Pens and the art of mood disorder maintenance.

February 16, 2015 § 1 Comment

When I was younger, hypomania was bright and shining, immensely productive, thrilling, vibrant. I was a joy to be around in those days and weeks when art and music and poetry and friendship just flew fearlessly right out of me, right up until I burned up in the stratosphere and came crashing down, a smoldering lump, to the ground.

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As I’ve gotten older, I still see flashes of that sparkling energy, that proprietary brand of effervescence. But more often than not, my hypomanic episodes are a crackling flame of anxiety and irritability. Medication and strict management have hemmed in the dangerous, bankrupting highs, and while this has kept me breathing (and married, and financially solvent), it has transformed the once scintillating creative energy into agitated, tightly wound fear. My manic traits now manifest in panic.

I once believed that if I could track precisely, eat perfectly, medicate consistently I would be safe. But even if you starve this disease of every trigger, it breathes. It attacks unprovoked. After two decades with this diagnosis, and eight years with babies in my belly or on my breast (and therefore unmedicated), I have become hyper aware of its movements. I have learned that the best defense is to move with it. It is not unlike holding a very hot cup of coffee in a moving car, anticipating the stops, starts, and potholes, inevitably spilling here and there and burning your mouth trying to drink it down to a manageable level.

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These movements are subtle. Taken out of context they are silly and strange. But these movements are purposeful, powerful, medicinal, so it’s no surprise that they become habit.

Pens are one of my small movements. Fountain pens require regular cleaning, inking, maintenance. They must be taken apart, inspected, thoroughly cleaned and reassembled. By modern standards, they are a ridiculously tedious and inefficient way of writing, but a remarkably effective method of managing anxiety. Pens, unlike children or husbands or most things living, have steady, predictable, constant needs. Pens have problems I can solve.

When I begin to buzz with panic, I clean my pens. I spread my ink cloth on the ugly blue laminate beside the bathroom sink, set up my little yellow bowl and baby blue bulb syringe just so. I select the most needly pens in my collection, remove the caps and unscrew the barrels from the sections. The eviscerated shells sit quietly and wait while their converters are twisted, pinched, plunged empty. The water runs wild in the sink, stained with Damson, Tsuki-yo, Tanzanite, and Ancient Copper. I fill the yellow bowl with cold water, suck it up with the bulb syringe, and cram the nozzle into the section forcing out the old ink. Again and again, until the water runs clear. Again and again until my nervous system is convinced that the threat is under control.

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Sometimes there are nibs to remove, breather tubes, feeds to reset, but no matter how elaborate the deconstruction, the goal is always the same. Empty the pen and make it new.

Often there are children pulling on me while I do this surgery. One might be clawing at my leg, another desperate to spray the mirror with water. All of them fascinated by the mess I’m making, the magic of ink and water and towels and mama’s intense focus. With each pen laid to dry on the cloth, my anxiety eases. My brain, satisfied by this focused, non-threatening, dopamine producing activity calms. My shoulders drop, my breathing slows, and I frequently forget the emergency that drove me to the sink. The trigger may still exist, but I have moved beyond the initial jolt, the panic that accompanies interruption.

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I get by with a little help from my pens.

February 2, 2015 § 1 Comment

My first fountain pen was a burgundy Sheaffer No-Nonsense. I taped a feather to it and kept it in a writing slope with some gilded stationery, sealing wax, and brass page points. I was thirteen and very sophisticated.

I didn’t have the patience to learn much beyond my first name in Gothic script, but that pen provided a still, quiet place in those early days of my mental illness. I could be raging and desperate when I picked it up, but the sound of the nib scratching at the paper, the feedback vibrating up the pen into my fingers, the ink flowing from the silver tines like a ribbon being untied caught me, slowed me down.

Many years, many doctors, many methods and medications to manage manic depression later and I still come back to this simple practice of putting a pen to paper. Any form of dragging an inky stick across a page makes me feel better. It is action where I am helpless, motion where I am stuck. I push my mood forward with the pen, nudging it, heaving it across the page until it goes quiet. It is less of a hobby than it is medicine. I take it daily, whether I want to or not.

Pens are just a trick. Bait. The shiny object that lures my hand to paper and coaxes me to write. My husband gives them to me as often as he can, like some men give flowers. Birthdays, bad days, just-thinking-of-you, hope-you-snap-out-of-it days. Some are so painfully gorgeous they can be almost impossible to use. Some are plain and hardworking. Some are always, always with me. My therapist once had me count how many fountain pens I had in my bag during our session. There were eleven. She asked how much time I typically spend writing with them when I am out of the house, carting three small children around town. Zero minutes. But just knowing they are there, my tiny Ebenezers, gives me peace.

Would you like to meet them?

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Less than satisfying.

January 28, 2015 § Leave a comment

Ten minutes this way, ten minutes that.

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Never been so jealous of the people moving faster than .13 mph.

First post-op visit.

January 22, 2015 § 2 Comments

Yesterday’s weather related euphoria rapidly dissolved in today’s cold, gray drizzle.  My walk was annoying, damp, and without any particular insight.  The pain in my leg cracked like a whip with every third step, and I had to stay very focused or get shocked.

In the afternoon I went to see my surgeon for my post-op visit.  He was late, so I studied the list of questions I had preparedand ran my fingers along all the models of the spine, discs, nerves that were tossed around the room like toys.  Dr. Tran burst into the room with the force and enthusiasm I have come to expect from him.  “Hello, Ms. Rachhhhellll,” he shouted.

Before asking me anything, he told me to stick my legs out in various ways.  I did as I was told and he seemed confused as to why I wasn’t moving faster.  He kept testing my right leg, my right foot, and finally asked me how I felt.  I told him that I was about 25% better than before surgery.  He looked as though I had slapped him.

He grabbed the laptop he had tossed onto the examination table and pulled up my file.  He clicked and mumbled and sat there in silence until I decided that maybe I was being to harsh.  “I can stand up longer.  I can walk to the end of the block.  I couldn’t do that before.”  He looked up, “That’s good.  But tell me about the pain.”

I told him about how it strikes like lightening when I turn in any direction, how it throbs when I try to sit still, how it forces me to move every hour through the night.  I told him my leg was still cold, my foot was numb, and my limp was still prominent (all things he’d assured me would be immediately gone after surgery).

He looked again at his computer.  “Here are my notes from your surgery, Rachel, and here is why I think your nerve is so angry.”  He explained that the extrusion (the amount of disc material that had ruptured) was so much larger than he had anticipated, that it had pressed the nerve hard into the bone, “I actually had to remove some of the bone to make more room for the nerve.”  He told me more about how much disc material he had removed, and admitted that it was possible he had not removed it all, that there might be some rogue pieces hiding in there, attacking the nerve when it’s supposed to be healing.

We briefly discussed more surgery, but I stopped him to ask, “Is it possible that I may just have to learn to live with this level of pain?”  He looked sheepish, which is not a look I particularly like to see on a surgeon, and suggested I try a new medication to “mask the nerve pain.”  I put the rest of my questions away.

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I hurt my back, skipping parts 2 and 3

January 20, 2015 § Leave a comment

I’m jumping ahead in the story of my back.  I did have surgery on January 9th, and it was “successful”, though my extrusion was much larger than expected, and my nerve damage more extensive.  The recovery thus far has been complicated by every member of my family, including myself, coming down with a violent stomach virus.  I am in far more pain that I anticipated I would be after the surgery (which was sold to me as something that would leave me completely pain-free).  I am going to try to post updates, simply because writing them does make me feel better.

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Today I took a walk. I shuffled slowly down the street, kicking a happy clump of ball moss with my weak but working legs. The sun was already low, but it was warm and bright and optimistic.

I walked further than I have been (I started these walks four days ago), cheered on by the perfect weather and the solitude. My mother took all the girls to gymnastics, so there was no one to push or answer or herd toward safety. It’s still January, and there are at least a handful of pitiful winter days to come, but every branch is humming with readiness for spring. Just waiting for its cue.

I was reminded of a scribbled page from the fall, when I was dissecting my depression and lamenting my productivity. My little graph holds true, I feel the ascension into the lengthening days, the big ideas, the boundless hope, the filled up pages. IMG_2473

Even with my raw nerve begging me to stay still, with the electric pain that jolts down my leg if I do not choose the perfect steps, the perfect execution, I feel better today than yesterday.

Tomorrow I see the surgeon. I assume he will release me drive, to hold Harriet without help, and to slowly begin some sort of physical therapy. He will likely also tell me that the nerve pain I still feel is normal, based on the how compressed it was when it got in there and cut it loose. He will tell me there is more pain ahead. But if my graph is accurate, I’ve got until July to deal with it before it crushes my spirit.

I hurt my back. Part 1.

January 14, 2015 § Leave a comment

I tend to invite injury on a liturgical schedule, so on the first Sunday of Advent I destroyed three discs in my back. I would like to say I was doing something amazing like throwing a Volkswagen or saving one of my children from an oncoming train. But I was just holding a baby, like I hold one every day, and cleaning up a spill with my foot and a dishtowel, like I clean them up every day. I did not fall, I did not slip, I just stepped on the towel to soak the coffee from the rug and an invisible hockey stick slammed across my back.

The pain was enough to force a phone call, and I carted my kids to the chiropractor three times that first week. Then I carted them to Costco, Whole Foods, Target, the YMCA, and round and round the lake as fast as I could, twice. I took some ibuprofen, I did some yoga. The pain was there, but it didn’t stop me.

When I woke up Saturday morning, six days after the disaster, it stopped me. Pain tore through my right leg like a serrated blade. I hobbled to the bathroom, leaned over the sink and promptly collapsed onto the floor. It was worse than labor, worse than c-sections (where actual knives cut through my body), worse than any pain I had ever felt. I dug through the medicine cabinet for leftover Norco from the last baby and swallowed them as fast as I could. They didn’t do much.

An MRI showed three herniated discs: one with a very large extrusion compressing my S1 nerve root, one with an annular tear, and one herniated and sharing space with a synovial cyst. The source of the pain was obvious, but the cause and course of treatment were unknown.

So I spent all of Advent on drugs, on the couch, in relentless pain. I tried to do the meditate on Mary thing, imagining how miserable it would’ve been to sit on a donkey for days and days while magnificently pregnant. I tried to pray for people with far more gruesome injuries. I tried to be thankful that I still had control of my bowels and bladder, that the miracle of Instacart was a thing, and that my husband was loading laundry and dishes, even if he was doing it completely wrong. I tried to stay calm. I tried to transcend.

I failed.

All the things I could say

January 3, 2015 § Leave a comment

I’ve been blogging for thirteen years. That’s weird.
The bulk of it doesn’t (intentionally) exist on the internet anymore, but it does exist. Lots of fits and starts, some long stretches, several apologies and silly promises to myself and whoever is reading that I will write more. I will write more! I will write better! You’ll see!

All of my favorite blogs tend to end with posts like that.

This is not an apology or an overconfident reintroduction. It’s just a post on my blog, because I do that sometimes.

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