This post is in two parts, the same story, told with different but parallel focus.

***

Once my endometriosis was diagnosed, my gynecologist said that my best choice for treatment was an injection called Lupron Depot.

Because the endometriosis small and diffuse, surgery was not an option — there were no large masses that could simply be cut out — rather, it was more like a thin layer covering everything in spots.

Lupron is a gonadotropin-releasing hormone antagonist; it is used for a variety of things including chemical castration of male sex offenders. In women with certain reproductive conditions, it works by stopping the production of the hormone estrogen in the body. Estrogen is what tells the endometrium to grow, and therefore what inflames the endometrial implants outside the uterus. Therefore, by stopping the production of estrogen for a set time — six months; twelve if the first six were unsuccessful — you would hope to shrink the implants that are already there. Essentially, what you are doing is inducing a six-month menopause.

Lupron is not aspirin. It is not a trivial drug. It makes serious changes to your body. Most women do not finish the full six months. I did, and the nurses were genuinely impressed when I came in for my last shot. None of their patients had ever taken a full round before.

And if the pain comes back immediately after stopping — which, in me, it did — they want you to go a second six-month round. (That is the limit due to risk of developing osteoporosis.)

Honestly — I kind of want to know the women who actually made it through twelve months of that drug, if my nurses had never seen anyone make it the first six.

It was not a fun six months. At all. (This is how it felt in real time.) I earned six months without any periods (I would have gone through one or two in that time on my birth control, so it wasn’t a huge benefit) and a couple months’ reprieve from the pain. In exchange, I went through numerous side effects, from the awful spasms, dizziness, fainting and tremors to considerable hair loss to hot flashes and uncontrollable sweating to sudden overwhelming nausea to weight gain.

And now, ten months after stopping the treatment? I wish I’d never done it.

I didn’t start birth control until age 19. Until that time, I was letting my body go through its natural cycle. Which must have been brimming with estrogen, because the pain was bad. It kept me out of school at least 1-2 days a month for period pain alone (before we even consider my fibromyalgia). It is by far the worst pain I have ever experienced — even with the awful migraines I get where, literally, a twitch (anywhere) causes so much pain throughout the body that I want to scream, but the movement and force required to make any sound at all would hurt just as much — so I stay stiff and silent and suffer until there’s enough of a window to down some pain meds.

The cramps I get on my “natural” (no hormonal medications) period — the pain comes in waves, crashing over me, exploding through every ligament and nerve in my body, rolling up and down the length of my torso. I spent many days in the fetal position on the floor of the bathroom, wishing I could just cease to exist right then and there, in too much pain for the thoughts to ever get as far as “movement to make it happen.”

And, well, suffice to say it affected the bathroom cycle too. I’ll leave it at that.

The pain, even in between cramps, is bad enough that I could not sit upright for more than maybe an hour’s total time throughout the entire first day — I was either in bed, on the couch, on the floor, or lying down in a chair in front of the computer. And the rest of the week, it was difficult to stand upright and walk — I needed to reach out a lot for balance; I couldn’t straighten my back it hurt too bad. There was this intense heavy pain in the muscles of my upper legs. And I needed heat — bad — any cold or dampness felt like my blood was turning to acid and eating me inside out. I reveled in the sun; I couldn’t leave the house without heating pads; I sat down under the hot hot water in the shower. Wintertime (which, in central California, got as low as the 40s during the day, but was damp and moist with fog) was excruciating.

I went through all of this approximately one week (or a little more) out of every month in my adolescent life. And this is all ignoring the actual period.

When I got on birth control — after a brief period on a tricyclic medication (Ortho Tri-Cyclin Lo), which made me break out in painful cystic acne and left me irritable enough that a fly could be cause for an angry breakdown — things settled down somewhat — especially after a kind gynecologist prescribed a low-dose monocyclic pill (Mircette) continuously; that is, skip the placebo week in the pack, taking four packs in a row before allowing that period week. That meant one period every three months, and a lightened period at that — it was still very painful, but not suicidal-thought-inducing painful like it was “naturally.” And during the twelve weeks on the hormones, I was mostly free of the continual lower abdomen/pelvic area pain that I suffered even between periods on my “natural” cycle.

I stayed like this until the beginning of last year, when the lower back/pelvic pain set in to stay, leading to the diagnosis of endometriosis and the Lupron treatment.

And after the Lupron, now — back on that same low-dose pill, taken continuously — I am going through pain that is far closer to my “natural” cycle pain than to the pain I went through for the three years prior to the Lupron. I am having cramps that sometimes keep me from being able to move to get out of bed in the morning and sometimes hurt so bad I have to get up because it hurts too much lying down. The back pain continues; my methods of treatment are definitely helping considerably, but the pain is more persistent and more severe than it was last year. My, um, “bathroom cycle” — which was relieved of pain completely during the three pre-Lupron birth control years — has returned to the cycle I had before I ever started hormone treatment. The only thing that hasn’t returned is that lead-like pain in my leg muscles, that acid-blood feeling.

And it is frustrating me. I wish I had never started the Lupron in the first place. I read up on it before agreeing to take it, and I knew there were a lot of horror stories and a lot of women really, really hated it. But what other treatment did I have? this seemed like something that — even if it was difficult during — would make a difference in the long run. So I did it, and I stuck it out, because how would I know what good it could do if I quit?

I don’t know if maybe it’s because I spent that six months estrogen-free, and now I am on a pill which, though low-dose, does contain estrogen — so suddenly my body is feeling an increase in estrogen, thereby causing more inflammation and therefore more pain. I have no idea; I do my research but I am still a layperson. But there can be no argument that my situation is considerably worse than it was before I went through the Lupron. And it’s been this way for ten months. This is no mere readjustment.

***

Next post: on the visible physical changes, body-image adjustment and dysmorphia.

[I am having with the WordPress backend and cannot paste the full post here. Once I get WP upgraded I'll put the post here as well. Visit Feministe to see the post for now.]

UPDATE, July 7: Via Lauredhel, the FDA has made a decision regarding pain pills Darvon and Darvocet, which are pain killers containing a different ingredient (propoxyphene, a pain killing ingredient related to methadone but less addicting) with similar concerns (accidental overdose). They have decided against a ban, but are imposing stronger warnings on the products.

The reason they give, at the end of the article: “the benefits of using the medication for pain relief at recommended doses outweighs the safety risks at this time.” If nothing else, it is somewhat encouraging. If this is their thinking on Darvon/Darvocet, we can hope that similar thinking will guide their decision on Vicodin/Percocet.

***

And according to the New York Times, the FDA

… is not required to follow the recommendations of its advisory panels, but it usually does.

Emphasis mine. In other words: the ball is rolling.

Vicodin and Percocet are two commonly-prescribed narcotic painkillers. They combine hydrocodone or oxycodone (respectively), the narcotic agent, with acetaminophen, brand name Tylenol.

Acetaminophen is coming under fire because abuse of the drug can lead to liver damage. The safe limit for acetaminophen has generally been regarded as 4,000mg per day. That translates to two extra-strength Tylenol (500mg each), four times a day (eight pills total). The dose of acetaminophen in various combination drugs varies, usually 325mg but ranging up to 750mg.

The panel voted against a ban on over-the-counter cold, flu and sinus relief medications, the vast majority which contain acetaminophen. Apparently these medications aren’t a concern, despite containing just as much acetaminophen and being available over-the-counter, where consumers do not have a doctor and pharmacist counseling them on how to take the medication.

After getting kicked off my low-income health insurance at age 18, going several years uninsured and uninsurable, sticking out the 24 month wait after being approved for Social Security disability payments before I could join Medicare, and then losing those payments and that Medicare because I had the temerity to get married (according to our system, my husband is not an equal partner but, because I am disabled, my expected caretaker, thus removing the burden of care from the state), I finally got a taste of the insurance all those class-privileged people have — you know, employer-based insurance (that actually is insurance and not those fake “discount plans” or “you can pay us a premium, but we don’t actually cover anything a human being might need” scam plans that low-skill employers offer to give the appearance of being socially conscious).

I am lucky that my husband is employed by the state, and represented by a strong union, so his health care benefits are good.

I was upset when I had to transition from one side of provided-by-the-state care to the other, because it was considerable work for me and for my health care providers, but over time I have come to be immensely grateful for my husband’s benefits. Rather than filling 30-day supplies of my medications at retail pharmacies and, every month, running into some hang-up or another that left me without one of my medications, or having to space out my medications, for days or weeks at a time, I now receive all but one of my medications in full 90-day supplies (including four packs of birth control pills, not three!) with no hassle. I order the medications online, and if the prescription is run out, my doctor is notified, and he sends a new one in electronically, and everything proceeds as normal. My medications arrive in the mail within days. It is the easiest it has ever been for me.

So now I am free of what was probably the biggest burden I had to bear in obtaining reliable health care. The only medication I still receive a 30-day supply for is my Vicodin, which is not considered a “maintenance medication” (despite filling the same function as my Lyrica, tramadol, Effexor, cyclobenzaprine and Mircette) and thus must be filled retail. Even that process has been considerably smoothed since the insurance switch, though not devoid of problems entirely.

And now I never have to deal with obtaining a referral for anything that wasn’t a yearly checkup with my general provider. And I have a single insurer, rather than feeling guilty every time I handed over my four insurance cards to my doctors (my retail employer’s scammy discount non-plan, my Medicare plan, the separate HMO for my MAWD and then the MAWD itself) and knowing the billing hell they were going through just to get payment for their services.

Alas, though: my troubles are not over. My husband’s insurer, like so many other employer-based insurance groups, has become enamored of these “incentive programs” that are supposed to, you know, “provice incentives” for patients to “lead a healthier lifestyle!” Mainstream conservatives and liberals alike seem to love these things. It’s a way to pretend you’re addressing the God-awful fucked-up shabby mess that is the American health care system and its soaring costs, but without actually, you know, doing anything to make these patients healthier. Actually paying for the health care they could use? Pfah! No, just “incentivize” them to exercise more or stop smoking.

These “incentive” programs, more often than not, do not take the form of an actual positive incentive for such “good” behavior. More often, patients feel the effect of a negative punishment for not being the Super Fit And Healthy Ideal Able Body. They end up paying more in health care premiums (by losing out on a “discount” for being a successful participant) or losing their health insurance altogether. Or, they simply feel the burden of having to jump through hoops no able-normative person would ever have to — the second shift for the sick.

These incentive programs would not be worth the money and effort if there were not a stick behind that carrot, a way to enforce good health on the people. It should go without saying: health is not something that should be enforced.

My husband’s ensurer has a yearly health survey that all participants — including every covered family member — must participate in to be eligible for the lower premium. This is not a five minute survey; it is fairly involved. And I am always nervous about answering questions from my health insurance provider: more often than not, when I inform them of this problem or that — even those insignificant in the grand scheme of things — it results in a loss of coverage, increased cost, or additional steps I must complete to continue receiving the care that I do.

This nervousness comes, especially, from my time spent uninsurable on the individual market due to preexisting condition. When I was younger, I created and held steadfast to a very important rule with my own family: Information Equals Ammunition. In the insurance market, this rule is sadly just as applicable.

Every year, after taking the survey, my husband is informed that he is dangerously underweight and action needs to be taken to correct this state of being. My husband is 5′9″ tall and weighs around 120lbs. This is his natural state. He eats a healthy diet, he walks to work and back every day and gets a fair amount of exercise beside that. He inherited his very lanky body frame from his mother, who is even skinnier than he, and jokes that when she was pregnant she never actually gained weight; at the end of her pregnancies, she looked just like she does now, but with a basketball contained in her tum.

When my husband played football in high school, he was actively trying to gain weight both through diet and muscle-building exercise — and he plateaued at 140lbs. Now that he is not weight-lifting on a regular basis, he hovers around 120lb. This is a BMI of 17.7, barely more than I weighed when I was a teenager — the difference being that I was significantly undernourished, and he was more-than-properly-taken-care-of.

So once a year, he gets yelled at a bit about his weight. He is healthy in literally every other way, his one and only health concern being a minor bit of TMJ pain which he now has completely under control. But he does not fit the widely-understood able-bodied “norm,” and so Something Must Be Done!

I take the same survey, and of course I am provided with tips for stress reduction and admonishment to see a pain specialist. I am now very slightly overweight, so of course I am also admonished to “park further away!” and “take the steps instead of the elevator!”

Recently, I have been receiving messages on our home phone from our insurance company, encouraging me to call them for the opportunity to participate in an unnamed program, for unnamed rewards. These messages piss me off, so I ignore them, even though I know there is a strong possibility that it might mean our premiums would go up. I planned to contact them at some point or another, but it was not high on my list of priorities, and still they kept calling every other day.

Then I received a letter, in a tone that can only be described as a lament, that I had not responded and would I please pretty please call them, this time finally informing me that it was for their “Healthy Back Program.” Oh great, I thought. And I caved in and called.

The woman who answered gave me the spiel I expected. And my reply, in a sweet voice, was (closely paraphrased): “Yes, I have chronic pain from fibromyalgia and endometriosis,” and she replied with a somewhat disappointed “Oh” — but I interrupted to continue: “I went in last year for lower back pain, and I spent the entire year going through various programs and treatments to help it. I had to go under for a laparoscopy which led to being diagnosed with endometriosis, and I’ve now been through physical therapy and even have a personal TENS unit to address the pain.”

“Well, unfortunately that means you are not eligible for our program, because your pain is chronic…”

Mm-hm. I am sure you can hear my disappointment.

This is the same health insurance company which paid for all these tests and treatments and has on record exactly what my condition is, what the background is, what medications I am on and which treatments I am partaking in. I provided this information in the health survey. It is very clear that I have chronic pain conditions. But because I even mentioned low back pain — a common focal point for people who like to cry about “overdiagnosis” and “overtreatment” — I was immediately flagged and referred to this oh-so-special program.

It’s just one more little thing I have to fend off to be able to continue on my treatment course. Just like every time I visit a new doctor, counselor or other practitioner and have to patiently go over every disclaimer about why I am on this Vicodin and why I have this symptom and why this and why that, and that yes I am being closely monitored by competent doctors and am following my treatment course as prescribed would you please leave me the fuck alone so we can get on with things.

And it’s exhausting, always having to be at-the-ready to explain these things. It’s just exhausting in a way that no able-normative person will ever fully understand, period, and I am confident in asserting this. It just drains you, even though each of these encounters is small and relatively easy when considered individually. But it accumulates, it weighs on you, and the knowledge that you always have more to come — that is the worst of it.

This is what people with disabilities go through in a health-obsessed culture, a culture that sees personal health as a responsibility to the collective, and any person who in any way deviates from the designated health “norm” (which changes regularly and is not as science-and-reason-based as these people like to think) is failing their family, community and nation, that they are dragging them down — being a burden.

And we all know what the result is when disability, or any health abnormality, is constructed as a burden.

It was a last-minute decision Friday night. My husband snagged two tickets to the Penguins-Capitals games at Verizon Center in Washington, DC and the next morning we started the five hour drive.

It was a great experience — I love the DC area and I was excited to go back. But five hours in a car makes for stiff muscles, and I was already dealing with some endo flareup. So I was dealing with spasms and pain even with my TENS on (here’s the trick: if you have a big bag, security doesn’t bother patting you down when you enter) and more painkillers than I should have taken.

We had nosebleed seats but whatever, they were seats. It was a great game, even though we lost. It’s hard not to enjoy an NHL playoff game. Especially being able to whisper at each other about the clueless fans behind us who had several amusing misconceptions about how the game is played. (It’s fairly doubtful that the linesmen are biased in calling off-sides. It’s one of the most objective and least arguable calls there is. But “they only ever seem to see ours!”)

Throughout the game, the people behind us kept tapping my shoulder and yelling at me for leaning forward. They “couldn’t see.” Of course, everyone else in the section was leaning forward, and I couldn’t see without doing it too. But most of all, my back was killing me, and doubling over stretches the muscles in a way that helps relieve some pain. (Ask mattw — I sleep in the same damn position.) I tried sitting back for part of the second period but couldn’t last.

After a few times of them tapping me, toward the end of the game, I turned around when they tapped again and stuttered, loudly, wide-eyed and annoyed, “I have a disability — in — back in a lot of pain –”

and they sneered and threw up their hands at me. So I turned back around.

I was steaming inside. I complained to mattw on our way out when the game was over, noting that my TENS was turned up all the way and I’d already taken way too much medicine. And when we reached the bottom of one escalator, the couple behind me tapped my shoulder and the middle-aged bearded guy said, with a smile, “They meant it nicely.”

There are several things going on here. We were wearing Penguins shirts at a Capitals game, and there’s a budding rivalry there. It’s a playoff game, and there’s the whole MVP debate going on (Malkin vs. Ovechkin), so of course it’s contentious. I severely doubt they would have bothered me if I’d been wearing red & blue rather than black & gold. So I understand it. All in good fun, in that respect. A little rivalry can make the sport more fun.

It’s a national sports game, though. At a huge arena. Some people pay attention to the game. Those people might lean left, right, forward, backward, so on. And as long as they aren’t standing up all the time, or wearing a very tall hat or something, that’s accepted, and you work around it. You lean one way or the other to get a better view. People move around as the puck moves around the ice to see better. You move too. And when things are really tense, they probably scoot closer to the edge of their seat and lean forward. So you do the same. And at the very end of the game, people often stand up. Which means you stand up too. IOW, it’s a rather ridiculous thing to complain about, no less multiple times, and angrily (not politely).

Finally, their reaction mattered. When I spilled out why I kept leaning forward, they didn’t do what I expected — look away awkwardly and quiet down as though nothing was ever said. I’m used to that. But instead, they kept gesturing and yelling at me.

That’s what’s so frustrating. It’s not respected at all. Or only respected for so long as it has to be — when you have any reason no matter how trivial to discount that person’s experience or opinion, respect goes out the window. People with disabilities are “protected” in this society only insofar as they are nonthreatening. And that protection is paternalism at its extreme. But that’s a separate issue. When they aren’t subjects of protection, they are objects of harassment.

It isn’t the worst case of harassment I’ve had related to my disabilities, but it bothered me.

Yes, that’s my bra strap. Why are bra straps so scandalous? OMG! That woman is wearing a… BRA! (faint)

My doctor is massaging my insurance companies to pay for me a good TENS unit.

I have been using the electrical stim at physical therapy for a little over a month and combined with some simply stretching exercises to help build strength and flexibility, my awful lower back pain is mostly gone. Woohoo!

My therapist sent me home with a loaner unit on Wednesday and I’ve been playing with it ever since. I love it. It takes some trial and error to get it to stick in the right places, but it’s helped quite a bit.

And it’s something I can have on my person at all times — not just at home (hard to keep a gel pack on my back all day) — that interrupts the pain signals, meaning I can reduce my pain killer use correspondingly. The fewer narcotics I take, the better. Especially with that full-time desk job I will be starting in a couple weeks.

But I am a naughty girl. I have been browsing Etsy for a cute and stylish case to carry it on my hip…

Welcome to the fatosphere, amandaw.

5′8″. 173lbs. BMI 26.3. Sizes 12 and 14 top and bottom. 38-34-44.

My habits have not changed. I eat the same shit I ate six months ago, and get the same amount of physical activity (trust me, that is carefully monitored). The only thing that’s changed is the shot in the ass I get once a month.

After my body settled down from puberty, I was 5′8″, 110lbs, 16.7 BMI, sizes 6 and 8, 32-25-36. I had no appetite and was visibly undernourished. Fending off accusations of anorexia, I would insist that “I’m not fat; I have fat.”

Just before I turned 19, I started on the Lyrica, which gave me a normal appetite. After about a year of slow and steady weight gain, my body settled in to 5′8″, 150lbs, 22.8 BMI, sizes 8 and 10, 34-30-40. And there my body stayed for just about three years.

Three years during which I lived a variety of lifestyles, to use the popular vernacular. I ran around college eating quite a bit; I ran around college eating almost nothing; I sat around my mother’s house eating fast food at least five times a week; I started working on my feet eating healthy portions of home-cooked family means (sandwiches, chicken, grains, pasta). And I stayed the same weight through all of that.

Last night, I went to a friend’s house to try on suits for an upcoming job interview. She used to work as a paralegal, so she had an abundance of suits. She is, well, the average American woman size-wise. She had several suits mostly in 10 and 12 but across a range of sizes.

I tried on every suit. I think there were seven or eight.

None of them fit.

OK — one fit… if I didn’t zip up the pants.

I was fucking humiliated.

I haven’t been able to fit my own jeans recently. I am fortunate that the only thing I’ve had to leave the house for recently has been physical therapy, so I’ve had official excuse to appear in public wearing sweat pants.

The friend was very helpful, and we ended up at Kohl’s where she bought me a fitting skirt, pair of pants, button-down top, and thong.

(Which makes her the first person to ever buy me underwear.)

I was not well. I had done far too much that day, to begin with: wake up early, physical therapy, driving to Canonsburg and back for aforementioned syringe in the ass, and shower, all without a single pain killer. I should have known to take one before going to the friend’s house, because trying on clothes always exhausts the hell out of me (I’d put it on the level of a long shower in terms of physical cost). But I didn’t until all the clothes-trying-on was done.

The physical consequences should be obvious, but something else happens when I’m in that kind of state. My brain goes blank. I am putting so much energy into staying awake, alert, upright, and minimally active that I don’t have any brain power to spare — to form coherent sentences, find the right word for the idea I am trying to express, offer responses that are relevant to the topic being discussed, or just plain make any sense.

Being social in this state is hard enough. It’s even harder when there’s the dark cloud of humiliation hovering over your head.

I looked myself in the mirror. I arched my back, sucked in my stomach, straightened my shoulders.

The gut didn’t go away.

God. I don’t know how to say this. It’s hard. It’s really hard. Up until recently I still saw myself as the skinny chick. My brain still thought it was stuck in the body I inhabited as a teenager.

And now? Now I’ve finally caught up: my brain feels like it’s stuck in the body I inhabited those three years prior to the Lupron.

I was OK, mostly, as I grew. I’ve been involved in fat acceptance for a while now, and body positivity has been a pet issue of mine for years and years; I trained myself to stop finding things to disparage, whether in myself or others, and instead find things to treasure. I accepted my fat rolls, and welcomed the substantiating of the tits. I admired my ass. I was building muscle; my thighs are thick and solid and I rather like them that way.

But now I can’t fit in my fucking clothes. And it’s fucking embarrassing.

***

I have a lot to deal with, personally. But right now I am fervently hoping that cessation of the Lupron will go hand-in-hand with shedding of the weight I’ve gained. I’m already damn sick  of it. The first month I suffered worse pain, dizziness and tremors and fainting spells; I had two months of reprieve after that, and in the last month the back pain came back like a boomerang and hit me in the ass, and brought with it cramping, nausea, and a scary amount of hair loss.

I have two months remaining. One more shot.

I’m scared. I’m scared I’m going to keep gaining. I’m scared there are some new and even more bizarre side effects in store. I’m scared that after the Lupron is done the pain will come right back. I’m scared it won’t have done anything.

I’m scared that all of this will be for nothing.

I’m scared that the Depo won’t do my body any better. I’m scared my periods are going to be as bad as ever when I come off the birth control. I’m scared we’ll end up running into trouble trying to conceive. I’m scared pregnancy is going to wreak havoc on my body. I’m scared of birth. I’m scared I won’t be able to keep up with kids once I have them. If I have them.

Most of all, I’m scared the pain is never going to go away. I’ll be thirty years old and living with the knowledge that I’m not even halfway done living and I’ve already exhausted all my options.

And when I look at that prospect, honestly? I want to die.

***

I meant this post to be about body dysmorphia. Fat. It ended up being something else.

I don’t know. I’ll be ok. But I’m struggling.

How the hell can Bush redefine abortion as “any of the various procedures — including the prescription, dispensing and administration of any drug or the performance of any procedure or any other action — that results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation”?

EVERY ONE OF MY PRESCRIPTION MEDICATIONS FITS THIS BILL.

Including the Lupron, which is a Major Treatment during which we are very strongly advised to be double-extra-careful in the area of birth control, because it can cause major serious birth defects. The Lupron which I am taking to shrink endometrial implants which can fuse together my organs and completely sterilize me.

Fucking caffeine fits this description.

It’s not just oral contraceptives, folks. It’s treatments which have no relation to family planning whatsoever. Just think of all the prescription medications that would be restricted.

How the hell? How the FUCKING hell? Are there any lawyers in the house who can address this one?

Tagging this one under accessibility just to emphasize how much this policy would affect my medical condition and my ability to WORK, to HAVE CHILDREN, to LIVE MY FUCKING LIFE without debilitating pain.

Fuck.

I weighed in at 164 at the doctor’s office on Friday. That is 0.1 BMI away from overweight! Whee!

But I also feel smaller. Maybe the Lupron is helping reduce the bloat in the tummy? There is definitely a difference looking in the mirror. Less to squish. Which is rather a surprise considering the previous immutability of my weight.

It is very obvious my GP does not like that I am on the Lupron, not at all. “It’s not like taking an Advil,” he says. That’s not news to me, though. When I told Matthew same, he remarked: “Then what are you supposed to do? At least this is helping reduce the stuff that is causing your pain.” Which is approximately how I feel about it. I know it’s a serious treatment. (GP does think the dizziness and spasms are probably attributable to it, since nothing else came up on x-ray and bloodwork.) But it will be an improvement over the status quo. A lot of the anti-medicine-type folks fail to understand that concept. GP has been reasonable so far, so his views on this matter were somewhat of a surprise.

Halfway through the Lupron, at this point, so long as I don’t have to repeat the therapy at the end. After that first monthish, my symptoms were greatly reduced. Including the dizziness and spasming. They aren’t gone altogether, but they’ve been largely stifled.

He is sending me to physical therapy for the back pain. Welcome development, that. Especially as I am applying around for new jobs, and kind of hoping for a clerical job with the state. I’m in contact with the local vocational rehab services as well. I mean, I sit on my ass all day anyway, but if I am working full time I am going to need some help adjusting to sitting on my ass in a place without access to all the accommodations I have built for myself at home.

I am still adjusting to the idea of working full-time. I’m not totally sure I can do it, but on the other hand, I don’t really have much reason to doubt it either. Especially considering I was unable to sustain any sort of work-for-pay before my current medicine regimen. I am the same person, with the same medical conditions. All that has changed is my treatment.

I don’t think I’ve ever written here about the catch-22 I faced there. Without that treatment, I was disabled, unable to work at all. When I was on disability, I qualified for Medicare, which would pay for that treatment. But with that treatment, I was (tentatively) able to earn SGA. Which would disqualify me from those disability payments. Which would mean I’d lose my Medicare. Which would mean I no longer had the treatment that enabled me to work.

Fortunately they do actually continue at least Medicaid coverage for workers with disabilities, at least in Pennsylvania, but only temporarily. After that, you’re at the mercy of your employer.

The fight for universal health care is, then, quite intimate for me.

Over and out.

OK, it’s time to put together my diagnosis/treatment list.

• Light asthma, diagnosed age ~8
  • Observation
• Fibromyalgia, diagnosed age 12.
  • Careful balance of physical activity
  • Low-impact exercise
  • At least 9 hours uninterrupted sleep every night
  • Lyrica, 150mg 3x/day, anti-epileptic that depresses the central nervous system to increase pain threshhold
  • Tramadol, 100mg 3x/day, non-narcotic painkiller
  • Hydrocodone, 7.5/750mg, narcotic painkiller, half pill as needed (average 2x/day) to manage excess pain
• Migraines, diagnosed age ~16
  • Careful management of stress to the upper back, shoulders and neck
  • Loose, comfortable, unrestrictive clothing
  • Limited exposure to light, noise and fragrance
  • Cyclobenzaprine, 30mg at night, muscle relaxer, relieves tense muscles and improves sleep quality
  • Applied heat as necessary to soothe and relax tense muscles
  • Hydrocodone, 7.5/750mg, narcotic painkiller, as needed when first symptoms appear, managed carefully due to risk for rebound headaches
• Anxiety disorder, diagnosed age 20
  • Carefully managed exposure to known triggers, including interaction with family (which can end in severe panic attack)
  • Makeshift “talk therapy” with husband, friends, or journal writing
  • Limited social interactions during times of stress
  • Deep breathing exercises
  • Effexor XR, 150mg 1x/day, SSNRI
• Fibroadenomas (benign tumors) of the breast, diagnosed age 22
  • Observation
• Endometriosis, diagnosed age 22
  • (Former) Low-dose oral contraceptive, continuous
  • (Current) Lupron Depot to stop estrogen production, 6 month therapy
  • (After completion of Lupron) Progesterone-only birth control such as Depo Provera, until ready for children. Pregnancies as close together as possible (to avoid as much estrogen production as possible). If symptoms return, possible hysterectomy.
• NEW! Mild scoliosis, diagnosed age 22
  • Observation

This list is limited to diagnosed medical conditions. It does not include the stronger symptoms of those conditions or the limitations they create, or the secondary conditions I haven’t bothered to seek diagnosis for (IBS, Raynaud’s, etc.) because there’s nothing that could be done for them anyway. It also does not include the physical idiosyncracies that contribute to those conditions (flat feet, long neck, excessively tense shoulder and neck muscles, low muscle tone, hair loss, chemical sensitivies, low blood pressure, and so on).

I’m sitting here shaking and taking deep breaths. I feel overwhelmed. I am constantly encountering some new way that my body is deformed, deficient, deviant, wrong somehow. And I can deal with that just fine; I’ve never fit in anyway. But all the limitations that are imposed upon me because of these conditions, and the stress and burden of caring for these conditions, are just too much to bear. The worst of it is the knowledge that this list is not yet finished; I am only twenty-two years old and I have many years left.

It is a struggle, understanding this body of mine, coping with the changes it requires, and then trying my best to have a positive self-regard through it all. I try; that is all I can say.