excerpt - Heart Disease: The Leading Killer of the Smile

It begins behind the sternum, just below where the ribs meet. Sometimes it is a dull and growing ache; other times it is more like a sucker punch. The heaviness that can steal the breath spreads to both sides of the chest, filling the cavity with a painful hollowness that exaggerates the intensity of the heart's pounding. Sometimes there is a burning or tingling, sometimes it is a seemingly unbearable pressure. It moves to the throat and neck, tightening them, as the arms become heavy at the sides. It aches, and something within screams and wails in protest.

Have I just described a heart attack? Well, in a manner, yes. But not an attack IN the heart. It is an attack, an ambush, a starvation OF the heart. One that needs its own type of intervention, much different from a call to 911 or the administering of CPR. This disease is sinister. It may lie dormant. It may come without warning. But in its most deadly form, it is always present, always looming, and any relief from its pain is short lived. In some ways, even a moment of relief is welcomed. But then, when the relief wanes, the returning pain is that much more crushing.

I am not sure how long I have suffered from this disease. Like many, I did not immediately recognize the symptoms. They came on slowly and intermittently and gradually grew in intensity. Then I thought I had encountered a miracle. But it was only a false remission....and then my disease slowly overtook me again. There are treatments. There is even a cure. But they are hard to reach, inconvenient, and require consistent and daily attention. And my doctor has lost the prescription pad.....or perhaps it is just hidden inside his desk. I am afraid to ask.

So I feel the ache, struggle to breathe, and die a thousand little deaths. I know the life span of those who continue in this sickness of the heart. Without treatment, the prognosis is negative. So I will endure the disease a little longer. And then I will write the prescription myself.

The best relationship analogy ever

My youth minister was a big believer in discipleship and having a daily, walking relationship with Jesus Christ. He used the following analosy often:

Let's say I call you or talk with you and say, "I want us to have a relationship. I really like you and care about you, so I'd like to get to know you and have a relationship." Now, you like me too, so you are very happy, and you say, "That's great! What kind of dates will we go on?" I say, "Well, see, I am really busy, and I have lots of important things to do. So I'm not sure how much time I can spend going on dates." You're a little disaapointed, but you understand. There are more things going on in life besides one relationship, right? So you respond, "Okay, I understnd. Do you need my phone number?" I clear my throat for a bit..."I'm not that much of a talker. It's just how I am. I don't really feel comfortable talking on the phone a lot." Again, you're a little hurt. But you really do care about me, so you try one more time. "Well, I like letters. I'll be glad to just write letters when you're busy." I finally get a little defensive. "You know, honestly, I don't really DO letters. But I told you I cared and wanted a relationship. Isn't that enough?" I apologize to Jeff Noblit for fancying up his analogy a bit :)

Do you know why this analogy is so powerful when illustrating the relationship Christ wants with us? Because if you have ever been in a normal relationship or seen one modeled, you KNOW that the relationship illustrated above is NO relationship. And you know that you would not be satisfied with that kind of relationship....it's built on selfishness and laziness. It made a lasting impression on me with regard to the kind of spiritual life I wanted to have, and even when I haven't stayed true to that level of closeness with God, I have known in my heart of hearts that it is what He wants and what I need.

So what IS the point of this analogy in a blog 25 years after I first heard it? I guess I just wanted to clarify again in my own heart and life what makes a relationship - any relationship - an actual relationship and not just something to pass the time, give us fire insurance, or change our last names. So look at your own relationships. Are they relationships in word or on paper or in theory? Or are they relationships is action -- regular, ongoing, unselfish action?

ponderings, philisophies, and poetry

I have done many things in my life, both before and after my diagnosis of the disability, Bipolar Disorder. Some things have been good things. Some things have been not so good. But here is a list of things I have never done as a bipolar woman:

1. I have never committed a crime
2. I have never been violent
3. I have never taken illegal drugs or become inebriated
4. I have never hallucinated
5. I have especially NEVER hallucinated about harming anyone (my personal favorite)
6. I have never taken an overdose
7. I have never been disrespectful or insubordinate to anyone professionally
8. I have never claimed to be perfect
9. I have never dealt with a personal problem by speaking ill of others without their knowledge. After all, I am not the boss of them.
10. I have not made any choices that would forever change the course of someone else's life

I wrote this poem several years ago. It is not pure or godly or kind. It is raw and honest. And sometimes....that's just how life is.

For All

For all those who
Contributed to my pain
I say thank you
For reminding me of
What is sure.

For all those who
Contributed to my pain
I say screw you
For throwing me away
Is your own loss.

For all those who
Contributed to my pain
I say bless you
For without you
I would not have become as strong.

For all those who
Contributed to my pain
I say I pity you
For an open heart
Is always more fulfilled.

For all those who
Contributed to my pain
I say see you (CU)
For I cannot be held here –
I am free.

out of the mouths of babes

Tonight I watched a special called Bipolar Mysteries on Discovery Health. It followed four families that had children with bipolar disorder. The eleven year old, Kelsey, was wise beyond her years. She was able to articulate what that rising, pressing, anger and frustration feels like...when the walls are closing in and your brain feels as if it is pressing against your skull, and you know that the fight or flight instinct is about to take over. And the despair that she shared with her other, being surrounded by people she had known for so long and yet never feeling a secure connection to them. Feeling as if she was walking a tightrope of acceptance, and she dare not miss a step. She talked about the things she said and did and felt when manic, things she wasn't even aware of and didn't always even remember until after the mania was gone. Being so very sorry for how grossly she disappointed those around her, but feeling helpless to say "I'm sorry" because the words were so weak, and she might do it again sometime. I watched these kids rage and cry and scream and throw things. I watched their parents talk about all the sometimes well-meaning and often condescending parental advice they got and tried, but to no avail. One boy was in the middle of a meltdown and began to cry, begging someone to make him stop. It was heartbreaking.

As an adult, I have more life experience, more tools with which to control my reactions and moods, and a thicker skin. I can easily discern the friends from the foes -- usually, sometimes they change teams. I am blessed that my illness was not triggered until I was an adult. I am also blessed that my husband loves me - all of me, and my children are mature and compassionate and intelligent. And that I have friends who have told me more than once (and mean it) that I can call them at 3:00 a.m. if I need to. In many ways, having a mental illness streamlines your life. It takes a lot of focus and energy to be who I should, so I have to trim the excess of my life. Regrets and Guilt? Blame and Shame? Gossip and Judgment? Too much baggage. Christian, wife, mother, teacher, sister, daughter, friend....that is what really counts. I have to get those right.

So tonight I am thankful that I have so many things to be thankful for.

mirror mirror on the wall

I have always had a love hate relationship with my mirror, mostly hate. At a very young age I began to question and sometimes fear what that large rectangular piece of glass had to say.
I remember when I realized I was ugly. I was in first grade, and one of my friends was to have a very special birthday party. A local television station had a cartoon-oriented show that they aired on Saturdays. Cartoons would be shown, and in between the cartoons the host would talk with children who sat in rows on bleachers. Caroline’s dad had managed to book a show for her birthday. I was so excited. It was a show I watched every Saturday, and I couldn’t wait to be on television. I even practiced: “Hello, my name is Laurie, and I am 6 years old.” It was going to be wonderful.
We arrived at the station, and one of the stage managers told us to sit by height. Lucky me, I ended up sitting on the top row of the small risers, directly in the middle. The host always talked to kids in the middle. After we were all seated, we waited quietly for the host to come in.
He looked even better in person. He wore a blue suit with a crazy tie, and he smiled a lot. But then I saw him wrinkle his brow. He looked at me for a long moment and then turned his gaze toward Jane, who was sitting on the end of the first row.
“Sweetheart,” he said to me. “Could I have you switch with that young lady over there? I think it would look more balanced.”
You should know something about Jane. She was petite with a very small nose, and her hair was cut into the latest Dorothy Hammel haircut. You should also know something about me. I was the tallest, skinniest kid in my class. My teeth were crooked, and my pointy glasses sat solidly atop my…generous nose.
So, at the host’s request, I switched places with Jane and tried to smile as he talked with her during the show. A few weeks later, I watched the episode, and Jane looked great. Me? I wasn’t even there.
There have been times in my life when I have made peace with the glass, even embraced it. But now, as medication has wreaked havoc with my weight and my complexion, and as I begin to see the evidence of my forty-one years, once again I avoid the glass. And once again, I wish I was Jane.

a woman's perogative

This blog was intended to focus on the experience of having bipolar disorder during the month of May. May is over, and I have chased a few rabbits here and there. However, as I see it, that is the bipolar experience...the experience of being human, of changing one's mind, of being more than a diagnosis or the sum of one's successes or failures. The "bipolar experience" is really just the human experience. Good days and bad, pleasant memories and unpleasant memories, decisions and directions. So for today I will simply share a poem.

What do I remember…
Eating my first sausage ball the day after a New Year’s party
Trying to decide between my dog and my brother
The strange Tony the Tiger dream I had when I was three
Caroline getting nosebleeds ALL THE TIME when we were in kindergarten
Winning 2nd place in a swimming race
Watching a scary movie that my parents told me not to watch and regretting it for weeks
Being the first one to hold Jon at the adoption agency
Being on Mickey’s beat-up list in 2nd grade
Being afraid of sunflowers
Spending summers hiking around the neighborhood with Bill
Having a crush on Brent
Foam rollers
Getting bitten by my own dog
Writing in that cool notebook with the different colored pages
Mr. Gardener
Piano lessons with a metronome – thank you Mr. Thomas
Wanting to be a brownie
Going to the Anchor Club sleepover when my mom was the sponsor and playing Old Maid with the high school girls
Typing stories at my dad’s office and being allowed to use the mimeograph machine to copy them
Starting my own magazine to send around the neighborhood
Being afraid of dogs and bees
Making homemade peanut butter and picking okra
How tall a horse seems in the second grade
Watching a dog break my brother’s arm by running into it
Not eating for two days because I was afraid to pull my tooth
Thinking my third cousin was cute and then feeling really bad about it
Getting hit in the head with my brother’s cast and pretending I was dead
David making me a Barbie Doll bed for Christmas in the third grade
“Publishing” a book of poetry instead of doing math in the 5th grade – boy was Mom mad at the teacher!
Kickball – God how I wish I could forget
Playing the part of a nurse in our 1976 bicentennial play
Allergy shots
Getting lost in a mall because I was looking for some puppies we had seen
Fire ants
Yarn hair bows
Metallic drinking glasses
Yellow
Falling asleep with a book in my hand and my glasses on
And dreams

chapter 1...foreshadowing

My vision was blurred, and even as I shook my head to clear the fogginess, I knew I wasn’t going to make it. There were 18 first graders in my classroom, and I was doing my best to stand and sing with them, moving to the beat of the simple song as my eyes rolled in my head and my body screamed its desire to curl up and disappear. Yes, I tried to keep going. But I was going down; it was that simple. I called over the intercom for their classroom teacher. I knew that if I fell asleep or fell apart it would not be good. She came to pick up her class, sympathy and questioning in her expression. Once the room was empty, the tears came in a torrent.

It was at this point that I made what was possibly one of the worst decisions of my life. I got myself together, and then I walked to the school office and asked to speak to one of the administrators. Add this to a long list of things I would undo if I had a time machine.

It had begun in January. I begged my doctor to change one of my medications because of weight gain I had experienced. It took a little convincing, but I left the office with a prescription for a different drug and another med to alleviate the temporary side effects. I was hopeful that this new med would manage my manias while allowing me to lose weight. That evening, I started taking a small dose of the new medicine while lowering the dose of my old medicine. Changing meds and doses is a tricky business, and I knew I might not feel immediately positive effects. But again, I was hopeful. At the end of three weeks, my old med had been completely replaced with the new.

The first time I noticed a problem was during a church service one Sunday morning. I had trouble focusing on the pastor’s words, and I felt groggy. I hadn’t slept well the night before so I shrugged off the strange feeling. I took a nap that afternoon and felt somewhat better. The relief was short-lived, however. It became harder and harder for me to get up with the alarm each morning. I began setting it later and later, taking my shower at night and getting up with just enough time to dress and throw my hair up into a quick ponytail. At first, the grogginess eased by around 9:00, then 10:00, and the progression continued. I felt like a walking zombie.

By the beginning of March, fog was my closest companion. It took everything I had to even show up for school, much less be any kind of teacher. Some days I just couldn’t and would call in sick. Somewhere in the back of my mind I knew I was headed for trouble, but I was in survival mode, as they say. I stopped going to church because I couldn’t even stand up in the choir. I stopped talking to friends on the phone because I was afraid that half of what I said wouldn’t make sense. And then one Thursday at school, I fainted. The police, fire department, and ambulance all responded. In a town our size, a 911 call apparently means excitement for everyone. I saw my two administrators standing in the hall as the EMT’s wheeled me out of the school building. And I wasn’t sure the expressions that I saw were those of concern. I missed school on Friday, came back on Monday, and the incident was never mentioned. I just kept going more and more slowly each day, wondering how long the “temporary” side effects were going to last.

So, here we are back to that fateful day that I lost it in the middle of a class. I am not sure why I thought going to the administrators to actually tell them the truth was a good idea. I should have told them I was sick, that I was vomiting, that I felt faint; I should have told them anything but the truth. Looking back, I cannot believe that I couldn’t see the obvious. But then again, it is hard to see through fog and think through sludge. I went to the office, asked for administrators, walked with both of them to a conference room, and immediately broke down and wept. I know I saw concern in their eyes, and because of that, I felt comfortable letting down my guard. I am not sure what I expected, but nothing could have prepared me for what took place.

I remember my head administrator asking me what was wrong, what was going on to upset me so much. I tried to explain to them the medicine changes, the depression, the grogginess. They looked at each other with inscrutable faces.

“Laurie, it is obvious that you are not doing very well. Have you considered a leave of absence?”

I had considered a leave of absence. I considered it impossible. My husband was a student and graduate teaching assistant. My disability insurance would not even cover half of my paycheck. I simply couldn’t afford to take time off from work. I tried explaining this to my administrators.

“I can understand your concern about your family’s financial situation,” Mrs. Jones said. “But, Laurie, you are missing a lot of school anyway. It is affecting the students and it is affecting your teaching. We have to think long term; we have to think about your future at this school.”

She wasn’t straightforward, but I knew what she meant. I was speechless. In the teaching world, having tenure meant your job was supposed to be secure. I knew she was threatening that security, but I pretended not to catch her meaning.

“Then I am so glad I am tenured so that I can get through this problem with my job and my family’s welfare intact.”

“Well, Laurie,” Mrs. Jones replied slowly, “Sometimes tenure can come into question when the children or the school suffer due to the teacher’s teaching or excessive absences.”

Let me say first that I did understand her position. I knew the children were being affected by my absences and inability to focus. But I also knew that my condition was considered a disability. At that moment, I knew that if my job was directly threatened, I would do everything in my power to make sure I remained employed, even if it meant legal action. I knew that if it came to that I might lose, but I wasn’t going down without a fight.

“I know my attendance and my teaching have been sporadic lately, and I am troubled about that and how it affects the students. I really believe that the medication change is to blame. I was not experiencing any of these problems with the other one. I probably just need to see my doctor as soon as possible and have her start me on the old meds again. That should bring me back into focus.”

The administrators looked at each other again. I wondered if all of this talk was a formality. Was my job already gone?

“Laurie, I do think you need to see your doctor as soon as possible. Why don’t you go ahead and leave for the day. Try to see that doctor. And let us know if you need time off from school.” Mrs. Jones looked me squarely in the eye. “And when we return, we need to sit down and discuss some things.” And with that, they both stood up; the meeting was over.

I left the meeting in a fog; but this time it wasn’t medication induced. This time the fog was full of two emotions: abject fear and anger. I was terrified of losing my job because I knew what it would do to our family. Not only would the money be a problem, but I carried our insurance. I needed medication and a doctor’s care. My husband has type 1 diabetes, so he needed all of his medication and supplies. There was no way we could take care of our health without insurance. I was also angry. Would we have even had that conversation if my affliction was cancer or multiple sclerosis or something else that was more tangible than mental illness? I suspected not. My mind and stomach churned as I drove home. I knew the doctor wouldn’t be there on a Friday, but I hadn’t told my administrators. I went home, made an appointment for the following Monday, and collapsed onto the couch.

That Monday, the doctor agreed that my medication should be changed, and returned to school on Wednesday. I did have a conversation with my administrators, but I’ll save that wonderful tidbit for later. I think it’s time to start from the beginning.