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Follow Up

July 19, 2018

Well, I got the news this morning that I wasn’t looking forward to: I have to stay on the higher Zyprexa dose for the foreseeable future. Dr. Goodenough is even faster at returning phone calls than Dr. Awesomesauce was; I called the office to leave a message on how I was doing at 0935, and he was on the phone by 0955. I continue to be impressed by how responsive he is. However, I was not thrilled about the terminology he used to describe my problem, e.g., he called it “rapid cycling”. I don’t want to be one of those patients who rapid-cycle. But with all the flipping in and out of hypomania these past four months, I don’t know what else he’s supposed to call it. I guess I hadn’t thought of it that way.

I’m also not thrilled about staying on the 7.5 mg, even though it obviously works because I’ve been sleeping like a baby for the past week and am settling down nicely. It’s just that I’m going through one of those phases where my brain has betrayed me again and I’ve had it up to my ass with this stupid illness, and it wants me to do something that’s totally against my best interests. I want to DECREASE meds, dammit, but it’s not going to happen.

I posted a little whine to this effect on Facebook, whereupon a number of my friends brought it to my attention that my behavior is following a pattern they are all too familiar with, seeing as how (as one put it) I go through these episodes two or three times every year. They want to know why I wish to be on less medication since I tend to decompensate when my needs change. They also want to know why I seem to see it as a failure on my part when something quits working well and I need more medication, not less.

I had to think about that one.

In fact, I’m still thinking about it. This is why it’s good for people to have friends and loved ones who can see clearly and ask the hard questions. Why DO I see it as a personal failure when my brain shits the bed and the antipsychotic dose goes up? As my constant  readers know, it’s long been an issue for me that I need to be on more than one of those drugs…it’s like I’m stigmatizing myself. I keep thinking that I should be like a lot of bipolar patients who manage the condition on a mood stabilizer, an antidepressant and one AP.

And I guess on some level, I’m still in a bit of denial. It’s been two years since I’ve needed a med increase, and it’s been relatively easy to forget how serious bipolar 1 can be. Even though these recent dalliances with (hypo)mania have been minor, they remind me that I have a dangerous illness which can flare out of control at any time, and the only things standing between me and disaster are these fistfuls of sanity. I don’t mind taking the extra dose so much as I mind what it stands for—the fact that without heavy-duty psych meds, I would probably be a hot mess. Or worse.

It’s been so easy during the stable times to become complacent. It happens to a lot of bipolar people, even though we almost always get slapped upside the head by reality. I take some comfort in the fact that I am far from being the only one to fall victim to this kind of stinkin’ thinkin’. There are many, many tales of unfortunates who, believing they’re cured, stop taking some or all of their meds; or who (like me) get enough relief  that they think they really aren’t that bad off, and can act like so-called “normal” people who can stay out late or be up all night watching TV and playing on the computer.

In the meantime, I’ll just keep taking the pills in the doses prescribed for me and try not to look at the situation as a reason to beat myself up. I was raised in a family where mental illness either didn’t exist or was the patient’s fault, and it’s hard to get past that. I guess I’ll have to do a better job of it.

 

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Been A Long Time Gone

July 17, 2018

Well, I got through it—the second anniversary of my husband’s death. I don’t know why, but it feels in some ways like I’ve lived the longer part of my life since he’s been gone. So much has happened, so many things to learn about myself and my place in this world. I’m still working on that one; I’m still not sure where I belong in life, but I think that’s par for the course for someone who’s only been widowed for a couple of years. I’m not too worried about it though, because I think this exactly is where I’m supposed to be at this stage.

Naturally, I’ve been thinking about Will a lot. I was listening to the classic country station on cable one night when our wedding song came on; but instead of crying, I felt a sweet sensation wash over me, and I could almost sense his presence in the room. I imagined myself caressing his handsome face and running my fingers through his thick hair. I remembered his smell, a slightly musky scent with a generous splash of Old Spice. I saw once again his big hands with their work-roughened palms and gnarled veins that I used to joke about trying to get an IV in. I thought of us, newlyweds at ages 29 and 21, and how we had NO idea of what life was going to be like as a married couple. We didn’t know that one day we’d have children and jobs and money troubles. We couldn’t foresee that I would go on to develop the mental illness that cost us so much in the long run. And we never imagined that three and a half decades later we’d have to say good-bye, long before either of us was ready.

All of which served to remind me of how much I’ve lost and how much I miss him. The night of July 12th was the worst; it was the night he suffered so terribly and it took what seemed like an eternity to get him the pain relief he needed so desperately. I will never forget his screams or the question which had no answer: “Why do I have to suffer like this?” As a medical professional, I have the technical knowledge to understand that one or more of his tumors probably exploded that night, causing massive internal bleeding and the agony that turned him inside out, but as a loving wife it doesn’t comfort me much. I still wonder sometimes if there was something more we could have done for him at home…but in my heart of hearts, I know that battle was over before it began.

In a few ways, reliving it makes it seem like it happened only last week. But I’ve gotten used to Will not being here, and it feels—shall I say it?—normal. I’m used to making my own coffee in the morning, although my son Ethan made it for me on a couple of recent occasions. I’m used to looking over at Will’s chair and not seeing him there in his bright orange T-shirt and blue plaid pajama pants (usually with a puppy or two). His voice, alas, is fading from my memory, although I can still recall his cackling when something really funny happened. I haven’t even watched Pawn Stars since he passed, and we used to watch it almost every day. I wonder if he’s run into The Old Man yet.

So I got through the 12th and the 13th, feeling anxious and tearful but not depressed, and now I’m OK again. Those days will always be difficult, but I’ve accepted that. I went out and had a great weekend celebrating Ethan’s 27th birthday, and today everything is business as usual. I’ve been sleeping well (more on that in the next post), I’m smiling and laughing, and life is being kind for the most part.

I think this is what healing looks like.

 

 

 

Going The Wrong Way

July 12, 2018

And to think I was going to ask if I could lower some of my meds…

I’m still having trouble with sleep. I don’t think I’m acting out much (although I have been spending too much money lately and can’t account for it), but I have to admit I feel a little fragile from the frequent nights of little or no shut-eye. I’m not tired in the mornings after being up until dawn, which is ironic considering that on the nights when I do get good sleep, I feel like a slug the next day. In fact, this morning I popped right out of bed three hours after my brain finally shut up long enough for me to drift into slumber, and went to my appointment with Dr. Goodenough.

I had the feeling he was going to propose an increase in one of my antipsychotics, and that’s exactly what he did. He is still concerned about hypomania even though I don’t think I’m in it right now. I was doing all right during questioning until he asked about racing thoughts and money. Oh, shit. I have admittedly spent a not insignificant amount of time dealing with hypo in one manifestation or another since mid-March, but I thought I had a handle on it. It’s like pinching a balloon or trying to contain a generous booty in a girdle…no matter where you squeeze, it’s gonna come out somewhere else. The spending is just the latest thing. I’m not kidding: I’m broke and it’s still a week till payday. I’m NEVER completely broke, or at least I wasn’t until recently. But there’s about two or three hundred bucks gone this month that I can’t explain, and my credit card balance is going up too. What the hell??

So to nip this in the bud and especially to promote sleep, Dr. G decided to bump up my Zyprexa dose from 5 mg to 7.5 mg. Not a huge increase, and (hopefully) it’s only for a week, unless it proves successful and I have to stay on it for the rest of the summer. I didn’t want to raise the Zyprexa. I want to be on fewer meds and smaller doses, and I’ve been thinking for a while that I would ask to at least come down on some of them. But I seem to be headed the wrong way. I was even going four months in between doctor appointments, and now I’m back to monthly again. Not that I mind seeing him, I just mind what more frequent visits and med adjustments stand for.

I hope this does the job and I don’t have to stay on the higher dose. I’m worried about weight gain, and Zyprexa is notorious in that department. I wondered aloud why we couldn’t increase the Trazodone (sleep med that does absolutely nothing), but he reminded me that it’s actually an antidepressant and could throw me into mania if I were to take more of it than I do now. Well, duh—I should’ve known that. Sometimes I wonder where the hell my nurse brain went. I used to be a walking encyclopedia of pharmaceuticals; now I can’t even remember that basic information. I have to call next Wednesday to report on how the med change is affecting me, which is going to be difficult because I HATE calling psychiatrists. Dr. Awesomesauce used to complain about this a lot because I always waited until I was desperately ill to call him. I guess I’ll just have to do better about that. Besides, with any luck I’ll be back to my normal Zyprexa dose in a week.

In the meantime, I just took the extra Zyprexa and I’m starting to get sleepy. I haven’t slept worth a crap in several nights…let this be the night that it all changes.

Thanks, Doc. I think.

O Sleep, Wherefore Art Thou?

June 30, 2018

It’s a little after 6 in the morning, and I’m wide awake writing this. Why? Because I can’t sleep. Again. I’ve been up all night, and I couldn’t even sneak in a couple of hours this morning. I tried going to bed around 4, but only lay awake with my eyes open, staring stupidly at the ceiling. My thoughts are racing; there’s too much going on in my head all at once and I can’t seem to shut it off. Just another day in paradise, right?

Now, I’ve finally recognized this for what it is: a manic sleeping pattern. It’s been quite a while since I’ve experienced it, so it took me awhile to figure it out. I don’t know why, because I’m certainly not manic. The meds are still working, so why the hell I can’t sleep some nights is a mystery. On other nights, I’m ready to go to sleep by midnight or 1 AM and I’m in bed till 9 or 10. The night before last, I went to bed at 2:30 and didn’t get up until noon. Then I have a night like this one, when I was so wired that I literally could not close my eyes. And I’m not the least bit tired.

I’ve been told I should shut down the electronics and bore myself to sleep. It’s just that it’s light so late in the evening that I don’t wind down until long after the sun sets, regardless of whether I cut myself off or not. As I’ve said before, my circadian rhythm is different from most people’s; left to my own devices, I usually go to bed around 2 and wake up at 10. But this sleeplessness happening several times a week is new. I can usually squeeze out a few hours between 4 and 8, but there have been a couple of occasions recently when I didn’t sleep at all. In fact, there was one 72-hour stretch about a week ago when I got about 10 hours’ sleep altogether. I followed that with 10 hours in one night. I literally fell asleep on the couch and gave myself a nice crick in my neck in the bargain.

So last night I had the TV on low, on a station where this preacher comes on at 4 AM and goes until 6. He usually bores me silly and I fall asleep to the sound of his droning, but this time he was putting forth some ideas that I, with my Catholic sensitivities, thought were rather dangerous. It made me think, though, and that was it for the night; I gave up at 5:45 and got up to make myself some coffee. Shelley joined me about 45 minutes later. We’ve got a picnic to go to this afternoon, so there won’t be much of a chance to sneak in a nap, as if I could do so after meeting a bunch of new people. That tends to overstimulate me, but I’m actually looking forward to it. I want to go places and do all the things.

Ah, well. I have the feeling that I’ll make up for lost sleep in the winter. I’m such a slug in the cold months. That’s why I love summer so much—I feel alive! The roses in our yard are in full bloom and so colorful that they almost hurt the eyes; it’s so good to feel the sun on my face and the breeze in my hair; even the air smells wonderful! Today is bright and the skies are blue, and I don’t mind being awake so early as long as I get to drink coffee and look out upon the vividly green trees while listening to classic country music.

Speaking of which: do you know what happens when you play a country song backwards? You get out of jail, you get your wife back, you get your truck back…

 

A Penny For My Thoughts

June 20, 2018

Here’s some of the crazy shit that goes on in my head on a night like last night, when I went to bed at 3:30 AM and didn’t fall asleep till after 5:

“Why do they show these revival meetings on TV at this hour of the day? Some pretty fine preaching going on there. Did I lock the front door? <insert lyrics to country song here>. I wonder what I’m going to eat tomorrow night when they’re having curry chicken again. I hate curry. I don’t know what I’m going to write in my blog next…I need to make a post soon because I’m only averaging 10 page views a day. It’s really warm in here. Is that a spider on the ceiling??

“I hate it that children are being taken from their parents at the border. (I’m politically conservative but I’m outraged at what my countrymen are doing right now.) I’m hungry but it’s too late to eat. Or maybe it’s too early. I don’t know which. <insert lyrics to another country song here>. Brain, why don’t you shut the f##k up so I can go to sleep? I’d better try harder because Dr. Goodenough is going to increase my Zyprexa if I don’t start sleeping better. I wonder how I’m going to get through this next month money-wise. I only made it with $17 to spare this time. Oh good, Law and Order is on all day tomorrow.

“I want one of those crescent rolls left over from dinner. Which reminds me, I need to buy groceries. That black thing on the ceiling just moved!! Where’s the Raid when I need it? Uh-oh, I forgot to mail that check to the Department of Revenue yesterday. Why am I so uncomfortable in this bed tonight? <insert lyrics to classic rock song here>. Oh yeah, I don’t sleep in a bed, I sleep in a recliner. Haven’t slept in a bed in years. I’ve got to get up at seven to get my hair done. Where did I put my phone? Oh look, it’s the infomercial with Jane Seymour again. They run this thing almost every night. It’s not normal for a 66-year-old to look like she does.

“Gosh, it’s 4:30 and already getting light out. I love these loooooong days. I sure hope I can get at least a couple hours’ sleep. I need to start taking vitamins. It’s only 72 days till our cruise. <insert “99 Bottles of Beer On the Wall” here>. I wonder who’s doing the homily at Mass this week, I like it when Father Edwin does it. He really gets into it. Where IS my phone, anyway?? I must’ve left it out in the living room again. Oh well.

“OK, I’m only going to go to sleep if I shut my eyes. I wish I didn’t have to have the TV on at night but I need it for company. I listened to my wedding song today and I didn’t cry, yay me! OMG, where did that black thing go!?”

So goes my fevered brain at the ungodly hours between the time I finally go to bed and the time I get up. Funny thing is, I’m not tired in the morning when I don’t sleep well at night. It’s worse when I sleep eight or nine hours; in fact, I drag myself through the day and usually need a nap in the afternoon. The dishes don’t get done and I feel guilty because it’s about the only thing I do around here besides keep my room picked up and (very) rarely clean the bathroom. I don’t cook often because we’re supposed to be eating sort of healthy and I don’t know how to cook healthy—I fry or roast everything in oil or butter. Mmm, speaking of food, I love fried stuff. If I could give that up, I’d probably start losing weight again. Ethan and Clark do a nice job of fixing good food. But every time we go out to eat, I end up eating fried fish & chips or a burger.

Well, this isn’t the entry I’d intended to post, but lunch is calling me. I went to bed hungry and didn’t eat breakfast, which is normal for me. I don’t see the point of eating at night. A peanut butter sandwich sounds good about now…I need protein and relatively low-carb.

And so it goes.

True Confessions

June 10, 2018

Well, I did it again—talked Dr. Goodenough’s ear off and confessed to all sorts of things I had no intention of disclosing. I told him how I’ve been flipping in and out of what I call pre-hypomania all spring, wanting to drink, sleeping poorly, and messing with my meds. I also had trouble sitting still while I was talking to him, and that combined with bright clothing and sparkling eyes (I’d just gotten my hair highlighted, and even I could see it in the selfie I took to show off my new ‘do on Facebook) led him to decide I was, indeed, a little hypomanic. I managed to talk him out of increasing my Zyprexa, but he did up my thyroid medication in the hope of getting things back under good control and advised me to try the amber glasses we’d talked about a few months back. And my days of going four months between appointments are over for the time being, now it’s back to monthly.

As I think I’ve said before, I don’t know what it is about this doctor that makes me spill my guts every time we meet. Maybe it’s because we have only 30-minute appointments, even though there’s rarely much ground to cover in that time. My life is pretty boring most of the time. The notable exception was our last session, when my nephew had just passed away and I was experiencing a lot of anxiety. That’s gone now, but this spring has been really weird and I have energy I can’t seem to channel in any meaningful way. I’m still sitting on the sofa in front of the computer day in and day out, the only outward sign that anything is amiss being my wiggling feet and the constant posting on FB, Psych Central, and my nursing forum at all hours. Speaking of which, my sleep is still messed up. Some nights I sleep nine hours, on others I’m lucky to get two or three, and when that happens I don’t miss the shut-eye and I’m not tired in the morning.

And I’m taking my meds. It’s difficult because I REALLY would like to come off some of them, but given the circumstances that’s probably not in the cards. The first thing Dr. G mentioned when I stopped talking long enough to take a breath was the possibility of bumping up the Zyprexa, which is the last thing I want. He thinks raising my Synthroid dose may take care of things so we don’t have to do that. That’s an interesting concept which I don’t totally understand, but I’m reasonably sure the medication kept me out of depression all last winter and I’m only too glad to take it for that reason. I didn’t even have to use my HappyLight.

Now it’s three days later and I do feel a little calmer on the inside. Of course, it could be another short-lived cycle and the next warm, sunny day or poor night’s sleep may start it up again. Dr. G is well aware that I’m highly sensitive to light and seasonal changes, hence the recommendation for the amber glasses. I’ve had trouble finding clip-ons; the regular ones don’t fit over my regular lenses and I refuse to go from 6 PM till bedtime not being able to see the TV or computer. But just like his predecessor, Dr. Awesomesauce, he has a solution to almost every problem, and he found some on eBay for only $35. So I’ll order a pair and see what happens. I’ve got a vacation coming up at the end of the summer, which is another dangerous time of year for me, and I really don’t need to be going ape shit on the cruise ship. (Ya think??)

In the meantime, he is not telling me to go to bed and get up earlier. I appreciate that, because I’ve never been and will never be a morning person. I can get up if there’s a reason to, like for hair appointments and church, but my usual pattern is sleeping from around 2 to 10 AM and there’s no reason on earth to change it. I’ll modify it a bit when I need to adapt my sleep hours to Eastern time, which I’ve done before with positive results.

Speaking of having to get up in the morning, I have jury duty next Thursday. I didn’t have the option of getting out of it this time, so I’m stuck going in at 8. I could have gotten out of it if I’d given the court a letter from Dr. G saying I have a mental illness and can’t serve, but unlike the last time I was called and I was really unstable, I think I could do it. They’ll probably ask that question during the interview process anyway and I’ll be dismissed, but at least I’ll have showed up and I won’t be summoned again for another couple of years.

That’s my story, and I’m sticking to it. Have a great weekend!

 

 

 

The Eyes Have It

June 2, 2018

One of the funny/strange things about bipolar disorder is the way people’s eyes change when they’re in a mood episode.

Seriously. I can always tell when I’m manic, even when I don’t think so otherwise, because my eyes actually sparkle and change colors. My hazel irises turn green and there’s this slightly mad look in them that tends to make others wonder just what I might be up to. My eyes also widen and the pupils dilate; friends call this phenomenon “psycho eyes”. If you’ve ever seen the Vraylar commercials on TV, they show a woman whose eyes do pretty much the same thing, which is about the only realistic part of the ad (come on, when you’re really manic you don’t even know where the sticky notes are, let alone have them lined up neatly on your office window).

Eyes also tend to change when you’re depressed, although not as dramatically. Mine will darken and take on a sad, dispirited look that gives me away even when I tell people “I’m fine”. My parents told me my face was way too easy to read, which is something I’ve spent a lifetime unsuccessfully trying to overcome because I was often punished for letting my emotions show. It’s tough facing the world sometimes when you know anyone with the emotional IQ of a seventh-grader can tell that something’s wrong.

My youngest son, Ethan, could assess my feelings even when he was three years old. I remember one evening in particular when I was putting him to bed, and he began asking me questions. “Mom, are you sad? Mom, are you mad?” he inquired, obviously concerned about me. At the time I didn’t think I was either, but sometimes my resting bitch face causes people to assume I’m upset and trying to hide it. Rather than try to explain my apparent funk, I told him I had a headache, and he said “You need an aspirin!” His ability to ‘diagnose’ problems has also served him well in his nursing career so far. LOL.

But it’s the mania that really brings out the crazy in my peepers. I have been told at various times that they almost glitter, and that it’s kind of frightening for the people who know me well. Others mistakenly believe I’m just super happy, and for the most part I’m content to let them think that. Believe it or not, I have a few friends who have NO idea whatsoever that I’m bipolar and I’m not about to let that cat out of the bag. They all came from a time when mental illness was something to be ashamed of and thus wasn’t often talked about, so I simply let them think I’m perfectly normal…and if by chance someone remarks about my wide-open, sparkly eyes, I only tell them I’m having a really good day.

Julie A. Fast, a well-known bipolar expert who herself suffers from bipolar 2, has actually posted pictures of herself in both mania and depression in BP Magazine, and it’s very easy to tell which mood state she’s in. I’ll do the same here one day if I can ever think to take photos when I’m one way or the other.

Speaking of moods, I seem to have returned to baseline for the most part…just in time to see Dr. Goodenough this coming Wednesday. I will, of course, have to fill him in on how I’ve been flipping in and out of hypomania this spring, and he may not be very thrilled with me given his repeated requests that I call in to report any deviation from stable and I haven’t done it. I will also have to tell him about my screwy sleep patterns; I sleep nine or 10 hours some nights, and two or three hours on others. Wednesday night I didn’t sleep at all, and last Friday I was up for 36 hours straight. And I wasn’t even tired. That’s never a good sign. So it’s probably going to mean an increase in meds, and not a decrease like I would have liked. We shall see.