Note: This piece was originally published on April 18, 2020.
I have been looking out the window and wondering what life on the other side of that pane of glass will look like as governors announce their plans to lift COVID-19-induced shelter-in-place orders. I don’t know when it will really be safe to go outside again, or when life will start feeling closer to the way it was before we began social and physical distancing, but I’m planning my future life or, more accurately, I’m mentally sorting through what I need to add back to my life when I can live on either side of my window pane, and which changes I shouldn’t reverse.
See, I take quite a few medications per day. Most of those medications were prescribed after months (or years) of dealing with intense pain or life-altering symptoms. Sometimes, my doctor would prescribe one medication and ask me to check in with him after a couple of days, because if the first medication didn’t work—or if there were some symptoms left, or if the side effects were intolerable — he would either raise the dose or add another medication. But my doctor would never give me three new medications at once to combat one disease because he wanted to know which medication would be the one that was actually working.
But when you’ve been living with untreated bipolar disorder, you don’t want to wait overnight, or for two weeks or two months, to see whether the atypical antipsychotic will stabilize your mania. When you’re diagnosed with ulcerative colitis after years of anguish, you want to tell your doctor to just give you the highest dose of medication to treat it from the get-go. If you have a fever that just won’t break, and you need to get better in order to get to work the next day, you don’t want to just take two and call your doctor in the morning. Because when you get a taste of hope, when you know that one day soon you’ll be able to leave your house and get back to life as it had been, when your doctor tells you that your symptoms should be controllable with treatment, you don’t want to wait until morning to feel better. Hope comes with a strong and intoxicating side effect: impatience. You want to feel that way now. You want life to feel stable now. You want to go back to the gym and work from your non-home office and buy your own goddamn groceries and not allocate 70% of your mental capacities to thinking about toilet paper now. You want to go see a movie at a theater with popcorn and refillable soda and other human beings. You want to see the elaborate, Easter-egg-filled background on Last Week Tonight with John Oliver again. You want your kids to go back to school so you can pretend you aren’t responsible for them for a few hours a day. You want to feel better and feel right, right now. Right goddamn now.
But when we’re able to go outside, should we run to add all of those day-to-day activities back into our lives, all at once, with abandon?
If you’re taking more than one medication to cover all the symptoms of postural orthostatic tachycardia syndrome (POTS), you want to be absolutely sure that you need all those medications. Because man, I could do without feeling really exhausted as a side effect of propranolol. It’s the strangest way to feel tired; I feel like my legs are too heavy to use, and my whole body is sinking into my legs. But I’ll cope with the exhaustion, even though it’s the weirdest way to feel tired, because I know that the propranolol was prescribed with purpose. I know that I started on pyridostigmine to treat POTS, and waited for a while to see if that would cover all my symptoms. I know that during those few weeks, I only saw improvement in certain areas, and when my doctor added propranolol a couple of weeks later, I did feel a marked improvement. Sure, I had migraines every time I spent more than five minutes in the sun during those few weeks. But that was worth it because now I know that the propranolol is definitely what is controlling my migraines. And I know this because it was introduced into my life by itself. That change was made in isolation; therefore, I know that I can track the outcome.
While I’m looking out my window and mentally listing all the things I want to do when I can go outside, I keep thinking about pyridostigmine and propranolol.
What do I really need to add back to my life when I get to the other side of my window?
How much of my pre-COVID-19 life was benefitting me?
Out of all the changes I had to make to stay at home, were any of them beneficial to my future?
For me, one of the hardest parts of following a stay-at-home order was that I could no longer go to the gym. I downloaded free workout apps like FitOn and BodBot to keep active, kickboxed my anger away, used my hallway as a running track, and did many hours of yoga. It took a couple of days to get used to, but these days I’m still getting the same amount of activity as I used to when I spent two hours at the gym most mornings. I’m just not spending fifteen minutes in the car every morning to get to and from the gym. Is that helping the environment? We’ve seen enormous and positive environmental changes since shelter-in-place orders were issued. When the shelter-in-place orders are lifted, what would happen if I switched to dancing in my living room twice a week (and driving my car half an hour less per week)? Would that have any sort of effect on my carbon footprint, even if it’s the equivalent of cutting off my carbon foot pinky toe?
Going to the gym is really important to me, though. When I have 24-hour access to a gym again, will I be able to sustainably make that change? I was a remote employee for years before a large part of the global workforce became remote, so going to the gym was typically the most social interaction I got. That’s pretty important, and so is working out, but how will I know if I can make a change in my gym habits to minimize my carbon footprint if I’m making many other changes simultaneously?
Take pyridostigmine and wait for propranolol. That means adding to your routine item by item, task by task, event by event. That means looking at all the things you used to do, one by one, and giving yourself some time to decide whether adding it back makes a positive impact on your life or the lives of others.
For a few weeks, see if you can continue getting all your groceries in one trip once a week instead of driving to the store every two days when you run out of each item. Does that work for you? Does that save a couple of miles on your odometer and a little bit of emission from affecting the environment? Or is planning your grocery trips too complicated for you and your family?
Have you changed date night from going out once a week to cooking, eating, and doing the dishes with your spouse from the safety of your kitchen and dining room? Chatting about your day or thoughts about politics or a great book you read recently while making lasagna may have had an amazing impact on your relationship, but you might be desperate to sit down at a restaurant and peruse a menu. Try going to a restaurant for half of your date night experience, and doing dishes from earlier in the day when you come home. Does that change you were forced to make actually help your relationship blossom?
Thankfully, we only get a few chances per lifetime to drastically reevaluate our lives (if that). You’ve had to make a ton of changes over the past few months, and that’s been a significant challenge. Most of those changes are ones you probably want to reverse immediately, and by all means, get back to working in your office, chatting with coworkers, and having friends over as soon as it’s healthy and legal to do so! But try to take the time to consider which changes haven’t been so terrible for you and your loved ones. Look at them one at a time. What you really want to keep as you move forward into the future might just be pyridostigmine, and if you end up taking propranolol with you as well, are you really willing to put up with the exhaustion just because you didn’t take the time to sit with pyridostigmine for a while?
Propranolol wipeout is a pain in the ass. Trust me. Maximize the benefits from this truly terrible experience while you still have the motivation to do so.
© Chapin Langenheim, 2020