"Not a Single Lesson Was Learned..."

--Shinedown, "Through the Ghost"

The doctors, searching around my thoracic spine, looking for some reason for my middle-to-upper back pain, well, they found fluid in my lungs (my GP described it as being a small amount, which makes sense since I'm asymptomatic).

"You know, I don't mean to sound melodramatic, but I could be dying," I tell my mother over the phone while sitting in a study room next to the computer lab. The assistant of the lab comes by, looking sheepish, and then closes the door on me.

"You're going to be just fine," my mother retorts.

I explain to her that I didn't mean I was going to die tomorrow or even in the next year, but if I have congestive heart failure, I probably won't make it to sixty, much less like my grandmother from my father's side who is eighty-five, and has no (read: none whatsoever) chronic conditions. I told her that sure, they can treat heart failure, but it still kills you anyway. Towards the end, you have all sorts of problems, including shortness of breath (I've read of people afflicted who could barely get out of bed without getting winded) and extreme exercise intolerance.

But I explained to my mother that that's the crux of modern medicine: we have the diagnostic tools to find something wrong with everyone (with sole exception, of course, of my father's mother). The problem is sorting through the data, and deciding what is really clinically significant. And from there, finding effective treatment. It's easy to hop on some test-this-test-that bandwagon because doctors want to feel that they're doing the best possible job, and they don't want the patient to think he/she is being undertreated. It's easier to justify an MRI than to tell a patient to take aspirin and go home. People want to know. We have this insane desire to escape death, that medicine can grant us this gift, we just have to be observant and proactive. We just have to take this pill and walk two miles aday.

We can better detect breast cancer, but it still kills the same amount of people every year. Same with colon cancer. Why? Well, that's out of my realm of expertise.

So, is fluid in the lungs clinically significant? In a thirty-four year old, it is certainly odd. Does it mean that I have congestive heart failure and will die in a few years? Well, I have no idea. Dirk had/has (if he's still alive) congestive heart failure, but had no symptoms. He was overweight, sure, but his cardiac problems stemmed from an undiagnosed sleep apnea, which went years and years without treatment.

And, oh, yes, I haven't contacted Morpheus for five weeks (and, technically, one day), and I figure I only have two people on this planet who I have to avoid, this should be easy right? I have thought about emailing the English instructor because the poetry professor has decided to hold a faculty poetry reading (I've been invited). I emailed the poetry professor, and asked specifically if he could include the English instructor. I didn't get a yes or no on that answer. I thought about encouraging the English instructor to attend either way, but I decide that I should just keep my mouth shut.

Grambo is Dead, Part VI

"Do you cry?"

"Yes, sometimes."

The Speed of Pain, Part II

Of course, I drank until I was properly intoxicated. I had dinner by myself at a good Italian restaurant, since my parents were up North dealing with my uncle.

I cried about my grandma. And then at some point in the night, I went to bed to read and then to fall asleep.

Children

During the weekend, while my mother and I were watching TV, she asked me if I would like it if she adopted a child.

"Not one who needs diapers," she explained to me. "What are you thinking? Are you thinking you won't get attached to it? Sometimes the older children have a hard time finding homes." She explained to me later that she was afraid I would end up all alone--since, well, I haven't dated in years, and it's now officially been more than a year since I've had sex (and that sex didn't last long, only a few minutes). Most people close to me know that it would be difficult for me to carry my own child because I would have to go off all of my meds and risk psychosis or depression.

"This is a conversation you need to have with Dad," I finally said.

"Oh, he always wanted more children, it was me who only wanted one."

I seemed to cheer her up some when I said that perhaps I would adopt after I was finished with school.

The Speed of Pain

--Marilyn Manson

"Just remember when you think you're free..."

The first thing I realized--I wanted a drink--

The community college campus is relatively small, and I'm there on campus everyday for hours on end. During the past four weeks, I've ran into all my former English professors--the Poetry Professor, my Engl 201B professor (now my Creative Writing Professor), and my Engl 201C Professor (who is now my World Lit Professor). Everyone except the English instructor--

Until today.

He's easy to spot. He's taller than everyone, and he has this signature stride, very long like a gangly  three-year-old Thoroughbred, fresh on the track, overconfident and striking.

I spotted him many feet away, and I knew I was easily recognizable--I have my dog always with me. So, I stopped at a patch of grass, and pretended to be occupied by Beck--I looked down at her, petted her head and her ears.

The English instructor disappeared behind one of the faculty buildings.

I ignored him, and he did the same.

Seeing him was like being squeezed around the heart, quickly losing oxygen and suffocating, a struggle for something clear and definitive, preferring a sharp pain to the dull.

Grambo Is Dead, Part V

I was in high school at the time, and I was taking a Bible class, probably as a sophomore or junior. We were taught by a Dutch Reformed Protestant viewpoint, and told that God fulfilled His will everyday, and that this was our fate, inescapable. One student, or perhaps it was me, asked, "Why then do we pray if it won't make a difference?"

My Bible teacher, Dr. Trout, replied because God loves hearing from His believers.

But if you listen carefully, you can concede that nothing in life matters--you are predestined to go to hell, or heaven, depending on some weird Godly luck, and then your death is written in some big book in the sky, you can't access it, you can't read it, but God knows. He allows the sinner to wallow in sin. He punishes according to some Master Plan, and often people don't get what they deserve, although this fact of life appalls us, and causes us to lay blame on anyone in our path.

I wrote a short essay during Creative Writing class on Monday about my grandmother, and I described my uncle as a "coward." To me, he is. He could have visited his mother more often, but he was unable to reach closure with her, to mend that relationship, and he is suffering now because of it, although I aptly warned him to settle things months ago. He lacked the emotional maturity. I'm being harsh and judgmental, but I feel that I am right. He contributed to their conflict, although I've never heard him admit such. And if I'm being honest, there were times when my grandmother and I shared harsh words, especially this past year. My grandmother would ask me, "Are you mad at me?" Not remembering our last conversation or even what she said. I, too, lacked the fortitude to deal with her on a daily basis. Her mood swings disrupted my entire emotional balance. I told my mother that unless something changed while Grandma visited, that I was going to move out, and live in County housing like my case manager wanted. Would I have done a much better job than my uncle? Probably not.

Grambo is Dead, Part IV

My mother is bending down to tie her own shoes, and as she's leaning over, she says, "Grandma is in a better place now. She's with her mom and her dad."

I can't tell if she really means it or wants to believe it or just wants me to believe it. Of course, I don't. I'm a materialist. I don't even submit to the idea of having a soul. We're just a long train of biochemical reactions. I find the idea of free will hard to defend, although not for religious reasons. Perhaps I believe more in deism, that God is there, but He just leaves the world to run on the premise of physical laws and chemical principles, and the other elements of natural order. But does He love us? Clings us to His bosom? Does He breathe everlasting life into us?

Grambo Is Dead, Part III

I have been throwing up, without fever or chills. I know it's not opiate withdrawal because I have been taking that somewhat regularly, and it's not correlated with any drinking I'm doing (I haven't had more than a glass of wine at one time). My mother has said that it's caused by the stress of my grandmother dying.

One thing that struck me hard was how my friends reacted to the news of my grandmother passing. Lucky happened to message me on Facebook on the day I found out. He said "I'm sorry" and then went on talking about himself, as if that was all anyone needed to say. The Advisor sent a TXT-message, saying, "Hope it was an easy trip." I hope too that my grandmother didn't needlessly suffer, but nevertheless, it sounded odd to me. The LSU Professor initially expressed concern for my mother, not talking at all about my feelings on the subject (he later said he was concerned about me, multiple times, over the phone).

Probably the people who handled it the best was obviously Amara, who TXT-messaged me all that day, as I ranted about my feelings, and Brandon, who sent a concerned email, and my other grandmother, who was genuinely worried about me. Harry also sent a caring TXT-message. Other people left wonderful notes on my Facebook page, and it was hugely meaningful to me--just to know that someone out there cared, people who I haven't spoken to directly in months or even in years.

What the Neurosurgeon Had to Say

I went to Santa Barbara to meet with a neurosurgeon who was highly recommended by my father. He had minor back surgery years ago, and it helped tremendously with his pain. In fact, rarely does my father ever complain of pain. That occupation is held by my mother and myself. One of us is always in physical pain. Mother suffers in the mornings and afternoons, and I suffer in the evenings.

The Neurosurgeon told me directly that surgery would not help my pain. He said he didn't know for sure if the herniated disc was causing pain, but it probably wasn't the major contributor. I have pain in other places that are unexplainable (if you just look at a MRI), and also I have peripheral neuropathy, which is not helped by anything other than CBT (cognitive-behavorial theory) and drugs like gabapentin and Cymbalta and sometimes opiates. He ordered an MRI for my cervical and thoracic spine, although the Neurosurgeon mentioned that it was likely to come back relatively normal. However, he wanted to rule some things out.

The vast majority of his argument had to do with what's called "central sensitization," which is basically how the brain processes and reacts to the pain signal. Initially, pain is sent to the medulla, and from there it goes to the high functions of the brain because pain is one part stimulus, but it is also an emotional phenomenon. And it's that emotional component that is probably the most difficult to treat. People with depression and/or anxiety interpret and experience pain differently than the normal population. The Neuorsurgeon spoke to all of this, and I eagerly sounded back with bits of learning I've gathered over the past month (I had a very rudimentary understanding of the nervous system). The Neurosurgeon said that while he was concerned about the psychosomatic aspect of the pain (how my disorder interacts with pain), he knows that it's no less real--it's just that surgery at this point won't help at all. He mentioned a man in LA who he sends patients to when he can't help them, and he also mentioned going to the Stanford Pain Clinic and potentially seeing Dr. Sean Mackey (I've listened to a couple of his lectures), who is constantly doing research on chronic, noncancer pain.

The Neurosurgeon didn't see any problem in taking a couple of Norco's a day. He said he would call me when the results of the other MRI's come in.

He's probably one of the best doctors I've ever met. 

The Neurologist is concerned that I have some type of demyelinating disease, and in a couple of weeks, she's doing a nerve conduction test on me with hopes of finding what neurons are affected. 

Grambo is Dead, Part II

Heading to school with Beck in the backseat, I was talking to my mother.

"I don't understand why she didn't just call you...I understand her not wanting to call me...but why not you?" My mother says, her voice heavy with emotion, and that troublemaker, the ol' guilt.

Grandma never called me, or at least it was so rare, I can't remember her ever doing it. The day she went to the ER because of chest pains--I had happened to call her that evening, right before my calculus class. It was just pure luck on my part. She told me about her chest pain, and asked what she should do. I, of course, freaked out, and drove immediately to Ridgecrest after explaining that she needed to go to the ER right now. It was that day that we found out she was diabetic.

Over the past year or even more, both my mother and my uncle made extensive efforts to call her on a frequent basis, only she never answered. After a while, she didn't pay her Mediacom bill, so her house phone was turned off, even though her cellphone bill was directly coming out of one of her bank accounts--so it always worked. But she didn't pick up her little flip phone either. A few times, over the months, my uncle and my mother called the police to do a "wellness check," and at one point, a few months ago, my mother rang the police with the specific purpose of them picking up Grandma on a 5150 because Mom suspected Grandma was "gravely disabled" (the police disagreed, and never did anything).

I told my mother today that I am guilty of "inaction." I wanted to have my grandmother conserved as early as December of last year, but I didn't follow through on that for a variety of reasons--one, my mother was venomously against it, two, it would cost several thousand dollars, money I didn't have, and three, the last time Grandma visited her GP, the doctor told me that Grandma wasn't disabled enough to merit such a drastic measure--that Grandma was in no "danger of eminent death" (she died about three to four months later, anyway), and lastly four, was I really ready to take care of my grandmother's health full time while I was barely hanging on to my own recovery (My mother thought it would be too much stress for me, just a few days ago, she called me "fragile")? The problem was, someone had to take care of her, and out of everyone in our family, she liked me the best. She expressed to me the last time that I saw her that she wanted to move to Yuppieville, and buy a condo where just the two of us could live since she made it clear to me that she did not want to live with my mother or her son. Such a solution would have been possible, at least for the next two years, but eventually, I have to leave Yuppieville because I'm planning on going to grad school.

My uncle is dealing with similar feelings of guilt, and from the TXT-messages I've seen of him talking to my mother, he is undergoing a huge emotional blow, with massive feelings of regret. While I do blame my uncle to a certain extent (he's the only one retired, and he had a new truck that could easily make the trip, two qualifications that I currently do not have) because he should have made a larger effort to go see her these past six months, but honestly, my grandmother refused to live with him, so he can't be held accountable for grandmother's nasty attitude. She had delusions concerning him that he stole her truck, that he ripped out a phone in her house, that he stole her TV (actually he bought her a bigger, nicer TV), and that he was violent when he lost his temper (he probably was at some point in his life).

My grandmother only told me that my mother was "too high strung," and that she didn't like being around her for large portions of time, and that my other grandmother irritated her, and Grandma refused to live with Grandma J for any length of time.

Over the weekend, my uncle threw a fit, and demanded that he and my mother and one of my cousins go to Ridgecrest, and clean up the house. Grandma was probably dead for days before anyone bothered to call the police. In fact, we're not sure who called the police or why. Apparently the smell in the house is unbearable, and my father couldn't walk inside, he was so taken back. There are large amounts of dead flies all over the floor. My mother told me that the carpet will have to be replaced, as the smell of death has permeated it. My uncle apparently was emotionally wrecked, and that only my cousin and my mother worked on cleaning the house. My mother, for good reasons, suggested to everyone that we just pay a professional to clean up the mess that dead people leave, but my uncle didn't want to pay the money. I told my mother before she left that seeing the house in that kind of shape could be highly traumatizing. She said that she conveyed similar to my uncle.

He just didn't listen. Just a day after he found out his mother was dead, he had to drive to Bakersfield to start the funeral arraignments. I mean, can't we just grieve for one fucking second before we get in a hurry to put her in the ground?

My mother told me today that Grandma "just gave up [on living]." I know my grandmother was a victim of learned helplessness, and of catastrophizing, two gateways to depression. Last time I visited her, she frequently told me that her "life couldn't get any worse" (actually, it can, try diabetic neuropathy, or a large stroke, etc). Despite this, she refused to let me help her by taking her to a doctor and getting some help for her chronic pain. She wanted nothing to do with it.

Grambo is Dead

Apologies to Amara, who I promised an entry days ago.

***

Today, while I was doing some weight training, I dropped a twenty-five pound disk on my foot, which now is swollen and has some zig-zag mark across the top of it.

***

Mom told me to sit down on the bed.

"What?" I thought this was some family intervention about my drug use, you know, a kind, concerned lecture about the dangers of addiction. She did look concerned.

"Sit down."

"The dog is in the way." There's the weaner, swagging her tail ferociously.

"Move her."

So, I sit down.

"I have some bad news about grandma."

I think that maybe she's just in the hospital, and it's interesting that we both know which grandma we're talking about.

"She passed away."

I put my head in my hands, and say, "I fucking knew it!" I leave the room, and go into my bedroom, where I start sobbing hysterically. This is, of course, the grandmother with dementia, who refused to move in with either my mother or her son, my uncle once it became obvious that she was sick.

She's gone.

I had been planning to visit her, but she lives in the desert, and my SUV needs a new radiator. My parents didn't think it would be wise to travel all that way in something as worn as my Mazda. The engine might overheat. I didn't have the money to replace the radiator until Tuesday of this week. So, I just didn't go. Weeks had passed since anyone had stopped by her house, then it became months. There are other family members who could have gone--but they didn't. Grandma made everyone around her upset and angry. No one really wanted to go. Even I was constantly consumed by the ideas that I really couldn't help her beyond driving her around, and paying her bills, using her checkbook, and assuming her identity. Her illness made her think that she wasn't sick, that she didn't need anyone to help her--that in fact, some of us were plotting against her in some degree or another.

The New Semester

My political science professor is a lawyer with a law practice a few towns to the south. He's probably the most lively character so far this semester.

I asked him before class if Beck, who was resting at the head of the room, if she was in the way.

He answered curtly, "Probably."

Days later, I sent him an email, letting him know ahead of time that I would miss class by driving to Palo Alto. In turn, he called me, although I'm not entirely sure how he got my cellphone number, which might just be in my student information that he can access. I figured he would be friendly since he went out of his way to personally call me, but instead, he was rather direct and to-the-point.

After mentioning a few recent political events, bits of news, he turned to me during class, and said, "I know you're going to read."

In his syllabus, he requires or recommends that we read the newspapers. I'm sort of ahead of the curve on that.

A Lot of Norco?

My GP called me today, and left a message, saying that he would refill my Norco prescription but that I'm "taking a lot of Norco" (which, in my humble opinion and from the research I've read--I'm not), and that he's concerned that I'm developing a dependency.

I guess, I can't come up with some kind of response without being condescending. I realize a little bit of knowledge (like I've obtained about opioid addiction and the physiology of chronic pain) is dangerous, making us think we know more than we actually do (I'm sure I've mentioned this phenomenon before). However, dependency is different from addiction, and dependency doesn't mean misuse or abuse; in fact, it's almost always happens with continued opioid use. Do I have a physical dependency? No, because I can go off of it, and suffer no ill-effects or withdrawal symptoms.

Tardive dyskinesia

On Wednesday while at Stanford Psychiatric Outpatient Clinic, I was diagnosed with tardive dyskinesia because I have a minor twitch on my mouth, close to my lips. This is caused by antipsychotic medications, although it's at all possible that the twitch is from some other disorder.