Maybe, just maybe

I saw Dr. Brain today.  She's a bit puzzled by why I'm doing so well on so little (for me, it's still a lot for most people) Depakote, especially since Depakote has been the foundation of my med cocktail for so long.  But I'm doing it.

I'm having bloodwork this week, and the level is expected to be low.  If it is (which it will be unless I suddenly started metabolizing it differently than the past almost 7 years), then we'll be attempting to wean me totally off it.

That would be amazing.  Considering that less than 2 years ago I was on high doses of both Depakote (very high) and Seroquel, plus lithium, plus a variety of other meds (antidepressants, various anxiety meds, etc) and not doing great, the fact we potentially are discussing me being on a normal Seroquel dose plus low dose antidepressants and low dose lithium is incredible.  It somewhat frightens me, as at least now my body is used to all this medication and there wouldn't be such a harsh adjustment if I needed more.  But I haven't needed more in so, so long.

This whole bipolar thing is SO WEIRD.

PS

This won't make much sense without reading my last post, but if you get bored, think of a short, chubby woman with very pale skin and brown, shoulder length very curly (currently very, very frizzy) hair walking around wearing these to type on the computer:

The dog ate my homework

This is a warning in advance that I'm going to be limiting my computer time for a bit, which means less blogging.

Every year in June I have a mixed episode.  I'm now there.  It's mild, mostly just a lot of anxiety and not-sleeping plus a few tears, but the problem is that it's hard to treat this annual episode.  What happens is I have the opposite of my also anual SAD episode.

SAD can be treated with blue light, which I did this year with huge success.  (It's also treatable with broad spectrum light; the blue technique is new and smaller and faster, but many people use the older systems).  

At this time of the year though there is TOO MUCH blue light.  For me, this means that my body gets too much daylight and then I have trouble sleeping and become manic.  For me, any mania is always accompanied by depression, turning it into a mixed episode.  The daylight right now is really messing me up, because my normal routine is to take my pills at 9:15 and be in bed asleep at 11:30-12:00.  Now it is 1:00 to 2:00 when I fall asleep because I need that much extra time to get rid of the longer day.

Another source of blue light, unfortunately is my computer monitor.  I already gave up TV so that's not an issue, but I spend a good bit of time right here.  

I promised Dr. Mind today that I would do a few things.  One, there are a type of welding goggle that block blue light.  I'm going to get a pair of those.  I also am trialing less computer time.  I don't know how I'll do because I don't have a lot of other things I can do when I can't focus well, but I'm trying.  Anything to avoid more mood stabilizers.

I hate this

So the anxiety/mood symptoms are now officially annoying me.  I'll live, but it's 12:45 AM and I am wide awake worrying.  Which has been fairly typical lately, which is why I'm exhausted all the time.

Also, I can't help what I'm worrying about.  Money.  Ick.  I'm so blessed to have a good job.  I'm in a place that I have so much more than so many.  Healthcare is one of those areas that the economy affects differently, and while things are tighter with healthcare there are still jobs.  But, I still have huge medical costs, and I don't work full-time.  I was figuring today that the difference between a 40 hour week and my week, combined with my meds and therapy, would mean the difference between living paycheck to paycheck and actually having money.

Right now I'm upset because I need a new mattress.  This was slowly approaching as my mattress aged, but I was hoping to get through paying my mother off several thousand dollars I owe her, plus I'm trying to pay off credit cards and feeling I'm making no progress (I had made a lot, then had to charge my crown last week).  And I was working on vacation savings.  I really need vacation time again and time away from anything work-like and home-like is something my doctors strongly encourage.  But my mattress had a spring that was poking the edge for months, and it has now torn.  So, good-bye savings.

This is all bipolar freaking out, and tomorrow I'll feel better.  But right now I just want to scream.  

I always forget how uncomfortable this stuff feels.

So, the mood swings

Not badly.  And I pretty much know why.  But it's still a dreadful feeling.  I've done so incredibly well for so long now.  I had an antidepressant increase in September before I was fired and that's it for even remotely hard times in over a year.  A year ago we thought I was depressed but it was actually a med reaction that was easily fixed when it was figured out.  (I was taking 2 versions of the same med, making me very tired).

But I'm feeling anxious and a little down.  And I really don't like it.  Partly this is because I feel I can't do much with my mood stabilizers to help, assuming I want to keep working.  Which I very much do.  

The main reason is simply that I missed 2 weeks of counseling in a row and I know better.  Two weeks ago he was out of town, and last week I had a dental crown and was just too exhausted to handle sedation followed by 2 hours of driving and an hour of talking I knew I wouldn't handle well because of the exhaustion.  However, missing counseling means lots of anxiety and that makes me feel depressed because it frightens me to feel off-kilter at all.

It's so weird.  I knew that if I ever was well again I would have to learn my triggers.  I even know that this is a big one.  And I also know sometimes it's unavoidable.  But I find it so odd that it is really harder for me to be careful to adhere to something simple like "I need to see Dr. Mind" than it is to take my pills.

36 more hours to that appointment....give or take.....

The end of an era

I just realized something.  I'm about to make a BIG med change.  

Way back in 2002 when I was first diagnosed I participated in a clinical trial testing the efficacy of a 3-pronged approach to treatment (I think of rapid cyclers, although I don't remember).  They already knew the combination of lithium and Depakote was effective in people who didn't respond to one med, and since Lamictal at the time was the new drug of great hope, the study was determining if the 3 together was even better.

The study was rocky for me.  I was already on lithium, so first Depakote was added.  I don't remember what the criteria for adding the placebo/Lamictal but that wasn't done until maybe week 10 or 12.  Depakote didn't do a lot for me.  My dose was increased over and over but my blood levels didn't go up accordingly.  

Then I started the placebo/Lamictal and at first did well enough we all thought I was getting medication.  After a week or two it became quite obvious that I wasn't.  I was offered the chance to stop the blind part of the trial and get on real Lamictal ASAP (along with offers of hospitalization, dropping out of the study totally to get on other meds, and who knows what all) but I felt I was so close to the end that I didn't want to quit and not have my data count.  After so many months of free meds you start to feel pretty grateful to the drug company, especially if you have horrid insurance that covers meds at 80% and you are on hundreds of dollars worth of meds.  (I changed jobs immediately after the study to get group insurance).  Plus, I have a thing about following through on committments.  Sometimes to my own  serious consequences, as we all know.

Near the end of the study we re-visisted my Depakote dose and level.  For Depakote to work the level should be >50.  Mine, even on a relatively high dose, was 47.  (Over the next years we'd actually learn my level needed to be 120-125).   A new version of Depakote, Depakote ER, was proposed as a way to see if my liver could be tricked into not processing it so quickly.  This, combined with a hefty dose increase, allowed me to finally start feeling somewhat better (at least not suicidal) for the first time in 13 months.

For the last 7 years I've been on Depakote Er.  I've paid the higher rate for it each month, usually $30 per refill.  This has been frustrating while regular Depakote was generic and much cheaper (probably a $4 script lots of places).  This winter I was thrilled when ER went generic.

Over the last 6 months my Depakote dose has gone from 3000 mg/day to 1750 mg/day.  For a long time I've been breaking a few of the ER pills daily to make them immediate release, so that I wasn't so tired all the time.  In the last month I have been breaking all of them.  Since we already know that I don't process Depakote well my doctor already has told me that monitoring my blood level isn't very relevant during this weaning process.  We're watching how I feel, because we have extensive evidence my blood levels react oddly to this drug (I've been monitored extra-carefully trying to see how to adjust accordingly back during more desperate times.)  I feel great.

On Saturday I will see Dr. Brain.  And at that time I'll more than likely get a prescription for regular old Depakote.  Which is another sign that Depakote is no longer such a vital thing.  In fact, the end of depending on it may be approaching.  I don't know if I get to come off it; I have the impression she wants some in my bloodstream in case I would need a boost.  But I'm going to push for as far down as possible.  

Interesting

So do you remember those word cloud things that were popular a while back?  You entered your URL and the page used a wordbot to find the most popular words in your blog and made a picture with those words.  I did this today and found something interesting:  bipolar didn't appear.  I guess that's how healthy I've felt lately.  Funny, because I've had a whole week of bipolar-related exhaustion, but I haven't written about it.  Not much to say:  I'm tired.  The end.

In my quest for more clothes that fit, I found a link to a page that does a really good job providing bra sizing.  They will quickly and nicely answer questions, and make product recommendations.  I'd say the prices were good given that these things for larger women are always pricey and I've always avoided paying what I should.  I also found a 10% off coupon at retailmenot.com that worked.  If you've never tried retailmenot.com it's a great place to get online coupons.  Some work, some don't, but it's always worth a try.  Anyway, the bra store is breakoutbras.com and although mine aren't here yet (next week.  Oh, and free shipping!) I'm anxiously awaiting.

Also, I recently switched to a gmail account.  This is annoying me with blogger, because it keeps saying I'm signed into blogger with my personal email.  It does not let me sign out easily; I have to enter random things as a password, then when it says I'm wrong it lets me change.  Is there an easier way, or do I need to think about wordpress?  I so, so don't want to try to figure out a change, but I also don't want to be frustrated and unable to leave comments.  Anyone know?

Hating Bipolar

I had a tough day and am just not in the best of moods.  Work stuff.  Let's just say I'm working Memorial Day but will be considering it a day off because of decreased staffing.

But now I'm really in a bad mood.  I'm having dental work done tomorrow, which is going to cost me $600.  My dentist does a thing where you can open a line of credit to pay the bills.  I was denied.  I know why, it's because my credit score isn't good.  I'm trying.  I've paid off a car and a major bill in the last few months and knocked another huge chunk off another which I'm trying to eliminate so I can transfer my final credit card to its lower interest.  But then I turned around and missed 2 months on another payment.  And over the years of being so sick there were plenty of months I missed plenty of payments.  I've never defaulted or anything but been late, but right now that is considered too risky.  It freaks me out because in a year or so I'll need a car loan and I'm going to suffer greatly.  

So now I have to pay $600 on my credit card and then will have to pay that off on my card as fast as possible.

Until I got sick I was obsessive about these things.  And I've done my best, it's just my best has been not so good sometimes.  

It makes me feel like crap about myself......

Blog Carnival

Fine.  I am seemingly incapable of getting the button up for this, but I am participating in a blog carnival this month.  It is through a webpage for Christians with chronic illness, and I'm greatly enjoying reading there and learning about how others experience life with similar issues.

The webpage.  Check it out.  I'm about the 7th down, but from the little reading I've had time for the others are much more worthwhile (plus if you read here anyway  this post has been up for a while!)

Victory!

Many times over the last years, in fact every.single.time I've tried to find clothes that fit, I have posted frustrated stories of how overweight women are maligned by the fashion industry. I still firmly believe this.

Today though, I had something awesome happen. I went shopping and for the first time since I started the ultra-high doses of Depakote and then Seroquel, I fit in clothing for non-obese women. In fact, today was rather humerous as the full extent of my weight loss was clear as I wore shorts from last year that were so large that they had to be pulled up to my bra to qualify as shorts, and a shirt that I was swimming in.

I've lost 25 lbs. and then haven't looked at a scale in quite a while. Even as the weight loss has slowed it has seemed to continue re-distrubuting weight around and I'm more balanced than I was before. Before the weight was in what I've noticed to be a common pattern for those on atypicals: lots of belly fat, little on extremities.

I will never underappreciate clothes that fit me all the way around again. I made someone laugh because I was so excited to show my mother that Misses pants fit. It was the biggest size, but the size below almost fits.

And that is about all of interest that has occurred around here lately.

It's a special job

I love what I do. I certainly write enough about that that we all should know it. Sometimes though, there are downsides.

Typically work-related injuries are muscular or joint related. Those can, of course, be quite major and I cannot even imagine. These are risks for us, although maybe a bit less since we're very highly trained in ergonomics. I will admit though to one back injury that put me on painkillers, and another time my dr. thought I had sprained my lower back and gave me muscle relaxers, although I think it was a UTI.

Today though I had one of the several minor injuries at work that make it clear that healthcare is unique. The first of these was before I was even an OT student. I was a counselor at a special needs camp and over 3 years had several incidents: minor bites from kids and a broken tooth. The worst was when I was holding a child while swinging. For no reason at all he bit my "chest" hard and didn't let go, probably because I was reacting to the pain. The bruise lasted for months. Last year I had to fill out an incident report because a patient grabbed the same area and twisted, deeply scratching me. Lots of gunk lives under fingernails so I had to fill out a report.

Today though may be the most amazingly bad luck in an incident I've ever had. I went to the dementia unit in the evening to show staff something. The patient we were discussing suddenly had massive diarrhea. The aide went to change her. I was walking out when I saw a huge puddle of diarrhea at the other end of the hall. Another resident had been dripping everywhere, then created the big mess. I got the other aide, who asked me to watch the other residents. They were playing catch, so I started tossing the ball. It was going very well and was very tame for nights on the unit. And then it happened. Someone threw a ball which hit my glasses just right so that they fell off my face and were smacked into my lip by the ball. It broke the skin and I have a slightly fat lip.

I wouldn't care, but the ball was bouncing on the floor and the floor was potentially very, very dirty. I cleaned it up, but time will tell if I was fortunate enough to avoid the nasty infections I'm sure I was exposed to.

Until then I look like I tried to shave my upper lip with a dull razor.

Fast Week

Hmmmm, not a lot to say lately. Last week involved a dental cleaning that turned into a crown, another difficult therapy appointment with lots of tears, spring cleaning all weekend, and then yesterday I was off work to get electrical work done at home. I'm thrilled to have that complete, and for a price about 1/3 of what I was afraid it would be. Today was absolute chaos with work and needing to be 2 or 3 places at the same time. I hate taking days off when there isn't coverage for me. I am now exhausted. Tomorrow will involve a lot of catching up from today. And Thursday is time for another therapy appointment, likely to be just as difficult. For someone who thought I was pretty much at peace with my past talking about it sure is hard.

I'm in the midst of a search for REALLY strong deodorant that won't break me out (sensitive skin). I typically use Lady Mitchum. It's not strong enough for summer. I've tried the crytal stick kind; useless. I currently am using Tom's of Maine; it merely makes me smell like apricot scented sweat. The area where I work is often over 80 degrees. I'm roasting. Any ideas? I know there are some prescrition-strength brands available, but I'd like a review before spending $10 on deodorant. I'm cheap that way. I also have to have something with more a fresh scent (there's something by Adidas that purports to be strong that I like) than very floral or especially not powder-y. Yes, I'm picky. It's hyperacuity, again. The wrong deodorant odor (read: apricot) really bugs me.

And, that's about it...