Daily Archives: February 18, 2014

I don’t know what to do?






I just posted on Facebook ......"I can't believe that it's exactly a year ago that I was on my way to hospital and really thought I was going to kick the bucket! Right now I'm feeling extra grateful that I'm still here... And very much alive and kicking :-)"
Truth is,  I don't feel alive at all. I'm really struggling with everything and I don't know what to do. I keep telling everyone I'm fine. I'm not lying, a lot of the time I am. I am managing to get by. I'm managing to hide how I'm feeling but it's so hard. I keep telling myself I'm coping well but a lot of the time I'm not and I really don't know how to handle it. It's a couple of months now since I decided to stop my medication. I can't say if it's made any huge difference. I was a mess with it and I'm still a mess without it. Some things are better, some things are worse. I've got so much going on at the moment and I can't seem to work out what's what. I've got stuff going on that would test anyone's mental health....bipolar or not. I don't want to panic and go back on medication just because things aren't perfect in my life. I've been trying to sort things. 
 The best thing that's happened is that I've got a part time job. It's been really good for me so far. I've got something different to focus on for a few hours.
The worst thing is that I just can't sleep. I haven't had more than three or four hours sleep a night for weeks. Sometimes less. I go to sleep ok but I just keep waking up every five minutes. Then I can't stop ruminating about everything and everybody. It's wearing me down. I can't think straight. This is the first time I've written a blog for ages. It's not that I haven't had anything to say, it's just that I haven't been able to concentrate for long enough to get it on paper.
When I went to see my psychiatrist last week he was adamant that he thinks I should go back on the Lithium. He gave me a long lecture about diabetes and what would happen if someone stops their insulin. I know all about diabetes, I don't need a lecture. It's a completely different thing. The only advice he gave about my sleep was to keep a sleep diary. I haven't done it. I can't. By the time I remember to do it I haven't got a clue what I was thinking of when I woke up in the night....anything and everything. I've got so much I want to write about but I've had enough for now. I'm reading back what I've written and I really don't have a clue if I'm making any sense at all. I feel really vulnerable at the moment and I know I need to try and get a grip before something bad happens. 

I don’t know what to do?






I just posted on Facebook ......"I can't believe that it's exactly a year ago that I was on my way to hospital and really thought I was going to kick the bucket! Right now I'm feeling extra grateful that I'm still here... And very much alive and kicking :-)"
Truth is,  I don't feel alive at all. I'm really struggling with everything and I don't know what to do. I keep telling everyone I'm fine. I'm not lying, a lot of the time I am. I am managing to get by. I'm managing to hide how I'm feeling but it's so hard. I keep telling myself I'm coping well but a lot of the time I'm not and I really don't know how to handle it. It's a couple of months now since I decided to stop my medication. I can't say if it's made any huge difference. I was a mess with it and I'm still a mess without it. Some things are better, some things are worse. I've got so much going on at the moment and I can't seem to work out what's what. I've got stuff going on that would test anyone's mental health....bipolar or not. I don't want to panic and go back on medication just because things aren't perfect in my life. I've been trying to sort things. 
 The best thing that's happened is that I've got a part time job. It's been really good for me so far. I've got something different to focus on for a few hours.
The worst thing is that I just can't sleep. I haven't had more than three or four hours sleep a night for weeks. Sometimes less. I go to sleep ok but I just keep waking up every five minutes. Then I can't stop ruminating about everything and everybody. It's wearing me down. I can't think straight. This is the first time I've written a blog for ages. It's not that I haven't had anything to say, it's just that I haven't been able to concentrate for long enough to get it on paper.
When I went to see my psychiatrist last week he was adamant that he thinks I should go back on the Lithium. He gave me a long lecture about diabetes and what would happen if someone stops their insulin. I know all about diabetes, I don't need a lecture. It's a completely different thing. The only advice he gave about my sleep was to keep a sleep diary. I haven't done it. I can't. By the time I remember to do it I haven't got a clue what I was thinking of when I woke up in the night....anything and everything. I've got so much I want to write about but I've had enough for now. I'm reading back what I've written and I really don't have a clue if I'm making any sense at all. I feel really vulnerable at the moment and I know I need to try and get a grip before something bad happens. 

I don’t know what to do?






I just posted on Facebook ......"I can't believe that it's exactly a year ago that I was on my way to hospital and really thought I was going to kick the bucket! Right now I'm feeling extra grateful that I'm still here... And very much alive and kicking :-)"
Truth is,  I don't feel alive at all. I'm really struggling with everything and I don't know what to do. I keep telling everyone I'm fine. I'm not lying, a lot of the time I am. I am managing to get by. I'm managing to hide how I'm feeling but it's so hard. I keep telling myself I'm coping well but a lot of the time I'm not and I really don't know how to handle it. It's a couple of months now since I decided to stop my medication. I can't say if it's made any huge difference. I was a mess with it and I'm still a mess without it. Some things are better, some things are worse. I've got so much going on at the moment and I can't seem to work out what's what. I've got stuff going on that would test anyone's mental health....bipolar or not. I don't want to panic and go back on medication just because things aren't perfect in my life. I've been trying to sort things. 
 The best thing that's happened is that I've got a part time job. It's been really good for me so far. I've got something different to focus on for a few hours.
The worst thing is that I just can't sleep. I haven't had more than three or four hours sleep a night for weeks. Sometimes less. I go to sleep ok but I just keep waking up every five minutes. Then I can't stop ruminating about everything and everybody. It's wearing me down. I can't think straight. This is the first time I've written a blog for ages. It's not that I haven't had anything to say, it's just that I haven't been able to concentrate for long enough to get it on paper.
When I went to see my psychiatrist last week he was adamant that he thinks I should go back on the Lithium. He gave me a long lecture about diabetes and what would happen if someone stops their insulin. I know all about diabetes, I don't need a lecture. It's a completely different thing. The only advice he gave about my sleep was to keep a sleep diary. I haven't done it. I can't. By the time I remember to do it I haven't got a clue what I was thinking of when I woke up in the night....anything and everything. I've got so much I want to write about but I've had enough for now. I'm reading back what I've written and I really don't have a clue if I'm making any sense at all. I feel really vulnerable at the moment and I know I need to try and get a grip before something bad happens. 

Quietly Onwards

Things have been busy out here lately, and while there’s a lot on my mind, I’m not quite at a point to where I wish to talk about it. It’s nothing bad though, I assure you — just a lot of things in general. But I can say everything being done is being done with prioritization to my mental and physical health, so that’s awesome. *smiles*

There’s one thing that’s worth noting right now, and that’s how delightfully cogent I have been in the morning. I don’t think that will last once I’m back on the Seroquel, but for now — I’ve been using it as a time to get caught up on my daily blogging, and to try to spend a spoon or two in education mode as I can. For example, one of my dear friends posted this on Facebook overnight:

7 Things You Shouldn’t Say To Someone With Anxiety
http://www.huffingtonpost.com/2014/02/17/things-not-to-say-to-some_n_4781182.html#307367461

And you know what? I went all out to try and explain why anxiety is totally unreasonable and stupid, and sufferers know the things they’re anxious about are unreasonable and stupid, but you know what? That doesn’t fix the broken wiring. I went so far as to explain one set of circumstances that pushes my anxiety to pretty suicidal levels, and I’ll share that here too (and if you’re also one of my LJ friends AND FB friends, sorry for all the repeat today, hee hee):

‘I am both blessed and cursed with a severe aversion to lying. I can’t even pretend to be what I am not without pushing myself into near-suicidal panic. Which is distressing, ’cause yanno, sort of a useful survival skill. Which is why I tend to use more resources than I have trying to explain things! Because I truly do want to help people understand for my sake and others, but because if I can’t hide it, well.

But it’s also why I make clear my stance against societal ‘niceties’ that I disagree with — pretending that I concur with them stresses me out to the point I want to end my life. This is not me being ‘dramatic’. This is a severe and dangerous fault in my broken wiring that I have NO idea how to work around besides utter honesty about the particular fault. So, of course, I prefer to just circle around it rather than having to out and out say these things! And yeah, normally wouldn’t just whip that out either, but I figured it was a prime example of ‘this is how anxiety is stupid and I know it is stupid but understand that it is stupid and just how dangerously stupid it can be’.

I have to be honest — I feel fucking fabulous for admitting that. Any time I can make myself break past the anxiety to explain some of its stupidity, I feel like it lessens its grip on me. Not all the way; I will never be happy being anything but who I am, and I don’t ever see a day asking me to be otherwise will be anything but distressing. After all, it invalidates me and my experience. It might not be a pretty one, but it’s mine, damn it. I am certainly happy when I can smooth out the ride, I don’t consider my existence or the way I function (however crappily) to be invalid.

So anyways, I can’t complain. I’m feeling fairly calm and happy about my life right now, even if it’s a bit busy and hectic. I’ll hopefully talk about that later, but for now — I’ve got pizza to eat. *grins*

Hope everyone is doing well out there.

<3

The post Quietly Onwards appeared first on The Scarlet B.

I. Am Terrified


It’s been a long time coming, but I finally had one of my major panic attacks.  It’s been a while, I am proud of that fact, but it doesn’t take away the pain and fear of this last one.  I know what sparked it; we are leaving for our trip tomorrow.  

I have been doing a lot better getting out of the house.  As long as my fiance is with me and I don’t look at the people I pass by in the stores, I have even enjoyed myself.  Last week when we had to stay at the hotel during the snow storm, I managed my OCD germ phobies without freaking out.  But now…now we must drive through ATLANTA!  We are leaving early enough to miss rush hour, but come on, it’s still ATLANTA.  Yes, that city must be in all capitals because, in my mind, it is a scary place that wants me dead.  It wants my children dead.  It will go out of its way to make us be in a horrible wreck or some other catastrophe.  Because, well, it’s ATLANTA.  

I know the odds of being in a wreck are just as common close to home or whatnot, but I am terrified of riding in more than two lanes of traffic.  It just seems to me there are too many lanes going on in Atlanta, too many drivers smushed together at one time, for there not to be a few deaths along the way.  Take into account my fiance’s road rage, travelling with two children, and the way my hyperventilating tends to piss him off even more in a situation like that, and…I really don’t want to go through it.

But my oldest daughter is counting on me to be there at her livestock show, so I have to go through this.  If I die, I will die trying.  What really worries me is my children’s lives…

But, I must try to push these thoughts out of my head.  There is packing to do.  A lot of it.  If all goes well, we should be home sometime Saturday.  I really, really hope all goes well.  I want to enjoy this trip.  It’s the closest thing to a vacation that happens for us.  We even bought swimsuits for the indoor pool…and public pools are another one of my terror-sites, but at the moment it is a distant second to the drive to get there.  

Beating Anxiety, Losing at Life



Fuck, I knew this was going to be a weird/bad day. First, I had a dream that a "gang" of 4 other black cats and 1 ruffled young crow were trying to stare down Frankie (my black cat seen in my pic, not vid) and scare her away. She stood by my side, and met their stares, then they slowly turned around and walked away.

I noticed I was standing on the curb of a corner on the street, and a flood had started. By the time I noticed the water had reached my ankles, covering my dirty white tennies, Frankie was in her own little row boat, rowing away, disappearing from the scene. I tried to call her back, but she was gone. Then I woke up. That's when I went into the bathroom and got the Don't Fear The Reaper treatment from the radio. It was almost 4.30am.

I had only 2 cups of coffee while watching The Walking Dead, and messing around on the computer. Then I switched to green/jasmine. TWD was over, I was still on the computer, and jumping around from screen to screen, trying to hide my google stuff from my spouse, 

I started to get cold. Then I noticed I was freezing and sweating at the same time. Great. Next came the shaking and realization that fucking anxiety or an attack was coming on. FUCK! So fucking early?! I had already taken meds, too, but then I looked on the table and noticed I forgot my nighttime meds... 600mg of seroquel and 1mg of clonazepam.

Fuck. If I take it, it's goodbye for the rest of the day, or dizzy weirded out woman. Unpredictable. Hmm...Maybe 200mg? Let's see if that does the trick.

I don't wan't the start of my damn week ruined because of my meds (probably) fuck-up! I have a schedule! I have some exercising to do! I don't want to be a lazy lump on a log and sleep the day away. I can't. I had that beaten into me, and it stuck. I would feel so guilty if I fell asleep or took a nap. Stupid, I know.

Hmm.. I'm not shaking so much. My insides still feel like they are, and my hands feel weird, like I can't completely control them, as if they have something else they want to do or write?

Breathe in. Breathe out. Breathe in. Breathe out. Breathe in. Breathe out. Continue...

I can force myself to relax my shoulders now, if I keep thinking about them, but it's getting hard, because I have to think of too many body parts and functions/control at once. Can't do it.

Breathing for a while...

Damn phone rings. I answer. Silence. Had enough silence and now irritated, "What the fuck do you want?" More silence then ""Blah blah blah" crash!

Down goes the phone. I hate a second of my time on the home phone wasted. Mean, aren't I? Some of it's part of me fighting the anxiety, the other part is just generally ugly hateful bitchiness toward telemarketers. Telemarketers = people that make me get off of the couch, move my computer, and have to deal with another person.

Ok...Try not to read too many sad things that some people have experienced and written about. It breaks my heart...

Reading email not good for anxiety..

Drinking water, the seroquel, and breathing is helping.

This is helping.

Or helped.

I watched HBO's GIRLS, then some other crap, and curled up on the couch with water and wheat chex. I didn't feel sleepy at all, and at some point, the anxiety decided to finally take a hike. Hopefully, it went and attacked someone truly evil, and took them down.

Green Lights and Blue Skies

You know it’s gonna be a good day when a doctor tells you that you don’t need his services.

Today was the day Will and I have been dreading for weeks: the appointment with the radiation oncologist. We were afraid this meant that the cancer was spreading to his bones and that we would have to undertake the daily routine of treatments for God knew how long…..and at what cost. He didn’t want radiation, he said; wanted only to continue taking the oral chemo and hope for the best. But with the threat posed by the likelihood of bone metastasis, it was something that had to be considered.

Needless to say, the suspense has been hard to bear. We’ve lived with our fears by day, taken them to bed with us by night. I’m pretty sure it’s even had something to do with my recent mood instability. And as we sat in the exam room this morning, I was silently frantic that he would refuse the treatment, even as I was busily trying to figure out how he would get to the daily appointments when I needed the car for work. Would I have to quit my job? And if so, what would we do for money? Or health insurance? I was lucky to have landed this position……it’s not like there’s a huge job market for 55-year-olds……and I didn’t fancy living in a cardboard box behind the strip mall…..

……and so on, and so on. That’s what I mean when I say I have this tendency to catastrophize. If I didn’t spend so much time over-thinking things, I might have found the CURE for cancer by now. But when the doctor came in and began to show us the results of the MRI and the X-rays, all of that went away.

Long story short, Will does have lesions on his bones, but the only one of any concern is located in his lumbar spine, and it’s obviously been there for a while. It is also not growing, nor is it causing the vertebrae to collapse (although that is a possibility down the road), nor is it giving him any pain. In fact, the risks of radiation at this point are higher than the benefits, and as for the rest of his tumors……the doctor called them “stable”.

There may not be a more beautiful word in the English language.

Naturally, the consensus among family and friends is that we’ve been given a reprieve, although it is in the context of stage IV cancer. We know the day of reckoning is coming, but it’s not here yet, and it may not arrive for some time…….as long as the medicines keep working and his overall health continues to hold. His spirit remains strong, and if you were to look at him right now, you’d never even know he’s sick at all.

So today, it’s all green lights and blue skies……and for once, I’m not going to worry about what tomorrow may bring.


Extremely Rare Side Effects From Psychiatric Medications

I’ve actually had 2 of these: Stevens Johnson Syndrome and Diabetes Insipidus. Aren’t I lucky?!

Diabetes insipidus

Info

Most common drug to cause this: Lithium

Occurrence: 5-20%

Nephrogenic diabetes insipidus (NDI) occurs when the kidney tubules do not respond to a chemical in the body called antidiuretic hormone (ADH), also called vasopressin. ADH normally tells the kidneys to make the urine more concentrated.

As a result of the defect, the kidneys release an excessive amount of water into the urine, producing a large quantity of very dilute urine. This makes you produce large amounts of urine.

Diagnosis: A physical exam may reveal:

  • Low blood pressure
  • Rapid pulse
  • Shock
  • Signs of dehydration

Testing may reveal:

  • High serum osmolality
  • High urine output, regardless of how many fluids you drink
  • Kidneys don’t concentrate urine when the person is given ADH
  • Low urine osmolality
  • Normal or high ADH levels

Symptoms: You may have intense or uncontrollable thirst, and crave ice water. You will produce large amounts of urine, usually more than 3 – 15 liters per day.

If you do not drink enough fluids, dehydration can result. Symptoms may include:

  • Dry mucous membranes
  • Dry skin
  • Sunken appearance to eyes
  • Extreme thirst
  • Urinating a lot

Treatment: The goal of treatment is to control the body’s fluid levels. Patients will be given a large amount of fluids. The amount of fluids given should be about equal to the amount of urine produced.

If the condition is due to a certain medication, stopping the medicine may improve symptoms. Never stop taking any medication without first talking to your doctor.

A medicine called hydrochlorothiazide may improve symptoms.

diabetesinipidus

Agranulocytosis

Info 1 Info 2

Most common med to cause this: Clozapine

Occurrence: 5%

Agranulocytosis is a rare condition that occurs when the bone marrow does not make enough neutrophils, the white blood cells needed to fight infections

Diagnosis: Blood test

Symptoms: The early symptoms of agranulocytosis include a sudden fever, chills, a sore throat, and weakness in the limbs. The mouth and gums may be sore, mouth ulcers can develop, and gums might begin to bleed.

Other signs of agranulocytosis can include:

  • fast heart rate
  • rapid breathing
  • low blood pressure
  • skin abscesses

Treatment: If the agranulocytosis is caused by a drug needed for another condition, a substitute treatment will be offered. For anyone taking several different drugs, it may be necessary to stop taking them. This could be the only way to find which one(s) may be the cause of the problem.

Antibiotics or antifungal drugs may be given to treat any infections.

F3.large

Stevens Johnson Syndrome

Link 1 Link 2

Most common med to cause this: Lamictal

Occurrence: 0.8%

Stevens-Johnson Syndrome is the most severe form of erythema multiforme and is characterized by ulcerated lesions on the skin and mucous membranes.

It is a serious, sometimes fatal inflammatory disease. It is also known as erythema multiforme major.

Diagnosis: The diagnosis of Stevens-Johnson Syndrome is usually based on the clinical appearance and distribution of the skin and mucosal lesions. A skin biopsy may be performed.

Symptoms: Typically, Stevens-Johnson syndrome affects the mucous membranes of the oral cavity, nostril, eyes, and both the anal and genital regions. It may or may not be associated with skin lesions elsewhere on the body. Oropharyngeal (mouth) lesions may be so intolerable as to prevent eating, and there may be recurring oral ulcers. Often, the skin lesions may look like a target-lesion (3 concentric zones of color change) or as bullae (bubble-like).

A painful conjunctivitis may occur in the eye, frequently with a pus discharge, and can lead to corneal scarring and loss of vision. In addition to the mucous membrane lesions, fever and exhaustion are usual.

Approximately one-third of patients have pulmonary involvement with cough and patchy infiltrates (material that has permeated into the tissues) on chest x-ray. In fatal cases, renal failure and pneumonia may occur.

Treatment: Every attempt should be made to identify a precipitating agent, and to remove it if possible. Antibiotics are appropriate if superinfection (a fresh infection added to one of the same nature already present) is suspected, or if bacterial disease, such as mycoplasma, is suspected to be the cause. Intensive supportive care is important in severe cases, including specialized care in a burn unit.

Fluid replacement is often required, and meticulous oral hygiene is necessary to prevent superinfection. Examination by an ophthalmologist is recommended for patients with eye lesions so that precautions can be taken to avoid permanent eye damage. Oral and topical corticosteroids are often used.

rash-on-the-arms

Priapism

Link 1 Link 2

Most common med to cause this: Typical (old) antipsychotics

Diagnosis: Your doctor will review your medical history and perform a thorough physical exam to determine the cause of priapism. This will include checking the rectum and the abdomen for evidence of unusual growths or abnormalities that may indicate the presence of cancer.

Symptoms: Priapism is a persistent, usually painful, erection that lasts for more than four hours and occurs without sexual stimulation. The condition develops when blood in the penis becomes trapped and unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction.

Treatment:

  • Ice packs: Ice applied to the penis and perineum may reduce swelling.
  • Surgical ligation: Used in cases where an artery has been ruptured, the doctor will ligate (tie off) the artery that is causing the priapism in order to restore normal blood flow.
  • Intracavernous injection: Used for low-flow priapism, during this treatment drugs known as alpha-agonists are injected into the penis. This causes the veins to narrow, reducing blood flow to the penis and easing swelling to the area. Oral alpha-agonists have also been used for the acute treatment of priapism.
  • Surgical shunt: Also used for low-flow priapism, a shunt is a passageway that is surgically inserted into the penis to divert the blood flow and allow circulation to return to normal.
  • Aspiration: After numbing the penis, doctors will insert a needle and drain blood from the penis to reduce pressure and swelling.

10331-0550x0475

The Letters After My Name

Laura P. Schulman, MD, MA, FAAP.  What do these letters mean, of themselves, and what do they mean to me?  Why do I use them, here on Bipolar For Life?  What, if anything, do they have to do with bipolar-ness?  And most importantly, why do I insist upon using them when the professional qualifications they symbolize are now meaningless?

MD: Medical Doctor.  A passion since childhood, hard-won.  I put myself through college (oh yes, another set of letters: BA, Bachelor of Arts) by holding down three jobs while taking a full course load.  I know, I know, hypomania.  But it was fun, and I would have graduated with honors except that the required Honors Seminar conflicted with one of my jobs.  Oh well.

The MD turned into a combined degree program in Medicine and Medical Anthropology, six years.  Graduated with a perfect grade point average, 5.0.  Number One in my class (actually shared with my then-husband, who also had a 5.0), inducted into the Alpha Omega Alpha Medical Honor Society.

My first year in practice as a Pediatric Emergency Physician, I was inducted as a Fellow of the American Association of Pediatrics, and added FAAP to the collection.

All that stuff, including the wisdom garnered while cocktail waitressing as an undergraduate:  I used it until that very bad day, April 4, 2000, when I locked my office door for the last time, drove home, and went into a catatonic depression that resulted in my permanent disability.

All those letters, lost.

OK, yes, I did earn them, every one of them.  And it could be argued that in so doing, I earned the right to keep them after my name, forever.  No one can ever take them from me.

On the other hand, I feel lost when I look at them.  It’s as if–no, it isn’t as if–it’s the reality, cold and hard, that I am no longer who I once was.  I no longer go to the ER or the office every day.  I no longer practice Pediatrics, or anything else.  I live moment to moment.  My energy goes into keeping my mind in a reasonably healthy trajectory, and it takes every once of energy I have just to keep living from one moment to the next.

For a long time I used the letters after my name as a reminder of what I have achieved in this life.  But now I feel that they have become a burden.  I look at them and cringe.  This is not what I wanted for a life.  This is not what I worked 20 hours a day during my undergraduate years, who knows how much during my Medical and Graduate School years, 120 hours a week during internship and residency–I did not work all those hours to be sitting around like a bump on a log just trying to keep my shit together so I don’t start screaming and scare the dog.

I look at those letters, and I start to cry.  I think about the people who read this blog, or my comments, and think I am a practicing physician with oodles of money, knowledge, and perhaps power.  And I think I am misleading them.  In fact, I know that’s the case sometimes, from comments I’ve received.

Those letters weigh upon my soul.  They sit on me like an elephant.

It’s not that I don’t want them anymore.  I earned them with my sweat, blood, and tears, dammit.  They’re mine.

It’s just that right now I’m feeling the grief of my lost life, and I don’t want them staring me in the face every time I look at my blog or my email signature.

So I think you will see the letters after my name disappear.  Not today; I don’t have the energy for it.  But soon.  Maybe tomorrow.