Dermatology Again

Ever since I developed that cancerous (squamous) cell on my upper lip and had it excised–some twenty-five years ago–I have seen a dermatologist annually. I have seen the one I saw today for about ten years; I don’t know where the previous one went to or remember what he looked like. But this guy and I…we are growing old together. He looks less young each time I see him; his hair is really thinning with male pattern baldness (somehow related to the depletion of testosterone). One thing remains the same. He has never been on time for an appointment. He always runs twenty minutes late. One day I came in early and I thought maybe I was his first patient, but he was fifteen minutes late for that.

Today, my appointemt was for 9:20 and I had another appointment, not five minutes away, at ten. No big deal. But I wanted to be on time, if only because I always am.

There I sat in the office in my “gown,” as they call it. Here, they say, put on this gown. I don’t know that the nurse would have said that but for the fact I said I was there to have the dermatologist check out my body. Sometimes I only have to talk off my shirt. So there I am all sagged down and slumping on that table thing in my gown, and I am not really pissed off. Not like I sometimes get. Tense in the face and toe tapping pissed at the wait. I am more like numb with anxiety. But damn I have been waiting 25 minutes, so I get up and go to the door, thinking I will call out and see what’s up.

I open the door and there he stands. He apologies for the wait perfunctorily, and I say equally perfunctorily, is OK. And he launches into something about dermatologists waging a war on melanoma. That freaks me out immediately because I think he must have spotted one. But no, maybe he has just been to a conference on melanoma because it turns out, as he looks me over, that there’s nothing really alarming.

“You have few moles,” he says. “Yea,” I say, “I am blessed that way.”

Then, on cue, out comes the liquid nitrogen.

“May I,” he says pointing at something on the back on my hand. What am I going to say? No?

So he starts blasting away.

He’s finishing up when I point out the red spot on the tip of my nose that he tried to get rid of last time, but it didn’t go away, and he starts into talking about how the only way to tell if it’s cancer is to biopsy–which freaks me out–and then he starts blasting away at the tip of my nose, so now six hours later I have this big ugly pustule on the tip of my nose.

So, I say, in effect, A-OK? Hoping for some reassurance given the melanoma scare.

“You look great,” he says with some enthusiasm and then qualifies the hell out of it with, “for the kind of people I am used to seeing.”

Now what the hell does that mean. What kind of people is he seeing?

But I will take what I can get.

By now it’s eight minutes to ten. The whole exam took a little over five minutes.

Seemed like forever.

Preparing for the Inevitable

I got a letter from the University telling me that I will soon be 65 (according to their records) and that they wanted me to sign up for Medicare Part A three months before the actual date.

I didn’t know what the heck they were talking about, but there was a number to call, so I did. I was on the phone 45 minutes being interviewed by a machine and two human beings all collecting information geared mostly towards determining, I think, whether I was the person I said I was. I said I was born in National City. They said I was born in San Diego. I didn’t quibble. Close enough. Also I couldn’t remember my mother’s maiden name. I kept saying Barret, but that was her mother’s maiden name. Finally I came up with Keller and that seemed to make my interlocutor happy.

Now I have an official Medicare contact person, Mary, who said I will receive a card in the mail indicating that I am now enrolled in Medicare Part A and that I don’t have to do any more paper work, but had I questions to call her and she gave me a number.

I suppose this is all for the good and means–Medicare Part A–that should I suffer some sudden relatively catastrophic ailment, like a heart attack, that part at least or maybe all ( I don’t know) expenses incurred in the course of the catastrophe will be covered by the government.

But the government doesn’t, as we know, cover everything.

So Carol, heroically, has been looking into getting us some sort of towards the end of life insurance to cover expenses for home care when the time comes when one needs home care.

I don’t want to think about that time of course. I have a hard enough time thinking too much about such things, and it was harder still having a person come to our home complete with laptop, pad, pencils, and assorted official documents to discuss diverse options such as how much might it cost to have home care start immediately upon being declared “disabled” or how much it might cost to have three years of home care covered as opposed to something called “forever” coverage.

This stuff is quite expensive, so at first I said I would opt for four years of care. I couldn’t imagine hanging around for much longer than that. And the insurance operative said I was pretty much right on with that number, and that the people who dabble in such things say the average length of care is from four to five years and that usually people start needing such care about 80.

But Carol got pretty upset about the four year thing. “You will lie there,” she said, “and worry about the money running out and think that you had better hurry up and die in four years.” Or something to that effect. She has come to know me pretty well over the years, and she is of course correct. I would lie there fretting about whether I was going to live longer than I was supposed to.

We don’t know what we are going to do yet. We are just applying.

The insurance operative said there are something like 8 criterion for determining whether one is disabled. Any combination of two means you are disabled. So if you can’t get out of bed and if you are peeing on yourself, well that’s disabled. Or if you can’t prepare your own food and you are peeing on yourself, well that’s disabled too.

I can’t remember all 8, but it was a damn depressing list.

But what is a body to do? We are trying to act like responsible adults.

It’s a bit difficult.

Nuff Said

This may be one of the longest breaks from the blog that I have taken since starting it.

I just haven’t had the energy to say anything or the energy really to think up something to say. My mind draws a blank.

The causes are various. Getting older doesn’t help. But I think primarily I have been under the influence of drug withdrawal.

Since the start of the summer I cut back completely on a morning dose of .25 milligrams of klonipin, and just about two weeks ago I took my last little bit (an 1/8 of a teaspoon) of something called Wellbutrin, supposedly for depression, though lord knows what that means. I am now on less medication than at any time since I started this business.

Unfortunately, while I think the direction I am taking towards withdrawal is the right direction, I am not in the least feeling up or any better. Sadly, the opposite (I guess it is the opposite) seems true.

I am fatigued and worn down to the nub. I used to rely on my brain as a source of entertainment. I would be driving or walking from point a) to point b) and I hardly noticed it because my brain was working on something. But now my brain is blank. It seems to take forever to drive to the drug store.

Even the days seem to take longer and longer. You’d think as one got older that having longer days (since one has fewer of them to go) would be a good thing. But that’s not the case. I just wait for the day to be over, to get done with whatever I have to get done with, and get on to the next in the hope that it might be a bit better than the previous one.

No wonder I haven’t written anything. This is depressing.

I came across a journal I kept in college. It was easy reading because I didn’t write anything. Just day after day, the date followed by something like: nothing happened, nothing today, further nothing, nada, too much to do about nothing, and so on. Day after day of nothing with some exceptions like, I feel sick. Or what is the meaning of this?

So apparently I have been in this shape for some time. Like 50 years. But when younger, I know I kept thinking there was still time. Things could change.

I don’t think that so much anymore. Maybe because the simple energy of youth and the expectation of things to come is on the wane.

Nuff said.

Update?

Nothing much to update

.According to the countdown calendar on my “homepage” I have 35 days left before the first day of classes for the academic year, 2010-11. So the summer is slipping away again. But today the temperature started to go up and the sun, mercifully, is out.

Carol went to a conference, Creativity and Madness, in Santa Fe. She said it looked like a good place and her presentation at the conference–which included a recently choreographed dance–went very well. She had a bit of a problem adjusting to the altitude, 7000 feet, the first day.

Speaking of altitude, Brother Dave and Sister-in-Law Teresa got back last week from hiking the John Muir trail. Wow! 150 miles, I think they walked it in about 14 days. They were at altitudes of 11,000 feet or better. I followed them on Google Maps; they checked in each day with a GPS device and a little flag would appear on the Google Map at the point they checked in. Way to go guys. Looked alike awesome country, the word “awesome” being warranted in this case. Don’t think I will be hiking that trail any time soon. Though Teresa said they met a really gnarly 62 year old woman who was hiking the trail and also a seven year old girl. But I am a long way from 7 and not so gnarly either.

Brother Dan and I have been meeting every Sunday to play guitar a little by way of practice for recording sessions. We record again this week. We may or may not be making a CD. It’s not a “for sure” yet.

It’s not a “for sure” either than I will retire July 2011, but it is looking that way.

I missed officially acknowledging the second anniversary of Brother Steve’s move to Clinton. He appears to have had a brutally hot summer.

Brother Dan turned 50. Damn. That’s crazy.

I am still enduring the pangs of withdrawal though I think I am leveling out a bit.

June Gloom and Beyond

I have the weather for Clinton, SC (where Brother Steve lives), on my home page, so I am pretty sure that the high for any given day over the last four weeks has not dropped below 90. And usually it has been in the mid-90’s and sometimes higher. And all of Russia appears on fire, the result at least in part of an intense and prolonged heat wave. Meanwhile, here in Santa Barbara, or more exactly here in Goleta…where I live..next to Santa Barbara, we recorded, one day recently, according to a guy I overheard at the club, the lowest temperature in the mainland USA and appear to be having the coolest summer on record. The average temperature for August in SB is 79 degrees. But I don’t think we have hit seventy once this month and the high one day last week was 62.

I don’t know anything about possible deeper causes for this cooling trend, but we seem to be going through an extension of “June gloom.” June gloom occurs yearly and punctually, obviously, in June and seems to be the result of the “marine layer” that usually hovers offshore deciding to move onshore and park there for a while. This year it parked in late June and decided not to leave. So each morning I open the blinds to leaden skies.
gloom1.jpgBut that’s not the whole story. The forecast for later this week is “sunny” and that would be nice, but the temperatures as forecast remain unseasonably cool. Usually, each summer, for a month at least I can’t control the urge to start going barefoot and end hopping around on the hot pavement. This summer…zip…not once have I felt the barefoot urge.

I think possibly that the exact spot where we are located–about a mile and a half from the ocean–may well be cooler than for Santa Barbara proper. I know that when I head out to work out at about two in the afternoon, I have on my jean jacket, and that by the time I reach the work out place, a couple of miles further inland, I no longer need the jacket.

It’s strange is all. Certainly, far, far, far better than broiling in the heat, but still a little spooky–those leaden skies–they have gone on so long.

gloom2.jpgGoleta sky at eleven AM August 10

Klonipin: Withdrawal Cont’d 2

I have now…of this day…gone a full week without ingesting an iota of my morning dose of .25 milligrams of klonipin. I was hoping by this time to be feeling a bit more up. But so far no go. Indeed, I woke up Carol last night by talking or rather mumbling in my sleep. She said I was very restless, and today I feel it: restless.

But these meds penetrate every aspect of the mind/body self (up to and including one’s dreams). I was alarmed to learn, for example, that not only is the med fat soluble (meaning it will remain in my system for however long it takes to completely recycle the fat) but, how to say, it is also “bone soluble.” I don’t know what I was thinking. I guess I had assumed bone material was static and unchanging, but apparently it too goes though cycles of rebuilding and as part of that the med get also incorporated into bone. Lord knows how long it takes bone to recycle itself, or, even if, at my age, it is capable of a complete recycling and cleansing. So, who knows, it might remain in my system for my short “forever.”

But that is distant. More immediate is the way the med withdrawal influences mood. Well, I don’t know if it’s more exactly, more like the psychology of affect. Whatever I am feeling–depending on the time of day (I am especially paranoid at night)–becomes–I don’t know–amplified or taken up a notch. This is very subtle. It catches up with me before I am able to recognize it, or let’s say I am only able to recognize it when it becomes extreme. I read for example that the unemployment rate in some cities near the Bay Area is at 20% and without really noticing the process I become bleak, and anxious, and below that: afraid.

At these moments some times I am able to draw back and not infrequently into my mind pops a line from Hamlet that I paraphrase as follows “What is Hecuba to me or I to Hecuba.” Actually, remarking on how an actor appears to have gotten himself all worked up over the fictional character Hecuba, Hamlet says speaking of the actor, “What’s Hecuba to him, or he to Hecuba/That he should weep for her…”

Indeed.

Klonipin: Withdrawal Cont’d

As noted in the previous entry, I have been engaged some time now in withdrawing from klonipin. I had no idea when I started that this would be a full time occupation. But that’s what it amounts to. I have not been able to do much of anything but feel miserable and try to accommodate myself to that. OK–it is as if–you are sick so act like it. Lie down and be quiet, because if I don’t do that I start feeling really miserable because I don’t have the energy or the concentration to do what I have set out to do, at least when it comes to brain work. So I end up compounding the biochemical misery with the psychological misery of feeling that I have failed to do what I set out to accomplish.

My old shrink used to talk about exercising loving empathy towards yourself, suggesting that since my parents were failures as parents I had to be my own parent and parent myself as it were. This is stupid and strictly impossible. Still lately I have talked to myself in my head saying such things as hey kid, it’s alright. You may think you are dying of cancer, but at this moment, at this very moment, you have no evidence of that. So it’s OK. Right. So you are feeling miserable. What can we do about that? What about a walk? Since brain work is not working. Or maybe go wash the car.

Yeah, go wash the car. I did that. Doing physical stuff does help. I washed the floor. I took out the garbage. Right in the middle of washing the car, I get this dark feeling–like what is the point of washing this damn car, exactly. I can’t answer that question. Better not to ask it.

And I exercise every day. But I am 64 years old. I can exercise only so long without completely wiping myself out. I used to exercise an hour a day. Now I am down to 30 minutes. Damn.

I have to say I feel lucky. If I had to work a nine to five job in an office doing brain work, I would be going nuts. Honestly, I don’t know how people doing that kind of work could ever get off a drug like klonipin. Because I couldn’t do it. Instead, being a teacher, I have the opportunity completely to ruin my summer by deciding to withdraw from a drug. So far I have taken good advantage of the opportunity and have pretty much shot this summer so far all to hell and back.

But, hey kid, chill out…

Anxiety–Klonipin withdrawal

As I noted here a while back–June 21 to be exact–I embarked on a campaign to withdraw from the .25 milligrams of klonipin I take each morning. I have been employing the tablespoon withdrawal method. Dissolve the .25 in a cup of water and every fourth day go down a tablespoon. At that time, June 21, I was taking out 4 tablespoons and now, July 26, I am taking out 16 tablespoons each morning. Unfortunately I still have about 1.5 tablespoons to go perhaps because the cup I am using is imperfect. But we live in an imperfect world. As Plato noted it’s hard to draw a perfect triangle. The concept–cup–seems only incidentally to match the reality.

But going down 16 tablespoons is probably in part responsible for the recent compulsive thoughts about the death and dying stuff. The anxiety is back. That’s what klonipin is for–anxiety reduction, or at least that is one of its uses. They use it on the TV show “House” each time somebody has a seizure (about every other show); “Five milligrams clonazepam,” you can hear them shout.

Whatever its uses, the anxiety is back. Not awful. But when I wake up I feel edgy and restless: it gets a bit worse as the morning goes on. Not pleasant. And another telltale sign. I do this thing of rubbing my fingers, thumb against the other four digits, rather unconsciously most of the time when anxiety is on the rise. The last two or three days I have caught myself doing that frequently.

Finger rubbing. In the olden days, I would be smoking more.

Also I have had odd dreams. This morning I woke at 6 and then went back to sleep for about an hour, during which time I had a kaleidoscope of unpleasant dreams. I can’t remember all. But in one I was in an apartment, with other people, and it was raining and the rain started to drip in at the bottom of the walls. Then I noticed the ceiling was sagging, presumably from the rain, though actually no ceiling could sag like that without bursting. I stuck a pole there to hold up the roof. And then we were hungry and found a DIY restaurant (I didn’t know such things existed except for Kramer’s make your own pizza place) and I cooked up some little black looking hamburgers, and went some where and came back and was told that W.B. wanted something too. This upset me too since I didn’t know W.B. was there. Or wanted something.

When the walls starting leaking, and the roof starts sagging, and I can’t find food, and I fail to do what W.B. wants…well, these are anxiety dreams.

So the anxiety is back. I will see how that goes. Six days left and then no more of the .25 morning klonipin. Then we will really see whaz…up.