Fuck Cancer

At the end of July, my mum died from cancer – the same kind I had in spring, endometrial adenoma, but where mine was early days and not very aggressive, hers was faster-growing and already in the last stage. It’s currently still being investigated whether there’s a genetic link behind the two of us getting or it was just coincidence. I had some factors that made the development of endometrial cancer more likely, like PCOS and nulliparity, but my mum’s lifetime risk was not elevated. And I already had symptoms in the very beginning, while my mum’s only showed up during her last month and were so unspecific that we all believed she had a stomach bug. There were only eight days between her cancer diagnosis and death, and I don’t want to go into details about her rapid decline because I’ve relived it often enough as it is.
I miss my mum every day. I wish we had more photos together from recent years, or any videos and voice recordings. I wish we’d had more time to say goodbye. More time in general.
Even though I’m doing ok, I wonder if I’ll ever be able to be carefree again. Even the most beautiful days are tinted with melancholia now – an underlying sadness which sometimes morphs into anger. Anger that the world just keeps turning, so oblivious about the fact that my mum’s not here anymore.
What helped me most was that the psychiatrist increased my daily dosage of escitalopram to the therapeutic maximum; by November I’m supposed to go back to my usual dosage. Any other medication I’ve been offered to help me sleep or keep me calm came with too many side effects and wasn’t worth taking. You can’t medicate away grief anyway.

Apart from that, I’m doing well. My own body has recovered and I’m back to pre-surgery levels of fitness now, even though it was only four weeks ago that I last felt the stabbing pain at the surgical sites inside my lower abdomen. They say a hysterectomy takes six to nine months to heal completely, which seems about right to me: surgery was in early March and the last time I felt anything was in early September.
I don’t miss my uterus at all, especially considering I went through over half a year of constant cramping and bleeding in the end. It’s a great relief to not have any of that anymore, and I don’t miss my periods either. For the first weeks post-OP that general region (bladder, intestines etc.) felt somewhat alien, but now I can’t tell any difference compared to before surgery whatsoever. I actually “forget” I had a hysterectomy until something reminds me of it.

I’m still attending aquafit classes, which deserve at least half of the credit for getting me fit again after surgery. (The other half goes to regular walks; without them I wouldn’t have gotten well enough to attend aquafit classes in the first place.) They are also really helpful for my mental health.
My weight is around 93.5 kg or 206 lbs right now. The week my mum died, I was actually down to 92.2 kg, but anything I lost due to grief came back on later. This month marks the first anniversary of my diabetes diagnosis, and during the past year I lost 10.5 kg (23 lbs) of fat and gained 4 kg (8.8 lbs) of muscle, so I’m a lot healthier now.
My milestone-targets are still in place: first get under 200 lbs, then get under 90 kg, then get to a bmi under 30, which for me would be at a weight lower than 88 kg.
Bloodsugar management is going ok. In fact, I think it’s the metformin which allows me to slowly lose weight. I have to be careful to not stray from my eating schedule too much or the metformin will give me the worst diarrhea imaginable. Seriously, my lactose intolerance problems, while more painful, appear like a joke compared to metformin shits. Which is the reason why my biggest weightloss goal is not reaching a certain number on the scale, but being able to at least reduce my metformin dosage if I can’t get off it completely.

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The C-Word

One of the last posts I wrote before going silent was about how I wanted to take care of myself to avoid health problems. Well, they caught up with me, big time.

The condensed version is that by late summer, I started having gynaecological problems like prolonged bleeding and cramping. I had it checked out, got a preliminary diagnosis of PCOS (polycystic ovary syndrome) and was sent to a diabetologist because there was glucose in my urine. Long story short, the insulin resistance that often comes with PCOS had already manifested as diabetes type 2, and so I’m taking metformin for that now.

The bleeding also got worse, hypermenorrhea and menorrhagia for three months straight, so back to the gynaecologist, who did an ultrasound of my uterus. Turns out I had endometrial hyperplasia which turned the endometrial lining more than twice as thick as it should have been. I got a referral to the hospital for an abrasion and hysteroscopy. Everything looked fine on the outside, but when the histological report returned, it was endometrial cancer. Earliest stage possible, slow-growing, and the least aggressive variety, but cancer nonetheless. I had a number of tests done on genetic mutations, all of them negative. Caught the flu immediately afterwards and was sick right up until the date for surgery rolled around: ten days ago, I had a total laparoscopic hysterectomy. The ovaries could stay since I had no genetic mutation that would increase the risk of ovarian cancer; the uterus, cervix and tubes were removed. The procedure was a success and I’m now cancer-free since it had not metastasized or grown outside of the uterus.

So far the hard facts. As you can imagine, it was an emotional rollercoaster, and the whole part from the discovery of the hyperplasia to the hysterectomy played out in under two months, so I’m still feeling like it’s going to catch up with me and hit me like a boomerang.
Physical recovery is going well, even though I have to rest a lot, but the pain is manageable.

I’ll try to write in more detail soon; for now I’m tired.

Easy Peasy Japanesey

Back in July, I’d signed up for a Japanese class. Mainly because I was bored and suffering from cabin fever; it provided a great opportunity to get out of the house and gain a new skill.
A month-long intensive course for a small group, we were taught the hiragana syllabary and basic grammar/ vocabulary. Even though it makes my usual problems (performance anxiety, social phobias) rear their heads again, I’m enjoying the learning process so much that I went back for round 2 earlier this month.

I’ve had a fascination with Japan since primary school, and as an added benefit you gain fresh perspectives from learning a new language, especially when it doesn’t belong to the same language family as your mother tongue. Different languages come with radically different views of the world around them, which I find very exciting to discover.
The first time I strayed out of the Indo-European branch was 20 years ago, when I started learning Biblical Hebrew at school. Shame that I haven’t had a chance to use it after I got my high school certificate, because even though I can still read it, I forgot 90% of the grammar and vocabulary.

Also, I like the challenge. I spent so many years at uni with the sword of doom dangling over my head that I forgot what it is like to pursue a skill just for the sake of it. As mentioned before, I am not completely anxiety-free in class, but there’s no big test in the end or target I have to meet: just attending and learning is the goal. And nothing or nobody forces me to go there, so I have the freedom to quit whenever I want to. Which is not anytime soon.

Learning Japanese is difficult. Not sure how much of that is the inherent nature of the language (from an Indo-European perspective, at least) and how much of it is my rusty brain creaking into gear… I usually grasp the concepts explained to us immediately, but the reading/writing and numerical systems are very complex, and it is intimidating to start off from a place of complete illiteracy. We stammered our way through the textbook like first graders, even though now, after eight weeks’ worth of lessons, the prospect of reading the lines out loud is not as daunting anymore. I did practice between sessions, though, because it’s a lot to take in at once. Come to think of it, I wonder how long it will be until it doesn’t hit me like a wall of cryptic text anymore – even if I know all the words, nothing jumps out at first glance.

Mass Shootings, The Media, And Mental Health

Dear media,

Like so many others, I have been following the events of Munich’s mass shooting on Friday night. Like others, I want answers. The answer cannot be, however, to publish psychiatric diagnoses without further comment or explanation by professionals.

You see, I happen to suffer from the same mental health problems which are now being shoved into the limelight as the Munich shooter’s conditions, depression and social phobia, so I might be more sensitive in that regard than your average person. But it is extremely unlikely for depression or social phobia to result in the desire to go on mass killing sprees – harming other people doesn’t even feature in the diagnostic criteria.

What you are doing is publicising facts which may have contributed very little to nothing to the crime at the cost of increasing the stigma for millions of people suffering from depression and / or social phobia in Germany alone. You are making life harder for all of us who are already receiving psychiatric or psychological help, and you are potentially discouraging others from seeking treatment because they don’t want to be regarded as a “loose cannon” or threat to society.

Next time, please consult professionals and add their opinion before releasing your findings. Instead of trying to be the fastest to get information out, how about striving to be the one who gets the best information out?

Medical Service Appointment

The worst part is over now that the appointment with the medical service is behind me. It went by no means great, but at least I did not cry afterwards like last time.

The physician took a little more time to ask questions, about 15 minutes, which was the one positive aspect of the appointment. On the negative side weighs in that she tried putting phrases in my mouth that I didn’t mean to say, kept interrupting me, and generally had a brash demeanour.

I wasn’t feeling my best to begin with: slept badly the night before because of anxiety about the appointment; kept confusing words; couldn’t remember which dosage of escitalopram I take, etc. And the doctor’s behaviour made everything even worse.

For example, I had tried to explain why I had not gone back to psychotherapy – that I want(ed) to, but for reasons already discussed on this blog haven’t. She tried to twist it into me saying that because I’d had such a positive experience with my first therapy, I was resisting seeing someone else now and idealising the first treatment. Absolutely not true. If health insurance wouldn’t limit the number of sessions I could have, I’d be way more willing to try things out. And even if, ultimately it was my psychiatrist who suggested to wait with that – and she knows me a helluva lot better than someone who judges me based on a 15-minute-meeting.

The doctor also had never heard of CBASP and when I said that the general consensus is that chronic depression is largely treatment-resistant with standard behavioural therapy, she called bullshit. Whatever, I don’t really care. It’s what the scientific papers say, not my personal opinion. Not trying to convert anyone, least of all her.

Also, she said I was “talking in diagnoses”, not how I felt. Well, last time I tried that with her colleague, he wouldn’t even let me finish. Also, it’s really hard for me to open up to strangers about such personal stuff. There’s a reason why my therapy sessions worked out so well, and that is that he took the time to make me comfortable. I realise the medical service was never meant for that kind of in-depth, trust-gaining discussion, but I had told her half a minute earlier that I suffered from social anxiety, and how at uni I would devote 75% of my energy to not freaking out and 25% to following lectures. It’s kind of a low blow to hold “talking diagnoses” against me after I just divulged that strangers freak me out.

Seven hours since I got out of there, and the knot of anxiety in my stomach only slowly starts dissolving.

Jobcenter Updates

The jobcenter sent us two forms as part of a „hearing“ regarding why they paid us too much money. Two separately mailed letters containing the exact same forms and the exact same letters, except that one was addressing my husband with “you earned income” and my letter read “Mr. Layara earned income”. So I explained for the fourth and fifth time respectively in those forms that the jobcenter pays in advance, but my husband’s salary only comes in about six weeks later since he gets paid retroactively the following month. I also asked for our monthly allowance to be reduced, to avoid having to transfer back hundreds of euros later on. We’ll see how that goes.

Tomorrow, I have an appointment with the medical service to assess my mental health. Last time was pretty bad; my one comfort is that with just a few more months to, the result of tomorrow’s appointment will only matter short-term. I was supposed to bring ALL my files from various doctors, but they gave too short notice of the appointment to get anything from the psychiatrist, and anything from the clinic / therapy is not available as it is part of a medical study and thus confidential. For the latter I still have a statement written by my therapist from the last time I had to see the medical service.
Also, I need to bring all the medication I take. Not sure why – to prove that I’m not making anything up? Shouldn’t they already have my medical records on that from the psychiatrist? And how would showing them a bunch of blisters prove I am actually taking that stuff? Seems rather stupid to me.

On Tuesday I have an appointment with my caseworker at the jobcenter. I am not sure whether I mentioned that before, but we got a new caseworker a year ago. She is nice enough, but I miss the old one. She was bipolar, so actually understood how mental health problems can influence your everyday life. Also, she would get in contact before setting the actual appointment. They don’t have to do any of that, but it was a courtesy she extended to me that made me feel as if they took me into account as a human being, not just a file that needs to be processed.

To say that I am afraid of the appointments would be overstating it, but they make me terribly nervous. I feel pressured, and “faulty” to boot. I understand that the state needs to check who they give money to, but this arrangement is not contributing to my recovery.

Misfortunes Never Come Singly

Over the past few days, I’ve had to deal with a number of frustrations and disappointments.

The aquafit class got cancelled after local authorities closed the pool and adjoining gym. Apparently there’s fault with the ventilation system, and fixing it will be so extensive that it won’t re-open before summer 2017. A number of schools and seven different sports clubs have now suddenly lost their training locations.
As for the group I was part of, any vacancies at aquafit classes held at different pools are first going to those who joined as part of their physical rehab. Anything that’s still available afterwards will be offered to the “prevention group”, or you can simply get your money back.
Financially it’s no loss, but I was so happy with everything concerning this: the group, the instructor, the time slot, the uncomplicated drive… On Friday I’ll find out if I can at least finish the last four weeks before the summer break.

Then, we are having jobcenter problems. My husband has a fixed salary per hour, but there are additional boni for night shift, Saturday or Sunday work. So he never gets paid the same and the difference can be several hundred euros in extreme cases.
As I mentioned before, welfare is slowly phasing out; we are still approved until the end of September and only get substituted right now to make up the difference between the threshold-income and his actual income. We have to hand in a copy of his payslip every month to prove how much he made.
Well, the first month, when my husband’s actual income after taxes was still lower than what we got from the jobcenter, they paid us too little and the missing rest came three weeks later. The second and third month, they paid us too much (way too much this month) – which wouldn’t be such a big problem if we wouldn’t get into trouble for that down the road. We basically have money sitting in the bank that isn’t ours, that we can’t touch because they might ask it back at any given time, and all attempts to contact them have been fruitless so far. They don’t react to emails, phone calls end in the holding line…

On top of all of this, the jobcenter ordered me in Friday morning to discuss my medical report. It makes me nervous as hell, because I don’t know the result and what they want to do with me. Worst case scenario, we would have the means to terminate welfare support on the spot. Last month we were just 60€ below the threshold and this month we’ll be over it, so the jobcenter would have (or should, at least) stopped giving us money anyway – we only wanted to stay until September because we could have used the “mobile pass” still, which gives you percentages off public transport fares, and as a security net until my husband’s probational period at the new job ends at the beginning of September. Last but not least, terminating now would be a nightmare of bureaucracy, whereas just waiting until it runs out does not require anything other than NOT requesting a renewal.

Logically, I am aware that no matter what they are going to say on Friday, they can’t do anything to me. I could just walk out saying “So long, suckers!” if shit hit the fan. But being the unconfrontational person that I am, it already stresses me out.

Busting My Ass

Today we had a substitute instructor at aquafit who seemed intent on turning the class into boot camp. Eventually it transpired that she had confused us with the aquapower class afterwards and drilled us with tabata, a high intensity interval workout. Finally the most brazen lady yelled from the pool: „This is aquafit for chubbies!“ Not that it made the instructor change her programme.

It was still fun, but I’m afraid my arms and legs will be screaming tomorrow. I prefer our usual routine, which leaves me energized afterwards – today just made me feel powered out.

My weight went up and down a bit this week, but the general trend is down. I was 98.9 kg this morning, – 1.7 kg from last Friday. Low carb is quite effective for me. I think I burned more fat than the scale shows, though, because I lost 2.5 cm (one inch) of girth on my belly in just six weeks, but am a mere 3 pounds lighter than at the beginning of March. I must be building muscle from all those exercises where we work with the water resistance. It’s doing wonders for my back, in any case!

Giving Low Carb A Go

Despite aquafit, cutting out the coke and counting calories, I gained 1.1 kg in a week – almost two pounds. After the initial disappointment, I knew I had to make up my mind: either continue as I did, with the very slow weight loss and occasional gains in between, or get serious about it. So I am officially dieting now. Calorie counting, and no carbohydrates after 6 PM; and in just two days the weight went back down to 99.5 kg.

I’m not going to lie, the low carb approach is hard for me. Contrary to popular opinion, proteins don’t fill me up longer than carbohydrates. Going hungry during the day is not too bad, because I know the next meal is coming eventually, but I also get hungry before it is time for bed. Last night, I got so desperate that I drank a huge cup of broth – at 23 kcal and a negligible amount of carbs, it was the only way to shut up my stomach without messing up.

During the day, I still eat carbohydrates. Partly because high protein breakfasts don’t sit well with my stomach, partly because I would fall off the wagon within 72 hours. I like them too much. Funny how it is not the cola or chocolate that are giving me a hard time, but stuff like rice or fruit.

I am not sure how long I am going to do this. As long as it doesn’t make me miserable, I guess. Even though I can boast a long history of unsuccessful diets, the last one was a few years back, and I never tried low carb. I hope that this new approach in combination with the depression treatment will give me the willpower to stick to it for a while.