Yikes

I just kind of thought through some of what may happen, and wow. I may be having to make some really rough decisions soon. At the same time I am supposed to be working on eliminating "what if" from my thinking, so this is borderline breaking the rules.

Next week I go for the MRI of my feet and ankles. As I understand it the left ankle MRI is mainly going to give a better idea of how bad the damage is to my ankle and help my doctor plan for how to treat further sprains and know how close I am to needing that ankle reconstructed. The right foot will determine why it hurts so much, whether there are tears in there or something unrelated to anything else that is causing pain like a cyst, or if I do indeed have tarsal tunnel syndrome. The end result of that MRI will be that Dr. Foot/Ankle will know if I need surgery to that foot to relieve whatever is going on.

Here's where the not allowed to think about "what if" comes in; right foot surgery would be a big mess. I'd be on disability for 6-12 weeks. I can't use crutches with my left ankle the way it is, so I'd probably be hopping around on a walker. I wouldn't be able to drive for a good part of that so I'd be probably getting home health therapy. I'd be stuck with phone therapy with Dr. Mind for most appointments probably. And I don't have a ton of therapy visits left for this year, just to make things worse, but I'd want the surgery this year as my deductible will be met or close to it by then.

I really am not sure I want to do this MRI thing......I don't want to know. Goofy, but true. At least I read about it, and know that I want to make a new tape with Dr. Mind this week that will help me relax without progressive relaxation as that looks goofy in public, but since I have to be still for 3 hours with my feet in a couple holes I really need something to make me relax and hopefully just sleep through it. Because holding still for 3 hours, even with meds, is asking a lot of me. (I also need to be sure to ask Dr. Brain how best to medicate myself for this).

Tonight I'm having hard time relaxing. I'm anxious about my windows coming tomorrow and all that I have to rush through in the morning. I have to leave by 6:30 for a meeting, so it's a rushed day which isn't my favorite way to stay anything.

Hopefully I'll be asleep in the next 30 minutes...........Doesn't help I slept too much during the day today but I was so incredibly tired. I feel better at least..........

I can't shut up today

After weeks of having little to say here, today I want to say a lot. I keep thinking "I want to put that on the blog", so I do. I think that is called "Jen, relaxed, for the first time in 3 months".

I'm pretty sure that I blogged that I got the results back from my tests done by the gynecologist with urological specialization. She found no blood in my urine, meaning my bladder is clear. I do not need the test I have worried about for 4 years. Praise God. While I'm so grateful I am also annoyed because I could have known this in February had Dr. I-can-fix-PTSD-by-arguing-with-you Urologist bothered to do an exam. She never touched me, she just argued about what I could tolerate and then scheduled the test. I kind of wonder if Dr. Amazing did the straight cath to show me I could handle it all, but the results were pretty much perfect urine. The only thing not perfect was the thing that is messed up by diabetes insipidus (the urine is too dilute) and even that was in the normal range, although at the last possible normal number. Still, that means my meds are working and I'm doing well at drinking enough. When I was first diagnosed my urine was so dilute that it came up at the lowest number testable. Now I am retaining electrolytes, just not as much as I should.

She did suggest I see a urologist about the cyst on my kidney and had a specific one in mind who she felt can handle my PTSD. I went to see Dr. Body this week and he is comfortable with monitoring the cyst with annual ultrasounds unless it starts to grow or something. So, the great blood in the urine thing is finally over.

When I talked to Dr. Mind last week I told him this, and that I realized now that my recent bout of PTSD was started in the hospital, but that it really kicked up a notch or ten higher after the awful urologist, and now that I've managed to handle the appointment with the wonderful dr. at Cleveland Clinic (and in advertisement for the Clinic, including the hospital doctors I have now seen 5 doctors there and every single one of them has been amazingly great. Three of the drs. were on the psych unit and they were far and away the best part of the stay (aside from the not wanting to kill myself thing). Dr. Brain is awesome, but I knew that for years prior to her moving to the Clinic. This doctor wasn't one I was referred to, Dr. Brain didn't know her, but she was heaven-sent. I can't tell you how happy I am that I now have a gynecologist who I'm not scared of.

I've really been working on what I finally decided was an aspect of the hospital PTSD: my food aversions. Essentially since I left the hospital I've eaten soups (which had to be pureed, no texture or I couldn't stand it; yogurt (4 specific flavors); pudding (1 specific type); toast with butter and strawberry jelly; cereal bars; scrambled eggs with fake cheese; pizza (but only thin crust and only with specific toppings) and celery with peanut butter or cream cheese. I've had almost no meat or fish. I have been able to eat chicken as an ingredient as long as it was shredded finely. Needless to say, this is not an ideal diet, and as time has passed and I've still not been able to eat, I realized much of this comes from the diet the hospital forced me on, the one that took away anything with broth, gravy, many veggies, and the typical MAOI stuff. I was left with nothing that seemed remotely edible since I went into the hospital barely eating and had just started eating the same day they took away my food. I think about 50% of the PTSD of the last months has been because losing control of what I could eat like that when I knew perfectly well that I truly could have those things and they were the only things I felt like eating at all. I think my abused brain just kicked in with a fear of eating. I've tried forcing myself to eat things, but I can't; I just either don't eat them or I gag. So I've been working hard for the past few weeks to increase what I will eat. I've been mixing up baby food with spices so that I can start to enjoy the taste of vegetables and stuff without dealing with texture. In return I've started trying different foods. Aside from a whole (small) fresh tomato yesterday I've not managed to upgrade to grown-up texture veggies yet, but I have had taco salad without cheese that included meats and cooked veggies; tacos with fake cheese; scallops; broccoli (I've eaten some of it twice, just not enough to count as really eating it); and a baked potato. In baby food I'm now enjoying squash, sweet potatoes (ready to try the real thing there), and some green veggies. I'm also reintroducing fruit and can now eat bananas and applesauce. I've had baby food peaches but am not ready for real ones yet. Another problem I've had is with foods with multi-textures and tastes and I'm working on that with baby foods too. Today I had the equivilant of beefaroni and while I'm a long way from the real stuff there it tasted pretty good.

I know this sound completely weird, a 34 year old eating baby food, but it's the only way i can figure out to relearn eating and it is working so I don't really care it is it bizarre. I want to get back to losing weight and to do that requires actually eating a variety of foods. I have 20 lbs. more to go and I really want to lose them.

and this should be today's last post..........getting sleepy. Sorry for typos. I am wearing a glove on a very lotioned hand per the dr. because the alcohol gel we use at work is making my birthmark crack and bleed. So we're getting as much moisture in there as possible, prescription steroid cream and really good lotions. It's not easy to type in the glove.

Tired and itchy

So I have a lot to do. My new windows come this week, so I need a clean house with space for the workers. My house is small enough making extra space and be challenging. I also need to clean and vaccuum several rooms. My bedroom needs about 20 minutes of work, the kitchen probably an hour since I have to do the floor and that takes forever because the linoleum is so worn that it is very hard to scrub (lots of deep cracks and the floor isn't totally level), and the living room needs vaccumming. The spare room that will be my sewing room eventually needs things moved out of the way and peeled off wallpaper needs cleaned up. I need to take apart my desktop and then hook it up somewhere so I can still have wireless. I also want to get my new scrubs ironed so that I don't have to deal with that for a while. Most of this I can do tomorrow. I plan to have everything outside for the NAMI person before she gets here so that I don't have to trap my cats in the bedroom and deal with the whole stranger in my house thing.

One of the last things still in my bedroom that I'm giving away is making me funnily nostalgic. It's nothing big, just a duffel bag that is from the luggage set I got when I went to college. It was the most versatile piece of that luggage and so has traveled everywhere I went for many years. When I got new luggage a couple years ago (the old stuff was difficult to fly with because it didn't have pull handles and when we went to Phoenix last year I was not able to drag my tippy old luggage around for the 10 hours or so of travel we were doing each way.) I don't get very attached to things, but that bag and I have been a lot of places together-college, camp, grad school, a conference in Detroit, many visits to friends in Pennsylvania, and at least 2 trips to Florida, along with being used in multiple moves--besides all the ones to and from college and camp and grad school, it's moved with me from Ohio to Michigan, my first home in Michigan (grad housing) to the trailer that was my first home of my own, Michigan to Ohio, my mom's house to northern Ohio, and northern Ohio to my current home.

The weirdness that goes with that bag is just part of what has happened to me because I have very few "things" from childhood. My father didn't release much of that to us because we wouldn't stay with him. And then for years I never was settled. Along with not having clear memories of significant chunks of my life since bipolar started about 20 years ago, and

anything familiar is important to me. Nonetheless I don't need the bag and so it is going. (That, and frankly I try to get rid of things like that because I find it somewhat pathetic that my mind wants to attach the meaning of memories to things when my brain was too impaired to make real memories. I need to focus on what I really do remember and what those things mean to me; I can't re-do those lost years and as Dr. Mind has reminded me many times I really am better off not remembering. Since he is able to remember half the years that I have so little memory of (other years I have limited but clear memories) I try to trust him on that.

The thing is that I'm soooooooooooo tired. I did a lot yesterday with painting, plus my allergies are bad and I can't take Zyrtec, which works much, much better than Claritin for me. Zyrtec is a derivative of one of my anxiety meds and if I take them together I feel very sedated and depressed. (We learned the hard way a few years ago because nobody put together how I was feeling with the meds until I picked up a different brand of generic zyrtec and read a warning about not taking it if you are sensitive to the other drug. I had Dr. Brain investigate and it quickly was apparent why I'd felt bad for several weeks, something we'd been calling an episode.

I really don't feel like doing anything. I think I'm going to take meds soon and try to get to sleep early and see if that helps. I have no idea if it will since it won't make the allergens go away.

I am so grateful for the 3 day weekend. I really needed this time. I wish we hadn't painted yesterday and I'd had 3 whole days to relax, but I'm also so thrilled with how my house looks. Next weekend I'll paint the porch and then it will look like a totally different house out there. (New windows, new shutters, fresh paint, ugly decorative edging on the porch gone, and the non-functional railing the prior owners threw up to satisfy the requirements of my FHA loan is also gone). No more barn red. I've never liked the colors of my house and so the new ones are really exciting. Red isn't my favorite color ever, but this shade was not pretty at all. But in just a few more days it will be a memory.

A real memory too, not just one of my partial ones symbolized by a stupid suitcase.........:)

So much STUFF

I am not a very sentimental person, in general. I hate clutter. I throw away birthday cards, Christmas cards, etc. If I buy a souvenir somewhere it will always be clothing. I am not one to change decor and I really don't have a lot of ornamental stuff. I don't really decorate for holidays. This all has a lot to do with time and energy; I know that if I have stuff I have to care for it and I just can't handle that a lot of the time.

However, in the 7 years since I moved here, I've been so sick that I've not been very good at getting rid of things if it involved any effort on my part. This has resulted in my having tons of books, clothes, one used items, and things I no longer need.

Having a yardsale is beyond my abilities. I've tried to donate some of the (no kidding at least 200 books) I've had sitting around needing new homes for years to the library but even that is too much. Finally a great opportunity arose: a sign in the post office for a yard sale to benefit NAMI that they would pick the things up. Well, that has all sorts of benefits. All I have to do is box things. It benefits a cause I believe in. I don't have to do the actual selling. And I have tons of new space in my house.

NAMI isn't going to know what hit them. I have an embarrassing amount of stuff to give away. And they aren't even taking clothing........I hope she has a truck when she comes tomorrow.......

Surprise!

One of the things all the meds I've been on has taught me is to never expect to know what side effects were/are associated with whatever med I happen to be on. And often they have the same potential side effects.

One side effect I've really struggled with for years, especially since the onset of diabetes insipidus, is heat sensitivity. I have not been able to be outside in the summer for more than a few minutes for so many years I can't remember, unless it happens to be a cool day. I've always immediately turned bright red from my chest up, felt dizzy and exhausted and sick. I've noticed this last week as it was 90 degrees and I was in and out all day that I wasn't having trouble as long as I kept sucking down bottles of water. (This new job actually lets me stay MORE hydrated than in the past.)

Today was quite warm. I don't know the high and am too tired to look it up. It had to have been in the high 80s though. I've been trapped inside completely at 80 degrees and only comfortable at 75 or lower for years.

I was outside painting for hours. I had no problems until the end when it hit and I got quite tired. (I actually took a 4 hour nap afterward). I suspect partially this was not drinking enough water and partially the normal result of sun.

I'm still on meds with all kinds of sun warnings. However, since last summer I've come off of 2 meds that had a lot of sun warnings and apparently those were the worse for me because today was the first time I've been able to do something like that in YEARS.

Plus, it looks SO nice. My new windows go in this week and they are also going to put on the new shutters I bought a couple years ago that haven't gotten put on. (The first year they were back-ordered through November and last year I never had time). I now have a beautifully painted porch, doors, and trim thanks to my mother and her friend who gave me time and help as Christmas gifts. There also was this decorative trim that I always found hideous. It turns out it was up there to prevent you seeing a mistake (modus operandi for building this house). We repaired the mistake and it is SO NICE to not have that ugly stuff (it looked like 3/4 of a wagon wheel with extra decorations around it.) My mom is going to help with the porch floor tomorrow evening, and then when the shutters and new windows are in I'm going to come home Wednesday to a totally new-looking house. I am so excited. The new windows haven't seemed real because I've been waiting on the list for so long to get to installation (they have to be made as they are made to fit my window spaces exactly and then there is scheduling to get you in). But it is finally time. Yay!

Debt to Society

I am listening to a book by Ann(ie?) Lamott right now. There was a line in there that struck home, meaning that for someone on psychotropics for serious conditions every time we take those pills we are making a contribution to society.

I have to get my Emsam at one specific pharmacy because most places don't stock it. I probably could find a 2nd one, but this place has treated me extremely nicely since day one. So I've moved all my scripts there and just have to pick up refills after seeing Dr. Mind.

I just spent $450 on meds. That is the out of pocket part. And it's not even all the meds; I have at least $125 more every 3 months, plus I'm on vitamins out of pocket, even though Vit. D is actually something I take because of prescription needs. Plus another $17 on intense lotion and cotton gloves to keep it on me at night. My birthmark is cracking open from alcohol use at work and I got prescription cream for it, but he suggested doing this as well. I've never actually succeeded at this, I rip the gloves off unless I tape them down, but I also need to not let this get worse. One open area already means I could have 12 in a few more days.

The awesome thing that came of an incredibly busy day (I literally was busy from 4 AM until a few minutes before 10) was that I saw Dr. Body to talk about my visit with the dr. about my bladder. He agrees that I don't have any great need to specifically know what my kidney cyst is all about and so as long as I agree to have ultrasounds annually to be sure it isn't growing or getting weird I don't have to see the other dr. recommended by the first. I'm fine with not knowing; I've known I've had this thing for a long time and I don't care.

And now I need to go. I can't think anymore. Today I spent a long time on my schedule, saw my first patient, drove around 250 miles, got new lenses for my glasses and new sunglasses, picked up a huge package of new-to-me-scrubs, didn't go home, drove to the podiatrist for a new brace, drove to Dr. Body's office, then Dr. Mind, then the pharmacy. I came home, showered, and threw the new scrubs in the washer, ate dinner and took pills and am now about ready to sleep. Getting up is going to be hard tomorrow.......

Whatever doesn't kill you.....

Better make you stronger. Because these last few days have lacked fun.

My accident with the MAOI hasn't had any major repercussions. However, I just haven't felt very good. My blood pressure has been up and down, sometimes very down, and I've just not felt fabulous as the stuff worked its way out of my system. I put a patch on yesterday but wound up skipping it today because I woke up feeling rotten and took my BP and found it was incredibly low, even for me and I run low normally. So tonight I'll put the lower dose back on, and then Thursday I'll go back to my real dose.

I didn't get the email from Dr. Brain telling me I might want to wait until today to try a patch until it was too late, so yesterday was apparently just too soon. I don't want to go without overnight because it affects my sleep.

I did actually write a blog that refused to publish. But mostly I've been resting. I don't know why the effects of this for me were to take away every ounce of energy, but it was. Hopefully that is over now.

I'll also admit that I've been caught up in reading my own blog. That sounds rather self-centered, but really it has to do with looking at some things again from a different perspective, and also gaining more perspective on my own state now as opposed to a few years ago. That's really important for me right now because it's time to get back to work on stuff with Dr. Mind and I need to see how I'm in an even better place right now to handle that than I was 3 months ago.

And I just got home and have to take meds, switch over some laundry, and feed my STARVING cats. I also need to pack for being in the place I work overnight tomorrow. Some of that can be done in the morning, but some needs done now so I don't have to rush if I feel bad in the morning again.

More tomorrow.

Finally made an MAOI mistake

I have been so good for the last 7 months with making sure I followed my diet. I read labels on everything and pretty much have avoided any restaurant or homemade food that had even a chance of hurting me. The only time I've had any issues with reaction was that time I got sick and didn't know if I was sick that the patch had to come off. Oddly enough I now know that being dehydrated that time made a huge difference; my blood pressure was within normal limits but on the high end of that. If I had not been on the patch and had huge amounts of it in my bloodstream my BP should have been very low from the dehydration.

So anyway, this morning I pulled off a patch on my side and put a new one on my belly. I mainly use my belly as it is covered better by clothes and if people can see the patch they ask about it. But I have to rotate to my arms, chest, and hips for skin protection. A few minutes ago my arm itched and I found another patch on my arm. I don't know how many days it's been on there, at least 2 and possibly 3. The highest dose of this stuff you should take is 12 mg/day and I've had more like 18 mg/day (the patch continues to deliver meds past 24 hours and the stuff stays in your blood stream a long time).

I just peeled off every patch I had on and emailed Dr. Brain. My BP is ok, high for me but normal for humans, so I imagine I'm fine, but that's so scary. Messing up this stuff too much can kill you, which is exactly why MAOIs are the last choice anti-depressants, even though they are highly effective. I'm half-tempted to call the on-call line but am afraid of being told to come to the ER to be checked. I don't think I need that as I can monitor at home well enough and nothing is wrong as of now, and the psych ER is 2 1/2 hours away. But I suspect that would be protocol. Therefore I'm opting for watching my BP and hoping Dr. Brain checks her email soon. Which is doubtful as I believe her daughter is having a graduation party today if I remember right.

At least I know why I've been so sleepy.......

So many things

I can't believe I've barely written here all week. I seem to be needing some quiet thought time. I'm trying to start working on things that I need to function, and I'm also preparing myself for resuming my PTSD-invoking discussion with Dr. Mind. I think next week I'm going to start talking about what we need to do to keep me from getting so overwhelmed going back to that topic. He's going away for a week soon so I don't want to start it yet, but this last time I sprung this on him, and while I did decide carefully to do it, going into it more cautiously might not be so bad. On the other hand I needed to do what I did the last time, because if he'd had warning I wouldn't have gotten to see his involuntary reactions to what I'd experienced, and I needed that. I don't know why, but it helped.

On some many levels things are better. I am going to really like home health. The autonomy is awesome and perfect for me. There are going to be scheduling issues with the fact that now that there is an OT for the first time everyone wants to sign people up for OT. Which is great, but I'm the entire OT department, so we have to prioritize and pace things as I have to do evals and treatments.

My insurance has out of the blue started paying for my visits again. There is an appeal in but they started paying before that was totally written. There is no way to know if they'll pay for any more visits since they are kind of rude like that, but at least this group was paid for, despite the denial of the visits the week before. Whatever. I'm very curious what they will do with this claim coming up. I'm having MRIs of both my feet and ankles. This is one MRI but is scheduled as 2. I expect this to blow their minds.

My courage in handling the pelvic/straight cath paid off. Urine obtained that way has no blood. The only thing not perfect was the thing the diabetes insipidus affects, and that simply was at the last possible end of normal, which is great for me and means my meds for that are working. This means no cystoscopy. I have to get in touch for a referral for someone to figure out what is going on with my kidney cyst that now is more than likely the source, and while I don't love that idea as non-invasive measures haven't done so much for figuring out what it is, I also fully expect it to turn out to be a vascular anomaly, quite common when you have my kind of birthmark, and part of a syndrome that I could have since the birthmark is on an extremity.

I'm working very hard on listening to my body about fatigue. It's hard because there is just so much I want to do that I'm too tired to handle right now. But if I get the rest caught up I'll be fine again. Dr. Mind had me doing this very well for a long time and I let it go the last few months. I think I felt so good I got cocky and thought things like that no longer were so important. One huge lesson learned. Tonight my body is telling me it's about bedtime. I have to put away some groceries and then I'm going to take pills and try to get to sleep very early.

I'm also pushing the eating thing. I waited for months for my body to get used to the patch and the taste aversions to go away. They have not. And I've realized that much of it isn't TASTE so much as I don't want textures in my mouth and have gotten so touchy about this that I have started not wanting tastes either. But I can't stand going on with only eating a few foods and I really want to eat fruits and vegetables again. And fish. I love it so much and haven't even tried it since the hospital. Yesterday one of my co-workers finally figured out who I was. We used to work together, back when I was so overweight. She didn't recognize me. I want to lose the last 20 lbs, but I have to eat more variety than I do. I also decided that some of this is because of all the bad things that happened with food in the hospital (the dietician put me on the strictest MAOI diet there is, even though at the dose I was on I didn't need a restriction at all and Emsam has fewer restrictions. Even my dr. couldn't get her to let up. So I ate very few foods for days after my appetite even vaguely was present after a month of eating nothing because of the severe depression, and it kind of turned into some ind of war in my mind. Plus there are many bad associations. So I'm starting at the beginning. If smooth textures are all I can stand then purees it is until I get used to tastes. And as icky as it looks (I'm making some and the others are made by mixing up baby foods (a meat, a veggie or two) and spices I actually at a whole bowl of it last night. I'm also eating baby food fruits as a segue into eating fruit again. And I am eating whole bananas already so it is working at least some. I've had meat 3 days in a row. So this is also good, although odd.

Otherwise, not sure what else. I've been spending time reading through old entries and am gaining so much appreciation for being able to think clearly and not being so sick all the time. The me of spring 2008 sounds so sure that she's doing well and is trying to force herself to be positive about a job that you can see is awful if she'd just listen to what she is saying, and the cycling is also there. The clear thinking of today is not. Dr. Mind would be mad at me for looking back at this stuff, but I'm looking for some answers he can't provide.

Speaking of listening to myself, it's time to go to sleep. Not sure I even need meds.......But i'll take them anyway.

Telling myself NO

I'm working really, really hard right now on unlearning my habit of the last few months of pushing myself as far as I could push. I'm making myself listen to my body, and that's why I've been quieter this week. I've done very little but rest and do simple things. This new job is a big change and while I really like it so far the change is tiring. And I have a zillion little things needing done. So I'm making myself put off picking up this or that, NOT going to this store now, and right now I'm going to take a bit of a nap before I go see Dr. Mind this evening.

Maybe more after that.

New beginnings

Yesterday was day one of home health. Once we got past the part where I was left sitting with nothing to do and no idea who to ask for more to do for 2 hours it went really well. Very different pace. I'm going to like it, I think. Hopefully though they'll be a bit more organized in letting me know what is happening and when. At the moment I know that: I filled out a bunch of forms nobody collected. I followed the PT yesterday. I have a meeting at 8:30. And that is it for my knowledge base.

Must go; have to iron pants and pack a lunch and then get dressed and braced and hair done. But I'll be home tonight by 6:30 or so.......

The way it ended

Yesterday was challenging. I had to do several hard evals, drive between buildings twice, say good-byes, and stay patient with the whole thing where people didn't know how to act, including me. But the worst thing by far was my last patient.

It wasn't anything about her. She was very nice. It just wasn't the best thing for me to see at that moment. Dr. Brain has been doing well, at least to the best of my knowledge. I try not to constantly ask her and she has given only short answers the last few times. She looks better. But some of that may be my adjusting to how she looks now, although she is getting some hair back and looks less pale and the steroid face is gone. But anyway, Dr. Brain's illness isn't something that my mind puts on hold; I worry about her as you would anyone you care deeply about struggling with a cancer diagnosis. And I also have the added difficulty of having lost a childhood friend to breast cancer a few months ago.

So this woman was very young, not a ton older than me, and she is at the very end stages of breast cancer. I really, really didn't want to go in there and I've been sad ever since I left. I know that Dr. Brain's situation is different, but I'm terrified of losing her and this made that all come back in a very ugly way.

After not doing anything all day (I've been awake but reading since afternoon) I'm having a hard time relaxing. Enough that I've had extra Klonopin and now Vistaril. I have now done some cleaning/sorting of the sewing stuff that has been taking over the world and I have (I hope) gotten my sewing machine working properly after a week of fistfights between it and I.

I'm starting to get sleepy so I'd better go.

So tired

I have spent today doing precisely nothing. I have about 40 things I need to do but I have been so incredibly tired that I just had to think what word I type in to write in this thing. And after nearly 1100 posts and more that never made it, I think I probably should know that.

The truth is that I am so tired I also just don't feel great, so I do have some reason for all this. And hopefully another good night of sleep will help, and if it doesn't, well, I'll just stay in bed again tomorrow. Plus I had 2 nights of very limited sleep and one night of not a ton of sleep, plus at least 1-2 nights with nightmares, so I am behind on the sleeping. So rest exclusively it is, because I need to start the new job with energy a lot more than with a clean house or sewing projects done.

This is where bipolar frustrates me. I know I'm doing the right thing. I know this is what I need, and that anything else would be a very bad idea. Years of scolding for doing otherwise by the Drs. Mind and Brain have taught me.

One thing.......since before I went to the hospital I haven't been able to read books. I fall asleep when I try, and I am not sure I've finished one in all that time which is very odd for someone who used to read a book or two each weekend. Well, FINALLY this last week I'm reading again and 3/4 of the way through my book. I can't explain how much I needed to have something come back right now, how much I needed a victory.

And now I want toast, which means getting bread from the freezer so I guess I'll throw in a load of laundry while I'm down there. (I did move some clothes from the washer to the dryer, and I ran out to the post office this morning. So you can't say I did nothing......)

I did it

The job is over. The stress may take a while longer. But I survived. I made it through some really hard weeks and it's over. And now it's time to move on. Which is good.

I just bought a LOT of scrubs on e-bay. I figure with the driving I need a good number of outfit choices so I don't have to do laundry so often, and so I bought some lots, a few shirts of which I'll just take to the resale store or donate to good-will. Even though it feels like I spent a fortune in reality I just bought 13 tops and 13 pairs of pants, plus I bought 2 pairs of pants yesterday, and the total of all that is the cost of 3-4 new tops. I am working hard on 4 tops that I really, really want but have to watch through tomorrow if I'm going to win them and then there are another 4 that I probably will win at a low price. It's an insane number of scrubs, especially with the ones I've been making, but I'm not going to be home every day and I will need to rest on weekends, not deal with washing and ironing scrubs. So, lots of scrubs it is. Plus, even with the shipping the 13 tops and 13 bottoms are costing me $2.40 each. Which can't be beat.

I am too tired to say more. I'm not sleepy, just really, really worn out. More later.

Last Day

Here goes........gonna be a big one.

So weird to have this last month of anxiety about work end.......

Also so good.

This proves it

We've known I'm extremely sensitive to meds. It has not been so much of an issue in the last few years, but if you read 2006-2007 you can get a taste, and 2002-2006 was really the time with meds, most of which is before the blog started or before I was as open. Again, the summary that makes it easiest is: I've been on over 45 meds in 8 years. I did not find an effective combination until 7 months ago, although I've been getting closer for the last couple years. But my sensitivities have been truly incredible at times. One drug, Abilify, illustrates this well. My doctor wanted to try it when it was still pretty new. I believe it was my first anti-psychotic. She suspected I would be sensitive to it and started me at 1/8th of a normal start dose, something that had to be ordered. After 1 or maybe 2 pills I had so much of a reaction I would up in the ER being checked for MS, followed by a 4 week period of constant double vision and the need to be constantly in motion (akasthesia). For all those weeks I was dependent on my mother to take me places, buy me food, etc (I was far too agitated to be in a store). I did therapy over the phone and I spent much of my time home, waiting to be able to see well again. I'm still thankful she was so insightful as a full dose might have me still reacting, 6 years later.

As part of treating my messed up foot my doctor had a medication compounded with a high dose of topical hydrocortisone, a muscle relaxant, an anti-inflammatory and something else I forget. This stuff is applied in a light coat to my foot 2-3 times per day. Except for me it's once, because that tiny amount of steroid keeps me awake. Tonight I'm awake because I never slowed down all day, but I've lost a lot of sleep on the 2 nights I've used that stuff.

So now I have to have an MRI and the word surgery came up again, except not about my ankle, now my other foot is at risk of carving. I couldn't do the MRI for a month, so hopefully as I'm off my feet less with the new job I'll start to heal.

This is one of those times I'm abruptly leaving for sleep...

Three more days. Can I do it?

My contract is ALMOST up. Thank God. It is getting harder by the day in some ways. I can feel a lot of resentment, yet at the same time those same people are being nice to me as per usual. Which gives me false security.

I am working off the clock a LOT as it is the only way to do the extra thing this week, deal with the difficult/one on one intense therapy caseload I am given, and stay under hours. I no longer care about productivity; I'll be productive if and when I am given a reasonable caseload. Otherwise, they can't fire me now.

The thing is that while things have been awkward and I'm aware that people who have said nice things to my face and never complained to me have said some pretty horrible things so I don't trust them, and I'm angry and they are resentful, and they are stressed as they have no replacement for me which makes them resent me more (even though they are the ones who made it so I couldn't stay and help a few more weeks; we were willing to do that while waiting for a placement more like what I wanted), there are also a lot of good things about this place and the people I've worked with. I hate that part.

I also hate the resentment. Today someone said something that made it pretty clear she has decided somewhere along the line that I haven't fully done my job, putting things aside for my own convenience. Whatever. The only times I have dropped minutes was if I was booked for insane amounts of hours and couldn't fit everyone in by bedtime. It hurt.

On the other hand, I'm excited for my change. I am ready for something new, and I am ready to see if I can do this (ie learn a new practice area, after 9 1/2 years in the same arena aside from very part-time home health 7 or 8 years ago). I'm tired of feeling bad about myself because I can't do what is impossible in this job. I'm tired of eating time just so they can get every drop of energy I have without paying for it.

To be totally honest I'm also tired of realizing that "oh, THIS" is another accusation they probably made against me and it wasn't fair or true. I never got a chance to defend myself because they made a lot of statements and then refused to answer the questions my company sent. In my company's view that makes me innocent of all charges, and I am very grateful they haven't told me details, but I can guess a lot and who what came from and it makes it hard to pretend everything is fine. I think my ethics were brought into question and nothing makes me more angry, especially when I've worked my butt off for them for so long.

Anyway, I may be getting sleepy. We'll see. It's hard to burn off the stress after a day like this.

HorrorScopes

Do you ever feel like writing your own horoscope? I don't believe in them, but sometimes think it's funny to look back at a day or a week and wonder how what occurred could be written into those horribly general statements.

For example, in the last few days I have managed to mess up more sewing that I care to think about, burned my armpit on the iron badly enough to cause a 1 in blister, had the ludicrous insurance letter. and last night had a little midnight party rather than sleeping. I just looked at my salon's online booking and it said I skipped my hair appt. without warning a couple weeks ago; I had left a message days before cancelling. Etc.

I'm sure being up last night had more to do with anxiety about this being my LAST WEEK, can't let anything go undone, so much to catch up on. But I hope that doesn't mean no sleep all week long. That could get rather old.

Today should be fun given I am sooooooooooooooooooo tired. We'll see what misadventures can occur.

I hate Anthem, part 12?(approximately)

So about 2 weeks ago I posted this. I can't believe I've not written about this yet, but I guess I needed time mentally to process it.

I got a letter this week from my insurance's behavioral health division informing me that a psychiatrist had reviewed my case, that I am chronically ill with no chance of being better and that what was going on was not my being worse, that I was unable to benefit from intense therapy, and that by standard clinical guidelines I was not only not allowed to have twice weekly therapy I was not allowed weekly therapy. Unless we win our appeal I will have to pay for every other week, plus all the 2nd visits I've had lately.

The appeal is pretty strong. The reviewer has no idea of my history, he is assuming based on my diagnosis. He is ignoring the fact that the previously submitted treatment plan had me at a level where I was functioning in an absolutely normal range, in full remission and that I sustained that until I reached a point where I was able to begin to address some of the issues that I had been too ill to face previously, and that this has triggered a clear case of PTSD which did indeed trigger cycling, but it was not random cycling, it was caused by a number of factors including PTSD and severe personal stress with work. Further there is a question of whether it is even legal to limit visits in light of our state's mental health parity act (or for a doctor not licensed in this state to dictate how I am treated, and I have a psychiatrist who is willing to say exactly what Dr. Mind is saying, and she carries the weight of being a specialist in bipolar at the Cleveland Clinic, not exactly a place known for poor quality of care. It was funny how much what her initial reaction was compared to his; they were practically word for word the same analysis of what has gone on. There are also two other really important facts: aside from being taken off my medication this is the worst I have been in 2 years, and WHAT WE DID WORKED. I'm rapidly recovering now and after next week will be back down to weekly visits because that's all I'll need. The reality is that Dr. Mind has treated me for a long time, and we know what works. We've learned over time that extra appointments both avert crises and make bad times better faster. This is very easy to prove in this particular case as the sequence went: started being symptomatic, increased visits, declined for a while, got better. That's never happened before. In the past we might have increased visits and I benefitted, but I have never before had an episode cause so much decline and then improve. And not just improve, but people, I handled a pelvic and catherization a few days ago WITHOUT TRAUMA. That is huge. Usually I cancel pelvics about 4 times before I have the guts to go through with it, and then I struggle for some time. This time I laughed during the exam. And why might I be able to do this? (And for the record I took LESS anxiety meds than usual that day just because of how I did the dosing and the time of the appointment). I can do it because I've worked through part of my PTSD. Which is HUGE. We still have to go back to that, and we will when I'm more settled (this is my last week at the job I've had since August; next week I'll start home health), but it won't be as hard this time. For one thing we will be prepared. For another, everything else is unlikely to fall apart all at once again; this time I did great until I found out my father made me run on a broken ankle, thus damaging my whole leg forever, then work fell apart, and it was just too much. There's obviously no way to keep life totally steady, but it is unlikely to have so much hard stuff at once again.

On a totally unrelated note, I know some of you are on the West Coast and this isn't the middle of the night. And perhaps someone else is awake. But please, please pray I fall asleep soon if you are reading this. I will be awake for the day in about 4 hours and I'm wide awake. Extra meds haven't helped. There is no reason. I am just not sleepy. This could mean that I'm so incredibly sensitive to meds that the topical high dose cortisone is causing me to be awake. Which is scary, since the topical foot med is helping and is my only option for getting the meds I need into that foot. It also could just be anxiety related to my last week, the need to gather up things and take them home, the whole change in what I'll be doing (long-term care may have become rather routine for me but I know what is going on and I have support available. In home health if I can't lift someone I just can't lift them; there is no external help. If someone is medically unstable I have to handle it, not just walk down a hall for a nurse. Etc. And that is scary. Although not so scary that I shouldn't be sleeping.......)

True Confessions

We're going to ease into this.......The most common comment I get about this blog is about my openness, and that has certainly been what I have worked toward, especially in this last year. I've written more extremely private stuff on here in the last year than I have ever written in a personal journal, and I honestly don't think I could write much of this out in handwriting. Nonetheless, today's post, after the next paragraph is going to get about as personal as possible. I will explain as I go, but be forewarned that if 1)you are the only male friend I have who might be reading this or 2)you are uncomfortable with rather specific sexual information, this isn't for you. You can read the next paragraph (I needed something mundane to transition) and then just leave. (Seriously, male friend? It will not be anything you want or need to know although you've heard worse from me).

Transitional paragraph....I realized recently where my screen name Just Me comes from. Many, many times per day over the last years working in nursing homes I've knocked on doors and announced "it's Just Me" as I returned to the bathroom where they were waiting, or brought a new item into the room, or whatever. I call myself that all the time.

Now, the rest of it. Let's start all this by saying that I made a decision a very long time ago based on faith that I would not have sex outside of marriage. That's a big deal to me, and it's especially important in light of the commitment that a sexual relationship would take from me. At this point I have kind of reached the conclusion over the past few years that it is just not very important to me, not something I cared to try to work on being able to consider, which means that dating also isn't really something I can do unless I'm willing to change my attitude if the dating progresses to a relationship. I already know that early in a relationship I would need to share my illness and the specific results of it, particularly that it would be a childless relationship as I can't have babies on my meds and nobody would ever let me adopt. So I know that first, I am not willing to have sex outside of marriage (and while I cite faith I'll also admit that this is just a safer thing for me as well emotionally), that I would need to go through some specific and difficult counseling to be able to have this be successful, and that a level of honesty about my past that I haven't yet achieved would be necessary.

In the turmoil of the last months I wound up having to abruptly stop talking about the sexual abuse as my extreme onset of PTSD symptoms meant that I needed to stop and deal with that. Which we really only sort of have as things have just been one stressor after another. Before I freaked out I was liking that I was finally able to ask questions I've always wondered, or to have Dr. Mind give me information that helped make memories that were odd make more sense. I am by choice very naive about sex. Some of the ways that I filled in gaps with my childish understanding of what was happening have now been explained with more likely scenarios. Obviously he is guessing, but the guesses make sense, usually more sense than what I've put together in my mind. There also is a level of denial I'm still facing with all of this. There is a level of knowledge I've never wanted to have. I know perfectly well that what happened to me repeatedly is at the more extreme end. I don't remember being raped. Physically there are signs that this didn't occur, although that is not reliable especially as it doesn't mean that rape wasn't attempted or partially completed or whatever. The hanging question for Dr. Mind when I'm back to talking about such things is actually "if so much other stuff happened, why was I NOT raped?" It's actually kind of hard to believe I wasn't, knowing other things that did happen. Except that I now may have an answer.

Another part of all of this that has been challenging has been becoming more aware of what some of the things I deal with mean. Going to the dentist is a challenge for all concerned because I gag horribly. I didn't find out until fairly recently that this is an indicator of sexual abuse, and that this is probably why my dentist goes out of his way to keep things safe for me. In reality that alone tells enough of a tale that when I gave Dr. Mind the list of things I know happened to me oral sex was one thing he said he already was pretty sure of just from context.

It's rather amazing to me how the body protects itself. It's amazing how my memories are protected by this nice wall of something that allows me to be matter of fact about it now, yet realistic and not hiding things from myself. It's just recently that I've decided to let these things from my past just be facts about myself, not my terrible secret.

I also am learning that over time people have kept things from me that would have been nice to know. I have had about 5 pelvic exams in my life. Each was excruciatingly painful. Each, I know now, wasn't because "I wasn't relaxed" as it was presented by each doctor. Each also had to do with why I've never been able to stand to wear a tampon because it always hurt. I have a condition called vaginismus which means that I have involuntary muscles spasms that essentially try to keep anything and everything away from there. This means little now aside from pelvics will be much more comfortable if someone helps show me what to relax because I can control it with cueing. But it is also something I needed to know. Because it means that not only will there be psychological treatment before any sexual relationship, it means there also will be physical treatment to teach my body to relax and not consign me to a life where sex is painful and which I would have automatically just attributed to either "it's just I don't know how to behave because of the abuse" or "stupid psychotropic side effects". And yet nobody has bothered to tell me. I know I've had this forever; as I now know severe pain with tampons and pelvics is a symptom. And rather than tell me this, despite that they must have felt it, the previous doctors let me think it was MY FAULT (I wasn't relaxing). Even the other dr I had that I liked didn't tell me this little thing that could impact so much so easily.

I am so tired of not being told things. My doctors are great, honest as much as they can be, although Dr. Body has not told me a few things that were minor but I'd like to have known before I read my own CT report. But at the same time last winter when I fell and hurt my ankle I went to urgent care. I had x-rays. I also had an extremely painful exam where the doctor asked if I'd previously sprained my ankle due to the ligament laxity. He never bothered to tell me that I had a previous fracture and having seen my x-rays from the podiatrist I seriously doubt it didn't show; it is a very clear healed fracture, not a hairline or anything. Had I known about the healed fracture I might have gotten treatment from a specialist sooner and while Dr. Body is fabulous and did nothing wrong I would have benefitted from orthotics as soon as I was walking ok, and a few things like that. He didn't know my ankle had been broken, so he had no reason to refer me on. Nor did the PT, who never liked how I walked, yet also didn't seem to notice how severely I was inverting.

Anyway, that's a long story. I'm sure it could be shorter but it's not comfortable to tell and I'm trying to distract you. I'm putting this out there because I truly didn't know this could be a sequela of sexual abuse and I can't imagine how angry I would have been had I suffered unnecessary pain because of it (I have already in short bursts during pelvics, but not like it could have been).

Definitely time to sleep now. I have to drive back to the city tomorrow to see Dr. Brain. More hours in the car........ugh...........

Major victory

I've talked on here before about my having had blood in my urine for years and after years of refusing to do more invasive testing than a CT (with oral contrast and considering my gag reflex that was PLENTY invasive--the hospital was being re-designed and the building I was in due to close in a matter of days, so the only private place I could drink and gag was the bathroom. I'm very much NOT into eating in public bathrooms.....). Back in November I was severely dehydrated and after many hours of not urinating was horrified to find that my urine was full of huge clots, yet I did not have a UTI. So I agreed to further testing.

The process has been slow because of issues with both my schedule and Dr. Body's. Then the first doctor I saw was the least understanding, most difficult to deal with dr. I have ever seen regarding anything where sexual abuse affects things. She was the only doctor "locally" (in quotes because she's an hour away from me) so then we had to find a doctor at the Cleveland Clinic and then get the referral through etc. So yesterday I went to see her.

I chose her because she is a gynecologist with a specialization in urological disorders and so I knew she'd be more likely to have training in sexual assault victims. And she was also young, which seems to help.

She was WONDERFUL. As in I went in prepared (and having promised Dr. Mind) that I would just talk to her, no procedures. She explained what she needed to do (surprise Dr. 1! An exam actually is a good idea....) and I felt ok about it, especially knowing I could yell stop at any second. Well, I had the first pelvic of my life that wasn't tremendously painful, scary, and she was so good at distracting me that I was laughing during part of it. I also had a straight cath and it appears one of my old issues, urinary retention, still is playing a role in all this. We figured that would go away when I went off the old antidepressant. I did so well that I'm going to try the cystoscopy without being knocked out and if I can't do it then we'll move on to anesthesia. Makes me happy because it saves me a lot of $, and I also feel really tough for being able to think about this.

So, not only do I have a doctor to do this no-longer-nearly-so-scary procedure, I have a gynecologist I like and trust.

I also think I may have a UTI, but that is not exactly a surprise for me......

This one is for Julia

Julia, for years I've been telling you that Gage will conquer his issues. I think I just proved it.

I was diagnosed (with bipolar; the other diagnoses are much older) nearly 8 years ago. In all that time if I hit a certain level of decline then there was no recovery without disability, threats of hospitalization, etc. I was learning to cope, but learning to control the illness was harder. Over the years I have learned to react and get help, but I've never managed to turn things around without damaging my life.

Yesterday when I talked to Dr. Mind I suddenly realized that not only am I feeling better, I am feeling better without losing everything, without disability, and without hospitalization. For the first time ever I managed (with a lot of help) to turn things around just by talking to Dr. Mind a lot and managing my anxiety meds (which I figured out myself, with Dr. Brain's approval).

I did it. So can he. So can anyone else who thinks they never will. Four years ago I was so extremely sick and barely staying out of the hospital, and battling lithium toxicity, and literally not even able to control my crying (I think I cried for a whole month straight, or so it seemed), and now I'm learning to control it.

Ewww..........(and yay)

Ewww is the sound of seeing what my new vacuum picked up from an allegedly clean floor. It's not been long since I did this room and the new one filled half the canister. Nasty. But at least it works. I was given gift certificates (homemade) to use for a housekeeper, per my request, for Christmas. But I never got around to it and now suddenly I don't need it; I can keep the house clean on my own. The first time I used a vacuum was a huge deal; I had not done that in years, relying on my mother. So the vacuum I had was very old, heavy, didn't do a great job, and I knew that I soon would want something else anyway because I'm hoping to switch to laminate floors in the near future and that one wasn't safe for them. So I did a ton of research on what vacuum is quietest and rather than having to buy the Dyson I was fearing paying for I found this Hoover model that has a "hush" mode that makes it more manageable. Hush is relative, but it is better by 1ox than the old one.

Yay is the realization my depression is lifting, the anxiety is somewhat improved, and I'm not cycling anymore. I have a long way to go before we celebrate recovery, but I'm not scared of myself anymore.

So, things are looking up. Thank God, because I truly couldn't take much more.

Guessing game. With a PRIZE!

If anyone can guess what this pile of fabric and batting is going to be, I have a prize for the first correct guesser (no this isn't that kind of blog now, I just happen to have a prize sitting around).

Rough Night

I was awake almost all night. I finally got sleep during the day after taking huge doses of Klonopin and Vistaril, all at once. I don't know why. I assume it started with a nightmare, but I don't remember it. Regardless I am now soooooooooooooooo tired and so behind on all the things I wanted to get done this weekend.

Not much I can do about that but it is still really frustrating. I didn't even start my crockpot, even thought I was awake, because I was afraid getting halfway done and realizing I was finally sleepy. So I still have to put together this week's food. I think for tonight I'll doing pizza. And then hopefully a very early bedtime. The last thing I need is to go into these last 2 weeks tired.

I hate those nights. I know I should just thankful they are rare now, but still, ugh.