The Mobius Strip of Depression and Loneliness

It's not something I talk about much. For one, I'm generally a shy, laconic person in the best of times. Two, how do you even bring something like this up in conversation.

Person you only superficially know: "How's it going?"
Me: "Well other than being depressed and lonely, I'm alright, I guess."

Yeah, probably not. I recently came across a collection of cartoons that conveys what I often feel like in my melancholy state. This one sums up pretty well what I was just talking about.

I feel as if I'm fighting battles with myself and that I'm doing just well enough to stay afloat. Barely. Many times I feel as if I'm on the verge of losing control and spiraling down and only the thinnest thread is holding me up.

The intense loneliness I feel makes it seem that much harder to imagine a path forward. Interestingly I just ran across an interview that summed up well how I feel there too.

Another tragic example concerns lonely people. The lonely are interesting because it’s so tempting to say: "Oh, lonely people. Yeah, those are just losers, or whatever. Those are people who can't make friends." Actually, the data suggests that the vast majority of lonely people don't lack any social skills at all. It's just they found themselves in lonely situations.

You move to a new town and you don't really know anybody. How do you meet people? It's hard to meet people. The longer that persists, now the longer you've been lonely, and then ‑‑ this is the key part with the lonely and the busy and the money and the poor ‑‑ now that you're in that state, your behavior changes, and the way your behavior changes seems to keep you in that state.

It's actually about how being poor changes how people think and often leads to people making bad decisions that leave them in a continual state of poverty. A vicious cycle if you will. I know exactly how that feels. I've had more than one person give me flippant advice along the lines of "you just need to get out more" or "you just need to focus on the positive things." Yeah, if it was that easy I wouldn't have a problem, would I?

It's a struggle. Some days are worse than others. Sometimes there's a reason. Sometime's there's not. This internal struggle is what I try to keep in mind when dealing with someone I want to punch in the face. Maybe they are going through some battle with themselves too, something that no one else sees.

Of course some people may be fighting their battles, but still need a punch in the face. Either way, I'll be wrestling my own demons while I weigh the pros and cons of following through with said punch. And whether or not I go through with it, I'll still probably be feeling sad and lonely.

Declaring a Truce with Infinite Jest

Back at the end of May, I decided I would read Infinite Jest by David Foster Wallace. It's now September and I've only managed to read about 150 pages or so. It is not an easy read and I knew this going in. After the first 80 pages, I ended up starting over again. However I am setting aside now as frustrating as that is for me. I fully intend to pick it back up again at some point, but for now I just can't devote myself to it like I need to in order to finish it. This is not a book where I can read a page or two at bedtime or during my lunch break. It requires a fierce concentration to make sense of it due to Wallace's style (or more accurately various styles which shift with each viewpoint) and his non-linear narrative and his enormous vocabulary which includes words he's made up. The book is quite intriguing, but in more of a dry, clinical way than an emotional connection. I do want to read it, but for the moment I can't devote the time and energy needed. The next time I take some time off from work, I may pick it up then. Wallace has not defeated me; I will read the book. Just not quite yet.

Until then I will find other things to read. For now, I'm starting with Snow Falling on Ceders by David Guterson. I've read the first twelve pages and don't feel my brain melting so that's a good sign.

Setting Sun Amongst Storm Clouds

Montana skies are amazing.

More pictures can be found over at my Google+ page.

Someone Spent Time and Money Putting This Cutting Edge Story Together

Stay calm. I'm going to blow your mind here. Are you ready?

Are you sure?

Here we go.

When someone we don't like or who plays for the wrong team does something even if it's relatively innocuous, we're more likely to not agree with the action than if it was someone we do like or who is on our team.

Crazy, eh? Mind. Blown.

So, I'm sure glad to see some cutting edge journalism from CNN on things that are clearly The Most Important of Our Time, things like...what people think about Obama putting his feet on his desk. Really.



I'm very glad they didn't ask people about things like whether or not we should take military action in Syria, the vast data-mining of the NSA, the drone war without borders, locking up people for small amounts of drugs, or any of the other myriad trivial matters that our nation faces. Thank God CNN can resist the siren call of such trivialities and get to the essentials. "Hey, this guy occasionally puts his feet on his desk (you know, like nearly every other male ever who has ever sat at a desk). What do you think of that?"

Next up: Wolf Blitzer showing people (especially people who aren't in the same political party as the President) a picture of Obama and saying, "The President is breathing in this picture. What do you think about that?"

What Are You Afraid Of?

Part of being human is having fears. Fear of the dark. Fear of spiders. Fear of heights. Fear of the number thirteen. It's normal, but I've wondered for a long time what I was afraid of because I never really could think of anything. Until recently.

A couple of weeks ago, I woke up in the middle of the night. It was dark and it was quiet, but I didn't know what time it was because I don't have a clock in my room other than my cellphone and laptop. I wasn't sure why I woke up other than something was...wrong. I couldn't say what exactly. I just didn't feel right and I really couldn't think. My head was foggy and it seemed more than just grogginess from waking up after a couple hours of sleep. The feeling was very frustrating as I lay in bed. Why did I feel strange? Why was I having trouble thinking? Something was very wrong, but I couldn't figure out what.

After a few minutes of this, I had the vague notion in the back of my head that I needed to eat something. There was no rational thought that went into this. It was just a feeling. I reached out for things on my desk and dresser and finally grabbed something which I proceeded to attempt to eat. As I attempted to stuff this thing in my mouth, I kept thinking, "What is wrong with me? Why isn't this working? Why can't I think? Why does this taste funny? What's wrong?" After several valiant attempts to consume the object, I got the sense that it wasn't going to work and I set it down. I realized in a hazy way that it was my Newton's Cradle which was now a tangled mess.

I still had the sense that I needed to eat something, but that I wasn't going to find anything in my room. That meant the kitchen. My bedroom is in the basement, so I began making my way upstairs. In addition to being unable to think, I was feeling quite clumsy. The stairs nearly proved my undoing as I stumbled and almost fell down. Twice. But I managed to make it to the kitchen where I opened the fridge and the cupboard next to it and began stuffing my face with whatever I could grab. Thankfully it turned out to be food items. After furiously stuffing myself with crackers, leftover pasta, chocolate, and some milk, some semblance of thought began slowly returning to my brain and I realized what had happened.

Hypoglycemia.

Your brain needs glucose to function and mine wasn't getting enough so it wasn't functioning properly. This is not the first time I've been hypoglycemic, but it was undoubtedly the worst. Based on previous lows I've had, my guess is that it was probably less than 32. Anything below 70 isn't good. The biggest problem with severe lows is that I am incapable of recognizing what is going on. I can't think clearly or call for help. I can't think, "Gee, I think my sugar is low. I'll check it and eat some glucose tablets." I just have this terrible feeling that something is wrong and that I can't think well enough to figure it out. No doubt it's scary for anyone who has been in the situation (protip: don't get type 1 diabetes), but it's especially fearful for me. If there is one thing I take pride in, it's my mental acuity. If the universe sees fit to bestow further diseases on me, I don't care what they are so long as they leave my brain alone. The fear I felt lying in bed, trying to eat an inanimate object, and unable to think was about the worst feeling in the world. There is no physical thing I think I fear as much as that.

I'm Back

So after an extended hiatus, I'm back. I've been thinking about posting again for awhile and the prodding of some friends pushed me over the edge. Writing is a great outlet and I'm looking forward to posting at least semi-regularly again.

It's been awhile since I've looked at this page. I've got a few ideas for updating it. As for what I post about, it will probably continue to be whatever happens to be on my mind. There is so much in the world I find fascinating.

I hope you find something interesting here and I hope to read your comments.

Live long and prosper.

Star Trek Teaser

It was nerdgasm time today as the teaser for Star Trek into Darkness debuted.

This has me very excited. I kept my expectations low for the last Trek film and Abrams did not disappoint. It was much better than I was expecting. Details have been scarce so far and the villain has not been revealed, yet. Speculation at first kept saying that it was going to be Khan (which would be a big mistake), but lately Garth of Izar and Gary Mitchell have been tossed out. Either of these would be fine choices. They are good characters and a lot could be done with either. I'm hoping, though, that the writers decided to create something new. You'd be hard pressed to find a bigger fan of The Original Series than me, but that's why I'm so interested in new stuff being done with these characters rather than just rehashing old material. Let it rest and peace and honor the memory of TOS by dreaming new stories up.

I still plan on forking out money to see this opening day and I'm confident it will be a very good film even if the villain is recycled. I will be a little disappointed if that's the case, though.

The High Costs of Emergency Medicine

A couple months ago, I had to take my youngest daughter to the Emergency Department. I picked her and her sister up from the park. She was in a panic because she had pain and a tightness in her chest and was having difficulty breathing. This is not something that could just wait for her primary care physician, so off we went to the ED. As it turns out, she has asthma like her sister and was having an attack. She got a breathing treatment and an inhaler and is now doing much better.

What was the cost for this excursion? I just got the bill yesterday. The grand total was $1417.30. After insurance, my share is only $551.72. I'll just write a check for that and it's over and done with.

Hahahahaha!

Yeah, right. There's no way I have that sort of money just sitting around. Thankfully, I work at the same hospital and it's (relatively) easy for me to just arrange to have payments taken out of my check for the next six months (or whatever) to pay this off.

We talk a lot about the soaring cost of healthcare in the country and there is a push to take more preventative measures to reduce trips to the ED. Sometimes those visits are unavoidable, though, and it will be really important for Congress and the President to ensure that good cost control mechanisms are put in place with Obamacare so that the average person doesn't need to worry about healthcare being unaffordable. Like I said, I'm lucky in that I can make payment arrangements with a minimum of fuss. Most people are not in that situation and it's trivial to find horror stories of people going bankrupt over the cost of healthcare.

The Importance of Actually Taking Your Meds

This morning was a bit hectic and I ended up skipping breakfast. That's when I typically take my modafinil pill. Right after lunch, I got a headache and started feeling really tired which is when I realized what happened. I couldn't get back to my office and by the time I did, it was really too late to be taking it unless I wanted to be awake half of the night. It's amazing how much different I felt. Tuesday and Wednesday were just awesome in terms of my energy levels. Today was completely the opposite.

So, the moral of the story, children, is that your meds don't do you any good if you forget to take them.

Drugs and Me

One of the most exciting things about getting multiple diseases is the drugs you get to take. Or something like that. There are plenty of people taking a whole lot more than I am, but just for kicks I thought I would outline what I am currently on.

We'll start with the big two; both are insulin. Without these I wouldn't live very long. You normals have a pancreas that kindly produces insulin for you. Mine no longer does. The first type of insulin is Lantus I take this once a day at night. It provides my basal rate of insulin. My body always needs insulin whether I'm eating or not. Lantus provides this. This is, of course, given by injection.

The other insulin I take is Humalog. This provides my bolus for when I am eating and need extra insulin to process it. I have to carefully balance my blood glucose levels. If it gets too low (if I take more insulin than I need for what I've eaten) then I risk becoming hypoglycemic. If it gets too low, I can go into a coma. I know when I'm getting low because my vision gets wonky and my brain gets foggy. Then it's time to drink some milk or juice (liquids are processed faster than solids). If my blood glucose gets too high, I risk becoming hyperglycemic. How do I know it's getting too high? My mouth is really dry, I'm thirsty no matter how much I drink, and I'm urinating. A lot. I have to check my sugar throughout the day and give myself more insulin as needed or eat more carbs as needed to keep it balanced. It gets old fast, but I sort of have to if I want to avoid being admitted to the hospital or, you know, dying.

Now we get away from stuff I inject and to pills. First up is lisinopril. Most people know this drug as something for high blood pressure. Thankfully that's not a problem I have. In fact, I don't know that I've every had high blood pressure. No, I take it for proteinuria. Thanks to diabetes, I have too much protein in my urine which can lead to kidney damage. The lisinopril helps protect them so I can keep 'em. Take a pill every day and keep my kidneys. I guess that seems like a fair trade.

This is one I finally got back on starting today (well, tomorrow). Like 80% of my fellow cohorts with multiple sclerosis, I suffer from serious fatigue. Even when I get a full night of sleep, I can struggle to be fully awake and alert throughout the day. Sometimes I'm sitting at my desk at work and seriously struggling to keep my eyes open. That makes being productive a struggle. Modafinil works against this, though I find it funny that scientists still don't understand how it works. Of course, they don't understand why people with MS have fatigue, either. The most common theory bandied about now is that the MS brain is constantly rewiring itself in order to most efficiently send signals where they need to go. Whatever the cause, fatigue sucks. And, however it works, Modafinil helps. I stopped taking it awhile back due to the cost. Just a couple of weeks ago, I checked with my insurance and Provigil (the name brand) would cost me nearly $600 for a 3-month supply. As it turns out, though, a generic was recently approved. That would cost me $18 for the same amount. That I can afford. So, my doc wrote me a script and starting tomorrow, I'll be taking one a day at least during the week. On weekends, if I can squeeze in a nap I might rely on that.

I'm not really big on supplements and this happens to be the only one I take. There is some evidence suggesting that a lack of vitamin D can contribute to contracting MS. There is also some evidence suggesting that taking a vitamin D supplement can help with the symptoms. It's not as if I can alter my diet to get more of it and I don't think my office will be located outdoors anytime soon, so I pop another pill every day.

So, those are the drugs I take. The insulin I have to take. The lisinopril is strongly recommended I take. The modafinil makes life easier. The vitamin D is completely optional and may or may not be helpful. I'm grateful that there are drugs I can take to keep me upright and I'm grateful that I'm not stuck taking 20, 30, or 40 different prescriptions like some people do. It would be nice to take something for the MS itself (rather than just symptoms of it), but even with good health insurance I would still be looking at hundreds of dollars a month in out of pockets costs. That's not something I can afford at the moment. All in all, though, I'd say I'm pretty lucky.

21 Years

It was twenty-one years ago today that Freddie Mercury shuffled off this mortal coil. Queen is my favorite band and I think Mercury was the greatest front man of all time. On top of his incredible vocals, he just had an amazing chemistry when he was performing. The way he connects with a crowd is just awe-inspiring. Here is Queen at Wembley Stadium in 1986 in one of their most famous performances

Here's to you, Freddie. Your voice is amongst the angels now, no doubt showing them how it's done.

Nightwish Has a New Singer

This apparently happened last month, but I just found out today. Epic symphonic power metal band Nightwish has parted ways with Annette Olzon who joined the band in 2007 to replace Tarja Turunen. Olzon was a somewhat controversial choice as she did not have the operatic vocals of Turunen. Tuomas Holopainen's compositions didn't change, but the delivery couldn't help but be different with Olzon who had a "smaller," poppier voice. Personally I ended up liking her more than I expected to, but I still missed Turunen's voice as did many other fans of the band.

The replacement singer for the time being is Floor Jansen. She was the lead singer for After Forever before they broke up. At this time she is just filling in for the remaining Nightwish concerts on their current tour. Whether she will continue with the band when they go back to the studio is up in the air. I'm excited about the possibilities. I always liked her in After Forever and her voice is definitely more operatic than Olzon's. Here are a couple of tracks from After Forever.

She definitely has the chops. I hope she does stick with the band.

Journalism, Drones, and Assassination! Oh, My!

Jeremy Scahill is one of the best voices out there covering American foreign policy, especially in regards to drones and American policy on terror. Here is a good interview with him about these subjects and the media that covers (or doesn't) these topics.

I do think the stuff about video games comes off as sort of a cheap shot. Kids have played at war games ever since the advent of kids and I don't think violent video games are much different than running around whacking each other with sticks.

Leadership in Government

One of the things that bugs me the most from people in government (typically from legislators) is the phrase along the lines of "The President (or governor or whomever) needs to step up and lead" on some issue. The latest version of this I've seen is from Senator Tom Coburn (R-OK) speaking about the fiscal cliff.

There’s a problem out there. It’s got to get solved; it’s got to get solved by the president leading. He’s got to put forward what we ought to do and ought to negotiate from there? The point is real leadership — get in the room, here’s what I ought to do. All of the speculation doesn’t do anything to do anything except muddy the waters. He needs a clear vision statement, what he thinks we ought to do, and specifically how. If his answer is only to raise taxes, that doesn’t stop the problem. We ought to stop sequester.

I wonder if Sen. Coburn (or other people saying this) skipped their government class in high school. It seems that he doesn't realize that the Congress is a co-equal branch of government. He or any other legislator can step up and lead on this issue just as well as the President. The problem, though, is that would require Sen. Coburn to put himself out there, to take some responsibility. It's far easier to call for some other guy to put forth a plan and then criticize it for not being exactly what you want. I understand that's the political game, but there's no reason for us not to call it out when it happens.

The Persistent Existence of Lunatics

A group of Georgia lawmakers got a briefing on the details of Obama's secret mind-control plot.

President Obama is using a Cold War-era mind-control technique known as "Delphi" to coerce Americans into accepting his plan for a United Nations-run communist dictatorship in which suburbanites will be forcibly relocated to cities. That's according to a four-hour briefing delivered to Republican state senators at the Georgia state Capitol last month.

I don't think there's much to be done about stuff like this other than laugh. There will always be a fringe group of people who hold out crazy notions (see also Birthers, Truthers, Grassy Knollers, etc.) The problem in the 21st-century is that the internet gives them an easy way to reach out to each other and connect, thereby reinforcing their foolishness.

About the only thing that can be done is to know the facts and be prepared to speak to them when those close to you start espousing nonsense. These people aren't going to be persuaded by the truth by anything they see on TV or read in a book. The only possibility is when it comes from someone they know and trust. Not that it's a guarantee, but it's a lot more likely than from someone else.

Also, for your own mental health: laugh. Because, really, this stuff is damn funny.

That Sparkly Vampire Movie

Tomorrow I am being dragged along to that movie about sparkly vampires, the dudes with tight abs that don't like them, and the wilting flower caught between them. The things we guys do for women. I probably won't be permitted to offer running sarcastic commentary, either. Damn.

News in the Online Age

Some time back, the local paper here, the Billings Gazette, decided that it was going to start limiting online access to its website to people who were not subscribers to the paper. It's not the first paper to do this; the New York Times announced a similar plan earlier this year. Naturally there are typically ways around these firewalls. I understand that this is a turbulent time for newspapers, but this seems exactly the wrong way to deal with the problem. As a result of the Gazette's actions, I am not purchasing a digital or hardcopy subscription. I am just getting my local news elsewhere. With no disrespect to the people that work there, the Gazette just isn't that good of a paper. It does a perfectly serviceable job, but it's just not good enough to part from me $69.50 for a one-year digital subscription.

Again, I understand that it's hard out there for old-school journalism, but this is not the way to save it. The Gazette is no doubt counting on the fact that it is the only daily newspaper in the area right now. But counting on that is no way to ensure a successful future. They need to get a lot more creative than just limiting online access to meet this challenge.

Why Reading is Important

In case you weren't sure and needed an excuse to read more.

What Do We Expect From Our Leaders

So, David Petraeus is resigning as head of the CIA after it has come out that he had an affair. Am I the only one that finds this odd? I'm not in anyway defending his actions which are rather reprehensible, but I'm wondering why any of the rest of us care. Sure, there's the off chance of some sort of security risk in that someone could potentially blackmail him, but the blackmailing would rely on the rest of us caring enough about Petraeus's personal life to care about whether or not he is cheating on his wife.

Of course Petraeus is not the first leader, nor will he be the last, who was caught with dirty laundry in his/her personal life. These people are frequently tut-tutted by the rest of us in some sort of odd cathartic release as we imagine that we're better than the person being drummed out of their position. I'm just wondering out loud if this is the best way to run things. Should we demand an impeccable moral standard from our leaders? Is that even possible as long as people are people? Should we care about someone's personal life and personal failings even if those failings are unrelated to their job?

I don't have a solid position on this because I think it's complicated, but my first instinct is to say that it shouldn't matter. If Petraeus is having an affair, that should be the business of the people involved and not a matter for anyone else to concern themselves with. However, I'm open to arguments from the other side. Let me know what you think.

Six Years On

2006 was not exactly a banner year for me. In addition to losing my dear friend, Patrick, I was diagnosed with multiple sclerosis on this day six years ago. I had been having odd symptoms for months and I knew it was serious. I'll never forget sitting alone in the exam room waiting for my doctor to come back with the test results, thoughts running wild in my mind. Never have I ever felt so lonely and I seemed to be sitting there for an eternity. When he finally came in and told me what was going on, I'm not sure I could even tell you what went through my mind then. It was a jumbled confusion whatever it was. What did this mean for my life? What was going to happen to me? Why me? A sort of fog settled over me as I tried to parse this information.

In a sense everything had changed and nothing had. I was still the same person I always had been. Now, I just had this to aspect to me that I had to accommodate whether I like it or not. At least in the short-term, nothing was much likely to change. Down the road would be a different matter, but how long before that happened? How long before I could look forward to using a cane, a walker, or a wheelchair? How long before physical difficulties started having a serious impact on my day-to-day living? These were now questions that settled into my head and are always there, always lurking in the background.

I was lucky enough to get involved in a study being done on two MS drugs that were currently on the market - Copaxone and Avonex. The study was looking at whether these two drugs worked better when taken together or separately. The Copaxone was a daily injection that had few to no side effects. The Avonex was a weekly injection that made me feel horrible with flu-like symptoms for about 24 hours. It's a good thing I don't have a problem with needles because I was now poking myself eight times a week. The drugs are not a cure for MS which doesn't exist. Their purpose is merely to slow down the advancement of the disease and delay the onset of more serious symptoms.

I was in the study for nearly five years before I quit. The side-effects of the Avonex were having a serious impact on my quality of life and I just didn't want to put up with it anymore. That meant, of course, that further treatments would have to come out of my own pocket. Even with insurance, I was looking at hundreds of dollars a month for anything on the market. That's not exactly feasible for me at the moment, so I haven't been taking anything since then.

The disease has definitely progressed. My most common symptom is fatigue which really hasn't changed much since my diagnosis. On most days, even when I have gotten a proper amount of sleep, I feel very tired by mid to late afternoon. Whenever I have a chance (read: weekends), I try to take an afternoon nap. What I do deal with more frequently now than I used to is numb spells. My right leg is the most common victim and it will just go completely numb for a few seconds. This can lead to some entertaining results such as when it happens mid step when I'm on a flight of stairs or jogging across a busy road just ahead of oncoming traffic. The spells are brief and then sensation returns as if it never went away. They're more an irritant now more than anything. "Oh, there's my stupid leg going numb again. I guess I'll keep forcing myself to walk and hope it goes away in a second."

One good thing the MS has helped me with is that when I was diagnosed with type 1 diabetes a year-and-a-half later, it wasn't all that big of a deal. What's an incurable disease when you already have one? Pssh, it's old hat. That sounds like a really sad sort of good thing, but it's true. The diabetes diagnosis wasn't near so hard to hear as the MS diagnosis.

I'm not sure there's anything else I could really say that's been good about getting MS. Oh, I could probably spout some banal platitudes about appreciating life more or blah, blah, blah; but those all sound so silly. Sometimes shitty things happen in life and there's nothing to be done about it. You simply have to adapt to it and not let it get the best of you. I think I do all right most of the time. I'm human, though, and have moments of feeling sorry for myself. But for the most part, I'm just like, "I'm Shane Noble and no goddamn incurable disease is going to get the best of me." Or at least I try.