Sunday, October 25, 2009

Vanity, Thy Name is Alopecia

As the old saying goes: "stereotypes are exaggeration, not fiction. All have a basis in reality". A very common one about gay men is that we are appearance-obsessed, vain, self-centered, fussy, body-obsessed, and fashionistas. If you were to ask any of my friends if I fit that profile, they would all tell you that I would have to turn in my gay card if that were the case. I've never really cared that much about clothing, as both my appearance and closet would attest to. I have a lot of clothes, but they are mostly a lot of jeans (and not Diesel or any other expensive label; I don't even know any of the other fashion denim labels!), t-shirts, athletic socks, tennis shoes and hiking/walking shoes, sweatshirts, sweatpants, house pants (as they now call PJ bottoms) and a few sweaters. I have two indulgences in fashion:

1) I have a lot of very nice fitted (tailored) dress shirts, which, by the way, I almost never wear, and
2) I have expensive underwear (bottoms). This is an indulgence that I developed some time after Ken died, and the one apparel indulgence that I continue to entertain. I'm talking briefs (boxer, mini boxer, boxer brief, briefs) that are $15-25 a pair. Part of the reason for this indulgence is that I like cute underwear, even if I'm the only one that sees it most of the time, but more importantly, they fit right. I've endured a lifetime of ill-fitting underwear, and now that I've appreciated how nice well-fitting ones feel, well, there is no going back. I have a weird body, and one that has gotten even weirder as I've gone down to a healthier weight (and aged). I have no hips, virtually no ass and big meaty muscular thighs (all from God in the leg department, no effort on my part). My dilemma has always been if I buy them too big, even slightly, they get baggy and I feel like an old geezer that can't fill in his shorts. If I get them too small, even ever so slightly, since I don't have a good shelf (round butt cheeks), but big thighs, i.e., ones that are too big for the leg holes, I walk around with a permanent wedgie. Seriously, I've taken underwear off in a public restroom and thrown them away because I've gotten tired of pulling them out of my ass crack. Too-small underwear on me becomes, for all intents and purposes, a thong. I'm really not fond of walking around in public picking at my ass to pull my undies out of it.

Other than that, I really don't care about clothes. I have 3 nice, beautiful designer suits, but I didn't buy them, they were Ken's. We were very close in size, so I was able to have them tailored to fit, and I just couldn't stand the thought of consigning or donating all of his dress clothing. Additionally I have 3 or 4 nice dress jackets, but I have them for one purpose only: dog shows. Dog shows are (ridiculously) a formal attire event. Like you really need to be in dress clothing to get down on your knees in the grass or on a dirty concrete floor to stack (pose) your dog. Cleaning up dog poop looks really classy in a nice suit and tie as well.

So other than those few exceptions, I have a large walk-in closet full of probably 100-200 t-shirts (and very few with a designer label), a lot of jeans, a lot of Giants (as in baseball, SF Giants) game gear and a lot of very un-trendy lounge wear for schlepping around the house.

I've never been much of a primping type either. I don't live in front of the mirror. To the contrary, I can say with confidence that on most days I look in the mirror twice: once in the morning when I'm shaving and doing oral care and once before bed when I'm brushing my teeth and brushing my hair to put it in a ponytail. That's it. I have friends that can't walk by a mirror without looking in it (or worse yet, getting glued to it). I usually don't look at myself in passing if I pass a mirror. I really could care less, and again, those who know me well would attest to this not being an understatement on my part. I really don't care. I care about my words, and want people to listen to me, not to look at me. Not because I think I'm hideous, I just don't choose who I associate with based on superficial things like appearances. I want to know what's going on inside the head. I hope that my friends feel the same way about me: that they are interested in me because I'm intersting; not because I'm pretty or a spiffy dresser.

Other than for about the first year after Ken died, I've never been the body-obsessed type either. I'll exercise as much as I'm physically up for, but in general I've never been interested in turning into a gym bunny to get big guns, tight 6-pack abs and big beefy pecs, even if I could. During the first year AK (after Ken), I hired my friend Brian, an amazing, albeit expensive personal trainer, and went on a rampage of exercise to try, for once in my life, to have a gorgeous physique. I learned a couple of things from the experience:

1) It's a lot of fucking work, and more than I was usually was capable of. I would kill myself, pushing way beyond what I should have and what I was able to put out, and exhaust myself to an uncomfortable (as in sick to my stomach) point; one that often took me days to recover from, and:

2) I also learned that my body isn't made for that gym bunny look. I have a slender frame that doesn't carry weight well (fat or muscle), and is better off just being toned and flexible. Over the last many years, even this has been a struggle to maintain, with my health often being so precarious and my endurance being abysmal. But even when I'm feeling my best, about the most I can do is a mild yoga class or low-impact, low-intensity cardio (walking, some swimming). These days: well, a lot of days it is a major success to just get out of bed. Between my blood being a viral soup, poisoning myself pharmaceutically in order to keep the most dangerous viri at bay and on top of it all, just dealing with the changes of aging, well, to say it's been a challenge is an understatement.

I've also never been terribly fussy about my grooming. I am clean, clean-shaven or facial hair well-cropped and hygenic, but I've never been terribly vain about the grooming, especially my hair. Or so I thought. I've always had profuse, fine (but voluminous) healthy hair, but I've not been one to get the every-six-week qoiffure and spend hours in the morning getting every hair in place. I've either had it so short i've not needed to even comb it, or long and in a big jew-fro, which is impossible to do much with anyway.

I've always said that if I started going bald, no biggie, I would just shave my head and be done with it; no problem. I thought I really meant it too. It's funny, because if I ever said it around a man who was balding, no matter how I said it, to say what I said above would make most of them visibly cringe. I just didn't get it, why was it such a big deal.

That is so easy to say, when it's not you. And now, with the interferon making my hair fall out, I'm obsessing on my locks the same way that most of my balding friends obsess on theirs. I have a new-found respect and appreciation for how much losing your hair really does mess with your body image. Now I'm really lucky here, because the loss is very gradual and well-distributed, so I don't get bald spots, it's just getting thinner. Nobody has even noticed it so far (or so they say), and when I show it to them, they still say that they can't tell a difference. Plus, it will come back once I stop the Interferon (8.5 months from now), to pretty much the same way it was pre-Interferon.

You see, the real irony here is that for the second time in my adult life, I decided to grow my hair long a couple of years ago; actually a few months after I lost Ken. I now think that it was subconsciously a David and Goliath thing; my hair was my strength, and if I got it long, the longer it was, the safer I was, and something like Ken's suicide couldn't happen to me again. This is, btw, a fairly recent insight, but one that rang true and close to home almost instantaneously after the thought.

So now, with my hair past my shoulders in length (I would guess my average hair length is 10-12 inches), every hair that falls out seems to be ten times as much hair as it would feel like to me if my hair was short. Every time I touch my hair it falls out in my hands. My scalp is sore and irritated, so it's hard to leave it alone, which is the best thing if I want to save as much hair as possible.

So now, I am obsessing on my hair. I tell myself that there is a lesson and a bit of payback here. I now know what my friends felt like when I would say that losing hair is not that big of a deal. To hear that makes me cringe. It's kind of the same feeling I get when people tell me that they like me better with shorter hair. So what? What am I supposed to say to that? Thank you for telling me that you don't like the way I choose to look? Saying either thing is disrespectful, and only now do I really grasp how disrespectful my past statements about hair loss have been when I talked to balding men. Even platitudes like "yeah, but you look good with your head shaved" or "you're more than your hair" are cold comfort, and in the future, I'll keep my mouth shut. At least for me, when I've moaned about losing my hair from the Interferon, I don't want to hear that I look ok or that it might look better if I cut it short. I just want someone to listen to me and to listen sympathetically and sans the dispensing of advice and/or platitudes.

Well, once again it's 1am and I'm just getting started. The problem is, if I don't stop now, the next time I look at the clock it will be 4am, so I am going to publish a partial essay. I'm doing it mostly because I'm feeling a little guilty that it's 3 danged days shy of it being a month since my last post. Plus, I know that if I publish it unfinished, it will drive me nuts if I don't finish it. Let me rephrase that: it will eat at me until I finish it, so that will force me to keep up with this project. Now it's become far more than a vanity project, though that is definitely part of it. It has also become therapy for me. Equally as importantly, it has also become a lifeline for me to reach a number of you, and not keeping up on this is akin to not returning calls, or calling to check in with your friends on a regular basis. So until tomorrow, or actually now, until tonight. There is a lot more for me to say. Imagine that, how novel: me with something to say.

(next day)

Monday, how do I hate thee? Let me count the ways. I know, said it before, but Interferon has put an entirely new twist into Mondays. I actually find it ironic that I (not purposefully) set it up so that Monday is my crappiest day. My reasoning was, I didn't know if I was still going to want to attend dog shows on occasion. Generally, dog shows run over a weekend. If they are more than 2 days in a row, they will wrap around a weekend. I figured that even if I was wanting to go to one, I wouldn't want to go for 4 days in a row, that would have been stupid. As such, I decided that since Sunday and/or Monday are the most common show days, I would inject on Sunday night, figuring that I would probably end up throwing away Mondays (and I was right, and sometimes more than just Mondays).

What I forgot to consider, but it ended up working anyway, was how exhausting I find a day at a dog show, even if I'm only there as a spectator. I know too many people in my area, so if I go, it turns into a "royal visit" day. This last weekend I actually tried to go 4 days in a row. In my head I had good reasons, but let me tell you: never again. I was so wiped out by the time that I got home last Monday afternoon it was ridiculous. I even ditched early, which I almost never do, but even though I left on Monday shortly after noon, I paid for my decision to do so much for the entire week. Yesterday I actually started to feel halfway "normal", whatever that is, but then what do I have to do in the evening? Take another dose of Interferon.

Mondays have gotten progressively nastier. Today, before I laid myself on the sofa and put my computer in my lap (this is my current status), I spent probably an hour and a half sitting on the sofa, staring into space. I have no idea what I was thinking about, what I thought I was doing, or even if I was really "here". It was one of those "lights dimly on, nobody home" moments. Only minutes before I started writing, I crawled out of the stupor and told myself "do something; anything". Well, I haven't eaten anything since early morning, when I had 2 hard boiled eggs (quick breakfast, had to get to the dentist), so maybe I should eat? Nope, not hungry. OK, maybe I should fold some laundry, or go through some bills and other sundry paperwork, or maybe I should clean up the kitchen, or maybe I should vacuum the house? Nope, too tired, too much concentration required, and I'm in LaLa Land, too much work and too much work. OK then, maybe I could work on my writing? Bingo, that I can maybe do. I go to the bedroom, get my laptop, come back into the family room, plop on the couch and spend almost an hour reading 3 short emails. Again, I thump myself out of my stupor, and here I am now.

I really can't bitch that much. It is a beautiful day today: warm but not too warm. I have the sliding door cracked open so I can hear the waterfall cascading into the koi pond. I have Bobby and Hillary (the two easiest dogs) in the room with me, the sky is sapphire blue outside, and my birch trees are quaking in the gentle autumn breeze, slowly shedding their summer clothing. I have a bunch of trees changing color right now: my Japanese maples, the red maple, the birches the pear trees and the curly willow. It's a show of autumn color that I never got when I lived in San Francisco, and I am now reminded of how much I missed that about autumn when I moved away from home 25 years ago. To live surrounded by a lush landscape populated by a wide variety of deciduous trees hearkens me back to a time I cherish. It also reminds me why autumn has always been my favorite season, and living in a City that really prides itself in how many trees it has is something quite special.

Walnut Creek is the greenest place that I have ever lived, even more than Montana in some ways. Not that Montana is lacking for flora, it's just that because of the mild 3-season Mediterranean climate in this valley, it supports an incredibly diverse landscape of greenery. There is just something about looking out the window, and instead of seeing a hillside packed full of houses, I look out my back window, coincidentally in the same direction as my back window in San Francisco (west), and see trees, flowers, ferns, my herb gardens, the pond, birds, squirrels and other wildlife, and bees and butterflies galore. I'm not saying that my view of Twin Peaks in my San Francisco home wasn't lovely, it was. The hillside of homes often reminded me of a Greek fishing village, but much bigger and denser than what one would actually see in Greece. What I am saying is that my view out of my current home's back windows is spectacular, and more importantly, serene. Granted, I do see a bit of my neighbor's rooftops behind me, but especially in the summer, they are mostly covered by the trees. Even my next door neighbor's house is difficult to see. I can't see it at all from the inside of my house, and out in the back garden, I can only see a small corner of it, and even that is pretty unobtrusive. Were it not for this peaceful sanctuary-like environment that I've been able to create, I shudder to imagine how crappy it would be to have to go through what I'm going through and not have my little oasis to escape to.

I'm having issues with vision now, most probably from the Interferon. For the last few weeks I've been noticing some blurring. At first I thought it was dirty glasses, then I kind of just ignored it somehow. What finally made things click for me was when I went to a meeting last Thursday at UCSF for all the retirees, so that they (the pension managers) could explain why the pension fund is in deep doo-doo, and what they're going to have to do to hopefully fix it. Cheery session, to be sure. Well, I was sitting probably 2/3 of the way back in the auditorium, and when they started the PowerPoint presentation on the big screen and I couldn't read a damn thing, I knew something was fishy. I was in a room of people where probably 90% of the audience was older than me. That not one person complained that the print was too small on the slides finally slapped me into reality. Since then, I've noticed that my glasses aren't cutting it for either my distant or near vision (I have progressive bifocals), and pretty much all print, unless it it big, is blurry. Actually, everything in my field of vision is blurry to one degree or another. In the last few years, I've had the usual "normal" degradation of near (reading) vision, but my myopia (far vision) has not changed in probably 30 years. That was kind of a big clue that something isn't right.

Well, this weekend I went online and did some research about Interferon, and lo and behold, there have been reports of visual changes by some patients on therapy. Quoting directly from VA (as in Veteran's Affairs) website:

Visual Changes

Visual changes are fairly common, but the exact incidence is unknown.(10) The most commonly documented eye complications are “cotton wool spots” and retinal hemorrhages, but most interferon-related retinopathy is asymptomatic and reversible.

Management

1. It is reasonable to perform a baseline eye exam in any patient with diseases associated with the retina (eg, diabetes, hypertension) to establish a pretreatment baseline. Any patient who develops visual changes while on interferon should be evaluated by an ophthalmologist. Treatment changes can then be made in consultation with the ophthalmologist based on the findings observed. Patients should know that there have been instances of serious eye injury (eg, optic neuritis, visual loss, retinal detachment) in patients taking interferon, although these are rare and may improve with discontinuation of the medication. (end of citation)

Great, retinal changes. HIV can also cause retinal damage, especially in advanced disease, in patients with severly depressed T-cell counts. I've only flirted with T-cell counts that low once, and it was years ago, But I will tell you this: for someone like me, who is primarily a visual person, and I define the for me by noting which of the senses are deemed most important, and the sense that gives the greatest initial impression, anything that affects my sight is terrifying. I am doing a good job of keeping that worry in check until I know more, but still, there is the faint cry of that scared little boy way back there in the far reaches of my consciousness.

But honestly, what can I do to change it anyway? Still, it's pretty scary, and I'm having to do a lot of self-checking to keep me from worrying myself into a panic. I have an ophthalmology appointment tomorrow, so that will at least tell me what is really going on. Also, and equally as important, the visual changes, same as most of the potential side effects from the drug, are usually self-correcting after discontinuation of therapy. This leaves me with having to continue to recite my mantra: This is working. If it's working, it's worth all the unpleasantries. Though uncomfortable, disconcerting, frightening. painful, whatever: it is a temporary situation. I'm strong I can deal with it.

That really is true, I am a strong person, in spite of sounding like a whiny little complainer. I have a very high tolerance for pain and discomfort. I am, by nature, a positive person, even though that has been mightily tested in the last few years. I can make it. But please God, can I keep my eyes? I know that isn't too much to ask.

Next gripe: When did people become so self-absorbed that they can't even maintain the simplest measures of infection control? We are officially in a flu pandemic. I swear, the next time I hear that walking pneumonia, death rattle cough in a public place, and then see that the person coughing isn't even covering their face, I'm going to go off.
It's bad enough to know you're sick yet still go out in public, almost willfully spreading infection by your reckless behavior, but come on, if you're not going to wear a mask, can you carry tissues and cover your face? And if you have sick children, do you really have to bring them with you if you know they're ill? If the answer to that last question is yes, then you, the parent, bear 100% of the responsibility for keeping your children from being vectors of disease, spreading infection like a sprinkler spreads water on a lawn. The infectious airborne droplets ejected by a sneeze travel in excess of 100 mph and can reach across a ballroom. Remember this please, and be considerate of your fellow human beings, aas well as setting a good example for your children to follow.

True story: I was in the grocery store about a week ago, maybe less, maybe more. I'm in the checkout line, and in front of me is someone holding a young toddler, probably around 18 months, talking on the cellphone, rifling through her purse and acting like she is using her very first ATM swiper ever. Meanwhile the little kid all of a sudden stirs, and I hear a rattling cough starting out in his chest. It's one of those that is so loud that I don't need a stethoscope to hear it. Now I'm pinned in line, between her and the customer behind me. It was a space not unlike the chute after the paddock in a slaughterhouse, the one that leads to a guy with an air gun to point at your head. There is forward momentum, and you can only go forward or backward. This distracted Mom, still trying and failing to do about four things simultaneously and yet completely oblivious to all humans around her, is completely ignoring the kid (he is in one of those front of the body papoose-like carriers), and this kid proceeds to start coughing and sneezing, directly in my face. I was so dumbstruck that I didn't know what to do, so I ended up standing there frozen, with what I'm sure was an expression of aghast disbelief. The Mom looks directly at me (actually directly through me), and walks off with her little virus sponge attached to her torso.

This is 2009, we know what causes infectious disease, and that many can be passed by casual social contact. Even though there are many simple ways to mitigate the damage that you can inflict, people continue to walk around in their little clouds, completely oblivious to their surroundings, and spreading viruses like they're going out of style. I thought this was supposed to be an age of enlightenment, one where we as a people are supposed to have a heightened awareness and understanding of the implications of one's behaviors on the community at large, and because of this, behaving in a more socially responsible manner. I guess not.

I will not be the responsible behavior police. If people don't get these incredibly basic concepts and principles, and understand the importance of being responsible for yourself and your children and reflecting it in your behaviors, then it's a lost cause. I just end up looking like a rude bitch, so I give up. If, however, I walk into a building or a room and hear a single person coughing or sneezing, I'm history. I don't have the luxury of taking risks this flu season. I can't get vaccinated while I'm on Interferon, and with all the insults I'm presently meting out onto my immune system, it's a policy of protection first, questions later. I'm not hugging people, shaking hands, kissing or eating out if at all possible. In the situations that require me to be around groups of people, I'm on red alert. I carry around a small bottle of hand sanitizer now, and act like an obsessive-compulsive germophobe. There is, however one very important difference between me and a germophobe: my fear is not irrational. At least I don't think so. I can get on my soap box in the town square and bloviate until I'm blue in the face, but where will it get me? Being right is cold comfort when I'm in an ICU on a ventilator and getting my veins pumped full of antibiotics for a pneumonia I got from "a little case of the flu"

I like my home. I have plenty here to keep me occupied, and enough food to make it through an apocalypse of biblical magnitude. I can keep my mind busy and my mood upbeat. I'm actually pretty self-sustaining, at least emotionally.

I love my friends, don't get me wrong, but consider yourself duly warned as of now: I would love to have any you visit, human contact rocks. But if you show up my door with so much as a scratch in your throat and I find out, I will kill you. Don't test me, I mean it. I will kick your ass.

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Doggydad's Life Now: The Viral Monologues by Parry Tallmadge is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Based on a work at doggydad.blogspot.com.
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