flagrant

today i have an appointment to establish a new relationship with a psychiatrist at ucla medical center. there is nothing to write about this other than the obvious: in the wake of resident doctor #4, this new resident doctor #5 has been predetermined to be ineffective, and, considering his inexperience, potentially dangerous. one wrong sentence and my ropes get tighter. i'm worried, but the perspective of illness is thrilled to attend and is dedicated to listening for the triggering insult.

my internist arranged this appointment. he insists i have a back up therapist in the ucla system should happen to resident doctor #4, or, as was the case of most of september, i am too restricted to be able to talk to him. when this referral was suggested, it felt excessive, and thought to be quite a waste of money. now it just defines a level of severity.


ucla daily/visitor parking permit

[later:]

my new doctor went home sick today. those staffing the clinic's reception, which is historically disordered on its own, adjusted appointment times and shuffled patients into the hands of substitutes.

of course, it wasn't until after managing the drive, paying for a parking pass, and then checking in for the appointment did anyone acknowledge the disruption.

AND that my appointment time had changed to an hour much later in the day.

AND that the substitute resident was a doctor of osteopathic medicine.

AND, none of this mattered because any change renders a reset, but, if the unappealing alternatives weren't enough, this replacement resident was female.

AND you know i would never engage a starvation evaluation in the face of bound fat bags and abundant pulsating estrogenic hell.

three seconds, or perhaps two, were allowed to freely consider the disaster which could be created by keeping the schedule, but no. this appointment had already been rescheduled once due to the original assignment of a female.

how unfortunate that my 'most favorite' incompetent receptionist has been replaced. i have been experiencing a lot of high volume rage lately (door denting.. kicking... wall pounding.. finger in one's chest.. due to the side effect of a medicine) but surprisingly caused no scene.

"okay, the next available appointment time is... january. january the eleventh." i paused to calculate and then conflict the ratios of time, energy, life, Death, and next year's health insurance deductible before nodding to accept the slot. it was *bizarre* to be treated normally.

a friday in january.
will i even be alive?
well, of course, but i actually thought about it.

the season is changing. i signed on to all tests presented and now don't know how to define time. might "life in january" illustrate that this last "period of reverse" was a secret inching back of the slingshot's tension? new goals are posted and a map between here, there, korea, and moscow has been drawn. when life happens, it moves too fast to care. aside from giving up this rental unit and moving back into my own home, i don't know how to suggest the options in this fluid future from the perspective of now. what or where or how will i be on january 11th?

i have not been seen in this particular medical suite at ucla in over 18 months. no one sitting at reception can be expected to know me, let alone know what is going on with me, but this rescheduled appointment is extremely offensive to my illness. anorexia considers itself a fantastic threat, and is much too arrogant to hear its severity can not only wait, but wait until next year. i am starting to enjoy the comedy. anorexia constantly expects to be the only point of concern -- even when standing with the uninformed or in front of those who cannot bypass policy. i'm supposed to hurt now, or something, because an unsophisticated receptionist hadn't the authority to act on the urgency.

on wednesday night, i lost the majority of my hearing again. this seems to be the same problem as was experienced last month-- where my parotid glands have swollen enough to put pressure on branches of nerves in my face. unlike last time, my senses of smell and taste remain, and i have been throwing up, but not to the point where salivary glands should swell to damaging proportions.

consider how the swelling due to my ankle injury was treated with an excessive amount of aspirin and nsaids at the same time i was experiencing hearing loss last month. over the last two years, i have needed to be convinced to take aspirin. my idea is that aspirin is based in a corn starch excipient, will influence corn allergy, and the subsequent discomfort should make me want to die. consider how an allergic reaction to aspirin and nsaids can cause an increase in swelling, and this might be putting pressure on the facial nerves.

last night, due to ankle and reasons relating to other discomforts, an aspirin regimen was renewed. this morning, ten minutes after five more aspirin tablets were choked down, dizziness and two new clouds moved in. i could also feel a surging discomfort in the parotid region of my face. sure enough, it's this aspirin cure which is causing more harm. an allergic reaction or salicylate sensitivity related to aspirin is causing my face to puff up enough to promote this hearing loss.

i have forced myself to throw up in such exaggerated amounts in the past that my eating disorder automatically was to blame for any itchy skin and swollen glands experienced afterward. this is good to reveal a negative response to aspirin, but unfortunate, too. it was taking a lot of work to ignore how "the eating disorder is beginning to seriously affect my health." i held the spectrum of feelings between whether to care or not. health did have a nice argument going for itself, but now needs to pin these physical concerns on 'allergy or sensitivity' rather than 'eating disorder.'

the only interesting thing is how i suddenly feel a lack of allegiance to either side, and how it is very odd to type from the point of a spectator.

consider:
- treating the swelling, thus hearing loss with pilocarpine, as last month
- side effects of pilocarpine are treated with aspirin/nsaids, too

consider:
- suffer well, exit the cycle
- how "i am not supposed to do that" but it works for everything

it got bad enough to decide i will retain my tuesday night appointment with resident doctor #4 this week. it was also determined that i need to force myself out of restricted speech, and tell him how imperative it is for me to take home a prescription. only after a long argument with myself, did i take .5mg of ativan (lorazepam) to facilitate the intent. ativan relaxes me for a few hours, but like everything else, never completely metabolizes out of my system for several weeks.

my sensitivities are unwanted and well documented-- resident doctor #4 would understand the urgency and send me along a medicine to collect or an idea to research. the problem is in how i need (something) now, but know there is not much chance i will ever fully get on it. i tolerate almost any prescription for two to four days, but after that, the subsequent discomfort and compulsion to get it out of my body is incredible.

unfortunately, i haven't taken ativan in awhile and forgot to put it to task. it played its part perfectly but i missed my cue, and therefore, basically just watched it work. ativan opens itself up to influence, but i needed more preparation to complement its properties of anti-anxiety this time.

i had taken three doses of it back in june after traveling in alaska with my mother. my return home was simple, yet somewhat involved. i travelled alone, not necessarily a problem, but on an endless train ride from vancouver, british columbia to los angeles.

the social aspects of "being stuck on amtrak for 48 hours", "amid strangers", and "without an available door to shut them all out" went smoothly. my seatmate throughout the journey was the nicest person in the world. he was a muscular security guard who worked a dangerous job in a notoriously crime-ridden area of oakland.

it's not funny how many trip journal entries have been interrupted by pages after pages of the same damn handwritten sentence: "only 33 more hours and 55 minutes of train travel hell. only 33 more hours and 55 minutes of train travel hell. only 33 more hours and 54 minutes of train travel hell. only 33 more hours and 54 minutes of...", or "twelve hours fifty one minutes until this plane is scheduled to land... twelve hours fifty one minutes until this plane is scheduled to land... twelve hours fifty minutes until this plane is scheduled to land..."

by taking the ativan, i was able to sleep on that train, get up often to use the restroom, and seek out the other facilities amtrak had to offer. ordinarily, i would have been stuck in my seat-- doing nothing but repetitive counting and recounting in an effort to keep my mind from focusing on the fact that i was alone, extremely uncomfortable, and amid strangers.

the ativan provided a comfort, but perhaps too much. since i was not provoked by every discomfort, i did not notice when sores appeared on my body. at this size, the bones in my lower back, my tailbone, and elbows are not protected and i can get open sores from the pressure of sitting too long without readjusting or from resting my elbow on an armrest.

a few weeks after arriving home, i told resident doctor #4 that i could still feel the medicine inside my body. the way i had felt prior to taking the ativan had not fully returned, and minor side effects relating to the pill remained. the same experience happened last november when i sampled topamax for a few days-- it wasn't until several months later that my body finally felt as though i had quit taking it. then, several months after that proclaimed release of medicine, i felt another huge release as though even more topamax had drained out.

resident doctor #4 refuses to acknowledge that i may be *that* sensitive, and instead likes to rephrase "processing the medicine out of my system" to "processing an experience the medicine allowed me to have."

consider how the ativan taken on the train offered me experiences much more relaxed than i usually allow myself. my amtrak seatmate tossed an unexpected bag of potato chips in my lap when he returned from seeing what the snack bar had to offer. it was a very normal, friendly experience for two people who were sharing such a close space. have i had similar scenarios? no, or, none since one in may of 2003. do you think the three weeks i spent "processing the ativan out of my system" was actually me taking three weeks to "process the fact that i shared potato chips with a stranger on a train without an issue?" it sounded ridiculous at the time -- coming to terms with that level of 'in public' sin -- but perhaps the terms and emotion are buried 'three weeks deep.'

the relationships and insight offered by medicines are extremely interesting. aside from a few pills to facilitate a sleeping schedule, resident doctor #4 has only tried to reveal or teach, rather than treat with a medication. he gave me zoloft, which made me go through wild daily rides of suicidality, but begged for me to continue taking it-- even while on a trip to peru! suicidal and dizzy at the top of machu picchu. i was mad at the world, sick of being nearly knocked down by llamas, babysitting my invalid friend chuck, and almost on the verge of altitude sickness. time goes by. those hellish experiences on zoloft were beneficial in learning how to manage my suicidal feelings.

tonight, if i mention to resident doctor #4 that i need to take some kind of pill, what prescription will i end up owning? he has wanted me to try zyprexa since the day we met but has left the topic untouched for awhile. no way. accepting a prescription for 'tremendous and rapid weight gain, served with a double side order of complacency' will never happen. it's an antipsychotic medication. i do not have a psychotic illness. i don't enjoy my involvement in prolonging the stereotype of antipsychotic medicines, either, or the facilitation of stigmatization, but it continues.

ssri antidepressants are useless in my case, since patients with anorexia nervosa lack sufficient central 5-HT-- essential for the release and reuptake inhibition. antipsychotic medications bypass that mechanism of ssri medicines, which is the reason for so many conversations about zyprexa. i love the first few days on an anticonvulsant (topamax) but am scared to death of the swollen fingers, breast enlargement, and apathy it supplied me. effexor rage is ever exciting but i find it dangerous to live without the sensation of pain. trazodone breasts, too, take too long to deflate.

resident doctor #4 is apt to push me toward infant doses of zyprexa/seroquel or abilify/geodon again. i don't welcome that conversation today and just need some help, not a fight.

perhaps this is the part where it is low enough to accept uncomfortable side effects from a prescription. i know better, though. i have blogged enough to know not to trade two easy days for the six weeks needed to process the pharmaceutical experience.