Almost two weeks ago, after an appointment with the Certified Nurse Practitioner at my doctor’s office, I went into the afternoon with one thought in mind: What are my triggers? It began to nag at me, until a few things dawned on me.

I keep a food journal to track what I’m eating each day. I’ve done this for a little over a year now, mostly because I wondered if something I was eating was causing my migraines to become worse than they were prior to my move. After going over it repeatedly, I genuinely don’t think my diet is triggering me in terms of stress or my migraines. It’s simple, boring, repetitive, crazy healthy (for the most part), and I’d probably murder you for a Triple Classic with bacon and cheese from Wendy’s and a baked potato with extra sour cream if I went within a minute of the place. Notice I didn’t say a mile. I haven’t touched fast food in almost a year and a half. I catch myself missing it when I’m stressed, or a few days a month when I just NEED a change of pace.

The CNP was exceedingly clueless as to what is causing my blackouts. I would refrain from blonde jokes temporarily, but she opened the door wide open the following morning when she called and yelled at me about the medication that was prescribed to me after she’d left for the day. And by yell, I mean she has a very shrieky voice and it is offensive to my ears, especially when it goes up an octave and she’s actually yelling. She blew off my lab work like it was no big deal when I questioned it, thus leading me to wonder if she can read lab results because I can, and I’m not a medical professional. I questioned the issues because they’re exceedingly visible (Elevated white count, which is NOT uncommon in Fibromyalgia sufferers or in anyone with an autoimmune disease, except I never used either word in my visits to this doctor’s office. I knew my blood work would speak for itself.) and her answer was “Can you like pop in next week and re-do it?” (Said precisely like that.) Um, NO. I’ve got a hematoma that spans three fingers on the inside of my left forearm that IMMEDIATELY bruised. I hadn’t even left the office and it was BLUE, which never happens to me. I’ve applied Arnica gel to help speed up the healing, and it’s looking a lot better now. It went from looking like someone had taken a mallet to my arm, to looking like a trauma version of Saturn, to looking like a heart, and now that it’s almost gone, it’s just plain ugly.), but I’m not rushing back for blood work any time soon. If you aren’t concerned enough to call me about that, which my physician did NOT, then I’m not concerned enough to come running in. In fairness, my doctor should have looked at it and called me to go over it. That’s what every doctor should do if something doesn’t look right. I went in running a fever and that was also blown off like it was no big deal. “It must be because it’s a warm day.” No, that’s not it, USE YOUR BRAIN.

The entire appointment was useless. I didn’t need to come in to tell you I could fail a baseline test, or that my neurology appointment couldn’t be moved up. You didn’t “save me” a trip to the emergency room by having me come in to “assess the situation”. And for the record, they thought I’d come in because of my migraines, NOT because I’m blacking out and losing time almost daily. Why would I go to a primary care physician’s office over migraines?! I wouldn’t.

A smart person would have ordered an MRI or a CT scan ahead of my neuro appointment, just to be on the safe side, but this chick didn’t even have suggestions (Did you know CNPs earn roughly $98,000 a year when they are part of a medical practice? Factor that in and you’ll be able to tap into my disgust.). I was so distracted that I forgot to ask about new anti-nausea meds and a muscle relaxer. It only took three phone calls for that to get cleared up.

When she called to yell at me about the medicine, it was because, in her words, I should “only take the muscle relaxers at night”. I had to bite back the “Duh!” that I was thinking when what I almost said was “Chill, blondie! I wasn’t prescribed an entire bottle of them. I was prescribed fifteen pills.” I paid roughly .30 cents per pill because the doctor who wrote it (not mine) was afraid to give me a full prescription. That annoys me, because it’s more cost effective for me to have a prescription that is a month of medication, as opposed to a few days worth. The normal daily dose for this drug is 80 mgs. I was prescribed 10 mgs. One pill does NOTHING. Two is slightly helpful, but 30 mgs does the trick and helps all of the muscles in my body ease up a smidge. I am going to be extremely honest with my doctor about that when I call for a refill. I don’t particularly like the drug, but if it helps my muscles not be stiff when I wake up, then I’d prefer to stay on it until another doctor says otherwise.

The anti-nausea medicine is for twenty-one pills, which is a little more practical. The whole “passing the buck” onto the neurologist pisses me off. Implying that they could get me in sooner to see him was obviously not handled properly, if at all. The neurologists’ office told me when I got the appointment that this was the first opening available with any of their doctors. There were literally two times on the same day, and I chose the earlier of the two. I took what I could get. I know they’d contact patients if they had cancellations, but obviously, there’s no room. As a first-time appointment, I expected to wait. I’d rather wait and actually get the doctor’s full attention, as opposed to deal with a rushed physician who is completely overbooked.

In all of this craziness, I learned that my ultimate trigger isn’t something I’m eating, but an actual person. Anyone who seems to gain from your misery, pain, isolation, and fear that something is seriously wrong with you is just plain evil and is someone you should probably avoid. It’s not often I find myself hating people, but I realized I hate how I’m being treated. I hate how anyone can deny how horrible their treatment of me is, and in the classic deflection technique, tries to turn it back on me. That’s not love, it is hatred, and it is so palpable, it enrages me.

This person is the ultimate “self-harm”. Rarely is a kind word spoken to or about me, unless there’s an insult thrown into the mix. I’d elaborate, but it chaps my ass to the point where I just can’t. Repeating hateful things said about me that aren’t true is giving the other person credence. When you tell someone who is chronically ill, and has been for the majority of their life, that they “Don’t want to get well.” because they didn’t go running to pick up two prescriptions the second they were filled, or ask for someone else to pick them up, there’s not a whole that that you can say to that, is there? It’s a crock of shit. If a muscle relaxer and anti-nausea medication would cure and/or “heal” me, then I’d have been on both years ago. Is waiting 48-72 hours going to change anything? No. Not one bit. Those medications are not cures. They’re temporary solutions to long-term problems. They will not magically heal me.

When you genuinely care about a person, you don’t ever want to cause them harm with vicious, hateful words. But now I see what others have been trying to tell me for probably the past twenty years; this person doesn’t love me. Maybe they think they do, but when you love someone, you want what’s best for them. You can always say things without being cruel, hurtful, or harmful. If you can’t, there’s something wrong with you.

When you realize that a person in your life, however close or not, is a serious trigger for you, you need to be self-aware when you’re around them, especially if you’re left without a choice. I feel my best when I am completely away from my triggers, both human and otherwise, but I know that’s not always a possibility for everyone. Hell, it’s not a possibility for me at the moment, but at least I’ve fully identified the target and know how to deal with it.

The neutered, “I’ve been to therapy” Lisa would disengage, say nothing, and walk away, but would internally be enraged. However, I’ve decided that particular version of me isn’t acceptable in my daily life any more, whether I’m going to therapy or not, so I’ve decided to let the other person (and people) know that their mouth is a problem and that I expect them to keep it in check with me. Yes, they will likely slip up here and there, but it’s my duty to correct them immediately, or the issue will get bigger and continue to fester. It’s easier for me to say what needs to be said and shut it down, so I am able to let it go. Mostly because, I don’t think I’d be a very good inmate.

When coping with triggers, it’s important to first identify them. If you are able to write them down and nail them the first time you try, that’s good. If you need to nail them down in therapy, or over time, that’s good, too. It shows growth. It comes down to “What/who hurts me the most.” I see a lot of people mention family issues as major triggers, or their wife/husband/partners, friends, children, etc., and all of that is normal. You definitely want to write those down if they’re affecting you and find a way to turn it around, but also look at your past and present, as well. You might even want to look into future things you know will take place that are causing you some form of triggered pain.

Ultimately, we’re all different. I’m not Zen enough to ignore rudeness and insults that are blatant and feel personal. I can let a lot fly, but there are things I MUST call people on. And if I happen to remain silent about something, it will eventually come out at a more appropriate time. I do believe in the “write it out” philosophy, too. I am lucky in that 99% of the people who effect me do not know I write and if they do, they don’t read my work, so I can come here any time and write exactly what I’m thinking or feeling. I can be my authentic self, and if they ever stumble upon it (they aren’t interested, so the chances are slim to none), they’re probably too stupid to know who or what I am talking about.

When I used to write about friendships, one of my best friends thought everything I wrote was about her (on occasion it was. She should know better than to piss me off or push my buttons.), but I never named names, and I never would. Most of the time what I am writing is a generalization and pertains to no one in particular. If I have to resort to calling someone out by name, that’s a pretty sad day in my writing career, but I’d do it in a New York Minute if I had no other choice. Otherwise, I like to keep my integrity in check.

From here on in, I am willing to “pull the trigger”. That’s my analogy for shooting down someone or something that is causing me any form of harm or emotional pain. No more.

I’ve been through hell and back. I have the scars and the ashes to prove it, but I’m done feeling victimized and/or excluded from my life. I’m in control. I am the boss. If you step out of line, prepare for the warning shot. I only warn once.

‘Pull The Trigger’ is copyright © 2017 by Lisa Marino & Blackbird Serenity, LLC. ALL RIGHTS RESERVED.