Hard questions #1

*WARNING: this is a blunt and honest account of hygiene, specifically the lack thereof – you may not look at me quite the same after reading this, but remember that I am the same person, just struggling to keep my juggling balls in the air*

What I write here, I write to share with you the side of mental illness that isn’t necessarily obvious to the onlooker, be they aware or unaware of the illness. Or maybe its obvious, but not understood. I write it to break through the stigma, if I can, that still settles over the mentally ill and to raise awareness of what life is like inside a head that doesn’t let you be the boss very often.

I know this isn’t going to be glamorous. But believe me: I’m not trying to sensationalise the truth. If anything, I’m under-selling the real story. So here we go:

Some questions are hard to answer.

Some questions are unanswerable.

Some you just wish were!

Like,

“How long is it since you last had a shower?” – husband

 

Ummm…well…

I’m not really sure…ahhh…

Maybe…I don’t know…

I think it was…

Hang on, when did I last work? Was it then…no, that’s right, I dry shampooed…

So, then…maybe on the weekend? Which day was it…

You changed the towels a week ago?

I haven’t used mine yet? Hmm…

…well then I guess…well then I guess that’s when…ah, yeah…so…a week you say…

Now where was I? let me just…slowly walks awaydrowns in shame

Plans to shower tomorrowknows it probably won’t happen

more shamethat’s life!

There are a number of questions that you try your best to avoid hearing, and therefore having to answer, once chronic illness has set in.

Like, when did you last have a shower.

I was never a shower-a-day person. I grew up out of town in drought years and whenever the rain didn’t come we had to buy in tanker loads of water to fill up our concrete tanks because we weren’t connected to town water. For longer than I liked we didn’t shower, we bathed because it was much more economical for water use to run a bath tub full of water rather than have individual showers. Plus when we were little its just what you do; everyone piles in. When we were little the bathroom was also outside in the mud brick section of the house: shower and bath in one room, laundry in another, and toilet at the end. Later on in our school years we got an inside bathroom (toilet still outside) and it was one after the other, and you got to top it up with hot water if it ran cold, which by the time the 4th person got in was a high likelihood, never mind the parents. Especially because some people liked to have a sleep in there, regardless of those following! Okay I was one of those having a sleep in the bath, but I went last or close to last. If you were washing your hair you got to quickly rinse the conditioner off in the shower, given that the bath water wasn’t the cleanest by that point. Then again, showering wasn’t all it cracked up to be since the shower head was too short! It was half a gym workout doing squats under the tap while rinsing your hair!

So I was an every second day washer, basically just when my hair needed washing or my leg hair was getting to liberated woman stage! So when I got sick I didn’t exactly have the best routine to fall back on.

Why is showering so difficult and so irregular now?

There’s no simple, snappy one-liner answer.

It’s a few things.

My shower is in a bath. Lifting a leg over the tub just always seems so…HARD! I think about having a shower, and I think about getting one leg up and over, let alone 2 legs into that bath without over-balancing, the effort of getting my big self up and over into the tub and its just…its…its so…its just, yeah, well, maybe tomorrow.

So there’s that. Plus it takes energy. If I had a store of energy, like in a barn, I would go get the amount of energy that I need with my forklift and bring it back to the bathroom and have my shower. It would be simple, straightforward. I would just take the exact amount of energy needed, use it to have a shower and it would be all good! Sadly, unfortunately, regrettably, energy doesn’t store. It just comes and goes, waxes and wanes. You either have it in the moment or you don’t. There are things that help or not, but there’s no guarantee of having the energy you need when you need it. So, lying in bed thinking about having a shower and I ask myself, do I have the energy to do this right now? And it’s an easy answer, it’s a yes/no problem. So it either happens, or it doesn’t. I.e. it doesn’t. Because all that thinking just used up my having a shower energy! Isn’t that ironic? So now no energy, no shower and I turn my attention to covering up not having a shower, if its been more than a day.

There are things that make it a bit easier. Hubby getting the shower running and frogmarching me to the edge of the tub for instance. Well that’s about it, actually. There are hardly any things that actually motivate me to the point of getting up off my tush and having a shower, even my amazing husband. Even when he asks me to, as a favour to him. This is a point that a lot of people don’t understand.

“Don’t you want to do it for me?”, “Yes I do want to do it for you”.

“Do it for me”, “I can’t”.

“Can’t you even do it for me?”, “I’m sorry, I just can’t, even for you”.

It hurts me to give these answers. I love my husband more than anything in the whole world. We have been best friends since 2003, since we met practically. We’ve been married for nearly 8 years and have shared everything together. If I could do it for him, I would! Come to think of it, if I could do it for myself, I would! But its not about that. Its about not having the energy, the motivation, the drive to do it. If one of those questions comes up, it just makes me feel worse about the whole thing, which is not the intention I know; that I wouldn’t even do it for him, after all he’s done for me. How selfish!!

And maybe it is selfish. A lot of times depressed people have to make selfish choices for their own survival, be it mental, physical, or emotional survival. And it hurts us to do it. But we need to, even if you don’t see why. It’s not about you, its about us; that sounds selfish right there. But we spend a lot of time conserving our resources and we know what we can and can’t manage. But doing that means a lot of navel-gazing, inward looking so you’ll have to excuse us while we’re busy sorting ourselves out, please.

I think it is a severe understatement to say that my husband is long-suffering! He is beyond patient and kind with me, beyond what I deserve for trying his limits so severely with such things as:

  • unwashed hair looking and feeling greasy
  • the same hair tangled into dreadlocks-style clumps that have to be cut out after who knows how long of not brushing my hair, then dry shampooing, then not brushing, then dry shampooing etc
  • eyebrow/underarm/leg/bikini waxing abandoned I don’t even know how long ago anymore!
  • tooth brushing I also don’t know…well I do know cos I brushed them last week once, but before that its anyone’s guess and he suffers them orange with food stuff and still bravely kisses me when I must be repulsive with plaquey teeth and bad breath
  • BO is one area that I think is mostly under control thanks to Dove Invisible Dry with 1/4 soap
  • avoiding hand washing except when its absolutely necessary, meaning much less often than I should

You would think that because I love my husband so much, and because I know that I owe him so much, and want to please him, that these emotions would motivate me to fix these areas. He hopes that I would do it for him, and I’d love to be able to do these things for him, but wanting to do it and doing it are separate entities that rarely collide, I’ve found. Because while I DO want to do it, especially do it for him, wanting it doesn’t give you energy, the kick, the ability to actually get up and do it. I wish. So often, probably daily, my husband may well think that I don’t care enough about him to do one “little” thing for him like clean my teeth. But there’s just something so difficult to overcome in myself to just start to think about doing one of these things. I want to in theory, but practice hasn’t really tallied out on my side.

It’s difficult to explain why its so hard to do these things. After all they’re easy things that most people just do without even thinking about it. But its a common happening in depressed people to get slacker on these things. It’s just one of those things that goes when your mind and your body slow down. It takes 10 minutes of pros and cons to decide that I absolutely can’t go another day without showering, that even my soapy deodorant, dry shampoo and perfume aren’t going to cut it today. Then it takes a good 10 minutes to plan how I’m going to get up, walk the 9 steps to the bathroom (actually 9 steps), clamber into the bath and get the shower going. Then I may actually have a shower, or can it after all and skip another day.

I’m not alone. I was relieved when I found this out. Depression tells you that you’re a slob, and disgusting, and no one wants to be around you, and maybe thats not far off. But knowing that this is a common symptom of depression takes a little of the pressure off, which helps you to take it easy on yourself, which in its own twisted roundabout way means that you’re MORE likely to pick up some of the hygiene slack. So here’s what others have said

“Literally not showering for months. Not changing your clothes for weeks. Not combing your hair for days. Not brushing your teeth for weeks. With depression, hygiene goes out the window.” — Zoe S – The Mighty ‘Worst Symptoms of Depression‘ article.

“Not keeping in touch with anyone, bad personal hygiene and extremely bad reactions to seemingly trivial things.” — Jenny B – Upworthy ‘30 Things Depressed People Do‘ article.

“I love not having to decide if I’m mentally and emotionally prepared to spend time drying my hair after a shower” – a friend who just shaved her head for cancer awareness and fundraising.

“Thinking about going to the gymhaving a shower like”…hopefully this opens to a visual aid giving you an idea of how I think about showers.

But now, a new directive:

“Danika, I strongly encourage you to shower daily” – my psychiatrist

Rats!! *snaps fingers* I was hoping to avoid such a direct instruction!

“Not for hygiene…”

Well that’s surprising! All I’ve considered so far is hygiene.

“…but for your own self-worth. You aren’t showering because of low self-worth, and then not showering further lowers your self-worth. *cue light bulb moment* You have come from a long way back to get back to work and it hasn’t been easy, especially having issues with the pharmacy board and your current job, but you made it. As far as work goes you’re back to where you came from, more or less. Showering daily will reinforce to you that you’re back to where you came from, and improve your self-worth. Your actions inform your mind, just as your mind informs your actions” – my psychiatrist, quoted as near as I can remember.

Well that was all a revelation, I can tell you!

Showering to improve how I think about myself. Not cause its the thing to do, or for hygiene, or cause someone thinks I should. In fact, its all about me! And don’t we like that?

So, here I am the day after yesterday when I talked to my psychiatrist, 5.26pm, wondering when exactly should I have this shower? Cos I’ve managed to not have the time for it so far: dropping off the car to get serviced first thing then doing a jobs run of picking up clothing repairs/script dispensing/groceries/posting a parcel then walking home, breakfast, a nap, another little nap, house inspection, groceries delivered, pick up the car, Officeworks. And now going out to dinner…is there time before? Or when we get home? Hmmm.

I do feel like my head is in a different space though, after that chat. Shout out to my darling husband for dobbing me in to the psychiatrist!! Sheesh!! So, about that shower…

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One of those things

[written sunny Saturday 9th July, 2016; updated 12th July, 2016]

Today I brushed my teeth.

It shouldn’t be a big deal should it, but it is. No one can remember the last time that I brushed my teeth…last year? It’s terrible I know, and doesn’t exactly match my pharmacists’ health promotion ethos, does it? And it’s not something my husband relishes! Or others, possibly; I haven’t heard! But it’s just gotten to be one of those things. You know, those things? Things that you should do, but it’s just a bit too hard. So they’ve slipped down the priority scale, and dropped off the to-do list. I know I have new cavities from being so slack; I can feel them on the lower left side of my mouth when I eat hot food, drink cold drinks, eat something sugary etc. It’s going to need some attention and I’m happy to give it that, but I’ve got an insurance situation to sort out before I can afford it. Soon. Interestingly, or not, I pack my toothbrush every time I go away. I even pack my dental floss, the same dental floss that I’ve had since no one knows when! That’s extreme optimism for you, right there! I don’t know why I think it’s going to be different on holidays, why I think I’ll get it done. I guess it’s something to do with believing I’ll have more time on holidays, that I’ll feel differently on holidays, that everything will fall into place on holidays. But that’s not how it works, is it? What you have at home, your routines, your schedule, your habits, you take on holidays with you. So it just gets put off a little longer, and a little longer. I’ve never been great at this, but I’ve been a heck of a lot better than this, even committing to daily bleaching my teeth for 3 weeks once! It’s probably one of the bigger of those things.

Today I washed my hands.

That, of all things, should NOT be a big deal but washing and drying my hands has become a stand off with myself! It’s like a rebellion against something, I don’t even know what. But you’re supposed to wash your hands, yeah? Well I won’t! Terrible, childish thought process, I know. But it’s there, and it takes a lot of overcoming! Every time I should be washing my hands, this something rises up in me and I just sneak away without doing it. So silly, yet it persists. Obviously because I work in a hospital there are safety limits but a pump of alcohol or chemical based cleaner is a lot easier to me; maybe I should install a couple of home! It’s just one of those things. It’s not that I never wash my hands. If I think an activity warrants it, like dirt from gardening, dusty or greasy hands from my bike, food matter etc then yes they get a good wash; or a good rub down on a hand towel that will disguise it! I’m practically a kid when it comes to this! It’s the little times when my hands aren’t dirty, but its tradition (and probably hygiene!) like before a meal, after a meal, little things. In my mind. Probably not in others minds, but it feels like unnecessary energy that I can’t afford to waste, so I save my efforts for something more essential, as least to my way of thinking. It’s one of those things which seem like why wouldn’t you just do it, but I feel like it will take too much energy. It’s a fight with myself.

Today I walked one kilometer.

Walking, any walking, has become a big deal since I got sick. I never used to think about the things I asked my body to do. I walked as long as I needed, I ran for exercise, I loved swimming for fun, weights were my favourite form of exercise, I’ve done a couple of bootcamps including one at a boxing gym, pilates was my relaxation, and so on. But now, I struggle a lot with it! For various reasons, I suppose: I’m fat and heavy, I’m slow and sluggish, it takes energy and effort and motivation, I’d rather catch ANY other form of transportation, my legs rub together and chafe til they’re red raw unless I wear undershorts or leggings, it drains my mind and my body, and I’ve come to associate it with pain and suffering. I know, a little over dramatic! But there you have it, it’s one of those things! This walk in particular was slow, and it wasn’t for exercise; it was for bird watching and photography. But hey, it was outside in the sun and breeze, and it was a kilometer. I take it however I get it, and don’t sneeze at the little bits of exercise however they come. I’m meant to be exercising more. Well that was more than yesterday, more than the day before, and more in one go than I’d done for the whole week and probably longer so I’m counting it as a win!

Today I rode my bike.

And it reminded me that I do love my bike! I’d forgotten that. I quickly forget the joys, and never-endingly remember the pains; it’s not a good way to be! I keep planning to ride with Wheel Women and sign myself up for rides optimistically hoping I’ll feel like it by the time they comes around. But then I pull out closer to the day as it becomes clearer that not having left the house or changed out of PJs for 2 days, it really isn’t going to be likely that I’ll be up and dressed by 8.30am ready to drive 45 minutes across the city! Or I heave a sigh of relief when a planned ride is cancelled due to rain, path flooding or wild weather. Then I roll over and go back to sleep. Well that’s been the pattern lately while I haven’t been well. Before today I hadn’t ridden or been on my bike even since the 3rd of June! Five weeks out of it! I think I’ve had 5 weeks out of a lot of things, to be honest. It’s been reasonably bleak for me and with me, and that’s when all of these things, those things, fall away because it’s too much effort to keep them going. But flying downhill brought on that high, that endorphin burst and suddenly I was in my zone, loving it! And I flew all the way home, even up the hills, and that was that, I was back, mentally. And when you’re there mentally, you’re there!

Today I climbed hills on my bike.

If you know me and my riding, you know about me and hills; we have a difficult relationship! Frankly, right now, I’m not built for going up hills! My weight is very much against me when trying to defy gravity by going up. Nevertheless, the hills are there and they do come across my path, and at the end of the day I do have to get up them somehow. So when Wheel Women ran a class on climbing, cornering and descending, it sounded like exactly the skill set that I could benefit from! So how did I get to that class when I hadn’t gotten to any other rides? My innate cheapness!! I put down money for this class, little though it be, but it’s a powerful motivator in someone with Scottish blood, however diluted it be! And I did learn some super helpful tips to help me up those hills. And then I flew down them again, but that’s the fun bit, the bit that gives you a rush! The other bit, the climbing is different, but I guess it’s a means to an end if you like. It’s still hard. But I did it today! I conquered one of those things, at least for now.

At the end of the day, what a day?!

Better than I’ve had in quite a while! I’ve been struggling with depression lately and it has sucked, but suddenly on Thursday night when I woke up from my nap, something shifted! I was high, elevated in an energetic and motivated frame of mind. Just like that! If only I could click my fingers and get that result! Who on earth knows what it was that tipped me over, impossible to figure out. But YAY!

So what you’re seeing here is the chemicals in my brain giving me a booster shot to actually manage to do some of those things. I even cooked tea one night this week! Rare event these days! When the chemicals all line up, life is good. It’s easy, way less effort, far less forcing myself around. It just happens and we’re all relieved. And vice versa, you understand. But for now, for however little time I have this little break, it’s nice to use it to do something. It’s not perfect. My ride was still hard! The hills still hurt. My walking was still slow, although that was more for the sake of finding birds, and it wasn’t far, but still. I washed my hands but not all the time. And I brushed my teeth.

What I didn’t do today was shower. It’s probably the hugest of the things. To get into our shower you have to climb into the bathtub. Every time I think of having a shower, I think of having to hoick my leg over the side and it just seems like too much effort! It’s such a small thing, right, but it literally seems like it’s impossible. Once I’m in its great; I love a nice hot shower and feeling clean again, once I’m there. It’s just the getting started, which is after all, the issue with all of these things; getting started. It’s pretty much classic depression: issues with motivation, energy, self care. It is amazing what lengths I’ll go to not to have a shower, and how long I’ll go between showers. And by amazing, I also mean embarrassing! After Bali, I had a mega battle and I almost lost count but I think I went more than two weeks and no shower, and unwashed hair! You may have noticed! I still used deodorant and perfume so hopefully I didn’t stink, but it wasn’t a nice episode and finally my husband had to drag me to the shower and make me get in. And it was delightful! All that fuss and bother and argument, vanished, and I had a lovely time and came out feeling wonderful! It’s one of those things!!

That’s today [read: Saturday 9th July]. Tomorrow we have to wake up and do it again so we won’t get too carried away, but today those things have had a bit less hold over me.

So, the next day: Sunday morning, the hardest morning of the week. Mainly because I ideally would aim be up and going earlier than I may have done for the other 6 days of the week. But today I was up by 9am and actually feeling like I was up and going, not sluggish or doped out. My anticipation of the coming Sunday can mean that I go to bed late, and so not take my tablets til late just before I go to bed, and so I can be a bit sedated by the effect of my tablets lasting well into the morning. I have this contrary thought process that not going to bed will prolong the next day’s arrival…obviously it’s just the opposite. But it’s another reason why waking up Sunday is a complicated thing. Sunday morning is also traditionally when I wash my hair. I should really change that, if common sense prevails. It’s just another thing to get past to get to church: waking up, clearing my head, getting fed and watered and tabletted, showering, dressing and getting out the door not long after ten.

But today was pretty successful. I actually had a shower, and even dug out some moisturizer and did my legs! A miracle of a day! I’m energetic but not irritably manic, the best way to be. Touch wood for more days like these. I’m active, I’m wanting to fill in my day instead of hiding from it; I’m like a normal person!! YAY!

Upbeat

Well let’s try something a little more upbeat, shall we?

– Amy Adams, Miss Pettigrew Lives For A Day

Time for some good news, don’t you think? The last 2 week’s blogs have been a tad depressing. But then again, that’s what we’re dealing with; depression. And it is depressing!

But, time for some good news. Just as long as you don’t think that’s how it actually works in real life. Good news following bad in a nice little ratio. It doesn’t happen neatly like that. The depressing topics can go on for quite a while without relief!

Thanks to my amazing psychiatrist I actually am feeling quite a bit better this week. My meds have been upped again and within 3 days of increasing the dose I was coming up from the depths and feeling better, and my energy and mood have kept on coming up. Thank goodness!

My belief has been renewed that it is possible to get properly medicated and live a reasonably normal life. I stopped believing over the last little while, thinking I was living a doomed life. I have been reminded how closely the analogy of diabetes fits my disease. When a diabetic’s sugar levels go off, they feel awful but they go to the doctor and the doctor changes the level of medication. I just forgot that I need to go to the doctor and ask for more meds when I start sinking; I tend to think it’s on me to fix myself, as if I could! I’ve been reminded very clearly this time that when I’m struggling, it’s not just that I’m struggling, but that there’s something chemical going on in my brain that needs a doctor to sort out. I need to recognize it, and ask for help. That sounds obvious, but it’s not obvious to me, not when I’m sick. I just blame myself, feel like I’m not doing enough to be better, and I hibernate.  So I’m reminded it’s the level of chemicals in my brain that are dictating how I’m going, and when I need more, I need more and I need to ask for it. I’ll try to remember for next time…

I have faith again now, faith that things can be better, and will get better, and will be better. Something I lost lately.

But if I wasn’t feeling better, I was planning to write something “positive” anyway.

You know, so you wouldn’t worry. So you wouldn’t think it was all bleak and dark. To balance out the last two posts. To alleviate your concerns and to reassure you that everything is okay. Because that’s what we do, or at least that’s what I do. People who are emotionally and mentally unwell.

I want you to know when things aren’t going well because I believe in my friends and family knowing the truth. I want you to know, I really do. I think it’s good for a lot of people to know how these things work; so you understand, and maybe so it’ll help you help someone else.

Until all the condolences roll in and everyone is so worried. Until dear friends get scared, and fret about how I am going. Then I think about you, and how it’s affecting you and it makes me anxious, thinking of more questions and concerns, and I back peddle. So sometimes I tell you its all good so you can relax. And so I can relax, and I’m no longer fielding afraid questions from loved ones. My husband says this is insulting to people. To coddle them, and not let them in on the whole truth. To decide what they can handle and what they can’t. To give them the amount of truth that I believe won’t overload them, and by extension, me.

I’m sorry to do this! I don’t mean to take control of the information stream, or insult you, or lie. But it quickly becomes too much for me. Despite this, I don’t want you to change a thing. Please don’t stop feeling concern, or asking me about what’s going on. I’m just letting you in on my crazy brain!

But I think this is a very common thing in people with mental illness. I read a piece recently about “smiling depression” and so many times it IS easier to smile. I try not to be fake, but it’s still my fall back, the easier option.

It’s not about restricting your access to information about my illness and how I’m going. Like I said, I want you to know; at least theoretically. I have a limited capacity for emotion, including other people’s, when I’m not well. This is why sometimes I still say “fine”, “okay”, “not bad”, “good thanks” to skirt the question of how I’m going. Because when I’m really not well, just a simple “how are you?” is enough to bring me to tears, and have I mentioned how much I hate crying? Especially in front of anyone else! But I’m trying to be honest and open, so bear with me.

Sometimes I want you to think I’m okay, or not so bad so I can slink back to bed without attention.

It’s not that I don’t appreciate your concern.

I want to promote understanding of mental illness, but sometimes the kind concern and loving questions, while so touching, are a lot to deal with when I’m operating at low emotional capacity! When I’m better it’s a lot easier to process and when I’m well it’s easy, just the same as you or anyone, but of course the same thoughts and  questions don’t apply then.

But I am well this week. I’ve got energy, motivation, stamina. I feel good! Everything is easier. I’m doing more, and it’s draining me less, and not exhausting me just to move. My husband is happy, the house is in a little bit shape, things are just good. So none of this is fake. These are the real positives that I can see clearly with my eyes right now. Yay!

  • I’ve gotten out of bed every day this week, and sometimes before noon! Really!
  • I’ve talked to a potential employer via email and on the phone, and done an in-person job interview
  • I’ve done groceries, dropped off some clothes to be mended, washed and dried sheets, posted some clothes for refund, tidied up my side of the bedroom, even cooked dinner one night! Don’t get your hopes too high though, that’s about all I’ve done!
  • I’ve been to my GP for an appointment, to a doctor for an ultrasound, to a careers counsellor for help getting a job, and to KFC when I couldn’t figure out what to eat for lunch! That’s a lot of outings and socialising for me! On the days I went out, I went to bed when I got home, usually for an hour and a half…but I didn’t nap on the days that I didn’t go out, so that’s something
  • All this out and about meant I got some sunshine on 2 separate days. Actually on the skin sunshine!

So that’s me for this week. It’s not a lot from the viewpoint of my old life, but these days I take whatever I can take, and this is relatively awesome!

How about you? How are you? I’d love to hear from you.

 

I did a bad thing…

I did a bad thing.

I got sick, and then I started getting better, then I stopped. I didn’t get better. I just stopped.

I’m in illness limbo. I’m much better than I was when I was severely unwell, but much worse than I was “before”, before I ever got sick. Well okay, maybe not much worse, but worse. I’m not going forwards, I’m not going back. I’m not bad enough to complain to my doctors, but I’m not where I thought I’d be, back to “normal”.

It’s been a long time now since I got sick, and I’m definitely well over the acute phase of crippling anxiety, black depression and the odd weirdly happy and effective days of mania.

I was just commenting yesterday that I never have dysfunctional anxiety anymore; just regular, everyday person anxieties that are reasonable and well founded and manageable. But I was wrong. At that very moment it was sneaking up on me again and bam! it got me!! But only a bit dysfunctional. I don’t have the darkness and hopelessness of depression, just the sluggishness and lack of motivation and tiredness…but even that waxes and wanes giving me better days and worse days due to no particular reason. Mania continues to be a little brightness on the horizon that breaks through any residual depressive effects and gives me a little happy and useful and wish-I-was-like-this-all-the-time day or so, here or there!

I’m medicated like you wouldn’t believe, and a recent experiment my psychiatrist and I tried of reducing my meds has shown me very clearly that without these meds, I’d be right back in the thick of my acutely unwell stage!! It’s not like they aren’t working; they are, they really are! My moods have been a very difficult case to crack and it has taken 4 medications for mood and months to years of appointments to get on top of the main symptoms. And they work. I can, somewhat distantly now cos it’s been a while for some, remember how I was before and after starting each one, which may just be my saving grace down the track when I, like every bipolar patient, get to the stage where I think I might just be better off not taking my meds. One request of you, friend: don’t be the person who suggests I should go off my meds. The consequences of taking on that responsibility may well be more than you can bear. You take my life in your hands if you suggest any such thing. For all I complain about where I am, I always know very clearly that I would be so much worse off without my meds. No question. Ever. Life isn’t perfect but taking away the crutch holding me up isn’t going to help. So save it, keep it, sit on it, hold it in, swallow it; you are not helping anyone, almost ever, by making any such suggestion. You are warned.

But here we are. I’m not sick, but I’m not as well as I thought I’d be. As I hoped I’d be, planned I’d be, “knew” I’d be. Isn’t this the dilemma of every patient with a chronic illness? I go to the doctor with my illness, the doctor says okay I’ll treat your illness, I hear “I’ll get you back to normal”, and go on my way happily ever after. I think I’m presenting the doctor with a chest infection that he can fix, and then return me to my previous health. But this is not a curable disease. The treatment works, the doctor says I’ve treated your illness, I look forward to getting back to being me, my old self, and then, as the Goons would say…suddenly, nothing happened!! Yes the treatment worked. Yes the doctor has done his job. But this illness doesn’t go away. Because that’s not how it works. The illness stays. The treatment stays. The illness has just been put back to bed for a while. But there are some residual effects that haven’t been buried and they remain and irritate me. Because that’s how it works. I don’t know what it would take to get every last little bit of it under the surface…I don’t think I want to know because it either isn’t possible, or the trade off would be too severe.

I’m starting to think “normal” isn’t a reality that I’ll ever reach again. I’m starting to think that my life has been permanently changed. I’m starting to think I’m stuck here.

I don’t know.

All I know is I’m here, and everyone seems to want me to get fitter, healthier, stronger, slimmer or shall we shall less large (keeping it to reachable goals), more energetic, more involved in my own life, more something or other. And don’t mistake me, I want that too. I want it all. It’s just that I can’t see how. I can’t see how to get there. Some people say, well you made it this far through, I’m sure you can do it. But my little/big secret is, all I did so far was hang on. Through all of it, I didn’t really do anything that active; I just hung on. Now the goals require something more active and I don’t know if I can do it. I’m not sure that I can do what’s required. I guess that’s why I’ve stalled here. The next step possibly requires more than I can give.

Aaaaahhhh. Sigh. I did something bad. I stopped getting better. Can I start again?

Avoiding a missed dose

Remember a little while back when I was talking about what happens when I miss a dose of my meds? [Tales of a Missed Dose, 22nd June, 2015]

It’s not a fun experience, and so I go a fair way out of my way to make sure that I avoid it as much as possible! Probably my motivation is just as much to avoid the unpleasantness as it is to keep on my prescribed regimen.

So, how do I do it? How do I manage my medications? What is my system?

strips, tablets, capsules

The strips. This is where the real stuff begins

Is it hard? Yes. Is it worthwhile? Absolutely! Does it get easier? Not so far.

Up until the last few months my medications have been all over the place, add one here, add one there, add one here…that went on for a while! Then the doses were changing and the psychiatrist was fiddling with timing and so on. But lately I’ve had the same meds at the same doses for a while, at least until a week or so ago, so at least I got into a bit of a rhythm with what I’m packing into my tablet box. Although then there’s the thyroxine which must be kept in the fridge, and you can only take 14 days’ worth out at a time. And there’s my lithium dose where I take two tablets every morning, but two and a half tablets on alternate nights with three tablets! That takes some keeping up with!

medication box, dosette

Blank canvas – my weekly medication box exhausted and ready to be repacked

Then there’s valproate which literally cannot be taken out of the foil stripping until you need the dose. I found this out the hard way! The problem arises because I take the lowest strength available which is soluble, and therefore designed to absorb water as fast as possible once exposed. So the first week that I packed valproate into my box, I went to tip out my tablets the next morning and had more-than-soggy valproate! In fact it was more of a glob of paste that smooshed on your fingers and fell everywhere all at once! So I had to fish out all the goopy bits from fourteen small sections of my box and throw out some of my other tablets that had also become soggy and learned my lesson. So NOW, I get out my scissors with my shaky fingers and cut out all the tablets of a ten tablet strip, fold each of the sharp corners of the square into the middle so that it’ll fit into the box compartment, then put it on top of all the other tablets, and try to jam the lid shut. P.S. DO NOT swallow the tablet still wrapped in foil! It has been done, but thankfully so far not by me. I think the sharp edges would give me the hint well before it got as far as my throat; or so I hope!

Epilim

So Valproate, I cut the strip into 10 squares, then fold the squares until they fit into the medication box with the other pills

But you’re a pharmacist, it’s probably easy for you?

I’m a pharmacist second, but a patient first. My systems and medication knowledge is invaluable in understanding my condition and sorting out my meds! In fact, I constantly wonder how people without that knowledge get by at all!! I say that because at times I feel like I’m barely keeping it together: what scripts do I need when I see the doctor (among all the other things I need to talk to him about!), what scripts do I have to take to the pharmacy to get dispensed this week, and when will I get there? What tablets are in low supply, do I have a current script for that? Have I got enough thyroxine downstairs in the fridge, an inconvenience to my medication box packing that the company did not consider strongly enough when developing their product?! Have I taken today’s tablets? Did I take the right time, like did I take the morning tablets in the morning or did I not look closely enough and accidentally take the sedating night time doses in the morning? Did I remember that I must not have fizzy drinks within two hours of taking valproate because it will dissolve much more quickly and make me drowsy? Loads of questions and loads of answers, and it’s still tricky matching them up properly!!

The many faces of scripts, handwritten, computer generated and the pharmacy yellow slip. And yes, my doctors have terrible handwriting!

The many faces of scripts, handwritten, computer generated and the pharmacy yellow slip. And yes, my doctors have terrible handwriting!

So here are my many systems.

A very short time into my Prep year, my teacher commented that I’d lose my head if it wasn’t screwed on! This wasn’t prophesy or prediction of how my life would turn out, but simply a comment on how I was then. I was only 5, but I remember it clearly. It was a kind of epiphany moment. She didn’t mean it maliciously, but it was a pretty apt saying at the time, and for quite a few years to come!

Being organised probably comes from my Dad’s side. Every week he would strip back his tradie van to the bare essentials, remove all the Coke bottles and get it stocked, clean and ready to go again. Of course a lot of his motivation was listening to a footy match on the radio on his own without noisy kids! He would come home at night and the messy house was a constant trial to his patience!! He would get up a head of steam and do a week’s worth of chores before dinner! We all just vanished into the paint work and let him get it done; making any kind of noise meant you might get a faceful of steam!! When I was in primary school, he taught me how to pack for a holiday systematically, starting from the feet and working all the way up to make sure you don’t miss anything. Shoes, socks, tights, skirts, tops, dresses, hair ties, hats etc. I used this for packing, but the rest of my life was less designed and more accidental. Rushing from place to place having too many things to physically fit into the hours of the day and accidents happening all over the place! That came from my mum. Surprisingly, since my mum’s mum is uber organized. Forgot my lunch, forgot my jumper, left my USB with my presentation at home, missed a deadline etc! None of this really taught me the life lesson you would think it should!

boxes, bottles, tablets, capsules

The real deal, all of my many tablet boxes and one bottle…and there’s one box in the fridge

Studying pharmacy was a revelation to me, and it really has gradually changed my approach to life. So has the last 12 years with my now-husband, who is very systematic and had taught me a lot about being organised. Pharmacists have to be so systematic that there is almost no possible way that an error can occur. Each of us has to work out our own system that doesn’t fail when curveballs come out of nowhere, but is a failsafe as much as possible. I’m not going to go through that because its tedious from the outside, but next time you’re waiting in a pharmacy, and they’ve told you the script is going to be 10 minutes even though that’s not possible, and you’re wondering what they’re doing, distract yourself wondering how that pharmacist is ensuring your health and safety.

pink bag, surprise, treat

Bag of medications disguised as something pink and desirable! Cunning

So my medication taking has become a system. It didn’t start that way, because at the start I was on one antidepressant. That doesn’t take a lot of managing apart from remembering to take it! Then I was on two antidepressants, one in the morning and one at night. That took a bit more remembering. Then the pivotal moment when I was diagnosed with bipolar and started on a mood stabilizer, and another one, and another one. It got too much to keep in my brain, so I took the old person option and got myself a medication box so that I could make up a week’s worth of pills at a time, and stay ahead of the game, instead of waking up in the morning to get ready for work, and finding I didn’t have any more of a tablet! Having to squeeze a trip to the pharmacy into my already tight getting-to-work schedule was essential, but stress-inducing!

medication box

Nearly done, got to visit the fridge and fold the silver squares

I have an up-to-date medication list that I’ve written on the back of the box, and that I keep a copy of in my handbag, and a copy of in the NPS Medicines app on my phone, and which I update after every doctor’s visit if any medication changes have happened. This is vital. If anything ever happens, the first thing your hospital pharmacist will ask for is your medication list. Having it up to date means increased safety for you. That’s the most important thing. We don’t want to give you something that will make you worse by allergic reaction or by interaction with your current meds or your medical conditions.

medication list

The ‘official’ medication list, updated every doctor’s visit…maybe I should type it out to make it look less made up!

Every week when there are only a couple of doses left in my box, I repack it according to my list. I cross check each tablet as I pack it, i.e. I take venlafaxine 450mg, which is 3 capsules of 150mg, so I check the list and pop out that many tablets. It sounds so easy, but an error right there could be catastrophic. Cross checking makes sure every prescribed medication ends up in the box, in the correct amount, at the correct time of day, every day. So I sit up on my bed and surround myself with boxes and strips and bottles, my list and my box. It’s actually a satisfying job, ticking each med off one by one and ending up with a neat and tidy box of lifesaving pills. I end up with a massive pile of rubbish, mostly in the form of popped out strips. Pharmacy isn’t exactly a green industry; the medications demand certain wrappings and changing that order would be unsafe.

medication box

Ready to go! Time to concentrate, accidents do happen but good idea if they don’t!

Unfortunately the names of the days have rubbed off the box and remembering the order wasn’t working so I had to relabel the medication spots. I ended up writing AM or PM as well, because a couple of times I’ve taken the morning medications at night and ended up not sleeping for hours, or taken the night meds in the morning and been doped out all day! That was because I started checking on autopilot and not really checking. So now reading the label of the dose reminds me, hopefully, whether I’m meant to take that dose or not.

System change #71! Always updating and changing to improve my safety

System change #71! Always updating and changing to improve my safety

Forgetting is a big part of my life now. I start a story and can’t remember why I was telling it, I can never remember names, I forget a conversation from earlier that day, and many other things. Pity help me if I get to 80!! My husband will have gone mad by then! So I have alarms. I’ve always done this since I only had one med. First it was an alarm that you switched off. Then I’d forget all the same. So I changed my alarm to being able to be snoozed three times. I’d snooze it three times, and forget! Procrastination much?? So I found the NPS (National Prescribing Service) excellent Medicines app and put some alerts in there for the morning and night. These can be snoozed endlessly so I know that it won’t let me forget!

reminders, alarms

The cool app from the good folks at the National Prescribing Service – recommended!

When it’s time for my tablets, I go to the box and look for the day and the time. I tip out all the tablets, and take the foil off the valproate. I count the tablets against the mental dose list, or actual dose list if I can juggle the tablets in one hand and box in another. I check that each tablet for that time of day is there, and in the right dose then scull them! My husband hates this, he thinks that I should take them one at a time, but that would take forever! I’d rather just get them down as quick as possible.

20150520_093805

I’ve developed a new system now. My alarms go off at 8.30am and 8pm. I’m meant to take my tablets when the alarm goes off, but however systematic I am I’m still a procrastinator. I know that my tablets are keeping me in the good life, and that without them I’d be in all kinds of awful, but there’s still that little part of me that doesn’t want the tablets, because it doesn’t want the illness! A small part of me that has the hopeful thought that maybe if I don’t take them everything will just go away. Of course that’s ridiculous! But it’s just how it is. So I snooze, and snooze, and snooze. Ridiculous and childish but there you have it! I can’t imagine how much more difficult it must be for people who don’t acknowledge their illness, are in denial, believe the medications are evil or unnecessary or poison, or are being medicated against their will.

My husband does a good job of asking me if I’ve taken my tablets, but my memory is absurd and I remember taking my morning tablets and say yes I’ve taken my night tablets. A couple of times I said yes yes, and I hadn’t taken them. So now, once I’ve taken them, the lid stays up, I don’t clip it down again, and so both of us at a glance can tell if I’ve taken them or not, no confusion.

Some are empty, some are closed and it helps me keep track and avoid slip ups

Some are empty, some are closed and it helps me keep track and avoid slip ups

Well that’s about all my systems. I try to avoid anything that relies on memory, and try to have a clear, repeatable, systematic way of keeping well. At the end of the day, its fingers crossed and trust in all the steps that have been taken to take care of me.

Hope you enjoy the pretty pictures!

Victory Part One

[Written 20th June 2015]

Victory is mine blog post

Okay that’s not going to be my title, way too grand and pompous for my usual style. But today was a victory and I want to talk about.

I was meant to restart work sometime last week. It was always a vague plan of sometime after the Queen’s birthday public holiday. From the time I took back my authorization to get a police check and stat dec to say that I wasn’t an awful criminal the suggestion was it would take the HR department about two weeks to prepare the contracts. Oh, and by the way, the hospital executive have just put a halt on recruitment until the end of the financial year! We may sneak in, we may not.

So it didn’t happen last week, and it wasn’t looking super likely for this week either. So my plan? Bike ride as much as possible until I go back to work! It is still amazing to me that I, in the dead of winter, in shall we say frigid conditions with rain and bleak outlooks and low teens temperatures, would be keen to get out there and get cold and exert effort! Crazy! Yet it turns out that my week is built around it! I would NEVER have thought that this would actually come to be in my life!

I mean, yeah, they said exercise was good for you and helped your mood and did wonders. I got started at the gym after moving back to Melbourne when I was beginning to put on weight in a vain attempt to keep that at bay. I did enjoy the classes, another women’s only special, and afterwards I loved that I’d been able to do it. My post-gym face made it into a couple of my ‘100 happy days’ posts. I made an effort to get to my classes after work, which was a tight squeeze, and then when I wasn’t working anymore I tried to get there and do the solos workouts my friendly coach had designed for me. But the cardio stuff sucked! I’ve always been good at weights and they are my preference. But right then, with the weight I’d put on and as the sedation overcame me, cardio was just a punishment! So I put the gym on hold, and it stayed there. My psychiatrist agreed that I shouldn’t be pushing myself with the gym and suggested walking each day.

Walking. Okay, seriously! I have a green, leafy park that I can get to, walking, in less than two minutes. It’s one of the awesome conveniences of where I live. Theoretically. There’s a beautiful walking loop made from perfectly poured, on camber concrete with an inner spongy lane perfect for running. It has marked distances and revolves around a pretty little lake with ducks and a foot bridge, a community exercise area always in use and a children’s playground. Perfect.

Two minutes to the park. Five minutes to the hospital, twelves minutes to the train station and supermarket. That’s my house.

But I don’t like walking anymore!

I used to walk up hill to the train station to get to work every day, from October 2013 to March 2014, and I just did it without thinking. Then I walked around the hospital all day often clocking up half my daily step count and a couple of kilometres. I’d often take a walk for 20 minutes under the Moreton Bay fig trees to chill out at lunchtime which was lovely, travelling from Commercial Road to Toorak Road and back, then walk back down the hill again to get home. My Fitbit got to 10,000 steps every single day and often quite a bit more. I was doing great physically and was in the shape of the last 10 years! I’d just spent more than 18 months up to August 2013 exercising and dieting my way to 78kg which was a 15kg effort that I was very proud of, and got me within a few kilos of my ideal weight! So I was enjoying my hard work.

But as I got sicker, my motivation and energy flagged and I started putting on some weight, and that morning uphill walk was taking me longer and was getting harder. I started to dread it! My breathing was way harder than before, my heart felt like it was about to hit the absolute red line or die altogether, my legs rubbed and chafed and turned to jelly mush, and I just didn’t want to do it anymore. Besides I had to conserve energy; I had the whole day still ahead of me!! I didn’t want to walk; I wanted to catch the bus. Once I did, there was no turning back. I would wait 15 minutes at the bus stop for a 7 minute bus ride that was full to overflowing where I sweated up a storm in the crush of body heat, rather than walk 10 minutes home, even though it was downhill. At that point, it didn’t matter whether it was uphill, downhill or neutral; I hated it!

I’m working on this. I wear shorts or leggings, I take my time, I breathe it out, I remember that my heart is actually a surprisingly resilient muscle and no one has ever yet died from it jumping through their throat into the open air and flying away! That last one is difficult and takes a lot of mantra-like chanting inside my brain! I will not die, I will not die, and I will not die.

We did an impromptu walk with friends a couple of months back. It was described as an easy walk, but that was their opinion not mine. They set a cracking pace over difficult terrain and I wished I was dead! Halfway through the caring mother figure asked me quite seriously if I was going to have a heart attack!! I was so red in the face I probably looked like I would in fact explode, I was dripping sweat, my feet and legs hurt…la, la, la; it wasn’t that much fun, apart from the scenery.

Cue the bicycle. It came to me, I now realise, at the perfect moment in my journey. I’d seen an ad for She Rides earlier and instantly dismissed it. The fact that when it came back around on Facebook, or email, or something else, I actually considered it, showed that I was in a place in my recovery where I was starting to open my very closed mind to the idea and possibility that starting gently into some exercise could really be something I could a) do, and b) maybe, somehow, I don’t know but people assure me I could, actually enjoy! So I tentatively put out some feelers. I’m not a committing person! I have to do a lot of thought before I jump in, and even then it’s more of a slow trip and fall that accidentally turns into a jump!

Ask my husband: we went out for 7 years before I “jumped” in! At least we got through the whole itch thing first. In that last year when it was blindingly apparent that of course we’d be together forever, and no sinister cosmic plan was floating through the universe waiting to hit us with its deadly and devastating bolts, or anything along that drastic and dramatic plane of thought, I gave my husband a model snail. I told him please wait, I’m getting there, I’m coming; it’s just taking me a while! That’s how I am, but I’m working on it. I can impulse buy now, not that I’m sure that’s a good thing! There are shops in Shepparton where I grew up probably sick of the sight of me, coming back for the third time to try on the same pair of shoes “just to see” if they were any different from every other time! Procrastination is what it’s really called, and it has gotten the upper hand of me in a lot of my life, but I’m working hard to crush it!

Getting going

I want to talk about motivation.

Again.

Because we can never hear this message too many times. Because understanding motivation might just make you someone’s hero. And it might make people with motivation more thankful and grateful for it, and help them feel empathy for someone in defeat!

Motivation is a BIG, HUGE, MASSIVE, ENORMOUS, GIGANTIC barrier to people suffering from depression.

If you don’t have motivation, the days are more than a huge struggle, a grueling drag, a marathon race, a torture ground, long, hard, awful and just something you don’t want to have to force yourself through again, just because the stupid sun came up!

Sigh, groan, urgh, ahhh, really, why? Do I have to? I don’t think I can. How about later? I just need a bit more sleep. Maybe tomorrow, I’m just not up to it today. Nah I think it’ll wait til tomorrow.

Motivation is what gets us up in the morning. We’re motivated to get to work on time, eat a healthy breakfast, do well at our jobs, keep house, bring up nice, healthy children and because we have this motivation we do what it takes to get these things done. We don’t even think about motivation until we have to make an extra effort, like participate in a sporting event or study for exams. It just comes naturally.

But depression vacuums up every last inch of motivation, unplugs the dirt bag and buries it deep in the middle of a Mexican desert where you will NEVER, EVER find it EVER again.

It’s gone.

Done.

No more.

So instead of going about your business as you normally would, each and every tedious step takes your fullest energy and effort!

Getting up took all my effort, and was delayed to the last possible second or a bit longer. Showering exhausted me: stepping into the tub, standing up for that long, lifting my arms to wash myself. Getting dressed was a Herculean task! So many motions to go through!

Walking to the bus stop took so long since I was wading through thigh deep thick, sticky treacle, figuratively speaking. I slept as much as I could manage on that bus, the train, and the next bus. I grabbed a quick takeaway breakfast of the oily kind and tried to get to the morning handover on time. There were usually some missing minutes before the work day started.

sausage, egg, tomato

Breakfast of the oily kind!

From then on the aim was minimal physical effort, pure survival until morning tea break, until lunchtime, until afternoon tea, until home time. These breaks were my vital link to survival. I got to sit down, and eat. And just be by myself.

Then came the end of the day with the new aim of getting home ASAP and getting into bed and desperately trying to get enough rest for the next day. That never happened, I never felt rested enough the next morning. I started every day in a severe deprivation of rest. I had had exactly the amount of sleep I needed physically but the adrenaline racketting around my body made me feel continually at the limit and exhausted.

But do you know what? I believe that throughout that time I still operated at my usual level in my job. Nobody noticed that I was suffering badly. They didn’t notice that I was suffering at all. All throughout I made a lot of friends and collegues. My peer review rated well. My boss was very pleased with me. I knew I was doing a good job. I was a good pharmacist. My team was tight and I loved the group of pharmacists that I was in. I was keeping up appearances.

That’s what was showing on the outside, and am glad it was cos I loved that job and wanted to do my absolute best. And I feel that I did. Somehow.

All this despite all of this other stuff screaming and shrieking on the inside. Once or twice a week I went to my GP across the road and that was my outlet. There I could cry, sob, not be okay, hate my situation, complain, whinge, feel awful. And he was happy with that. In fact that’s what he wanted, that I could keep going elsewhere, even at home, but have at least that one outlet where there was no hiding, no pretending, no pushing on. Home was my other outlet, no pretence. Or so I thought. My husband says to this day that he had no idea of the extent of my illness. I guess keeping up appearances got to be a habit!

salad

Dinner I made in November 2013…must have gotten up some momentum! It wasn’t all bad news, and no wonder my hubby was fooled! Looking back at this photo, I’m fooled!

This, my friends, all of the above, is why when ANYONE ever suggests that I should “push through the barriers” or “make a bit of an effort” or “just try a bit harder”, my hackles rise, my respect for their understanding and knowledge bungee jumps off a cliff with no rope, and I from then on out try to avoid them as much as possible. Then. These days I try to educate them, but I give up quickly if I’m not making an progress. I don’t have the energy to waste.

Try a bit harder? Do you realise that I am constantly at the absolute limit of what I can physically, mentally, spiritually and everything else manage just to be here, out of bed, dressed, among other people, smiling and giving the general impression of being okay? No, of course you don’t. I know it may not look like it, or feel like it. In fact it probably looks the opposite, that I’m not doing very much at all. But to me, right now, I’m doing the very best that I’m capable of. So I smile harder and walk away.

Of course I’m talking mostly about the time before, during and after my diagnosis of generalised anxiety disorder, depression, and bipolar disorder. And the time following each of these when I started medication which was adjusted and added to and removed from and monitored. They were awful days. Not every day, and not all day, but in general they were just hard to get through! And they aren’t gone completely, but I have not had SUCH a bad day in many months now.

These days I’m doing better for motivation, still not back to my old high achieving self with good self care and standards of house keeping. But getting there. It has taken a LONG time to get back, about a year from when I first restarted antidepressants in December 2013 and has been greatly helped by starting lithium in May a year ago, which I still consider to be not only my life raft but the instrument of getting back to my old life. My life takes less thought, less meticulous planning and less energy and effort to conduct. I have reserves of energy that don’t get fully drained, and life is just more enjoyable because of that.

There are tricks and tips that I still have to use against myself. Making things non-negotiable by paying for a course because my inner coin counting self won’t accept waste. RSVPing to organised bike rides so everyone else is expecting me and will be let down if I don’t arrive. Making dates and times to meet people for lunch, coffee etc so that I have to go. Keeping going while I’m going, and doing just one more job, one more chore, tick one more thing off my to-do list before I sit down and don’t get up again.

bed, winter, ginger cat

Getting out of bed is harder. So I make my doctor’s appointment each fortnight at 10 or 11am so that I have to get up on time that day to get there on time, which is also non-negotiable because that GP saved my life more than once and I owe him my best effort. Any other appointments that I have I try to make in the morning also, for the same effect. Lately it has been easier because my miracle working psychiatrist, in one fell swoop, has erased all sedation and daytime drowsiness and sleepiness. So I actually wake up at the time that other adults wake up! Sometimes even earlier like 4 or 5am. And go back to sleep for a bit but often I’m wide awake by 8am or a bit earlier. So that greatly helps!

Showering. This is an issue. I don’t know why, but I just have such a hard time working myself up to getting in the shower! It’s gotten to the point of a serious aversion. My husband has to get the water running (no mean feat with our current plumbing) and frog march me in. Once I’m there its fine, not a problem at all. It’s the getting started that’s the problem. Which, in it’s essence, is what motivation is. The drive and momentum to getting things started. So there’s still a ways to go, but I have come a ways which is comforting.

Launching Place, rail trail, sign

Launching Place: sounds like a good place to start!