Next steps

I heard back from Dr. Brain who is out of town for a family function and can't really access my chart.  But she agreed that this was probably toxicity and I'm on the push-fluids, no lithium plan until I see her this weekend.  She said we may re-start it then but I'm not sure if she means that.  She knows stopping it will scare me and if I were her I'd want to have that discussion in person.  I'm not sure I want to re-start it.  It is a really important drug for me but that is 3 times that it has made me scary sick.  I'm still dehydrated by all my observational powers (and by knowing that I"m just not drinking enough). 

I did remember that I had lab orders that were supposed to be for a baseline for Dr. Body.  They were to be drawn this week but I decided to do them today instead even though he'll have to draw baselines again later.  This way labs go to him and if I need to go in for fluids tomorrow he will know.  So I used Medicare on day 2 of having it, although I realize that I should have gone in yesterday.  It just was too overwhelming and a plan for this kind of thing is also on the agenda for Dr. Brain.  The best option is always to get to Cleveland Clinic.  However yesterday there was no way that was possible.  I don't know how I could have gotten to the hospital 15 minutes from here without having major issues.  That hospital is not a good one.  I had an awful experience there that ended with my telling a nurse off and throwing my advanced degrees in his LPN face (not something I do often) and included them refusing to medicate me for a headache from a 200/100 blood pressure because I wouldn't/can't take ibuproferon and they didn't believe me and refused to look it up and then when I asked to speak to a doctor prior to taking a specific diuretic that I knew was not an ideal choice with lithium they said I refused the med and tried to send me home saying I declined treatment.  Which I didn't, I just wanted to ask a simple question.  I had to be nasty repeatedly and the care was terrible.  They even yelled at me for requesting a ltihium level, the most basic thing that should be done for a nauseous person taking lithium when it is 100 degrees out and the air conditioning at work is broken.  The 3rd option is about 40 minutes from here and has inpatient psych so they should have some competency in the meds.  The risk there would be someone screwing with my psych meds and I don't have the threat of an angry Dr. Brain there as I do at Cleveland Clinic.  But something needs to be planned.  Honestly if I have to go for fluids tomorrow I have no idea where I'll end up.  Dr. Body's practice was bought by a hospital which probably means he has the ability to call their ER and say "I'm sending a patient with ....." but I HATE the hospital he now works for. So hopefully that plays out in some way I have no control over.  Or I am fine.

As far as quitting lithium....ugh.  It is so effective.  It is also so scary that it can make me so sick.  I guess a lot depends on what Dr. Brain thinks the likeliehood of a 4th round of toxicity is.  I know it would be high compared to someone with no history.  But my level has drifted up and we've let it because I felt fine.  I think that had begun when I was toxic the last time.  I'll have to look it up.

And I forgot to give my cat her antibiotic because I was involved in writing this.  This is the hard one.  Pain meds are easy.  Antibiotic is not.  It is a big amount and appears to taste nasty.  In fact it DOES taste nasty; a drop got in my mouth last night.  Hopefully she's groggy and it goes right in.  We'll see.  That isn't the way my luck has been this week.  Actually not this year.  But things have to be looking up.  Surely.