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.

Freak Out

OK, so I haven’t been blogging much lately.  Lots of things going on, and yet, nothing going on.  Same as usual.  I guess.  Well, not exactly.

I’ve been having freak-outs lately (as in 3 in the last 3 days).  It’s never been this bad.  DH says it’s like I was before the diagnosis.  So why isn’t this damn anti-psychotic working???  Or maybe it is, but it’s not treating my freak-outs.  They may be related to depression.  I thought I was over the depression because I was feeling better last week.  I found out that Geodon does act like an anti-depressant because it inhibits serotonin & norepinephrine reuptake, so I thought it was working.  But maybe it’s just not enough.  This week I am back to the same old thing: procrastination, self-recrimination, and a general sense of no self-worth.

Then there are the freak-outs.

WARNING:  I am not suicidal, but there is a discussion about suicide below, so if this bothers you, then abort now!

Now, to explain the freak out.  It’s somewhat complicated and difficult to put into words, but I will try.  DH & I were at the mall.  He wanted to look for new sneakers.  He pointed to the store he was going to look in.  I wanted to look somewhere else first but then I would meet him in that store.  When I went to meet him, he wasn’t in that store.  I called his cell.  He didn’t answer.  I was so angry all of a sudden that I wanted to throw the damn phone down a level, where it would land (coincidentally) in front of the Apple store.  Fortunately, a small bit of logic remained in my clouded mind and I was able to refrain from destroying a $300 phone.  When I finally found him in a different store (we disagree as to which store he had pointed to) I was a snarling, rabid thing.

Last night, we had some kind of disagreement, and I was off reaching for knives and threatening to slit my wrists.  The night before, I stormed out of the house saying that I was planning to go “play in traffic”.  Mind you, I was perfectly fine when I saw the psychiatrist Monday morning.  I had had about 4 or 5 consecutive days of “normalcy”.    I don’t know what prompted this disaster.

How can I describe a freak out?  It’s like there is something inside you that when triggered you just lose it.  You become a wild, mad thing.  It feels as if all of your synapses are firing at once, but none of them in the correct direction.  You can’t slam the door hard enough, you want to crush what is in your hand, scream, cry, rage, slam, punch, kick – you name it – anything to release the energy that is built up inside you.   When it’s over, you feel drained and no longer taut like a bow string about to break.

A lot of times, these outbursts involve suicide threats.  Am I really suicidal?  I don’t think so.  Could I do myself harm in one of these states?  Quite possibly.  This is where you tell me to go to the hospital, right?  It wouldn’t be worth it; by the time I got checked in, it would be over.  These states are very short-lived, typically less than an hour.  Today’s freak-out for example, was only about 10-15mins.

So, I know I have to call my doctor’s office, but I really don’t know what to say.  I’m freaking out, just doesn’t quite seem to cut it.  And how do you explain the situation to a nurse/receptionist in 10 words or less?  I’m at a loss.  But I need something. NOW.

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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?

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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.

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Missing: One gallbladder

I thought my life (health) was supposed to get better after surgery but I’m starting to debate that theory. DH made me a nice, low-fat meal this evening (I confess I ate a bit too much) but now I am SICK! Not really bad sick, just ill. The gas, the nausea, the pain – how can something that isn’t there hurt??? (Phantom pain I suppose, but it is weird.)

OK, so I am only 2 weeks out of surgery. But this was laparoscopic – easy stuff, right? Recovery is a bitch. I’m still wearing sleep clothes that are 2-4 sizes too big because otherwise the waistbands encroach on the bellybutton incision and – ouch!  I wore jean capris all day today and boy am I paying for it now.  I can’t find anything that will make my waist area feel OK.  I can feel the scar tissue building up around the smaller incisions… they feel like little knots.  I know, it’s weird.  And it’s hard to explain.

And now I’m nauseous, even with the nausea medicine.  It’s the weekend and I don’t know what to do.  I don’t know that there is anything I can do – I can’t call the doctor’s office.  And even if I could, what would I say?  ‘You’ve given me nausea medicine and I still feel sick.’  Yes, I suppose I could, but is it worth it?  Sometimes there just isn’t anything they can do.  Take it easy – rest – that’s not easy for a anxious bipolar.  Am I anxious right now?  You bet I am.  After all, I feel sick – just as sick as I did before they took my gallbladder.

Maybe I need it back.

 

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Dear Klonipin

To my dear friend Klonipin,

What would I do without you?  I know, I would pace and fret and waste a lot of energy, accomplishing very little. You calm my nerves, help me regain control of my emotions, and allow me to focus a little. However, I find that you demand a price for this brief measure of peace: a piece of my memory or an unquiet rest.

I don’t understand how you can wield such power.  Power to rescue, power to curse.  You threaten to addict me.  And they tell me you are the weakest of your siblings.

And so it is a dance with you, my friend.  I will allow you to lead when I have need, but I will leave the floor when I wish it.

It is with great regret that I say we can not stay friends forever.

 

 

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In the beginning…

Like many of us, I struggled to find a topic to blog about.  A million ideas went through my head: I could talk about random things, I could talk about television shows, I could talk about my hobbies – any number of things. I’ve been going through some health issues recently and I thought about blogging my mystery illness and my quest for a diagnosis and cure.  I sat on the examining table, after having gone through the litany of coordination tests, and listened to the neurologist’s conclusion. He told me that my most significant problem is that my bipolar is out of control.  This upset me.  Wouldn’t it upset you?  But at some level, I recognized the truth beneath the pain.  And I realized that what I should be blogging about is my struggle with bipolar.  It’s the largest thing in my life.  I can’t avoid it, or side-step it, or ignore it, because as soon as I do, it clubs me over the head and drags me off into a deep, dark alley that’s difficult to crawl out of.

As I sat there, listening to the neurologist tell me that my symptoms were related to my bipolar, I grew agitated.  At that time, all I could hear was, ” it’s all in your head.”  The doctor asked me many pointed questions: If you know you’re bipolar is out of control, why haven’t you done anything about it?  Dredging up my past, he wanted to know why did I stay in an abusive relationship for seven years?  I told him it would take a week to explain.  I felt as if I was on trial.  I felt betrayed.  I wanted to ask my husband: why are you siding with them? Why are you ganging up on me?  Why is it not enough for me to say: yes, my bipolar is out of control, but let’s talk about what is really wrong with me?  What has bipolar got to do with my aching joints? What does it have to do with the deep, throbbing, chest constricting pain that sends me to the hospital?

I have neuropathy – idiopathic of course,  because only 40% of neuropathies can be identified.  A 60% failure rate.  How do you like those odds? Also, I probably have multiple sclerosis (MS), but it isn’t active and doesn’t really require treatment at this time.  He said that I don’t display any neurological symptoms.  Ha!  So I can touch my nose with my eyes closed and I can flex my feet and feel a pin.  But I can’t walk too fast or I will trip and fall.  There’s an odd stitchy feeling – like a tickle but not quite – that wraps around my torso and it will trigger the neuropathy pain.  I can’t find a word I want when I want it, or I substitute a different one and never realize it.  I don’t know what I am saying anymore and I can’t remember what I’ve said.

But it’s all in my head.

Except that’s not what he said.

But in a way he did.

There was the explanation that it’s all in your head because all pain is in your head since the brain interprets pain, etc.  The nurse was no better, trying to explain to me that the guy in the room next door has broken more body parts than he can count and yet he wants to know why his arm hurts.  It’s all in his head too, she explains since that’s where the interpretation of pain is.  But I’m not buying it.  No.  She gives my husband the schedule for my new neuropathy medication – 3x/day, evenly spaced, gradually working my way up from 300mg to 900mg.  She gives the instructions to him, because the crazy lady wouldn’t understand.  Or wouldn’t be willing to follow it.

My husband was there acting as a translator between what the doctor said and what I heard through my mania, but all I could hear was his betrayal.  He was on their side.  When did I lose my only ally?   I didn’t hear the doctor say that my symptoms are real, but that my instability is amplifying the pain.  The doctor kept saying, the bipolar is preventing you from dealing with the pain. Whatever that means.  It still sounds like “it’s all in your head” to me.

But yesterday I made an appointment with the counselor.  It had to be done sooner or later anyway, and this is as good a time as any.  I’ll have trouble finding a psychiatrist since I live in a small town, full of (apparently) crazy people because they aren’t taking new patients.  However, I have accepted that the neurologist was right about one thing – my meds need to be reevaluated and I do need therapy.  But I think he’s wrong about one thing too – the pain is real and it’s not in my head.

 

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