“Womanly” potential

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After “Quincineara Beat Down“, you can see that I’m struggling with a topic, and still trying to find a way to say EXACTLY what I mean.

At this point, I’m still struggling with my lack of sexual activity.  Part of it is due to my underlying illness, and part of it is due to family obligations where my partner is raising his foster son (again), and being the primary caregiver for his 80-year-old Mother. It’s a long and complicated story, but it’s sufficient to say that I’m not getting any and it’s ok.

But, just because I’m not getting busy with anyone does not mean that I am blind to the reality that women are facing today – the fact that we must be “feminine” and “womanly” before we’re anything else.

That focus on womanliness has been the bane of my existence because I’m not a girly girl.

In fact, if you’d asked me, I’m more like Mr. Spock on a good day, with everything being analyzed, especially intimacy and sexual issues.

For me, the need to don war paint, wear “feminine” clothing, and otherwise be anything but what I choose to be on any given day just feels like a fraud.  Why aren’t I good enough, just as I am, straight out of the package?  Why must I be dressed up and focusing on my appearance 24 x 7 x 365 in order to be “womanly”?

No answers here, but it’s still lingering in the back of my brain as the liver doctor wants me to see a nutritionist (which appears to be code for bariatric surgery), and I want nothing to do with that request if it involves surgery, or if it means I’m going to lose weight.

My weight is part of my wellness program (moving to CA 33 years ago and putting on 60 pounds happens to be choices that allowed me to live much longer than expected, AND stay out of the hospital).

 

Diplomacy challenged.

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I belong to the MyCOPDteam website, which is a support group for people battling COPD and trying to find resources in fighting this crazy disease.

I say COPD is crazy because even the so called “experts” on the disease – the docs, respiratory specialists and patients themselves – can’t all agree on it’s causes, triggers, definitions, etc., etc., etc.; making for a rollercoaster ride of things to consider and try in order to remain healthy on a case-by-case basis.

Into these care and treatment considerations come the various personalities of the patients and their caregivers and loved ones, willy nilly, with very little opportunity to filter in or out anyone who may be unhealthy for your individual state of mind.

There are key issues to be addressed with any chronic health issue, but the most important questions don’t get addressed until much further in the online support community, long after you have emotionally engaged with an internet friend or foe and their health outcomes.

Being a crabby New Englander, I was taught that a friend, no matter how boon a companion in real life, is still an “acquaintenance” until you’ve known them and been friendly for at least five (5) to ten (10) years.  What then are the rules for boundary management in internet life?

The reasons for the 5-10 year minimum getting-to-know-you period or reasonable limit is because people lie.  Or prevaricate.  Or put on one personality in public, but may actually be a whole other soul-sucking personality over time.  Until you’ve been in the trenches with someone, you don’t kniw who they are, but rather have bought a bill of goods they are selling you about their personality.

Into this picture comes the art of real life vs. internet life, and how well one manages the graces and decorum in the troll-filled universe we sometimes inhabit in the internet determines in a big way whether or not one is a fan of spontaneous interaction.  With strangers.  And their relatives.

I’ve done pretty well in the 1:1 world of Better Breather Classes.  I am who I am, and I participate fully.  Take me or leave me, but you won’t say you didn’t “notice me”.  And, we all have an unstated but clearly understood rule about manners and communication and kindness.  When in doubt – don’t say it, don’t do it – keep things running smoothly and ensure everything is non-confrontational and polite.  Everyone handles their chronic illnesses differently, and it’s not my business to police your interactions with others.  There is no “right” way to handle how you deal with your illness aggravations and vulnerability as you age.

I’ve also done pretty well in the world of internet dating, breaking through the safety wall to meet and date (or drop) the object of my potential lust and affections.  Because of the boundaries I created to protect my real world identity, few people got to be facebook-level friends  as my answer was always, “No.  You have my contact info on this (other) site.  Until we meet in the real world and decide that we know what we want from each other in terms of public behavior and manners, we’re fine staying friends on this (other) site and not on facebook.  There is no “right” way to handle how you deal with your love life and carnal desires, but I draw the line at starring in an episode of “Cheaters”, or of having your relationship drama rain all over the people in your life – online or in the real world.

So, with these experiences in mind, as I’m dealing with the bleed-thru of the MyCOPDteam friendly acquaintenances and their connections into facebook, I’m finding more things are getting on my nerves.

First, I’m not religious, so the whole “Prayer Warriors, I need your help” demand as a constant background battle cry is exhausting.

Second, we don’t all deal with the inevitable complications and end of life decisions the same way, so my diplomacy is being stretched thin as I go on facebook at all hours of the day and night, unprepared to deal with what can be endless drama in my otherwise lighthearted facebook experience by people who are chronically ill and showing their chronic illness panties – intentionally or otherwise – for all the world to see and remark upon.

Unless it’s siloed among my own family and extended family members – a place where it’s much easier to identify the landmines and avoid them through years of real-world exposure – I don’t wanna know.

 

Childhood Trauma

I’ve been away from this site for quite awhile, as everything I’ve wanted to write about seems pointless and Debbie Downer.  But, I have 5 posts that I’ve been editing over all these months, and a blog by DrugOpinions on trauma got me to thinking about why I’m stuck in writer’s block hell.

Can ACE helps to solve our societal problems?

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Backstory:  It’s been a challenging Summer, with a bunch of myCOPDteam friends passing away, and with my budget being incredibly tight due to a car accident that totaled my new (4 months old) car, and dealing with the pain involved in the (relatively minor) injuries I received.

I’m broke due to being out of pocket to replace my car (found an IDENTICAL model, yes!), and the ongoing physical therapy co-payments as I work to rehab my body without relying on pain killers or other aids that might make my existing ailments worse, (for those who might have lost teack – Asthma / Emphysema / COPD;  diabetes;  non-alcoholic fatty liver disease; blah, blah, blah).  With all this being said, writer’s block is an additional bonus to my frustrations for dealing with my life right now.  Usually, I write until whatever’s bugging me is purged, and that outlet has been closed for quite a bit of time.

So, to try and clear my head, I’m going to try and figure out my ACE score to see if it adds any clarity to the crap floating around behind my eyes and between my ears these last few months.

ACE Questionnaire

Prior to your 18th birthday:

  1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
    No___  If Yes, enter 1 __  [ 1 ]
  2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
    No___If Yes, enter 1 __    [ sort of?  Touch was used for control and silencing me, after all spankings stopped at age 5, when my Mom was afraid my father would beat me to death at my refusal to be apologetic when being defiant ]
  3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
    No___If Yes, enter 1 __   [ No ]  but, I had lots of surgeries, including one on my bladder, and I often wonder if that impacted my early interest in how the body parts worked…
  4. Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
    No___If Yes, enter 1 __   [ No ]
  5. Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
    No___If Yes, enter 1 __  [ No ]  My father was a functional alcoholic, but my Mom was the bulwark of the family and we were well cared for.
  6. Were your parents ever separated or divorced?
    No___If Yes, enter 1 __  [ 1 ] yes, thank heavens !
  7. Was your mother or stepmother:
    Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
    No___If Yes, enter 1 __  [ No, never in front of me.  That trauma was reserved for my Aunt and Uncle, who I was sent to live with for 3 Summers after my parents separated, and who seemed to get aroused by the violence after we were all in bed but unable to hide from the sounds of their fights, violence and sex, late at night].
  8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
    No___If Yes, enter 1 __  [ 1 ]  Yes.  My father and my Aunt were both functional alcoholics.
  9. Was a household member depressed or mentally ill, or did a household member attempt suicide?                        No___If Yes, enter 1 __  [ No.  While I believe depression runs rampant on both sides of my family tree, my father was on lithium when I was 9, which contributed to the quietest 6 months in our household before he couldn’t stand the peace and quiet and refused to continue on the medication].
  10. Did a household member go to prison?
    No___If Yes, enter 1 __  [ No ]

Now add up your “Yes” answers: _ This is your ACE Score


It turns out that as the ACE score increases, so does the risk of chronic diseases, social and emotional problems later in life.
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To continue the topic for scoring, one summarizes the scoring as follows:

What’s Your ACE Score? (and, at the end, What’s Your Resilience Score?)

There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. Five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. So a person who’s been physically abused, with one alcoholic parent, and a mother who was beaten up has an ACE score of three.

There are, of course, many other types of childhood trauma — racism, bullying, watching a sibling being abused, losing a caregiver (grandmother, mother, grandfather, etc.), homelessness, surviving and recovering from a severe accident, witnessing a father being abused by a mother, witnessing a grandmother abusing a father, involvement with the foster care system, involvement with the juvenile justice system, etc. The ACE Study included only those 10 childhood traumas because those were mentioned as most common by a group of about 300 Kaiser members; those traumas were also well studied individually in the research literature.

The most important thing to remember is that the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences.

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The focus on the ACE scoring that I find most interesting is how “toxic stress” is defined to highlight impacts on your health.

While I don’t consider my ACE score particularly high based on the questions asked, it’s the focus on resiliency which really captures my attention.

I consider myself extremely resilient.

But, considering the fact that my first chest surgery occurred at about six months old, and involved breathing issues due to a physical deformity involving my chest and ribs, as my bones curved inward, endangering my lungs and heart and preventing proper growth as I aged, it comes back to a whole chicken vs. egg question for me.

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Looking at this score image in particular, focusing on COPD, throws the entire dynamic into the trash bin for me.

If I started life with a birth defect, and the inevitable evolution into COPD is a foregone conclusion if I lived long enough to wear out my body, then the ACE score has no relationship on my likelihood of contracting COPD.

This is one of those kitchen sink analogies where everything impacts one’s quality of life and rate of illnesses, negating the value of the cause and effect study for me.

So many people with horrible childhoods are hale and healthy into old age, so I’m going to lump this into the, “if you only have a hammer, then everything looks like a nail” theory.

So, let’s look at the resiliency scoring from another study:

Aces Too High

RESILIENCE Questionnaire

Please circle the most accurate answer under each statement:

1.  I believe that my mother loved me when I was little.

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

2.  I believe that my father loved me when I was little.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
3.  When I was little, other people helped my mother and father take care of me and they seemed to love me.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
4.   I’ve heard that when I was an infant someone in my family enjoyed playing with me, and I enjoyed it, too.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
5.  When I was a child, there were relatives in my family who made me feel better if I was sad or worried.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
6.   When I was a child, neighbors or my friends’ parents seemed to like me.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
7.  When I was a child, teachers, coaches, youth leaders or ministers were there to help me.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
8.  Someone in my family cared about how I was doing in school.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
9.  My family, neighbors and friends talked often about making our lives better.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
10.  We had rules in our house and were expected to keep them.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
11. When I felt really bad, I could almost always find someone I trusted to talk to.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
12.  As a youth, people noticed that I was capable and could get things done.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
13.  I was independent and a go-getter.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
14.  I believed that life is what you make it.
Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

How many of these 14 protective factors did I have as a child and youth? (How many of the 14 were circled “Definitely True” or “Probably True”?)   [ 8 ]
Of these circled, how many are still true for me?  [ 8 ]

Valganciclovir Risks and Costs

cCMV positivity

As written in my prior post, Home Front – Medical Ethics, the new baby is on some type of anti-viral to help her fight off the effects of cCMV.

When one starts doing their research about potential costs and side effects, it gets pretty scary pretty quickly.  While the most publicized antiviral for cCMV is listed as Valganciclovir or Valcyte by Genentech (yet another company I have been honored to work for as a freelancer), the list of risks and side effects are overwhelming.

To quote:

The most common side effects of VALCYTE in children include:

  • diarrhea
  • vomiting
  • fever
  • low white blood cell counts in blood tests
  • upper respiratory tract infection
  • headache
  • urinary tract infection

That’s a lot for anyone to have to deal with, never mind a newborn with pre-existing health issues.

The average cost of the medication is outrageous:

Valcyte costs

I’m thankful that both my #1 Nephew and his wife have excellent jobs.  I’m also hopeful that both of them have excellent insurance that will help with the ongoing costs for dealing with their fragile baby girl.

I have to think about their first child, and how much the situation between these two children is echoing my brother and myself for birth order, for wellness issues, and for the next chapter – the financial burden of caring for their daughter while they figure out what she needs and how best to provide everything necessary to give her the best start in life.

Given my own struggle with pre-exisiting conditions, though, I have to hope that the future will be kinder to this defenseless child for enabling her to be able to afford to care for herself for the rest of her life, once grown.

I have to remember that time changes perspective, and that anything is possible given time.

Miracles Take Time

 

Home Front – Medical Ethics

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As I have written in many other posts, I am grateful for my life.  I am grateful for my Mother’s choice to fight for me when I was born seemingly healthy, and later appeared to have birth defects that needed significant attention.  That doesn’t change the fact that I wouldn’t willingly give birth to a child with a high likelihood of health issues.  And, it also doesn’t change the fact that I support parents of disabled children for having the courage to make the hard decisions for themselves and their children.

Now, as originally written about in Pariah II, there has been another generation born into the family with birth defect indicators, cCMV, and it’s now a wait and see period of time as G’s parents work to ensure that the baby has everything she needs to fight the virus she carries, and to have the resources she needs for the best life possible.

I’ve been doing a lot of reading since I learned the news about G, and the part that sticks with me the most is something that’s bringing back memories of my Mother, Betty.  Oh, how I wish she was still with us for her wise counsel in getting through the next five (5) years, minimum, as my #1 Nephew and his wife work to ensure their baby girl is as healthy as she can possibly be.

My Mom gifted me with a phobia about germs.  No kissing on the lips.  No sharing of food or drinks.  Careful attention to sanitation and details when hand washing dishes.  You name it, Mom was on top of it.

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Almost to the point where I had my own phobia about shared germs from kissing and such, putting the kibosh on a comfortable sex life in the age of HIV and AIDs until I could come to terms with sharing the simplest of germs with my partner.

Herpes contageon made me crazy with dating and trying to determine the honesty of my potential partners (yes, I was anal enough to demand a “clean” and recent STD test results, or there would be no getting nekkid together).  No way was I dealing with catching anything from a liar.

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Seeing all the information about how easy it is to catch CMV, I have to wonder if my Mom was aware of the risks (having raised me, lost a couple of pregnancies to miscarriage, and having lost a younger brother to SIDs).  It’s times like this where I wish the older generation was around to provide guidance to the great grandchildren’s parents about things that have been lost in the mist of time.

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There is so much positive information, along with so much scary information, that I have to keep my mind focused on the fact that they can treat much of this with anti-virals today, that she is not wearing a feeding tube in her baby picture, and that my #1 Nephew has said that he’s overwhelmed by the bad news but determined that his daughter will be all that she can be, regardless of whatever happens.  No disease or birth defects will determine her destiny.

Having read all that I have about things the mother coulda / shoulda done to prevent the contraction of CMV in the first place, I can now see why #1 Nephew was so quick to come to his wife’s defense and say that how the baby caught the disease was “water under the bridge”.  Absolutely right, and I never for a moment thought about blame – not just because I didn’t know the baby was here and was ill – but because blame doesn’t change reality.

I absolutely agree with his fighting stance on behalf of his wife and daughter, and I hope that the baby ends up healthy and defect-free.  I have to pray that her hearing and vision and cognitive abilities will not be effected, and that her anti-viral medications work wonders for her during the next five (5) years of her life as they wait and wonder and fight to give this child every opportunity to be everything she chooses to be in life.

cCMV positivity

As shown in the image above, the statistics look good for early intervention preventing many of the side effects, so now we wait and see what the Docs are concerned about, what impairments present themselves, and whether or not the intensive antiviral protocol helps her fight off the risks of her disease.

Interesting cCMV Blog:

Grace’s Story  of the journey through a cCMV baby’s life

When you look on Insta-gram, there is another little girl, Lilah, all over those pages as her Mom shares her ups and downs.  Ditto for all the other children fighting the effects of cCMV on their lives.  So many happy children, finding options for great quality of life.  I’m hopeful that my #1 Nephew and his wife will be able to field this challenge and find their marriage stronger than ever as they pull together to raise both their children to be all that they can be in this world.

 

 

Medical Ethics

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Alex Trebek and Garry Armstrong’s latest blog are on my mind as I sit down to deal with the issues of aging, and the cases of medical ethics which face all of us daily, whether or not we believe it.

First, the blog:  Remembering My Mentor – Jeff Krause

Next, Alex Trebek’s news:

Pancreatic Cancer Announcement

And, finally, Peter Zhu, who was left on life support despite being brain dead, due to his parent’s demand they be allowed to harvest his sperm to carry on the family name despite his premature death at 21 from a skiing accident.

What do two of of three of these cases have in common?  Money.  Money and the ability to change the outcome of history due to inroads in medical technology.

Garry wrote a lovely blog about his friend and mentor who died way too young, at age 53.  There is no ethics controversy there; I simply include it as a cross reference point for accepting the inevitability of death as a part of life.

(Stick with me here – I promise I’m not writing a Debbie Downer post).

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In the case of Alex Trebek, he’s 78 years old.  Please let that sink in.  78.

Due to an incredible income, believed to be $10 million a year, Alex can defy the odds of aging and do whatever he chooses to do with his disposable income.  In effect, he has suspended time and the normal effects of aging in his own life.

Alex also appears to be the king of his own domain, evading the stresses of life and retaining the joy in life and the will to live.

The reality, however, is that Stage IV Pancreatic Cancer comes with some complicating realities that may kill him, even if he survives the cancer diagnosis.  When one is at Stage IV, the cancer has spread to other organs in the body, which adds to the intricacies of the battle he’s facing.

Last night was “Survivor” night (my version of being a sports junkie is to watch the psychological dramas playing out on a deserted island among strangers who consciously became castaways due to the lures of money and insta-fame).  So, during the evening a conversation occurred, as they often do, regarding medical ethics, Alex Trebek, the deceased 21-year-old’s sperm, and whether or not Alex will be saved thru the removal of his pancreas.

Yep, that’s a typical conversation among me and my various friends.

We harked back to a conversation we’d had in January, about a friend who’d had her pancreas removed (becoming an instant Type 1 diabetic), and my Roomie’s belief that one could not live without a pancreas.  At that time, the Roomie mentioned another friends wife, and wondered why she’d died instead of having her pancreas removed if it was truly possible to live without a pancreas.

Well, last night we got more of an answer from the Alex Trebek story.  If other organs are infected with cancer, a pancreas removal may not be worthwhile.   (Side note:  I also went on to study my friend’s situation, the one who had her pancreas removed, and found that people live an average of 7 years following pancreas removal, so there is also the aspect that the ill person is only delaying the inevitable, as well as adding a major quality of life complication – T1 diabetes – into their life).

So, that brings the whole story around to death, accepting its inevitability, as well as embracing new medical science advances while also accepting that only some people, mostly affluent, will be able to take advantage of the options for cheating or delaying death, as well as the options to create new life.

Money is what drives the options.

Money is what enables freedom of choice.

Money is what disguises the normal ravages of time.

Money, resources to maintain quality of life despite complications, and the financial stability to pursue alternative choices that are out of the reach of most occupants of this planet.

Inevitability, the ethics debate becomes one of resource allocation.

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Because the Cadet’s family chooses to pursue it’s specific family genes in creating life, they are bypassing their option to adopt a child (or many children) already here and in need, and instead focusing on finding a surrogate to be impregnated with their dead son’s sperm.

One presume’s that the Zhu’s will choose to raise this child (or children) themselves.  And, if they find the surrogate is pregnant with female children, the question must also be asked – will they terminate the pregnancy until they get the desired boy?  Or,  will they have multiple children until the golden boy child is safely delivered?

Into these ethics concerns appears another question or influence:  Legacy tales.

As Garry has so beautifully written about his friend gone too soon in life, what will be the tales told to these surrogate-produced Grandchildren / children?  Will they have the issues with drugs, alcohol and early death as exhibited by the Kennedy Children, who were raised by grieving families?  Will the expectations put on their shoulders be the making of them or the ruination of them?

At what point do these moneyed people accept that death is a part of the circle of life, and not something to be feared?

No answers here, but I do continue to observe the human condition quite closely.   Especially the part where one is warned to “be careful what you wish for” as no one knows what repercussions tomorrow holds regarding the decisions made today.

 

 

Breakfast

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My magical elixir against reality.

Every two weeks or so, I have to pack my COPD and NAFLD and diabetes medications and supplements.  I pack them in a grab and go plastic baggie for each day so that I, a) Don’t have to think about or deal with assembling the magical stones meant to offset mortality, and, b)  Do my best to comply with my medication orders while also supplementing my Rx’s with dietary magic to make up for the fact that I don’t eat fruits and veggies, and with the hope that these vitamin fortifications will help me beat the reality of my physical frailty.

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I have a daily diary I keep, as if that will offset the Endocrinologist’s belief that I am gorging myself daily on sugars and carbs, sodas up the yin yang, and working to actively sabotage my various doctor’s efforts to keep this old carcass upright and moving.

I also try and cook most of my own meals to ensure I know exactly what I’m putting into my body, and that any forbidden sugars and carbs were in my diet with purpose and pre-planning.

Tonight, I’m going out to see Gabriel Iglesias, Stand Up Comic, and enjoy the crowd, the laughter, and share a moment with my buddy, R, who also loves stand up.

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So, knowing that I have to be able to stay awake for an extended period of time, and knowing that I don’t want to miss any part of tonight’s performance by mis-using my limited number of “spoons” for the day, or eating the wrong thing, etc., etc., etc…  I’m sitting on my couch and being oh so good.

Perfect, even.

I’m up.  I’m showered and groomed and resting.

I’m perfectly aware that one wrong decision could leave me exhausted and unable to hide my chronic condition, so I’m behaving.

I hate behaving, but I understand that’s it’s for the greater good.  I understand that self-sabotage by fighting against my reality hurts no one but me.  And, I’m ego centric enough that I want to pass for normal for as long as possible, whenever possible, so I do what I actively dislike and live a regimented life.

 

As Springsteen says in his recent Broadway show, it’s like my own litany of “Church, school, homework.  Church, school, homework.  Greenbeans.  Greenbeans.  Fucking greenbeans.”

In my case it’s:  Get up.  Take my meds with whatever food won’t derail my plans for the most energy in any given day.  And repeat those fucking steps ad nauseam until the weather improves so that I can leave this tin can of a home, or until my next trip comes around.

I know I have it better than so many other folks who can no longer leave their rooms or their homes.  Who are confined to a hospice bed in a hospital waiting for the end.  Or worse, who are out on the streets, truly destitute and without a place to call home.

But, as I sit here contemplating my medicated breakfast of champions, I just hear Springsteen in my head making me laugh.  “Greenbeans.  Greenbeans.  Fucking greenbeans.”  Yep.  It could be worse.

I might be at home in my childhood, dealing with my daily medication routine under the watchful eye of my mother, and facing a dinner of creamed peas and tuna.

Find your laughs where you can every day, and find a way to accept reasonable compromises so that you can do whatever you still desire to do despite the odds stacked against you.

Whatever you do, though.  Stay away from that fucking creamed peas and tuna.