’t know what hit him. Even my clients would say I’ve never been known for my delicate touch.

No wonder my blog readership is increasing at a snail’s pace. Should I reconsider the social media approach? It’s less intrusive. Now I just need a teenager….

Social media icons (twitter, Pinterest, youtube

Give him an inch, he goes a mile.

I have two real-live clients this week. Two hours to be a bona fide psychologist. Two people who I have the potential to help (or harm, if I mess up). That’s a lot of responsibility.

Sometimes I’m well aware that my clients are doing all the work. They know what they need to do, they just need the occasional reminder. Take one of my recent clients, who came in for help with anxiety. He was going to be late for this week’s session, so he emailed earlier that day to inform me. What a brilliant solution, I thought: this way, I’d know he’d be late, and I wouldn’t fret about it. Also, he wouldn’t be stressed by his delay.

I was struck by this client’s problem solving in this situation. He anticipated something that might cause him anxiety and preempted it altogether. When he arrived, I commended him for dealing with his tardiness proactively. Many times over the course of our contact, this client has shown me that he will act to reduce his stress rather than raising it through avoidance. Way to go, buddy.

As an anxious person myself, I often forget to apply the same principles in my own life. I’ll put off the letter I need to write or the phone call I need to make if I’m nervous about what to say. If I am going to be late for an appointment, I am more likely to become stressed than to notify the person who will be waiting for me. I may avoid situations that cause me anxiety, even though I’m well aware I’ll feel better as soon as I act. I have to make a conscious effort not to do things that cause me to worry more.

My years of personal experience have taught me that overcoming anxiety is hard work. It takes awareness and vigilance and, for people like me, even a bit of therapy. I may deal with my stress more effectively than I used to when I was younger, yet I am not anxiety free. My goal is to ensure my worries do not interfere with my living my life fully. I have the same goal for my worry-prone clients.

At the end of the session, I asked this client whether he wanted to rebook. I had the feeling he’d say no, since he’d come so far with such little help from me, and he was effectively applying so much of what he’d learned. He chose not to set another appointment. (Insert sad-face emoji here.) We left the door open, as I always do.

Then, as he was leaving, he gave me the dreaded termination talk. I know this talk well. He said, “Thanks for being my cheering section.” I responded, “You’ve given me a lot to cheer about.” It’s a variation on the you’ve-helped-me-so-much theme. (Let’s assume, for the sake of argument, that this is true.) Expressing gratitude this way seems easier than saying, “I no longer need your help.” This fellow certainly doesn’t, or at least not right now.  And so another one bites the dust, but in a good way.

Good bye emoji--hand waving

 

In certain circles, I’m known as Little Miss Sunshine

Stuffed toy of Little Miss Sunshine

If you think Sadness and Fear are my constant companions, I beg to differ. Sure, I’ve been a little off kilter lately due to my gouty complications, my unrelenting fatigue, and my difficulty handling doctor change, but the rest of the time, Joy prevails.

If you know me only by what I write, you may envision my holding back tears all the time. You may even wonder how I ever managed to become a psychologist. Before you write my provincial regulatory body to rescind my license lest I harm the public, I beg you to hear me out.

Despite your negative preconceptions, under the right conditions I am an unimaginable bundle of joy. I bring light and life to those around me. People can’t help but smile when I enter a room, and not only because my fly is undone.

To demonstrate my point, I’d like to share a story from earlier this week, before I became unduly distracted–and distressed, I might add, in case you didn’t pick that up–by the Trauma of the Changing of the Doctors. My moment of unbridled happiness took place on Monday afternoon while I was volunteering at Canadian Blood Services.

I’ve been on the Monday shift since I started volunteering at the clinic last September. It turns out that donors often set their appointments on the same day of the week, and that over the months I’ve become familiar with many Monday donors. I haven’t yet gotten to the point where I can anticipate their soup preferences or cookie choices, but I do see them on a fairly regular basis.

Earlier in the shift, I was feeling somewhat verklempt because I had met a donor who was profoundly hearing impaired. I did not realize her impairment until I noticed her reading my lips and heard an unusual lilt in her voice. Her hearing was impaired, but her blood was not, so in she came to give. The range of people who attend the clinic never ceases to amaze me.

Then Mr. Platelet entered. Mr. Platelet is a lovely fellow who donates frequently. Platelet and plasma donors often attend the clinic more often because they can, and thus we get to know them better. For the first time, Mr. Platelet called me by my name, which is on my little red volunteer vest. We had never chatted before but we spoke briefly as he was leaving. During this conversation, he told me he liked donating during my shifts because I am “all smiles and sunshine”. Not wanting to disabuse him of that notion, I thanked him warmly and told him he was very sweet.

And in truth, I am Little Miss Sunshine at the clinic. I look out upon the donors slurping their soup each week and imagine, “Are you the one who saved my life when I needed blood (or platelets or plasma)?” Thanks for that.

After Mr. Platelet left, I broke the volunteer code of conduct: I neglected the donors while pulling out my phone to text J. I wrote, simply, “I am all smiles and sunshine.” She promptly responded, “I know.” And so, too, should you, dear readers, in case you sometimes forget. I’d forget too if I were you.

Tears for fears

Pill with image of Canadian flag on it

I visited the pharmacy today and left $74 poorer with a large medication stash. I whipped out my credit card to pay for the portion that was not covered by my insurance plan. I am lucky that I have adequate funds to pay for my drugs. Some people don’t take their drugs as prescribed because they can’t afford to.

The prohibitive cost of drugs in our land of universal health care has been in the news recently. The reality of the problem hit me last week, when Dr. Foie Gras seemed overly preoccupied with the prohibitive cost of the new gout-busting drug he thought might help me. He actually checked whether my drug coverage would be adequate during our visit.

Then yesterday at the Cancer Centre, I asked Dr. Blood’s fellow about the safety of my taking this new medication. Dr. Fellow noted that, in order to cover the drug, the insurance company would need a letter explaining that I could not take the cheaper alternative. Since the cheaper drug may have caused my liver to fail 4-1/2 years ago, I’d imagine that letter would be fairly straightforward: I’d be taking my life in my hands if I took the cheaper drug.

Then Dr. Fellow questioned who would write the letter, asserting that hematology was too busy and that I should ask Dr. F.G. or even Dr. Family, although he wondered whether Dr. Family would have the authority to speak to my exceptional status, blah blah blah. After Dr. Fellow left the room, I became overwhelmed and even a bit teary.

J., a master at not reacting prematurely, ignored Dr. Fellow–or is that Dr. Roadblock?–and hushed me up so she could listen to his conferring with Dr. Blood. Dr. Blood immediately recruited the clinic pharmacist, who wrote the necessary letter.

Then Dr. Blood came in to inform me that she would be facilitating my approval for that drug. She noticed I was a wreck and said, “You look teary.” Of course her compassion sparked more tears. As I collected myself, J. said, to my surprise, “Annie is just worried about your leaving.” Why hadn’t I thought of that? Of course I was, and am, worried about Dr. Blood’s departure and how I’ll manage with her replacement. I’m worried that simple things, like getting approval for a new drug, will become more difficult. That’s enough to make anyone cry, isn’t it?

There is an ease that comes with a doctor’s knowing me and understanding my needs. Were I not so overwhelmed by her imminent departure, I’d have trusted that Dr. Blood would solve that day’s problem on the spot. And now I must trust that whomever she chooses to replace her will do the same. I am relieved to report that Dr. Roadblock won’t be her replacement; he told us as much.

I have one more appointment with Dr. Blood before her sabbatical starts. I’ll probably cry since, among other things, she’ll be missing my fifth cancerversary. Without her, there would be no fifth cancerversary. But there’s a more important matter at stake: what if the new doctor doesn’t like my baking? I’d rather worry about something trite for a while, if you don’t mind.