let's see...you don't know a lot

I have no idea where I left off and not enough motivation to look, so forgive repeats.  Essentially I spent 2 hours with Dr. Brain.  She told me she would admit me next week if I wanted but didn't know what the benefit was and what could be done there that we couldn't do in the world.  I told her that I just couldn't take being slow and careful for the purpose of pampering my beat up brain, that I and everyone else has said the same thing about "being through soooooo much and needing to give it time" and that while I am saying it too and understand it I am also feeling like we're getting nowhere because we are trying to be slow and then something else happens and I am setback further.  I told her I felt sorry at times that I had started hallucinating and thus been led to diagnosis with the lithium toxicity and that if that hadn't happened I might have just been done trying to live without any issues and that I was concerned that if we didn't do anything drastic and didn't admit me I was going to wind up being an ER admission to psych next week anyway because of how hard I am fighting to not be suicidal.  By the time I was done with this she'd sent requests for 2nd opinions to the director of psychiatry and another doctor that I'm not sure why she picked him.  She told both that med changes may be necessary to get to optimal stability ASAP and that I was aware hospitalization may be needed.  That may be why doctor #2 was included; he is the head of one of the psych units I don't go to and also sees the occasionas patient where I go.  She then went through these 2 antipsychotics I hadn't tried-Saphris and Latuda.  Saphris seemed perfect; it's been tested on mixed bipolar and done well.  It also is the first med that bipolar and schizophrenic patients respond differently too, right down to different side effect profiles.  It had a lot of things that met my needs.  She has used this with a few people and so felt better about trying me on it as she tries to avoid unknowns with me.  Unfortunately it interacts with Seroquel.  So after thinking hard about if the risk was worth it (it's slim and could be monitored with the annoyance of needing periodic EKGs) she decided that it wasn't a good risk.  That left Latuda.   There's a not a lot to say about it yet.  I don't think it's been out long.  It is approved only for schizophrenia.  Dr. Brain actually said that she had been kind of sad about that as she doesn't treat many people with schizophrenia and wanted to try this out.  So since it's essentially my only option  I am the guinea pig.  As I've said so far so good; not wanting to do things because I'm tired enough I feel like my arms and legs are heavy is quite preferable to not wanting to do things because I can't get out of the fetal position.  I have to be very careful about any signs of akathesia; so far so good but I have to be stabilized on some dose before I can be sure I'm not going to have it.  She didn't want me to know how frequently it occurs but agreed to let me read the print out if I promised to not panic.  Good promise to evoke although I didn't read it until yesterday when I was already not very likely to fight much very hard.

I left with her and had a very open talk with Dr. Mind about the cycle I feel like I am stuck in where I start to improve, then things fall apart, then I want to die.  We had to review safety crap AGAIN because of that, and I swear having to do that keeps me from talking about it more easily.  It was also hard with both doctors to admit that I was a touch closer than usual with the feeling that if I hadn't just been reminded what an overdose feels like.  I actually told both I would get a lockbox for the meds but couldn't because it was so late by the time I got done with Dr. Mind and then got my script filled.  So tomorrow I need to do that although it is much less necessary now.  I feel like there's a good chance that I have had terribly broken sleep that is now improving and it makes me a little less on the edge of the edge, if that makes sense.

The other thing that has happened is I finally found out about work.  Dr. Brain is to send them a letter explaining my circumstances and why I can't work despite having used my entire leave period already.  They will have a committee meet to determine if additional time is indicated.  If they agree that it is, and I am not sure that it would be possible to say it isn't with 3 hospitalizations, a 4th possible, recovering from toxicity, barely sleeping in months, and most of all unable to make myself shower, dress, or do basic hygiene unless I have to leave the house, as well as living most of the last 10 days on cereal until I ran out of milk today.  There's also my anxiety, which on a scale that is something like normal, mild/moderate, moderate/severe, extreme/panic I am scoring consistently over weeks in extreme/panic.  Which is humbling to think that what feels fairly normal, just somewhat worse than usual, is a typical person's idea of panic.  Anyway, if they approve it then my boss is asked if they can manage without me, which I've been told they could, so that part should be ok.  I also got some reassurance from work that I am ok and not being fired, which is a good thing.  If the committee decides I should be working or my work can't make it without me then I officially lose my job but am eligible for rehire if a position is open upon medical clearance.  So it is fair.  And if they say I'm ok to be off then they still pay their portion of my benefits, which is a HUGE blessing as benefits, car payment, gas for all my appointments and mortgage is hard enough without paying the extra $300 plus for COBRA.  I asked Dr. Brain to not hold back on that letter to protect my privacy and to please make me look bad.  I actually somehow managed to phrase this as a joke which she seemed glad to hear.  I feel much, much better about this now.  I am making myself adjust to the idea of I may not get to stay with my current agency (although hopefully the same company) for a long time.  If I don't totally stabilize then the commute is probably too much as is the extra pollution exposure in that area.  I'll find that out when I go back and then will figure out what to do.  I should know about work in a week or 2.

Otherwise, life is moving along.  I'm still not anxious to survive this period with Dr. Brain off for surgery for 3 weeks or so (I can't ever remember when she's coming back.  My memory is also still not perfect from the toxicity/adjusting to the new med/everything else.  And that's a huge understatement).  But it sounds like I'll be getting plenty of psych evals during that time and I may also go see Dr. Sweetheart because there is some concern that I got the Mirena and haven't been stable since.  The original idea was to make it through 6 months, but her input on whether this could be a cause may change that.  There is almost nothing I can find that makes me think it is that, as I have read many, many research and personal experiences (what is the word that means that? see, brain fried.  Good thing, but annoying). and all I find is occasionally someone reports having it removed because it was causing something, but it is so rarely mentioned and so many people have the Mirena that I'm not sure how much to trust that.  I am waiting to make that appointment; I was going to schedule for a couple months out then realized better to do it now, but I think Dr. Brain was going to contact her too and so I'm waiting to see Dr. Brain again Saturday.

I just got notified that my new purse is done.  I'll link to this Etsy if it is as awesome as it looks.  I could NOT find a purse that I liked anywhere, including many Etsy stores.  Finally I found the style but not colors, so I got a custom on and if it is as nice as the picture I'll be using it for a long time.  Good thing since my summery purse is looking weirder and weirder as it gets colder.

I think that's enough of a novel for one night.  Tomorrow we'll see what else happens.  Dr. Mind and I am are advancing a step although he doesn't know this yet.