I Need New Knees
Somewhere around this time last year, a friend of mine had a birthday, and she decided to get a group of her friends to go out dancing at a Manhattan club's Goth Night. This in and of itself was an experience. Who knew there were still Goths, much less enough of them that they could have their own night? And yet there they were, some of them young kids who probably thought that Goth was a really cool and original thing that they themselves had come up with (I hate young people), others old fogies like us who clearly wanted to relive their golden years of angst, but all of them in black, with jewelry that looked like it could poke your eye out, dancing wildly to Depeche Mode.
Not being the owner of enough high-end black club-wear, I was clad inappropriately in brown. Still, I like to dance and I was having a damn good time. Until I had to stop, because my knees hurt.
I know I have mentioned before that I have bad knees, the kind of knees that a person should not have in her late 30s -- or in her late 20s, which was when they suddenly appeared, attached to my legs, the legs that I thought I had known my entire life. Not that these legs had not betrayed me in the past. It started with the running, and the fact that I am built poorly for it, which is why I've also had shin splints and ankle problems, because I have the unfortunate combination of hips and flat feet, which pronate, and thus, according to my first orthopedist, who seemed to think he had a sense of humor, I "run like a girl." Ha ha.
But a large problem with my knees is, of course, the film business. When you bend all day and lift heavy shit you have to use either your knees or your back, and after learning the hard way, in film school, that using my back often meant not being able to move for several days, I went on to wear away all of the cartilage surrounding my kneecaps. I suppose it's sort of neat to see someone who has done this to themselves, at least my physical therapists seemed to think so, because I remember them standing over my kneecaps for several minutes, moving them around.
"Wow, look at that," said one of them.
"Yeah," said the other, "they're so mobile."
"You should get carbon-fiber knees," suggested the French guy I was dating at the time. "Like the skiers."
Not being Jean-Claude Killy or somehow otherwise in possession of the gold medals to melt down to pay for such new knees, I chose instead to lift leg weights at the gym, wear an unflattering and itchy knee brace from time to time, and leave it at that. But it was not to be the last time I would be made to feel like a medical oddity.
At some point, when I had finally gotten comfortable with the low-grade status of my knees, I started having problems with my stomach. In my family we are not strangers to indigestion, probably because we are accustomed to eating everything in sight without any real regard for the concept of hunger, or even peckishness. But I found that I was having it all the time.
I went to Dr. B, my GP, and she sent me to a GE. Dr. M was a chipper young man who had the ability to seem really, really engaged with you for the three minutes of his time that he allowed you to sit in his office. He prescribed a battery of tests that began with something only mildly humiliating -- having to collect my own stool sample -- and progressed to a combined endoscopy and colonoscopy, which required not eating for 18 hours in advance except for clear liquids and jello and then ingesting some horrible substance in powder form that completely voided my system, all night long. Dr. M's pleasant bedside manner didn't keep him from making fun of my incoherence the next day when I came in to have the procedure.
"So when did you eat last?"
"I don't remember exactly…"
"You don't know?"
"It was whatever time they said to stop eating."
He turned to share a chuckle with the anesthesiologist. "Ha ha, you're a little hypoglycemic, aren't you?" Then they put me under.
The next time I saw him was when I came in to get the results. He pulled out a detailed, color illustration of the human digestive system on a slender piece of paper similar to the placemats you see at family restaurants -- though why anyone would want to eat off of a picture of their intestines I have no idea -- and placed it on the desk between us.
"Well, you have a stomach in the shape of a J," he began, modifying the bottom of the cute little stomach by extending it into a slight curve. "Which is interesting, but doesn't have anything to do with your problem. You also," he continued, "have a hiatal hernia."
"Oh," I said, sitting up a little straighter at the sound of the word "hernia." Now we were getting somewhere.
"Which is not uncommon, it just means that this little flap here--" he circled a small, rose-colored area at the top of the stomach "-- stays open and allows acid to bubble up into the esophagus. This might be related, but it's not what's causing your problem. The good news is --" he moved his pen along a long, puce stretch above the circled flap, "-- there's no esophageal damage. So it seems you just have IBS. Irritable Bowel Syndrome."
Irritable Bowel Syndrome. It sounds pretty nasty, not to mention like something else that people should only have when they're old, and crotchety. But apparently this is not the case, as many young people, particularly women, get IBS. So what does it mean?
"It means there's basically nothing wrong with you," said Dr. M, handing me the picture, apparently thinking that I might enjoy further contemplation my J-shaped stomach at home. "But I'd like to do one more test."
He drew blood, and got back to me with the results a week later.
"You're lactose intolerant," he announced triumphantly. "You just need to stop eating dairy."
I did. I also gave up coffee, Indian food, peanut butter, and for a while, wheat, eggs, alcohol, and pretty much everything that makes life worthwhile, until there was nothing I could eat, or at least not eat without fear. I lost weight. I went on Aciphex, then Prilosec, then Nexium. Things would get better, then worse again. At one point, the pain made its way all the way up to my ears, and I wasn't sure if this was related. Dr. B sent me to an ear doctor.
"Let's give you a hearing test," said Dr. D when, after an hour, I was finally given admittance to his inner sanctum. Nobody else there seemed to mind waiting, they seemed to think they had all the time in the world, which they were clearly wrong about because the median age in the waiting room was 75.
"But there's nothing wrong with my hearing," I said.
"How do you know?" he said. "Have you ever had a hearing test?"
The hearing test consisted of wearing headphones where tones were played in each ear at random intervals and varying volumes and frequencies. Having had this done to me fairly often by sound mixers over the years, I found it strangely comforting.
"You seem to have had some hearing loss in your right ear," said Dr. D. "That's fairly common, though. It could be caused by loud subway trains, or sirens…" Perhaps children and method actors screaming at high volume without warning? Probably not something included in most medical journals. "Anyway, I didn't see anything abnormal. But just in case, I'd like you to get an MRI."
"We just want to rule everything out."
Everything being a brain tumor? This was immediately where my mind went, and I know what you're thinking, because I was starting to think the same thing myself: when did I become such a fucking hypochondriac? I'd had a healthy childhood. In my mother's world, we were not sick unless we had a fever of over 100 so I hawked and sneezed my way through school every winter, and took it like a…well, like a sniveling child, but that's what I was. I'd had my quotient of the usual childhood diseases -- chicken pox, stomach flu, strep throat -- but that was the worst of it. My brother even got all the allergies. So before the knee business started, I'd really only gone to the doctor for my annual check-up, if even then. But maybe it's because of this that I was also unused to dealing with the medical profession. I trusted doctors, and assumed that, like my mother, who had formerly been the one to determine whether or not I was sick, they had an interest in keeping me well. It never occurred to me that a doctor would ask for a hearing test if I didn't need a hearing test for the sake of, let's say, getting more money out of my insurance company. I just thought, This guy's wearing a lab coat, and who am I to say I don't have a brain tumor?
So I went for the MRI. I had it done at a place called "Stand-Up MRI," not as in "he's a stand-up kinda guy," as one might hope, but as in you physically stand up when you get one -- which is, in fact, preferable to lying in that claustrophobic little tube the way I'd had to do for my knees. Actually, since I was having my head examined, I was able to sit, and even watch a movie, though not one of my choice.
"You have to sit very very very still, you cannot move at all," squawked the technician's voice through the loudspeaker that was pumped into my little white room. He repeated this adamantly every time he was about to take an image, which made me think that either I was somehow moving without my knowing it, or that the last person who'd been in there had had some sort of uncontrollable twitch. Still, after about 20 minutes, he released me.
"You did very well," he said, looking pleased. "You only moved a little bit on the last one, like this." He demonstrated, tilting his head ever so slightly to the side, like a confused dog, or as if perhaps Jim Carrey's performance in "The Majestic" had somehow moved me. Heck, anything was possible at this point.
"You're perfectly fine," Dr. D told me, looking at the translucent, black and white images of my skull taken from four different angles. "It's probably just the acid reflux." Ka-ching for him.
The acid reflux wasn't going anywhere, apparently. I went back to see Dr. B.
"Are you under a lot of stress?" she asked.
"No," I replied. "I mean, not more than usual."
"Well, there's nothing physically wrong with you," said Dr. B. "Maybe you need to go on medication."
"I'm already on Nexium," I said.
"No," she replied, "I mean you need to go on medication."
I was already in therapy. I mean, it's New York, who isn't? Plus, I've got a few issues, in case you haven't noticed. But this was the first time anyone had ever suggested I was crazy enough to be making myself sick.
Dr. B recommended psychiatrist Dr. L, who did not wear a white lab coat, in fact, she was turned-out in a stylishly sexy short skirt, furry sweater, and chunky jewelry. But she still seemed authoritative because she was European. She welcomed me with an icy smile and then walked me into another room to watch a videotape. It began with Dr. L reading off the teleprompter with a deer-in-the-headlights expression, accentuated by the fact that she appeared in the video without her hip glasses, the kind that architects wear.
"I'm going to ask you a series of questions," she began, in her Teutonic accent. "Answer the questions simply 'yes' or 'no'…Has there ever been a time, when you were not your usual self, when you were so irritable that you started fights or screamed at other people? Answer question one now."
I looked at the accompanying clipboard where I was supposed to mark my answers. It read, "Irritable? Screaming fights?" Did tightly-wound sound mixers or assistant directors screaming at me count? I suddenly thought of a couple of people who perhaps could have benefited from watching this tape. Then I marked "no."
"Has there ever been a time, when you were not your usual self, when you felt as if you could not stop talking? Answer question two now..."
This went on for about a dozen questions. Had I ever not been my usual self and had too much energy? Had I ever not been my usual self and spent money uncontrollably?
"Now watch this video. In it, you will see a series of people telling stories about themselves. If you hear something you identify with, write it down."
What followed was a series of badly-produced and poorly-acted off-speed re-enactments to moody music, showing people behaving like, well, mental patients. All of this in front of a background of animated images of a sky going from blue to cloudy. It was all sooo subliminal, what could it possibly mean???
"So, you think you have some tendency for manic depression?" asked Dr. L. I wasn't sure how she was getting this from the series of "no"s and empty spaces on my clipboard. Then again, she hadn't really looked at it.
"Well, no. Depression, maybe, but I'm in therapy to deal with a few problems --"
"Yes, but these things are chemical. Do you worry about these problems?"
"Yeah, sometimes. I can obsess over things."
"Has this always been true?"
I thought back, to the report I'd written on salamanders in third grade, which extended to five blue test booklets full of pencil-drawn lizards and run-on sentences punctuated with SAT words. I thought of how, at age 11, I'd developed insomnia over the possibility of nuclear war. I recalled a paper on Ancient Greece in 7th grade, that ended up being over 50 hand-written pages, on which I'd attempted my first all-nighter, only making it to 3 am, my cheek indented with the grain of the table when I woke up the next morning (to a snow day! Boy was that cool...).
"I guess you could say that," I grudgingly replied.
Dr. L put me on Lexapro. It didn't seem to do anything, so she switched me to Depakote, which did seem to keep me obsessing a bit less over, say, whether or not I should leave my boyfriend, although who's to say this was not something worth obsessing over? But the dosage irritated my stomach. That's right: the reason I'd started taking the drugs in the first place, and it was making it worse.
"We can cut back on the Depakote," said Dr. L, on this day dressed in a fiery orange tweed suit and gold pumps. "But then you'll have to take the Ambien to help you with the sleeping. Have you been taking the Ambien?"
"Well, sometimes, but I don't want to take it every night…"
"Depression causes brain damage. It causes dementia in later life. Which is worse, taking a pill every night or dementia?"
I had no snappy comeback for this.
"If you don't want to take the Ambien, you could go the natural way," she continued. "This means setting your schedule so you get up every morning at 4 or 5 am. This is the best thing for your mood. The most productive and successful people get up this early, you always read this. Of course, then you must be in bed by 8:30."
" Do these people live in New York? I don't really have a regular schedule so it could be tough -- "
"I don't see why. This is not Southern Europe where you must eat at nine or ten o'clock at night, here it should be fairly easy."
I went home wondering if I should move to Southern Europe just so I could be cut some slack, but then realized I couldn't, because Dr. M had told me that if you have acid reflux, you're supposed to eat at least three to four hours before you go to bed. This also ruled out parts of Latin America, and probably Iceland. But as I continued to contemplate, or perhaps obsess over, depending on your choice of terms, the list of places I could not now visit, I realized something: not that I could get up at 4 or 5 am every day, hell no, if we were talking bad moods, there's nothing that puts me in a crappier one more than getting up before 7 -- just ask the people I work with. But the fact that it kept coming up: my lifestyle. Here I'd been going to all these doctors -- I now had a section just for them in my address book and it was the length of my arm. I had diagnoses for several different parts of my body. But I wasn't really trying to figure out what was wrong with me. It occurred to me one day when I was late, racing to get the subway, which I just missed, and having to wait another 20 minutes, knowing that my being late to work would stress out my boss and that he would take it out on me all day, that I would return, at the end of that day, having accomplished nothing I could be proud of, to a home where things weren't good either. I felt stuck with a job and a relationship that were taking me nowhere, and frustrated at not getting what I needed from pretty much anything in my life. And I'd come to think of that as normal.
I stopped going to the doctors. With all the free time that gave me, I put together an after-school program and started writing this blog. Then I broke up with my boyfriend, put all my stuff in storage and went away for seven weeks by myself; climbed some volcanoes, jumped off some waterfalls, hitchhiked, talked to strangers -- I had no choice, everyone was a stranger -- and in general, stopped worrying about what I ate or how much I slept. Sure, sometimes I suffered, but in general, I felt healthier than I ever had. Eventually I came home, got a new place, finished a new screenplay, started teaching college. This year I even stopped going to therapy -- partly because my therapist seemed to have filled my slot in her schedule, but I figured she must have thought I was healthy enough to drop. Either that or she got sick of dealing with my insurance. And I got off the meds. Not that I don't think they're a good idea for lots of people, but they really weren't doing much for me. Besides, if I didn't obsess a little, I'd be unrecognizable.
Not that my life is perfect. I wouldn't try to get that past you people, who've spent enough time here listening to me bitch about the thorns in this bed of roses to know better. But a couple of months ago, I managed to trek for four days straight in these knees, up and down some pretty serious mountains, as well as go clubbing until 5 am in Buenos Aires. I still avoid dairy and spicy food, but sometimes I cheat. And while I've let go of a lot of things, I've still got those MRI images of my skull. I think some day they would make a nice lampshade.