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

Friday, August 31, 2007

This is well, insanity

I don't know what's up with me. I'm firmly holding to a levels issue until I hear a result, but after being so tired I missed work (I NEVER miss work just for tired) last night I had the worst insomnia I've had in over a year. I slept a grand total of 90 minutes. And I've been no different than usual today.

I think my mood is fine. But I don't know early mania sometimes. I'm going to get a psychological check-up tomorrow to see if he can verify or point out anything. Today I've felt maybe a touch of mania, but not the huge signs that usually exist. I also haven't really felt any depression to explain the fatigue. Yet something is off.

It just feels so strange. Typically if I were cycling by now I would KNOW it, or on rare occasions I would be completely out of control, and in a way I know that as well, I just couldn't care less. I'm neither of those places. I think when I am forced to evaluate in a very quiet room in therapy tomorrow I'll find that I'm taking a trip through Mania-r-Us, but in such a mild way it's not a big deal yet. But still, it's just not right. I haven't even taken on one ridiculous project....

New links and seeking more

Another post with some (?) substance a few hours ago, but I finally got around to adding a bunch of links. Some are to people who have become part of my bipolar community. Portable health profile is something I recommend for anyone with complications of any illness. It's essentially a flash drive medic alert bracelet. It has a program on it that walks you through a history and all kinds of other information, then you wear it as a necklace or carry it as a keychain. I need it because nobody can be expected to keep track of all my allergies. My only issues so far have been that the first few days the cap kept coming loose so I taped it on, and my sensory issues combined with the learned reaction of years of psychiatric work make having something around my neck challenging. I am afraid of the key chain feature as I know I'd lose it and that's too personal. (It does have a password).

Most of the new links are people I've come to know and enjoy reading. I read a lot of blogs and these are favorites. If you want to be included on my list please leave a comment or email; I do need to monitor somewhat the content of the blogs I link out to. It's nothing personal, it's that this thing was started for students at a college where things need to be kept tame. Although those are my values and the way I'd write anyway, I am willing to read and often read things by people with different values or ideas. I just can't fulfill the purpose I want this thing to have and link to absolutely anything. We bipolars sometimes live far too exciting lives and all that.

Thursday, August 30, 2007

Dear Drivers

Dear Other Drivers:

I share the roads with you. I'm often annoyed by things you to as well. I react in ways I shouldn't sometimes too, and sometimes I try to "help" or "remind" you. But we all need to be more forgiving.

We all make mistakes. Sometimes we have worked 9 hours or so taking care of sick people plus 2 hours of commuting plus getting bloodwork drawn plus just not feeling well. During that time we didn't eat lunch, had one bathroom break, and didn't drink nearly enough water. Our heads might be swimming and we might be tired.

When we are tired we might forget to turn down our headlights. We know this is bad and we even appreciate quickly blinking them at as. However, when you turn yours on as well and shine them directly in our eyes, you are risking hurting both of us. This is particularly true if you are driving a truck or SUV and we are in a sub-compact.

See, we might have visual problems you have no way of knowing about. For example, one might have, oh say a combination of: naturally very large pupils that cause light sensitivity; multiple medications that cause dilated pupils and light sensitivity; and strabismus, which causes light sensivity. Oh, and because the strabismus wasn't treated young enough? One might not really have much functional use of one eye alone because the affected eye is so dependent on the other, and so if you happen to blind one in the eye that sees well because of how the glare hits it, well, that's how you find me drifting across the road at you as I blindly struggle to find the switch to turn off my lights so you might let me have a chance of making it home alive.

So please, please think twice before turning on bright lights (or even worse FOG lights) just because someone forgot? You've forgotten before too, I promise, and it's just best for all of us. I apologize profusely for the rest of my life, but I'm going to make mistakes sometimes.

An hour later still seeing spots and with a headache,
Yours truly,
Just Me

Monday, August 27, 2007

Being a good patient

Things change so quickly in bipolar-land. I have been doing so great, but over the last week felt myself getting more tired. I've been working and generally over-doing for too long, so I was afraid this would happen before I had a chance to catch up on rest. It did.

This morning I overslept by a lot. I woke when I absolutely needed to leave. That doesn't work well.

Then I slept all day, getting up only to go to the psychologist. I did that, and with his encouragement decided to take one more day off. So tomorrow I'll sleep again and hopefully that will give me enough rest to get back on track.

I can't believe how exhausted I am and how quickly it happened.

Saturday, August 25, 2007

Briefly

Not much to say really. Having a hard time with heat again this week, so basically feeling physically like crap even though my mood is reason to celebrate. However, I'm learning that I have little patience for feeling physically lousy because of bipolar when I am mentally well, because I have a firm belief it is a mental illness. I always seem to need hard reminders it is an overall chronic illness and doesn't discriminate.

Really glad about one thing. I asked for depakote level orders a while back because we changed my medication delivery and I wanted to be sure it wasn't affecting my levels. It shouldn't, but I respond oddly. Plus there's a need to be cautious as we know my levels are very high and I've had signs (hair falling out) that it's pretty high still. But for one reason and another the labs didn't get done. I emailed my doctor today to tell her I haven't forgotten but it will be another week at least because I consciously decided to reduce the dose (and therefore my levels for several days) for a night to try to manage this heat reaction. She's always encouraged me to follow my instincts, but depakote has not been up for manipulation because it is level controlled. I got a response that told me it's ok, to do what I need to do to feel ok. That means a lot. Two years ago I messed up royally by putting off bloodwork. The circumstances were different by a lot (I just had a level 7 weeks ago and have had them about every 4-6 weeks for a year; this is depakote and not lithium and the danger zone is quite different), but nonetheless she is not treating me like I automatically will always make bad med decisions because I did once. Keeping her updated is part of that, but even that shows we've moved on and I no longer have to prove myself again. It also means I am not being clumped as "bipolar: will stop taking meds immediately if not watched".

I needed that. Now if we just could have a nice cold front for the next 6 months or so.....

Wednesday, August 22, 2007

How not to start the day

I got up this morning much earlier than usual because I was very anxious. I sometimes have panic attacks when sleeping, and while I don't recall having one, I felt as if I had so I'm assuming that was the cause. Eventually I decided to just get up and start the day and get the anxiety meds going.

I signed onto email and had a credit card statement with a charge I didn't make. I spent an hour on the phone sorting that out. Many other frustrations followed all day long.

I just realized that I didn't charge for my drive time when I moved from one building to the other. See what I mean????

Bad start=bad day. But at least it's not cycling! (although the stress lets me remember I am most decidedly bipolar as I can feel the edges thinning a bit)

Tuesday, August 21, 2007

Let's see what you know

I'm hoping someone can save me from some research.

I'm losing my hair. Badly. It's from the Depakote level I have, and is a common side effect. It usually levels out over time and has for me before. But this is the worst it's ever been and it's looking scary. (Thankfully I have a lot of hair to lose).

I am using treatments my salon person highly recommended. They sort of help.

I remember in the past being told to take Centrum silver. I tried; it makes me wake up very nauseous about 3 hours later. I can't do that.

So what nutrients in it are beneficial? I'll see if I can sneak them in individually and go back to children's multi-vitamins.

Any ideas? (other ideas on the hair loss are welcome too!)

This close to needing hair plugs.

Sunday, August 19, 2007

A test will follow

I keep posting about doing well. I'm trying so hard to learn to live day-to-day, and for the most part seem to be succeeding.

However, the truth is that I need to be so careful. I'm facing the new week absolutely exhausted. I have not had 2 days off in a row in several weeks, and really haven't hadn't many weekends that were purely restful in the last several months. That's a bad thing. This week that is especially bad because I traded a work day for a weekend day, which works well in terms of not using a whole vacation day to go to the dentist, and I'll use most of my day off to relax, but it means that the dentist day I have other appointments, plus I have to work all day Saturday.

These are danger signs. I need to keep focusing on my 3 day weekend coming up, and vacation in less than 2 months, but this is the kind of thing that scares me.

If only I could take tomorrow off......

Another day, another milestone

Things continue to go so well I'm not really sure how to handle it. Yesterday I saw the psychiatrist again. For the first time ever I was able to say I've been feeling stable. I got an "in remission" diagnosis. I have only had that once before.

My only problem is exhaustion. I'm sure it is heat related. It's the reason for so few posts lately, and until it is cool again probably will continue. I work and I sleep. That's the extent of my life. But that's ok for the time being.

Thursday, August 16, 2007

Big deal

Today is a huge accomplishment. As of tonight I've completed one year of employment after my 4 month disability leave. I went back to work one year ago not knowing if I could do it. I also knew that I would be very likely to need to change jobs. That part did happen, and dealing with that change also was not easy.

I remember that first week that I was asleep by 6 pm every night. Now I wish I could go to sleep that early, but I can handle full days.

So much changed this year though. This morning I woke up for my PT appointment and realized I could barely move I was so tired. I didn't sleep well, I didn't sleep well the night before, I was exhausted from a hefty workload. So I called and cancelled PT and went back to bed. It was supposed to just be for a little bit, but I must have slept through the alarm. So I wound up going in late, which I vastly needed.

A year ago I never would have cancelled PT. But I am so much more aware now that the decisions I make now affect more than just today, they affect how long I will be able to do this. I have finally accepted the likeliehood of a time I can't do this and felt how near that time was.

Now I get to make the most of my life, taking the good time one day at a time, yet maintaining my preparedness for days I'm too tired and the time I eventually will need to decide to pursue other avenues.

I wish I hadn't learned all this the hard way, but I am so glad to know it.

Wednesday, August 15, 2007

If only I were this popular in high school

One of the good things about being an OT is that around here we're desperately needed. I've talked about this before.

Never did I realize this so much as today.

(Sitting on exam table while PT looks at my leg)
PT (getting confused because my form is filled out in therapist-ese and I'm talking it as well and he hasn't looked at my chart (big mistake)): So what do you do?
Me: I'm an OT.
PT: Oh. WOW. (Talk shop for a while)

Another PT that I know walks by, comes over, and chats with me for a couple minutes. He asks if I want a job, I laugh, he tells me he's serious, they need someone badly. I say that I'm actually watching for nearer positions, so maybe. Everyone got serious then. I got a tour of their OT facilities and everything.

Emilijie, I totally know what you like OP so much. Quiet. Decreased stimuli. Space. It was the antithesis of what I've always known.

The assistant was even more excited that I'm experienced, until I admitted it's not at all outpatient. Outpatient is so far from 7 years of geriatrics I wouldn't even attempt it without a lot of refresher training (and initial teaching; when I went to school there was this little veer away from teaching OTs modalities that has been undone in the last few years, but I can't officially do them except the easy ones.)

Nonetheless, it was kind of funny.

Sunday, August 12, 2007

I just never knew

When you hear the words "I think you have bipolar disorder" spoken by a psychiatrist the first time you know your life has changed forever. I remember holding my first dose of lithium in my hand forever and finally calling a friend to talk me through taking them. I knew it was time, but I was afraid to start the spiraling effects of the medication.

It's funny though. Even at that point, even now when I'm pretty thoroughly educated about what I'm living with, I still am surprised sometimes what is affected. I've been trying to ignore that I've gained quite a bit of weight since increasing to so much depakote. I also just haven't been the best eater lately because it's hard to find stuff that is appealing when I'm hot. I have been surprised this summer at the extent to which the heat can affect me. It has since I was first on lithium, but this is the first year heat has been absolutely disabling. Last week I made it through work and thought I had put in a lot of hours, only to learn I hadn't even hit the number that is supposed to be my minimum.

The thing that I never knew psychiatric illness could change though was my hair. I have known that since I started Depakote of course. Depakote can cause hair loss and it always has for me if my levels were rising. It's one of the ways I can very accurately predict my level without bloodwork. The consensus has always been that I have significant hair loss but that it's toleralbe because I have very thick hair. But this time it has gone farther than ever before, and my beautician is able to see lines where it is thinning. So, I now get to use treatments on it and add even more vitamins to my list. It's one of those things that is easily fixed by backing the dose down a bit, so I'm not that upset, but it's weird.

This week is when I'm going to start my new psychological adventure. It is time, I believe, to begin to determine how to not put myself in the same position I did this last time. I made myself miserable for a long time by insisting on believing that "better" meant back to the way I was, the way I knew myself. Instead, when I finally gave up and accepted that I lost ground that was permanent, I was feeling better (in new ways) in a matter of weeks. I do not ever want to not believe an episode will totally go away (because they have and do), and I don't want to focus on the idea that my path with this illness has been a slow but fairly steady decline over time. That part just goes to the whole idea that the right medicine for me hasn't come along yet. And I do believe it will. But I have to balance having hope with realism, because this last time I kind of messed that up. It was a really bad idea to let myself believe that I wasn't better until I was like I used to be. Nobody is the same now as they were 2 years ago, and illness doesn't change that. It just makes it harder for me to understand the passage of 2 years in a blur.

Let the healing commence.

Thursday, August 09, 2007

Learning

I was beat by the heat today. I woke up dizzy and so tired I couldn't function. I stayed home, slept until 4, then went in the evening to do a few hours. I'll now have to work Saturday.

But I admitted I couldn't, admitted I had to be "different" (always hard for me), and I survived.

Go me.

Wednesday, August 08, 2007

Bipolar Good. Heat Bad

I'm continuing to feel really good. I'm managing to continue through even some stressors, so I guess it's real.

The only thing is that the heat is KILLING me. I barely am able to work because I'm just so hot and sick from it. I'm managing to do remarkably well with lithium and not really getting toxicity issues, but I am not feeling great. I'm so tired that I'm sleeping a minimum of 13 hours. I'm drinking at least 2 liters of water, plus a can of pop, plus random other drinks, while at work, then whatever else I drink at home, and I'm not peeing much. Going to have to get that checked. Especially since I really don't sweat, not nearly as much as I should be. (Side effect).

My thinking is getting slower and slower. Another week of this and I'll be back to infantilism.

I'm actually struggling enough to understand why I'm supposed to have FMLA paperwork in place all the time; I'd take a FMLA day if I did.

Oh well.....It just gives me extra reason to understand why most people hate cold.

Monday, August 06, 2007

Overly Therapized

Today I finally acquiesed to what I have known all summer, that I need a round of PT for a knee injury. I have a long history with this knee, and it is weak. I banged it around a few times this summer and now it is sore most of the time. I can feel it isn't moving properly. I kept trying to put it off, but finally admitted that I needed to have it checked. Which I knew meant PT. And PT it is. Nothing against PT, I just don't want more therapy after I'm done doing it all day. Nor do I have time. But I'll make time. I've made it about 15 years since I last had therapy; that's really pretty incredible. But ick!



On the other hand I finally started verbally agreeing to think about reducing my bipolar therapy sessions by one per month, at least while I am doing so well. I really love the idea of a break, I did fine while the psychologist was on vacation, and I am starting to believe that I'm going to feel well for a while. With the exception of some fairly significant but expected mania after I had to go off Lamictal so abruptly I've really been doing well since May.

Even if I do drop that one psych session there is going to be way too much therapy in my life for a while. Oh well, win some/lose some. If I get really lucky I'll know my PT and maybe talk them out of some of the sessions; I can exercise at home and I don't think I need a lot of ultrasound or anything.

But it's a way to a bigger tax refund! (Not sure how sad it is to think that this occurred to me.....)

Saturday, August 04, 2007

Bluebirds and rainbows

The last few days have been something I've been awaiting for so long that it seems unreal that I'm here. I am happy. The last time I felt this good (and not too good) was years ago. Absolutely no mood swings.

Partly this just has been building ever since my last few med changes. Partly this is because my experience Thursday was so incredibly empowering.

I needed this so much though and the timing couldn't have been better. Finally admitting I lost some parts of myself that I was pretty attached to (like the ability to be nice) has been hard enough, but admitting that I didn't know if I could ever be happy about anything again was much, much worse. Now I know that at least that much isn't gone for good, it's just been on a long vacation.

I spent today completely knocked out. It was a busy, busy week with 2 emotional days in a row at the end. Never easy. Then it has been the hottest days of the year, and the heat has nearly wiped me out. I had to skip several lithium doses and finally got that going again today. Hopefully it will be cooler this coming week. That was another way though I could tell I'm doing well. I emailed my psychiatrist to tell her I had to do that, just because we know I really need lithium. Her response of ok, be careful, let me know how far I've come. I was learning to manage a lot of adjustments to different meds before I got so sick 2 years ago. After I was so sick I was terrified to adjust anything alone. Now I'm allowed to adjust even lithium alone (normally I couldn't do this, but I take a dose so small it is not likely to give me even a minimally effective blood level on normal scales; I have signs of toxicity at the minimally effective level point, so we treat it as if we know it is dangerous if myu levels are at the typical "too high", but also dangerous based on body signs. I am so glad I'm well enough to be trusted again.

Thursday, August 02, 2007

Closure, ain't it great?

Did you ever see the Friends episode where Rachael decides she is romantically interested in Ross and decides to tell him the same day he returns from China with his new girlfriend, having given up on her? She goes on a blind date to distract herself, gets drunk, borrows the date's cell phone, and leaves a message for Ross about how she has moved on, "and THAT, my friend, is CLOSURE". All sorts of comedy ensues when he gets that message.

Well, today was a rather amazing day in the closure department. I certainly didn't plan for it. I planned for a long day. I had a continuing education course all day, and while it was a really good course, sitting still is not my thing, nor is leaving very early as I had to do. I then had an hour plus drive and then a job interview. It was a job that sounded good and was closer to home. It was not a job change I was seriously considering without an incredible offer, and so I was able to be fairly relaxed about the whole thing.

I got there and had a large shock. Waiting to meet me was the rehab manager, known to all of those in my world as The COTA (assistant) From Hell. Go ahead, read that link, I'm not going to go back through that whole story again, other than my one sentence summary: she worked with me before and caused me to have to be transferred from where I had been working by spreading lies about how I was "psychotic, committed, on antipsychotics (ok, I was, but still nobody's business)" and heaven only knows what else. She and her accessory would sneer in team meetings "What does she know, she's crazy?". All that is plenty bad enough, but on top of that there were serious clinical issues. I'm not going to go through them because I'm tired, but let's say she was not doing her job, a cognitively intact patient was able to describe this in explicit detail for me and my supervisors, and I handled it and other situations precisely according to what I'm supposed to do. She got in trouble so she stirred up more trouble. That time she managed to extend it to include another totally innocent victim, a vendor friend of mine. Words were actually thrown around insinuating I somehow caused a 93 year old woman to get pneumonia and die, which would be tricky if I were there, but when she died I was at home on disability and unable to see well enough to drive, along with a lot of other problems from a medication reaction. The process was started while I was there that led to her eventual termination. The company made it pretty clear that they totally supported me but did have to go through procedures to get rid of her, and they ultimately did.

At the time of the incident I did not sue. I considered it, but it was more complicated than just an ADA thing, and it meant going very public, even more than it would have been to start with because there were 4 other women suing one of the parties involved for discrimination. I had a lot of evidence, but it gets all murky with contracted work. I had just gotten hurt so badly by someone knowing that I was all for not telling anyone. So I didn't, and then it quickly became obvious that in a way it was really good because I loved the psychiatric work that I was transferred into doing. It let me be far from the ugliness.

I think if this happened now I would sue. Not even so much the companies, but her for defamation and a lot of other things meaning "you're a big meanie". I had documentation for my supervisory issues and witnesses and proof she had said some pretty offensive, wrong, things which had come to her attention in her role as department manager.

Anyway, so there we were. I thought at first of just ending the interview before I wasted an hour of my life and a lot of cortisol, but at least it was cool in the building. And I was curious because the pictures were so pretty. So I saw it and answered many questions. Her questions, of course, were very pointed and could loosely translate into "Just Me, aren't you an evil old cow?" "Are you not a TERRIBLE superviser?" "Don't you treat your assistants like crap?" A couple probably violated the ADA because they were gathering data about something that could affect how I do my job because of my disability, based on her prior knowledge of the disability. I don't care about that.

I was SO proud of myself. I answered every question straight back, and I talked about the good situations in my life. I talked about the teamwork with most assistants. I talked about the good I do. I talked about my responsibility versus my assistant's responsibilities. I admitted that I get frustrated if assistant's don't pay attention to the information I give them, but since that is their job I really think that's fair. (I believe she was one of the ones that I had issues with this on, but I'm not even sure). It may not have been a 100% smooth interview because it was so very not anonymous, and the bias was clearly against me from at least her, but it was a chance to finally fight back. The worst part was that I could not maintain eye contact with her. Everyone else (eye contact during stress is something I only do with a lot of thinking), but not her.

I wrote the HR person an email withdrawing my application. I explained that based on history I will not work with her clinically, and also that even minus clinical issues there had been major issues related to improper treatment of me related to a disability. I told them that I understand if they throw my resume away, but that I was very impressed with them and would love another chance if one arose. I tried hard to make it a simple statement that there were major issues, that there were 2 sides to them, and that mine was valid. I hope it came across like that, because to them she is their employee telling them what a psycho I am.

I've wondered before what would happen if this came up. Now I know. And instead of re-opening old wounds, finally, finally I have won.

Wednesday, August 01, 2007

Fast but Fat

I am allotting only 5 minutes for this as I must get to bed, like an hour ago.

The last 2 days have involved shopping for clothes for this interview. I retain a lot of water sometimes, I assume from lithium issues. It's worst if I'm hot and these last few days have been the worst of this year. I had to clock out and take a nap on my desk at work today because I felt so crummy.

But the worst part by far has been the clothing stores. I knew I had the water weight which is why I just went for new clothes. Even my bras weren't fitting right. So I got a bigger bra (ah!) and pants that seem huge and will be eventually, but right now they are just right. I could not find a shirt that worked though. Either they make me look too old, they have long sleeves (I think not), they are made of a fabric that makes my sensory issues reel, or they are designed to be flowy and look like maternity wear on me. Not such a good thing.....

I finally got one shirt that sort of is ok; not fabulous but it is going to do.

I never realized that skinny just is simpler.