January 10, 2011
In a few days I'm off to Egypt for three weeks on a trip I've dreamt of all my life. The trip is disabled friendly I am told. My partner's doctors don't believe he's up to a long flight so I am going by myself. All of my doctors have told me that my neurological issues may flare up on the arduous trip I am undertaking. But, you just have to tuck your chin in sometimes and take a chance.
One of my neurological problems is that my body does not produce enough neurotransmitters to handle stress such as too much physical effort or too much sensory input. In the past I have had instances where my body shut down to the point that I didn't have sufficient strength to walk or talk. I also suffer from panic attacks brought about by too much sensory input such as you might experience in a large crowd.
I was worried that I would suffer panic attacks during my trip; however, I have been working with my psychiatrist on some strategies to avoid panic attacks. One of them is to limit my sensory input by concentrating on one thing until the panic attack subsides. I have learned also to be aware of a fast heart beat or a flushed feeling as the warning signs of an impending panic attack and to take counter measures, such as concentrating on one thing or removing myself from the situation. If all else fails, I carry 2.5 mg of Xanax, which is very fast acting. So far just the comforting thought that I have that Xanax available has been enough to stave off a panic attack.
The physical weakness is quite another thing. I have just so much neurotransmitters available and I can exhaust them with what other people would consider light effort. The physical weakness is made worse by emotional stress. Working with my psychiatrist, I have increased my neuropsych meds to control the emotional stress. It is up to me to be in touch with my body and know when I have to rest. In the past I have found the physical weakness to be very embarrassing as I walk with a slow shuffling gait and I cannot lift my arms. Now working with my psychiatrist and my neurologist I know to ask for help if I get weak. The stimulating effect of alcohol also depletes my neurotransmitters so I have sworn off my usual two glasses of wine with dinner for the duration of the trip. The tremor in my hands I can hide by keeping my hands in my pockets.
Another neurological problem I face is that I have a hard time making myself understood; sometimes what I think I am saying is not what other people hear. This problem is associated with my control of my tongue which feels as if it is too big for my mouth. I often bite the edges of my tongue and have been startled awake many times after I crunch down on it. I have learned to pay attention to what I say, to be polite if people don't understand me, and to repeat myself if necessary.
The old problem of the ghostly shapes in my peripheral vision has returned. I am often startled by those shapes, which can look quite threatening. I take medication to quell these hallucinations; nonetheless, I still see them. I try to control my reactions; but, I still react to them sometimes. My psychiatrist tells me these shapes at the periphery of my vision are a symptom of early dementia. Humorously, I used to think I was psychic because I saw these shapes.
I also continue to have auditory hallucinations during which I hear people say things they haven't said. I used to think I was hearing people's thoughts. I have learned to distinguish an auditory hallucination from actual speaking by not responding unless I am facing the person speaking and I see their lips move.
I have medivac insurance in case I have a major neurological episode and there is an acceptable American hospital in Cairo. My CD4 count is 375, my CD4/CD8 percentage is 17%, and I have a viral load of 6,000. I have had all my shots. Whether or not a trip to Egypt is a risky venture for me is to be seen. I think sometimes you have to take the plunge with a calculated risk. I may not be able to go on many more foreign adventures in the future so here I go. I'll tell you how this old boy holds up in late January.