Filed under: Counselor A, Dr. Neuro B, Dr. PCP, Fear, Husband, Mental Health, RX, Seizure
Sex? What sex? The drugs they give me for depression destroy my libido. The drugs they give me for seizures mean I can’t take the only drug for depression that is less likely to destroy my libido. The seizures are directly linked to the depression. So it’s all circular.
Then, there is Ritalin. Hmm. Or rather, Hmmmmmmmmmmmmmmmmmmmmm. That’s what my doctor wrote when I sent him an email about considering me using this drug. There is some evidence that it boosts the effectiveness of anti-depressants. There is some evidence that it can kick start a person’s libido that has been made dormant by other drugs. And of course there is a lot of evidence that it can improve energy levels and executive functioning. So I sent this email to my PCP:
Quick question. Is it worth our time for me to make an appointment to come in to talk with you about the possibility of Ritalin to address the total lack of libido in our home (Well, on the left side of the bed, anyway. The right side of the bed is doing just fine, if you don’t count frustration intense enough to cause a man to chew paint.) thanks to these pretty little “take these so you won’t kill yourself” pills, or would you just tell me to shut up because you’re laughing to hard you’re going to pee your pants and you don’t have a spare pair at the office?
To which he replied:
hmmm. I’ve never seen anyone use Ritalin for countering the decreased libido issue. I’ve only heard of changing doses and adding Wellbutrin (which will worsen seizures, which would be a bad thing for you). I wouldn’t want to cut down the dose because of what we’ve been talking about. hmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm. I dunno. If you want to start Ritalin, you have to come in because it is a SUPER controlled prescription requiring a SPECIAL prescription paper to fill it.
The hmmmmmmmmmmmmmmmmmmmmmmmm cracked me up because I could just hear him doing it. He does it all the time when I’m in his office and he’s thinking. The thing is, when I sent him this email I included an article by a physician who is a Professor of Psychiatry, University of Pittsburgh Medical Center and Chief, Division of Adult Academic Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania called “Sex and Antidepressants” where he discusses many possible “remedies” to address the problem and one of them is Ritalin. I did some research on all the drugs he mentioned and this was the one that best fits my problem and would give me the fewest side effects. The point of this whole thing is that I know there are many doctors who would react negatively to a patient doing something like this but my Dr. PCP is open to all sorts of things and, as you can tell from his email, doesn’t out of hand dismiss something just because he hasn’t encountered it before.
In the mean time, I’m due to see Dr. Neuro B in two weeks. At 600mg Lamictal I have returned to a manageable but still every day seizure pattern. I’m both looking forward to this appointment and dreading it. Looking forward because I’m sick of standing still, which is what I feel like I’ve been doing for about a year, and dreading it because my lack of success with Topomax will be my official 4th “failed” drug. Last time I saw him he said “alternatives” are our only next option with a 4th failed drug if I am still having seizure activity. So I’m both happy and nervous about all of that. It’s a good thing and a terrifying thing, too. Fingers crossed for an update in two weeks. All fingers. And toes, too.
At the same time, Counselor A says she thinks I don’t cry enough. I was in her office and she started talking about how she doesn’t think I talk to the people who love me about all the stress and pain I still have from this accident, and how hard it still is for me and always will be. I saw her the day after the 3rd anniversary of the accident and we talked about that. It made me cry so hard. I told her I didn’t want to do that – to sit in her office and cry about the anniversary and all the things it brings up in my head. She asked why I hadn’t talked with my husband about the anniversary and all the feelings it brought out. I told her that it’s just another day for everyone else, that it’s only an important day for me. She doesn’t think that’s true. I don’t go on and on about all this stuff with my family because geez you know they’ve got to be tired of listening to it.
It’s been three years – it shouldn’t be this big gorilla in my life anymore. Other people get hurt and they get on with it. So she thinks I should cry more – by that she means I should talk with my husband and friends about all this and she knows that if I did that I would blubber like a whale, but she thinks that would be a good thing. I have just never been a person to dump on other people. I explained to her that when I was hurt and physically unable to do for myself I had no problem asking for help. If your leg is broken you can’t get up and reach the top shelf of a cabinet or scrub your own feet. But just because I’m sad doesn’t me I’m going to dump on people. Everybody goes through hard stuff and I’ve gone through a lot of it in my life. A few months ago I was in Dr. PCP’s office and he started talking about something close to this and I waved him off. I told him that if he kept talking about it I would cry and I didn’t want to do that. He said he thought maybe I should. So two of the people who know more about what is in my head that anyone else in the world think I should just dump on my husband and my friends and sit around crying my heart out and feeling sorry for myself. I’m just not like that.
Filed under: Counselor A, Dr. Neuro B, Dr. PCP, Mental Health, RX, Seizure
Since July. I look at that little icon over there and think, man, I need to update this. But I keep putting it off. First I think – I don’t know how to put it all down. Then I think, eh I’ll be lazy today.
So I caved – I went back on the Lexapro. And I caved – I went back to Counselor A. The Lexapro is helping which somehow pisses me off a little bit. I’ve still got those razor blades and I still look at them but I am able to have this cognitive discussion that says “Hey, dummy”.
I had a couple of emails back and forth with Dr. PCP about a couple of things. He sent me the newest Lamictal levels and the report had the HIV report on it. Wrote back to him and said I didn’t know what the report meant but that I was guessing it meant negative? He said “Oh – yeah. It’s negative.” I told him that maybe that was the most important thing and he should have addressed it first. I love the man but HEY!
I’ve just avoiding writing what is going to happen in October.
I saw Dr. Neuro B at the first of July. The seizures had gotten a lot worse at 900mg and the tremor in my hands was bad. Dr. Neuro B said the tremor was from the high dose of Lamictal. He said to drop the Lamictal back down to 600mg, which is where I was when I had the best control. So I went straight down – no titration. And he added Topamax. So I ramped up on that. After about three weeks on that I was falling asleep at my desk in the afternoon and Diet Coke tasted like ass. I could have lived with both of those if it had gotten rid of the seizures but if really had no effect whatsoever. So I talked to Dr. Neuro B and he said to step down. I have one more week and then I’m off of it. The good news is that the tremor is gone and I had my first Diet Coke in weeks today; MAN it tasted yummy.
The bad news is that in July he flat out told me that if I was still having seizures in October that it was clear that medication wasn’t going to do it and that we would have to talk about alternatives. We all know what that means. 72 hour EEG. VNS? Brain mapping? More horrible? What? Me? Stress????
Filed under: Counselor A, Dr. Neuro B, Dr. PCP, Dr. Psych, Fear, Husband, Mental Health, RX
I remember when I last saw Counselor A. I told her that I just wanted to stop. That I was only willing to do what is absolutely necessary to get by and nothing else. So I go to work. I take a bath. I eat. I try to sleep, often with little success.
Sometime on Wednesday I realized that I’m doing things that I don’t absolutely have to do.
I don’t have to see a psychiatrist. I went to see Dr. Psych yesterday and I told her that. I told her that I can’t afford to see her since she is out of network and that the only thing she can do is give me pills anyway.
One of the other things I realized is that I don’t have to take all these damned pills. I told her I am quitting the Lexapro. I told her I wanted to know how to get off the Effexor. She didn’t think any of this is a good idea but you know what? She doesn’t live in my head and she doesn’t know what it does to me every time I dump a handful of pills into my palm every morning and night to swallow. She asked if she could talk with Dr. PCP about this and I told her it was fine, and that I would be seeing him that afternoon anyway. She asked if I would talk with him and tell him and I told her yes, of course, I don’t keep things like this from him. She gave me the names of two psychiatrists she knows who are on my insurance and said that if I can’t see her that I should see one of them. I don’t absolutely have to, and I don’t see the point anyway.
I don’t absolutely have to see a counselor. I’ve talked with Counselor A since November and it sure as hell hasn’t helped. I’m in much worse shape now than I was then. Understand, that isn’t her fault. She was so kind and I felt so safe sitting in that room with her. Our time together was good. But I was going down instead of up.
I don’t want to go down any farther.
I did see Dr. PCP yesterday afternoon. I told him I want to get off all these pills. He didn’t comment but he did tell me how to do it. I don’t know what his thoughts are, which is strange, because usually he tells me. I showed him how my hands have started to tremble over the last month or so. He stuck his finger in the air and had me move mine from my nose to the tip of his finger. He kept moving his finger farther back. He said the tremor got worse the farther back he moved his finger. I told him I’m seeing Dr. Neuro B on Monday and he said I should talk with him about it.
I had actually set the appointment with Dr. PCP because I needed to have blood drawn for Lamictal levels to take with me on Monday. I told him that I know he can’t code me for just a blood draw and asked him to look at some sores in my mouth. They’re small and white, and when I scrape the top off them there is a depression inside. (Depression. Ha. HA!) Dr. PCP said the thinks it might be thrush. THRUSH???
He wrote me a prescription for Nystatin. I said, “It’s not a pill, right?” He said no, it’s not a pill. He said take a teaspoon or so, swish it in my mouth and then spit it out. I said, “Swish and spit?” He said yes – that he was even going to write that on the RX. And he did. Made me chuckle when I got the bottle. I did it for the first time this afternoon. It didn’t taste so bad. Until about ten minutes later. A horrible, revolting, sour, metallic after taste. Hours later it is still there. A couple of times I thought it would make me throw up. I have to go do it again soon. I hope I can do this for five days and that it works.
I said to him, THRUSH??? He said that’s what it looks like. And then. THEN. T H E N he said he wanted to take a tube of blood to run an HIV test. I asked him why? It’s like my brain stopped. When he said thrush I immediately thought of a friend who has HIV and who also has had problems with thrush for a long time. I thought thrush=HIV. Of course, that’s not necessarily true. BUT. Dr. PCP said HIV test. I agreed and went about my day. Now, a day later, I’m stunned. I’ve been in a monogamous relationship for fifteen years. I reminded Dr. PCP of that when he said HIV test. He said to do it anyway.
So I’m stunned. I’m thinking of what it’s going to be like to be off all the psychiatric meds, and tonight I am sitting in bed terrified that on Monday he won’t just email me my lab results. If he calls me instead, I am pretty sure I won’t stay here. I’ve seen so many people slowly waste away with HIV. Back in the 1980’s my friends were dying left and right. A couple of them who were infected back then are still alive and their lives, how the disease has changed them and warped them, it’s horrific. When I said in a previous post that I know people with HIV who take fewer pills every day than I do, I was serious. But HIV is something I can’t face.
My first thought is that if Dr. PCP calls instead of emailing that I will loose my husband and job and home and car because I will have to be put in a rubber room. Or, I will go on and execute (Ha. HA!) that “How bad is it today?” plan because that will be the day I will have to say “Yeah, it’s that fucking bad.” Sitting across that exam table from Dr. PCP an pretending that I can even in my wildest dreams think of any way to deal with that talk, the “This is why I asked you to come in” talk, is so outside the realm of possibilities that I think it would be easier to fly across the sky. So I hope he emails me. If he calls me on Monday I don’t think I’ll answer the phone.
Counselor A called me back the Monday after I left her the message that I’m taking a break. She was very nice. She said she had gotten my message and then “You’re right of course, I don’t agree that this is the best thing for you”. We talked a bit and I explained that I’m just worn out – physically and emotionally. That I think it’s pretty obvious that I’m not making progress. Instead actually I’m getting worse. She asked if it was OK for her to talk with Dr. PCP and I told her yes. She asked if it is OK if she calls to check on me in a couple of weeks. I told her yes again. Such a nice lady. Not her fault I’m such a mess.
Dr. PCP called me the next day. Such a kind man. Wonder what I ever did to deserve him? Wonder what he ever did to deserve me? Poor guy. We talked for about 15 minutes. We talked about how everything is getting worse. He was very supportive and reinforced Counselor A’s belief that I should consider continue seeing someone, if not her. He told me he wants me to think about seeing a psychiatrist. I told him that all they do is write pills and I didn’t see the difference between them writing them and him. He said that psychiatrists can be more “aggressive” than he can with my kinds of needs. He said he would continue to pray for me. He touches me deeply by just caring for my with such sincerity.
I thought about our talk a few days and I went to see him Friday. His schedule was running behind and I had to wait about half an hour. I don’t mind this – I know that he works hard to be on time. I know that if he is late it is because another patient needed more time with him, and I respect that completely because heaven knows he gives me as much time as I need, often as much time as HE thinks I need which is sometimes more time than I want. I was very stressed about everything that is going on, and that I was going to have to talk with him since I am so embarressed to be what I consider is burden on him. I was rubbing my fingernail back and forth across the back of my hand in a line from the bottom of my index finger to the bottom of my thumb. I started rubbing it harder and then really digging in. I didn’t draw blood but I did dig a big gash in the skin. The next day it was a big dark scab. I’m keeping Neosporin on it and I hope it doesn’t scar badly.
Dr. PCP and I talked about where I am in my head. I told him that I had thought about his psychiatrist suggestion and that I had printed out a list of network providers from my insurance company’s web site. I gave him the list and he circled four names. He said that most first appointments for psychiatrist take about two months. He said that he doesn’t personally talk with the four he circled, but that he knows people who go to them. I asked him to write the name of some that he personally talks to and he did. We talked about how much trouble I’m having staying asleep – that I’m waking up all night an sometimes it’s very hard just to get to sleep. I told him I take a “swig” of NyQuil and that helps. He wanted me to try another drug, Seroquil. I said I had never heard of it. He said it is an anti-psychotic but that I shouldn’t worry – he doesn’t think I’m psychotic (“I don’t treat psychotics.”) but that it is used off-label to help with sleeping and depression. I had a hard time agreeing – one more damned pill for the pill box. Finally I said OK and he gave me some samples. He asked me to email him and let him know how I was doing.
I asked him to look at my thigh and tell me if he thinks anything is infected. He did and said, “No. You’re healing.” I told him it had been two days since I had cut.
None of the doctors he circled were available for at least two months – just like he said. I called the doctor that he knows and got an appointment in late June. He’s out of network but I think I can afford it since you really don’t see a psychiatrist regularly.
I tried the Seroquil that night. This is the email I sent him on Monday:
Hey Dr. PCP-
I took 50mg of Seroqiul about 10pm Friday night.
I slept as if in a coma until 1pm Saturday. Got up, paid homage to the pill box, went back to bed.
Woke up at 4pm sprawled sideways across the bed, on my belly and naked. My panties and t-shirt (which I had been wearing when I went to bed) were at the top of the bed in a big pile, along with my blankets. My head and left arm were hanging off the bed and my dog was stretched out by my side, my right arm wrapped around him in a death grip.
Got up, got dressed, had something to eat. Read for about an hour, until the words started swimming in circles on the page. Went back to bed about 6pm. While going to sleep my hands kept reaching up to turn the page of the book I had left in the living room. I kept thinking “there is no book here” but also kept trying to turn the page. I could feel the paper and hear the sound of it turning. That was really, truly weird.
Woke up around 8pm. Watched a movie with Husband. Stayed up until 2am, took another round with the pill box and 50mg of Seroquil, and woke up Sunday at 8am.
Fell back asleep at 11am and the day continued with weirdness. Staying up for a couple of hours, falling asleep for a few, and waking up again.
At one point I was sleeping on the sofa and became about half awake. I needed to pee but was so drugged I didn’t think I could move. I had a serious conversation with myself which involved a debate about just peeing on the sofa. The argument on the side of not moving included “There is a blanket under me. It will absorb most of it. The sofa is leather so I can just clean it when I get up because it won’t soak in.” I am proud to say my potty training won out. (As I’m sure Husband is, also.)
All of this plus some of the strangest dreams I have ever had (and that is saying a lot). I can see why this drug is used to control a psychotic. It knocked me on my ass. I didn’t take it Sunday night and don’t think this is the answer for me.
I did call the psychiatrist offices that you circled. As you said, next available appts Aug and Sept. I called Dr. Psych’s office. Next appt. June 27. I booked even though he is out of network and we’ll see how that goes. I have an appt with you before that but I’m going to cancel it since I don’t know that there is much of a point to it until we see that Dr. Psych says. So please let me know when you want to see me next. Very much want to visit Mr. Razor Blade but keep chanting in my head “Dr. PCP would not approve”. See? You help even when you don’t know you’re doing it.
I hope you slept a lot less than I did this weekend and didn’t seriously think about peeing on your sofa. Thanks for your time and help!
We emailed back and forth a few times yesterday and he asked if I want him to call Dr. Psych’s office and see if he can get me in earlier. I told him that I wouldn’t turn it down if he could. We’ll see.
I want to cut. I had planned to tonight when I was driving home. When I got out of my car I brought my blades into the house. I got tied up with email and snail mail and before I could cut my husband got home from work. He’s practicing guitar right now and I think it would be safe to do so. All my other cuts are healing. They’re past the scab stage and have progressed to the pink, itchy stage. We’ll see how it goes tonight.
Because I always try to do what Dr. PCP says, I talked with Counselor A about cutting. She was so freaking irritating. “Do things to distract yourself!” “Write about it!” “Exercise!” “Play a game!”. What a lot of twaddle.
I told her that I’m just tired. I’m tired of being the strong one. I’m so tired of being on edge, waiting for the next bad news. I thought it would all be over. I thought if I put everything I had into rehab and making my body work again that it would be over. But it will never be over. Ever. And I just don’t think I can face that. I didn’t do anything wrong. In fact, I did everything right. And I’m stuck with this for the rest of my life.
When I went up to 700mg on the Lamictal like Dr. Neuro B told me to the burping started getting a little worse. Then when I went up to 800mg about 10 days ago it got really bad. I mean almost as bad as it was when we started this whole thing what was it – more than a year ago? Gasping for breath, long, strong series. Totally demoralizing. I called his office and spoke with his nurse. Told her what was happening. She said he wanted a Lamictal serum level. So I went to Dr. PCP and he took the blood. That’s when I told him about the cutting. He sent me the results this past Tuesday and told me they were “normal”. The range is 2.0 – 20.o and I’m at 10.0. Seems normal to me, too!
But when I got a call back from Dr. Neuro B’s nurse she told me that he wants my level to be much higher, and said that I should go up to 900mg. NINEHUNDRED?? Holy frankincense I feel totally beat up. So now I’m taking more drugs. You should see the pile of pills I dump into my palm every morning and night. I feel like a freak.
I told Counselor A that I just couldn’t keep it up. That I was going to shut down as much as I can. I’m only going to do the things I absolutely have to do. She asked me what that included. I told her, I have to go to work. I have to take a bath. I have to have clean clothes. I have to drink and eat. That’s it. She kept urging me to do the things that used to give me joy. Creative things. Artistic things. I kept telling her I have no interest – have had no interest since the accident – in any of those things I used to enjoy. None. She went to far as to suggest that if I feel so compelled to cut that I might want to consider taking a break and go into a hospital. She laughed when she said it because she knew what my reaction would be.
I’m just so tired. I’m empty. I don’t have anything else to give. There is too much pain, too much hurt, too much bad news. That’s where the cutting comes in. When I told Counselor A a couple of weeks ago that I was thinking about it she suggested that I use ice instead. She said if I held a piece of ice to my skin that it would start to burn and the pain would be similar to the pain of cutting. When I left her office on Wednesday she asked if I had tried the ice. I told her “Yeah. It numbed the skin so the razor didn’t hurt as much.” I’m pretty sure that’s not the answer she was looking for.
She doesn’t get that it’s not the pain I’m after. I don’t like the pain. Pain is a big problem for me. Pain in my knees. Pain in my pelvis. Pain in my brain from just being overwhelmed and exhausted. I explained to her that the blood is very satisfying. I’ve found that watching it, soaking it up with a paper towel, pressing the wound to clot it, is a mesmerizing process. I told her that every day it helps me focus. It helps me put my mind in one place, instead of having it fly around to all the problems and pain. Every time I take a step I can feel the scabs rubbing against my thigh. Every time I cross my legs I can feel the pressure on the wounds. I can think just about that an nothing else. The focus is tremendous.
This past Wednesday when I was with Counselor A I had looked at the clock and could see that we had gone over my time. I said, “We’re done.” She looked confused. I pointed to the clock and said we’re past time. She got up and we left. On Friday it struck me that what I had said was true. We’re done. She can’t help me. It’s not her fault. I left her a voice mail early this morning telling her that I’m not going to be seeing her anymore for a while, that I’m not making any progress, that I am grateful for her time and concern, but that I need a break. Apparently she isn’t on the list of things I absolutely must do.
When we were talking he asked me, “Are you thinking about suicide?” I told him that of course I was. He asked, do I have a plan? I said “We’ve talked about this before. I’ve always had a plan.” He nodded his head in agreement. I told him that I wasn’t thinking about doing it, but it was always in my mind.
I told him that what was scary was that I had never thought before about hurting myself. That is when he asked, “Are you hurting yourself?” I nodded yes. The first thing he asked was “Does it cause bruising?” I shook my head no in shame. I don’t remember the second thing he asked but the third was “Are you cutting”? The shame this time was much deeper. I told him, “It hurts when I do it, but the blood is very satisfying.” He is the only person who knows. He asked where I do it. I told him it was somewhere that no one can see. He asked if I had told my counselor. I said no. He asked if I’ve told my husband. I said hell no, are you crazy? I told him it helped me focus the pain.
This was the first time I cut myself. The blood was in fact very satisfying. When I cut I waited for the blood. I did’t cut very deeply, and sometimes is took a few moments for the blood to start oozing. I pulled the skin on each side of the cut away and the blood flowed more quickly. I dabbed at it with a paper towel.
With every cut I used a different part of the paper towel, carefully marking it with blood so it was almost covered entirely with my redness. He asked what I used. He said, “A razor blade? Scissors? A knife?” I laughed in a morbid, quiet way. I told him the only really sharp knife I have is “this” long, stretching my hands apart to demonstrate a length of about ten inches. I told him it would have be very hard to control. He smiled at me. He looked at me as said, “It helps you focus”. I nodded my head yes.
When I knew I was going to cut myself I had wandered around the house trying to decide what to use. I first thought about a razor blade but I use a safety razor to shave and didn’t think it would work to tear it apart. I did consider a knife but mine are too big. I thought about an Xacto knife but didn’t think I had any new, sharp blades for mine. I was standing in the kitchen, trying to think, when I saw a utility knife on the kitchen table. I took a butter knife and used it as a screw driver to open the utility knife. There were three spare blades inside. I removed one and screwed the utility knife back in place. I knew the blade was thicker than a regular razor blade, and that it wouldn’t be as sharp, but it would do. I didn’t clean it. I didn’t care if I got infected.
He leaned back onto the counter behind him. He pulled one leg up and put his shoe up on his rolling stool next to his thigh. His right hand moved to his mouth and he looked off into space, thinking. Again I told him that I was scared because I’d never thought this way, much less done it. I made no move to show him the lines of clotted blood, the red rimmed wounds.
He rolled back over to the exam table where he had laid down my chart. I rarely if ever sit up there. I sit on the visitor’s chair. He rolled close to me and took my hand in his, grasping it tightly in both of his. His skin was warm and smooth. He has held my hand before. I told him that I was afraid. I told him that when I increased the anti-seizure medicine at the instruction of my epileptologist that my seizures had increased dramatically. I told him that it is almost as bad as it was before we started all of this so long ago. I told him that my epileptologist wanted me to have a blood test to check my Lamictal level. He nodded his head. He had been watching me and listening to my repeated hard burping since he had come into the room.
He told me he would continue praying for me. I told him thank you, that it meant a lot to me. When the tears started to roll down my face he reached behind him for a tissue. I remember that they were tan instead of white. I wondered if they were ordered that way on purpose or if it had been a mistake. When I couldn’t stop crying he brought the box to me and put it on the exam table next to my chart. He started writing. He told me that cutting is tied to self esteem.
He pulled out his prescription pad and told me he was going to increase the Effexor. He told me I have to talk with my counselor about what I was doing. I told him I would think about trying.
When he stood up to leave the room he stopped, turned around, and leaned over me. His hand went behind me and he bent at the waist. He hugged me tightly but didn’t use any platitudes, didn’t say “It will be alright” or “Be strong” or “You’ll feel better soon”. He just hugged me tightly. I hugged him back. As he walked toward the door he told me he would send a nurse in to take my blood. He closed the door behind him. I took another tissue and tried to look like I hadn’t been crying, because of the shame. The nurse came in and did her work. I asked her if I could see the doctor again for a moment. As she left the room she said she would ask him.
When he came back I was standing against the wall near the door. I told him I hadn’t wanted to freak him out, that I’m not gouging myself. He said he wans’t freaked out, that he had had people come in with ten staples in their arm after they had hurt themselves. I told him I wasn’t digging for my femoral artery. He smiled and said yeah, that would be bad. So much blood would be hard to clean up. He smiled and said it would make a big mess. He told me to come back to see him in about a month, or sooner if I needed to. I told him thank you.
As I walked down the hallway to check out at the front desk I started to think that I might change my plan. I started to wonder if I could dig deep enough to reach my femoral artery.
I am scared.
Well I can’t tell you how much I hate to say this, but Effexor appears not to be horrible. I have to admit this – it’s helping. I hate that because there is this stubborn stubborn person (me) who, regardless that I know it’s crap, just hates that I can’t will myself not to be depressed. I KNOW depression is a disease and that if my leg were broken (again) I couldn’t will it to get better so it makes no sense for me to expect myself to be able to will myself to not be depressed but STILL. You know?
So it’s helping. And I’m grateful. But it still pisses me off.
AND. I think that seeing Counselor A. is helping, too. The two things we’re working on are:
1. Get In and Get Out
2. Choice: Victim or Working Through
I guess those should actually be in a different order. A couple of weeks ago we were talking about the choice of going to a therapist to address the crap I’ve got in my head because of this accident and this injury and all the stuff that it has lead to. She talked about two examples of clients she has had who had been raped. She said one had come to therapy and worked through her trauma. The other had chosen to just plow forward and try to deal with it all by not necessarily denying it but by just going on. I don’t remember the exact point in the conversation but at some point I said, “Choosing to not let the rape define her.” I’ve thought a lot and I mean a LOT about that statement. Last week with Counselor A. I asked her – it that what I’m doing? Am I choosing to let this trauma define me and is that why I can’t get past it? Is this something I’m doing to myself? Her reaction was very strong in the negative. She said on the contrary that, by choosing to address what’s in my head and try to work through it that I am choosing NOT to let it define me. She said that she thinks this is a choice of courage. I’m doubtful that that is true, but I’d like to think so. She said that some people, when the trauma is severe, just can’t plow through it. And that if they try, it comes back to bite them on the ass later. We’ll see.
The Get In and Get Out part? I’m adjusting to the thought process. The premise is that I push it all down. Every time I find myself running this accident and all the crap surrounding it through my head, I try to get away from it. I tend to think I’m dwelling on it and fight against it, and the going theory is that this is why it’s become a “white noise” that won’t go away. Counselor A. has suggested a different approach, which is, when it comes to the forefront of my thoughts to let it be there. To pay attention and look at it both ways. And after a period of time, to choose not to think about it for a while, but to make it OK to think about it for a period of time. Get into the thoughts and then get out of them. Sounded like woo woo crap to me, too.
For example. I was in the shower one day last week and I was washing my hair. The recovery period came into my head. I started thinking how horrible it was to just try to do basic things, like get clean. How helpless I was, and how I depended upon The Husband for the simplest things. Like taking a bath. Before I would have run through the horrible thoughts – the pain and shame of not being able to clean myself, of having to ask for help just to wash my hair. But this time, instead, as I went through the process of bathing, I took each step and looked at how it was and how it is now.
Just getting into the shower was terrifying. There is a lip at the shower door that I had to hop over to get in. My husband had to brace my whole body and hold me by my right elbow. I had to hop over the lip onto the slippery tile with my right foot. It was shockingly scary. I was so afraid I would not hop far enough and that I would fall. I never did, but what stayed with me was the fear. So this time when I thought about it, I focused on the fact that I did it every time. I concentrated and I was strong, and I forced myself to have faith in myself and my husband that we could do it. And we did.
As I stood under the hot water spray I remembered how I had to sit on this plastic shower chair with my broken leg sticking out of the door. I remembered how hot and sticky my skin would get under the plastic and tape we had to wrap around my leg and arm so I could bathe. I remember again the total helplessness of my husband having to scrub my skin and wash my hair, how he had to lift my feet to clean them, and how he had to rinse me off like a baby. I was grateful but I felt weak and worthless. At first I could barely sit up in the chair long enough to get through it. I was exhausted by the time it was over and had to sleep for hours afterward.
This time I thought about how I got stronger. I remembered the first time my husband helped me make that hop into the shower without the chair in it. That was the first time I stood and tried to scrub myself. I was only able to scrub my chest and the front of my thighs, the top of my right arm and my face. I was able to sort of wash my hair with my left hand. By the time we were halfway through I was leaning against the tile wall and my husband was basically holding me up. I was exhausted. But I got stronger. Eventually I was able to stand by myself. Then one day, I was able to be in the shower with the door closed and my husband sitting on the bathroom counter outside just so he would be there to help me in and out or if I got too tired. Finally, I snuck in there and took a shower by myself when he wasn’t home. He was upset when he got home and found out, but I felt very proud. I hadn’t told him or asked him because I just wanted to see if I could do it. It was scary and I was so tired when it was over, but I was very proud.
So as I washed my hair this time, I concentrated on how good it felt to have both of my hands working the shampoo into my scalp. When I washed my feet I thought about how far I have come that I can stand on one leg and lift my foot up to clean it, then do the same with the other. I am strong enough to do it, I have my balance so I don’t have to lean against the shower wall. Hell, I can even shave my legs!
I have come so far. I had incredible help from so many people, but I am the one who chose to make progress. The other night my husband and I were laying in bed talking before going to sleep. He was telling me about a guy who is in a sport club that he participates in. He had been out with the club that morning and the guy had asked about me – I’ve never been out even though a lot of other member’s wives have. My husband told me that he replied “She is the most incredible person I’ve ever known.” He told me that he went on to tell the guy about the accident and how badly I was hurt, how hard I worked to come back from it and how well I’ve done. I was embarrassed by all of this but also very proud that HE is so proud of me. I told him that I didn’t feel like I had done anything that anyone else would do, and that I was able to do what I’ve done because of his support and help. He said no, that he doesn’t think that if it had been him that he would have tried so hard. He remembered how much pain I was in, and how I pushed and pushed and just didn’t give up. How I kept saying “It will never be easier that it is today.” He said that if it had been him that he thinks he would have just stayed in bed feeling sorry for himself. I told him I spent a lot of time feeling sorry for myself. He said yes, but that I did it sitting up in the wheelchair working for 12 hours a day to bend my hand or in physical therapy making my legs strong so I could walk again.
I told him again that I couldn’t have done it without him. He said that he wouldn’t have done anything he did if I hadn’t asked for it. He said that every time he helped me to the toilet, or helped me into the wheelchair, every time he stood beside me as I used that one hand to wash my hair, it was because I was pushing to get better and asking for help to do so. He said that he told that guy repeatedly, “She is incredibly strong.”
So I’m working on letting that be OK. And the Effexor is helping me feel good about it.
Filed under: Counselor A, Dr. Hypnotist, Dr. PCP, Fear, Mental Health, Pictures, RX
Wow I was in a pretty ugly place last night. I just read over my last post and if I were you reading it, I would think “Damned that girl’s in bad shape!” Well, where I am these days is not terribly pretty but it isn’t as ugly as it might seem from last night.
Last Wednesday was a marathon of co-pays and struggles.
It all started on the way to my first co-pay opportunity, an appointment with Counselor A. On the way to her office, at the corner of Chimney Rock and Memorial, I had a really scary encounter with an HFP Heavy Rescue truck. I heard their siren, I pulled into the left turn lane to get out of their way. The truck came to a full stop in the open lane next to me, but a little behind me, and let go with their “HEY YOU STUPID FUCKER I’M HERE CAN’T YOU SEE / HEAR ME? I’M HUGE AND LOUD” horn. I damned near pissed my pants. I know I wasn’t in the way of the truck – and there wasn’t any cross traffic on Memorial so I can’t figure out why the truck stopped behind me and tried to burst my ear drums. I was so scared. I looked up and down Memorial and, figuring I MUST be in the trucks way even though I was totally in the left turn lane, I tore out of the lane and crossed in front of the truck across Memorial, pulling to a stop in the right hand lane about 20 feet from the intersection. The truck pulled across Memorial and passed me. I didn’t know what to do!! I wasn’t in the truck’s way, and I was so afraid when I crossed in front of it that it would pull out at the same time and crush me! Ironic, wouldn’t it have been. Crushed again by a truck, but this time the Heavy Rescue people would be right there to cut me out of my little car.
By the time I got to Counselor A.’s office I was still shaking and crying. It had been a really tough couple of weeks anyway and I just completely fell apart in her office. I’ve never done that before, and honestly, it was good to be in a safe place where I could just cry and not be concerned about who would see, or what they would think. After a while I calmed down a bit and we talked. She wanted to know what was going on since I was obviously in a bad place before the encounter with the truck. I told her that since she had urged me to write about what’s going on, and since I had told her I keep this anonymous blog, I had taken my laptop with me that day. I pulled up my previous post about cutting and showed it to her. Her reaction was great. It may have been the best thing I’ve ever been told about being in mental pain. She told me “It’s OK to think about it. There is nothing wrong with having thoughts.” Of course, we went on to agree that there IS something wrong with acting on those thoughts.
I explained to her how out of control I’ve felt these last couple of weeks. How I have come to the point where I have to admit that the evil word “depression” is now unavoidable. I wondered if the last meeting I had with Dr. Hypnotist might have a connection. We talked about what I had written about that in the previous post. She was, of course, very concerned about me and told me to come see her tomorrow instead of waiting until our customary Wednesday. She also urged me to talk with Dr. Hypnotist about my worries.
So off to Dr. Hypnotist I went. We talked about all of this and in response to my “What the hell?” he assured me that he hasn’t gotten anywhere near anything having to do with the accident in our time together. He suggested that possibly my current state is connected to my problem with missing such a big chunk of time from the accident. Since I don’t remember anything of our last session, he said maybe my mind is reacting strongly to that, connecting it with missing more time. I fell apart in his office, too, and just cried my heart out. He was very kind and patient.
That afternoon I had an appointment with Dr. PCP, yet another co-pay opportunity. I went to him to get a referral authorization for a biopsy my periodontist wants to do and while I was there he asked about my progress with the Cymbalta. I told him that I had stopped taking it a week after we last met and we talked about the extreme sleeping pattern. He asked if I was feeling depressed. I just held up my hand and told him I couldn’t even talk about it, that I would cry if I did. Gee. Guess that answer says a lot, huh? He said he understood but stressed that I have to take something. He gave me month’s sample of Effexor and when I told him I didn’t want to take anything he said, “I want you to feel better”, stress on the “I”. So I took the samples. I’m due to see him in another month. I feel like I practically live in his office. The truth is I get a lot of comfort from seeing him, from knowing that he is watching me and cares about me.
I know that they say that when a person starts a new anti-depressant that things can get a lot worse before they get better. That’s what I’m chalking this up to, and I’m trying to be patient.
I did a little housekeeping on the page today. Yahoo and Flickr have done something evil on a corporate level that make it impossible for folks who aren’t signed in to Yahoo to view The Visuals, and my Flickr account is so screwed up I can’t access it. So I’ve dumped the link to that and just added a page with The Visuals. In case I forget.
They call it dysthymia. They call it depression. They call it PTSD. They call it all sorts of things but all the names don’t mean anything. Give everything a label so they can make it fit into the ICD-9 code structure because, you know, everything has to fit.
Where are the lines? Is it dysthymia if you just feel a little blue? Is it depression if you think about that “How bad is it?” question? A long time ago I had this discussion with Dr. PCP. On Wednesday I had it with Counselor A. “Are you thinking about suicide?” Am I? I think about it often. Now, that answer would lead “they” to say I have “suicide ideation”. I wonder what the ICD-9 for that is? I bet I could Google it. There are bad days when yes, it runs through my mind. There are horrific days when it is a conversation I have with myself. But mostly, days are good. Some days are very good. And most days, the average day, is wonderful. I am loved, I am fortunate, and I am grateful.
The truth is, life is a choice. It is a regular choice. Will I live today? How bad is it? Is it THAT bad? Then the answer would be no, I won’t live anymore after today. How bad is it? REALLY? It can’t be that bad. It hasn’t ever been that bad. I’m living proof. Now, it’s been unholy unbelievable bad sometimes, believe me. It’s been lonely, it’s been grief, it’s been horror, it’s been abandoned. It’s been scared and angry and tired beyond all belief. It’s been lost inside my own mind, it’s been without hope. But it just isn’t THAT bad yet.
Suicide Ideation. The Merriam Webster dictionary defines it as “the capacity for or the act of forming or entertaining ideas”. Damned. That doesn’t sound so bad, does it? I definitely have the capacity to form or entertain ideas. I have ideas every day. I have an idea for lunch, I have an idea for which treat to give my dog. I have an idea to make chocolate butter cream frosting from scratch. I have an idea to have wild monkey sex with my husband. I have an idea that maybe today isn’t THAT bad, so I will choose to be alive tomorrow. Those are all ideas I have on a regular basis. But somehow, the last one, just because I actually THINK about it, is a bad thing. Dr. PCP never asks me, “Do you have chocolate butter cream ideation?”.
Filed under: Counselor A, Dr. Hypnotist, Dr. PCP, Fear, Husband, Mental Health, RX
Quitting Cymbalta was a good thing. Just two days after I quit my sleep returned to normal. Which was great. I’ll see Dr. PCP in about a month and tell him I quit. Counselor A and my Husband both thought I should go see him when I was quitting but I want to wait. I feel like I’m running to him all the time with every little thing. He tells me I’m not a pest but he’s such a nice guy I doubt he would tell me I am even if he thought so.
I’ve seen Dr. Hypnotist three times now. He’s done the hypnotist thing twice. The first time when he began I just couldn’t help but tell him I felt silly. But it went pretty well. I was very aware of the world while it was going on – the sounds of traffic outside, the air blowing from the vents, his voice, my body and how it felt. But I was also not totally conscious the way I am on a day to day basis. Sort of hard to describe. I remembered everything he said to me afterward. I didn’t know what to expect but he just talked to me, told me a story. It was about Erikson and his daughter. I have to tell you – when he brought me out of it – I can’t remember feeling so languid and comfortable. I took a big big stretch and told him I thought he should change his practice to include a room with a sofa, pillow, and blanket so people could take a little nap after being hypnotized. I felt that relaxed. He asked me how long I thought I had been in trance and I told him 10-15 minutes. He smiled and said I had been down 45 minutes. Unbelievable.
The second time I saw him it was totally different. I remember sitting in the chair and I remember the beginning of the process he used to take me down. I remember a tiny bit of the story he told me – something about someone having had stitches and then that person’s brother needing stitches and there being a competition that the second person wanted MORE stitches that the first had gotten. Sibling rivalry at its best! I also remember at one point he told me that one of my hands would feel like it had fallen asleep – tingle and numb. And I remember that it did feel that way. That’s all I remember and I know I was down about 45 minutes again. I’ll see him again this week and ask him what happened last time. I have no idea if he just kept talking or if I responded or what happened. Also, for the last week I’ve been having very strange dreams. My Mother and Father are both dead. My Mother has been dead for almost 20 years, and my Father for 10 years. I can’t remember the last time I dreamt about either of them. But in the last week or so I’ve had at least one very, very strange, very detailed, very vivid dream about each of them. Just last night I had a bizarre dream that involved Ganny, my mother’s mother. In each of these dreams there has been at least a few moments that took place in the house I grew up in. This house does not have happy memories for me. And in each of these dreams something violent or scary happened that involved me.
I was out of town last week so I didn’t see him. Both times after I have seen him I’ve felt so darned good most of the week after. Very relaxed, a good bit more positive than I have been for a long time. But last week and especially this weekend things have been really bad in my head. The “white noise” has become a lot louder. It is now more of a conscious thing that I think about a lot every day. The accident has been front and center in my brain and I’ve been actively trying to remember the feelings I had in the hospital, how badly the physical therapy hurt, how isolated I felt all those months at home in the wheelchair.
Worse of all, I’ve been thinking a lot about pain. I hate to admit this – really hate to admit this – but I’ve been thinking about causing myself pain of hurting my body. Not in the suicide ideation sort of thinking – nothing like that. But I’ve been thinking about those girls who cut themselves. I’ve been wondering what that feels like and what kind of mental release it gives them. I’ve been picturing taking a razor blade and carving tiny little parallel lines in the top of my thigh. Not deep, just enough to draw a little blood. I’ve never ever had these kind of thoughts before. It worries me, and it fascinates me all at the same time. I think the only thing that has kept me from doing it is that I can’t figure out how to hide the marks from my husband while they heal. I’m thinking I should talk with Counselor A about this but at the same time I am scared to. It is such a self destructive thing to even think about much less do and I don’t know what she will feel like she needs to do. I certainly don’t want her to talk to Dr. PCP about it, or Dr. Hypnotist, or worse of all, my husband. I can ask her not to, but I know that there are exceptions to the rules of confidentiality and that if she feels compelled I probably can’t stop her from trying to reach out to Dr. PCP or my husband to help me. I feel compelled to talk with someone about this because it scares me to be thinking this way, but at the same time I am scared that she won’t keep it between us.
I am scared that this might be some sort of side effect manifesting from the Lamictal. I’m at 600mg a day now and that’s a relatively high dosage. Also, for the last few weeks I am having the experience of the tip of my index fingers going numb. I also worry that this might be connected to the increased Lamictal dosage. I know these are not side effects that are listed on the Lamictal information sheet, but I also know that Lamictal is a very quirky drug that is known to have strange side effects on different people. I’m afraid to even ask Dr. Neuro B about any of this because I am afraid that if he thinks these things are connected to the drug that he will take me off of it. I am having so much success with this drug I don’t want to give it up no matter what. At this 600mg dosage I am down to 10-15% days, and I have even had a couple of days where, when I do burp, it surprises me because I actually had forgotten about burping all day. That is a heaven sent blessing.
So basically right now I am afraid of a lot of things. I am afraid I might have this drug taken away. I am afraid that maybe I could hurt myself. I am afraid that it is an attractive idea. I am afraid that maybe this hypnotism is somehow manifesting these feelings in my, and allowing the “white noise” to become so much stronger. I am worried that maybe this hypnotism has something to do with these weird dreams. I am just plain scared right now and that’s a hard place to be.
In case I forget. 