Laid up

I've been laid up, on mostly bed rest, for a second day now.  As restful and relaxing as it may sound, for me, it's actually frustrating, boring and gives me a lot of anxiety.  There's too much time to think and far too little to do, and because I'm feeling like crap (more to follow on that), I don't have much motivation to do anything other than turn on the TV and watch it.  Yesterday, my plan was to let myself watch a little TV, maybe a couple of hours.  The rest of the time, if I wasn't napping, the time was supposed to be spent reading and writing.  As I read it again in print, that sounded like a great idea; unfortunately, the plan suffered in execution.  I'm already feeling physically like crap, and doing nothing does the same thing to my psyche.  I need to remember that in the future.

I woke this morning and told myself that it's going to be different today, and so far so good.  I turned the TV on for less than an hour, then turned it off.  OK, to be totally truthful, it's still on, but it's not something that needs to be watched to appreciate: I have the TV tuned to one of the Sirius classical music stations (Symphony Hall, Sirius 80).  I have DISH network, and as an added bonus when you're a DISH subscriber, you get most, if not all of the Sirius music stations.  No call-in talk shows (thank God), no political shows (thank God), no news (thank God) and also none of the mindless drivel stations, like the Martha Stewart channel (Thank God).  Don't get me wrong here, I'm a big fan of Martha, I love her work.  She has given me more inspiration in how I cook and keep my home than any other popular icon of her ilk.  I'm not sure if there really is anyone else in her league, with the breadth and depth of knowledge, and her many practical hints, tips and ideas that make it easier for one to make their home beautiful.

I also know her pimples: she is supposedly a horrid neighbor.  I have a friend that grew up very close to her, this was when she was living on the CT shore, and Martha at that time was well-known to take flowers and other plants from her neighbor's gardens.  But if somebody accidently turned up her private road (lost their direction), I'm told that she would come barreling out of her home, and come running down the road, cursing, waving her fists, just generally being a bitch.  She is well-known to steal ideas from people and sell them as her own, no credit given to the originator of the idea.  Allegedly, if she is out being Martha, sees something that she likes - good food, beautiful arts and/or crafts or household tips, for example, and she likes what she sees well enough, you may be invited on her show to share your ideas, otherwise know as your intellectual property.  Thing is, when you do go on her show, you have to sign a release giving Martha carte blanche to use said intellectual property as her own: publishing it, sharing it through her media outlets, etc., and she can take claim for it being her idea.  Many times when she has tried to pull this, the originator of the idea tells her nicely to go jump into a lake, only to get treated to a viewing of Bad Martha, the one that chases cars down Turkey Hill Road.  The one that will bite off the head of anyone who is in her employ for the slightest infraction.  She is the Anna Wintour of domestic arts, if you will.

So now as I lay here, with Devienne's Bassoon Quartet #1 playing in the background, I am actually writing.  I finished a book this morning (Promised Land: Thirteen Books That Changed America by Jay Parini), and was going to start a Michael Pollan book, but as I plotted out my day, I decided to get up (check), take care of the dogs, cat and fish (check), do my daily morning meditation (check), then have a little breakfast and a mug of tea and start writing (check).  But I guess I should backtrack and explain why I'm holed up in my bedroom, my right leg elevated on a mountain of pillows and my calf wrapped in a heating pad.

Maybe 3-4 weeks ago, I started getting all kinds of weird bruising, and it was all below my waist.  Then I had this big area (maybe 10-12 cm) on my lateral left thigh, just above the knee that started out looking like a bruise, and hurt like one, but within a couple of days, it got hard, hot, and red.  I thought I may have gotten an insect bite.  I react very badly to spider bites - it is a big deal if I get one.  I don't get an allergic reaction, but every time I've been bitten, I've gotten a major infection from it.  After a couple of days, it the area got very hyper-pigmented, turning a dark brownish purple; a sort of aubergine, if you will.  It was still slightly painful, but now, it's almost completely normal.  My PA (Physician's Assistant) put me on some biggish gun antibiotics for 10 days, and I thought that was the end of it, sort of.

I continued in the intervening time to get a lot of bruising on both legs, attributing that to a low platelet count, and then, 3 days ago, what had happened to my left thigh started happening on my right calf, starting just a couple of cm above my ankle and circumventing my calf up about halfway to my knee.  This didn't start out a bruise, it just went straight to red, hot and swollen, and by Wednesday evening, it was all I could do to hobble around the house.  I started to get a lot of edema (swelling caused by a buildup of fluid under the skin), and that lower leg was noticeably bigger in circumference to my lower left leg, maybe by a half.  I got a bit more concerned about this event than when it had happened on my left thigh, since everything was more localized with that event.  This time, it was covering more surface area, circumventing my leg and creeping slowly up toward the knee.  This was looking like classic cellulitis (a closed infection in skin - very difficult to treat), so I called the doctor's office before they closed and got an appointment for the next morning..  I elevated that leg on pillows all night and went to bed.

I woke up Thursday morning to find that elevating the leg had brought the swelling down appreciably, but the leg still looked bigger around than my left leg.  It was also still very inflammed, hot as a torch, and painful to even the slightest touch. (I forgot to mention, the pain had also started on Wednesday evening, but I was chalking it up to being on my feet too much that day).   That morning I got my butt on a BART train and headed into the City to see my PA.  He looked at it, shook his head, and said it was a good thing I came in.  I told him that he never needs to worry about that.  Even though I'm an RN, I am not a know-it-all, and I know when I'm over my head.  I don't screw around with something like that.  Infections like this one can easily turn into sepsis (infection in the blood), pneumonia, amputation, some other catastrophic secondary infection, and at its worst, it can kill you.

Cellulitis by its nature is very difficult to treat since your skin is really not that vascular.  Your body was wisely designed to dedicate most of the blood supply to your brain, heart and other vital organs.  The skin is merely a protective shield, and so it doesn't neet as much blood supply.  The bad part of that equation is that when you get a cellulitis, or a closed skin infection, it is far more difficult to treat than an infection in almost any internal organ.  If it's an open wound infection it is much easier to treat.  You can do a lot of aggressive wound care, put in drains, flush out the wound, etc.  With a closed infection your're relying on a limited blood supply in a poorly perfused organ, and that in itself is why cellulitis is a big deal.  Cellulitis is what turns into gangrene.  That can happen in open wounds as well, but it's catastrophic in closed infections.  What this means is that you have to use bigger-gun antibiotics, often more than one, put someone on bedrest and have them keep the affected limb elevated to drain the edema (skin pulled tight with edema is much harder to get a good blood supply to), and put a lot of heat on it.  As much as you can take for as long as you can take it.  This is counter intuitive at first glance maybe.  With any musculoskeletal inflammatory process the conventional wisdom is ice, ice and more ice to keep the swelling down.  With a closed infection what you're using the heat for is to increase blood supply.  Your blood vessels will expand with heat - it's how they get rid of the excess heat, and bigger vessels mean more blood which means more oxygen, nutrients and antibiotics get to the infection site and work more quickly and efficiently.

Thus, the remainder of Thursday and most of the day today, I've been in bed, leg elevated on a tall mound of pillows with my calf wrapped in a heating pad.  It looks like it's paying off; as I'm writing this now, at 9:20 pm on Friday, the leg already looks perhaps 50% better than it did Wednesday evening or yesterday (I say perhaps, since I'm really not that good at quanitfying things like that, it seems arbitrary and probably inaccurate.  I would rather look at objective, easily quantifiable data:  temperature of the affected area, change in size, amount of pain and the patient's general feeling of well-being.  Yesterday, I felt like I had the flu: I was completely drained, no second wind to be found, lethargic, and aching all over.  I knew this wasn't the flu.   I've had enough serious bacterial infections to know how they affect the body as a whole.  My assessment was shown to be accurate, since as my infected area has started to decrease in size, the skin decrease in temperature and pain and the skin color turning more normal (or transiently becoming hyper-pigmented, the aubergine I described with my other leg), that seemed to be the best indicator of healing.  But the pigmentation likes to hang around like the houseguest who won't leave; reminding one of their infirmity and giving one something to obsess on.  Though everything was on the mend, it was 2-3 weeks before the pigmentation went back to normal.

I am definitely on the mend though - I feel a lot better than I did on Wednesday.  The affected area is shrinking in size and the edema is slightly improved, though still noticeably present.  I'm still a bit gun shy about being on my feet for too long.  Every time I do, within an hour, the swelling and pain are getting worse and the area starts to heat up, which is the most ominous sign.  I fully expect that tomorrow I'll try to spend a bit more time bearing weight on the leg, but I'll do it judiciously and observantly.  Bearing weight causes the most pain, enough that it's necessitated me having a cane on standby.  It's kind of pathetic to see me hobbling around with a cane, but that cane also decreases discomfort greatly by allowing me to take weight-bearing duties off of that leg and distribute that load down through the cane.

You know, if this whole debacle of the last year has done anything good for me, it's that it has forced me to let go of my pride and allow myself to show my vulnerabilities and Achilles heels that the infirmities have inflicted on me.  I've had to go out in public with a face mask when my white count was low and my immunity severely compromised.  It's forced me to slow down to a snail's pace most of the time, something that I'm not used to.  Even if I'm limited in my energy and strength, I can usually not show it.  There have been times over the last year that it's been so bad that I couldn't cover up my weakness.  Now, with the cane, yet another indignity has been forced upon me, and I'm forced to display some weakness, wear my own scarlet letter.  I never considered myself a terribly proud person, but get your pride snatched from you, and you'll find out just how proud of a person you are.  It's a great reality check.

As I'm reading back on my writing so far (I do my first edit while I'm writing, usually writing no more than three paragraphs ahead of copy that I've edited), I really like seeing that I've been able to let go of a lot of my hubris and show my vulnerabilities.  That's new for me; I don't like to talk about my health with people, even people close to me.  I've always tried to show as little vulnerability as possible, preferably none.  I don't like a lot of attention on me.  I duck the spotlight as much as possible, it's part of my social phobia.

This new state of affairs has not only kept my hubris in check, I've found that I'm actually able to deal psychologically with the entirety of the what this last year has thrown in my lap, and not just deal with it, deal with it in a way that makes me feel better about myself.  Being able to keep my depression and negative thinking in check has had a great deal to do with my ability to navigate this experience and keep my wits about me.  This revelation alone has been enough for me to extoll the merit of the experiences and not dwell on the unpleasant parts.

I don't know what this is all about, but the last three antibiotics that I've taken (cephalexin, Bactrim and doxycycline), have been leaving me with the nastiest taste in my mouth, kind of like my mouth is full of tarnished metal.  I know it's the antibiotics, because when I finished the course of antibiotics with the first leg infection, within a couple of days, the bad taste was gone.  Now that I'm back on them, deja vu, I'm right back in the bad taste zone.  If the drugs themselves (like the HIV drugs and the Ribavirin) aren't enough of an appetite killer, a metallic-tasting mouth will finish the job toot sweet.  Even here though, there is a big silver lining:  I've been able to indulge myself in rich desserts and not care a whit about the calories.  As long as the rest of what I eat is healthy and comprises a complete and balanced diet, I'm not worrying about enjoying a nice big gluttonous bowl of ice cream, or whatever sweet is striking my fancy.  As long as desserts are not making up the lion's share of my diet, I'm not going to worry about a little extra fat and sugar from my gastronomical indulgances, and as long as I maintain meticulous oral hygiene, which for the most part I do, then I'll do any necessary self-absolution.


This anorexia against my choice has also really helped me in reprogramming back into my brain the common-sense approach that I used to have about my diet, rather than having my choices dictated by laziness or fad.  Also, eating without paying attention to your eating behaviors is an invitation to gluttony and other bad choices.  My basic philosophy of eating is as follows:

1. Eat whole foods, not manufactured food-like products.
2. All things in moderation, especially more empty-calorie foods.  I don't have to deprive myself, I just need to check myself if I start going overboard.  
3. Eat only when you are hungry and stop when you are full (satiated,  not gorged).  For me, this means that I eat 5-6 times a day at least, but by the end of the day, I've still not taken in more calories than I've expended.  When you are eating, pay attention to it, rather than just stuffing food in your face with a book in your other hand, or eating with the TV on.  One of the activities can wait, you choose.  Be present in the moment, savor the experience, and listen when your body tells you "enough".
4. Eat and shop seasonally and locally.  Farmer's markets, farm stands and local ranchers provide  meat and plant foods that are far superior in taste and healthiness to anything found at a traditional supermarket.  And stay away from places like Whole Foods, or as I like to call it, Whole Paycheck.  Go in sometime and see how much locally-produced food you can find.  It's really sad, and expensively so.  It is very true, eating right is more expensive than eating chemically laden crap to survive, a lot more expensive, but that expense pays off over the long term, when you watch yourself age more slowly and gracefully than most of your contemporaries, and outlive most of them as well.
   
5. Eat a variety of foods.  Eat less meat and dairy and more plant-based foods.  Meat and dairy have their place in a balanced diet, but they shouldn't capitalize it.  Additionally, meat, especially beef, leaves a huge carbon footprint.  Have you ever driven past a stockyard?  Did you like the smell of the 5000 cows farting?  Not only is the smell disgusting, but the methane gas that they expel contributes greatly to global warming.

I think I may have already discussed all this before, way back in the early days of my blogging experience, but even if I have, this bears repeating, over and over and over.  We Americans have thrown our common sense out the window and put ourselves at the mercy of chemists and other food scientists, relying on them to tell us what we should be eating, instead of listening to our bodies, which tend to be far more accurate.  I'm a baby boomer, really the last generation of children that had parents that made our food choices far less on a scientific basis, and just relying on good old-fashioned horse sense.  Once my generation is gone, it's likely that will be the last remaining vestiges of that legacy of nutritional common sense amongst the American populace, one that was passed down generation to generation, mostly from our mothers and grandmothers to us.  Since every generation forward of me (and most of my generation) have for most of our lives made food choices based on fad and trend recommendations that we've been fed by food scientists and the agribusinesses that sign their paychecks.  At least that's the state of affairs so far.


I don't want to sound like a food evangelist, savior, authority figure or expert.  These are the very people that have sent the proverbial car down the road with a brick on the gas pedal and nobody in the driver's seat.  It's why we're a nation of obese, overfed and undernourished nutritional no-nothings.  As in so many other facets of modern Amercan society, ignorance is glamorized.  We've become a nation that is the sanctuary for no-nothings, and we're proud of it - that's the only way that I can rationalize the appeal of George Bush, Sarah Palin, Glen Beck, Rush Limbaugh and Bill O'Reilly.  The NASCARs and the teabaggers and all the other members of the NeoCon-loving freak show like them because they don't feel intellectually intimidated by them.  Well, that, and there is always the lunatic fringe law of attraction: Shrill seems to beget and attract shrill.  Screaming is a lot easier than thinking for yourself or reading a book.  Gore Vidal once called our nation The United States of Amnesia, and I can think of no better representation of the truth to that supposition than the above-mentioned members of The Angry Mob.  Back in the early 1960's Richard Nixon called the predecessors to these freaks of today "The Great Silent Majority".  Oh my God, what I wouldn't give to have these Fox News-loving, "Obama is Hitler"-screaming baboons shut up.  Nice thought, but it won't happen.  When you're intellectually stunted, yelling and self-righteous indignation are about all you have as a voice.  Well, that and your guns.

Lest you think I'm totally partisan here, my own lovely Democratic party has it's share of shrill no-nothings, though certainly in a ratio far below that of the right.  If you were to ask me what the biggest problem is with my party, I'll say that there are two that immediately come to mind:  1) Hubris.  The perfect illustration of this is the recent Massachusetts Senate race to fill Ted Kennedy's seat, a seat that a liberal/progressive Democrat held for over 50 years.  That election should have never been lost to a Republican, unless the Democratic candidate was a puppy-kicking, Mom-hating pedophile; and 2) Inability to play nicely and share their toys.  When these bozos up on The Hill can't even keep their own party members together, united and committed to cooperating with each other to get health care reform passed, then what are the chances that they can answer with an authoritative, resounding and unified voice when they're dealing with the party of "no"?

I really can't honestly label the American democracy experiment as staying faithful to the importance of a two (or more) party system of governance.  We are now a one party society, with nut jobs at both ends of the spectrum.  If you think that Barack Obama is a progressive Democrat, then let me give you a reality check: He is far more akin to the pre-God Squad Republican party, the party of fiscal conservatism wed to social progressiveness that died about the time that Watergate happened.  That is much closer to his politics than the old New Deal Democratic party is, a party which was both socially and fiscally progressive.  It was the party of the WPA, Medicare, Head Start and AFDC, all admirable additions to American society, and all socialist programs.

Head Start helped make sure that young children were getting more nourishing food to feed a rapidly developing brain.  AFDC makes sure that families with babies and toddlers who are living at, near or below the poverty line at least get some of the basic foodstuffs needed to give a child a fighting chance for his future to be successful.  Medicare is the one thing that our country has gotten right in dealing with health care.  Ask any senior citizen if they are willing to give up Medicare, even though it is a socialistic program.  If they say yes, they are either stinking rich or lying.  Even the ridiculously wealthy seniors use and like their Medicare.

OK, I'm not really sure how I got here.  I started with confinement to bed, then I visited Martha Stewart.  After that it was on to cellulitis, followed by anorexia, then food choices and now I've landed in the land of "How Do You Fix a Broken Democracy?"  I'm not going to try to explain myself or rationalize my writing style, other than to say it's tangential and often a victim to a writer prone to ranting; one with a tenuous grasp of many of the basic principles of correct writing style.  It's all probably true in one way or another, but you have to admit: agree or disagree with me, love me or hate me, I still make you think, and think more in the tradition Socratic learning, less on the spoon-feeding "facts" method of learning that is so popular now.  If you want to get spoon-fed your beliefs, go to church or watch Fox News and believe that their journalism is credible.  I'm not anti-religion; anyone who knows me knows that is about as far from the truth as it could possibly be, but I am not impressed by any religion (or cult, to be more accurate) that asks for your unwavering faith, ability to suspend belief even when what you are being told seems ludicrous and/or any belief system where one authority figure is the repository of all the knowledge and doctrinal authority, and has a direct phone line to God to boot (hello Pope Benedict).

We want our future leaders to have a basic grasp of the 3 R's, but don't stop there and forget to teach critical thinking skills and instilling a desire to question convention.  This has been my experience in talking with high school and college aged kids (or young adults, if you're bristling at me calling them kids):  The public education system today is far less concerned with teaching your children how to think than it is concerned with controlling an overcrowded classroom full of poorly mannered and hormone-driven teenagers.  While all this is going on, our teachers are managing (barely) to cram enough facts in their skulls so that the children they are responsible for teaching can pass a competency exam and move onto the next grade.  Nowadays, it seems quite ordinary to hold kids back.  When I was a kid, I can remember one, maybe two kids being held back a grade in my classrooms, and this was over a 12 year span of living and learning by the old-fashioned, public school education system, one where you were expected to care enough to at least learn enough to graduate up to the next grade, and that was the bare minimum expectation.  My teachers always expected me and my classmates to excel, not to pass.  Being held back was embarrassing beyond measure, and a student would either avoid it, or in rare cases, drop out of school.  Yes, we did have dropouts back then, but even the dropouts at least tended to have a better reason for dropping out than just saying "I didn't like it so I quit".  Look at it this way: I'm kicking it old-school with my way of looking at and navigating modern society.  Even though I'm all over the place, pretty much all of the time, there still is a thread that connects every part of my philosopy, no matter how frayed or tenuous that thread might be.


And with that, there's really only one thing I can say that will tie all of this together:  Think for yourself.  Don't be a sheep, stand up for yourself.  Stick to your convictions, but also never stop questioning them.  Be in tune with and follow your moral compass; never compromise on your guiding principles.  To me, this is the beauty of incorporating a philosophy into your life: There is no right answer, only a lot of questions, and if you're being a good member of society, you're both asking and thinking about the big questions.  Don't stop doing that, please.



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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Sorry, It's the Drugs Talking

This first paragraph is an open letter to my psychiatrist, therapist and my medical team, in no particular order. Thank you for keeping some semblance of sanity in my life. Thanks for helping me come up with a life plan as I approached this next phase in my crazy life. Thank you for giving me the drugs that I needed to get through this; more aggressively in the beginning, and now, keeping on top of things (and keeping me on top of things) so my pharmacology needs are appropriate to my current life, condition and state of mind. Thank you for listening to me when I told you that I needed to be able to try to manage my life, even the painful parts, and that I didn't want to anesthetize away all unpleasant emotions. Most currently, thank you for trusting me when I said that I thought I could get through this tough period of the Interferon; your trust is what makes me comfortable enough to be fully open, disclosing and truthful with you.

Six months seems to be the magic number for when the depression really kicks in, full force for patients on Interferon/Ribavirin therapy. For me, 6 months was at the end of December. I don't know whether the warnings I had heard from nearly everybody I know who has been on therapy maybe planted some seed in my brain and I was victim to the power of suggestion, or if in fact their warnings were accurate and prescient and this is just extremely common. Whatever the case may be, and I'm tending to think that mine is indeed the latter scenario, Interferon from month six on can really play a number on your head.

Psychiatric side effects are the most troublesome SE's for this drug. The patient warnings aren't just a sheet of paper; it's a booklet that you get every time a box of 4 syringes pre-filled with Interferon comes in the mail from my pharmacy. I can tell by reading it that is has been frequently revised, most likely at the behest of the FDA, as new and/or maybe more troublesome problems have been reported. Since I have a health care education and background, as I read through the booklet, and I occasionally do review it since I seem to get at least one new surprise a month (usually more), I always think to myself "this booklet is the perfect example, the pinnacle if you will of a pharmaceutical manufacturer playing Cover Your Ass".

Before you think that I'm concocting a conspiracy or taking potshots at the drug companies here, I'm really not. When I do jump on the bully pulpit, and I am certain that at some point that it will happen, trust me, you will know it. Years working in health care, as well as navigating the system on a continual basis because I live with a chronic disease requiring lifelong management, has left me with a veritable arsenal of horror stories about the drug companies, and how there is barely a hint of altruism in their corporate structure. It's different once you start talking about individual researchers; I know a few, so I know of what I speak. Most of them really went into their profession wanting to save lives, alleviate suffering and cure and prevent horrible diseases. Once in the "real world", however, they often find that they are assigned to projects that are of a questionably real value for the human race, like coming up with the next great boner drug for octogenarians (who for the most part have no business fucking unless they can get their dick up on their own) is generally not how they dreamed of their life as a medical researcher turning out. It's a living that allows them to pursue their real dreams, of curing real life-threatening diseases. They're kind of like the actors like Nicholas Cage, who will do the big-money blockbusters that they know are total crap, but they also know that the salary will be ridiculously generous. That is what allows them to produce, finance and act in low-budget independent films, most of which never make it out of the art house theaters in larger cities, and often don't even break even financially. One can argue that both cases involve selling one's soul to some degree in order to try to save it on the other end by bringing a creation to the world that is of some genuine import.

But once you get to the corporate level, to The Man, these very virtuous and admirable researchers more often than not get hamstrung, their hands tied, or their pet program gets starved of money. There is a lot more money to be made in helping old men get hardons and give depressed people pretend happy lives then there is in treating what is know as an orphan disease: ones with a relatively low incidence in ratio to the population at large, and/or ones that primarily affect minority populations, or ones that could prevent millions of unnecessary deaths in undeveloped or developing nations. In big business, no matter what line of crap the multinational corporations are feeding you, one of the dirty little secrets is that it's still ok to kill the poor and non-white, as long as you do it quietly and inobtrusively. Translated to non-circular speaking, that means to do it with neglect.

But as much as I would like to go off onto this tangent even more, that isn't my point. My point is, at first appearance I thought "classic CYA". Now that I've lived through taking it, I have to say this: I never seen as many adverse events reported for any drug that is still on the market as I have with Interferon. Even more telling, I've never actually had as many of them happen to me personally as I have ever had with other drug I've been prescribed, even Thalidomide, and that is some nasty stuff. Seriously, every time some weird new thing happens with my body, something that never happened pre-Interferon (or if it did, with not nearly the ferocity), I'll immediately assume it's the Interferon - my version of guilty til proven innocent. Then I'll go look up the reported SEs/ARs, and darned if it's not in there. Or conversely, I'll be bored and decide to look up Interferon and Hep C data, look down that previously-mentioned long list of SEs/ARs, only to find that I've probably had almost half of them by now.

Now I'm sure that the FDA forced Roche (the manufacturers of Interferon) to make a big scary pamphlet and document every minute little adverse event, but I also know that Roche has a big stable of lawyers back at headquarters in Nutley, NJ, and those guys' primary goal in life is to keep Roche's ass covered, out of the courtroom and also below the FDA's radar as much as possible. [useless trivia - Nutley, NJ is also the hometown of one Ms. Martha Stewart. Yeah, that one.] But all of my conspiracy theories aside, I'm very thankful that they made this drug look as toxic and scary as it is. I'm having a very good course; the majority of people have a much worse time, and considering its statistically less than stellar success rate, those people have some cajones to put themselves through it. Just off the top of my head, here are some of my memorable AR's thus far: hair loss, itching, weakened fingernails and toenails, nausea, vomiting, fever, headache, mouth sores, lethargy, poor appetite, weight loss, anemia, neutropenia (low white blood cell count), anemia, decreased CD4 (T cell) counts, compromised immunity, infections (which can be life-threatening; so far so good there. Only garden-variety), visual changes, retinal edema (swelling of the small blood vessels that supply oxygen to the optic nerve much of the rest of the internal structure of the eye), increased frequency and worsened outbreaks of psoriasis and eczema, excessive bruising, skin infections, irritability, depression and anxiety. Let me repeat this: these are just what I can inventory off the top of my head - there are surely many more that I could find if I went to the literature.

I'm going somewhere with all this, and that's to have a little discussion about the psychiatric SEs/ARs, because right now, even in spite of all of the other annoyances it's placing on my life, these have been the most vexing, crippling and frustrating. From pretty early on - I would have to guess within a couple of months from the time I started in late June, the irritability was there. I'm not talking about the grumpy old man type or the got up on the wrong side of the bed type, it made me a complete and utter ass to be around a lot of the time. When I figured out what was going on, I started to preemptively warn the people close to me that it wasn't taking much if anything to set me off, and so if my reactions seemed to be out of proportion to the situation, or equally as commonly, they seem to come out of the blue, it's the Interferon talking. I've done my best to bite my tongue, think before I speak, take the 10 deep breaths, all the usual ones, but more often than not, the little monster will find a way to speak for me. I have to admit, that has gotten a bit better, but I'll also say that what is most helpful is just to be left alone when I'm in that place. This is another benefit that has come from living alone - I couldn't imagine dishing that crap out to a partner or even a roommate day in and day out. I'm sure that many couples have made it through this, but I would also wager that many relationships haven't survived this. As much as you reassure your partner that this isn't you, it's the drugs, eventually they will come to the conclusion that part of it probably is you; just you without a filter.

Over the years, we've all heard people say "It's the booze talking" or "It's the drugs talking", but in the past, I've almost always felt that is a cop-out. Alcohol doesn't make you lie, to the contrary, it's what I've always called "The Lie Filter" - it sifts out the lies and good manners and serves up truth: fresh, piping hot, and without any sugar coating. As for other drugs, if they make you stupid, antisocial, inappropriate, paranoid or violent, then you shouldn't be using them as the fall guy for your bad behavior. For that matter, if this is what they do to you, you probably shouldn't be doing them at all.

With Interferon, it's a different story. Anger comes out when there isn't any perceptible trigger, and it's often misdirected. The idiosyncrasies of those close to you, especially a partner, quirks which you've either always thought were cute, or at the worst, not that important, become monumental. I have an acquaintance who just recently finished his course. He had a good response, so fingers crossed that it will stay that way, but more to my point, he is a very sweet guy. I've rarely heard an unkind word come out of his mouth, ever. If he is in the company of someone he finds offensive, he's always polite, and you really have to know him well to be able to tell that he doesn't like that person. He'll still smile and nod his head to whatever stupid thing they are telling him, but the smile is just slightly different. Those that know him know it is one of both pity and disgust.

Toward the end of his course, a mutual friend described a conversation he had with this guy where all he could do was recite a litany of grievances about his partner. Not just one, the list went on and on and on, and as my friend (who is a health care professional) was listening to this, he told me the first thing that came to his mind was "this is the Interferon talking". Hearing that made me laugh so hard. He had no idea that I had been using exactly the same phrase to describe my moodiness for months. When I told him that, and also told him the way that it affected my moods, he was really empathetic. It was nice to have my "I'm not crazy, this is the drugs" belief validated from outside myself, as well as having someone I don't have to explain myself to every time I turn into Mr. Hyde.

Going way back, to when I was just entertaining the notion of starting the treatment, I have had numerous current patients and Interferon veterans tell me about the 6 month mark. Honestly, I've heard it so much I couldn't even venture to guess how many people described this to me. It seemed to be as common as the terrible twos, the seven year itch, the mid-life crisis and day-of wedding jitters. Me being a skeptic anytime I hear a gross generalization, decided I would take the warnings with more than a grain of salt but far less than the certainty of the law of gravity; in other words, I was consciously trying to not let the power of suggestion set me up to psych myself into a somewhat serious but situational bout of drug-induced insanity. I'll be danged if what had to be no more than a couple of weeks after my 6 month juncture (which, coincidentally is also pretty close to the midpoint in my treatment plan), the sky started falling.

The way that this came on was so insidious that it took me a bit to figure out what was going on. It was just after the holidays; it could have been holiday blues, I had just broken up with Brian a month earlier; there were a number of excuses that I tried to put to this. Then, the apathy, ennui and a pretty complete demolition of what scraps of motivation, energy and joie de vivre that I had left from the last year was gone, seemingly in an instant.

Note: for around 6-9 months prior to the Hep C diagnosis, I had pretty much constantly felt like crap. Both my physicians and I were stumped. My PCP (primary care physician), who by the way is phenomenal, didn't think to test for Hep C, since I had tested negative less than a year prior. I didn't fit into any of the most common risk catagories (IV drug use, needle stick, transfusion or organ transplant prior to 1982) - sexual transmission in the absence of all typical routes of transmission (blood to blood exposure), is extremely rare. I'm not saying that I'm a poster child for Murphy's Law, but at least medically, if something completely out of the ordinary, extremely rare, unlikely to happen, or difficult to diagnose or treat is out there, it usually finds me. If you watch the TV show House, I'm a non-fiction version of one of his patient cases. Finally, out of futility and after my doctor threw her hands up yet once more, she decided to go ahead and test me for Hep C. I had just gotten over Hep A less than a year before, and I'm vaccinated against Hep B, but there had to be some reason why my liver function tests never got back down into the normal range after recovering from the Hep A. She ran the test (I think this is in April 2009), and darned if I don't have Hep C.

But back to the sky falling: like I said, it was pretty insidious, not at all like a house of cards falling, more like a tire with a slow leak. After the apathy, came the pretty complete crushing of my self-esteem, followed by bouts of sadness with occasional crying, though the crying was usually completely out of context to the situation. Then finally, the gray clouds went black. Perhaps from the outside what was happening seemed pretty obvious, but from the inside, nothing was obvious. Changes that weren't insidious or subject to a healthy dose of denial were masked by my apathy.

I started to not really care if I left the house. Then, I wasn't showering every day. I also was socially isolating myself, both by not returning calls or emails, and also by not keeping in touch with my small close circle like I already had. One of the biggest problem with the social isolation in this situation is that you take away the perspective that others would be seeing, and seeing the situation only through your eyes. Then the irritability and crabbiness came back with a vengeance. Finally, (wait let me change that) FINALLY, it clicks in. The proverbial light is switched on, and I finally realized what was happening.

Now before any of you think that I let this get to a dangerous point, that my life lost all meaning or I became a danger to myself, not even close. I never harbored suicidal thoughts and I didn't have the desire to numb the pain with booze and pills. Those who know me pretty well know what a control freak I am, so I really have to be climbing the walls or in severe pain before I'll medicate myself. I just don't like feeling out of control. Sometimes I won't even take a non-narcotic pain reliever; I really am that stubborn. More than anything, it was just that nothing really seemed to matter to me. What got me out of bed every day was knowing that the dogs and the cat depended on me to feed them, get them out to go to the bathroom (at least the dogs) and at least give them some half-assed attention. Once I was up, I could usually stay up for at least a few hours, but had I not had the commitment of caring for creatures that relied on me for their health, well-being and safety, there are probably a bunch of days that I would not have ever gotten out of the bed.

But at the time that it got the worst, I was at the point now where I knew what was going on, and knowing you need to change or get help is a very important first half of the battle. I have to say here, with a tinge of humility: I was more than a little disappointed that I couldn't prove every other current and former patient of Interferon therapy that warned me about the psychiatric issues that this doesn't happen to everybody. Of all the SEs/AEs that inhabit that list on the pamphlet, a list so long it would rival the Bayeax Tapestry in length, I would put money down on depression being one of the top 3, if not THE most common SE/AE associated with Interferon. It's horrid and paralyzing, far worse than losing hair, having a mouth full of painful sores, anemia, nausea, vomiting or lethargy. All I can say is, thank God for Welbutrin. Had I not been on an antidepressant from the get-go, I don't want to even imagine what this would have been like.

Which now takes me back to where I started with the beginning of this latest post: I really have to wholeheartedly thank my psychiatrist and therapist both for listening to me when I said that I wanted to try to manage this on my own, like I have with any difficulty I've faced in the past. I refused to take antivirals for HIV for many more years than my physician was comfortable with (a decision that turned out to be a very good one), but as with my challenges here and now and in other situations in my past, I've proven that I do know when I'm over my head. I still believed that despite this spell that I was in the full throes of, I remained mentally clear enough to know when to ask for help. Both Rex (shrink) and Jason (therapist) were skeptical, with what I now have to admit may have been good reason. As I proofread this, and in the process get a rear view mirror view, it sure sounds a whole lot more hellish than it felt like it was at the time. But it taught me something very important, something I couldn't have learned with an emotionally-numbed psyche: more than anything, what the experience gave me was the confidence that I could deal with this and with other difficult challenges that life can and may throw at me. However, I have to give some credit where it is due here: I learned a lot that prepared me for this in the course of many years of trying to manage Ken's depression with him. Yes, it's different to be on the other side of the mirror, but even though the perspective is different, depression is depression is depression. I was and still am certain that I could realize when the shit was going to hit the proverbial fan well before something really awful happened, and more importantly, I was not too proud to do something about it, even (God forbid) ask for help. I may be stubborn, willful and fiercely independent, but I'm also pretty attached to this thing called living, and I'm not in any hurry to do the big final check-out from Hotel Earth.

For the last 3 months, Rex has been trying to convince me to go onto a 2nd anti-depressant, at least temporarily, until the course of treatment is finished in July, and I'm still fighting with all my might to stave this off. My rationale here is that sadness and pain are normal emotions that are part of being a fully evolved human being. I don't want to numb away all the emotions I don't like, because they hurt are inconvenient. I want to live fully, and be fully present. I've taken drugs that have severely narrowed my emotional range, but only when Ken died, and at that point, I didn't need a big range of emotions. What I needed was a chance to heal my mind and heart, and that would have either been impossible or severely delayed had there not been aggressive psychopharmacological intervention. But I'm not where I'm at three years ago. Yes, reading this back to myself does show me that this has been a little worse than even I was realizing. But more importantly, I'm also learning that I can work my way through these things in a less-medicated manner, a manner that lets me feel more control in regard to my mental health and my life in general. I wouldn't trade that part of this experience for anything.

But would I ever do this solely for the purpose of personal growth? Not on your life. As valuable is this experience has been, I don't think my life would have been a whole lot worse had this never happened. In the end, however, it's purely conjecture and a rhetorical and academic argument. It happened, and the bell can't be unrung. Learning through adversity can be a good and lasting lesson, but it's also one that you shouldn't be going out there and seeking. If it's the hand you're dealt, you have to play it somehow, but gamble with knowledge, forethought, more than just a single perspective, and perhaps most importantly, a Plan B. As I love to say to someone who tells me they see no way out of a situation: there is always a Plan B; and a C, D, E, F and G. Some roadblocks are small enough that you can look through them, but more often than not, you have to be creative and look around, under or over them. Don't limit your options just for the sake of expediency, painlessness or ease.

And now, to quote the late great (and completely unique) Bob Ross, I'm going to go paint some happy little trees.

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.
Permissions beyond the scope of this license may be available at http://www.runnymedesilkys.com.

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The Battling Bickersons

Note to the reader: I have things that are important to know before you read this post:
1) It was started on January 5. For reasons that cannot be excused or rationalized, I've been sitting on this for weeks. I'll spare you the big stinking bag of BS and not insult your intelligence. I've just been lazy. And
2) There are discussions in this post of sexual matters that are' for an adult-audience only, and even then, probably too graphic for some of you. Now with that said, let's start the show...

It's interesting, I think, how some people can really jump the gun in their thought process, then share it unfiltered, as if they have the answer to whatever it is, or have a plan for you. I've started sharing with some people that my relationship with Brian has run its course, and more than once I've gotten this question thrown at me almost immediately: "Are you going to start dating again?" Holy crap, could you at least let his side of the bed get cold? I still have a lot of his belongings in my home; he hasn't emptied his drawer in the closet, I'm still working through this whole thing. That shouldn't be a shock; it's been all of 15 days since this happened. I don't bounce back quite that quickly in the best of circumstances.

This one is tough: there is no bad guy, nobody is to blame (I hate the blame game anyway), this isn't easy for either of us. I know I can speak for myself there, and if I'm making a false assumption on Brian's part, I'll be very surprised. We went out for 2 1/2 years, I know him pretty well. But if I'm off-base, my apologies to him. Sometimes things just don't work out. I think that is actually the case for a majority of breakups where you have been with the person for a significant period of time; for argument's sake, let's say a year. The majority of the time, at least in my experience, is that there isn't bad vs good, black vs white. Relationships, for the most part, are completely gray. Breakups usually involve two good people who have made mistakes. Maybe they figured out they didn't belong together, maybe never should have been together. Maybe the timing was wrong. Maybe one (or both) has no business in being in a relationship, period. I'm not going to say if any of these are the truth in the case of me and Brian, because honestly, it's irrelevant, it's private, and it's disrespectful to him to say much more. Those were merely examples that came to mind, nothing more.

But back to the first question I was discussing the answer is an unabashed "no, absolutely not, are you crazy?" In retrospect, I fell into this one far too soon and far too quickly, but that isn't a big surprise; new love is exciting. It sweeps you up and carries you away, in the best sense, at least in the beginning. Then, a year later, 2 years later, real life as a couple has really set in. You hear people talk all the time about the honeymoon being over, as if that is a bad thing. Honeymoons are great, they're exciting, they're passionate, they're usually full of hot sex and they pick you up like a wave. It's fun, but it's hardly relaxing. To the contrary, it's pretty exhausting. When the endorphins run out, everyone eventually crashes.

The period that follows the honeymoon is actually the time that I like the best (if the relationship is working, naturally). You're getting to really know each other, you're meeting the other person's friends and family. Even if you don't live together, you set up house if you're committed. It sounds silly, but giving somebody a drawer in your bedroom is a big deal, not that far from moving in. Some of their stuff is there, they have a drawer in the bathroom as well for their toiletries, they can come and go as they please, and if they're hungry, just raid the fridge, it's normal and expected. I've always had the "mi casa es su casa" mentality with lovers, friends and house guests anyway, it's how I was raised.

But back to the post-honeymoon phase; this is the period that I find most interesting. This is the settling in. You're finding out what that person's eccentricities are, what they like and don't like, what you like to do together. You can spend an evening together and not say a word and have it be completely comfortable. Well, I can. I'm quieter than most, especially at home. It's the cross you have to bear when like me - I'm cerebral, and for the most part, I live in my head. Unfortunately, it is also the time that you really start finding out how you push each others buttons. It's rarely done in a sinister manner, most people aren't going out and purposefully looking for ways to piss their partner off. But you sure find those buttons, and so do they. It's all subtle clues: body language, a look, a funky energy in the room, a sudden and uncomfortable silence. And then you log it. Usually it's more of a "take note of it so I don't do it again" thing, but even if that is the original motive, it also ends up being something that goes into the arsenal, to be used when you inevitably have a big disagreement.

I was talking in therapy the last couple of sessions about the whole breakup thing, and my main observation about relationships, especially from the outside looking in, is how combative, nasty and cruel most people are to their partners. This isn't just a few people, it's most people. I never really noticed it when I was with Ken, and I now know that it's because I was the same way. Even in relationships that I consider to be very good and very solid, communication between partners can be really nasty. The gloves are off, and you know where all the buttons are. After Ken's death, and pretty much continually for the last 3 years, I've noticed how terribly even the poeple that I know well and consider to be good people treat their partners.

At a dinner party, or an evening out on the town, I've found that you will inevitably hear people say terrible things to their partner. You'll see passive-aggressive behaviors that will leave you speechless. People will criticize and belittle their partner, all the while treating that partner like they aren't even in the room. You'll also hear grievances aired, some very personal in nature, out in public and in the presence of friends. I never noticed this before, and now, to be perfectly honest, I find witnessing it to be horribly uncomfortable, even if I've watched it happen for years and I know that these people really do love their partners. The whole scene will make me want to crawl out of my skin. I've tried every tactic to shut it down: change the subject, deflect the anger or defend the person being attacked, even telling people to knock it the hell off. None of them work, so I've now just taken the strategy of sitting silently and mentally checking out as much as possible so that I don't have to listen or risk getting drawn into the fight.

The old saying that "you always hurt the one you love" is far more true than I ever would have admitted before having this enlightenment. I know that for me that also affected my ability to have a good relationship with Brian; I could be a real dick to him. I could be really subtle, and most people wouldn't even catch what I was doing, but I knew full well what was happening, as did Brian, I'm sure. Seeing that side of myself and finally having the ability to realize what was going on really soured me and gave me little hope that I can sustain a happy and loving partnership.

In addition, I really don't feel the compulsion to couple up that I've always felt in the past. For the first time in my adult life, I've lived alone for an extended period of time, and for the first time I love it. I like myself, and I especially like getting to know myself better. I also think it's easier because I no longer feel the compulsive need to have a soul mate; I already have had one. I think you're lucky to have that once in your life, and having had it, I don't feel the need to search it out again. I've gotten older, hopefully wiser, definitely more open to new personal insight, and as such, I'm plenty of company for myself.

I was talking a few weeks ago about this with my friend Gene, since as he knew, I had pretty much always had a partner all my adult life, and when I didn't have that I always had at least a roommate. I was telling Gene that this was the first time in my life that I could picture living alone for the rest of my life and being very satisfied with it. Gene had a very astute insight: after hearing this, he said "Parry, you're an Aries (and so is Gene); Aries always think that they can't live alone, but once they live alone, they then don't think that they can ever live with someone else again." Now I'm pretty skeptical of Astrology, but he did have a point; that pretty much does describe me. At the very least, I can picture never living with another lover and being happy with it. But I also am pretty sure that at some point me and my best friend Deanna will live together, probably after she retires. For years now, we have talked about her retirement, and have had a plan that at that point she will sell her house, I'll sell some of my property off, and we'll buy a plot of land in rural Western Montana and build a big house for us and all of the animals. For me it will be for about half of the year, for her, likely most of the year.

Deanna is the only person that I can realistically see that working with. We love each other, we accept each others' eccentricities without judgment or a desire to change each other, and we know that no matter what she may do to me or me to her, we will never hate each other. I have to give Deanna credit for that definition, and I have to say that I've never really heard a definition of a best friend that I've related to better than that one: a best friend is someone that will never hate you, no matter how badly you screw up or what you do. She is one of the few people I can be around 24/7, never say a word, and not find the silence to be the least bit disconcerting. We don't need to talk, our true communication is at a much deeper level. I also know that if I call her on the phone and say that I need her with me right now, she will be on the next plane, no questions asked. She has actually proven that already, when Ken died. I called her sobbing, trying to tell her what happened, and all she said was "I'm going to get your mother, buy the plane tickets, and we'll be on the next flight out." And she was.

But as for a lover: I'm not excluding it, so to honestly answer it I'll say "I'm not seeking it, but I'll also never say never". I also will be far more cautious about entering another relationship if I decide to take the leap. I need to not let myself get carried away in the excitement of new love. Right now, what I really miss more than anything is not what I expected, and not what you probably thought I was going to say: I miss companionship. I miss having someone to snuggle with in the evening or on a Sunday morning. I miss having somebody to fall asleep holding or them holding me. I honestly would not mind having a sort of steady companion, we wouldn't even have to live together. Someone whose eccentricities don't bother me, or mine them. Someone who knows when to be there and when to leave me alone, or at the very least, they don't get bent out of shape when I tell them I need to be left alone. I'm not well-known for sugar-coating my words, you need to take them at their face value and not read anything into them. I've found that there are very few gay men that can work with that. Now if more straight men would just sleep with me, I would have it made. Sorry to generalize folks, but most straight guys get my communication style and demeanor a whole lot better than most gay men do. As the old saying goes "who do I have to sleep with in this town to get a drink?". My version is "who do I have to sleep with in this town to find someone that gets me?" What I don't miss in a relationship, however, is the fighting, bickering, undercutting, and small-minded insults which are hurled just for the sole purpose of hurting someone.

I've now actually started, sort of fitfully and uncomfortably, going out on what I'll call, for the lack of a better term, dates. I'm not going out to find someone to partner up with; to be perfectly honest, I'm out there looking for a couple of normal, sane, sober and easy-going guys to shag. Ideally, I would love to have a stable (don't I sound like a pimp?) of 3 or so guys that I can count on for semi-regular sex and companionship. FWB's (friends with benefits), if you will. Now the traditional gay way of doing this is to meet guys and shag and then see if you work well together. But as I get older and more discerning, I would really like to spend a few hours with someone, in our clothes, in a social setting, just to test the waters, and expressly without the intent of getting laid that day. The other benefit of this approach is that I really don't want to sleep with a plethora of men in the pursuit of my goal. I really would love to not ever get another STD, and the way to decrease your risk, as with any communicable diseases, is to decrease your exposure. The other way is to make educated choices.

In a manner that would come as no surprise to my friends, I have a rather direct interview process before I sleep with someone (or at least most of the time, my goal is to always do it, though). Once we figure out that we like each others company, my list of questions comes out, and are as follows:

How many people have you slept with in the last 6 months?

What recreational drugs do you use? That includes alcohol, prescription drugs, weed, mushrooms, alphabet soup (the party drugs: A, E, G, K, T - if you don't know what I'm talking about, Google it), crystal meth, cocaine, crack, heroin...you get the idea. I will say, I've never had sex with a heroin addict. Or if I did I had no idea, and that would be unlikely. I can sniff out a guy on crystal meth better than most, and they can actually maintain better - until they're addicted and paranoid, or taking out the wiring in their house, picking open their skin, etc.. But early on, they're harder to catch. Not for me. I take an ADHD drug, so I am much more tuned in to someone who is spun out on stimulants. And btw, the answer for my typical recreational substance use is a rare glass of wine, an occasional bowl or two of weed (less than once a month), which is prescribed - I really don't use weed as a recreational drug anyway; it makes me too stupid, and I'm stupid enough already. I generally use it for nausea and neuropathic pain. Very rarely, I've had a line of coke at a party, I won't lie, but basically, I'm pretty L7 (square). I barely hit caffeine on a regular basis, except for chocolate, and my morning tea, which more often than not, gets a sip taken out of it and is then forgotten.

Next question: how often do you have an STD screening done? Note: for sexually active gay men, the gold standard is a screen every three months, which includes a syphilis test, throat and rectal swabs (for gonorrhea), urine test for UTI's (like chlamydia), a visual of the groin for any suspicious lesions and a check of the poop chute for rectal venereal warts (they are often internal). I know, that last sentence wasn't pretty, but medicine usually isn't pretty, and I'm a clinical thinker. Would you have rather I said rectum than poop chute? I think rectum sounds nastier, personally.

Next question: on average, how many different men would you say that you tend to have as sex partners over a 3 or 6 month period? There's really no cut and dry number that I'll cut off at, but let's say that if that answer surpasses 1-1.5 guys per month on average, I'll probably red-flag it and base how much it concerns me on how they answer the rest of the questions.

Next, how often do you practice safer sex, or more importantly, how often do you have unsafe sex? And yes, a lot of guys still have unsafe sex, most of us aren't perfect (actually, I don't personally know a single HIV+ guy that hasn't barebacked (again, Google it if you don't know what it means) at one time or another. It's definitely more pernicious in the HIV-infected community, and even more so, among drug-addicted people. HIV+ men tend to conveniently forget that there are other STD's out there besides HIV, and drug addicts tend to make poor choices about safer sex when they are high and their judgment is impaired. Then, and these are even more disgusting, there are a couple of groups of guys out in the gay community (I haven't heard of it outside of the gay community, though it may well be there) whose behaviors are nothing short of atrocious. The first is a group that we less than affectionately call "the bug chasers". These are HIV- guys (allegedly) who have prolific unprotected sex with the sole intent of getting infected. It used to be, and is still thought to often be the case that many of these guys wanted to go on disability for the rest of their lives. It's not that simple now, as I'm sure many guys who have tried it have found out. Personally, I think that it is more of a thrill-seeking behavior. This is the macabre extreme of the mentality of guys that compete in extreme sports, a lot of it is for the thrill. The next is the group that I call "the AIDS commandos"; far less common, but even more heinous, these are HIV+ guys that knowingly and deceptively have unprotected sex with (allegedly) HIV- guys for one or both of the following reasons: the first is to just knowingly throwing caution to the wind and not consider the consequences their actions have on others, or even worse, guys with the sole intent of infecting negative guys. Thankfully the latter group is pretty small, or so I suspect. Before I leave this, the point has to also be made that these negative guys bear equal culpability. They can say "no" to barebacking at anytime, unless they're rufied, raped or otherwise not having consensual sex.

Now I really try not to judge when it comes to sexual practices. I probably have a more perverted brain then at least 80% of the population out there, so I would be hard-pressed to be the first to cast aspersions on the choice of others. That said, bug chasing and knowingly infecting people are right up there at the top of my Creepy Sexual Practices list, along pedophilia, bestiality, necrophilia and rape (which is really a crime of violence, not a sexual crime, but I'm not going to split hairs here). I really do think it's that bad, and also that devoid of any rational explanation. That's akin to licking the drinking glass used by someone with SARS or H1N1 or worse yet, Ebola, or getting on a subway train with a vial of anthrax, the sole purpose being to willfully inoculate innocent people with a dangerous or deadly contagion, just to see what happens.

And my last question, and this can often be the most telling if they are honest is: do you prefer anonymous/one-time encounters, or do you prefer someone you have some familiarity with? Most guys will actually be pretty honest about this, because if they really and truly are one-timers, they aren't out on a date like this. But sometimes they are, and if so, they will often tell you so. It's a waste of time to not be honest, and worse yet, you're likely to really piss someone off by your dishonesty. In my experience, the reason that guys don't get past the first shag, even when they meet on a no-sex date first, is because sexual chemistry is a strange and fickle thing. It happens for no better reason then that it just does. It's happened to me more than once, and it's happened to most gay men. Another way to ask this and elicit basically the same data is to ask: after sex, do you like to linger, cuddle, talk and maybe go at it again if you have the stamina, or would you prefer to get out of bed and get on with the rest of your day or get home and go to bed? Again, my experience is that guys usually don't lie about this, because it does them no good; they will get busted the first time the clothes come off.

So I'm now (sort of) back in the game, but with a far different attitude and perspective than ever before in my life. I think there are a lot of reasons why I look at sex more respectfully, even sacredly, than I used to:
1) I'm getting older. I'll be 50 this year, and I don't have the libido I had 30 years ago. Thank God for that; I would probably have a heart attack in the act.
2) I'm a far more spiritual man than I ever have been in my life. It's true that I've spent a lot of my life shopping and soul-searching to find a spirituality that made sense to me and gave me a rational perspective on my life and the world at large. The difference now is really that I've been far more disciplined about my study. I actually study nearly every day, and have for almost (a couple of months shy of) 3 years now; something I've never done in my life before this. Interestingly, it's now become a lot less about getting closer to God (though that is often the result); it's about seeing what in my life has put me spiritually where I am now. Why do I have the same struggles as always, but also let them have a far less deleterious effect on my psyche and self-esteem? Why do I want to study every day, rather than see it as a chore? Why does it seem to permeate my life far more completely than any study I've done before; not just my sexual life, but more generally, my entire secular life? There is far more blurring of the lines between sacred and secular for me now, and I think it's good, and the move has been in a more sacred and spiritual direction. It feels like it matters more to me, in spite of what anyone else thinks of my views (which is immaterial).
3) I want my sexual experiences to be about more than my genitalia and an ejaculation, I want it to be a connection with another person on many levels: intellectual, spiritual, corporeal and emotional. Half the time, I don't even orgasm when I have sex as of late, nor do I need to in order to enjoy myself. I just look at sex differently from most men, especially now.
4) I don't ever get so horny anymore that I'll bend my rules, compromise and settle for less than what I want and know I can get. No sexual partner is worth that. If I'm going to do that, it's no different than going to a prostitute or a strip club, and at least then, I'm being more honest about my motives.

Now that said, it's been a pretty crappy last couple of months with the Interferon, emotionally about the worst so far. I'm really going to delve into that more in my next post (which I'm starting tonight or early tomorrow, by the way), but I say this now, because what has been crappier is my mental health, more so than anytime prior during the course of treatment. Rather than true deep clinical depression, which is very common with this drug, and as I've heard validated by many former patients, for me it's been a deep sense of ennui and apathy, which has been expressed by me not being productive. I've not been writing, I've been reading less and I've been watching TV more. I've also spent an inordinate amount of time online on the hookup sites. I've not really hooked up that much, but I've pissed away far too many hours at it. More that the actual waste of time, what I hate about it is the way that wasting tons of my time looking at porn online and cruising the hookup sites makes me feel about myself. It's not that I feel bad about being low-energy, it's that I feel bad about how I'm acting on it. To put it simply, I have an insidious and all-permeating case of the I Don't Cares. At this point I can handle it, and I feel that way only because I've been here before in my life, but in the past, it took me a much longer time to even realize what was happening, much less doing anything about it, and that was long before I ever injected interferon into my abdomen. I think that having my radar set so sensitively because of the potential psychiatric adverse events that have been reported with this drug has given me a profound and healthy respect for the drug. I've been far more consistent and honest in my soul-searching; right now, that is on a daily basis. For the last couple of weeks I've done my best to start the morning with an honest emotional and mental health self-inventory. I look at how I feel, compare it to how I felt the day before, the week before, the month before, etc., and then figure out what I need to do to achieve the most positive possible outcomes for that day.

What I've noticed from this is the following: I'm setting a limit on my computer time (except for my writing and any official business that needs to be done). I'm setting a limit on the amount of TV I'm watching. For the last two days, the televisions have not been turned on in my home, even to watch a movie.

I'm living in a quiet house, no background TV or music and really paying attention to my surroundings. It's amazing how all the media that we now have available has effected the amount of quiet time that most people have. I'm hearing sounds I've never heard before in my home: the birds out in the trees around the feeder, the cat wandering around the house, the sounds that the house makes, the sound of the refrigerator cycling on and off, the sounds of passing cars, and even just the background electrical noise. The other day, I caught a failing transformer in my cook top (for the electronic ignition) long before I otherwise would have; it probably would have failed before I caught it, under normal circumstances. Even the repairman didn't hear it right away. I can hear things that amaze me, and I find it quite eye-opening. I'm also rather stunned that I like the silence. I'm a guy that for most of my adult life have had a problem falling asleep without the TV or radio going. Now I fall asleep better without it making noise.

I'm also reading again, daily and for a good couple of hours at least. I've continued to study the course and meditate daily, sometimes twice a day. The one thing that has probably taken the worst hit is my writing. I've been really bad about writing every day, even once a week. Because of this, my head gets clogged with too many thoughts because they aren't getting written down, and I'm losing some really good material out into the ether, because I'm not making note of it in order to expound on it later. I shudder when I think about what I've lost here, but I also need to let go of those regrets, and instead, observe what these regrets feel like and hopefully have those observations have a positive effect on changing my habits.

I look back at the last 3 years of my life, and at the time before that, and I realize how much I've changed. The world around me has changed much as well, but what really stands out is how different I am. I think back to that time shortly before Ken died, and the person that I am now barely recognizes the man I used to be. I don't look at anything of importance the same way that I used to. It honestly feels like that person of 3 years ago isn't even me. All my memories of that time are very cloudy and disjointed, if I remember things at all. There was a period from around November 2006 to March 2008 that also feels, to a substantial degree, like I was sleep walking. I remember little of that time, much less than I would expect, and what I do remember, I take those memories as suspect for accuracy. There is much good that has happened to me, along with much bad. I'm glad for all of the experiences, but I'm also completely disinterested in reliving most of these memories. I've not had a life bereft of excitement, drama, tough times, hard lessons, ecstatic joy, high highs and low lows. I have actually had a very interesting life. More than anything, what keeps it interesting is that it is always evolving and changing. I'm also observing as of late that what I find interesting in life these days is far less of the exciting variety, and far more of the subtle but life-altering variety, on a very deep level and one that is far from transient in nature.

To put it simply, it seems that finally I might actually be growing up.



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.
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