A Potential Change of Plans

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Yesterday I wrote about my discussion about school with my therapist, and mentioned that she wanted me to contact my Texas Workforce Commission case manager regarding changing my action plan with them. Here’s why.

Late last year, I began working with TWC on a plan to get me back to work. They could either give me assistance with trying to get work in an area that I was already capable of doing, or they could give me assistance with retraining me for a job in a new field. I have two vocational certificates, one in massage therapy and one in pharmacy technology, and both of those fields require long hours on my feet, something that I can’t do anymore because of my back. So rather than risk returning to generalized clerical work, something that I’ve spent a good portion of my professional life doing, I opted to pursue education in a new field.

I initially looked for an associate’s degree in architectural drafting, but subsequent job searches turned up precious few leads statewide, and none within commuting distance from where I currently live, so I started looking at another field. After discussing my options with my case manager, I decided to go to my final meeting with TWC intent on pursuing a bachelor’s degree in mass communications. That meeting went disastrously, as I discovered from my case manager that everything that I’ve suggested as a potential field of study wasn’t considered feasible by TWC standards, and I was basically given the choice of accepting a certificate in medical billing and coding or walking out the door empty handed with nothing to show for my time spent with TWC. (TWC has a 90-day window to design and approve an action plan. This final meeting was on day 83 of my window.) So I settled for medical billing and coding and went home to research what would apparently be my new career.

It turns out that medical coders make decent money, better than I would have gotten as an architectural drafter, and there were better job opportunities, so I decided to make the best of the situation I found myself in and start looking into everything that I needed to do to enroll for the fall semester.

I had my orientation on Tuesday afternoon, where I learned what the next steps to enroll were, and I had a good meeting. I wrote about it on Facebook, and a friend of mine told me that she was pursuing an associate’s degree in essentially the same field out of state. I was curious, and after a few minutes of research discovered that Austin Community College, the institution that I would be attending for my certificate program, offered an associate’s degree in health information technology, which covers both medical billing and coding and medical records analysis. The potential for becoming gainfully employed would be increased significantly with an associate’s degree, so I filed that information away for pursuit after I had gotten the certificate and had worked enough to afford the degree, if the field interested me. I was further encouraged that the associate’s degree at ACC would transfer to Texas State for a bachelor’s degree in health information technology, so there would be the potential for even further education in the field.

I mentioned this to my therapist yesterday, and also mentioned that in the pursuit of the next steps for the certificate program I had learned that my former case manager, who had stuck me with this field in the first place, was no longer with TWC, and that my case was being handled by someone new. My therapist recommended that I reach out to TWC and ask what the possibility of switching my action plan to the associate’s degree would be. I didn’t really hold out much hope, but I told her that I would try. So this morning I sent my new case manager an email explaining the situation.

My new case manager called me this afternoon to follow up and ask a little more about what I was looking to do, and why. So I told her briefly about the background of my case and how I was pretty much assigned this field by my former case manager, and how the addition of the medical records analysis would increase both my earning potential and my employment prospects. She said that she would need to meet with me to discuss this in further detail, so I have an appointment on July 11th with her to go over my suggestion.

I honestly don’t hold out much hope for a switch, mostly because I know that TWC won’t cover the expense of prerequisite classes, and the associate’s degree program has five prerequisite courses before the start of the six-semester program. But at least I will have talked it over and found out the answer instead of assuming what it would be.

If I don’t get to switch to the degree program, that’s fine. It just means that once I get back to work, I’ll start saving money to be able to go back to school on my own, should the field prove to be interesting to me. If I do get to switch, that’s even better – an associate’s degree in one field is better than none at all to some employers, so even if I choose to leave the field eventually, I’ll have an education under my belt.

I’ll keep you posted on what I find out.

Back to School

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I’m going back to school in the fall for Medical Billing and Coding, and today was my orientation at Austin Community College. It was a good session, but short, and likely would have been shorter had there not been  a couple of obstacles in the way.

When my adviser brought me back, she took my application, reviewed it quickly, then started telling me about the coursework that I would be taking. First semester was recommended to be three classes, then second semester would be four, and third semester was two more classes and the practicum. This differed from what I read online, but I figured there was a change to the program that hadn’t made the website yet. The fall 2017 continuing education catalog was just released today, and this was the first time that my adviser had looked at it.

I told her that I could likely take the full four classes since I’m on disability and not working during the day, and she told me that the fourth class was largely on campus, with some of it taught online. Again, this was different from what I learned online, but I went with it. Then she told me that she couldn’t find the class listed in the catalog, so she checked online to see if it was in the system, and it wasn’t, so she told me she’d have to get back to me with all the registration information I’d need for that fourth class.

It’s at this point in time that she asked me if I was sure I wanted to take the medical assistant program, and I corrected her. She looked back at my application and said that she must have read it wrong, and then she wondered about the medical assistant program being “on the run” and probably not something someone coming back from a disability would want to jump into. She was thinking medical billing and coding given that piece of information, and I told her that was what I wanted. So she scratched through the classes that she highlighted and started over.

She told me that there were two semesters, the first being all the non-coding classes, and the second being all coding classes and the practicum. That meshed with what I’d learned online, so I felt we were back on the same page at this point. She went back through the catalog to highlight the correct classes and noticed that one of my four wasn’t listed. She checked online and sure enough, it wasn’t in the system, so she told me she’d give me a call when it was live and accessible. She asked if I had any questions, and I told her that I’d never done online classes before, and would she give me an idea of what to expect, and she filled me in on how they were run. That was the only question that I could think of, and she said she was available if and when others came to mind.

We shook hands and I left, making a stop past the registration desk to make sure that when I registered later online, I knew what information they needed from the catalog.

The whole thing was over in about thirty minutes. It was a good meeting and I’m looking forward to registering. My next step is to contact my TWC liaison at ACC and start the ball rolling on tuition arrangements, and when she clears me – and I have information on the fourth class – I can get online and register. At that point, it’s simply a question of picking up textbooks and waiting for class to start.

The online classes are arranged differently than the classes on campus. Each class is taught sequentially, so I’m only taking one class at a time. The downside to this is that each class lasts just a few weeks, so there’s very little room for getting behind. I’m going to have to stay on top of my classwork in order to succeed in this program, but I believe I can handle it.

I’m really looking forward to getting this first step to getting back in the workforce underway.

Steady As She Goes

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I had my first follow-up appointment with my new psychiatrist this afternoon. He asked how things were going, and I told him about the event on Saturday – how I didn’t have panic attacks beforehand like I’ve been doing recently, and how I handled the minor panic attack at the event. He said that it sounds like the Zoloft is working as expected to control my anxiety, perhaps even a little bit better than expected, and he said that he was going to keep my meds where they were. He wanted to know if I felt myself wanting to do things that I had been avoiding and I told him that the event on Saturday was my return to an aspect of the SCA that I hadn’t felt up to pursuing in years, so he was pleased to hear that. He inquired about side effects and I told him that I haven’t seen anything. I was honest – not every day is rosy, but very few days are truly down right now, and he commented on how things seem to have turned around for me pretty notably in a short period of time. He advised that the Zoloft still hasn’t reached maximum efficacy, so I might see that similar attacks like the one I had on Saturday are even easier to deal with in another month or two. He asked if there was anything on the horizon that might test the Zoloft at full strength and I told him that I was returning to school in the fall, and that the plan was for me to be working again about this time next year. He was happy to hear that I’m looking forward to school and to getting back to work. He wants to see me again in August, just to follow-up around the time that the Zoloft has well and truly kicked in. All in all, it was a very good appointment.

Improvements in Two Generations

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This morning I made an appointment to have my knee looked at post-ER visit to see if there’s a necessity for further testing. I’m inclined to say that there won’t be, although my doctor might decide to be safe and send me for an MRI anyway. My range of motion is diminished somewhat, but I can bend it to greater than 90 degrees and I went up and down a flight of steps – slowly, holding the handrail – without any trouble. So I think I’m going to be okay.

I was writing that paragraph when I got a call from North Carolina. More on that in a minute.

I called the hospital this afternoon to get an update on Mom. Her nurse says that she’s communicating well and responded appropriately about being teased about the taste of her medicine (Mom teased right back). This was the same nurse that watched over her on Friday, and she said that she sees an improvement in Mom. They’re planning to do a doppler test of her carotid artery – they told me it’s kind of like an ultrasound – to help pave the way to determine the severity of the stroke.

So you can understand my absolute shock and delight when my mother called me tonight.

Mom’s speaking in full sentences at a time, although there was one point that I was on the phone with her that she lost the word that she was trying to think of, but rather than resorting to the repetitive babbling that she was doing, she was all “uh” and “um” before working her way around the word with a summary of what she was trying to say. She’s still not entirely rooted in reality – she was speaking of a present that we are unaware of, and how not finding it meant that she didn’t have the money to do something or other, and she wanted to know about when we were changing stations, something that once again we have no idea about. But she was communicating, and that’s a good thing.

I’m still inclined to think that I’m going to have to step in and take over her finances at least temporarily to make sure that things get done while she’s still struggling with reality. But I’m not resigned to thinking that it’s going to be a permanent thing anymore.

 

A Matter of Fitness

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I’ve been thinking long and hard for a while about my fitness level, which is to say, I don’t really have one. I’m five foot seven and weigh 293 pounds. My back is more often than not in some level of pain, and my knees wouldn’t be up to running long distances even if the rest of me were in shape to do so. My fitness routine up until recently has been to walk leisurely around the complex, which is about a half a kilometer or a third of a mile (or less, depending on how my back is doing that day). More recently, it’s consisted of three round trips down and up the staircase leading to the apartment, which winds me and makes me feel much more like I’ve been exercising than the walk ever did. The thing is, the reason I only do three is that my legs don’t feel like they can do a fourth round trip.

I know I get more exercise than that, but there’s nothing tracking my steps here in the apartment, since I don’t usually carry my phone with me, preferring instead to leave it on its stand on my office shelf. I’d love to get a Fitbit or some other wearable someday and see just how much exercise I am getting here at home. I’d also like to ramp what exercise I do get up a bit.

One of the books I’m currently reading, The Anxiety & Phobia Workbook by Edmund J. Bourne, PhD, recommends thirty minutes of vigorous exercise a day, four days a week. The easiest way of getting that done is going to be by walking as briskly as I can around the complex. It’s also the safest for my knees and my back, and it’s something that I can trade out for trips up and down the stairs on days when my back isn’t feeling like much. I can do the stairs very slowly even on days that my back is really bothering me and still get a fairly decent workout out of it.

The timing of this decision is not ideal, however. I just opted to add a couple of new definitions to my daily checklist a week ago and I don’t want to take a chance on overloading myself with new things to have to do and then not doing any of them. So this push for more exercise will likely have to wait until the next round of upgrades at the end of this 60-day period, once the new stuff has become second nature. I know that it’s supposed to take 21 days for a new habit to form, but I’ve found that I’m apparently a slow learner when it comes to new habits, so I’m sticking to 60-day increments right now.

That’s two things that will be new at the end of this 60 days – between the upgrades to my learning and exercise, I think I’ll have my hands full, especially when it comes to time management.

I’m not giving up, just being realistic about my abilities and my limitations when it comes to forming new habits, and I really don’t want to lose forward momentum. I’m scared that will bring everything crashing down around me.

Sixty Days and Counting

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It’s been a long while since I’ve written a post explaining who I am and my situation, so I’m going to do that before getting into the meat of my post today which, admittedly, is not going to be that long.

My name is Steven and I’m a happily married 47-year-old. Currently I’m on disability due to PTSD and bipolar disorder, but also suffer from borderline personality disorder and generalized anxiety disorder, as well as type 2 diabetes and high blood pressure. These ailments pop up frequently in this blog as I describe my life in sometimes intimate detail.

A very regularly mentioned aspect of my life is my checklist. I keep this in two Moleskine notebooks, one squared and one lined. In the squared one, I track my daily accomplishments on 21 separate line items. These include taking my medications and my vitals throughout the day, my meals, hygiene, exercise, a daily to-do item (my daily to-do list is comprised of things that aren’t daily occurrences like calling to make doctor’s appointments, cleaning house, etc., and that list is kept in the lined notebook), as well as a few other habitual items that I feel round out my day pretty well. Writing in this blog is one of those items. I also keep track of my vitals – my blood glucose and pressure throughout the day – in the second half of the squared notebook.

This checklist is meant to challenge me, and for the first 27 months of me doing this checklist I was only able to complete full marks on a day’s checklist some 30-odd times. There were long periods that I didn’t feel up to doing everything, and just let some things habitually slide for months at a time. (It is important to note that I take my medication almost religiously, only missing two doses in the past year. The important stuff I’ve been doing.) It’s also showed me that starting in early February, I tend to take time off from the checklist completely, sometimes going into May before picking it back up again. This was a situation that I wanted to avoid this year if I could.

Back on January 17th I completed full marks on my checklist for the first time in four months. I completed full marks again on the 18th and 19th and started wondering just how long I could keep that up, knowing that my longest ever streak of full marks days in a row was twelve.

Yesterday I also completed full marks on my checklist. That represented a milestone for me – sixty straight days of full marks. Two months.

I’m very proud of being able to say that I’ve kept that streak going for that long, and I credit my desire to keep the streak alive with keeping me engaged in my checklist during what’s traditionally a time of a very hard downswing in my mood and energy level. But I also realize that there’s not much challenge left in completing full marks anymore, so as of today I’ve altered the conditions that two of my checklist items are considered complete. The goal is to get me more prepared to get back into the job market, and that checklist is a tool that’s helping me do just that.

I’m not at the point of adding anything to the checklist just yet. I know that historically new items added to the checklist tend to fall by the wayside within days of being added, and the list of items that I include in my checklist hasn’t changed for close to a year now. But making the changes that define completion, to make things more challenging for me, is a step in the right direction.

One of the things that I’m supposed to be dealing with is how I handle embarrassing situations. Generally situations like that automatically trigger a fight/flight/freeze response rather than a more socially acceptable “whoops, guess I’ll know better next time.” So I’m going to stick my neck out and tell you what those two changes are, knowing that doing so will be extremely embarrassing for me.

The first isn’t embarrassing at all. I tend to keep my to-do list in my head, just keeping that to things that I see that need doing around the house and doing them, rather than recording them in my lined notebook. As of today, for it to count as a to-do item, everything has to be written down in my second, lined book. This serves two purposes. One, I can better remember to look in the book for things I have to do if I’m writing in it every day. Two, I can see a list of just what I have accomplished around the house in a given day and can feel good about that rather than minimizing what I do here, something I almost always do.

The second isn’t so easy to talk about. I’ve had a lifelong issue with remembering to brush my teeth and shower. If I’m heading out to do something social, I do both, but during the long stretches of days that I sit here in the apartment alone for most of the day, without ever walking out my front door, those things tend to get forgotten about. My new hygiene requirements are that I brush twice a day (I’ve been gargling with mouthwash twice daily during this streak, but even that’s better than I usually do) and regularly shower and shave, regardless of whether I’m leaving the house or not. The shaving will be the hardest part for me to do, since standing in the shower for too long tends to hurt my back, and it takes me a while to shave. (I shave my head, for those that don’t know.) 

I’m still formulating what I want my new challenges to be after the next sixty days of full marks. Perhaps I might even bump that down to thirty days instead of sixty and only redefine one item at that time, who knows.

The end result is that I’m making strides in the right direction, and I’m very pleased with the results of the past sixty days. Here’s hoping that the next sixty days will be more of the same.

Updates and Ideals

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First of all I want to say THANK YOU to everyone that has donated or helped spread the message so far to help us help our neighborhood stray Stormy Cat. He’s dealing with what we think is a broken leg that’s beyond our capabilities to care for, but since he pretty much calls our balcony home (he even follows us partway around the complex on our evening walks when he’s feeling 100%) we feel like he’s adopted us as much as we want to adopt him, and we’re of the opinion that if we don’t help him, no one else will. Thank you all for everything you’ve done. If you haven’t seen the GoGetFunding page yet, it’s here. We’d love it if you could donate, but getting the word out to others is just as helpful. As of this writing we’re already just over halfway there, so thank you again!

Now onto today’s blog post.


I’ve been reading two books lately: Daring Greatly by Brené Brown, PhD, LMSW; and The Anxiety & Phobia Workbook, Sixth Edition by Edmund J. Bourne, PhD. Both have been helpful in their own unique ways. It’s the latter that I’m going to talk about today.

At the end of the third chapter, “Recovery: A Comprehensive Approach,” after it covers introductions to “interventions addressing seven different levels of contributing causes” and gives four examples of a comprehensive recovery program from case studies, it goes into detail about developing one’s own recovery program. There are five aspects to a recovery program, according to the book: taking responsibility in a context of support; motivation (overcoming what Freud called “secondary gains,” or unconscious payoffs); making a commitment to one’s self to follow through; willingness to take risks; and defining and visualizing one’s goals for recovery. Today’s post will focus on that last part, visualizing my goals for recovery.

In order to give me something that I can visualize during times of meditation, it recommends I write out a script, as it were, of my ideal scenario for my life after I’ve recovered. This task involves answering a few questions. What are the most important positive changes I want to make in my life? What would a complete recovery from my present condition(s) look like? Specifically, how will I think, feel, and act in my work, my relationships with others, and my relationship with myself once I’ve fully recovered? What new opportunities will I take advantage of once I’ve fully recovered?

It’s important to note two things as I go into detail about this writing exercise. This is based on my own feelings and opinions as they exist today, and as such is a fluid statement, subject to change or improvement as time goes on. I’ve arrived at multiple decisions about what I want to do with my life professionally, for instance, and I’m currently not doing any of them, nor am I able to do anything that I’m specifically trained to do thanks to my back problems. Life tends to toss you obstacles to overcome. My anxiety is one of them. Also, due to the nature of my anxiety, it is very possible that the best I’ll ever be able to do is diminish it to the point that I can once more be mostly fully functional, with only rare panic or anxiety attacks. That’s okay. It’s a far cry from where I am now and it’s a level of recovery that I will happily accept over my state today when I get anxious any time anyone suggests I leave my home or the balcony outside it.

So what does that ideal scenario for my life after I’ve recovered look like?

Well, the most important positive changes that I want to make in my life are pretty simple. I want to get back to work, and I want to be able to handle the work environment better, with less anxiety, than I was able to do previously. I want to get back to the point that I can freely socialize with my friends in my chosen hobbies, without fear or concern of repercussions or shame. I want to be able to go out in public, whether to a quiet dinner for two or a crowded concert venue or anything in between, without any sort of worry or fear of what might happen. And I want to feel free to be able to try new things without the overpowering feeling that I’m going to make an idiot of myself in trying. I want it to be okay that I fail.

What would a complete recovery from my present conditions look like? Well, simply put, it would be a life lived without fear of commonplace activities, such as driving or going to the store or hanging out with friends, without fear of making a mistake, without fear of embarrassing myself any time I open my mouth, without fear of hurting someone else through my words or actions. That last part isn’t to say that I want to be able to go out and say what I want and do what I want without caring if it causes harm to another person or persons – but right now there are so many things I don’t do because of what might happen or who might get hurt or offended by what I say and what I do. Despite my illnesses and my anxieties, I am a passionate person and I hardly ever scratch the surface of talking about what I’m passionate about for fear of it coming back to bite me. I want to be able to pursue my passions completely but respectfully.

Specifically, how will I think, feel, and act in my work, my relationships with others, and my relationship with myself once I’ve fully recovered? At the workplace, I will be a conscientious worker, as I’ve always been, but without the crippling fear that any mistake will forever be an indelible demerit where only a handful of demerits will result in termination. I’ll understand and accept that people – including me – make mistakes on the job, especially when they’re learning, and that mistakes are oftentimes how we learn the best. I won’t let an error become a self-fulfilling prophecy. I’ll feel confident in my ability to do my work and will seek out pointers on how I can improve when I don’t feel quite so confident. In my relationships with others, I’ll act as I used to, happy-go-lucky and confident that my company is accepted and appreciated, and that people aren’t just putting up with me because they feel they have no choice. I’ll also not be waiting on me to be in a happy-go-lucky mood to socialize – as much as I enjoy my own company, I enjoy the company of others as well, and I won’t shy away from opportunities to be social just because I don’t feel like it at the time. I’ll be more proactive in arranging social activities with others, and because I’ll be working there will be more spare cash to pursue social activities outside of movies or games at someone’s house or the occasional cuppa at a coffee house. And as far as my relationship with myself is concerned, I’ll be much more accepting of my limitations and my needs, as well as my desires. I’ll fight for the things that matter to me, and allow myself both the time and the space to re-energize. (Even at my most egregious, I’m an ambivert at best, leaning strongly toward introversion.) I’ll be more confident in my own skin and with the person that I am and will be becoming, since life is a journey and one must keep moving forward or stagnate.

What new opportunities will I take advantage of once I’ve fully recovered? I’m not sure that “new” opportunities are really what I’m concentrating on, although there is one – it’s my desire to return to school for a degree, not just a vocational certificate. Most of what I want to do when I’m recovered is return to the things that I used to do – performing bardic at SCA events (hell, going to SCA events with regularity again), doing karaoke, maybe even trying my hand at the theater again. I’d like to get into thrown pottery, since I tried my hand at it several years ago and loved it. I’d like to become a better and more varied cook. I would like to finally feel confident enough in myself to try tabletop roleplaying games. And as regular readers of this blog will know, I’d really like to unlock the writer within. But the most important thing is that I want to be receptive to new opportunities when they arise, and embrace the ones that interest me, something that I’m not very receptive to now.

So there’s a very personal look into what I want my life to look like once I’ve fully recovered, at least, there’s today’s version of it. Most of the things on that list are things that I’ve wanted for some time, so I’m pretty confident in saying that if there’s going to be any changes to this scenario, they’ll be additions, not subtractions. The name of the blog is Married White Male, In Search Of Self-Esteem, Living Fearlessly for a reason. Hopefully this workbook, and the therapy that I’ll receive alongside it and in tandem with it, will help me realize that goal.

EDIT: The two passages in bold were added at the request of my therapist and were not part of what was originally posted – but she considered them to be important enough for me to go back and make the changes, so I felt they were important enough for me to single them out in bold.