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, December 17, 2015

69 and 70

It's been a long time since I wrote here.  Not much has changed.  I've put in a lot of time waiting and hoping for samples of one of the new anti-psychotics but that didn't happen.  I did not want to be in bad shape for Christmas when I knew it was probably going to be a rough one as my brother was recently sentenced.  (Which is a whole other post in that he got off very easy and I've been very upset about this).  It's another one that is a big change for everyone and my being extremely unwell or in the hospital wasn't going to help anyone.  So the deal was that I added a very low dose of lithium to my meds (that's cocktail 69) and I see Dr. Brain Monday and we will plan for tapering off Seroquel/admission to complete that and go onto clozaril.  

The reality is that I've done everything in my power to avoid the clozaril.  It is supposed to be a very effective drug but can have some nasty side effects, the worst of which is death.  So for 6 months you have to have bloodwork every week and you only get your week's meds after that bloodwork.  Then it's every 2 weeks for 6 months and after that monthly.  They are checking to be sure your immune system doesn't drop off, which has killed people.  It also has excessive saliva causing nighttime drooling and potential bedwetting as side effects.  You can imagine how exciting those things are.  

I dread the whole thing.  Coming off Seroquel will be hard.  My body is used to it and has tolerance and there will probably be some withdrawl effects.  Apparently I may also have to come off Klonopin and that will DEFINITELY have withdrawl.  And while they will start the clozaril in the hospital it is a drug that you go up slowly on so Dr. Brain already told me I won't be feeling good when I come home from the hospital.  

If things work on the schedule I have in mind (depends what Dr. Brain says; I'm trying to get a few more therapy sessions before I go and I think she's off for a week anyway) I'll definitely be spending my birthday in the hospital.  

I will try to update when I know more but this is the current plan and there isn't anything that should disrupt it.  We agreed in November that I could manage one more month and that was enough of this.  And since I've been having hallucinations and some more extreme paranoia lately that's just another sign that I need to get onto an anti-psychotic that is fully working for me.  I've handled this episode for 11 months.  I think that is enough and obviously it's not going to be all better without drastic measures.  So I will be glad to get through that part of my life.  This is my 40th birthday and I want a small party (family) and so have already told my mom that I still want to do it but when I'm feeling better so maybe a birthday party in March. Please God let me feel better by March.....

Anyway, I have done a bunch of sewing tonight.  My goal was to finish except for final touches one huge project and to cut out 2 small projects.  I got the huge one done, just needs a seem fixed and something else fixed.  I had a pattern all ready to cut out the other and my cat sat on it and got something gross on the pattern.  So I really need to go crawl around on the floor and make another pattern so I can cut out the 2 doll blankets for the girls.  I'm becoming very aware of how little time I have to finish my goals for sewing.  I've done 2 enormous projects (patchwork picnic tablecloths) and both are ready for me to check seams, repair a couple places, wash and iron  and wrap(yay!).  So that's probably tomorrow. But I'm also making doll blankets for each niece and hope to make them a 2nd smaller blanket for tiny dolls they already got from their great-grandma (and b/c I bought fabric to make a blanket for the baby and then it wasn't enough so I need to use it somehow) and then I have to finish one pair of pajamas and make 2 more.  So I have a busy week ahead.  Which is good.  I can't read a book or follow a movie but sewing is automatic and repetitive so I can do it and it feels a lot better than aimlessly reading the internet or playing solitaire which is the thing that I can do better than nearly anything else.


Sunday, October 04, 2015


I know I'm not posting here anymore but I need to.  At the rate I've managed to shut this thing down maybe I'm not meant to do that.  Although it is still the plan.  When/if I ever feel better.

I feel so weird right now.  For months I've been a depressed lump with no energy and nothing but sadness.  As recently as Wednesday I felt that although I'd started laughing about once a day and was told my speech was improving I was just not getting better and all the bad things in my future plan with Dr. Brain were going to happen.

Then I honestly just let my junk food cravings take over.  I've just been getting my appetite back and it's still limited to a few things and a lot of it was junk. Once I ate a bunch of junk I had more energy.  Not surprising since I've had a lot more chocolate that I should and there's caffeine in that.  Since I'm not used to caffeine enough crappy low-caffeine chocolate still seems able to affect me.  So not good.  But self-limiting as the candy will be gone soon and I'll be back to healthy food.

I don't even known if it's the food.  I tend to think it is because this seems to be anxiety.  I've gone fro not being able to stay awake to having trouble falling asleep yet have no other real signs of mania except a lot of fast thinking about what I'm worried about.  I still am very low energy; a shower and getting dressed is a huge ordeal.  So the depression continues to rage on.  But it maybe is a little different.  I'm not going further than that because in 10 months I've thought wrong too many times and I know perfectly well that the med situation makes really having something big happen not so likely.

The med thing is scaring me.  I don't know what to do.  I know that I am 100% maxed out on everything I'm taking.  The next step logically is to try a tiny, tiny bit of lithium, mainly because the difference between this episode with its' psychosis and duration and the years of other episodes has been that I was always on lithium before.  But because of my toxicities it will mean really watching closely for my level to go even close to a normal level.  And I am concerned about taking away my ability to take advil as that's my best bet for most migraines when they start since they never start at home where I can take my triptan.  Driving is my biggest migraine trigger and if I can't pop advils I'm going to be taking a lot of norco which isn't so great.  We have to talk about that.

But if I don't try lithium then we're left with the 2 brand new anti-psychotics, neither of which is approved for bipolar depression and neither of which is necessarily the most ideal med for me.  There are 3 others I haven't tried because 1 I did try but not long enough (Latuda), 1 interacts with Seroquel and one is the active metabolite of risperdal which causes my blood pressure to skyrocket.  I keep wondering if I should find a way to shell out the several hundred dollars to get one month of one of those just to be sure before we get more drastic.  After some trial time I could go on patient assistance if it worked.  But I don't want to waste money if they are unlikely to work.  I need to talk to Dr. Brain about that possibility.

And then there is ECT which I still don't know if I was accepted to do (and if this little boost of anxiety will negate that) or clozaril, the drug that requires weekly labs and can have some side effects ranging from annoying to deadly.

Or maybe I need to try to change Med D plans to one that covers another MAOI and just hang in there until January.  If that's even possible.  I can't price programs until the 15th.  

I worry about money.  If I am re-admitted to the hospital before Oct. 27 I don't have to pay a 2nd co-pay so if we are doing ECT or clozaril it is financially beneficial to choose that at my next visit in a couple weeks.  But those are both enormous decisions.  Which means that I probably will be delaying admission and my medical debt will be increasing.  By a lot.  Every admission costs about $1200 plus some assorted dr fees.  ECT will have more although I'll just hit my medicaid spenddown and that will be the end of that.  

I just feel like I am at a place where there is no good decision left.  I've been on 68 cocktails now, without counting the hundreds of dose changes.  It is reasonable that there is this looming NOTHING LEFT thing.  That's been coming for years and we've barely stayed ahead.  It sucks enormously that Medicare makes name brand meds so ridiculously expensive.  If I get one month of one of the meds I've not been on that's more than 10% of my income gone just for one med.  Granted if my hospital allowed samples it would work a lot better but still.  Sick people should be able to get newer, better meds.  Because in reality I still have meds I CAN try.  But they are likely to just cause EPS all over again.  Very likely.  And I'm not willing to do that 8 or 10 more times just to have tried the remaining very old meds on my list.

I also feel like I'm running against the clock.  In November SAD will hit.  With nowhere to adjust my anti-depressant.  Or mood stabilizers.  My light helps but only if I'm stable enough for it to not trigger cycling and I don't know that it has ever taken care of the problem without med adjustments too.

I'm overwhelmed and yet I feel like I should be so happy because I'm not the same as I was Wednesday.  But I'm not sure how much that word I'm not saying this is; it's maybe some but it's also maybe just being masked by anxiety.  And possibly chocolate.  (Which I've really not had that much of today, I'm exaggerating.  Yesterday yes, I had way too much.  Today, not that much).

There is so much I'm missing because of being sick.  I haven't seen my older niece in well over a month.  I NEED to see her.  The baby I've seen but it's been several weeks and she has really started talking since I saw her.  But it's hard because the older girl is in school all day every day now and getting up to go see her on weekends is so incredibly hard when I am this tired. Until earlier this week I was sleeping constantly.  Then about Wednesday or Thursday I started sleeping a lot less but still have no energy for anything big.  And she is noticing.  The last time I saw her was right before I was hospitalized and she noticed both that I was sad and that I kept staring off into space.  Which is a lot to explain to a 5 year old.

There's just so much.  Dr. Mind keeps telling me I've been sicker.  I'm sure that's true but treatment has never been so scary.  And because I don't remember the other times it doesn't seem like this isn't as bad as it gets even though I have vague memories of other times that I was.

I just don't know what to do.  I can't wait to see Dr. Brain again.  But even she only has so many answers at this point.

Thanks for listening.  Now maybe I can sleep without extra meds.

Happy.  I remember feeling that once.

Thursday, September 24, 2015

Current status

I haven't updated here in a long time and while I still intend to take this down the depression has to go first.  So here's the story for now.  Yes, I am still severely depressed.  The hospital got my meds back to where they were when this episode started.  It wasn't enough.  After some confusion with Dr. Brain last week I saw her Monday.  We have a complicated plan.

She contacted my inpatient dr. to see if I am a good candidate for ECT (shock therapy).  I am rather hoping this is possible because it is something new and not medications. But there is still trickiness; we have to have some med to go on when the treatments are done that will hold me and keep me from just winding up back in the hospital for more ECT.  

For right now we increased Emsam to the absolute highest dose.  So now I'm on a strict MAOI diet which is weird after being able to be fairly lax with it for years.  I'll know if that is helping in about a week, so about Monday.  So far I've slept all day the last 2 days since increasing it.  I don't think  it's related.  

There are 2 new anti-psychotics on the market and Dr. Brain is checking into whether one of them might be helpful.  One of them I discovered last night has a high risk for the same problems I just got over so it's probably out.  The other is a derivative of Abilify which I had problems with when I was on it years ago.  So she has to figure out if the same risks exist for it.  Getting off Seroquel is one plan because it doesn't seem to be as effective as it once was.

If all that fails then I will go in the hospital and come off Seroquel and go on the last resort medication, Clozaril.  It's a big deal to go on that one; every week for 52 weeks blood has to be drawn and you get 7 days worth of medication after the labs are checked.  So it's a big commitment just for that and some of the side effects can be scary beyond the one requiring the blood draws (which is that your immune system can tank and you can get really sick if not monitored).  I am terrified of this drug but I'm also terrified of what it will do to me to keep trying and failing meds.  That makes me feel so very hopeless.

So I'm not sure what else is going on.  Dr. Brain thought she'd know about ECT yesterday to tell me but I didn't get an answer.  So either the hospital dr. didn't answer her or she ran out of time because today was Yom Kippur and she'd be off work for that.  I'm not even clear whether we'd go for ECT now or at what point in that plan we'd try that.  I know she wants to avoid the side effects (memory loss) if we can treat this otherwise but it's no secret that there aren't a lot of options remaining.

So the status right now is increased Emsam and something else will happen soon.Which is a lot better than waiting to see if my body would stabilize itself after the hospital made a lot of changes really quickly.  It did not.  I understand why we had to do that but oh the wait was awful.

9 months of this.  I don't even remember feeling good anymore.  And now I need to go change my patches and set my alarm to see Dr. Mind tomorrow.  Because I will forget and then everything blows up.

Saturday, August 29, 2015

Loxapine the end

I got home from the hospital yesterday.  I wound up with a fast taper of the loxapine.  I spent 30 hours in the ER waiting for a bed (every psych bed in Cleveland Clinic was full) and getting meds Sunday night was tough and they only got 5 mg of the 10 I was supposed to have. Then Monday I didn't see a dr. for admission until midnight and the pharmacy was closed so I didn't get any.  Tuesday we agreed to just end the taper even though it was a harsh ending.

I am still feeling very depressed but I no longer want to hurt myself.  I'm home with the caveat that I might have to come back in.  The dr. said I should expect depression for at least another week, possibly 2.  My body has been through so much with the rapid loxapine withdrawl, a bunch of weirdness with my patch (it couldn't be changed for 60 hours with the ER and pharmacy being closed and then we were going to stop it and go to Nardil until I looked up what Nardil would cost out of pocket), increasing my Seroquel, etc.  So I guess feeling good may take some time.  In a few days my Seroquel can go back up and then I'll be on the same meds I was on when this started.  That scares me but it will be easier to add something later if needed and I needed to get out of the very dark place I was in first.  Adding another anti-psychotic isn't a good idea until loxapine's effects are gone.

My tongue is still moving weirdly but inside my mouth and there is no chewing motion unless I'm having spasms of the muscles in my jaw.  So that's better and in a few more weeks the rest should be gone completely after the last of the drug really works its' way out of my body and my body chemistry has had time to level out.  

So in time this will become my past and my present is taking care of myself the best I can and staying home instead of going back.  (I have a well-earned horror of spending more time in the ER any time soon.  I was there for an unusual situation but I don't ever want to do that again.  It was as good as it could be but 30 hours in a psych ER is a tough thing.  I no longer eat hamburgers because I had 2 of them cold and then refused to eat the 3rd.  So instead I had ham sandwiches that caused migraines and I didn't even care.

Anyway, loxapine is over with.

Saturday, August 22, 2015

Loxapine taper

I'm not handling this well.  I have so much less medication in my body than it is used to because my antidepressant and Seroquel doses are lower too and at home I can't increase those while tapering the loxapine.  The last week of the taper is now.  I will be going into the hospital Sunday to get help getting through the taper and hopefully onto some meds to help the horrible depression that has hit very hard in the last 2 weeks or so.

More later.....

Tuesday, August 18, 2015

loxapine-the beginning of the end

Loxapine worked very well for me.  Unfortunately it also isn't the right drug for me.  I wish that it was going to work out but the end is near.  I saw Dr. Brain today (after seeing Dr. Mind who was concerned enough to send Dr. Brain an email about me) and it's just not possible to stay on loxapine and so tonight I started coming off it.  Not only am I still having oral motor movements I am also depressed now, enough to get an offer of the hospital which I decided to not take.

The oral movements just won't stop even with lowering both the dose of it and the dose of seroquel.  Which means it is the loxapine causing it.  This week I am taking 20 mg every other day and 10 every other day and then next week will be 10 every day just to be sure that I don't have no side effects and feel good on that.  However it is very unlikely that will happen.

Since we have to know what changes the loxapine is making no other changes can be made until that it over.  Which means I am facing a couple weeks of probably feeling pretty lousy.  

I think that I'm going to get Dr. Mind to monitor the depression but I'm going to ask a question that came up at the end of the session with Dr. Brain and was only partly answered because we were over time and hurrying:  if the hospital can expedite what I'm going through I will go to the hospital next week.  This week I'm dogsitting and don't have anyone to step in for me.  I'm ok for now but worried if it gets any worse.  I don't want to go to the hospital but well, I've never been in the summer so might as well add to my collection?  Or get better as fast as possible.  This has gone on for 8 months now.  

We don't know what med we'll try next.  But if I fail one or two more I'll be going on clozaril which is the scary med.  If I go on it for a full year I have to get blood drawn every week to be sure my WBC is ok.  I only would get a week's worth of meds at a time and every week would have to have a new order until the next blood draw.  And I'd have to get off Seroquel before starting it which would be ugly and has the word hospital all over it.  It has potentially strong side effects but less likely to cause the things I've dealing with now.  It is the med of last resort and nobody wants to see that happen but I need to be on a med that works and the trick with clozaril is that it often really works.  I just don't want to be this close to having to take it.

And I am so tired....I've been sleeping 12-15 hours per day and today I had to get up for my appointments so I'm seriously tired yet not at all sleepy.  Lovely.

So that's about the end of it.

Tuesday, August 11, 2015

Loxapine update

The last time I posted I was reducing my Seroquel dose because I was having uncontrolled oral motor movements.  Unfortunately this continued and since Dr. Brain was on vacation I lowered my loxapine dose myself.  Which didn't work and then my mom and Dr. Mind started worrying about my flat affect (basically appearing to have no facial expressions).  So when Dr. Brain was due back today I left a message for her that it was continuing, I was concerned, etc. along with huge apologies because I know that it is awful when she comes back from vacation.

She called at 8:45 tonight, I think on her way home from work.  We decided to try to keep the loxapine by adjusting Seroquel and Emsam if possible.  So I'm lowering my Seroquel tonight and then will probably lower it again Thursday.  I see her Monday and that will probably be the final decrease to half the Seroquel I was taking 2 weeks ago.  

The trick is not bottoming out.  So far the flat affect is over-medication but it can happen from depression too and that would not be good.  So I have to be carefully watched for depression as I'm on less Seroquel but hopefully the same amount of medication overall.

There is no choice about this.  I have to stop the movements or I could develop TD (tardive dyskinesia) which is permanent uncontrolled movements.  No thanks.  I'm less at risk because this is happening while on the meds and not while coming off them but it is still a risk and still needs to be alleviated.   I have no desire to go through life visibly chewing nothing.

So it's a bit scary.  But my mood is ok and that's a good thing.  Some depression but there's fear and med changes involved and so it could be anything.

Off to buy my niece's 2nd birthday present.

Thursday, July 30, 2015

Loxitane continued

It's been a few weeks since I wrote about the EPS.  With Cogentin and valium I have pretty much eliminated the muscle pain.  But I'm still having issues that may be deal breakers.

I went back to my normal dose of my Emsam (MAOI) last week and during dinner my face flushed deeply.  I finally took my blood pressure and instead of my usual 103/64 it was 135/84 or something like that.  It shouldn't interact but that is what an MAOI reaction looks like so it probably was and so I had to cut the Emsam back down to 6 mg.  Which is fine now but won't be when SAD season hits and that is coming soon.  But that was just something to discuss with Dr. Brain later.  She wanted me to come down on the loxapine because I was still having muscle pain but because it was working I asked if I didn't complain until I saw her if I could stay on the dose and then in a month we had already planned to lower my Seroquel dose.

That seemed to be working until several days ago when I realized my mouth had movements that I couldn't control.  Mostly my tongue is constantly moving (it stops if I think about it but starts before I even have it back in my mouth) and my jaws are making small chewing movements.  I left it alone to see if anyone noticed from the outside and yesterday my mom did, from a distance.  And since the inside of my mouth is getting pretty chewed up and visible oral motor movements are pretty much my one thing I won't tolerate (and I think it is a bad thing that must be stopped or it can turn into tardive dyskinesia, permanent uncontrolled movements) so I emailed Dr. Brain who said she doesn't want me to suffer with EPS and I can lower the Seroquel now  and will start another med (ironically a blood pressure med) in a few weeks if this doesn't calm down.  I know what the reality is; I'm getting close to failing this drug.  I'm terrified of that; the other typical anti-psychotics are not pretty.  Loxapine hasn't been bad except for the EPS which is just something I'm more prone to getting for whatever reason.  But hopefully lowering my Seroquel fixes my brain chemistry and everything will be fine again.  Dr. Brain is on vacation so if it isn't then I'll be dealing with another dr which I dread the idea of.  

So, for now, great drug, big problems handling it.  Very disappointed because I am feeling better and hate the idea of losing that.

Tuesday, July 14, 2015

Loxapine update

I have been on loxapine for about 5 weeks now.  I really like it.  It is so different than Seroquel; it's not super sedating, it doesn't make me crave carbs (the opposite in fact), it works fast and then is out of my system, and I'm not aware all the time that I've taken it.  It is weird that I can feel it in my system through the time I've taken it until it is at peak concentration 4 hours later (the side effects are present then and then dissipate); I've never had a drug I could feel like this.  I am on 20 mg and we're aiming for 30-40 mg to be my dose we hope.  20-60 is normal.  Normal dosing is divided and I am taking it all at once because I'm not good at taking meds more than once per day and I have Seroquel to keep things level during the day so just having the added meds/sedation at night is better.

There is one problem and that is that I am having some EPS (extra-pyramidal syndrome).  Essentially there is more of some of the brain chemicals than my brain wants and this is the reaction.  You have to be really careful with this reaction because it can lead to some scary and permanent issues or a situation where the vitals become unstable and dangerous.  I've had it before on drugs much less likely to cause this so it was kind of expected; I had a prescription for treating it from the day I started the loxapine.  The problem was that I missed what was going on.  In the past EPS has been uncontrolled oral movements (my tongue flicking in and out like a snake all the time) or akasthesia which is the feeling that you have to move all the time without stopping.  I was hospitalized with that a few years ago and was afraid that would happen again since I've had it on a few drugs.  So far so good though.

What did happen was muscle rigidity.  My body has just HURT for weeks.  I kept explaining it away though; my back hurt from bending over my sewing.  My legs and feet hurt because my shoes weren't right.  My jaw hurt from grinding my teeth.  Etc.  And then suddenly Friday I realized that I wasn't just in pain my muscles were tight.  So I took some extra klonopin and nearly immediately things relaxed.  I took a big dose of valium that night and most of my pain has been gone since with a little more valium or klonopin when needed.  My jaw is still very sore and the muscles are kind of spasming.

I saw Dr. Brain today and she did a test and so we have a baseline to watch and she changed meds around.  I started Cogentin tonight, which is a med that helps with the rigidity and any other movement disorder symptoms I might get.  I'm going to be changing my nighttime benzo to valium if I can find a dose that gets me to sleep but doesn't knock me out so that I get the benefit of that too since it also treats the EPS.  And I'll monitor and we'll watch and wait and hopefully the Cogentin will fix things and I'll be tolerating this well and without pain.  I sure wish I'd realized that the pain was this before it got to my feet. That hurt so much and I kept putting the blame on my shoes because I'm still working on finding shoes that I like and that meet my very picky requirements for shoes right now with the ankle still recovering.  They must be supportive, have a thin sole so I can feel stones and things that I step on, have a wide toe box, and look ok to wear in public.  It's hard to find shoes that meet these requirements and so when I thought I'd found a pair a month ago I was thrilled and then when they started hurting so much I thought I'd wasted another chunk of money on shoes I couldn't wear.  But I was wrong and so glad to be.

Now I just have to get all the med changes done in the next few days while still maintaining the schedule I had set up ahead of time.  I have to not be too sedated but be sedated enough.  That's a fine line I do not enjoy dealing with.

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Wednesday, June 24, 2015

Good thing my favorite color is green

I still am liking loxapine.  But I had the dose increased and I am so nauseous for several hours every night.  It keeps me awake although I'm still asleep much earlier than before I started it.  

When I was initially on it the nausea passed after a few days so hopefully tonight will be better than last night.  I am not about to give up on this because it is working.  But it really is hard to take it knowing that I'll feel bad afteward.  I take it with food and last night tried taking it with MORE food but that didn't help.  I'm only on 20 mgs which is a tiny dose.  But it will work out.

I also finally figured out, I think, why I was so much worse this episode with psychosis.  I've never had a bad episode since diagnosis without lithium.  Last year after I was toxic and had to stop it I had an episode that responded quickly to a Seroquel increase and then I had a long time I was grieving/just sad about my brother but I hadn't had a bad episode that didn't respond to immediate med changes in a while.  This was the biggest difference in anything that I'm aware of so I'm pretty sure that it is connected.  Lithium always was good at helping me, I just had too many toxicities.  I guess it did even more than we knew.  I'm anxious to talk to my drs about this.

But that is over at least.  No psychosis for almost 2 weeks now and that is a blessing I hadn't truly understood before.  Before now psychosis has been intermittent and inconsistent and this time it was everything but those things.  Loxapine seems to have squelched it though even with my tiny dose.  So hopefully 2 antipsychotics makes up for no lithium although I suppose I won't know this until I have another episode.  The depressed phase of this one has hit so probably another couple of months before I'm over it fully.

I'm still not back to life as usual, mainly because of nausea and sleeping off the new dose of medication.  But it will get there eventually and I'm glad for that.

Wednesday, June 17, 2015


I know it's been forever.  It's been just too much to write with the paranoia, the agitation, the hallucinations, the sleeplessness.......I was in a very, very scary place for a while.  It was so bad that Dr. Mind told me I should go to see Dr Brain prepared to be admitted.  He has been really worried about admissions and that's come up a lot the last while.

Last week I started a new med.  It is actually a very old anti-psychotic.  Almost nobody uses it anymore and it's hard to find anything about it on the internet.  Most of what is out there just says the same thing that is written about all old antipsychotics. But occasionally you find that this one is a little different in that it turns into a kind of antidepressant (but not something exactly accepted as an antidepressant) on the way out so it has an antidepressant effect and Dr. Brain felt I needed that.  I was scared of it because old antipsychotics can be really scary and this one that nobody uses seemed especially scary but I am actually loving this med.  It's improved my sleep (I need a dose increase and sleep will be much better), it has stopped the psychosis as far as I can tell (nothing for several days but I've not been out of the house much), and I've lost 3 lbs in a week because it takes away my appetite.  I'm on 10 mg and you can go up to 250 so it also has a ton of room to grow.

So the risk of hospitalization is down to low again barring some weird problem and I'm feeling so much better than a week ago that I don't have words to describe it.

I still plan to take most entries on here down but I'm not really at the place where sitting and doing that sounds like fun.  I am going to keep some posts up and leave posts about loxapine up because I'd like to help someone else looking for anything about this drug besides the same generic profile.

So that's my story.

Saturday, May 30, 2015

Not gone yet

I'm not gone yet. I'm just unable to write at the moment.  I can but it takes forever and I make a lot of mistakes trying to make sense.  So I'm not doing it much.

I'm not well enough to do anything with the blog just yet.  Right now it is a fight to stay out of the hospital.  I've had so many times I've had to fight symptoms and do things but it turns out you can't control psychosis.  And I have psychosis.  Dr. Mind is pretty concerned.

I'll be back at least once more.  Who knows maybe I'll stay.  I doubt it but I have had so much horribleness going on that I can't make decisions.

Thank you again for the kind comments and understanding.

Friday, May 15, 2015


I have had a lot of time to think lately.  I'm still not sleeping very well although I am responding to my meds and doing better slowly.  Right now the big issues are that I always get manic in June so I need to get stable and hopefully avoid that and I'm still not tolerating my antidepressant except at a very low dose so I am at risk of crashing hard although everyone is watching to hopefully catch that if it starts.  I hate the side effects of the very high dose Seroquel (it makes it so that I have a great deal of difficult urinating and that is quite painful unless I wait until my bladder is so full there is no choice which is also not comfortable, plus I just don't feel good on it.)  But it is helping and my mind is slowing down enough to think.  I'll catch up on emails soon, I promise.  I saw Dr. Brain and once samples have been obtained (it's a process due to Cleveland Clinic policies) I'll be trying Latuda again.  I am hoping that it can take some of the need for Seroquel away and that I might get down to a dose that gives us options if I get sick:  raise Latuda or raise Seroquel.  Raising Seroquel is simply not an option I can tolerate any more of.  So hopefully adding a little more medication will help me function better without a lot of bad side effects.  I tried it once before without side effects but I was such a mess at that time I didn't give it a fair trial. 

I've also made a decision.  I have been blogging for 9 years and 5 months exactly as of today.  I think at this time I have said everything that I am going to have to say that is new and different.  I've loved blogging, it is great to share a story and press a button and know that people everywhere might be reading it and that maybe I've helped someone.  But that's 25% of my life.  There will always be ups and downs and episodes but they aren't going to change much.  Therefore if this blog isn't boring already and I think it is, it is certain to become so.  There will be family issues but honestly I'm not comfortable posting them online, especially with the nature of what is coming up in my life.  And so I am going to end this blog.  It will be sometime within the next 2-4 weeks and my plan is to take down all but a few posts.  Those will be left for anyone who stumbles into it to see and I will keep writing but not actually posting anything new.

I've appreciated all the support I've gotten over the years and it has meant so much that you have come and shared my mixed up, difficult stories, whether for a month or for years.  I hope that you will consider emailing me from time to time.  I don't check that email account all the time but would love to see more than junk mail when I do.  I haven't gotten to know many of you over the years and would feel privileged to have that chance.  At the same time I totally respect your privacy as I hope I always have.

I will miss this.  But it's just time to move on.  I've posted less and less in the last year with the only change being when I have felt bad and that's no fun to read.    I suppose there is always a chance I'll come back.  But I think my time is about up here.

More information to come as I figure out exactly what I'm doing, what I'm leaving up and how obnoxious it will be to get to the point that I am down to only those posts.

Sunday, May 03, 2015

Still here

This blog will be going private at an updated date of June 1, 2015 depending on my mental health stability at that time.  Please watch here for details.

I am still here.  Still struggling.  Mostly it isn't quite as bad.  Sunday night I got 75 minutes of sleep so my mom took me to see Dr. Mind.  Since then I've been getting enough hours of sleep although sometimes a little broken up.  One day I thought I was starting to get depressed, which will happen eventually because I'm on so little antidepressant but by that night I was manic again.  It's frustrating.  But it is not as severe as it was and the psychosis is gone which is really good.  I did increase my Emsam last night so I'm not sure how tonight is going to go.  So far not looking great but I had a migraine today and slept a lot so that may be the cause as well.  I do seem to be almost at the point for my 2nd dose of valium. 

Not a lot going on.   I sprained my $50,000 ankle Friday which was scary.  It seems to be ok but is still a bit sore.  I may wind up going to see the surgeon just to be sure I didn't injure anything.  I didn't do anything except take a step backwards on even pavement so what happened is a bit of a mystery but it turned under just like it used to which was bad.

I've been through a lot of stress with my Anna cat.  She had UTI symptoms and had pulled out all the hair on her belly to the point of having skin damage.  So she went to the vet Monday and despite my better judgment I let them do a bladder tap.  Something in that process hurt her arthritis and she screamed and screamed.  I wasn't in the room but it was awful.  After that she just shoved her head in my armpit and wanted me to hold her that way.  My back is still sore.  So she got antibiotics shot for both the skin and urinary infections and I was told that usually she'd get a steroid shot but her kidneys really couldn't handle it and if we have to do that I'd have to accept it was quality of life over quantity and keeping her last months comfortable.  This became completely ironic since I got her home and the first night she let me hold her and calm her.  After that for days she cried if I picked her up.  And being held hurt her a lot.  So I called and asked for pain medicine yesterday.  Her vet (who I'm not so sure about anymore after the horrible bladder tap; I think she is very young and it is hard to accept that I'm letting death occur naturally without a lot of intervention when intervention is available but not right for my cat) had given me this glucosamine stuff to sprinkle on her food but she avoids that food.  The other vet looked at her chart and said she'd have to have labs before she could have that medicine.  Before I realized that the medication in question was glucosamine I had done a search and found grain free glucosamine treats for her.   And I did a ton of reading and don't know why the other vet was worried about her kidneys as there is little evidence of a problem if any really.  Plus she is not going to hurt.  So the treats will be given without guilt.  She's really much better today and yesterday.  The wound is healing, she has climbed on my bed to wake me to feed her, I can pick her up and she purrs.  I am so relieved; I was afraid this was the end.  But Anna isn't going to give clues.  We've been down the "almost time" road before.

The other thing the vet wanted me to do was give her Advantage.  The other cat is very allergic to fleas and is on it.  If there were a single flea in this house I'd know from him.  Plus Advantage says to not give to sick cats or cats who have had seizures, both of which are Anna.  The vet probably doesn't know about the seizure as it was many years ago and she felt it was safe but I decided not to do that unless I find a flea or evidence of one. 

And that's been my week.  Cycling, mania, exhaustion, and anxiety over the cat.  Also Medicaid but I'll spare you that story aside from it would be SO NICE if  calls were returned. Granted they finally did try after my 3rd message in a month but I missed it and they didn't leave a message with the answers.  And then they didn't answer when I called back and didn't return my call.  So I have no idea if I have Medicaid or not right now.  Lovely.

Copyright 2006-2015 www.masterofirony.blogspot.com

Sunday, April 26, 2015


The blog will probably not go private May 1.  I still intend to do that but before I do I want to find a way to merge the MOI Med List blog with this one and right now I don't feel well enough to figure out anything.  But it will go private so watch here for updates.  Maybe the new goal should be June 1, just to keep that easy to remember?  

So a lot has changed.  I talked to Dr Brain and because I needed something immediate and I can't afford even a week of Latuda (it would be about $200 for 7 days) that's not going to work right now.  So she increased my Seroquel to 1500 mg, an incredibly high dose.  However she says I can stay on it that way for some time if I need to.  I'm also back on valium pills because she thought maybe the alcohol base for the liquid was causing problems.

So far I've gotten between 5 and 8 hours of sleep each day.  It's never been consecutive but usually I wake up for a while and then take a nap.  I'm much less sedated than I expected which is probably how strong the mania is.  

IT is working somewhat.  The better sleep is really good and really important. Dr Brain said that's the thing to worry about right now.  Tonight is a bad night and hopefully soon I'll be calm enough for my 2nd dose of valium.  Last night I didn't need the 2nd dose at all.  The voices are quieter now although my thoughts are still racing terribly.  I usually wake up feeling quite depressed and by afternoon am manic and it increases until I pass out.

I was completely off Emsam for 3 days.  I put 1/3rd of my usual dose on tonight and will wear it 12 hours then it will be off 12.  We're doing that very cautiously as I don't need added agitation but I don't need to crash into depression.

Right now I'm safe from the hospital if I keep improving.  That is very good.  I was pretty scared that was coming.  

It's still really hard.  This is the worst I've felt in a long time.  It's so hard to function at all like this.  But I am getting some sleep and am not totally knocked out so that's good.

Wednesday, April 22, 2015

Getting worse

I'm on more valium now and getting less sleep.  I'm more manic than I've been in years.  I'm mixed as usual really but the mania is so bad that it's all I know most of the time.  Last night I pretty much didn't sleep.  I dozed through the morning (interspersed with awake times) and then slept 2.5 or 3 hours this afternoon.  I woke up wired and am still wired at 2:30, an hour after the valium.  I actually probably wasted my chance in a way because I was too agitated and got up and cleaned a bit.  It's almost like the valium is adding to the agitation although I don't think it really is.

I'm trying to get hold of Dr Brain to see if I can try Latuda again.  I tried it a few years ago and felt it helped for a bit and then didn't.  But I was SO SICK then, just off a lithium toxicity where the hospital messed up all my meds, I was starting to come to terms with not being able to work anymore, I'd tried to go back and failed, I was suicidal, and Dr. Brain was off work and not there to bolster doses or whatever might have helped.  Latuda is a really good drug for a lot of people and certainly the safest add-on left to me.

But first I have to get to Dr. Brain. I sent an email with a fairly desperate subject line and she didn't answer.  Maybe she's off work, maybe she didn't get that far in her emails, who knows.  So now I have to call her secretary and have her tell her that I'm in bad shape.

The only way I can do Latuda is patient assistance and I'll have to have an exemption b/c I have Med D.  Usually that's not a problem as long as I send a letter explaining the cost of the drug versus my income.  But it does mean that if we agree on this it will still be a week or so before I have any.  I can't imagine another week of this but I guess that's a bridge to be crossed later.  Maybe I can buy a week's worth or something.

Overall this is just bad.  Even my mother commented that she's afraid I'll wind up in the hospital.  So am I.  Everything is upside down and horrible.  I should be seeing Dr. Mind again this week, I know I should because I honestly can't tell if my thoughts are THAT fast or if I'm hearing some voices mixed in.  I think it is voices mixed in because rapid thoughts aren't usually mean to me.  Voices are.  I forgot to call to try for tomorrow. Thursday I'm going to see my brother and that's more important.  I feel urgent about that so I'm going with that feeling.  And they are closed Friday.  So Monday it will be.  

I am perseverating on avoiding the hospital.  It's a hard place to be when manic and I don't want to add the cost onto my medical bills from my surgery, a big chunk of which is still going through the system.  Medicare is being obnoxious.  They've paid for anesthesia and PT but not the surgery that came between the two.  They've paid for casts but not the surgery that required them.  It's bizarre.

I just want to go to sleep and wake up feeling good.  Somehow I think that's unlikely.

Monday, April 20, 2015

Been a while

This blog will be going private around May 1, 2015.  Please read here or email at masterofirony@gmail.com for details.  I will post details before going private although that may be delayed due to severe episode.

Sorry I haven't been on in a while.  Things are really bad.  I'm in a full-fledged mania with so many thoughts racing through my mind that trying to get words out and to make sense is very hard.  I've not had much sleep and went 39 hours with only 1 hour of sleep one day last week. 

I am using 2/3 of a patch each day to try to decrease agitation and have liquid valium to allow precision dosing of that.  The stuff tastes terrible and so far hasn't done a thing.  Tonight I'm going to increase my dose by a tiny amount.  I got the script Monday but didn't get the med until Friday because it needs prior authorization by my insurance.  That still hasn't come through but I just paid for it because I needed it badly and it wasn't much more than I'd pay with insurance anyway.  It so far has not gotten me to sleep any earlier although it works just like the tablets were and eventually it knocks me out so that I sleep into the day and that just makes it harder to get up the next day. 

I'm really barely functioning right now and am beginning to fear that a hospital stay is in my future.  I know Dr Brain has one more med tweak to try (Depakote, a drug I loathe, but only a tiny dose she promises.....I know how that goes though.  It doesn't work at low doses so we try it and I wind up on a ton because that's what it takes to work at all.  I'm really opposed to that but there are few options).  After that I don't know what happens but it's not something good.

I hoped this was all exacerbated by my thyroid.  I had all the symptoms.  But it's fine.  Apparently complete exhaustion and hypothyroid share a lot of symptoms.  Still waiting for the rest of my bloodwork but it shouldn't show anything relevant.

I don't know how to make my head stop being so loud.  It feels like my head is stuck in a very loud barrel.  I'm not reacting normally to things.  Something actually said I'm just numb.  A commercial makes me cry.  There is no logic or even any explanation for how my mind is working now.

So that's about it.  I'm feeling pretty horrible, trying to remember I've survived this and worse before and utterly failing.  So tired I can't explain it.  And feeling like a robot who needs to take her pills so she's ready to take nasty liquid valium in a couple hours.  When it probably won't work but at least it's a try.  I hate that this stuff isn't working like it used to.  It's made agitated times so easy in the past; I took it, slept about 8 hours and was fine.  This time it seems to think it is a sleeping pill and sleeping pills do nothing but upset me.

Copyright 2006-2015 www.masterofirony.blogspot.com

Friday, April 10, 2015

Tears, toes, and Medicaid

First, I should have been more specific about my inability to cry here.  It's not my mom.  It's me.  I apparently need 30 miles between us to just cry.  I can't say that I'd cry at all when she might come over or call me but she goes to bed at 8 or 9 and I can easily cry then.  And even when it's earlier I keep my door locked because we have a lot of drug related crimes and it is safer so she isn't going to get in without my letting her in.  She respects my privacy, I just can't seem to settle completely into "this is home" mode.  I think I'm afraid of that in my own way; I think that if I get too comfortable here something will happen to my mom and I'll have to move on. That's the danger of living with an aging relative; hopefully she'll be healthy for another 30 years but she's not young anymore.  After our community just lost a young person who was so special it's hard to not think about that.  I also tend to shut down when I'm in a bad place because I get afraid if I cry I won't stop or that I'll wind up in trouble.  Dr. Mind can help fix this. 

Toes....I just broke a toe on the foot that is recovering from surgery.  I broke one pretty close to where the tendons I had repaired attach so I have to watch this one.  It was so stupid, I tripped over an ironing board I should have taken down 2 days ago and snap.  I'll tape it tomorrow; just before I did it I had put a ton of Burt's Bees foot crème on it and it is very greasy right now.

Medicaid is about to become the recipient of my mixed episode.  I think I mentioned that an address change wasn't done so all my paperwork wasn't received in time to meet the deadline for updating.  I sent everything in but too late so I started re-applying.  Last night I went to finish the application and it was gone.  Today I called my caseworker but you never actually reach them so I left a message.  In the mail I had a list of documents received like they are using those for the re-application and I may have wasted the hours I've put into getting together esoteric information like every savings account I have that has $.41 in it, the payoff amount from my house sale, my back-pay from SSDI 3 years ago, etc.  So I'm pretty annoyed.  I really hope the caseworker calls back or my annoyance is going to grow a lot.  At least this one doesn't say on her message to not call her back under any circumstances; that was the friendly greeting from my prior caseworker.  But if I'd done that work and it is lost and I have to redo for a 3rd time I'm going to loose it. That's hard to do once, much less 3 times.

Today was a little bizarre here.  We had several enormous storm systems and got 4 inches of rain in 24 hours, 1.25 inches of that within one hour.  Flash flooding was an issue (we are on a big hill so are fine but it can be a huge issue around here) and we still have more storms coming tonight.

I'm tired.  I hope that means sleep.  It would be really good if it did because I've had a patch on and changed it tonight.  I need the patch and I need sleep.  The combination of both would be marvelous.

Copyright 2006-2015 www.masterofirony.blogspot.com

Thursday, April 09, 2015


This blog will be going private May 1, 2015.  Please watch this space for details or email me at masterofirony@gmail.com and when I have organized the password I will send it out.  Don't worry if I don't respond immediately; I'll do it all at once when this is complete.

I finally realized today that it is possible part of the reason I feel like I'm on the verge of falling apart isn't just because I'm tired, it's because I've been pushing myself to keep it together the entire time I've been living here.  For almost 2 years I've kept a "public face" on most of the time.  I cry but I don't let myself cry like I am depressed.  I am letting so much build up inside and then I wonder why I feel so flat.

This is something Dr. Mind and I are going to have to work on.  It used to be that I at least cried with him but now I'm not even doing that.  And I think I need to cry.  I need to say good-bye to my professional life now that this has become a more real situation and I need to say good-bye to other things I have lost because I had to lose my career.  I need to feel sad and I'm refusing to do that.  Anxious, yes.  Hypomanic, yes.  Exhausted, yes.  But sad, that I refuse to do. 

Dr Mind and I have been talking about my need to keep people happy and not complain or push and potentially annoy someone and that I sometimes need to push a little more.  I've gotten worse at this since I moved here, I think because I find it hard to push at my mom when she financially is helping so much.  But my mom having free reign over my life isn't good and my feeling like I can't cry in my house because she is next door isn't good.  I have a list going of times I should have pushed at people lately and the biggest is Dr Brain; I didn't want to pester about getting in sooner yet I needed to be seen sooner and someone needed to acknowledge the request even if it were impossible.  I am planning to ask her how to handle this next time so that she knows it happened this time and so I do know what do in the future, but it really bothers me that she potentially didn't pay attention to an email about this when I have never asked to see her sooner in 12 years.  There have been times we've moved appointments up but that has always been based on email or phone conversations.  I've never asked just because I wasn't doing well.

I don't know.  I finally realized today that I am not only feeling bipolar I am also feeling hypothyroid.  So I sent an email to Dr Body asking for labs to be drawn.  Hopefully that will happen in the next day or two.  It would be wonderful if there is a physical reason for some of this.  My synthroid hasn't been adjusted in years so it would be a little surprising for a change to happen but anything is possible and I think when the bipolar gets going that it can have complex effects on the entire rest of the body.

Anyway, I think I'm a little tired.  We'll see how that works but I'm going to quit doing things that aren't going to help me relax, like writing.

Copyright 2006-2015 www.masterofirony.blogspot.com

Wednesday, April 08, 2015

What goes up.....

This blog will be going private May 1, 2015.  Watch this spot for details or email masterofirony@gmail.com and I will contact you when have things set up.  Don't worry if I don't acknowledge the email immediately; I'm saving them all for when I know what to do.  Thanks.

Last week I got a few nights of sleep.  This was related to just taking my patch off and leaving it off for several days then wearing it only every other day.  Once my levels started to go back up sleeping got a little more difficult.  I'm concerned about not getting enough anti-depressant (and questions to Dr. Brain went unanswered although partly probably because I thought Dr. Mind had emailed her as he said he was going to so I wasn't as detailed in how bad I feel as I could have been and when I tried to move my appointment up she and her secretary were off and the person filling in said she'd do.....something........but nobody followed up so I guess something wasn't much.  And I made bad decisions about not pestering.)  So everyone has had some failures here and I still have no idea how to keep my Emsam levels lower without plunging them too low and I'm completely frustrated that I've been trying to find out for 5 weeks and everyone fell through on me.  But I see Dr. Brain Monday so I just have to live a few more days and I think Dr. Mind was going to email although I have no real idea as that conversation got weird and went off on a tangent and I'm not sure he heard me say it was ok to do it.

Anyway, once I got Emsam in my system I quit sleeping again.  And so this is day 3 that I've been up all night, although I have gotten a few hours of sleep in the day so still better than 2 weeks ago.  I probably should take valium but it has been so unhelpful at anything but drugging me until I just lay there that I don't want to.  If I take enough to sleep I sleep so late that getting to sleep the next night is affected.  I have no solutions.  I have been trying to exercise more but my ankle demanded a couple of days off.

Therefore I feel awful again.  I have no idea how to manage this whole thing with people communicating or not communicating.  I need to talk to Dr. Brain about this thing with trying to get in sooner; if they'd called and said she had no time that would be one thing but no response is just confusing and kind of irresponsible since I don't think I have ever called and asked to be seen sooner in 12 years. 

Not much to say really, I'm tired and cranky and very anxious because I have to re-apply for Medicaid because someone didn't update my address last year when I called about it and so my paperwork got to me after it was due and so first I sent in all the paperwork for renewal only to get a letter that I was too late, then I filled out the wrong application and then tonight I did a lot more and saved it only to get a message that at 2 AM it shuts down and since I saved at 2 on the nose I don't know if my stuff saved.  There is absolutely no warning that you are about to be kicked off.  It's really frustrating.  The application is also frustrating because there are no comment boxes and some things are ambiguous. 

Oh well.  I've got to get calmed down.  Being angry at Medicaid never helped anything.

Copyright 2006-2015 www.masterofirony.blogspot.com

Friday, April 03, 2015

2 nights but......

I slept about 12 hours last night, maybe a little more although I was awake repeatedly until early morning.  This seems to be a theme.  I had agreed to go see Dr. Mind again today to check in since I'm alone all this week and they get anxious when my mood is bad and I don't have support.  But we'd also agreed I'd cancel if I was sleeping and I did just that.  I'm glad too since I slept about 4 hours longer than I would have if I'd gotten up.

Tonight I am not sleepy at all.  I have a feeling tonight will be a valium night.  I dislike those.  It means tomorrow will be hard and I have things to do tomorrow.  But I don't want to start the not sleeping at all cycle again so I'll do what I have to do. 

I still am surprised that this evened out even a little on its' own.  That doesn't usually happen for me.  I can't really remember a time things got that bad and then improved independently, even if for only a short time.  I've had times I've gone a long time without sleep and crashed but this didn't seem to be that exactly.  I am not great but I'm not horrible either.  I don't know.  Menopause is definitely changing my symptoms and making things easier to manage.  And I know there is an effect because every so often I still have a month that it appears that there are some more hormones operating and this month has been one of them.  In fact this led to my sad experiment.  I wanted chocolate badly but didn't want to eat it all quickly so I decided to buy some and freeze it so that I had to wait a bit to get my treat.  I got mini Reese's cups and guess what?  The middles don't freeze.  So I ate a lot more chocolate than I should have this week.  Oops.

Today is a strange day.  Last year April 4 was when we found out about my brother.  And I remember thinking so many times that I wanted to go back to April 3 when life was so much easier and I didn't have that terrible knowledge.  And now it is April 3 again, a whole year of living with this.  I thought it could never get easier but it has although it is still so hard.

Anyway, back to reading and trying to sleep.
Copyright 2006-2015 www.masterofirony.blogspot.com

Wednesday, April 01, 2015

One night of sleep

Last night I slept.  I have no idea why.  I didn't take valium because I had to be able to wake up when someone came to help remove the huge branch that fell from a tree yesterday, blocking the driveway.  I can't remember when I fell asleep, only that I was surprised that I felt somewhat tired and decided to try closing my eyes and then I was waking up and thinking that I'd slept a little while.  I was awake for about an hour and then slept again and took a nap this afternoon as well.  Right now I feel tired but I am not going to guess whether I'll fall asleep or not tonight until I know.  If things have fixed themselves I'll be stunned as that's never happened before but I am so thrilled to not feel sick from exhaustion that I know I can survive another night if tonight is bad. 

Tomorrow I go back to see Dr Mind, mostly just to check in and show that I'm still ok.  This is partly because I haven't been good the last few times I saw him and partly just another of the things that I have to do until people are confident that I won't do the dangerously suicidal thing again.  Because the last time was really serious and I stayed that way for so long I have a long time (if ever) before they will really trust me on that again.  It got so close to being really bad without my saying anything.  So I live with this still and I understand but it still feels kind of weird.

But anyway, I finally did sleep and if I am very fortunate my brain will decide to turn this around.  Especially since I haven't heard back about moving my appointment with Dr. Brain up.  She and her secretary were off when I called and the person covering said she'd send an email.  I have no idea what that means in terms of what Dr. Brain actually sees or is aware of.  And I hate to call again because they didn't say how long she was off and I don't want to pester her, especially if I call and she's only been back 3 hours and I'm bugging her.  Or something like that that probably wouldn't happen. 

More to come, hopefully positive.

Copyright 2006-2015 www.masterofirony.blogspot.com

Monday, March 30, 2015

At last, a Band-aid

Please note that this blog will be going password-protected on May 1, 2015.  Please watch this space for updates.  You may also email me at masterofirony@gmail.com and I will contact you with the password when I have set things up.

So finally last night after 3 hours of fighting and the maximum dose of valium I am allowed to take I got some sleep.  I think I slept about 12-13 hours, was awake a few and slept another 2-3.  Now it is 2:15 and I'm wide awake because I slept all day but at least I got enough sleep to stop feeling sick and that I can continue to live a few more days. 

Tomorrow I see Dr. Mind and intend to call Dr. Brain's office to try to get in there earlier.  I don't think another 2 weeks of waiting is going to do any good and I can't take this a lot longer.  The amount of valium I took last night does get me some sleep but it has such a huge cost that I'm not sure it is worth it and it is definitely not sustainable; I can't sleep all the time and be too sedated to move when I am awake.  And for whatever reason I am not adjusting this time around to the valium.  Last year it was such a blessing because I could take it and sleep and after I was used to it there weren't hangovers or over-sedation or anything, just a good night of sleep.  This time that's not happening and it is not good.

But at least I'm not still operating on a few hours of sleep in 3 days.  That was awful.  Now I'm just very tired, awake and still very sad that I'm not on vacation.  I know all the reasons I'm not but I just wish that my timing were different.  The pictures of everyone in the hottub looking over the ocean today looked amazing.

But this is just how it is.  Life goes on.

Copyright 2006-2015 www.masterofirony.blogspot.com

Sunday, March 29, 2015

For Pete's Sake

I waited all evening to take the bigger dose of valium I'm planning to use to knock myself out until hopefully tomorrow afternoon.  I was so tired but not that sleepy and I thought it best to be sleepy before taking something that is capable of making sleepy but not falling asleep torment (I've done this before after all).  So I waited until my meds were in my system and working.  And my body decided to get less sleepy.  I'm taking the valium in 40 minutes no matter what and if I suffer I suffer (I'm also open to taking more valium and some klonopin if I have to) but this is ridiculous.  I know it happens and I've survived before and will again but wow.  It would help if I weren't hungry but nothing seems to be what I want to eat.  This is a reminder of why I don't work.  And I didn't really need one.

Copyright 2006-2015 www.masterofirony.blogspot.com

Saturday, March 28, 2015


Thursday night I slept 4 hours straight.  This was good.  Then I woke up, took Vicodin for my migraine from not sleeping enough and drove to my sister's.  She was getting ready for vacation while my brother-in-law was at a conference and this morning my sister had to go in to work for a while before my brother-in-law was back.  When I was going on the trip this was all worked out but there wasn't a solution when I realized I couldn't go so I went and stayed.  And so I had the kids all afternoon and evening and while I had a good time (the baby has preferred my mom over me for a long time and this was the first time I'd seen her without my mom and it was so sweet for her to snuggle in, say "nap", cuddle her 2 babies and drift off to sleep in my arms.) it was a lot of energy.  Then I was up until 2 something, heard the baby cry a couple times and was up for real at 4:45.  I had the kids until about 10 and then drove them to my sister's work and then home.  I slept 3 hours when I got here.  I was so cold when I got here that nothing warmed me up, not a ton of blankets or fleece pajamas or wool socks.  I woke up hot and sweaty and then have proceeded to be very, very cold all evening.  I finally looked it up and when you are really sleep deprived your body gets cold to make you fall asleep.  Not working.......I also just feel sick.

So I've made some decisions.  Pretty soon I'm taking more valium than I have been taking.  I may sleep way too long and pay for it tomorrow night but I have to have more than 4 hours of sleep.  I also am going to beg to see Dr Brain this week if at all possible.  I know this means I probably will have to go on another, older anti-psychotic this week and that sucks but I have to sleep and for whatever reason valium is more making me lay around and drool.  Klonopin helps me sleep a little better although not for long times but I am hesitant to use my PRN dose at bedtime without approval because it means I'm taking a lot pretty close together.

I can't even begin to describe how tired I am.  Nor does anyone really want to hear it.  And to make it even harder to sleep I got home tonight get my national board certification retired certificate which just sucked and a packet from Medicaid that was dated 3/10 that should have been returned by 3/20 that was for renewing my status and I didn't get it until 3/28.  Which makes it a bit hard to get it in by the 20th. 

Anyway, this is past the point of playing around.  I am so glad I'm not on the trip, all the while wanting desperately to be on the trip.  But I'm better to be here where I am not sharing my misery with anyone trapped in one house with a lot of other people besides me. 

I hate when my body forgets about sleep and that this is a required part of life.  It seems so simple......need sleep so sleep.  Why on earth would a body give up on something it needs?  It's bad enough to have a crappy mood so my body enhances that with not sleeping.  But tonight, no matter what drugs it takes, I'm sleeping.  I hope.  Just waiting to get to the point I'm sure I'll fall asleep because nothing is worse than drugging yourself heavily and then not sleeping.

Copyright 2006-2015 www.masterofirony.blogspot.com

Thursday, March 26, 2015


Dr Mind was concerned enough to contact Dr. Brain.  He said that was the worst I've been in about 2 years.  I can't tell because I remember last spring as being horrible but it was the reaction to things with my brother, not an episode but it makes it hard to remember when I felt bad and it wasn't for a reason.  Regardless, it's not good.

I just can't get enough rest.  Valium makes me groggy and I get some rest but the sleep is very broken and not sound.  And I don't take it until I am getting sleepy (if I took more it would have me out until evening and then I wouldn't sleep the next night so I'm choosing the lower dose that is harder to fall asleep with but which lets me function in about 12 hours).  So mostly it just makes me feel lousy.  I kept my patch off a couple of days which was good for decreasing the agitation but I have enough depression that I can't do that long or decrease the dose much. I'm hoping for some guidance from Dr. Brain on that one.  It can be cut in half but I'm not sure that's enough medication.  But it is stimulating and that's not so good right now.

Today we cleaned my house heavily for several hours and I went on a walk with my  mom and the dog.  I should be exhausted.  But it's 2:35 and I'm still wide awake and so agitated I'm shaky. 

I am going Friday to my sister's to help her with the kids so she can load their car to be ready to go for vacation and then to watch the girls on Saturday morning while she goes to work and their Daddy gets home from a conference.  I dread this because I have a feeling I'm going to be watching 2 little girls who need to be very active in the morning before a long car trip while I've had about 2 hours of sleep if that.  I just couldn't stand not doing this because my not doing it would have left her in a bad place.  Dr Mind would be very unhappy with me about this; I'm supposed to be learning to just say no.  But I've just said no about so much this week and  I don't want to feel guilty because I messed up my sister's career or something. 

Anyway, time to try to drug myself into semi-sleep.  Blech.

Copyright 2006-2015 www.masterofirony.blogspot.com

Sunday, March 22, 2015


Please note that this blog will be going private May 1, 2015.  Please watch this space for instructions on getting the password.  You can also email me at masterofirony@gmail.com and I will follow up when I have figured out how this works.  Don't worry if I don't respond immediately; I will make sure I do in time.

I've had 2 nights of valium induced coma.  It doesn't feel like sleep, it feels like being sedated.  And it's not even close to getting me on track with a sleep cycle; I'm too manic for that so I take it when I'm calm enough for it to work.  I can take more but it would knock me out for so many hours that I'd still be messed up.  Figuring out the hours I'm sleeping can happen when I'm not so mixed.

It feels like everything is far too overwhelming right now.  I am so tired and when I'm awake I'm still groggy and stupid from the valium.  I'm taking such a tiny amount, just 1.25 mg (I'm allowed 5 mg), but it kicks my butt.  I feel restless and too tired to do anything.   I over-exercised my ankle tonight because I'm too manic to know when to stop.  On the other hand I can do one legged squats on a wobble board.  Not big squats but this is still impressive control. 

My Noah cat is much, much better although he is currently furious with me for putting flea medication on him.  He won't even cuddle with me.  Too bad, he's allergic and the only way to treat the fleas is to treat him for 6 months solid to be sure they are all dead in all stages.  And since I bought 6 months of meds and he already had another month he still has 6 months to go.  But at least his butt isn't bald anymore.

The Anna cat decided she hadn't had enough attention and got a UTI so we went back to the vet.  She seems better although she kept waking me up last night every hour.   But she's not peeing on the bathmat which is a good sign.   It was funny, her being alive and thriving is so counter to common sense that when the vet saw she gained 2 pounds she checked her for a tumor very carefully before admitting it was real weight.  I've done everything wrong according to traditional veterinary medicine and Anna's thriving.  But I've also read a lot of recent research supporting what I'm doing and one article that was kind of way out there alternative stuff that made a lot of sense that said cats can have inflammatory kidney disease with grain allergies and you take away the grain and the kidneys function again.  They may have chronic kidney disease from the damage caused by grain or they may be fine on grain-free.  This is unproven and esoteric but I truly think it is what happened with my girl.  Nobody can explain why she is alive, much less thriving and looking so healthy, just a few months from turning 20 when a year ago they were sure she only had a few months of kidney function left and when I've been feeding her exactly the opposite of the diet they'd normally recommend.  We agreed that hospice care was appropriate and with that I'd feed her what she'd eat and that led to the discovery of her current diet and that couldn't be better for her.  The vet didn't even say what she wanted to about my use of egg yolks which are controversial as well; some vets say great and mine had a display up listing the reasons not to give them.  But Anna eats them so they are fine with me.

So the feline members of the house are doing better and I'm really struggling.  I feel bad about not going on vacation.  I love the beach and I know I'd have fun with my nieces.  But there are so many reasons not to go that outweigh the reasons to go.  I'm just not well enough and that's the final answer.  Noah needs me is secondary.  And all my symptoms are also a big deal.  I just wish that it had worked out.  Yet from the beginning I've felt iffy about this as Dr. Mind has reminded me several times.  Mostly I'm unhappy about it because I hate when bipolar takes things from me.  But the beach will be there another time and I'll be better then.  Right now I do not need anything introducing more stress.  

And that's about it.  Hopefully I'll get sleepy enough to take valium soon.  What a mess that I'm not taking it until 2 AM or so.....But whatever it takes.  First thing is to get rest.  Next is to fix when I rest.  I have to feel a little more together before that matters so much.

Copyright 2006-2015 www.masterofirony.blogspot.com

Wednesday, March 18, 2015



I can't stop crying tonight.  I'm just so tired.  I sleep but it is manic sleep and it doesn't do much.  I think I'm waking up a lot and not getting any rest out of it.  I'm exhausted and it doesn't matter.  I want to take valium but I need to take the other cat to the vet for a UTI (of course, she made it since October but everyone wants to go to the vet this week) and that means being able to wake up.  I tried to nap this afternoon but all I did was lie there. 

I am no longer used to having these things hit so hard; it's been a while.  It's not a surprise, I was going to have one happen eventually and the retirement thing has been tough, but I just am always surprised how off-kilter things feel.  A teacher/coach from my high school died suddenly 2 days ago and I've cried several times about that.  He was just one of the nicest people you could ever know and he was young and it's just sad.  He'd had some kind of brain surgery in the last few years and just didn't wake up Monday so presumably he had a major stroke in his sleep but it's so weird that he was commenting on facebook just days ago and we were talking about him then because of something he posted and then he was gone.

Even reading the news makes me cry.  I don't think it matters if it is good or bad, I'm crying. 

I am having a lot of memory issues and that always makes me mad.  I hate when I can't remember to do something just from the time I think of it and then do it. 

There's not much to say.  I need sleep and probably more time with Dr Mind and a med change that probably doesn't really exist.  I think I'm sad about the beach and yet I know it's the right decision.  My sister said today that the family we're going with would be so understanding and at first I thought she was right and maybe I should re-consider again but the truth is that I've not been involved with them for 20 years for a reason and that reason is they weren't good at handling this stuff.  They are nice people but this is just different than they are used to.  It will be ok.

But this will end eventually.  I just realized I can have my mom call and make an appt for the cat to be seen later in the day for me and then I can sleep a bit later if my body allows that.  That would be good.

Anyway, not much of interest here.  Just having a rough time.

Copyright 2006-2015 www.masterofirony.blogspot.com

Decision Made

This blog will be going private May 1, 2015.  Please watch this space for details on accessing it after that time.

So the vet said the cat really shouldn't be boarded right now because it is so stressful.  And so I am staying home.  My mom pushed me really hard to admit that I don't feel up to going which she says is absolutely fine and she agrees with much of my logic.  She does feel bad that I could feel better and regret not going but with Noah we'd have to find someone to come and check on him daily.  The person who used to do that never saw him because he hides, so the person would have to search for him and then search for vomits and try to guess who vomited since both cats do often and they would also have the risk of coming in and finding him in shock or dead. And I can't imagine doing that to a pet sitter.  Nor is it what I want; I do not want to be 10 hours away from home and get a call that he is dying.  The vet today told me he very nearly died last week.  He is doing very well now; the jaundice I saw the other day is gone and he appears healthy although not happy to be at the vet's. 

We had this happen a few years ago.  We were on vacation and had one day left and planned to go to the beach and souvenir shopping.  The petsitter called to say that she was taking the dog in for an emergency visit and that he was very ill.  I think he'd had a prior episode of the same thing because we knew it was probable he was dying.  We managed to pack everything and clean the rental house in 2 hours and get onto the ferry boat back to the mainland and just took off and drove.  We got here and brought the dog home after the vet said that he would breathe heavily but not suffer and he'd just drift off.  Instead I had to go get pain meds for him because he was uncomfortable and couldn't rest and then he had to be euthanized the next morning.  If we'd been home I think he would have been saved 3 days of suffering.  I don't want that for Noah nor do I want to make a decision about ending his life when I can't say good-bye.  It looks good right now that he'll be fine although he'll probably have episodes of this throughout his life (not that severe though).  But for a few weeks he needs to rest and have things calm and just recover.

And I'm truly not in the right place to go somewhere with people who don't know what this illness is like for me and who will be living on a schedule that would leave me out of everything anyway.   My sister's family and cousin's family both have small children who nap so they'll want to do things in in the morning.  I currently am not functional in the morning.  I'm often awake but not functional.   It will be loud and I am needing a lot of quiet.  I just can't explain exactly how I feel right now but it is not good.  I contacted Dr Brain about a med change but I don't know that there are any options unless things are worse than they are now.  I just don't feel like this is the best time for me.  This sucks, I would love to be able to go but right now I need to take care of my bipolar and myself and that means staying home and trying to control this episode. Another thing is that going out with a bunch of people not used to me can mean that all kinds of things get messed up.  My sister and her husband try to make foods I can eat but at one of the girls' birthdays I had American cheese on a hotdog bun because they made something MAOI unfriendly.  Usually at the beach our family eats a lot of seafood, which is generally pretty safe anyway and people make sure to at the very least set aside things to have portions I can eat.  But for this trip my cousin is "planning menus" and that means that it is likely that a decent number of meals would be things I can't eat.  She has no idea what all you have to avoid when cooking for me.   And since some of it is migraine restrictions as well as the MAOI you can't even look it up if you think that far which is asking people to do more than is reasonable anyway.  Plus why go to the beach and not eat seafood?

There are just a lot of reasons I don't think this is a good idea and then this episode is the last straw.  It theoretically could be fine in a week but it has been building for months and I tend to doubt we'll get it controlled that quickly.  It's been a year since I had a bad one so I'm also just due.  I wish it didn't work that way but it does; there is not at this point in my life going to be a continual period with no episodes and the bad ones are going to come sometimes.  It's funny, I can almost diagnose a bad one now because when they get bad I immediately have dreams about the hospital.  Last night I dreamed about the nurse I (and every patient I've known but one) dislike (last time she was my nurse for nearly 2 weeks and had a maximum of 5 patients.  On the 12th night or so she asked "Lisa" to do something.  When I didn't respond she kept staring at me and I was looking behind me for "lisa" until I finally realized she'd never learned my name.  3 hospitalizations, 2 times she was my 2nd shift nurse throughout and she didn't learn my name.  Plus she pulled me aside to grill me on suicidal stuff one night, implying she cared but if she cared she'd have learned my name.  Anyway, the first time I was in there they had a 8 pm group that she usually led that was deadly boring.  She'd hand out 10 page handouts and read them to us.  And they were not ever that helpful and were often kind of condescending.  One night I was anxious at 7 pm so she gave me my Seroquel.  Like I've been trained to do I took it and then went to bed because if I missed it working I wouldn't sleep.  She woke me up and forced me to come to group then tried to force me to say why I was crying.  I was humiliated is why.  The next day I told the dr about it and at first he said that I should know I was required to go to group but when I pointed out that I've been strictly taught Seroquel means bedtime, that I had said "well that will make me sleep anyway" and that I was not informed that my choice was to take it and stay awake for group or not take it and suffer anxiety for another couple of hours he changed his mind and she got really snotty with PRNs after that for everyone because he said something to her.  So she mostly hates me.  So I was dreaming about all that and that I was in the hospital again and that she was insisting that she have that awful 8 pm group because "everyone used to benefit so much from it".  Which is a huge lie, we all made fun of it.  Truly terrible group.  One night she was off and someone else ran it and just asked everyone to say something about their day and that was good but oh those handouts....awful.  I'm not headed there but I think it's always lurking when things get bad mostly because of that time when I was on the edge of landing there pretty much every day for about 9 months. 

I'm so anxious about telling my sister I'm not going. I was supposed to ride with them to be an extra adult.  They'll manage without me but she also needed me to watch the kids in the morning while she went to work and my BIL got home from a conference in another state.   I'm going to offer to spend the night, keep the kids in the morning and then come home.  It means a night of little to no sleep but at least it doesn't screw everything up.  my mom texted her to call me and she never did so I've had an anxious evening waiting for her to get around to me and she didn't.  She gets mad about such weird things that I have no idea what her reaction will be.  I wish that part were over.  My mom was surprisingly supportive and ok with it; I think she saw it coming because I look like I have been beaten up I'm so tired.  But my sister is a whole other entity.

Oh well, time to work on sleep for tonight.


Copyright 2006-2015 www.masterofirony.blogspot.com

Tuesday, March 17, 2015

Better and worse


 I wrote most of this the other night and then my computer wouldn't let me finish. So I'm going to leave it as is but edit in some changes.

My Noah cat is home and doing very well.  He's eating, managed to poop (the last thing I really had to watch for) and is getting a lot of rest.  He's playful, eating well, and spending lots of time wanting to be cuddled.  I think he knows how sick he was.  But he clearly feels better and so hopefully this is over.  We go in 2 weeks for more labs. (Edit:  On Sunday he threw up several times and I noticed his gums are jaundiced.  So we're going to the vet tomorrow.  She said he may be anemic from being sick.  He won't let me look today but when he meows it doesn't appear that the jaundice is still there.  But it will take 4 people to hold him down to look to know for sure.  I'm going to talk to her about my trip; I think I should stay home because if anything happened while I was away I would feel awful.  Boarding is SOOOOO stressful for him, more than the average cat which is pretty bad and I don't want to maximize his chances for getting sick.  There are other reasons which I'll discuss below).

I am struggling.  I know anniversaries are essentially meaningless.  However they are still hard.  Tomorrow will be a year since my final large ankle injury which means a year that I've been restricted in movements.  The snow and ice are finally gone so I'm walking without a brace and it's hard. My ankle swells up pretty big and hurts and I'm limping again.  I may have to go back to PT.  But since we're going on vacation (I'm planning on it but won't be sure until I know Noah's test results and if the vet thinks he can handle the stress) in 2 weeks I'm not dealing with PT now. It's hard because I thought I was done with this kind of thing and finding out I still have to go through the same process is frustrating.  I'm feeling extreme anxiety and am being extremely hard on myself.  I know I'm doing it but I still can't stop it. I am being absolutely mean to myself over the smallest mistakes and it's not good.  I'm feeling like I'm causing all these problems that are not my fault and then it snowballs into this anxiety that is beyond severe.  Plus I've not been sleeping normally at all; I missed most of 2 nights worrying and then last night slept 12 hours and still was exhausted but can't get to sleep tonight.  So it's just that everything is out of sync.  This doesn't seem an ideal time to go on a trip with family who haven't been around me since before I got sick.  I want to go to the beach.  I want the time with my nieces.  I do not want not to be politely social right now and I don't want to throw my sleep issues into a social situation.  Honestly I fear I'd go there and not see the ocean much because I'd sleep through half the day.  But it's hard to say no to a memorial trip.  So the cat is hopefully going to be a good excuse.  I have other reasons including my vet bill is pretty big and I hate to spend a lot of money on a trip with that hanging over me and I have to buy a new dawn/dusk simulator and those things are expensive.  I've had 3 break in the last 6 months.  One was very old and worn out and that was fair.  The 2nd absolutely shouldn't have broken and was a piece of crap.  The 3rd was a re-furb and I guess it wasn't re-furbished well.  And I sleep so much better with a dusk simulator.  But they cost a lot so I'd feel better buying it with my gift cards combined with saved money.  I want to go on the trip and something deep inside says "bad idea".  But I don't know if I should trust this negativity because I am feeling so down.  But I think probably it is right and this isn't the time to get acquainted with family again.  It will mess up my sister's plans badly and I hate that.  But that's the guilt thing again and she'll deal or I'll find a way to help her deal or something.

Along with all that it's that this is the last little bit of time before my brother's arrest last year changed everything.  I remember  saying over and over that I just wanted to go back to April 3, the day before I knew.  I still feel that way.  And I won't even go into what it is like to wait for a year to even be charged for real.  I know that doesn't make a ton of sense but it will once this is private and I can be more specific.  As it is we just keep waiting.  And if nothing else if I don't go away and he is arrested I can pick up his pets.  His cats have to go to the vet before they can come home; they have to have shots, feline leukemia test and be thoroughly de-flea'd since the boy who is already so sick is very allergic to fleas.  I have to find out if I can do his monthly flea med tomorrow when it is due in fact.  I really hope so, he is just getting his hair back from the last episode.  He is so allergic that one bite is all it takes to make him pull out half his hair and he is miserable.

Otherwise I think Dr Mind and I are ok again.  I think the test comes when I'm less of a mess than the last few weeks but I think we're on the same page again.  I think his health issues have made him just be ready to retire and he is stuck for a few more years while he has a kid in college.  I hate that thought but I think he is ready for life to be easier. I don't know if that's what will happen since he'd be retiring before social security eligibility but I think he'll want to be done as soon as he can find a way to do that.   It's just hard for me to know that half the time he feels as bad as I do.  I hope that they figure out what is going on for him but until they do he just doesn't feel good and it is hard to do that kind of work not feeling well. 

Anyway, I think I'm getting sort of sleepy.  Hopefully tomorrow I'll both know more about what my cat is going through and the prognosis and about my trip.  I know that I'm going to not be happy about deciding either way so I hope the vet makes the decision easy.


Wednesday, March 11, 2015

Brief Update

The Noah cat is improved.  He needs to eat but they aren't sure he'll do that with a cone on to keep him from removing a 2nd IV (the first he removed within minutes of insertion despite how sick he was) and with the stress of being there.  So tomorrow they'll keep trying and I think they'll send him home Friday whether or not he is eating.  He had a syring feeding today which didn't go very well (he hates this kind of thing more than most cats) so hopefully they don't have to do it again and I REALLY hope I don't have to try.  I've done it before and it's awful.  If they go in tomorrow and he's eaten a bunch I think maybe he'd come home then but I'm not sure since his vet is off tomorrow. He is no longer seeming to be in pain, not vomiting and he finally peed so he is getting past the dehydration.  I saw him for a bit and he moved around and was glad to be petted although not so glad I wasn't removing the cone.  He had a test specific for pancreatitis and it showed it had a pretty bad case which was pretty clear but this confirmed and lets us re-test to know things are settling down.

So things look promising.  I am not sure that he's entirely out of the woods until he's not symptomatic and is eating again but it's much better than yesterday.  I am exhausted; I didn't really sleep last night and have had some naps today but am really groggy and out of it yet not quite sleepy enough yet.

I'll update again soon.


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So today was mostly really groggy.  I started what was supposed to be a well-planned program of using Valium to get my sleep on track and hopefully more normal by my vacation.  The first dose knocked me out and I was drowsy all day.  I intended to just take meds early and go to bed about 9.  Thank God things happened when they did.

My Noah cat was normal all day.  He was in the bed with me and clawing at me to pet him (he tries to pat but forgets about the claws) at 5:30 and still there and getting petted at 6:30 or a little later.  About 7 he threw up a little (happens frequently b/c of hairballs) and headed for the basement. He was down there half and hour and came back up crying.  That was weird so I checked him and he was not wanting me to touch him, was breathing a little heavy and had some foam at his mouth.  I honestly thought he'd somehow gotten into detergent so I checked the basement; all of it would require pressing a button.  There was nothing unsafe for him.  So I then came back up and he threw up foam that looked so much like soap that I got down and smelled it. No soapy smell.  He seemed a little better.  He moved to a towel I'd put down in the kitchen a little earlier when I spilled water.  He was ok there and let me sit with him until I offered water.  At that point I called my mom and by the time she got here he was hiding in the litter pan, a very pathetic thing to see.

We packed him up to go to the emergency vet clinic an hour from here.  While she got the car I remembered that my vet has emergency call and so I called them.  Which was good; it was so foggy driving was dangerous.  So she was going to be half an hour but when I described the symptoms to her and said he seemed "shocky" she agreed.  She thought he probably had an obstructed urethra, common in older male cats.  She actually had a tech who was still working come to the car and bring us in and got him under a heating pad with gloves of hot water around him and my arms around all of that to add my body temperature.  His temperature was 96.4; normal for a cat is 100.5.  That is mild hypothermia associated with mild shock.  There is little doubt that had he not gotten sick until I was asleep he would have died and if we hadn't gotten to the vets he would have died soon.

So the vet got there and he had a low heartrate, arrhythmia, the low temperature, lethargy and little urine in his bladder so it wasn't a blockage.  So she did a bunch of bloodwork and that came back showing pancreatitis was probable. He was dehydrated as well.  He'd lost weight but it's impossible to know how much was from the change to healthy food (he did lose weight then) and what was acute. They did Xrays as well to be sure he hadn't swallowed something and while it can't be ruled out neither can the area being a hairball and his symptoms just weren't very consistent with ingesting something.  Plus there just isn't a lot of things to ingest around here that I wouldn't have known about.  And to do anything more about a blockage would have meant driving to another facility, probably a couple hours away, and with the weather that wasn't a great idea.

And so it's now 5:30 and I can't sleep.  I almost fell asleep once but it didn't work.  I can call at 9 when she's had time to examine him for an update.  It is possible that he won't be here when they get in.  I don't think she felt that was a big risk since she didn't send him to somewhere with 24 hour care but it could happen if the shock took a turn from being "shocky" to "in shock" and nobody was there.

At this point I think I'm "shocky".  I knew the right words to use on the phone, including "shocky" and after I said "pancreatitis" to her "elevated lipase" she said "are you a healthcare provider?" and took me back to show me xrays.  I'm just so afraid.  This kills cats.  It is often fatal.  Caught soon enough and treated aggressively it is survivable.  I just don't know if we caught it soon enough.  I haven't seen signs of distress or anything unusual from him; last night he was chasing a fly and my toes.  He doesn't act remotely 13 years old which is why it is very hard to remember he is a senior cat (plus compared to Miss almost 20 he's a baby).  Earlier in the day I scolded him for bugging me.  It was a normal day until it was dangerous. 

This is his 2nd brush with death.  The first time he was only 11 weeks old and had a nasty respiratory virus.  I got home from work to find a listless, limp kitten.  I threw him in a carrier and ran to the car and to emergency vet where they took the carrier and ran back to triage him.  Eventually they returned him and we waited a long time but he had pneumonia and spent 3 days in an oxygen tent with a IV.  He had hated the vet, car, and carrier since that and he didn't even complain tonight no matter what they did.  He cried when they did a rectal temp and maybe with the blood draw; I left the room because I didn't want to see him not fight. 

For me it may be changing some things.  I am a lot less sure about going on vacation.  It will depend how he is doing.  He can be boarded still sick but we'll see how I feel about this.  It makes some financial decisions for me. 

I'm terrified, horrified and scared.  3 hours and 15 minutes until I can call.  Then hopefully I can sleep for a while.  I'm so afraid and have this deep feeling that he'll be gone when they get there.  But after losing a cat to something slightly similar several years ago I read a lot into this that is not there.  Nonetheless nobody promises a cat will recover from this.  If it isn't bad it is likely but I don't know how bad it was aside from "shocky" (which means signs of shock but not IN shock) and that shocky is just above where you absolutely don't want to be.  Yet he was stable enough that aside from getting him warmed up there wasn't any rush to do anything.  No emergency meds, we didn't start the IV until the testing was done, no oxygen, no great rush.  That says he was ok, just sick and probably in a great deal of pain.  

To make it worse they found that he had a claw that grew into the pad of his foot and was infected.  I had no idea.  He hadn't been favoring it or showing any signs that it wasn't fine.  And it looked icky although certainly not icky enough to cause any of what was happening.

Time to see if I can sleep a little again.  I know not sleeping isn't helping him, my brain won't shut off. Dr Mind and I discussed and worked on helping some of my "very severe" anxiety yesterday and that was when I didn't have anything good to be anxious about.  This is even worse.  Incredible anxiety.

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