Xanax and the Diet Dilemma

"Food is an important part of a balanced diet."~ Fran Lebowitz

My psychiatrist finally got back to me today. I left a message for her on Tuesday, explaining that my therapist thought I'm being a bit overwhelmed by anxiety. She suggested upping the ante of my regular Xanax dosage. I told Dr. W. (psychiatrist) that my appetite never returned after I finished chemo. I'm aware of that unpleasant empty stomach feeling when I haven't eaten in too long, but I'm never hungry. Dr. W. thought maybe it could be a thyroid thing. I actually like that answer more than the Xanax answer. I have serious misgivings about raising the amount of potentially addictive substances in my life. I have addiction problems on both sides of my family. Very dangerous.

Dr. W. considered raising the amount of Elavil that I use to help me get to sleep (post traumatic stress disorder caused me to wake up many times every night before I was medicated). That would improve the appetite situation, she said. Somehow, we decided against that. We decided to stay with the current level of Xanax, but I'm supposed to get the extended release version. Maybe this will help the jittery feeling I walk around with all the time. I didn't even have to develop a closer relationship with any addictive substance. The conversation was a roaring success, as far as I'm concerned.

The food thing is beginning to make me a little nervous. I've always flirted with a potential eating disorder problem. So far, I've managed to sidestep anorexia. Bulimia will never be a problem. I just don't do the finger down the throat thing. So unattractive! This morning I had a whole bagel (it's a very large bagel) and six prunes. For lunch, two pieces of toast. And a cookie. I also ate most of a bag of popcorn. I find myself worrying about the calories contained in all of that non-nutritious food. It's not a good sign.

The only reason today's diet is so lacking in nutritional value is that I didn't manage to get apples and oranges this past weekend. I usually have two pieces of toast, a large apple and a Clementine orange. That doesn't sound like much, does it? My therapist pointed out to me last week that I'm not eating enough. It was she who raised the specter of anorexia.

If you're never hungry and you always feel bad after eating, it makes it hard to know what constitutes enough. When I finish my usual lunch, I feel pretty full. My therapist thinks that's because my stomach has shrunk. Once I establish the amount of food I'm supposed to be eating, I'll still have the problem of feeling crappy afterwards. It's not much of an incentive to eat, period. I'm very clear about the necessity of eating, though.

Dr. W. said that I should just treat food the same way I would medication. Got to do it. No skipping doses. I'm fine with that, but I'm seriously going to have to figure out how much food to add. At the moment, I'm thinking about adding a container of yogurt to my regular lunch menu. The only problem with that is that I haven't been able to get through an entire container of yogurt. I can do half. My therapist is stunned by this lack of capacity. That gets my attention.

I've been trying to maintain a low-fat diet because there's strong evidence that less fat equals a lower chance of getting breast cancer in the remaining girl. I can't do chemo again. I have to do whatever I need to do to ensure I won't have to try to endure it again. On the other hand, I don't have a lot of fat in my diet at the moment and I could probably add some without danger.

This is when thinking about myself as my best friend is helpful. When I'm trying to determine the best course of action or when my nasty little inner voice starts beating me up, I always just think about what I would say to a friend if she were in the same situation. I end up being much kinder to myself when I do that. As I said before, I've always had food issues. I'm just going to have to find a way to eat more. Damn.

Present Moment

Looking out of my office window, the skies are so blue and cloudless. All the leaves are gone from the tree tops, but it's not quite time for my little squirrel friend's afternoon nap. The tree limbs sway a bit in the winter winds. I've been listening to Gregorian chants and chamber music all day. Right now. This moment. Present moment, wonderful moment. It's all I have.

Red Tailed Hawk

My office is right across the street from what used to be the Municipal Airport. It's been closed for several years now, since they built a much bigger one out on the outskirts of town. The land is being cleared now for mixed use development. There are already some buildings in the process of construction, including a children's hospital. Those areas are on the opposite side of the old airport.

When I went out to get in my car and go home for lunch, I noticed a bird sitting on the ground across the street. (I'm fairly certain that "sitting' isn't the right word here, but I know "setting" isn't it, either.) It looked too small to be a buzzard. It was about the size of an owl, but it's rare to see owls just hanging out in the middle of the day like that.

As I was standing there, trying to figure out what kind of bird it was, a white pickup truck pulled in right next to my car. I smiled because I thought it was the husband of one of my co-workers, K. Then I remembered that K. wasn't in today. A guy who looked to be about my age, heavily tattooed, got out of the truck and said, "I have binoculars." His girlfriend or wife or daughter got out of the other side.

"What the hell is that?" I asked him. It was a red tailed hawk. The man explained to me that all raptors will eat dead things, as long as it hasn't decomposed too much, in which case the buzzards get it. As we stood there, it picked up its prey and flew into a nearby tree. The two people got back into their truck and left.

I love all raptors. They're so fierce and dignified looking. As a matter of fact, I have a photograph of a red tailed hawk sent to me by a friend that I use as wallpaper for my office computer.

I can't help but believe this is a good omen. In celebration, here's one of my favorite poems, written by a man who was a bit of a hurt hawk himself, Robinson Jeffers.

Hurt Hawks The broken pillar of the wing jags from the clotted shoulder, The wing trails like a banner in defeat, No more to use the sky forever but live with famine And pain a few days: cat nor coyote Will shorten the week of waiting for death, there is game without talons. He stands under the oak-bush and waits The lame feet of salvation; at night he remembers freedom And flies in a dream, the dawns ruin it. He is strong and pain is worse to the strong, incapacity is worse. The curs of the day come and torment him At distance, no one but death the redeemer will humble that head, The intrepid readiness, the terrible eyes. The wild God of the world is sometimes merciful to those That ask mercy, not often to the arrogant. You do not know him, you communal people, or you have forgotten him; Intemperate and savage, the hawk remembers him; Beautiful and wild, the hawks, and men that are dying, remember him. II I'd sooner, except the penalties, kill a man than a hawk; but the great redtail Had nothing left but unable misery From the bone too shattered for mending, the wing that trailed under his talons when he moved. We had fed him six weeks, I gave him freedom, He wandered over the foreland hill and returned in the evening, asking for death, Not like a beggar, still eyed with the old Implacable arrogance. I gave him the lead gift in the twilight. What fell was relaxed, Owl-downy, soft feminine feathers; but what Soared: the fierce rush: the night-herons by the flooded river cried fear at its rising Before it was quite unsheathed from reality. Robinson Jeffers

Thanks for the Christmas Gift

"...the crime of suicide lies rather in its disregard for the feelings of those whom we leave behind." ~ E. M. Forster

Anxious. Anxious. Anxious.

At the very last minute, I decided to add festivity to Christmas dinner. I got out a set of my Christmas china (I have two. I'm very into Christmas, usually.) and created a centerpiece out of a candy dish and some red cinnamon-scented tea candles. Mid-way into the meal, I remembered that I should have used more festive flatware, but you can't have everything, I guess. Maybe next year. I'm hoping to be all well and feeling great next year, so maybe I'll have more energy to decorate.

My husband and I didn't do the gift thing. I like that a lot. No shopping! I gave my mom a gift and she gave me a gift certificate for Borders. Excellent choice!

On Saturday, Hubby got a call from a woman from one of the magazines for which he does freelance writing. The editor of the magazine died over the weekend. Hubby had known this guy for over a decade. His house caught on fire and, though his wife escaped, he did not.

There was daily newspaper coverage and, over time, we found out that the man (I'll call him Editor) committed suicide. It's the strangest method I've every heard. Maybe he overdosed on some prescription drugs...that's just speculation, though. What we do know is that he set some newspapers on fire in the closet in the "back bedroom."

Women attempt suicide more than men, but more men die from suicide than women. That's because men choose methods that are highly lethal. They choose guns a lot. My dad chose a gun. Setting your house on fire doesn't guarantee the anticipated outcome. You could be rescued. You'd definitely want to increase the odds, because burn treatment can be excruciatingly painful. I'm guessing he didn't own a gun.

Of course, no one knows why. No one ever knows why. The person who called Hubby talked about the conflict Editor had been having with the publisher of the magazine. The publisher demanded increased profitability. Editor hadn't had a raise in ten years. She also mentioned a "crazy" ex-wife who wouldn't let him see his kids. I guarantee that it wasn't just the job. As for the ex-wife and kids, I don't think co-workers are in a position to know the truth about those situations. The co-worker was clearly hoping to blame someone for it, whether it be the ex-wife or the publisher.

The only person to blame is the person who set the newspapers on fire. No one can make someone else commit suicide. It's never about just one thing. Or two. Generally, people who decide to check out have had difficulties all of their lives, both in relationships and in coping skills. Typically, people who commit suicide have always chosen to deal with problems by running away. Suicide is the last ditch effort at running away. It trumps everything.

I'm so sorry for his family. My dad died shortly before the holiday season and I know what it's like to spend Christmas just trying to get through every minute of every hour. The pain is of a type and magnitude that is unimaginable unless you've lived through it. The minute I found out that Editor killed himself, I became furious with him. Thanks, Dad, for fucking up Christmas now and forever more for your kids. Thanks from the wife for setting the house on fire and causing damage that won't be covered by their insurance. If the blaze is deliberately set, insurance companies don't have to pay. His wife will have fathomless guilt to deal with and, probably, abandonment by many of their friends. People don't know what to say, so they withdraw. That withdrawal just increases the sense of responsibility survivors feel.

It took me years to get angry at my dad for killing himself. I've been angry about it for the past two or three years. He died 8 years ago, 9 days before my birthday. From that date through the holidays, I always experience flashbacks. Sometimes I can identify the triggers, but the majority of the flashbacks are seemingly random. This has been a huge trigger. I talked with my mom about it. She has flashbacks, too, but hers are worse because she found him.

We talked about how my dad had wanted to call me shortly before he died. We both believe that, had that happened and had I gone there, my mom and I would both be dead, too. I'm grateful that he didn't take my mom. I'm grateful that I didn't have time to make the trip there I was planning.

Editor's death invokes profound sadness. In part, it's the sadness I felt for my father. What a lonely place to be, the moment you make the decision. Lonelier still the seconds before the end. Then, all the suffering is left to the loved ones who must go on living.

I wish everyone contemplating suicide could know what they'll leave behind. A nuclear holocaust for survivors.

http://www.suicidology.org