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

My First Day as a Grown-Up

maks balloon

Apparently I set my alarm wrong or didn’t set it at all because at 9:32 my youngest daughter Sydney called and scared the snot out of me. I was so confused and I dropped the phone and missed the call. Oops. I got the phone off the light stand and onto the bed with me so I could call her back but she beat me.

You should know that while I’m only 53 I have rheumatoid arthritis, osteoarthritis, and I’ve had cataracts removed and I wear full dentures. I ain’t got no choppers. This is interesting to know because of what happened next. Getting the phone in the first place was painful and I almost dropped it behind the bed because of the arthritis in my hands. Morning is especially bad for my hands.

Sydney called before I could call her. She was very excited and upset. I was still effectively asleep. She launched into her problem which has nothing to do with my morning in general so we’ll skip that.

I was trying hard to sound like she hadn’t woke me up, but it was no use. In morning especially trying to talk without my teeth in is like talking to me drunk with mashed potatoes in my mouth. Fortunately Sydney can translate most of what I say so that’s good. Thankfully I don’t have to make up a story of why I sound like I’m drunk.

Next I try to get out of bed. This is not as simple as you would think. I’ve had my right knee replaced twice so I’m careful getting out of bed because I don’t want to skip forward in time and have to have the other one done especially since I live alone now. I tried to get my feet to the floor but I couldn’t slide off the bed.

During the day, I can sit on the side of the bed and my feet dangle a good ten inches above the floor. On a normal morning I can’t find the floor. I couldn’t find the floor today. I swear this bloody memory foam mattress conforms to where I’m sitting and won’t let my butt go. So there I sat, trying without success to scooch over to the edge of the bed where I could work at getting off the bed. No luck.

So I try switching it up and go for trying to get just one bun closer to the edge. Finally, a little movement. Slowly I start the long and slow effort to the edge, all of four inches to the edge. I made it! I was finally sitting with my legs dangling over the edge of the bed. I leaned back and started the fearful journey of trying to fall towards the floor. It always seems like it is farther away from my feet every morning.

Yeah!!! I make it to the floor.

Next, the pain and stiffness of the arthritis in my legs and ankles speaks up and rudely tries to make me stand there like an old woman frozen in place. I wonder how my hair looks.

Eventually I make it to the living room and sit on the stool and slowly put my shoes on. It’s painful to bend over and pull my feet up on my knee to get my shoes on.

Eventually, success!

Why am I putting my shoes on without socks on and teeth in? Gotta take the doggie out to do her business. Then she wouldn’t poop. I’m out there getting my feet wet in the lumpy thickish dewy grass and fast getting annoyed. I give up and we go back in the house.

Ah ha! I remembered to feed the cats when I came back in the house. They’re food is downstairs so it’s not like I normally think about feeding them, which, is now my job.

The cats were Kyle’s job. Of course, now that job falls to me. None of the kids took a cat with them. I want them to take the cats with them! I tend to forget to feed them and when that happens Maks, the older of the two, goes in the kitchen and opens and closes the cabinet doors and lets them bang shut and do it over and over until you get up and feed them. Little asses.

My dog is a heeler/kelpie, meaning, she’s a herding dog. She loves to herd the cats. Somehow she knows when they cats are doing something wrong and chases them downstairs at full speed. It’s pretty funny. So if I’ve gone to bed all I have to do is open my bedroom door and poof! The cats are downstairs. Then I go feed them. If I have to be woken up it’s good to know the culprit that woke me up is getting theirs for doing it.

Sometimes Maks (cat) plays with helium balloons. I got one for Valentine’s Day from the kids. The cat takes hold of the string and takes it around the house. When I had my first knee replaced he started bringing all the balloons to me at night. The record of overnight balloon commando maneuvers was 15. He grabs them by the bottom of the string and carries them into a bedroom. The balloon in the picture ended up in Kyle’s room all the way downstairs this time. I don’t know why he does it, but it is so funny.

Now that my Oxycodone, Ritalin and my other pain pill have kicked in I feel like a human. Now would be the time to take Bailey out, but she can’t wait this long.

My first night alone was good. My two youngest kids both called to make sure I was okay. I love them. Kyle reminded me to feed the cats, which I had already done. Yeah me! We’ll see how I do tonight.

What am I going to do today? I’m going to work on my writing projects. I’ve been neglecting them. Fortunately, using the computer isn’t impacted by my prematurely aging body. I wonder how my brain is doing. I do have some mental health issues, a whole bowl of alphabet soup full of them, but I don’t have any old people brain issues. I’m awesome!

And thus began day one of my new life living on my own.

Ew, now it’s my job to do the litter box. I hate that.

Bipolar – PENS & Oxycodone

I love pens. I really, really want to get one of those very expensive jobbies. I saw some in a gift boutique downtown Wednesday afternoon. They were 2013 models and at a bargain 50% off the normal $450 and $300. Oiy! Maybe not today. I’d love to get one for myself and one for my eldest daughter. We both love to write.

Writing can be a passionate thing. It is with me. Always with me I’m investing something of myself when I write whether it’s something blatantly obviously personal or if it’s something going on in my head that I want to talk about.

Right now I want to say something that I think is very important so sit up and read carefully. I’m putting this in terms of applying to myself so I know this from personal experience.

I have chronic pain. I have something wrong with my L4 and L5 disks, degenerative disks all the length of my spine, osteoarthritis, and fibromyalgia. I have a twice replaced right knee (replaced twice in two years, the first time it didn’t work) known as a TKR. I am 51 years old and I must say I do not appreciate needing to go to a pain management specialist and taking narcotics… every day.

I’ve been having what i can only label as nightmares now that I’m taking closer to the prescribed amount each day. (I also take Tramadol but that gives me migraines after a few days use). I don’t normally have nightmares. I was having trouble discerning reality fro dream when I would wake up in the morning.

Tonight I woke after another “nightmare” and remember something quite startling. When I was “incarcerated” in a facility to recover for my TKR the second time because my parents were moving and my kids wouldn’t be around to care for me giving me meds and such. It was a horrible experience. Besides generally feeling like I was incarcerated I was on Oxycodone at my maximum dosage every single time I could take it. The staff were only too happy to let me have it.

Unfortunately I had several nights in which I had terrifying and convincing hallucinations. It has taken me a long time to admit they didn’t really happen. Add to that, that I don’t remember my eldest daughter calling me daily from the MacDill Air Force base where she works as an air traffic controler. We live across the country from each other and that eats at my heart. We’ve always been close and the distance is difficult. But I don’t remember her calls and I know that bothers her. She took care of me during my first recovery and had to go through my even having two blood clots below my surgical knee. That was also a nightmare.

Last night and tonight I’ve been about at the level of Oxycodone that I was at in the rehabilitation center (read: nursing home) and I’ve started having hallucinations, not nightmares.

I suspect my use of pain medications is on the way down. We’ve tried a number of things and nothing seems to help.

I have an idea that I am sure will help. Ever hear of neuroplasticity? I’m sure you’ve heard of Luminosity, that’ s neuroplasticity. For me, this will mean using mindfulness to “remap” my brain and in doing so enable my actual brain structure to interpret pain differently. It won’t seem painful to me.  I guess I could put it like that without going into detail right now. I will soon though.

Neuroplasticity is becoming my key to dealing with my much of my troubles. Think of it, how awesome it will be to control my chronic pain, Bipolar, FM and OA… at least to a degree. Many advanced meditation practitioners are known to change their brains in a manner like the mindfulness I’ve mentioned.

Mindfulness. Neuroplasticity. How great to have the possibility of using these disciplines to help myself!

I’m not likely to be drug free… but I’ll get as far as I can.

I’ll talk about Mindfulness and Neuroplasticity in depth soon. They are very important disciplines that science backs up. I mean they are both proven scientifically to work in the areas I need. They impact many other things too.  After all, they are not confined to “topics” the brain considers. They do however, change the brain in ways we cannot comprehend considering the vast expanse, the last frontier as they say. At night I’ve taken to listening to Pandora. I searched and found a Mindfulness station to listen through the night. It’s playing right now. I finally decided to subscribe. Know why? The commercials were scaring me as I slept. Ew.

Watch your consumption of drugs like Oxycodone. You could have side affects you would think would anticipate.

Be cautious. Be ever vigilant.

Catch you later.I’m trying to stay awake for a while. Those hallucinations were getting very weird. Scary.

Robin

Bipolar on the Lawn

As it happens with so many “normal” events in life, I made certain that I was taking all my meds on time and the correct way during the week before and the days of… the nasty garage sale. I say nasty because we had maybe a dozen people stop by. Most of them bought something. Most spent about $2, which I’m thankful for. I think I have $270 more to save up before I can go see my eldest daughter in the Air Force over in Florida. I’ve not had a vacation in… um… I dunno. Doesn’t matter really. I want one really bad. I miss her and want to go see her. She’s having trouble swinging time to come home right now so it seems like it will be easier if one of us go to her. Me!!

I do wish the sale had actually SOLD more STUFF. Well, books mostly actually. Yes, like many other folks who dance the Bipolar dance I have my manic bits about me and inevitably one tenant of my mania tends to extend to …….. BOOKS. It has always been so hard to part with my books.

The weather today and yesterday was pretty perfect. So far this summer each time we tried to have the infamous sale either the weather thought it was in Washington (which it is, the state) or my other two kids were off doing things. There was no way in Liverpool that I was going to do this all myself.

So we get it all out there after I tolerate their not being able to wake up “hitting the ground running” and they’re enduring my lack of silence and immense energy. Yes. We are polar opposites. We annoy the heck out of each other. Since I talk the most I am the most likely to announce that I’m irritated that they seem dead for the first 3 hours they’re “up” on any given morning. Their faces silently curse me out. I know they’re thinking something like that. I know I would if I were they.

We got on each other’s nerves all morning. Till sometime around the 11 o’clock hour I think. I had a free mocha coming from one of the dozens of coffee shops, so I left them to their silence for 15 minutes while I went and got one. The pain meds I was going to have to take so I could work the garage sale would kick my butt soon after I took them. Best to have caffeine now and be prepared.  I picked up a blueberry muffin and had it warmed for Sydney, hoping it would cheer her sleeping psyche up. Nah. It’s her “time of the month”. Nothing is going to help a sleepy teenager when that second blow of the double whammy hits. Said it was good. Made her feel sick. Yeah.

To add to the excitement my service doggie in training, Bailey, who isn’t used to people coming and going so fast nor her humans being outside and her being inside all day. We closed the curtains and put the TV on a country music station and turned it up a bit. This way she couldn’t see us and hopefully, not hear us too much either. She calmed down pretty quickly. But indeed, she did need to come out to do her business. And then she took the opportunity to bark and whine and do somersaults and tie her leash around me and Kyle letting her trip me after hog tieing me.

Bailey has finally devoured every toy we’ve bought for her and even all the ones we’ve invented, like empty “Simply Lemonade” containers. They’re nice and sturdy and …. she eats them now. I used to put treats in them after she’d smashed them up good and stand them up in a group in the living room. She’d sit quietly by (after I told her to). Then I say, “Go!” and she’d leap into action. Oh all kinds of inventive ways to empty those treats out would then come forth. Let me tell you… she’s one smart cookie. I swear she’s ADHD just like me.

The kids’ grandmother on their father’s side came today and brought Bailey a new toy. Everything we’d tried the last few weeks has seen the inside of her stomach far too much for our liking so when she arrived with a potentially workable toy we were overjoyed.

At the time of this writing, Bailey and I are on the back deck. She’s going from one lawn chair to the other. Back and forth. Her toy tags along. It’s a rope with … I mean a ball with a rope toy going through the center. The ball is just hard enough for her to only pierce it a bit. The rope makes it easy to handle, sort of. That’s the fun of sitting in the camping folding chairs on the deck. She keeps bringing it up with her – and losing it as soon as her feet let go of their death grip on it. Yes, feet. How they use them like hands I’ll never know.

It’s all very funny.

We’re out here alone… nope. She’s gone in to eat. Anyway, reflecting over the day. Okay, maybe I’m just wanting to be outside a little longer and listen to all the strange birds and frogs. And airplanes. And cars. And rabbits.

Kyle torqued Sydney and I off by bugging out at 2 o’clock to go babysit my parents dog. Not puppy. Dog. This i find always annoys me. It’s usually when I need whatever child they steal from me when they snag them. Like today. A huge table full of books is still outside waiting for Kyle to come home (maybe around 9 o’clock) and cart them all in. Sydney’s knee and girl parts ran out of gas and into the pain danger zone and my back (degenerative disk disease from the top to the bottom) shot past said zone and into the “I’m going to throw up soon” level of pain. Yeah. Does wonders for my state of mind.

I started my day off making sure that I ate breakfast and took a chill pill before anyone else got up. And I took another one mid day. And another one when we came back in afterwards.

Sydney fell asleep on her bed wrapped in a pile of blankets hours ago. I’m finally able to rise from my ice chair with minimal pain levels (ice and pain meds make a nice kick) and I don’t want to puke now.

Bailey hasn’t stayed still in either of the two camping chairs nor the deck nor her very own large cardboard box for more than perhaps two minutes at a time thus far. I think two minutes might be generous. She’s finally left her new toy on the deck. She’s trying to keep her eyes open and listen to all the sounds around us. She’s fading. Me too. Been a long weekend.

I met my goal of not losing my mind and hollering at the kids. Yeeeaaahhhh!!! Ah, but now I’m slapping bugs. Time to go in. Oh man. Bailey just settled down in a chair next to me and is asle… nope. She’s just pretending to be asleep. Oh little bark. Sydney just popped her head out and startled Bailey. Time to go in. I think a bug went down my shirt. Little bugger. Now that, will piss me off.

Thanks for the meds doc. I’m feeling better.

Drop me a line! I answer all msgs. Let’s kick things around a bit.

And… Tell your friends!

Robin

Bipolar 1, ADHD, FM, PTSD, Anxiety, Chronic Pain, OA – Now What??

If I’d started my blog off listing all my bits of my alphabet you might have clicked off and dismissed me as a hypochondriac. Personally, I might have too. However, the fun facts pile continuously up and I wonder if I might be much older than my drivers license says I am.

I’m 51 degrees old. Wait. 51 years old. Yes, that’s it. I think it’s time I leveled with you and give you my “medical” life. I am much more than my medical stuff. I’ve had my right knee replaced twice – in just two years. I know, that’s very young to even have it done once, but twice on the same knee… Skip that. Here’s a “brief” list. Each item is a medically real thing for me.

Bipolar 1
ADHD
FM
PTSD
Anxiety
Chronic Pain
Degenerative Disk Disorder
OA
2 Total Knee Replacements
Cataracts
Allergies – environmental, biological and food
Depression
Manic
Stress – Excessive
Obsess
Asthma
Dentures – Full

I’ve also had a ruptured appendix, broken ankle, blood clots, carpal tunnel syndrome, rage… I think you get the idea.

Over the last couple of months I’ve thought I’ve been falling asleep while driving. It freaks the freak out of me. No matter what I do I don’t seem able to prevent it. I even pull over and try to nap just so I can complete a 40 minute drive home. I’m not able to nap when I pull off the road. I try. No go. I can sleep in a parking lot when I’m too tired to drive, but it’s not working now. I sing, I scream, I pound my feet on the floor, I hit my steering wheel… Nothing helps.

It’s very scary. No, it terrifies me. Suddenly I’m about to rear end another car or find myself drifting to one side or the other. I’ve been asking my health care people what it could be. I eventually got around to my pain management specialist. I described it to her and asked if she thought it might be any of my many medications. Like my med provider, she didn’t think so. She wanted to know if I was born prematurely. Nope. Seizures? Nada.

Michelle, the pain specialist, asked if I could describe what happens as a “loss of time”. Maybe I’m not really falling asleep. Maybe I’m just losing time and tune back in just seconds later. Do I remember actually falling asleep or feeling sleepy. No. I’ve even tried coming home and trying to sleep. Not sleepy. No naps.

She sent me home charging me with looking into Absence Seizures. She knows I love to research stuff. I appreciate that she lets me learn and talk with her about my health care. I have read a bit about Absence Seizures. I think she might be right. Before I left she agreed she would get me in to see a neurologist she likes to use in a city about an hour from here. I’m going to have an EEG to see what’s going on.

New bipolar med on Wednesday… Friday a possible new diagnosis to add to my alphabet soup. Know what I keep thinking?

… Well shit.