I had a sclerotherapy procedure on Friday afternoon last week.

On my lower, right leg.

Today is Saturday now (last week), and it’s going well.

I’m sore, for sure.

And a bit swollen.

I had to limp a bit on my walk with Brucie today.

But I remember through the haze of the drug cocktail, that John, the ultrasound tech, said the procedure was successful.

I have a follow up ultrasound on Thursday this week.

Which I hope will go well too. 

(it didn’t go well at all.. I talk about this at the very end).

Right now I have the bandage on still, and I can’t take it off till tomorrow evening.

If I would’ve remembered that part, I would’ve showered yesterday just before the procedure.

But I didn’t.

Oops.

Thank goodness it’s the weekend and I don’t have anywhere to be!

I thought I was coming around the corner with that last psychotic episode.

But I’m still hearing voices.

I guess that’ll never stop though.

But they are a bit fewer.

Yet, I’m feeling all over the place, mood wise.

I’m still anxious as fuck.

But I think that’s from my benefit renewal next month.

My anxiety feels like it’s in my fucking throat.

Ready to pounce into my brain, and take over my body at any second.

And I’m sad.

I’m just really fucking sad.

And I haven’t really been that sad on my Duloxetine yet.

The past year or so on it has been really quite nice.

So, I’m hoping it’ll pass.

I still have some wiggle room on that med, but I don’t want to go up on it.

I really don’t.

I think it’s just part of coming out of this episode from April and May.

I think it’s just part of the after-affect of it is all.

At least, that’s what I’m hoping.

It’s now Monday and I had my primary care appointment today, and I cried the whole way through it.

She already knows about my weight issues – we’ve talked about them in length.

But we talked today about my binge eating, my disorganized eating, and how I realized that’s what I’ve been doing this whole time.

We talked about how relationships with people are hard, and how they impact what we eat even.

She told me that I need to have circles of trust with people.

It starts with a small circle around me, with folks that I trust 100%, with my life.

The next circle is a bit bigger, with people who I trust, but they’ve been known to bail on me from time to time.

The next circle is even bigger than the last, with people I don’t trust nearly as much, or maybe don’t really trust, but they’re still in my life.

Then the very outside circle, the one that extends into eternity, is full of folks that I don’t trust at all, and they’re not in my life.

I like that way of looking at things.

It’s easier than the muddled picture of things I had in my mind.

This helps me sort people a bit better, helps me organize things.

I swear, our visits are not only primary care visits, but mini therapy sessions as well.

I seriously love my primary care doctor.

She’s so amazing.

And then we talked about medications.

And I asked her, because she said that she can’t prescribe Ozempic to me because I’m not diabetic, then how come so many people are on it?

She said they’re on the “compounded” brands.

Aaaahhkay.

The kind you can get through an online visit or a different doctor.

She said to go through the office I’m at, my primary care office, they don’t have much of a choice on the bracket, or type, of things they can prescribe, and their only choice is for when the patient is struggling with type 2 diabetic issues.

So, that made sense to me.

I’ve seen that on all the commercials, they do talk about Ozempic, or the other brands, being “compounded”.

So, I’ll have to let that go, because all of that is self-pay.

We talked about my Propranolol, “Extended Release” and how well that’s been working for my anxiety.

I told her I still need to take the 20mg’s, “Instant Release” tablets from time to time, usually when I’m having a panic attack.

It’s extremely helpful at reducing some of my anxiety symptoms.

At least, getting my heart rate down to a tolerable level.

She asked me how the Topiramate was going for my appetite suppression.

It’s going okay.

(it’s now Tuesday) We just upped it to two full tablets a day, one in the am, one in the pm, on the 12th of July.

And I looked it up, because I felt that just Monday afternoon and evening it started to kick in, and sure as shit, Topriamate takes five days to come to full potency in the body.

Because on Monday, I realized, I sorta felt full all day – and my primary care appointment was at like 10am, so I didn’t notice while I was there, I noticed in the afternoon.

I didn’t eat nearly as much as I have been eating.

It was an interesting feeling.

It sorta cut out the desire to eat – the “food noise” even died down.

I wasn’t even thinking about food.

I wasn’t obsessing about it.

I wasn’t planning around it.

It wasn’t in the background either.

I hope that wasn’t a fluke.

It’s only noon on Tuesday, so we’ll see how today goes too.

We’ll see about when 6pm hits.

But I’m hoping it’ll be the same.

I looked at the visit notes today, from my primary care appointment yesterday, they had posted overnight.

I had to google a couple of things.

She had put in there that I had “tachycardia”.

Because they do an EKG on me every year, and just did one in May again.

I’m not sure if she caught it on the EKG, or if she’s going off of what I’ve told her from my smartwatch data.

But I am on a high dose of Propranolol ”ER”, and my blood pressure is normal now – it’s not high anymore.

So, maybe that’s a factor too, I don’t know.

I do need to schedule an appointment with a cardiologist, my primary care doctor has mentioned this out last three visits.

I’m sure when I do, they’ll schedule an Echo.

Well, they’re supposed to schedule one.

I was told at the age of 18 to have one scheduled every 4-5 years after I turned 18.

I used to have to get them… I think every year growing up?

I could be wrong, it could’ve been every other.

But there were a lot of them, I remember.

The reason why is that I was born with pulmonary valve stenosis (PVS), it’s mild.

But I still need to go through the tests and imaging every so often to make sure nothing has changed and everything’s still good to go.

It is what it is.

But I think my primary care doc is encouraging me to see my cardiologist because of all of this.

And because it said “Possible right ventricular conduct delay”, which, I googled, and it is related to pulmonary valve stenosis.

Like, that’s what PVS is, a right ventricle delay.

So, I’m sure my primary doc is just being cautious by making sure I get to the cardiologist soon.

But I understand her concern.

She knows I have a congenital heart condition too.

I’m sure she’s just covering her bases (and ass).

But everything else in my chart was easy to understand.

And sort of sad.

My whole chart is anxiety ridden.

Just full of anxiety and depression.

She told me on Monday that she thinks the Abilify should be lowered to 2.5mg.

She said she hasn’t seen me cry this much in a long time and can’t help but notice the correlation between me crying a lot and the adding in of the Abilify.

I told her I’ve been crying a lot since before the Abilify too.

I told her really, since the airbags deployed in my old car, I’ve been having a terrible time with my anxiety and depression.

I told her that since then, I’ve been on high alert, and thing after thing has been happening.

I told her I’ve just been having a hard time lately.

She told me that she just doesn’t want to see me so sad.

That I’m a good person, and I deserve to be happy.

Which made me cry more.

It’s now Thursday, and I had Hannah yesterday and we also talked about how the Topiramate is doing.

It’s now been a few days since the second, full dose kicked in full force.

And I have noticed a positive difference.

Like I said earlier, I’m not obsessing over food as much this week.

I noticed I had the urge to go to the 7/11 and buy some candy bars, but the more I sat and thought about it, the more I realized I was full.

I made some Banza chickpea pasta the other night, and had to put half of it away because half way through, I literally lost interest.

Which has never happened to me.

I’m still the hungriest after 6pm – really, after 8pm.

But I’ve been noticing that I haven’t been eating as much later at night this week.

I’ve just been eating one thing, as opposed to four things.

And that’s a huge step in the right direction.

I just didn’t think that the Topiramate would really do anything.

I mean, I noticed a bit of a difference when she upped it last time, but not this much of a difference.

This is big.

I’m losing interest, which is huge.

Actually, you know what?

I did that yesterday too…

I was eating apples and peanut butter and put half of it in the fridge.

It’s still there.

Damn.

That is big.

Peanut butter is good for you, but it’s calorie dense.

I seriously am amazed that I’ve been doing that – and I didn’t even notice that I did it again yesterday.

Wow.

I’ve noticed the type of hunger I have is different too.

It’s like, it’s coming from a different place.

It’s like, it’s deeper down than the hunger I was having.

And the fullness isn’t a “stuffed” feeling, it’s just… full.

It’s weird all around.

I’ve been listening to this audio book “The Hungry Mind: Rewriting the Story Between Food and Feelings – How to Ditch Diet Drama, Change Habits, and Heal from the Inside Out.”.

And the author talks about how the hunger from stress, and binge eating comes on quick.

Like, it comes out of the blue, and with a snap of the fingers, you’re suddenly starving.

And how you’re never full when you’re stress/binge eating.

How the brain gets literally wired to seek out food when that’s what you’ve been using as a form of stress relief/emotional relief, because the human brain is wired to seek out what’s comfortable and easy in times of high alert and high stress.

The author went into what it feels like to actually be hungry – which, I guess I’ve never realized the difference.

I’ve thought about it before, and I’ve wondered if this is stress talking, or if this is actual hunger.

But she talks about how you’re going to feel maybe down, a bit drained, you may have a rumble in your stomach, you may even feel a bit light headed when you’re hungry.

And then she said when you’re actually full, you’re going to feel content, not stuffed, not uncomfortable, not frustrated with yourself, not embarrassed, or shameful, you’ll have a sudden burst of energy, and that drained feeling of hunger will dissipate.

It’s a great book because the author talks a ton about how it’s not my fault.

That it’s literally a wiring issue that I need to work on, and rewire in my brain.

It’s something I can change, with a lot of work.

But she also said the urge to binge eat will probably always be there – it’s how I accept, and look at that urge that matters.

That being mindful is what it comes down to.

And she said being mindful doesn’t mean eating super slow, or changing what you’re cooking.

It means taking away any labels of “good” and “bad” foods, and just being more aware of the amount and kinds of food that you’re putting into your body.

And it’s a bummer to know that the binge eating thoughts will always be there, ya know?

I figured as much, because just like using drugs, the urge comes and goes.

It just lessens over the years, the further away I get from it.

So, it’s more of the same stuff.

The hunger pangs and fullness queue changes are interesting though.

The Topiramate has changed them, for sure.

I found this little blurb if y’all are interested in Topiramate and the weight loss effects it has – it goes into some detail about how it works in the brain.

It’s funny because my primary care doctor really put me on it for my migraines.

I mean, she was hopeful it would help with appetite suppression too, we had that talk as well.

But originally, she had put me on it for my headaches, mainly.

And it’s helped a ton with that too.

Since starting it, I haven’t had to take my breakthrough migraine medication.

Which is wonderful, really.

I’m just so glad that something is finally curbing my appetite a bit.

So, now, to talk about one more thing before the end of this entry…

My follow up ultrasound from my Sclerotherapy last Friday…

The procedure I was talking about at the beginning of this entry…

*sigh*

I was told Thursday morning, at my appointment with the ultrasound tech, at my pain management doctor’s office, in San Antonio, that I basically had the Sclerotherapy “foam” in a good vein, in my right leg, from last Friday’s procedure, which is NOT good.

He told me suddenly, with an unpleasant, almost agonized face, that I was going to have to be put on blood thinners.

I was like wait, what?

I started crying – wispy crying, not full blown.

Because foam wouldn’t spark that kind of response.

And I noticed the imaging session had been cut very short, that he hadn’t gone down my entire leg yet, so how did he know what I needed yet?

And I tried to ask him why I would be put on blood thinners – why would that happen?

And he kept dodging and weaving my questions.

I started crying a bit more.

He just kept telling me that the “foam” had gotten in the wrong place.

He was reluctant to talk to me, and had called Dr Zoch to talk to him several times with no answer on the doc’s side.

Finally, about five to ten minutes later (which felt like forever) John, the tech, was talking to Dr Zoch in the provider hallway, several times over, so I couldn’t hear him.

The whole process was about twenty minutes, half the time I was on the bed in the ultrasound corner, half the time I was sitting in a chair, waiting on the next step.

And John has never been this evasive and secretive at any other follow up appointment.

And I’ve had about a dozen, literally, with all of these vein procedures over the last year.

He finally came back out and said rather matter of factly that yes, I needed to be put on blood thinners, Dr Zoch wants me on them, but he can’t prescribe or manage them, so first I needed to go to the ER.

Wait, what?!

Now the ER is involved?!?

I started crying a bit more.

He said that I need a second opinion ultrasound to start, and because Dr Zoch can’t prescribe or manage the blood thinners, the ER will help me start them and get me on track until I can see a doctor that can manage them.

I asked him if I should go to the ER in San Antonio, or go back to my town, and go to the ER there.

Like, how concerned should I be?!

He said that I “should be fine” until getting back to my town, roughly 30 minutes away.

Should be.

Geeze-o-petes.

Should be.

I had already been crying when he got off the phone again, but now I started crying for real.

He said that he knows, and that he’s super sorry, and he knows this is scary, and he’s sorry that this is happening to me.

He asked me if I wanted a hug, and I said yes.

And he hugged me like a bear, and I cried more.

I asked him if I could take anything to the ER paperwork wise, because I didn’t really know what was going on, and there’s no way I could remember anything by the time I got there.

And he said he was filling some paperwork out now for me to take, and it wouldn’t be too much longer.

I eventually started driving back to my town – in the left hand lane the whole way.

Not speeding, but not not speeding.

It was a long drive and everyone was driving like they had all the time in the world.

When I got back, I noticed on the paperwork he sent with me to the ER, he called whatever it was a “DVT” – or the same as a blood clot… 

I knew what DVT meant from doing hospital registration years ago.

That’s when I really started to panic.

I was already panicking, but this was a deeper panic.

This is basically when my top blew.

Silent tears streaming down my face.

Stuffy nose sounds.

I was texting multiple people at the same time.

Trying to make it feel like someone was sitting there with me.

I do remember too, the triage nurses, when I was checking in, they said that I’m not showing the physical signs of the blood clot being in my lungs or heart, so that’s a good thing, and for me to remember that, and that it’s very treatable.

I’m not having any shortness of breath, or very much pain where the clot is, and those are all good signs.

Whoopee. 

Fuckin awesome.

I’m still freaking the fuck out because I have a fucking blood clot in my leg.

But I sat in the ER waiting room for hours, crying most of the whole time.

About five or six hours I was in and out of that waiting room all together.

They didn’t have a room available for me or a few other folks, so they kept bouncing us back and forth between this chair in the ER, and the fucking waiting room.

So, I got called back, the ER did bloodwork on me, I got to sit there for about 15 minutes, then I got sent back to the waiting room.

Then, someone came and brought a wheelchair, and they wheeled me to a room where they did a second ultrasound, then wheeled me back to the waiting room.

Hours and hours apart from each other.

I spent easily an hour and a half after the second ultrasound to wait for the doctor to come get me and give me the results.

They finally pulled me back, and gave me the ultrasound results of this being a legit DVT, a legit blood clot and I fucking freaked out.

Remember – John had given me the hopes that this was just “misplaced foam”…

Well, I started balling and my glasses fell to the floor and I asked the doctor a billion questions and I can’t remember any of them or the answers right now.

I just remember he pulled up a chair to be eye to eye with me.

I just remember him being very kind.

I remember him being soft spoken.

I remember him telling me he didn’t have all the answers and needed to speak with a cardiologist.

I told him I have pulmonary valve stenosis.

I told him about everything and I was so fucking terrified – I still am.

And then, they were trying to decide what to do with me.

The nurse told me they’re debating keeping me overnight, and were going to make a decision whether to keep me or discharge me fairly soon.

That ended up being about an hour and a half, two hours later. 

In that time, Dr Zoch, my pain management doctor called me.

He actually had to call me twice because I don’t answer numbers I don’t know, but he called me right back after I ignored the call.

So I figured maybe it was actually someone who wanted to talk to me.

So, we talked for a bit.

He told me he was so sorry that this happened, and that this can happen sometimes with Sclerotherapy, even though my procedure went seamlessly and by the book.

He said that this is exactly why we do follow up ultrasounds after those procedures, you never know what you’re gonna catch.

He kept telling me how sorry he was.

I kept telling him that I’m scared and I don’t know what all to do.

He said that the blood clot was caught early, and it’s only half something… hardened basically… 

He said that we caught it so early that it should be able to be broken up by the blood thinners rather easily. 

(now I just have to be hopeful that I don’t have a clotting disorder)

And then thankfully, the ER doctor just prescribed me, then called me back again, gave me the first dose of Xarelto when I was about to be discharged, and then I was discharged.

Well, before I was discharged, I had to find my medication first.

The first pharmacy he called it into – they were out of stock.

Same with the second.

It was a nightmare finding a pharmacy that had my blood thinner in stock.

So that was a thing for a minute as well.

They wouldn’t discharge me until I found a pharmacy that could fill it and have it ready that day.

So that was another hurdle.

But luckily, it worked out.

I was finally home after picking up my prescription around 6-6:15pm, after I got to the ER around noon.

On Friday, I had to make some appointments and get a couple referrals to doctors for follow ups.

I have to see a hematologist, a cardiologist, my primary care provider and my pain management for follow ups for the DVT.

Like holy fuck.

Four doctors?

It’s fine, I guess.

It is what it is.

I already had appointments set up with Dr Zoch (PM) and Dr Rocha (PCP) for the first week, week and a half of August.

On Friday I was able to make a Cardiologist appointment on August 7th, with a Dr Remo here in town. 

She had a referral sent already by my PCP, so it was one less step for her to do, so I’ll try her out first, see how we get along.

So I just had to send out a referral request for the hematologist/oncologist.

And the office I requested it be sent to said that they got it, and someone will be calling me early next week to make an appointment, so that’s good.

So, all of that is rolling and in a good spot.

And that’s not all I have to do. 

I’m quitting vaping too.

Quitting the nicotine gum.

I know I have to. 

Fuck my life!

I don’t want to.

I really don’t want to.

But, I seriously can not keep smoking right now….

I just can’t. 

It’s a medical necessity that I stop.

FUCK!

I’m annoyed and angry about it, but I’ll get over it.

I’ll get over it.

Give me a couple of weeks, and I’ll get over it.

Because it’s really, honestly, for the better.

And I know that. 

I know this.

But fuck, man.

FUCK!

It just sucks, is all.

Just sucks.

It’s like all I had left was nicotine and caffeine as my vices.

Guess I only have caffeine left.

Fuck, man.

I’m okay, I’m gonna be okay.

It’s fine.

I just had to vent it out, just had to complain for a second.

All humor aside, I truly am terrified about all of this.

I’m trying really hard not to be.

I’m trying to be strong.

But let Bruce smell my body if I die, please.

Don’t let him think I just up and left him.

Help him understand that I’m gone if something happens to me.

That’s my one big request.

I texted Hannah Thursday night, and then I called her and left a voicemail just now.

It’s Saturday around 12:45pm.

I’d love to be able to talk to her for just like, 15 minutes.

But I understand that she needs her weekend, and needs time away, and I don’t want to intrude any more than I already have.

As I was complaining, she texted me back for a second.

But I’ve gotta calm down.

How?

I’m not sure.

I don’t know.

I have no idea.

-Keren