When Christmas is Gone

Just when I thought no one understood, I saw my dog and kitten sleeping like this.

The kitten had her girl bits taken out and it’s really been hard on her. Bailey, true to her nature, is taking care of Savvy just like she does me.

Instead of asking “where are my people? Who’s going to rescue me?” I’m going to reach out to others more, and be one of their people.

Opioid Dependence and Mental Illness

Pile of pills

I’m not an addict. I’m not! I’m mentally ill. I have Bipolar Disorder. I also suffer from chronic pain in my lower back.

My primary care doctor (PC… PCD? Uhh… let’s go with MD) had been prescribing me oxycodone for the server and persistent (chronic) pain that I’ve had for years. After being active and doing something super strenuous like gardening for 15 minutes I think I’m dying. I’m exaggerating of course, but when I work as hard as Atlas does while holding up the world my eyes leak, I whimper and sit down. Sometimes I end up laying on the floor. The floor is such a very bad idea. If I straighten my legs my whimpering becomes desperate and I realize I’m crying. If I forget myself and straighten my legs I’m done. I can’t move. The pain paralyzes me.

I’m NOT an addict.

When I can think again, I try to find my phone. If I can’t find it right away I feel the panic rising and it triggers thoughts and emotions I thought I’d had under control.

This last time I thought I was managing my mania and depression (mixed state, rapid cycling) pretty well. I haven’t bought piles and piles of books on ducks or Oprah or how to be an astronaut. Honestly, I really haven’t. But please, don’t ask me what I’m thinking about. Also, I’ve been able to get out of bed AND wake-up in the morning and even go for walks. My depression skips through the dandelions with the mania comingling into a mixed state, which is always confusing.

I’m not an addict.

After many months of giving me a legal way to get my the Oxycodone I take for pain legally, and for free. The label on the bottle says I’m to take the little unassuming pills three times a day. They are 20 mg. Currently, I’ve convinced the assistant fellow at the pain clinic to reduce my Oxycodone to 20 mg twice a day.

I’m not an addict.

I’m mentally ill. I have Bipolar Disorder, ADHD, chronic pain, and other stuff.

I was referred to a pain chronic clinic… ah… chronic pain clinic, where my Oxycodone prescription was reissued. A five-minute verbal probe, that’s what it took for the doctor to determine whether or not I needed the narcotic. We didn’t talk about Bipolar Disorder or any potential interactions the Oxycodone might have with drugs that are meant to manage my wild emotions or tame my fantastic panic attacks. I’m not certain she has any record of my current medications. She asked questions, and I quickly tailored my answers to fit what I thought she was waiting to hear. She made a few notes on a paper as small as her palm. I wondered if she was actually making notes that she could refer to later. She thought for a few seconds and then wrote the prescription. I sighed in relief.

I’m not an addict.

A while later, like over a year or maybe two, I’m still taking the narcotic. The clinic has new owners and staff. They no longer asked me questions. Sometimes they required a urine test. Then, they stopped asking me anything at all. We spent my appointment chatting. I started asking if we could please try to figure out what was causing the pain and try to deal with it by correcting the problem. I wanted the pain to stop.

They didn’t listen. They wrote the prescription without hesitation.

I’m telling you, I’m not an addict.

My mental health drug dispenser began paying attention after I updated her about my drugs and included Oxycodone in the list. She stopped talking about whether or not my meds were working to stabilize my moods and started talking about “Black box” warnings.

She had my attention. I started to panic.

At the time I had over five medical people prescribing medications. They didn’t know what the other office prescribed me. They relied on me to tell them the truth. I didn’t have to tell anyone I was taking Oxycodone. That got me thinking.

I’m not an addict.

Later…

I’m still asking the medical folks to figure out the cause of my chronic lower back pain. I’m still not getting results. I’m getting way too much Oxycodone every bloody month.

Because I can, I’ve been researching my of collages of illnesses, disorders, and psychological malfunctions.

Ah ha! Black box warning. Do NOT take anti-anxiety medication (benzine’s) – death may result.

Oxycodone 20 mg

I recently saw Dr. T, my very superior knee surgeon. He saw the condition of my spine when he was looking at the x-rays of my hips. He was making certain that my persistent knee pain, post second replacement, wasn’t being caused by anything running amock in my hips. He was eliminating any possible cause of my knee pain before he even considering using surgery to further correct the inept effort Dr. B made the initial knee replacement. Dr. B successfully replaced my knee, but that’s where the project ended.

It sucked. My leg from the knee down, well, it kind of turned the wrong way.

Dr. T corrected the first replacement. He tried to minimize the damage his surgery could do while trying not to blow up my entire joint… okay, the joint that was already gone.

Dr. T showed me the x-rays he’d just had taken and explained where and why he left Dr. B’s “efforts,” while replacing the replacement. A month ago we tried a shot to relieve the pain and keep from having to have surgery again.

Nope. I’ve had no relief from the pain. In fact, my brain was overjoyed and thought that my knee was doing awesome. Holy cow! I should NOT have knelt down like that! Looks like surgery is probably what our next conversation will be about. I’ll need to be on pain medication again…. I intend to be off Oxycodine ASAP. I would really like to have some kind of painkiller to take after surgery – assuming I have it. Always be prepared! Sigh…

I’m not an addict.

After my constant complaining about my back pain that happens every time, I do regular human type activities involving the lower back. I’ve finally had x-rays of my back taken. Holy heck. Next stop is at a spine doctor.

The online personal information provided by my medical organization includes this: Opioid Dependence.

My chronic pain clinic instructs me to continue taking the Oxycodone. I haven’t been able to identify any specific relief from the pain in a long time. I have never felt any “fun” results from taking it. It has never made me feel sleepy.

I have found that taking Oxycodone at bedtime with the medication I take for Restless Legs Syndrome (RLS) helps me to get to sleep and not wake up in agony caused by the RLS.

Am I an addict?

“Taking opioids over a long period of time produces dependence, such that when people stop taking the drug, they have physical and psychological symptoms of withdrawal (such as muscle cramping, diarrhea, and anxiety). Dependence is not the same thing as addiction; although everyone who takes opioids for an extended period will become dependent, only a small percentage also experience the compulsive, continuing need for the drug that characterizes addiction.”*

I’m mentally ill. In my opinion taking any medication, especially one that alters my brain chemistry (opioids do this), should be thought about and discussed with other medical personnel who are also responsible for my continued living – and to live my best life.

Am I an addict?

No.

I have Opioid Dependence.

Dependence. I can live with that, but look, let’s get rid of that too. Okay?

{I have Bipolar Disorder. I’m a little manic now. I’m using it to write and post while I can. So, for now, I will post often because tomorrow, I may be depressed and unable to say what’s on my mind. I may not have anything on my mind.}

* https://ghr.nlm.nih.gov/condition/opioid-addiction

Waking Up Depressed

The sun was up and shining on the wrong side of the house as usual. The sun only ever warmed the living room and kitchen side from sun up to sun down. I swung my legs off the bed began the inevitable. I got dressed and put on my shoes and socks. Bailey studied me lazily. I knew she wouldn’t get out of bed unless she knew I was going to take her outside to do her business.

I sighed, irritated that I’d woken up late. My inner perfectionist was already at work, and I was worse for it. I should have already taken Bailey out and fed her and everyone else. I mentally smacked myself for my indiscretions.

After doing the morning chores, I sat down, and I thought I was attempting to complete an online class that I hoped would move me towards earning an income.

An income. I haven’t had one of those since before I was married, not since 1988. 1988. That’s so long ago.

I feel like a failure again. Always a failure. I took a breath, trying to calm myself, and felt depression flow into my chest. It’s a crappy way to start the day.

Struggling, I remembered I’d fed all the animals, now it was time to take care of myself. I got my pill container and flipped open the lid for today. Dumping them in my hands my heart sunk lower. It looks like I’m an addict. My hands shook as I took my meds. At least today, I remembered them.

I eventually went outside to do some trimming in the garden. It wasn’t raining yet, and the sun was out. My beautiful Bailey was out with me. Oh my god we’re both so fat! I’ve been trying to help us both lose weight, but…well, we’re still working on it. Great. I feel like crap again.

My daughter came home a few hours later. My glum mood had moved on, and I encouraged (read: told) her to come out and work with me. I felt good and my head, my emotions, felt clear, maybe even happy.

The question I have to ask myself is this: What the hell did I do to change from feeling crazy-eyes depressed to happy and joyful? That’s exactly the right question. And can I do it again?

I believe that my poopoo mood changed and lifted me higher because I “acted” like I was happy. I played with the animals. I did some of the work for my online class. I took Bailey for a walk. (When I take her out I use an app that maps our trip and counts the miles and such. If I think we’ve done well, I take a screenshot and send it to my kids and my Mom.

Then I sat my hiney down and did my class. That really felt good.

Now that I’m recalling how bad I felt this morning, I’m beginning to feel like I’m grieving. I think I’m grieving for myself, for all the time I’ve lost standing in the clouds, not functioning like a normal person at all. Maybe I wasted my life. I’m supposed to have all these mental illnesses, but why can’t they cure them or at the very least enable me to act normal.

Normal. That’s a fat laugh.

Uhg! I’m tired. Figuring all this out and, exercising and learning to understand myself… yikes. Maybe I’ll go barf now. What’s tomorrow going to be like? Huh, maybe it will be the way I choose to make it. Chose to make it a good day and it will be a good day? On the other hand… maybe I’ll need to stay in bed. Need. What will I need?

Tomorrow, I think I’ll take more of an active role in my day and use the S.M.A.R.T.

5-Minutes

5minutes Are you listening? Can you hear me?

I need you to hear me.

I need you to know what I mean when I say, “I just can’t!”

You really need to understand this illness before we talk about, “I just can’t” It will make so much more sense then.

I’ve written about my troubles for years in my paper journals. I’ve always imagined that when I die, one of my family, my kids perhaps, would read them and finally understand me. They would finally understand that I’m not a bad person, a lazy person, or a freeloader.

I’m sick. I’ve always been a sick person.

With technology what it is today, it’s easy to find an informative book that explains what it is to have what I have. I’ve searched YouTube for videos that explain me and have found a few that try to do it and seem to do it well. We’re all different of course so what describes one person may not completely fit me. But if the person watching will just listen, listen and hear the pain and the wrongness of it all.

Wrongness. That’s what it is.

You’d think, maybe this is the child whose rage never seemed to end, a brat that pushed and pushed…. Wouldn’t you like an explanation?

I’d think someone who claims to love me would take a few minutes to watch a 5-minute video, just a five-minute video, to learn about me. Surely, someone, anyone of you must care enough to sit for five-minutes for me? Did you hang out in line for coffee or in line at the grocery store? Is that silly? Have you “liked” any funny pictures or memes today? Did you watch ANY TV? What were you doing on commercials? Why is this so hard for you?

Did you watch the news today or read your Facebook feed? Have you texted anyone or talked on the phone?

Would you think I didn’t love you if I didn’t return your calls or texts for two or three weeks? Would you call and check on me?

How much energy does it take to watch a video?

What are you afraid of?

I’d have thought I’ve shown you enough of what this illness is that you have nothing left to fear.

And yet, you don’t hesitate. You completely stop.

“I don’t have time.”

Will you have time to visit me in the hospital?

I’m not going to try to kill myself just to get your attention. But I can’t promise to do what’s best for me all the time.

Maybe I’ll have to mourn the death of you so that I can learn to live without you. Because you see, I already live like this. You are emotionally unavailable to me. Without “my people” surrounding me in a protective layer of love to cushion me when I fall….

Adults are just like children. We all have a fair expectation of being loved. When that expectation is not met we wither and begin to slip away.

Do you have five-minutes?

I need you to listen to me today.

Just follow the link.

Then maybe we could talk.

I’ve had a thought. I’ve unwillingly learned more about inappropriate relations whether they be physical, racial, or political just watching prime time TV than you’ve learned about me on purpose.

It isn’t rocket science. But it is science. I am sick. Unlike some illnesses like some cancers where the patient may go into remission or finally be overcome by it, my sickness has not given me a moment’s rest.

Sometimes I wish I had an illness you could see so that you would mourn me when I die. But for today, I live as though I’m normal. That’s how you see me. Normal. That’s how I look. This illness is rude beyond anything I’ve ever seen. It grabs hold and never lets you go. It bombards me from within, from where you cannot see. This illness, it stays in the “ON” position from before I was diagnosed until I die.

That’s right. I have it now. You cannot see it. I will die with it.

Would you watch the video?

Or would you rather I had cancer? Then you’d have something you could see.

I’m tired of being unseen for who I am.

Please, are you listening? Can you hear me?

I’m wondering if you’ve ever felt anything like this. This is all true in my life. What about you? If you have known that, I hear you. I will listen to you. I have way more than 5-minutes to give you.

* I had my counselor read this yesterday so that he could see what’s in my brain. I told him I was going to edit it, polish it up before I posted it so it would be clearer in some places. He suggested that I not do that. He felt that letting you see where my brain was at was a place of raw emotion. He urged me to keep the “rawness” in it. So, here it is. Right from my brain and served up to you on a virtual platter.

What My Med Provider Means to Me

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I’ve complained about my med providers and their apparent inability to comprehend the word ANXIETY for over a year now. You could assume that I don’t like med providers… that I don’t trust them, that I think they’re stupid. Well, umm, yes, that’s basically how I’ve been feeling. I’ve been living a nightmare that has been driving me downward toward my old companions: anger and rage. It makes me feel like they’re getting out of prison and are moving into the house next to mine. I’ve been really scared that I was about to lose control of my emotions again, and eventually, my mind. It has happened before.

I last week I spoke with my counselor (Lee) before my visit with my med provider (Susan) this week. He thought the Ritalin obviously wasn’t working and that my ADHD was out of control. I allowed myself to interact with him the way I do at home with Jessica. My inability to control things like how fast, how much, and how many topics I covered while speaking certainly indicated that this was true.

<OMG! Alexa is playing music from the 1950’s for me. I LOVE THIS MUSIC!>

I was stunned. ADHD? If he was right, this could change everything about the way I approached my brain. I was told I had ADHD just a few years ago and had never taken the time to learn anything about it. Wow, that wasn’t like me at all. I love research! Following rabbit holes is my favorite pastime!

Anyway, I assumed Susan would look at my chart to see what notes Lee would have put in it before she saw me. Doing that would give her knowledge she should have used to help her understand where I was at and she would have seen what Lee was concerned about. It was an assumption I shouldn’t have made. Apparently, things don’t actually work that way.

Every time I see Susan 12 times a year. Yikes! So many times. One of the first things she asks me is if I feel like… if I FEEL like the Ritalin {1} is helping me focus? Focus? What does that mean? How can I tell it’s working? I can pay attention in class. Is that what she means? My attention is crap at home. I can’t ever do just one thing at a time. I have to leave the commercials in when I watch from the DVR (DISH) so that I can read or research stuff online that they just talked about. Is it working? I suppose so? I always replied that I guessed it did. I guess that was silly of me. I would say that because I had no idea what else to say. If I was a little boy, I could probably mean that I’d slow down and stop bouncing off the walls and maybe stay in my seat. But as an adult… I had no idea what that looked like. If I said the wrong thing, she might mess with my meds and right then, they were treating me okay. I wasn’t raging at anyone that day and I didn’t feel depressed.

After I mentioned what Lee and I had talked about and that he was very concerned she took a minute to read his notes. Suddenly she made a whole new treatment plan. I had been on Lithium when I was first diagnosed with Bipolar Disorder (BD). The first book I read on it was: “An Unquiet Mind: A Memoir of Moods and Madness” by Kay Redfield Jamison. I was deeply touched. I felt like I understood what she was talking about, like we were kindred spirits, linked through the ether by BD. Jamison was very sick when she was diagnosed.

Let me attempt to generally get right to the point for once. Jamison was placed on Lithium to treat her BD and it worked. So, that’s what I asked to be given. My personal doctor (MD), was the one who initially treated me. He said that Lithium has been around for many years and there is a lot of evidence that it works.

The Lithium worked.

Susan felt that since the Ritalin was obviously not helping me focus. I guess that made her rethink her strategy. She finally agreed that my brain was hopping along on two of four legs. She told me that does think I have ADHD she now believes that I’m far more manic, which was making me act like that bouncy ball they teach kids to sing songs with. Do you know what I mean? It might be too old for some of you. They wanted to teach kids songs so a character on a film or on TV would get you to sing along as it had a bouncing ball hop around on the lyrics so we could see the lyrics while we sang. It was great fun! than anything else. Sure I talk incessantly to Jessica, but my brain was exploding with ideas. It was time to help me continue to be creative, but to control my mania so that I could be productive.

The plan: no more Clonazepam, no more Ritalin. Start Lithium.
*The reason I went off Lithium was that my PC (Primary Care) had been highlighting the dangers of being on Lithium more than he was the benefits of it. It was because of these side effects, that I requested I be put on something else that didn’t have the same drawbacks. Lithium toxicity can occur even at a low dose. While on Lithium, the user has to be closely monitored so that the dose can be adjusted as needed. The symptoms of Lithium toxicity are numerous and I already have several of them for other random reasons. This website lists the long lists of side effects. In addition to these potential problems the user (remember this is me) has to carefully watch their intake of salt, caffeine, and alcohol. And get this… some of the other medications that may interfere with Lithium and increase the risk of toxicity are ibuprofen (Motrin, Advil) and naproxen (Aleve). Oh, and I can’t leave out this one: acetaminophen (Tylenol). So… yeah. I had a lot of scary reasons to ask to be taken off the drug that was helping me but was also kind of terrifying too. 

Susan believes that this change in medications should make my extreme moods in control much better.

Excuse me? As long as I’ve been seeing the professionals in this clinic, I’ve never had anyone decide to try Lithium again. All this time… lost. Years of feeling my little grey cells melting, running out of my ears. But then again, Lithium toxicity…

I want to be a writer when I grow up. I once heard that writers go through life with their head cocked a bit to the side. I showed Susan a piece of paper that was covered with writing on both sides. It was filled with websites, blogs, and email addresses that I’d created. She studied it for a while. I asked her if I was stupid and delusional to think that I could do all these things and believe that they were not just good ideas, they were great ideas. They were creative ideas. Is my mind actually existing in a consistent state of delusions of grandeur?

Delusions of grandeur. I’ve always been afraid that people would remember that part of the list of symptoms for BD and dismiss me as a kook. Am I brilliant? Or am I bonkers and deluded? I’ve always believed my ideas were great. Yeah. Delusions of grandeur?

She said no. It wasn’t that. Yes, my thoughts are crazy fast, but I am very creative and smart.

Me – creative and smart. OMG!

Of course, now I respect her. She believes in me. She agrees with me that I’m smart and creative. No one has really said that to me. No one has said, “Robin, you’re not delusional. You’re smart. You’re creative. You have good ideas… cleaver… innovative. Don’t worry about being crazy. We just need to slow you down so you can get things done.

Since then, I’ve discovered additional information that indicates that one aspect of BD is the tendency to be super goal oriented. Yep, that’s me. Why haven’t I’ve seen that before?

Watch out! Corner coming!

What are the good things about having BD? I’ll have to think on that for a while.

Go ahead, get mad when the medical professionals don’t seem to be listening. Pester them until they hear you. Then, you listen to them. Work together. Hope that things will finally start to workout. Now that Susan and I are communicating, now that she hears me, we have a new plan. Maybe my mind won’t keep leaving the scene without me.

Yes, it really has done that. We’ve called professional trackers to find it a few times now. It-is-very-embarrassing when your mind is so exposed, so naked.

New plan. New hope.

Bring it! I’m ready.

I’m more than ready –

{1 – Concerta and Ritalin are stimulant medications used to treat attention deficit hyperactivity disorder (ADHD). They’re both different brand-name versions of the same drug, called methylphenidate hydrochloride.  https://www.healthline.com/health/adhd/concerta-ritalin}