I'm having a terrible time trying to figure out how anxiety has benefited me. I can't see that it has served any useful purpose in my life, aside from making me hyper-vigilant. Perhaps that is a good place to start.

It would be nice if I could say that hyper-vigilance has made me extraordinarily observant, but this isn't necessarily the case. It's more of an introspective vigilance and a physical vigilance that doesn't tend to extend beyond my toes. I'm so focused on my own neuroses and health that I fail to notice the world and the people around me. Not much of a benefit. Also, it's not that I'm paying careful attention to all of my body or all of my health at once. Rather, I obsessively focus on one event or ailment at a time to the exclusion of other important issues. In lieu of that, I don't see the benefit.

I'm not sure if this is what he wants. There is a benefit there, but it is followed by a huge BUT. There is no way, that I can see, that anxiety has been a help to me or benefited me without there being a caveat.

When I was a child, I had panic attacks along with the anxiety. I still have them now, but with much less frequency - from weekly to monthly to what is now typically every few years. I suppose they aren't really a separate thing for me - more like the crescendo of the anxiety caused by whatever ailment or trivial body-weirdness I am over-focusing on at the time. As a child, that ailment was nausea.

I don't know when my phobia of nausea and vomiting started. I remember a time, around 4 years old, when it didn't produce such a fear response. But somewhere between 4 and 8 that changed and suddenly nausea was cause for terror. It was worst when I lived with Mim. I'm not sure why. It might have been stress - my parents had just separated and in the carnage of their separation, my siblings and I went to live with our grandparents. We were uprooted very unexpectedly - one day we lived in Norfolk, Virginia and by the end of that day, we lived in Lexington, Kentucky. My mother was distraught, so Mim told her to leave the kids there and go get her life back in order.

I suppose what stressed me the most was not knowing what had happened. My father was in the Navy and often away at sea for long stretches. My mom stayed home and took care of us. I never realized anything was wrong between them before then. Looking back, I can see where the cracks were forming, but as a child, I was oblivious to that sort of adult minutiae. But the end result is that we ended up at Mim's, in another state, going to a new school, and unclear on exactly what had happened.

I'm not blaming anyone. And I'm not even sure that was the cause of the phobia - I think it had already manifested by then. That's just what happened, in its simplest form. Of course, there was a lot more going on that I learned later, but that's not for me to share here. But as a child, all I knew was that we were moving to Lexington, Dad was gone, Mom was mad and sad and scared, and no one was telling me why. That was my favorite question as a child. Not getting an answer was scary.

The panic attacks started while I lived at Mim's, as far as I recall. I don't remember having one before I lived there. They typically hit at night, after I'd been sent to bed. I would lay there trying to sleep, but then I'd feel nauseated. And then I'd get panicky. Most nights, I would lay there for a while, trying to reason and will it away. I didn't want to get up. Mim would always take care of me, but I could tell she didn't always want to. And even then I was embarrassed. But if the nausea or the panic got too intense, I'd get up and find Mim in the family room. We would watch TV and she would read to me while I paced back and forth behind the couch for hours until weariness made me sit and exhaustion put me to sleep sitting up. If I was at a sleepover, I was even more appalled and horrified and Mim would have to come get me in the middle of the night.

If a benefit exists within that hell, it was only that I did not have to go to bed. I have always had a difficult time sleeping at night, sleeping at all really. Anxiety allowed me to stay up later. But it came with terrifying nausea, psychotic pacing, crying, embarrassment, disapproval, and self-loathing. I hated it. And I hated myself for allowing it to happen, for not having the fortitude to make it stop.

So, if that's the benefit, cui bono?

There is very little I am unwilling to discuss here and in person, but you know what embarrasses me? Anxiety. I am very self-conscious about my anxiety disorder. I am not ashamed of my depressions or being transgender or much of anything else, but my anxiety shames me. It's partly because of the social stigma of mental illness, partly because when things have calmed down I always feel rather stupid for having panicked, but mostly it is because I cannot control it.

My anxiety has been bad for the past year or so. Last year, it was caused by all the nausea. It got bad enough to land me in the hospital for four days in February. Once the nausea was controlled, though, the anxiety abated. Klonopin helped, too. In fact, it was wonderful. I was calm. I felt normal. It didn't make me feel drugged or impair my life in anyway. I'd have stayed on it, but I'm allergic. About four days after starting it, almost my entire body broke out in an itchy rash. And that means I may be allergic to all the other benzodiazepines. Oh well. It was a nice dream.

After the Klonopin failed me, I resorted to Zoloft. It works, but it also eradicates my libido. And by "eradicates," I mean it strips me of nearly all desire for sex and even when I do find some prurient spark buried beneath the medication, it is a struggle to coax it into anything usable. And even if I can do that, it does not guarantee my body will respond in kind or that I will reach any sort of satisfaction. This is tolerable for a while, but it always ultimately proves unacceptable as a long term solution. So, around June I stopped the Zoloft.

Since then, I have been dealing with Zoloft withdrawals. Zoloft and the other SSRIs are not considered addictive, so the "withdrawals" have been cleverly titled SSRI Discontinuation Syndrome. Over a month of "brain shocks," a sensation similar to having a bug zapper going off in my head. The return of the anxiety. Agitation. And several months of rapid and raging mood swings, from euphoria to immobilizing depression. That was the longest I have ever been on Zoloft and the longest withdrawals I've ever endured.

I will never take it again. I lost an entire summer. Considering that, I would rather just be sedated.

Lately, I've been having problems with vertigo again. I assume it's my ear and if that's the case, there is nothing to be done about it. Fortunately, it's not the flailing vertigo of the past. But in some ways it's worse, because currently it's just this constant feeling of disequilibrium with occasional mild spins. Before, I could avoid the vertigo if I just didn't lay my head this way or that, but this time it's unavoidable no matter what I do. It is not helping me quell the anxiety. Strangely, it stops when I am driving, but it starts again as soon as the car comes to a stop.

So now, I am back in therapy. My first appointment was yesterday. I like the guy. It's the first male therapist I've ever had. I'm interested to see if there is a difference in technique between men and women. Thus far, he has given me homework and that is different.

Here is what I'm supposed to do before our next meeting:

-Exercise at least 20 minutes every other day (because I sleep better when I'm worn out)
-Develop a schedule and then maintain it
-Set aside time to write every day
-Get sufficient sleep
-Gather up some of my poetry to bring to our next meeting (he wants to read it)
-Write about my anxiety
-Figure out how my anxiety has benefited me

I guess I'll count this as my writing for today. In the future, I plan to use my writing time to work on my book or poetry. But I think it might do me some good to come back to this, so I suppose this will mark the end of my long silence.

Until recently, I had not read my friends list for nearly a year, so I hope all is well with all of you.

Since I was a child, I've had sporadic weak spells where I feel like I will faint if I don't sit down. My body will feel physically weak and exhausted, my thoughts get slightly confused, and I just cannot stay on my feet for long. If I do try to remain standing, my chest will get tight and sometimes hurt and only sitting relieves it. My heart races and my pulse feels weak. Sometimes I get shaky and nauseated and have hot flashes and sweats. And sometimes, no matter how deep a breath I take, and can actually physically take, I still feel as though I'm not getting enough oxygen.

Sounds scary when I spell it out like that, but I've just gotten used to it through the years and when it happens, I sit down and take it easy until it passes.

Except last week I had three days of spells and by the last day, even laying in bed, I still felt weak and nauseated and out of breath. That really did scare me. But I had a theory and I tested it. I got about 2 tablespoons of peanut butter, mixed some honey in and topped it off with just over a quarter teaspoon of salt. The peanut butter and honey weren't important; I just thought they would make the tastiest salt delivery method.

About 20 minutes later, I felt fantastic. Better than I had in days.

So I went to the doctor today to definitively find out what they were. And it is as I suspected: I have very low blood pressure. As my doctor put it, when it drops, I have no reserve. If I had normal or high BP and dropped 10-20 points, it would be no big deal, but my average BP is 100/70 and if you figure that most people are a little nervous at the doctor's office and thus register slightly higher BP's than normal, then mine is probably lower than that on average. Simply put, I have no room for error. If my BP drops 10-20 points, it leaves it way too low and I have a weak spell.

She said that she normally wouldn't say this to her patients, but I need to eat more salt.

And this explains so much. Low BP and low sodium levels are associated with mitral valve prolapse, which probably explains why it's happened all my life. It also explains why I have mad salt cravings some days and cannot seem to get enough.

Of course, mitral valve prolapse is also associated with anxiety, which these spells produce quite a bit of (who am I kidding, almost everything makes me anxious), so my doctor also wants me on an anxiety medication. She's prescribed the generic celexa, so we'll see how it goes. I've pretty much beat my depressions, but I haven't been able to fully shake the anxiety. Though, I am going to wait to start the celexa until I call the doctor on Monday, because it can apparently cause low blood sodium levels, which would be slightly contraindicative. I want to check and make sure she doesn't want to switch me to something else. But, hey, if it works and doesn't derail me with unpleasant side effects, then yay.

Mostly, I am just glad to finally have a definitive diagnosis and the reassurance that it's not all in my head.

The endoscopy went well, from what I remember of it. They rushed me in, saying we were very late, but we were only 5 minutes later arriving than the receptionist recommended, so I'm not sure why we were so behind. The nurse who ran my first IV very painfully missed it and it still hurts, but that's all the discomfort I'm feeling now that it's over. The second IV attempt went well. The saline solution was freezing, of course, but they gave me a heated blanket. Damnen was allowed to join me very briefly before they took me back.

In the endoscopy room, the nurses were all very friendly and reassuring, which was good because I was quite anxious. Having a tube shoved down my throat is just not the most appealing thing to me, but they assured me I would be knocked out when they did it and they wouldn't shove. I did have to lay with the bite block in my mouth for several minutes while the doctor kept asking me questions. The nurse would laugh, remove the bite block so I could answer, and put it back. And he'd ask another question and we'd do it again. I was very impressed that they asked several times if I recognized my doctor and knew the procedure I was there to receive.

Even though I was trying to remain calm on the surface, everyone there could tell I was anxious because my heart rate was over 100. It started off in the 70s, which is a bit high for me, and as the procedure got nearer and nearer, it crept up and up. The sedative burned when they injected it into my IV, but I was out pretty quickly and pleasantly.

All I remember of the actual procedure was feeling pain and pressure in my throat and muffled conversation. I have a vague memory of being wheeled back to my room. The nurse asked if I had someone waiting for me and then went and got Megan.

At this point, my memory is a bit spotty, but Damnen tells me I repeated myself many times. I would tell her all about the procedure and how it wasn't so bad, then close my eyes for a minute and when I opened them again, I would tell her all about the procedure again and how it wasn't so bad. She just nodded and smiled. Then I would ask her questions that she would answer and a few minutes later I would ask them all again. I was also very excited that the blankets were warm. I told her about that several times. I do remember I was being quite chatty.

The only thing I filed into my long term memory was the fact that it was not cancer. I didn't ask about that again.

It only seemed like I was in the recovery room for maybe 20 minutes, but Damnen says it was about an hour. They came and got her after the procedure at 11:05, so it really was over quick. When I had to get dressed, Damnen says I was swaying all over the place and she finally turned me so I was in front of a chair, just in case I toppled over. I do recall getting dressed was challenging, but I had planned ahead and worn a sweater instead of a button-up. I chatted away the whole time. We left a little after noon. I was still telling the same stories over and over.

Though, actually, I did tell one different story when they told me not to drive for the rest of the day. I told Damnen the story of the one time I drove drunk. It scared the hell out of me and I decided to never do that again.

On the way home, I kept chatting, but I was starting to remember things now. They took a biopsy of my stomach to test for bacteria and they also tested me for hyperthyroidism, which might explain why I'm having trouble gaining weight (though I think it's just not being able to eat properly). Damnen says I asked her several times if they were testing me for hyperthyroidism (I vaguely remembered them mentioning it), she confirmed they were, and on the ride home I told her that they were testing me for hyperthyroidism as if she didn't already know.

Damnen informs me that before went home, she drove about a block to our general practitioner's office to leave copies of our living wills and advance directives. On the way there, she explained what she was about to do and when we got there, she told me I was going to wait in the car and I said, "Why?" So she explained it again and told me not to let anyone steal me while she was gone. I agreed and said something about keeping the cops from towing the car. When she got back about five minutes later, she says I looked at her like, "It's you! Where were you? Where am I?"

She also says I was very happy the whole time. I guess, then, if I ever develop dementia and short term memory loss, I'll be in a happy place.

Just now, she tells me that I did initially remember the tube going down my throat and that it hurt, but I was glad it hadn't made me gag. She says that as time worn on, though, I seemed to forget about it, so she let me, since that was the part I'd dreaded the most. I kind of vaguely remember the doctor saying he had given me something to kill my gag reflex.

When we got home and were getting out of the car, I remember thanking her for being there for me. I was afraid I might have forgotten to let her know I was grateful for her. But no, I'd apparently thanked her several times already. At least she'll never have reason to doubt my gratitude, I guess.

Oh, and I had the best apple juice in the world, or so I said. I remember them giving me apple juice to drink afterward. Actually, I remember them throwing a list of options at me and apple juice was the only thing I could clearly remember them saying, so I went with that. But Damnen tells me that I actually said ginger ale sounded delicious, but I remembered that the diet forms they gave me said to eliminate carbonated beverages, so I asked to hear the list again and when they didn't have orange juice (which I'm also not supposed to have), I went with the apple juice. And I was just thrilled about it. It was the best apple juice I'd ever had. So delicious! Damnen says she took a sip of it later out of curiosity, but just found it to be overly sweet.

She really should have asked me some incriminating questions. Or at least some strange questions. I bet my answers would have been hilarious.

My stomach as been really good to me this past week, which left me worrying they wouldn't find anything at all, but they did. So here's the results:

Reflux esophagitis and hyperacidity, mild irritation from acid reflux, mild gastritis, biopsy taken to check for bacteria, blood test for hyperthyroidism.

Bearing in mind that my stomach has been much much worse in the past, I guess it's finally healing up.

I'm to avoid citrus and citrus juices, tomato products, coffee, alcohol, chocolate, peppermint, and spearmint. I should stop smoking or markedly reduce how much I smoke. We should prop up the head of our bed. I'm to discontinue all forms of carbonated beverages. I can no longer take aspirin or NSAIDS. I should take antacids as needed 3-4 times a day.

I really dread cutting out my tiny morning glass of low-acid orange juice... and chocolate. Oh, I shall sorely miss my chocolate. But perhaps these will be only temporary restrictions until my stomach has fully healed. I have learned to live without coffee (and I was drinking it for the taste, not the kick), but I still miss it. I'm not sure I can live without chocolate.

Anyway, that was my big adventure and now I'm off to do other things.

My endoscopy is scheduled for 10:45 tomorrow (or today, depending on how you view these things). We have to be there at 9:45 for all the intake and prep. The actual procedure will only take between 5-20 minutes, depending on what they find, if anything.

I sincerely hope they find something. I'm tired of all the tests showing nothing and the medications working for a couple of months before I relapse again. A diagnosis would be wonderful. But I'd still like the first words I hear to be "It's not cancer." I may even tell my doctor that.

I realize the chances that it's cancer are rather slim, but I cannot forget the sheer magnitude of cancer that runs in my family. Granted, most of the cancers form later in life with few occurring before the mid-forties, but it still worries me. To give you a general idea, here are all the people cancer has taken out in my family thus far: Grandfather (stomach/duodenal), great grandfather (stomach), great aunt (lung, never smoked), great grandmother (primary brain tumor)... I feel like I'm forgetting someone.

Some have survived. Mim successfully beat cervical cancer years ago and metastatic melanoma more recently. Another living family member had cancer removed from a part of her body that I will politely not name aloud and she's fine. I had pre-cancerous tissue removed from my cervix almost 20 years ago. One of my father's sisters had cancer of the jaw. I still feel like I'm forgetting someone.

With that much cancer in the family, no matter how unlikely it is that I have cancer right now, it remains a concern.

I suppose it is needless to say I am a little nervous about the endoscopy. But my anxiety has more to do with the procedure itself, than the risk of a cancer diagnosis. They are going to shove a tube down my throat, and while this is certainly less invasive or physically devastating as major surgery, it still squicks me. And there's always the risk of complications, however rare. Mostly, though, I am nervous about being knocked out. I really dislike anesthesia, so much so that I have had tubes put in my ear with a local anesthetic, even though my eardrum doesn't numb up. I felt everything they did and just gripped the bed rails and held still. It was preferable to being put under, in my opinion.

But when they are planning to shove a tube down my throat, I would rather not remember that, so I will take the sedative. It's a "light" sedative, but one that I hope will wipe my memory of the procedure. The twilight sleep that they use at the dentist's office completely knocks me out, so I have hope this will be no different.

I think my fear of anesthesia started when I was about 10 or 11. I was getting another tube placed in my right ear and they used a general anesthetic. Only, it didn't knock me out quickly. I took deep breaths and counted backwards, but just as I was starting to drift off, I panicked. I opened my eyes, but instead of seeing a room full of people, I saw white static like a television tuned to a dead channel. In the middle of the static, a circle formed and began to spin wildly. On the outer edge of the spinning circle was a silhouetted, winged figure that at the time I thought of as an angel. The angel was holding tightly to the edge of the spinning circle, fighting against the inertia. And the last thought I had before the anesthetic took hold was, "I could die right now."

It was my first real acknowledgement of mortality and it still bothers me to this day.

In other news, the neurologist found no evidence of a Chiari malformation of my brain, so my headaches are still assumed to be common migraines unless proven otherwise. Once I have one, I will take the migraine medication - if it works, we have a diagnosis and if not, we look for another cause.

And now that I am past the point when I am allowed to have food or drink, it's probably a good time to go to bed.

I have long had my suspicions, but now it is official: I am allergic to the world.

I got an allergy test done today at the behest of my ENT, as he thought there might be a chance that allergies were hindering my Eustachian tube from functioning properly.

I know I am allergic to something in water, as I break out in hives every time I take a shower. I know I am allergic to something in rat and horse bedding, as again, I break out in hives when exposed. I also know I am severely allergic to something that grows in Norfolk, VA, and on Chincoteague Island, so I wanted the test done in hopes of figuring out what it is, as I am afraid it may grow here in the Northern Virginia area. As for the test, I figured I was probably allergic to ragweed and a few of the tree pollens.

But no. I am allergic to everything. EVERYTHING. I had a strong reaction to everything they tested me for: ragweed mixture, grass mixture, politics, English plantain, taxes, tree mixture, elm mixture, reality tv, eastern cottonwood, clowns, oak mixture, dog, gorilla, house dust, dust mites, drama, cats, feathers, helminthosporium, pullularia, common molds, children, and grass smut.

I may have made a few of those up, but their inclusion accurately represents my feelings on the matter. Not the grass smut, though. That's really an allergen; it just sounds dirty.

Looks like I will be scheduling weekly allergy shots in the near future. And who knows, maybe I will see a dramatic improvement in quality of life, but I doubt the shots will be effective against politics.

I've been trying to write a bit on one of my books tonight, but it's slow going. I am far too easily distracted.

Christmas was lovely, aside from all the driving. In Springfield we hung out with the cats and their wrangler, visited with Sarah, and Dave and Emily. Then we drove to Lexington for Christmas with my family on the Eve and to Ashland for Christmas with Damnen's family on the Day. Both were pleasant, though we arrived a bit late in Ashland. Our nephew had already been up for hours and opened all his gifts, so everyone else did the same. By the time we arrived, only our gifts remained and those we brought for the family.

We got gift cards to Kohl's and JC Penny's, which we will probably try to use before the end of the week, so we can take advantage of the sales. I need some new jeans and Damnen needs a new pair of black pumps. We also got a book of poetry, scent diffusers, some neat ornaments, and a set of dishtowels and cloths. I got new boots, which were needed. They are my usual Carolina Poleclimbers and they are so much more comfortable and quiet than my old pair, which had developed an obnoxious squeak. I got a drill, too, that is more powerful than the one I currently own. We got a gas card, but that got used on the drive home. Damnen got the most hilarious book: All My Friends Are Dead. It has a dinosaur on the cover. I also got a David Bowie cd and dvd. I'm probably forgetting some things, but that does not mean I appreciate them any less. It just means I am tired.

My favorite gift, though, was a camera from Dave. He gave me one of his old point and shoots that he wasn't using anymore. I am thrilled beyond belief. It is the one gift I really, really wanted, but didn't ask for because there were other, more important things that we needed. But I missed having a camera and now I have one again. I have taken scads of pictures already, that I will get around to uploading to Flickr as soon as I get a power strip. Right now, the only free outlet is too far away from my computer. I am amused at how stupidly happy I am to have a camera again. I barely put it down the whole time we were visiting family and driving from place to place. Dave, you have my most profound gratitude. You are truly a gentleman and a saint.

I did not have it in my hand, though, when we were driving the first leg of our journey home from Ashland to Reston. The roads weren't great when we left on Sunday, but they were decent. Damnen and I had decided to sleep in a little, drive halfway home, and get a room at a hotel using her rewards points saved up from all the business travel she did over the summer. That decided, all we had to do was get to Morgantown and enjoy an evening curled up in bed watching tv. At about the 24 mile marker on I-64 heading east, while I was using my phone to reserve our room, I realized absently that Damnen was muttering things like, "Oh my god," and "Oh no," and "Oh, shit." I looked up and she was staring into the rearview mirror with her hand over her mouth.

Here's what she saw: There was a car behind us going faster than we were. It was about to pass us, when the driver lost control on the slick road. They fishtailed, then turned completely sideways sliding toward us. Damnen kept going to keep them from hitting us. Then, the car caught traction while they were still sliding sideways, which propelled them into the hill on the side of the road, where they flipped over. Damnen is pretty sure they landed right side up.

We pulled over about a quarter mile up the road and called 911. By this time, several other cars had pulled over to assist, so we waited until the cops showed up a few minutes later and drove on. I tried to find a news article about the wreck in the West Virginia news, but there was nothing, so I hope that bodes well for the driver.

I'd like to say the rest of the drive was a breeze, but it wasn't. There was a snowstorm just sitting over West Virginia, so as the drive worn on, the road conditions deteriorated until we were cruising along at a nerve-wracking 40mph because the roads were snow covered and slick, if you could see the road at all. Most of the other drivers were going much faster, of course, because they are immortal or something. We saw one guy who had passed us a while earlier sitting in the median facing the wrong way, surrounded by cops and a fire truck.

But we finally made it to Morgantown, found food and our room and enjoyed a quiet evening watching tv. The next day's drive was cake - the roads and sky were dry and clear.

We were a bit strapped this year, so I gave out several drawings and books of poetry, which seem to have gone over well. I drew a picture of my nephew sitting on my mom's Basset Hound for my mom and portraits of my sister-in-law's daughters for her.

And it's a good thing we saved as much money as we could, because when we got home, our dear Fathead was leaving lots of tiny pee-balls in the litter box, very unlike his usual humongous pee-balls that make me wonder at the apparent size of his bladder. We took him to the vet today and he has a bladder infection that we caught just a day or two before he started forming crystals, which would have complicated things and been very painful for him. He is recuperating and has a 2-week supply of antibiotics to take. We have a wallet that is about $217 lighter for it. But we shuffled some money out of the Gas Fund to cover what we were short in the General Budget and I think we'll be fine until the next paycheck, barring any other unforeseen catastrophes.

And one more thing - a while back and on at least two occasions, a guy with an air rifle has been trespassing at the abandoned house next door to us in Springfield. I've called the cops every time I see him, because he appears to be shooting at the cats. I hadn't seen him for a while, but our Cat Wrangler says he came back the other day and apparently shot our ashtray and took a shot at Flop. Not cool. He called the cops, but they didn't do much. That just pisses me off, but I don't know what more we can do besides call the cops every time he shows up and hope they catch him before he shoots one of the cats.

And now, I will go write on other things.

I saw a breast surgeon today, but not for the reason I would like. I've had bilateral breast pain for the past three or four months. The mammogram showed nothing, so no cancer, at least, but also no explanation for the pain. The surgeon was a wonderful doctor (I really wish she was a general practitioner), but she had no explanation either. There are no cysts or masses or anything. She says it could be three things: breast pain with no discernible cause, muscle pain in my back that is radiating around to the breasts, or lowering my T dosage last year may be causing some regeneration of breast tissue and it just happens to be painful.

For now, she has prescribed evening primrose oil, as it apparently helps in some cases of breast pain, and wants me to follow up in three months. She said, if nothing else, we'll keep an eye on them and make sure it doesn't develop into something more. She also did a breast cancer risk assessment and my risk is only 11% - pretty low.

I'm a little disappointed that I don't need surgery for cysts or the like, but I'm not sure it would matter at this point. I don't feel healthy enough for such a major surgery right now. Nor do I think we could afford to pay what the insurance doesn't cover.

On Thursday, I have a CT scan scheduled to look at the temporal bones of my ear and check for a cyst. In the meantime, I was able to take a 2+ hour nap today laying down and did not wake with the spins. I also don't feel as much of the disequilibrium as I have for the past week or so. This recent bout of labyrinthitis may have passed, but it is still important to check for damage to the inner ear. The damage could be as much from the labyrinthitis as the chronic otitis media caused by the dysfunctional Eustachian tube. I never realized it might have been damaging my ear all these years - I just considered it an inconvenience. But so far I do not notice any more hearing loss than I already have, which is good. If I don't wake up with the spins tomorrow morning, I will be ecstatic.

I still need to reschedule the endoscopy, but it's been difficult working around the holidays, the doctor's schedule and Damnen's schedule, since I will need a ride home afterward. I expect I won't be able to get it done until January.

The neurologist says I probably have common migraines (i.e, pain, but none of the "classic" symptoms), but he wants me to have an MRI to rule out a Chiari malformation, wherein the tonsils of your brain are crowded into the spinal canal. It is a rare condition and he believes it is unlikely that is the cause of my headaches, but he wants to rule it out just to be safe, since any kind of strain during my headaches makes my brain pound at the back of my head. I've got the MRI scheduled for the 27th (kind of excited to see my brain, actually), and the doctor gave me some samples of a migraine medication. I'm take them during the next headache. If it goes away, then they are migraines, and if not, we'll look for other causes. I have a follow up with him scheduled for January 7.

I am starting to feel like a hypochondriac and have to keep reminding myself that I am just finally taking care of health issues that I've been putting off for years. The headaches have been very real for 21 years. The chronic otitis media has been real since my childhood. The breast pain was concerning because it might have been cancer. And the nausea has got to go away already. The mitral valve prolapse was a surprise and not something I was looking for or concerned about.

So really, I was initially only looking for answers about four conditions. That's not that much, considering I haven't had insurance in four years and couldn't afford to use the insurance I had for the three years prior to that. It's just that these doctors are extremely thorough, so they are ordering a lot of tests to rule things out. And that is leaving me a little overwhelmed.

I was also worried for a bit that my enthusiasm about the tests was a sign of hypochondria, but I'm pretty sure that's not the case. Upon further reflection, I realize it's a consequence of being curious and loving knowledge. I mean, I get to see my brain. That is cool. It is also really cool to get to see the inner workings of my ear and the insides of my breasts. Even the sonogram of my heart was fascinating, if a little chilling to see it beating in real time on a screen. I don't think I'll get to see any of the endoscopy, since they'll knock me out for it, but I'm okay with that seeing as I'll have a tube down my throat. I don't really want to be awake for that.

And on that note, I should probably stop being awake now.

Back in April or May, I came down with labyrinthitis - inflammation of the inner ear that causes vertigo. Damnen was already in Virginia, so I was home alone. I awoke from a pleasant night's sleep, rolled onto my back, and the world dropped out from under me.

I flailed and flopped madly until I was sitting on the edge of the bed. Once upright, the vertigo quickly abated, but I still had that terrifying moment of wondering if I was having a stroke. But I could read the clock and a receipt on the nightstand and my smile wasn't crooked, so I just sat very still and a bit freaked out.

It lasted about 2 weeks or so, during which time I could not look up without my head spinning so violently that my arms flailed of their own accord. I slept sitting up on the couch with a rolled towel around my neck to keep my head from falling to the side. I missed a week of classes because I was afraid to drive, except for the one harrowing trip to the doctor. She prescribed an antibiotic and said to give it time to resolve, which it finally did.

Last week, it came back. Thankfully, it is not nearly so bad this time, but it is more pervasive. Last time, as long as I did not look up, I was mostly fine. This time, I have a fairly consistent feeling of disequilibrium and only get the spins if I lay down for more than a few minutes. It is worse if I lay on my left side, but not much better on the right. So, I'm back to sleeping propped up with a towel around my neck.

Today, I had an adventure going to the ENT to see what can be done about my spinning head. My stomach was bothering me until late in the night, so I got about 3 hours of restless, uncomfortable sleep. The alarm went off at 7am and I managed to drag myself from the bed, get dressed in many layers and trudge out the door by 7:45.

I wasn't sure if I was walking 2 miles or taking the bus - it all depended on whether the bus arrived on time - but as I was walking to the stop, the bus pulled up. I hadn't even stopped walking yet. It was freezing and windy out, so I was thrilled not to have to wait and just hopped on. And as we pulled off, I realized I wasn't sure what bus I was on. I knew I was supposed to be on RIBS 2, but nothing inside the bus confirmed or denied this. I figured there was a good chance that no matter which bus I was on, they would all stop at the downtown hub. But then we pulled up behind a school bus and I saw 2 SBIR reflected in the window.

At the hub, I checked the map on my phone and since I was only a few blocks from the ENT office, didn't bother to transfer to another bus. After about a 5 minute frozen and wind-blown walk, I arrived at the office a full 45 minutes early. Lovely. But not to fear, I brought a book! I just didn't look forward to 45 minutes of a runny nose with no tissues or restroom facilities in sight.

Ten minutes later, they called me back. I had wanted to schedule this appointment last week, but the receptionist said the vertigo test took a while and Monday was the earliest availability. So, I was a little dismayed when the doctor proceeded to just ask questions and request I get a CT scan to check for a cyst in my inner ear. There was no test. Granted, it may be because I have a history of chronic fluid in my inner ear and labyrinthitis, but had I known there would be no test, I'd have insisted on a much sooner appointment. He did prescribe an anti-vertigo medication at my request, though, so I might sleep comfortably tonight.

The bus ride home was relatively uneventful, except for the woman who kept waving her hand in front of her face and covering her mouth like she was about to vomit. My stomach was already upset and that did not help. Still, she didn't spew and got off way before I did. I tried to think happy thoughts.

Back at home, I realized the major flaw in this plan. You see, Damnen had to be at work today. She was going to leave me the car, but I didn't feel safe driving and said I would walk or take the bus. And that is what we did. And it would have been perfect except for one thing: I do not have house keys and when I returned there was no one home.

Of course, I didn't have the number of the one roommate who might be back at a reasonable hour, so I called Damnen. She said she would call the roommate and get an ETA for me. In the meantime, I realized that if the roommate hadn't locked the deadbolt, I could probably still get in. I whipped out my road emergency services card, prayed nobody noticed and called the police, and jimmied the lock. I cannot say I came by that skill honorably, but it has come in handy more times than I care to count. Success! The deadbolt was not locked and I was inside before Damnen could call me back to say the roommate hadn't answered her phone.

So now I need to schedule a CT scan. As soon as the vertigo is resolved, I'll reschedule the endoscopy I canceled the other day. I really don't want to put that off, but it requires I lay on my left side which I can't do without getting the spins.

Finally, the roommate returned home about five minutes after I'd gotten in, so at least if I'd been stuck outside, it wouldn't have been for long.

I never fully appreciated the difficulties of dealing with a chronic illness until I had one. I've had and still have friends who have been seeking diagnoses and relief for years, and it's not that I didn't believe them, but that I could not understand. Until going through it myself, I never truly understood the toll it takes on someone's life. And not just their lives, but the lives of those around them, as well, who watch and worry and wring their hands, unable to help.

It just wears you down as it drags on and on and slowly strips away hope and optimism. The only way I can deal with it is to try very hard to forget about it in the times when I am not nauseated. But because the nausea is tied to the pressing need to eat, it is hard to forget for very long. Still, I've learned to do it. It's almost a form of denial.

It is frustrating not knowing exactly what is wrong with me. Frustrating because I can't predict anything except that eating may nauseate me. Frustrating because at this point, I am afraid to eat much of the time. I am continuously torn between hunger and the potential of being nauseated for the next few hours. I have to carefully consider what and when I can eat. Some foods I know will upset my stomach and those I avoid. Others only bother me sometimes and then I must consciously decide if it's worth the risk to eat. I supplement my diet with foods that are generally safe, but that means I am a 36 year old man living on a diet consisting primarily of granola bars, Balance bars, and peanut butter crackers.

That constant potential for nausea means I must plan my day around when or if I eat. If I want or need to go out, it is best not to eat. It means I go hungry, but at least I can go out and enjoy myself and get things done. Otherwise, I find myself stuck in a car or a grocery store while my guts churn, or sitting at a table with friends while the smell of their food turns my stomach and I struggle to be polite and sociable. Sometimes, though, all the careful planning backfires. Megan and I were going to go out tonight, but my stomach had other plans, even though I'd only eaten a Balance bar all day. We stayed home and watched a movie instead.

I am equally frustrated at having very little to talk about anymore that does not deal with my health. When people ask me what I've been up to, all I can say is, "Not much," because I do not want to bore them to death with a rundown of all my doctors' appointments. I don't want to have to say to them that all our plans have been waylaid by my stomach. I don't want to say that we had planned to go to a museum this weekend, but I wasn't feeling well. Or, we were going to go to the DC Trans Coalition meeting this evening and get registered at the transgender clinic so I can get back on testosterone, but I was too queasy for such a long drive and meeting, so we stayed home.

I feel like a broken record, just repeating the same complaints over and over again. Ad nauseum, if you will.

I also understand now the importance of a diagnosis. It is bad enough that I am ill, but worse that I have no name for the cause of my illness. I do not know what is wrong with me. There is a lot of frustration and fear in that uncertainty. I know my symptoms, but without a diagnosis, I cannot know what to expect in the future. Will it get worse or spontaneously disappear? Will I ever gain back the weight I've lost or will I eventually starve to death? Will I ever find relief from this nausea or do I need to accept it as a permanent part of my reality and deal accordingly? If it is cancer, will we catch it soon enough? Even if it turns out that I have an incurable disease that I must manage for the rest of my life, just having a name for it would be a form of reassurance. I worry sometimes it is all in my head.

But on the other hand, there have been some benefits and I try to remind myself often. It has helped me get over my long-standing fear of nausea and vomiting. Years ago, being nauseated always resulted in a panic attack. Now, I've learned to work around the nausea that used to paralyze me and leave me unable to speak for fear of gagging. Back then, I would sit trembling on the couch, desperately changing channels on the tv in search of distraction or pace the room in obsessive circles. Now, I just deal with it and get on with my day as best I can. I have learned to speak while queasy, and do laundry and housework, grocery shop and attend class, bend over to feed the cats and clean their litter boxes. And sex - I've even managed sex a few times while queasy. It's not ideal, of course, but after a week of queasiness, I start to miss my wife.

When I'm strongly nauseated, though, I usually find myself mute and back in front of the tv or the computer. Can't win them all, I suppose.

And while suffering through this for two years has been stressful on me and on Megan, it has made us both feel very secure about our relationship. She is infinitely patient with me and never judgmental. Not once has she ever gotten angry with me for feeling ill, even though I know it frustrates her at times. She tells me as much and I want her to tell me, especially if getting it off her chest helps her cope. More than that, she puts up with me when I've had enough and turn irritable and short-tempered.

She has never made me feel guilty for being ill, either. I'm not sure how I can hold a job outside of the home while I am sick like this. I already know that my school work suffers greatly, so I am not returning to school until I am well again. Even my writing has suffered and I have gotten very little done in the past two years. While I do what I can to keep the house clean and in order, I still feel lazy and unproductive, but never once has Megan ever accused me of mooching off of her or not pulling my own weight. Instead, she thanks me for doing what I can do.

But more than that, the simple fact that we have weathered two years of this without any animosity restores my hope and optimism. I do not worry about us. I adore her more every day and implicitly trust that she will be there for me no matter how bad it gets. That's a good feeling to have and it goes a long way toward making the nausea bearable while I wait to find out what's causing it. In some way, it amuses me that I am sick and kind of miserable much of the time, but ultimately happier than I have ever been in my life.