Today I pulled out the planner where I'd written my assignment list, full of lab reports that need to be written and topographic maps that need to be sketched, and then I put it away again without opening it. All fall semester I had faithfully completed each task I wrote down in my planner, and then put a little checkmark next to each one, and when spring semester opened I copied down each assignment, next to its due date, from every syllabus I'd received. But I haven't made any little checkmarks for two weeks now, because I haven't been going to class and I haven't been doing my homework, and I haven't been leaving my apartment except once, four days ago, when I left to get something to eat because the box of Froot Loops that had kept me going for ten days had finally gone empty. Today I got out from under the blankets where I've spent the last two weeks and sat down at my desk, promising myself that I would get some work done so I could start going back to class. I pulled out my planner to see what needed to be done, but I found that I couldn't stand the idea of facing two weeks' worth of assignments with no little checkmarks next to them, so I put away my planner without opening it, got back under the blankets and went to sleep.

Tomorrow I'll probably withdraw from the university and pick up a job application from the Chipotle on Jaggard Avenue, or else I'll jump out the window. On second thought, I'll probably do neither of these things, because they both would require courage. I'll probably turn in some half-assed work by the weekend and struggle through the rest of the semester to finish with a 2.5 or so.

I fired my therapist yesterday.

Well, more laid him off. It wasn't for immediate cause, but because therapy's inability to make a dent in my mental state made his position redundant. I don't think this is his fault - he's a smart guy, he was honest with me, and he tried a variety of different approaches. At the end, however, he settled into what I consider one of the really unforgivable assumptions of the New York therapy model - the notion that long-term therapy, measured in a duration of years and years, is an acceptable and effective option for someone like me.

News flash: It fucking isn't. For so many reasons, not least of which that insurance had told me they weren't going to pay for most of it and I couldn't afford it, really, at all. I'd been sucking up the debt since around June, when the insurance company cut me off, because I felt that abandoning the treatment just because they decided it wasn't cost-effective was a bad idea. But six months later, I'm forced to admit that I don't feel I have received really any benefit over the past two years, and continuing the therapy would just plunge me fairly deeply into debt (whereas when I started, two years ago, I had a fairly comfortable chunk of savings I was willing to allocate to the attempt). I'm not saying therapy alone drained my coffers, but it surely hasn't helped, and I still owe the man for several months of treatment. I'm obviously going to pay him, but I couldn't afford to let that number continue to rise.

His primary argument against me quitting was always "what other option do you have?" My counter-argument is "None, but I can't afford to choose this one anymore." I don't think he was charging me unfairly; based on what I know about New York psychiatry, he was being quite reasonable with his charges - but the whole model is so fucking broken that it doesn't matter how reasonable he was being, I (as a 99%er) can't fucking afford it. If I had felt it was making a significant difference, I might have been willing to sacrifice my fiscal well-being (and it probably would have been the right move) but it wasn't, so I wasn't.

What's really sad to me is that I think he was genuinely trying his best, but he ran up against the same thing I've run up against time and time again - modern psychiatry really has a shallow and fairly pathetic bag of tools. Not, like some will tell you, because they are charlatans; not because they don't care - but because the science of the human mind (not brain, mind) is so poorly developed that they're basically reduced to trying the equivalent of leeches and cupping. Modern psychopharmacology and an actual scientific method (people think psychiatry doesn't have a scientific basis, but they're wrong, generally - it's the tools that are lacking, not the method) means that they do have a bag of tricks they can go through other than the incredibly fuzzy talk therapy genre. They will, too. I've been on more drugs and drug combinations than I can count. The reason I don't feel betrayed by the profession is because with one exception, my therapist has always observed me carefully and said "No, this isn't working" and taken me off them again. The one exception was Zoloft, which actually did work for me for a few years and pulled me out of a dark place, but eventually (as apparently can happen to many) lost its effectiveness.

So what now?

I really have no idea. I have no idea what to try next. I have had people suggest all kind of pseudoscientific or even completely woo-based bullshit to me - well-meaning people, I mean - but I won't do that kind of shit, because that would mean fundamentally violating some of my deepest-held tenets.

The Daylog: 14-Feb-2012

W/us By Type says 19 new nodes were posted to Everything2 on Feb-14-2012. Enough that I didn't have time to read them all (an uncommon occurrence, currently). Among them:

Dr. doyle noded another of his signature w/us on simple biology, this time on the subject of Malt:

Malted barley has undergone rigorous biochemical analysis because beer matters. Throw unmalted barley into a pot of boiling water, and you have hot mush. Throw malted barley in hot water, holding it at certain temperatures for a bit of time, and now you are mashing, on your way to making a fine wort, the mother of beer.

If you want to understand mashing, bear with me--a teeny bit of biochemistry follows ...

One of the Great Old Ones of primordial Everything, rp, chimed in with two new definition nodes. One of them-- ideolexicalization, a made-up word to describe the act of making up your own words-- proved quite charming and gained 2C!s

decoy hunches submitted a writeup on the album Combustication by jazz trio Medesky, Martin, and Wood that tweaked my interest enough to make me want to seek it out myself. If you're a Spotify user, you can listen to the album here:
http://open.spotify.com/user/mwkelley/playlist/25Y6D9kBWRsFTL2cvvOQOU
(You're right, dude. This is quite good.)

Jet-Poop contributed a small, tidy bio on Bram Stoker, Zephronias added a Valentine's Day prequel to The life and times of a fallen angel, teleny had two nodes about colonial U.S. glasswork, and three noders added poems. My favorite of the three was the one by brand-new noder rosetinted: It would have been an excellent story but I had to get off the train

listen to the planes circle home
(spiral skies in an endless flight)
listen to the rains falling shorewards
(sound of waves in the harbor night) ...

The joy of these was somewhat lessened by the pain of four frankly harrowing daylogs about depression (from The Custodian and first-time noder massey), chronic pain (by corvus) and, less seriously, computer woes (by BranRainey). Please send some love to these folks, noders. You know how I worry.

Rounding out the rest: a w/u by Pandeism Fish on something called Omnietheism that I honestly could not make heads or tails of, and a short story about love on the subway by jmpz. What'd I forget?

Another year with Thoracic Outlet Syndrome


Elsewhere on this site I have written about living with the chronic pain caused by Thoracic Outlet Syndrome (TOS). Since 2001-2002, my particular incarnation of TOS has caused dramatic changes in my life. Like most young Americans, by the time I graduated from college I felt like my life had really started to come together. I was married, beginning a new professional career with a lot of growth opportunities and promise, and reasonably sound of body and mind. But as I have already discussed, the first couple of years out of college began a nightmarish descent into a labyrinth of doctors' offices, pharmacies, physical therapists, and medical tests. By 2004 I had lost not only my job but my original career, the strain of the previous two years had significantly contributed to my divorce, and my finances were in shambles after having to pay thousands of dollars for an unsuccessful surgery.

In the second half of the decade, I slowly rebuilt my life. I largely removed the things that caused me the most pain from my regular schedule. Though still requiring arm braces to drive the car, I minimized computer use at home and work, and removed high-impact activities like golfing, bowling, playing guitar, and playing video games so that my arms would hurt less. A progression of jobs allowed me to step back into an office environment. From teaching, to surveying, to community planning, until I finally landed a position for a defense contractor. This position utilized voice recognition software, pen tablets, arm braces, and a liberal amount of understanding from my supervisor to allow me to use the computer on a daily basis. In my personal life, I began to take better care of my body, and crawled out of a significant depression that allowed me to be more positive. I met my wife, and eventually we had a daughter. I even started participating in Everything2 again, though in a limited degree.

By 2011, I began to believe that I was starting to recover, if not physically, at least mentally and socially from the impairment of having Thoracic Outlet Syndrome. But that optimism has diminished recently. Over the last year, work has required greater and greater computer involvement from me directly. This is because at some point I became a civil servant responsible for software development, and that software had an aggressive development cycle in the past few months that recently culminated in its first public release under my watch. Additionally, last summer I finally picked up a smartphone thinking that the touchscreen would allow me to use the Internet without any of the pain associated with regular computers. But over time the sliding and tapping has contributed to renewed pain throughout my arms together with the much higher computer use at work. During this time, I have sought hobbies that do not affect my arms but even those, like playing card games, are no longer available to me. Shuffling a deck of cards now causes instant pain. One of the other methods I have tried to allow me to use the Internet for e-mail, social media, and all the other variety of uses my generation has for it was to get an iPad. Like the smartphone, my initial plan was that the touch screen could replace regular computer usage. And for several months that was how I accessed this website, but now it hurts too much.

A few weeks ago I decided I need to return to a more spartan like existence in relation to my arms. I have not been able to check Facebook, or any of the websites I have frequented in the past. Last night my wife checked my messages on the site for me here, but it had been a few weeks since I have been able to log in on my own. I have stopped playing in my weekly card game, and also at lunch with my friends. Any number of household chores involving torque or tension on my wrists, elbows, or shoulder have fallen by the wayside. Instead of any of these things, I'm trying to spend my free time reading trade paperback books (because of the large soft spines), and not much else. I have a first doctor's appointment in over a year scheduled for the end of this month. The last time I saw him, he had just verified that at this point little could be done outside of pain medication or generic exercise to relieve tension. Essentially, I am like this for the long haul. I'm returning this time in an attempt to discover some new treatment or surgery. Maybe they can inject cortisone straight into the scar tissue, which I can feel as a large knotty mass just above my collarbone. I don't know.

I'm sorry for the down tone of this node, especially on Valentine's Day. It is hard to say what kind of effort and how many years it took me to begin being positive again, and I have tried to reflect that in some of my other writings on the site, but some days it is a tough row to hoe, as my grandparents say. Some days hope is hard to come by when I worry about providing for my three-year-old daughter, about losing another career, about how the stress and pain can poison the relationship I have with my wife if I am not extremely careful. But I miss participating here, because if nothing else this place has often proved therapeutic, and has given me an outlet for my energies.

Congratulations to Jay. I am pleased that the ownership issue seems to be resolved, and I look forward to seeing the direction he takes us. I'm going to try and continue using moments to capture writeups with the voice recognition software, but I just don't know how frequently that will happen this coming Spring. I'm almost certainly not going to be able to respond to messages for quite some time. I hope and pray that you are all well, and I hope too that each of you has someone to love on this day.

Happy Valentine's Day,
corvus

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