Daily Archives: December 5, 2012

Crazy People Get Sick Too

“Crazy people get sick too.” a professor of mine in medical school told me, as we walked through a crowded urban emergency room.  He firmly emphasized to his small crowd of followers that it was nothing short of criminal to instantly brand every human being who presented to the ER (or anyplace else) with a medication list that included psych drugs, or was delusional, or disoriented, or hallucinating, or even violent, as being a “crank,” and ignoring the possibility that this person might be physically ill, just like anyone else.

I took that lesson very much to heart, even though I was not officially among the mentally ill at that point.  It made all the sense in the world that mentally ill people could still get heart attacks, and strokes, and kidney stones, and life-threatening infections.  It even made sense that people who were not diagnosed with a mental illness could have conditions that might mimic conditions normally associated with, say, a psychotic break or an overdose: acute liver failure can cause hallucinations and stupor; uncontrolled diabetes can cause disorientation and lethargy progressing to coma; hypoglycemia can cause uncontrollable tremors, delusions, and hallucinations progressing to unconsciousness and sudden death; brain tumors can cause auditory and visual hallucinations, personality changes, depression, mania, paranoia, and just about anything else.

Then there was the lady who kept vomiting and vomiting for almost a year.  The gastroenterologists did every test in the world and it all came back normal, except for her serum electrolytes, which were screwed up from her constant vomiting.  They branded her a psychogenic vomiter, which means  they blamed the vomiting on something psychological and that was not their department, so they discharged her from their care.  A few months later she presented to the ER, this time vomiting up fecal matter (sorry).  Yes, it was really gross, and my heart went out to this poor lady, who had been branded a “crank” simply because the doctors did not know what was wrong with her.

This time the ER requested an acute surgical consult.  The surgeon decided to take her to the OR the next day for an exploratory laparotomy, which means they would open her up from guggle to zatch (my terminology) and wudge around in her innards to try to find the cause of her awful condition.  Luckily, I happened to be on the surgery service then, so I was pressed into service holding retractors.  (N.B. anyone who has a question about any of these terms is welcome to leave a comment and I will explain.  I figure that most people watch all these medical shows they have now, but since I don’t own a T.V. I don’t know what they have on them.)

Where was I?  Oh yes.  Holding retractors.  So.  When the surgeon got in there, he found, to his great surprise, a gigantic tumor in the middle portion of her small intestine.  Now, the small intestine is notoriously difficult to evaluate due to its extreme length (about 20 feet) so you can’t just stick a periscope down there and look around, like you can with the large intestine.  So all kinds of weird shit (excuse the pun) can hang out down there and go on with its dirty business undetected.   So when he opened this lady up and found a grapefruit size tumor like a donut surrounding the tube of her small intestine, he was shocked and amazed.  I was ecstatic.  The lady was vindicated.

The surgery turned out to be very messy.  I will not go into the particulars.  I had the immense satisfaction of bringing the news of the positive surgical findings to the attention of the arrogant asshole gastro people, who pretended that they thought something was the matter all along.

Oh, I forgot to tell you, this lady had a diagnosis of anxiety disorder and was on two or three meds for it.

One piece of good news is that since then there have been many new developments in medical imaging.  It is doubtful that things would have got that far without a CT scan, or an MRI, or both; and either of those would have revealed the weird tumor.  But given her diagnosis of anxiety disorder, would she have been taken seriously enough to even get to the point of imaging before she started throwing up shit?  I really don’t know.

Next post, I will tell you why I wrote this one.


Sitting Here Watching Airplanes

It is that time of year when people go to great lengths  to be with family members for the holidays. I mean literally.  Some travel thousands of miles every year, some not by choice, to celebrate. I say not by choice and mean mostly the kids who are shipped back and forth for the holidays. … Continue reading

I told you so

It’s 9 am.

Thus far my “new” car has overheated and started gushing anti freeze,leaving me stranded and carless (R picked me up.)

My glasses broke.

I lost my cell phone.

That icky feeling in your gut?

LISTEN TO IT.

This day sucks, I am in panic mode, I feel hobbled with no car, now knowing my small Christmas money budget will have to go on a car R told me was solid…

How am I not supposed to be panicking and depressed?

I know shit happens, things go wrong. Fine.

But must it all be at once? For fuck’s sake, I can’t catch a break.

mUST

REMEMBER

TO breathe.

I hate using a computer that isn’t mine.

Fuck.


Identified

Way back when I started this blog, I mentioned wearing a MedicAlert bracelet. At the time, I was kinda freaked …

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A soul not at peace

I have been trying not to flood post, although I don’t consider two posts a day flooding, some people do. To them, I apologize. But I have a head full of neurotic mental garbage that I feel the need to purge before it makes my head implode.

I took my Xanax. Eventually calmed down. Ran a couple of errands.

Now my kid has gone to bed and it is 7:53 pm

My brain keeps telling me:  it’s time to go to bed.

Which in my world doesn’t always amount to immediately going to sleep, especially as of late, as the Cymbalta is not making me sleepy and does not keep me asleep.

But stuck in the mental rut that I have been for the last year, there is this inner compulsion that dictates I MUST be in the bedroom before 8pm. I keep asking myself what bad thing could happen if I am not in the bedroom by 8pm. I have yet to come up with an answer. I just know I feel unsafe, and it is illogical and borderline insane to feel this way when there’s barely a hallway between this living room and the bedroom. Why do I feel this  fragile when I don’t adhere to my own strict “bedroom by 8pm” edict?

I wish I knew.

I wish I knew how to break out of it. I hate this, it makes me feel like a nutbar.

In the background of this mental war, another mental war is raging.The paranoia panic war. It’s getting ugly. I am almost now convinced something catastrophic is about to happen. Like them terminating my disability checks. Short of something happening to Spook or my own demise, losing the income we rely on while my brain is tapioca would be ultimate ruin.

Now why would they suddenly rescind it when I just jumped through all the hoops back in March to get it extended by going to the doctor of their choice?

Oh, let’s see. The government is broke. People en mass don’t believe mental disorders are an actual disability. You had two good days so they declare you cured…

Any litany of things, whether real or paranoid imaginings.

I have this feeling of unrest in the pit of my gut. It manifests as a knot that makes me perpetually sick to my stomach.

Every time I have ignored that bad vibe in my gut, I lived to regret it.

Things, while semi sucky, are shaping up semi decently.

Which means to let my guard down even for a second and allow myself to be happy or at least content would certainly seal my ruin.

The counselor would undoubtedly classify this as unfounded paranoia and melodramatic thinking.

I’ve learned my lessons the hard way.

How do you shake a bad feeling in your gut that is embedded like a damn boat anchor?

How do you tell your own brain that the messages it is sending are just crazy? How do you convince yourself of this when your brain just keeps throwing them out at you?

Is this one more side effect of coming off Effexor?

(Oh, in a note of reassurance in our prescription plans, the insurance turned down my script for 37.5mg Effexor, the last week of my weaning off, so I have gone cold turkey.)

I am trying to convince myself to watch a favorite show, read a book, do something that makes me feel at peace.

Unfortunately, my racing heart and spinning brain are not cooperating.

Is it asking too much to just want your brain to send the proper messages instead of always misleading you?

Wow. Sudden downshift of mood.

I felt manic earlier.

Now I feel crawl-in-a-closet depressed.

WTF?

Or is this some sort of bad reaction to Cymbalta? It makes my heart race like a racehorse. I don’t know what is normal or will go away or is it withdrawal…

Perpetually confused is not an optimal way to spend one’s life.

My kingdom for some clarity.


prison sentencing

i am fucking bitter today.  in fact, just call me oscar the grouch.

i had high hopes for my psychiatrist appointment.  since the seroquel has been working, and since i am taking ~subtherapeutic doses of lithium (600 mg) and lamotrigine (100 mg), i thought i might have a shot at tapering off of them while remaining on the seroquel.

of course, in hindsight, my thinking was too simplistic.  i was only considering the unique effects of each medication.  whereas lithium made me not *as* depressed (but still flat), and i didn’t even really notice anything with the lamotrigine, seroquel was the drug with noticeable, measurable effects on my mood.  i’ve felt like “myself” for the first time in 2 years.  so of course, i concluded that i should be able to remove the other drugs while remaining on seroquel.

not so.  my psychiatrist reminded me that there are possible interactive effects that i’m not considering.  it’s possible that seroquel works well *in combination* with lamotrigine or lithium.

moreover, he recommended that i remain on treatment for at least 9-12 months after the onset of remission.  NINE TO TWELVE months.  fuck my mother fucking life.

why 9-12?  well, for people with a *first* episode of depression, the probability of relapse increases substantially if treatment is not continued for at least 9 months (while in remission).  that’s not even considering people who’ve had more than one episode of depression; for them the relapse rate is even higher.

so, my intellectual side is responding to these data and to an obligation to the “responsible” thing to do (i.e., stay on medication).  everything else is up in flames.  i am so angry, so disappointed, so frustrated, so defeated.  these medications are not just medications.  they are symbolic representations of my intense struggle with the bipolar diagnosis.  i want to be DONE with them.  i want to move ON with my life.  and i want to be off medication so i can begin to truly explore whether i am bipolar or not.

except today, i learned that i will not be able to do this.  in fact, i will not be able to do this for a very long time.