Reflections on Vomit, Part 1

Last winter I sat in the dentist's chair with my mouth propped open. The sounds of the drill and the music from my MP3 player mingled in my doped up brain. I listened to one song in a continuous loop for 30 or 40 minutes before I realized it was the same song. Bits and pieces of the conversation above my head floated through as I contemplated the events in my mouth. “Preparing” a tooth for a “crown” involves more than a pep talk. The smell of my tooth being methodically drilled away was acrid and pungent. Luckily, three Ativan neutralized the anxiety portion of my brain, so I could consider my fate placidly.

The recovery was misery and once I healed from the first four hour procedure, I still had three more procedures left to do. It hadn't been all that long ago that I had sat with the dentist and reviewed the results of the x-rays. The results were impressive, and not in a “you are going to have all your teeth when you are 84 years old” sort of way. I had 17 cavities and was in need of at least one crown with the possibility of a root canal. He was shocked that I didn't have any pain. I told my mom and she nearly cried over the loss of my healthy teeth. I nearly cried considering that I was looking at $3000 of dental work.

Seventeen cavities makes it seem as if I have very poor hygiene or smoke cigarettes or drink too much pop or something. Something very, very wrong has to happen to get 17 cavities in 6 years.

 Friday, March 14, 2014 marks seven years out of that something very, very wrong. Seven years of out of my tour of duty. Seven years past the battle of my life. It is seven years being past Hyperemesis Gravidarum (HG). HG is a severe illness that strikes less than 1% of pregnant women. According to the Hyperemesis Education and Research Foundation, HG “is a severe form of nausea and vomiting in pregnancy. It is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. If severe and/or inadequately treated, it is typically associated with: loss of greater than 5% of pre-pregnancy body weight (usually over 10%), dehydration and production of ketones, nutritional deficiencies, metabolic imbalances and difficulty with daily activities.” It usually resolves by the second trimester but often lasts the entire nine months.

I think I am ready to write about it. I wrote about it while I was pregnant and then I stopped. After my daughter was born, I didn't want to speak of it, write it, think of it, remember it, know about it. I wanted to have my baby in my arms, drink water, eat what ever I wanted and never, ever vomit again. My little girl is turning seven this week. She is a beautiful, glorious girl. She is smart, sweet, athletic and the spitting image of her dad. We are having a celebration with our friends and her family. She is super excited because she is having a pool party and her best friend will be there. She doesn't understand how much of a celebration this really is.

Not only is this a celebration of her seven years of life, it is a celebration of living through the war that was my pregnancy. It is not just a celebration of creating life, it is a celebration of not dying and not losing my baby. It was a war against my body as it turned against me. Shockingly, horrifically turned against me. Any joy and excitement stripped, replaced with fear, nausea, vomiting, helplessness, grief. It was daily battle to survive and grow a baby. This battle cost me 9 months of my life, $43,000 in debt, my teeth, the ability to eat entire categories of food, future children and a whole host of other things that I probably don't even notice because it has been etched into my self and is no longer identifiable.

My pregnancy seemed normal enough at the beginning. I peed on the stick of home pregnancy test and a plus sign showed up in the “indicator window.” We weren't trying for a baby and I hadn't really expected to see a plus sign. I had been confident in my math skills when figuring out if I needed to use birth control one particular afternoon five weeks previously. Here's a tip, never do math during foreplay, especially if you are bad at math! My husband, who was my boyfriend at the time, went into a daze and repeated several times “What do we do now?” He also tripped and cut his foot open on the baby gate we used to corral our dog. We were pretty stunned, but my biological clock had been screaming for the last year, so it was a happy event to see the unexpected plus sign.

To be continued...

Part 2

Part 3
Part 4

Part 5
Part 6

A Poem to My Small Self

Little girl within-
    frightened, choking, with no breath.

Take my adult hand.

You Can Run but You Will Just Die Tired or...How Being a Therapist is LIke Being a Marine Sniper.

From time to time, I have these girls sit on my couch doing the standard cagey teenaged "my parents are making me come to therapy and you can fuck off" look.  I have a lot of these girls- they have boyfriends that their parents disapprove of, often rightfully so.  These girls are moody, irritable, lash out at their families, most especially their well-meaning but anxious mothers, sometimes they harm themselves or experiment with substances.  These are girls who are hurting and who really do need to be in therapy.  They think that when they come see me that I am going to be like every other adult and gear up to fight me.  But, like a Marine Sniper, my skills by far outpace their futile attempts to evade me.  The sniper motto, "You can run but you will just die tired" has many applications.  By the end of the first session, or the second, tops, they are crying on my couch.  Resistance is futile, they have no idea what to do with an adult that comes along side them.  A little empathy, refraining from telling them what to do, taking their perspective and not nagging about the use of curse words are my weapons.  If I have to pull out the big guns I use curse words, which coming from a lady in a cardigan and glasses, usually shatters any defenses they have left.  If they weren't so distressed it would be humorous.  Eventually, they will view me as an ally and my voice will be in their head encouraging them to make healthy choices.   "What would Dr. Clark say?" becomes their motto.  Maybe I can have t-shirts made. 

Monster- a short story

She saw his little velvet paw when it was too late, and silenced the yelp of pain she felt when his claws gouged the delicate skin on one of her ankles. She was trying to get dressed without waking up the entire house but Monster, the cat, thought it was a fun game to ambush her in the early morning light. Monster actually felt like it was a fun game to ambush anyone at any point in the day. Elise ripped off tiny pieces of toilet paper to stop the blood flow as she continued with the morning routine. If she hurried, she would have a few minutes to sit with a cup of tea and a book before everyone else woke up.

As she sat down with her favorite mug, stained with years of use, Elise felt overwhelming gratitude that Monster hadn't woken any of the kids. These moments of quiet had been especially important since her husband, Branden, deployed. He left for Afghanistan about 4 months ago. Some women count down the days until their husbands return. She preferred to get lost in the days and the routine of chasing, toting, chauffeuring & otherwise corralling her three kids. It was easier to avoid acknowledging that she had a husband at all, so oppressive the burden. The emotions involved in counting down to his return made it feel like she was drowning.

And Elise didn't have the luxury of thoughts that swept her into emotional currents she couldn't swim. She couldn't afford to drown in her emotions. All her concentration and focus needed to be on the kids. Most days raising kids felt like herding cats, entirely futile & frustrating for all involved. They needed her to be present, especially because Daddy was glaringly absent. Grubby faces, sticky fingers, tiny socks, the concerns of small people; this was the land where her thoughts needed to dwell. Not the land of dusty faces, wounded bodies, combat boots, the concerns of a nation; the land her husband had to dwell.

Monster, seemingly contrite, curled around her wounded ankle, purring. She could never figure out if he was worth the hassle or not. Elise was an animal person but frequently contemplated murdering that cat. He was unwanted and a lot of work. His attack on her ankles was just one example of complications she didn't need. But, then again, much of her life was unwanted and a lot of work. She certainly hadn't wanted Branden to be deployed and she had no plans to get rid of him. Elise hadn't wanted to be pregnant at 22, either. Babies were something that she had planned to have after she had been married longer, after she had finished college and after she had established her career. Her college plans, all her plans, came to a screeching halt. It was then that she first began to learn that something unwanted, unplanned, could become very precious.

Still, she hung on to this idea that there should be a plan, that she would have a life that followed a plan. Rather than give up on plans, she just revised them. Now the plan was that she would return to school when her three kids were all school-aged. Her husband would have a desk job then and not be required to deploy. Elise closed her eyes briefly, images of her children speaking in full sentences and no longer requiring diapers flitted through her head. The cat had made its way to her reluctant lap, insisting that he be petted. This movement jerked her back to reality. She glanced at the clock and realized that only 5 minutes remained before she had to get the oldest, her son, out of bed and ready for the bus.

The morning routine was like running a gauntlet. First, she woke her son. Like her, he was not a morning person and getting up to go to school was not on his list of preferred activities. If she were lucky, his two little sisters would stay asleep until after he got on the bus. She wasn't lucky often, especially since the baby seemed enjoy being awake as early as possible. Attempting to get her sluggish son out the door while the baby was perched on her hip was not on her list of preferred activities, but she had gotten pretty good at it. If the girls didn't wake up until after their brother got on the bus, she got breakfast ready and then woke them up. On those mornings she was tempted to let them sleep in but in the end that would make bedtime a total nightmare. Elise's daily life was carefully structured about minimizing nightmare situations as much as possible. Typically, she didn't have to overcome that temptation because they woke up well before their brother was on the bus. She then made breakfast, while attempting to get her son out of his pajamas and into clothes appropriate for school. She fought to brush his hair and routinely contemplated giving him a buzz cut, so she could skip dealing with that battle. She wasn't ready to give up his curly mop of auburn hair, so, she continued the good fight. He then gulped down food and dashed to the bus. Most days she was pretty sure that no one was going to call Child Protective Services.

Her mind drifted to the current plan. This plan was based on the idea that it was important for the kids to have a stay at home mom. She felt lucky that she had the freedom to make this choice. Many people she knew were two income families by necessity. When Elise and her husband were devising this plan in the early stages of her first pregnancy, she had no idea how demanding parenting would be. It seemed like there wasn't even room in her life for her own self. Every inch inside her and nearly every minute of her day was consumed by caring for her children. Even going to the bathroom alone would be a luxury.

Branden didn't like cats. He grew up with dogs and planned to get a dog as soon he returned from deployment. Transitioning from a war zone would be difficult and it seemed like it would be good to have something positive for the entire family to focus on. Elise was also worried about Post-traumatic Stress Disorder, and she knew that dogs helped ease the symptoms. A cat, however, was definitely not part of the current plan. Getting a cat also wasn't part of their future plans. A cat had no place on the master plan for their family.

Monster purred happily on her lap as she continued to contemplate his fate. She had agreed to watch the kitten for a week while an acquaintance was out of town. When the woman returned from her trip, she had decided that she didn't want keep him and would take him to the local shelter. Elise couldn't stand thought that he might be put down, so she decided to keep him until she could find him a home. She hadn't anticipated that no one would want a kitten. Ads in the newspaper, on Craigslist, and on the bulletin board at the local pet store, only lead to one interested party. It was a sketchy looking couple who told her that their last cat died in the ditch outside their house. She didn't want that on her conscience, so Monster stayed with her.

By now, Monster was purring so hard that he was drooling. Elise could feel the moisture on her hand as she scratched his charcoal gray chin. She had cats growing up. Living out on a dirt road, it seemed like new strays showed up weekly. She couldn't remember being so frustrated by them. The scratch on her ankle this morning was just one example of the extra hassle the little guy created. She was trying to figure out how to get him to the vet without hauling all three kids with her. He was due for his next round of kitten shots and probably needed to be dewormed.

Elise noticed with surprise that the baby wasn't awake as early as usual. Maybe she would get lucky today. She also noticed, with a sigh, that it was time to wake up her son. As she tread lightly down the hall, ever mindful of her sleeping daughters, she realized that having constantly changing plans was about the same as having no plan. The idea of having a plan was supposed to create some security and some consistency but Elise was at a point in her life where there were just too many variables to manage. Her plans were an attempt to keep herself from getting washed away by the flood waters of her life. None of it helped. The drowning sensation was ever present.

Monster followed her down the hall, meowing for his breakfast. Elise reversed direction to get his food, knowing that his persistent meowing would wake the girls. It had happened just yesterday when she tried to ignore his request for breakfast. He could be so annoying. It was beyond her why she couldn't just take the little nuisance to the shelter. She scooped his food into the dish. He had eaten nearly all the food she had bought to feed him while waiting to find his new home. She mentally added a larger bag of cat food to her grocery list. And maybe some wet food, he was kind of a scrawny little thing. She stopped abruptly. These were not the thoughts of someone who had no intention of keeping the kitten. These were the thoughts of a cat owner.

Elise gave Monster a rub on the cheek and headed back to her son's room. The detour to get the cat food caused her to fall behind her morning schedule. She was going to have to hustle her son a bit more to get him to the bus on time. She sighed inwardly as she bent down to kiss her son's cheek. He would be so excited to learn the kitten was staying.

Get

Me (about 3rd or 4th grade) & Dana (about Kindergarten or 1st grade). 

Dana, my little brother, uttered "get" as his first word.  As in "Get out of here!" "Get lost!" and "Get away!"  He probably also heard "Get down from that!" and "Get over here!" but not from me.  The last latter usage of "get" was from my mom or other concerned adults, who were likely afraid that he was going to kill himself before he made it to his 2nd birthday.  Dana had a tendency to hurl himself off of high places, climb on top of things and generally go full speed with out paying any attention to safety.  The former phrases were used by myself, his not so adoring sister. 


It started out alright.  I was almost three years old when he was born and I remember being taken to visit by my Aunt Gail and my Aunt Jen.  I wasn't allowed in the hospital room, so they took me to the window of my mom's hospital room and let me peer inside.  I don't think either of them was old enough to drive, so my grandparents must have been around as well, but I don't remember their presence.  It seem like an exciting thing at the time.

Then he became mobile.  The entire family was wholly unprepared for him.  I was the first grandchild and I was a very complacent, docile infant.  My mom has said that she could put me on a blanket on the living room floor and would stay there, even after I learned to crawl.  Dana, on the other hand, could be better described as possessed.  He was everywhere and into everything.  He used to eat snails he found in the yard.  Thus, the constant use of "get."  I could never get away from him, there was no escape and no respite.  My little girl self was constantly trying to get rid of her brother.  I'd try to lean against a door to keep him from following me or try to sneak away without him noticing.  I had very little success, he got stronger than me quickly because I was a smaller than average kid and he was a larger than average kid.  People used to think we were twins. 

As his motor skills improved, his level of danger increased.  He started taking his bike apart when he was 4 or 5, but couldn't quite get it back together.  Making a face plant off of a racing bike surprisingly only resulted in a fat lip.  My best friend and I called him "duck face."  He taught himself how to ride a bike by stealing my bike.  At 14 he taught himself to drive a stick shift in an old truck with a column shifter.  By the time he was 18 he'd been in more car wrecks than any one I know.  Just small wrecks, though.  Nothing life threatening, right? 

We annoyed each other in the way that only siblings can.  Especially since he was 100% "go" and I was at the extreme opposite, "not so much."  I was a bossy kid and as the younger brother, it was his job to fall in line with my expectations.  I didn't physically fight with him, my usual tactic was to overpower him verbally.  I could get some mileage out of big, confusing words, usually in an attempt to get him to slow down or stop being naughty. 

Once we got older, though, we were friends.  We liked playing together and pretending different scenarios.  We were especially bonded by our trips to Minnesota.  Our parents divorced when Dana was an infant and I was still a toddler.  Eventually, the arrangement came to be that we spent summers in Minnesota with our dad and the school year in California with our mom and step-dad.

We flew to Minnesota every June and back to California at the end of August.  We made those trips by ourselves, starting when I was about 7 years old.  We were assigned to a flight attendant and she delivered us to which ever parent was waiting on the other side.  Once I was about 15 years old, the airlines determined that I was old enough to fly with my brother without adult assistance, so I navigated any connecting flights or travel needs. 

I don't think there is as anything bewildering to a child as being without a trusted adult.  The flight attendants were all kind and attentive, but they were strangers.  Dana and I had to be anchors for each other.  When I was crying because I was sad about leaving one of our parents, he took over and explained to people what was wrong.  When someone in first class was smoking and we were in the seats immediately behind the smoker, I asked the flight attendant to make them stop because my brother had severe asthma.  It was my job to take care of my brother. It was his job to take care of me.

We were never apart as kids, other than occasionally spending the night at a friends house.  Our first separation was when I went to college.  Our separation continued as I went to graduate school and later moved to Washington.   Taking care of each other still continues to this day despite the physical separation.  Now he is the person I call when something big is happening or I need help figuring out what to do.  He is still my anchor.

He is still in California and now I tell him "get up to Washington" and "get out of California."  It turns out that "get" is a very versatile  word!

Back to the Grind

Tomorrow it all begins again.  After two delicious weeks off of work, tomorrow I go back.  Tomorrow my daughter goes back to school.  I am anxious.  Not because I dislike my work or because there is something especially stressful but because of the schedule.  Rather than getting up when we are rested, eating when we are hungry, doing what interests us at the moment, we must conform to the rigors of a schedule.  Up in time to get to work and school, eat when there is a gap in your schedule to do so, doing what is prescribed for that moment, there isn't much of an option for each day.

Not that I dislike routine.  I really appreciate routine and pretty naturally establish routines, but that is different than a schedules.  Routines are more like gentle suggestions.  Schedules are cruel task masters.  The sad thing is, my schedule is so much easier than it used to be and it is much, much easier than what most people deal with.  No wonder stress is a national epidemic. 
 Historically, when I have started to feel out of control, I attempt to exert control over my external circumstances.  It is often still my first impulse. My initial thought after I identified feeling anxious and the source of the anxiety was to get a bunch of stuff done.  If I get the laundry or housecleaning done, I have less to do in the upcoming week.  That sounds logical.  However, I often just work myself into a frenzy and become exhausted.

Instead, I am going to focus on cultivating inner peace.  I know that sounds Zen-like and you may have visions of meditating on a mountain top.  Unfortunately, inner peace and I are not really close personal friends.  We are acquaintances.  I am going to use my current anxiety as an opportunity to develop a closer friendship with internal peace. 

Which is why I am writing this blog, why I will walk my dog, why I spend time playing with my daughter and watching football with my husband.  Those things help me feel calm and grounded.  Those things will help me have an easier week because I will be balanced, not exhausted.  Hypothetically, I could have a spotless house and exert perfect control over my circumstances.  (I have a St. Bernard and a six year old, so you know this is really only a hypothetical!).  I am pretty sure I would still be anxious though.  My anxiety is not actually based what is done or not done.  It is not even fully based on what I do every day.  It is based on how I think about my life and how I treat myself.

Life with a schedule, life with expectations other than to be, create opportunities for failure.  One of my hardest tasks, emotionally, is to be accepting of myself when I make mistakes. I have always been a perfectionist.  Rather than attempting to achieve perfection in my week, I am going to focus on balance.  I am going to focus on self-acceptance.  I am going to focus on listening to why the anxiety is present and address that, rather than attempt to control external circumstances.  A closer friendship with peace and letting go of perfectionism is on the agenda and my schedule is going to help get me there.

Thank-you horrible schedule.  Thank-you anxiety. 

Resolved

I am not much for New Year's resolutions.  Life is constantly changing, every day and even every minute if you look at the cellular level.  I figure I need to resolve different things at different times depending on what is happening in my life.  However, on two instances, in my memory, have I made a New Year's Resolution.  The first was December 31st, 2004.  I was with my dad, step-mom, first husband and four younger siblings.  I had just finished graduate school and my husband and I had moved to the Pacific Northwest.  I resolved that year "To grab life by the horns."

And grab I did.  Five months after that I determined that my marriage was dead and, in fact, had been dead so long that it was rotting.  I left the marriage and started dating someone new approximately 30 seconds after that.  Five months after that I moved in with the someone new and 7 months after that I was pregnant.  I am still with the someone new.  He's not so new, now, but it feels like it was just yesterday, so he's new to me!  We got married when our daughter was 8 months old.

Also, during the last six months of 2005, I did the following: I studied for and passed the licensing exams to be a licensed clinical psychologist, I went on 4 weekend get aways, got a puppy, grew a garden, dyed my hair, made new friends, filed for divorce, updated the someone new's house so I could move in, got two pet rats and got two pet mice.

Fast forward to 2011.  I hadn't made a resolution since New Year's Eve 2004.  I determined that it was time to "Grab the bull by the horns again."   In 2012, I didn't as much as 2005, but it was a lot, nonetheless.  For financial purposes, my husband and I got a legal separation that year (you can read a little about that here).  I left the group practice after 9 years and started a smaller solo practice.  I also stopped adding children to my client load because I was burned out.  My daughter started Kindergarten.  My husband and I finished paying off $40,000 in credit card debt ($36,000 was accrued when I was pregnant because I was very ill but that is a very long, separate story).  We also bought a house and moved.

I didn't resolve anything for 2013 except to adjust to 2012's changes!   I also haven't resolved to do anything in particular for 2014.  I need to exercise more and I plan to write more.  But those two resolutions are not new, I've been working on those for the last 12 months and will continue working on them.  Otherwise, I am going to continue with the day to day resolutions.  I figure I can leave the bull alone for 5 years give or take!