Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Wednesday, June 28, 2006

From the world of sleep

I just can't wake up. I have done nothing but sleep for days. My therapist doesn't think I'm depressed. I sort of do, but in a weird way. I just feel really weird.

However, with this many hours of sleep per day I sure have nothing going on. Next up is a big trip to the city to see the psychiatrist Friday. I get to stay in a hotel. Actually it sounds like a fairly nice one and hopefully I'll get a good supper out. Plus, free toiletries!

Tuesday, June 27, 2006

The Great Experiment

THIS should get me some awful searches (so far I've only had one porn search but it was pretty bad), but today I was bored and decided it was time to conduct some research.

I think it's fairly common knowledge that lithium makes you pee a lot, and certainly all psych patients know this well. I remember the day I started it telling someone it would change my life because I would have to learn to drink water (which I hated) and eat salty foods (which I normally avoided). Well, cravings quickly took over and I learned it wasn't hard. For a while I had to watch that I drank water instead of juice or things with calories, but mainly I took to water quickly. I was told to drink 80 oz daily; generally I drink at least twice that. I am on a high dose, so I think that is more expected (as in don't be scared if you're holding your first lithium in your hand and reading this), and I seem to have very active kidneys as they handled my recent toxicity with no signs of the expected distress.

So I pee a LOT. Everyone I know is used to it; I need a water and potty break about every hour, especially in the summer and I get grouchy without. I've paid $3 for bottled water at the fair 1/4 mile from the car so I wouldn't kill my mom. We're not talking quick trips either; my bladder is full and to prove it one summer I wet my pants driving home from work. Twice.

So, today I counted the trips. Ideally I'd say "the average woman urinates...." but OH MY. That's a nice way to learn about things you do not want to know, and I'm not referring to anatomy.

My total? And I'm pretty sure this is a good day: EIGHTEEN. That's right, every 1.33 hours. Around the clock. Actually it is more at night because of how I take my pills.

Stayed tuned for more chaos as I have a lot of time to fill in the next few days.

Sunday, June 25, 2006

I Lied

I said the next post was going to be about the changes in how I have to approach some things, but I lied. I did, however, remember that was my intention so we're doing pretty well!

Instead, I'm still cycling. I had to accept that I really felt depressed yesterday and today. I had the pills already to increase my antidepressant dose very carefully (this one works very well for me but puts me over the top into mania far too easily so we're doing this very, very carefully) so last night I did that. If I remember it takes about 3 days for this one to work. I'll be allowed one more increase after that before moving on to another last possible choice (it seems like we hit those every so often, but then something else in some other odd combination always comes along).

I know cycling is very, very normal at this stage. I know that's why I keep refusing to say I'm getting better quite as positively as the psychologist wants. I always cycle every 2 days or less at this point. This is not that bad, and the meds will fix it quickly. But I was ready to move on and I think I was starting to believe that was happening faster than it really will.

Back when I started writing this blog it was often hard to know what to write. I could write how I felt about certain things I ran across or that were said to me or that I observed. Now it's easy to write about my experiences because my whole life is centered around bipolar illness. I'm ready to go back to the other way for a while. I think that was why I wanted to write my other post idea. Which I will still get to. But first I have to feel crummy and it's not going to come out well if I do it when I'm feeling angry at the world, which I currently am.

Anyway, this isn't going anywhere so if anyone finds my point let me know!

Friday, June 23, 2006

Happy Things

I seem to really be getting better finally. I never will say I AM getting better because trusting that means it hurts too much when I cycle and land on my butt, but right now every day is a bit better. Things are coming back to me, like my attention span (thank God!) and ability to sleep. I'm starting to taper the sedation because it's actually too much now and I'm bored all the time because I don't have the energy to do anything during the day, but today I'd had a good bit less sedation and felt so much better, even did some very wet yard work.

Many things about me are finally showing I'm improving. Each time I've seen the psychologist lately he has noted the improvement. He says I sound better too; that one I can't see for myself so much. Yesterday I was back to being sarcastic (this is my normal and it has been totally gone for months) and even made a joke. It's been so long since that felt natural.

I spent a lot of the week fighting my disability insurance company and a large check will be coming any day now. The fight was ridiculous, even worse than I've already written about, but finally I refused to get off the phone until they answered all my questions and resolved the claim. It only took 20 minutes that time. Since assertiveness is not really my best feature I was pretty proud.

Things start moving faster now. As long as I stay moving forward I'll keep seeing the psychologist twice a week and I imagine taper down close to the time I go back to work. I see the psychiatrist every three weeks until the end of July then I assume the add-in appointments will end and I'll go back to monthly. I see the regular doctor soon about thyroid medication. My return to work is scheduled for 4-5 weeks. For the first time that feels possible.

Other things are starting to feel normal as well. Summer is kicking up my dreaded lithium thirst and the need to eat salty foods is at an all time high. Everywhere I go I must stop for a drink and a bathroom. Sometimes I can't drive the hour to or from counseling without stopping. I did mess up my lithium dose this week; I took the old dose for about a week, the one that made me sick. I caught it before anything happened, but it did frighten me because it was so easy to make that error just out of routine. For 4 years I took 4 of those pills, taking 3 is a big change. But it's very needed.

Next time, if I remember (which is also starting to come back-today I even knew what day it was most of the day!), I want to write about what I'm learning this time. This is definetely going to be the episode in which I learned the most (aside from the beginnning which does not count).

For now, I'm going to get a snack and see how much fun I can have with my 16 pills! (I have this mental idea that less pills is better because I hate them; I am not good at swallowing them although I've learned. My high is 23. I was on 8 or 9 for a long time, so this 16 thing is well, hard to swallow....:)

Monday, June 19, 2006

Tomorrow is Fight Day

I haven't heard from my disability provider yet again, so Tuesday is the day something will happen. I plan to be on the phone all day until someone tells me something that is useful. I have a lot of ideas of people to call, inside and outside my company, and who knows I may make a new friend up in the scary higher reaches? It's not my company that's the problem anyway, it's the insurer, but I'm going for any help I can get.

I hate doing this kind of thing. Glad I've got lots of Ativan.:) Hopefully tomorrow I get to report something really good, like the biggest check I've ever seen is headed my way.

Zombie

I'm not writing because I'm complying with my meds. (Novel idea when it comes to this as needed stuff....I rarely take as needed meds. I don't think that's the point.....)

That means tons of sedation and mostly right now I'm sleeping or not very clear when I try to talk. Last night I wound up half the night bouncing off the walls; I think I forgot a pill. But most of the last few days have been very sleepy. I'll be back when I'm awake.

Thursday, June 15, 2006

Best Doctor Ever

I had a very long appointment with my psychiatrist today. We compared what we had said and done with the disability insurance provider (who I had a very good experience with just 2 years ago) and found out that they keep telling me that my doctor isn't sending information, and that they tell my doctor (if they say anything, because mostly they haven't indicated a problem to her, just not processed paperwork) that "the patient knows that a claim number must be indicated on all paperwork you submit". Now, that is sooooooo not true. Where I would be supposed to know that is beyond me. I know my claim number only from human resources at my company and was just given it yesterday. But funny enough, I called to GET my claim number days ago and was told I wasn't in the system and therefore didn't have a claim number, despite the claim having been submitted several weeks ago.

So she called them. They continued to throw blame around and not make sense, nor provide any answers. She got pretty mad at them and finally told them they need to realize they are creating so much additional stress that I will be on disability longer. Then she took the number to complain to my human resources department that this company is the worst she's ever dealt with.

I came home with more meds for stress and depression. I also came home feeling so much better because I have someone fighting this with me.

I'm exhausted, 4 hours of driving and a doctor's appointment that lasts over an hour is a big day for me, but for once I don't feel totally hopeless.

Wednesday, June 14, 2006

Daily News

I have been off work 6 weeks and 2 days. I was eligible for disability effective day 14. My company took 2 weeks beyond that to get me the paperwork, then my doctor had to fill it out. From that point on I have no idea what's going on except that I NEED money and I have none. Last week the disability provider couldn't even find me in their system; now I do have a case number but apparently not a case worker (a case worker greatly seems to help). They keep saying that my doctor isn't sending them stuff, but they contradict what they say, plus I have 2 people at the doctor's office who I trust inherently refuting that. Regardless, I have to make a mortgage payment tonight and then things get really tight in this house.

Which is too bad since I finally have more signs that just serious food cravings that my body was malnourished during all those bad months. I have a rash that is from a deficiency. So I am eating weird-tasting vitamin chews daily and know that I need to keep it up with the healthy eating. If only healthy were cheap.

I also got my results back for my 3rd thyroid test. Lithium can injure the thyroid and we're watching mine to see if the injury was permanent. I had a normal test in there, but #3 was off again and the initial damage from my toxicity should be gone. So another test was ordered with extra blood from that draw (convenient; I've had 5 draws in 6 weeks so I'm all for not taking more), and then in 3 weeks I do this all over again.

I did one of the worse things on ambien I've done yet. Somewhere in the night I locked my cat in the basement. She was NOT happy. I don't think she was there long, and it's not a bad basement, but just the indignity. I still wonder WHY though...

Tomorrow I am going to see my psychiatrist. I've never seen her at her real office before. I see her at a clinic where she does 3 half days/month. This is a big (2 hours each way) drive and I have no real idea where I'm going. I get really anxious driving in this city because when I was first diagnosed I was in a clinical trial and when I was trying to drive home I somehow hit a city bus. It was ok, but it was really embarrassing and I don't want to repeat. Where I live we barely have SCHOOL buses! I knew I was getting an add-in appointment somewhere. I'm surprised how fast. I hope this doesn't mean I have to have my anxiety poked at some more. I'm handling it better now that I'm taking (and agreeing to take) more drugs.

Otherwise, today was slightly better. I think I partly just needed a vacation from my problems. Or lots and lots of sedation. I'm not very smart right now, but at least I'm not crying. I guess next week I can worry about weaning off some of this stuff.

To bland-ish days!

Tuesday, June 13, 2006

My last few days

The point of this post was supposed to be about the nightmare I'm having getting my disability to go through and my fear of running rather low on money soon. You'll note none of this is addressed. My mind is a wondrous thing in it's autonomy right now.

Sometime early in this episode I decided it was time to face a lot of really harsh feelings. For years I have swatted away anger and sadness with every episode, calling them "symptoms". Every so often I'd have a period I would do better and be faced with sadness because the "better" me was so far from normal and so unable to do what I wanted to do. But then I would bat way THOSE feelings because who wants to wreck a good mood when you only get one every 6 months or so?

This time there was no excuse. I was already on disability, I already had so many things going on that I was going to be off for a while, and I needed to do it. So we've started. And it's been so hard. Good, but hard. I almost always leave the psychologist's office feeling like I was there for hours because I put so much effort into that hour. I've come to cry freely, and that's something I've never done except when my emotions were totally out of my control.

The problem is that things have gotten more and more stressful as we've done this and somewhere last week I hit a breaking point. Friday night I was crying so much I wasn't even bothering with wiping my face and my shirt was soaked. Saturday I think I cried before the therapist was in the room. Yesterday I referred to Saturday's tears as having been "out of control" and he agreed, so I guess that describes that. In combination with my not sleeping the last few weeks and waking up screaming and with nightmares when I did, I wound up with this being an "easy" week to rest. Already I'm getting myself together again.

Last night I slept, which people have been able to see without my saying so. I must have been looking great lately. It wasn't a ton, it wasn't great, but it was an improvement.

Now I have 6 days to hold it together all by myself. That is the longest I've gone in about 2 months. It's time for a new achievement (funny what can become an achievement...).

Sunday, June 11, 2006

Help Me Please

I'm writing this as way too many meds flow through my body so please forgive spelling errors.

There's an easy way blog readers can help. I am very bored (in fact that will make me cry) and very limited in what I can do right now. I love gardening but don't have the energy. I can't be in the sun or heat. I don't have the attention span to watch movies; I do have individual episode DVDs of a few shows and I can usually watch 30 minutes. I can read some. I need more books.

I need books that a short attention span doesn't affect comprehension. Books with short chapters work well. I like mysteries. Currently James Patterson is ok. I just worked my way through a Janet Evanovich that I'd read before. It went slowly.

Reading helps me sleep. PLEASE, if you have ideas, post them! I also am always looking for books on bipolar disorder. I've had some success with Dave Barry recently.

Thanks.

Saturday, June 10, 2006

Sail away, Sail away

I'm doubling my sleeping pill. I went 2 nights with practically no sleep and then did some relaxation stuff with the psychologist today that bought me a short nap. Hopefully this will just let me sleep more normally, but I'm expecting to be pretty out of it for a couple days. I may not be posting until I'm awake. I already had one embarrassing moment of loose lips to remind me that a regular dose of ambien can make inhibitions take a vacation.

Both the psychiatrist and the psycholost are telling me that I'm reacting normally to working on some very hard stuff, so apparently crying and not sleeping are normal. I'm all in favor of moving on though.

Back when I'm awake. Which could be tomorrow--wouldn't be the first time I've been stronger than the strongest amount I'm allowed to take of a sleeping medicine.

Tuesday, June 06, 2006

Cried a lot today

I got a bit less sleep than the night before, although I guess it was a reasonable amount. The quality though, left a lot to be desired. And it was so highly medicated I'm not sure it was sleep as much as it was a short coma. I'm dreading trying tonight; I need to take pills in a few minutes. I felt bad enough to email my doctor to tell her that I know we're one notch below a med I've always not wanted to take and I'm willing to take it.

I cried a lot after I talked to a work friend. I've been sort of hurt because I've not heard much from work. I get an occasional phone call. I've not even received a card, and that's atypical of where I work. At the beginning of my working obsessively and making myself sick I organized a wedding shower one day and a memorial donation the next. And today my friend was telling me all about how my new assistant is wonderful and has done this and that and the other. That's great, but it makes me feel like nobody wants me. I feel like by the time I get back to work, which is still so far off everyone is repeatedly saying "one day at a time" (which translates to "you're too sick to think about the truth"), nobody will care that I'm back.

And so I cry. Which is probably good because I'm not very good at crying to expressing feelings and crying helps with the stress. It might even burn some energy. But I'd really like a picture of the future so I can believe it is really there....

Every day you want a little more

This insomnia is becoming all I think about. Last night I finally slept a lot. I slept about 15 hours, and apparently had only 1 wake-up period in there, according to my notes. I think that had to do with a phone call from my disability insurere and doesn't count.

Tonight is another story. Tonight so far the meds and sleepy time tea are not working. I just added a whopper sized bolster to my ativan dose. I feel a little lightheaded, but not really sleepy....

It was expected that the ambien that was added yesterday would not last long. I hope one day wasn't all I get...I think it will be ok, I had a very teary session with my psychologist and at one point thought I was going to share a panic attack with him. I think I sort of worked myself up for this one.

It's just so hard to remember this is not forever, and that even on Thursday of last week I wasn't complaining to him that I thought insomnia was killing me. I knew it was getting bad, but it wasn't until Thursday night that I knew I was in trouble.

But every day is more desperate for sleep, and for signs that that sleep will continue.

This part is so hard.

Sunday, June 04, 2006

A pox on insurance companies

I'm very, very blessed to have good insurance. I'm even more blessed than most people because I live in a state that doesn't have mandated mental health coverage but am insured through my company, which is based in a state that does require it. That saves me a ton in psychiatric fees and allows me to be hospitalized, although I still pay for counselling because I insist on seeing a Christian therapist. (And I wouldn't change providers when I got insurance). So I only have 15 partially covered visits a year.

However, sometimes the rules just annoy me to the point I'm speechless. As described in my previous post I am requiring enough sedation to kill a bear to get a small amount of sleep right now. The insomnia is painful and overwhelming, and everything I do dissolves into tears of frustration because I'm just so tired.

After my few hours of sleep last night I was trying to spend the day being quiet. Which is really, really hard when you're manic, but again if you are in a mixed state and you get tired enough you can at least lay down and think chains of nonsense. Or write emails that make no sense and include words you create yourself because you no longer can type because you need sleep. (In other words I am benefitting from the depression part of the mixed episode negating some of the mania; if this were mania alone it would probably be pretty intense). Normally when I'm mixed I still feel one end or the other, just alternating very quickly and with great force. This time I feel both things at once.

Anyway, I needed to go get the prescription my doctor had called in last night for me to have sleeping pills. I've been using samples and needed a higher dose. I got there and was told there was a glitch and I needed to come back. I groaned because I barely got dressed to do this; I was planning on driving through and so I put on jeans and a bra with the sweatshirt I was sleeping in and combed my hair. No deodorant, no toothbrushing, and clearly this glitch meant going inside. So I did that, trying to stay away from everyone, only to learn my insurance wouldn't pay for the prescribed drug without a war that would take a week. Not an option. So I took a chance and called and emailed my doctor with the situation. A few hours later she called back, said she doesn't work on Sundays but got my message and wanted to help. (This is why I LOVE my psychiatrist). So ultimately she had to call in 2 different scripts today to another pharmacy (stupid insurance rules), warned me I may need a higher dose but she'll give it to me from samples, and she even had my birthdate memorized to almost the correct date. So then I had to get dressed again, this time with toothbrushing and all, drive nearly 30 minutes to the nearest pharmacy that is open Sunday nights because I live in a cow pasture, enter all my information into their computer (I lied to avoid giving a med allergy list; hopefully that doesn't bite me some day), and then I had to get a tank of gas and drive another 30 minutes home.

All this because the insurance doesn't like certain drugs. And the one I now have I know won't work for long; I've taken it before. Not that I want to use this long, nor should I need to, but I want something I know will work because this is getting really old.

I'd love to know who decides that insurance companies should control what meds are appropriate for any individual based on statistics...

drugs, drugs, and more drugs

One of my least favorite symptoms is insomnia. This is one that I tend to have pretty severely. However I'd gone a long time without having to remember how bad it can be. Mood stabilizers at high doses solve a lot of this normally. This time I am not doing very well.

Last night I took a sleeping pill, 2 (double dose) ativans, a higher dose of depakote (each increase should make me more tired and that was the increase to my previous HUGE dose that means normally I take another med to help me wake up in the morning), a small amount of risperdal (which has a drug category of major tranquilizers), and a sedating antidepressant. I slept about 3 hours. I took more ativan in the middle of the night and fought my way through another 3 hours. Now, at 6:15 I'm giving up. That's 8 hours devoted to fighting to sleep maybe 4. Today I may go to my mother's to see if I can sleep in an unfamiliar place. Sometimes that trick works for a little bit.

This isn't the worst it's ever been. The worst was sleeping a total of 4 hours in 3 weeks. Even a few weeks ago it was really worse because I was up all night and catching a few hours of sleep randomly. At this point it's just frustrating because I am out of ideas and it's one of the things keeping me from getting better.

Friday, June 02, 2006

Thinking

My mind is going over and over a new idea. I just can't find a good answer.

Yesterday in my therapy appointment I realized that I am able to say that I have a disability but I don't give myself leeway to be disabled. I don't think I actually know quite what my limits realistically are. In fact I know I don't, as this is in large part the reason I am on disability: I kept trying to do more than I thought I could because I felt I had to.

I have all sorts of training in disability. Mainly it was in dealing with patients with physical disability though. Physical disability is a bit easier because if you have a limb amputated, you obviously cannot use that limb. Mental disability is less easily defined. I'm used to working with people with psychiatric disabilities, but it is easy to not consider my needs to be like those of my patients because they are so much more severely affected. My patients are basically those people who show no potential to develop skills to live with any level of independence greater than constant supervision and cueing. (Often they need much more than this). That's not the same as me, and I haven't thought of my limitations like that.

Instead I've thought of my disability as "making things harder" and then when I couldn't do something I got mad at myself. One of the things that is hardest for me is that at this point, and for a number of years now, I can't go to church. There is too much stimulation and it triggers symptoms. For years now I've been angry at myself for not trying harder, instead of simply admitting that this is something I cannot do. I have a ton of paperwork waiting for me at work that I haven't been able to do. It never occurred to me that it wasn't getting done because I couldn't do it. I thought I was just being lazy or bad at my job or something. I'm not sure that I had considered anything beyond my abilities if I pushed hard enough until last night.

Somehow admitting this feels like giving in. Yet it also makes so much sense. This is what I will be trying to figure out now I guess.

Thursday, June 01, 2006

Maybe I am a little dangerous when manic

A few weeks ago I went to a therapy appointment much more manic and agitated than usual, even for a day in the midst of the worst part of this episode. It was at the time of day that the mania was always the worst, I was trying to handle quite a bit of stress related to my lab values and as has been the case throughout this episode the agitation was so bad that I was unable to relax or sleep. I had found an outlet, but sometimes my manic outlets risk my getting mentally caught up in it to the point I just wear myself out and keep going because I don't know how to stop. I think this had happened in this case.

One of my projects involved removing some old carpeting and cutting it up to be thrown away in manageable pieces. The psychologist said I should not be using carpet knives. I laughed. He persisted in telling me I shouldn't mess with the knife and if I insisted that would be a factor in the hospitalization decision that was pending at that time. I argued that I had no desire to harm myself with the knife, I just wanted to cut some carpet. He told me it wasn't that he thought I wanted to hurt myself, but that I would accidentally hurt myself because my judgment wasn't good, my thinking was not good, and my hands were very shaky. He asked me to promise I wouldn't use the knife. I wouldn't promise because I knew that I wasn't going to be very patient about waiting for something so stupid. I was fine. So he asked me to give him the knife.

I got it back this week. My judgment and cognition are better and I've been less clumsy, I think. Tonight I went to work on my project some more and tried to assemble the knife. I am still way too shaky. At this point I know to stop and not fight to do anything with a razor blade. I know that 2 weeks ago I would have kept going until I hurt myself.

And I had no idea....It's a humbling thought.