Protected: On the Inside : DBT and Talk Therapy

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The Trickery of Remission

Warning: Content has potential triggers. Reader discretion is advised.

I had come to terms awhile ago that Bipolar Disorder is a lifelong disorder. There is no cure. There is treatment. An abundance of treatment.

It was disheartening. It was a huge, ever-looming, oppressive idea. I’m going to go through this for my entire life. Not just a portion, for instance, the rest of my adult life. No. This, this bipolar disorder has been a companion for longer than I can remember. In fact, I could even conclude that it was the very fire of Bipolar Disorder that gave me life in the first place. Born out of this fire and ice.

Not a cure.

When I first started taking Vitamin L, I researched it.  And emblazoned at the top of the Lamictal website is the following statement: Prescription LAMICTAL is used for the long-term treatment of Bipolar I Disorder to lengthen the time between mood episodes in people 18 years or older who have been treated for mood episodes with other medicine.

Lengthen.  Not stop.

How long is that?  A few days?  Maybe a couple of weeks?

Another resignation.  I pitched any hope that there would be any long-term stability for me.  I resigned myself to the idea that I would always be in some state, whether I was slipping down to reside at the bottom of the abyss, streaking through the sky.  It didn’t seem as though there was another option.  Things are the way they are sometimes.  It’s up to us to come to terms with that.

I had decided that there was no such thing as remission in mental health disorders.  For some, it was either dormant or active.  For me, with Bipolar Disorder, there were three states: Depressive, Stable, and Hypomanic, none of which are permanent.  It is just the nature of the disorder.  Hardly anything can have any permanency with ever shifting landscapes.

At the end of October, something incredible happened.  I was not in a state of any kind.  It was like standing between heaven and hell.  Limbo, waiting for the other shoe to drop.  I was convinced that the great plunge was coming, but I only floated down easily from the mother of all hypomanic episodes.  I planted my feet firmly on solid ground, perhaps for the first time in my life.

Initially, I didn’t roam freely around this strange terrain.  There had to be a sinkhole, a bed of quicksand, something, disguised in this lovely place.  About a month of living in this landscape, with the help of others, I started to believe that there was a possibility for full remission.  I was cynical at first.  I had no evidence in my own experience to back up this notion.  However, I began to idealize a wonderful life without living in the constant fear and ever present shadow of Bipolar Disorder.

Idealization is dangerous, and it is something I often fall victim to.  I am not sure if it is a part of the human condition, as much as it is just a characteristic of certain people or disorders.  It remains to be one of the most perilous mechanisms of my delicate mind.  Typically, I knowingly guard myself against this with great cynicism unless I am proven otherwise.  Defy me.

When idealizations occur for me, it is akin to a shattering mirror when realities emerge.  In this instance, it was as if I had come to the ledge, holding tight and gazing deeply into that mirror reflecting my stable illusions.  Distracted by the beauty of it all, I took one false step.  All it takes is one to shatter the illusion, and wake up in the murky depths of depression.

Prior to this run of stability, I had no frame of reference.  A great many people mourn the loss of their lives that occurred prior to the onset of symptoms.  There was no such frame of reference for me.  My diagnosis was a relief.  It provided explanations as to why I was different, and no matter how hard I tried, I couldn’t seem to function properly in any capacity.  I was always content with the diagnosis itself, even if I was affected by the disorder itself.  It gave a name to many of the awful things I had started to believe were just me.

I’m not sure which is worse.  Suffering the constant bombardment of symptoms with little reprieve, or mourning that loss of a blissful, stable state and life I had, but slipped away.

This post brought to you by Tallulah, my Blackberry Bold.

The Heath Ledger Paradox

Warning: This post has contents that may be hazardous to mental health.  It contains strong themes of suicide, suicidal behavior, and substance abuse.  Reader discretion is advised.

Have you ever had a moment where you heard the distinct and deafening sound of your own clock ticking down?

I have only heard this sound a handful of times. The first few times, it was difficult to distinguish from the other garble in my mind. But, the last time this occurred, the sound was unmistakable.

Tick.
Tock.

It happens when my physical state is badly threatened, but I’m not mentally aware. That is my defense mechanism that seems to be biologically programmed to protect me. It is what creates the Heath Ledger paradox.

And that’s what I experienced.

The Heath Ledger Paradox

Some things happen by accident

Personally, not proudly, I have attempted suicide between a half of a dozen and a dozen times in my life. I don’t really keep score; there is no tally anywhere. In fact, in total, I have only left a handful of notes behind. They don’t always correspond to the actual attempt, though.

I am not a violent woman. My method of choice was almost always centered around substances. My very first attempt landed me in a bathtub with a belly full of pills. It was an unintentional coincidence between Sylvia Plath’s and Virgina Woolf’s suicides. I know this to be truth, because I was only in my early teens at the time. I had yet to read about these authors. And despite these attempts, even some carefully orchestrated with blatant drug interactions, I never succeeded.

What was different about me that made me a survivor of my own wretched malice? Many a person has done these things accidentally! Marilyn Monroe, Michael Jackson, Elvis Presley, Janis Joplin, Jimi Hendrix, Bruce Lee, Brittany Murphy, and many others are examples in our modern culture of how accidental overdose happens.

I met a guy in college that I stayed friends with. Eventually, we ended up working together. He was dismissed for failure to attend, and we all suspected he had a drug problem. A few days later, he was found dead in his apartment from a multiple-drug interaction. The guy ended his own existence with his own carelessness. How could he do it by accident and I couldn’t possibly do it on purpose?

That’s the Health Ledger Paradox. It is easier to succeed when the mind is unaware.

Last night, I accidentally set my foot onto the other side of the fence for a moment.

I still have impacted wisdom teeth on both the bottom left and right sides. These wisdom teeth have risen up partially in the back, causing skin pockets to form. Occasionally, I will get something trapped back there and a small infection will form. If I treat it immediately with a rinse and keep the pain manageable, I can usually escape a trip to the doctor and an antibiotic.

I detest going to the doctor to hear the same thing repeatedly. Yes, I know I need to have those teeth out. Though, I now have dental insurance, I do not have the money for a serious co-pay there. I just had a major surgery a month and a half ago. I don’t have the time or energy to spend in recovery. And I always feel worse on the “cillan” antibiotics than I did with the infection. Other women will feel me here. I usually end up with a worse infection in the end.

I had some Vicodin remaining from my surgery. Admittedly, I hadn’t taken many. I had a problem where the Vicodin would cancel the Temazepam out. I would be up for hours, sleepless and still aching. I decided that my body needed rest more than I needed pain relief. I had to heal. Last evening seemed like a good time to take it. I don’t know how I let the situation with my teeth go from uncomfortable to agonizing. But, it happened more quickly than my mind could have processed. So, I took the Vicodin.

Bad choice.

I spent the rest of the night staring at the white porcelain bottom of a toilet bowl. At first, it was akin to other bad reactions I had to other narcotics. I do not respond well to Oxycontin or Percocet. And this was a similar episode. But, by the sixth hour, I knew there was something terribly wrong. My stomach had already emptied itself twice and was going for a third. This time, only water remained.

By the seventh hour, it became clear to me. I leaned forward and wretched. It felt like my stomach was turning itself inside out, in hopes to vacate an invader. I literally felt empty, as if I had evacuated every ounce of anything I’d eaten in the last 36 hours. And it dawned on me. My body was having a reaction – but why? I had taken Vicodin before with great success. I took it after my surgery and this didn’t happen.

I couldn’t muster the strength until the morning. I had only slept five hours out of fear that I’d never awaken again. I decided to refer to the almighty Medscape Mutli-Drug Interaction Checker. I thought I remembered doing this. Typically, I screen all new medications coming in. As I was trying to rattle my brain for all of my prescriptions, it occurred to me. I did do this, but I had forgotten a very important medication, Wellbutrin.

Significant – Monitor Closely

bupropion + hydrocodone

bupropion will increase the level or effect of hydrocodone by affecting hepatic enzyme CYP2D6 metabolism. Significant – Monitor Closely.

lamotrigine + acetaminophen

lamotrigine decreases levels of acetaminophen by increasing metabolism. Minor or non-significant interaction. Enhanced metabolism incr levels of hepatotoxic metabolites.

That’s just the tip of the iceberg there. That’s among four additional interactions. Those are the most important though. That’s the reason I was hugging the toilet, wondering why my sedation was outrageous and my pain relief was minimal.

And I realized, I just set foot on the other side of The Heath Ledger Paradox. If it wasn’t for that mechanism, that beautiful inborn, DNA encoded device inside me, I would have been dead. Something in me told me not to take more medication when my pain relief was marginal. And that same thing kept me safe by alerting my body that there was a dangerous toxin that needed to be rejected from my stomach. There was still a tiny bit of knowledge encoded from some source that this was life-threatening.

Not everyone has that, and most people with it can bypass the safeties with enough of a loading dose. That’s the aim in a suicide – to get past the safety, just like a gun. Except, when most people knowingly stand on that ledge and look into the void, they turn back. The point with accidental overdose is that all of that is gone. It’s like playing with a gun without knowing if it’s loaded or if the safety is on.

That gun was loaded last night. Thank the powers that be in the universe that I have a safety.

Marginally Clear

Thanksgiving will hopefully be a day of thanks. It marks two weeks since the LEEP procedure. Since it falls on a holiday, my doctor’s office was kind enough to squeeze me in on Wednesday, Nov. 23. I’m sure the scheduling nurse I spoke with was aware that I’d have a Sword of Damocles hanging over my holiday table. It was kind of her to be so considerate. (Note to self: Be thankful for considerate, compassionate people).

The Healing Process

I was briefed after the surgery about care and restrictions. No worries – this is not going to get graphic. I’ll admit, it was not quite as I expected it. They likened it to a colposcopy with a biopsy. I know there is a huge difference between the two. One is a little snip and the other is more akin to taking a sizable section. Like trimming the hedges versus pruning a tree.

They under-exaggerate when they describe the more unpleasant parts of post-op care. I was in nearly constant, serious pain for the first four days. I would wake up in the morning in severe pain, because a full bladder likely pressed against the area. The more I moved, the more the pain increased.

Mothers will especially stand this next part. It is more akin to the physical sensations to about a week after labor and delivery. My bottom half was sore. It was pain like a T, across my hips through me, and into my back.

They don’t tell you the real story on a lot of it, although they are still defined within the parameters of “typical healing”. To sat the least, it was a lot more intense than I predicted.

The healing time takes longer than I predicted too. The doctors assured me that I’d be back on my feet, doing my daily activities in a few days. But, those activities are not to include any aerobic / strenuous activity. I haven’t been able to do any housework. No stairs, so I have to limit my use of them at home. It’s frustrating to leave something on a different floor.

I’m still not quite back to normal. I always feel like the doctors overreact when they give you restrictions. Possibly, it is because they know patients will not follow them to the letter. But, they weren’t kidding here. I’m moving better, but I am still in pain. I need extended time sitting. I’m tired.

The biggest thing they don’t tell you is the emotional rollercoaster that follows. I don’t know if it’s hormonal, but I have been completely out of whack. I described some of it in With This Pill. Manic Monday touched upon the subject in 2.5.

This is a conversation C.S. and I had on Friday.

I swear. A lot.

I thought I was on the cusp of a depressive episode. Mobility is difficult. It is irritating and frustrating to be at the mercy of others. I am a control freak. I like things done my way, and I like to be an active participant at all times. But right now, I feel like a useless invalid watching life pass as I’m bound immobile, as much as possible.

I feel useless. I can’t take charge of classes because I have to meet them in their classrooms. I must have children assist me in classes by passing out lyric sheets and retrieving items for me from across the room. I hate asking people for help. Then, I start to feel like an inconvenience, a burden, if you will.

Tomorrow’s Follow-up
I was under the impression that they were going to poke in there and assess my healing.  Then, they were going to report how much had to be excised, and what my chances of having more children is going to look like.  What they failed to mention is that tomorrow is also the delivery of the results from the sample they took.  What I thought was going to be a completely benign appointment turned malignant fast.

What the doctor is looking for is are Clear Margins.  Essentially, if the tissue they collected has both the cancerous cells and a margin surrounding it of healthy tissue, then we can be assured that all of the cancerous cells were excised.  However, if the margins are not clear, then cancerous cells still remain and pose a possible threat.

The course of action after that is typically to wait until the results from the follow up Pap smear come back.  If they are positive, then we visit colposcopy land to see how bad it is.  And, there is a possibility of yet another procedure.

You guessed it.  This poses a greater threat to my future pregnancies.  The more cervix that is removed, the higher the risk of miscarriage and pre-term labor.  I have a plan, but I need to get C.S. on board.  If the issue is forced, I want to make the Hail Mary pass in order to conceive another child before I would have another surgery.  We have two months to make a decision, because after that, it’s do or die.

I really do want another child, even if it’s not at a great time.  If I have to do it and take some risks, I’m willing to do that.  However, C.S. has not expressed a great deal of enthusiasm about another child.  I don’t want to come to blows over this.  But, if there is a serious disagreement, I know it’s going to turn into a serious problem.

One bridge at a time, Lulu.  One bridge at a time.

Emerging Patterns in Cyclic Analysis

I wrote With This Pill in extreme aggravation.  I have a theory based on observational findings about the pattern.

I cycle around every two months.  Pendulum began June 19, 2011, with the post To See If I Still Feel, describing an incident involving depression and self-injurious behavior.  Three days later, on June 22, 2011, in Shifting Gears, I described the sparks of a hypomanic episode.  Eight days later, on June 30, 2011, I detailed panic attacks and highly reactive emotions in Overdrive Mode.

There was a period where I went through a fluctuating depressive episodes varying throughout the spectrum of twos through fours.  It was a result of Somatopsychic trauma from a six-week long, progressively debilitating bout of Walking Pneumonia.  During a two-week long prednisone treatment, I had erratic emotions, which sent me reeling into a serious depressive state.  It was quickly fixed in two weeks by a medication adjustment.

That medication adjustment threw me into the first dysphoric hypomania I can ever remember having.  I had another incident of self-injurious behavior reported in Confessions of the Pain of Payment, on September 22, 2011, three months after the first noted episode.

That was followed by the longest, most intense hypomanic episode I have ever marked.  I marked it at 16 days, but I have a feeling that it was closer to 30.  I had a brief reprieve when I was down for the count during an illness.  I eventually attributed the extreme hypomanic episode with a chemical change in Big Money, No Whammy, STOP!.

Prior to my first post, my last hypomanic episode happened three months prior in late March into early April for 14 days.  That was my first record breaking hypomanic episode.  I attributed that to anxiety, that led to insomnia, which paved the way.  As for what happened between then and late May when I recall my depressive episode first beginning, I’m not sure.  I will have to check my personal logs to shed some light on that.

I’ve always looked to external factors to explain the occurrences.  But, the pattern is emerging.  I cannot deny that.

Now, I’m waiting for the other shoe to drop.  I have always had a depressive episode closely follow a hypomanic episode.  What Bender? detailed an alcoholic relapse at the start of a long depressive episode.  The depressive episode lasted for about two months and left three weeks until the onset of my next hypomanic episode.

However, it has been three weeks since my hypomanic symptoms subsided, and I am now only feeling small pangs of depression here and there.  I am not entirely convinced they are depressive.  I am irritable and reactive, but I have not yet had the urge to isolate myself.  I am not entirely disinterested in enjoyable activities – actually quite the opposite.  I am only interested in the most enjoyable activities and have had quite the hedonistic urge to indulge myself.

That is unusual for me.  I am not a creature of hedonism.  The Irish and Scottish had a philosophy that with every great pleasure in life came a great pain.  It was kind of their own yin and yang in their society – a way to describe the balance of the universe.  I am mostly of Scottish heritage and was raised in such an environment.  There was no escaping the pain that accompanied indulgence.  Therefore, I am not inclined to do so.  In fact, I am quite disciplined to do the opposite by taking on the role of the martyr.

What to do, what to do?  Do my brain and my body know something that my conscious mind does not?  Is this impulse a way of circumventing a depressive episode?

Just A Little Short

“Just got out walked by someone twice my age. Rawr surgery #FML”.

(Shameless self-promotion alert).

All over my Facebook and Twitter. I’ve been relying on these social media outlets recently because I’m honestly too bushed to piece together something resembling a coherent post. Besides, I already have plenty of intoxicated ramblings on the internet if you know what username to look for.

Life during a recovery from a surgery is complicated. I’m not used to following doctor’s orders down the letter. And I’m especially unaccustomed to restrictions.

Restriction #1: No lifting.
The conundrum: I’m a mobile teacher. I have one storage closet and multiple classrooms with varying duties. Typically, I’m a one woman gypsy wagon. I carry everything but the kitchen sink. Maybe that too, I’m not sure what’s inside the void more commonly known as my purse, anymore.

Challenge: Make my purse and my teaching bag lighter and more functional.

Solution: My mother was gifted one of those infomercial purses with dozens of compartments. I shed anything with excess weight. Then, I was able to combine both my purse and teaching bag into one functional bag. And, I think it is under 10 lbs.

Restriction #2: No aerobic exercise.
This is actually a more difficult order to follow than imagined. When they say aerobic exercise, they mean nothing strenuous enough to increase heart rate and blood pressure. Only because that means the activity is too hard on the body.

I already knew that I’d have to leave early so I could halve my speed. The walk was more strenuous than I imagined, and it was all downhill. I felt inadequate. Normally, I tore down those streets and played frogger while jaywalking across four lane roads. You know, jaywalking is a Pittsburghian birthright. (Although I wasn’t born here, I still cash in on that!)

And then, a woman who was easily twice my age power walked past, leaving me completely in her dust.

Sigh.

And when I got to the stop, I was relieved to settle onto a bench to ease the soreness.

Restriction #3: Restricted use of stairs
The conundrum: My typical classroom is on the third floor.

Challenge: I had to make copies in the third floor office. This office is not connected to the other third floor, nor is it accessible by elevator.

Solution: Typically, I am hesitant to ask for help. I am self-sufficient. But, not right now. I considered just sucking it up and doing it myself. However, I am terrified of hemorrhage or further damage in that area.

My boss is a wonderful woman. I approached her and explained I had some limitations and errands to run. The elevator is key operated only, and she was much obliged to send me up to my classroom. She even sent a couple of teen workers to check in on me and do my errands.

Restriction #4: No standing for prolonged periods of time.
The conundrum: I’m a vocal teacher in the middle of putting together a musical.

The solution: I sat with a CD player next to me. I assigned children to pass out certain music. And I conducted from a hard chair.

The other conundrum: I have cafeteria duty. Standing provides maximum visual observation. And I am solely responsible for seventeen fifth graders, two of which apparently had a fight during school. Ugh…

The solution: I repositioned myself between the kids with hot-heads. Still nearly maximum visual. I explained to the kids that I had surgery and I was feeling poorly. And I warned them that if I were to be antagonized, that they would face my full wrath.

Oh kids!

I’ve had other shortcomings. I can’t lift T.D. It’s made caring for him and disciplining him much more difficult. Dressing him is a task.

I came home sore today. I do know one silver lining. It will be easier in future days as I heal. The more I sleep, the more I heal.

Good night!

Mind-Reading: A Futuristic Possibility

I’m not typically one to report the news.  In fact, I tend to keep my opinions on religion, politics, parenting, and most other volitile subjects to myself.  But, this was entirely too disturbing.

An article on CNN’s belief blog entitiled Keep Government Out of Mind-Reading Business caught my eye this morning.

How would you feel if someone where able to reach into your brain and extract any information that they wanted to?  I would feel pretty violated.  I’ll admit, I still feel pretty violated after an invasive exam.  But, mind-reading goes above and beyond any procedure.  My mind is my mind.  The end. 

I see the practical applications of this technology.  It would provide more accurate lie detection in law enforcement and aid in national security.  It could solve crimes without sufficient physical evidence and out possible terrorists.  All of these things could help make our society safer.

But, how invasive is too invasive?  I agree with the author, Paul Root Wolpe, in his sentiment that our legal system is already incredibly invasive when it comes to violating our human rights.  Once we are a suspect, it seems as if our civil rights go out the window.  We become subject to searches in every aspect of our physical and internet lives.  In fact, there was just a story about how a judge ordered a divorcing couple to swap Facebook passwords in order to collect evidence against one another.  It goes down to even providing DNA samples.  We are fingerprinted for jobs now.

Again, I see the useful and probably life-saving application of these measures.  But, it’s completely unnecessary.  Some may retort, “Why would it be a problem if you have nothing to hide?”  This is where mental health concerns come into play.  The differences in brain chemistry between a typical brain and an affected brain would become apparent in these mind-reading brain scans.  Then, do we become profiled?

It’s already bad enough that many of us hide in the corners of the internet, safely writing behind our screens.  This is all out of fear that someone will discover that we have (insert disorder here), and then the sensitive information is in someone else’s hands to do whatever they want with it.  We can go on about how this information is protected under HIPPA and The American’s With Disabilities Act.  However, we’ve seen people circumvent the law before.  I’ve seen people use the knowledge of my disorder against me in many different ways and make my existence unbearable.  Why should I be in favor of someone extracting this information by accident?  Ben Franklin once said, “The only way to keep a secret between three people is if two of them are dead.”

We would become profiled.  I’m sure it would be notated in some government file somewhere that would come back to haunt us.  I can only imagine it.  I go to renew my clearences for work, and I’m denied.  Why?  Because someone, somewhere in the chain of command sees me unfit for my job.  Ridiculous, but true.

Your thoughts?

Taking the Bullet

I went to the dreaded LEEP surgery consultation, as first mentioned in Leep-Into-Cin – Part III, and more recently in  A Peach and A Catalyst.

Dodging Bullets
Honestly, I’ve been dodging this since I received word in May that my Pap came back bad again.  I put off the colposcopy until July, as I mentioned in All the Pretty Things.  The results of the colposcopy were among many things that triggered my breakdown in August, most noted in Meet Me in the Magnolia Tree.  I was informed at that point that I would need the surgery.  And I failed to go to both my August consultation and my September consultation.  I couldn’t face what I knew she was going to say to me.  I couldn’t hear that I may never be able to have more children.  And after the debacle from my last surgery, mentioned in Leep-Into-Cin – Part II, I couldn’t fathom the idea of having to go through another one.

The Reader’s Digest Version
It’s a lot of history to take in all at once.  I understand.  So, for those of you that really don’t have the time, or simply don’t want to sift through all of it, I will provide the abbreviated version.  I was diagnosed with HPV in August 2007 and had cervical dysplasia as a result.  At the time, I was in my early 20’s and the doctors all insisted that it would clear up on it’s own.  I got pregnant at the beginning of 2008 with T.D. and it only got worse.  In fact, so bad that I had to have the worst colposcopy of my life when I was 34 weeks pregnant.

Due to some insurance problems, I wasn’t able to get another colposcopy until May 2009, when it was discovered I had CIN-II and III in some places.  Essentially, I had the worst precancer before it became real cancer.  I had a very traumatic cryosurgery done in June 2009, and that was that.  For then.

Here we are, two years later.

My Worst Fears Realized / Speculated and More
From the moment I got the call, I’ve done my research.  I knew the words that were going to come out of her mouth.  And, I had face it alone.  C.S. and I decided that it would be better to save that 1/2 day off, in case I need it after the surgery.  Not that emotionally agree with the decision.  I see the logic.  But, I knew I’d need him there.  In a way, I am hurt that he doesn’t consider my health more important than his work.  I know he is only trying to make things stretch.  But, I feel like if he cared enough, he would have been there.

Like I already knew, I risk cervical stenosis, scarring of the cervix and cervical canal, that may make natural conception impossible.  I am at a higher risk for cervical incompetance, which may make carrying a child to term impossible.  I risk infection, hemmorage, etc.  But here’s what I didn’t know.  I risk damaging other organs in the vicinity, such as the vaginal walls, colon, bowel, etc.  And that made the whole ordeal so much worse.

All my doctor could say was, “The risks and complications are a possibilty.  I can tell you that these risks are small, but I can’t make any guarentees about what’s going to happen.”

On the subject of future children, “Cervical stenosis isn’t as much of a concern as cervical incompetance.  It depends on how much we have to remove.  We can only determine that when you’ve healed.  I’ll check at the 2 week follow-up and we’ll have a better idea then.”

My Aching Heart
I cannot get my mind away from the possibility that I will be incapable of having anymore children.  I wanted one, maybe two more if I feel my biological clock start to tick later on.  I cannot fathom the idea.  It breaks my heart to think about.  I may never have another child, ever again.  I could end up barren with the thoughts of the child that I could never have.  The child that would have been a sibling to T.D. and a child to C.S. and I.

Worse, is the possibilty of having multiple miscarriages.  I had one, and I know it was my fault.  I didn’t know I was pregnant until I miscarried at about 10-12 weeks.  I was drinking heavily at the time.  And that likely did it.  If that child had lived, he / she would be 9 in January.  It took me a long time to accept the truth about it.  But, I knew it wasn’t meant to be.  The day after I conceived, my boyfriend broke up with me.  I told him a year later about what happened.  His response was, “It was better this way.  I wouldn’t have left her (his girlfriend) anyway.  Now, we can all get on with our lives.”

It was cold-hearted, but he was right.  I was in no position to be a mother.  I was too young, with no college education, no income, and hardly a stable place to live.  The child would have had a deadbeat dad, and I would’ve been outcasted by my family.  This is not to mention that I was not yet diagnosed with bipolar disorder.  That baby has a better home in the life beyond.

Will I have to go through the unimaginable pain of losing a child?  Losing multiple children because my body just can’t do it?  I’m terrified at the idea.  I cry when I hear about it.  How could I even begin to handle that?

My doctor tried to be reassuring and said, “Most of my patients who have undergone one LEEP have gone on to have successful, complication free pregnancies.” Most.  Not all.  This is my second surgery.  I don’t know exactly what I will have left when all of this is said and done with.

The Worst Case Scenario of Them All
What if this LEEP doesn’t do it? What happens if the dysplasia grows back. I only have so much cervix. Do I have to face another LEEP? And if I do, that will destroy all hopes of another child. Beyond that, we’re looking at a hysterectomy. I’m too young to have my uterus removed. So what then? Hormone replacement therapy for the next 10 – 15 years? Or will I just have to bear early menopause?

That is honestly the worst of it all. Not being able to have children and having to go through menopause.

The Only Good News
The actual surgery isn’t nearly as bad as cryosurgery. I will have a cervical block, as well as IV sedation. Instead of being in the office, I will be at the hospital. The procedure is supposed to be painless, and afterward, I should sufffer no symptoms worse than a light menstration.

The after care is much like having a colposcopy, and heaven knows I’ve had enough of those.  Literally, I’ve had four or five.  With the last one, I wasn’t doing great the same day.  But, within a few days, I was back to my regular self.  I should be healed enough to resume normal activity within two weeks (like aerobic activity), with the exception that I’ll have a lifting restriction for a month.

The Plan
The date of the surgery – November 10th or 11th.  I have off on the 11th, so I tried to schedule it for then.  But, I can take the 10th off, if needed.  My doctor specializes in treatment for woman cancer.  I trust her and really like her.  She reminds me of the wonderful OB that delivered T.D., except she’s a little more forthcoming.  She’s the only doctor that has sent my specimens to an oncologist for review.  She is the only doctor that has been extremely proactive about this.  And she is the only doctor that hasn’t treated me like I’m a case, or I’m insane, or anything else.  She’s regarded me as a person every time.

I just want to get this all behind me.  I want to be able to deal with the aftermath as soon as I can.  And, I need to make the attempt to get pregnant as soon as I can afterward.  Because, if I have to face another LEEP or hysterectomy, I’ll be damned if I don’t at least try to have another baby before we come to that.