exhaustion...

geeze.
Can't spell anymore...


well, spoke with the doc's secretary. Surgery scheduled sometime during the last week of the month. G-scope same week. I'm aiming for that golden bedpan - frequent flyer miles except this one is for hospital visits.

The last scope revealed nothing. The gastro doc had mentioned that I should see a urologist to cover all my bases. What's next? Heart? Lung? Brain?

Ouf. Just should have a scan done of the whole body. That's it, that's all.

Seeing the breast doc in two weeks to address the lump issue.
Psych doc will just have to wait. Unless i have a meltdown before then. Fingers crossed that it does not happen...


What is keeping my spirit up is the hope that I will be well enough to visit my family in B.C. And if things go well, E will be heading down to California for work, so that means I could hitch a ride with him. It won't be in L.A, but close enough to the shore for me to enjoy it. Just hope to GOD that it does not slide into the water while i'm there. With my luck, it might...

And also have been looking at images from the tourist videos of New Brunswick. Every time i watch this, it brings tears to my eyes. The sheer beauty is something that I want to experience in person before I die.

E is on board with me on this, but thinks that we will have to do it next year (hoping he will get some sort of raise, because after 6 years of nothing, we are getting pretty desperate. No money in the bank at all. Zero. Living from paycheck to paycheck) also because to hike to the best spots, is a 4-5 hour uphill journey. He has trouble going up stairs now. I don't want to kill him!

but i look at this and hope for the best, cause that is all I can do. That is all we can ever do...

Because I still struggle with this...

as promised, and long overdue, my first sound 16mm student film. I made this during the first year of (my 2nd degree) Film Production specialization in what is now called the Mel Hoppenheim school of cinema.

The sound is crap, i know. The picture is shitty but the idea is there and for now,

that is all that matters...

(tip - click on the little square between the bars and the "Vimeo" logo". This way you can see it larger, which is better...)


Clair Obscure - a visual autobiography from Kathy Slamen on Vimeo.

I did everything here, aside from act.

That is my voice you hear. This is my experience you are seeing.

My professor warned me about the pitfalls about making a film on mental illness, because it was a complicated subject, and because i was a rookie, there was a fine line that needed to be balanced upon - because too serious or too light and the message would not come across as intended. I'd either end up with a bad comedy or a bad horror film.

But i was determined, and for 6 months of my life, i was this film in ever sense of the word. And my professor as well as a few close friends and family believed in me when nobody else did. And the day i had my final "rough cut", 12 people were stunned silent for minutes as they absorbed the film they just saw.

And this film has gone on to touch lives, win awards and open minds to what is the major leading cause of illness next to cancer - mental illness.

After the past two years of my public struggle with manic depression, the urgency to put this film "out there" and embark on a new project has come, but I have to lay the foundations first.

This film has already won numerous awards, brought many people to tears, but in the end, it was about sharing my story with the world, and i think that after all is said and done, perhaps this is my purpose in life - to illuminate, educate and reach out to those who are familiar and not so familiar with this disease.

So the next time somebody says that mental illness is not real, tell them from somebody who suffers from it - mental illness is a cancer of the mind and spirit.

it's real, and this film and i are living proof...

i am the little filmmaker that could...

Something you need to know...

What you need to know.
What i'm going through is real.
It's pain, it's horror, it's fear and hopelessness.

It's real and if I could possibly have any wish is that everybody on the planet who says that "bipolar illness isn't real" have one day in my shoes during one of my worst episodes.

But I know that will never happen, so it remains my mission to give a shout out whenever I can. To educate the ignorant and to shout at those who choose to feign  hearing loss.


It's All in Your Head And Other Thoughtless Things Said!
By Marcia Purse


How often have you been accused of whining or being a hypochondriac? Do people think you are just a complainer, an attention-seeker, when depression makes it difficult for you to cope with daily life? Are you told that "there is absolutely nothing wrong with you?" Do people tell you to "get over yourself?" I am sure that everyone with bipolar disorder has had those completely thoughtless things said which we can quote verbatim 5, 10 and even 30 years down the road.

Sometimes those with whom we interact can be narrow minded and cutting. And for every person who says something deliberately hurtful to a person with mental illness, there are a dozen who say things thoughtlessly or out of ignorance. Unfortunately, regardless of intent, words wound, fester and scar.

The following is a short list of things people say that are often intended to be helpful, but are actually tactless. Perhaps these will better equip you to respond to the thoughtless comments and to illustrate the need for each of us to better think through our word choices.

What was said: It's all in your head. You are a hypochondriac.
What may have been perceived: You are either completely deluded or making an excuse for poor behavior in order to get my sympathy. I don't believe in that psychiatric mumbo jumbo. I don’t believe that you actually have a real illness.
The Fallacy: Mental health problems are the result of a character flaw or weak personality. Mental illnesses are not real diseases.
The Facts: Bipolar Disorder is a medical illness with a physical cause probably rooted in structural or biochemical abnormalities in the brain. In short, it is very real, just like diabetes or heart disease.

What was said: We all go through times like this.
What was perceived: You are overreacting. Stop making mountains out of molehills. You can't handle life as well as I can.
The Fallacy: Everyone has the symptoms of Bipolar Disorder.
The Facts: An article by David A. Kahn, M.D., and colleagues entitled Treatment of Bipolar Disorder: A Guide for Patients and Families1 offers an excellent perspective for addressing this fallacy. "We all experience a variety of moods -- happiness, sadness, anger, to name a few. Unpleasant moods and changes in mood are normal reactions to everyday life, and we can often identify events that caused our mood to change. However, when we experience mood changes or extremes that are out of proportion to events or come 'out of the blue' and make it hard to function, these changes may be due to a mood disorder."

What was said: Just shake it off.
What was perceived: You've created this problem for yourself, so just get over it and move on. I am out of patience with you. Don't bother me with this again.
The Fallacy: Everyone can and should control their emotions.
The Facts: Bipolar disorder is a medical condition. Those with this disorder can no more snap out of it or shake it off then those with a broken leg.

What was said: He must be demon possessed.
What was perceived: I am righteous. You are not. Everyone who believes in God is perfect and does not struggle in life. You are a sinner and got what you deserved.
The Fallacy: Bipolar Disorder is the result of misconduct.
The Facts: Bipolar disorder is not your fault. It is not the result of something you did or didn’t do. "Bipolar disorder has no single proven cause, but research suggests the illness is due to abnormalities in the way some nerve cells in the brain function or communicate." (Kahn et al, 2004).

Sources:
Kahn, D.A., Keck, P.E., Perlis, R.H., Otta, M.W., & Ross, R. (2004). Treatment of Bipolar Disorder: A Guide for Patients and Families2.

NeuroSkeptic

Critical information on something I have been thinking a lot about.

Thanks Neuroskeptic for the information!

Saturday, 2 January 2010

"Cortical Stimulation" for Depression

The last decade saw a number of new experimental treatments for depression based around the idea of using electricity to alter brain function - deep brain stimulation (DBS), vagus nerve stimulation (VNS), and transcranial magnetic stimulation (TMS).

The mechanics of these technologies differ, but they're all being promoted as options for "treatment-resistant depression" - depression which hasn't responded to more conventional approaches. They're also alike in that their usefulness is uncertain - either because there have been no randomized-controlled trials (DBS), or because the results of randomized trials are mixed at best (TMS,VNS).

Now there's a new kid on the neurostimulatory block: epidural prefrontal cortical stimulation (EpCS). This involves implanting electrodes beneath the skull, but above the meninges, the "skin" surrounding the brain. So it's unlike deep brain stimulation (DBS), in which the electrodes are placed inside the brain itself.

Late last year, Nahas et al reported on EpCS in a paper,Bilateral Epidural Prefrontal Cortical Stimulation for Treatment-Resistant Depression. They took 5 severely depressed patients, with either major depression or bipolar disorder, who'd all tried many treatments and experienced no benefit:

The mean age was 44.2 years. Four were women, and three were diagnosed with recurrent major depressive disorder; two others had bipolar affective disorder I, depressed type. All were unemployed, and three were receiving disability. The average length of depressive illness was 25.6 years. The average length of the current depressive episode was 3 years, 7 months ... participants had received an average of 9.8 unsuccessful clinical treatments during the current major depressive episode ... They enrolled in the study taking on average 6 psychotropic drugs.

Electrodes were implanted bilaterally over the "anterior and midlateral frontal cortex". This is as sensible a place to stimulate as any, although we really don't know what these parts of the brain do, or how they relate to depression. Nor do we know what "60 Hz, 2–4 V, 30 min on/ 2.5 hours off from 8 AM to 10 PM." stimulation does to these areas.

2 weeks after surgery the electricity was turned on, and the stimulation was then optimized over 2-3 weeks. Did it work? Out of the 5 patients, one didn't get any better, two felt somewhat better, and two were greatly improved at the end of the study 7 months post-op. And there were no major side effects or cognitive changes; one patient got a bacterial infection, but it was treatable. Hurrah!

But hang on. There was no control group, so the improvement could have been due to the placebo effector, more likely, the passage of time. The guy with the single best response, Subject 2, was as depressed as ever during the first 4 months, but then improved dramatically by month 7. It may not be a coincidence that this subject was bipolar. Bipolar people who are depressed eventually stop being depressed - that's kind of the point.

Indeed, all of the others who improved did so between 2 weeks and 4 months after the stimulation was started, not straight away. So it's not like flicking a switch and turning off the depression... but on the other hand it'sexactly that if you listen to what the patients say during the operation itself.

They reported feeling happier and less anxious as soon as the current was turned on (they weren't told when this was, so this is unlikely to have been a placebo effect). Some said things like

“I feel attentive,” “feel better and I can talk now,” “I can think clearer.” A patient noted during anterior frontal pole stimulation feeling as if a “weight [was] lifting off my shoulder,” “I feel calm”; another stated, “and although I am worried, I feel
dissociated from it. I can think back at my worry.”

Subject 2, the guy who got much better a long time after the operation, was the only patient who didn'tenjoy any nice effects during the operation itself, which only adds to my suspicions that he would have got better anyway.

What does all this mean? It's hard to say. The results are very similar to those seen with DBS for depression - patients report suddenly feeling happier as soon as the current is turned on during the operation (the only placebo-controlled aspect of the trials), but afterwards the improvement seems gradual, taking weeks or months.

There's two main ways of interpreting this. The optimistic view is that stimulating the right bits of the brain instantly treats depression, and the apparent "time lag" in improvement after the operation is a product of the fact that when someone's been depressed for so long, as these patients have, it takes time for them to readjust to normal life even once they start feeling much better.

The pessimistic view is that stimulating the brain doesn't treat depression, it just causes a "high" which doesn't last very long, and the subsequent slow, gradual improvement would have happened anyway.

This is why we need randomized controlled trials. Nahas et al note that there has been one randomized controlled trial of EpCS for depression, comparing active EpCS to placebo EpCS with the electrodes switched off. It hasn't been published yet, but a preliminary analysis found no difference between the two conditions - it didn't work. And that trial was more than twice as big as this one (12 patients vs. 5). But, they point out, in that trial only the left side of the brain was stimulated, whereas they stimulated both sides.

Overall, just like DBS, EpCS could be either a great leap forward or a waste of time, money and neurosurgery. Hopefully, by the end of this decade, we'll know. Watch this space.

this could not have come at a better time...

This is a brilliant post by the amazing actress Glenn Close.

I thank her for writing this.

it needed to be said, and i could not have imagined of a better time than today to stumble up this.

Mental illness and I are no strangers.
From Alex Forrest in Fatal Attraction to Blanche Dubois in A Streetcar Named Desire to Norma Desmond in Andrew Lloyd Weber's Sunset Boulevard, I've had the challenge -- and the privilege -- of playing characters who have deep psychological wounds. Some people think that Alex is a borderline personality. I think Blanche suffers from post-traumatic stress disorder and everyone knows that Norma is delusional.

I also have the challenge of confronting the far less entertaining reality of mental illness in my own family. As I've written and spoken about before, my sister suffers from a bipolar disorder and my nephew from schizoaffective disorder. There has, in fact, been a lot of depression and alcoholism in my family and, traditionally, no one ever spoke about it. It just wasn't done. The stigma is toxic. And, like millions of others who live with mental illness in their families, I've seen what they endure: the struggle of just getting through the day, and the hurt caused every time someone casually describes someone as "crazy," "nuts," or "psycho".

Even as the medicine and therapy for mental health disorders have made remarkable progress, the ancient social stigma of psychological illness remains largely intact. Families are loath to talk about it and, in movies and the media, stereotypes about the mentally ill still reign.

Whether it is Norman Bates in Psycho, Jack Torrance in The Shining, or Kathy Bates' portrayal of Annie Wilkes in Misery, scriptwriters invariably tell us that the mentally ill are dangerous threats who must be contained, if not destroyed. It makes for thrilling entertainment.

There are some notable exceptions, of course -- Dustin Hoffman in Rainman, or Russell Crowe's portrayal of John Nash in A Beautiful Mind. But more often than not, the movie or TV version of someone suffering from a mental disorder is a sociopath who must be stopped.
Alex Forrest is considered by most people to be evil incarnate. People still come up to me saying how much she terrified them. Yet in my research into her behavior, I only ended up empathizing with her. She was a human being in great psychological pain who definitely needed meds. I consulted with several psychiatrists to better understand the "whys" of what she did and learned that she was far more dangerous to herself than to others.

The original ending of Fatal Attraction actually had Alex commit suicide. But that didn't "test" well. Alex had terrified the audiences and they wanted her punished for it. A tortured and self-destructive Alex was too upsetting. She had to be blown away.

So, we went back and shot the now famous bathroom scene. A knife was put into Alex's hand, making her a dangerous psychopath. When the wife shot her in self-defense, the audience was given catharsis through bloodshed -- Alex's blood. And everyone felt safe again.

The ending worked. It was thrilling and the movie was a big hit. But it sent a misleading message about the reality of mental illness.

It is an odd paradox that a society, which can now speak openly and unabashedly about topics that were once unspeakable, still remains largely silent when it comes to mental illness. This month, for example, NFL players are rumbling onto the field in pink cleats and sweatbands to raise awareness about breast cancer. On December 1st, World AIDS Day will engage political and health care leaders from every part of the globe. Illnesses that were once discussed only in hushed tones are now part of healthy conversation and activism.

Yet when it comes to bipolar disorder, post-traumatic stress, schizophrenia or depression, an uncharacteristic coyness takes over. We often say nothing. The mentally ill frighten and embarrass us. And so we marginalize the people who most need our acceptance.

What mental health needs is more sunlight, more candor, more unashamed conversation about illnesses that affect not only individuals, but their families as well. Our society ought to understand that many people with mental illness, given the right treatment, can be full participants in our society. Anyone who doubts it ought to listen to Kay Redfield Jamison, a psychiatry professor at Johns Hopkins, vividly describe her own battles with bipolar disorder.

Over the last year, I have worked with some visionary groups to start BringChange2Mind.org, an organization that strives to inspire people to start talking openly about mental illness, to break through the silence and fear. We have the support of every major, American mental health organization and numerous others.

I have no illusions that BringChange2Mind.org is a cure for mental illness. Yet I am sure it will help us along the road to understanding and constructive dialogue. It will help deconstruct and eliminate stigma.

The World Health Organization (WHO) estimates that by the year 2020 mental illness will be the second leading cause of death and disability. Every society will have to confront the issue. The question is, will we face it with open honesty or silence?

letter to a doctor

Today, I was just so desperate.

Got a message from my G.P, that my shrink said he wanted to take my meds down by a huge chunk. I can feel the difference between 10-20mg, but 150 made me so nervous i cracked.

All the ooze just came spilling out.

It had to come out. I was rotting inside.

make of it what he will, but you know, this month being "mental health awareness month", it might be a good thing that this gets out.

Dear Dr. C

just got an email from my g.p who informed me that you advised I decrease my Welbutrin to 150mg from 300mg (i kept on forgetting to take the extra 50 mg because i had to manually split the pill, and by the time i did remember, i had started to get manic) and no Starnoc or Xanax.

I can honestly tell you that is going to be a big problem...

Since you are not at the office right now, i have reluctantly resorted to email because i think this needs to be sorted out very quickly. and apologize profusely for bothering you, but since we can't speak on the phone tonight in detail about this matter, i don't know what to do or who to turn to because I am so completely desperate, and if my mood gets worse, might have to make a trip to the emergency tonight.

I'm a) worried about going down to 150mg of Welbutrin. From 300 that is a HUGE jump for my system. And if the current 300mg is keeping me barely afloat on good days (in terms of depression), I don't even want to think what 150 will do to me. Those lows terrify me. I have tried to commit suicide in the past, and with those thoughts lurking close to the surface these past two months, would a huge decrease like that be a wise thing to do during this time?

and b) without Starnoc (with was the only thing that helped me sleep in the past, and i believe had been taking it while on Welbutrin approximately 3 years ago, and had taken it 6 months ago, and again on the night before my wedding because i had "an emergency stash) i don't see why it would be a problem now since i am still on Welbutrin, unless there is some policy about doctors giving prescriptions for getting medications over the border, or via the internet that nobody wants to tell me about directly, because up to now, i have not had any solid comprehensive answers as to why i can't take it now.

I find it beyond frustrating and infuriating that I should have to be penalized for not being able to get a medication that is readily available in the U.S but not here in Canada because somebody didn't do their job marketing it properly at the corporate level. I will call Servier Canada again this week, as well as the people at Wyeth (who are holding on to the patents but not giving information to if or when they will put Starnoc back on the market), but this time i will get all the names of people i speak to as well as everything i was told in writing (which was) "Starnoc was taken off the market - purely for marketing reasons", because when i explain my story, it seems to me that every doctor i tell thinks I'm full of it. I'm not a liar, just desperate to be able to get the drugs that help me get the sleep that i so desperately need.

as you know, Ativan and i do not have a good history. I skipped a dose one night and thought i was honestly going to die. And nobody bothered to tell me that going off "cold turkey" was equal to somebody detoxing cold turkey from alcohol or harder drugs. I had to find out the hard way.

It was beyond any word that terrifying can describe, and i never want to feel that way again. I don't want to have to take it (Ativan) on a regular basis because i don't want to be dependent on a sleeping pill, but the catch 22 is, if i need it, i will take it, but if i do take it for more than one night in a row I will have to keep on taking it because cold turkey or skipping a dose one night is not an option - so the only way to do so is to taper off. I want to take something only when i need it, and not worry about going "cold turkey" when i don't.

I hope that you understand my predicament.

And i'm not sure if I shared this with you, but, when i was on Ativan in the past, I had gone up to 2.5 mg (about 6-8 months ago ?) because the 0.5 mg initially prescribed stopped being effective. Right now, i'm up to almost 1mg. The pattern is sure to repeat itself, which once again, as stated above, the eventual outcome is not an option.

Immovane makes me physically ill, because the nausea from the metallic taste in my mouth last for 24 hours. And unless i take large doses of Trazadone (which recently, I have taken up to 2 pills a night), I feel as if i am completely stoned, clumsy, disoriented BUT not sleepy.

Sleep plays a big part in the regulation of my bipolar, and perhaps because i have not been able to sleep, has made me in turn, more manic. At this point, i am so completely desperate, I don't know what to do, and I'm sure it's not easy for all the physicians treating me, but I am so very terribly distraught right now, and with my mom's scan at the end of November, it's imperative that I remain calm, focused and be able to sleep, which will in turn, will allow me to be able to be calm, focused etc. If and when the cancer comes back, i can't afford for my sake, but mostly for hers, to be the one who needs an incredible amount of emotional support and/or physical care because i have had another meltdown.

And yes, I have tried yoga, acupuncture, meditation, hypnosis, Valerian root, Nytol, Tynenol PM, Benadryl , holistic/natural sleep medication, warm milk, bananas, turkey, Melatonin (which my pharmacist advised me against because of my thyroid problem), and have also asked her about SAM-E, but she also advised against it because i am on the Welbutrin and Lamictal, but aside from knocking myself unconscious, I don't know what else to do.

I will as of tomorrow, try to scramble to find somebody who will see me through the system for free because after consulting with my husband tonight about our finances, we simply can't afford to pay anybody through private practice. I had maxed out this year's limit with other "therapy/councelling/life coaching sessions" (at 175$ hour, and my yearly limit being $500) and since i am not working, or in any real shape to do so, unemployment has run out and welfare not really an option since we are "supposed to be making enough income" to survive, life seems at best, bleak. Over the years, I have been through the system many times. I know that after my first nervous breakdown some 21 years ago, the average waiting time back then was 3-6 months at best to see a doctor through the hospital. Honesty, I don't think that i will be able to last that long, (if not longer now) and that scares me, well, to death.

Once again, I apologize profusely for sending you this email, but i want you to know what is happening since you are following my case and do know me and my sorted history, but also because in my current state, am manic so can type quickly, and i can still type and weep at the same time, unlike talking on the phone - this needed to be told and don't know if i will be as coherent or in any shape to talk about this tomorrow.

If you would like, you can call me at home tonight.

I will take another ativan to try to stay calm, but 1mg will be tonight's limit, and i really hope that will be enough. If anything, my husband is at the ready to take me to the hospital if need be.

And tomorrow, I will be on a photo assignment from 10 to 1pm, and then away from 5-11pm, and Friday morning might be the best time to call me at home, but because i am (trying to) working with an organization that needs photos quickly, my computer is always on.

I'm attaching my mood charts so you can see what has been going on. In all actuality, October has been quite an uneventful month, and normally, that would have in turn, stabilized my mood. When things around me in my life get out of control, i tend to swing, but with a calm environment, my swings came out of the blue and have taken me completely by surprise and have terrified me.

Dr. C, thank you once again for your compassion and understanding of my difficult and complex situation, and once again, sincerely and deeply apologize for troubling you.

Sincerely,

HpK

ride the dragon

life has been chaotic these past few days and I have no clue why.

Usually, there is a direct corelation between my mood and what is going on around in my world, but lately, things have been, well, quiet. Non eventful. Mom saw her doctor who is sending her for scans in November (our little 3 month window has opened up wider for a few weeks), but no real "news". A follow up of sorts. So there was no real reason to get anxious.

but i am, and it's rough.

I have not swung this high or low in many many months. I'm thinking back to maybe a year, or two? And I'm not even taking the extra Welburtin that the doc prescribed to me. I don't even want to think what that would be like. When i tried it two years ago, I was flying into walls, and if i decided to augment my dose now, i might fly off of buildings or bridges.

so i try to put one foot in front of the other but I can't help but to be very nervous that at any moment, my manic instinct will kick in and i'll be running in the other direction, well, actually, with no direction in particular, in circles perhaps, until i collapse into a heavy weeping mess, looking to get lost in the spaces between horrible thoughts of suicide and exalted grandeur.

last night, I happened to stumble upon the movie - Control.

I had watched the whole film about a year ago, and it still affects me deeply. An instant vivid snap into a time in my life when death was a welcome respite from the exhausting whirling orbit of fear and elation that i lived every moment of every day for months on end. The fact that it is so breathtakingly beautiful to look at did not help to pull me away from not watching it, but as a result, i regressed to the tender age of 16, when life should have been full of promise and possibilities, but was devoid of life and hope, and where suicide was the only path to calm and rest.

15 minutes was all it took, and time began to warp.

And what i find odd was that my regression into these dark memories began during the point in the movie when the band is actually doing quite well; their career is taking off, interest in their music is growing, and the young men from Manchester are still filled with hope and optimism.

Just like i was once, a long long time ago.

"you know, E, the thought of suicide is never far enough in my brain. It's always "this" close to moving into the liquid plasma of my current existence. It's never far enough, and that scares me."

i silently wept as he lay on the couch. He was too buzzed after a night of jamming with the guys to truly grasp what i was saying, and I am not angry at him for that; it's the exact opposite - I feel sorry for him that he has to live with such a ticking time bomb.

when i was 16, Ian Curtis' deep oily crooning of life left unfinished resonated with something almost primal in my soul. Beyond the words, beyond the tempo, a mysterious and macabre comfort connected me to him. He got to complete what he wanted to end before i did. Each song is a testament to this.

Sometimes i am thankful for that, sometimes i envy him for beating me to the finish line.

change skins

augh.

I'm throwing up my hands for this one.

It seems like there will be a never-ending who hurt who first cat and mouse game.

I mean hello - the man is 67 years old. Grow the fuck up!

His email was like a kick in the face, transporting me back, 30 years ago when i sat at a table across from him. It was the final settlement of the alimony child support fiasco. I had moved in with my boyfriend, and he and his wife deiced to pay a visit. Turns out it was a fact finding mission, not a friendly drop in - according to my father (through his lawyer), since i was living with somebody now, there was no need to pay child support. So he began the process of claiming that he was going to sue me for all the back child support/alimony payments.

it was ugly - even more disgusting than the divorce. I was 20 years old, just recovering from a severe breakdown, sitting in front of a man who called himself my father. His eyes dead, black, not the brown i had remembered them to be.

Back room discussions between lawyers finally ironed things out.

He would continue with the original agreement as stipulated in the divorce papers 19 years ago. Child support until my 21st birthday.

As our lawyers passed around the papers to be signed, i passed him a paper with all the names of my current doctors. Three psychiatrist, an endocrinologist, gynecologist and a general doctor all agreeing that i was in fact, suffering from a severe hormonal imbalance, and severe Premenstrual dysphoric disorder (PPMD) and manic depression. My "fits of crying and depression" were not in my head, and were not tools to "manipulate" him into giving me more money. They were real.

I said this, pointing to the list of doctors and their phone numbers.

"every one of them said you can call them for details. Every one of them said they would be happy to explain all of this to you. My problems are not "in my head". They are real."

Without blinking , or looking up, he snarled:

"well, if i asked my doctor when all my problems started, they would say they all started when you were born!"

and that was all he said.

He stood up, pushed the chair away, shook his lawyers hand and bolted for the door.

We all sat there - mouths gaping wide open.

Stunned.

In shock.

did he just say that?

His lawyer began to apologize profusely, sincerely disturbed by his client's outburst.

What could he say? What could we say?

Our lawyer took me into her office, and gave me a big hug.

"He's just an evil man. In all of my years of practice, i have never seen anything as despicable as this. I am so sorry this had to happen."

I was in shock. My mom was in shock.

We sat in the car, running the scenario over and over in our head for days.

Days turned into weeks. Weeks into months, and then into years.

And then one day, it just happened.

I learned to let go.

I woke up and told myself that he did what he did for some strange alien reason that i would never understand (which turned out to be his psychotic wife who always believed i was out to steal him from her) and that holding a grudge was only poisonous to me. I had to accept and love him nonetheless.

So then i opened the door to forgiveness. Opened the lines to dialogue.

And one day, out of the blue he called. Left a long message on my phone. He had cancer, had beat it, was retired, and looking forward to reconnecting.

And we did, and it was wonderful. Finally, as adults, we were able to talk, laugh. I had my father back in my life again. Not as my father per say, but a wounded man who was happy to reconnect with a young woman he had once loved dearly. A part of him. He a part of me. Associated by blood lines.

Blood is thicker than water.

but after months of spotty correspondence, old patterns re-emerged again. "Yea, we will get together, come up north", but something would always come up.

Here we go again.

I was the 11 year old girl, sitting on the stoop of her front door. Tiny suitcase in had, waiting for dad to pick her up for a nice weekend up north.

he never came

"I forgot..."

I forgave, moved on. Accepted and then let go.

Life went on.

Then one day, the nasty email from facebook.

"I'm entitled to know what is going on because I am your father.."

whaaaatttt???

I wrote back, calmly. Logically, giving all the facts.

His reply, short and sweet. Something about he suffered pain of loneliness, and that certain people and situations kept me away from him.

cryptic.

I moved on, opening the door to dialogue. Besides, i wanted him to be a part of the biggest day of my life. He was still my father. Not a very good one, but still one.

It was pleasant, but that was it. He only came up to me to say goodbye at the end of the night. We laughed, took a few photos and that was it. The joy of the day overshadowed the awkwardness of that final exchange. But I was still happy he came.

Then the lovely email - a day after my honeymoon.

Another kick in the stomach.

Then the news mom's cancer had come back.

Sucker punched again.

wounded and weary, knowing that another boxing mach would begin soon - round x with cancer treatment. Not again, fucken cancer. Can't you stay away?!

so i replied. Trying to be as honest as possible. What did i have to lose anymore?

Dad,

All i can say is that i'm so very sorry that you felt the way you did. It was in no way done to hurt anybody. I was very saddned and very depressed when i got this email a day after my honeymoon. I didn't know what to say - what could I say after all? I think sorry would not be enough...

You know, not having you in the wedding party was such a tough decision. I was very very confused and it caused me many sleepless nights, but please try to see this from my perspective, please try to understand - if things were different in both of our lives and i had to make decisions on how our lives would have turned out - we all would have been a happy family - both mom and dad walking me down the isle, but the reality of it all is that mom has been all alone to raise me all by herself for the past 30 years. I could not make you a bigger part of this wedding without causing her a lot of pain, and because of everything i have seen her go through first hand, and all that she has done for me and seen me go through, i felt it was my way of thanking her for taking care of me and loving me so much. She was involved right from day 1 - driving me to every store in the city, spending late nights with me making the invitations, planning, and all while in between, doing her il2 treatments. Lots of stuff happened so quickly - it seems like i blinked and the day was over.

It was a hard decision but i hope you understand that as an adult, people have to make difficult decisions in their life, and this was one of them...

And the day really went by so quickly - it was hard for me to get to everybody. People were coming up to me to talk, i really wished you had taken a moment, taken me aside and had a nice father/daughter chat, wished me well, and told me how pretty i looked, because every girl wants to hear that from her dad on her special day - regardless of the situation. But I want you to know, that despite the way things turned out, I was so very happy that you came, and yes, i too wish we could have taken some photos together - but you know what? Nobody got family photos. I have none of us with eric's parents or with you or mom, so don't feel left out. Somebody was supposed to be looking out and making sure all of this got done, but it happened. We can't go back in time and change it or be angry because of it.

but alas, things happened the way they happened. We live and move on.

i think there are a lot of unresolved issues - and the wedding was not the place to talk about them. I know we need one on one time so we can really talk. Email is so hard, and not very personal.

In an email long ago, you wrote: Some situations and some people had kept you away from me

what did that mean exactly? I was always there, always waiting, hoping that we could reconnect, and i hope that we still can.

hpk

Mom had her operation. Another hell experience in the hospital. They didn't give her medications to her for 4 days. Prozac, synthroid. Anti depressant and thyroid medication. Two very important meds. She was going through serious withdrawal. You don't come off cold turkey with prozac. It can make you lose your mind.

Seriously...

She was let out of the hospital too early, without any dressing on her 30 inch incision across her belly. No follow up appointments. Nothing.

She got sick, the wound seriously infected. Rushed to the hospital again.

The never-ending saga.

Then a reply.

Mute and dazed, i walked away from the computer. E was away on business and knew that re-reading this would drive me insane. I fwd it to him and waited for his call.

He came back. We talked. I cried, yelled and cried some more.

I had no more strength. Fighting for my mom in the hospital with incompetent and insensitive staff, seeing my poor mother suffer again drained me. And now this.

Thank you for your email.


It still does not change or lighten up my hurt.


I'll make it short, like your comment, "as an ADULT, people have to make difficult decisions in THEIR LIVES and that things happened the way they happened." You certainly made yours.


In closing, I truly wish you and your mate all the best.


Dad.

I guess that was it.

or that is it.

There is no solution to this never ending fight.

He is now dead to me. How anybody can do this to their own child is beyond my comprehension. Grow up old man. You will forever be under the iron thumb of your so called wife. She got you to tie your tubes, she will make you cut the strings with your only daughter.

You are made for each other.

so i try to walk away, not looking back,

not looking back.

“To change skins, evolve into new cycles, I feel one has to learn to discard. If one changes internally, one should not continue to live with the same objects. They reflect one's mind and the psyche of yesterday. I throw away what has no dynamic, living use.”

~Anais Nin

fuck logic

Fuck logic

here is a letter to a friend.

I am so upset right now and hate having my eerie ability to act on my gut questioned.

I will have to go through my archives to find ALL THE TIMES (and yea, there were many) that i did act on my 'intuition" and amazing things happened. But this time, Mr. Logical had to ruin the day.

Mom goes in for surgery 2mrw to remove the mass.

I was shocked when she said: "you have to take this trip. Even if i have to take a cab to or from the hospital before/after the surgery, so be it. You have to go..."

and this is my mom...

so here is the email i sent to Y, the woman who many months ago, out of the blue, while holding my hand and feeling my energies, told me that I had to go to Lake Placid, because there was something there for me. This is the same woman who has told me and my mother many times of many things that without a shadow of a doubt, have come true.

Mystic perhaps?

Or as e would say - "lucky guesses"

but one guess is lucky, 20 is more than luck...

and lake placid - what were the chances that e would have to go there?

And of all places in the U.S - there???

Hi Y,

thank you for getting back to me. I passed along your email to my mom. She is in prep mode - right now she's at work and 2mrw she goes into surgery 1st thing in the morning. We are all very stressed. The doctors have been very supportive of her and she is getting the best care. Her new surgeon is so wonderful and the moment i met him, i had such a wonderful feeling. i know she is in good hands.

She will have to take another unpaid leave, which is pretty disturbing as she has run out of paid medical leave time. And it's tough too - I don't think either of us has had time to grieve the loss of her mother/my grandmother. it was her death, my wedding and now my mom's next surgery. Cuba honeymoon was a Godsend. Without that, i don't think i would have been able to survive this next journey.

Speaking of journey...

I need your advice.

The man just got an invitation to go to Lake placid for a business seminar/trade show. This came up completely out of the blue, and of course, I flipped when he told me because i remember your telling me that you had a feeling that lake placid was the place for me to go (that time we sat on my mom's steps when you felt my palm/energies). I told my mom - she said: "Go. Even if i have to take a cab to and from the hospital. If Y said to go, you have to go!"

I feel the same way. As does she still.

But e on the other hand, is not really sure.

He's trying to make excuses for me not to go - "ah, it's business, you'll be bored and stuck in a hotel room" and his latest: "we can go another time"...

but I have been telling him - IT"S NOT THE SAME THING!

but alas - a skeptic is always a skeptic, and now he has me doubting my gut feeling which is telling me to go.

But would it be the same thing if we go another time?

I feel that this chance is like a gift of fate - and that perhaps something will happen, perhaps not, but i don't want to not take this chance. In my experience, if i act on something that feels right - then something usually comes out of it. But if that instance/coincidence is changed in any way (like e's wanting to 'reschedule") - it just won't be the same.

Y, please tell me i'm crazy, but without e being able to take me down on this trip, it just wont happen - whatever is to happen.

You can't 'reschedule" fate! Am i right?

E will have to leave on monday so that does not give me much time to make a decision. I have been quickly looking into alternative ways to go down there but there are none. The amtrack route or the buss routes don't stop there, there are no planes that fly there and there is one transfer buss point and it will take 5 extra hours. I don't know what to do.

What is your gut feeling??

I have been feeling so lost, and weep all the time. I feel that i am running out of options, time and faith.

Photography has become painful - a grim reminder of something that i had once loved so much but is now giving me grief because every avenue i have taken in terms of getting my work out there has closed in my face. The same with film and writing.

I don't have much energy - and with trying to be supportive of my mom, it leaves me empty - both emotionally and spiritually. This void has become my cancer....

I'm so sorry to have to end this on a sour note, but i am such a mess right now, i can't even type any longer.

if you can get back to me before next week, it would be so very much appreciated.

and yes - i need to come down and see you and N. Your kind kindred spirits would be just the kind of prescription for a wear soul that the doctor would order.

take care of yourself and we will talk soon