Round-up of some things

leg, meds, books

New publications: a story on Terraform; then there’s this cool accompanying piece putting the story in context; also I don’t think I mentioned my Lightspeed story about portals (I still love portals!); and an accompanying interview; one of my stories made it into the 2017 Best American Science Fiction and Fantasy anthology (whoo-hoo!) (two other stories of mine are notable stories for that anthology as well); and my creative non-fiction experiment “A List of My Utopias” is reprinted in the fall Utne Reader.

Writing on antidepressants update: for my depression I have moved on from Lexapro to….Prozac (read initial write-up here). I did get up the courage to ask my new psychiatrist what about Wellbutrin (Lev Grossman’s anti-depressant of choice), though I realize that probably is one of the worst reasons to think a drug is good for you (because you like the author). But due to my past history with eating disorders, Wellbutrin is countraindicted for me, says my psychiatrist, which means….no. I was bummed, as Lev Grossman doesn’t take Prozac, and Prozac does not exactly have a great reputation in the media–in my mind, it is kind of the poster child of anti-depressant overuse or the numbing effect you hear stories about. But it is also supposed to be the most activating (I love this use of the word) of the SSRI’s. So far, after ditching Lexapro and taking a week of very low dose Prozac, I’ve noticed it’s harder to fall asleep at night, but at the same time I am no longer falling asleep at the computer while I write. Whoo-hoo! Or needing 2-3 crazy long naps during the day!! This is a very exciting development. Lexapro works great for a lot of people, my psychiatrist explained, but other people experience sedation/drowsiness as a side effect, and I happened to be one of those folks.

As with Lexapro, there is still a kind of muting of strong emotions with Prozac. I don’t find this necessarily an awful thing, as my personal life is a bit crazy right now, and staying calm or unbothered helps keep my depression from spiraling downward. Though I do miss having this urgent need to process and write about the shitty stuff that happens in my life. Before meds, after some huge family blow-up, I’d race to the computer and just plow out pages of pure grit and emotion that would usually end up being very dark but also very interesting to me. I find it a lot harder to channel that emotion now or to even want to record my crazy last week for a future story idea. On the good side, that distance is helping keep me functional. And also it’s easier to imagine writing about something other than myself. Downside: those emotions are what fueled my writing for the past few years. Maybe it will just require some extra effort. Suicidal ideation: even on meds, I’m still struggling with this, though to a slightly lesser degree. My therapist thinks a higher dosage might help. But higher dosages worry me, as already I’m aware of that distancing/muting effect. What’s helped this week is trying to clear my mind of all the repetitive thoughts and worry and negative stuff, and forcing myself instead to think of 1 small thing I want to do that will happen in the next few hours. For example, I want to work on revising a story I am almost done with. Or, I want to use my arm bike and watch Stranger Things this evening. I want to bake an apple cake with my son! Etc. Then I tell myself I am going to be here until I do that thing, because that thing sounds nice. And I just really focus on how that one thing is going to happen and I want it to happen. Once that thing happens, I pick the next small thing. Then, repeat. Still an experiment in progress. 

Reading: Norman Mailer’s The Executioner’s Song. An amazing book and ideal for insomaniacs as it is very long (1,000+ pages) and not available as an audiobook. So I would never have the time to read it were it not for my sleepless nights. But man, the ending is so beautiful, and also so bleak. The book is a masterpiece in its ability to make every one of its characters human and relatable, including Gary Gilmore (check out a fascinating photo of him here), the convict who murdered two people and ended up being executed by the state of Utah. Also Lincoln in the Bardo. An almost perfect book. Daring, heartfelt, moving, funny…and the audio book rocks. Also my kids have insisted I read the Mighty Jack series as well as all three Zita the Spacegirl graphic novels (all of these books by Ben Hatke). I really loved the first Mighty Jack, where a boy gives away his mom’s car in exchange for some magical seeds. He does this because his assumedly autistic sister speaks about the seeds. That’s a great set-up for a story.  

Watching: I’ve gotten kind of tired of movies this past year–something artificial or forced about having to wrap things up in about 2 hours. Instead, I’ve been watching more TV shows, Just finished The Bridge (Bron / Broen – the Nordic version), season 3. Heartbroken that season is over. I am in love with the two detectives in that show. I’ll write more about it later. Also loving Lady Dynamite, Maria Bamford’s Netflix series. It’s a great funny smart show about mental illness that has kept my spirits up during broken leg recovery. And Stranger Things. I love so many things about this show, but most of all for the character of Will’s mom, a mom who believes her missing son is still alive, even if such belief makes her appear insane. She toes the line between insanity and other worldly stuff, which is a fascinating and complex line that fantasy or horror tends to ignore. 

Leg update: I told my husband, people ask me what happened, and I tell them I have a broken leg, and then they get really quiet. He informed me it is obvious I have a broken leg, and maybe instead I should try saying, “I had a hiking accident.” This has turned out to be a much better answer and generally has made for longer conversations. Though I still struggle with talking about the whole incident casually, and turning it into a neat little story with a happy ending — look, I’m healing! etc. That somehow seems to do a disservice to the violence of the whole incident. I miss my surgeon in Saranac Lake. It’s weird thinking that my leg is just one of many legs that he has operated on and will continue to operate on. He does appear to have a LinkedIn page but I am guessing that is creepy, when your patients want to be a contact. Being a surgeon must be an amazing job. You are putting people back together, and you get to see parts of them that they themselves will never get to see.

The language of surgeons: I received a record of the postoperative report, dictated at either 1:40 a.m. or 2:23 a.m. on August 22. I find the language fascinating and oddly moving (maybe because it’s about me?). But there are also these lovely turns of phrases – my leg was “draped in a standard fashion” and how my patellar tendon was “carefully retracted medially, ” and how “across the fracture site held a nice position.”  I wish I knew where my surgeon was, what kind of room he was in, when he recorded this and how soon after the actual surgery. I think judging by the time it was fairly immediate. Still, how could someone remember all these details? This is as close as I can get to the iphone photo I wish someone took of my surgery, which is a weird impulse that kind of disturbs me, but I want to see a photo of it anyway. What was the expression on my face? I find it fascinating and odd that I have no memory of the time, and this surgeon, and all the people who participated in the surgery, know more about what was happening then to my body than I did or do. Anyhow, here it the report:

    The patient was placed on the operating table in the spine position, placed under general anesthesia, and the leg was prepped with triple prep and draped in a standard fashion. The leg was exsanguinated with elevation only, no Esmarch bandage was used, and tourniquet was inflated to 250 mmHg. A closed reduction of the fracture was obtained and the fracture was held with traction and on the radiolucent triangles. A longitudinal incision over the patellar tendon was made through the skin and subcutaneous tissue and a longitudinal incision in the patellar tendon was performed and it was carefully retracted medially and laterally giving access to the proximal tibia. The guide pin was advanced under fluoroscopic evaluation and found intraosseous. Then reamed over that with a 8-mm reamer and then used the beaded guidewire to advance it to the proximal aspect of the tibia mid shaft across the fracture side into the distal tibia. It was noted to be a nondisplaced posterior malleolar fracture. We then began serial reaming the tibia and decided that a size 9.3 nail would be the appropriate size, so we did ream to 10.5 5 and then 11.5 proximally. With the fracture in a reduced fashion, we advanced the 9.3 x 34 mm nail proximally across the diaphysis of the tibia across the fracture site and into the distal tibia in appropriate position. The fracture was well reduced in the AP lateral projection. we then did a static locking screw proximally, drilled off the guide itself medially medial to lateral, drilled both cortices and then placed in the 3.5 cortical screw. We then went to the distal aspect and did a medial to lateral screw using the perfect circle technique and a 3.5 screw was used there and then with the foot in a dorsiflexion position to keep the posterior malleolar fracture reduced, we did an anterior posterior 3.5 locking screw with perfect circles and that across the fracture site held a nice position. The area was widely irrigated. All the incisions were irrigated. The incisions were closed with the 3-0 Monocryl and staples. We did put a 5 mm end cap in case the nail needs to come out some other time. The insertion site was irrigated out. The patellar tendon was closed side-to-side fashion with a 2-0 Vicryl. The peritenon was closed with 3-0 Monocryl, subcutaneous tissue closed with 3-0 Moncryl and staples. Sterile dressing was placed and a posterior splint was applied and the patient transferred to recovery room in stable condition. 

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