I had my follow-up appointment with my doctor, after getting back some labs around cholesterol that weren't good. As I said then, when you start putting odds on your health, frankly that's something that my mind understands in more certain terms, and it comes with a fair amount of freak out.
This is where talking to a good doctor, and mine is pretty great, offers a bit of humanity that you don't get when researching things on the Internet. He will go deep on the science and lay out cause and effect in pretty plain terms, while exhibiting some real humanity. He's concerned about the cholesterol, and feels pretty good about taking six months to address weight, along with diet and exercise, to see if we can move that needle. In the event that I can do that, if the labs aren't improved, then it stands to reason that genetic factors are at play, and we can start going the medication route. This is a long game... it's not likely to kill me today, but that long-term percentage odds of having an "event" of 46% isn't good.
He referred me to a dermatologist as well, not because anything on me is super concerning, but I'm just at the age, living in Florida, where a good once-over is a good idea. Like I have this dry thing on my jaw that wasn't there a few years ago, and something else on my leg that's something "people get with age and probably not a thing to worry about." Welcome to midlife!
He pointed out that the rest of the blood work actually shows a lot of good news. My prostate is actually getting younger (exaggerating) based on a particular marker that came in lower than last year. Importantly, despite my weight, which he reminds me is not morbidly obese, I have virtually no current risk of diabetes. My pancreas seems to be doing a great job and fasting blood sugar is excellent. Liver and kidney function seems to be good too.
My mental health probably needs some work. Since my check-up, I had what he says likely qualifies as a panic attack, the physical manifestation of stress and anxiety. This is new territory for me. What's different about life that would cause this? You can often group anxiety causes into work, romantic relationships, parenting, and the thing newest to me, hyper-awareness of the time I am in for life. Work can certainly be stressful, but I've learned to roll with that more effectively. Relationship status: easy. I don't think I could have a better partner at home. The parenting is the incrementally difficult part, and that's a blog post for another day. The summary is that I find it difficult to work with him in the moment, but I get intense feelings of despair that if I can't help him in the moment, I'm setting him up for failure at life. It's irrational when I describe it, but feels pretty terrible.
So the doc wants me to try lorazepam in the event that I have physical symptoms of anxiety. As much as I've come to accept the use of drugs for mental health use, given that Simon needs takes an amphetamine for ADHD, this one makes me uncomfortable. But the intention actually makes a lot of sense. A panic attack can seem like a heart attack, so if you take the drug and the symptoms don't stop, you're having a more serious problem.
I think that, psychologically, all of this stings in part because dealing with it is admitting that there's a problem. I'm not sure why that's so hard, seeing as how I'll be the first to tout the benefits of seeing a therapist. Mostly, it's because spending the next six months getting my shit together is going to be really hard.