Lost It, Again

I lost it in the office at the psych's. Completely, utterly broke down. Shaking, sobbing. I think I used half his tissue box. I couldn't stop. And he just sat there and let me cry, which made me feel stupid and dumb and broken. I admitted I hadn't been med compliant and that I couldn't keep up with the hydration on the Lithium to offset the side effects. And when he suggested Abilify, I had to shoot that down because I'd been on it and gained 50lbs. And that's when my last psychiatrist suggested bariatric surgery rather than meds. What the fuck?

So I'm out in the parking lot outside the office, calling Jb, because I suddenly realize what day it is and that he's not getting paid 'til next Friday, and I blew all our foodstamps on food for, like, 4-5 days and a bunch of crap, and we've a whole other week we need groceries for. So I fucked up. And I'm bawling on the phone to him about that. And I can't stop. I can't stop crying. Up and down, up and down, up and down. Fucking roller coaster, and I want off. But no, the psych says, "That seems to be symptomatic of your illness." So it's official: I'm a rapid cycler.

Anway, prescription changes: off the Lithium. Still on the Lamictal and Klonopin. Wellbutrin is now gone. Zoloft has been up from 50 to 100MG.

Psych Check-In

I haven't felt like writing here much. I had a good bout of depression going last week. Slept until 2:30 one day, got up for a few, then went back to sleep until Jb came home. Couple fights put me so low that I was thinking about the hospital and suicide again. It passed, though, which is good. I did make up an excuse to not see my therapist last Friday. Jb'll have a fit when he reads this, as I told him I was sick, which I was, just not in a way he could understand. Or so I felt.

There's other little things. I haven't cooked in a week or so. Haven't made a grocery list yet for this two weeks. Haven't done dishes in a week. Let the apartment go to hell. Jb helped me clean up this weekend (i.e. Jb mostly cleaned up. I've yet to do the dishes). On a side note, I did apply for unemployment today, and we'll see how that goes given the obnoxiously ridiculous situation that was my work's request for a voluntary resignation and then an unpaid LOA without any documentation whatsoever. I finally just quit, and I'll probably have to explain that.

Did see the psych, or rather, the nurse practitioner, who I like better anyway. She still considers me unstable and has put me on yet another medication, Zoloft. So that's what? Five psych drugs. You've got to be kidding me. I'm really unhappy with this. I'm almost to the point where I'm ready to throw up my hands, throw out all the fucking meds, and just try to work through things with this therapist, who I'm liking quite a bit. I mean, seriously, five fucking meds:

Remeron 30 MG 1x a day (Sedative/Anti-depressant)
Lamictal 150 MG 2x a day (300 MG total) (Mood Stabilizer)
Klonopin 1MG 3x a day (Anti-Anxiety)
Wellbutrin XL 300 MG 1x a day (Anti-depressant)
Zoloft 50 MG 1x a day (Anti-depressant)

Plus the Benicar, the Levsin, and the Protonix that I'm always on for hypertension and IBS. I honestly need a pill organizer at this point. A quarter of the time, I forget to take my meds. Maybe not so much. But I'm not daily compliant. I don't remember until too late in the morning, or I totally forget at night. Maybe an organizer would help. I don't know.

Feeling increasingly frustrated.

Here's The Thing

Complete and utter breakdown in the middle of a movie that triggered me, right? Today? Zilch. Some anxiety about going to the class on being your own defendant for a bankruptcy suit, which would probably cause quite a few people anxiety, but otherwise, nada. Course, the extra dose of Klonopin could be helping with that. As soon as I feel The Nerves coming on, I pop my mid-day pill. It seems to work quick enough, or so my mind thinks.

But some days, like today, I'm still amazed at all the fuss, the taking of pills, the two sessions a week of therapy. I feel -- really feel -- that I could handle this on my own if I'd only pull myself up by the boot straps and be brave. And get this, of all the things I remember today when writing about this, I remember a random Dolly Parton song I caught while changing channels past CMT:

"A girlfriend came to my house
Started cryin' on my shoulder Sunday evening
She was spinnin' such a sad tale
I could not believe the yarn that she was weavin'
So negative the words she had to say
I said if I had a violin I'd play."

And that's why we have therapists. Because I mean, truly, who wants to listen to such a person. Waiter, pity party for one please, with some cheese and whine to go with it. I'd certainly rather belong to Our Lady of Piss and Vinegar and show a little more backbone. Sometimes I wonder how much of the mental illness is what impairs me and how much of it is my grief over the diagnosis. In time, the mental illness I can manage, and God knows, I'll get over the grief.

Disintegrating Oral Tablets, Redux

On third try, the disintegrating oral Klonopin tablets don't get any better. There's the issue with the blister pack. The damn peel back corner does not open the whole blister pack. It has this annoying tendency to rip off a tiny strip and only just to the edge of the depression where the tablet sits. Thus, you're forced to find some other damn way to get it open. I found out the hard way that disintegrating tablets are, apparently, more fragile than regular tablets when the tablet disintegrated in its depression while I was trying to get the thing open. It's all fun and games until you have to tilt the stupid blister pack upside down to try to get the crushed bits of tablet onto your tongue.

And then there's the thing about it supposedly disintegrating within a few seconds. Nuh unh. It won't disintegrate at all if I don't sort of rub it against the roof of my mouth. Then it turns mealy and sits there on your tongue. I'm not really sure if you let it sit there. It doesn't seem to disintegrate, unless whatever's needed to be released has been absorbed by your tongue and you're left to swallow the binding agent. Either way, it's oogey. And that's a scientific term.

Klonopin Disintegrating Tablets

For some unknown reason, the last time they filled my Klonopin description, I got orally disintegrating tablets instead of my usual tablets. Let me just say this: (1) they do not disintegrate in a couple seconds and (2) the tastes lingers like no one's business. I would not recommend these. Ever.

8:10 a.m. Meds Check

Saw the psych doctor on Monday, the day after the move. Told the psych nurse practitioner that I had been feeling depressed, wishing I were back in the hospital, thinking bad thoughts, but not to the point of having a plan. Just the beginnings of them. I was crying more, acting out and difficult to handle, and not interested in much, despite the obvious need to pack and move. I told her that I know change is a trigger for me, and that I usually go depressed afterward. I'm still sleeping a ton. So she tweaked my meds and actually put me on an antidepressant along with the sleep aid and mood stabilizer. Why I wasn't on one before this, I've no idea. There was also talk of raising my Lamictal because of the anger and irritability, but we never settled on a dosage.

Here's my new list of psych meds:
Wellbutrin XL 150 MG 1x a day (antidepressant)
Lamictal 100 MG 2x a day (mood stabilizer)
Remeron 30 MG 1x a day (sleep aid/sort of an antidepressant; up from 15 MG)
Klonopin 1 MG 2x a day (anti-anxiety)

Other meds:
Benicar HCT 40/25 MG 1x a day (blood pressure)
Protonix 40 MG 1x a day, as needed (gastro-intestinal pain)
Levsinex .375 TIMECP 2x a day (abdominal pain/IBS symptoms)

Add to that the 2 Tylenol or Ibuprofen I've been taking for my left knee (osteo-arthritis is acting up with all the rain and change of seasons), and I'm starting to feel like I need a day-of-the week pill box with separate day and night chambers. Not to mention that you'd think someone with Bipolar, IBS, GERDS, lymphadema, and osteo-arthritis could get a response on her medical assistance application from the county. It does hurt the morale.

12:01 p.m. Pharmacies, Insurance, & Copayments, Oh My!

Thwarted at the pharmacy. I swear. Took a bus all the way out to the hospital, and I could only get the Lamictal filled. Luckily, it was the one I was completely out of. Since I seem to have dropped off prescriptions elsewhere, insurance won't pay for them until June 13th. Nevermind that my prescription has changed. But I've enough Remeron and Klonopin to last me a couple days more. I checked out my receipt for my Lamictal and about went into sticker shock. $20 with insurance. Without? $276. My god! I need to look up one of those free prescription programs my nurse practitioner (PCP) told me about. (This is when I seriously consider moving to Canada.) Health Insurance will certainly be a big influence on who gets my vote, that's for sure.

On another note, side effects today. I was falling asleep on the bus and in the pharmacy waiting room. And walking was this odd sort of seasick weave out to the bus stop and down the halls. My feet kept wanting to go in front of each other, and my body kept wanting to gravitate toward the nearest wall. It's a strange sort of gravity, this dizziness thing. And I feel weak, unable to really get to work and start cleaning the kitchen and the bathroom, both of which need it. I was also planning on making this Creamy Sausage Casserole with Biscuits, but that might be overkill for today. I hate having to conserve and space out my energy. I understand how, even when a patient might be feeling better, that person might still be unable to work. I do believe it'd be frowned upon if someone was found, head on their keyboard, at work. Not to mention the walking like you're drunk. Stellar review, I'm sure.

By the by, I love my nurse practitioner. She gave me two months worth of samples of Benicar so I wouldn't have to pay for them because she knew I'd lost my job. Psychiatrists, on the other hand, are stingy bastards I'm finding, and look at you like you're a junky if you ask for samples. Given the fact that they're the ones prescribing the medicine, it just makes me wanna slap 'em.

7:36 a.m. Early Mornin' Check-In

Was up around 5ish this morning, then again at 7ish when I heard Jb getting ready for work. Took meds with a Barq's, and here's the fascinating thing about Barq's (yes, yes: we all know "it has bite"): it also has caffeine, unlike almost every other brand of root beer out there. So I've a 12-pack of the stuff, and my stomach is not a happy camper (TM). Caffeine exacerbates the IBS, which is always fun, and feeling sick to my stomach, literally, does nothing for my mood.

Note to self: No vivid dreams of late. Or, at least, none I remember. I'd like to say there was something just on the edge of memory when I woke up this morning, but it's long gone now.

7:06 Meds, Check

2 Lamictal, 1 Klonopin, and 1 Seagrams Ginger Ale (Note: Caffeine Free). Went to bed at 1:30 a.m. Maybe more like 2 a.m. I resent the way Jb rolls over and is out like a light and snoring within a minute of deciding he's tired while I lie there, thoughts random and a mess. Forecast for staying up? Slim to none. Maybe. If I dreamed, I remember nothing. Haven't in days. May be starting a downward trend. Too early to tell, but spent parts of yesterday and the day before morose and in a general funk. Emotionally sensitive. The regular symptoms. Could it be the lower dose of Remeron -- an antidepressant -- finally leaving my system? Unsure. Maybe going down 15MG was a bad idea.

7:01 a.m. Spoonful of Sugar

So, up at 7. Taking my meds with a 7 Layer Bar from the batch I made yesterday, which, apparently, Jb doesn't like. He's more a brownie/cookie man. Ah well, more for me, I say. Being good about taking my Lamictal and Klonopin. We'll see if I crawl back into bed this morning or not. Too tired now to be coherent. More to say later.

6:03 a.m. Compliant

Up at 6 this morning. Having my breakfast, which I don't want, and taking my 200MG of Lamictal and 1MG of Klonopin. My neck muscles and shoulder muscles and most of my other muscles are sore, like they've taken a good beating. I've read this can be a side effect. My eyes are also bloodshot, which is new, and somewhat disturbing. If I had any dreams last night, I don't remember them. Too tired to say much else.

11:02 a.m. Stupid, Stupid

Stupid, stupid me. I didn't take my Lamictal or Klonopin this morning. I wonder if it's too late to now. I wonder if I forgot to yesterday, too. I'm not used to taking anything in the morning. And I wonder if this has anything to do with the tireds. I think I took my Lamictal last night without thinking and wonder if it's worth taking two this morning or waiting now.

And speaking of stupid, my morning dreams are coming back to me now. I'm in a college dorm and Jb and B, an old co-worker of mine, are stripping naked and jumping out the window to a snow-covered ledge below to... flaunt their nakedness? I've honestly no idea. It's clear they think it's a good idea, despite the snow. There is some public security officer talk out on the roof, and a little defiance, but eventually, they come back upstairs. I, of course, am only afraid of getting into trouble and don't see the humor in the whole thing. This is typical of me. Everything must be just right, I must be just right, I must not get into trouble, I must keep the status quo, I must be perfect.

Because deep inside I know how truly imperfect I am.

Later in the dream, I'm frying my uncle Frank a salmon sandwich, except the salmon curls up into grey little elephants that talk to each other in the pan, and I'm wondering how I'm going to be able to serve this on a sandwich, and they're certainly not big enough for two sandwiches.

Strange take on the usual pink elephant dream, especially considering I was completely sober this morning. Unless a lack of meds can simulate such things.

11:58 a.m.Perky!

Didn't wake up until 11 a.m. I could have woken up earlier, but I was having this delicious dream that involved some sort of family business rivalry, and perfume, and sex and seduction. I kept trying to fall asleep and recapture it because my dreams are so vivid right now, but I couldn't. And finally, a lady from 1-800-THERAPIST called me back and woke me up. We talked for a few minutes and she gave me some numbers for a few places with sliding scale fees, medication management, and support groups. The support group is every other Thursday, but downtown. I'm not quite sure how I feel about a support group at the moment, but it's a good resource to know about.

And here's the reason I'm unsure about a support group: I feel perky! I feel awake, I feel fine, I feel... just great, really. I took a Klonopin and more Lamictal this morning, so maybe the Klonopin took the edge off the more out-of-control fine I was feeling yesterday. I don't know. If I do what McMan calls a "systems check," I can still feel a little fraying at the edges.

Yesterday was bad, though. I kept doing a shuffling dance waiting for the bus. Everything was so slooooow, and because I didn't want to miss my second appointment, I got there an hour and a half early. So I sat down on a bench outside to get my 10m of sunlight, like the therapist I broke up with, said I should. In case there was any benefit to the hooey. And I kept calling Jb, like 3 times: "You're driving near home? Oh, hi! -wavewave-," which he didn't get and I repeated many times, then I called him about bumble bees because there was a big one, and he was all up in my space: "Do bumblebees sting? No, the big ones, like at the arboretum, do they sting? Wouldn't their stinger be even bigger than regular ones? Wouldn't that hurt more? Are you sure they don't sting? But you said they don't sting! I don't care if they sting different! Are you suuuure they don't sting? 99.9% sure? Well, okay. I just wanted to know if they sting."

And so on and so on. I already mentioned the fiasco in the office, hands shaking, trying to show the psychiatric nurse practitioner my list, being told things about my medications I wasn't quite sure I'd remember, talking too much. Then not being able to wait for the bus because it was so sloooooow, and the wind was getting my hair in my face, and doing that shuffling, rocking dance again at the stop, and deciding no, no: I'll go wait in the hospital cafeteria, yeah, which was a longer wait, but which also had food, which the nurse said I needed. So I ate a salad with eggs and nuts and cheese for the protein and read more Madness.

When Jb finally picked me up, I couldn't stop talking. He definitely noticed I was a little hyper, a little too happy. In the Subway line, I couldn't stop giggling and laughing. I'd just thought of the funniest joke, and it was so funny I couldn't keep the laughter in. And that was the ride home, giggling, and all the way up in the elevator, where I just wanted to laugh and laugh, and should have put both hands over my mouth to keep it in, but couldn't. He called me "crazy," which I sort of resented, but then, inside, he said, "Hey!" And I asked, "What?" And he said, "I love you." And I asked, "Even though I'm crazy?" And he said, "Unh huh." And I said, "I love you too. ... Even though you're sane." And we were good.

I'm finding that I'm also getting more pokey and wrestley when I'm like this. I antagonize Jb into getting into small wrestling bouts. I'm more touchy, but not in the good way. I poke and prod and try to get him to pay attention, and he ham-handles me back, which I deserve, but then, which I resent, and so it sort of escalates until someone gets pinched too hard and pouts. Sometimes me, sometimes him. And we're mad for minutes at a time. But then, I start up all over again, and it's not something I can help. I think it's a need to be doing something, I want for attention. I'm bored easily, and Jb's the nearest one around.

I take my meds at 9 p.m., but I'm not asleep until almost 12. My new meds as of May 19th, 2008 are:

• Remeron 30MG taken as 15MG 1x a day
• Lamcital 200MG taken as 100MG 2x a day, or if it starts messing with my sleep, 2 100MG tabs in the morning
• Klonopin 1MG 2x a day
• No Adderall refill
• Benitar HCT 40/25 1x a day

I see the psychiatrist again in 2 weeks.

Doctor!

So, um, it was good: I took a list. Kinda scattered, very talky. She made me eat a piece of candy 'cause I hadn't really eaten all day. She says I should get blood work to make sure it's manic and not diabetes, but I told her I'd had all that blood work 3 months ago, but she said do it anyway.

Med changes. Yes. Of course, always tweaking. Twice the Lamictal I was on. Half the Remeron. She didn't believe me that Remeron made me crave sugar. She thinks I'm making that up, I can tell. That's what the blood work is for. She thinks I could be diabetic. But I was shaky, so she made me eat candy out of her drawer, which was sorta disgusting. It was all dusty with that powder they put on hard candy in tins, and I didn't want it, but she made me.

Forgot to take the Klonopin. Adderall now a definite probably no. Caffeine probably didn't help.

She said I'm supposed to eat three times a day, protein to stabilize my moods. I can't afford to eat three times a day. Jb jokes we'll get me protein bars, which is better than the other joke he could have made. Jb also called me "crazy" in the car. Very clearly manic. Or hypo, really. Up up. To-may-to tah-ma-to. We went to Subway after (Jb picked me up because I couldn't wait for the bus; it was too slow), and that was a great joke. Whitebread! Very funny. Can't explain more, but it's giggly good.

I need to write down my prescriptions, but not now, I can't focus, and I doubt I could read her writing. They use those squiggly things to signify how many and how many times a day. Feh.

3:25 p.m. No Downtime

Note to self: 2 p.m. came and went and no down time today as in the past 3 days. Exhibiting some possible signs of hypomania since Friday. Feels full blown today. Because I have to go to the psych? Unsure of trigger if there is one.

Have also gone from thinking the meds might be kicking in, to thinking I don't need no steenkin' meds, to thinking maybe I need more meds, because I can't quite get myself under control.

Will take a Klonopin and catch my bus on time. Will also not drink any more caffeine. Will not continue to blog or look up studies on Lamictal on McMan's website.

12:25 p.m. The Big Forgets

I forgot to take my meds last night. I remembered, then forgot. Somewhere between walking from the fridge to the bed. I do that now and then. Forget my meds. I ask Jb to remind me, but his ADD/ADHD makes him as forgetful as me sometimes. I used to be the responsible one. Now we're both in a boat without oars.

My Med List

• Adderall 10MG 2x a day
• Lamictal 100MG 1x a day at night
• Clonazepam (Klonopin) 1MG 2x a day
• Mirtazapine (Remeron) 30MG 1x a day at night
• Nexium 40MG 2x a day
• Benicar HCT 40/25 1x a day

I keep them all in a white plastic bag that says, "Washington Adventist Family Pharmacy: Thank you for shopping with us, and please come again." When I go to see my primary care physician, I take the bag with me and clutch it to me as I wait for her. I can't remember my meds and the dosages without my bag.