Good problems

When I think of good problems to have, I think of things like, oh my gosh, we have too much ice cream and not enough room in the freezer.

This blanket is so soft and snuggly it's making it hard to get out of bed.

My pants are uncomfortable because I ate too much pie.

Ooh, the tea is too hot. I have to wait to drink it.

We have too many puppies. (Can you have too many puppies? I want a puppy.)

These are the things that spring to mind with good problems.

I don't know if you ever read, "Where'd You Go, Bernadette," but there's a part where one character calls the brain a "discounting mechanism"—discounting in that you get incrementally less excited about something new, or less upset about something terrible.

They said something about it being a survival mechanism. Humans cannot stay super excited about every new thing because then in the olden (prehistoric?) days you wouldn't process threats, or something like that.

So your brain makes sure it gets less and less shiny and exciting, or less calamitous, as time goes on.

I find this idea soothing. It makes sense to me.

You can get used to anything. 

Anything.

I have known this forever.

The problem is, it can give you a super fucked up worldview, and in the Venn diagram of life, your circle might not even have any overlap with most people's. You could just be your own adjacent circle.

Or anyway, it might feel like that. If you feel like you're always inside outside.

But just about anything can be normalized.

I'd known this for a long time, but hadn't thought about what our brains were doing. 

Discounting! If you act fast, you can have 30% of this emotion. Today only.

So on Monday, Nick went with me to my quarterly oncology checkup.

We passed the Pope, we walked across the walkway, we hung out all masked up in the very full  oncology waiting room.

Friends who'd had breast cancer told me that at first you thought and worried about it all the time. And then after a while, it becomes normal, and you just live. Which makes sense.

Because there are so many other things that require your focus in life. So what else are you going to do?

Anyway, I wanted Nick to come with me, because when I told him I didn't need him to accompany me to my annual visit with my breast surgeon, that's when she found the lump.

I'd rather he were with me than not.

Last time I saw the oncologist, so this time I was seeing Terri, the Nurse Practitioner. She's terrific. She asked me if I'd considered the new medication that she was under the impression the oncologist had suggested to me three months prior.

And I was all, maybe I was too sick to remember? Or maybe she didn't talk to us about it because she was so worried about me having pneumonia?

I couldn't remember any medication discussion, and neither could Nick.

So according to Terri, there's a medication that is not new, but it's newly available to a lower-risk group of people than before. Because I had lymph involvement, I now qualify. And so they wanted to know if I wanted to try.

I know that I had a .3 mm spot in the one lymph node they removed. I know this. And I know I didn't need chemo, and my scores were so good that radiation was optional, so after a second opinion, I decided not to.

Because there might be more in other lymph nodes, but there might not. And radiation has its own complications.

At first I worried about my decision all the time. And then, after a while, I just kind of stopped thinking about it.

I know the facts, but I don't feel them all the time. Sometimes I ruminate. Sometimes I what-if, particularly about my parents.

But I try not to do this, because it doesn't solve the past. It just hurts me now.

You have to live.

But suddenly, there I was, feeling the big anxiety feelings again.

This new medication would be in addition to, rather than replacing, my current medications, and would  further reduce the risk of recurrence.

The risks, because there are always risks, include liver injury and heart problems, so they monitor you carefully in the beginning.

So Nick and I were like, it seems like you think it's a good idea, even though it's adding another medication with possible side effects?

She said yes. If I couldn't tolerate it, then I'd just quit taking it. But no harm in trying.

It takes a while, because it comes from a specialty pharmacy, plus insurance has to approve it, and that is its own process.

So maybe I'd be starting it in the new year.

It felt like something huge, adding another medication. 

And I'm already on medication that makes my joints hurt, and it's aging my skin, and when I look in the mirror, some days I feel like I look like that actor who plays River Cartwright's grandfather. If you've watched Slow Horses.

Although a friend assured me I don't look like River Cartwright's grandfather.

But even if I do, that's just vanity. I want to be around for my kids.

So then I wouldn't want to not have tried, because what if I didn't try, and then down the road it comes back?

And then I'd be all, fuck a duck, I should have added that other medication.

Right?

This news felt so heavy.

Maybe it's because it's winter, or maybe I just got used to things being the way they are, whatever that might be.

We talked about it on the way home. Of course I should try it. Then no regrets.

Then, shortly after we got home, Terri called me. She'd spoken to the oncologist.

As it turns out, the oncologist hadn't offered it to me because I don't qualify. My risk of recurrence isn't high enough for this study. My tumor wasn't big enough in the first place. And I only had a micro-met. 

Metastasis, but super tiny, which they call a micro-met.

Like if you get introduced to someone, but only briefly. Steve? Oh, I micro-met him at a party last year. 

I was like, "Wait, so now I can't have this medication?"

She said, "You're too low risk. It's a good problem to have."

Which is, of course, true. Being too low risk is a good problem to have.

But then suddenly I felt like I had this amazing option taken away. Like, what if this was the solution, the thing that bumped me over into safety from a future problem I might not even have?

When, realistically speaking, it might've given me annoying side effects for three years and not made any difference.

You don't know until you know. Which I guess is true about everything.

But now it's been four days. And the discounting has begun happening. Monday felt like crisis. Tuesday less so. 

It's Friday, and I can talk about it in a more dispassionate way, because I just don't feel it so much.

And plus, now we are in the end-of-year-holidays-are-upon-us frenzy, and there are so many things to do. 

The tree us up, and that's a whole nother thing, and holiday sads do catch me unawares and wallop me every once in a while.

So actually, while I'm thinking about it, I would definitely take a coupon for a massive discount on those feelings.

Neurodivergence, or: We always hang in a Buffalo Stance/We do the dive every time we dance

OK, so, I know you're not supposed to diagnose yourself using social media.

And this is not exactly what I've done.

But I've discovered that one of the best things about memes is that they've helped me learn about my neurodivergence, and they've shown me I'm not alone.

I was diagnosed with ADHD a couple years ago. It was a huge relief. I've been very open about this and written about it a little.

This diagnoses explained so many things about me that were either pieces of me that frustrated me and made me insecure, or were things that made me feel like I was kinda quirky, and if you appreciated quirky, you might appreciate me extra.

Or not. Because it works both ways.

There were things I'd try to hide, because for a long time I wanted to seem normal. Ha. 

And there were lots of things I did that I didn't think about one way or another until someone pointed them out to me.

Now, there are numerous memes about autism and ADHD, and it seems like they share commonalities and maybe even significant overlap. I don't know anything about autism. But a lot of these memes resonate with me.

I don't assume that just because my brain works in a particular way means that someone else's brain works the same way.

But ooh, it's nice to learn that those similar-brain-working-people are out there!

I've delightedly learned that I'm not alone.

There are other people in the world who will choose a song and play it on repeat 372 times. There are people who will go back to the beginning of the song if they dissociated and missed part of it.

I honestly didn't know other people did that.

I also didn't know that other people just checked out for a while and then dropped back in and realized they'd missed a significant part of the song. Or the conversation. Or the lesson.

Whatever might be going on, that continued to go on while my brain went myriad other places. Or not really anywhere, but not here.

So sometimes I learn that all along, I've been approaching things in the same manner as other neurodivergent humans.

And then I sometimes I learn I take a neurodivergent approach from someone telling me not to do what they assume I do, because it's (apparently) what most people do.

Like, my yoga teacher is always making daily tasks into opportunities for strengthening or stretching.

So the other day he was giving us examples like when you soap yourself in the shower, do forward fold. When you're drying off, raise your straight leg up and put your foot on the sink, so you get that strengthening and stretch.

And so on.

He said not to just stand at the sink when you brush your teeth. He, personally, holds horse stance.

Use all the small opportunities.

But I was like, who stands at the sink when they brush their teeth?

(Do you?)

When I brush my teeth, I'm always wandering around trying to do also something else. Like remove or put on my socks with the other hand. Or pull on or take off my pants. Or open a jar.

I  have successfully removed my tee shirt while brushing my teeth, but it's a big hassle and the chances of getting toothpaste on your shirt are high.

The chances of flinging your electric toothbrush through the head hole and across the room are also high.

So it's really not worth it.

But I've always tasked my self with something hard to do one-handed. I guess most things are hard to do one-handed. 

This is never a time-saver, in case you're wondering.

I'm not offering up helpful tips or tricks.

No. 

It's more like it never occurred to me to stand at the sink. Why would I just stand at the sink when I can wander and even mildly complicate my life?

Who, I wondered, stands at the sink the whole time?

My husband. 

My husband stands at the sink the entire time he's brushing his teeth.

He's surely done this throughout our 16 years of marriage, because he's done this every morning and night that I've observed in the last couple weeks.

But I've never noticed, because I'm busy not successfully accomplishing tasks one handed in the next room.

Me, I'm now aiming for horse stance.

(Also, this is really the only way to eat raspberries.)

I see a red door and I want it painted black

You know how people say not to google health stuff because it will lead you to the worst possible scenario? You should just wait and speak to your doctor.

Because if you google you may end up thinking maybe you have, oh, say, liver failure when in fact the likely explanation is hay fever.

So today, at the start of my annual physical, when the nurse asked me the list of mental health questions, I answered honestly.

Have you felt depressed, hopeless, or down in the past month? 

Yes. 

Rarely, often, almost every day? 

Almost every day.

They asked whether I've lost interest in things that usually bring me joy. 

Yes. 

Lost motivation? 

Yes. 

Am I thinking of harming myself?

No.

And then she did an EKG and the doctor came in.

My heart is terrific, apparently.

I had a whole list of questions for my doctor. 

One of them was about the whites of my eyes.

Because the other day in yoga, we were facing the mirror wall, all up close. And I was like, the whites of my eyes are not white.

I didn't think they were yellow, but they were not white.

As soon as I got home I googled and I was all, oh my god, my liver.

I've never had hepatitis, and when we lived in India, we got regular gamma globulin (painful, in the butt muscle) injections to prevent Hep A. In Peace Corps those of us who worked in health had to get Hep B shots.

But I'm on some intense medication. What's it doing to my liver?

So today at the doctor I bugged my eyes out all, "Look! The whites of my eyes are not white!"

And my doctor said, "It looks like either you've been rubbing your eyes a lot or you have allergies. Have you been rubbing your eyes?"

No.

"Do you have allergies?"

Yes.

"Did you google and freak yourself out?"

Oh, absolutely.

She was like, "These look like allergy eyes." Her suggestion is take allergy pills or get allergy eye drops.

So we did the whole physical, and I was about to head off and get blood work when my doctor said, sooooo, about these mental health answers...

At which point I started to cry.

Because that is how I am right now.

And this is what I told her: I know I'm struggling. I just don't know what to do about it.

My favorite antidepressant makes my hips hurt because of whatever the aromatase inhibitor is doing. And it's my favorite after years of trying different ones and titrating up and down and being tired and gaining weight and being all clenchy and angry and whatever else side effects. 

My favorite one is my favorite for many good reasons. Except that now, in conjunction with my aromatase inhibitor, it makes my hips ache quite badly.

And choosing between cancer prevention and mental health, I have to go with the former.

If chronic pain is optional, I choose not to have it.

So I've been doing the following: Using my full-spectrum lamp. Eating really well. Exercising every day. Getting as much sunlight as I can. Seeing my therapist.

I know all the things you're supposed to do.

I think this is seasonal. Though I wasn't diagnosed for years, I've had seasonal depression since high school. 

Sometimes people say things like, but it's so warm! It's not even winter! 

It's true, it's been delightfully and alarmingly warm. But the fact is that I could be 100 degrees, but if it's pitch dark by 5:00 pm, that is hard on people like me. 

Our serotonin gets re-uptaken too easily or something like that.

I know this kind of depression. Hello darkness, my old frenemy.

One of the tip-offs for me is that I'm gravitating to all black. I've forced myself into some of my fun clothing, because I firmly believe in dopamine dressing.

But right now it just feels like I'm in someone else's clothing.

I bought a second pair of black leggings for yoga. Basically all of my yoga wear is brightly colored.

So, yah. (A phrase Nick hates.)

I cry easily. I don't want to do much of anything. I hate most of humanity, although it's hard to know if that's depression or warranted.

I would prefer to never leave my house, but I do, every weekday morning, for yoga. I walk the dog. I bike a couple miles to therapy, and then I bike back.

I feed myself. I feed my family. I bathe pretty regularly. 

I hate my face and I hate my hair but I don't know if that's depression and I'm hoping whether it is or isn't it's not permanent.

But I currently feel kind of like when that bug came to earth in Men in Black and put on a human suit. I'm doing many normal human things, but kind of fakely and somewhat awkwardly.

But things feel kind of pointless. Hopeless. Not completely, but mostly. But again, it's hard to know if that's my depression talking or the way the world is.

I really enjoy my family most of the time. I'd like to spend all my time at home with them. 

I am able to find joy, and sometimes I laugh out loud. I still have my excellent sense of humor.

I'm not contemplating self-harm. I'm nowhere near the bridge.

I want to curl up in a ball and sleep most of the time. I don't. But I want to.

Anyway, I told my doctor, who I love, that I just don't know what to do.

So what do I do?

Do I maybe try Prozac, the OG, which I've never tried, to see if that helps my mood and doesn't cause me physical pain?

My hesitation is that I don't want to further burden my kidneys or liver. And it might make my joints hurt.

Even though I am very happy to know my eye issue is allergies and not my organs failing.

Or do I just keep doing what I'm doing, with the knowledge that in just over a month the days will begin to lengthen again? The sun will return.

The next couple months will be hard, but there is hope on the horizon. Like, maybe March-ish it'll start improving?

She didn't know. I don't know. We'll see how my bloodwork looks. I'm going to discuss it with my therapist.

And then we'll make a plan.

So, yah.

And the days go by, like a strand in the wind

Dear Nick,

Seventeen years ago tonight I walked into the Tabard Inn on what would be my last first date. 

I love this date, and used to document it annually, but I've kind of fallen off on that. But I love the first year post.

We hadn't yet had kids, so I didn't yet know the phrase "warmy-coldy"—but warmy-coldy perfectly describes the November weather that evening. Which I wasn't dressed for when I left for work in the morning.

I'd have been on time if I hadn't gone home to change.

Well, I've contended that for years, but with my current understanding of my ADHD and my fraught relationship with time, and my jaded view of dating, I probably would've been slightly late anyway.

Back then, I didn't wear my glasses all the time, because I could see clearly at distance. And so if men hadn't treated me like I was smart when I wore my glasses, and not so smart when I didn't, I wouldn't have started wearing my glasses out at night.

And then after that one Match guy asked if I wore my glasses to look less pretty, I defiantly always wore them on dates.

But otherwise, I wouldn't have been wearing my glasses, so they wouldn't have fogged up when I arrived, slightly late and slightly blindly flustered, at the Tabard.

And you wouldn't have had something to tease me about immediately, and something to repeat very probably until death us do part when telling people about our first meeting.

Sometimes I think about the what-ifs, and so many of my what-ifs are wishing the past were different. My what-ifs are anxiety driven.

But recently I read this thing that said something like, "What if everything works out?" 

And sometimes, like 17 years ago tonight, when I wasn't exactly on time, but was barely late, and you were already sitting on a sofa drinking a beer—which, let's be honest, is not a hardship at the Tabard Inn—things do in fact work out.

Seventeen years ago tonight, we'd been working in offices about five blocks apart for a couple years, and yet we'd never bumped into each other in a coffee shop or lunch place, or on the street corner waiting for a light. 

In a movie, we'd have done one of those things.

But in real life, we were both on the Internet, and this night, November 13th, worked for both of us. And once my glasses cleared, I spotted you, and you stood up, and I put small hand into your big one, that was that.

And I've never looked back. 

Love,

Lisa

Hallelujah "nothing concerning"

I put that in the title because I hate it when you click on a link thinking you're going to get the number of minutes to cook unsoaked beans in the Instant Pot, and then you have to scroll through many paragraphs of how the blogger backpacked through Albania.

I want to thank all my kind friends who offered words of love and support on FB, in messages, in texts, and on the blog. I'm tremendously grateful for my community. 

And my goodness, I'm so relieved.

At Georgetown, at least from the entrance we use, you have to pass the Pope and photographs of other figures of historical import to get to appointments. The Pope gets his own sort of corner, though, which I think you can see.

I had to turn right at the Pope for surgery. I go straight past him for my regular appointments.

When I sat on the table the radiologist asked if I had any questions. I got all teary and was like, "Well, I guess what I want to know is if it's more cancer."

I don't even know what other question I'd have.

I said, "My tumor was behind my left nipple, and this little bump is under my left nipple."

So it's not an insane leap to imagine both implants removed and going through chemo and radiation.

These are actually possible scenarios with a recurrence.

This is not like envisioning sliding down the inflatable slide onto the life raft, imagining sharks circling just because you hit the kind of turbulence that makes pilots use their stern voice when they tell you to fasten your seat belts.

I told the radiologist that my surgeon thought maybe it was fat necrosis, and he said he couldn't say what it was, but the appearance was consistent with fat necrosis. 

Mostly we talked about the Hinkley Hilton, which he calls the Reagan Hilton (while I don't call anything the Reagan anything), and the Air Florida flight that crashed into the 14th Street bridge (and which, oddly enough, the dad of my friend Debbie had crossed just in time). We lived in the US the first time during both those events.

I also learned that he was born in Georgetown Hospital after his parents immigrated from mainland China. 

I don't know if I should capitalize mainland?

Basically, the radiologist said he saw "nothing concerning" and he had me sign a paper saying he'd given me this information. 

I don't recall having to sign a paper before, but to be honest with you, the other day I couldn't remember the word for dresser. I was talking to Nick and India and I said, "It's like a table with drawers that you put your clothes in."

So maybe I always sign a paper?

The radiologist told me to follow up with my surgeon, and then told me that she'd have ordered a biopsy if she were particularly concerned.

I found that extremely comforting.

So I texted my surgeon to say he found nothing concerning and wants me to follow up with her, and she hearted my message.

I don't know how I would fare with dating in the age of texting and emojis.

I had a flip phone (ooh, and also that wonderful Nokia brick, if any of you remember that) when I was doing all that Internet dating, which only partially explains realizing en route to meet a guy for a Match date that I couldn't remember his name. I had no time to go home and log into my computer. We hadn't talked on the phone.

Anyway, when I checked out I asked if I should make an appointment and they said she'd contact me once she'd seen the scans if she wants me to do anything further.

Phew.

And at least I know that I will see the oncologist in under three months and my surgeon in six, so that's helpful.

But for now, whatever this is is "nothing concerning" and I will take that. 

If I learned anything from Nicole last year, it is to dress up to feel better. So the photo above is what I wore this morning.

It's fall, which is not my favorite, because of course it is a precursor to winter. But at least it's sweater and boot weather, and I love both of those things.

I cannot take my antidepressant in conjunction with my aromatase inhibitor because for whatever reason, it makes my hips hurt like holy hell.

So I need to get out in the sunshine, and use my full spectrum light, and eat well, and exercise, and do all the mental healthcare things.

I know all these things, and I need to do them all consistently.

Yesterday, though, yesterday I ate an entire box of palmiers from Costco, and if you go to Costco, you know they sell everything in packs of five million.

Often when I'm stressed I just don't eat. 

But yesterday I ate one palmier after the other after the other while watching Love is Blind (which Nicole thought was a show about blind people). 

I never watch TV during the daytime. I did laundry concurrently to mitigate daytime TV guilt.

Some days are just like that.

I think despite going to yoga I was basically holding my breath for 10 days. And now I need a big cry. 

I used to cry almost every day. If I felt it welling but not coming out, I'd watch the English Patient. Back then, I had more time to commit to sobbing over a beautifully filmed three-hour romance tragedy. And I knew which scenes were my triggers, if I were short on time.

But I haven't watched it in over a decade. Could I just skip to where he's carrying her to the cave? Would that still work?

I'm so incredibly thankful to currently be in the position to be wondering about this, rather than making all the appointments and plans I was terrified I'd have to start making.

And that's where I am today.