Category Archives: Med Provider

Insidious Black Box

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I apologize for the length of this post. Please consider reading the entire post. It’s very important. Your life could depend upon it. (Robin)

Emotionmasks insane faces

I take two medications that I considered to have a Black Box warning. They both depress breathing. Together they can stop my breathing altogether… There are other dangers.

I have chronic pain with Bipolar Disorder and Generalized Anxiety. I am prescribed both Oxycodone and Clonazepam by two different providers. They both know that I take both medications.

I see a pain management specialist for my pain. I have for some time now. To be treated there, I have had to sign a contract that governs my behavior with regards to taking pain medications, I have to take a pee test every time I go in and they count my pills every time as well.

My med provider handles my Clonazepam prescription for anxiety. I suffer from extreme anxiety. Sometimes I feel like my brain is going to explode. Recently, this woman, who is the 4th or 5th provider I’ve had since I started going to this clinic, told me that I’m more likely to kill myself because of anxiety rather than depression. I was always told that a depressed person was more likely to commit suicide when they started to feel better. When they started feeling better, they finally would have the energy to follow through with their suicidal inclinations. Apparently, there is more to it than that.

My counselor and every med provider I’ve had is intimately aware of my massive anxiety and my inability to get it under control. We’ve tried all the counseling type of solutions including Cognitive Behavioral Therapy (talk therapy), mindfulness and other techniques. I’ve not had success with any of them.

My med provider is content for me to only take Lamotrigine, which is primarily to treat my Bipolar Disorder depression symptoms, and not to take anything other than Clonazepam for anxiety. From talking to her, it appears that this is primarily to treat the depressive symptoms that I experience. I have not been able to get any of the med providers who have treated me to give me anything for anxiety other than Clonazepam.

She, my med provider, told me at our second meeting, that people with anxiety are more likely to commit suicide than people with depression. Since I suffer primarily from anxiety, you would think someone would have warned me of this. I understand now why I feel so self-destructive while I’m exploding with anxiety.

She has told me that her goal is to get me off the Clonazepam completely. Now that I’m taking my runaway anxiety and the real chance I will kill myself because of it more seriously, I’m also taking the mix of these two medications seriously. I always have, but my frantic response to my anxiety has created a situation where I’m so afraid of what might happen if I stop taking the drug for anxiety.

I’ve always felt like I’m most insane when my anxiety is at its peak.

I understand that long-term opioid use for chronic pain is not the most effective way to treat it. I’ve wanted to find a different solution for a long time. My pain management provider doesn’t offer other alternatives than pain medications.

I normally don’t want to die. I’ve always had urges that are normally short in duration towards it, but I haven’t had times when I sit there with my bottle of Oxycodone ready to take it all. But, I could.

I’ve never told any of my mental health caregivers that I have suicidal thoughts. I know that my community does not have good facilities to treat acute mental health emergencies. I don’t want to become one of those people who is shuffled into a hospital emergency room with a guard sitting outside my little room. That’s what they do. I have first-hand knowledge of this.

So what’s the answer? Do I chance dying in my sleep? Or do I chance ending my life while I’m awake? Both are real dangers.

I’ve decided to deal with my feelings of self-destruction now. With the danger of the two medications and my new understanding the relationship between anxiety and suicide, I have promised my family that I will talk to my counselor on Wednesday when I see him. I will admit that I think about suicide. That’s a huge step for me.

I’m afraid. Admitting how I’ve been feeling for years is like admitting that I can’t control the one area of dealing with my mental health that I always felt I could say I didn’t have a problem with. I’ll finally be admitting I have no control over my depression or my anxiety in relationship to staying alive.

As I say, I don’t want to die. When my anxiety runs away I cannot always control myself. I can become violent and destructive. I break down and cannot function. I become paralyzed yet also hysterical.

Yesterday I talked to my mother and all three of my kids and admitted the truth to them. My youngest who is a psych major at the same university that I attend (so is her partner) said she had been wondering if that was a problem for me. They all agree that they would rather I call them than I call a suicide line. I’ll talk to my therapist about that.

I have tried to learn to practice mindfulness several times in the past. I never fully committed to it. Mindfulness was just part of the learning experience in one of my classes I just finished. It’s time for me to review the materials I have about it, I have lots. I need to try to learn how to harness it’s potential in earnest this time. My life depends upon it.

I have a particular fear: I’m terrified of my anxiety. I know what it does to me. I sometimes feel the insidious devil of insanity creeping through my mind trying to take over, and it literally shreds my mind.

If you have any Black Box warnings for medication yourself, please take it seriously. Now that I am self-aware of my true situation I’m ready to find a way to deal with my symptoms.

 

My main medications:

Chronic Pain – Oxycodone / Nucynta

Anxiety / PTSD – Clonazepam / Benzodiazepines

Bipolar Disorder / Depression – Lamotrigine

 

Oxycodone – Warnings

“To make sure this medicine is safe for you, tell your doctor if you have:

  • a history of drug abuse, alcohol addiction, or mental illness
  • if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others)”

https://www.drugs.com/oxycodone.html

Clonazepam – Warnings

Risks from Concomitant Use with Opioids
Use of benzodiazepines, including Clonazepam, and opioids may result in profound sedation, respiratory depression, coma, and death. Because of these risks, reserve concomitant prescribing of benzodiazepines and opioids for use in patients for whom alternative treatment options are inadequate.

Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioids alone. If a decision is made to prescribe Clonazepam concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation.
(The above Warning is taken from: https://www.drugs.com/pro/clonazepam.html)
Concomitant: (synonyms: attendant, accompanying, associated, related, connected)

Lamotrigine – Warnings

To make sure lamotrigine is safe for you, tell your doctor if you have:

  • A history of depression or suicidal thoughts or actions
  • Some people have thoughts about suicide while taking this medicine. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

https://www.drugs.com/mtm/lamotrigine.html

Nucynta – Side Effects for Health Care Professionals

Psychiatric – Common (1% to 10%): Insomnia, confusion, abnormal dreams, anxiety, depression, irritability, nervousness, drug withdrawal syndrome, restlessness, sleep disorder, hallucination, depressed mood.
https://www.drugs.com/sfx/nucynta-side-effects.html

 

Benzodiazepines

Benzodiazepines may be used in the treatment of anxiety, panic disorder, seizures, or sleep disorders.
https://www.drugs.com/drug-class/benzodiazepines.html

 

Bipolar – Tick Crisis!

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tics7089581_sThe last month has been a horror. I’ve developed my facial tick again and nothing we’ve done has slowed its march to make it so bad that I can’t have a conversation. In my classes at University I’m usually very outgoing and participate in class a lot. With this disability, and yes, that’s how I think of it, I can’t talk and participate with the others. It just kills me to just sit there. Sometimes I choose something short to say and I raise my hand and try to say it. My courage is met with stuttering, ticking and humiliation.

On the 10th I went to the ER because it was so bad that I couldn’t be understood when I talked. My eldest thankfully happened to have time to take me in. It was good because she had to translate for me at times. The doctors took me off my last added medication and prescribed me to take Lorazepam. The problem with that is I can’t take the Lorazepam if I plan on functioning. I have classes five days a week and two of those days are in the morning and in the afternoon so I couldn’t just come home and take it. So, it didn’t work. The ER wanted me to see my MD within 3 days of my visit to the ER. I tried, but my MD said that the ER always said that and that it wasn’t necessary. I disagreed. I was still ticking at a 7 out of 10 in intensity. It was a nightmare.

I finally got in to see him. He was of no help. He rudely informed me that it was probably permanent and was caused, he felt, by my Latuda, which I’ve been successfully taking for some time now. He also told me he wasn’t going to prescribe me anything new because he didn’t want me to go to the ER again for it because it would get him black listed at the hospital. I don’t know if he meant that there was a real black list, but he acted as though there was.

I asked to see a neurologist. After some maneuvering he agreed and picked a random one out of the directory and sent the referral through. I don’t think he thought that a neurologist would be of any help. Then he prescribed one of the medications I’d already tried for the tick. The problem with that is I’ve lost track of which medication caused which reaction or positive outcome.

I got ahold of the neurologist on my own and they could tell I was in crisis and tried to get me in earlier than the July dates that were for new patients right now. The helpful lady called me back the next day and sadly told me that they refer ticks to the mental health people and would I like their number? I told her I had it already. She was nice.

I had an appointment with my counselor this morning. Unfortunately, I locked myself out of my house and out of my car. I texted my eldest daughter and begged for help. She left class early and came to my rescue. I did happen to have some homework with me so I spent my time waiting for her doing that.

When I got back inside I called my counselor and got through! I asked her if we could do the appointment on the phone. She was great and agreed. My tick was at about a 5 for most of the visit although sometimes it got worse. She listened to what I’ve just recounted to you of my last few days and weeks and said I need to talk to my med provider ASAP. She put me on hold and went looking for her. Amazingly she found her and she was free so we stopped our conversation short and I waited for Sara, my med provider, to call me momentarily.

The call from Sara came right away. I went over all the stuff again and through asking questions about what new prescriptions I’ve started taking in the last month. I started a medication for restless legs (which worked!) and Lyrica. She has me discontinuing the Lyrica (which is funny because we’ve been fighting with my insurance for months to get it approved) and the last med that my MD had me start taking for the tick. Then she did some research and found out that indeed Lyrica can cause the tick and so can Latuda, which I’ve been taking for some time. Now were stopping the Latuda. I’ve just gone from 120mg to 80mg tonight. Last time we tried to lower my Latuda was during the Christmas holiday and it didn’t go well. Instead of being well medicated and under control, I began to have violent emotions and lashing out at my loving family. It didn’t feel great. But here we are, trying it again. I’m going to have to watch myself.

So now were taking action. I feel better about it. I see Sara on the 11th I think. We’ll reevaluate my condition at that time. She’s not happy with the way this has been handled. The ER should have referred me to my med provider, not my MD.  My MD couldn’t give a shit. I’m looking for a new one. Around here it’s really hard to find new ones. New patient appointments have waiting lists going out months. It’s frustrating.

I’m a communicator. It’s what I do. I am fully involved in all my classes. I can’t do that right now. It drives me crazy. Sometimes I raise my hand thinking I’m going to say something brief. Unfortunately, it turns into a long ordeal as I stutter and tick my way through what I want to say. Sometimes the friend I sit with tries to finish talking for me. It’s embarrassing. I know there’s nothing to be embarrass about. It isn’t my fault I can’t control my mouth. Thankfully I can control the content of what I want to say.

I’ve been using my situation to really make sure that what I want to say will really be helpful or ask a really good question.

My kids have been good about it. They laugh at me when it gets really bad. I’m glad. I can’t take it too seriously (though god knows it is). They help me keep my chin up. And, thankfully, they translate for me. Seriously. Even when I’m just talking to them they have to finish my sentences for me (when I’m at a 7 or higher). I’m thankful for my kids, my mom and my brother for their patience in waiting for me to struggle through a conversation.

So, maybe the next few days will be better. I’m not going to class tomorrow. I’m going to work on calming down. I need the time to rebound and relax. I have a ton of homework to do so I’m going to give myself the time to do it. Lowering my stress can only help my situation.

If you find yourself in a similar situation remember that freaking out doesn’t help. Well, doesn’t help much. Sometimes you get like I did and can’t talk at all and they take you seriously. But, in general, it’s best to persevere and keep bugging people, doing research, calling anyone you can think of till you find the right person to talk to. Now, I hope it works.

Tonight, as with the last two nights, I’m up late with back problems. It’s like all the nerves in my lower back are firing at the same time. I can only describe it as sever lower back pain. I take Oxycodone for that. You’d think that would help my tick and the stress associated with it. Nope. Nada. Zilch.

Sighing…. This tick seems like such a waste of time. I was thinking of getting a summer job, but that will never happen with this tick.

I’ll let you know what happens next. I’m afraid of myself. I’m afraid my Bipolar is going to come raging back like it was in the past and torment me. Hopefully I can use the tools I’ve learned since my last crash to keep me from going into crisis but you know, if it’s going to come, it’s going to come. I can’t stop it. But I can combat it.

So here we go, on my first day with my Lyrica gone and my Latuda going down. I have to admit, I’m more than a little scared. What if I flip out? What happens if the tick becomes permanent? What if? What if? What if? What if I get better?

My back is feeling better now. I’ve sat on ice and now the heating pad. Time to try to go to sleep again. Good night my friends. May you be able to speak your mind wisely and with confidence.

Bipolar – Danger Signs

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solar-flare-1Now that I’m taking 120mg of Latuda again I can consider the signs I was having that I was going into a crisis. I believe it’s important for me, for everyone, to know what happens before we reach a full-blown disaster so we can take precautions and get help early. That said, I recognize that it is often difficult if not impossible to tell when we’re slipping. It’s like standing on a beach when the tide is out. You’re talking to a friend or looking at the beautiful water or a sunset. You’re not paying any attention to your feet, which is unfortunate, because your feet have been slowly sinking into the sand. Now, when you try to move, your feet stick and you fall on your face because you didn’t realize what had been happening while you weren’t paying attention.

The biggest sign that I’m crashing is that I lose my temper violently and in an instant. Most of my life I have been consumed with anger and ill temper. It has kept me from getting to know my family. My father, who is gone now, was as bad tempered and mean with me as I was with him. We reacted to each other like lighter fluid on a bonfire. I believe that he also suffered from Bipolar Disorder.

In addition to a catastrophically hellish temper I was angry all the time. I don’t mean mad. I mean angry like I wanted to hurt someone. My adrenaline was (and is) on all the time. To this day my muscles are hard as rock, cocked as if to lunge into flight or fight. Even after a massage my musculature remains as solid as steel. I never relax.

Over the years I’ve taken medications that cause my face, my jaw in particular, to violently jerk and I can’t talk. I look like I’ve got a massive tick in my face and I sound like I’m hiccupping. Now, when I’m stressed, the tick comes back. As a matter of fact, I’ve been having it happen daily now even during Christmas vacation when I don’t have the pressures of school work. It really frustrates me. It’s so remarkable that people stop talking and stare at my face. It stops conversation dead.

So this time, when my temper soared uncontrollably and I saw my family react to my words as though they’d been slapped, I realized I was in trouble. I thought I was just feeling my temper returning. I felt like I was keeping it under control. I didn’t realize others noticed it until we were celebrating Christmas Day at my brother’s house and I was talking to my daughter and her fiancée when suddenly Sydney stopped short and looked at me as though I’d just stabbed her. I shut my mouth fast. I knew I was in trouble. I had to stop myself from talking the rest of the day unless I was paying attention to what I was saying and how I was saying it.

My med provider and I had a backup plan in place incase reducing my Latuda to 80mg didn’t work. I was to return to the 120mg dosage immediately. So that’s what I did. I couldn’t wait until I was able to get back in to see her in three more weeks. I’m feeling much less volatile now.

I know it is rarely as easy a fix as returning to a medication that I already know works for me. It’s never that easy. This time was an exception for which I am grateful.

We, you and I, impact those around us. Our behavior doesn’t happen in a vacuum. We have a responsibility to control our behavior for our own health and for our family and friends. It’s funny that I say we need to control ourselves because that’s exactly what I’ve never been able to do. Not till I got well medicated.

The take away – be vigilant for signs of crashing. Then take action swiftly.

Bipolar – Hidden Emotions

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After months of not really feeling anything accept sever anxiety, my emotions are waking up again. I’m hoping that all the months of counseling have prepared me for my feelings, my moods.

I took a poetry class this last quarter. I had a difficult time writing the poetry because my emotions were packed away in a closet inside my brain. I wrote very clinically, very much cerebral and didn’t feel inspired or moved at all.

I’m enrolled in the disability program at the college and one of the things I get is time and a half for exams. Of course there aren’t exams in poetry, but the first quarter that I had this professor with I’d gone in and went over my disability papers with her and explained about how this was my first year back to college and I that was having a hard time. I took a chance and told her about my having Bipolar. I haven’t really thought it was necessary to tell my other professors what my disability is, but I felt like I was connecting with this professor and I also felt like I would be able to come and her and talk if I needed to.

I talked to her about how my BP was affecting my writing and she suggested I read “Touched with Fire” by Kay Redfield Jamison to see how many artistic people have mental illness (especially Bipolar Disorder). Funny thing was, I have read it. I’ve spent so much time in it that the pages have come off the spine of the book and nearly every page has notes and things underlined in it. It is in such bad shape that I purchased another copy so I could read it again. This is one of those books I bought in paper back and not as an eBook. If I have a book I want to markup I always get it in print. It’s just easier for me to make notes and find things in.

The first thing I encountered in Jamison’s book was a through recounting of all the symptoms having to do with Bipolar Disorder. Having been only anxious and not having mood swings for a few months per se, I was shocked as I remembered all the emotions that are currently hiding behind my medications.

I’m glad that I read what the symptoms are again because of the fact that we’ve lowered my Latuda and I need to be on the watch for symptoms to return. I have to admit, I’m worried now. I forgot how bad it has been for me. I rate on the top of the Bipolar Disorder Type 1, but I’m also high functioning so I’ve been able to hide it from most people. At least I think I have. Who really knows what others think of us when we’re in the midst of an active outburst of violent emotions.

So here I go, with an intentionally lowered mood stabilizer, and me waiting to see if any of my old enemies come sauntering out of the closet. I must remember not to hold my breath.

Bipolar – Being There for My Kids and Real Anxiety

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We did something amazing today, something we haven’t done in a very long time, my three kids and I all made dinner and ate it together around our family dining room table. We did it alone, without their girlfriends and significant others. It was nice. It was unfiltered. It was honest.

My son and our cars were some of the topics of conversation. My car is doing really well, solid, for being over 200,000 miles. My son, wants out of his relationship with his live in girlfriend. She (girlfriend), is not doing as well as my car.

She’s a bit on the mad side and I do mean both mad-angry and mad-bonkers. He’s concerned she might do something to him if he breaks up with her. I hate to see him going through that fear, that pain. I was in a similar situation myself many years ago and things did not go well. Today the digital actions of the other person would be illegal. I don’t think this girl has the resources or the wherewithal to try to make his life hell like I experienced.

I must tell you one thing I think is particularly amusing that she does every week. I thought I was being nice when I was moving and going through my cookbooks, when I let her pick some out to take for her own. I shouldn’t have let her have the one on Herbs. It goes through all the major cooking herbs and talks about how they are used. So, being the incredibly wise girl that she is, she is going through the book and making a dish around one herb at a time.

Unfortunately, she isn’t a cook. She sees her herb of the day and then Googles it and picks the top recipe and decides to make it for dinner. For example, they had mint the other day. The recipe called for dry mint in a certain amount. She sent my son to the store for fresh mint. Then she added the fresh mint to the recipe in the same amount that it called for as DRY. Yeah. He’s been getting sick a lot. She also has no concept of cleanliness in the kitchen and uses knives and forks for raw meat and other foods at the same time without washing them. It’s no wonder he’s losing weight. It’s a wonder he’s alive. Her lack of common sense with cleanliness in the kitchen really troubles me.

Without going into the grimy details let me say that he’s smart enough to know that he’s made a mistake and that he needs to disengage himself from her asap. I’m gratified that he knows I meant it when I said any of my three kids could home if they ever need to. I don’t have any fear that he’s scared to live with me. There was a time when that might have been true.

My anxiety is going up and down but is mostly manageable especially now that I’ve seen my med provider Sara and she’s standing with me. She sees the stress the pain management doctor is putting me through and is concerned about the affect it is having on me.

I’m feeling supported tonight. I reached out to a friend tonight that I haven’t talked to in a while and she was there and open to chatting even though she’s feeling lousy. It feels good to be able to do stuff with people. I still have homework to do tomorrow, but I’ll do that tomorrow. That, and watch the Seahawks!

My well of anxiety is still open and active, but I’ve taken steps to try to control it. For the short term it seems to be working. It isn’t a forever fix, but at least I made it through the first week of classes and am almost ready for the second week. (I attend school at one of the University of Washington campuses.)

I made a major accomplishment this first week of classes: I went to two movies and had the kids over to dinner which are all time consuming activities. Last year I couldn’t have done that. It isn’t that I’m not afraid I won’t have things done on time or good enough, it’s just that I have to listen to my family when they remind me of what my GPA is and that people work full-time and go to school full-time and spend less time studying than I do. Okay, it’s that and meditative music all night. Well, that and my doctor sanctioned chill pills. I can take them when I need one and not feel guilty.

It makes a whole huge difference to have the support and two-way trust with my doctor. I tell her the truth about how I’m doing and what I’m taking and she doesn’t abandon me and tell me to just talk it out with my counselor. Sometimes counseling and medications have to go hand in hand. At least, that’s what I’ve found is true. All areas of my life have to work in concert to make me function.

I picked one thing at a time and as fast as I could I got the pieces working for me. I failed a lot and still have a lot of setbacks, but right now, I feel 60% pretty good. I’ll take that all day.

I started trying to deal with the extreme anxiety by talking with my counselor who immediately went to find my med provider knowing it would take more than thinking to help me. Then I listened to meditative music and “talk downs” I found on YouTube. I searched for something like “meditation sleep music”. Try it. I recommend it. Now I listen to “Soundscapes” on my local cable provider all night. And I’m exercising every few days, playing with my dog and training her and keeping up with my house cleaning chores.

Monday I have classes and then seen the pain management doctor… that worries me. Ok, now I’m needing to chill again. I’m so silly.

Bipolar – Anxiety Rising

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(Sept. 04) I’ve been sitting here trying to think of how to begin writing this and I’ve been getting nowhere. School is coming and I’m stressed out about that.

I have tremendous back pain and I go to a pain management doctor for my pain medication. The doctor that I’ve been seeing for like two years has stopped working in pain management and has opened a family practice. She was great. She really worked with me and worked to manage my pain knowing that I have Bipolar Disorder, PTSD, GAD, ADHD and so on. She was the one who prescribed my chill pill (medication anxiety) that I started taking during the school year last year when I had an anxiety meltdown.

The new pain management doctor started out by accusing me of selling my oxycodone and refused to refill my chill pill. I had a prescription of Oxycodone at the pharmacy to pick up which she didn’t take into account. I didn’t do anything wrong. I don’t like her. I don’t trust her with my health. My next visit to her she accused me of breaking my pain management contract by not bringing in the second pain medication I’m on. I was never told to bring the bottle in with me. Oxycodone yes, the other stuff, no.

My back has been bothering me.

My facial tick is back. It comes with anxiety like snow falls in the mountains… when the cold and precipitation is sufficient, the snow comes. Actually the vicious tick came with my beginning to take Gabapentin gain instead of Lyrica (Gabapentin can also be used for anxiety as well as for FM, which is why I tried taking it again).

FAST FORWARD TO TODAY Sept 28

I’ve been taking my chill pill daily. I survived my first day of classes because of the pill. I usually wake up in a cold sweat whenever anything remotely stressful is going to happen during the day. Like, for instance, going back to school.

Anxiety is such a huge part of my being right now that although I’ve lived in my new house for about two months I haven’t been to the grocery store by myself even once. I needed to buy some poetry books from the bookstore about 20 minutes from my house and instead of just going and getting them I called my eldest daughter and bribed her (I’d buy her a book if she’d come with me) to come with me. I just find it stressful to do things alone. I do not have a rational reason. I’ve done all the thinking and reasoning about my anxiety that my counselor and I have come up with and the anxiety does nothing but get worse.

I stopped taking the Gabapentin and the facial tick immediately started going away. When I’m stressed it comes back. I hope it isn’t permanent.

I see my med. Provider (the gal who manages my mental health medications) Sara in the morning. I’m asking her for something to treat the sever anxiety on a long term basis. The chill pill is great but it’s for a crisis and not meant for long-term consumption.

I get so wigged out about things that earlier tonight I already mapped out in my head the route that I would take to get to see Sara and then called my daughter to make sure that I could get to the grocery store from where I was coming from. I’m planning on going to get some milk on my way home in the morning. I need to do it on my own. I think if I have the chill pill I can.

It’s amazing. I wish I could take it all the time. I’ve been having to use it to go to sleep at night. When I don’t take it I’m awake until after 2 or 3 in the morning. Then I wake up sweating. I’ve even resorted to listening to relaxing meditative music/waves on YouTube all night. I found a channel on my TV provider to listen to that works as well called Soundscapes.

The struggle I’m having with anxiety is so severe that I’ve not been willing to blog and that makes me sad. My counselor has put forth the idea that perhaps my mania is manifesting as anxiety and that It’s really part of my Bipolar Disorder. I sort of hope that’s the case. If it is, I’m confident we can deal with it.

Why haven’t I been in to see my med. Provider sooner? She’s been booked. It’s been over a month since I last saw her. I’ve talked to her on the phone and my counselor talked to her on my behalf too.

Hopefully tomorrow I can communicate clearly how absolutely painful this anxiety is. My counselor is supposed to go to that meeting with me. I hope she can actually make it. It would give Sara a clearer picture of what’s going on with me.

Now, I’m going to listen to Rachel Platten’s “Fight Song” then I’m going to go to bed. I might read for a few minutes. Maybe one or two. Seriously, that’s as long as I’ll read.

I have high expectations for my visit with Sara and Rebecca (my counselor) in the morning. We got this. I have to believe, we got this.

Bipolar – Video Games I Play and Why

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I play Diablo 3: Reaper of Souls and Forge of Empires. 

D3: RoS – on the X-box
Why? Because I like to shoot things … a lot. So I play on a pretty low setting … just so I can blow stuff up and shoot the rest of it.
I’ve been playing this game for years. Many years.

FoE: Free Browser Game
Why? Because this strategy MMO makes me slow down. A lot. And I have commitments to friends I’ve made (some have carried over to become real life friends) and my guildmates. Also, if I want to advance I have to think. You know, strategically.
I’ve been playing this game for about a year and a half.
Interested in playing? Go HERE

I have agression (read anger, temper tantrum, irritation, yelling, “tossing” things issues occasionally…). I find playing both these games helps me a great deal.

I see my med provider tomorrow. I have a cunning plan to aid in my “stability” and questions about possibly increasing my dosage of a medication.

Hmmm… I’m trying to find a way to learn to add biofeed back to my regiment of strategies (there’s that word again) to maintain and/or achieve a healthy lifestyle. Well, to achieve a healthier me. A healthier me makes for a healthier family. This is a huge motivation. I’m talking about both reasons. Also, my puppy will know when I’m coming and when I’m going. Presently she comes when I sneeze. Yes, for real.

Licked by Lamictal

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Licked by Lamictal. Yep. I had requested that we lower the dosage and find another drug to use for my Bipolar 1 mixed state because I’m fair skinned (millions of freckles) and as soon as the sun made it’s annual appearance I started burning… in the shade, with sun screen on and with a long sleeve shirt. I mean what the heck is that all about? I didn’t want to go through it all again so I begged my med provider to change it. Not my shirt, the drug.

We backed off from 200 mg twice a day to just 200 in the evening. Within 2 weeks my youngest daughter (17) was actively searching for large boards to bonk me up side the head with. Yeah, I really sucked eggs. The really sickening things about it this time were that “I” chose to lower the medication and “I” slid head first in the inferno that is my brain roaming freely like a blind cat on a boat in high seas.

I called Jane, my med provider, and asked to come in to see her much earlier than my scheduled appointment. I was in her office in two days. We changed the dosage, raising it again over 3 weeks. I had met my new counselor when I was rapidly sliding into the pit and was a manic momma for the first two visits. Then, this week I had my third meeting with her.

I sat calmly and we talked. We talked back and forth. We worked together. It was nice. She mentioned that the change in me from the first two meetings to this one were remarkable. Indeed they were, they are. I asked her, “If you met me today and I behaved as I am doing now and I told you I’m a raging Bipolar 1 mixed state would you believe me?” Her answer was exactly what everyone says… “No.”

The Lamictal gives me the ability to fence in a lot of my insanity and I can pretend I’m “normal” and that I don’t really want to jump up and tell you how stupid you are. I’m smart. I know how to fake “normalicy”. It has come in handy (in fact I felt it was necessary to keep my ex-husband from getting his moronic, I live in another plane of reality, over the top and burning in hell as a terrible father, rotten Christian and ex-husband). I didn’t want them to take my babies away from me. No way. I fought myself like hell. I learned how to fake it really well.

At the end of our meeting I asked Julia (counselor) if she had just met me for the first time today would she believe I was as overwhelmingly Bipolar 1 as I say I am. Absolutely not. I let my secret out with more than a little pride I must confess. I told her that when I met new medical people (new to me) I always “let the crazy out” enough for them to believe that I’m more than a tiny bit messed up. She was amazed. Then I reminded her of my situation with the kids and that that desperate motivation and my above average intelligence giving me the messed up strength to stumble on each day. Mostly… Kind of. Sometimes. Blah…

Now before you jump up and down and up again shouting that I’m suffering from our common trait lovingly referred to as “megalomania” or “delusions of grandeur” understand this: I have lived most of my life believing that we each need to have an accurate estimation of our abilities. If you’re amazing, it’s perfectly fine to think it and sometimes, when the time is appropriate, to say it. “I am a high functioning Bipolar 1 mixed state. Very high functioning.” Never let that fool you into lethargy and believing wrongly that I’m perfectly fine and don’t need to be watched with due care. If you do, you are a moron.

Got good meds that are working for you? With your med provider’s help? Then keep taking the bloody things. Don’t ever risk sliding down that dark shoot to the garbage bin of your soul. Will you do that for me? Trust your people. If you can’t, find someone you can trust.

Just never, ever, stop your meds without a safety net.

I mean it. Watch it.

Mind the gap.

I Am . . . Afraid

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I’m still depressed. My Lamictal dosage is rising steadily and is currently at 350 mg daily. Maybe it’s starting to work because I already was taking 200 mg daily. Maybe I realized how afraid I really am. Oh sure, I go to see my med provider every two weeks again (back up from once monthly) and my counselor weekly, but somehow I “feel” worse off. It’s almost as if having my mental/emotional needs addressed again with such intensity tripped me up really hard. I’m at a place in life where I am so afraid… it’s the kind of fear that sucks your brain out and leaves you stunned and unable to think straight. The depression, anxiety and anger seem like they are swarming about me. They suck at my soul. They lap at the fallen corner stone of my very being…

I’ve lost my purpose and I’m so afraid.

I was trying to think of an image that would demonstrate how I feel. It’s pretty hard to Google “afraid, depressed, anxious, without purpose” and expect anything helpful to pop up. I thought of Leonardo de Vinci  and some of they dramatic faces he drew. I looked at a few and this one seems to come kind of near to what I want you to see… my fear. The man is shouting. The setting is the Battle of Anghiari.

 

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da Vinci’s “Shouting Man”

Let me try to explain to you my friend, what I mean. During some of my very dark periods I was able to hold on to one thing, one certainty, that kept me going and gave me purpose… a reason to live. That purpose was to be the best mom that I could be and raise my kids to be the best people they could be. Growth them strong.

Now, they are old enough to not need me to keep my hand locked firmly on the tiller of their lives. They steer themselves. They are moving on and I am lost. From the time my eldest was born in 1992 my passion, my calling, my purpose, was to be “Mom”. I’ve thought that I have had other purposes along the trail of my life, but somehow being “Mom” over shadowed them all and now I am fighting myself just to remember what I believed I needed and wanted passionately to do… to be.

I am afraid that I’m a failure. No one needs me any longer. I keep to myself mostly. My family and I are not particularly close. I don’t work or volunteer. Putting it short: I don’t feel that I have anything to contribute to the world.

My fear has driven me off my path. I allowed bushes and hedges to crowd my chosen path and completely obscure it from my vision. I know, well, I think I knew what my “vocation”, that is what my passion was. I feel empty and bruised. I don’t want life to touch me. I seem to think it will injure me by exposing my worthlessness to me.

I’m trying to pull together my wits and engage in the monumental fight with myself to reclaim who I am and what I’m about, my purpose.

And, my pain meds for chronic back pain (degenerating disks all up/down my spine have kicked my butt and I just nodded off. Tomorrow I’ll attempt to pull myself together enough to begin discussing with myself how to deal with myself this time. I’ve already worked it out in advanced, but this lack of purpose, this is new and frighting.

I’m letting the drug induced sleep take me away from the fear for a time. Starting physical therapy this last week had kicked up my pain, as I knew it would. It makes the whole of me even more difficult to deal with. At this particular moment I feel like in the morning I can begin to pull my will back together. That is, unless I conveniently forget what I intend on doing with myself, again.

Time to sleep.

You Can’t Have My Leg!

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It would seem that I’m not done with me yet. I’ve paralyzed myself for a long time, not willing to write, telling myself that I don’t know where to start. So many odd and terrible things have happened to me… are happening each day… that I rationed that I was waiting for a lull in the storms that are me so I could present you with a neat package all polished and not like I am now. If I were a color book I would never have drawing inside my lines.

Here I am. This is what I’m thinking tonight:

My right leg is going to fall off.

Seriously. That’s it. Oh sure, with my alphabet soup (Bipolar 1, ADHD, PTSD, FM, OA… for now) crowding me for more undeserved attention. They annoy me. Like a flock, a gaggle of Canadian Geese launching themselves at me unreserved and underrated. They scare me. They are impossible to reason with. No matter where you are if they decide you need to be chased, you’ll be chased as long as they can chase you. No lie. Your heart will pound excitedly when the medium sized birds take after you on the ground like a Disney movie gone terribly wrong.

My leg. I had my right knee totally replaced in January two years ago. By the following year it was clear that the surgery had failed. The prosthetic that was implanted in my leg bone failed to graft with the bone it was supposed to graft to which would, had it worked, have given me a working and reliable new knee.

Wrong.

August 2013 a surgeon specializing in replacing messed up knee replacements replaced my replaced and prosthetic knee. Both times I suffered terribly (differently each time). I suspect that no surgeon would appreciate me talking with any of their patients and telling them how the whole sordid mess went. (To clarify – Sordid meaning: involving ignoble actions and motives; arousing moral distaste and contempt, sleazy, dirty, seedy, seamy, unsavory, tawdry,cheap, debased, degenerate, dishonorable, disreputable, discreditable, contemptible, ignominious, shameful, and abhorrent. The exact opposite of: respectable.)

The up-to-the-minute report is this: Friday I showed my MD that my entire surgical leg (right) was bigger than the left. No sense in studying it to see if I was imagining it. It obviously belongs on some other person’s body. This is a problem. I don’t even know what the problem is and already I realize it’s a problem. I think my name must translate in some language to “problem”. I’m certain of it.

I exposed the bare and big leg to my doc on Friday last. He sent me back to my surgeon, but not till after we get another and new authorization to see the fella. Seriously. Same leg. Obvious connection. Gotta have that new authorization. I called his office and explained the situation. The woman at his office agreed to request one for me from my MD. (Yes, I’m saying “MD” and not PP, PC or any other ridiculous set of the alphabet… again with the alphabet. He’s my doctor, my medical doctor. That’s Medical Doctor. MD.

What I didn’t realize was that my MD had that very day put in an order for me to have a vascular study done on the affected leg. They would take me as soon as today (Tuesday). Getting an appointment that fast freaked me out. (Just a little FYI.) Since my doc referred me to my surgeon I assumed he was done with me regarding this particular medical happenstance (coincidence).

That last sentence looks strange to me, but my brain refuses to use any other word.

Anyway, the surgeon didn’t order the imaging before he even saw me. I wondered if maybe he had so he would know ahead of time what might be going on. But.. no. My MD ordered it. When he starts a process that really should probably be ordered to the specialist I was being sent to I hit the “worry” button and all hell breaks loose. Again.

Today the resounding thought that pestered me like the rain does every time it soaks me when I take the puppy potty was: “They are going to take my leg off.”

Seriously. “They are going to take my leg off.” That’s what my brain has been saying all damn day.

Just to show you how badly I freak myself out living inside my head with my alphabet soup, my MD has ordered me to have a service/companion dog. This, is our puppy, my service/companion dog in training. She’s so awesome. But more about her at another time.

I’m going to jump now through the rest of the day to now. I’m having considerable back pain which has kept me from sleeping. I began to write this. I got half way through it. Suddenly I see my bedroom door open, but I see no one opening it. Ahh. It’s Maks. Maks is one of our awesome cats. Throughout all my ailments Maks has been my healing kitty. Cat. He’s too old to be a kitty. Just don’t mention that to him and we’ll all get along just fine.

Whenever (most of the time) I’ve been doing particularly terrible, like today and taking my leg off, he comes to me and loves me up. Right now he’s purring and clawing, I mean needing, my right hip. This isn’t where he normally lays. He usually takes up station keeping on my left side somewhere but since we got the puppy (Bailey) he hasn’t been up to see me very often. I’ve been having my son bring him up to me when I retire for the night so he can get used to puppy smells and sounds. It’s working. He’s beside me doing his magical cat thing. How the hell do they know when we need them? Of course I’ve heard about the cats and dogs that can smell/sense impending death or various illnesses. He thinks he’s one of these special and extraordinary furry companions. I agree with him.

He’s been urging me to pet him and love him up stabbing me gently and now snoring at me. The look of love on his face is wonderful. (I know what you’re going to say. Cats don’t make that kind of face and they don’t feel like that you bozo. And then I would tell you to shut your trap. It works for me.) I’ve been alternately petting him and waving his loose fir away and writing this. I like it. I feel better. He knows my alphabet is haunting me. I do… feel better now.

Tomorrow afternoon I’m having the vascular imaging done of my entire right leg. It’s weird and cool to watch. Stay tuned in to this same bat time, this same bat channel.

Wow, can this cat snore.