As soon as I explained the situation (see below post) to Dr. Brain she agreed that we needed to plan this if I wanted to avoid having it happen out of control. Planning it also allows things like an enhanced chance of admission to that particular area, and hopefully in the controlled environment I can actually start the Emsam while still taking a tiny bit of the current antidepressant, so that I don't have to totally bottom out.
At first she asked if I wanted to be hospitalized and I said I thought it likely but didn't want to commit to it. But as we talked it was clear she wants me there.
It's also a longer process than I'd hoped. I don't get to come off the antidepressant cold-turkey, which I'd hoped but not expected. In fact, I'm going to make the first taper later this week. And it will take a bit to work, so I need to be off work for 2 weeks. That is bad because this job doesn't include paid vacation, so that is 2 weeks without income. I won't exactly be spending much, at least much that won't come as a hospital bill, but I'll need to be saving every possible penny from now until then.
Knowing I'll be in the hospital is both good and bad. It's good because I can plan ahead for things like care for my cats, the need to have clothes I'm comfortable with that meet safety restrictions (including some kind of shoe or slipper without ties; I'm going to get slippers since mine are totally worn out, but it's something that preparation is a good thing.) It's bad because that is a long time to think about it. If only I could just see pictures it would help, but there aren't any. She described it, so I have an idea what it will be like, but I didn't think of some questions that are important to me, things like since it is a tiny unit are there still semi-private rooms or will I get to be alone; can I bring my weighted blanket so I have a ghost of a chance at sleep; can I bring my own toiletries; and who knows what else. I didn't even think to ask if I can be admitted on Saturday to get it over with ASAP. She's probably going to be sorry I have her email address.........
At least this can pretty well ensure I don't run out of things I'm afraid of to discuss with Dr. Mind anytime in the near future.
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2 comments:
I think it is a good decision to be in the hospital when making such a big change in antidepressants, it is good that you are being proactive about this. Being in the hospital also lets you do things faster because you can be medically monitorred. I have never been able to switch antidepressants outside of the hospital (tried a few times, but had emergance admissions). I wish you the best. I don't know much about Ensalm, but I had very good results with Parnate and Nardil for several years. The biggest problem was orthostatic hypertension for me, but that was tempory.
Thanks Emilija. I know this is the right decision, I just wish I could go in today and get it over with. Even though the place I'll be in sounds pretty nice, and the pictures of the main locked unit are nice enough and I believe this unit is nicer than the main one, the word "locked" still sounds scary. I know it's amazing I've made it this far without a hospital stay, but it still is scary.
Part of what is hard is that I've done many AD changes outside the hospital. However at the time of the changes the meds never were working well anyway, so I wasn't going from feeling ok to feeling terrible. And one of the biggest things here is avoiding an emergent visit because that would make it less likely to get in the small unit.
Orthostatic hypotension is one of the reasons I'm being admitted. I already have it from Seroquel, with a low enough BP to nearly require meds last year. Apparently the med I take for diabetes insipidus can also cause it and the Emsam can increase it. So I'm possibly/probably looking a few dizzy days.
I'm glad to know MAOIs worked for you. I was actually going to email you to ask, because I knew you'd been on them. I do not have much experience with people on them.
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