2.5

It’s been 2.5 weeks (or so) since my surgery and I haven’t written in over a week.  Nothing’s happened.  That’s not true – lots of things have happened:  I got my splint off, I started PT,  I’ve even been out of the house a couple times. I haven’t written about any of this because it doesn’t seem like something worthy of writing. But that’s not fair to you.  It’s not my place to determine whether my blog is a waste of your time or not.  It’s your time to do with as you please. If you wish to read it, then the least I can do is write it.

I think the true cause of this attitude is because the depression is returning.  It’s not a train barreling down the tracks at me like before.  It’s slowly creeping up behind me, carrying a cloak of darkness.  It’s a silent stalker, waiting for me to pause in my step, so it can work its dark magic.  Tendrils of familiar sadness flowing over me, binding my arms, slowly dragging me to the ground.  I’m fighting to keep moving but it’s not easy.

The physical is taking a toll on me as well. I can’t use my right hand for much of anything.  My arm doesn’t straighten all the way.  I can’t lift it to my mouth because it won’t go past my chest.  If I try to make a fist, I can get the tips of my (long) nails to just touch my palm.  Last night I was in a lot of pain.  I took a Percocet but it didn’t do any good.  It didn’t even make me tired.

My electronic communication is limited to left-handed typing and dictation because I can’t type or write with my right hand.  It’s taken me an hour to get this far in my post.  I have to ask for help with almost everything.  No wonder I’m depressed.  Maybe it’s situational, but it still feels the same.  Wisps of darkness enveloping me, beginning to drag me into its murky depths.  I feel like I am living in a cocoon, cut off from the rest of the world.

We increased my antidepressant but I have a hunch Celexa just isn’t going to work for me.  Sure wish I could go back to Paxil, but it will render the Percocet useless so it’s no good until after this surgery recovery is over.  I hate being so limited and dependent.  I am trying to stay upbeat but it is hard.  I am trying to be thankful for the small things but that gets hard too.  I am thankful that I have a good surgeon.  I am thankful for good doctors. I am thankful that my Dad is doing OK.  I am really thankful to have a good husband.  It’s the little things that help.  Like knowing someone will read this – so I don’t feel quite so alone.

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Under the Knife

I get my elbow reattached in the morning.  I’m not sure there is enough Klonopin for me to deal with this. There are a million things going on in my head, but I don’t feel manic.  I do feel anxious.  VERY anxious.  I called the pre-op department today because I had forgotten to tell them about my Lyrica and I mentioned that have severe PTSD from a past medical trauma.  (For a brief description see Donation: One Slightly Used Gallbladder.)  She asked what the trauma was from and I said a car accident that nearly killed me. I told her how I get very upset and start shaking and my blood pressure goes up, etc.  Then she asked what time I was due to be at the center and I said 7:30am.  She said not to worry, I would be the first one on the schedule and they would get me set up with an IV and a sedative.  I forgot to ask if my husband can come back and keep me company while I wait for the surgeon and anesthesiologist to make their rounds.

I’m already trembling, how will I survive the hour long drive down there?  And I certainly hope they give me something to keep the pain at bay for the long drive home.  (I’m assuming that I will get a script but it will take time to fill and I still have to get home.)  I’ve prepped a pillow for the car ride and a spare bottle of old Lortab in case they won’t give me a parting dose for the ride.  I have backups upon backups and still I don’t feel safe. I worry about the procedure, I worry about the recovery, I worry about everything.  Worrying doesn’t do any good, I know, but how do I stop it?

Today I was really busy with therapist & doctors appointments and the like.  I just settled down to write this about an hour ago.  Just to update on other things – worker’s comp appointment wasn’t as bad as I feared.  He is sending me to a hand specialist to check but it seems that I have inflammation in the wrist joint that will probably go away over time.  Maybe.  We’ll see.  Oh and I was able to get a copy of my job description from my nurse case manager.  I’ve never had one before.  It’s interesting to note that my job description (as a professional with a PhD) is the same description as the technician’s job.  Remind me again why I went to college for 10 years???

Thank you all for the good thoughts for tomorrow.  I’ll post when I can.

Bipolar 1.5

I saw my psychiatrist yesterday.  It was my 3 week checkup on the new Geodon dose.  She asked how the Celexa was doing, but I said I didn’t think I could adequately answer that question since it’s only been a week since I titrated off the Paxil and onto it.  So another followup in 2 weeks to check on the Celexa.  I think this “medication soup”, as I called it, is bringing my moods into line.  But I wonder… how much control do I really want?  Will I never get excited about things?  Will I never experience sadness again?  Yes, I want to feel better but I don’t want to lose myself in the process.

So we talked about a lot of things, and my time even went over by 10 minutes.  I love talking to her.  I feel completely respected, almost as if we are equals, but at the same time master and student.  We talked about panic disorder and Generalized Anxiety Disorder (GAD).  She read snippets from the DSMV-IV.  We agreed that since my anxiety problems are not something that happens more often than half a week, and usually stem from specific events or situations, I do not suffer from GAD.  (I do have OCD.) We talked about medications and we talked about bipolar.

Then I asked her the question: do you think I am bipolar type I or type II or NOS? I was originally diagnosed NOS, but I’m not sure that has much meaning to it. She took a moment to collect her thoughts and then she said, I think your symptoms resemble bipolar type I more so than type II… but it’s really a spectrum… She pulled out a copy of Stahl’s Essential Psychopharmacology where he describes the bipolar spectrum and read some of the classifications to me.  But at that point, my brain had stopped listening.  I had the answer to a question that’s plagued me for a long time, but I’m not sure I really wanted it answered.

My first reaction to the call was to make light of it and say, “Well, if you’re going to do it, you may as well go all the way!” This is not meant as a slight to any BP IIs out there, it’s more of a statement as to my coping mechanisms.  I affectionately refer to my time in outpatient therapy as Daycare for Psychos.  I have my chill pill (Klonopin), my crazy pill (Lamictal), and now I need good names for Geodon and my antidepressant.  I once introduced myself to a pair of interns at the neurologist’s office with, “Hi! I’m crazy.”  (The neurologist politely corrected me saying that I wasn’t crazy but rather bipolar.)  Labeling myself, my medications, my experiences with these terms somehow lessens the emotional blow.

Yes, this is the same woman who won’t tell her best friends that she is bipolar.

Because I don’t trust them or because I don’t trust myself?  I don’t know.  Silence is a burden, but it is better than ridicule or pity.  I don’t want to be known as the bipolar friend.  One of my friends already has a bipolar friend and I hear about her every so often.  All the crazy things this woman thinks and does.  When we bought our house, our realator wouldn’t shut up about her crazy ex-daughter-in-law who was bipolar.  I think I wrap myself with twisted humor as a shield against the true face of stigma.

While my brain and my soul are still wrapping themselves around the idea of being bipolar I or perhaps bipolar 1.5 might be a better description, I still have to contend with my impending surgery.  I will try to post a little something tomorrow as it is my last day of two-handedness for a while, but if I can’t eek out the time, I guess I’ll report in when I can get the iPad to cooperate with WordPress.  (It ate half of my original post.)  Good thoughts requested for Thursday AM! 🙂

Surgery Date

I have a date for the surgery on my elbow: Nov 10th.  I’m not looking forward to this – I’m not sure my medical PTSD is actually made any better by repeated exposure to hospitals.  I am better than I used to be.  There was a time when I couldn’t walk into a hospital.  I’m used to going to the ER at my local hospital in the wee hours of the morning.  They are actually not too busy then and the nursing staff is quite nice.  (Last time I had a really hot male nurse- woo!  😉 )  But back to surgery… that’s a whole different ball game.  Based on previous experience, I don’t seem to react well to anesthesia.  And I certainly don’t react well to pain.

This new nurse, the one for the surgeon, is not nearly as supportive as the one for the specialist.  I was trying to schedule my surgery date and she said she could fit me in next week, but when I told her I wanted November, her attitude changed rapidly.  I didn’t tell her this, but I have a wedding to go to and I have worker’s comp doctor appointments and I just can’t handle that much medical all at once.  Then she starts asking if I’m working, and why not, and I’m trying to explain it to her – it’s political – etc.  “We usually don’t do paperwork if your employer takes you off work.”  So I’m trying to explain that it’s a requirement by my employer that I have paperwork and her tone keeps getting snottier with every question.  I finally just asked her to talk to another nurse, the one who works with the specialist I’ve been seeing, because she understands the situation.  By the end of it, this nurse was snarling and I was so rattled that it hadn’t occurred to me that the simple explanation is:  I have work restrictions but my employer does not wish to accommodate them.  That’s why I’m not at work.  Why can’t they just look at my damn chart?

This new nurse probably figures that I am just trying to get out of work.  Part of me is, I suppose, but mostly, I’m just trying to get to a point where I can deal with the surgery emotionally.  Should I call her back? Should I change it?  Should I explain it in a letter submitted with the paperwork that I am going to drop off? I don’t know. My brain is going to explode.

But they don’t want me back to work until I am 100%.  And then I am sure they intend to torture me with tasks that require a lot of manual labor.  They tout safety but they don’t mean it – it’s more get the job done and if someone gets hurt, let’s sweep it under the rug or pretend it’s their fault.  That happened the first time I was hurt at work.  The head of safety was so pissed that I submitted it as an incident that he said further incidents should be reported to him first before they go into the system. What the fuck?  (Please pardon my language.)  If they hadn’t been pushing me to violate my work restrictions, then I wouldn’t have gotten hurt in the first place.  And if you get hurt, well, they will find a way to toss you into the bottom 10% and put your job in jeopardy.

I had such a nice weekend – the Paxil is finally starting to work – and now this. I’m so upset that I took a Klonopin and I haven’t done that in days, maybe even a week.  The only good thing about today is that I get to see my councilor tonight.  God, I wish I could get drunk.

 

© Manic Monday (manicmonday123). Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Manic Monday (manicmonday123) with appropriate and specific direction to the original content.

Dear Paxil

Dear Paxil,

What happened?  We used to be such good friends.  We were happy together.  I know we haven’t seen each other since 2004, but are you holding a grudge?  You need not make me anxious just to prove a point.

Perhaps you are angry because I have let Geodon into our family.  Please, it’s not personal… well, OK it is, but I was hoping you would understand.  You make me happy – too happy – we just can’t be left alone together.  Geodon is our chaperone.  I swear, it is nothing more than that.

We were united twice before – once in 1997 and once in 2003.  You didn’t treat me like this those times.  Or is my memory just hazy from the beauty of mania we have shared?

Please Paxil, I beg of you, send your side effects away.  I wish to be friends, good friends, but not BFFs as we once were.  I need you to do this for me, because Klonopin does not play well with Geodon, so he must be used sparingly.

I plead my case.

Thank you,

Monday

© Manic Monday (manicmonday123). Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Manic Monday (manicmonday123) with appropriate and specific direction to the original content.

4 am

It’s 4am and I’m blogging.  I’m blogging because I can’t sleep.  Why can’t I sleep? No clue.  Well, maybe I have a cue, but it’s a bit tenuous.

I suspect it has something to do with Geodon.  Geodon must be taken with food.  Apparently it doesn’t work right unless you take it with a meal that contains at least 500 calories.  Granted, I can reach 500 calories with two candy bars, but that doesn’t appear to be the correct method.  The correct method would be 500 calories worth of steak, potatoes & vegetables.

But maybe I don’t always each the right kind of 500 calories because Geodon affects me differently on different days.  Some days it makes me loopy and I can’t think after about 2 hours. Other times it does nothing.  Like tonight.  I took my Lyrica, nothing. Geodon, nothing. Klonipin, nothing.  Nothing put me to sleep.  (Although I have to admit this second bit of Klonipin seems to be helping. Don’t worry, it’s shrink-approved.)

If this lack of Geodon side effects is really related to the right kind of food eaten, then probably it is also related to how you take it.  Be sure and take it right after you have finished eating, not just before you eat, nor 30 minutes after you have eaten.  It doesn’t matter if you are still full, you will need more food.  But at that point, it’s really just too late.

So here I find myself, blogging at 4am.  Oops, make that 5am.

Hmm, I think I’ll try that sleep thing again.

© Manic Monday (manicmonday123). Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Manic Monday (manicmonday123) with appropriate and specific direction to the original content.

Geodon

Oh Geodon, what have you done to me?

The Depression Train was coming for me. It was. I want it to veer off, but it won’t and I can’t move off the tracks. It not only does it run you down, but it grasps you and takes you for a ride. Flinging you into a pit of despair when it’s done with you.

Geodon has slowed the train for me.  It’s still there, the blaring headlight blinding me into submission, the great black steel body intimidating me into compliance.  And it will catch up.  I know it will.  It’s smokey tendrils have already grabbed a hold of my ankle and are trying to knock me off balance.

But can this powerful drug save me? Not completely, not at 40mg, it seems.  And there are other trade offs as well.

Pros:

1) Geodon appears to work.

2) It has not caused any weight gain.

3) Blood sugar levels remain within normal range.

Cons:

1) It makes me dizzy/sleepy so that I have to go to bed within a couple of hours.

2) It has to be taken with a full meal.  (minimum 500 calories)

3) It works best taken twice a day because its half-life is 7 hours.

4) Low levels of Geodon cause anxiety.

Taking it twice a day is impossible because of con #1, 2, & 4.  Let’s start with con #1 –  I need to be a functional individual.  I took 80mg the second night (as prescribed) and I could not move for 14 hours! (2 half-lifes!) So now I take 40mg at night.  Sounds like a good plan, right?  Except that by mid-afternoon, I am a total ADD/manic-depressed nutcase.  No, seriously.  This stuff doesn’t just cause anxiety, this creates mayhem!  So by my rough calculations, this means that there is approximately 10mg of medication in my system leading us to #4.  The problem with #2 is that the only time I eat a total and complete meal is at dinner.  I rarely have more than 200 calories for breakfast.  The other problem is that if I have to travel for work (conferences, etc.) I can’t control when I am able to eat.  It might be 6pm or 9pm, then I would have to be up by 6am the next morning.  And I only get ~2hrs (sometimes 3) between taking the pill and getting knocked off my ass with side effects.  How is that going to work if I have to wine & dine a colleague?

So what’s a girl to do?  All the anti-psychotics cause weight gain and/or blood sugar issues.  Most docs would say, well, I’ll just give you some Metformin and be on our way.  No.  I did not work for a year to lose 40lbs and bring my glucose under control just to take a medication that will kill off more pancreatic cells.  I would rather be crazy.

Plan of Action:  I am going to try to take 80mg at night until I see my p-doc on Monday.  (Don’t worry, this plan is doctor approved.)  Hopefully, this will give me enough data points to draw a conclusion regarding the tapering off.  Can I wake up after 6-7 hours of sleep and be functional?  Does it keep that damn locomotive at bay later in the day?  Otherwise, what’s left for me?  Abilify, with a 30% chance of weight gain at $10 a pill, or lithium.

By the way, has anyone out there ever taken lithium?  Would you be willing to share your experience?

Update: I have found that higher doses of Geodon help so that I am not running into the really low does at the end of the day. Klonopin also seems to help with the anxiety.

© Manic Monday (manicmonday123). Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Manic Monday (manicmonday123) with appropriate and specific direction to the original content.