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

Thursday, March 31, 2011

Fighting

Today I learned my car repair bill is huge.  Just what I needed with more medical bills about to hit on top of hte ones I already am dealing with.  Then I actually had time to take a quick nap before Dr. Mind and was feeling better when I left here (only worked a few hours as I'm training someone Saturday).  On my way to Dr. Mind with no time to spare I got a flat tire.  Thankfully AAA got it fixed quickly and I was able to make most of my appointment after crying at the idea of missing.  I needed him badly today.

No big surprises, I'm not in a good place. He says I've tried to avoid dealing with a lot until Dr. Brain was back and that this has not worked well for me.  I'm bad enough to have said something a couple times that made him ask the dreaded suicide questions.  Not an issue, bad phrasing of what I said but still.  ick.  Lots of tears and a bit lesson on backing up to the very basic places I am sent when I'm not well and am overwhelmed.

I then got home and my uterine growth attacked me with severe pain. I have a very high pain tolerance and this was BAD. It did this earlier in the month and apparently can as hormones change and while this time it was bearable because I knew what it was and that last time it only lasted a few hours, this time it wasn't that long but it was bad.  I guess tomorrow I'll talk to a nurse because I may need surgery sooner than i want.  No clue how that will work.  But I can't do this each time my hormones spike either.  This may be a case of saw the dr. just in time to avoid not doing this the way I want.  plus if it is certain kind (I don't know and don't know if the surgeons know either) it can twist and pinch off it's blood supply causing that kind of pain.  It's weird, now I know it is there and I can feel the slight change there outside that I never would have guessed before.  I think my dr. was able to feel it from inside, I think she knew what it was before I had pants on.

still waiting for Dr. Body to respond.

not stressed at all...

Wednesday, March 30, 2011

pray for Dr. Body

I just sent him an email.  In trying to reassure myself that if i am willing to get manic and be hospitalized that there are other treatments I found out about a new one.  I will go into it later if it's an option he'll consider (it's extreme in a way) but it is not contraindicated by my other meds and has no psych side effects.  Please just pray he'll think about it.  I suspect it will stretch his comfort zone and from what I read it's not a well-known treatment because it is rarely indicated.  I think for me it just might be.

Thank God for a doctor who won't be mad at me for asking for something specific I found googling.....

Wormie Wednesday

(For the moment my freak-out is on hold.  We'll see how long that lasts, but for the moment i am waiting to hear from Dr. Body and talk to Dr. Brain.)

Ok, if you are squeamish this is not the post for you.  I've had my worm farm running for maybe 2 months now.  It's getting established and doing well.  in fact i'm ready to pull out the first tray of compost as soon as I get another fully ready to go (has to sit a few days).  I got compost a bit faster by using compost that was broken down by time as part of the starter.  I would not recommend this, it killed a lot of worms.  In fact i hate looking in that bottom bin because of this.

The top bin is where the action is and should be though and those wormies are kicking butt.  Because of an invasion of some fruit fly relations that come if you overfeed that was seeming excessive I did what I do through this whole process and followed my instincts.  The worms live in a bunch of shredded cardboard and newspaper and the flies were laying larvae on that and on the lid of the bin.  So I just spent quality time with the wormies, sorting through their bedding, pulling off "worm pods" (the eggs are so neat.  They are hard little balls that change color as they develop, in one stage they are bright gold.  I guess that at some stages you can see the worms inside with a flashlight; I've not tried this yet), and getting rid of the pieces of newspaper that had the most fly gunk.  This also let me really see what is going on in there. It's neat.  I have baby worms that are the width of dental floss and maybe a cm or two long.  I have lots of healthy adults.  I have tons of pods, which is another sign they are doing well.  I have fresh, clean smelling compost, which is the goal.  I even saw some mating going on.  I also have huge worms.  One was so huge i dropped the paper because it startled me; it had to have been 5 inches long.

There's also healthy organisms setting up in the soil, things that help break down the food.  I have to go about a week without feeding because I have definitely overdone in my learning process, but it does feel good that I have managed to get this going.  I definetely don't have the thousand worms i started with, but I don't need that many and at the rate of reproduction I'll have huge quanties soon enough.  They do self-limit their population, which is good, but right now I have a lot of very healthy adults (hundreds) and who knows how many nearly invisible babies.

it did just occur to me that I didn't even check the bottom tray for flies.  Drat.  Tomorrow maybe.

No title comes to mind

Tough night.  I had to use Valium to sleep and didn't get a lot of it then.  So this morning was very groggy.  Still is.  I'm going in to work a tad later and that helps get the crud out of my body.

This whole thing started when I let Dr. Body know that for whatever reason this time the one medication is drastically increasing my anxiety, making it more obsessive than usual.  That led to him being blunt about what I've been ignoring, he doesn't know what else to do besides this.  If the issue were only the anxiety I could deal with it.  Dr. Brain would fix that.  But I am still having almost daily breathing issues.  And I have no quality of life.  Even though I had heard him say that before I hadn't processed it; don't think I was ready to.  I think I needed to know Dr. Brain is with me before I thought about this.  I assume (pray) he means he's stuck without going into meds I want to avoid.  I have had 11 months of my life that were relatively normal and that I got to enjoy living and found out that I am able to do things i secretly was afraid i was just too lazy to deal with.

So I wound up writing him version after version of the same thing, trying to find the words to say that I will make the awful decision to throw my psych. issues way out of whack if there's a chance of it letting me breathe.  At least we know those can be stabilized albeit not easily.  But this isn't stable either and this life is not what I want.So it's not much of a loss I guess.  I wound up saying that and trying to be sure that I am correct and that if this was not me that there would be more of a chance of success.  Because I suspect we're going to have to pretend it's not me and get aggressive.

I just have found another part of me that has been deeply hurt by what I've survived, but this time it is what I survived trying to live so long with unstable mental illness.

I don't like it.

Tuesday, March 29, 2011

Short

First, I am ok.  Nothing terrible has happened.  Basically I am having a very, very hard night as I found out the rather grim outlook for controlling my asthma as is(which I had ignored my doctor saying several times) and had to go to the questions I've dreaded, basically asking if I am willing to risk serious psychiatric effects, what happens then?  I realized finally tonight that I am once again fighting not just temporarily but fully and longterm for quality of life again, and I am just not able to to consider this without a lot of tears and wanting to give up.  I am not handling this well.

Please pray for me.

More when I can talk better.

Monday, March 28, 2011

Weird

I just published the last post and was thinking about it a little, and realized once again that expectations are just a waste of time and thought.

I remember years ago, after I was diagnosed and was in the clinical trial, they did a lot of education as part of the program.  I remember being taught that I would learn to recognize depression and mania (and when my diagnosis was changed to bipolar I mixed type, the combination thereof).  So I expected it would be like the checklists I filled out each visit there.  If I had too many answers indicating one thing then I was depressed, or the opposite.  Granted, mixed episodes are harder and resulted in some of their testing being impossible, and I gave up on mood charting because I couldn't figure out what to put since I had 18 moods daily.

But what I didn't know is that it is my own behaviors that tell me my mood.  It is the behaviors of my cats.  It is how often I change my sheets, how and what I eat, whether I have folded laundry or not, how much anxiety medication I need, whether I want to blog a lot or hide totally away from people.  It is my patience, whether my temper flares at bad drivers, how much I can tolerate noise or excessive movements/lights/etc.  It is a feeling in my chest that is not ashtma.  It is in the hours I sleep and how easily I get there.  It's got to do with when I shower when I arrive home feeling gross. It's my ability to remember stupid things that are important.

Those and others are the things I look at every day and assess in myself.  Not so much like the little checkboxes I thought it would be.

Mixed emotions

As I described before I asked for and was granted an asthma break.  I am struggling with the psychiatric effects of steroids on my mood and need a break to gain some perspective emotionally, to try to sort of some of what I'm feeling, to hopefully get a chance to get the cycling under control (I get to see Dr. Brain in 2 weeks!) and to not have any chemical changes except maybe some psych meds for a bit.  Ideally asthma should be much more controlled than mine.  I am on 4 meds and using my rescue inhaler nearly daily and when I use it it is multiple doses.  I should be using it more like once a week or less, something like that.  .Having said that I'm not sure how possible that is going to be without taking major steps like hospitalizing me for steroids.  I haven't be told specifically that this is the case, but it has been implied.  I am not yet ready to give up and would rather to go through the hell of steroids than know we haven't when my life is so limited and depressing.  Too bad we can't just do surgery then steroids one after the other and get everything icky over with.

I can't even describe how I feel.  I'm frustrated by all that I can't do, and I'm tired.  So very, very tired.  I'm depressed about losing so much I worked hard to have in my life, and because I've been fighting this for so many months.  I am improved.  There is no doubt whatsoever about that.  I no longer cough constantly.  I am wheezy about 90% of the time and have the symptoms I consider signs that I'll need more meds soon probably about 25% of the time.  That's better than it was; I was much more severely wheezy all the time and had the coughing, tightness and chest pain nearly all the time 2 months ago.  However, I want to be better.  I can't quite move behind the feeling that I have put in my fight against one major illness and that this is so unfair.

Part of what made me ask for time off is the realization that I've been trying so hard to be positive about anything the meds did at all combined with my emotions are so changeable I can't really label an emotion at any given time, just sort of give a summary of recent mood swings, which go everywhere.  I can't just let loose and cry and I need to do that.  On the other hand I need to be able to NOT cry when I don't want to; I read something my grandmother had written about her abusive mother and I was trying to read it to my mother and couldn't even get the words out because I was sobbing even though I had already done my crying about it before talking to my mother.

On the other hand, I know now that some of the fatigue may be related to the oh, so there is an actual reason for the gushing blood thing.  My hemoglobin mid-cycle is at the very end of normal and I take an iron supplement daily, so that's a decent sign that I probably have been tired at least sometimes because of anemia. I also have discomfort and now that I'm admitting that there's a cause I actually have minor cramping/twinges throughout the day.  No big deal, but I suspect that also adds up to tired.

It also doesn't help that when my mood is out of control so is my anxiety.  I cannot seem to manage to let things go when I feel like this.  I think it is because my depressed mood hyperfocuses on things while my manic state results in things seeming worse than they necessarily are. I was really upset at the realization that I need sedation to do this procedure until I finally checked my insurance and learned it probably costs LESS since outpatient surgery is just a copay.

What I do know is that my anxiety has become fully obsessive right now and there's not a lot to do about that until Dr. Brain is back.  As it is I'm just using anxiety meds more than usual.  Hopefully I can talk to Dr. Mind about it this week and that will help control it, but I don't know.  He knows I'm doing it, it's come up a few times.  I am struggling so much that I actually took myself off his waitlist for tonight because I HAD to get my taxes done as I was freaking out about  money.  Taxes are done, I'll survive that one, but another crazy idea is sure to form soon.

Anyway, now am obsessing about the date on this one eval I did today.  Must be right or I have to finish it now.

Saturday, March 26, 2011

The next part of the story

Glynnis made me laugh.   Thank you.  No need to bicker, I wish I could do it tomorrow.

I got an email from Dr. Body clearing my break from messing with asthma meds.  The rule apparently is that if I'm not having attack-induced car accidents I'm allowed to slide for a month or so.  That was a huge relief and since I see Dr. Brain in a couple weeks I will  be able to see what she can do to help with the mood being crazy before we try more stuff.

I also talked to my gynecologist.  She wants me to have the surgery done by someone who does more of these surgeries than she does.  (She specializes in uro-gyencology).  While I am doing it she is going to do a test that was determined to be not important last year, an exam of my bladder because of a history of blood in my urine.  I'm somewhat confused as I'd assumed the uterine thing probably did that, but there is a strong impression being made that although this is most likely benign it's time to be careful.  She wants it done in the next few months because of this as well.

The problem is that it's going to be July or August before I can do it.  I'm going on vacation at the end of May-early June and all my accrued time off up to that moment is already going to be used up.  Plus realistically the fastest it would be done is mid-May because there are several weeks needed to consult with the 2 surgeons, and Dr. Brain will need to have input into the safety and possibly the psychological effects of doing it with/without anesthesia.  She things it will be easy enough but I have decided after some thought that this has to be done without me aware.  I'm happy if they sedate me heavily as I can't have general anesthesia easily with the MAOI, but although I've handled several exams well lately I can't handle this.  I'm going to be sure Dr. Mind agrees, but I think the risk of triggering PTSD is greater than the benefits of not being sedated as we're talking a somewhat extended period of time with the exam, the removal of the polyp/could be fibroid, presumably cautery to stop bleeding, I believe biopsy of tissue nearby to be sure, then the scope of my bladder.  I know that if I explained the situation at work they would give me unpaid days off  but I really don't want to go into "I have another health problem" if I can avoid it.  That few months also lets me cope a little better with it all since my ability to cope with medical issues is currently just not there.  And she said a few months is ok.  Truthfully, while this is a nice size compared to my uterus it's not that huge and it's clearly been in there at least a year, so no matter what it is a few months of growing is not that important, especially because it is most likely benign.  And really?  I'd be surprised if 2 surgeons can schedule something together all that quickly when it's not emergent.  If she wants it out sooner I'll do what i have to, but I am hoping to not really tell work what is going on because I'm embarrassed by all my health issues this year.  The other thing is that one reason I like this doctor is that she is aware that these things are very hard for me and that I will avoid them if needed and she's blunt.  Blunt as in "you can wait a few months, no longer.  Your age makes cancer less likely but we need to biopsy this."

So, here goes medical adventure #120341 and also the "yay there WAS a reason for my episodes of pelvic pain in the last year or so and I wasn't making it up"........

Thursday, March 24, 2011

Breaking point

I've not been coping well all week.  I feel so overwhelmed.  My life won't go on hold to let me cope, there's so much I'm dealing with, and my biochemistry is very mixed up from the symbicort to advair to symbicort dance.  It had to be done and while symbicort is harder psychiatrically than Advair it does have the advantage of actually helping me breathe.  It doesn't really CONTROL my asthma but it helps.

Waiting for the test results, and still waiting to know what happens next (I'm going to call and beg for mercy tomorrow because even if the dr. wants to talk to me because she knows I'm going to be traumatized by the ideas she is presenting) has not been easy.  Then I never, ever expected this to be the cause.  I was positive it was just early menopause and that nothing really could happen although I wanted to discuss and endometrial ablation.  I did not expect to hear biopsy and I did not expect to have anything in my uterus.  I looked at the report more carefully and this polyp is not small, it's about 1/7th the size of my uterus.  This makes me more sure it is going to be removed.  Plus it's causing too much bleeding.  I don't really want to keep it.  Yet how do you begin to explain that you have to have minor surgery after all the health problems I've already had at work?  I won't be doing this for a bit because of when my vacation is scheduled (although ugh, vacation is right in the middle of a probable blood fest) but I honestly think I'm going to call it personal and not tell anyone if possible.

I've tried to get in to see Dr. Mind extra all week; it didn't work. Next week he is booked so far but I'm waitlisted and prioritized on that.  I cannot deal with all of this alone.  He told me the longer I was there today the sadder I seemed.  I told him he watched me run out of the manic energy I force into getting me through each day.

I finally decided that it is time for a semi-break.  I emailed Dr. Body to be sure that he's ok with me hanging with partially controlled asthma for a few weeks.  Dr. Brain is back soon and hopefully can adjust something to help me manage the biochemical swamp in my head.  I simply asked for a break.  Allergy season comes soon enough and I'll need to have things changed then.  Medically having asthma only sort of controlled like mine is considered not great.  I want to work for more control but until I can cope with everything that the last 5 months have brought I just can't.  If he wants a check-up that's fine, but unless we have to change meds I want to see if we can handle a month or so at this level where I can wrap my mind around everything that the last months have brought without the assistance of even more screwed up brain chemistry.  I think that will be fine with him; he knows symbicort is really hard for me to handle.

Until then, well, I wanted to just go to Dr. Mind and cry.  Instead I continued the matter of fact story I keep telling and then get teary when he asks questions.  But I'm not optimally letting him help, so I need to be there more so he can see when I'm hiding.

I am just so tired and so confused and so overwhelmed.  I want nothing more than a few days of feeling truly good.  I'm afraid they'll never, ever happen.  I've been here before with my mood, it will improve.  I've never had medications making it all worse though......

I hope a few weeks where I can let my mind think and adjust and my brain chemistry even out will make me a better patient, maybe even more successful at the whole treatment thing.

We'll see.

Tuesday, March 22, 2011

Test results

I know what is wrong with me.  I have a vascularized polyp in my uterus.  I have to call the doctor to find out what happens next, although from what I read typically it will need to be removed.  And I don't have much desire to hold on to it really, it's annoying.

I'll be happiest after I talk to her and know things for sure, but I'm just glad to have a reason.

Mine

I've had a hard time lately finding time to blog.  I'm tired when I get home and can't.  I've been doing paperwork what seems like all the time I have that isn't free.  And this morning I just decided that I can't keep doing that.  I am officially waiting on one person.  Ok, so it sounds more rebellious than it is: I need to talk to the caregiver who isn't available until 8 AM before I can finish.  I am actually physically relaxing from this decision.

I have reached a place where, well, where I need Dr. Mind.  But he's booked and I'm wait-listed.  Not surprisingly because I have so much going on I'm finding everything makes me feel more and more stressed.  Soon I will tell the story of the man who tired to convince me that black was silver (it's actually pertty funny) but that alone was a nightmare of stress.

Most of my labs are back from my doctor's visit last week.  From what I know/can tell from reading a bit, I do not have polycystic ovaries and from what I understand it looks like either something is messing with my hormones or I truly am beginning menopause, as according to the 3 big hormones I am in 3 phases of my cycle.  I am still waiting for the tests that sound scarier and an actual diagnosis.  Because this year has included so many times that things that seemed far out and nothing to worry about that have come true I am really struggling.  The wait is almost over, and I know that not hearing sooner is a good thing, but it's just more stress.  I also switched back to the other inhaler and i can breathe again but am having adjustment issues there as well.

There's more to say about what happened with my mother.  Thank you all for the support.  Don't ever worry about what you say B.  I promise as long as things are said respectfully I like hearing them.  I also need to say that I was not being very fair in one way.  My maternal grandmother died last week.  She never was in my life.  She is undoubtedly the source of some of my bipolar genes and she simply disappeared for 30 years.  I grew up thinking she was dead.  Then suddenly she was back, wanting to be part of our lives.  I talked to her once in my life.  My mother had a civil but limited relationship with her.   Anyway, after she died the nursing home made errors that made it appear my grandmother had lied about having preplanned her wishes and my mom spent tons of time trying to figure out what to do.  So things haven't been easy for her either.

My time is about up.  I can't wait for vacation.  Just over 2 months....

Later.

Friday, March 18, 2011

That will take care of that

Because of the required frequent business use of our cell phones my company pays $30/month and then we get a pretty hefty discount as well.  I was having problems because I needed unlimited minutes but that isn't discounted.  However they were able to help me find a way to rearrange my minutes so I don't have to pay so much.  One of the main reasons I needed unlimited was to talk to my mother.  Well that's not going to be such as issue.

Apparently she feels like I complain through most of our conversations and then get mad if she tried to tell me it's all fine, no problems, etc.  She thinks I am completely negative.  I am not.  I am tired, under a HUGE amount of stress at work trying to keep up, I don't feel good, my bipolar is acting up, work has so much going on that anything that doesn't go according to plan messes me up hugely and stresses me out further, my hormones are way out of whack (from what I can tell from the blood tests and a reference guide), my body is still fighting with steroids, I'm trying to learn to deal with another chronic illness we can't see to control, and oh yeah, I may have to have a biopsy to rule out cancer.  My psychiatrist who normally would help me handle this medically is out for surgery, the doctor handling my asthma has been out, I've had to walk around on 2 sprained ankles and can't take anything for pain and i find being desk-stuck humiliating, I keep getting sick, i barely spend anytime at home out of bed because I'm so exhausted, (I'm also borderline anemic, probably from a combination of not eating well because I'm not hungry and the extra blood loss).  This week I took one day off and have spent the rest of the time making it up because nobody else can.  My company owes me $1500 and I've been waiting on that for months; if I don't get it in the next week I'm in trouble because my car insurance is due.  In fact, I just now realized that it's due Monday so I have to pull out the money saved for family photos if I can't put it on credit.  Oh, and since I scraped the paint off several places on my brand new car and I am not telling insurance I have a huge bill coming there too.  (Don't ask how.  It wasn't something I did, I just feel like I screw up everything somehow).

OK, so yes, I probably complain a lot.  My mood alone would cause that.  But apparently it is too much and she's not wanting to talk to me b/c I don't like her unreasonably happy responses (ie, my asthma is NOT going to go away.  If it does it will be a miracle.  But I'm not supposed to believe that.  I'm also supposed to not think my bipolar could ever get worse again even though realistically we hope for that but there's not promise.  In fact the steroids plus hormone imbalance make it so I'm really doing a pretty good job).

But complaining is NOT my whole conversation.  however, since it bothers her she'll be getting a lot less calls from me.  I know everyone has stress and that we all handle things differently.  However, I suspect that what i'm going through now is on the extreme side.  (And it's not even just that.  I can't have children because I couldn't handle raising them, I wouldn't do pregnancy on meds, and Dr. Brain has told me pregnancy and I would not mix well, as in hospitalizations and general misery.  But now my body seems to be saying "yep, that part of your life is over."  And that's sad.  I'm 35, and while timing doesn't matter it does make me sad.

So, my cell phone minutes will be going down rapidly.........Because she can call me.  If she wants to criticize how I'm coping with all of this then she can talk to me when I get around it to.  Whatever.  I also got criticized and blamed for "winding up" my niece the other day too close to bedtime.  My sister didn't say this, at least not to me.  And the whole "not in her bed, not her house, etc" is apparently not relevant.  Plus she was having a blast and when she got tired and immediately snuggled and read to her.  So again, whatever.

I want time away from the whole world.......except if I leave i pay when ig et back so maybe not......

(Oh, and did I mention this conversation came after I had just left work at 7:20 and have hours of paperwork to do but have to leave at 6:30 AM for my next patient so won't be doing it?)

Wednesday, March 16, 2011

NO.

Today was my trip to the gynecologist.  It was a very long day, oddly NOT because of the gynecologist and NOT because of how the system worked; it was incredibly effecient.  It's just that I went in sure that all that was wrong was the onset of perimenopause, and I left having been tested for that but also a lot of other things and if not of those are positive I will have to have a uterine biopsy.  It seemed as though they think polycystic ovaries are most likely and that's fine if it's true.  I am at a much, much greater risk for that because of meds I take/have taken, so it would not be a surprise.  However, it also doesn't match my symptoms well, at least not unless PCOS has oddball sx that I'm not seeing.  I know I thought about PCOS way back when this started, because I knew my meds put me at risk.  But it didn't fit well then so even if I have it it wouldn't make a ton of sense as the reason for all this female craziness.  On the other hand, I'm praying for it.  For one reason it is easily treatable with just one med that also helps lose the weight etc. that goes with that diagnosis (with side effects, of course and a big diet change).  I also had about a gallon of blood taken, to see what my hormones are thinking, and an ultrasound that was both abdominal and transvaginal (yeah, that was not on my list of things to do ever) done.  The potential answers at this point range from hormonal imbalance of some kind to having contacted HPV when I was molested (tI've been tested for STDs twice at least but she wants to check that again; I don't know if she sees something (I think she did based on when she decided to do this but I can't imagine I've had that hanging aroung for almost 20 years) to uterine cancer.  And there must actually be some risk of that because she said I had to have a biopsy if the other tests are normal and she also told me that while she did the pelvic she was assessing whether she felt she could do it with me unsedated and that thanks to some little anatomical glitch she thinks I can.  Good to know I guess.

I am not worrying about it (at least any more than you do when cancer or biopsy is even a possiblity).  I think she knows I prefer bluntness and probably was just telling me the whole plan so that if things are all normal she's not calling me to say 'um, you need a uterine biopsy as this can be cancer'....I think she was also trying to fix the blunderings of her resident who had trouble following my story, and then insisted 2 things were important:  exercises, which I'd love to be doing but first I have to be able to breathe and then  I have to have energy to do more than sleep and work, and the fact that I am not a candidate for birth control.  I kept explaining hormones don't help me and she kept saying if there is an imbalance that's the only way to fix it and I kept saying then fine, we won't fix it or perhaps we can try ________ instead.  She was really insistent that the Mirena IUD would be great but I pointed out that I thought some people only recommend it after having a child and that since I've never even had sex it might be a bit hard to insert, especially with vaginnissmus that is significant enough I can't use any tampon and the fact that pelvics are highly traumatic for me, much less forcing something into my uterus that might have to just be removed if it had the effects previous treatments have had.  (And that if I am going on hormones we want the thing that will get out of my system fastest, and that i can't start hormones until my asthma stabilizes which seems to be a ways off.  She had clearly not bothered to read the notes from my real doctor.  I kind of think my real dr. chewed her out because she came in and took over.  No more mention of hormones.  My dr. did the exam, which I was going to request anyway because she has a magic trick that makes it not hurt and totally, totally removes all anxiety.  After knowing she would do what she did last time to make the vaginissimus better (and ladies, FYI, there is a muscle or group of muscles at the bottom of the vaginal canal that if you are shown where to relax takes away much of the discomfort of a pelvic and she says this is true for everyone but that few practitioners know/use the technique.) I had no problems with her doing it at all.  I also thanked her for removing the fear from something important for me.  The resident stood and watched and was quiet.

I don't mind the residents.  I've griped before on her about them and I want that clear.  They are there to learn and I am there to help them learn. I've been a student therapist.  My problem is that they consistently want to not listen to the specifics of my condition and history and this results in them trying to force things upon me that are not appropriate for me.  My situation is complex so therefore listening to me a bit about what I can and cannot do is reasonable, and  they need to meet me with the knowledge that my set of issues makes me different.  I'm probably not the best practice patient, although one of my favorite psychiatrists ever was a resident/fellow when I was in the clinical trial before I started seeing Dr. Brain.  I think as a student you want people to fit into a box.  I don't fit.  I remember having this man with an undefined rapidly progressive neurological disease when I was a student.  His plan was to go home so I started treating him the way we treated everyone going home:  time in the morning working on dressing, bathing, etc. and time in the afternoon in the gym.  Problem was that he simply wasn't capable of putting on pants and I was too inexperienced to know this, or to know that sometimes every trick in the book wasn't going to help when the problem was too complex or the pt. too ill to succeed.  I made him cry, and that made me learn the hard way to always consider not only what they can't do, but is it reasonable for them to do it at all at this point.  I apologized, but I have felt bad since and whenever I have a resident who won't listen I feel the same.

I need time to think about all this.  And sleep.

More later.

Saturday, March 12, 2011

laughing

I really need to laugh lately.  Dr. Mind has even noticed that I distract myself with him for a while each session to laugh about something, anything.  Well, tonight I'll share my laugh because it's truly a new one on me.

This is Noah:

Noah is precisely as goof as that totally randomly chosen picture looks.  I love him dearly because he is actually very smart but very, very funny in how he uses his intelligence.  He will sit and look at something with his head cocked for 30 minutes figuring it out, and only act when he has.  He is the cat who constantly finds himself in predicaments; he is afraid of plastic bags and hides if I open a trash bag because he spent an awful 3 minutes flying around the house once with one stuck on his leg until I literally tackled him; when I left him and my other cat in a "playpen" device on vacation I arrived back at the cabin to find Noah guiltily emerging from under the bed.  Somehow he managed to figure out how to undo the (tight) velcro on the bottom of the thing and get out, but leave Anna inside. 

I got tired of laying on my right side or sitting up and so I laid on my left side.  Noah likes to lay on my side when I'm falling asleep.  Well, after a while I felt poking and little head butts on my back.  I petted him, but he continued to try to get me to do something.  I tried to get him to jump up on my side when I realized he won't lay on my right side because that is NOT how we sleep around here.  Poor little guy.  I just won't do what he wants and flip over.......

More from Thursday

I guess I didn't talk about a few more things from Thursday's check-up that I should.  Like I said I forgot to ask/didn't have time to ask a lot.   I also had to hear that I may have to consider changing jobs.  At that my answer at the time was just "no", but I also know that he would not ever say that if it weren't an issue,  and that  I need to think about it as possible.  What I forgot though was to ask little things, like would working somewhere other than the county where I work help, and what on earth I'm supposed to do, because I am NOT going back to nursing home work?  I can travel and try to focus on home health, but there's no promises there and I could wind up in bad circumstances there too.  I'm trying not to think about this because to me it is a very, very last step option.  We're talking the option that happens AFTER I trial steroids inpatient.

The other thing I did that I can't believe I forgot was to neglect to talk about the loss of quality of life and what/when/how that can come back (without giving up the first job that I've been happy and successful for years).  I'm planning to go back in for a check-up in 4 weeks; he didn't say when but by then we'll know if the Advair works and I still need to be able to ask questions that I didn't get to ask yet.  I guess then is when we'll discuss it.  I'm kind of setting a goal in my mind of November as when I need to feel better, enough so that if I make it that long without steroids I will be talking to him next time about doing steroids at that year mark to see if I can get to be Jen again.  I am so tired of this bed.  I'm kind of assuming that by then Dr. Brain will have my moods stabilized again.

I also need, and this isn't just with Dr. Body and I have no idea how, probably more a Dr. Brain thing, but I have no clue what is asthma and what is depression. I'm having manic periods too, but seem mainly to be depressed and intensely anxious.  That seems to be Dr. Mind's view as well.  But how would you not feel depressed after months on end of feeling physically crappy with no end in sight and the ability of anyone to make you feel better being very tricky because of 2 conditions that negate on another?  I also, and i am ashamed to admit this, i've had trouble with remembering patches. i had a case for them in my purse and I lost it and keep forgetting to put new ones in my purse so that if i forget it I really forget it.  I need to come up with a system; I'm just not used to needing on because putting one one was so routine.  i don't know what's making it hard now aside from my memory isn't great, I am more tired and more hurried in the mornings, and I think to some extent I feel depressed enough to feel like it doesn't matter, it doesn't make my life better.  I have to talk to Dr.  mind about this and he's going to be less than pleased.  he won't get mad except that i have taken too long to admit this, but because I'm on the fragile side I won't get that response as much as i will get a stern reminder of how stupid that is.  Which is true.  (Stupid being my word)

Anyway, i need to take pills.  Which means finding food.  I did eat mac and "cheese" and some corn tonight so that's good, but I have to have a pill food as well and that I'm unsure of.  Maybe I can eat an egg.  Protein would be a good thing....

Processing

Sorry for being so quiet.  This week has my head spinning.  I am constantly thinking about and praying for Dr. Body and his family.  I have been through 1/21st of that experience (my younger brother had a serious stroke at birth and nearly died) and it left a strong impression on me.  In addition I think and pray for Dr. Brain, who is about 2 weeks into her recovery process.  She ordered me not to worry about her, but it's kind of hard to not worry when you care.  And I do care.  Sometimes she makes me mad, but I still love her and know what she has given me in the last 8 years.

I also am not past my fearful experience with the yelling person.  I have asked at work if there is a way to document this so that I have something that says it happened and if there is anything to do to help me not spend my life afraid he'll see me.  The truth is that I may be afraid easily, but it is not a sign of stability when he is still angry enough to make a point of letting me know he was aware of me and angry at me nearly 3 months after he got upset because I followed medical protocol he didn't like.  I do at least feel like I've taken control in some way by doing this, but I still have to work on some of it to make myself feel ok again.  I also want to find some way to complain to the hospital about the nurse who made fun of my meds and then didn't even listen when I needed to be somewhere safe before refusing.   I have no doubt she thought I was paranoid because I'm "psychotic" (the diagnosis you get from taking antipsychotics even though the point of the "anti' part would be to not be psychotic, and also as Dr. Mind pointed out not all people on them are even psychotic at all, although I countered that with 'at my dose they are' and that's true.)  Regardless, it doesn't matter what she thinks of my meds, keeping me safe should be a goal, and not lecturing me because she didn't clearly go through discharge instructions or listen when I said i was going to the ankle surgeon for follow-up (if this makes no sense don't worry about it, just more of the overall annoying experience) would be reasonable. That was a very bad experience, period.  And it's taking time to get past it.

I also got a little more idea of the complexity/severity of my asthma from Dr. Body.  As with everything for me (and because of the inability to manage things by aggressively starting with oral steroids or doing oral steroids at any time when I have gotten worse as typically would be done), I'm being considered hard to control.  I changed inhalers for primary control again and this is the last "typical" primary med.  And to emphasize the difficulty we've had with control I'm starting at the maximal dose.  Although the original point was to let me ask questions, we didn't get to do that with as many as I had given that Dr. Body was busy, behind, and needed to do an exam as well.  I did ask the question I am most afraid of; what happens if I get a cold.  He avoided it for the most part.  He told me to immediately email him for antibiotics and to tell him which has worked in the past and he'll get me on that the second he knows and that avoiding sinus infections (which I get with 100% of colds) is important.  He did note that part of my sinus infections are because my nose is very small with crooked nasal passages (deviated septum, I try to not think about where that came from because I have no memories but suspicions) making this even more critical.  Unfortunately because I can't use cold meds sinus infections have resulted from every cold I've had since starting lithium 9 years ago.  I have avoided colds this whole winter, kind of like having whooping cough makes up for that, but eventually I'll get one.  And I think he's not answering the question because from what I've read the standard at that point would be the steroids we've avoided so carefully.  In theory I should be able to take Mucinex (unless it's against the MAOI rules) but both doctors have said no to it for years because I was taking it when I had the reaction to Lamictal (a rash that can, oddly, become fatal if not treated), and they are afraid I would have a related allergy.  They may need to rethink whether trying it is reasonable in this situation.

I've tried to read about asthma but it's so confusing.  My other issues make nothing apply to me and I am not the typical asthmatic in any way except that I have the right history for it.  It makes it hard for questions to get answered, and then when I can't get answers i try to find my own, and that doesn't work either.  So that has been frustrating.

Anyway, way too much on my mind.  Hopefully my head stops spinning soon.

Thursday, March 10, 2011

Pray hard

You all know how much I love my Dr. Body.  Well, I've had 2 visits cancelled with him lately because of a family emergency.  Today I saw him, and in the last 2 weeks he has basically saved his wife's life because he reacted fast to something that would have seemed minor, he became the parent of a premature baby, and he has had his wife near death because of complications.  Things are improving now and his wife finally met that baby yesterday.

Please pray for all of them.  He looks relieved but exhausted and I can't even imagine trying to be in 2 ICUs at once, going through what he was with the medical knowledge of what all happened, and well, going through that at all.

Rough

I didn't post this last night because I have to be very careful what I say. Assume you are getting a very tiny portion of a very complicated story.  But basically yesterday was geared to be hard.  I had to be 2 hours from here at 8:30 to cram a treatment in.  Then I had a followup with worker's comp people, and a day of training my new helper and driving lots to see patients.

A while back I had a caregiver of a patient who became verbally abusive to me when the caregiver disliked a clinical decision I had made, one that I made based on rules, not my own ideas.  I walked out of that place and knew I was fine because I was right.  However I was afraid of this person.  I fear people who scream for irrational reasons and knew this person would attack me verbally anytime possible.  I actually ducked under a counter to hide when in the same store once.  But yesterday during the course of getting my legs checked this caregiver was also there and made some nasty, loud comments to the entire huge waiting area.  I then proceeded to be more traumatized because I begged them to let me back to the locked area and the receptionist seemed ok but the nurse, the one who was nasty about my med list last week, didn't listen to what I'd said just told me to sit and she'd get me when she was ready.  Then when i was back she wanted to know what my problem had been. She refused to make me safe and didn't bother to listen to what i was afraid of.  I was shaking by this point and then had a confrontation with her because I broke the center's rules by seeing my ankle dr. and I had signed something acknowledging this.  You know, while in pain and shock and after being given an ace wrap to apply myself and asked to put my own restrictions in place.  I did sign, I'll admit that. However she kept saying I should have told them I planned to see the surgeon.  And then i remembered I did tell her, when it was, etc.  She told me she assumed I meant the bad ankle.  I told her i had been talking about the new injury and that I can't really help what she assumes, that this is why you aren't supposed to assume.  I was nicer than that, but I've had it with her.

They did let me out a back door and I walked through the parking garage with 911 ready to go if the caregiver was around and said one word.  I also talked to my manager and told her that I was scared by not feeling threatened.  That was because i am not so good at identifying true threats.  At this point I am changing my mind and am probably going to ask to have something documented somewhere because I can't spend my life avoiding this person and documentation helps show it's occurred when I was in a public place with nothing to do with this patient whatsoever.  I'm still going to talk to Dr. Mind before I do that.

Anyway, I got almost no sleep then worked 10 hours and now I'm about asleep whichI need more than anything. (And with the magic of antipsychotics I then fell sound asleep before hitting post.)

Tuesday, March 08, 2011

My meds

I have realized that I am developing a strong anxiety to seeing healthcare providers outside of my little circle.  Why?  Because of this:

Please list all meds you are taking, doses, and when last taken: (3 little lines)
Seroquel XR 600 mg (150 mg more PRN)
Klonopin 1 mg AM, 2 mg hs, 1 mg PRN
Valium 1.25-2.5 mg hs prn
Lithium 450 mg hs
Multivitamin
Vit. D
Vit. B complex
Spiriva
Singulair 10 mg hs
Symbicort 2 puffs bid
Emsam 9mg/24 hr transdermal patch q 24 h (****MAOI!!!!*****do not give any meds without my permission and review of safety)
Nuvigil 250 mg AM
Amitiza 24 mcg AM
Synthroid 88 mcg AM
Amelioride 10 mg AM
Nexium 40 mg AM
Xonepenex 1-2 puffs prn, used 1-2 times daily on average.

I am on a lot of meds.  I can't help that.  I'd love to be on less; in fact one of the reasons (the least of the reasons but one that we were happy about) for the patch antidepressant is that I would be on a lot less pills as I was making up my own dose of antidepressant and had to take 7-9 pills daily for that alone. So for a while I was on less lithium (I was on a lower dose of that for years), no spiriva, no singulair, no symbicort, no xopenex, no valium, no amitza (although I was on other laxatives and am one of the few pts. my doctor says needs and benefits from that so that one is not a real addition), and I wasn't on Nexium until I left the hospital but had been on it for most of the years before that because if my Seroquel dose is more than minimal I have bad reflux and with a history of multiple stomach ulcers (thankfully years ago) careful on that is good.

But nearly everywhere I go I dread it because I nearly always overhear "look at THAT med list", assumptions are made, and then people think I make things up or like medical attention.  I hate medical attention.  I always want to ask when they come in the room, "so what med do you want me to not take?  All of those meds treat only a few diagnoses, 4 of which are because of side effects/damage to my body from psychotropics.

I am actually sending a thank you card to my ankle surgeon and his staff because they are one of the few places I have never heard this, one of the few places the doctor has known my meds, and where I have never been treated differently.  I love that instead of saying "MAOI, um, not operating on you" he just says "no problem". I think he thinks he'll do it with a spinal; the truth is that I'm terrified of those and have had knee surgery which probably was deeper than this goes with a local block and some meds to relax me and I'm going to ask to do that for this as well.  And he'll be nice about it.

I have to go to occupational health today and show them I'm ok.  I dread it because I heard them talking about the meds last week.

A very long time ago, I'd only been on psych meds about 6 months, I started working for a company whose billing included a few grids that visually were very confusing to me.  I was always in the wrong box, then recopying things.  This was before anything was computerized so it was a lot of work.  Eventually I realized I couldn't focus on the boxes, so I went to the eye doctor.  I didn't have vision insurance so I went to Wal**mart.  Bad move.  I filled out the card they ask you to, including something about "difficulty focusing on small boxes on work grid".  I brought in grids.  I also wrote out my psych dx that was still a tender point for me, and heard the doctor laughing at me and my "problem".  i actually confronted him.  He denied it, but I made it clear denying it didn't mean I didn't hear it.  And I refused to talk to him or be treated until he stated he was capable of treating me with respect despite my mental illness.  He proceeded to figure out that I have strabismus with a lazy eye but didn't explain that to me.  He also put me in bifocals.  The next year when I saw my current eye doctor he took one look, explained the whole thing to me, and threw a prism in the lens of my bad eye that fixes the problem much more easily and cheaply and without making my good eye weaker.  Again, the difference between "ewwww, bipolar" and "hi, you're my patient, let me help you".

So I'm touchy about this.  But there's not much I can do, and not a lot of chance of any of this changing soon. So I am stuck with learning to deal with it.

I just wish I could make that list shorter......

Monday, March 07, 2011

never gonna get caught up

Ok, my shift key worked fine until I started to blog.  It best continue or we'll be having words.

So I am so overbooked right now that it's not even approaching funny.  I have to leave home early tomorrow and drive to the midst of nowhere, then back to the town I work in to see the worker's comp people and show them my ankle brace and scabbed knee, then go to another pt.  After that I can go back to the office and schedule as fast as I can, as many people as I can cram in.  My trainee will be there soon after and we'll go cram in visits.  Not sure how many yet or how to space them as I basically am booked for the week yet still have lots of evals to fit in.  They just are going to have to wait.  I am going to have to keep chanting that just because there's more work that I have that I am not expected to get more done than a reasonable week.  That's hard for me, esp. since some of these are very delayed thanks to my week off patient care.

I saw the ankle dr. today and am sporting 2 ankle braces for a 2 week or two.  It's REALLY attractive.  I should take a picture.  Let's just say I'm very glad it is not summer.  Of course summer would have meant no ice, no fall and probably no sprain.....

Otherwise, not a lot.  Very tired but not falling asleep.  I had a migraine and couldn't stomach meds.  Now that it is over I regret that.  I think I'll at least get some in so I do fall asleep soon.  I have to leave so early that I need to be ready to move, move, move when I get up, esp. since I have to finish writing one eval still.  I figure at worst that will be a little late and will get done while I'm at occupational health.

I think my mood was better today.  Somewhat irritable, but controllably so, and not nearly as tired after I got plenty of rest.  It helped that my ashthma was way better.  Whether that was the time isolated in my house in what seems to be my safe zone, that I was not near the worst chemical places, o rmaybe something working properly I don't know, but it was nice.  I didn't get hoarse even until later in the day and even then not like usual.  I love when I sound like me; somehow it gives me hope.  Not somehow, it means that whopping cough didn't damage my vocal cords but just asthma makes it hard to breathe.

Anyway, I may be falling asleep.
Night.

Sunday, March 06, 2011

Breaking rules

OK, trying again.  my shift key won't work so please forgive the lack of capitalization on letters from the right ride.  

i did something that weekend i'm more or less allowed to do but probably to to the extremes i took it to, especially not mid-clear-episode.  however i am convinced it what i needed and i am sure i feel better for it.

Starting Friday night i avoided the meds that make me wakeful.  the one i shouldn't mess with this way mostly is the steroid but i had to get some sound, not only due to meds, sleep.  i knew i'd feel better if i did, and in fact i was right.  i could use a few more days, but for the most part i am better rested and feeling a bit more able to stand the thought of resuming life than i have been in a while.  Granted it's also been a very long time since I was able to rest like that as i've had few weekends without committments or stomach flu in forever.  But while it didn't change the depression i do feel like i am not bouncing into 30 minutes of mania then back to depression (aka i'm not quite as mixed) and because mixed episodes burn so much energy just because they put your body 
(this is based on my observation, not medical fact)  through so much drastic change, quite so much.  When i have to face leaving home and facing the world tomorrow, including a checkup with the ankle doctor, we'll see how 
I feel, but for the moment i at least feel like i'ave had some quiet time.  Desperately needed quiet time i should add.

And now i must take the meds i forgot about a bit ago and get more sleep.

And fix that stupid shift key!

Thursday, March 03, 2011

Title evades me

So Dr. Mind and I talked for a long time tonight and established some things.  Some I knew, some I didn't.  My anxiety is out of control.  He thinks this is partly because it is scary to not have Dr. Brain available, and because her surgery is a reminder of her illness, even though this is a positive step.  I sort of refused to cope with what her illness could mean a year ago and I think he believes this is the result of that.  Probably that and my anger last week.

Also, I'm cycling and he thinks I'm depressed.  Hard to know why; steroids, stress, frustration and now pain all could be part of it.  I told him that I'm extremely sensitive and tending to hear things very differently than they are said sometimes/frequently.  I also am getting hurt feelings easily when it's no big deal.  

Way back, before most of you were reading and before I wrote as specifically about many things on here, there was a time that Drs.Mind and Brain had a meeting about me and Dr. Mind told her that he felt my anxiety, anxiety that is so severe that it borders on OCD, was holding me back.  They agreed to several things.  First Dr. Mind sat me down and asked me to let him talk a while.  He talked about my progress and that I was at a point I could make a lot more of it but it was going to need some committments.  He told me that first I had to know they were there for me and both really wanted to help me do something, but that to do it I was going to have to trust both of them and he would help me do that.  Then the next stage would be treating my anxiety.  When I was ready Dr. Brain would increase my anxiety meds and I would need to be consistent about taking doses throughout the day. At the same time Dr. Mind would use the less anxious time to help me learn to deal with anxiety.  It really worked.  I used to obsessively (said factually, not just descriptively) spend HOURS thinking about "what if?".  One of the numerous things we addressed in that time was that if I thought "what if" I needed to immediate think "STOP".  Then I need to re-arrange what I was thinking.  It was ok to worry when indicated but "what if" is a problem for me.  A big one.  As I learned to not do that I improved immensely and this was while I still wasn't on effective meds.

I handle this well now and really am good at stopping when I catch myself.  Except when I'm cycling and coping with too much. So right now I'm to work hard at regaining control of that.  I'm also much more aware of how much I'm cyling simply because I got pretty upset during the session and popped up again by the end feeling better and he thought I was just feeling better from talking and instead it was more that I felt better because my mood suddenly went way up and now I'm having some trouble coming back down.  Could be a lot worse, but it was another sign of cycling  that I haven't felt sure was happening although I suspected it.

The type of support that I have on my ankle I have learned has a built-in feature that sometimes it put into this kind of thing:  If my foot is down too long it swells and I get a nice reminder to get it up.  It doesn't have to be way up, but it does need to not be down.  I guess Dr. Mind is my same type of reminder.  The biggest problem right now is that I need to be seeing him twice a week.  We have talked about this the last 3 weeks.  i need monitoring and help coping right now.  But I am too tired to make it work.  Essentially one of the best ways to treat the depression is too much stress to make it feasible.  I know that listening to my body when it says sleep over talking is good, because I'm pretty structured with seeing him more when needed.  And even Dr. Brain thought I needed those extra visits for a while especially why my body is dealing with steroids.

I think I'm going to try to get to 2 sessions in the next few weeks.  First I have to (foremost) get rid of the ankle pain since it makes me so very tired.  I need to mess with my meds a little this weekend and see if I take an even smaller amount of valium if I get better sleep that stops the exhausted all the time thing.  I also would like to find myself eating again, although that may take more treatment of depression to happen (catch 21).  But not eating is part of why I'm exhausted.  Yet this is just part of depression for me.

(and for those keeping track my mood has again plummeted while writing).....

The rest I can't control.  I need to stop thinking about what the dr. says Monday and if I can work then.  I trust him to protect my ankle and I know that doing so is vital to my ability to walk period.  I have a perfect example hooked to the other side to show why treatment and compliance is so important.  If i can't work I can't work.  I can't control that Dr. Body has been away with a family emergency for 2 weeks and so my inhaler still needs to be changed to a new kind.  I dread the change, but I wouldn't have been changing until this weekend anyway because of Dr. mind's recovery schedule, so whatever. Cycling I can't do much about but take meds and be good about my PRNS during the day and work with Dr.Mind.

I told him that there is a sequence I believe.  I know that I feel bad because of my asthma and that it has rocked me to the core.  I know that exhaustion alone from that has a big role and that's before the side effects of the treatments come into play.  I also know that there is no guide for how to treat your severely bipolar ashtmatic patient who is med intolerant and on crazy doses of many meds.  Therefore this is trial and error but with many choices ahead and one will work.  I also believe Dr. Brain when she says she can stabilize me once we're done destabilizing me.  I do believe I'll feel better.    I know that belief is important.

I also know that waiting for that is stretching my abilities.  Tonight though is the first time I saw in this point of my illness, even without being told, that I had at least 4 big mood changes in 65 minutes and another in the last hour, and that this is a major reason I feel miserable.  Cycling sucks.  I have meds that might help but would sedate me more and I need less of that not more.

Catch 22.  Again.

Wednesday, March 02, 2011

Well...weird used a lot

I did sprain my ankle more than a little.  I had more xrays to be sure I didn't have an odd-angle fracture because of the existing problems in that foot and some of the pain.  The doctor agreed that I'm in an awkward place because I already limp and so now the leg that bears most weight can't.  So he is treating it like a worse sprain than I think it is.  I think.  I should say, he is being very conservative.  Which is good, because it hurts.  Not like the other one did, and if weren't for the other problems I think it would hurt a lot less,but because even though I've figured out the world's most crazy new gait pattern (think very not pregnant woman walking like she's 10 months pregnant and in labor without bending either ankle) there's still stress on it because I can't take the weight fully off it.  I have a supportive taping thing done that ironically I read about only the day before in a training video.  It stays on essentially as long as I can stand it (it means sponge baths and I assume will start to feel stinky and itchy) or until I go back to the dr. Monday.  Until that point I'm at a desk.  He was going to keep me home but I was able to promise to do desk work and I did a LOT of it today.  I got in trouble for chatting too much but I worked every second I talked and was getting 100% on my tests on my learning modules so whatever.  (In trouble is a strong word).  This is BORING and my bottom hurts from sitting strangely to keep the leg elevated.  I've now tried out every angle for this my desk offers.  Thankfully it's a decent sized cubicle but it is still not ideal.  I keep thinking how sleepy I am (I suspect this is a response to pain since meds aren't really an option and I have lots of sore muscles, a badly skinned knee, etc along with the ankle, and my normally bad ankle is achy too as it tried to twist but couldn't thanks to my brace.  I'm just glad I had him, that he got me in fast, and that he is very compassionate with the situation.  He makes me feel more than almost any doctor has without having worked to gain my trust that I truly have a problem and that no, i am not incorrect to question that an ace wrap is not the treatment of choice for this sprain.  To be fair to the people who saw me yesterday it waited until overnight to swell or bruise.  They also just clearly didn't know what to do with the starting point being a bit weird.  They should have sent me to him, but thankfully as therapists I'm surrounded with people who can say "um, yeah, Jen walks weird all the time and this doesn't look right".

I had the weird experience today of being in the office when few people are around and hearing something I had no clue my company provides but which is awesome:  someone corporatey was there to do a lot of education and retraining for a nurse (there were 2 involved but I heard one) who they were calling "frustrated staff'.  Both are newerish and are the two who I most dread getting referrals from because they tend to make a lot of poor calls and make a lot of errors.  I know that one of the two repeated their trial period and had to be nearing the end of #2 and was still not doing things well.  So I thought this was so neat rather than just discipline or fire them.  I just completed my first 90 day period without being invited to repeat it well ever since I've had that 90 day thing only twice before and both times had trouble.

I also had a kind of troubling experience.  I am not sure what to do about this one.  I've mentioned a few times that I've tried to reconnect with different people and apologize for the things I did that caused the end of relationships back when I not diagnosed, not treated, and not always nice.  One of the losses I never wanted to deal with because I feared rejection was this one cousin.  My mom and her sister had 5 girls.  I'm the oldest; the youngest is 3.5 years younger than me.  We grew up very, very close, especially me and the one a few months younger than I am.  We even both went into therapy although different kinds.  While I was in grad school she married and for the first year or so we kept in touch with phone calls and emails.  And then suddenly the last year I was in Michigan the email responses stopped.  I remember this clearly among many jumbled memories as I remember writing and getting no response, writing and getting no response, lather, rinse repeat until I gave up probably a year, maybe 18 months later after I'd moved back here and was on my first job.  And then came the time I was sickest and just didn't care, and then for years this has hurt me, I have cried and cried and cried about it.  In all this time I've seen her once and it was totally awkward.

Well, I wrote to her.  I told her that she was my best friend for 25 years and I missed her, and that I didn't know what happened but that knowing I'd hurt her somehow made me very sad.

She answered quickly.  She answered nicely.  She also lied.  First, she said she thought we just grew apart and that it was a lot harder back then without emails.  We emailed all the time.  Email was available through the colleges we went to and we emailed then, and then later through the freebie services that were plenty popular and common by grad school.  So I KNOW we emailed.  Also, email and IM were the only way I could afford to stay in touch with people in grad school.  Therefore, I'm even more positive.  So I may not remember what happened to cause problems, but I know that's not it.  Then she said after she learned about my bipolar she figured I didn't want to talk about it.  That translates to "I didn't know what to say to you because I didn't know how to handle mental illness".  And while that is something I understand, she said something about b/c she's a private person (yet not so private that the whole family didn't know every detail of some personal health issues she had a few years ago) she figured I'd want to be private about this.  Now, to give her credit for one thing, my mother told the world about my diagnosis when I had asked her not to.  I'm sure my cousin feels weird that she knew when I didn't tell her and probably when she was told not to let me know she knew.  But at the same time, it is so illogical to think "hmm, she has a serious illness so I'll just not talk to her for 10 years?".  That's not about privacy.  That's about discomfort with mental illness.  And while I don't expect a lot of honesty about that kind of feeling, I also am mentally ill, not stupid, and I know perfectly well that if another illness had been substituted the reaction would have been different.  But I'm tired and achy and grouchy to begin with from the steroids and so I can't respond yet because I want to be nice and not say what I am saying here.

I need to do meds and bed now.  Been trying to get hungry.  I even stopped and got something that sounded good.  No luck.  Guess it's toast again. I hope that the next steroid isn't so hard on my appetite.  Assuming Dr. Body is ok.  Tomorrow will be 2 cancelled appointments 2 weeks in a row because of a family emergency.  So I'm worried about him.  It was especially weird this week as they didn't cancel until nearly 7 pm tonight for tomorrow.  Hopefully my bad luck is not spreading to my doctors'; Dr. Brain had surgery this week.  Funny enough she told me not to get sick this week.  So instead I got sick last week and hurt this week.

Tuesday, March 01, 2011

Remind me

Never to feel sorry for myself......

This morning I started off waking at 2:45.  At 3:15 I gave in and got up.  But it was actually a good morning, I cut out baby clothes and generally enjoyed myself.

I then proceeded to slip on ice going into work and wound up with a badly bruised and scraped and surprisingly stingy left knee and a sprained good ankle.  So for now I'm limping off 2 legs.  The sprain isn't bad but since the ankle isn't perfect and it feels wobbly and hurts and I wasn't given very good direction I am going to see the podiatrist in the morning.  I think I probably need some kind of support for my ankle so that I can work safely.  Then to make matters even worse my mother and I had a sort of disagreement--while I was on the way to the hospital to get this checked--and I've had a horrible headache all day that tylenol won't cut.  I felt a ibt better when i took a nap for a few minutes but my cat woke me decided she had to eat NOW and so I yelled at her.  Because it's her fault she's old and sick?

I think I am giving up complaining/letting myself feel sorry for myself ever.It just seems to cause something else to happen and I cannot.take.much.more........