#And I went to the pharmacy to pick up my daily pain medication

[patchyourbrokenwings]

I did such a good job of taking care of myself today!

[nsk96]

Personal rant:

I'm getting real tired of my mom always talking down to me as if I'm a kid that doesn't know anything. I'm tired of her insulting my intelligence.

I talked back to her today and stood up for myself. I was washing some small tomatoes, the tiny ones, for my breakfast. I always wash fruits and veggies with soap (I usually use the dish soap). One dropped into the sink for like 3 seconds and I picked it up and was ready to wash it with soap again. My mom made a fuss saying to throw it away because "the sink isn't clean" despite me washing it with soap before consumption.

I told her we shouldn't be eating on the plates then. She asked why, and I said they touched the sink too and we only use the soap to wash them. She was like "they're not fruits though." I kept going and said we shouldn't be using forks. Then she was like "forks are fruits?" in a condescending way.

She was like "you're the pharmacist, you should know about bacteria" and I said that doesn't mean shit. Pharmacists pick your pills off the ground and still give them to you. Then she was like "well do you think that's right?" I said "no, that's my point."

I went on about how she doesn't believe me anyway, and she was like tell me when I didn't believe you. I reminded her of the time I got a small burn and she told me to put it in ice water and I told her no I need to run it under room temperature water first. Her response was "okay, keep believing in doctor medicine" in a condescending tone.

She was like "I was sharing my opinion, and you shared yours." The problem isn't that she shares her opinion, the problem is that she treats her opinion as fact or the law of the land, and has to make a big argument out of it if she gets any push-back. She literally can't handle being wrong and has to insult my intelligence if I don't do things her way. When you prove her wrong she just goes, "oh." Only a couple times have I heard her say, "you're right," but again, she would never admit that she was wrong.

Another example: in the morning times I'm a little congested and I cough up mucus. She makes a big deal out of it saying that I need to take the cough medicine she gave me a year ago (when I had covid) to stop coughing because it "sounds like it's in your lungs. It shouldn't be there. You need to take the medicine to dry it up". She's referring to a cough suppressant. I don't cough all day, it's seriously just when I have a little mucus which is at most 3 times a day (but usually just the morning). I tend to get it if I eat food I'm hypersensitive to like wheat, egg and cashews. I get a post-nasal drip because of my allergies (despite taking an allergy pill daily). I tell her that I can't take a cough suppressant if I need to cough up mucus.

But she she keeps bringing this topic up and I tell her that if I take a cough suppressant long term and cause myself to not be able to cough up mucus from my lungs, I run the risk of getting pneumonia. She still insists on me taking the cough suppressant saying it will help "decongest" me despite me telling her no. She's brought up the argument over 5 times already, me telling her the same thing every time that I need an expectorant and decongestant, and telling her that cough suppressants really just reduce the feeling to cough. But she's convinced it will help with congestion, and of course her response is "keep believing in doctor medicine", insulting my intelligence every time, as if I didn't spend 3 years in hell of pharmacy school to learn this stuff and apply it to make people's lives better. Next time she says this, I should probably say, "oh that's why you're taking so many medications for your blood pressure, type 2 diabetes, anxiety, and nerve pain, right?"

Honestly, it hurts that she doesn't believe me and would rather me risk getting pneumonia just because she wants me to do as she says.

Then after the whole tomato argument, she still kept going about how she shares her opinion and then "stops talking". I said "no, you don't (stop talking)." That triggered her so much she felt the need to compare me to my dad saying that's the line he uses. I asked what line, and she went on about how he wants her to just shut up. I told her "i never said that".

I told her that what I mean is that she just keeps repeating herself (she repeats herself 3-5 times in the same argument/lecture/talking down to me etc. and keeps bringing things up later on). She was like "i repeat myself because you don't listen. I talk and you don't say anything." Not my fucking fault that she raised me to silently obey her, and scared me into silence all throughout my childhood and teen years. I look at her when she talks, but look away when I'm busy doing something (I learned is okay from her because she does the same). It's funny she expects more when she never taught me that, nor gave me a chance to speak much in the past. And when I say she never taught me that, I mean that when I talk to her when she's busy, she doesn't answer me either. Sometimes when I talk to her she changes the conversation while I'm still talking (which I think could just be that she gets distracted easily like I do, but she'd never admit it). But it makes me feel like what I'm saying is never interesting enough.

I do the same quiet behavior when other people are talking to me. I look at them and either nod, but I don't really say anything unless I have something to add. It's only recently, now that a preceptor on rotation bluntly pointed out that I have a tendency to give him this blank stare, that I started forcing myself to at least go "m-hm" when people are telling me something. It's so bad, that sometimes I don't process what their saying because I'm too busying worrying about when to go "m-hm" and when to make or break eye contact.

Now she wants to call me rude and act like I'm mistreating her when I return her energy. She's done it so much to me, it's ingrained in my behavior now, and I didn't realize this until recently when I started paying more attention to my own behavior and feelings, and how she ignores me or at least fails to acknowledge what I'm saying. I spent most of my life feeling unheard, unseen, not believed, scared (of her especially), crying myself to sleep and comforting myself, and now it's biting her in the ass as I'm finally getting my voice.

She's probably getting scared now, thinking I won't take care of her when she's old and frail. Lucky for her though, I'm a person of my word. She sometimes rants about how the culture in the U.S. tells children that they don't need to take care of their parents (partially because she's still bitter about how my brother left)...while not understanding that:

1) you chose to have a child; they have no obligation to be your retirement plan. It's unfair to dump that responsibility on them for just existing. Btw, she didn't have to take care of her parents, despite wanting to, because they were in Trinidad being "cared for" by her brothers and sisters. So, she doesn't know the sacrifice it takes especially here in the U.S. for one single child to do it. I know, because I see and hear about people who go through it here. I don't blame those people who decide not to care for toxic parents. How your kids treat you when they're grown, is often a reflection of how you treated them as kids.

2) she seems to forget that this same U.S. "culture" tells parents to kick their kids out at 18, and iirc it was once allowed younger in some states. When you choose to become a parent, you choose to raise an adult to have opinions of their own and they will learn things that you probably don't know. You don't have to agree to everything they say, but at least respect their opinions and knowledge instead of talking down to them like they're stupid. You should not be raising them to be your personal caretaker and if you are, you shouldn't be a parent at all.

If she thinks I'm getting like my dad, then she probably shouldn't have forced me to live with him. But I'd say most of my "rude" behavior I learned from her.

One of the things that hurts the most is that I can't even talk to my brother about everything that's been going on. His view would likely be that I should just leave like he did, forgetting that when he left, he dropped out of college because he apparently couldn't balance a job with college (just like me) and his pay barely affording his rent that he wasn't eating. After all he went through when he left, no sympathy for what I've been having to deal with dealing with both our parents and school. Btw, it was our parents' he was running away from, and let's just say they got much worse towards me after he left. He himself even admitted that I got the most corporal punishment and saying "I'm surprised you didn't become a serial killer". When my mom told him what she and I are going through, his response was along the lines of "either put up with or leave" despite knowing I'm on rotations, and rotations are pretty much a full-time job (40 hours a week not including commute time, projects, assignments, and studying). My mom attributes it to brain damage from his motorcycle accident, but honestly, I think he was always like this; his lack of empathy is so much like our parents...like my dad. The only difference is he's always been colder.

The moral of the story I guess: You live what you learn

[thedeliverygod]

Sometimes it’s worth it to “adult” and make painful phone calls even though your anxiety screams at you not to and you also stress about being considered a Karen

But today at Walgreens I was charged $115 for 3 medicines I need to take daily. Both me and the pharmacy tech found it weird but she also shrugged it off quickly while I was still concerned. I had to use my dads credit card he gave me for emergencies because I cannot afford $115 for my medications.

The entire drive home I wanted to puke. Which was also not great because this was during my lunch break and I needed to eat something. I texted friends and called my dad and was like “I have the most expensive plan my work offers, I don’t understand how this could happen” because I was just in such shock.

I got home with just a tiny bit of time to eat before I had to get back to work. I finished what documents I had and then I started looking through my health insurances website for answers. Maybe I hadn’t met my deductible and or maybe I didn’t order from the right pharmacy.

I didn’t really get any clear answers so I bit the bullet and called the helpline on the back of my insurance card. I called and was like hey I just need some clarification since this insurance just started on the first of this month. I just picked up medication from Walgreens and it was more expensive than I’ve ever paid with insurance and I was wondering if I need to meet a deductible or if I need to use the online pharmacy through you guys?

She immediately was like “I don’t even see that they ran your insurance” and then asked me about my medications and called Walgreens for me. We figured out they somehow ran my old insurance card which was basically the same as not having insurance.

All because I didn’t let my anxiety win my medication went from $115 to $14. And even though it was a bit of a pain in the ass I feel so much better now.

[euphoriahrs]

bittersweet | jjk [ii.]

» pairing: manhwa artist!jjk x female oc

» genre: roommate au

» word count: 2.1k

» disclaimer: contains strong language and drinking, but very little

» rated pg 13

* lowercase is intended *

[series mlist]

chapters: i. | ii. | iii. | iv. | v. | vi. | vii. | viii. | ix. | x. | xi. | xii.

© euphoriahrs (please do not steal or copy in any form)

a/n: make sure to reblog and let me know what you think about this chapter!

𝐇𝐀𝐄𝐖𝐎𝐍 didn't arrive at the apartment until evening time. on her way back, she received an unexpected call from work informing her that a coworker was caught stealing customers' medications and needed to get there urgently.

she worked at a local pharmacy that was run by a lovely couple in their 50s. haewon was in urgent need of a job so when she saw that they were looking for an extra hand, she was elated. she would finally have a job that fit her major.

the jung’s started their pharmacy soon after they got married and raised three children, all of which moved out of the average-sized town and into bigger cities for better opportunities.

the only help they had was a man in his early 30s who was working to pay off debts, and since none of their children wanted to inherit the pharmacy as well as old age creeping upon them, they began to search for the much-needed help. now the sweet couple are practically her parents.

she reluctantly cracked the door open, wide enough so she could peek through without anyone noticing her. she expected to see an alert guard dog waiting to bite off the intruder’s finger, but there was nothing so she opened it wider.

instead of finding a vicious guard dog, she was met by what seemed to be an adorable puppy-like dog that was fast asleep waiting for its owner to come back so that they could go on their daily walk at the park.

disappointed but not surprised, she closed the door behind her and walked closer to her roommate. she slowly walked towards the boy until she was close enough to hear his soft snores.

from where she was, she squatted down and positioned her elbows on her thighs to place her head in her hands, so that she can look at his face from a safe distance without getting caught.

she examined his features of his sleeping state.

his brows were furrowed creating a crease right between them, his slightly scrunched nose, and a frown that was formed on his lips.

"i wonder what's on his mind," she whispered.

"you better turn that frown upside down, idiot," she motioned with her fingers. she stayed in that position a little longer before getting up, not wanting to be there in case he woke up.

she stretched and sauntered towards the kitchen thinking of what she should eat for dinner.

"do i cook or get takeout?" she mused making her way to a stool. she tapped the counter like a drum while trying to decide.

she was too lazy to cook and besides that, they haven't gone grocery shopping in a while so there was no food in the fridge.

"takeout it is," she pulled out her phone and opened postmates. "now the question is what(italics) to eat," she sighed scrolling through the options.

"order from that chicken and beer restaurant," a voice croaked behind her. she dropped her phone from the sudden sound, "oh, jeongguk you scared me," she let out an anxious laugh and placed a hand over her heart.

"you should really make it known when you're around," she picked up her phone.

"well, you should start paying more attention to me then," he fired back smugly while getting some water from the fridge to quench his thirst.

ignoring his comment, "when did you wake up?" haewon questioned.

with his tired stare, "just now. i just so happened to see what was on your phone." she hummed in response and searched for the restaurant, "i guess we could get that then. i didn't know what to get anyways." jeongguk moved to sit on the stool next to her and sat in silence.

after a minute or two, jeongguk broke the silence, "i haven't forgotten about this morning just so you know," he sang in a threatening way. "of course," she replied in a bored tone and she jokingly added, "so, how was your guest last night?"

"she was amazing," he amused sarcastically. haewon perked her eyebrows, "oh really? how did it go this morning hm?"

"quite refreshing actually," he seethed. haewon peered further, "not terrifying? not even a little bit?" while squinting her fingers.

jeongguk shot her a threatening look. "of course that shit was terrifying! i thought murdered someone while i was drunk last night! how do you expect me to react when i woke up to see a bloody body laying right next to me?!" he barked.

"um let me think," haewon pretended to think. "over the moon," she faked gushed. jeongguk was about to respond when the doorbell rang. "i'll get it!" haewon rushed to the door.

"hello, are you park haewon?" the delivery boy asked. he was tall and lanky with dark brown eyes and hair, probably around 17 years old.

"yes i am," she answered. the boy smiled, "did you order a mixed box in with two beers?" haewon nodded.

"okay, that'll be $14.76," he gave her the bag. haewon was getting her wallet when jeongguk gave the boy money instead.

she scrunched her eyebrows and looked at jeongguk, "i can pay for it myself you know." jeongguk gave her his famous bunny smile. "i know, but i wanted to pay anyway."

“what's with the sudden mood change?” she muttered.

the delivery boy looked over to haewon to make sure that he was okay to take the money from jeongguk. she smiled and nodded, "it's not my money anyway." the boy was about to take the money when jeongguk interrupted.

"you know, actually you can pay for it yourself," he took the money back and walked away.

haewon whipped her head towards jeongguk, "how do you just say 'oh i'm going to pay for our dinner today' and then decide to take it back?!" she looked confused with a tinge of annoyance.

"i don't know," he stood there with his hands in his pockets. haewon rolled her eyes and turned back around to give the delivery boy money. the boy awkwardly smiled, "would you like your change?"

"no thank you, have a good night," she smiled back.

haewon closed the door and leaned against it. she stared at jeongguk trying to figure out why his mood kept changing. one minute he seemed like he was going to kill her, the next minute he was all nice and stuff, and another minute later he wants to take back his kindness.

jeongguk cleared his throat, "if you take a picture it'll last longer." she thought about his remark and did what he said to and took a picture. jeongguk was surprised but covered up quickly before she could take the picture. "there i did it." she said in a monotone.

"but you know what? you don't deserve to be in my camera roll, more like in the trash." she paused, "actually you don't deserve to be in my phone at all," with that haewon deleted the photo in her camera roll, then went into the trash and deleted there so that there was no trace of the photo left.

"come on, let's go eat before the food gets cold," she walked away. jeongguk stood there processing what just happened. "and she did that for what?" he shook his head and couldn’t help but form a grin and made his way to the kitchen to eat.

haewon had just finished placing the food on the counter when jeongguk came in. she handed him a beer and swung her piece of chicken, motioning him to sit down.

"so, how is your progress going on getting a company to accept your manhwa?" she asked being nosy and wondering how his life was going.

jeongguk almost spit out his beer, "how did you know about that?"

haewon scratched the back of her head, "well, you see, it was only a peek-"

"just a peek?" jeongguk interrupted raising an eyebrow. she sighed, "okay i went through it. but only because i was trying to at least tidy up your room since i did just leave something possibly life traumatizing in your bed." she sheepishly smiled. "sorry," she added and took a sip of her beer.

“that’s bullshit,” he rolled his eyes.

“okay, you caught me, i was snooping,” she said exaggerating the ‘a’ and put her hands up surrendering. “but being nosy is in my nature, i can’t help it,” she shrugged and took a sip of beer.

“whatever,” he exhaled. his shoulders slumped, "none of the companies are responding. i doubt they even took a glance at what i sent them. so i guess i'll just have to continue to work on webtoon," he confessed and chugged his beer.

"from what i have seen, your works are really good. you just haven't found the right company yet, all of those other companies are just blind jerks that can't see that there's a great manhwa in front of them," haewon tried her best to console him while not sounding fake. she hated being in situations like these without sounding awkward, it was rather hard for her to console someone.

jeongguk showed a pained smile and stared off into space.

silence consumed over the two as they finished their food. haewon glanced at jeongguk for a second, he was staring at his drink with his tongue poking the inside of his cheek. he reminded her someone that she used to know, who was long in the past. not wanting the thoughts to continue, she rubbed her face as a way to get rid of the memories.

she ended up staring at him much longer than she intended, she was so caught up thinking about her past that she hadn’t noticed that jeongguk was staring right back at her. he quickly looked away when he noticed that she came back to her senses.

after they were finished eating, jeongguk got up to throw their food away. haewon rested her head on the counter and played her favorite game on her phone. jeongguk leaned forward against the counter and asked, "why did you come home so late? i thought it was your day off."

haewon stared at her phone contemplating whether she should answer him or not. she didn't feel like talking because it would take too much effort.

she conversed in her head, “should i answer? do i want to? no, but... ah whatever.”

finally making her decision she lazily explained, "my coworker was caught stealing customers' medications at work today and my boss needed me to come in to take over the rest of his shift," she moved her head so that she could face him.

"apparently he was an addict but hid it well i guess. every time we had to take drug tests he would have a way to fake them so that they would turn negative,” she paused to take a break and rubbed her eyes, “we also had him do inventory at the end of each day of our over the counter pills since he had been working there for a year or two now, and was trusted," she yawned wanting to stop talking but it was too late now.

"but it turns out that he kind of faked those as well. he would get different friends to buy some every other day, so he wouldn't have to put much work into faking everything and so that nothing looked suspicious when our boss checked everything at the end of the month," she finished explaining, thanking heaven that she could finally stop talking.

jeongguk was nearly speechless by how dedicated that man was. "that's crazy," was all he could let out. "i know right," haewon chuckled.

she got off the stool, "i’m going to head out now. night," she left the kitchen dragging her feet to her room.

"goodnight," jeongguk softly replied. he stood at the counter for a little longer before walking over to the couch and turning on the tv to a random late-night cartoon.

since he was his friend's p.a, it was his job to review the busy work schedule for the next day and memorizing it, or at least he tried to, but he mainly tried to find when he would have time for a break.

feeling drowsy, he tossed his phone onto the coffee table and got comfortable on the couch. he was too tired to even think about going all the way to his room, so he just stayed in the living room. listening to the t.v in the background, he closed his eyes and let sleep wash over him.

[of-another-broken-heart]

I’m just going to copy/paste this because it took me hours and I’m drained. 

I guess I have to format it again if I want it to show up at all... 

I couldn't even make it back home before breaking down crying again.

Driving while chronically sleep deprived, exhausted, fatigued, and dissociating is bad enough. Doing it with all that AND without being able to see? How special. 

I barely had time to sit down, my phone rang. I answered it, begging for someone to hear me. For thirty straight seconds. "Hello? Hello? Hello???" Finally someone spoke, but they couldn't hear me. I'm sobbing. They hung up. I scrambled to call back, from my computer, because at least then I'm not fighting a lack of reception as well as my anxiety. They called again. I didn't answer. I waited for my computer to ring through instead. I'm put on hold.  I'm sobbing. It was just to ask what my pharmacy is. Which I already answered on my paperwork. Which I answered, again, at check-out. And I was forced into a third confirmation via a pointless, needless, anxiety-attack inducing phone call hazing. For something I already answered. 

It's not fucking fun. People don't choose this. I didn't choose this. But does it matter? "Call," the command comes. "Just call." "Call to confirm." "Call to ask." "Call." "Call." "Call." 

I want you to think of something that takes physical hold of your body and brings to you to tears. I want you to hold that and sit with it until it does those things. I want you to choose to reduce yourself to a sobbing mess, struggling to breathe, alone. And I want you to picture a world where you are commanded, demanded, required to do this. For virtually everything. Imagine needing help - but you must first re-traumatize yourself with your most painful memories until your nose is running and your eyes burn from crying. And you're exhausted for the rest of the day, too. Maybe multiple days. Absolutely exhausted. So fucking depleted that taking yourself to the bathroom is almost impossible. Feeding yourself - even eating something out of a can, or microwaved - is a herculean effort. Does that sound fun? Of course not. 

As for the appointment itself: It's the same. Much better bedside manner. But it's the same underlying capitalism-serving "care" system. It's my fault. I'm not trying hard enough. I'm not blacking out alone on the side of the road enough. I haven't dissociated hard enough and/or blacked out while driving yet, so it can't be that bad, right? Not until I'm maimed or dead, right? Why address the root of a problem when we can just plaster on endless band-aids instead? When we can blame you for hurting, instead of the environment that's poisoning you? I'm not medically sedating myself into an obedient little wage slave, and that's the real problem. I should aspire to produce capital for someone with most of the remaining hours of my life. That's the purpose of living, that's the reason for "health"care - not to care about health, no, just to keep the wheels of capitalism well-oiled with wasted human life. Inherent human value? Quality of life? Nah. 

They refused my medical history. I brought the 72-page pdf on a flash drive. Because that's how I was given it. Because I can't afford to buy and operate a personal fax machine and/or print out a chapter book's worth of pages of medical records. I went through the trouble of getting the files, and it took over a month - only to be told "we can't take anything but paper or fax." I filled out a file release form as best I could. But I didn't have the phone number or address memorized. Not even before that place became synonymous with medical neglect and trauma for me. So now they're going to go through the ancient months-long ritual of requesting the self-fucking-same documents from LISH, either by mail or fax, because they "can't" access a flash drive or a pdf or use email. Welcome to 2021. We're back to "normal" and teleheath never existed and the internet is fake and technology is a myth and why do anything efficiently when you can waste time and do damage to people instead? My Aunt called to check in on me during her lunch break. (Thank you again) She offered to get the file printed and try to hand it in for me. I'm too tired to hope. I'm too exhausted to think they'll accept it without fuss. Anything and everything to make things harder.

Top priority order of business is the whole "diseased for life" thing. Hashimoto's thyroiditis. Hypothyroidism. Daily hormones for every day of the rest of forever, gatekept behind eternal doctor visits and prescriptions and pharmacies and copays and and and and did I mention this is forever? I've got a referral to have a thyroid sonogram done. Haven't ever had one of those before. Need to make that appointment. I was able to have my blood drawn for the thyroid testing without needing an additional appointment, which was a nice change of pace. Normally you're supposed to fast for that, but I wasn't expecting that could be done during the visit. Three years of having to make additional trips to the lab for blood work. I ate immediately before getting there, so hopefully nothing had a chance to metabolize and skew the results. Even though it was great not to have to juggle yet another appointment for health shit, it was stressful. The nurse took three tries before she had all the supplies she needed in the room. I already have anxiety spikes (which also raise my blood pressure and heart rate) for all doctor visits now. (White Coat Syndrome, I learned, it's called) I didn't need to have a rubber cable tied around my arm, popped off, tied again, popped off, and tied a third and final time to make it worse. A pro to that con: she was incredibly accurate and gentle. I normally have sub-dermal bleeding and some bruising after having blood drawn, and keep the bandage on for a day or two. The bandage didn't last even an hour after I got home - but there wasn't a single spot of trapped blood, and I almost couldn't even tell where she stuck me.

I have another new diagnosis to add to my growing collection. Hypertension. High blood pressure. I used to have slightly low blood pressure. It stunned the first doctor I ever saw (you know, because I'm fat, so that sort of thing is supposed to be ~impossible~) and it frustrated my last doctor at first, too. But now, with years of building stress and anxiety? It's almost like living with your most basic human needs barely provided (food, shelter, healthcare - let's not bring up social needs LMAO those don't count anyway, right?), and at constant risk of being taken away, for months (years, in some cases) on end, is some form of stress. It's almost like being constantly dismissed and told "you're just not trying hard enough" (WHILE TRYING YOUR BEST JUST TO SURVIVE EACH DAY) is some form of stress!It's almost like perpetual, ongoing, worsening stress has a negative impact on your heart! It's almost like there are decades of data that spell this out, plain as day!It's almost like I noticed my elevated heart rate back in NOVEMBER and mentioned it out of concern to my last doctor - who dismissed it outright because my reading in-office wasn't *that* bad, and also shouldn't I be on 5487 psych meds instead? If I was sedated out of my mind, I wouldn't be physically capable of feeling stress in my body despite the presence of real-world stress factors. That's healthy, right? Don't bother to solve the stressors, just neuter the body's response to them. Super healthy response. (Not) My GYN took note of my concern in December, when my vitals DID show as high in-office. Not that my GYN had the jurisdiction to do anything about it. I'm being put on another medication to try to mitigate this, and potentially also address some anxiety. I haven't picked it up yet. I don't know the name. I don't know if I'll be able to afford it. "Your copay is only a dollar!" Yes well, when you don't have a dollar, you can't afford a dollar, can you?

I was given a list of psychiatrists. To "Call!!"Precisely none of them are a reasonable distance away. Nearly half aren't even in my insurance network. Some explicitly exclude Medicaid. Others are exclusively for children. I was suggested a medication for depression and anxiety. I can't remember which one. Either Abilify or Lexapro? I declined it for now, either way. I wanted to be able to research it. Lexapro is just another SSRI and I already know those don't work for me. Adding a chemical bouncer to my brain to make sure the happy chemicals stay out to play doesn't help when there are no happy chemicals in the first place. A quick search for Abilify doesn't address anxiety at all so it was probably Lexapro. In which case, I am not interested in repeating a different-flavor-Prozac experience. It was not good. I didn't get any notes with that medication, regardless. I got a sticky note with "Valerian Root Extract (tea or tincture)" and "Magnesium Glycinate 2 capsules" scribbled on it, instead. Out-of-pocket home rem-maybes. I can't afford to experiment with snake oils, so mostly I'll probably just spend a bunch of time looking for data and research and studies for those substances, and that's it. If I get around to psychiatric care, I will have to start from scratch in my insurance's shoddy search tool, again. And, frankly, it's not a priority. My mental health struggles are the result of a lot of physical factors and external/social factors, and no amount of artificial chemicals bullying my brain is going to solve any of it. When your car starts leaking oil, you don't just commit to buying more oil forever and dribbling it all over, wherever you go. You fix the fucking leak. If your house has a gas leak, you don't invest in gas masks. You fix the fucking leak. If you end up with a burst pipe, you don't commit to wasting water and money and damaging your environment. You fix. The fucking. Leak. But in these comparisons, I'm getting prescribed oil and gas masks and infinite water damage/waste/bills as long-term care.

I mentioned my fatigue. It was the final straw that made me give up with the last doctor. It just keeps getting worse. It's been getting worse for over 3 years. And I'm so, so fucking tired of it getting pinned fully on the fact that I'm not on psych meds. I WAS on psych meds during part of those 3 years with my last doctor. And it didn't fucking make any difference! A daily chemical lobotomy does not address or restore my lack of physical energy. My decades-old medication-resistant insomnia has never vanished with psych meds before, and it's not likely to do it now. Especially not with yet another of the same family of chemicals that I already know don't work. I want my concern to be taken seriously. I don't want it just brushed into the mental health corner, again. Being too tired to even do the things you used to enjoy - no one fucking wants this! I don't want this! I miss being able to go for walks. I miss going to the gym. I miss seeing how much I could do, and feeling good, and feeling strong. And I can't do any of that now. Not without risking harming myself in the process. 

No one wants this. I keep talking, but it feels like no one listens. At the earliest opportunity, we're back to repeating the same tired old shit that doesn't work. I try to come prepared, and the stress and time and system make sure I fail to stand up for myself anyway. I didn't get to document my disordered eating history. The relapse this year. Restricting, sometimes to the point of not eating at all. I declined to be weighed, because I want my care to be based on relevant data, vitals, blood results - not the shape and size of my body. But I was too tired to realize I needed to dodge a verbal ask for the same information. Which, it turns out, is nearly as bad a trigger as having the scale spit it out for me. Being your own advocate for equal care, when you're already tapped out? I'm not winning that challenge. 

I'm frustrated. I'm not giving up, but I am frustrated and beyond tired. I don't really expect anyone to read this mess. But it's here.

[lovemesomesurveys]

What battery percentage is your phone on right now? 44%.

Do any medical afflictions run in your family? Cancer and diabetes. 

Who did you last talk to in person and what did you say? My mom. We were talking about the story being covered on 48 Hours on the ID channel.

What's your favourite Mexican dish? I like burritos, especially from this local Mexican restaurant. It’s simple, just beans, rice, cheese, cilantro, sour cream and guacamole, but it’s so good. I like to have this gravy and cheese dip on the side for dipping, too.

Have you ever been to a professional sports game? Yeah, I’ve been to a hockey game once.

How far do you live from New York City? I’m all the way across the country on the opposite side in California. 

How often do you talk to your parents? We live together, I see and talk to them all the time.

Do you prefer pads, tampons or something else? I just used pads. TMI, but I say “used” because I don’t have a menstrual cycle anymore due to health reasons.

What was the weather like in your town today?  It’s supposed to be 77 F today. It’s slowly been starting to cool down. I need it to drop down more for my liking, though.

Are there any phrases or words that you say a lot?  Yes, but for some reason whenever I’m asked this I can’t think of an example.

How many boyfriends or girlfriends have you ever had? One.

Have you ever ordered a specially made cake from a cake shop? Yeah, my childhood birthday cakes were ordered from a cake shop.

What was the last movie you saw and who did you watch it with? In the Tall Grass on Netflix with my mom and brother.

What's the name of your first real boyfriend or girlfriend? Derek.

Do you clean your ears daily? Not daily, but a few times a week.

What accent do you have? As a Californian I feel like I don’t have one, but I guess it would be a Californian one? *shrug* Like I said, I don’t feel like I have one but everyone does. It’s not distinctive like someone from Boston or North Dakota, ya know? Ha, I Googled Californian accent and it even says, “Their accent is indeed similar to General American, meaning it sounds to American ears like it isn't an accent at all. Everyone has an accent, however.”  Then it talks about how we pronounce certain sounds/words differently and some of our sayings and slang. Ha, it also brings up how if anything, non-Californians would probably think of a Californian accent being valley-girl or surfer dude, which yeah that’s true people do tend to associate us with that and words like “hella” and “stoked.”

What scent of air freshener do you keep in your bathroom? It’s a pumpkin cinnamon scent or something like that.

Have you ever dated a model? No.

What's the best job you've ever had? I’ve never had a job.

How about the worst? --

Do you have naturally straight hair? No, I have wavy hair.

What is your ultimate goal in life? I don’t know. 

Have you ever visited someone in prison? Yes.

What months were you and your siblings born in?  I was born in July, my younger brother was born in February, and my older brother was born in November.

Do you write down your passwords in a physical place to prevent losing them?  Yeah.

What are your three favourite vegetables? Potatoes, spinach, and broccoli. 

How many times a day do you check Facebook or any other social network? I check Facebook and a few other social medias a few times a day.

When was the last time you had a blocked nose? It gets stuffy now and then, but it doesn’t tend to last long. I haven’t had a real stuffy nose, like because of a cold, since earlier this year.

Who is your favourite comedian? I don’t have one.

What colour are the socks you're wearing today? White.

What did you have for dinner last night? Wingstop. 

What was the last concert you went to? Green Day back in 2009.

Are you an ugly crier? Yeah. I’m also just ugly.

What scent is the soap or body wash you use in the shower? It’s just Caress bar soap, it smells clean and soapy.

Have you ever had sex in/on a vehicle? No.

Who do you live with? My parents, brother, and doggo.

What letter does your street name begin with? --

Do you do anything to groom your eyebrows? I pluck them.

When was the last time you ate at McDonald's? A few months ago.

What's your favourite Popsicle flavour? Not a popsicle kind of gal, really.

Who was the last person you sent a Facebook message to and what did you say? My aunt. She was just checking in and seeing how I’ve been doing.

Do you have any injuries at the moment? Yes.

Have you ever been to an ophthalmologist? I’ve been to the optometrist numerous times, but I don’t think an ophthalmologist. 

Do you own any animal print clothes? No, not my style.

Are you tall, short or average? Would you change this? I’m short and “I wish I was a little bit taller.”

When was the last time you went to a drug store/pharmacy? Hm, I don’t recall. My mom or brother always pick up my medicines for me, I haven’t gone in awhile.

Do you ever binge-watch TV shows? Yeah. My current binge-watch is Sabrina: The Teenage Witch (the one from my childhood with Melissa Joan Hart). 

Have you ever mustered up the courage to tell someone how you feel only to be rejected? Yep. Twice. Not a fun time...

Do you keep your files and documents organized in one place? Unfortunately, no. I’d like to be organized with that kind of stuff.

What's your favourite sweet treat to bake? I don’t bake anymore, but I used to like making cupcakes or cookies during the holidays.

Are you good at flirting and letting people know you're interested? Ha, no. I’m too awkward. There’s been times I thought it was obvious I was interested only for them to be like, “I had no idea.” 

What did you have for breakfast today? It’s 1:22AM.

Do you prefer sweet or savoury breakfasts? Savory.

Do you like chick-flicks? Yeah.

Have you ever taken an acting class? Yes, which is really shocking for someone as shy and awkward as I am. I actually took two while at community college.

What is your favourite kind of berry? I don’t have a favorite. I really only like strawberries out of the berry choices, but I couldn’t even tell you the last time I had any.

When was the last time you watched one of your favourite movies? I’ve been watching some of my favorite horror movies. I plan on watching a lot this month.

How often do you use Youtube? Quite often.

Do you prefer Prince or Michael Jackson? I like more Michael Jackson songs, but I like some Prince songs as well.

What's the coolest thing you've ever dressed up as for Halloween? Not sure about “the coolest.”

Are you ignoring anyone right now? I guess that’s what it’s called when you don’t respond to messages or make any attempt to contact or reach out to them. :/ That was never the intention and even now it’s still hard to admit that that’s exactly what I’ve been doing the past few years. They eventually stopped trying to reach out and I don’t blame them. I’m such a shitty person.

How do you usually style your hair? I throw it up in a pony tail or bun; not much styling going on.

Do you have any tattoos? Tell me about them. Nope.

Have you ever worked in a store while someone shoplifted there? I’ve never worked at a store. I’ve witnessed it happening while shopping at stores, though.

When was the last time you used a stove? I just made my ramen.

Is there anything you absolutely refuse to eat? Insects, seafood, stuff like bull testicles, etc. 

Are you sitting, standing or laying (or something else) right now? I’m sitting on my bed.

How many hours per week do you typically work? Zero.

What was the last pill or tablet you took? My pain medication.

How far away from your house is the closest grocery store? Just down the street.

Have you ever lived in university/college campus housing? Nope.

Who was the last person you complimented? My mom.

Are you the type of person to take naps, even if you've slept plenty? “Even if you’ve slept plenty” ha, right.

Do you have a crush on anyone at the moment? Nope.

The age old question: dogs or cats? Dogs.

When was the last time you saw your best friend? I see her everyday, all the time. We live together. She’s my mom. 

Do you know any couples who resemble each other? No, but I’ve seen couples who do.

Have you ever been fired from a job? Why? Nope.

Are you tired right now? I always am. <<<

Do you like spring rolls? Yeah.

What do you live on in terms of a street, road, crescent, place, court etc? Lane.

How many purses or handbags do you own? Six. Do you get along with all your aunts and uncles?  There’s one uncle we don’t talk to for reasons, but otherwise yeah. I haven’t seen any of my aunts or uncles in awhile, some I haven’t seen in years, but there’s no drama with them. I have one aunt that I’m really close to, though.

Have you ever eavesdropped and heard something you didn't want to hear? Yes.

When was the last time you used a pen, pencil or marker? I used a pen yesterday.

What's your favourite type of curry? I don’t eat curry.

Do you often go to do or say something and then just forget? It happens. Brain fog.

Who makes you laugh the hardest? My mom and brother.

Have you ever had casual sex? No.

What was the last thing you paid for with cash? Food.

What's the last letter of your middle name? Nah.

If your phone rang right now from a number you don't know, would you answer? Nope.

How long is your hair? Down to my butt.

What was your first pet's name and how did you pick that? The first pet whose name I picked was our dog, Scruffy, when I was about 4 or 5. I’m not sure how I chose that name. Do you drink diet or regular soda? Regular.

Have you ever been to Europe? No, but I’d love to.

Do you worry about your own health? Always. Yet, I admittedly don’t do some things I should be doing. I certainly could be doing a lot more.

Who did you last make plans with, and what plans did you make? Uhh, I made plans to watch something on Netflix with my mom tomorrow haha. Those are the only kind of plans I make nowadays.

Can you smell anything right now? My ramen.

How old were you when you got your first cell phone? 15.

When was the last time you bought a pair of shoes? I got a new pair for my birthday from my mom. All the shoes I have were birthday or Christmas gifts, to be honest. I don’t recall the last time I bought a pair of shoes myself.

Do you like fruit and vegetable combo juices? No. Or any kind of juice, period.

Have you ever been on a spring break trip? Yeah.

Would you rather be warmer or colder right now? I’d like if it were cold enough to need a blanket. We’re still not there yet in California even though it’s almost mid-October. :(

How tall are your highest heels? I don’t wear heels. I couldn’t even if I wanted to.

What's your favourite flavour of frosting? Good ol’ vanilla is the best, but I like strawberry, lemon, and cream cheese as well.

When did you wake up today? I haven’t gone to bed, yet, it’s 3:58AM.

Do you change your appearance often? No. I haven’t in quite awhile.

Have you ever blocked someone on Facebook? Why? Yes.

How many people do you work with?

What was the last thing you ate? Ramen.

Do you have any plans for three hours in the future? Probably attempt sleep.

Has anyone ever made a comment about your weight that offended or upset you? Yeah, it’s frustrating.

[kierarutherford]

Vent/Shit overload

I’m going to post this, leave it and that’s that. So, if you want to travel down the Kiera’s last week of insanity rabbit hole, it’s under the break.

So, as per usual this week started rough. Couldn’t sleep well, my youngest started school (Last monday, I’m venting remember) and things seemed to kick off to a miserable start. He’s my baby, my LAST baby and he’s got issues. The first day went well considering and the poor thing came home, stripped to his undies and curled up under a blanket; instantly zonked. WELL we could not wake him for anything. Que midnight wake up and 6 am sleep.... We forced him to school, got to get that schedule going right. Tuesday... He goes straight to class, curls up into a ball on the carpet and zonks out for 3 hours. *Sigh* comes home to sleep a couple more. AGAIN, a late night. Wednesday repeats, but no nap at home. Thursday comes... Ah fuck me thursday. He is due for his Psyche Eval - A.K.A an IQ test for kids with issues. He comes in with: IDD also known as Intelligent Development Disorder. Link here, scoring between mild to moderate. My precious baby will “never catch up.” Or so I am told. I get all this access to help, but NO direction.... My brain melts. I zombie the rest of the day.

Friday comes. My two older children go to visit their grandparents. Enter phone call, daughter is ill. I work at a pharmacy. Pick up the staples, ginger ale, chicken noodle soup, meds. Drop EVERYTHING off, stick around for a cup of tea and chat. Dad’s been fired.... What?! He’s 60 this next week... Where’s my dad going to get a job at his age? He can’t retire yet, doesn’t have enough in savings to survive.... I zombie again... 

Storm rolls in, kills internet. No writing. 

Back track to Tuesday. It’s been a week since my husband had intervascular imaging on his legs. -Born with club feet, link here. He’s experiencing pain, swelling and general bullshit of having a mother who IGNORED all the medical work he needed done throughout his growing year. Call Dr. Office. “No records have been recieved yet.” -I work at a pharmacy.- We fax that office daily. I’ve been getting scripts from him. So, I know his fax works. Call imaging center, they’re “resending the paperwork now.” 

Que to today; call Dr. Office, knowing they now have the paperwork. Leave voice message. Recieve multiple faxed with Dr. Signature on them.. NO. CALL. BACK.... 

OH, and I am dropping out of my University Major (haven’t started yet so whew, caught that in time) to pursue a learning course to earn my Pharmacist Technician certification. And my doctor doesn’t have my vaccination records.... 

Needless to say, Fuck me, fuck my life, fuck it all. NOTHING has gone right this week. NOTHING. Tried to apply for a mortgage, a whooping $250,000 in a market that starts at $389,000. Checked for rentals. NOTHING. 

I’m behind in writing, behind in just about everything, including rent. I owe for this month, and I’ve put nothing away for next month... Which increases too... So, ya. Mental health is important folks, venting is important.... and the final nail you ask? I have 0 friends. Literally no one near me I can go vent to, cry to, coffee with. I sure as hell can’t unload this on my mother and father, they might be losing everything. My sister is going for MASSIVE surgery in a few weeks... so.. fuck. Fuck, fuck, FUCK, 

I can’t tell if I’m numb, or just in triage mode. I should be a balled mess in a corner, but I just keep moving. 

Anyways, helps to rant. Helps to unload. Even if it’s just a thing on the internet. Makes me feel like I’m not alone. Ya know? I’m going to try to put words to page and maybe that will help? Don’t know, but it’s worth a try. Take care of yourselves, all of you. It’s hard enough out there.  

[sullivanstinylife-blog]

The best laid plans..... *sigh*... you know what they say. After a long trip home we realized we needed to get our RV checked out. But where to go?? We pulled into Tucson with no place to put this trailer. So we decided to leave it at Lazy Days RV to get it serviced. Over $3000 later and over 2 weeks in the shop, we realized what a mistake that was. In hindsight, we were able to do some minor maintenance that didn’t show up (or was overlooked) in the service process. And we found other places to get the bigger things replaced (like the bearings, etc). But that’s another story. 

We were nearing the end of our vacation rental. Our plan was to only be in the rental for one month and then begin staying at Prince RV park for $400+ a month. BUT... here’s what really happened.

• The trailer was still at LazyDays and we had 2 days to go.  • We extended our vacay rental for 2 weeks. That cost $600. • We also found out Prince RV did not allow RVs older than 2001. • Our backup at Tra-Tel park decided to become 55+ in September. • We discovered that nearly all the RV parks in Tucson are adult only or 55+ • Two days later the trailer was finished. Figures. • Trailer goes into storage while we plan to wrap things up at the rental. • THAT VERY SAME DAY, hubby is feeling bad. Doc said he’d have ups/downs. • By that night, hubby has a raging fever, huge swollen leg and a lot of pain.

I’m freaking out. It’s Friday night. Everything’s closed. Somehow I manage to get a hold of his surgeon, text him photos and he says hubby has an infection. Luckily we weren’t far from the only place in Tucson (that I could find) that still has a pharmacy open and I race down to get antibiotics. Monday morning his leg is draining and it’s just GROSS. I start freaking out again. Docs office says to go to the ER so his surgeon can see him. Four hours later and he’s finally admitted. Surgeon takes a look at his leg, drains it and says, Yeah, you’re going back under. We have to remove everything, sterilize it and take out more hardware. You have a staph infection. 

Unbelievable. How could this happen? This is not what we planned. Turns out it’s not uncommon and nothing we could’ve done would’ve prevented it. Just one of those things. That week I was an ugly stressed out mess. I began spiraling into a dark place, yelling at the kids, crying ugly tears, no sleep left me totally exhausted. On top of that, the kids just went back to school. Our youngest has sensory processing disorder and does NOT do well with a lot of change. Our whole summer was a load of change!

Blessings came in many ways. Friends picking up the kids from school so I could be at the hospital. People bringing us food. My good friend came down from Phoenix to help pull me out of that dark hole. Our church praying for us and pitching in every Sunday. A successful surgery (in fact it healed much better the second time). The infection meant Don had to have a PICC line surgically installed over his heart so he could inject daily antibiotics for 6 weeks.  It left him totally wiped out, extremely fatigued and very foggy headed. He couldn’t hold a conversation for 5 minutes before he felt like collapsing. He was down for the count. And I would be nurse, single mom and decision maker for quite awhile. 

And we only had 2 weeks in the vacation rental. Fortunately I was able to rent the rest of the month. Good but expensive. By Sept 1, we were able to move out of the rental and into the Tucson KOA. Our $400 month we planned turned into $1900+. *gulp* Not to mention medical expenses racking up.

Our budget was gone, stretched thin. I discovered I don’t handle the unknown and last minute major decisions very well. This is not my kind of adventure. It was just the beginning of my learning how to roll with the punches and trust God. Looking back, I can see how he carried us through this summer.

[retiredguyinpa]

Staff shortages causing Mid-state pharmacies to close, change hours

LOWER ALLEN TOWNSHIP, Pa. (WHTM) — Staff shortages at a popular pharmacy chain in Cumberland County are causing headaches for patients.

Not all medications can wait to be picked up. It could be lifesaving or put someone out of a lot of pain, but one woman tells abc27 her local Rite Aid was closed without a lot of notice on Thursday.

Tisha Dominick just had knee surgery and has a need for pain meds.

“My doctor called it into Rite Aid this morning at 7:30. The Rite Aid they called it in to is not open today, which meant if I didn’t get ahold of my doctor to call it in to another pharmacy, I’d have been without my medication,” Dominick said.

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She typically uses the Rite Aid in Lemoyne, which posted a sign directing customers to go to the Camp Hill Rite Aid on Market Street.

“They don’t call nobody and tell them. They just put a piece of paper on what days they’re going to be open and what days they’re not, and it changes. If you can’t drive, you don’t know when they’re going to be open and when they’re not,” Dominick said.

It’s not the first time this has happened to her at this pharmacy, and she’s not just concerned for herself.

“I’m concerned about people that have heart problems, diabetes, cholesterol, like blood pressure, all that, like they need their medication,” Dominick said.

“They’re telling me it’s a lack of employees. Well, do something about it. You have enough money to fix it,” Dominick said. “And if that’s the case, then close that one down. Open another one and tell us all to relocate.”

Her daughter was able to get her prescription for her at the Camp Hill Rite Aid.

“The Rite Aid she went to said they are overwhelmed with prescriptions to fill today because there are locations that are closed, and she’s trying to fill them for other people,” she said.

Industry experts say staffing in all community-based pharmacies is a challenge because of the pandemic, working conditions in some situations, and the overall job market.

“I just want it taken care of, that’s all, because I don’t want the public at risk, and I don’t want myself at risk, and I’m tired of going through it,” Dominick said.

A cashier at the Rite Aid in Lemoyne says the pharmacy will be back open Friday and Saturday, but closed Sunday.

abc27 reached out to Rite Aid corporate for more answers but has not heard back yet.

[accidentallowcarb]

The Questions Begin

To be clear, I am writing this now in November of 2021 and we'll be taking a look back (journey began in March of 2021). As the weeks go by I'll add to the story to get to present day. It's been a journey of learning and the experience has been pleasant and worthwhile.

Leaving the doctors office in early March tasked with getting a MRI as well as my bloodwork. Of primary importance was getting the pain in my back to subside and was provided a steroid for pain relief. The steroid treatment seemed to reduce the pain in the back to a moderate level, and that was a step in the right direction.

I made my appointment for both the bloodwork and the MRI and had my Florida Department of Health waiver for the Covid-19 vaccine. The fact that I had the waiver for obesity (BMI>30) was a reminder to me that I had to take action, but getting the vaccine at the time was a big relief mentally. Within 24-hours of my initial March appointment I was in a Covid-19 vaccine drive through and got my first shot.

In the next two weeks I scheduled my bloodwork and my MRI. During this time, I was trying to eat healthier, but wasn't committed to any particular knowledge based eating program. There's much more to diet and I'll expand on that as time goes on.

The MRI results showed a fatty liver and an enlarged spleen. The bloodwork revealed elevated LDL, Total Cholesterol, low HDL, and high triglycerides. Those are the areas of the blood most people focus on. As the knowledge journey continues I spent much time examining the bloodwork results and discovered other things of interest, more importantly, what did these numbers really mean?

I was prescribed a statin to lower cholesterol. I was on the same statin a number of years ago (20 mg/day) but now my doctor upped the dose to 40 mg/day. Being the good patient, I went to the pharmacy to pick up the medication and added it to my daily regimen.

I like to leave a little knowledge of what I've learned at the end of each of these posts. The first piece of advice was to avoid the scale as you begin your journey. I believe it leads to too many additional ups/downs emotional stimulus.

What I leave you with today is that we begin our journey in the same spot, some more severe than others, but often overlapping symptoms. The symptoms are both physical (obesity, hypertension, type-2 diabetes, irritable bowl syndrome) and mental (depression, anxiety). Since we all begin in somewhat the same spot, recognize that there are support groups out there on Facebook, Twitter, and other social media platforms.

Developing a support system early will only help you on your journey. You'll need support as friends who are lean and healthy may not understand your issues, may not understand the path you take, and may offer advice that works for them but won't work for you. Even if your support system is initially scanning videos on YouTube for information, that works as well. Knowledge is power after all.

[mediocrethoughts]

How Today Went

Written: October 21, 2020

It’s the second day of the midterm exams. Aside from that, it was also a pretty eventful day today.

For Subject D, I was already given a task to be graded without having to attend the rest of her classes, and she also said that I may not take the midterm exam for it, so I didn’t. 

The next one was Subject E and the exam was unexpected easier than the summative exam that we took a few days before the midterms. It made me question my answers...

As for Subject F, I can say that this is the only subject I actually haven’t really studied on or actually understood the content. I tried checking the content that the teacher posted in the platform, at first it was interesting, but on the next posts, it just doesn’t seem like it’s complete. It’s like we’ve skipped around to reading these strokes of lines and letters when we don’t even know the proper pronunciation of each one of them. I mean, it was briefly shown how this stroke or these combination of strokes are pronounced, it’s just that there are no practices. This is probably just me justifying my laziness to study for this particular subject that I am not interested in. I was actually very interested in doing it when I learned that I was gonna learn something that’s out of the usual (when it came to my previous schools), but I think I would’ve fared better if it was taught in a physical way where we can really interact with the person who spoke the native ‘strokes’. 

Our Subject G teacher messaged us in advance that we won’t be taking our midterms exam today which was what was expected. Now I only had to wait for the clock to chime 9:00 to take my last exam, Subject C.

After answering the examination for Subject F, that was around 8:40 something in the evening, I heard a loud cry from the living room. It was Amber’s cry. It sounded as if she was in pain so I went out to see what happened. She was standing on the automan, crying after having peed on the floor while she was playing. The act itself wasn’t why she was crying, but the fact that her bikini area was probably seething in pain from the acid that her pee had. We didn’t put diapers on her before because we saw that her bikini line had redness all over, and she also seemed to scratch it. We think it was because we changed her usual diaper recently. So I picked her up, and she didn’t stop crying at all. So I went back to our room together with her, made her lie down on the bed, and checked her bikini area. It was red indeed, and there was a little blood on it. We were really worried because we thought she might have UTI. I messaged her pedia right away and talked to her about the situation. She told me to get Amber checked up the next day in an open pedia clinic. I thanked her for her help, and doubled the gratitude too since ever since the pandemic started, she was our go-to doctor whenever we had important medical questions... even if it wasn’t regarding Amber. She’s a really good doctor to still give us advice on what to do even if we didn’t pay her.

Anyways, aside from UTI, we also suspected that it was also the fault of this diaper that we introduced to her, Huggies. There was a previous time before when she was younger when we made her wear that, and she also had bouts of itchiness on her bikini area. It was really my fault for buying Huggies since there were no Pampers during the time Tito Gil, Nivan’s dad, made us go on a shopping spree for Amber’s necessities. I should’ve never sacrificed Amber’s quality comfort just for the amount of diapers we could’ve gotten that day. 

Since we didn’t have any Pampers in the house, we loaded ourselves in the car around 8:50 and drove to the market to see if there are pharmacies open still so we can buy Pampers diapers there. We drove for a while, we even reached the Liloan proper to check if Rose Pharmacy was open, but it wasn’t. So we traced back the road we passed by, and stopped over 3-4 sari-sari stores to test our luck if they were selling Pampers XL. However, they didn’t have any. Our last resort was to try and check 7/11 if they had Pampers, and luckily, they did! Amber’s yaya only got to buy the Large one though, but thankfully it still fit Amber.

We arrived back in the house around 9:30, and I thought I was going to run out of time while taking my exam. Thankfully, it seems that our teacher has extended the exam in advance, since the Time End that I saw was around 11 PM? I’m not so sure now.

I proceeded to answering the midterm exam for Subject A Some of the parts of the examination was pretty confusing; it’s as if you’re being tricked into thinking that letter a is the answer but when you check the next options they could also be answers! To be honest, on those confusing items, my answers were choices that I wasn’t sure of.

A while after I finished answering the examination, I made the little pyonie (Amber) sleep! She’s been a really good girl lately, I haven’t been carrying her while dancing and singing to put her to sleep. For the past few days now, she just nurses for a while, and then when she’s done, she closes my shirt, turns her back on me, and close her eyes. I know that when she does this, she’s not yet fallen asleep fully yet, so I still sing my song to her while hugging her until I can feel that she’s really already asleep.

Then, I decided to finish watching Dead Poets Society. I tried watching it yesterday, but I was only able to watch it almost halfway until something interrupted me. I’m not really sure what, but it interrupted my movie watching, and I just picked up where I left off. It was a really good movie, a quite unexpected turn of events, but it was a really good one. After watching it, while my emotions and reactions are fresh, I started typing out my Movie Review. It’s one of the requirements for Subject A, and I guess I’m glad because I have something to pour my heart out to after just being squeezed by the movie. I think it was pretty lengthy, but I’m not sure if it’s as lengthy as this blog for today though. I might post it after this blog. It won’t be counted as a daily blog though, since it’s for schoolwork. 

I think I’ve had enough chitchat for today, Tumblr. See you again  tomorrow!

Sincerely, Angel

[yourbolderswedish]

Sad dogs, sick days and life hacks

Our dog, Bravo, was pretty sick this weekend. After a few sleepless nights and a new antibiotics prescription, Bravo seems to be doing better. We all remain sleep deprived, though.

Bravo was sick this weekend.

Really sick. Go outside and spend hours pooping kind of sick. So, the weekend was lost to an unhappy, sad dog and a trip to the ‘weekend vet,’ seeking treatment.

When our 140-pound yellow lab is under the weather, it’s difficult not to feel for him. Certainly, when any loved one is sick, having empathy is key. For Bravo, however, it seems he needs just a bit more TLC on his down days. He’s a big dog. When he’s down, he’s really down.

I snapped a photo of Bravo Saturday afternoon as he napped on his favorite pillows, trying to recover from a sleepless night.

Looking at the photo reminded me of how intermittently wiped out our family has been for the past several years.

Like his sister, Rio, Bravo has had a few health issues in his 10 years.

He has seizures. Usually, they come from out of the blue. It’s difficult to see him collapse and tremble on the floor. When this happens, The Weed or I try to comfort him. We hold his head in our laps, tell him he’s a good boy, massage his ears. Eventually, he comes out of the seizure and invariably looks around like ‘What the hell just happened?’

In addition to seizures, Bravo has hypothyroidism. To treat this, we work with a compounding pharmacy to concoct a special thyroid-replacement formula in olive oil. Bravo receives two synthetic thyroid doses daily. Every six months, his levels are tested and we adjust the doses as needed.

Bravo also has had a cancer scare. Several years ago, we noticed two large lumps developing beneath his right front leg and in his ‘armpit.’ We took him to the Veterinary Teaching Hospital at Colorado State University. There, the veterinary cancer specialists diagnosed the large lumps as lipomas, fatty, non-cancerous tumors. However, he also had a few areas of mast cell tumors. Cancer. Bravo underwent a five-hour surgery and had everything removed. When we arrived to pick him up after the surgery, I’ll never forget his pitiful state. He had two fluid drains safety pinned to a makeshift post-surgery T-shirt and the largest, saddest puppy dog eyes. The heavy sedation helped make him look rather pitiful but he did a lot of that on his own.

Fortunately, the surgeons were able to remove all of the mast cell tumors and lipomas. Bravo’s recovery went smoothly and since he has enjoyed relative health, aside from the occasional bacteria bloom and his seizures. Today, he is still a bit punky from the weekend of gut woes. Antibiotics have helped bolstered by near constant dog naps.

For Rio, there was the torn ACL, a scary, swollen reaction to a bug bite and canine allergies that took some serious diagnosing. She had special medications for allergies and ate special food for many years. Aside from that, our girl hates loud bangs or thumps. Thunderstorms and fireworks make her mental! She also hates when The Weed and I loudly curse. She especially hates the F word at higher decibels.

Aside from these small issues, Rio really is the energizer bunny of yellow labs. She takes a licking and keeps on ticking.

For The Weed, he’s also a pretty decent war horse. Of course, there’s been the occasional cold or flu. When he’s sick, he tries his best but he’s also a little like Bravo. He needs more attention than usual. Grilled cheese sandwiches and Gatorade almost always make him a happy human again.

As a former world-class athlete, I suspect The Weed has a really strong system. He swam, ran and rode his bike through several international competitions and emerged successful and proud. He did all of this on a rather shoddy knee. As a teen, he tore something in his knee while fencing. He never had it repaired. To this day, he has bouts of ‘bad knee’ days. A few Advil and some beers usually get him back on his feet.

For me, my checkered health history is well documented. Several badly broken bones, Breast Cancer 1.0, Breast Cancer 2.0, surgical recoveries, chemotherapy ills and mental health coping issues.

After compound fracturing my ankle, I had a decent case of PTSD. In those days, if I thought about what happened while hiking and falling, I got dizzy and had near panic attacks. After a few therapy and EMDR (Eye Movement Desensitization and Reprocessing) sessions, I learned how to better cope with those intense, vivid memories. I am lucky to have emerged from that situation with only a few mental, physical scars.

As for emerging from Breast Cancer 1.0 and Breast Cancer 2.0, I’m still working on that. There are days when every muscle or bone aches or my brain just doesn’t fire on all cylinders. I suspect I have some chemo brain issues. I try to work through them as best as I can. When I read words strangely, I stop, look at the word again, and try to figure out why my brain read ‘tollhouse’ instead of ‘toll free.’ Seriously, that happened just this morning. I wasn’t even hungry for cookies.

There are some cheats to this life with cancer. Some helped me through treatment. Some help me today as my recovery continues.

So, here’s a laundry list of life hacks I try to keep handy in case anyone asks me what to do when going through life with cancer.

Breast Cancer Life Hacks > Medicine. We are prescribed certain meds for certain reasons. Whether to help combat pain or ease nausea, the doctors really are trying to help. If you have a medication that doesn’t seem to be helping with vomiting or stomach issues, tell your doctor. After the first few doses of The Red Devil for me last year, my nausea was intense. I told the oncologist and he switched my prescription, giving me a dissolvable tablet that worked immediately and helped get me through some really barfy days.

Also, I had terrible bone pain after Neupogen injections to boost my blood levels. I told the oncologist and he prescribed a pain killer I could take on difficult days. There’s no need to suffer in silence. Tell your caregivers. They can help.

> If you have a metallic taste in your mouth when eating while going through chemotherapy, use plastic utensils. During Breast Cancer 1.0 treatment, the metallic taste bothered me so much that I didn’t want to eat. A friend reading my blog saw my complaint and offered the plastic utensil suggestion. It is one of the most helpful tips I remember receiving.

> Whenever returning home from the hospital and a surgery, be sure you have a pillow with you. Clutching a pillow can help ease jostling to any new incisions and really helped reduce pain for me while in the car.

> If you can’t turn off your brain at night to sleep, request a sleeping pill. There is a lot to contemplate and consider with a cancer diagnosis. Sleepless nights are par for the course. However, they shouldn’t impact your day-to-day life. If you can’t sleep, that’s not a healthy way to prepare your body for the surgical and chemical treatments on the horizon.

> Chemo brain issues can creep up on you after chemotherapy treatment. Chemo brain is a term used by cancer survivors to describe thinking and memory problems that can occur after treatment. It’s also called chemo fog, chemotherapy-related cognitive impairment and cognitive dysfunction. According to MayoClinic.Org, many questions remain about the memory problems some cancer survivors feel. Some symptoms include being unusually disorganized, confusion, difficulty concentrating, difficulty finding the right words, fatigue, short-term memory problems, short attention span, and trouble with verbal memory, like remembering a conversation. For me, I sometimes have trouble reading/tracking words correctly. Also, I have trouble remembering what I’m doing when I’m trying to juggle a lot of work. To combat the mental ‘scatteredness,’ I often make notes for the day ahead, especially if I will be doing a host of different tasks. One of the biggest issues I have is forgetting something when I’m busy. If I walk into a room and can’t remember why I went there, it is particularly annoying. I think this is part of my life now after cancer treatment and getting older. I try to cut myself some slack, laugh it off.

> Food can be a blessing and a curse when going through treatment for cancer. One important tip I like to tell people: If you have a favorite food, do not (DO NOT) eat it while going through chemotherapy. That sounds like a real bummer especially at a time when you want to treat yourself well. What I found is that food tasted different for me. It also affected me differently. So, when I went through chemotherapy and tried to eat my favorite meatball sandwich, it didn’t go well. I had immediate ‘buyer’s remorse.’ I can’t eat meatball sandwiches anymore.

That said, some foods really saved me during my most sick days. Oranges and mashed potatoes were the magic bullets for me. I clearly remember one difficult day when I asked The Weed to stop at the grocery store and pick up some oranges and ready-made mashed potatoes. He grudgingly obeyed and I had those strange bedfellows for dinner that night. I felt so much better almost immediately. Today, oranges and mashed potatoes aren’t as appetizing but I can stomach them.

> Some people have reactions to chemotherapy and develop brittle fingernails and toenails, darkened nails and nails that lift from the nail best. For me, I Iost several toenails that eventually have grown back. BreastCancer.Org suggests a few tips that can help keep nails healthy and free from infection, including: Keep nails trimmed and clean; wear gloves; don’t bite or tear at your nails; don’t pick at cuticles; use a cuticle cream or gel; and, avoid artificial nails and adhesives.  

Do you have any Breast Cancer Life Hacks? I’d love to hear them!

[lovemesomesurveys]

What battery percentage is your phone on right now? 97%. Do any medical afflictions run in your family? Some family members on my dad’s side have had cancer and diabetes runs in my mom’s side. Who did you last talk to in person and what did you say? My mom and brother. I was just talking about how I was hungry and if they were going to go soon to get the food. What’s your favourite Mexican dish? Burritos. Have you ever been to a professional sports game? Yeah.

How far do you live from New York City? The previous survey just asked me how far I live from New Jersey. Anyway, it would also take about 43 hours by car,  5-9 hours by plane. How often do you talk to your parents? Everyday, all the time. We live together and we’re close. What was the weather like in your town today? It rained a bit off and on and was super windy. Are there any phrases or words that you say a lot? “I don’t know.” ha. How many boyfriends or girlfriends have you ever had? One, technically. I always count what Joseph and I had, whatever it was. Have you ever ordered a specially made cake from a cake shop? Yeah. What was the last movie you saw and who did you watch it with? In theaters it was Glass. I saw it with my mom. What’s the name of your first real boyfriend or girlfriend? Derek. Do you clean your ears daily? No. It’s not good to do that. What accent do you have? A California one? It’s weird cause I don’t think of myself having an accent, but I guess we all do. What scent of air freshener do you keep in your bathroom? A lavender scented one. Have you ever dated a model? No. What’s the best job you’ve ever had? Never had a job. How about the worst? Do you have naturally straight hair? It’s more wavy. What is your ultimate goal in life? I just want to get to a good place health wise, both mentally and physically. That’s my main thing right now. Some things I’ll always have to deal with, but I would like to be able to get to a place where things are better managed. I don’t want my health to hold me back and have this hold over my life anymore. Have you ever visited someone in prison? Yeah. What months were you and your siblings born in? I was born in July, my younger brother was born in February, and my older brother was born in November. Do you write down your passwords in a physical place to prevent losing them? Yeah. What are your three favourite vegetables? Broccoli, spinach, and corn. How many times a day do you check Facebook or any other social network? I go on there at least a couple times a day. I don’t spend much time on it, though. I just scroll through the feed for a few minutes. When was the last time you had a blocked nose? Back in January. Who is your favourite comedian? I don’t have one What colour are the socks you’re wearing today? Black. What did you have for dinner last night? Salisbury steaks and mashed potatoes. What was the last concert you went to? Green Day back in 2009. Are you an ugly crier? Yeah. I’m just ugly, ha. What scent is the soap or body wash you use in the shower? Soap scent. Have you ever had sex in/on a vehicle? No. Who do you live with? My parents, younger brother, and doggo. What letter does your street name begin with? Nah. Do you do anything to groom your eyebrows? I tweeze them. When was the last time you ate at McDonald’s? January some time. What’s your favourite Popsicle flavour? Not a Popsicle fan. Who was the last person you sent a Facebook message to and what did you say? I don’t recall. Do you have any injuries at the moment? Yeah. A permanent one (spinal cord injury) and something else. Have you ever been to an ophthalmologist? No. I’ve been to the optometrist, though. Do you own any animal print clothes? No. Are you tall, short or average? Would you change this? I’m short. When was the last time you went to a drug store/pharmacy? I haven’t been myself in quite awhile. My mom picks up my medicine. Do you ever binge-watch TV shows? Yeah. Have you ever mustered up the courage to tell someone how you feel only to be rejected? Yes. Twice. Good times. Actually, it was a few times with Joseph. Do you keep your files and documents organised in one place? No. I need to be better with that. What’s your favourite sweet treat to bake? Cupcakes. Are you good at flirting and letting people know you’re interested? Ha, no. What did you have for breakfast today? Eggs and fried potatoes. Do you prefer sweet or savoury breakfasts? Savory. Do you like chick-flicks? Yeah. Have you ever taken an acting class? Actually, yes. Two. :O What is your favourite kind of berry? Strawberry. When was the last time you watched one of your favourite movies? I’m watching one now. How often do you use Youtube? Everyday. I listen to a lot of ASMR, and I also watch some vlogs. Do you prefer Prince or Michael Jackson? Well, I liked a lot of Michael Jackson’s music, but now with everything currently going on and all the allegations... What’s the coolest thing you’ve ever dressed up as for Halloween? Nothing all that cool. Are you ignoring anyone right now? Not intentionally, but that is what has happened. :/ How do you usually style your hair? Up in a pony tail. I don’t do anything with my hair. I grew it out down to my butt after having the short “bob” hairstyle for awhile, and shoulder length before that, only to do absolutely nothing with it. Part of me wants to cut it short again because I just don’t have the energy to deal with the maintenance of long hair and it’d be so much easier, but ugh it took so long to grow it out like this. I’m torn. Do you have any tattoos? Tell me about them. Nope. Have you ever worked in a store while someone shoplifted there? I’ve never worked in a store. Or anywhere. I’ve witness someone shoplifting before, though. When was the last time you used a stove? Yesterday. Is there anything you absolutely refuse to eat? Seafood. Are you sitting, standing or laying (or something else) right now? I’m always either sitting or lying down. How many hours per week do you typically work? What was the last pill or tablet you took? My pain med. How far away from your house is the closest grocery store? Less than a 5 minute drive. Have you ever lived in university/college campus housing? No. Who was the last person you complimented? My mom. Are you the type of person to take naps, even if you’ve slept plenty? Haha I never feel like I’ve slept plenty. Do you have a crush on anyone at the moment? No. The age old question: dogs or cats? Dogs. When was the last time you saw your best friend? I see my mom all the time. Do you know any couples who resemble each other? No. Have you ever been fired from a job? Why? Are you tired right now? Always. Do you like spring rolls? Yeah. What do you live on in terms of a street, road, crescent, place, court etc? Street. How many purses or handbags do you own? A few. Do you get along with all your aunts and uncles? Yeah. I’m not close with all of them, but yeah we get along. Have you ever eavesdropped and heard something you didn’t want to hear? Yes. When was the last time you used a pen, pencil or marker? I used colored pencils this afternoon. What’s your favourite type of curry? I don’t eat it. Do you often go to do or say something and then just forget? Not often, but it happens now and then. Who makes you laugh the hardest? My doggo and brother. Have you ever had casual sex? No. What was the last thing you paid for with cash? Food. What’s the last letter of your middle name? Nah. If your phone rang right now from a number you don’t know, would you answer? Nope. How long is your hair? It’s down to my butt. What was your first pet’s name and how did you pick that? Scruffy. I don’t recall how we picked that name, I wasn’t even 5 years old, yet. Do you drink diet or regular soda? Regular. Have you ever been to Europe? No. I’d love to go, though. Do you worry about your own health? All the time. It’s something I worry and deal with every single day, all day. Who did you last make plans with, and what plans did you make? I haven’t made plans in a long time. Can you smell anything right now? No. How old were you when you got your first cell phone? Like 16. When was the last time you bought a pair of shoes? Myself, personally... I don’t recall. The last few pairs my parents got for me for Christmas or my birthday. Do you like fruit and vegetable combo juices? I can’t get behind putting vegetables in my smoothies. lol. Everyone says you can’t taste them when mixed with fruits, but it just sounds gross. Have you ever been on a spring break trip? Yeah. Would you rather be warmer or colder right now? Colder. How tall are your highest heels? I don’t wear heels. What’s your favourite flavour of frosting? Vanilla. When did you wake up today? 530 at first, then about 8ish. Do you change your appearance often? No. What colour are the street signs in your town/suburb? Green. Have you ever blocked someone on Facebook? Why? No. How many people do you work with? What was the last thing you ate? Burger King chicken sandwich and fries around 130 this afternoon. It’s now 930 at night. Normally I would have had dinner by now, but first there were car troubles that prolonged things and now the place we got takeout from is busy and it’s taking forever. Ughhh. Do you have any plans for three hours in the future? No. Has anyone ever made a comment about your weight that offended or upset you? Yes.

[memsmedic1]

La Primavera e L’estate Circa (Jan 2, 2018-Nov 4, 2018)

The next day, after delivering our last patient to the tender mercies of the hospital, the EMT class commenced at our Yangon headquarters with 6 students, mostly our more advanced team members who had already been EMR certified.

Every day I usually taught two or three separate lectures in the morning, and then skills practice in the afternoon, with emergency responses and company responsibilities filling in any extra time.

The class went very well, especially considering it was the first time we’d taught it. Occasionally there were interesting side notes interspersed throughout. On January 11th and again on the 13th we had 6.0 magnitude earthquakes hit nearby, but they were both far enough away that the only damage at our apartment was a few pieces of flaking paint and rotten concrete chips shaken loose. On another occasion two of the omnipresent geckos were having an unusually violent row up and down the apartment walls. After a bit I glanced toward the action again and was shocked to see what looked like a giant tongue protruding out nearly half of one geckos body length and lashing furiously back and forth. Upon closer inspection I realized that he had pulled off the other geckos tail and was in the process of eating it! Also, on the night of the last day of class we got to see a spectacular full lunar eclipse combined with a blood moon which I thought was an excellent sign!

By January 30 we had plowed through through the entire EMT curriculum and the students took the final practical skills tests. The next day they started taking the online final written exam.

At this point Nathan took over administering the written tests and ambulance rideouts that remained, and also prepared for and lead out in the next EMR training that would take place while I was gone, because on February 1st I got on a plane in Yangon and started on my way back to the US.

This trip had been set in stone almost a year before when my best friend and longest-running ambulance partner had asked me to be a groomsman in his wedding!

It was so nice to come back and see all my friends in Texas again! It felt as if I’d only left just a few days ago even though it had actually been over four months! It was inspiring to see how quickly roads, homes, and businesses had been repaired compared to how everything looked when I saw it last. The only obvious signs of the historic flooding from last summers’ Hurricane Harvey was the high water mark still visible in the trees along the road and lots of dead palm trees which was partially due to flooding and also the result of exceptionally low temperatures earlier in the winter.

After 3 whirlwind weeks in Texas that included lots of motorcycle riding and Mexican food, I flew north and got to spend two more wonderful weeks visiting family and friends in Montana! Here I shared more stories of my work and was even able to go skiing in Canada!

As my time back home wound down my mom and I drove to Spokane where my return flight started from and I was able to see two more dear quondam-Texas friends before flying out on March 7th.

I arrived back in Yangon just in time to help pack up our 4th floor office in town and four story apartment in Hlaing Thar Yar and consolidate both into a two story house where we additionally transferred the company and NGO address and registrations.

While the new house was still located in Hlaing Thar Yar township, which is generally considered the worst township because of its poverty and the intolerable volume of traffic over only a few, poorly maintained roads, it had several major improvements; we no longer had a dusty, noisy street directly outside our front door and a permaswamp out the back door, and now we had real doors instead of large metal roll-up “shop” doors which were always letting snakes, rats, and mosquitoes inside through their large gaps.

On March 12 I started teaching an intensive Advanced Emergency Medical Technician (A-EMT) course at our new office headquarters. A-EMT class ran until July 16 because there is both an hour (400) and content requirement for certification, and as we were more busy than ever teaching other classes and responding to emergencies I wasn’t able to hold class every single day. This course was quite similar to January’s EMT course except it was significantly longer, covered many additional topics, and went into a lot more detail on everything. While an EMT certification is not a necessary prerequisite for a student interested in becoming a paramedic, successfully passing an A-EMT course is required.

On March 22, M-EMS was invited to the US embassy in Yangon to meet with the ambassador, the Honorable Scot Marciel, about medical development needs and challenges that we had observed while working in Myanmar. The next day, I and one other employee went back to the embassy to teach a long-scheduled class for security and maintenance staff focused on triage, first aid, and medical evacuation procedures in the case of an attack on the embassy.

On Wednesday, March 28, I drove across the city to the Road Transport Administration Department to apply for a drivers license so I could finally drive legally, although I hadn’t had any trouble with my Texas license so far. Fortunately all the offices I had to visit were in the same building, but there were so many steps and repetitions that it took nearly the whole day. That evening however I was able to walk out with my Burmese license in hand!

On Saturday night, March 31st, Nathan and I along with a couple other team members loaded up in our ambulance and struck out for Myitkyina, an average of 24 hours drive north of Yangon. We have good friends here who had finally been able to bring our Land Cruiser ambulance down to their home from where it had been languishing uselessly 3 days drive further north in Putao, the original intended location for our volunteer ambulance service in Myanmar.

Sunday night after arriving and Monday morning we met our friends and worked to get the Land Cruiser back into working condition. Then we drove over to the pharmacy to pick up some needed supplies before starting on our return trip home that evening.

The pharmacist was an acquaintance of ours from previous visits and when he recognized us he told us about a patient who was the relative of a friends friend who desperately needed a ride to the hospital in Yangon. This was particularly interesting to us, in addition to possibly being able to help someone, because our Land Cruiser was unable to be licensed and therefore vulnerable to confiscation in the central parts of the country, so if we had a patient on board we would be much more likely to make it past all the tolls and checkpoints without arousing too much suspicion.

Therefore we agreed to evaluate the patient and see if he qualified for us to treat and transport. After the pharmacist made a couple phone calls the son of the patient came to meet us at the pharmacy and immediately insisted on taking us out for lunch (shrewd). Next we drove over to the tiny local hospital where we found the patient in a small dark room with several other sick people.

The patient was a 90 year old Sikh man who had been completely healthy until March 22nd when he suddenly began experiencing weakness, shortness of breath, chest pain and a productive cough, and low oxygen saturation.

When I examined him he was polite but was anxious and confused, and in significant distress, having difficulty breathing and hypoxia that was much worse when laying flat, and chest pain that was much worse when he sat up. These are the only two options for taking a patient on an airplane, so without sedating and intubating him first, he would have to go by ground.

After starting an IV, giving him oxygen, and connecting our Lifepak 12 cardiac monitor, we moved him from bed to stretcher to ambulance and then drove across town to his house where all of his family had assembled to say goodbye. They had prepared a traditional feast and insisted we eat with them before starting on our journey.

After the meal and endless goodbyes we got the patient loaded up and pulled out of town just after dark Monday night to begin the 734 mile drive to the “special diagnostic hospital” in Yangon which was the closest thing Myanmar could offer to what the patient needed. I was in the back with the patient performing patient care and Nathan was driving.

After about 16 hours on the road we made it to Mandalay mid morning on Tuesday, April 3rd. The patient had a doctor relative who lived here so we brought the patient to her house where they had a bed and an oxygen tank waiting for him (the oxygen tank was empty however so we had to keep him on our own dwindling supply while they rushed to fill it). After that little excitement we temporarily turned over care to the family doctor so we could wash the ambulance, buy more medicine, refill our O2 tanks, eat, and rest for a bit. Late that afternoon we again loaded up the patient and drove the last 7 hours to the hospital, finally arriving at 1230 AM on the 4th, approximately 30 hours after starting the call.

On April 20th, almost halfway through the A-EMT course, a fire broke out at the 300 acre Htein Bin landfill a couple kilometers from our house. The most likely explanation was that the fire started by spontaneous combustion, since Yangons’ 2,000 tons of daily garbage that avoids the ocean has been dumped here indiscriminately for the past 17 years, without any safeguards to prevent decomposing organic waste from self igniting, but whatever the cause, it was a terrible stroke of misfortune for the people of our township.

Burning dozens of meters underground in many areas, the flames that were visible broke through to the surface unpredictably and were no larger than campfires, and unlike the billowing black smoke from the nearby Hlaing Thar Yar factories, the heavy, suffocating white smoke of the dump fire easily blended in with the clouds and regular smog, creating a false sense of normalcy.

You could tell the smoke was in the air when you breathed though, as the toxic, vaporous miasma permeated everywhere and burned and stung when inhaled, even inside the ambulance or the house. For several days we took to wearing knockoff N95 masks in a vain attempt to shield our lungs. The toxins from all the plastic, textiles, household and commercial trash were so bad and so concentrated that at least 5 people died and dozens of others were hospitalized.

Hundreds of volunteer firefighters descended on the dump with minimal to no personal protective equipment and antique fire engines, each rival group competing for recognition and donations as they heedlessly dragged fat, leaking, low pressure hoses around disregarding warnings from international experts that adding water to that much organic material was just helping the fire to spread faster. Walking around the burning wasteland it appeared that the people who lived in the dump or made their living scavenging for recyclable objects were carrying on with business as usual, picking their way around the flames that occasionally burst through the surface.

Myself and a team from M-EMS paused our ongoing training and spent several days onsite at the fire passing out fake N95 masks that had been donated for the purpose, and treating firefighters injured by trying to fight the fire in flip flops and/or stepping in hidden sinkholes, along with burn injuries, inhalation injuries, other minor trauma, and dehydration.

We also participated in a massive effort to vaccinate all the firefighters and other exposed personnel on site for tetanus, which was also donated for us to administer. The general population was amazingly supportive of the firefighting efforts. We received dozens of calls from random citizens asking what supplies we needed and what they could help us with, and other groups providing different resources received the same assistance. Private citizens also showed up en masse with homemade food, water, snacks, ad hoc rehab shelters, and other amenities for the firefighters. In fact, the government had very little to do with the event other than the precipitating factors.

The fire burned unabated for over two weeks until a couple of early monsoon rains were finally able to drown it out.

On May 1st I took a bus to Myawaddy and crossed over to Thailand intending on doing a quick visa run and then coming back. But as I was walking down the street in MaeSot I saw a familiar truck parked along the side of the road with my good friend —the nurse who I’d helped at her mountain clinic just before I started working at M-EMS— in the back of it!

It was so nice to see her again after all this time. She was in town dropping off a patient at the hospital and resupplying for a return trip to her village that afternoon and she persuasively invited me to come with her again, so I talked to headquarters and ended up taking a spur of the moment trip back home with her and her wonderful assistant and our mutual friend Blet Jaw.

I was able to help her treat patients, garden, hike to different villages to hold medical clinics, and play football (soccer) with Blet Jaw and the local kids.

During this time we were extremely fortunate to be able to sell our Land Cruiser ambulance which had just been sitting idle for nearly the entire time we had owned it. Even though it was very painful to let it go, it was perfect timing because only two weeks later the government took the next step beyond just prohibiting old or improperly imported vehicles from getting licensed and banned all unlicensed vehicles from the roads (you would think this would have been the case all along, but until this point the government only attempted to confiscate fancy attention grabbing vehicles without a license, which is why we’d always been leary about driving our Land Cruiser).

This took an enormous number of the volunteer rescue groups’ ambulances out of use, since most of them are either too old or improperly imported or both, and certainly included our Land Cruiser, which we found out after first importing was two years older than the 16 year old limit to receive an emergency vehicle license.

An interesting postscript to the Land Cruiser saga is that not two months after purchasing it fully stocked and equipped from us, the group that bought it drove it from their border region to Mandalay, where it was promptly impounded and its three crewmen arrested and thrown into the infamous Mandalay Central Prison, currently filled to three times its designated capacity.

Early on May 17 I crossed back into Myanmar and met up with Nathan and several other team members in Myawaddy, who had brought across a load of supplies we needed at our office. I was happy about the timing since it meant I wouldn’t have to subject myself to the grueling, slow, uncomfortable, 2nd class bus ride back to Yangon.

Let me talk about the Burmese busses for a minute. There are three distinctive levels of bus quality in Myanmar: VIP and 1st class, (which are both brand new arrivals to the country even since I’ve been here) which sometimes have semi-comfortable air conditioning and seats, either silence or relatively quiet music and chanting monks on the speakers, and hardly any unscheduled stops or breakdowns.

Next there’s 2nd and 3rd class, blaring loud obnoxious movies or music, and all but guaranteeing extracurricular stops and breakdowns. Sometimes they are chintzy new Chinese models (if you think Chinese products are bad in America, you should see what they export to the rest of the world) and have aircon set to Antarctic Winter, or old no-aircon post-war Japanese models clearly made for post-war Japanese legs. Often the storage compartment size to amount-of-stuff-to-be-stored ratio is inverted and any available space in the passenger compartment including the aisle is packed with everything from suitcases to bags of rice.

And finally, “Cattle Car”, which is the main method of transportation in Yangon other than taxi, with either large songtau-like open trucks, or busses that may be missing windows, side panels, or seats, and filled to beyond capacity with more people standing wedged together in the aisle than sitting on the seats.

But I digress.

After helping to load the van with our Thai spoils we crammed ourselves in after it and started on the time-consuming but short distance-wise (153 miles as the crow flies) trip back home. Driving around the northern tip of the Andaman Sea adds another 107 miles to the trip, but the steep serpentine mountain road and rough narrow dirt road coming into the Central Valley disproportionately lengthen the journey.

Early afternoon we were making good time and were about 2/3 of the way home when our automatic transmission cargo van started making alarming sounds and having trouble downshifting. First it struggled to get into 5th gear, then it started having trouble getting into 4th gear.

We stopped in the only “town” between where we started having trouble and Yangon and found a little teak and bamboo mechanic shop. They took a look at it and said there was heavy transmission damage but they could try to salvage it if we left the van there for several days. We decided to spend the night nearby and have someone drive our ambulance down in the morning to pick us up so the van could stay at the mechanic, but the only government approved hotel for foreigners was closed for remodeling leaving us with very few options.

We decided to screw the probably already screwed transmission and just drive it as far as it would go and then figure out what to do from there. The noises kept getting worse and we started smoking as we screamed along down in 3rd gear, and the “slow, annoying” bus I would have been on cruised effortlessly past us shortly thereafter. Happily, the transmission survived all the way back to the office, over 12 hours after embarking on what should have been an 8 hour drive that morning.

On June 28 I drove up to the capital with a couple teammates where we had been invited to attend a 4th of July celebration hosted by the US Embassy. We were invited because we were friends with several of the embassy officials and also because we’re the highest trained and by far the best supplied ambulance in the country, and the head of the medical unit wanted us to be available in case the ambassador or any of the guests were to have an emergency.

This meant that we had a special clearance to park in the restricted area right outside the hotel the event was hosted in!

The evening was a blast, getting to see the ambassador and hang out with my embassy friends and meet other expats was awesome, plus there was various pieces of artfully curated Americana scattered around and a surfeit of almost American tasting food to gormandize if desired. Out of the several hundred celebrators, somewhat surprisingly not a single one needed medical attention, and our evening’s festivities went uninterrupted.

The next day we visited a beautiful and expansive botanical garden in Naypyidaw for a few hours and then drove back to Yangon that afternoon.

*******************************************************************************************

The summer monsoon was an extraordinarily wet one and caused unusual amounts of damage this year all across Asia, with powerful storms, record rainfall, and shoddy infrastructure combining to wreak havoc on cities and countryside alike...

...While exploring the ‘Tham Luang Nang Non’ cave in Mae Sai, far northern Thailand right on the Myanmar border, heavy monsoon rains caused a flash flood which trapped an entire middle school soccer team deep inside the cave from June 23 to July 10, setting in motion a truly heroic cave rescue which some of my friends participated in but which cost the life of a Thai navy seal diver...

...Remnants of Typhoon Prapiroon combined with sustained heavy rainfall resulted in major flooding and mudslides throughout June and July in western Japan, forcing over 2 million people to evacuate and leaving over 200 dead, with dozens still missing...

...On the Vang Ngao river in Laos, the 410-megawatt Xe-Pian Xe-Namnoy hydroelectric dam collapsed Monday night, July 23rd, triggering the catastrophic release of 5 billion cubic meters of water, leaving 40 people dead, hundreds still missing, and over 6,000 homeless in Laos and northern Cambodia...

...In Myanmar also there was extensive flooding, even more than the normal monsoon rains cause. The 2018 North Indian Ocean cyclone season was the most active season since 1992, with the formation of fourteen depressions and seven cyclones, though not all of these affected Myanmar of course.

In Hlaing Thar Yar we are far enough away from the coast to escape the brunt of these storms, but we still had so much wind that the rain constantly blew up under our roofing tiles and our poorly fitted windows leaked like a sieve; I had a constantly multiplying family of Aedes albopictus wigglers living in my windowsill all summer! Every day for months it seemed, we were out on the roof calking tarpaper nail-holes under the roof tiles. In Yangon there was sometimes six feet of water over certain parts of the city, which usually drains off quickly after the rain abates but has to be factored in when responding to emergencies or transporting to the hospital!

One day, the entire Myaungmya suspension bridge, the only bridge connecting Yangon to Myaungmya, fell into the Irrawaddy river, killing two people and providing a real boon to the ferryboatmen.

The Ministry of Construction told the public not to worry about the other 29 aging suspension bridges suspended around the country because “it has carried out maintenance work on them regularly”.

We felt very reassured upon hearing this message as we regularly traversed two of these bridges nearly every day on our way to and from downtown Yangon 😆.

On July 16 the final online written exams were administered and the A-EMT course was successfully completed, much to the delight of everyone!

I had to renew my visa again so I took the night bus to Thailand on July 17th. Since I had a little extra time I caught a Songtau out to visit my friends at Sunshine Orchard that afternoon (Wednesday the 18th) and spent the week with them. There was a group of student volunteers from Asia Pacific International University helping with some construction projects around the school campus so I got to know them a little bit and helped out where I could. On Wednesday the 25th I was able to hitch a ride in their van as far as MaeSot where I was planning on crossing back to Myanmar.

However, even though the road from the Thai-Burma border to Yangon is elevated several feet above the surrounding countryside which is mostly rice paddies, heavy rains had covered a hundred kilometers of the road in over two and a half feet of water that even the largest vehicles couldn't get through. I waited for over a week but ended up having to take a bus up to Chiang Mai and fly back to Yangon instead.

On August 29th, the Hswar Creek Dam, holding a large irrigation reservoir in Bago Region, central Myanmar, collapsed, which flooded or destroyed 85 villages and displaced over 63,000 villagers. Incredibly, only a small handful of people were killed or went missing but the deluge did manage to wash out bridges on the only two roads that connect Yangon to Naypyidaw, Mandalay, and the rest of the north half of the country.

One of M-EMS and MFA’s long-time areas of interest to expand into was disaster relief, so earlier this year we implemented a disaster response protocol to respond to these uncommonly severe cyclones, the dam bursting, and regular monsoon flooding.

We immediately had more requests for flood relief than we could handle, both in regard to the need, and to the donations of food and clothes that continuously poured in for us to distribute. We provided aid locally and also made trips to deliver loads of donated supplies like rice and other food, clothes, and medical supplies to the hardest hit areas in Bago Region, Mon state, and Karen state.

The villages that aren't situated right on a river usually don't have boats, and are often flooded out of their homes or at least stranded when rapid or unusually high flooding occurs.

Usually we collaborate with various local rescue groups we know in order to get help hauling more supplies to our flooded destination, and with other friends at the destination to find out where the needs are the greatest and set up boat transportation to get us there when we run out of road. At that point we load the boats and take the supplies to the affected villages and either give everything to the villagers directly, or meet with monks from the local monastery who are involved in feeding and housing flood victims already and leave the supplies with them.

It's amazing to see how everything looks so different when there's 5 or 6 feet of water covering the ground. In some places the flooded rice paddies and fields look like an enormous shallow lake with little islands of coconut and sugar palm trees, tall grasses, and sugarcane being the only things still visible. I would think that this would dilute the fish but the fishermen have a heyday. On our way to one village we passed an isolated bamboo house that was on stilts, and the floor appeared to be floating on the water it was so high. The only dry thing near the house was a huge mimosa tree, where some children from the house were playing and waving to us as we floated by! Another village had made a makeshift paddlewheel boat out of a bicycle lashed to the middle of a raft of plastic 5 gallon gas cans with wooden slats tied to the spokes of the back wheel.

Not all the villages we visit are still flooded. Sometimes there's several flooded villages in the vicinity of an easily accessible non-flooded village, or the water has already gone down but no one from the government or other aid groups have donated any supplies to that area, and all their rice and clothes were washed away or ruined when it flooded, so we helped them also.

On top of flood relief we were still constantly occupied with becoming certified to teach additional courses, and teaching CPR, First Aid, ACLS, PALS, EMR and specialty courses, and responding to emergencies. During my time with Myanmar EMS I personally taught or oversaw over 50 different classes and courses! The demand for training far exceeded the supply and only increased the longer we offered it.

From August 27 through September 7 we taught another 80 hour EMR course at a monastery in Yangon for 40 rescue volunteers, including a small contingent that traveled all the way down from Putao in order to attend!

One night we were woken up by a caller on our emergency line telling us about a possible suicide somewhere in Yangon. Astounded by this remarkable vagary, we pressed for details and found out that the caller was calling from America! It turns out he had been chatting with his Burmese girlfriend and at some point, she had gotten all depressed and told him that her cat had just died and she was so lonely without him and now without the cat too. She then said she had decided that she was just going to overdose and die and then hung up on him and turned off her phone. He had rushed online to see if there was any kind of emergency medical service in Yangon and found our website so now he was calling and asking for help.

We asked for any address details and fortunately he had an apartment number and partial address which was obviously meaningless to him, but we had a general idea of the location and soon we were on our way. After interpreting the address two or three different ways without success we struck on the right combination and arrived at the apartment only to find that it was on the third story and the entrance was through the lower apartment which was locked and shuttered. We beat on the lower apartment until we were convinced no one was home and tried shouting up to the third floor without success.

It was at this moment we discovered that the only time you can truly be alone and have some peace and quiet in Yangon is when you just really need someone to notice you!

Walking around looking for an alternate entry point we discovered an antique British era fire escape bolted to the crumbling bricks on the back of the building. Pulling the ambulance around back we could stand on top and just reach the lower rungs. The bottom sliding section of ladder was rusted solidly in place and we were hopeful that everything else was solid as well.

Clambering delicately up to the second balcony we knocked on the door which was opened after a while by a groggy looking gentlemen who didn’t seem the least bit phased by our unorthodox approach.

We explained who we were and why we were there and then he said “yes; I have a daughter, she’s in her room sleeping at this very moment.” (By now it was nearly 3 AM). We said “Oo ley; (uncle) why don’t you go check on her right now and make sure just for our sake that your daughter is ok.” He acquiesced and pottered off into the bowels of the apartment leaving us floating out in the ethereal third story Yangon smog layer. In a couple Burmese minutes he was back smiling and assured us that she was sound asleep in bed.

“Oo ley; if she has poisoned herself she may appear to be sleeping peacefully when in fact she is dying or already dead. Just wake her up and let us see that she is well before we leave.”

The man was gone a little longer this time but when he came back he was moving much more rapidly and said that she wouldn’t wake up. He finally invited us in and led us to the girl’s room where we found her to be unresponsive in bed. She was cool, pale, and diaphoretic and was only breathing 8 times per minute. We assisted her breathing with a BVM and checked her blood sugar which was 31 mg/dL. After starting an IV and administering 25 grams of D50 (50% dextrose) she rapidly began showing signs of improvement. We searched her room and found an empty bottle of antimalarial medicine which causes rapid hypoglycemia and can cause blindness if overdosed on.

By now she was fully conscious and cooperative and her vital signs were stable. We carried her out to the ambulance (via the stairs this time) and took her to the hospital in case there was anything that they could do to protect her vision.

Since before teaching our very first EMR course, one of my main behind-the-scenes responsibilities was to develop and improve our course materials, which is a never ending process, and as our lineup of available courses increased so did my job of upgrading our teaching materials.

Because of the complete lack of credible Burmese language medical books, we had also begun editing, formatting, and translating both a basic first aid book and an EMR textbook into Burmese. This was an enormous, frustrating process, but after over two years of work, both projects were completed and published this year!

[banhbae]

Fertility: IVF

Tuesday, April 23rd, 2019

12.45 PM: Consult with Dr. Foong at the Regional Fertility Program

This appointment consisted of filling out a lot of paper work such as, consent forms, acknowledgments, etc. Met with Dr. Foong and she went over the whole IVF process. First, she went over the women's reproductive system and how the process of hormone injections works to stimulate multiple eggs. After that she went over the science and technology behind IVF and the statistics. Basically, compared to freezing eggs is a fairly new procedure (around 6 years old) but it is successful and at this specific clinic, the longest they've stored the eggs for is approximately 6 years. There are currently no statistics as to how long eggs can be stored but, obviously, doctors recommend patients to unfreeze their eggs as soon as they are ready to start a family. After going through the statistics, Dr. Foong explained what is required of patients for the days leading up to egg retrieval. Patients are required to do regular blood tests and ultrasounds at the clinic. Once a patient decides they want to freeze their eggs they are provided hormone injections which they must self-administer for 10 to 12 days. Following the 10 to 12 days, the next day is the "trigger" day which is when patients will take another self-administered injection 48 hours prior to the egg retrieval day. Once the eggs of retrieved they will be frozen and stored until the patient is ready to use them.

Dr. Foong advised that the number of eggs they take out and freeze often varies. Sometimes they can take out 20 eggs but only 12 will be mature enough to be stored. She also noted that even if 12 are stored, not all of them will become a baby as there are other factors that come into play when the egg is implanted back into the woman's ovaries. As such, there is always the possibility that none of the frozen eggs are viable in the future (a factor to consider as well).

As of this date, Dr. Stewart (my hematologist doctor) wanted to started my chemotherapy on  May 10th, 2019, which would (hopefully) give me enough time to do the egg retrieval (if I decided to). This appointment was the first time during this whole process I went home feeling stressed, confused, sad, and a little depressed. I remember going home and crying for a bit because it hit me that at this moment, I now have to make a decision about my future; a future I always thought would include having a family of my own and at least, one child of my own. Freezing my eggs sounded like the a definite yes but with the steep cost and the statistics, I was conflicted as to what to do. What if I pay all this money to freeze my eggs and in the end, none come out viable? What if I pay all this money to freeze my eggs and in the end, I'm still fertile and can get pregnant naturally? Or, what if I pay all this money to freeze my eggs and it does work out in the end? Dr. Foong understood how big of a decision this was and left me with the information she provided, and I was instructed to take time to think about what I wanted to do. If and when I decided to freeze my eggs, all I was required to do was call the clinic and let them know I wanted to move forward with the procedure. Then, come into the clinic at 7:30 AM the next day.

Thursday, April 25th, 2019

At this point I was still unsure of what to do regarding freezing my eggs since the steep cost and the slight chance that none of my eggs could turn out viable even if I froze them. So, to help decide whether to freeze my eggs I decided to e-mail my Nurse and let her know that I would like to wait to get my PET scan results to determine what stage of cancer I have and how aggressive of chemotherapy I would need. If we caught the cancer early and I would only need to endure the less aggressive chemotherapy, which would have less effect on my fertility in the long-run I would then decide not to freeze my eggs. However, if the PET scan results came back that my lymphoma has spread and the doctor would likely recommend the more aggressive chemotherapy then I would definitely choose to freeze my eggs.   Within minutes of sending my e-mail, Dr. Doherty called me at work to discuss what I had sent in my e-mail. He advised that he understood my reasoning and that he had my PET scan results on hand, which he could provide me with to assist with my decision making. From there, he went on to tell me that unfortunately, my the cancer has spread to my bone marrow and categorized me at Stage 4 Lymphoma. As a result of this, I would be a candidate for the more aggressive chemotherapy but, again, he reminded me it was still my choice as to what I wanted to do. I did ask Dr. Doherty whether I could begin with the less aggressive chemotherapy (ABVD) for my first round of treatment and if my body doesn't respond well to it, before going on the more aggressive chemotherapy (Beacopp) - could I at that point freeze my eggs? Unfortunately, he explained that that wouldn't be possible since any type of chemotherapy would have an effect on my ovulation and my eggs would not be viable at that time. At this point, I knew it was not a question anymore and I made the decision go through the procedure of freezing my eggs.   To begin freezing my eggs with a "random start date", as the clinic calls it, I was instructed to call the clinic the day before to let them know of my decision and that I wanted to move forward with the procedure; and then attend the clinic the next morning at 7:30 AM. Because I made the decision in the late afternoon I wasn't able to call the clinic until around 4:00 PM and had to leave a message. As such, I assumed I wouldn't be able to start the following day and waited for their call to confirm instead.

Friday, April 26th, 2019

The Regional Fertility clinic returned my call and went over what I needed to do before attending Saturday and what to expect.

5.00 PM: Blood Test - for Regional Fertility Program

Saturday, April 27th, 2019

7.30 AM: Attended the Regional Fertility Program clinic - To begin process of freezing my eggs

Had to do an ultrasound of uterus so the doctor could identify how many follicles (or something?) I had. He determined I had 9 which is relatively low for a 26 year old he said, which scared me a bit, but the nurse reminded me that there are many factors that can effect this and every month could be different so it wasn't something to be concerned about.  Based on what the doctor saw and taking into consideration my age, weight, height, etc., he recommended the dosages of each injection I would need to take per day. The nurse went over in more detail each injection I was to take and how to administer them.  As I was beginning the process on a weekend their pharmacy was closed, the nurse provided me with two days worth of injections and I had to return on the Monday to receive the remainder of my injections. (During this whole appointment I was very nervous and felt so lost and confused, especially when the nurse was going over all the injections, how to administer them and how to measure them. Some of the injections are a lot harder to administer because you have to measure the liquid and then mix it with a powder. For this reason, I strongly recommend and think its advisable to have someone with you during these appointments who can act as an extra set of ears and assist you with the injections.)

9.00 AM: Pick-up Fragmin injection (pain = 3/10) from local pharmacy

The Fragmin injection was not provided by the nurse at Regional Fertility Program clinic. They gave me a prescription and I had to go pick it up from my local pharmacy. Fragmin is to be injected everyday at 8:00 AM, so as soon as I filled my prescription I was to administer it. Since I'm afraid of needles and this was the first of many injections, I wasn't able to do it myself and cried for a few seconds. I can positively say though, that it doesn't hurt and there's just a slight sting at the end but a bit of pressure on the injection sight for a few minutes following definitely helps.  

1.00 PM: Gonal-F injection (pain = 2/10); & Menopur injection (pain = 1/10)

These injections are to be administered between 1:00 to 5:00 PM.

Sunday, April 28th, 2019

8.00 AM: Day 2 - Fragmin & Baby Aspirin

1.00 PM: Day 2 - Gonal-F & Menopur

Monday, April 29th, 2019

7.30 AM: Attend Regional Fertility Program clinic - To get medication (hormone injections) for the rest of the week

Also had to do blood work and ultrasound to monitor how the follicles were developing. Not much had developed within the last two days and I was a little worried but reminded myself it was still early.

8.00 AM: Day 3 - Fragmin & Baby Aspirin

1:00 PM: Day 3 - Gonal-F & Menopur; Day 1 - Cetrotide A third hormone injection was added to my daily injections on this day.

Tuesday, April 30th, 2019 – Wednesday, May 1st, 2019

8.00 AM: Day 4 + Day 5 - Fragmin & Baby Aspirin

1.00 PM: Day 4 + 5 - Gonal-F & Menopur; Day 2 & 3 - Cetrotide

Thursday, May 2nd, 2019

8.00 AM: Day 6 - Fragmin & Baby Aspirin

1.00 PM: Day 6 - Gonal-F & Menopur; Day 4 - Cetrotide

Friday, May 3rd, 2019

7.30 AM: Attended Regional Fertility Program clinic

Again, had to do blood work and ultrasound.

A lot more follicles were observed at this appointment, I believe 8 in total. The follicles in my left ovaries were showing and developing a lot faster than my right.

8.00 AM: Day 7 - Fragmin & Baby Aspirin

1.00 PM: Day 7 - Gonal-F & Menopur; Day 5 - Cetrotide

2.00 PM: Blood Test - for Regional Fertility Program clinic

This blood test they were testing for something else, which is why they couldn't do it at the Regional Fertility Program clinic. I know that when I do my blood work there, I believe they are only testing my estrogen levels.

Saturday, May 4th, 2019 – Sunday, May 5th, 2019

8.00 AM: Day 8 + 9 - Fragmin & Baby Aspirin

1.00 PM: Day 8 + 9 - Gonal-F & Menopur; Day 6 - Cetrotide

Monday, May 6th, 2019 – Wednesday, May 8th, 2019

7.30 AM: Attended the Regional Fertility Program clinic

All 3 days I was requested to come into the clinic and was required to do the routine blood test and ultrasound. Normally, I don't think they would have patients come in everyday but because I had my chemotherapy initially booked to begin on Friday, May 10, 2019 the doctors were monitoring to see if I would be ready by day 10 to do the "trigger" and retrieve my eggs. On Monday everything looked good at my appointment and they hoped for just one more day of the hormone injections and Tuesday to do the "trigger". Unfortunately, when I came in on Tuesday the ultrasound showed that my follicles were not of the size the doctor would like. On Wednesday, my doctor advised me that my blood test from the day before (Tuesday) showed that my estrogen levels had dropped from about 6700 to 4000; which was very concerning considering the dosage I was on, my age, and height. As a result, at this appointment my doctor informed me that if my blood test results came back and showed my estrogen levels continuing to decrease, they would have to cancel the whole procedure because the probability of retrieving good quality eggs were very low and they wouldn't want to put me through an invasive procedure with low outcome results. After hearing this I immediately started panicking and breaking down inside, I remember heading straight to my car after appointment and sitting in the underground parkade crying. I felt like at first freezing my eggs was an option and now, if my estrogen levels don't increase, that option was taken from me and I had no choice but to begin chemotherapy and down the road, when I wanted to start a family... hope for the best... The thought of not being able to have children or my own family really made me breakdown and feel purposeless as a woman. Luckily, the clinic called me at 11:00 AM to let me know that my estrogen levels did increase (went back to 6000) and I was still on track to freezing my eggs. They have no idea what might have caused my estrogen levels to decrease; it could've been that when I went to inject my hormone injections I didn't inject it all the way (especially considering by this date my abdomen area was so sensitive and covered in little spots from all the injections).

8.00 AM: Day 10 + 11 + 12 - Fragmin & Baby Aspirin

1.00 PM: Day 10 + 11 + 12 - Gonal-F & Menopur; Day 7 + 8 + 9 - Cetrotide

Thursday, May 9th, 2019

7.30 AM: Attended the Regional Fertility Program clinic

Blood test and ultrasound again. My follicles looked good and of decent size, and it was finally the last day of my hormone injections. "Trigger" day was set for Friday night and egg retrieval for Sunday morning.

8.00 AM: Day 13 - Fragmin & Baby Aspirin

1.00 PM: Day 13 - Gonal-F & Menopur; Day 10 - Cetrotide

 Friday, May 10th, 2019

"Trigger" Day - Required to start taking my antibiotics [doxycycline], two times per day.

8.00 AM: Day 14 - Fragmin & Baby Aspirin

1:00 PM: Day 11 - Cetrotide

10:00 PM: "Trigger" shot - 7500 IU of HCG

Saturday, May 11th, 2019

"Rest Day" as I had no more hormone injections to administer.

8.00 AM: Day 15 - Fragmin & Baby Aspirin

Bedtime: Valium - to help me get a good night rest before the procedure

Sunday, May 12th, 2019

*Instructed to not take my Fragmin or Baby Aspirin the morning of and wait until after the procedure.

8.15 AM: Check-In at the Regional Fertility Program clinic

9.00 AM: Egg Retrieval Procedure

I was provided Tylenol 3's after the procedure to manage any pains.

12.00 PM: Day 16 - Fragmin & Baby Aspirin

Monday, May 13th, 2019 – Sunday, May 26th, 2019

This was the first week that was normal and it was nice to have a break from all the hormone injections and strict schedule the last couple weeks. I managed to go to the gym almost every morning as my strength and energy was back. The only side-effect/symptom after the procedure I had was being bloated and it was more uncomfortable than painful. My abdomen was very swollen and looked as if I was a few a weeks pregnant. The swelling, however, only last for about week. I had to continue the Fragmin injection and Baby Aspirin every morning for 14 days following the egg retrieval. The clinic managed to retrieve 22 eggs and freeze 19 of those eggs in total!

[soyunaprofesora]

Preface: I am okay.

Another new experience here in Mexico. Last week I got to get an inside look into the country’s hospital system.

Last Sunday, I spent the entire night awake in agony feeling like someone was stabbing me in the ribs. I hoped that it would go away on it’s own, but by the time my alarm went off Monday morning, I hadn’t gotten any sleep and the pain was not any better.

I called in for a sub and waited for my landlady to get up so she could take me to the doctor.

Here in Mexico, all pharmacies have an in house doctor who can prescribe medication. Laura took me to one and the doctor diagnosed me with Colitis. She gave me a prescription and sent me on my way with medicine, a diet plan to follow for the next few days, and some Gatorade.

I went home and took the first dose and tried to lie down. The pain got worse. I called my mom to get a second opinion. She called my dad who told me to go to the actual hospital and get some tests done. At this point, I was crying and scared and feeling very out of control. My landlady dropped everything she was doing and took me to the emergency room. Conveniently, the hospital is close enough that I can see it from my house. We made it to the ER and I was seen right away.

They took some blood and sent me for an ultrasound to confirm what they believed was wrong. The ultrasound showed two gallstones floating in my gallbladder and one stone blocking the duct. I had to have my gallbladder removed.

I was terrified. I had never had major surgery before. I’ve had my wisdom teeth out and I had to go to the ER for some stitches when I cut my finger, but nothing this serious.

I got on the phone with my mom and my dad and they talked me through everything. I would have my gallbladder removed laparoscopically with just three small incisions. Easy surgery, easy recovery. Sometimes it really comes in handy to have a dad who is a surgeon and does these sorts of procedures on a daily basis. My mom made arrangements to fly to Mexico the next day to help me after my surgery.

I was admitted overnight to get antibiotics to calm the inflammation before surgery. My mom arrived on Tuesday just before I was taken down to get prepped. It was extremely reassuring to have her with me. Surgery went well and I was moved back up to my room after waking up in recovery for a few hours. My mom took excellent care of me as I came off the anesthesia. Sorry to tell you, but nothing too embarrassing was said or done while under the effects of anesthesia. Just some whining and complaining about being hot and dizzy, which I’m told is a normal side effect.

I slept through the night on Tuesday into Wednesday. I was able to get up and go to the bathroom on my own the same night as my surgery. The doctor checked on me around noon on Wednesday and told me I was free to go home to rest. I was in the car heading to my apartment around 1 PM.

I spent most of the week recovering. I took small walks around my neighborhood and I tried to show my mom around my city in a car. On Friday, I felt well enough to go into school for a quick meeting with my English department. I also wanted to show mom my school and classroom. It was hard, but I survived for an hour and a half.

On Sunday, I was feeling good enough to take mom to some new places. We went to a lookout point at Obispado to take pictures and visit a museum to learn about Mexican military history. Then we went to the local mall to walk around a little. 

Monday was a national holiday here in Mexico, we went out to lunch with my landlady, Laura, and her daughter. Then we drove around some more to show my mom some different things. We would have stopped to walk around some places, but the weather was rather dreary.

I went back to work on Tuesday and mom flew back to Virginia that evening. It was hard to come back to an empty apartment after having her there for a week, but I’m also looking forward to getting back into a routine.

I survived school okay. I think I’ll get a little bit better each day. I have a doctor’s appointment today to check my incisions and make sure I’m healing properly. Everything seems fine, though.

The one thing that has made this entire ordeal a somewhat positive experience is the supportive response I got from so many people. I am by nature a pretty shy, quiet person. I keep to myself and am perfectly happy spending time alone. I’m too much of an introvert in that respect. But I had so many people reach out to me to check on me in one way or another. 

My landlady, first and foremost, has been incredible. From cancelling her entire workday on Monday to help me get to the pharmacy and then the emergency room and staying with me the entire time. Her calming mom presence was essential in helping me survive the crazy day.

While I was still in the ER, I had visits from my principal, my literacy coach, and several members of HR to check in on me and help me in whatever way I needed. Those HR people also dealt with all of the insurance and paperwork for me in addition to picking my mom up at the airport and bringing her to the hospital. I would have been lost without them.

On Tuesday before my surgery, I had texts and calls from many coworkers in addition to a visit from my assistant principal. Their support and well wishes blew me away. In this instance, thoughts and prayers actually did help me out a lot.

I had several coworkers visit me on Wednesday before I went home and then a few more came by once I got to my apartment. One of them came bearing Get Well cards from students in my homeroom class, which was more than heartwarming. Another coworker ran some errands for me and grabbed some groceries for me and mom, which was incredibly helpful. The flowers she brought were also appreciated.

More people came by on Thursday and I got many hugs when I got to school on Friday. 

Now, I knew that my coworkers were kind and supportive people before all of this, but I had no idea the lengths people would go to help me through something like this experience. People across subject areas and grade levels and even people I assumed didn’t like me all that much reached out in one way or another. It was eye-opening.

Good news: I am doing fine. I get better each day. My mom got to see my new home and meet my self-proclaimed Mexican mom, Laura. Mom and I spent a week together just the two of us and actually managed to communicate without snapping at each other (a really impressive feat from both of our perspectives). I got a week off from school, which was actually really welcome mentally. My new lack of gallbladder requires me to eat more healthily, which will hopefully force me into losing some weight (an ongoing challenge for me). 

Someone told me I was surprisingly upbeat about this entire experience, but I honestly haven’t had any reason to be anything except positive. I consider myself very lucky in that regard.