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, March 31, 2010

Coming clean

(Typos courtest of Noah the huge orange cat)

I'm not doing great. I realize I've said this a lot lately, but it's becoming more and more clear. I am not having so much bipolar as I am severe anxiety. Which can be part of bipolar and certainly is related, but I am having more and more trouble staying happy because I'm so incredibly anxious. The problem is that my bipolar treatments make anxiety hard to treat because the MAOI limits the meds I can take, I can't tolerate any more Seroquel (which is what Dr. Brain prescribed but it knocks me out), I'm already taking a pretty good sized dose of an addictive med (Klonopin), and the non-additive choice I have works for such a short while that it is not worth much. I don't know if I'm developing tolerance to Klonopin already; I don't think that is it. For one thing it took me nearly 10 years to become tolerant to Ativan, and when I did it was after a prolonged period of taking it more than usual. For another I'm not on THAT much Klonopin. I did start off at a dose higher than maybe normal, but it's not like there has been any suggestion it was time to back off. And for that matter I was mainly only taking 1/day for about 2 months. Dr. Brain told me that when someone like me achieves remission after so long that protocol is going to be that nothing changes for an extremely long time, many months to a year or more. Obviously they'll add meds, but there won't be weaning. So maybe I've been allowed to stay on more Klonopin than was ideal for this long, but I doubt that. It's just not that much.

The problem is that I'm not having success contacting Dr. Brain. Originally when this started she prescribed more Seroquel and did answer my email asking for much less than she proposed. Since then I've tried to make it until my next appt. and felt I couldn't. I've sent several emails, including one about why Seroquel wasn't working and heard nothing.

Normally this is when I'd get mad and call her office and really pester her if I had to. Or pull out the code words that mean pay attention. But this isn't normally. This is the time in radiation that she is most likely to be ill and exhausted, plus there will have been a personal thing this week. And I'm not on the verge of death or suicide. I just need to be patient unless it becomes emergent, which it is not.

But the thing is that feeling like I don't have my usual options to turn to is making this much worse. It's hard enough with Dr. Brain not being accessible, but then with Dr. Mind not here to talk me through waiting the next 10 days out until I see her it is TOO MUCH. It's also been a little longer between visits with Dr. Brain than usual and that has a history of getting tough.

I'm pretty sure that what is going on is that I'm experiencing PTSD without it just being something going on underneath the bipolar for the first time. I've had the diagnosis for a long time but just considered it a minor evil in the scheme of things. When you have 5 or 6 psych diagnoses you tend to do that, I think. They can't all be of the same importance, so you pick one and ignore the others. Because really, when it is beneficial to list bipolar I, PTSD, severe generalized anxiety, OCD characteristics (barely enough to qualify but if you look at it a certain way then I do), etc.? Never, that's when. I don't usually even admit to having PTSD unless it's time for a scary medical procedure.

The problem is that I'm not equipped for this. This isn't what I know how to handle. I can handle mood swings and hyperacuity and irritablity. Relentless anxiety that doesn't respond to mood stabilizers is new (aside from right after the hospital which is different) and while it seems like it should be minor it is not.

This morning I sat down and made a list of Financial needs/Financial Wants/Financial things that can wait and I can calm down about, figuring what needs done to get me to the ultimate goal of windows in the next few weeks. I know what windows I want. I know my mother thinks I'm stupid because I'm going for a more expensive brand, but I can get online and read about these. I can read great reviews. I can tell there is a difference in quality, and I don't know that I could recognize well-down but not good replications. So I'll pay very slightly more for that choice. I just need to get money shifted that direction, heavily, for a few weeks. Further I can't go through more estimates. Having people here stresses me out too much and I've reached my limit. The list helped, but I just found 200 other things to be stressed about. I'm not really worrying, worry being something I"ve learned to cognitively control. Instead it's just stress.

I had hoped to be asleep by now and that's not happening. So it's time to shut the computer and rip seams out of things for a while so that maybe it will help me relax.

Please God, let me relax.


Overload!Overload! Brain exploding.

Yesterday started with a panic attack and today is just as anxious. Money is driving me up a wall. I promised Dr. Mind I'd totally stop trying to figure out the remodeling stuff for a couple weeks because of this, but then other things happen and money is completely making me nuts.

I can't believe it is only Wednesday. I really could stay home and sleep all day today. I'm really hoping that Saturday I can rest a good bit. But it will be nice and I may want to be outside......

I need to go to the car and get a few things.

We'll have to do 2 days of accomplishments tonight. I fell asleep before I got there yesterday.

Monday, March 29, 2010

Today's YF-9659

OK, so I have NO CLUE what YF-9659 is, but when I went to type in today's accomplishments for the next thrilling saga in that sequence that filled in for some reason. And it struck me as funny.

Today finding an accomplishment is a bit harder. I overslept and missed a dr. appt to get the orthotics I needed desperately, so I rescheduled my whole day around that. But there is accomplishment there. Oversleeping isn't good, but at the same time my body was tired and it did what it is supposed to do. (Granted there was a bit of a med error involved, but why be nit-picky?). But I did get the orthotics, learned how to use them and oh wow what a difference. I was supposed to try for 1-2 hours, more if I could tolerate. I wore them for 6 and even then only 1 foot was hurting. The foot with tendonitis felt better today until I took the orthotics out than it has in months. And the bad ankle is so much more stable when it is forced to be. I'm going to love these things despite being sad that they don't expect immediate relief.

I think the big thing today was that I had a hectic day and I kept my cool.

Oh, and I ate beef. That's like 5 times since September........STrange achievement I realize, but it's not the beef that is important as much as the fact I ate something different than my few favored foods.

I made it through a hwole day with my emergency medical alert necklace patched to my neck. Which is huge because messing up a patch means throwing away a $20 piece of plastic and I fiddle with that necklace all the time. I did finally remove the patch a few minutes ago because it was itchy and I've learned if it itches it needs to come off. I was right, it was getting really red under there.

And now I'm going to sleep and recognizing that need and following through is the biggest thing of all today.

Tomorrow is a major day of schedule juggling. We'll see what happens........

Sunday, March 28, 2010

Today's YF-9659

OK, so today hasn't gone as planned. I did do laundry. I did make the ubiquitous soup of the week/flavor of the month. I did sew some. I did not rest. I have tried. I just can't.

So today I did two things. One, I wrote an email to Dr. Brain asking for anxiety meds. Two, I found a website the rest of the world obviously has known about but I haven't and I have been laughing out loud. Hard.

That website is cakewrecks.blogspot.com

My favorite is this one, which made me laugh until I cried. Both my cats are staring at me as if I have lost it.

Perhaps I have.

My secret fear

There's something I've not talked about much yet with anyone. I feel like I don't have time with Dr. Mind right now for anything but the most pressing things, and I'm ashamed to admit it elsewhere. But yesterday I heard words come from my mouth that made me realize more solidly how much I fear this.

I've mentioned many times that I'm going to be an aunt in a few more months. I'm excited, I'm making baby things and have had a lot of fun anticipating the baby. Recently ultrasound pictures came and they are really good quality, enough to know a bit about what the baby will look like, although it certainly needs to get much fatter. (Actually, come to think of it, in only 1 week the baby will reach the point it could live if born. Which is crazy when you look at the ultrasound and see how scrawny (and beautiful) it is. Mainly it looks peaceful, which is good since my sister thinks it is afraid of the ultrasound machine. (There is one funny shot of the baby high-tailing it away from the probe.). Yesterday I was telling a couple women about the baby and the ultrasound pictures, and how clear they are, and I said something about it having very delicate features, a deep love for thumb-sucking, and a tiny nose. Then I said, well, I guess that would be MY nose. I have an extremely tiny nose. Small enough to affect what glasses I wear. It is a direct inheritance from my grandmother.

But later it really hit. This baby is really related to me. It shares my genes. Please God, not the scary ones. But this child will have as much biological relationship to me as my half-brother, and while he and I don't really look alike, we can have the exact same facial expression and have the appearance for a moment of looking more alike than I do to my full brother.

And I am afraid. My sister and I get along ok, but we are very, very different people. In the past we have not gotten along all that well at times, including one time that I believed I could never have a relationship with her again because the hurt went so deep.

In the past I have loved 3 children, the children of two of what I thought were my best friends. As it turned out they weren't such good friends. One was using me because she had her own set of psychiatric issues and I was a willing target, and the other judged me for my illness and blamed me for it because it meant I didn't have a good relationship with God. Then she had people who had never met me vote on this. All three of those children called me Aunt. Losing them was as painful as losing the friendships that weren't what I thought they were. And now this child will call me Aunt, and if I lose that child because of some problem with my sister I will not know how to survive the hurt.

I'm going to be an aunt. I'm terrified.

Saturday, March 27, 2010

Achievements of the Day, Day One

I think I said this yesterday, but Dr. Mind is on vacation and I won't see him for 10 days to 2 weeks, depending on if someone cancels for the 10 days. Since I've been doing twice weekly visits the last few weeks and struggling, this is challenging. Usually if I'm not doing well before he leaves for a vacation we work towards getting to a level point that I can handle. Unfortunately this time it didn't work that way because I didn't really fall apart too much until last weekend and there wasn't time to get me stabilized. We did get off the hard topic, but just wound up with an even harder one: I still have limits and I have to start recognizing and respecting them.

Anyway, one of the things that came up Thursday was that I stayed home sick (and exhausted) and my stomachache finally went away when I talked to him for a bit and relaxed, then returned Friday morning when I knew I had to work. So we talked about how I need to just talk, whether it be to my cats, to a tape recorder, to myself in the car, to God, or just writing. He doesn't know I have this blog, although he does know that I do a lot of writing and only feel safe with writing where I can password things. This stems from having my diary read as a teenager and I no longer trust anyone to not invade my privacy. So I promised that if nothing else I would write a lot. I think I promised to write at least 4-5 times per week. Which I was doing until things started to get so stressful and my average posts have declined accordingly, which is backwards if I'm using this blog as a coping tool.

I realized that as I'm trying to learn to pay more attention to my body (ie, what hurts, when, and how much; it turns out that I don't like that because I'm realizing that first my ankle aches a lot and second if I pay attention I'm getting headaches daily after reading a lot, and since my meds mess with my vision I need to get to the eye doctor), I also need to pay attention to what I am doing that is good. So my goal is to try to find something every day that is an achievement, some tiny way I'm overcoming what feels so overwhelming right now and then when he comes back I'll actually have a positive list to give him along with all the stress.

So, here is the first day's achievements:
-I vacuumed. That doesn't sound like much but it is the first time I have used my own vacuum in about 8 years. I haven't been able to stand the noise. I did use my mother's once because she was coming back from vacation and the pet sitter had been a slob and I knew my mother would freak and was trying to help prevent some of it. But really, I haven't been able to stand a vacuum in over 25% of my life. I've had to have help for all that time.
-I shaved someone. That seems small and like part of my job. And it is. But thanks to a childhood experience that Dr. Mind finally gave me some information to help me understand that I may not have had enough understanding to realize that when I remember being attacked with shaving cream it may have been something else, I finally decided that it was time to try to touch something I've avoided for years. This man is dying and needed a shave and so I did it, bare-handed. The only other times I've touched the stuff has been with a layer or two of gloves on. He was so pleased; he is medically not showing drastic decline but talking like someone at the end and his heart barely works so I think he'll slip away by Monday. But one of his comments was "I'll look so good at the end now". Which made touching the stuff totally worth it.

And since I started at 4 AM and just finally got home at 8:45, I think I'm going to find some food and meds and get some rest. I just put in one very intense day and tomorrow I am grounded. I am allowed to sew and do laundry and make a pot of the soup of the moment (carrot orange ginger soup; this will be my 3rd batch. Taste aversions are so strange, and I did finally find proof that Emsam (the patch) does cause this in a very tiny percent of people and since my hospital doesn't use it much no wonder nobody had heard of it; it just hasn't come up because they've not had enough people on it) and read and play online and that is it.Oh, and I am allowed to work on the email for my boss that is going to explain that either I need my contract to decrease the stress or I need to move to another one after this one is up in about 6 weeks. And next weekend I'm on the same restriction for the whole weekend. That was another agreement with Dr. Mind. I have not rested nearly enough. The day I planned to rest on vacation I wound up going to see him for help dealing with the whole "broke my ankle and was too afraid to speak up" trauma.

So, more tomorrow. You all get to be my therapists this week. Let's see how you measure up to Dr. Mind. After all, if you're good enough you could save me a lot of money.......:)

Anxiety anyone?

I guess my sleep problems are over because I was back to AWAKE at 4:00 this morning. Which is good, that's my normal. But I'm anxious enough to have trouble slowing down. It's now 8 AM and I have:
  • -Washed a sinkful of dishes
  • -Washed, ironed, and re-hung 2 sets of curtains
  • -Washed the cats' bedding
  • -Partially finished 2 sewing projects
  • -Straightened up the whole house
  • -Moved my compost bin to the basement where there is less light and maybe the wheatberries I threw in there will quit growing grass (I'll try to take a picture, it's actually pretty funny)
  • -Made 2 shopping lists for later today
  • -Paid my homeowners insurance
  • -Took care of another financial obligation
  • -Partially sorted out my socks into ones I can't wear with my brace and ones I can
  • -Continued my ongoing research into vermiform composting and trying to find the best prices. Oddly worms cost about as much as the composter.

And since I have someone coming to do window estimates again in a couple hours I need to go so I can sweep, mop, vaccuum, change the kitty litter and wipe down the bathroom. I really want to get the painter's tape up in there today to motivate me to paint. The painting takes only 30 minutes or so because the room is so small, I don't know why I keep putting it off. OK, I do, I've been exhausted and I'm not putting it off, I'm taking care of myself. But I want it done, badly.

More later.

Wow (And, New Poll!)

Ok, I don't know yet what I'm going to do with this, but it is an amazing gesture.

After my post about the scary window man, I've been in contact with Sears several times. They have repeatedly assured me that he will not know who complained. I still worry about that as I can't imagine how it could be addressed without him being able to figure it out. Regardless at least it is being addressed.

The amazing thing is that they have offered me a $100 gift card. I don't know if I'll take it, I don't feel Sears themselves deserves to be punished. However, that's an impressive offer,and I will remember that they really did reach out to fix things more than I remember the scary window man. Eventually.

Even my mother, who is not full of insight into why things are upsetting has mentioned the likeness this man had to my father. Which is exactly why neither of us reacted the way we should have, and is also a huge lesson in how much he still impacts us, even as it is nearly 12 years since I have seen him. And I imagine that is playing into this current serious anxiety issue, as I just didn't need one more reminder of him and what life was like with him.

That's the problem with agreeing to re-live any part of my past. It brings it all together and so every issue I've ever had comes back. But at least I can do this and there is a good reason to do so. I do know though that each time I go through something from my past it gets a tad bit easier. Even though I'm really having a ton of anxiety and it's unpleasant this time around I also am talking more freely and being able to learn a lot more than ever before. Which is the whole point. I'm beginning to learn that I had a linear view of life post abusive family. I thought for many years, probably right up until Dr. Mind, that it was a sequence of survive the home, move out, discuss things that happened and how they affected me, go on with life because those things were "better" now. I was wrong. It's not that what people tried to tell me for so many years is true (that I can't ever get better and that the kind of abuse I survived will always affect every minute of every day), but it also true that I will always be touched by my past, and probably more so because my present and my future are so connected to my illness.

And, as I said, total free association here. I fell asleep before I finished writing this and I honestly don't even know what it says at the beginning.

Friday, March 26, 2010


I now know for sure what is wrong with my stomach, why I felt crummy enough to stay home yesterday. Stress.

It was pretty easy to recognize this when the stomachache went away about 30 minutes into my time with Dr. Mind. And is back now that I'm getting ready to go to work. It is especially true since I'm so tired and have to work some tomorrow, and it appears they are shorting my hours a bit now.

The thing is that I've been seeing him twice a week for the last couple weeks and now he's on vacation. So if something opens on the cancel list I'll see him in 10 days and if not it will be 2 weeks. Which is a long time for me.

So I have a number of things to do to try to relax a bit. One of them is writing here. So be prepared for some free association, and possibly a lot of posts as I really need to get calmer.

(I also have a request in for a change to my anxiety meds. Don't know if she'll get it (radiation), have time to handle it (radiation), or grant it as it is a request for a tiny dose of Klonopin mid-day and I'm already on a decent dose of that. It's just that my between doses of Klonopin med only works for a short period and I am taking more of it than prescribed, which is ok in that I am on a very low dose, but it needs to just work all day without me having to remember to things repeatedly.)

Thursday, March 25, 2010


I'm thinking that perhaps I need to make a long list of things I don't do because of my childhood and what I learned, and then start doing them all.

For example, staying home today. I don't feel that good. There really is something going on, it's just not major. But I'm well enough that I've been up doing easy things. Then I have to rest again. until recently I NEVER would have stayed home like this. In fact, back in November when I had a horrible bug that wound up with testing for appendicits, parasites, and involved 2 ER trips and 2 days off work even though I got sick Friday evening, I felt rotten all that afternoon. My stomach just didn't feel right. I mentioned it and was teased that it was psychosomatic because of all the patients getting sick, but I'd felt bad before that started. Nonetheless I made it through the whole day and was driving home before I admitted I felt awful. The vomiting started soon after I got home and continued for days.

I'm so proud of myself for staying home and resting. I needed that more than anything in the world. I wish I could nap a bit more, but even if I don't at least I'm sitting still most of the day.

There are so many other things I learned wrong that I need to re-learn. I used to joke that I had to take "grown-up lessons" because some things that were so simple were so scary to me. Well, that may be true. Stupid things like:
-it's ok to feel sick
-it's also ok to admit you feel sick
-AND, it's ok to take time off for more than mental health (and it doesn't have to be a crisis to do that)
-it's ok to set boundaries for work
-It's ok to feel and admit pain. Pain IS treatable and usually means something isn't right. Like I tell patients and believe fully for them, all the time.....
-it's ok to tell people who are scaring you to leave your home
-it's ok to not chose to be afraid
-I am the only one who makes decisions about my body. I don't have to let doctors be mean or inconsiderate just because they are doctors
-It's ok to be tired. (On this I've gone from the extreme of knowing I can't get tired to not paying attention when I do).

Who knows what else. I'm going to try to nap a bit. We'll see.

This is weird

I think I'm actually not at all sick. I think I am so tired my body is sitting on the sick fence, almost like my body is forcing me to rest. Fine by me. I have lots of symptoms of stomach flu, but I'm not getting actually sick. I got hungry and ate some bland stuff (not that this is surprising since I hardly even own things that aren't bland) and I've slept, and I
right now the worst part is just that I ache.

So I'm going to go back to sleep for a while and take advantage I guess.

At least this time even if I am sick the patch won't make it worse; it somehow got just wrinkled enough to pull yesterday so I took it off early.

The only icky thing I have to work on Saturday now. Blagh. But I can't give up the $. Too many house expenses right now.

Still alive

I slept again last night. I'd set a time limit that if I was still awake I'd do my relaxation tape. I woke up just fine without.

I don't feel very good though. My stomach is really upset. I'm hoping it is just stress. Money is making me crazy at the moment. I feel like there is just money coming out of EVERYTHING. The most recent major stress was a letter from my mortgage company basically telling me that everything my new insurance agency told me about changing policies was wrong and I have to pay a whole year's premium upfront, and then in Sept when my escrow is reviewed I'll get the balance back. I already got the refund from my prior company, which is about half of what I owe, but the whole thing is just frustrating. I need a 2nd job or something.

I also finally decided to stay home. I'd be vomiting if there was anything to vomit, and I feel bad everywhere; achy, headache, nausea, stomach cramps; dry heaves, dizziness, etc. I knew this would happen eventually because of not sleeping and stress, and it has. I'm working very hard right now on listening to what my body actually is saying. Learning that I've managed to ignore pain to the point of running long distances on a broken ankle and never knowing it was broken was an eye opener. As I pay attention I realize things like my right foot, the one with the tendonitis but not the bad ankle, it's no wonder that it was getting into the worse end of soreness for plantar fascitis. I thought it was all related to the ankle. But yesterday I didn't tape as well as I usually do and realized that I've had symptoms of this in that foot for at least a few years. I know that the x-rays showed that while that foot has more arch than the other that it still is less than normal, still enough that the orthotic will "be more complex" than the sample he showed me. Again, I've put myself down for being sore. So in the interest of taking better care of myself, I'm staying home. This isn't going to get any better if I go to work.

I've really come a long way on this. It used to be that no matter how physically ill I was I'd make myself work. I never would go to a doctor either because nothing was every "that bad". I had a friend who would pressure me into going and even into taking sick days occasionally. But I was so reluctant to ever complain that I'd been working 2 years I think before I took my first sick day ever.

I'm also realizing I don't know how to be nice to my body. I know how to push, but I don't do much to just relax or feel good. One of my next goals when I can afford it and am ready is to get a pedicure. My feet have been through so much, something nice might be pleasant. It's not not happening for a while......

I just wish someone would answer my text so I could relax and sleep.....In reality if I were to get sick today is the best possible day; no evals waiting, lots of tx help today, treatments can be done Saturday easily enough and I have overtime so they want to shorten my day anyway.

Wednesday, March 24, 2010


Dr. Mind had a last minute cancel, I took it, and he helped. I actually managed to fall asleep and more or less stay that way last night. I feel better. Exhausted, but at least thinking of work isn't making me want cry. Honestly just hearing "this isn't good......we need to fix it helped a ton" and I started relaxing a bit then.

This weekend is going to involve serious rest. I don't care if it is drugged or whatever, I'm going to rest a ton. Next weekend I'm going to make a "Just Me does nothing" weekend.

I need to get ready for work. More later.

Sunday, March 21, 2010


That's about how I feel. I took a nap but I am still so incredibly tired. I dread sleep because I know that it may be bad again. I've had my tiny bit of Seroquel and in a bit I'll take the rest of my meds. Hopefully I'll be asleep early tonight and sleep soundly.

I got nothing done this weekend. I moved stuff out of the bathroom for painting, then didn't paint. That will be stupid by next weekend when I have more window estimates and will need things neat and tidy again. I seriously doubt I'll have time to paint, so I'm likely to be either moving the bathroom stuff back this Friday or stuffing it in some closet and having a weird, empty bathroom when people come. I really don't care though what they think, I just want good prices.

I feel oddly depressed. That's been going on for a week or so, off and on, but right now it feels much more real. I think that is mainly the dream though. It was so scary, and I'm struggling with the idea that some of it was real. The problem is that I have absolutely no clear memory that such a thing happened, and no way to know if what might be a fuzzy one is true. Essentially the dream is based on something that did happen. My mother tried to leave and my father got out a gun to kill the pets. She stayed, the pets lived. I was away when this happened and found out about it when my mother told me, so I have no memories of it. The dream now is that he is forcing me to watch him shoot the pets I have and my mother has now. Clearly that part is made up. But I do know that something in my past makes me terrified of guns, and we had so many pets. There is no way for me to remember all of them, much less what happened to all of them, and so maybe I saw something/was forced to see something scary? I have no clue. I don't want to know that one.

I just can't explain how tired I am and how much I want to sleep and not work this week. Last week was totally draining and I'm not ready to go back. If I don't sleep I'm going to take a sick day, but that just means working Saturday and I'm not interested in that. Tomorrow I'm scheduled for 8 hours already, and I have to do paperwork from Friday, when I had to leave due to being biohazardous.

I guess I really should change my sheets and then get ready for bed. I'm hoping to be asleep by 9:30 or 10:00. I'm also hoping that I don't work long hours this week. If I can just get home by 7 or 7:30 then I can actually rest and start to feel ok again.

I can't believe how short this weekend was. I also can't believe I used to sleep like that all the time. I don't know how I survived.

PTSD 1, Just Me -1

Dr. Mind has expressed surprise that I've not been complaining of nightmares during this. Well, that's over. I don't know what happened yesterday, nothing new upset me, I didn't think about scary things much, but it hit. Hard.

First was not being able to fall asleep, despite taking meds early. That's a bad thing. Finally I did fall asleep and woke up screaming and terrified at 1:45. I got up and did something, as I'm supposed to do in that situation but couldn't calm down. Finally I took valium and slept an hour before more of the same nightmare woke me screaming. I got back to sleep within an hour that time, woke once but went back to sleep because I still had a lot of valium in my system. Then I woke 2 hours later sobbing, and had obviously been crying for some time. Same nightmare.

So I guess I'm on the extra Seroquel Dr. Brain prescribed earlier in the week. I've been hesitant to take it because of sedation, but I'm not doing that kind of night again.

I truly thought I was going to make it through this without this happening. Guess not.

I hate nights like this

I couldn't sleep. I finally took my PRN Seroquel and fell asleep about 12:30, only to wake to 1:45 with a bad nightmare. It's now 3 AM and I'm wide awake. I'm going take some valium now which means Sunday will be a pretty much lost cause. But I have to sleep.

PTSD. The gift that keeps on giving.

Saturday, March 20, 2010

Week in Bullets

I have had a really tough week. Some of it is cycling. Some is exhaustion. Some is that it was stressful. Some is pain. Some is counseling. It all concluded with coming home last night and crying myself to sleep, and then getting my hair cut this morning and coming home with all these plans to work in the garden and instead sleeping all day.

So, just to bring you up to date:
  • -I went back to work after a day off. That should mean working 32 hours. Instead I worked 40. There were a million evals and all my treatments were one on one for various reasons. Plus the company I'm contracted to knew they wouldn't have to pay overtime unless I worked more than 40 hours in 4 days. They came close. What they don't know is that I'm not going count Monday as a vacation day. Which is great because I have to get a filling done in a front tooth and I know it will be difficult, so I can actually take a whole day off to do that.
  • -The manager then mentioned that her boss wanted to know why I'm not doing groups and why my productivity is low. She said she told her lots of evals, etc., but that's such an unfair question even. They told them they wanted me scheduled differently so that I wouldn't have overtime. But doing that they took away the only way to meet my productivity requirement and also anyway I could double up visits so paperwork time was still counted as productive. (it makes no sense. Just trust me.) I'd anticipated this and warned my own boss, and I tried to document yesterday what my week had been like. Except that the list got diarrhea on it when my patient exploded. So this week I'm keeping a list all week.
  • -I completely flipped out last night because I thought someone was intentionally ignoring me because they were mad at me. Turns out that they used my old, never checked email address. I felt pretty stupid, then pretty amazed at how exactly tired and stressed I am.
  • -I also realized I'm getting somewhat tired of this work setting. I'm considering changing contracts next time. It depends on who the new manager is and whether they really do work on balancing my schedule and their requirements a bit. I don't mind overtime. I do mind being taken advantage of, and that is what happened this week. I did all the work I didn't do while on vacation this week. That's not fair, esp. if they are going to complain about the hours. Then there is the thing where I have one simple request: I need to be done on time on Thursdays. I keep having to go back to work after Dr. Mind, and right now that is not a good thing. Sessions are rather draining and I need to be able to think. I also like the people I work with, but I'm not "one of them" because of several reasons, mainly that I'm not permanent. Also, they are advertising the position at a crazy high rate and then they don't want to pay what my company considers normal for my experience level. So a new contract is going to mean a raise and a bigger one than the last one.
  • -My knee is very sore from falling. I also have a very bruised elbow (and more mildly bruised elbow and knee), but the knee is 100% bruise.
  • -Interestingly I got that comment from the Sears person my post but they haven't answered my actual complaint. I'm going to contact him next, but have to have time and energy to do so.
  • -I priced windows and doors at the DIY store today. I don't really want to use them, but I know now that I have enough saved to do a patio door/screen and 4 windows, and then I can do a front door/storm door later in the summer. So I'm a bit less stressed now. The patio door alone including installation is 1/3 the price of Sears, and it's a top brand name.
  • -I think it's going to rain. My ankle is beginning to predict weather. Either that or it's mad because I dared get my hair cut without a brace on this morning.
  • -My foot with plantar fascitis also hurts. I get my orthotics a week from Monday. I can't wait. I hope that they are as helpful as suggested. Funny coincidence my mother was also just casted for orthotics. I've been taping it but didn't today because I wasn't doing much and taping it is not simple when done by myself. Plus I want my skin to breathe and have time off from adhesives. With the patch I don't need to develop any type of adhesive allergy.
  • -I have backed myself into a fiscal corner. I've got tons of savings but I don't want to touch them as I need the home improvements. I had ordered my mother and I a bunch of garden stuff and didn't realize it didn't go through my debit card until Thursday when there wasn't enough money in there. So this week I have to be careful that there is a given amount left by Friday. Which meant moving money from my precious kitchen account. Blagh.
  • -I've found it funny that I let a friend use one of my therapy experiences as an example of something bad and fairly unethical on their blog. (Which I'm not linking to because I don't really want the people who read and discussed my story to find me). That person's blog is controversial and people constantly make weird allegations. Sure enough, one comment first suggested that this was just a shot at a certain other controversial figure, then that they had read this before somewhere (um, on my blog? it's linked, it's possible), and then that they thought that the blogger had made me up. So to those of you who have wondered, apparently I'm not real. Explains a lot.
  • -This who sexual abuse discussion is both empowering (I'm so proud I'm doing this, and even more proud that I'm handling it pretty well) and exhausting. Partly this is because of the way things seem to play out. From the day I realized I was ready to talk about this, I have tended to walk out of his office after a very intense hour and realize that I knew what needed to come next. Then I have to wait a week to ask that question. Since the questions tend to be both difficult and things I truly do not know an answer to a lot of waiting is involved because it's not really easy to put this stuff aside. It's also going to get tough here as I have to go 2 weeks from this appointment before I see him, because he's going on vacation. I suppose I should try to add an appt. when he gets back, but I'd bet there will not be any openings.
  • -One of my greatest gains of the last month has been an understanding finally that the sexual abuse in my life was severe. I knew that it was a lot of abuse and that it was very long-term. But I never really understood if this was typically what happens to that high percentage of girls who are sexually abused or if it was more extreme. Making a list of what I remember, especially when divided so that I could see what I know happened to me before I was even in double digits, much less puberty, made me understand that it was bad. Also watching Dr. Mind's body language while reading the list helped. I'm now at a place of acceptance of "ok, this was really bad" and now I've moved into something I've not really tried before, trying to make sense of it and understand it. This is tending to be talking about something, Dr. Mind makes some observations, and 2 weeks later I'm back with questions about what he said as I realize that there may be truth in what he is observing or at least it leads me to understanding something else a bit.
  • -I finally found evidence that the reason food tastes strange to me and I eat such a weird diet really is the Emsam. It's a relatively rare but potential side effect, which I think about 3% of patients have. The thing is that since it's not used that much, even at the place I go to, 3% of the total patients my doctor has seen on it won't be very many. I think she has around 5 people on it. So it makes sense now for it to not be something she'd seen. Regardless at least some things seem to rotate in and out of tasting ok, and Dr. Mind really helped by suggesting nut/berry mixes. I'm making my own now because I go through a ton of it, and have been decreasing the fruit to not ratio gradually and adding things like flaxseed to it, so that at least is pretty healthy. The current soup of choice also is nice because is it cheap to make. It sounds weird but tastes really good to my messed up tastebuds (ie don't take food recommendations from me). But oh does it sound weird......carrot orange ginger soup.
  • -It's 7:35 and I've had pills. I'm serious about sleeping tonight and sleeping well.I should be about asleep by 9.
  • -And with that I'm going to go.
  • -(Oh yeah. Sorry if there are bullets and hyphens. Bullets don't seem to work right usually, so I'm doing hyphens in case.)

Friday, March 19, 2010

The doctor I have forgotten

This has been a very, very hard week. I actually came home and had a total meltdown tonight. I'm cyling some and trying to decide whether or not to take the little extra Seroquel I picked up this morning (which I was supposed to pick up Tuesday and never could get to the pharmacy).
I'll write about this all soon, but tonight I need an easy topic.

I am continuing to make gains in the discussions of the sexual abuse I survived. I'm starting to be able to ask questions and learn about it, which not only gives me power over it but explains things that I can clearly remember but that don't make sense because I don't have context. However, it is stressful and requires a lot of mental preparation and often I go not knowing if this is the week I'll be ready to say whatever.

Anyway, one of the easier things to talk about because Dr. Mind knew anyway was that part of what happened to me a lot, how do i say this without attracting weird searches, involved my mouth being used for things a child's mouth isn't intended for. I did not know until just a few months ago that the kind of gagging and horrible difficulties I have with dental work as a result of not tolerating anything foreign in my mouth (I can't even stick a spoon in my mouth to carry it if my hands are full without gagging) is a pretty clear indicator of that type of abuse. So I'm getting a bit more comfortable with that.

But it wasn't until now that I realized how much I owe my dentist. The way I found out about the gagging being a strong indicator of this stuff was when I started researching how to control gagging at the dentist I read a lot about how dentists should be sensitive to gaggers similar to me because of a high chance of sexual abuse. I felt really weird that anyone could know that easily, so it took months to process. But then when Dr. Mind and I really started talking about this he told me that based on the dental issues he had assumed that was part of it.

What I didn't realize until this week was the lengths my dentist has gone to in order to help me. In keeping with tradition, he is Dr. Teeth. When I first saw him I had not seen a dentist in years. I tried once, the hygientist didn't listen when I told her I gag easily and wound up getting bit stuffing an x-ray in. So I went to Dr. Teeth's office scared but determined.

I explained the gag thing and they were great. They told me all about the things they do to assist with that. The tricks help a lot, although I usually gag a few times. They've also been incredibly supportive and patient, scheduling extra time for me, and my dentist has told me that it's fine to cancel an hour before if my symptoms are too bad to do work that day. He also is knowledgeable about my meds and that is very useful.

But what I hadn't realized was the extremes they go to in order to make this work for me. I finally figured it out this week. I am given as few variables as possible. There are only a few people who do anything with me. The dentist stays involved with every visit. They try to float extra staff in and have had extra staff in for whole procedures sometimes. They even seem to make sure I'm usually in the same rooms. They use a lot of techniques and devices to help and have signals worked out to let me jump up instantly when needed.

I realized that this takes effort on their part and that they certainly don't have to. So Dr. Teeth definitely has earned his own name.

I fell asleep writing this last night. More later.

Tuesday, March 16, 2010

4 months = 4 Guess Whats? /scary window man update

Four Falls! That's right, I fell AGAIN. Once per month now, ever since I came home from the hospital.

This one taught me a few things though. I should have stumbled. Someone left the loop of a sling used with a mechanical lift that gets people we can't lift hanging down instead of tucking it safely away. My foot caught in it, I didn't know it and when I went to get something I flew instead. I learned 2 things. One is that I'm losing my balance totally instead of stumbling. The 2nd is that my protective reflexes are on vacation. I missed my face by less than an inch. My hands did not go up to my face. Instead I landed on both forearms and my knees, with one thumb twisted under my hand. I have 4 enormous bruises from impact. Thankfully I had my ankle brace on and it was my new one that doesn't allow turning. The worn out one would have left me with an injury. So thank God I got that Friday.

So, because I've been feeling like I was cycling some these last several days, I was supposed to add some more seroquel tonight. Instead I'm filling the script and holding on for a few days because I'm scared of what else might happen if I take more.

I also saw Dr. Body in his new practice. It was neat; he asked me to be the trial patient for this new interactive computer feature they have. Except it isn't really online yet. Which makes that rather tricky. We'll see if he remembers to contact me when it is available. He also told me the nurses had looked at my chart and told him "she must be difficult" and he told them I was one of his easiest patients. I appreciate that so much, because too often people see my diagnoses and med list and the list of allergies and decide I'm a whiny, impossible patient. Which I am not.

I know I wanted to post more here. I even pulled this page up last night and didn't actually post. But I can't remember what i wanted to say. I"m tired, and I'm emotionally struggling. And now I'm getting really sore. My left arm is going to be quite uncomfortable tomorrow.

I also did see Dr. Mind yesterday. Talking helped. Not done yet, but it helped.

Oh, and I DID report the scary window man. I realized partly I didn't want to because I'm afraid he'll retaliate. So I included the request that he be told that I realize he's going to know who complained, and if he is in touch with me in any way I will immediately call the police and file for a restraining order. What a weird experience that whole thing was.......

and now I must go or you'll be reading my dreams. So sleepy suddenly.......

Saturday, March 13, 2010

The Scary Window Man (Now with Poll)

So I have been saving like crazy to replace my patio door because it leaks. I also want to replace my windows (I only have 4) and from door/storm door because they are less than energy efficient and the windows are starting to mildew (even though they are aluminum, not wood), so obviously they leak some too. I want to do that this year for the tax credit; I got part of it this year from my furnace but still have about half of it left. And I have just about enough money per my research.

The problem is that this area is rural and it's hard to find people to do things sometimes. I couldn't find any contractors, and the one who was supposed to come out for an estimate never showed. I hate the big-chain DIY store nearby who do install windows and doors, because they tend to be expensive, and they charge $30 for an estimate. So I decided to try Sears (I did have that in blog code, but you know what? I want people to read about this, before it happens to them) first. You know, they advertise about all the happy things they do and they do at least have the benefit of a good reputation.

So, yesterday the man came for the estimate. thankfully I'd asked my mom to be here to help ask questions. I should have known it was a problem when he corrected me when I used the word estimate in the first 40 seconds. Then he stopped to answer his cell phone. And kind of complained about the drive. I guess he came from the Big City; I'm sorry about that but I didn't exactly know and besides, that is his job. He was kind of hard to get on task, but eventually got around to measuring windows. Then he did this boring sales presentation. Then he stopped and asked for water. Which was a bit odd, although ok. And then he presented the price. Which was around $6000 for 4 windows and a slider. Um, can we say a bit high?

So then he pressured me to commit then. I told him I couldn't, that I could not afford that much and would need to get some more estimates. He then proceeded to argue about how that wasn't high, that getting estimates was stupid (I believe he used that word). He demanded to know what I had planned to spend. I refused to tell him. He demanded to know why. I told him I feel my finances are my own business, not his, and he'd made it clear we weren't bargaining so it was none of his business. Then he kept wanting to know why we thought the price was high. My mother pointed out that she had just had windows installed for $250 apiece and they are high quality windows. He kept insisting she was wrong.

And then he made his crucial mistake. I'm doing great now, but I am still bipolar and I still have characteristics of it. And yesterday was a very rough day. Which means more symptoms will come out. One of the things that I really, really struggle with in making eye contact. Having said that, one evaluation I had for vocational rehab indicated that I have the best eye contact of someone with severe bipolar that the assessor had seen. However, I work very hard at it and doing so is conscious unless you are one of a few people. And so I'm also very, very sensitive about it. And he started insisting I look him in the eye. At which point I became furious, barely able to spit out a sentence. I knew I should tell him to leave and reach for the phone and my friendly police if he wasn't out the door in 3 seconds. But I just couldn't TALK. I mean, this is how he tries to sell me things??????

He proceeded to argue for another 10 minutes, including demanding (I know I keep using that word but it is about the only word that works) why my mother was there, if she was there just to keep me from deciding to go with the best? And also when we talked about my mother's windows being done by a contractor he wanted to know why I hadn't had them do an estimate if they were so great. Um, let's see. 1) They are 30 minutes away and would charge extra for the drive. 2) They are wildly popular and it can take 6-8 months to get something done with them. 3)This was my first "estimate". I've not put a lot of time into this because I haven't HAD a lot of time. He just kept arguing and arguing, with this scary anger just under the surface. All because I wouldn't spend more money than I have. And it's not like this house is the greatest ever. It is warm and dry and does what i need it to do, but it is also not ever going to be worth a ton of money, and putting in the most expensive windows in the universe would be a bad investment because I'd never get the money out of them.

I think that he mainly left because my mother could see I was about to blow up and hustled him out. Literally she picked up his samples and said "let me help you".

I'm still rather flabbergasted, and so mad at myself for reverting to abused girl and not making him leave when he was scary and inappropriate. It's funny now, but it wasn't then, and knowing my reaction was not the safe one still isn't funny. I've just never really considered using the words "leave my home or I will call the police". I guess I have, if my father shows up that will be way more polite than what would come out, but since he has no idea where I live that idea is so remote that it's not a practiced reaction like it was 10 years ago.

So anyway, Sears windows not getting my seal of approval....And I'd highly recommend if you live in what is considered the northeast portion of Ohio out to Toledo that you very carefully avoid Sears salesmen named Marty. Like if you get an estimate request that it not be anyone with that name. Because he will scare you. And you will not complain to the company directly because you know what one complaint can do to someone's job these days. Except you still might complain, just without being overly specific. Because if he knows who complained he might come back and kill you. In your sleep.

So, blog readers, vote. Complain or stay quiet? (See poll on right.. If the placement is weird, I don't know why; it is on my computer but this computer isn't always great with the graphics. I think though that my template doesn't allow everything I could ever want in the sidebar since this happens whenever I add something. Or it's just my computers and it's fine. Who knows).

Friday, March 12, 2010

Child abuse sucks

I have no more appropriate title. Today was really, really tough.

About a month ago I wrote about my occasional issue with tolerating pain too well. At that point I blamed in on anti-psychotics as I have seen this with my own patients and my dentist also mentioned noticing it.

Well, today a whole industrial sized can of worms opened up. Everywhere. I'll be chasing them for a while I imagine.

I had my follow-up at the podiatrist today. When I made the appointment for the first visit last week I felt sure that I was overreacting to my sore foot (injured soft tissue from how I have been holding my weight while my ankle healed). But I can't take anti-inflammatories and every OTC insole and support I had tried did not help. So I figured I'd go and leave with a recommendation for different insoles.

Instead the doctor focused on my ankle injuries. He was very thorough with both sides, but the ankle got a lot of attention. He told me that if I didn't have the brace I have he'd have sent me out in one of them. He took a ton of X-rays of that ankle and foot and only a few of the foot I had come in for. He taped that foot, said if it worked a pre-fab orthotic would help, and that I should come back today for follow-up and x-ray results if they showed anything. He seemed suspicious that there would be a healing fracture of one of the bones in my foot, which I'd had symptoms of but was treated the same as if I'd had it anyway so it was never pursued.

When I got there today they said something about "he'll give you your x-ray results" and so I thought "huh,must have broken that meta-tarsal". He came in and put a film up. A film that shows quite clearly where I broke my ankle before. It's very healed; I didn't do it this winter. I know when I did it. When I was a sophomore in high school I fell twice during the same cross country meet. My ankle hurt afterward, but so did nearly everything else. And in my house there was no complaining of such things. My father had me totally convinced that I overreacted to all things medical. He told me it was fine and so I went back to cross country practice immediately. He wouldn't even buy an ace wrap until the coach pulled me from practice. Even then I was running the next day. I then proceeded to increase my running until 3 months later I was running up to 10 miles per day, 5-7 days per week. Which was when I fell and destroyed my knee.

Nobody ever could explain how I managed to do such a thorough job of tearing up my knee in just a fall from tripping over a curb. I did land hard, and there were some mitigating factors in there, like the dr. who said "girls shouldn't do sports" and left me with torn cartilage that I then proceeded to tear very badly a few months later in marching band while executing a tight turn. Even then that doctor insisted nothing was wrong and ordered a test my insurance refused to pay for, insisting on a much more expensive (and still rather new) MRI instead because of the degree of pain associated with the outdated test. That ultimately led to the removal of my cartilage, and then after months of doing pre-season with the boys' track team to recover my strength I started track and one of my hamstring tendons (which had acted weirdly all along but hadn't really bothered me much) began locking and making weirdly audible across the room snapping noises (it had done this intermittently but now it was always) as it wrapped around and around itself. This was an injury nobody had seen before, and so the surgery for it was rather involved as the dr. went in with no real idea what was the solution or how the problem had happened. The chief of orthopedics at this big hospital was in the room observing as were many residents and med students. I was actually awake for a good part of it so that I could kick on command so they could see what was wrong. When it became painful even with numbing I was put to sleep, but was awakened before they closed to kick again, although that part I don't remember. The surgeon actually was able to opt to do little, making recovery easier. There was no saving the tendon or reattaching it in a better place as he'd planned (hoped). So he cut it and let it just retract and scar into place. I wound up ultimately with 1 hamstring tendon gone, one mainly covered in scar tissue, and the 3rd fully functional. So essentially the only thing to do was to strengthen the quadriceps muscles the best I could, and 6 months later he told me I could run again or do anything I wanted except for roller or ice skating due to the high risk of falling on a knee that had no cartilage. (To illustrate how much cartilage was removed, while recovering from the tendon surgery I tore the fragile new scar tissue that holds my leg together and fell down some stairs. The leg swelled and turned bluish. The doctor saw me emergently and said that if I had any cartilage he'd go in suspecting it was torn but there wasn't any to tear so it had to be the scar tissue, use the brace and crutches for a few days and go slower on the stairs next time). He also told me that it would hurt and that repetitive movements were likely to give me repeated tendonitis, so I might want to find alternative sports although he wasn't going to restrict me. I tried running for a while but it did hurt and while I made it through my senior cross country season as an active athlete except when it was muddy and the coach wouldn't let me run or on one particularly hilly course, I gave up running not terribly long after. I learned about the tendonitis thing the next fall when I had to take a swimming test for gym class in college and wound up on crutches for a couple months.

I've had to adjust many things around that stupid knee over the years. I don't use normal body mechanics. Mainly I've relied on my ankle and hip to stabilize that leg and I lift partly with my back and a lot with my arms and other knee. Since I hurt my ankle I've had to learn to lift differently again.

Anyway, back to the present. From the time this sprain happened there have been questions about previous sprains because of ligament laxity. I remembered the "twist" in cross country and another minor sprain about 5 years ago, plus the twisted ankle in Nov. on that side. I don't remember any of these as particularly painful. Yet the proof is clear: I broke my ankle and it had to have hurt, yet I kept running on it, right up until the not-close-to-healed fracture caused me to fall and destroy my knee. I got that confirmed today as the likely story.

As soon as that X-ray went up and I saw that healed fracture (it was quite obvious) I realized exactly what has happened. I don't have a high pain tolerance from meds. I have a high ability to ignore pain because to do so was the only way to survive in my home. I was yelled at and probably worse and called a hypochondriac for so many years as a child that I had to have someone pretty much teach me against my will when to call a doctor when I was an adult. For years I would only call if prodded repeatedly, even if it was something like my new AD was making me vomit and not eat and I'd lost 20 lbs in a few weeks. Since starting with Dr. Body I've developed a comfort level and will see him and be honest about how I feel/what I need, but that's a pretty new skill for me.

Therefore, during the worst years of the abuse, there is no way I would have complained. When my knee was at its worst, before the 2nd surgery, the coach actually had to pretty much physically stop me from running stairs and then tell me I wasn't allowed to even come to practice until cleared by a doctor, and that if I was seen running anywhere I'd be done. I was too afraid to tell my parents (father) how much it hurt. After my second surgery, which was a fairly long procedure with a lot of poking around trying to find solutions, and a very deep, several inch long incision the doctor wrote for a week off school. Surgery was Monday, i was in school Wednesday and off painkillers by thursday. At which point I nearly fainted and was kept home Friday, but i never took another percocet and never missed another day with it except for check-ups. Better that than to hear about how awful i was for complaining.

And so now I will pay the price. My sore foot will heal. It's got some biomechanical issues but they aren't that bad and my custom orthotics will fix it. I do have to get custom ones, which are quite expensive and not covered by insurance. I think that's more for the bad ankle, but the other foot needs support too. My bad ankle? Not so much. It has a lot of issues. Enough that I will have a custom orthotic in there too, which will be made to correct a number of issues. I also will be wearing my ankle brace not just for work, and not just until it is stronger (I was told it was to be worn long-term but wasn't planning to adhere to that), but forever and anytime I'll walk on any uneven surface. Meaning all the time I'm not at home. I got a new brace today because mine was already worn out. If I go through them that fast normally we're talking about $300/year just on those. A more permanent one would, I assume but need to ask, be too restrictive and just add to the weakness while this one lets me move pretty freely except for turning my ankle in or out. I have been reminded twice today that we've discussed surgery as a potential if/when I hurt my ankle again. I also will have some more specialized xrays and possibly an MRI at that point.

So, that's been quite a bit of knowledge to gain in one day. I am still processing the implications: basically because I was so afraid of my father that I was willing to ignore what had to have been considerable pain I am facing an entire messed up leg that didn't have to happen. My knee always was considered "one of those things" because without knowing I was running on a partially-healed fracture it was impossible to guess that as the root cause of the issues. Now I know that this was preventable if only someone had bothered to be a normal parent and treat a fractured ankle. What's more, I probably wouldn't have all the ankle problems. And since I'm now aware that both of these joints will likely be giving me problems for the rest of my life, I'm just a little angry. I already knew I would have 1-2 knee replacements on the left in my lifetime. Now it appears I may have ankle reconstruction too and since he keeps reminding of this I'm assuming it's something I should get used to.

I am so incredibly angry right now. I certainly grieved for the loss of things I loved, like running and swimming (which I taught myself to do without repetitively kicking through the bad knee eventually), and for a knee that made me not entirely "normal" for someone my age. But now I have to grieve both for the loss of a normal ankle and from the knowledge that the entire thing might have been prevented had it been safe to actually fall and break a bone in my house. And that's before we go into the implications of this kind of thing on my career. Because if my ankle becomes more unstable I'll be unable to lift patients which is really a big part of my day. From what I've read that would be the time for reconstructive surgery which would apparently be horrible but effective. But theoretically this ancient fracture with so many negative consequences might end my time doing what I do and force me to work in another practice area, which has it's own set of problems, as in thanks to how sick I was getting in grad school I didn't exactly absorb a ton and what I know I've learned on the job for the most part. I may be qualified in name, but I am not qualified in practice, to do other areas.

And after all this you didn't even get to hear about the scary, scary window man. Tomorrow.

Thursday, March 11, 2010


I've been going to counseling for more than half my life now, with several breaks of a few years duration. Let's see....I went a few times at age 9 and 10 to the guidance counselor, generally because I'd freak out during movies/presentations about sexual abuse. Which they though I just was scared of, I think. Then consistently from 14 until 17 with someone through children's "protective" services. Then from 18-22 with maybe a year off in there while I grew up a little. (Really. I was a brat the first year and had to gain some maturity to do more than sit there and see if I could win control and prove I didn't need to be there. I lost). There was a period in there where it was incredibly high intensity as we met 4 times/week for 90 minutes at a clip. I didn't talk much then in therapy, I wrote out what I had to say and let the therapist read it, then discuss, so I also devoted a lot of time to it outside of that time. It was so intense (and I was so messed up) that I cut my courseload to a bare minimum of hours, focusing on easy classes and mainly abdicated from my role as president of 2 organizations for a several month period). Counseling was what I did then. From 22-24 it was off and on as I tried many therapists and clicked with none of them. From 24-26 I refused to try because I'd had so many bad experiences. And then it's been continuous and intense from 26-34 at the same place, with 2 different therapists. During those almost 8 years there have been many months of bi-weekly sessions, sometimes because of my illness level, sometimes to let me adjust to new therapists/say good-bye to an old one, and sometimes because of how intense things were.

In all those thousands of hours of therapy I've had some intense sessions. I've learned that some sessions are going to make me want to do nothing but sleep as I process. Some make me angry and needing to DO something. Some make me think, sometimes practically non-stop from the time I leave until I return. It used to be that I would often go an extra time on those times, but now I try not to.

Dr. Mind and I have settled into a routine over the years. I'll bring something up as a "big" topic and we'll talk about that for the next number of months. Generally during those times most sessions are 95% or more about that topic and I eventually come out better than I went in to it, although I always go in to it hating the start because I know it will be hard. Dr. Mind has an important job in these times which I believe we discussed long ago, or else he figured out quickly: I'm allowed to determine if I need to talk about something. I can say "I need a break this week" or "we need to talk about this instead" and we do that. But for the most part during these times he keeps me from wandering off topic to avoid painful discussions. During periods like right now he will make sure to start guiding me onto the topic within the first few minutes. This is because it can be hard for me to bring something back up. So when we start something big we always talk about "do we need to keep talking about this" and do I want to initiate it when I'm ready or should he.

After a big topic we take some weeks or even a couple months and stick to simpler stuff, going back to the big thing and weaning towards something else gradually. I can't do intense 100% of the time, and I don't think that it would be good to try. Nor is it reasonable given my fluctuating mental condition.

This last year has been a bit different in the pattern. We went from intense through last spring to kind of in and out intense and then I lost my job. (I was fired in July for those catching up. The company refused to give a single reason. It had clearly been in the works for weeks, as they'd arranged coverage for Sunday at least a month before, and equally obviously my assistants knew before I did.) At that point it was survival mode time for a couple weeks, then I got the new job and we worked on the adjustment. When Ohio had the highest unemployment rate in the country and was making headlines (12% I think), I was one of those people. Soon after I started the new job we went into a new topic that was quite difficult. We did that for about 2 months and then didn't get to finish because the entire coming off my antidepressant, preparing for the hospital, suicide watch thing began. We went to bi-weekly during that time for monitoring, and then stayed bi-weekly until mid-January, until I was really adjusted to the meds and feeling better. Since I felt better we've kind of been floating, and working on my adjusting to feeling normal for the first time in my memory really. Then a few weeks ago it was time to start talking about my history of sexual abuse, a topic that was made clearly off limits in something like our first session until I brought it up.

I've been doing incredibly well with this. Dr. Mind keeps asking about nightmares, and I told him today that I had one or two but didn't even remember them, just that I thought I should remember to say yes, I had one. He reminded me that in the past every time I have gone near this (or other difficult) topic I have had daily, vivid nightmares. This time I'm doing so well even my PTSD seems to be relaxing. In fact it's relaxing enough for me to realize that it DOES have a significant role in my life; I've always known I had it but I didn't like to talk about it or acknowledge that it made things difficult too.

Today though was tough. I'm still processing the conversation and I don't want to go into it too much yet, but what I think happened was that I went in ready to talk about one thing and it was related to something that Dr. Mind has been waiting for me to come near so we could talk more about it. And then it got even more intense than he was planning for. I know this because the last 20 minutes of my session, which I'm fairly sure went pretty long but I don't even know, had me in tears and him not far off I don't think. I know that after I left he was gathering himself before going to his next appt., which is unusual for him when he gets off his schedule.

The thing is, he's asking me to try to do something. Something I don't know how to do. I'm supposed to try writing it. But it's just so hard. I have a feeling I'll be writing "why I can't do what you're asking yet" first. Which is ok, because it lets me move toward what I do need to do. It's just so very hard, and so not even remotely clear to me what step one is. (That thing is to forgive someone. Or forgive a situation because it was that which was bad, not really the person.)

I guess fortunately (?) I'll have lots of time to think. I cleaned my oven today and it heated the house up horribly. It is so hot in here that I still have windows open and am sweating. Sleep won't come easily between that and the agitation. Unfortunately my cat woke up at 3:30 and I've only had a 2 hour nap since.

I guess so much for a carefree vacation....

Monday, March 08, 2010

How did I forget this?

I guess the answer to that question is that it is very hard to believe it is true.

One more thing came from my appt. with Dr. Brain Saturday. We were reviewing what needs refilled, and got to lithium. She said I had just filled 3 months worth and I said "for what it's what that's worth. I'm not so sure it does anything anymore." I then confessed to taking larger doses than the tiny bit I should take of anti-inflammatories during these months of ankle and foot pain from time to time without any signs that my level was too high. Ever since my toxicity anything that slightly bumped up my level gave me signs of toxicity, so this is big.

My history with lithium is long. I've been on it a few months longer than I have been diagnosed with bipolar. Essentially I had been on just about every antidepressant out there and had been taking ativan for about 5 months when I started to feel a bit better. Which would have been positive had it not gotten me just better enough to realize that I had severe, recurrent depression and would be facing episodes for the rest of my life, in all likelihood. I came to an abrupt realization one day that I would much rather die than to face another severe depression, and so I started to plan to kill myself as soon as the next episode started. After a few days I realized this was a serious problem and got myself to the psychiatrist and into counseling. The psychiatrist offered lithium as the most effective boost to the antidepressant possible, and also because it is known to be effective at reducing suicidal thinking. I agreed out of desperation, and that night suffered through my first dose. Taking that pill, that little capsule that meant "seriously ill" was so hard. Over the next weeks lithium didn't really work as advertised, but instead did something better. It did take away the suicidal thinking, and it also make it crystal clear that I was cycling. So essentially lithium gave me my diagnosis.

I took it for 4 years before developing a toxicity in the spring of 2006. At that point I was on a pretty high dose of it and had been for a long time. For those in the know, my levels back then ran about 1.1. Toxicity starts at 1.2 or 1.3 I believe. When my toxicity was found my level were 2.0. Which is not good.

After the toxicity I had a hard time getting back to an effective dose. I would do ok on a dose but then as soon as I got hot, or didn't drink enough, or anything changed that caused my level to get a little bit higher than usual I'd have signs of toxicity. We kept lowering my dose and it didn't work. Finally, about 6 months later, I stopped taking it and started another drug (trileptal I think; trileptal was a total failure in that I was incredibly sensitive to it and so I was taking something like 7/8ths of a pill and not getting a high enough dose but anymore knocked me out). So I only was on it maybe a month. I don't know what we did next, but by late March of that year, 3 months after stopping lithium, I was desperate for anything to help. I read later that 3 months after stopping lithium the body sometimes reacts with depression. Mine did. I was down to very few options; the only meds I hadn't tried were Seroquel, Zyprexa, and Clozaril. Clozaril is a last resort drug due to serious side effects and the need for constant labs for the first year to be sure it won't kill you. Zyprexa I did not want to try until the last resort before Clozaril because of its link to diabetes and my family history being scary on that score. And Seroquel (and Zyprexa too I believe) Dr. Brain didn't really think would help me because I'd done so badly on all other atypicals. Out of desperation I agreed to re-try two meds that hadn't worked out. The easiest and therefore first was lithium. We messed with dosing and ultimately learned that I could handle only the tiniest dose, 300 mg. A therapeutic level is .6; I need to be at .4. We joked about homeopathic lithium. But Dr. Brain had 2 other people in the same situation; unable to tolerate more but expressing the same thing I did "I don't feel right without it". For me it seemed to reduce the rapid cycling more than anything, and that's a great thing.

The problem was that my body continued to not like it much. In 2008 I was diagnosed with diabetes insipidus, a problem with how my kidneys sort out electrolytes and keep them. Mine don't; I just pee out everything I drink and so my urine is very dilute. I've been on medication for this for a long time now. For most people on lithium they stop it for this condition, but a lot of discussion among my team determined that I needed lithium and would be responsible about the condition, and Dr. Body would closely monitor, assisted by Dr. Kidney as needed. So that added 2 more pills to my day. But at least the peeing got better. After I was first diagnosed I timed it and I was peeing every 45 minutes around the clock. It just happened so gradually I didn't notice it.

But now, back to the present. After I said that Dr. Brain said "well, in cases like yours we traditionally do not change a thing for many, many months of stability. But.......I think you are right." I hadn't had a level done in a long time, at least not one that either of us knew about. I think i had one in December but never heard the result from Dr. Body. So I'm to have one drawn next week when I see Dr. Body for my introduction to his new practice, and then I may be coming off lithium.

Because of what happened last time I'm going to ask to taper extremely slowly, like 6 months to get off the micro-dose I'm on. I know that way I can be aware of what is happening and if it needs to change.

But, I may be coming off lithium. In theory that would mean my kidneys will work normally again, although i suspect that since I continued lithium despite the diagnosis this may not be totally true for me. After all, damage is damage, and I essentially have accepted some damage in exchange for feeling ok.

And in other news, I MAY have found Dr. Bladder. I spoke to a receptionist today who is going to talk to the dr. and get back to me, but she sounds wonderful and I really liked the receptionist. More on that later.

For now, must sleep.

Sunday, March 07, 2010

Helpful hint for those on Miralax

If you don't know what miralax is, count your blessings. It's something very important to me, but it's also kind of annoying.

Miralax is a stool softener. It is very gentle and is seemingly the drug of choice for constipation. For me it's not the best but the other options don't work alone, so it's part of my life. The reason it doesn't work for me is the reason it's great in general; it kind of diverts water to the bowels making things easier. For me, because I'm constantly dehydrated by diabetes insipidus, it is only sort of successful. But nothing else works well either and at least it isn't a pill or bunch of pills.

Miralax is a powder that you theoretically dissolve in virtually any drink and drink, allegedly without any taste or residue. The thing is that it makes water cloudy and that make me unable to try it in water. It doesn't dissolve well in milk. And those are my main drinks. I usually keep grapefruit juice around to drink it in but I've now hit on a great idea.

Because of where I work and my constantly high stress level from illness I tend to get sick easily. So I try hard to consume lots of vitamin C. One way I really like is this stuff called EmergenC. It's a powder that dissolves in water into a carbonated drink that tastes pretty good. So lately I've been adding the miralax to it, and it dissolves great in there, there is no residue whatsoever, at least the carbonation prevents that from being noticeable. It's a nice way to combine 2 things at once.

I am waiting for my sheet to dry. I didn't realize it was still damp until i started to put it on the bed. I'm so tired, it better dry soon or I'm going to be asleep sitting up, and cold.

Another Day, another doctor

I haven't been posting quite as much. And I realized why. Doctors have taken over my life.

Generally I see Dr. Mind every Thursday evening, Dr. Brain every 4-5 Saturdays, and Dr. Body every 6 months and as needed, which generally was maybe once between those. Since September my doctor visits have been out of control. From October through mid-January I saw Dr. Mind twice/week. I have seen Dr. Brain monthly except for the month she was off. I of course saw lots of doctors in the hospital (3). And I've seen more of Dr. Body than ever before, I think. Let's see. I saw him for follow-up right after I left the hospital. I saw him 3 weeks after than because of my horrible stomach virus/appendicitis scare. I saw him 2 weeks after that with my sprained ankle. We combined my 6 month visit with that one so I also had a ton of bloodwork then. Then I saw him yet again for my re-twisted ankle in February after I fell on ice. Soon after that I saw the urologist-without-a-name-because-she-doesn't-deserve-one. Then this week I saw Dr. Foot and Friday afternoon got a call that Dr. Brain needed to change my appointment to this Saturday instead of next. I go back to see Dr. Foot this Friday (and who knows how much after that; explained below), and then I have my "new patient" appointment at Dr. Body's new practice on the 16th. And this isn't all; Dr. Body and I have been in touch via fax/phone numerous (probably 5-10) times, and I had that month of PT.

Dr. Foot....well, first off he was WONDERFUL. Of the 3 drs. there he was who I hoped to get. He was extremely thorough, seemed to understand my med situation and the limitations related to that, and was also respectful of my professional knowledge. I do have plantar fascitis, and apparently it's not exactly mild. I actually may have a full-blown tear in a tendon in there, something that is seeming more likely as the taping that was done to see if it helped (which indicates a new orthotic would make a big difference) has been worthless. It's been on 3 days and stays on until it falls off or day 5. I'm a bit unclear where it goes if this doesn't work. He said something about an MRI but I'm not sure if that was "that's the next step" or if it was a possiblity. Apparently this can become surgical but I'm probably not there yet. (please no). I was also glad that he took my ankle issue seriously. I didn't really know podiatrists were ankle specialists and I probably should be been there a bit sooner. Regardless he told me that if I didn't have the brace I do he would have put me in that exact kind that day, and that made me feel much better. Bracing things in some ways goes against my training, as bracing (while necessary at times) also means certain muscles are encouraged to be weaker. Affirmation that I need a brace was a good thing. If my ankle has any more issues I'll have some special x-rays taken. As it was I had about 6 or 7 views taken total, a few of my sore foot and most of my ankle. He seemed to be somewhat suspicious of something I wondered about at the time of the injury because the symptoms fit well, a small fracture in the bone below my small toe, which often doesn't show up on initial x-rays, and which apparently wouldn't have shown up in the x-ray series that was done anyway. I'll find out x-ray results this Friday; he told me the only thing I'd find out immediately would be an acute fracture. He also suggested that I continue to work on this thing I've been considering buying, a circular thing that works on ankle control called a wobble board. Probably I'll order that after I get paid this week. I'll also be doing ultrasound on myself at work when I'm not taped up. So this is going to be a not one visit issue, but I'm so glad I went because apparently it was not about to get better on its own, and as painful as it has started to become I can't imagine standing it getting much worse.

And then there's the search for Dr. Bladder.....I'd hoped Dr. Brain would know someone who met the criteria of female, good with psych patients and experienced with sexual trauma. Did not happen. The only one she knew was a man and I'm not ready for that. So we looked at some names and she told me what to say when I called, and then when I pick someone I'm to contact her and she'll send them some psych info and Dr. Body will send them his portion, and Dr. Mind also will send something this time affirming that psychologically he feels I am unable to do this without sedation. Since he's the only one of them who knows WHY in specifics I think this is valuable. But setting this up is going to be a pain in the rear end.

Oh, and then the other wonderful news I got yesterday.........jury duty. I am not appropriate to be on a jury. I can't sit still and pay attention, and at this moment in time I'm dealing with too much of my past to really risk anything triggering PTSD. It's a miracle I'm not dealing with that intensely at the moment, and all I need is a trigger from outside. So I got a note from Dr. Brain excusing me from that, which is at least a reason the timing yesterday was wonderful. Otherwise, not so much. I am so extremely tired, and having my plans changed was hard. But at least I know I can take care of jury duty easily now. Hopefully. Apparently psych excuses are no longer as effective as they used to be. The last time I got jury duty they barely even looked up after the first couple words. Apparently that's not necessarily so true. I hate this, I'd love to serve on a jury. I find much of that really interesting. However, I also know my limitations.

I've also been busily working on insurance quotes. I actually found a plan that is less than half what I pay for car insurance, and about $100/year less on house. So that is good.

I think my washer load just stopped, so I better go throw things around again. I seem to have way too much wash for only one week, but then I think I didn't do everything last week, and I also think I've been doing at least one load/week in the morning and I'm not sure I did that this week either.

So that's what has been happening here. Not very exciting.....

Wednesday, March 03, 2010

Lots of stuff

First, a few times in the last few months I've had people request to talk to me privately. You don't have to post on the blog. I, of anyone, certainly understand not wanting to. Please feel free to email me at masterofirony@att.net . I may not answer that day, but I will as soon as I have time. I'm happy to talk to anyone about anything. These last months I've gotten into a lot of stuff on here, and if you have experiences you want to share, or want to talk, or think you can help me or vice versa I am so happy to hear from you. And please, if you are suffering and want to talk about it or ask about how that ended for me, PLEASE do. I remember spending much of 2 years trolling the internet trying to find the elusive answer for myself. I mainly just found out how unique my situation was. However, I will also say that the internet was the source of a huge amount of my success because after being on Seroquel for 10 months and dealing with the difficult issue of needing a high dose but being far too sedated from it, even with Provigil to help me wake up, I read about Seroquel XR which was either just about to be released or had just been. A week later I came in to see Dr. Brain armed with a million questions about this new version that was allegedly designed for people like me who needed a high dose but had difficult with excessive sedation. She was very reluctant to let me try it because she has a firm policy against my going on anything new. However the next month I wore her down and she wrote the script with a million cautions. The med was so new that I went to something like 5 pharmacies in 3 cities to find it. And within a week I no longer needed to sleep all the time. Within a month I was no longer acting like I had always acted on antipsychotics-numb and groggy and zombie-ish. I'm now on a high dose of XR, in fact I think the highest dose you can take of it, and it continues to make a huge difference. I haven't really cycled more than a little since right after the first dose, if you don't count the depression from coming off antidepressants on medical advice and I don't.

What else? Today I had an unexpected scare. I've spent so much time trying to figure out what happens if Dr. Brain's illness affects her ability to be my doctor. I knew Dr. Body was changing practices and I was thrilled to find him on my insurance the other night. I'm almost out of a med, so I called today to be established with him, only to be told they are not taking new Anthem patients. I asked if there were any exceptions. No. I asked if they did a waiting list or anything. No. I started to say "ok, well, then I'll private pay because I am not giving him up" when they said to wait a minute. They put me on hold, and after a few minutes hold started ringing. I let it go on a long time without anyone answering so I hung up and called back. Apparently they had gone to answering service while I was on hold. They said they'd transfer me back. They just hung up on me. I called again. This time the guy basically said I couldn't talk to them until tomorrow. I protested that I had just received some rather significantly bad news and I needed to know about getting my meds refilled and had been cut off. So he finally got me through and the receptionist said Dr. Body has agreed to take me anyway. Not sure what that means aside from I am amazed yet again at his commitment to me, something that has not changed in years of being his patient. It started with me meeting him and telling him I needed someone who would work as a team player with Dr. Brain, that he would have to accept Dr. Brain has the final say about everything, that he would have to agree to look up meds every time before giving them to me and that I'd ask hard questions if he didn't and that he needed to know that I was dealing with a very difficult, uncontrolled illness and that if he couldn't handle/didn't want to handle someone with significant psych issues please tell me then. He has stuck to that commitment far beyond what I ever expected, including through 2 changes of practice.

Tomorrow is Dr. Mind day. Time to talk about my new memories. Oddly this week has not just been about sexual abuse memories, I seem to have opened up a faucet. Only one other memory, but it has some play on what happened as well, I just have to get to the next step of it. I have a feeling talking will do that. I just can't believe how ready I am to do this. Instead of being scary it's actually a relief. It's also a step how much better I am, because just over a year ago I told him I was ready to talk about my family history, but that this stuff still stayed away because it didn't matter, I did not think I would ever be strong enough to move on from this and I had decided to accept that there were areas of my life that would never be normal. A year later and we're talking about it and I want to do it.

Ok, I'm falling asleep sitting up. Guess that means it's bedtime. More later.

Monday, March 01, 2010

One more doctor

So Friday I get to see yet another doctor. This time it is a podiatrist. Because after my ankle sprains I was forced to stand with most weight on my good foot and I stand so much I wound up with tendonitis in my good foot. Which has now become more painful than my ankle is ever anymore. I've tried various things for it but have come to the conclusion that I probably need custom orthotics, because I need something that keeps one ankle from rolling in and the other needs to keep the ankle rolled out more. I'm just so glad that I got in so soon. It really is getting sore. I will, however, scream if told I need PT (I'm not doing that for this particular problem). There are night splints that I may need as well, but those pose some issues because typically they aren't to be walked in and I'm too sedated to figure out taking something off at night. So we'll see. I just hope it is a nice doctor.

I also may have to switch insurance companies. My home and car have been with the same people since before I had a home, actually probably as long as I've lived in Ohio which is 9 years now. I recently had them reduce my policy to reflect the fact that my car has so many miles on it that it is not worth much. The point was to reduce my bill. Rather than do this, or asking how I wanted it done, they simply credited my January bill and then continue to bill me the old amount until this policy runs out. I essentially told them no, that since I wasn't given the choice to do that and that is not what I wanted I will be getting a new insurer if my premium doesn't go down very soon. I'm so frustrated with this. I changed things specifically so I'd have more money and then they took that away from me. I would much rather have paid the new amount in January and ongoing.

Not feeling really upbeat today. I had one of those days where nobody was where I needed them to be, paperwork wasn't in order that I needed, a patient/family got a little more intense than was required and they were wrong but didn't give me a chance to explain, and I've had a throbbing headache for the past 10 hours. Nothing is helping it. I'm sure it's from my sinus infection and the weather changing but it hurts.

I also just want to get to Thursday and my appointment with Dr. Mind. I've been through a lot of tough discussions with him in the past and I know that once we talk about this for a couple weeks I'll feel ok between sessions, but right now I just feel weird about it all. And yet so ready to talk more. I suddenly feel like really talking about this whole thing and feeling that is a new one for me. I've talked about it before, but then it was more just this "I must say it, often repetaedly" compulsion that is how I handle PTSD. (Just like my repeated hospital stories. Say it enough and it loses power).

I think that sleep rule is going to kick in within moments here. Good night.

Contribute to the future of psychiatry

I'm explaining this not to insult anyone but because I have no idea what laypeople know sometimes.

There is a book called the DSM (Diagnostic and Statistical Manual) the American Psychiatric Association puts out that gives all current psych diagnoses, the criteria to meet them, etc. They don't update it all that often, so when they do it is a huge deal.

The next edition will be out in 2013. Right now they are accepting comments from healthcare providers, psych patients and the general public about the proposed changes.

I'm so grateful to have had a chance to give input, as they actually intend to shove mixed episodes (depression and mania together) into mania, which takes away the power of describing this, because it is not a type of mania, it is far worse than mania.