Archive for the ‘The Health’ Category

For the last month I have been keeping a secret from you. It has pretty much almost killed me and I have almost told you about twice a day since then, but I didn’t. I actually kept a secret. And a pretty big one too.

You see, a month ago, this happened.

RIGHT?

In case you don’t know me well enough, you should understand that I have probably never been as shocked or excited about anything in my whole life. You guys. A baby. A BABY.

I went to my obgyn for the first time yesterday, had a wildly invasive exam and then I got to see this.

That? Is my baby.

Wow. That sentence may never not be weird to say.

At the ultrasound yesterday I was measuring at 8 weeks, which is a few days earlier than the period math led us to believe, but I’m okay with more time passing because this has been the longest month of my life. My due date is tentatively May 12, 2012, which in case you wondered is the day after I’m supposed to graduate from Graduate School. We are SUPER good at planning.

I realize that it is still early in this pregnancy and there is a fair possibility that something could go wrong, but I got to stare at that tiny little blob with it’s tiny flickering heart beat (160 bpm for you detail people) and I just about died of happiness on the spot.

I had planned to wait a little while longer to tell you, but I was offered the opportunity to join the Babble Being Pregnant team and I thought that might be a good way to share what’s going on with this whole baby thing without making this blog all about babies. I mean, this blog is still going to be all about babies, but it’s probably good to have a secondary location to share my crazy.

So there. That’s my secret. It still doesn’t feel real, but I’m not gonna lie, it feels pretty freaking exciting.

A baby.

(p.s. For those of you who happen to be Facebook friends with me on my real last name account, I would really super appreciate if you could not post anything on my wall about this yet because we are not telling the whole world for a while. You guys get to hear early because you’re special, don’t abuse my generosity or I’ll unleash my hormones on you.)

I got the MRI/MRV results last night.

I didn’t tell anyone except my husband and a friend. Not because it wasn’t good news, but because it was. They were clean. Nothing showed up.

Nothing showed up.

Please don’t misunderstand me, I wasn’t hoping for a blood clot, I wasn’t hoping for a tumor or something requiring urgent brain surgery. But I was hoping for something. Hoping for anything. Because the thing about a clean MRI is that it’s not always a good thing. A clean MRI does nothing for me. It doesn’t mean that I don’t have unrelenting headaches. It doesn’t mean that I’m suddenly sleeping more than 3 hours at a time. It doesn’t change anything. If anything, it is the opposite of change.

A clean MRI means that we have no plan. It means that we are absolutely no closer to finding a way to slow down these headaches. It means that we are back at square one.

For the record, I hate square one and the fucking horse she keeps riding into my life on.

I didn’t sleep much last night because I kept having dreams about my headaches. Over and over I’d dream about sitting in doctor’s offices and being told that there was nothing to be done. I woke up short of breath, in a cold panic. I realize that this dream may not sound like much of a nightmare, but it is for me. It’s my nightmare, my future.

All day I’ve wandered around in a fog. My doctor told me to call and schedule a follow up appointment, and I put in the call, but have no expectation of being called back anytime soon. (The only way I got the results was to email my doctor and she said that she hadn’t gotten any messages. Yes, that does make me want to scream.) But I also just keep thinking, why even bother?

We know that there aren’t any medication classes that we haven’t tried. We know that we’ve done all the tests. There isn’t really anything left to do. These headaches aren’t going to kill me. They don’t seem to be doing any real damage to my brain (if you let go of that whole brainstem slumping business). There’s just really nothing to be done.

For the last two years I’ve had a headache for every moment of every day. I haven’t had a day off, I haven’t had a night off. There is literally not a moment where there isn’t pain. I know that some of the people in my life think I’m exaggerating. They think that the pain cannot be that bad because I still go to school, because I bake, because I go on vacations. Because I refuse to give up on the life I chose.

I have learned to live with pain. It was not something I ever wanted or hoped to do. It was a necessity. It was the only way I didn’t have to give up on everything I’ve worked for. The pain is very real and if anything, it’s generally a whole lot worse than I make it out to be.

I don’t know what the next step is. I don’t know that there even is one. Right now things feel tired and hopeless. And in a way, I think that’s easier. This cycle of hoping and hurting sometimes feels more exhausting than the pain. Two years of disappointment only intensifies the ugliness of the two years of pain.

I just keep thinking that maybe it’s time we stop trying altogether. Maybe it’s time to stop thinking that this is just a phase. Maybe it’s time to realize that it isn’t something that’s going to suddenly stop.

That this is just my life.

I know I didn’t formally update (I hid it in the comments), but my MRI/MRV got moved from when it was scheduled on Wednesday to today. According to the guy who called me, it had to be moved because there wasn’t a radiologist on site to administer the contrast on Wednesday. So they moved it to today and it worked out alright because I was already going to be in the general vicinity. Frankly, as long as it was done before my insurance year started over again on Monday, I was okay with the change.

So I arrived and waited in the waiting room until it was my turn, then disrobed and gowned up to make sure I didn’t die from the zipper on my shorts.

When I got into the MRI room they went ahead and put an IV in for the contrast, which isn’t unheard of, but normally they just pull me out and inject the contrast in the middle of the scan without actually doing the whole IV thing. And then they hooked up the IV to this huge machine with two big fluid containers, and I my curiosity got the best of me.

Me: “What’s that?
Radiologist: “The Auto Injector 2000.”
Me: “Oh. Okay. How is that different from what you guys normally use?”
Radiologist: “From the Auto Injector 1000?”
Me: “Um, no. From a needle in my arm and you pushing the plunger.”
Radiologist: “Oh. Well, this is an MRV so we’re going to give you a lot more contrast quickly with a bolus of fluid and it needs to be timed with the scans.”
Me: “Oh. That sounds unpleasant.”
Radiologist: “…”

So that’s what happened. They sucked me into the tube and about 20 minutes in I got a warning that the first contrast injection was about to go in. It wasn’t too bad, definitely not worse than usual. A little cool going in my arm and I got the nasty gadolinium taste, but totally tolerable. When that scan ended, they did nothing for a while. Which was disconcerting.

After a 5ish minute break, they did a few more short scans, then they informed me they’d be injecting more contrast. And let me just say, holy crap. This was like a metric fuckton of contrast. I wanted to rip the IV out because it hurt A LOT going in. It wasn’t just cold, it was cold and stinging and really freaking unpleasant. And besides that, I not only got the nasty taste in my mouth, but also the all over flushing, feeling like I peed my pants and my tongue tingled for a solid minute. It took everything in my power not to scream to be pulled out because I was convinced I was going to die of something gadolinium related, but I didn’t. I knew that they needed those scans right then to time it with the contrast, so I managed.

Now I need to back up for a minute and clarify something- the reason they decided to do the MRV in addition to a standard MRI was in large part to make sure that I hadn’t developed any clots in the veins in my brain which can happen when you have low pressure for an extended period of time. Clearly clots are not something to be messed around with and until I got ready for the scan, I really wasn’t all that worried.

So in light of that, you can imagine my absolute freak out when the radiologist came to let me out of the tube and goes, “So, uh, have they started you on anticoagulants?”

Gah.

I was told my doctor would get the results in 2 days, so I’ll start calling Monday, but in the meantime I totally plan to spend my time freaking the hell out about potential clots in my brain. Because I was totally out of things to worry about. Whew, that was close. I almost got a mental break on my summer vacation.

It’s been more than 4 weeks since I saw my new neurologist and in that time I’ve been taking the (stupid) Vitamin A and waiting for a call to schedule the MRI/MRV that my neurologist ordered. Those are the only two things on our treatment plan and I have been totally unable to make progress on one of them. I really like my doctor, but this whole process has reminded me of how much I dislike her office.

When I left my appointment that day, they told me I’d get a call within a week to schedule the MRI/MRV. They were just going to get my insurance authorization. So I waited a week. And nothing. I gave them a few extra days and then I started calling.

Each day I called and listened to the whole stupid choose your options menu, I was bounced around to about 8 different desks where I left messages with my name, date of birth, patient ID number, phone number and the entire story of how I just want to schedule this damn test. In all, I left more than 10 messages, and it wasn’t until Friday that someone finally called me back to tell me I could just call and schedule it, my insurance was good to go.

SIGH.

So I called, and the earliest they could get me in on Monday, August 15th, in the evening, and not even in the main radiology center, but at a satellite center. Whatever, I took it. I had to. It was all set and I was willing to wait.

Then I got a phone call today. Let me just tell you that when your doctor’s office calls and says they have “bad news” they are not exaggerating.

So, funny story. My insurance year ends on August 14th. So on August 15th it’s like a blank slate. I have no authorization to see any medical professionals besides my primary care physician (COUGH*the student health center*COUGH) and in order to get the MRI/MRV I would need to first go to my PCP and get a referral to see my neurologist. Then I’d have to wait to get in to see her. Then I’d have to have her write new orders for the MRI/MRV. Then I’d have to wait for them to get insurance approval and wait to get it scheduled. And sometime next year, I’d get an effing scan.

Oh, and as icing on this crap cake, my deductible would reset so it would cost me in the neighborhood of 2000 bucks to get it all done. Which, we totally have laying around.

I cannot even begin to tell you how very angry I was. So I called the radiology center and I groveled. I explained that it needed to be done soon because it was ordered a month ago, because I was about to start a new job that I couldn’t get time off of (job, clinical, same difference) and oh, I also didn’t have all kinds of extra money laying around.

He put me on hold for half a lifetime, then came back and said he had a few options. But only if I was willing to drive to Manhattan Beach, which frankly, at that point he’d have said I needed to drive to Arizona (which is not that much farther away from me than Manhattan Beach), I’d have said yes and kissed his feet in gratitude.

So I am getting these scans done tomorrow, finally, in Manhattan Beach, in the early evening. My day will be spent in my car, fighting traffic, but fighting traffic is better than scheduling 2 unnecessary doctor’s appointments and spending money that we don’t have any day.

I’m not sure what to hope for with these scans, so I’m just going to hope that in some way, they points us in the right direction. Whatever direction that might be.

I had an appointment for physical therapy yesterday and my PT asked me how I was, and to my dismay, the answer was better. I cannot tell you how many times I’ve come to see her in the past few months and the answer has been some derivation of “ugh” or “not great” and what I really mean is “freaking awful.”

She started poking around at my neck like usual, assessing how my muscles and joints were moving and she stopped with a gasp. For the first time in months, my neck is actually moving the way it’s supposed to be. Apparently having a few days off of really ugly headaches is a pretty great cure for chronic neck issues. Who knew? We always assumed the neck pain was tied to the headaches but it’s been so long since I’ve had more than a day without a really bad one that we’ve not had a chance to test the theory.

It was nice to see something improving for a change.

I started the Vitamin A last week, just around the same time my head finally settled down a little. I started at a low dose and have been slowly upping it every day. As the dosage has gone up and the headaches have gone down, I’ve been letting myself jump to conclusions about the headaches, about the Vitamin A. I know that this Vitamin A was a shot in the dark, but it seemed like it might actually be working.

Spoiler alert: it’s not.

Last night I upped the dosage again, and am now feeling the real wrath of the side effects of the vitamins. But even more fun, I have a substantial headache. I actually opted to drop the dosage a little tonight to give myself a break from some of the side effects, especially considering how much my head hurts today anyways. I’m a little bummed out, but I’m not really surprised.

I know it’s too early to draw conclusions, but given that I was on 5 times the normal daily dose of A and have been for several days and still got this headache, I think we can safely assume that the Vitamin A is not a miracle cure. Not that we ever expected it to be, but still. It would be nice to have a miracle cure.

Or even a miracle break. A few more precious days in a row, where life can be a little closer to normal would be more than enough. I’m not stopping the Vitamin A altogether, I said I would give it a fair shot and I intend to, but I’m done putting a lot of hope in it, because I know better.

I’m hopeful that the rest of my time in San Diego is more gentle and if it isn’t, then I hope my tolerance to the headache improves. I want to make the most of this experience and going to bed early and missing out on fun isn’t really part of my plan. All I can do now is hope that tomorrow is better.

Sigh.

As I was attempting to mentally pack for my trip, I realized that the transportation of pills to BlogHer this year was going to be different than in years past, primarily because I now have a whole lot more of them. The great irony is that though I’m taking more pills each day, all the pills I am taking daily are non-prescriptions. They are all vitamins and supplements, but ones that my doctor has prescribed and that I’ve gotten through my pharmacy.

In trying to figure out how to pack the pills I realized that it was time. Time for a thing I have long avoided. The pill sorter.

Hi, I’m my grandma.

After I filled all the cells for the days I’d be gone, and to be honest, I had to put some AM pills into the PM box because THEY DIDN’T ALL FIT, I realized that that wasn’t even all the pills I needed to bring with me. The pills in the box are only my daily meds, and there are a whole lot of other “as needed” ones that need to be brought along too.

I try really hard not to let health stuff get me down more than it has to, though some days that easier than other. And it’s worth mentioning that the past few days have actually been good ones. The headaches have been totally bearable, for which I am extremely grateful. But when I take a look at all those pills, of how big a role medicine plays in my life, I just feel old. I feel worn.

I feel like I’m falling apart at 28 years old.

I look at my friends on Facebook and I see pictures from their hikes, their marathons, their pictures of their kid(s), I see these lives and I feel like I’m both behind them and ahead of them. Like in some ways I haven’t reached that point in my life and in other ways, I’ve already passed it up.

I know clamoring for normal isn’t a healthy thing to do, I know that it won’t get me anywhere. But that doesn’t stop me from wishing for it anyway.

Today has been a hard day. After yesterday my mind, my moods have been in a constant state of change.

As most of you observed, I am hopeful. I hate that I am because hope has led me no where good yet, but damn, I am. I don’t know that the next scan (an MRV with gadolinium for those interested) will actually show anything, but at least I feel like we’ve got a real, somewhat reasonable plan, for the first time in MONTHS. And I feel like if the scan doesn’t show anything, I can go back to this doctor and she won’t try to toss another band-aid onto these headaches, she’s going to try to find a way to stop them altogether. I don’t know if she’ll ever be successful, but it feels like we’re finally trying to treat the cause instead of the effects. I like that.

On the other hand, I’m scared.

I really, seriously do not want another brain surgery. I especially don’t want it because it will unquestionably derail my schooling. I can barely tell you how hard I have worked to not have to fall back a year in school. I’m not trying to paint myself a hero here, and probably I should’ve given in and gone on a 4 year track instead of staying on 3. But I didn’t. I’ve lost hours studying long after I normally would. Weekends lost to trying to relearn things that I didn’t get to learn in class, that didn’t make sense because I had missed the previous week due to pain or tests.

I caught up. I passed all my classes. I am on track to graduate in May. And the idea that this scan could show what the others hadn’t, and that it could show that this can and should be repaired now? Kind of sucks. In a warped crazy kind of way.

I don’t want surgery. I don’t want to start my next clinical and my fall classes late. I don’t want to be behind ever again.

But on the other hand (I have a lot of hands, okay?), there’s no way I can turn down a fix. If this scan shows a leak, I will have it fixed, almost unquestionably. The quality of my life depends upon it. It would be crazy for me not to. And given that my brainstem is slumping out of my head, there’s no question that physiologically, it would be crazy not to also. I try not to get too dramatic when I can avoid it (shut up, sometimes I try), but your brainstem is essential for your ability to live. I’m not willing to mess around with mine.

And so I wait, somewhat patiently, for insurance to authorize the scan, for the pharmacy to fill the pills. I craft scenarios in my head of what if the scan shows something. Of what if it doesn’t. I find worries where I don’t need them, I push others away. I make plans tentatively right now, knowing that the future is still very much uncertain.

That everything ahead is now unwritten. That it all remains to be seen.

Late Thursday night I sent an email to my former neurologist to see if he could help me get an appointment with the headache specialist he wanted me to see. He had given me his email for just this occasion, but I felt guilty using it anyway. To my surprise, he replied 4 minutes later and said he’d take care of it. I got an email the next morning, followed by a phone call and less than 12 hours after I had hit sent, I had an appointment with the new neurologist. For today, at noon.

Yea, I was surprised too.

So I met my new neurologist today, she’s just begun a fellowship in headaches in the same clinic as my old neurologist. It’s a pretty coveted fellowship, so clearly the girl is smart.

She had me take her through my whole history, starting when the headaches started in 2005. Going through the Chiari diagnosis, the watching and waiting, the progression of symptoms, the surgery. Then the CSF leak from the surgery, the period of no headaches, the return of the headaches, the lumbar punctures, the low pressure, the negative tests and on and on. We talked about all the medications I’ve tried for these headaches (there are a lot, none of which have helped) and the outcomes of all those medications.

Then she did a neuro exam, which was nearly perfectly normal. After the exam she just sat and talked with me. She said she’s confident that it’s not a number of things, most of which I already knew. It’s nice to be on the same page with a doctor. And even better, she believes she knows what the problem is.

Low pressure caused by a CSF leak.

Now, when I told my family this like 3 of them said (and I quote) “And?”

So yea, this is not a new diagnosis. The difference is that she finally made it make sense. My last neurologist ruled out a CSF leak and low pressure as the cause for a few reasons. First, my previous scans (cisternogram and myelogram) were negative for CSF leaks. That’s pretty strong evidence against a leak. Second, my headache was not positional. Typically with a CSF leak, when you are upright, it is severe, when you are laying flat, it’s better. And mine is not. And third, when I get leaks from lumbar punctures, the headaches are different.

But, it turns out most of that is not actually a persuasive argument agains a leak.

The new neurologist thinks I have a CSF leak around my brain, not my spine. And in those situations, the cisternogram and myelogram would not be sensitive tests to detect it. Especially if the leak is not constant and not huge, which is her belief. She thinks it’s a slow, relatively small leak that might not be open when I’m laying still in an MRI tube.

She also said that the reason the headache is not positional could be that the leak is not always open. She thinks the reason that my head sometimes hurts more when I’m laying down is because the leak itself is provoked in different positions. So it might be that I’m sleeping in a position that causes the hole to open. And the reason the headache isn’t as severe is because the leak is small, unlike the ones I’ve had after lumbar punctures.

The thing that sealed the deal was a review of my MRI from November.

My last neurologist had told me that the MRI showed that my cerebellum had herniated further, indicating a progression of my Chiari that might require further decompression surgery. It turns out, that wasn’t actually the case. The MRI showed “slumping” of my brainstem, which is a sign of significant low pressure. It’s also not a sign that we want to toy around with, the brainstem is pretty freaking important.

Her attending, who is a really well respected and very experienced headache specialist, agreed with her assessment. And he threw in an extra tid bit that has me reeling a little. He thinks that I may never have had a Chiari Malformation at all. At least not in the technical sense. I absolutely did have my cerebellum squish out into my spinal canal requiring brain and spinal surgery, but he thinks mine might not have been caused by having a small skull or a low lying cerebellum, but instead of from low pressure. He thinks my entire 7 year history of headaches might all come back to a CSF leak.

Bam.

It’s like for 7 years everyone has been telling me that the sky is blue because it reflects the ocean. And then today they were like, actually, it’s turquoise. And now I’m all, holy shit. The sky just might be turquoise. THE SKY MIGHT BE TURQUOISE.

I’m hesitant to be too excited because if we find a leak (and this is a big IF since it has alluded several scans already) using a scan I’ll be having later this month, the only way to fix it is surgery. You may or may not know this, but I am keenly disinterested in more surgery. Especially since if we find it on this scan, it’ll be brain surgery, and that’s pretty much my least favorite kind of surgery. And more than that, I just can’t quite get my hopes up that we’ll find it at all because I’ve been down this path before and the results have not been great.

Thankfully the new neurologist is aware of that possibility, so she’s trying a two pronged attack. In addition to the scan, she’s putting me on a SUPER high dose of Vitamin A, which should increase my production of CSF, which should cause the headaches to decrease. It could further validate the hypothesis that low pressure is the cause of all of this and might even make it easier to see on the scan.

I’m teetering on the boundaries of excited and scared. It’s been a while since we thought we knew what the problem was, and instead we’ve spent a lot of time taking stabs in the dark. Today someone turned on a small light, and got us on a path. The end of the path is uncertain and scary, the odds that we’re still lost are fairly high. But we’re trying.

And for now, that’ll do.

This is just not my week.

Life was finally returning to some semblance of normal today. I managed to get home in under 2 hours of traffic and even early enough to see my husband before he left for work. While I was waiting for him to finish getting ready in the other room, I decided to start unloading the dishwasher and grabbed a pyrex bowl to put away.

At some point someone told me that pyrex bowls didn’t break if you dropped them. I have disproven this myth multiple times, but none quite as spectacularly as today. In a single moment I somehow dropped the bowl and then lifted my foot and stepped on a huge shard of glass. When I looked, I had a piece of glass, at least an inch and a half long hanging out of my big toe. Honestly, I don’t even know how my foot lifted up and landed on glass, it happened that quickly.

I plucked the glass out and well, there was blood. Lots and lots of it. I sat in the entry way holding pressure on it while my husband tossed my curious cat in the bathroom and started sweeping up the glass on the floor (somehow, he managed to sweep up the glass, but not a single other crumb on the filthy floor. That might need to be added to the special skills section of his resume.)

10 minutes later it was still bleeding. 15 minutes later, still bleeding.

My husband had to leave for work and since I didn’t want to ride 30 minutes to his hospital, I drove myself (even though the cut was on my right foot) to the nearest Urgent Care center.

After a pretty substantial wait, I was taken back, and the nurse took a look and decided to soak my foot in a betadine solution while I waited for the doctor. The doctor came in and did the obligatory cringe at the cut. It was really pretty damn deep. She poked around at it and decided that it was definitely deep enough that it needed stitches.

But here’s the thing, I’ve never had to get stitches before. I may break bones like it’s my job, but I have never cut myself and gotten stitches. And I am quite proud of this. And also stitches totally creep me out.

So I suggested glue. She thought for a second and said it sounded like a good idea to her, especially since she didn’t really like placing stitches anyway. It was pretty much the first bit of good news I’ve gotten all week. I would’ve kissed her on the lips, but that’s not really my style.

About an hour later they had done a high pressure flush of the cut (OUCH), glued it and bandaged it and I was on my way with instructions to keep it dry and to try to stay off of it. Which is exactly what I can’t do during a clinical rotation. I can get it into a shoe, so my goal is to work a half day tomorrow since I know that standing on it all day is going to suck pretty hard core. We’re short a few people, so it would be a problem if I took the whole day off, even though neither of my clinical instructors will be there. It’s tempting to just stay home and sleep the rest of this week away, but I don’t want to leave anyone else in a lurch. Being responsible sucks.

I have to keep it dry for several days, keep it elevated and check for infection, but otherwise, like other things in my life, this should heal with time.

Sometimes I come to write and hesitate. I officially market myself as a “health” blogger, ironic though that may sound. The reason I started blogging was to share my story with others and along the way I’ve found that I love writing about more than just my body, my brain and my health. But there are days where I just want to talk those things out and I don’t know whether I should. I know that these are often not the most interesting posts to read and so I sometimes silence myself. You are welcome to not read, but I want to write it out tonight, boring or not.

Once again, the headaches are coming fast and furious and on top of that, I feel like my baseline headache pain is higher than it used to be. I’m off one of my headache meds now and I find that each morning is more of a struggle, each evening closes with more pain. I would restart the medication, but honestly, I don’t think it’s to blame. Before I stopped taking it, I was still having many HUGE headaches and wasn’t sleeping, so I hesitate to give it any credit for anything positive.

The other things I’ve noticed lately is a generalized decreased ability to concentrate. I miss important things, misread things constantly, I write down the wrong times on paperwork almost every day, I get words switched around in emails, I mis-spell simple words, sometimes repeatedly. And I don’t always catch these mistakes, which is odd for me and is very often embarrassing as all hell.

And then there’s the dizzy/vision stuff. Monday night I have multiple episodes of this pseudo-dizziness. It’s not pure dizziness. The world doesn’t feel like it’s spinning, I don’t feel like I’m spinning, but that’s the closest thing I can compare it to. I guess it’s more vision being lost. I can’t focus my eyes and things get hazy and blurry. And then my heart starts to race and then it’s over. Monday it happened several times within an hour. I was definitely a little dehydrated, which is historically when this has happened and I know better than to let myself get to this point.

But I’m frustrated. I crave simplicity. I wish that I could have a day where I get side-tracked and don’t drink enough water without major consequences. I wish I could go through a stressful time without knowing that pain is in the very near future. I wish I didn’t wake up first thing in the morning to do a quick scan- how much does my head hurt? Am I dizzy? How’s my stomach?

I feel like things never get easier. Every time I get into a routine and start feeling confident and comfortable, another shoe drops somewhere. Sometimes it’s a quiet one, it’s just a string of obnoxious headaches. Other times it’s a big freaking boot, it makes a crashing noise that makes me cower. It brings pain that doesn’t have words, it brings paralyzing dizziness and vision loss.

I’m tired. I want a break desperately. I know I’ll survive, I know I’ll get into a new routine and accommodate to whatever comes next, I just don’t want to.

I just want to be normal.