Wednesday, June 26, 2013

I'm Not Crazy, I'm Just a Little Unwell

At least I've got my mental health.

Well, maybe not exactly. Sanity is relative when you're talking about a hopeless hypochondriac like me. Let's just say I've made some progress. I no longer spend hours at a time looking up medical terms on Wikipedia and poring over medical websites, trying to self-diagnose every time I feel the slightest ache or pain or spot any blemish barely noticeable to the naked eye.

Meanwhile, I'm kicking some other old habits, too. I wasn't sure that I could do it, but I've learned to co-exist semi-peacefully with my panic attacks. It's been a nearly 15 months since I popped a Klonopin or Rivotril pill, after a nearly six-year dependency on the anti-anxiety drug that was first prescribed to me in September of 2006, when I was diagnosed not by myself but by a licensed psychiatrist a few days before I left New York City as suffering from panic disorder. Although I still have regular anxiety episodes (about once or twice a week at last count), I no longer crave those 1 mg doses of Clonazepam to dull the scary sensation. I've learned to live with the panic. Eventually, it always moves on.

I've also learned to stop living in fear of occasional bouts of sleep paralysis. Now every time my mind wakes up before my body does, and I'm lying on my back (it always seems to happen when I fall asleep on my back), immobile, I tell myself, "Just don't give up. Keep trying to move, and eventually you will." It's always worked. So far.

Even more impressively, I've kicked my decades-long addiction to decongestants and antihistamines. For years, Actifed was my allergy drug of choice, one that my doctors in New York City all told me was perfectly safe. I'd pop one pill every night, get drowsy within minutes, and eventually fall into a light fitful sleep, my nostrils completely unobstructed. Nearly seven years ago, shortly after moving to Buenos Aires, I gave up Actifed (the brand that was sold in Argentina was missing a crucial decongestive ingredient, apparently, the one that gave me relief) and moved on to harder stuff on the recommendation of a 24-hour Farmacity pharmacist I went to seeking relief when I fell into a sneezing fit one Saturday night at Sitges.

For the next nearly six years, I was hooked on Dexalergin, a nasal decongestant with a combination of dexametasona, clorfenamina and nafazolina that wasn't intended for long-term use (as is the case with all over-the-counter nasal decongestants). So much for following instructions. For nearly six years, one daily drop per nostril was all I needed to keep me breathing freely for 24 hours at a time.

Then last October, fate stepped in and forced me to kick my Dexalergin habit in much the same way that I gave up Klonopin last year. (I misplaced my Klonopin stash in my Bangkok apartment and didn't have a prescription to get more, so I just quit taking it completely.) Before moving to Melbourne from Buenos Aires (the only country that I know of where Dexalergin is sold), I bought several 60 ml containers, which lasted me about a year and a half. As my stash dwindled down to the last drops, I started going from pharmacy to pharmacy in Bangkok, looking for something under a different name with the same ingredients, but I had no luck.

I knew I had to give it up (cue the intro of Marvin Gaye's "Got to Give It Up" in my head), which actually ended up being easier done than said. One Monday morning early last October, I fell asleep after a wild night out and forgot to take my regular dose. When I woke up the next morning breathing freely, and I realized what I hadn't done, I knew I'd won another battle. I haven't touched the stuff since. I did get a 60 ml emergency fix before I left Buenos Aires three weeks ago, but I haven't even broken the seal on the container yet.

You'd think that I'd be happy to have control over my body again -- only I'm not. I'm not happy, and I'm not in control of my body. Or maybe it's my mind, my overactive imagination, that has all the power. Every night when I'm lying in bed in the throes of insomnia, I stare off to the side (never the ceiling -- remember, I try not to sleep on my back), listening to my body, searching for clues, waiting for any sign of irregularity.

I always seem to find something, whether it's a pain in my chest that bounces around from side to side, or a sick feeling in the pit of my stomach that I usually convince myself is the onset of appendicitis, or liver failure. It's gotten worse the last few days, ever since I heard the news about James Gandolfini's sudden death from a heart attack in Italy. He had nearly a decade and at least 100 pounds on me, and I have no idea what his medical condition was, but I've convinced myself that if it can happen to him, it can happen to me, too.

Yesterday, I decided to do something about it. I went to BNH Hospital for the first time since my return to Bangkok exactly two weeks ago, looking for answers -- or trouble. Thank God for Dr. Rekha Hanvesakul, MD. I don't know what it was about her, but she immediately put me at ease. Maybe it was her own calm demeanor, her perfect English, or the stylish eyeglasses that suggested that not only was she knowledgeable, but she was caught up with all the latest medical trends, too.

As she listened to me explain my myriad ailments (which, for once, didn't include headaches, a chronic and uncomfortable fact of my life that I never even thought to mention, though I'm secretly convinced will ultimately be the source of my medical undoing), there was no judgement on her face. She seemed politely concerned, and I got the impression that it wasn't because she thought there was actually something wrong with me but because she felt bad that I was having such a hard time convincing myself of that despite so much evidence to the contrary. She pointed out that in the 20 months since my first trip to BNH Hospital, I'd had a urine analysis, an ultrasound, an MRI, several EKGs and an echocardiogram, and everything came back normal. According to all the BNH doctors who had seen me, I was in perfect health.

After she did a routine physical examination, she concurred. I still wasn't convinced, though. I asked if she could do a blood test to make sure my cholesterol, my glucose, my blood cell count and anything else she could think of was where it should be. I liked her even more for humoring me. She was just the kind of doctor I'd been looking for all my life. For a moment, I even considered staying in Bangkok just so that I could see her every few weeks. I haven't had a female regular physician since I was a kid, though. Would that be kind of weird?

Today when I returned for the test results, as I looked around the waiting room at several patients and BNH personnel wearing mouth masks, I asked myself, as I have been since I first spotted the curious accessory upon my first arrival in Bangkok, "Why?" Are they trying to not to breathe in the polluted Bangkok air, which I imagine must be even worse inside a hospital? Or are they sacrificing good fashion sense to ward off germs? When I started pondering whether it was hygienic, or how a person could be enough of a germaphobe to spend all day wearing a mouth cover, I cut myself off: Am I any better than they are?

That was around when the nurse arrived to bring me to my fate, which in the worst-case scenario going round and round in my head, involved something dire that would require months of intense treatment. After spending way too much time questioning me about my current physical state, Dr. Hanvesakul finally announced that her suspicions had been confirmed. My blood work was normal -- better than normal, very good.

If I wanted to, she said, I could do another ultrasound, another MRI and more heart tests, but the results would likely come back the same. It was possible that the chest sensations -- which by then I was comfortable enough to admit to her may very well be all in my mind, the hypochondriac version of voices in my head -- could be from my workout routine, and the stomach discomfort was likely just a digestive issue that could be resolved with the week's worth of Miracid capsules that she prescribed. For the first time in years, I was convinced that I was going to be okay.

But who would I be if I didn't give myself something new to worry about? Yes, I'm okay now, but for how long? I'm no longer a spring chicken. How many weeks, months, years will it be before I go to the doctor, and I get the bad news that I've been looking for, expecting, for as long as I can remember? Yes, I'll probably die another day. But how long will it be before I'm lying in bed (on my side), once again listening, waiting, anticipating the worst?

Until then, maybe I'll make an appointment to have a colonoscopy and a prostate exam next week. You can never be too safe, you know.
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