Healthcare Update

The system might be effed up, but there are people in it who can be pretty awesome. Not long after my last (April 11th) post, I received a voicemail about my health insurance application with the state. I’d gotten fed up with the Healthcare.gov website and applied to my state’s program directly; when I finally received coverage under my birth name I didn’t ask any questions.

Anyways, I called the person back hoping he could resolve my name change over the phone. We played phone tag a couple of times, but within about 2 hours he said he had taken care of it. I received a piece of paper a couple of days later saying I, [my married name], do indeed have health insurance through the state. That man saved me a trip I really didn’t want to take. He’s my hero!

And it gets better. My and Fox’s primary care provider (PCP) is a short walk from our home. It’s a small practice shared by a couple of doctors, a nurse practitioner, and a friendly-professional staff. I didn’t get to see the doctor who’s listed as my PCP, but that’s okay because I really like the nurse practitioner. She prescribed an anti-inflammatory for my upper body pain and suggested I have a sleep study done to see if I have sleep apnea; they should call me by Thursday to set up an appointment. I asked to have blood work done; the nurse who drew my blood was courteous, respected me and my knowledge of my own body, and caused me minimal pain. I left feeling quite good about the whole experience.

The one downside is that I’m still not sure if I need a referral to see a psychiatrist; the nurse practitioner didn’t think I should but suggested I call my insurance to be sure. If I need one I just need to call the PCP and the staff will get me a referral, no problem. Well, that’s a relief!

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Back on the Healthcare (Headache) Bandwagon

Wakana has been urging me to see a psychiatrist, so I’m finally starting to move in that direction (now that I have health insurance, thanks to the Affordable Care Act). I found a local psychiatrist in my plan, but I think I need a referral from my primary care provider to go see her. I was concerned because my healthcare ID cards have my birth name on them, but I’ve updated my social security and driver’s license to reflect my married name. I don’t want to be denied healthcare because of the inconsistency.

So I called my HMO, and had to talk to a machine, and finally got to talk to a person, who gave me a number I’d already tried and gotten a busy signal, then transferred me to an automated health screening. (The person was nice and as helpful as possible, given the bureaucratic red tape.) When asked to rate my overall health, I rated it as “fair” – but the other questions led me to think perhaps it’s a bit better than that. I don’t need the equipment or assistance they specified (though help remembering to take medications might prove useful, and I’d love to have someone come in and help me declutter on some kind of regular schedule). I only answered “yes” to one of the conditions mentioned: symptoms of depression. The thing is, there were no questions about the severity of my symptoms. The only other clearly mental-health related question was “Have you been diagnosed with schizophrenia?” There was no mention of bipolar, anxiety, PTSD, dissociative disorders, or other mental health issues.

After being screened, I tried calling the bureaucracy again and selected the option to talk to a human being. I was forwarded to an answering service, which then disconnected me because the mailbox was full. I don’t know if going through the automated service would have worked better, but think I would have been transferred to a human answering service disconnected anyway.

“Oh, well,” I thought. “I’ll just have to go there in person and deal with whatever stupidity awaits me. I’ll bring water, snacks, and a good book.”

Of course I didn’t feel up to it today. I was barely able to keep myself from crying while I was on the phone, and I’m sure some degree of distress came through in my voice.

The human being I’d talked to assured me that healthcare providers would accept my insurance as long as I had the relevant ID, even though the name on it doesn’t match the name on my state-issued photo ID.

So, I tried calling my primary care provider. Might as well make that appointment, right?

“The office is closed. Please leave a message after the tone.”

I think I’d rather go eat some ice cream…

Let’s Play Skyrim

I had an epic day of being awesome on Thursday, so I was exhausted on Friday. I spent what part of the day I wasn’t sleeping practicing Zentangles and hanging out with friends. Saturday was similarly low-key. After drawing my Zentangle for the day, I was itching to play a video game: something beautiful and epic and new…

So I started a game of The Elder Scrolls V: Skyrim on PC. Next thing I knew, the sun was rising. I took a nap and basically spent all of Sunday playing thoroughly immersed in that fictional world. I’m enjoying the game and want to experience the story, but to be honest there are aspects of it I find rather stressful. Melee combat, for one – especially since the default difficulty was too high for me and I kept dying. I’ve been doing much better since I dialed it down a notch, but I still prefer to avoid melee combat when possible.

The other thing I find stressful is that, whether a character is attacking me physically or not, they’re talking at me. The physical attackers hurl insults that can hurt more than their blades (except that they’re obviously wrong, because I end up killing them.) Other characters I pass might say something mean, ask me for something, or randomly tell me their life story.

Some of the other characters in Skyrim say very mean things to the player character, especially if you’re playing one of the less popular races. The same is true of Oblivion; I haven’t played the other Elder Scrolls games yet, but I imagine they are probably similar. It’s quite unpleasant, and worse I’m concerned that it could have similar psychological effects to being bullied. I know it’s a game and gamers are well aware that it’s fiction and they can turn it off and walk away from it. Most people have a strong healthy boundary between themselves and the character they’ve created. The bullies can’t actually keep them from achieving their real-life goals – or the ones in the game, for that matter. (In other words, it’s quite different from being bullied in real life.) But I’m still concerned that hearing negative talk consistently for hours at a time can be harmful… at least for me.

On the positive side, I just figured out that I can mute the voices and only have subtitles during dialogue (audio and display settings, respectively). It makes the game a bit less immersive, but perhaps that’s also better for my mental health. I guess I’ll see how it goes next time I play.

Now if only we could do that to real-life politicians…

Anyways, as much as I want to just play the game and have fun with it – learning things as I come across them and making decisions spontaneously – my mind wants to plan out a Let’s Play. The most basic definition of a Let’s Play is a video that combines actual gameplay footage with simultaneous audio commentary by the player; it can be a walkthrough, a challenge run, friends goofing off (whether playing competitively or collaboratively), even a talk about a topic that has nothing to do with video games. Fox’s favorite Let’s Player (LPer) is HCBailley.

I love the idea of Let’s Plays and have wanted to do one for a few years now. I had a couple false starts, but on some level I’m convinced it’s only a matter of time before I get one going that I can be consistent with (and get all the YouTube followers!). It’s an opportunity to do some video editing – which I enjoy for the process at least as much as the product – and share my thoughts about the game. I want to share the story, be witty and entertaining, and give a feminist critique.

I’m trying to convince my mind to put the Let’s Play idea on the back burner for now. Let me learn to be consistent with things that are important to my real life before I start a project that requires me to play a long and involved video game on a regular schedule (and in manageable doses). I need to play through the game at least once before I’ll know it well enough to do it justice. I’m still trying to figure out my priorities for my character; something I haven’t encountered yet could inspire me to change my entire focus. So there’s no need to determine exactly how I’m going to introduce myself, what I want to include in the first episode, or how to include the feminist critique without ranting too much. Those things can develop over the weeks, months, or even years I’ll need to prepare for such a monstrous undertaking… and to be honest, I doubt anyone will particularly care about Skyrim anymore by then. It already has a successor.

The thing is, if I think about the game when I’m not actively playing it, there isn’t much to say. I have my character. I’d like to improve my smithing and melee combat abilities. I’m really glad I can mute the voices and determine when subtitles appear. I’m not entirely sure it was wise to drop all of my gold on a house this early in the game, but it’s a place to keep the dragon bones and scales I’ve been collecting. It also enabled me to adopt a child; interacting with her causes me to feel warm and fuzzy inside. I could think about which quest to start next, but they’re all in a nice convenient log for me so I can just decide next time I play.

The above don’t give my mind much to grab onto, and it doesn’t like that. Moving forward with my real-life career goals, dealing with real-life people (especially strangers in positions of authority), and even just being fully present in the moment are all things that provoke my anxiety. My mind needs something to grab onto, something to think about so incessantly there isn’t room for thoughts about the real world in general and my own life in particular.

It was hoping the Let’s Play would provide such a security blanket; it wants to lure me into thinking about my ideal character build instead of actually developing skills I need in real life. It wants me to direct my creative energy into witty commentary about the game instead of into composing original music, creating original art, or writing anything worth reading. It wants me to feel good about earning virtual money to make a virtual home pleasant and cozy… instead of finding a real job, earning real money, decluttering my real home, and raising a real family.

Oh, Mara, I thought I’d gotten past this. I should have known! How could reading a few chapters of a book once truly change the way I think about and perceive myself? How could it counteract a lifetime of internalized messages reinforced by my perception of my experiences?

My mind is trying to annihilate me. Suicidal thoughts don’t work if nothing else because I don’t want to cause my loved ones pain. So it tricks me into thinking I don’t need therapy and clings to whatever fiction I have some interest in, becoming so wrapped up in that universe I can hardly even feel it when Fox expresses his very real love for me.

I thought I was doing better but then… I don’t know! Did I push myself too hard and need some downtime to recover? Did I relapse? Am I making any progress, or am I just walking in circles completely lost? I hate being unable to trust my own perception of reality.

An Epic Day of Being Awesome (Zentangle Days 2-4)

Today was one of those days I wish I could have every day, and it still had its bumpy moments. I was able to move through it with confidence and take care of some important things. My one concern is that I hope I haven’t burnt myself out by doing too much in one day.

I attempted to ignore my alarm for half an hour this morning, then finally reset it to (ostensibly) give myself an additional 90 minutes of sleep. I didn’t exactly sleep during that time, but my body was relatively rested and my mind got to run though some things. When it went off again I was quite grumpy, but I pulled myself out of bed and started my day with a breakfast of cold cereal and milk. I ate most of it before plopping down at the computer to pay my credit card bill (in full, on time, booyah!)

A sadness has been descending upon me every morning that I can’t quite explain. I attribute it to the family wedding ceremony & reception we’ve been planning (it’s very fresh in my mind, especially since Mom and I ordered my dress on Monday) and the fact that my father can’t be there. Now that I’ve forgiven him, I kind of wish he could come. I’m also a bit raw from the memorial service for my undergrad mentor who died last year, which was very beautiful and nostalgic and extremely inspiring but during which I kept expecting him to show up and had to remind myself… well… yeah.

Anyways, I let myself feel the sadness and cry a bit and not try too hard to rationalize it. My emotions come and go like waves on the shore; it’s much easier and safer to let them do so unimpeded. The really strong waves will break down any defenses I try to put up, so I’m better off directing my energy elsewhere.

Fast forward a bit to find me power walking across campus to meet with my academic adviser. We came up with a plan for me to get back on the horse and trot around a bit before the show jumping that is applying for internships. He seemed happy to see me again (for the first time in about a year, actually) and I was glad to see him as well.

Next I was power walking across campus to participate in a LGBTQ group I’ve been meaning to join since I found out about it in January. My mind kept repeating something Mom had said about punctuality: “If you aren’t where you intend to be at least 10 minutes early, you’re late.” I asked it if that thought was going to help me get there any sooner; obviously the answer was no so I gave the order to stop thinking it.

I got there just in time and had a rather enjoyable experience talking with absolute strangers friends I hadn’t met yet about topics ostensibly connected in some way to the gender binary. They kept thanking me for coming, so I imagine they’ll be pleased if I show up again next week. Honestly if this was the only thing I’d done today I would still say it was epic. I overcame a lot of insecurities about not only groups and social anxiety but my own identity as well; I felt accepted and comfortable (well, mostly) and contributed in a positive way to others’ experience. It was definitely a huge improvement over feeling too anxious to get dressed and go.

I had some time before my piano lesson, so I grabbed something to eat. A wasp of some description seemed inclined to investigate my iced coffee; this made me very uncomfortable. My bee/yellow jacket/wasp phobia has been becoming more severe; just this morning I had a nightmare involving them. But I remained calm, gathered my things without making any sudden movements, and walked away like a sane person.

Okay, here’s the really nifty part of the day – and where the Zentangles come in. Since Monday I’ve been following the instructions in One Zentangle A Day by Beckah Krahula. I sat down at the beginning of my piano lesson to play an exercise from Hanon: The Virtuoso Pianist in Sixty Exercises that I haven’t practiced very much and didn’t look at all week (oops). As I played it my mind was completely clear; there were just the written music in front of me, the sensations in my body (especially hands), and the sound of the music I was playing. I was completely in the zone, just like that, no real conscious effort required!

Even after I had a thought and trainwrecked, I was cool and confident talking to and playing in front of my teacher. Maybe the beginning of a piece or exercise wouldn’t be as strong as it could be, but once I got into it… Boom! Like someone had flipped a switch, everything else just melted away and there was just the music. It flowed through me. My teacher said I have an instinct for piano and she wishes I’d started playing when I was much younger. It’s another thing I got from my father – another thing I wish I could share with him now.

It was our most productive lesson to date and I think a lot of it – possibly my entire day – was made possible by the meditative practice I’ve been getting from the Zentangles. I’ve been able to calm and focus my mind so much more easily. I love the way I can direct my energy when I’m drawing (or playing music, or doing anything else creative), to have some party of myself – my will – flowing out of me and onto paper or into an instrument. It feels good and it helps me develop my confidence.

After the lesson I went to talk to someone in the graduate school about a failing grade I would love to remove from my transcript. It’s from an independent study I attempted 2 years ago and was unable to finish. I had an incomplete but by the time I was ready to try and complete it the grade had automatically converted to an F. To be honest I’m not sure why I didn’t address it sooner. The person I talked to was very nice but she doesn’t have the authority to help me, so she gave me the contact information for someone who (ostensibly) can.

Based on our conversation, I expect I’ll have to come out as having depression. It’s the best explanation I have for why it’s taken me 2 years to address this. I’m not sure if I want to bring up the anxiety as well, but I am prepared to mention the self harm and suicidal ideation. I can ask Wakana for documentation and might also contact the psychiatrists I saw to request their diagnoses and the dates when they treated me. Thinking about my difficulties (especially having to drop my graduate-level classes last year) was very painful, but… well, I hope it will be worth it.

On the way home (after spending 5 hours on campus) I realized I was utterly exhausted. Fox invited me to join him outside while he practiced using his new katana, so I agreed. He taught me a couple of moves that involve the whole body, big muscles moving together. The katana is simply an extension of one’s arm, oneself. As I became familiar with the movements and comfortable using my whole body as one unit, I could really feel the katana as an extension of myself; I could feel my energy flowing through it. That was awesome.

I sat on the stairs watching him dance with it and listening to him talk about the history and how those blades are traditionally made. I’m somewhat interested in the topic, but mostly I was interested in seeing and listening to him. His geeky interest in and nerdy knowledge about an esoteric topic, the sound of his voice, the way his body moved, the way he was enjoying himself… I haven’t seen him like that in years. It was amazing.

And I continued my daily practice by drawing my fourth Zentangle. I don’t like it quite as much as I like the others, but then I didn’t like them either while I was drawing them and now… well, let’s just say my opinion of them has improved. I do think I managed to use shading to make it look like a light is shining from the upper left corner onto 3-dimensional objects. So… it’s another 30 minutes of practice, another learning experience. It’s helping me overcome my perfectionism, too!

To end my epic day of being awesome, I have written this blog post! Without further ado, here are my most recent Zentangles:

Ziya’s 2nd Zentangle

Ziya’s 3rd Zentangle

Ziya’s 4th Zentangle

A Note on Trigger Warnings

This is something I’ve thought about quite a bit, as many of the topics I write about are very difficult for me and I imagine they might be triggering for others. I’m not always sure whether a particular post needs a trigger warning, though; maybe I should just put a generic warning on my blog? Any thoughts/feedback on applying trigger warnings to my blog, based on its existing content, would be greatly appreciated. Thanks!

The Daily Post

If you read a lot on the internet, chances are you’ve seen a trigger warning on a post — a disclaimer used to warn readers that the material that follows might be potentially traumatic, objectionable, or offensive. It might look like this:

Trigger Warning: This post discusses self-harm, bulimia, and eating disorders.

Or simply:

TW: racism, sexism.

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