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

Tuesday, November 30, 2010

tired

I'm getting more exhausted by the day.  It's the combination of work, not falling asleep early enough, not feeling great, and depression.  Not the best mix.  I'm not hearing back from Dr. Brain even though I have request in for more meds to help me sleep and feel better.  Getting frustrated with her; I've been emailing for 3 weeks now.

Dr. Body offered me an antibiotic for what he assumes was a secondary infection I shouldn't have been able to fight off last week but did, sort of.  I think though that part of my tired is that I didn't fully fight it off, I have a sinus infection, but how do you know when your throat has been red and sore for so long you can't remember otherwise, you always have thick gunk in your throat, and you haven't felt well in so long that you barely remember a month of time.  So I asked if I could try it on the basis that we know I always get sinus infections if things are clogged, I can't do the one natural treatment for that I usually do (sinus rinse bottle) because I wouldn't be able to breathe from the pertussis crud in my throat, and I'm willing to do anything to get over this.

I told him I fought off the fever and the rest just by prayer.  I was so afraid of trying to get an urgent care doctor (known no matter where I go for putting me down and not believing me because of my bipolar diagnosis) to believe that I even have had pertussis, much less that anything was wrong beyond that and that no, I couldn't take what they wanted to give me most of the time.  I could just see them deciding I was paranoid and making up rare illnesses.  Pink slip on a platter (that's involuntary committment for those who don't have to know these things).  I think  secondary infection is what is keeping me so wiped out.  It may even be keeping me awake as I still have trouble clearing all the crud.

I was going to post pictures but I just might be falling asleep so I'm going to see if  that's real.  Please God, 6 hours of sleep sounds amazing.

Monday, November 29, 2010

Ok

I'm ok.  Just very, very, very extremely tired.  Depression and recovering from 3 weeks of being so sick are not the best combination.  I'm trying to get Dr Brain to do something but she's still not answering.  I am surprised b/c Dr. Mind was going to update her and that usually gets a response.

On the other hand I think I'm getting over the coughing.  Slowly but surely; I haven't gasped for breath in a few days and I seem to be off breathing treatments.

I'm also spending all my blogging time trying to place one stupid order on Petco.com.  It FINALLY went through, but I'm not kidding when I say that it quite likely took 15 attempts.  It better be worth it and I better not get 15 sets of dog collars.

I did find out today that I get Thursday off this week and next because I have to work all weekend.  That helped, as I was really concerned about my ability to work 12 days in a row and then go see Dr. Brain on the 13th day.  I am barely handling a regular schedule as is; I'm just tired and no wonder since I've done very little for a month now.

I got pulled over tonight.  Apparently I cut a sheriff off when I pulled onto the road?  I truly don't think I did, maybe it was closer than it should have been but it looked to me like he was in the other lane when I pulled out. But I am so tired I'm not reliable.  I only got a warning, which was nice of him.  I got the insurance cost for my new car today and let's say insurance shopping begins this weekend for a VERY good reason:  this new policy is EXTREMELY expensive.

Anyway, I need to work on sleep.  I have to finish an eval when I get up.  So much for starting off right with the not doing work in the mornings thing.  But this one is complex and I need to be able to think clearly to say everything right.  Plus, it's really all Petco's fault.:)

Friday, November 26, 2010

Weird. Yet I'll take it

I am so puzzled.  Yesterday I was so incredibly sick.  The fevers and coughing finally calmed some and I slept around midnight.  I slept all day except for when my mother woke up up while excited about shopping and kept asking questions.  But even that didn't wake me.  I did try to call Dr. Body's office but they were closed.

However, things were better.  Tired, but without fever, less coughing than usual, no drippy nose or sinus pressure, and the wheezing even was having probably the best day in weeks.  So I had a 24 hour cold?  Which made me feel that bad?  Makes no sense.  If it had been stomach issues I'd call it stress from being sad about the holiday, but it wasn't that.  Just plain old weird.

The only thing  new today was diarrhea which came out of nowhere.  Because of my meds I get diarrhea about once a year or less, but today I got surprised by it.  My stomach feels fine and my guess is that it's related to so much drainage,but yuck.  That can go with whooping cough but usually during the most sick period, not now.

I'm still worn out and intended to go to sleep early, but this entire thing has been bizarre.  Yet pleasantly better than I'd thought.

Thursday, November 25, 2010

Thankful, I guess

I spent today being miserable.  I feel like crap, I have had fevers most of the day which seem to be breaking again right now judging from the sweating, I am very pale, my heartrate is back up to 100, my nose is sore from being wiped, and I cried for hours.  Not getting to see my niece kills me.  She is just over 4 months now and I haven't seen her since she was 2 1/2 months.  Huge changes there.

So, my somewhat pathetic thankful list (this is for today.  I'm too sick to think about beyond today).

  • -Because I know the material already and was given special permission to do training at home on the weekend I was able to get nearly 3 1/2 hours of work done.  Since this is a holiday I'll make a good bit of money from that and a good bit of the time I was actually listening with one ear and reading blogs with my eyes.  (Don't tell, although the suggestion that I might be ok to do other things while listening came from my boss jokingly).
  • I have had a new showerhead for some time now.  I haven't had time to change it out.  However, with the breathing crap I've wanted to because it has a mist feature that may feel good.  So, working slowly and unsteadily I have a new showerhead to try out when I get enough energy here in a few minutes
  • I have been so feverish and gross today that I've been dying for clean sheets and far to unable to move to change them.  Thanks to generally feeling disgusting and bothered by my messy house (I've been extremely sick for 3 solid weeks now, remember.....) I have managed to get down to only one sheet on the bed.  Again after resting that is coming off and clean ones are replacing it.  That and a shower might actually feel good.  
  • I'm thankful for having the nebulizer.  If I didn't breathing would be incredibly hard today.
  • I'm thankful that I'm apparently ahead of my time; when trying to find out why this stuff takes FOREVER to get through a treatment (45-60 min) I discovered that it has been shown to effectively treat bipolar and further trials are underway.  I know few bipolar people who could actually sit still and do this routinely (I find it absolute torture) but apparently it's widely available in pill form outside the US as a cold med I think.  I still don't know why it eats up hours of my life.
  • I'm thankful I took the initiative to get the mask.  Since I'm clearly not done needing this and feel more gaggy with extra drainage the mask makes a huge difference in comfort level.  I think it slows it down even more though.
  • I'm thankful that I can email my doctor and as long as he gets the email early he'll know that I'm very sick again and really need to see him.  The office is only open for a partial day on Fridays and with being closed today I'm going to assume it's going to be hard to get in to see him tomorrow, and that's going to mean trying to get a message to him that lets him know what is wrong well enough to treat it and make a decision about steroids, again.
  • I'm thankful for a shower after a treatment.  This stuff is sticky.  The directions crack me up by telling you that if your face is sticky after a treatment to wipe it with a damp washcloth.
  • I'm thankful for water.  I'm consumed an ocean of it today.
  • I'm thankful for the internet that has kept me quiet and entertained today.
  • I'm thankful for having done that load of whites which I wrote about a few days ago; I've been through a lot of handkerchiefs today and would have had to switch to tissues if I hadn't done that and been patient through three dryer cycles.
And now I'm getting sleepy, which is too bad since I'm an hour away from sleep, but at the same time is a huge blessing as I've been awake for 12 hours and not been sleepy at all because of discomfort/inability to breath.

I quit

I woke up this morning FREEZING.  Then I realized I did not feel well.  My whooping cough symtpoms come and go; today is a come day.  Seems like about every other day is bad.  But I also have what seems like a sinus infection.  So, tomorrow morning will be up early to call Dr. Body's office and either get more meds or go see him.  Again.  Because once a week is an appropriate frequency to see the doctor....At least I've been making the most of my COBRA coverage.  I had to purchase it for only 2 weeks coverage, but it's covered 1 visit to Dr. Brain, 2 (now maybe 3) to Dr. Body, a month of Seroquel (thousands of dollars), a month of patches (hundreds to a thousand dollars), a month of several other meds, a nebulizer, the meds for the nebulizer which I suspect are also expensive, 2 rounds of antibiotics (soon to be 3 and the 3rd will be a strong one) and 1 visit to Dr. Mind (sort of since it barely covers those).  So for once $362 seems reasonable for Cobra, especially since my deductible was fully met.

On the other hand I do not feel well, and that's making me more emotional.  I'm also more sensitive, making me have hurt feelings because my mother didn't notice I was crying when we just hung up.  I sound so crazy all the time now with the changes in my voice from the illness(es) and coughing that I'm sure she thought I was just starting to choke again, but still.  I hate this alone thing, even though if I ONLY had the sinus infection I probably would be grounded then too.  Of course I wouldn't have the sinus infection if I didn't have the other.........

I am so frustrated and tired.  I left my sewing machine at my mom's because I fully intended to be down there today using her washer/dryer and watching her puppies.  Now she has to curtail her time at my sister's to be back for the dogs and she's disappointed because she made me some dessert that I won't be eating today. My mother is not at her most supportive lately.  In fact she's driving me crazy but that's another post for another day.  For now I got my tears out and I should try to find something to eat for lunch.

Wednesday, November 24, 2010

Not participating

I imagine a lot of people want to read thankful blogs this week.  And while I am very thankful for many things and am very well aware of the miracles I've had happen in my life in the last year, I am also struggling.  Last weekend when I thought I was going to be hospitalized I felt a secret relief in that at least in the hospital I wouldn't feel so isolated.  But that didn't happen, THANKFULLY (see, I'm capable even though I'm not emphasizing it this year) and quarantined. So tomorrow I'm trying to keep as normal as I can for a day off.  I'm not sure how else to cope.

I'm very excited right now as I got home and decided I just had to try out knocking down the walls of that basement room.  OK, can we say FUN!  I wore a particulate aspirator and goggles so I look like a huge bug (I may take a picture) and so my lungs were protected and about 1/4 of that wall (plasterboard at least) is gone.  Soooooooooo stress relieving.  Dr. Mind will be happy I didn't find this one until now; I think when he first knew me he was convinced I would one day rip apart my entire house including things like walls when I was manic.  Not manic now, just dying ot know what I took on.  I can do this.  I have to read how to take down non-weighbearing studs, but it can't be too hard.

Anyway, I had a long day.  Because I'm a new employee for a job I've been doing 6 months I'm having to do new employee training that can include things I've been doing 6 months.  I spent an awful hour this afternoon "learning" how to operate the computer program that I have used every day since June 1.  One of the test questions included pictures of several buttons, including one that said "edit patient" and asked which button you'd click to edit a pt's profile.  It also taught you how to scroll up and down and how to click to fill in radio buttons.  It was the longest hour of my entire life, or so it seemed.  And there's a million more of them to do......

I have to set up my breathing treatment before I fall asleep.  That's the real reason I started beating on walls; I needed to wake up a bit.

More tomorrow I'm sure...

Tuesday, November 23, 2010

Random assortment of stuff

Tonight I may have carried the strangest set of things into my house ever to enter these doors at the same time.  My list:

1)  Overloaded clipboard with stuff I should look at tonight but won't because I'm tired.
2)  Oxygen mask to replace the tube thing on my nebulizer that I was supposed to hold in my mouth; it gagged me.  For anyone's reference in the future you can get an oxygen mask at a medical supply store without a script for $3.75.  I wish I'd done that earlier in the week; I'm doing my treatment now and handling it much, much better.  I also have issues with having my mouth and nose covered so I've had more fun but this is better.  Plus when I cough I don't lose meds because I'm holding the gaggy thing away from my mouth.

  •        2a)  Funny, well, more like ironic.  Dr. Mind and I were talking Saturday about how to get me comfortable         enough to sleep.He suggested a recliner; I explained I don't have one, only couches because I hate them although I was considering buying one if I got desperate enough.  He looked puzzled ( (who has strong opinions against lazy-boys?) but we moved on; I wasn't in the right place to explain the role of a recliner in the early childhood abuse.  Two seconds later we were talking about how I have to keep my mouth and nose covered while outside until my lungs heal, and while this was given as a warning not a directive the fact is that cold air can make me choke like nothing else does.  The problem is that I also HATE having my face covered.  Dr. Mind said something mildly about that probably being from someone holding my mouth to keep me from yelling.  It is, but what he didn't know is that some of the memories that make that the worst are from being held down in a recliner.
3)  A burrito from Sheetz.  For those who don't have Sheetz it is a gas station chain that has a kind of short order kitchen that has relatively decent food.  I'd never had their burrito but it sounded good tonight.  I got 2 meals from it and it was good.

4)  A 3 lb. hammer thing for taking down walls.  Wimpy walls, not sledgehammer territory.  

5)  A respirator for use with construction projects to prevent inhaling crap into my lungs that would then have to sit and rot until I can cough it up which I'm beginning to think is never.

6)  Paperwork for my new washer and dryer.  Have I ever explained my theory about houses and cars?  They talk. I bought the house and my 35000 mile Focus fell apart (piece of crap car).  I bought a car, my dryer died.  But there was a really good sale at Sears on a front loader that met several criteria I had in mind for new washer/dryer when the time came (which I just didn't expect to be yet, but maybe it wasn't a good idea to wash a 22lb blanket repeatedly in a standard weight only machine) so now I have to knock down two walls in my basement (hence 3 and 4 since I can't brethe in dust but these are wimpy walls) because the ahem, very nice and thoughtful people who built this house added a bedroom down in the basement by sticking up some plasterboard.  The problem is that this traps the washer and dryer in the laundry area;when I moved in I had to pay a plumber to move the hot water tank so they could be installed.  This time I am not doing that; I have realized how obnoxious that bedroom is because it blocks light, messes up the logical shape of the basement and it is disgusting and I'll never use it as anything anyway.  So this weekend the walls come down and the DISGUSTING carpet  comes up.

7)  Paperwork for my new Sears card which gives me one year with no interest.  I'm fascinated by this.  My credit was so poor 2 years ago that Sears cancelled my card while it still had a balance because I was so bad at paying it.  And now my credit is good enough to get a new credit card AND a new car with a good interest rate.  I've worked my butt off fixing my credit, so this is certainly something I've earned, but it's hard to get used to it. (My credit score is about 150 points high than it's lowest point; I REALLY was in bad shape for a while.)

8)  As always, the dreaded scarf so I can make myself believe I'm suffocating again tomorrow.  Yay.

(And by the way, I'm totally freaked out about buying a car and a washer and dryer in the same few weeks.  I haven't made big purchases in so long (well, except my furnace and windows but I had saved and paid those off immediately).

Also, I find it funny that Sears offers 2 choices:  Free delivery, saving you $69, or 0% APR for one year, so for a $1000 purchase at the 26% interest,it's $69 versus over $250.  Hmm, what should I choose....Now I have to make it through 3 weeks either drying my clothes 3-4 times per load or dragging laundry to my mom's.  Which should be fun since I have very little free time in the next few weeks; I have an all weekend training next weekend and the following is Dr. Brain and after that I'll have my own machines again.

Ok, I've been writing for 30 minutes and this nebulizer is STILL running.  Tomorrow I'm going to start cutting the dose a little. This med is hard to find so that means unavailable around here and I won't be back to the city to get more until next week.  I think I can get by with less per treatment and make the possibility of treatments last longer.  I could be wrong, but I'm going to try.  I wonder how much longer this is going to run....Or how long before I give up on the last of it.  Often when I see less medicine coming out I decide it's been long enough, another reason that I am going to try to cut the dosage.  I don't have 45 minutes in the morning to do this.

Who can guess?

OK, so in the last few weeks I've managed to get whooping cough, spend 2 weeks horribly sick, get so sleep deprived I nearly wound up hospitalized, had my dryer stop working properly, and now......well, you guess.  The clue is that it is from my vacation and I never once sat down outside naked.

Otherwise, today actually went well.  I got a decent amount of sleep, got up on time (even more important now because the nebulizer thing takes FOREVER.  I am so thankful he put me on the lower of 2 doses of the higher concentrated of 2 solutions.  It's like an hour and half investment by the time I prepare it, do it, and cough stuff up until more is loosened.

Dr. Body and I had a good email conversation.  He admitted to not looking the inhaler up and that while he thought the interaction potential wasn't extremely high that caution is best with me and so it wasn't a good idea.  (I'm realizing how much worse the inhaler made me Saturday because it agitated me, which was the last thing I needed).  He said he wasn't insulted  at all by my decision to stop.  He told me that I'm right and that steroids would be most effective but at that point Dr. Brain would have to take over.  In turn I told him that I've never explained my fear of steroids and that he needs to not be afraid to tell me it's time for them even though it does mean hospitalization. When I was 24 I flew from grad school in Michigan back to where I did undergrad in PA for a wedding and the day after I arrived I broke out in hives over both legs.  My insurance found a dr. for me and I was started on prednisone, a fast taper.  I don't think that would have been so bad but on the way home I started feeling sick.  Since it was an extremely turbulent flight in a small plane I thought it was from that, until I starting expelling a week's worth of food.  I didn't know that when  on prednisone that means "GO TO DOCTOR" and so when I woke up the next day with hives from my toes to my scalp I was rather freaked out.  I then had to go through a high dose steroid taper and it messed horribly with my mood.  I screamed at a classmate in front of the rest of the class and the "teacher" (didn't deserve the title); I wrote a paper on the ADA and sobbed my way through it; my moods were out of control.  Now we know why and that I was having a mixed episode, but at the time it was just scary.  And from then on I don't think I have been 100% asymptomatic again.  It was another year before bipolar really affected my daily life, but those steroids changed things forever.

I fell asleep right there and have no idea where my thoughts continue.  So I guess I'll just post.

Sunday, November 21, 2010

Well, there's some good observation

Whooping cough starts with about 2 weeks of cold-like symptoms then turns into what I've been through the last few weeks, then coughing tapers off over several months.  In my case I totally ignored the cold symptoms.  I kept complaining that my allergies were crazy this fall, that I usually don't have fall allergies and here I was with a dripping nose and sneezing clear through October/early November.  The "allergies" never got worse and I had been having allergic symptoms for a while before that, so there wasn't a definite change.

But.....I just washed a giant load of whites.  I don't use a lot of white stuff (only socks really and I have a LOT of socks), so I sometimes go a couple weeks or even 3 between waiting to either need socks or have a full load.  The other thing I consistently use that is white are handkerchiefs.  I'm allergic to most tissues so at home I typically use handkerchiefs.  I had no clue how many I'd been going through until I just folded my laundry and realized how many I've used in the last 5 weeks (how long it's been since I did whites thanks to illness and being away).

Those were SOME allergies.....

Breathing

So the nebulizer helped clear enough junk that I slept last night and napped a little this afternoon.  It wasn't as effective at getting stuff necessarily out of there, but at least it opens my airway a little.  Sleep has helped a good bit.  I don't feel great emotionally but I don't think this is going to land me in the hospital at any time in the near future either.  If it does it will be physical, not because my depression is scary.  It's bad now, not scary.

After spending $35, about 2 hours, all of my patience, 7 large insect bites and some screaming in frustration where not-nice words were used, I finally have my dryer hooked up.  At least theoretically.  I'm not sure it is hooked up well, but everything is where it should be.  That was not a good project to take on while sick.

Tomorrow is back to work. Not sure how that's gonna go; I feel bad enough still that if I hadn't been off for 2 weeks I wouldn't be going in. Please pray I can work out for Tuesday to be work from home or traded for Friday in  the office.  I really, really need that appointment with Dr. Mind.

I felt better enough today to sew a bit.  Not a ton but I've been dreading it because it was a new experience and potentially tricky but so far so good.  I made my niece a bunting for winter wear but thanks to a typo on the package I made the wrong size and it's huge on  her.  So I'm making another, but using fabric I already had.  The  problem with it is that it has a back side that sends off my sensory issues, so I got a liner to put in it.  Which has meant sewing on a slippery surface, trying to make sure the stitching for the lining doesn't make the overall bunting look funny, and I couldn't take the stress until today.

Not much else to say.  Trying to be patient with the nebulizer, which is very loud and makes multiple noises at the same time, which is unpleasant, especially combined with the dryer noises from downstairs.  Ever since I ripped up the carpet in the spare room which is over the dryer the dryer has become very loud and in this case the noises are additive.  Oh well, the neb. should be done soon.  Or so it seems.  This thing is so slow.  No wonder my patients find them so annoying.  I'll deal with annoying though if it gets me sleep and breathing without wheezing.

And then I shall begin the preparation for bed because I'm hoping to find a way to sleep earlier than midnight-2 AM.  Midnight is the best I've done lately and that's way too late for a work night.

Saturday, November 20, 2010

Some progress

As easily anticipated Dr.Mind was very worried about me.  I've fallen into all the thought patterns that accompany severe depression for me and he understands the need for hospitalization feels imminent, be it for steroids or because if this gets worse it is going to get a lot worse, very quickly.  He was going to email Dr. Brain and give her his take on the situation.  He also tried hard to find any time he could squeeze me in next week.  I managed to squeak out my concern about  having to wait until 12/2 for another appointment and he has nothing available. He finally added me to Tuesday morning and I'm going to try to talk to them about doing my computer training from home that day or working on Friday instead of Tuesday.  I have no idea if that will work, but allegedly I'm doing computer training nearly exclusively right now and I'm pretty sure it can be done out of office.  Please pray for that to work out.  My mother has me all anxious about it because she threw in about 50 negatives on this, which I do not need right now.  There is already way too much stress and depression of my own making, I don't need help.  He also pointed out that I've kind of have system breakdown; he had to cancel one of my appointments, I had to cancel the next.  Two weeks between is never, ever good.  Then Dr.Body goofed yesterday which freaks me out more than it should, and Dr. Brain isn't responding quickly.  It adds up to my feeling very unsupported.Which is none of their intentions or even their faults, it just scares me.  With Dr. Brain it's especially hard because there is a lot of playback of last year as I got sicker and sicker and she didn't answer and didn't answer, because she was dealing with her  newly diagnosed cancer.

I went and got the nebulizer and the stuff that goes in it.  One treatment into it I knew that this is what I've been needing.  I actually have coughed up actual nasty stuff a couple times.  Which is gross but I've had my throat and lungs full of crap for over 2 weeks and this is the first stuff to finally come up.  I coughed a lot after the first treatment and then actually slept for 3 hours or so.  It felt so much better.  The 2nd treatment didn't seem to be as effective and I'm very wide awake so my nap that I needed so badly may have cost me. I am a little frustrated that I had to find this medicine myself and ask for it because it actually fits the profile of what I need very well.  It's just rarely used and apparently almost never outside of a hospital.  But it's effective including for my current diagnosis (whooping cough caused this but now I have tracheobronchitis--ie my who breathing apparatus above my lungs is a mess) and has few side effects and no interactions.  So I know why it didn't immediately pop into the doctor's head but I just wish I hadn't had to wait for it.

 Since tomorrow is my last chance to catch up on sleep before work starts again I'm going to take hefty psych meds as soon as I quit writing.  I have a few meds that I have a little leeway on using.  I've been holding off on the extra until I knew I wasn't sleeping because I don't want to snow myself.  But I also need sleep, and a lot of it, if I'm going to turn this around.  I feel like there is a little more hope of that after Dr. Mind and that bit of sound sleep.

Good night, I hope.

MAOIs, a little about them

WinnieNinnyPoo had stated on my last post the very truthful statement that just because a side effect can happen doesn't mean it will.  And that made me realize that I may never have talked much about MAOIs and the restrictions and the difference from a side effect.  And people in general don't know, and therefore they get insulted sometimes when I can't eat ________ or they don't believe I can't and that I am being picky.

MAOIs work differently than other antidepressants.  Instead of affecting serotonin and/or norepinephrine they block chemicals called monoamines (the I stands for inhibitors).  When these meds are in the body they can interact with an amino acid called tyramine.  Tyramine is mostly found in soy products, aged foods (cheese, alcohol, aged meats, sauerkraut) or foods that have spoiled even slightly (and other things I don't care about and didn't learn, although I do know many products and brands that use soybean oil as a main ingredient)`, and I assume in a lot of meds (it might also be that any med can potentially trigger the same side effects the MAOI has is contraindicated.).  If you eat tyramine or have a reaction to a med your blood pressure can skyrocket and kill you.

Obviously this means that starting an MAOI is a commitment to watching out for interactions.  The foods I pretty much have down although I've messed up slightly a few times without issues (I've never had more than a tiny amount of what is off limits).  The meds are too many to memorize, especially since I also have a list of meds that I can't take with lithium and a list of meds I'm allergic to.   I also don't want to memorize them and have anyone rely on me to know them as I do with lithium because a mistake could be literally fatal if it's the wrong mistake.

That's why I was upset last night.  It's not a side effect, it's totally contraindicated and inappropriate for me to have that med.  It's like my doctor having me eat a huge chunk of cheese.  At this point in my life side effects are nothing; put me on a med, pick about 5 of the worst side effects and you've got my life.  I don't care about side effects and I deal with a lot of them.  I do care about dying or having a stroke though and that is where the problem lays.  Even though my blood pressure was fine when I checked it doesn't mean that I had I taken another dose or two it would have been fine.

Last year I got severely dehydrated and the patch was new to me and I didn't know I had to remove it if I was dehydrated.  The contents of it concentrated in my blood stream putting way more than was safe out there.  When you're really dehydrated your blood pressure should be low; due to the patch concentrating it was quite high for me.  That's all it takes; MAOIs are volatile meds and that's why they are very rarely used (you have to fail on basically every antidepressant out there to wind up on one of these usually) even though they are extremely effective.

And there's your  psychopharmalogy lesson for the day...

Sleep.overrated......

I got about 4 hours of sleep and  then woke up.  Better than none.

Have I been offensive with my whining and complaining the last few days when I should be talking about my happy vacation?  I ask because when I log in I'm told how many followers I have, and while people come and go 2 people left since last night which is an unusually high percentage of you.

I''m sorry if I have offended you.

Friday, November 19, 2010

Oh yeah

I forgot one small detail in my last post.  I paid $50 for the inhaler I shouldn't have had.  He offered me a sample of the less fancy version but described side effects as agitation; I asked to not go there as I'm agitated enough.  And really I think the stuff he gave me agitated me anyway.

Fantastic.

When MAOIs suck/Time to review the rules with Dr. Body

I always read about meds before starting them.  Always.  I also require my doctor to check interactions before giving me any meds.

Today he was in a hurry.  I figured he ran it while out of the room because he always does.  We did discuss why I wasn't using this previously and I didn't know.  I do though remember him looking something up at my first visit and I think it was the inhaler he gave me today now that I have the memory.  But I was so very sick last week that nothing registered. He's used to my being aware and defensive about anything that comes up, and I wasn't today because these meds are so far from my experience.

So I got the inhaler and started it immediately.I have only used it twice, thankfully, when I pulled out the patient pamphlet and saw that it interacted with MAOIs (that's my patch).  I ran a search and sure enough, severe interaction because it can skyrocket my blood pressure.  So, end of inhaler that was actually helping a little.  More tears.

Tomorrow I'll be getting a nebuliser.

I've now sent him another message which means he's probably ready to get rid of me.  I feel horrible because I've been very, very needy lately.  Or all year.  I have seen him so many times in the last year between him taking care of my psych care when Dr. Brain was off work, then the flu from hell, then my ankle, then a work physical, then there's been my weird pain/UTI thing in the summer, and then I was in for lab orders, followed by an email request for something for my head yeast infection (as gross as it sounds), and also a few general questions.   We also had an appointment to discuss my decreased pain sensitivity issues and my confusion about how to know sick from not feeling well and that I'd felt I had wasted his time not knowing.  That was our first discussion of specific abuse. And during my lab appt we had to discuss my crazy female problems.  Days after the yeast med was "um, tell me about whooping cough" and a few days after that I was in with it.  And then I was in today and frankly felt he was half blowing me off, not in any sense but he was rushing and didn't listen as well as he might have.  He was nice, but he made that major error of not looking up the inhaler.  And then I came home and sent a message to let him know that I've let Dr. Brain know that I may be needing/opting to try steroids and will need to be locked up for that.  And now ANOTHER message that he tried to kill me.

Part of my feelings come from the difference in his practice.  He used to spend a lot more time with me and was more careful.  He used to schedule extra time for me and made a show of caring how I was doing.  Now it's always hurry, hurry, and I don't know if it's the practice or because the practice hates my insurance. Regardless I'm going to go to private pay for visits when my new plan starts if they don't accept it because they take it as an exception for me and get paid almost nothing.  I can pay out of pocket since I'll get it back at the end of the year anyway in taxes and I want to see if getting fully paid for a visit nets me enough time that he does not make this kind of mistake.  If he makes this kind of mistake again I will have to actually talk to him about it and that he can't kill me and I can't imagine changing doctors but he committed YEARS ago to taking the time to make sure my allergies and interactions were safe and he really failed me today.  Had he said "it does interact with Emsam but it's mild" I'd be fine.  Or "check your blood pressure a couple times to be sure", again, I'd be fine.  But now I have no way of knowing if he made a mistake or not, so I'm now off the med that seemed to actually help a bit.  And I'm just so very tired.  The sole reason I love Dr. Body is that he doesn't put me through this kind of thing.

Again, it truly may not be anything.  The Emsam papers do  not specifically rule out this kind of medication.  The inhaler papers do very specifically state that it should be used with extreme caution if at all with the MAOI. So maybe I can use it.

I DON'T KNOW......And I won't know until Monday night.

Right this moment I truly hate my life.

Medical status

So last night I realized that feeling so bad so long is making severely depressed.  It took about an hour to write 3 paragraphs to Dr. Brain to tell her I feel like I'm in trouble.  Then I realized my sats and heartrate are all messed up.  Dr. Body and talked and found an inhaler and some kind of cough medicine stuff that I'm trying.  If that doesn't work I have a script for a nebulizer and a med that apparently will be hard to find, meaning I'm going to be trying to get it while in the city tomorrow to see Dr. Mind.

The whole thing is about avoiding steroids.  Steroids make me manic and they also correlate strongly to the one and only time I've taken them I was not diagnosed and they made me so out of control manic that it was the beginning of the end and I never really went back to where I was before them.  However, steroids will work.  The other stuff might, maybe work.

I don't know what is next on his list, but I made a pretty drastic decision today.  If I keep feeling like this I'm going to wind up hospitalized as it is, because my depression is significant.  Therefore I have contacted Dr. Brain about whether I can be hospitalized for safety while using steroids, hopefully briefly, and I just let Dr. Body know that unless he has something else up his sleeve he really thinks will work, that if I'm not better in a couple days (deadline enhanced by the holiday) that my preference would be to go inpatient, be sedated and get through this than to go on not sleeping and feeling like I can't breathe all the time.  I would much rather have a place saved for me on the mood disorders unit that I didn't use than to wind up going through the ER on a holiday, which also eliminates Dr. Brain's control of things.

Hopefully one or both will get back to me soon.  And nobody will think I'm playing doctor. I don't want to do that, but I also don't want to keep feeling so crappy and the difficulty breathing is getting very, very old as it makes me feel anxious and panicky all.the.time.  Which is no fun at all.  Someone has to look at mood disorder plus physical health and I'm the only one who sees both ends of it.

Hoping for an email or 2 soon.

Oh.

So I know that I'm depressed and tired of not feeling well and that has a lot to do with my hours of crying last night.  But I did some quick experiments and there is a much bigger reason:  not only do I feel like I can't breathe when I'm laying down, I really can't.  I did some monitoring of my oxygen saturations and at one point they were down to 83% (should be 95, 90 is acceptable minimum, 83 is not good).  I also discovered that moving  lot of ways makes it much, much worse trying to breath, but that leaves me laying the direction where my sats drop the most.  So I have lots of stuff for my doctor to consider.  I also had absolutely no idea of how stressed I was about money, and I paid bills and I'm fine, should make it through this week without hitting the savings fine.  Ideally I can make it through next week too, but we'll see.

Basically I think I left all the stress behind and then came back and it all smacked me in the face.

I will try to put up my vacation stories later today.  I need to get ready for the doctor.

Thursday, November 18, 2010

Snarky

I don't know why I feel crabby, but I do.  And while I'm ashamed to post this, I need to because it is another sign that my whatever-she-would-be-called (ex-friend doesn't feel like something that is possible or something) hasn't changed in the making things your way vein.  She was one year behind me in college, but a change of majors kept her there for a 5th year.  Therefore she graduated 2 years after me, even though it wasn't really her "class".  Nonetheless, you graduate when you graduate.  On her facebook she has listed her graduation year as the year it should have been, not what it was.  I had to count back to figure that out.....But how goofy.

I'm having a very frustrating time uploading pictures to get prints.  I've been working on it for 3 hours.  That's a lot of the crabbiness, on top of the whooping cough related stuff.  I'm going to give that a few more days, pray I get some sleep, and if I'm still teary by Monday I'll contact Dr. Brain and maybe up my Seroquel a bit.  I have the authority to go up another 50 mg but am scared to while already so tired.  But I'm not sleeping much or well which then makes me cranky and emotional.  Two weeks of sleeping tons and not resting well is definitely adding up.  I'm so glad next week is only 3 days long.  On the other hand going back to work while this tired is going to be HARD, and going back and having to carefully seek out info on each referral to determine how careful I need to be is going to be stressful, as is wearing masks a lot and not really telling the patients why.  The plan is "oh, I've had bronchitis", but some people will not believe it's not contagious, esp. if I'm wearing a mask.

I'm also emotional because getting left out of Thanksgiving sucks.  I think I came home and thought everything would be back to normal because I was home, and instead I'm still sitting here trying to swallow glop. I know that every year I whine on here about how hard holidays are, and they are very hard, but this is 2 years in a row without Thanksgiving.  Last year we just had a pot roast and kept it to my mom and I because I was still so messed up from the hospital and med changes, and literally was told by Dr. Mind that he would write me an excuse but no Thanksgiving.  This year I think it would be totally overwhelming as it is the merging of our tiny family and my brother-in-law's large one and I think the baby will cry a lot as she is used to a very quiet, gentle routine, not 48 relatives wanting to make a fuss over her all at once.  But still, it's my niece's first Thanksgiving and thanks to whooping cough I didn't get to see her yesterday as planned and I won't see her until Christmas.  Which means I won't see her between 2 1/2 and 5 months old.  And there's the tears, so there's the issue.  I'm just so very frustrated; the last time I saw her she was fussy, so I've not gotten to hold or play with her since Labor Day.  And for something I'm trying so hard to stick to, building a relationship with her, this just sucks. That was Dr. Body's synopsis of this disease and he was not kidding.

So I've now cried and cried and emailed Dr. Brain that I need help, so hopefully that will take care of the rest of this.  Hopefully Dr. Body can help me breathe tomorrow, and if I'm really not seeing patients this coming week I may talk to them about working from home.  I probably WILL talk to them about working from home for Thursday at a minimum, because if I can get even a few hours of my training done then I'll feel like I did something productive and will have something to not feel sorry for myself about, and the sooner I can see patients again.

Now I just need to figure out how to not flop over when I try to sleep.....


This was the actual path I was supposed to be following.  Clearly the lesser traveled path......I had to search for the way a few times.

Spoiled cats.....The one on top cried the whole way there and until 5 minutes from home on the way back but he loved every second of it.  The one on bottom said "Jen, it's COLDDDDD" when we arrived, which was quite accurate.  She also had just puked about 4 meals up, thankfully all in her carrier.  Not thankfully her stupid owner never considered car sickness as it had never come up before, so she had fish for breakfast.  For the trip back today they each had a tiny bit of chicken because I was not doing the all windows and moon roof open for air deal again.

Back. And very, very stupid

I have lots of great stuff to say about my vacation, which was perfect.  I also have tons of pictures to share gradually.  But unfortunately I'm also sleep deprived and in that state have been so very, very stupid.  I'm sleep deprived because my throat is full of glue and if I lay down I can't breathe and so I can't sleep very well at all.  I'm going to the doctor, again for this tomorrow.

But in my fatigue I just broke every rule I have for myself.  I keep thinking about how I was starting to work on building back some of my old relationships.  I have not been doing this lately because of stress and instability and med changes and whooping cough and not seeing Dr. Mind in 2 weeks.

So I got curious and I have no idea why, and so I decided to go looking for trouble.  Specifically I did a facebook search on the person who hurt me more than anyone ever has, including the abusers, because she was someone I worked hard to learn to trust and to love.  And I found her.  Not a lot as she has privacy on most things, but I read her husband's blog and found out enough to be sad again.  And to wonder what would happen if I contacted her now and finally was able to say what I didn't get to say back then because I was too sick.  I feel like I've been waiting to do that for years now, and yet there's also a part of me that just wants my friend back.  My friend who was there for so much.  My  "friend" who hurt me so badly when I was so sick that I wanted to die and when confronted with the notion that one does not attack someone who is suicidal told me it was "a risk she had to take".  My "friend" who accused me of being possessed, of making my other friend be part of my life because they felt sorry for me. My "friend" who had strangers vote on whether I was a Christian.

But also someone who was young, and hurt by my illness and the behaviors related to that, and someone who didn't understand.  The strong part of me says "But she was given every option.  She had free access to the person I confided in most (a psychologist friend) with or without me; she was offered the chance to come to my therapy sessions; I even offered to meet halfway and I would pay for ADDITIONAL therapy.  She declined all of this as well as any books or webpages which might have helped her understand.

There is nothing to gain from contact with her.  Except maybe closure.  Which is weird because I spent 3 months writing a letter to say good-bye, and before those 3 months were another 10 1/2 months of huge distance between us after the attack.  But something in me wants to see if she's changed, if she cares, because in my heart I can't find a way to not still care about her.  And to some degree I want to say that I'm sorry I hurt her.  She hurt me deeply and may still be totally convinced she is right in all ways.  I don't want to know that.

I look at my life and I see so much.  I see happiness and friends, and tentative family relationships, and although I've had bad moments with bipolar I have not missed a day of work because of mental illness since I got out of the hospital last year.  I don't see a life permeated with illness anymore.  I see a life affected by it, a life that always will be affected, but not a life devastated.  I see a Christian, I just don't see a church-goer or a detailed Bible reader.  But Michal makes sure I have Bible study, and we discuss faith in therapy (Dr.Mind is an ordained pastor), I pray, a lot, and I do what I can.  And now I know, after taking 7 years to figure out that because God give grace it doesn't matter what Christian traditions I can or can't follow, it matters what I believe.  I'm not sure though that would do any good to say all this.  I know I wouldn't, matter of fact.

I just want my second chance, a chance that is not wise. And part of this is an abuse thing, because you don't get to fight back against abuse if you are being smart (I was often not smart), and the fact I was far too ill when all this occurred to fight back and instead I AGREED with it makes me feel cheated somehow.

I don't want to hurt her.  I just want to show her that I was ill and now I'm not.  But not such a good idea.....Especially when I'm so tired.

Speaking of, I have to get up relatively early (for someone who has done nothing but sleep for 2 weeks) and  go to see Dr. Body, so I should stop now.  But because I have to share at least ONE  three pictures:



Sunday, November 14, 2010

Off to camp

Very quickly:  I own a Forester which came with more add-ons than I thought but without them seeming to affect the price.  (ie I got a very, very good deal).  I think they got the most basic model they could in, charged me base price for it and added what I wanted and charged for that.  Regardless, I love it.  I will love it more after I have time to read the manual today.

I'm off to camp soon.  I'm taking my computer so I'll probably write and then make a bunch of posts at once when I'm back.  Hopefully with great nature pictures.

Anyway, I need to start loading the car.  I'm feeling better but that kind of thing is still exhausting.

Have a good few days!

Friday, November 12, 2010

whew

I am exhausted.  I have just returned to bed after 8 hours away.  And I did things in those 8 hours:  carried in the contents of my turnk, got mail, drove through the pharmacy, finally realized that what sounded best in all the world was a slushy and when I got that the girl didn't wipe off the drips so I got covered in grape slushy.  Then I drove to work, did stuff for an hour, drove to my moms, cleaned part of the car, boxed some Christmas gifts, ate dinner, cleaned the car, drove home, brought in more stuff, threw in some laundry, drank tea, and am trying to stay awake long enough to flip over laundry again.  I can't believe how tired I am.

Oh, and when I talked to my mother about the COBRA thing mentioned in the last post she got all pushy about couldn't I go to the City today and get my meds?  Well, it's kinda of 70 miles north of here and I was going 70 miles south of here....so not so much.

Tomorrow is going to be insane.  I have to go to 2 stores, do the paperwork for my car, and see Dr. Brain.  I'm hoping to do all this and be home by 5.  That lets me finish packing and get to bed pretty early.  Then Sunday morning I have to give my cat his shot to stay calm for the trip, load the new car, and drive to Camp Jen.

I'm officially showing signs of moving into the 3rd stage of whooping cough, "convalescence".  It's the longggggggggg stage, and during this time I'll still cough very easily.  I hate scarves and don't own one (yet) so I wound up having to wear a mask driving today because I couldn't have air circulating without choking.  But as this stage develops it's suddenly understandable how my ugly raw throat hasn't hurt much or how I have been unable to cough anything up to help me breathe; according to what I've read the crud thins some around now and from what I've seen if this is thin I must have had concrete in my system previously.  As I understand it the sore throat etc. will be around for a while because the disease damages all the cilia in the throat (the little hairs that move stuff around) and until that re-grows things stay irritated.  Apparently every cold in the new few months will bring back the cough of doom, although at least not the real illness.

Convalescent or not I'm just about to fall asleep so this laundry either hurries or gets changed first thing in the morning and I deal with not having a clean shirt to wear then.

I made this

Before I got sick, probably needless to say.....The picture is crummy but I'm pretty proud of it.  (And the shutter in the background is a touchy subject....don't ask!:)



More pictures to come later if I feel ok.  I forgot about my recent photo project and haven't even looked at the pics, but I have Appalachia on the go  for your viewing pleasure.

Right now I have to drive to work for 30 minutes, then I'm stopping at my mom's on the way back so she can help me scrub my car since that's outside of my abilities right now and tomorrow is the big trade-in day.  Hopefully I'll get to her house in time to nap a couple hours.

I have to go to the post-office and pharmacy on the way down so I suppose I should get moving.  I just don't want to.  (A theme I believe we'll be hearing frequenty for the next while.)

Thursday, November 11, 2010

The cost of whooping cough

...is a LOT!  At least when you time it as I have.  For one thing I lost an entire week plus a couple hours of pay.
There are the direct costs:  2 co-pays for doctors, $50 of meds, $10 for a box of masks.

But it all gets worse.  My insurance stops tomorrow, although they may back-track to when I actually quit working; that happened when I was in the hospital.  I had planned ahead and ordered refills on meds that would run out before my new insurance starts.  I was hoping to avoid COBRA; I was going to have to pay for one visit with Dr.Brain and 1-2 with Dr. Mind, but those I could live with.  However, my psych meds come from a pharmacy in the city that actually handles them (most chains don't stock and can't obtain Emsam), and I didn't go see Dr. Mind today.  Which means that I'll not have insurance when I fill them Saturday.  And since I am therefore going to be charging what I think is about $1500 worth of meds (2 scripts only), COBRA becomes much more cost effective.

That means that I'm going to have lost a week of salary AND a COBRA payment, which is another big hunk of money, AND I am not getting out of my vacation quite what I intended, making it a bit more expensive.

Oh well......it could be so much worse. I kept watching the sales lady at RiteAid tonight stare at my mask and then my (thick, not falling out) hair and then my mask.  The questions literally were bursting out.  She settled on "is it hard to learn to wear those?" instead of asking my diagnosis like the other time I've been in public.So I thought you asked, you get to worry, and explained I haven't worn them much (which is a lie, I have worn them plenty on the job but that's boring) and that I have whooping cough.  Her exclamation of "WHOOPING COUGH!" probably got the attention of everyone in the store, but whatever.  I'm masked and Purelled, I'm not contagious when masked and it's not my fault I caught this.  In fact I caught it doing something good.

There is also going to a psychological cost as I had to skip Dr. Mind due to lack of ability to think, talk, or care.  I see him next week, but the week after that is Thanksgiving.  Which means we'll have 4 weeks with 3 missed sessions.  Which frankly scares me to death.  Can't help it, but that's way too many missed sessions especially while I am facing both a job change and the painful restriction on seeing my niece.  Which makes me cry if I think of it.  Or of her for that matter.

Regardless, out of the few hours I've been awake lately there've been a lot of tears and stress.  I can't explain quite how much stress I feel just wanting to be well, but it is a LOT.  I know perfectly well that this kind of thing happens to me more because my immune system is weakened by my meds and by the high stress level I live with as part of the illness.  But just think, in my first 2 years with this job I am anticipating reconstructive ankle surgery, a couple days off this spring I HOPE for an endometrial ablation which may mean testing before that is done but that is my ultimate hope so I am no longer having periods 50% of the time, a week off with whooping cough, 2 days off in July with mystery pelvic pain plus UTI (probably related to the endometrial ablation thing), and who knows what else.  That's ridiculous, and that's before any psych related stuff.

Anyway, getting sleepy.  Need to take cough meds.

Night.

Some good, some bad

Today I slept until about 2.  I was up for a while with stomach cramps and for a while it looked like I was going to add fluid loss from both directions simultaneously to this experience.  (Both vomiting and diarrhea are part of it).  I've already done the vomiting bit and figured it was about done given that it is supposed to happen with the worst of the coughing.  Ultimately I decided to try hard to lay off the cough med for the day.  I have, but my belly is still quite upset and well, I really didn't need to hurt anywhere else.  My lungs and throat already burn all the time.

But I did have a little more energy today and did a few of the things that must be done.  I took a shower (here's how sick I've been:  it was the first since Sunday), emptied some of the stuff out of my car, went in for more meds and masks for the next few days and found out that one med had to be ordered so I have to go back tomorrow.  I'm in the midst of washing sheets and blankets; I just need to feel really clean and after 5 solid days in bed nothing you've been near feels all that clean.

I've coughed less today and had a bit more energy but it's unbelievable how tired you get.  Right now I'm trying to recover from sitting up to sew for about 10 minutes then walking to the basement and back.   I am getting a bad headache from all of this activity, something I had a lot at the beginning.

I'm starting round 2 of antibiotics, this time for a possible ear infection.  I don't think it is but I'm not sure.  It hurts but not constantly.  I have the stupid high pain tolerance thing as well. And Dr. Body didn't look when I was in, probably because at that point I was coughing so constantly it would be been chasing a moving target.

Otherwise, I'm pretty much just really grouchy.  I feel overwhelmed by things that I need to do between now and leaving Sunday.  None of it is huge, but it's enough to make me very tired.  I hope this vacation isn't a huge mistake.  If I'm still so sick all I do is sleep then it's not worth the money.  Hopefully it will be nice and I'll be out of bed some and find something enjoyable.

Time to change out laundry.  Then hack.  Then go get the 2nd bag from the car, the one that actually has my antibiotic in it.  Then hack. Then feed cats.  Then hack.  See the theme?

Wednesday, November 10, 2010

The hip bone's connected to the knee bone...

I don't remember that song in full, but that's enough.  The whole body is connected.  Important to remember.

Since getting sick I've wondered how this would affect my bipolar.  When it very first started I actually thought it was benzo withdrawal because I was at my mom's and forgot my meds and I'm on a high dose of klonopin and have been warned missing it can cause withdrawals.  Well, that theory didn't hold up.

However, it all comes together.  I'm so tired all the time and I'm sure that the antipsychotics and benzo at high doses probably have their role in the fatigue, although certainly not the major one.  The major part of the fatigue is that it goes with the illness.

But I finally found out how it's going to affect things.  First I had to cancel with Dr.Mind, or do a phone session which may be hard since my voice is very raspy and hard to understand.  We'll see how I'm feeling.  I don't have a lot to say, but we know from experience missing 2 weeks in a row is always bad.  So we'll see what we figure out.

The icky part for now is that I have not been good at taking my AM meds while sick.  I haven't worried about, thought about, or cared about them.  My AM meds are all meds I take because of problems the other meds cause.  Well, I'm finally paying for that.  I've not had any Nexium in a week and Seroquel for me means Nexium is a must.  So now I'm trying to calm down heartburn while not able to take anything fast acting because of interactions.  Maybe that will teach me.  Maybe not.

Anyway, time to try to get to sleep.  Again.  (Actually I only took 2 2 hour naps today. Big change).

Car buying Just Me style

I think that for me the biggest thing was knowing my own strengths and weaknesses.  I am not easily talked into things, but I do start to trust when I shouldn't.  So I had to go into this with a clear idea of what I did and did not want and readiness not to waver on that.

I did a lot of research first.  In reality I did a lot of research on the wrong car because I was convinced I wanted an Equinox until about 5 days before I tried out the Forrester.  I also gathered information on comparable cars because I knew I wasn't supposed to let the dealer know I really wanted their car.  That let me counter things with "well, I'm pretty sure the Equinox also is rated for higher mileage.  Not by much, but some", which shows I'm not doing this blind.  Had I been actually testing the Equinox I probably would have made sure I was full of facts about the Honda CRV and Toyota Rav4.

I find Consumer Reports really helpful with major purchases and this was not different.  I read their instructions on test driving before I went and was therefore ready for some trickery.  I didn't get much of that from this dealership, in fact I only caught her once and that may truly have been nothing more than her not thinking (the 2011 model has a different engine with more expensive oil but fewer changes.  She was recommending a 2010 which probably was just to get rid of 2010s).  If I did catch a discrepancy with any dealer I called them on it.

After I had driven the Forrester and knew it was what I wanted I started doing a lot of research on it.  I used edmunds.com for this.  Edmunds has this thing that lets you find out what you should be expecting to pay for the car you want in your area.  It also has tons and tons of reviews, consumer reviews, etc.  There is a piece on there I was fascinated by; they sent a journalist out to sell cars at 2 types of lots over a few months and write about it.  What he shares is fascinating, including that the first job he got he was hired (on the advice of another car salesperson) based on his answer to "what makes you want to see cars".  The answer: "I want to make a lot of money".  There was a lot of information in that story.

I also was able to submit requests for pricing to several dealers through Edmunds.  Subarus aren't common around here so there weren't a ton of choices.  But I found this very educational.  When I test drove my car I felt comfortable with the young woman selling the car and she proved herself by answering every one of my thousand questions over the next several weeks.  The other dealerships ruled themselves out during the brief period of negotiations.  One dealership actually got angry when I asked to test drive a 2010 loaner they had when I said that unless it had what I wanted and was a good price I wasn't really ready to buy yet.  Their snottiness got them sent to spam right away.  Another refused to deal at all on the internet.  One thing I know about myself and that was really shown to be true for most people in my research is that if they can get you into their bargaining area, on their turf, they'll get the best deal for them.  So they were excluded.  The 3rd dealership kept giving me great prices, but not on the car I was reqesting a price on.  So I'd go back to my salesperson and say OK, here's the offer from ________ and she'd say "um, check on that.  It doesn't make sense and this is why (inevitably it would be that the dealership would lose thousands of dollars)".  Each time they were quoting me the wrong year, the wrong model, whatever, again to get me to come in and then find out "oh, that's a mistake if you want a 2011, THIS is the price for that".  They also kept offering to knock money off and give me coupons and things if I'd just talk to their finance person.

The place I dealt with wanted me to give what I thought was a fair price.  This was hard as I have this guilt that they may not profit enough, which is goofy since they're not taking a deal where they don't profit.  The biggest trick with my car was that I wanted remote start which had to be purchased and installed as an add-on, and that was expensive.  But finally I told them if I could have everything I wanted under a specific price I'd take it.  Suddenly that remote start got a lot cheaper (like free I think).  I knew from Edmunds that this was a totally fair price, a few hundred less than average for this area.

The other thing that I did that I'm really happy about is that I got precisely what I want. I think I mentioned that I had 2 things I really wanted and beyond there are a lot of "luxuries" on this care because it's not the base model because one feature I wanted required the 2nd level up.  That feature is adjustable lumbar support and well, let's just say 4 hours in the car daily, sometimes more.    The other thing I really wanted was remote start.  This saves me going on the ice to start the car to warm it, which isn't great for my ankle. That they had to put on the car, but like I said I managed to get it for a good price.  The other few things I wanted were things I found out about after I trialed the car, little things like a cargo net, a screen to cover the back area for privacy, and this thing that goes over the back part that is hoseable to keep it clean.  I like that idea a lot.  So those few things were only a couple hundred dollars.

Normally the dealership is going to try to say "we don't have just those features, but look at this car" and they may even take some off the car with the other features but it will still cost more and still you'll have things you didn't want to pay for.  That was one of the things the bait-and-switch dealer kept trying.  I'd ask for a quote on "exactly this car:  2011 Forester premium with remote start, cargo net, cargo cover, and cargo tray and nothing else" and I'd get a quote for (if he was really with it) a 2011 with remote start, package A (which includes my options plus other things for about $300) and one other additional feature I didn't want, like integrated GPS.  I have a brand new GPS unit, why do I want another?  So I got them (and they offered because the person who wound up making the sale did listen) to trade for a base model with no features and put on what I wanted.  I also could have ordered a car even more specific to what I wanted but then I'd have had to wait 2 months and for various reasons I want this done by 12/01/2010.

The biggest struggle I had was making sure I was getting the best deal and not going with the person I liked.  I became pretty sure though the 3rd time the other place quoted me for a car I did not want.

Now I'm in the phase of avoiding extras.  I had an extended warranty on my last car and never used it be did like the piece of mind.  However, I'll blow through a 100,000 miles in a year or 2, so it doesn't make sense now.  I also just turned down scotchguarding and waxing (read what Edmunds has to say about those extras, it may be in the journalist turned car salesman thing), and a maintenance plan.  The maintenance plan may make sense for someone who was not going to use up the miles included in the next 6 months, but I am, and it also is difficult as I live an hour from the dealership (any Subaru dealership), so I won't even get there easily.  The only extra I'm interested in is there is a car/homeowners discount policy for Subaru owners and I will check into that.

Otherwise, I'm trying a new tack to get through the signing part fast.  I was very honest about my whooping cough and that I would not be contagious but probably would wear a mask (it's very hard to cover your mouth through the whole cough when it hits) and that I needed kept away from infants, etc.  My bet is they get me out of that dealership FAST.

This may be be the best method, but for me internet dealing levels the playing field by removing shyness.

I'll still be very glad to be done with this.

Just my luck

I talked to work this morning.  They don't want me back until I am 100% contagion free, which isn't until Friday night (unless you have no immunity, then it is a ways off).  So I don't get to work Friday.  Which is fine.  Then they called back and need my computer because it's due for an upgrade to a whole new computer next week and among several reasons including that this is really important because my computer is dying rapidly and needs replaced ASAP, and also there is some stuff that has to be done before I can start as their employee.  So Friday I have to drive down, spend about an hour in the office, and drive home.  It's unavoidable but exhausting to think of.

Still waiting to hear about my earaches.    Hopefuly I will hear back because my cough med choice (only option) comes in liquid and tablets.  I didn't even know the tablets existed and have always had liquid.  Well, turns out the liquid is better for sleeping.  So I asked for some of that too.THe only reason I really care when they call back is that I'm so tired and I have a hard time falling asleep while waiting.

I have a done a few minutes of stuff today.  Mainly just moving things around so I can start packing for vacation and moving things in from my car before the great trade-in adventure.  Tomorrow it's getting professionally cleaned since I'm too sick to do that, and so I have to empty it gradually between now and then.  I wonder what my mom has tomorrow.  It may be that she can help me get things in.

Up next, per request, the car buying strategies that worked for me.

Well

I just talked to work.  They want me off all week.  Which is fine as I was thinking working Friday might be a bit much.  They were so sweet about it, just said I've been working really hard and this happens.

I think I know what patient I caught this from.  I wasn't near the one we knew had this, but if one person has it in an area others do, and it is usually misdiagnosed.  I remembered suddenly last night this patient who was coughing her head off, but she had a pneumonia diagnosis so I figured it was that.  Now I think it she had pneumonia it was secondary to whooping cough.

I had to call in for meds for earache.  I don't know what earache is like exactly since I've not had it in forever and only once in my life, but I have 2 ears that don't feel so good.  The one thing about that is I'll finally get out of the house.

I can't believe 15 minutes on the phone exhausted me, but it did so I guess I'm outta here.

Tuesday, November 09, 2010

Welcome to my world

Want to hear what I sound like?  Follow this link and in the right column under sounds go to the child without whooping (2nd one down).  Note that it plays continually until you stop it, which sounds about right from how it feels.

Thankfully with constant strong cough meds I cough like that only maybe 10 times daily now.  Through yesterday it was too many times to count, and it still increases if I move out of a few positions.  I can't still up straight or stand for long or I trigger coughing.  I also trigger coughing if I try to do anything more difficulty than throw food in the microwave.  Even though it's less frequent it's still intense and I have had things go black a lot of times in the last few days.

I'm concerned I'm getting an ear infection too.  I've only had one of those in my life and don't know what it feels like, but one of my ears has been hurting consistently for hours and it doesn't seem to be changing.  So if that doesn't improve I'll be calling the dr. again tomorrow.  Undoubtedly more antibiotics will follow.

And now it's time to get ready for feed-cats-take-meds-sleep again.

I believe

I was reading something that it mentioned a song I'd pretty much forgotten.  Yet it's an inspiring song and inspiration is going to be valuable during the next 2 months.  I'm going to have to stay strong or I'm rapidly going to add depression to my problems.  Today has been a bit teary, anxious because I've not heard from work and I have this fear of being fired; sad because not being allowed to see my niece for so long is killing me; disappointed because my mother of "don't buy a new camera you can borrow mine for vacation" forgot it at my sister's and in her usual sensitive way thinks that it's ok to suggest I stop and pick it up on the way to vacation, just staying in my car and only having contact with adults.  But that is unbearable sounding.

Anyway, this song came out in the summer of 1997.  That was my last summer as a camp counselor, and also the summer of manic fun.  I had more fun in that summer than in the rest of my previous life combined and even if some was because I was manic it was also sort of my little gift from God before the illness began to really batter me.  It was like the theme song of the campers that year, every session (it was a camp for kids with special needs).

So here's my little reminder:


"I Believe I Can Fly"

I used to think that I could not go on
And life was nothing but an awful song
But now I know the meaning of true love
I'm leaning on the everlasting arms

If I can see it, then I can do it
If I just believe it, there's nothing to it

[1]
I believe I can fly
I believe I can touch the sky
I think about it every night and day
Spread my wings and fly away
I believe I can soar
I see me running through that open door
I believe I can fly
I believe I can fly
I believe I can fly

See I was on the verge of breaking down
Sometimes silence can seem so loud
There are miracles in life I must achieve
But first I know it starts inside of me, oh

If I can see it, then I can do it
If I just believe it, there's nothing to it

[Repeat 1]

Hey, cause I believe in me, oh

If I can see it, then I can do it
If I just believe it, there's nothing to it

[Repeat 1]

Hey, if I just spread my wings
I can fly
I can fly
I can fly, hey
If I just spread my wings
I can fly
Fly-eye-eye

Probably all kinds of cheesyness in there but it's also just a happy memory thing and I am going to need happy....

Now if they just would invent a STOP WORRYING THAT YOU'LL BE FIRED song I'd be in good shape......

Feeling whiny

I am going to be learning patience in the next 2 months.  I am getting bored laying in bed.  However any activity triggers coughing.  By any activity I mean that I went to the kitchen and started mircowave mac and fake cheese, carried my very small very light TV 20 feet to my bedroom, got a cup of orange juice and brought my food back to the bedroom and that was enough to make me need cough meds.  Which make me very, very tired and slow to think and do cut the cough but I have to stay still for that to really make much difference.  I tried TV; it just annoyed me.  And frankly money is scaring me.  LIttle things add up.  I realized I'm too sick to get my car adequately cleaned up to sell Saturday.  That means paying for detailing, which is undoubtedly a good thing, but also not cheap.  I have to buy vacation stuff including food; my plan to take pre-made leftovers is pretty limited by my fatigue and inability to cook the last several weeks.  I am all worried because I need a scarf because I can't breathe in cold air.  I don't know why I'm so worried, it's hardly a bit deal, but I am because my mind is just not able to problem solve right now.  All I want is to sleep, and right now I'm sleepy but not able to fall asleep because I'm worrying.  I am even worrying about things like work saying that they don't want me anymore because I'm a pain.  I don't intend to be....I know they won't do that, but after 15 months of everything being about being sure the customer is happy I don't know what else to do.

Again, this worked out right.  Even if I have to use my credit card more than I wanted in the next week I have already gotten the financing on my car so it doesn't matter if my credit score is affected.  That's the most important thing to remember about money.  That and it IS only money and I'll get through this.

Now I need to get my fingers busy.....

Monday, November 08, 2010

Ok, truth time

I haven't wanted to go into what is going on with me until I knew for sure.  This seems so far out and unlikely.  But sadly it is real and going to change my life for a while so here is my new reality for a bit.  Please forgive typos, I'm on strong meds and typing isn't easy.

About a week ago I found out that someone our agency is working with had pertussis (whooping cough).  I haven't seen this pt, but those who did before she was treated were at risk for catching it.  I knew that I may or may not be immune to this because I am allergic to DPT shots and was given them in 1/2 doses as a kid, then later told that this may not actually do anything.  So I requested that if anyone got it that I be notified, and went on my way.  I did check in with the dr. about it to be sure that I couldn't do anything to prevent it.  He told me if I got it I would have a very bad bronchitis and that nothing could change this now.  He also told me what med I should start if I got it.  Thursday night I felt extremely tired.  I went to be very very early and had a bad headache that woke up repeatedly for more tylenol through the night and the next morning.  Friday morning I didn't feel well but in a totally nonspecific way.  By noon on Friday I was coughing hard enough to have to pull over on a road with nowhere to safely to do this in order to vomit.  I left work early and saw an urgent care doctor who was completely clueless about MAOI/lithium restrictions.  He also gave me no dx.  He did though give me the correct antibiotic.

I spent the weekend alternating between drugged sleep and coughing fits.  I have coughed hard enough to have everything go black, a bunch of times, to have near incontinence episodes, etc.  It's been very bad.  It was obvious by Saturday that I wasn't working today and I saw Dr. Body today.

So now what I know is that I'm going to feel bad for quite a while.  I am facing about 8 weeks of coughing although my contagious period will be slowly reduced over the next days and mostly will be over by the time my antibiotics have been doing for a day or so, which is mid-week.  The antibiotics only help other people though, they don't make me feel better.  I have a lot more prescription cough meds for that and the dr. said I would benefit from an inhaler or aerosols, but I can't have those because they'll make me manic.  He explained that my unfortunate situation is that I can have the major meds, the ones that keep me alive and things like that but there is very little that can be done to keep me comfortable under most circumstances.  The worst part is that I am not allowed to be near my niece for 4 weeks and that means I'll be spending Thanksgiving posting from right here.  I am deciding that this is God's way of protecting me from what tends to be an overstimulating holiday which would be increased by a thousand as we start a new tradition wtih my sister's in-laws and our family all together, which is LOUD and which I suspect will cause my niece to cry.  A lot.  Like all day.  Which would be hard for me.

What is good is the timing.  I'm allowed to work in the office on Friday with a mask.  Next week is vacation; I'll be unable to hike unless the air is warm, but I can at least rest a lot.  Then I go back to work for 3 days and have 2 days off for Thanksgiving.  So during the time I'll feel worst I'm only going to miss 4 days that weren't planned.

However, I've made a lot of plans lately.  None of them included being this sick or for so long.   I'm going to lose a week's pay now, which is bad.  I have no clue what happens to my patients; I'm trying to make myself remember that coverage is not my job and that I can hardly go expose people to this, and that I'm far too weak and tired and groggy (when medicated) to work right now; I'd not be any good to anyone.    I just can't believe this happened.  When I first felt bad I actually counted the months and realized it was the longest I'd gone without a sinus infection needing antibiotics in YEARS.  In fact, probably since I started seeing Dr. Body and he convinced me that since we knew every cold becomes and infection thanks to all the meds I can't take that I needed to start treatment as soon as it felt bad rather than the traditional wait for a week to be sure it's not a virus.  And that's been about 5 years I think......

So, that's what is going on.  Right now the emotional parts of this haven't really hit.  I did learn that Giant Eagle is fairly stupid and when I stood there with a mask and told them I was contagious and could they fill my script faster than 30 minutes they refused to jump it over others.  So I wandered Giant Eagle focusing very hard on not coughing as my cough would scare anyone.  That was fun......People stare.  A lot.  I needed some things but could have been done and out in 15 minutes but they kept me for 30. I'm sick enough my doctor didn't expose himself to my mouth or nose, but Giant Eagle will expose everyone to anything apparently.(Not that I told them I had whooping cough, that appears to induce panic based on whispered conversation about my mask while I was in line). And then I learned some really important:

IF A STORE PROVIDES WIPES FOR CARTS, USE THEM.

I had fully intended to wipe down my cart on the way out.  Too bad that they take your cart from you at checkout and fill another with your groceries and then the person behind you gets your pertussis germs.  I will never get groceries again without cleaning the cart.  Not that this in any way protects the person who got my germy cart and I was too stunned to say no, don't use that cart (too sick, really, just couldn't think it throughout until I was writing this as at the time all I could think was that I couldn't clean the cart,not that someone was immediately getting their food stuffed into it).

So I'll probably be posting more soon out of boredom.  This is not going to be my favorite week I'm afraid.

Jen

Saturday, November 06, 2010

Sick

I will explain this more in a day or two, but just know that I'd really appreciate prayers.  I'm sick, and I'll explain what it is likely to be when I know for sure it is or isn't, but it's nothing that bad, yet nothing that it would be good for me to have been spreading.  And I feel rotten.  For now let's say I have severe bronchitis, bad enough to make me vomit from coughing and I've had to grab a wall for support when the coughing made everything go black.  My heartrate is racing after the coughs and I'm very tired.  So I'm not able to be coherent and really am not awake all that much.  As for prayers, please pray this is ONLY bronchitis and for protection for my patients, also that I can get in to see Dr. Body Monday and that I will be cleared to work. There's a chance I won't be allowed to work for several days and since I am on vacation after this week (and I'm carefully not asking but I don't think they have coverage for that really) and can't make up anything on the weekend I don't know what would happen.  I also have one patient who I am worried about as I think she damaged something but I need to see her again when it is less acute (planned for Monday) to assess that.  And I seriously doubt I'll be working Monday because it would be a huge leap to recover enough to be able to do that safely.

I know this makes no sense and a lot of that is what happens when the only cough med you can take is liquid vicodin and you mix it with high dose psychotropics.  I've backed off of the Seroquel a bit, but I have to keep my lithium level stable and I can't skip Klonopin while I'm on such a high dose.  I missed my daytime dose but have to keep taking a pretty stable amount or I'll go into withdrawl, which frankly doesn't feel good.  I'm just not very clearheaded right now and this is the best I've been all day.

More later when I can make sense.......

Thursday, November 04, 2010

About you

On the last post Michal posted this and then I answered and realized the answer was becoming a post.  So, here's the conversation.


There IS a point to doing this! Yes, there is a lot of stuff that's been difficult to read but your aim was not to amuse! I appreciate your honesty. This "diary" has value to you, too. Thanks for letting us ride along.


No, you're right Michal, this is NOT a funny blog.  I think when I started I thought it could be, but that was before I realized that my sense of humor had changed.  I used to be  funny, the kind of ability to pop out funny statements or put together random bits of information and come up with some "only Jen would see that" observation. Some of that was mania.  Some of it was really me but has been lost or changed by my illness.  I can still be funny, but in very different ways now and being able to tell funny stories about this illness isn't where I am yet.  But when I first couldn't do that I felt it was one more thing I'd lost and this blog was supposed to discount the notion that bipolar meant loss.    I had this idea that I could write and show how normally I lived--never mind that I was terribly ill and living far from normally.  I thought I would be descriptive but not personal.  One of the original aims of this thing was that my friend a psychology professor sends students to read this to see what bipolar life is REALLY like.  I had to warn him away this time as it  was just a bit too intense for some college student to jump into some of my posts of the last 6 months with no warning.  But one thing, I actually did myself one better this way as I have changed to making this be bare naked honesty and while I can be proof that bipolar is not the end of the world (nor is abuse), I also have a blog that shows that you can't be severely bipolar or have my past and not be affected somehow.

You're right though, it is more for me than for anyone and that was the reason I didn't stop back then, although I never imagined back then when I had days and days nobody came or one person came that I could get as many hits as I do now or that I would actually have followers and be on people's Google reader.  I love all of you who come here and your support is invaluable in a world where nobody knows about such central truths to who I am, but that you come and handle my horror stories tells me so much about all of YOUR strength and compassion.  Through this blog I find more compassion in people than I have found in my life as few people have such compassion in my life.

Those of you who come here and read not knowing if you're going to want to vomit, or cry, or be angry or sad or laugh, I admire you so much.  It takes courage to READ this blog.  Believe me I do know how much.  You have no idea how many people will ask a questions that gives an answer that indicates that perhaps my childhood was hard.  Some people just change the subject not knowing how I'll feel about that.  Others are scared at the notion, like I'm going to immediately start sharing everything bad that happened.  And that's just not happening.  The only people who know most of what has been on here are you readers and 2 psychologists. That's it because I don't talk about it ever.

I read a lot of blogs.  Sometimes they are about painful topics because I find I can learn a lot from people going through their own pain.  I've been reading lately a blog called www.careforannabella.com and right when I learned of it and started reading the baby died of a horrible disease that makes the skin so fragile that a brush can peel it off.  The grace with which her family has handled her illness and loss is something I find myself thinking about frequently.  But I also know how hard it can be to go to a blog where you know there may be/will be stark pain.  And that's before you add in mood swings!

So thank you to each who comes here.  Thanks to my faithful support commenter team, and to those who read and don't comment but see something that makes you come back anyway.

Wednesday, November 03, 2010

On bravery

A topic quite frequently on here has been my very gradually learning to see myself as brave and acknowledging I've been strong through a lot.  It took 4 years of trying before Dr. Mind succeeded in this, and it was the hospital that finally made me say so softly he could hardly hear that yes, I had been brave and it had taken tremendous courage to go off my familiar antidepressant knowing how sick I'd get, then to react to my suicidal thoughts by making myself safe by dumping hundreds of pills out and then admitting myself to the place I feared the most.  When all that was over and started to recover I knew that this had taken humongous amounts of courage, especially because I made the decision myself and matter-of-factly did what had to be done.

I don't know if I mentioned this here but about 2 months ago Dr. Mind kind of took over the start of my session.  He told me that something we'd been discussing had made him think of someone he knew who grew up with a serious illness that killed them at an early age and how he had always been so impressed by how brave this person was and how she kept on living no matter what.  He said I'm like that.  It was kind of mind-blowing, because that's a huge compliment and I didn't know how to answer.  I still don't, to tell the truth.  You also have to understand that Dr. Mind has in the last year really brought down a lot of the dr/pt. wall he has held firmer than pretty much anyone else who has successfully treated me.  (I think I needed that with him at first, but he's pretty careful about such things by nature).  For him to go that far is HUGE.  But it still felt strange to be compared to someone with a life-threatening illness.  Except later I realized that bipolar is a life-threatening illness.  15-25% of us succeed in killing ourselves, and my risk was (I suppose is since this a statistic for over the course of having it, not just for when sickest as sometimes it's when well people kill themselves) probably higher than that.  I also say (truthfully) that I was lucky to have my risk become negligible because of 2 things.  One is that I one time in college felt so desperate I thought I wanted to die.  But I didn't have any way except my biology scalpel.  I put in a fresh blade and fiddled with it.  In the course of thinking while holding a very sharp blade I cut myself.  It wasn't really intentional, it was kind of touching myself with the blade and my hand slipped.  It was enough to draw some minor blood and I then crawled into the middle of the floor, curled up in a ball and cried until a roommate came home and was able to help me feel safe again.  I learned though that day that I can't hurt myself that way.  I then always thought if I was going to it would be a med overdose, especially once they started handing out lethal doses of meds to me.  But severe lithium toxicity taught me far too much about how horribly sick med overdoses can make you, and since lithium is the most lethal drug I have and I'm not about to OD on it that's pretty safe (as is working out for Dr. Mind to hold pills for me if needed and some other things).  So I guess my point is that it seems like it takes courage for me to be alive and to do what I do, but frankly it is easier to handle this than it is to handle an actual suicide attempt, esp. with Dr. Mind about to do random brain scans and know when I'm at risk.

I was thinking on the way home about firefighters.  That is courage and bravery.  That is intentionally going into a dangerous situation, repeatedly.  I have no intention.  I am not saying that I don't have strength and that I use it pretty well, but I think that this is what has always bothered my about courage  .I've been courageous at times, but I don't think it's one of the greatest traits I possess because my courage has been selfish:  please save my life...
I just don't know what the word is for what is meant here.

Please help your healthcare workers help you-don't LIE

So today a nurse who works with a patient I've been having difficulty with for some time came over to ask if I knew the patient had taken herself off her blood pressure medication.  I did not.  Apparently only the social worker knew, and she called the dr. but didn't let the clinicians know.  And I'm pretty annoyed by this because this pt. has had some odd new symptoms develop, symptoms that caused us to get a consult with a specialist, and all the time I'm sitting there trying to figure out what was going on she was smugly congratulating herself.  Not to mention I make this woman work hard and since I had no idea her blood pressure was a bit higher because of being off meds rather than just a little fluctuation she kept explaining away by being active before I came I went ahead with pushing her and she could easily have stroked out on me.  So the next visit isn't going to be so pleasant because we have to talk about honesty and how if she's not honest with me I could accidentally KILL her.  Apparently she thinks (per what she told the nurse) that I'm responsible for people reacting to this.  I didn't even know, I just knew she had new symptoms that could be serious and she couldn't exactly hide them from me.

I'm so frustrated.  Everything is a game with this patient and I'm tired of being a pawn.  I'm almost done being a pawn as she's going to meet her goals relatively soon, but I am very, very patient and she is pushing me to the edge.  I'm thinking we're doing great and she's thinking "haha, I feel good because I know something you don't know".

I did complain about the social worker not letting us know.  I have no desire to kill my patients and if they take themselves off meds that I need to monitor something I want to know.  Hope this lady like having her blood pressure taken as if she's going to be off meds I'm checking it as frequently as I desire until I know for sure how it is reacting.  Even worse, imagine if this had happened and my holiday coverage had not known and she'd stroked on them.

Public service announcement over.