I'll accept this

Not sure how I was linked up with this thing, but this week I got a notice that my blog has been listed on a site called www.blogged.com . It is a ranking site. My blog is in the conditions and diseases category and I'm pretty proud of it because it not only is in the top 20% of the 617 in it's category, it is the top listing dealing with mental health in that category. It received a "great" rating from the reviewers. I'm not entirely sure why I wasn't in mental health, but whatever works, I guess. There's a button that may eventually appear here but so far it hasn't cooperated.

Not much else to talk about tonight. I made stew today and am finishing a few loads of laundry. I was totally out of clean scrubs. All kinds of excitement this week: July 4th is a holiday. I'm working a few hours but with a pretty good financial incentive. Wednesday will be the last day I have to deal with the therapist I haven't gotten along with. I won't mind the end of that stress. And next week I only work 2 days and then I'm on vacation! Lots to get done before that though....

Weirdness

I am really struggling to adjust to the minor med changes from a week ago. There is no good reason for this, it was so minor it shouldn't have been noticeable, but instead I've been dizzy and exhausted and nauseated.

I also just feel weird. The change helped some, but not enough to be a definite fix. I'm still having lots of mood symptoms and that's not helping how I feel. But the mood symptoms are tempered by feeling completely in control of the situation. I'm just not worried too much that they are here because compared to other times they are so incredibly minor. However, they are frustrating because they hold me back. I don't feel good, I don't feel like doing anything but sleeping and I can't necessarily do that on my schedule.

I think it's not helping that it has been hot and very humid. I am pretty paralyzed by heat this year, even more than last. However this year I am in A/C in the office. I can't begin to explain the difference.

Hopefully soon I'll know more about what's up. I'm hoping to get a thyroid check on Monday and a Depakote level. I really think my thyroid is partially at fault here and if it is then I'll be able to increase that med within a few days.

For now, another attempt at sleep.

Sensory Integration (for Freda)

Freda posted a comment on a very old post of mine about sensory integration and bipolar in adults. In short this is an OT theory that is for children, which I began using with mentally ill adults in 2005 with profound success. In 2006 when I was on disability and not responding well to medications even after months off, and was unable to sleep despite enormous doses of sedatives, mood stabilizers, and sleeping pills I finally decided to treat treating myself for this disorder I'd known for years I had. My first weighted blanket weighed 9 lbs and was child-sized, so every night it would fall off my bed, but it also let me sleep for the first time in months. Not only did I sleep but I didn't have nightmares or frequent awakenings and I didn't toss and turn consistently. That had never been true for me. In the spring of this year my custom made weighted blanket arrived. It is 22 lbs, fits a full size bed nicely, and I choose the fabric, a fleecy material with raised dots (Minkee dots) to rub that is typically used for baby blankets. With this I have even fewers symptoms of the disorder.



There are a number of symptoms associated with the disorder. Different types of the disorder show up differently. My main issues are that I lose my sense of where my body is, and I'm hypersensitive to my surroundings. The weighted blanket provides feedback and helps me relax. The hypersensitivity is demonstrated by things like being totally unable to stand tags in clothing, being unable to tolerate many fabrics (I really can only wear cotton or every so often a certain synthetic).

The trick is getting treatment. I think many mentally ill adults have this and I've been extremely successful applying it to adults. In fact I had one patient who was so incredibly violent that he had to be cared for by 3 staff at all times for safety. He'd broken someone's ribs, attacked other patients, and generally couldn't handle any noise or interaction. The first time I treated him they thought I was crazy because I got close to him, talked in a low voice, and touched him. He tried exactly once to fight me, and that was only an attempt to assert power; he tried to walk away. I let him walk then took him back to his seat and continued. I saw him 3x/week for one month. After one week there were no more violent outbursts. In the entire month there was only one minor one and it was understandable. When I started his community activity was McDonald's with 3-4 staff; at the end it was with one staff. And by the end he had dental work without anesthesia. His behavior management psychiatrist was amazed. But I didn't do anything special, just thought a different way. If I'd lived closer to that area I could easily have opened a practice with that psychiatrist's referrals, I think. But it was 2 hours from home and I couldn't do it anymore than one month.

Your best bet is to find an OT who does this, maybe has a small private sideline with kids. If you live near an OT school (and if my sitemeter logic is correct you live in the city where I was trained--do you live near WMU? Sorry for spying that way, normally I don't connect comments to city, but if you are there then this gets easier. If you're in that city email me (in sidebar) and I'll tell you more.) then the easiest way may be to call them and see if they know anyone who does this. I know we had at least one person who came in that did it. We also had a professor who specialized in it but she is now retired. A school would also give you some chance of maybe being a clinic patient, but generally they'll be gearing it towards kids. You'll need a full fledged program, not an OT assistant program.

I wish I could say this is easy. It's not. Had I not known this for myself I probably never would have done it. My psychologist had seen weighted blankets used in the hospital but had no direct experience. Now I know of several people who recommend them because of me.

Sensory integration is so important for me that I'm working on a whole room where there is decreased stimulation and lots of ways to calm myself. I hate that it's an issue for so many and that the only reason I know how to figure out what I need (because sensory integration takes many forms and many possible and sometimes opposite approaches are needed) is my training to treat others. I get so many people searching for information on this topic, and I really wish there was more I could say. If I weren't bipolar I'd probably be doing research on this stuff with adults, but I am bipolar and I can't handle more than I do.

Hopefully this helps some. Please email me (masterofironyatroadrunnerdotcom) if you have further questions, or leave a comment. Sorry it took a while. Bipolar just takes over everything....As you know.

Tuesday

I wound up staying home today. I woke up and couldn't walk straight. I was falling and walking into walls, a pretty good sign my body needs to adjust to the med changes. I wound up sleeping all day long, so apparently my body REALLY needed this. I'll work Saturday instead.

I still feel ok, not great. I guess that's ok though. Probably normal.

I'm just so very, very, very tired.....

Hodge-Podge

1) For the person searching for "bipolar and steriods", what happens is mania. And it is NOT pleasant. Rage, beyond all imagination. I had this happen when I took steroids for a rash and thanks to the rash deciding that the original locations weren't enough, it needed to take over my entire body, I wound up on a lot. I wasn't diagnosed yet and had no idea what was going on. It was actually quite scary. There was once this guy that I was in grad school with was pestering me about something. I was rightfully angry with him for something and kept telling him not to talk to me about it right then, I was angry, and after I calmed down I would talk to him. He kept it up, getting in my face, and I blew up at him. Loudly, in public, and so that he's probably NEVER messed with a woman since.

2) I was diagnosed with a moderate mixed episode the other day. The diagnosis has been coming for a long time; I've been symptomatic for 6 weeks and enough so that Dr. Mind wanted Dr. Brain involved several weeks ago. I got 2 med changes and sent back to my regular life, with the goal being that I won't be overly sedated but will lose the symptoms. There's a huge risk involved, as we upped my antidepressant, something normally very much against the rules in summer.

I don't feel great, but also don't feel anywhere as bad as I know I can feel. I have had moderate episodes much, much worse than this. I still feel I'm in control, and I even feel that some of what is occurring is a result of my choices to deal with some painful parts of my life. I'm well enough to take that kind of risk, for the first time ever. I don't doubt I'll get well.

At the same time, it's a mixed episode. I'm now on suicide check-ins as an automatic. I have no strong desires, but I can't say that the usual "I do NOT WANT TO DO THIS AGAIN, how do I stop it from happening for the rest of time?" thoughts are there.

Mixed episodes are generally accepted as being about the worst mood experience ever. Someone who hasn't had one cannot understand. And from my perspective I think you have to have had repeated ones to truly understand. I've never seen a statistic, but I'd be shocked if most suicides among bipolars don't happen in mixed episodes. It's the only time I make truly horrid decisions.

So my weekend was spent trying to adjust to this. I don't make major pronouncements at work about how I feel at any time, although I do talk about bipolar in general. Nobody knows, to my knowledge, that this is an episode for me, or how much I'm struggling.

One of my co-workers tends to always have something wrong with her. I realize I probably sound like that on this blog as I talk about the various health issues BP has caused me, but truly I don't do this elsewhere. Today it was depression and desperately needing antidepressants and she can't face working until the meds kick in and various things. I'm sorry for her, I know how badly it stinks to realize you need meds long after it would have helped to start them, but at the same time my patience is quite thin. My med changes are to powerful drugs and have a high risk and I'm just quietly waiting and not letting my life be disrupted. It also doesn't help that this leads to everyone talking about when they've felt like they were suicidal, and lots of jokes about hospitalization. I don't hear anyone describing true suicidal ideation, not the kind that you cannot shake for days on end no matter what you do, the kind you scream at your brain to stop.

I'm just frustrated that I have to call this "a normal part of life" and for her it's a big, huge deal.

3) Well, actually I forget 3. So more later.....

About as I thought

I saw Dr. Brain today. It was hard. I was so much more anxious than usual, because I knew that I was going to leave with my remission gone and whether I liked it or not, this is a mixed episode. It's not bad compared to my past, which makes it confusing, but she finally said it was of moderate severity. She seemed uncertain of that, I assume there was some chance it was still mild, but it wound up qualifying as moderate.

Not that this means much. It can't when there are 4 qualifiers on the scale (mild, moderate, severe, with pscyhosis) and in my personal experience I've lived working for 2 solid years with a severe dx, but also been totally disabled by more severe than severe episodes.

I've got a couple med changes to try. The hard part is that in summer it's easy to trigger mania with changing things. But there is no choice. I've given this 6 weeks and it's not healing itself.

The one really good thing is that when asked about hearing things, etc. for once I had really good news. In the past few years summer manias have included hearing voices, especially in bed. I very rarely have ever had psychosis that I wasn't able to question myself or find someone to question until I knew whether it was real or not. But sometimes it is tricky, and it's occurred plenty when I'm waking, making it even harder. A few weeks ago I was in the basement at just the right place when the A/C, which is located directly outside my bedroom on the wall with my bed, came on. And my voices in the bedroom turn out to be the A/C unit (they sound much different in the basement).

So, I'm supposed to try new meds, keep a low profile for a couple weeks because hyperacuity is kicking in a bit, and of course, like always, rest.

For now though it's time to turn the computer off; we're gearing up for a big storm it looks like. Time to cuddle up with a book.

And now I know

For weeks I've not been sure if I've been depressed. I've been borderline, but have been deciding against, based on knowing my thyroid is probably messed up and that I've been working on extremely hard topics in counseling. Plus I've just been hoping it would go away. I know that this is, as usual, not going to be a good place for me to have issues. My doctor REALLY doesn't want me on any more antidepressant. I REALLY don't want me on any more Seroquel, because I'm exhausted at a lower dose just as much as the higher one.

Today I had yet another painful counseling session, in which we didn't even hit the painful thing I've been saving up for 2 weeks because everything else kind of came first. It turned into a conversation that's been had many, many times but never so directly: my handling and emotional processing of criticism hurts me. And never before have I seen so clearly what a major part of my issue is--I have not yet moved past the abused child who was not criticized without nastiness or physical punishment. When someone criticizes me, especially when it is unfair, I tend to react like they are symbolically going to hit me.

I realized this in a way I don't think Dr. Mind noticed, and which I probably still need to talk about: he gave me a very matter-of-fact listing of examples of my not doing well in this area. I listened and nodded, there's not really much to argue about as he is right. But the trick was that as he talked I realized I fully expected him to get angry with me. I got scared. I realized first that I actually DO trust him, and that even so it was hard to hear this very mild critique of the last year because I was scared he'd get mad. Which in reality has occurred and I've survived although when it's happened when I'm not manic it's been hard. The fear was because that is my immediate response to anger (non-professionally). I react the same as I did when I was a child and anger was dangerous.

So I guess now along with everything else I need to learn a few more things. I need to not equate criticism with anger. I need to not fear either of those things. Because I know I react wrong. But I didn't know I wasn't reacting to the wrong thing.

It took me hours to sort through all this. I actually went shopping since it was cool enough for me to go in and out today and I needed baby gifts. Once I started I hit a really good sale and did some Christmas shopping too, since I have no way of ever knowing that I'll have income at Christmas. I actually got several things. The entire time my brain was churning.

The next step is seeing Dr. Brain this week and hopefully she can do something useful without drugging me. And next week I'll have to tell Dr. Mind the rest of the story. Which scares me also because I feel like I'm now getting bogged down with too much at once, and yet it's all inter-related. I feel like it would help to see him more for a week or two, yet logistically that's really, really hard.

And then at the end we had a new version of the conversation that triggered this post a year ago, a conversation that has been food for thought for nearly a year. It was a little startling because I get little praise that direct from him.

For now I need to sleep. Well, my cat just came to tell me I need to FEED THE CAT and then maybe sleep, if she believes this is the best option after careful reflection.

Dear World

Dear World:

Many things. None are related. Too tired to make them cohesive.

1) The phone service just sent me an email telling me they added the new services I requested, blocking 900/976 #s. Since I don't have much of an issue with that, nor did I put the services on, I have no idea what their problem is.

2) I have finally found THE cure for constipation. Months ago I was embarrassed to write about this, but now have spent so much time writing about it that I no longer care. My recipe: 500 mg Colace daily + 1 fiber one bar (so yummy) + 1 bowl air-popped popcorn with 1 T. olive oil based margarine. It is so nice to not be in pain.

3)My next problem is that every day I use mouthwash just for people like you, and every day it makes me gag and gag. I hate this.

4) People keep walking/biking out in front of me in the dark, wearing dark clothes and when I honk or glare at them they laugh. Getting smushed really isn't all that funny.

5) It is possible for counseling to increase my anxiety levels above where we've worked so hard to get them. I really don't like the return of the anxiety. I need to work on this stuff, but I'm getting more tense already and my appt. is 2 days away. It is SOOOO hard to talk about stuff I haven't talked about in 10 years. Or ever.

6) It's 10:30 pm and I didn't eat lunch or supper so I really need to find some food. And take pills. And a shower. And hopefully sleep really quickly for a change of pace.

Explanation

A long time has passed between posts....

Things are kind of weird right now. I'm in the middle of some thyroid adjustments and thyroid symptoms are similar to depression, so I can't really tell them apart. I'm also working on new stuff with Dr. Mind that is extremely hard, possibly the hardest stuff I've addressed with him. That alone makes me pretty tired and sometimes just plain old sad.

Two years ago I spent much of the summer on disability and seeing Dr. Mind twice weekly. For all of those hours we talked mainly about the grieving for things I lost thanks to this illness. Some things that make me sad are such minor things in comparison to most of life's tragedies, but at the same time there is a lot that I'll always be sad I've never experienced.

I thought at that time that what we'd discussed was hard enough and that it covered most everything. However, at that time I was still plenty sick, and still far from well enough to see much of what was missing in my life.

Now things are different. I've been relatively stable for 7 months. I'm trying to learn some new skills, like sorting out "normal" from "something to worry about". And I am finally well enough to care about things that I stopped caring about long ago.

Years ago the friend I trusted more than anything in this world came to me during a time when the depression was scarily deep and said a lot of things that were unfair. They reflected her lack of knowledge of the topic she was addressing, but she managed to convince me that I wasn't worth knowing, that I was not doing what God wanted and I couldn't get better unless I did specific things spelled out by her that would change my relationship with God. Eventually this ended our friendship.

For the years since then (6 1/2 of them) I have refused to have friends. I have not wanted to get hurt again. There are other reasons I've not formed friendships, closely correlated with being bound to A/C in the summer, noise sensitivity, etc. Plus I thought it was easier to not risk being hurt like that again, because I'm pretty sure I could not handle it again. I also just haven't found a good way to trust people, or desire to really try. That just never seemed like something that could be a major way energy was expended.

For the last while I've been forcing myself to talk my way through some of this. I have a long way to go, and it's painful enough that I cry the entire way through each discussion. This week I took a day to not hit anything painful because I was feeling overwhelmed.

Doing this takes all my strength. That's why I'm quiet lately. It's for a very good reason, and it's a really big step FORWARD in my life. Only a year ago it seemed like that direction was impossible. Doing this has re-opened very painful old wounds, plus it has involved a great deal of anticipation each week in the days before therapy, then for several days after I'm recovering. I'm also expending huge amounts of energy trusting Dr. Mind more than I have ever done before.

So, good stuff going on, but lots of needs for alone time and peace.

Here goes

Regular readers know that a few months ago I was diagnosed with something called diabetes insipidus (DI). It is a rare (of course) kidney disorder that can have several causes; in my case the cause is lithium use. In most cases if it's caused by meds they take you off the med, but I don't do well without lithium and my level is impossibly low so that there's no reducing it.

Much consulation among 3 doctors resulted in a plan where I am on medication to help this. If I have vomiting or diarrhea I am supposed to be very careful to get lots of fluids. I also have to be very careful with heat, because I already am at risk for things getting out of whack and heat increases the risk of electrolytes being out of whack.

Tonight I'm not feeling well and it's the first time I've had to worry about this. I feel suddenly like I didn't ask enough questions. I also have been off the DI med for several days thanks to the pharmacy and my being busy and that's not helping as I'm peeing off a lot of fluid my body needs to hang on to.

I hope this fixes itself. I think I was hoping the first time I got sick it would be during the week when I have easy access to the doctor. Never would I be so lucky (esp. since that would mean a day off work :).

Ugh

I don't want to talk about how horrible today was. I spent hours meeting with managers and hearing about things I've done wrong that nobody comes to me about but instead everyone complains to everyone over my head. Which does nothing to let me change.

I have visual perceptual issues. Copying things is hard for me. I apparently make mistakes. I was unaware of this although I do know it is a risky proposition. So how is it then something that is a major issue? I had several areas I was able to point out the same thing, I can't fix what nobody tells ME is wrong. I know how to do it differently; if I had known I was making mistakes I would have filled in the visually difficult areas all at once instead of as they pop up on the page. That fixes that problem. And one area I sat through a big thing about because I didn't understand, then later when it was re-stated I realized I had done NOTHING wrong and that someone else had way, way overstepped bounds and practically accused me of not doing my job when she totally has no business saying that. Plus what I had done was correct per the chart.

And there was the usual things where they try to tell me that if I "only do this" I'll be the way they want me to be. They are wrong. I am so tired of them trying to tell me they know better than I do how to fix this. They might have good ideas, but the ideas they try to force on me are always the same. They are always standard management things and I don't have a standard problem.

So I spent hours of my workday crying. Lovely. But at least I get vacation time now, and have scheduled some days off next month.

Now I think it's time to sleep for about 2 days solid.

The pharmacy bites the hand that feeds it

I spend a very large amount of money on meds. My insurance spends even more.

I dropped off a script for the medicine for my kidneys (for the diabetes insipidus), which is a diuretic called amelioride on Tuesday. I picked it up Wednesday and forgot it in the car.

In the car on Thursday morning I started to take one, but noticed that instead of "take 2 5 mg tablets" it was 1 10 mg tablet, and I thought the amelioride didn't come in a 10 mg pill. I looked more closely and the medicine was amolipine (Norvasc).

Norvasc is a blood pressure med. Since my bp is actually pretty low, low enough that raising it was a factor in deciding to cut a bit of my Seroquel dose in April, I really don't need that. Norvasc is also a drug I've never taken so I could easily be allergic. I have to approach all meds like that. We don't mess around with untried things for me.

I checked, and the dose I was given was the highest made.

So, now I have to add dealing with that situation to my Friday, which already includes a variety of stressful events.

I believe tomorrow at least I'll know if I get to keep my job.

Deep Breaths

It is 2:30 AM. I just got home from work. I haven't had meds yet, going to do that in a minute. But I just had to publicly state that I had a HORRIBLE day today, horrible in a way that I can't discuss most of it because that would violate confidentiality. I have never hated confidentiality so much in all my life. Let's say I had to take an ativan during the day. I've had 2 Ativans in the last 9 months or so and the other was when I had to help do the heimlich. I'm waiting for guidance from a way high up in the company because the situation is THAT crazy. Thank God for witnesses.

I can say that one part of it involved people making comments about my tremors. Someone I work with corrected them, but that hurts. Especially when said in a roomful of people. On the other hand the person in question has such horrible public behavior that she's got way more to be ashamed of than tremors.

I also am really really mad at a co-worker because she took over something she has NO business touching without talking to me, made me look stupid in public, and is doing something that is just wrong. That alone irritates me, but then we add in "how dare you complain about not having time?" and yet you can override my totally correct decisions. She is not an OT, she is a PT and I would never override her. She isn't even an EXPERIENCED PT, and I will say there are a few areas I might do something PT-ish just because I've been around a long time and I know it. So there's a confrontation in my future. This is the 2nd time this happened since I took this job and the people in that section are going to have to just face the way it is.

I'm just so stressed. There's a million things more. I need to get some meds in and sleep. I just cannot believe the day I had.

All that's happening

Time for one big post.

First, please know that I'm trying to write. I am so sad to see my numbers cut in half. However, right now is not the easiest time. I'm in my last week of probation at work; next week I'll officially find out if I keep my job. We've been ultra-busy; I don't even have time to get done stuff that I have to.

Second, physically I'm not feeling super. My thyroid needed adjusted yet again, and I ran out of medication while my doctor happened to be on vacation. The only solution was to take a lower dose than my prior normal and I just got the new dose today. So this week that should feel better. I also ran out of kidney meds and I now have a clear idea why I take them: I am drinking several gallons/day again and peeing constantly. It's annoying.

Third, and probably most importantly, I have been working very hard in counseling for several months on the preliminaries to trusting people. I've struggled beyond all explanation with even talking about some of the reasons I gave up on that, and how hurt I was in the past. For weeks I talked about various things and generalities. Last week, after a number of weeks of trying to be strong enough to really get into the painful part of this, I moved into a whole new realm with Dr. Mind. A realm where he has a chance to agree with all the things that have hurt me most. It's been very hard. I've been in therapy most of the last 15 years. There was another time, with another therapist, that hurt like this, but mostly this is about as hard as it gets for me. This takes away what remaining energy I have left after the thyroid mess.

And I'm stressed out because as of next week my pharmacy will be closing at 9. I can't explain why this bothers me so much, but it does. One more thing to have to remember, I guess.

So, who knows what the next post brings. Tomorrow is my meeting with my supervisor; hopefully there won't be anything making me run for the computer. Friday her supervisor, the one I now fear, may be down, and that's the thing I dread the most. But we'll deal with that then, I guess.