Medicine

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You blogs, you stones, you worse than senseless things!

Hello and good morning.

It’s Thursday, and here I am writing another blog post to prove that yesterday’s was not a fluke nor a false flag nor any other term beginning with “f” other than perhaps “fair play”.

By the way, I may have previously used the Shakespeare-based title above‒it’s just so easy to make, and I’ve always loved that line from Julius Caesar‒but I don’t care.  It’s too perfect for my current circumstances to miss the chance now.  I mean, blogs and stones?  Come on!

I’m on my way to the office, and speaking of stones, I am far from being over the process of having, let alone passing, my kidney stone.  I’m trying not to overuse my pain meds, largely because they tend to have diminishing returns, and I want them to work when I really need them.  Also, they are quite…well, constipating.  Now, it’s true that I didn’t eat all that much over the course of the early part of this week, and of what I did eat, much of it didn’t stay down.  Still, I went Sunday through Wednesday without doing anything but peeing.

I have been doing a lot of that of course, deliberately.  It is not pleasant.  The pain is not like it was Saturday night, Sunday, and Monday, but it still doesn’t let me forget.  And, of course, we’re moving office this week, and that adds extra hecticity*.  

I don’t know how much you all would want to hear (that I haven’t already said) about what went on in the hospital.  I did talk about it a great deal yesterday.  I suppose I’ll play it by ear and just bring up things that occur to me as interesting.

I have not yet made my follow-up appointments, but I need to try to do so today, if I can.  Even writing about it makes me feel very tense and anxious.  I know there’s no good reason for feeling anxiety and resistance toward such things, but at least now I know something of the cause:  It has to do with ASD, with possibly some pathological demand avoidance, but also just with associated, fairly severe, social anxiety.

But I have to try, and I want to try.  I’ve been rather impressed by the hospital and its associated staff and attending physicians and their network and such, and I would like to get myself plugged into their system if I am able to do so.

They seem quite generous and caring as a tendency and policy.  They do everything from providing free meds for when you go home to getting you a Lyft if you don’t have a ride.  I think that’s pretty nice.

It was oddly nostalgic, being in the hospital.  Well, I suppose it’s not so odd.  I spent much of my earlier adult life in and around hospitals, from med school to residency to medical practice, nineteen years in total.  I guess I miss it.  It was nice working with intelligent, disciplined, professional people at all levels and being able to relieve and even prevent suffering, all while getting a good amount of intellectual stimulation in the form of understanding and solving complex problems.

I don’t expect that I will ever do it again, though.  There are ways, I am sure, to fight to try to get my license back and so on, but it’s not the sort of process for which I have any avidity.  When civilization falls apart, as it appears to be about to do, I can perhaps find a time and reason to lend my skills to the survivors, if I am one of them, which seems unlikely.  Otherwise, I don’t feel a lot of enthusiasm for supporting the world as it is.  Humans have revealed themselves over and over‒by and large‒to be inadequate to tasks that require actual cooperation and consideration and compassion and humility.

It’s ironic that humility is so challenging for humans.  Given how profound their limitations and failings are (despite undeniable strengths, as well) you might imagine that humility would be easy.

But somehow, the default setting even of those who try to be humble is to characterize themselves as absolutely worthless‒which from a certain point of view is always true, but which misses the point of real humility.

Humility is not self-hatred or self-contempt or self-destruction (from which, to some, the only rescue is through some imaginary supernatural being); it is a recognition that one is and will always be limited, capable of error, and incapable of being perfectly objective about oneself and the nature of one’s existence.  With such self-knowledge, one will tend to be better able to make good choices about oneself and others.

Maybe I should try meditating again, to try to keep myself calm when possible.  It might help with my serious social anxiety.  It would probably also help me to get less upset over the idiocy of the current administration**.  And perhaps my mind would then be more useful overall.

Anyway, that’s enough for now.  I hope you all have a good day and try not to get too upset, yourselves.  The world is going to end soon, but that has always been the case‒it’s just a matter of time scales.  On other scales, even a single mayfly’s life is practically eternal.

TTFN

*I think I made that word up, but it seems too good not to use.

**It would be nice to administer a fair amount of current to the members of this US administration, though‒alternating current, with enough voltage and amperage to cause serious discomfort, but not enough to kill them…at least not quickly***.

***See?  Upset.

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I am not Thorin, son of Thrain, son of Thror…

…nor am I King Under the Mountain.

Nevertheless I return.

I hope no one was too worried about me these last few days, though I have probably given you cause to worry.  Honestly, though, I was in a fairly dire situation.  On Saturday night/Sunday morning I woke up just after midnight with what started as right lower quadrant abdominal pain, which at first I thought was some “normal” GI cramping, maybe from something I ate that I shouldn’t have eaten.

As it rapidly worsened, I became more concerned.  I checked myself for fever (didn’t have one) and for abdominal tenderness, including rebound tenderness.  That wasn’t really there either.

If you are a medical professional, you might recognize that I was worrying about my appendix.  And though the location was right (lower quadrant, ha ha), there were some things missing.  Still, I was concerned, and the pain was worsening.

To make sure I wasn’t being reckless or silly, I bothered my poor sister with a phone call in the middle of the night (she was very kind about it).  She asked me a few questions, tried a little light-hearted banter to try to relax me (I was, regrettably, not amenable, and I fear I might’ve been rude).  The final thing she said was to point out that I have chronic, often severe, pain.  If this was much worse than that‒and it was‒then I needed to get it looked at.

She is wise, my sister.

I had to finish the call quickly and call 911 because the pain continued to increase.  There was no other credible option but an ambulance.  I don’t have a car, but even if I did, I was not capable of driving at all, let alone safely.  There was no one who could drive me, nor was I going to call an Uber or Lyft.  The delay in that, both at pre-pickup and at the hospital, would be intolerable.

As I tried to keep speaking with the 911 operator, I went outside, onto the back patio, where I eventually laid down on the concrete, confusing at least one cat to a level that would have made Monty Python proud.  I figured it would be easier to get to me there, outside.  The lying down part was because I didn’t want to sit or stand, and didn’t care about getting dirty.  I also didn’t have any shoes on.

Then it occurred to me that I didn’t want to awaken my housemates, who have dogs that would bark if people walked up beside the house with a stretcher, so I made my awkward way to the front of the house, to the sidewalk, where I sat down, first with my back to the gate post.  Then the first real right mid-back (or flank) pain added itself to the mix and I think I cursed as quietly as I could and slumped to my side, trying to ease the pressure.

The 911 operator told me the EMTs were just arriving, and she was right.  I thanked her and said goodbye (my Mom and Dad did not raise their children to be rude to those who legitimately and professionally help others in emergencies).

The EMTs were very professional, and they were the first to recognize what turned out to be the case, though the ER doc also took one look at me and ordered an immediate non-contrast abdomen and pelvis CT which revealed the specifics of what he and the EMTs had clearly recognized:  I had a kidney stone in my right ureter.

So, to bring an already drawn-out explanation to a provisional conclusion, that’s why I’ve not written a blog post either on Monday or Tuesday of this week.  I’ve been in a torture chamber of my own body’s making.

Still, there are some compensations.  One gets pretty thorough evaluations when in hospital.  I learned, for instance, that though my blood sugar was rather high at first, largely due extreme physical stress, it came down to just above normal.  A hemoglobin A1C that was added on showed that I was high normal/low abnormal, or pre-diabetic.  Diabetes does run in my family, and also, I’m sure I have chronically elevated levels of cortisol and related hormones in my body that make such things worse.

Of more mild interest was that I had lowish hemoglobin and hematocrit, and my blood concentrations of hemoglobin and RBCs were low.  In other words, I was borderline anemic.  This was a mild surprise until I thought about how much aspirin I take.  As part of taking that aspirin, I also take acid blockers to protect my stomach (and to combat GERD).  So, from two ends, that can explain a bit of anemia:  some low-level blood loss over time from aspirin’s antiplatelet effects and probably chronic gastritis, and somewhat decreased iron absorption, since the acid in one’s stomach facilitates that absorption.

I know this much in such detail because of a cool service the hospital offers, which is an app on which you can access your test results and (to some degree) other medical records.  It’s really quite nice, because too often, people have only vague ideas of what their tests mean, and they arrive when the occasion might already be fading in their minds.  That doesn’t happen to me, of course‒mine is the superior mind, like Khan, who was even more in his own way than I tend to be.

Ha ha.  I am of course exaggerating, and not just about Khan being more in his own way than I am.  This app’s data is great information to have.  They even give you little notification dings when new stuff is added.  It can be handy.

I’ll go more into what happened in the hospital at another time, but I will give a spoiler or two now:  I have not passed the stone, but I have a stent in my right ureter and I am on meds to try to help that to let the stone pass.  My pain is not completely gone, but there is only a bit of right flank ache and spasm sometimes when I use the bathroom*, and a fair amount of blood and irritation in the urethra from the stent placement.  That’s always fun.

Also, I kind of pushed to get out earlier than they really wanted me to leave, because I have to do payroll for the office today.  It would be possible for my coworker or my boss to do it, but when you’re doing something you don’t usually do, there are much more likely to be errors, and I don’t want people to be accidentally underpaid (or overpaid).

Even before I finished the first draft of this blog post, I already found two places where that would have happened had I not come back.  So, while I was probably somewhat foolish‒I’ll tell you later about another extremely foolish thing I considered doing when my pain first subsided a bit on Sunday‒I am also confirmed in my judgement.  And the needs of the many (ceteris paribus***) outweigh the needs of the few or the one.

One final thing, the most important of all things, before I go.  While I was in the hospital, my youngest, Ezra, having followed my little comments on Threads or Instagram, realized that I was in the hospital and why and contacted me and came to visit me in the hospital!  That’s right, for the first time in almost 13 years, I got to hug my child.  They also made plans to get together with me more regularly.  

So, let me address the notorious question:  Is a kidney stone the worst pain I’ve ever experienced?

Absolutely.  And I’ve been through open-heart surgery and fractured my right scapula and had back surgery and “failed back surgery syndrome”.  We ASDers, supposedly, do not like to exaggerate if we can avoid it, but there was at least one time, and I think several, when I was asked what my pain was on a scale of 1 to 10, and I said 10 with no hesitation.  Sometimes I only said 7 or 8.5 or 9 or 9.5.  I try to be as precise as feasible.  But there were 10s in there, and I normally treat 10s on such scales like massive objects trying to go the speed of light, or probabilities in the real world trying to get to 1.

Was it worth it to get to see my child again?  Well, I would be afraid to offer to experience it again with that outcome in mind, but I would be willing.  Yes, it was worth it.

I will speak more about this tomorrow.  Thank you for your patience and apologies for any anxiety you might have had on my behalf.

*Perhaps because I’m not using it for that for which it is intended, which is, obviously, to bathe**.

**That’s an attempted joke.

***In the real world, ceteris is almost never paribus.

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I have not become comfortably numb

     Well, I misjudged things a bit, and though when I wrote my post yesterday I didn’t realize it, I had developed blisters on my feet from my long walking‒especially the right one, on which I had been wearing a spandex brace (prophylactically*‒I hadn’t yet been having any ankle problems, but wanted to avoid them if possible).  So, today, I am not walking, at least not to the train/work.

     I have realized that topical lidocaine creams, such as the max strength versions of “Icy Hot”, dull the irritation of blisters.  That’s nice to know, in a pinch, though I don’t know if it would dull the pain of a pinch; it seems only to work with superficial pain, not deeper pain.  Curiously, it also seems to dull some of the local signs and effects of inflammation (though Ibuprofen contributed to that).  Don’t worry, I’m not expecting to cover up my pain and forget about it.  That doesn’t seem doable.  I’ve tried.

     If I could slather lidocaine all over my body and thus numb all my pain, believe me, I would do it.  But I always hit a wall beyond which the numbing doesn’t reach.  Heck, I’ve had multiple steroid/lidocaine epidural injections and they didn’t seem to do anything to my pain, even temporarily.

     I should probably study up on the nature of congenital insensitivity to pain, just to see if the metabolic pathways involved in the condition shed any light on the sorts of things that might make a person have their pain sense shut off.  Mind you, given the nature of that disorder**, I suspect that its effects come about through some aberrant development of the nervous system, not by the presence (or absence) of some neurotransmitter.

     If memory serves, the saliva of the vampire bat has significant pain-reducing as well as anticoagulant properties.  I’ve heard all my life about people thinking it would be good to investigate as a source of potential powerful analgesics, but nothing has come of it, as far as I’m aware.  It wouldn’t be all that hard to separate out the molecules in vampire bat saliva and examine them and try to replicate them.  Heck, if you can figure out the bat’s biochemical process for making the molecules, you could develop transgenic bacteria that could produce the substance en masse, like how replacement thyroid hormone is made.

     No, either there were unforeseen difficulties with using the vampire bat’s saliva analgesic, or no one was interested in doing the research (which seems unlikely but is not impossible), or “big pharma” has blocked the research because it would interfere with the sales of opioids and NSAIDs and so on (see picture below for an example of such interference).  I would like to think that’s unlikely; after all, there would be tremendous potential for legitimate profit in a revolutionary new pain treatment.

     Still, if it turned out that anyone in a big drug company or companies did block research into such a potential pain killer, then all the people involved would need to be strapped to tables and have all their joints and other “tender areas”, like genitals and nipples and lips and eyes, injected with some combination of‒for instance‒capsaicin and gympie-gympie leaf extract and fire ant venom, with some uric acid crystals*** thrown in for good measure.  Oh, and also they should be given constant, powerful stimulants so that they cannot escape their pain by losing consciousness.

     That’s if I don’t think of anything even better to do to them.

     Obviously, I take pain treatment seriously.  That should come as no surprise, given my personal, decades-long chronic pain and my own having gone to prison for trying (naively) to treat other people’s pain, only to be thrown under the bus by people who were taking advantage of my naïveté.  I have very little patience for those who would interfere with other people reducing their pain and suffering, or who would make light of the suffering of innocent people.

     Mind you, though I think vindictive thoughts and entertain vindictive fantasies, I would probably (like a moron and a sucker) feel pity even for people who had done such horrible deeds, and I would probably end their lives with minimal pain.

     I would not feel bad about that though.  People who willfully engender greater suffering in others for their own short-term (or long-term) profit, whatever form that might take (unless it is truly and honestly and reasonably something they perceive to be an emergency or an absolute survival need) are more than worthy of being erased from existence.  And while it might be reasonable for those who knew them to miss them, they would not deserve to be mourned.

     Look at me, getting all murderously vindictive about purely imaginary people, when there are so many real people who are thoroughly deserving of such animus.  But, anyway, that’s enough of this weird-ass blog post for today.  I’ll let you go to enjoy something more wholesome.  Please have a good day if you’re able.

*I am pleased to note that my right ankle is in no danger of an unwanted pregnancy.

**And yes, it is a disorder, not just a “difference”, because it significantly reduces the survival and thrival of people who have it.

***Look them up; they’re related to gout.

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Please eschew sour grapes, or at least don’t chew them…they’re sour.

I don’t really remember what I wrote yesterday; I remember that I was angry, but it wasn’t really about anything solid or sharp, more just a general sense of frustration and despair.  I really felt and feel at a loss, with no sense of meaning or purpose or deep value.

I can’t claim to think that feeling is unreasonable; the world provides plenty of evidence for the pointlessness of all things.  I suspect that most people just try to avoid thinking about it.  They distract themselves with religions and other ideologies and with social interactions, whiling away their time until everything finally breaks down and they die.

Some surely die in a state of bewilderment and fear, never having accepted or even having truly contemplated their own mortality.  Some probably find comfort in the aforementioned religious ideas or just in community.  Having the love of family and friends, especially if such people are with them near the end, must help relieve at least some of the dread and pain as things wind down.

It must be at least some comfort if, when one is dying, one has loved ones nearby, helping to provide reassurance or at least just company.  If one has loved ones who willingly and lovingly attend to them while they are dying, or even just want to be there with them, one must at least be able to think that one has done something right in life.

Anyway, I’m on my way into the office, still rather sick but definitely improving.  I’m coughing, but not as badly, and the goo I’m bringing up is thinning out and looking less like some weird, opaque resin made from peas.  I’m still far from optimal, but then, I only started getting sick about six days ago.  If I’m substantially over it by, say, Friday, well that will have been a decently circumscribed illness, especially considering just how badly I’ve been feeling.

Somewhat ironically, my illness at least distracted me‒temporarily‒from the degree of my back, hip, ankle, and shoulder/arm pains, and those are becoming more prominent again as the illness recedes.  This leads me to wonder to what degree interferons or “tumor necrosis factors” and other aspects of the immune response can have beneficial effects on chronic pain, or if indeed they can do so at all.

It might be interesting to do a retrospective study involving, say, people who were treated with strong doses of interferon (with ribavirin) for Hepatitis C, or even for cancers such as melanomas, and who came out the other end healthy, then to try to learn whether any of them had chronic pain before starting treatment, and how the pain responded to the treatment.  We could compare them to age (and otherwise) matched cohorts who did not receive any such interferon treatments but who had similar amounts of chronic pain and see if their courses differed in a statistically significant way.

Of course, those high-dose interferon treatments for Hep C had their own serious complications and side-effects.  For instance, they could trigger serious depression even in people with no previously known disposition to have mood disorders.  These outcomes were generally worth the risk, if one could thereby eliminate chronic Hepatitis C, which is associated with significant morbidities and pathologies, not the least of which are potential liver cancer and sclerosis.

Still, if I could go through, say, a six week course of such treatment and thereby reduce (or eliminate) my chronic pain, I think it would probably be worth it.  I’m depressed and suicidal anyway.

Of course, we’re a long way from such a study outcome, even if we had unlimited funding and could start the study tomorrow.  Money can help make a lot of things easier to do, but as Kansas pointed out in Dust in the Wind, money has no effect on time*, and some things just take time.

I don’t expect to see such a study done, let alone to be able to benefit from the results, and honestly, I don’t have a high credence that it would show clinically useful effects.  After all, my own pain is not diminished now as I’m getting over my illness; it’s just changing back to baseline.  And, unfortunately, taking a vacation from one pain to another only to come back to the original one is probably not something anyone would really seek out***.

That’s enough for today.  I hope you all have a decent one‒do please try, at least.  Someone should, and it would be nice if most such people were reader-types who like blogs rather than wealthy assholes who don’t give much of a shit about anyone else, though those are the people who seem most likely to have happy days most often.

Not that wealth means someone is undeserving of happiness; that’s a non sequitur, really‒sour grapes projected onto the world by those who resent and envy the wealthy (sometimes with good reason, sometimes without).

Do your best.

*Okay, if you had enough money, all in one place**, you might form a massive enough object that it would measurably slow the local passage of time.  Heck, you could make a “money black hole” if you could get enough of it together and compress it enough, and at the event horizon, time would stop (to an outside observer, anyway).  Of course, according to GR, a black hole is a black hole is a black hole, with only mass, angular momentum, and charge differentiating one from another, so it wouldn’t matter if the black hole was made out of money.  Quantum mechanics demands otherwise, though, and thus we have the famous “black hole information paradox”, which isn’t really a paradox, anymore than is the “Fermi paradox” (When you come to an apparent paradox or contradiction, that’s just an alert, saying “something you’re doing here is incorrect or incomplete.”)

**Even if you’re just storing that money as information, with no bills or coins, there is still energy associated with the information, always.  So enough information about enough money could still have gravitational effects.

***Then again, there is the phenomenon of deliberate self-harm, and I can tell you from experience, it is sometimes a way of diverting oneself from a pre-existing, chronic pain to another pain, one deliberately and personally chosen.  Does that count as a pain vacation?

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It seems appropriate that coughin’ and coffin sound alike.

It’s Monday again, though I know of no one who asked it to be.  I am not going to write much today (I suspect) because I am quite under the weather‒I’ve been dealing with some form of bronchitis that started Friday, and I’m not feeling much better yet, though my oxygen saturation seems good, and I have no fever (but then again, I am always on NSAIDS and acetaminophen, so it’s hard to be sure I haven’t just suppressed a fever).  By rights, I should probably not be going into the office today, but my coworker is out of town until tomorrow, so basically, I’ve got to keep the office running.

I do have masks to wear, and I don’t just mean fun and/or scary ones.  Neither do I refer to “autistic masking” which is what many autistic people do to fit in with other, neurotypical people.  Lord knows I’ve always tried to fit in, and I definitely put on “masks” and tried to shape myself to please those around me.  I feel almost that my autism presented a little more the way it does in girls than in “traditional” autistic boys, at least as discussed by other people with autism.

Anyway, I’m not really doing this blog as a venue via which to discuss ASD.  That must be the case, since I didn’t even consider the possibility before the last few years, and this blog has existed for much longer.  I suppose it might be interesting for someone (but not me!) to look back at my older posts and see if there are any hints about ASD in the way I write or discuss things.  I doubt that I’m interesting enough for anyone ever to do that, though‒I certainly don’t find myself interesting enough.

It may go without saying that I did not play guitar or go for any walks except to the convenience store this weekend.  I was mostly just laying around and trying to rest.  It’s a bit annoying that I still didn’t sleep well, and only stayed asleep for a while under the effects of delta 9 gummies and 2 Benadryl.  I slept a little more than usual, but of course, it’s not really restorative sleep.

I wonder what it is about the autistic brain that leads to the tendency to sleep poorly.  Is it atypia in the hypothalamus, or are the effects on the amygdala leading to hypervigilance which is consistent with my tendency?  I don’t know for sure how well the neuroscience of autism is progressing, but I guess I could get on Google Scholar and/or check the preprint servers.

Anyway, I think I’m pretty much done for right now.  I’m really very tired and worn down.  I guess I’ll be talking to you all tomorrow, though it’s less likely that you’ll be talking to me.  In the meantime, if you’re able, please try to have a good day.

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“…the only thing that’s real.”

It’s Wednesday morning, and I’m writing this on my smartphone instead of the laptop computer.  There’s no important rationale for this choice, it’s just the way it turned out.  There are causes for everything that happens, but there aren’t necessarily reasons.

I was terribly stressed out yesterday, though arguably nothing too Earth-shattering happened.  Just quite a few unexpected and frustrating but relatively little things occurred that led me to want to hurt myself, and I wanted just to give away my black Strat at the office as well as a very cool piece of hiking equipment that I have that my boss really admires*.  I just wanted to divest myself of everything and go off and, I don’t know, try to swim to Morocco or something**.

I don’t feel much better this morning, but at least it’s been going reasonably “according to plan”.  I’m still in stupid amounts of pain, since right when I woke up.  Nevertheless, I did my morning exercises and got ready for work, though I feel almost as though my upper body and my lower body are hanging by a thread from each other.  Only nerves seem to connect the two sometimes; otherwise it feels as though my upper half is merely balanced atop my lower half, and as I sit, stand, lie down, walk, and so on, it wants to fall off its perch, and that process hurts.

I haven’t actually played guitar in weeks.  I’ve “wanted” to, intellectually.  I even got the red Strat out at the house, putting away the SG, because the Strat is my second favorite***.  However, that hasn’t led to me playing it, though I came close at least once over the weekend.

I of course also haven’t played piano/keyboards, partly because my keyboard is covered with superfluous clothes and other things that just need a place to be.  It’s shameful, I know, but I have little room for storage.

I also haven’t written any fiction or done any drawing, and I don’t even have any modeling clay, though the discussion of my pain made me think of when I used to play with clay every day (hey hey!).  Occasionally, one would get a single hair mixed in with the clay by accident, and then if you were splitting the clay, the two bits would sometimes be held together only by that hair; that’s how my back feels a lot of the time.

When I shift a little, at the wrong moment, in the wrong way, it feels as though my upper and lower halves want to separate, but they’re held together by the collected nerve fibers that carry all that lovely pain and spasm and electrical sensation back and forth to and from my brain.

I won’t say I wouldn’t wish this pain on anyone‒there are quite a few people in the world who merit such pain and much, much more, and yet they live with impunity.  Many of them have been doing their dirty deeds for quite a long time, and even if they were to die violent deaths tomorrow, they would already have gotten away with nearly a lifetime of successful villainy and will suffer no more than most people are near the end of their lives.  Indeed, these people will probably have better, more attentive health care in their final moments than most people who have done no willing harm to anyone.

Lovely universe you’ve got here.  (It wouldn’t) be a shame if something happened to it.

Also, you can’t threaten such people with stupid points like “history will judge you”, because such people don’t tend to give a shit about that kind of thing.  Many of them probably secretly believe themselves to be immortal; they certainly don’t care about what the milling masses think of them after they’re dead.  And any concept they may have of an afterlife is clearly not worrisome to them, or not enough so to deter their foul deeds.

And here I am, feeling like I am slipping very painfully off my lower half even as I write this, despite aspirin and naproxen and Tylenol and heating pads and Icy Hot and Voltaren cream and CBD and Delta-9 gummies and all that.

It’s too much.  If I cannot get this to improve soon, I may move up the deadline of my plan, because I am tired of being not only depressed and anxious and autistic (with all that that entails) but also just in chronic fucking pain every fucking second of every fucking day for more than 20 fucking years!!!  There is no sign of it abating.

Have a good day if you can, and thank you for reading.

*It’s a machete; I don’t know why I’m being coy.  It’s a beautifully designed and made machete, no cheap throw-away crap.  This is the sort of tool one could see being handed down with pride from generation to generation.  I bought it because of the aesthetics; I rarely need a machete for practical purposes.

**I would not succeed.  I am not that good of a swimmer, but even if I were, I don’t think any human or humanoid swimmer ever could swim across the Atlantic Ocean.

***My favorite is my Les Paul (see above), which was also, like my red Strat, made by my former housemate.  That guitar has such a beautiful sound, but it is very heavy.  It’s what I used for all the guitar parts, including the little arpeggios and whatnot, on Like and Share, and also for my cover of Something, with no pedals and only a little delay.  I used the red Strat almost entirely for Schrodinger’s Head and for much of Catechism, including the solos.  I used the black Strat for the solo in the middle of Breaking Me Down.  I have not recorded anything using the SG.  That’s no criticism of it; the timing was just wrong.

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What shall I do now?

I wrote the beginning of a first draft of a post for yesterday (which was Monday, since today is Tuesday) before it became obvious as I was getting ready for work that something in my GI tract, something that I had eaten, was taking its vengeance upon me.

I ended up not going to the office yesterday, and I ended up not even posting the draft, which I considered posting as was*.  However, there was really not much substance to it.  I think I realized as I was writing that it was St. Patrick’s Day, so I mentioned that in passing, but it’s never been a holiday that means much to me, at least not now that I cannot eat my mother’s homemade corned beef and cabbage.

Anyway, that’s a lot of the gist of yesterday’s post, at least if I recall correctly.  Oh, right, I also mentioned that, starting yesterday morning, I am not taking St. John’s Wort anymore.  I gave it well over the 6 week potential time frame for antidepressants at least to start to make a noticeable difference.  Some enterprising reader can‒if you are so inclined‒try to work out based on mentions in my posts roughly how long I’ve been going, but clearly it’s not been making my depression diminish; I think we can all agree about that.

I was also worried, probably unnecessarily, that it might be contributing to the recent apparent worsening of my chronic pain.  I don’t think that’s the case, but it’s a bit too soon to tell, and the matter is muddied by my recent GI trouble, which still leaves me feeling a bit bloated and sore this morning.

As for anything else, well, I don’t know.  What else do I have about which to write other than depression and illness and pain and insomnia?  I suppose I could write more about autism spectrum disorder, but I feel that would be a bit presumptuous of me.

Of course, I’ve learned a fair amount about autism in the research that eventually led me to seek a diagnosis, and my medical and scientific background gives me other advantages in understanding.  But I have been someone diagnosed with autism (level 2, not just level 1, so apparently I need significant support**) only for a few weeks now, so I don’t know about what even to talk.  What of the people, places, and events of my life are explained or explicated by the autism diagnosis?  Does it, or will it, help me come to terms with any of it?  I don’t know.

I certainly don’t feel that I can just waltz into any discussions of or by people with autism, or communities of such people, and have anything useful to say.  I also don’t feel that I have found “my people”, though I certainly can “get” at least some of the things they discuss better than I can some of the things that other people discuss.  But I still feel very much like an alien, an outsider, a changeling, a replicant, something that doesn’t belong on this planet‒even when I’m interacting with neurodivergent people.

So, I guess we’ll see what happens with the DCing of the Wort.  I doubt it will really affect my pain, though it may pain my affect*** if my depression worsens even from where it is now thanks to stopping it.  In any case, it really doesn’t matter, because I really don’t matter, so Batman knows what will happen.  If I implode completely, or if I crash and burn, or whatever figure of speech you want to use, there will be no significant loss, not even to me.

I don’t know what else to say.  I’m not doing anything creative or artistic.  I haven’t played guitar (or any other instrument) in weeks now, and I haven’t written fiction, and I haven’t drawn.  I’ve barely read anything other than rereading my own stuff to try to inspire or at least trigger myself.  That hasn’t worked.

So, who knows what will happen?  I certainly don’t.  But in the meanwhile, I hope you have a good day.

*The past tense of “as is”.

**I don’t really have that support, but just because someone needs something to be able to thrive doesn’t mean that thing is available to them.  Reality is heartless.

***Ha ha.

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“…my mind is on the blink.”

It’s Monday.  I almost don’t know what more needs to be said.

I’m probably going to make this relatively short, because I’m having quite a bit of pain in the bases of my thumbs as I write this on my smartphone.  I took three aspirin* already this morning, but it certainly hasn’t kicked in.  If it’s not going to help my pain, I wish at least the anti-platelet action would make me have a massive GI bleed or something.  I know, it’s kind of gross, but it’s one of those things where no one can claim you’re malingering or lazy or whatever.  If you’re vomiting blood, only a fool could say, “It’s all in your head.”

Speaking of it being all in your head, though, it’s of course a worry that aspirin could cause a hemorrhagic stroke instead of a GI bleed.  Obviously, since my brain is my greatest strength, I would prefer not to have that happen.

On the other hand, it’s not as though my brain is my friend or anything.  It’s where my greatest difficulties lie, as well as my strengths, and those difficulties dominate most of my days and‒to say the least‒my nights.  I’m depressed and “anxious” and angry and pessimistic, and I cannot sleep properly, and I am in constant pain, and I also have all these attributes that led me to have my assessment done last Friday to try to determine if I have the second kind of ASD or not.  So I can’t exactly feel too worried about my brain.  I don’t even wear a helmet when I ride my bicycle.  If I get brain damaged, it seems like the least my brain deserves.

I’m tired.  I’m so tired.

I know there are people out there who are able to try to put the best possible spin on events, and who can honestly say that they love themselves, and that’s great.  I envy and admire that.  And I have tried very hard to develop those habits, through self-hypnosis and autosuggestion and meditation and even pharmacology, but I have not been able to alter my programming so far.  Maybe I need a factory reset or something.

Anyway, I’m supposed to receive my report about my autism assessment within a week, so I should have it by this Friday at the latest.  I can’t say I’m not nervous about it.

Well, I can say it, I guess.  “I’m not nervous about it.”  See?  But saying it doesn’t make it so, no matter how loudly you say it, or how often you repeat it, or what oaths you proclaim, or what authority you cite.  It doesn’t even matter if you really believe it, even if you believe it so fervently that you’re willing to die for the belief.

If that were any measure of truth, then suicide bombers would be more likely to be right than Nobel Prize winning scientists, and such people are not more likely to be right.  They are almost certainly wrong about everything important that led them to blow themselves up.  In fact, certainty of anything beyond literal mathematical and deductive, logical conclusions is the hallmark of a mind less likely to be right than would be a mind that is full of doubt and willing to criticize itself.

So, I am nervous, but there’s nothing I can do for now but wait.  In the meantime, I really should start writing on my laptop computer again.  This phone writing is losing what charm it had, since it’s making my thumbs hurt worse over time.

With that said, I’m going to end the first draft of this now.  I don’t have more to say that I’m sure I haven’t said elsewhere, before, probably eight-thousand times.  I tend to repeat myself a lot.

I hope you have a good day and a good week.

*Sometimes I feel that the plural of aspirin should be “aspirins”, but I think it’s generally just “aspirin”, like “deer” and “fish”** being both singular and plural.

**Sometimes one sees the word “fishes”, but that is generally used, I believe, when one is discussing more than one kind of fish.

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Detritus

Well, I’m getting ready to go to the office this morning.  It’s payroll day, which means I’ll be more stressed out than even I usually am.  It’s really gotten to be more complex over time, with different people being paid in different ways and rates and with different incentives, and people in our new, other office.  Oh, and now we’re getting yet a new “product” to sell which is going to require more differentiation and so on.  Huzzah!

I don’t know why I keep writing this blog.  I feel like I’m just continually rehashing the same things, saying the same things over and over again, not even really expecting different results.

Incidentally, there’s no actual (reliable) record anywhere of Einstein saying words to the effect of “the definition of insanity is doing the same thing over and over again and expecting different results”.  Frankly, it doesn’t even seem like anything he would have said.  It doesn’t make sense, either‒it flies completely in the face of the idea that someone can improve with practice at something, or that in some circumstances retrying something over and over again occasionally brings about different outcomes.

Einstein apparently did say that there are two things that are infinite, the universe and human stupidity, and he wasn’t sure about the universe.  Of course, as a Jewish scientist, he left Germany in the 30s (I think) because he saw the products of the breed of human stupidity that arose there at around that time, so you can understand why he might take a dim view of human intelligence.  I wonder what he would think of us now.

Anyway, I’m still taking my “antidepressant” and also trying to adjust things better to control my chronic* pain.  I can feel the immediate effects of the St. John’s Wort, which I always do when I take it.  Dry mouth, slightly less reactive, and feeling a bit stiffer (metaphorically) and more socially withdrawn in the morning for a while after I take it.  It’s not making a difference for my sleep, that’s for sure.  But, again, maybe it will at least give me enough of a boost finally to act on my desire just to stop existing.

It would be nice if it at least gave me more will or drive to exercise, which it has done in the past, though not every time I’ve taken it.  At least it doesn’t tend to give me the asthenia that I would get with SSRIs, and it doesn’t give me the rampant and intolerable tension and anxiety that Wellbutrin and Effexor gave me.  It’s closest in character to the old tricyclics‒amitriptyline and nortriptyline‒but not as groggifiying.  Anyway, hopefully it does something to help me make some changes.

I think of depression as being at least partly a disease of gumption, a disease of the will, where the sense of motivation is impaired.  Or perhaps it’s more of a psychological autoimmune disorder, where the mind turns upon itself.  That’s an oversimplification, and there are certainly more aspects to it than that, but that is at least part of it.

Of course, there may be other factors at play in my brain.  I’ve encountered a place online that does reasonably priced autism assessments (I found it through Threads) and I may avail myself of that.  It is slightly worrying, of course.  It sometimes feels nearly certain that, if assessed, I would be told, “No, you don’t have ASD or anything related to it.  You’re just fucking out there like Vega, you don’t even count as human.”  Which would come as no real surprise, but it would be somewhat disheartening.  How does one treat, or at least accommodate, someone who is an alien?

I don’t know what I will do with any knowledge I gain through that process, if I do it.  Maybe I won’t do anything.  Maybe I’ll just flush it all away with every other bit of information I’ve ever taken in.  I guess that’s what’s going to happen one way or another, anyway, right?

Whatever.  I hope you all have a good day, or have good days, if that should be plural to match the subject.  I suppose I’ll probably write another blog post tomorrow.  I’m sure you can hardly wait.

In the meantime, here’s a little “video” (really more of a slide show) that I threw together this morning, to the tune of Another Brick in the Wall Part 3.

*I originally made a typo there and wrote “chromic” pain, which sounds like something from which a synesthete might suffer‒a chronic discomfort that they experience with all the colors of the rainbow.

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Fetter strong madness in a silken thread, charm ache with air and agony with blogs.

Hello and good morning.

As anyone who has read my recent posts will know, I have not been doing well, depression-wise*.  Yesterday afternoon, after sharing a “memory” on Facebook (a picture of my son from one of the last times I was with him) and explaining in the comments that the reason I hadn’t seen him was that he didn’t want to see me, I felt particularly low, and had to fight to keep from crying openly in the office.  Thankfully, it was a slow afternoon (as opposed to a very stressful morning, in which I was working on payroll among other things), or I wouldn’t have been involved with Facebook, anyway.

I was so low that I started Googling (on my phone) the lethal doses of everything from CBD gummies** to aspirin to Benadryl to a combination of fentanyl and Valium.

That latter combo, of course, is the only reliably life-threatening thing among the many that I searched, but honestly, I knew all that already.  I am a trained medical doctor, after all, and I have a long-standing interest in ways to make one’s quietus‒including, but not limited to, a bare bodkin.  I was mostly reviewing things like the mg/kg dosage needed to be more or less certain one would die.

The biggest downside of the opiate/benzodiazepine combination is that they are controlled substances.  Just try to get a prescription for the two of them without a terminal cancer diagnosis or something similar.  Go ahead, try.  If you succeed, please get in touch with me.

Of course, there are illicit sources of both classes of medicine, and I even know some people who might know where to get them.  But such people, and such illicit medicines, are supremely untrustworthy, so that’s not great.  I probably wouldn’t accept anything that wasn’t a name-brand pill, like the Valium tablets that at least used to have a big V stamped in them.

I suppose one could try to con one’s way into getting a veterinary cocktail such as might be used to euthanize a large dog or something similar.  I can do injections, obviously, even to myself.  But I am not good at conning people, and I certainly wouldn’t want to deceive a kindhearted veterinarian.  That seems very uncool.

Alas, most OTC medicines are unreliable for many reasons, including limited absorption, nausea/vomiting, and other rather unpleasant symptoms that would precede death by quite some time, and might be awful enough to cause even the most committed would-be suicide to seek relief.  It’s very hard to fight deep-seated biological survival drives, believe me.

Oh well, there are always many options, I guess, and I have the necessaries for many of them.  I even used to have some helium tanks and a nonrebreather mask, but I gave the helium to people making balloons for parties‒they didn’t have the right kind of connectors for the regulator and mask I have, and I wasn’t confident of my ability to jury-rig something.

I don’t want any of you to think I simply wallow in depression, and my chronic pain, and my horrible sleep issues, and possible neurodevelopmental difficulties.  I am constantly attempting new exercises, new habits, autosuggestion, self-hypnosis, meditation, dietary adjustments, postures, medicines, and so forth to try to help my problems.  I don’t ever stop doing all that, which is exhausting in and of itself.

It’s likewise exhausting to keep trying to act as normal as I possibly can, because I don’t like to cause other people more trouble than I absolutely must.  Also, it’s just my lifelong habit to try to act upbeat or to try to be funny, at least during direct interaction.  But it’s very tiring, and over the years, my grumpy side has definitely gained more ascendance, particularly at work.

Not that I’m an asshole at work, at least not any more than I’m just an asshole in general.  But the noise in the office and people making really unreasonable, sloppy mistakes, stress me out quite a bit, and the frustration bleeds through more than it used to.

Sometimes that happens literally.

Anyway, more and more I’ve been just working and struggling merely to survive.  I haven’t been working anymore on Outlaw’s Mind since the last time I mentioned it here; I haven’t even been taking my little laptop back and forth with me, though I type much more quickly on it than I can on my phone.  The closest thing to any creativity I’ve done recently is as follows:

On Tuesday morning, something I read (I don’t recall what) made me think of infrasound and low-pitched noises that are reputed*** to be able to instill a sense of fear or dread in people.  There was some indication that a 7 Hertz noise would be troubling in some way‒I don’t recall how‒but one needs a serious sub-woofer to be able to generate such a pitch at all, let alone with useful volume.

However, the low range of the human audible threshold starts around 40 Hertz, so I thought I would do something at least mildly interesting.  I pulled up Audacity and generated two tones:  one at 47 Hertz and one at, I think, 73 Hertz, and merged them.  I chose those frequencies because, since they are both prime numbers, their waveforms would not tend to overlap very much, and so their constructive/destructive interference would tend to be relatively chaotic, producing a pleasing (so to speak) deep and unsteady rumble.

Then, I recorded myself doing an impromptu recitation of Hamlet’s soliloquy****, which (of course) I know from memory.  I first lowered the pitch of that recording a bit, but not using the optional maximum quality pitch change (I didn’t want it to sound normal) after filtering out background noise and even breath sounds*****.

Then, I copied that track and shifted its pitch a step and a half, then copied that and did the same again.  This produced three simultaneous recordings of the same thing, but with pitches at intervals that make it into a constant diminished chord (that’s where the third and fifth tones of a major triad are each reduced by a half step, making an eerie, haunting, somewhat dissonant chord).

Then I combined those three vocal tracks into one, put a bit of reverb on it, lowered the pitch again until it was at least close to that of my background tones, and combined them all after trying to adjust the balance to make sure that the vocal stuff was not quite clearly present against the background sound.

I then turned it into an MP3 file and put it on loop on the big TV we use as our room sales board, starting it once people came in, and only very slowly increasing the volume from too low to hear to just audible.

One coworker noticed it, and she kept trying to figure out what it was saying, or if anything was being said at all.  I explained what I had done, to her and to my “main” coworker, who also sort of heard the noise and looked puzzled.  They both thought it was odd but funny, but it was apparently also mildly irritating (almost the point of it, really), so once they said that, I stopped the playback.

I’ll embed the audio file here, below, in case you want to listen.  Feel free to use it to annoy or unnerve other people, if you wish.

And that’s it, that’s all I have for now, from the most creative to the most wishfully self-destructive (not in that order).  I hope each and every one of you is feeling better than I feel.  On any given day, at any given time, I think my odds of that being the case are good.  If I were able to bet even money on it even once an hour, I think I’d pretty quickly have an excellent return on investment.  Though, that might improve my mood and so alter the expected payoff rate of my investment…damn those economic feedback loops.

TTFN

*Though my depression, if considered as an entity with a “life” of its own, is thriving, thank you very much.

**There more or less is no practical lethal dose, it seems.  The sugar in a gummy would probably kill you before the CBD would.

***Almost certainly untruthfully.

****The most famous one, “To be or not to be…”

*****Removing these throughout a recording has a curious way of deadening it, and it’s rather unpleasant if you’re trying to produce something that sounds good, so was ideal for my pseudo-purposes.