TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
THERAPIST: All right, well just...
CLIENT: It's only been a week and, you know, it's my first week back.
THERAPIST: Do whatever you can and just, you know, let me know. (inaudible at 00:08) for you.
CLIENT: Sorry I never called you back. What happened was that I was supposed to get surgery on Thursday.
They came in and they told me that it's subject to infection and they took my appendix out. Then it became like a wait, wait, wait because, you know, they also told me there would be a lot of problems with it, this and that.
(crosstalk)
CLIENT: Because of bleeding issues, this and that. I have a bleeding disorder called (inaudible at 00:41), which they're not really familiar up here with treating it. Apparently I didn't realize that but that's weird because it's just what everybody in Brooklyn has. It's an Eastern European genetic disease.
THERAPIST: I see. Is it (inaudible at 00:51)
CLIENT: No, no. I was over at (inaudible at 00:55).
THERAPIST: Oh really?
CLIENT: Yeah. It was the closest place I could get.
(crosstalk)
CLIENT: I didn't think it was going to... So, blah blah blah. But they admitted me into the hospital and they had me on an IV for days and days and days. Like, I was there for, like, five or six days.
THERAPIST: Wow. (inaudible at 01:14) in a hospital five or six days.
CLIENT: Yeah. They want to, like basically the problem is I have an infection in my appendix. It's not like the way normal people do it's due to the immunosuppressants. The steroids keep it from swelling up, so that's why I've been walking around with this sort of infection for months, they think. So they've got me on, like, serious (inaudible at 01:42) antibiotics now and they're just sort of, like, trying to figure out who wants to do this or what would be the appropriate method to do this because I have a bleeding disorder, I have very high dose steroids, I have immunosuppressants. If I stop taking those though there could be a lot of other things that go wrong.
So they just have me keep getting blood tests and trying to figure it out. It's really frustrating because I am not in a really Good position to be my advocate, you know, because I'm not feeling so great.
THERAPIST: Yeah, sure. (laughter) You're not in a good position to do anything.
CLIENT: I have never really spoken with many surgeons who seem, like, seriously reticent (ph) to do a surgery that was possibly needed, you know. And I understand I've had a lot of orthopedic surgery mostly and so that's been much less bloody surgery I guess, I don't know. And so it's very unusual, to say the least.
THERAPIST: So I follow they're deciding whether and when and how to take-
CLIENT: And maybe if I need to go to someone who deals with a lot more, like, people who have problems with it. [00:03:00]
THERAPIST: [With that disorder] (ph)?
CLIENT: Yeah. Not just that but also, like well, we had to come back to Brooklyn to find out what they gave me. And it was just really, like, a really complicated thing. Not just that but like somebody now, like, the last so, the residents, like I said, very hesitant. The attending's like, "Well, this gives me an autoimmune feel thing. So if we can just get you like the infection could go away if we could just like" I'm like, you know what, I want to talk to someone who does immunology or rheumatology or something because at this point I've gotten all these different ideas and answers. They know that there's an infection. They know that there's a swelling in that area. They couldn't necessarily tell me because I couldn't get a contrast in me to tell me if it's actually (inaudible at 03:48) but most people have their appendix. So they just put me in the hospital for a long time until my white blood cell count got low enough that, like, they could release me. Because, you know, I have a very, very high white blood cell count. So that's very odd.
And of course everyone from work came to visit me. I hate being like this because it's like, it would be easier if I just had normal appendicitis so that people come to see me and see what's happening but I can't have the normal, so it's, like, these awkward conversations about what's wrong with me, you know. Like, well, this is the perfect storm (ph) of no immune system but yet having my swelling, of (ph) all things, being dampened so that, you know, I've just been walking around like this for months.
THERAPIST: How much do they think it's been contributing to the way you've been feeling everyday (ph)?
CLIENT: Surgeons don't really talk about feelings. You see what I mean?
THERAPIST: I don't mean, like, emotions. I mean -
CLIENT: No, I'm talking about feelings. Yeah, yeah.
THERAPIST: (inaudible at 04:46) on their radar.
CLIENT: Honestly, yeah. That's not even really all that much on their radar really that much. I think that when I talk to a gastroenterologist that will be a different story, you know. But no, that's not really yeah. I knew it was getting better when they started to it's funny because they're being so hesitant because I have a bleeding disorder. And at one point this lady's like I had this really bad nurse and she's coming in and she's trying to give me Heparin. First she's insistent that I have been getting this the whole time. I'm like, I would know if I were being in the stomach, thanks. But second of all, you don't give the Heparin to someone with a bleeding disorder. That's a blood thinner. I had this argument back and forth and she's like, "Are you refusing this treatment?" I'm like yes, yes I am. Obviously she's [getting better] (ph) because she's thinking this through. We aren't supposed to be just letting things happen.
And I went through, like, back and forth. I actually was on morphine and it wasn't helping. That's bad. So I was being put on this other stuff that is apparently, like, this new type of one that's very similar, which made me extremely lightheaded. (inaudible at 06:03) what the stuff's called anymore but it's basically stronger than morphine. OK, so then they're, like, pressing on me. You know, I really don't like the feeling of pain but I really want to get this out of my system so I can tell you where things hurt because at this point I can't tell you anymore, you know. It was just monolue (ph), very (pause) confusing, you know? [00:06:25]
And In the middle of this my husband has a kidney stone and he's not feeling very well and he's very cranky and just like, you know. It was very hard. But luckily I had, like I said, some friends that came to visit me and seeing them helped out but I'm still not remotely well. I was very lucky it worked. They actually had me just answer the phone today and yesterday, so I didn't have to get up and down and all that kind of stuff all that much, which is good. This is sort of at this point though I'm just completely and totally wiped.
THERAPIST: Mostly (ph) exhaustion?
CLIENT: Yeah.
THERAPIST: Are you in pain?
CLIENT: A little bit. I sort of fight through this. Like, at night I take the pain pills but during the day the only way I'm going to gauge if I'm getting any better is [I stop it] (ph). Does that make sense?
THERAPIST: Yes.
CLIENT: On top of it, I've never been especially fond of the way that those kind of pain pills affect me. They make you very dizzy, lightheaded. It's never really although I've been on these kind of things long term before it's just something that I don't like the way it feels. But this is the first time, today especially, so I got up and got to work on my own. I got back from work on my own. And although I only worked like four hours, I am beat.
THERAPIST: Oh, I bet.
CLIENT: And I still have ten more days of antibiotics, maybe more than that. The worst part is now they scared me. Apparently now I found out that I could potentially have another infection from these antibiotics because apparently there is a bacteria that lives in your gut somewhere called c. diff, that if you kill off all the other things it takes control and that's the one that you end up with a colostomy. So every few days they test me to see if my c. diff's out of control. I try to be so I have not been compliant. This time around I'm being really compliant. I am taking the antibiotics when I'm supposed to be. I'm eating tons of yogurt. I'm doing everything they tell me I'm supposed to be doing, just because I want it to go away. And no one's telling me that I'll have to have surgery but no one's saying that I won't. And I really find this strange because there's nobody I mean, supposedly there's this possibility of never having your appendix out if it's, you know.
THERAPIST: (inaudible at 08:48) infected.
CLIENT: I would like to believe in this town that if they're hesitant for it there is a really good reason because it's normally extremely straightforward surgery.
THERAPIST: You would think there's a doctor around here who'd know what they were doing.
CLIENT: And I think that the reason why they are hesitant is because they do know what they're doing, you know what I mean?
THERAPIST: Yeah.
CLIENT: But, like, when the nurse told me when I called, like, the she called me. She had this (inaudible at 09:15) "we're going to have a surgery in a few hours. I'll have the surgeon come down and talk to you. This and that. We're going to be worried about this and that because you're having a lot of problems with bleeding and you have this in your system and it has to be done." So I just called them like, "I am freaked out because I have just been told that I could die. I could bleed out but I have to have surgery." It was, like, panicking (ph) call. But then the doctor's like, "Yeah, not tonight and we have to get you off steroids because I'm not doing it, not on my watch." But the surgical nurses were prepping me to have to have a very bloody nonlaparoscopic surgery.
THERAPIST: Wow. I assume you just can't take out an appendix (inaudible at 09:55)
CLIENT: Oh they do, most of the time. I can't because I've already had one laparoscopic surgery and apparently if this is going to be so strange to explain. Apparently things rearrange themselves. This is also why they can't really tell if it's my appendix or not.
THERAPIST: I see. Like your guts rearrange themselves?
CLIENT: Yeah. So I have my gallbladder out and therefore, you know, if you measure this many like, they have these things where they say, "OK, this is 3.5." You know, based upon your size and weight, like, this is there. They can't guarantee that that's where it's going to be. So they likely will not. I mean, there's a possibility it could be laparoscopically done but they can't because they don't immediately know that's exactly where the position of this organ is, which I think is weird. Again, I think there has to be some sort of philosophy -
THERAPIST: (inaudible at 10:40) and try to find it, yeah.
CLIENT: Yeah, but I guess the problem is if they find it they may have to do more than one, like I don't understand it either. I find it weird but they seem to think that, like, if you've had one laparoscopic surgery that you're they explained that how did they put it? They put it in, like the not geology (inaudible at 10:57) put that. Something like the landscape of things are different and therefore, like, we put one hole in but we always end up having to make it into a full surgery afterwards. And it's like, yep, that's my luck. So I'm just...
THERAPIST: Are you very worried?
CLIENT: Yeah I'm worried. I'm worried because I'm not getting a straight answer. I have a very dear friend of my father who is an anesthesiologist who seems to think that if I really needed to that he could he did his residency up here. He was in school up here up at a medical school. So it's not that big of a deal. But he seems to think that if there is a reason why that it (ph) has to that he could potentially arrange to have me (inaudible at 11:43) down there. And he could justify it because of the fact that I have enough medical conditions. It's not a lack of medical expertise but it is a lack of rapport with the -
THERAPIST: History with the (inaudible at 11:55)
CLIENT: The history with the patient. But the thing is that's weird because I don't have, like, a gastroenterologist down there. But I don't know. We'll see. It's just exhausting. It's really freaking exhausting. I think I may very well try to get surgery down in Brooklyn, just because I don't have the kind of support network to have somebody to take care of me with an incision. John's took enough time off work and he really needs to be back.
THERAPIST: Have your folks been up at all?
CLIENT: No, they couldn't. my mom is right now going through a series of knee injections and therefore can't leave. Yeah, so. It's not bad. This was scheduled well in advance, that kind of thing. She couldn't come up. My friend offered to come up at one point just for the day when I thought I was having surgery just to make sure I you know, like, while Mike was at work (inaudible at 12:49) that kind of stuff but, you know, she owns her own wine shop so she can't spend much time. So she had to drive back. But it was just really, really freaking brutal. I still feel exhausted.
THERAPIST: Yeah, [sounds pretty hellish] (ph).
CLIENT: And I don't like the fact that they are saying the word Crohn's because Crohn's is heavily fueled that's another autoimmune disease, you know. But there's a lot of things that look very Crohn's like about this infection. And that one is extremely stress-driven. There's a 100 percent correlation. Not, like, one to one necessarily but between the amount of cortisol that is in your body and a Crohn's outbreak. So it is heavily stress-oriented and that stresses me out to no end because I do not need an autoimmune disease that I mean, all of them are influenced by stress, you know, but it's heavily fueled by cortisol being dumped into your system and, like, having problems with that. Yep. I do not need a disease that is highly correlated with stress.
So on top of it I'm very, in general, when it comes to gut pain, I'm almost like a I'm a big wimp about it. The type of things that people would shrug (ph) off as just being like a little bit of, like, a hangover I'm just like, "I'm spending the day in bed, thanks." Like, you know, I am serious (inaudible at 14:24) about it. And that's OK, I know that. Because I have walked around. You know, I've walked around and broken limbs. You know, I know that that's something I can cope with. This is just not in my, you know, my repertoire of things that I can handle. And things, [like I said] (ph) have been pretty bad.
THERAPIST: It sounds like it's been awful.
CLIENT: It's been really awful. And, like I said, having both that happen and having my spouse still hasn't passed the kidney stone. And of course I can't push to advocate for him because I am, at that point, like -
THERAPIST: You can't do anything really.
CLIENT: Can't do much of anything. Like, for a little bit he wasn't taking his pain medicine because he had to be able to drive and yeah.
THERAPIST: Right. [That probably means] (ph) he's in a lot of pain.
CLIENT: Yeah. And so it's like yeah. And of course hw as insisting he had to be at the hospital at certain times and I'm like, "Go home. Go home and do something. I don't care if you play Sims till the birds are chirping. Just go home and take care of yourself right now." No one's going to like, every time I went to the bathroom he desperately wanted to like, he's scrambling up to try and help me with my IV. I'm like, "I got it. Don't worry about it." Like, disturbingly enough, this isn't like the first or even the 50th time that I've had to, like, navigate with an IV pole attached to me. Before they [do that] (ph) injections for autoimmune diseases you have to go and get regular IV. So I got very good at "I'm healthy but I'm hooked up to a pole" kind of thing. But I was just like I just lost almost everything and I had problems with, like, my IVs this time around. I just didn't want to like, "Mike, I will tell you when I need you. But I need you to conserve your rest." He just doesn't get it though. He needs to be vigilant. And you need to conserve yourself now so that when things are really bad and I need you to be, like, have these things, you know. [00:16:18]
THERAPIST: Right. Should the shit hit the fan at another level you want him to be able to handle it.
CLIENT: Exactly. But I think that he wasn't able to rest for sleep knowing that I was in the hospital. And of course he's in pain and there's, like, all this stuff's going on, you know. I did appreciate that he wouldn't leave me for certain things because there was a period of time several years ago where I don't think I've ever told you this or not. But I had a seizure or something. They don't really know what happened. They know that it looked like a seizure on the thing at work. Something that looked kind of stroke kind of seizure-y kind of thing with, like, lots of things. So I ended up in the hospital. And while I'm there apparently they told my husband and my family that nothing was going to happen for a few hours, so just home. And of course, my husband has my clothes, my glasses, my underwear, everything. I don't know what's going on. They put me into an MRI machine. When you go into these (inaudible at 17:23) in the IV they have contrast forcing through you and the contrast knocked the IV lose and started spraying everywhere. I'm in an MRI thing and I kind of -
THERAPIST: In the tube?
CLIENT: Yeah, in the tube, OK. Like, far in the tube because it's my head. So it's spraying everywhere. I'm pressing the panic button and apparently this person walked away and there's no one coming for the panic button. So I am freaking out because all I can do and there is blood but the thing is that I look a little bit and it looks much more like I'm just spraying blood everywhere because your blood tends I mean, if it's only little bit of it it's mostly contrast. I didn't know this.
THERAPIST: Yeah, you didn't know what the fuck (ph) was going on.
CLIENT: I was crying and peeing myself and everything for minutes, for like what probably was whole minutes but to me seemed like much longer than that.
THERAPIST: [Yeah, I'm sure] (ph)
CLIENT: Until they came and pulled me out and then they're like, "Where's your husband? Where's your family? Where's your clothes?" That kind of thing. Like, "I don't know. I'm in this MRI tube, you know." I just had this stuff happen and so while that happening he was acting out at home because he was freaked out, of course. I find this out much after the fact. It was not easy to find that out. But the point was that I felt really, really alone and so I think to him that conditioned him, like, not to ever leave me alone. If I knew I was going back into a MRI I would be calling him. Even now. Like, I've had two after that and I've told the story of what happened and they're like, "Yeah, we're giving you a Valium just (inaudible at 18:53)." To me it was a very, very traumatic experience.
THERAPIST: Oh, absolutely. Just being in one of those things can (inaudible at 18:58)
CLIENT: I don't mind being in one of those things. I am one of those people that kind of likes to be wrapped up and, you know. It's more like swaddling. It doesn't really bother me except for the fact that if it had happened and I pressed the, like, emergency button and somebody came to get me I think I would have been OK too. But the fact that this was happening for a very long time and I wasn't being helped, that's what really, at that point, made me panic. I mean, really panic. And so yeah. And apparently, I mean, it's very common to have, because the way that they're pushing the contrast, to have the IV pop out. It is not as common to have it mixed with your blood but it does happen. It's not all bad (ph). It's super uncommon but it's, you know. But the fact that everybody was shocked to find out that there wasn't somebody immediately there. Because there's actually supposed to be, like, as soon as the contrast pops, they're supposed to get an alert before I even press the panic button.
THERAPIST: Oh, I see. (inaudible at 19:59)
CLIENT: Yeah. So I never found out what happened and quite frankly it's, in theory, none of my business what was going on in the medical world of that. But it made me feel like crap, especially because I have a feeling this is the same person that told my family to go home. I have a tremendous in Brooklyn I have a really good community around me to care for me but also I have a lot of people in the medical field that can pull things up, that kind of thing. Although no family friends will actually do surgery on me (inaudible at 20:38)
THERAPIST: The anesthesiologist?
CLIENT: The anesthesiologist. He stopped in, you know, pre-op, made sure everything's OK, kept an eye on things, gave people real updates, that kind of thing.
THERAPIST: Wow.
CLIENT: Yeah, back in the day. He is able to pull up a lot of stuff. He can see at the time what my oxygen pulse thing. Because (inaudible at 21:09) he's going to be able to see that. So if I [sign off] (ph) on that, for him to see that, it's OK. So I feel like I'm not really taking too much of a gamble but we'll see. But quite frankly I think that the biggest problem I'll have is with these stitches and therefore I think I need to have someone around to care for me.
THERAPIST: This is just...
CLIENT: After the surgery.
THERAPIST: After the yeah.
CLIENT: I really just the biggest reason why I'm moving to Brooklyn is I need to have someone who can help me get to the bathroom and help me with my stitches, that kind of thing. But (sighs) yeah. So it's been pretty traumatic the past few days.
THERAPIST: Yeah, it sounds really awful. (inaudible at 21:51)
CLIENT: It's really awful. But I'm still here, which is good. I've got the energy to get here today, which is good, sort of. I'm getting a taxi home instead of walking, like I normally do.
THERAPIST: You know where to go?
CLIENT: Oh good, yeah. I just figured I just need to be a little extra careful right now.
THERAPIST: Absolutely.
CLIENT: Oh yeah. There's lots of stuff going on.
THERAPIST: Is there something else?
CLIENT: There is something. It's not that big of a deal but just, you know, I was just thinking through, like, what has to take place. I just don't have time for this to be honest, you know? I really don't. Losing this much income from not working is going to be brutal, you know.
THERAPIST: Is there some kind of short-term disability that you can do?
CLIENT: Not for part time employees.
THERAPIST: Really? No family medical leave or nothing (ph)?
CLIENT: I have to look but I don't think you get paid for it. Maybe (ph) just to protect your job.
THERAPIST: I'm pretty sure, like, for family medical leave you take a week or so unpaid but then you get I think you get [paid that] (ph).
CLIENT: Yeah, I have to look into it because, like I said, you usually have to be a full time employee to get those kind of benefits.
THERAPIST: I see.
CLIENT: The good news is that my usual pain in the ass customers, like, I got a chance to, like, they're like, "Yeah, I left all these messages for you. You never called me back." I'm like, "Yep, been in the hospital." I definitely was able to be like, "I assure you that while they were dripping (inaudible at 23:58) in my blood I was really deeply concerned about the problems that you have with Safari." (laughter) I didn't actually say these things quite like that but... I was able to at least not let a single person make me feel bad, which is good. Most of those people are, like, really good at guilt trips.
THERAPIST: I'm very glad they were ineffective.
CLIENT: I wanted them I ran into her today. She apparently was stopping by the store every other day to see if she can find me.
THERAPIST: Oh my god.
CLIENT: She thinks that I helped erase her calendar. What actually happened was that she got and she will never admit this. She got frustrated because having to sync she had never synced her phone in five years. And so she got frustrated and she thought nothing was happening, so she yanked it out the sync and lost everything.
THERAPIST: Yeah, that's bad, right (ph)?
CLIENT: That's not my fault.
THERAPIST: No.
CLIENT: No. She's like [it hung] (ph) and, like, yeah, again, nothing that I told you to do, you know. I'm sure that there's a potential we could find some of it but your impatience is not going to make me feel bad today. It's (ph) just been whatever (ph). A hard two weeks. [00:25:16]
Yesterday well, Sunday and yesterday I went home and just went straight to bed and I think that's pretty normal, at least for now, for having, you know, a hard core infection. But I am extremely grateful that everybody at work has been letting me take it very easy, which is good because I really, really can't be running around right now. And bad news though, one of my bosses, the one that's really, really been a huge advocate for me, is leaving.
THERAPIST: Oh no.
CLIENT: Yeah. So that's hard.
THERAPIST: That sucks. Could she possibly bring you over at some point?
CLIENT: I texted her saying, "Bring me with you." And she said, "Ha ha ha. Get better first." So we'll see. I would love that and we'll see, but like I said, she's been such an advocate for me in terms of, like, taking care of putting my health first, putting my life first that...
THERAPIST: (inaudible at 26:32)
CLIENT: Yeah. So, pretty much. But (sighs) I'm just glad that, you know, she's going on to bigger and better things, you know. She's a good person. It's not like she's going on to something that's unpleasant, you know. It's good for her though. Hopefully she'll think of me fondly and take (ph) me over because (inaudible at 26:59). The commute is just getting to be too hard for me. If things go well, it's not so bad but it's like today because of the fog it took, like, an hour and a half to get to work.
THERAPIST: Wow.
CLIENT: Yeah. Because the buses can't see and, like, nobody can see. And it seems, like, every in the winter time there's always something wrong. It's snow, it's rain, it's I don't know, you know, turkeys in the road or something. Yes, there were turkeys in the road once. They just take forever to get past. And then it's, like, I am some days and when I say some days I don't mean one per month I'm talking, like, probably one per week. It takes me longer to get back and forth than it does to actually the amount of work I do. And although I could work longer hours, that's not the point. The point is that...
THERAPIST: (inaudible at 27:58) that you had (inaudible at 28:00)
CLIENT: Yeah, so. A lot of people don't want to work short shifts because of that, because they feel like the cost of gas or whatever is not worth the shift. Unless I do the bus. But...
THERAPIST: It's harder especially, you know (inaudible at 28:24) to work a longer shift.
CLIENT: Yeah, pretty much. I did a longer shift on Sunday and yesterday and then today's the short one. And we'll see. I may have to just start pulling (ph) things back again. So, I have to see if it's I have no idea how [I will] (ph) feel. At least it is something. It sounds stupid but even if it isn't, like, they immediately know what they're going to do and where it's going to go with this, it's not like the ever popular "we don't know what's wrong with you so you're going to stay (inaudible at 29:09)." They know it's an infection. They have the actual, you know, they have white blood count and stuff. They've seen it.
THERAPIST: Pretty sure they know where it is, right?
CLIENT: Don't know really. They've got a general quadrant region, which is good. It's just a matter of getting it better. I don't have an easy way to explain to many people how much it doesn't contribute to my ability to get any better by thinking about the fact that I can have something that's stress-driven, if that makes sense. That itself is exceptionally stressful for me. And I'm not very good at people just saying, "Quit it." Like, yep, that's not really possible.
(phone rings)
CLIENT: [Give me] (ph) just a minute. (inaudible at 29:54) It's my husband. Hold on for just a second. Hello? Hey. No, I'm in therapy. OK, bye bye.
THERAPIST: Everything OK?
CLIENT: Yeah, everything's fine. (inaudible at 30:21) what time of day it is. (sighs) I figure since it was so dark out it must be time. But, you know, it's like the idea of having something that's going to be stress-driven is not something I really, you know. But there's nothing I can do other than sit around and worry (pause) and hope that whatever comes that there will be somebody to take care of me. But I think that right now, I think that I've sort of reached my limit right now in terms of pain and exhaustion. So if it's OK to sort of wrap things up early? I'll see you tomorrow?
THERAPIST: Yeah, sure.
CLIENT: I'm really out of it and just really tired.
THERAPIST: No, I understand.
CLIENT: I will be back tomorrow though.
THERAPIST: OK. I look forward to seeing you then. I (pause) hope you can get a little rest.
CLIENT: Thanks. It's not an easy thing to say to somebody else because it's, like, yeah, it's not easy to explain you won't feel better by tomorrow.
THERAPIST: (inaudible at 31:55)
CLIENT: I'll see you tomorrow.
THERAPIST: I'll see you.
END TRANSCRIPT
