healthcare, mental health, musings

Death of a head shrinker…

A few days ago, I read an article in The New York Times about new drugs that can help treat obesity and perhaps “end the stigma” of being overweight. I’m old enough to have seen a lot of so-called magic bullet obesity drugs on the market. I remember in the late 90s, there was Meridia, which used to be advertised on TV all the time. This ad showed pleasingly plump women in loud prints, breezily lumbering along with smiles on their faces… The ads promised that the drug would help fat people control their appetites and lose weight. Then it was voluntarily withdrawn from the U.S. market in 2010, because it was shown to increase risk of heart attacks and strokes.

I remember this ad so well…

In the 1990s, there was also the Fen-Phen combo of drugs, which was said to be very effective in helping people lose weight. Bill says his ex wife took that combination for awhile. Apparently, she was very upset when it was taken off the market. I remember that combination of Fenfluramine and Phentermine was removed because it supposedly caused heart valve problems as well as high blood pressure. Ex, indeed, reportedly had issues with her heart, other than the fact that it’s so small. She had to have surgery at some point.

And then there was the drug my former psychiatrist gave me. For some reason, my former shrink felt besides the antidepressants I definitely needed, I should also take Topamax to help me lose weight. Topamax is a drug that is used for stopping seizures, curing migraines, and treating bipolar disorder. My shrink didn’t give it to me for those purposes, though. He prescribed it because one of the side effects of Topamax is decreased appetite. He felt I was too fat, and Topamax would help me lose weight.

Granted, I wanted to lose weight… and I was tired of hearing him harp on my body when I went to see him for prescription refills. So I tried Topamax for awhile. I often got the third degree from pharmacists, since I was also taking Wellbutrin, which is said to cause seizures in some people (but not me). Pharmacists would become alarmed at the drug combination and question me, and I would have to tell them that I wasn’t taking Topamax because I have seizures. It was embarrassing.

The Topamax did kill my appetite, which Bill didn’t like, because I didn’t want to cook or eat dinner. It also made carbonated beverages taste terrible, which wasn’t a bad thing, since I was addicted to Diet Pepsi at the time. But even with health insurance, the drugs were expensive, especially since I was also taking name brand Wellbutrin (the generic version didn’t yet exist). I also didn’t lose a lot of weight, much to the psychiatrist’s dismay. He wondered if I had a slow thyroid.

I remember feeling really horrible about his comments. At the time I was seeing him, I had actually lost a lot of weight because I was waiting tables and didn’t have time to eat or sit down. The pounds came off pretty easily and most people thought I looked pretty good. However, I was constantly sick during that time, partly because I was fresh from the Peace Corps and kept getting skin infections and also because I was run down because I was always working. I developed a distinct disdain for that shrink because even though I suffered greatly from body image issues, eating disorder issues, anxiety and depression, this guy kept harassing me about my figure… even after I was happily married to Bill, who didn’t care that I wasn’t skinny.

I was reminded of this shrink the other day, as i read the article in The New York Times the “new” magic bullet drugs that could help people shed pounds and the scorn and harassment that comes from being overweight. I shared the article on Facebook and my former therapist, who is now a friend, commented that the article is interesting. I wrote that I thought his “friend”, the psychiatrist, should see it. My former therapist wrote, “Yes, but he’s dead.”

I hadn’t known the former head shrinker had died. I went looking for his obituary, and lo and behold, there it was. He actually died two years ago. I had no idea. Several people had left kind comments about his memory. If I’m honest, I could see how they came to their conclusions about him. On the surface, the former head shrinker was “nice” enough. I remember thinking he had kind of a gentle, steady air about him. But he also really pissed me off on a regular basis by calling me “kid” when I was a grown and married woman, making comments that were belittling, and giving me a hard time about not being thin when I already had terrible issues with self esteem. I got the impression that he had a personal bias. I also didn’t like it when he acted in a paternalistic way. He was very much an old school kind of doctor who treated me like a child. It wasn’t very helpful at a time when I was trying to launch.

Fortunately, I only went to see that doctor for medication. I saw my therapist, a younger, hipper, and more empathetic guy, for psychotherapy. I will give the head shrinker credit, too. He was a competent psychiatrist in that he found the right drug for me. Wellbutrin changed and maybe even saved my life. Within just a few days of taking it, I felt like a completely different person. After taking it for several years and then getting off the drug, I still haven’t gone back to the awful way I used to feel every day… the way that was normal for me, but made other people think I was legitimately crazy. People used to ask me if I was bipolar all the time. They don’t anymore, although I don’t spend much time around other people anymore.

In 2007, before we moved to Germany the first time, I requested my records from the shrinks. I needed them because the Army required all of my medical records so I could be evaluated for the EFMP (Exceptional Family Member Program). This was supposedly a must before they would send us to Germany, but as it turned out, the National Guard (Bill’s official employer– he was a full time “federalized” Guardsman) didn’t give a fuck about my EFMP status the way the regular Army would have. I was forced to join the EFMP, but it turned out that I could have skipped the whole process and the National Guard wouldn’t have been the wiser. It would have been nice if I had known that, since the whole EFMP screening process was traumatic for me on many levels. I won’t get into that now, though. I think I reposted about my experience with the whole EFMP business. Thank God Bill is retired.

Unwisely enough, I read the notes my shrinks wrote about me. My cool therapist wrote positive, affirming notes. The dead head shrinker wrote things that upset me… like, for instance, I had a “garish” appearance. I was a bit taken aback by that. People have described me in a lot of ways, but never “garish”. That implies that I looked tacky, gaudy, or like a clown. And I didn’t see what my choices in makeup and clothing had to do with my mental well-being. Isn’t it better if someone with depression isn’t wearing black? He also made comments about my weight in his notes… and on more than one occasion, seemed a bit frustrated that his chemical cures weren’t slimming me down. I know very well that I’m not a thin person… but he made it sound like I was just disgustingly obese. When I was seeing him regularly, I wore a size 14 or 16… which is pretty average among American women, even if it’s not ideal in terms of most women’s most attractive body size.

It was a little strange reading about this man’s death. I mean, I know it had to happen… he was old enough, although he was several years younger than my father was when he died. I noticed the obituary didn’t mention a wife. I remember he was married when I saw him. I’d heard she was his third wife, and she had been about my age, while the shrink was old enough to be my dad. He’d had a young daughter back in the late 90s, which would mean she’s a young adult now. He also had four other children. I remember thinking that I hoped his youngest daughter didn’t have weight issues when she was growing up. I had a feeling he would ride her about them. And I guess, just based on his obituary, that his wife was no longer married to him when he passed a couple of years ago. He was a tall, somewhat handsome man, and he didn’t have a weight problem. But that didn’t stop him from having problems of his own.

I don’t like seeing doctors. I haven’t seen one since 2010, when Bill made me go because we thought my gallbladder might need to come out. It turned out it wasn’t bad enough to be yanked. One of the reasons I don’t like seeing doctors is because of that shrink… as well as the horrible OB-GYN who did my very first (of only two) gynecological exams. She physically and mentally hurt me so bad and shamed me so much that I became a bit phobic of medical people, even though I have a background in healthcare. Now I don’t go to doctors unless I’m about to die.

But maybe I shouldn’t blame these doctors for turning me off of their services so much… They’re only human, right? I’m sure they had my best interests in mind when they fat shamed me. The OB-GYN wrongly predicted I would get very fat in Armenia. I actually lost a lot of weight there. I did gain it back, but then I came home and waited tables and lost even more weight. And then I gained it back when I quit waiting tables… which was a good move for my overall health– especially my mental health– even if I didn’t have as pretty a package for people to look at. I’m glad to hear about the new drugs that might help people lose weight. I think it’s a good thing to think of obesity as a medical problem rather than a character flaw. However, this is not the first time I’ve heard about drugs that can help with weight loss… and so many of them turn out to be harmful.

Well… one more week to go before Bill is home. I continue to try to keep the faith. Last night, I was thinking about places I might like to visit when we’re finally able to travel again. Funnily enough, I’m planning based on whichever place is the least likely to give me a hard time rather than where I’d really like to spend time. One of the many luxuries of living in Germany is that there are plenty of places to see, and a lot of them are not so hard to drive to. Last night, I was thinking about visiting Krakow, Poland. It’s about a 9 hour drive from where we live. Maybe we can go there this year… after my second vaccine next month.

Also… I guess I’ve now arrived. Yesterday, I was made aware of someone having made a cloned account from my Facebook profile. It had one of my photos from last year, a cover photo using a picture I took in Rothenburg in 2018, and claimed I was a Mexican living in Nashville. I reported the profile, but Facebook naturally says they can’t do anything about it because it “doesn’t violate standards”. Meanwhile, they can give me bullshit warnings because they claim one of my comments was racist hate speech when it was really a criticism of a racist game being pitched on Facebook. They really need to get some real people evaluating these reports again. Facebook sucks, and is becoming more of a joke by the day. Anyway, I left several more complaints, along with a profane comment on the cloned profile. I doubt it will amount to anything. I changed my passwords, just in case.

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healthcare, Military, rants

Repost: EFMP… There’s nothing “exceptional” about it.

I am rerunning this post that appeared on my original blog, back on March 10, 2013. I am no longer an “Army wife”, since Bill retired in 2014. However, we know the lifestyle and this post got tons of hits… plus, it came up last night as we were remembering how I was FORCED to join EFMP because I had taken antidepressants. And then, once we got to Germany after I had dutifully enrolled in EFMP, Bill got a shitty email from some uppity guy at Walter Reed Army Medical Center in Washington, DC, wanting to be “apprised” of my “condition”.

We were laughing about it, though, because unlike “Big Army”, the National Guard didn’t give a fuck about EFMP. They cut Bill’s orders for Germany before I ever visited the medical people in DC, so I probably could have skipped the whole thing and totally gotten away with it. Of course, that was in 2007, and things have probably changed.

Anyway… Bill was funny last night as we were remembering that time because he said, as we remembered the email, “No, you don’t. We’re already here. Fuck off.” He’s obviously benefiting from my “charms”, which have rubbed off on him. To clarify, no… that’s not what he actually said. Bill is very good at politely telling people to fuck off. He basically told the guy to leave us alone and they complied. But thirteen years later, he might say it. That makes me proud. So here’s the post from 2013. Maybe it will be interesting/helpful to someone while I wait for fresh inspiration.

Back in 2007, my husband was deployed to Iraq.  We were also planning to move to Germany.  Because Germany is not in the United States, I had to do some things to prepare for the move.  One of the things I had to do was get a physical.  I was really dreading having to do this for a lot of reasons.  First off, I’m not a big fan of going to the doctor’s office.  I especially hate going to military doctor’s offices.  It’s a pain in the ass to set up the appointment.  Military medical providers tend to talk to their patients as if they are either children or in the military, even if they are civilians.  I also had a very traumatic incident with a military provider in the 1990s that continues to haunt me today.

Anyway, I had to get this physical and then I had to be screened for the Exceptional Family Member Program, a supposed benefit for military families.  Basically, what EFMP does is allow a servicemember’s command to consider the medical and educational needs of a family member before moving their “sponsor”.  I have already ranted about the term “dependent” to describe spouses.  My husband is considered my sponsor.  How’s that for demeaning?

So I got a friend to help me set up my appointments.  I saw a physician’s assistant who turned out to be really kind and patient with me, especially after I told her about my first and last disastrous attempt to get a pap smear when I was 22 years old.  She thought I had high blood pressure, but it turned out my high readings were caused by white coat hypertension.  That was proven by 24 hour ambulatory blood pressure monitoring, which involved wearing a sphygmomanometer for 24 hours.  As soon as I stepped out of the military hospital, my blood pressure readings dropped to normal.

Finally, I arranged to be screened for the EFMP, which I had been told involved having a doctor look at my records and determining whether or not I had any conditions that warranted special consideration as to where my husband could be assigned.  From 1998 until 2004, I took antidepressants and went to therapy for depression and anxiety.  The worst of my issues were from 1998-99.  I chose to stay on antidepressants while I was in grad school mainly because I didn’t want to feel shitty while I was dealing with such a stressful time of my life.  At the time, I had no idea I would ever marry a military man.  I could have gotten off the antidepressants earlier than 2004.  I got off them because I dropped civilian health insurance and was hoping I might get pregnant.  I got off the drugs with no incident and didn’t even miss them, except they helped me keep my weight down.

What I didn’t know was that my time on antidepressants would come back to haunt me.  The EFMP required that I submit ALL of my medical records for the past five years.  Those records included my therapist’s notes about my depression, which were very personal.  I suppose in retrospect, I could have removed the records from before 2002.  I didn’t think to do that.  I showed up for the EFMP screening and was left sitting in the waiting room in the pediatrics department of the local military hospital while the doctor looked at my paperwork.  She finally came out and told me I needed to be in EFMP because I’d had depression and it might be risky to send me to Germany.  She listed the reasons she thought I was at risk.  I might have trouble adjusting to culture shock.  I might get depressed if my husband got deployed (even though he was already deployed when I met with this woman).  I might have problems with the fact that Germany isn’t as sunny as the USA is. 

Our conversation was laughable.  Here was this young doctor in a military uniform telling me that it was a good thing we were bound for Germany, since if we were going to Hawaii, I probably wouldn’t get to go.  She claimed there weren’t enough therapists in Hawaii.  I looked at her dumbfounded and said, “You know, I have an MSW.  The Army could hire me.”  Moreover, this move to Germany would be my third overseas.  I had already survived clinical depression while in Armenia.  I knew Germany would be a piece of cake for me.  But that didn’t matter… my thoughts about my own stability and personal desire to stay out of EFMP meant nothing.  It was fruitless to argue with the doctor, who was just covering her own ass.  She said I could try to disenroll in 2009 and maybe the EFMP would grant my request.

She then told me that if I didn’t comply, my husband could get kicked out of the Army.  And she said he wouldn’t get his orders if I didn’t do what she said.  Her face registered shock when I pulled out a set of orders, already listing me as having command sponsorship.  Apparently, the National Guard couldn’t care less whether or not I have depression.  She spluttered, “You’re not supposed to have those yet!”

It was truly ridiculous.  But because my husband was in Iraq and I didn’t want to cause issues, I complied with the demand that I join EFMP.  I filed the paperwork and we went to Germany.  Some months later, my husband got a nastygram from the very pushy EFMP coordinator in DC, demanding my status.  They needed to be “apprised of my condition”.  My husband sent him an email letting him know that I had no desire to be in the EFMP and didn’t need it.  We never heard another word about it and I got through my time in Germany without incident.

The military is pretty intolerant of head cases… even though if you read my articles about nutty Army folks, you know that the military is rife with them.  The official policy requires that servicemembers who are depressed seek help for their issues.  The unofficial policy is that if you or a family member see a therapist or take psychotropic drugs, your career will probably suffer.  You might lose your security clearance or be stuck in some shitty assignment indefinitely or get sent somewhere you’d rather not be.  I sought therapy for my depression and anxiety when I really needed to.  I’m glad I did it; it probably saved my life.  I had no way of knowing that making the very mature decision to seek help would end up in a ridiculous conversation with an intractable doctor who didn’t know me from Adam and was basing her medical opinions of me on three year old notes from other providers.

I understand why EFMP screening is mandatory for people going out of the country.  I just wish the process involved more subjectivity and people using common sense.  I wish that competent adults were treated more like stakeholders in their own healthcare and given more of a partnership in the process, rather than given the bullshit line about how the screening is for their own good.  The screening is about covering asses, saving money, and controlling people.  Moreover, you can get around the EFMP.  A lot depends on who you are and who you know.  I personally know someone who had her paperwork changed so the EFMP restrictions would be lifted and she could take her kids to Germany.  In her case, it worked out fine.  I know of other people who were not allowed to go abroad because of EFMP and they could not get their EFMP status changed. 

I don’t mean to say that EFMP is not a valuable program for those who need it.  There are families who have kids with special needs that need that special consideration.  It’s not good to go to a new duty station and find there are no suitable facilities to handle someone’s medical or educational issues.  That tends to lead to the family having to be sent elsewhere, which costs a lot of taxpayer money and causes lost productivity.  It’s also a pain in the ass for the family. 

However, the EFMP requirement is not good when it’s forced on a family, particularly when the “exceptional member” is a competent adult.  People know that EFMP can cause plum assignments to get cancelled.  Supposedly, this is not true… the military will tell people that EFMP won’t mess up a person’s career.  But in reality, being limited in where you can go can mess up your (or your sponsor’s) career.  Because of that, some people won’t get help for depression if they need it.  I mean, it’s hard enough to get help for depression because there’s so much stigma.  If it might also mean you can’t go to Germany with your husband, you might also hold off on calling for help.  And that can lead to tragic consequences.

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Neighbors, psychology

The neighbor from HELL!

Yesterday, I was on Toytown Germany, an English speaking forum for expats. I used to read it all the time when we lived in Germany the first time. Those were the days before Facebook, and I found it had a wealth of information for English speaking non-Germans. I still like reading it sometimes, because a lot of the people who use that forum are from Europe and aren’t affiliated with the U.S. military. They offer interesting perspectives and insights that my countrymen can’t deliver.

A little mood music for this post…

So anyway, I came across an interesting thread from 2011. A woman calling herself Gutgenug was living in Hesse, in a town called Heppenheim. Her husband was in the Army and she worked for the Army herself, at an installation that has since closed. Gutgenug’s story was an amazing one… and she had a few skeptics in her midst. I must say, having lived in Germany for awhile, I believe what she writes. I especially believe that she works for the Army because she has mastered the Army writing style.

Back in November 2011, Gutgenug wrote that her next door neighbor was suing her because she used incense in her house. This man, who, along with his wife, was a chain smoker, claimed that the incense was “offensive” to him. He also didn’t like that she was using candles in her house. He called the police on her several times a week. The police would come over and talk to her. When she later called the police on him, they would hang up on her. She got so freaked out that she had anxiety attacks and didn’t even want to leave her house.

Now… this would be bad enough, but over the weeks of her very long thread, she described increasingly bizarre harassment from this man. She claimed he set up an industrial sized fan, which he aimed at her house and ran for hours. She even shared a picture of the fan, the kind of equipment one uses to quickly dry paint or carpeting. She wrote that he climbed their fence and took down her windchimes. According to Gutgenug, he would purposely block them in their driveway and surveil them as they went about their daily business.

I started thinking about all of the neighbors we’ve had over the years. Some of them were annoying. I’m sure we’ve annoyed people, too. I have never encountered anyone quite as psycho as this lady’s neighbor was. I kind of hope some of what she wrote is made up… because just reading about some of his tactics was raising my blood pressure. It’s hard to believe that the local police would do nothing to help her, either. According to her, she actually had to call someone at the Army installation in a position of high authority. That person had connections with the German police and they had to go jerk a knot in the people running her local police department.

As the matter continued to escalate, the neighbor brought criminal charges against Gutgenug for filming him. She was actually filming the fan he kept aiming at her house, but he was apparently in the film and evidently, that’s against the law. He allegedly told her she and her husband should go back to America, since Germans didn’t want us here. And he supposedly is “better” at using the law to harass people, so she should just give up and leave.

Later, it came out that her landlord used to be friends with the neighbor. They are both handymen and now compete for business. Some people speculated that perhaps the neighbor was getting back at the landlord by driving out his tenants. By the end of the thread, it was revealed that the guy had driven several other families out using the same tactics and the local police reportedly didn’t care.

As interesting as the story was, I was even more intrigued by the solutions people came up with, a lot of which included their own stories about Nachbarkrieg (neighbor wars). One lady wrote about how one of her neighbors had committed Ausländer Unfreundlichkeit by calling her “Ausländer Schwein” (foreign pig). It’s against the law to insult people in Germany. The neighbor also called the police on her for having people over on a Sunday. When she opened the door to the police, she wrote that she almost fainted, because she was afraid something had happened to her kids. Actually, it was just the neighbor harassing her for having company that was too “loud” on Sunday. When the woman’s German husband went to mediation, the insult was brought up and the neighbor was quickly shamed for resorting to personal attacks. In the end, everything was settled amicably, and the troublesome neighbor moved away.

ZZ Top also does a version… it’s a bit different. Bill went to the same high school Billy Gibbons did, though not at the same time.

Another person suggested screaming at the guy in English. As tempting as that sounds, it also sounds like the kind of tactic that only works if the other person is in their right mind. It sounded to me like this woman’s neighbor, if he was the way she described, was not quite sane. He seemed to have a lot of time on his hands, as well as the imagination on how to creatively drive someone up a wall. And one guy suggested finding a large person to beat the living fuck out of the guy. Of course, he also mentioned that taking that approach might make the legal issues even worse.

Complicating matters for Gutgenug is that she was raised in an abusive environment. Having been brought up by an abuser, she has issues with anxiety and is passive. I got the sense, having read her post, that she may have served in the military herself. I would imagine that if she was, in fact, a veteran, she probably had some trouble with the job. I don’t know this from personal experience, but I think it would be difficult for a woman to climb the ranks if assertiveness is an issue. Also, I was a little surprised that if she had all of these anxiety issues, the Army let her come to Germany in the first place. Before people in the military are assigned overseas and allowed to bring their families, they usually have to go through EFMP screening. EFMP stands for the Exceptional Family Member Program, and it’s intended to identify people with special healthcare or educational needs so that they don’t get sent someplace where their needs can’t be met.

I had to undergo that screening myself the first time we moved to Germany and, because I had been treated for depression and asthma, was forced to join the program. Fortunately, my husband’s command didn’t have a problem with it and it was a non-issue for us, but I know other people have had assignments cancelled over EFMP issues. It sounds to me like Gutgenug’s problems, if known to the Army, would definitely warrant being put in the EFMP. I ranted about my own experience with EFMP. But anyway… I have also learned that in the military, when it comes to things like EFMP, a lot comes down to who you know, who you are, and who can “unfuck” things for you.

A few weeks ago, I wrote a post about German passive aggressiveness. That post is mostly about a couple of recent legal cases within Germany that involved two different men who were covertly trying to kill people. One man was a handyman who had issues with his neighbor and booby trapped her firewood. Another was a guy who just wanted to see what would happen if he poisoned his co-worker’s lunch. Although there are not nearly as many weapons here as there are in the United States (where the harassing neighbor guy might have been shot for his shenanigans), it’s easy to see that pissing someone off in Germany can lead to repercussions that may be just as sinister as being blown away.

In any case, it looks like Gutgenug eventually went back to the States. Her landlord was placed on the “no-referral” blacklist, and the housing office was no longer allowed to refer Americans to his home. It made me kind of sad to read Gutgenug’s story. I really enjoy living in Germany, for the most part. Yes, I’ve run into some true assholes here, but none any worse than people I’ve met in my homeland. And among the assholes are many wonderful people who are helpful and kind. It’s hard to be so far from home and, I’m sure, being in a foreign country where you can’t speak the language fluently and the natives are doing their best to mess with you, is extremely stressful. Life is short and no one has the time for that. If it had been me, I probably would have just moved out, but if Gutgenug’s story is for real, then it does at least sound like the situation was dealt with at last. Kudos to her for that. Not everyone has the courage or ability to fight back in these situations.

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