Daily Archives: May 13, 2014

Color me confused yet again

I wasn’t having a bad day aside from the weather turning from scorching hot to wet and cold overnight. Definitely brought on the seasonal thing. It wasn’t until after the appointment with the child behavioral counselor that things seemed to shift to a not so nice place.

It isn’t as simple as hearing things I don’t like.

I am fine having my own flaws brought to light so I can attempt to fix them. But therapy is a double edged sword inasmuch as it can help while hurting. They say one thing, then contradict it with another, and you’re left feeling like an idget. I am not a fan of this new mamby pamby approach to child rearing. “She’s just being a normal kid, let her be.” “You have to take back your authority and give her boundaries.”

HUH? Had I not been confused to begin with, I would be now. Maybe it is all just me. I just don’t buy it, though. I am a contributing factor but I still think 4, nearing 5, is old enough to know strangling a cat is WRONG. I was also chastised for viewing her behavior as manipulative (why am I not surprised the truth is frowned upon) and also using the ” satan voice” which the counselor said concerned her. Puh-leeze. Everything that is effective is somehow bad in mamby pamby parent land. Not like I’m beating her with wet noodles or something heinous. I’m just speaking in a voice that gets her attention.

This counselor’s idea of validation is “Your insecurity makes you second guess yourself and you have to stop that or your child wins.”

30 years of therapy hasn’t made me less insecure, so how will this help? It’s like being on a hamster wheel and I think that I want off. It’s not helping. I’ve played it by ear from the start, I think I am just gonna keep doing that. Least then the confusion is natural and not something insurance paid for me to be.

I thought I had a dr appt tomorrow. I didn’t get a reminder call and can’t find the appt card so…I have no idea. I can’t retain short term memory these days. Hell, the other day it hit me I didn’t even check to see if my kid was wearing shoes when I put her on the bus. I know I told her to put them on but then…BLANK. Disturbing, to say the least. Its like my brain has become swiss cheese, solid yet full of holes. I blame the meds but I am sure they’ve done research and determined its cat dander, anything but the pharma companies.

It’s so weird. Earlier, I felt okay, muscles weren’t stiff, stomach wasn’t in a knot, energy was up. And a partial day’s outing just wiped me out. Now I ache, my stomach burns, my energy is nil.

I have so many weird days. Like Sunday when I barely moved out of my safe spot in the chair because “I felt” like something bad would happen if i did move. Those mental states are disconcerting.

Every day is the same with the world going on around me. Same routine, mundane, pointless at times.

Every day is different, in my own mind. Ever changing, shifting, evolving, going neurotic, getting bold, growing paranoid.

I’m just fucking confused by it all.


Bipolar Medication Cocktails (With A Side of ECT)

I find it helpful to read what drugs are working for my fellow Bipolars. One of my most popular tags is “Best Bipolar Medications” so I know it’s something that other people are searching out too. I thought I’d give an update on what’s working for me, especially since I’ve come back from the very brink, in that I was very, very seriously suicidal at the end of January and I’ve managed to make my way back to the point that I actually have some hope for the future (amazing even to me).

When I was hospitalized in January, the psychiatrist and medical director at the hospital got out what he calls his “big guns” and put me on Clozaril 100 mg and unilateral ECT. Although this has been effective, I don’t recommend it unless you are profoundly desperate, as the Clozaril will cause weight gain due to marijuana-like munchies. In addition, I am on Topiramate 50 mg (to try and give me some impulse control over the munchies), Bupropion XL 450 mg for depression, and Clonazepam .5 mg for sleep. The Clonazepam is a recent addition, as my sleep was quite disturbed and my psychiatrist was worried that I would cycle back into depression. I took it for the first time last night and I was happily zonked.

So people, what’s working for you? Please share in the comments. Let’s help each other!


Filed under: Bipolar, Bipolar Disorder, Bipolar ECT, Psychology Shmyshmology Tagged: Best Bipolar Medications, Bipolar, ECT, Hope, Mental Illness, Psychology, Reader

Another Day, Another Tap

Hello from the Tapping Headquarters of Boulder, Colorado. Yes I am still Tapping and yes it is still working me over. It’s so monumental to me to see a willingness to look at and let go of this old shit that has been ruling my life!! I have to say that I think one of the most powerful healing tools we can employ is WILLINGNESS!! I have spent a lot of time being stuck, being defiant, being justified in my anger, grief, pain, and/or just general stuck-ness. I have to say, I’m over it! I don’t want to do it anymore! But these feelings have become HABITS that are like well-worn grooves in my brain, the record wants to play over and over again! Tapping is helping me to let go of those old habits that for sure do not serve me. It takes courage to change! I don’t know what’s out there! I don’t know what’s next! But I DO know that I don’t want more of the same. Onward and upward!!


Filed under: Bipolar, Bipolar and Stuck, Bipolar Disorder, Psychology Shmyshmology Tagged: Bipolar, Embracing Change, Hope, Mental Illness, Psychology, Reader, Tapping, Willingness

Body Image

When you suffer from depression, many things that might have been just a slight inconvenience in your life suddenly begin to define you.  As a child, I was always a bit overweight.  I was bullied constantly, sometimes even by my own family.  The older I got the worse it got, even though when I look back on those photos from those times, it occurs to me, I truly was not fat.  I would give a million dollars to be that “fat” now. 

 

So, as time goes on and you’re constantly subjected to name calling and abuse, the bad stuff starts to become easier to believe.  If someone were to pay you a compliment, your standard response becomes,

“Yeah right” and you walk away.  My self-esteem was always in the gutter.  From the days I had to shop in the “husky” department with my parents at Sears, while all of my friends were wearing Guess or Esprit.  The bullying got worse as people decided my eyes were too big, my forehead was too big….you name it. 

 

So, by the age of 18 when the depression was really taking over my life, these were the only things I could think of when I looked in the mirror.  I had long since been abusing laxatives and starving myself, and sometimes I actually lost weight.  However, the damage I did to my body still affects me to this day.

Some of us who deal with depression let it take over our thoughts, and it teaches us to hate ourselves, and our bodies.  Which is why some of us resort to self-injury.  I can remember not eating, taking laxatives, and doing sit ups incessantly.  I studied every inch of my body and believe me; I knew what self-loathing was at a very early age. 

 

Now that I am older, I can’t seem to get beyond those feelings.  If you fast forward to now you will see someone who is miserable, has no self-esteem, and is overweight for many, many reasons.  The primary reason, despite all of the other obstacles in my way, is that taking care of myself has always been too hard.  Too much of a burden.  Don’t get me wrong, I shower, do my hair, and will at times wear makeup…..try to look nice for events and for my husband.  But, what most people would consider just being lazy, I call depression. 

 

One medication in particular that I take causes weight gain, and I’ve been on it over 10 years.  You do the math.  Every day, I look in the mirror and I beat myself up.  Why haven’t you done this?  Why didn’t you do that?  You swore you would lose this weight by the time you turned 35, what is wrong with you? 

 

Oh, if only it were that simple.  Depression causes you physical pain, not just mental or emotional.  When you are hurt or injured, many times the depression amplifies it so that you feel more deeply than the average person.  This pain is what keeps me from doing whatever I can to exercise and get rid of some of this weight.  Now, I know there is just no way around it.  I am miserable.  I don’t leave my house anymore.  I don’t want anyone to see me like this.  Baby step #1 starts with trying to figure out my excruciating back pain, and once we come to terms with that, Baby step #2 will be determined. 

 

One day you will wake up and realize that every scar, every stretch mark, and every imperfection is what makes you beautiful.  Every day you fight what most would consider a losing battle, and you come out on top because you made it through. 

 

When the time comes, and you are ready to maybe drop a few pounds, start an exercise program, and change your eating habits, you will have the confidence to succeed because you are a fighter.

 

Just try.  As hard as it is, just try.  I KNOW it’s easier just to lie in that bed and cry.  I have resorted to that myself on many occasions.  Please…..for you, your family, and for me, just try.  I’ll be right there with you, trying as well.  You can do this.  You are not just a survivor, you are a warrior. 

Stress Reduction From Our Four Legged Friends

I want a pet. Soft and cuddly, scaly and cool, or wet and wiggly. I don’t care. I want a pet. I want a non-human, easy to love creature that I can take care of. I’m not too picky, I just want a critter, that I believe, will help reduce stress and anxiety. Studies going […]

Stuff That Really Grosses Me Out

WARNING: Not for the faint of heart…..or stomach ;-)

You might think (being a nurse and all) that mine is made of cast iron and nothing gets to me—blood, guts, puke, poop et. al. And for the most part, you’d be right, because none of those things bothers me. I’ve had patients pee on my shoes, seen an elderly woman projectile-vomit blood across a hospital room, and cleaned up literal rivers of something people do a lot of when they’re preparing for a colonoscopy. I’ve even had dead toes drop off in my (gloved) hands when changing a dressing.

No, what makes me want to yak are the easy things…..like feet. Oh, dear God, how I hate feet. If you’ve ever had to pull the socks off a homeless guy who’s been wearing the same pair for six months, you’ll have an idea why. I don’t even like messing with my OWN feet, even though I have to because I’m a diabetic and we tend to have foot problems. I have consistently refused to do foot care on other diabetics throughout my nursing career, because while my feet are bad, their feet are disgusting! I have nightmares just thinking about their thick, horny toenails and flaky skin and…..well, you get the picture. Feet are ugly, feet are stinky, feet are gross. Yeccccchhh.

Mouths are nasty too, especially when you’re dealing with someone who doesn’t clean their teeth regularly. I almost quit nursing school when I had to scrub several days’ worth of crud and corruption out of an elderly woman’s dentures…..it was all I could do not to hurl in the sink. Unfortunately for me, I’ve never quite gotten used to dealing with the damned things, and equally unfortunately, Will has a habit of leaving his partials around the house. I’ve found them on the nightstand, by the coffeemaker, even on the dining-room table. `ulp`

My other Kryptonite is eyes. They’re basically jelly and goo; for a remarkable organ they are made of some fragile stuff. I was just watching an old episode of Criminal Minds in which this dude was going around killing people and taking their eyes—a process called “enucleation” when doctors harvest them for corneal transplants—and I had to watch most of the show with my own eyes shut tight.

It’s easy to figure out where that particular phobia came from. Years ago when I was working nights in a nursing home, we got this fellow in who’d had almost half of his face removed due to oral cancer. We nurses literally had to go in every 2 hours, night and day, to spray saline solution inside his skull to keep the remaining mucous membranes from drying. I mean, you could see the muscles, the cheekbone, the eye…..and the smell was unspeakable. Even the old battle-axes had to hold their breath when performing this procedure. The poor man died within a couple of weeks, and I think all of us were as relieved as he was when it happened.

Now, give me a good old-fashioned double-ender or an infected wound any day—I can take care of the problem and eat lunch while describing it in detail half an hour later. Because that is what nurses do. And I have the feeling I’m going to be one again, in one fashion or another, before too much longer. I have an interview tomorrow for a case manager position at a local home-health agency. The idea of overseeing the care isn’t too scary since I wouldn’t have to be in charge of the nurses actually providing the care, and I like the idea of working 1:1 with clients and helping them find the services they need.

We shall see, anyway.  Wish me luck!

 

 


Here There Be Monsters

When I was a little girl, the space underneath my bed was rotten with monsters.

I had to take a running start to make the three-foot leap into bed, so that a scaly hand or tentacle would not snake out and snag me, dragging me into the dark waiting maw, where they would all fight over my little body, tearing it to shreds, and that would be the end of me.

Now I’m finding that that leap is impossible; it’s futile; the waiting monsters are licking their chops.

My dad is declining rapidly.  He’s been hallucinating, confusing familiar sights and sounds with threatening nebulous images.  Well, he IS an artist, and my favorite show of his was called “Fantasies and Daydreams.”  And now his imagination creeps up on him from behind, casting veils of illusion over his senses.  He dozes, and sudden terrors trigger his fight-or-flight response: he flails with hands and feet, and today twice pitched forward, and would have launched himself out of his wheelchair face-first on the floor, had I not been right there to lay a reassuring hand on his shoulder and tell him it’s OK, nothing is going to harm him.  He wakes from these fits, thank God, when someone intervenes.

The hospice nurse brought up the possibility of giving him a small dose of Haldol, a major tranquilizer and antipsychotic, but my mother voted it down.  She’s worked with the elderly for most of her life, and seen Haldol used as a way of drugging “problem residents” in nursing homes, so that they cease to be a trouble to the nurses.  I’ve tried to explain that the idea here is not to drug him into a zombie, but to relieve him of horrible experiences that are eroding the little quality of life he has left by transforming the music he loves into threatening voices, and the beautiful forest where they live, which has always been an inspiration to him, into a hall of shifting and changing faces, leering with evil eyes and gaping mouths.

I think she will reconsider the Haldol shortly, if for no other reason than to relieve herself of the exhaustion of constant vigilance.

Last week he even got out of his hospital bed somehow, in the middle of the night, and must have wriggled across the floor–he can no longer walk, and he can’t control his arms and legs enough to crawl–and ended up wedged between the sofa and a chair.  The only reason my mom found him at six in the morning is that the upstairs bathroom was being worked on and she had to go downstairs to use that one.  And she heard him moaning, and there he was on the floor.

The drill now is that when he ends up on the floor, we call Hospice and they decide whether to send over a nurse, or to call the First Responders to look him over and get him back into bed.  That is what happened in this case, and my mom said they were very rough and literally dropped him on the bed, didn’t bother to get him pulled up onto the head of the bed but left him with his feet hanging over the foot of the bed.  Mom tried to shift him up, but couldn’t do it, so there he lay until the morning attendant arrived.  Dad was so worn out by the whole process that he was unable to even sit propped up that whole day, and besides, he had hit his head again and was really “out of it.”

In the past, when those scenarios occurred, we would call the ambulance and he would be taken to the hospital, and we would spend an anxious and exhausting eight hours waiting for the CT scan and all that to be done, and he would either be discharged home or admitted for observation.  Now that we’re on Hospice, we don’t go to the hospital any more.  We’ve all agreed that we are at the end of Dad’s life, and the aim is to make him as comfortable as possible as we wait for the end.

It’s devastating to see the man to whom I have compared all other men, and found them all wanting, wasting away before my eyes.  I know I’m not the only one to have this experience; and compared to many others, his deterioration is blessedly mild.  He is not in some hospital hooked up to machines.  He is in pain, but it’s controllable, and he’s able to sleep most of the time, day or night.  He still recognizes me, and we still have our “le’chaims” every afternoon.

Today was different, somehow.  I think he was exhausted by the hallucinations and terrors.  He had trouble holding his little whiskey cup, one he had made himself (we always have our whiskey out of these cups), and the liquid didn’t always make it exactly into his mouth.  The right side of his mouth droops from a stroke he had early on in this process, and his food and drink often make their way down the resulting crease into his beard.  My little dog Noga loves to clean his face, if the opportunity arises and no one intervenes–just the way she loves babies, because they usually wear most of their meals on their faces and hands.

Mom has been sick for months.  She’s been very short of breath, breathing at a rate of around 30 breaths per minute.  Normal is 12-14 for an adult.  I’ve been hounding her for months to go get a chest x-ray and pulmonary function testing.  Finally she started wheezing badly and her girlfriends began to make comments, so that propelled her to make an appointment with the “doctor.”  I put that word in quotes because the person who wears this particular MD is, in my experience, completely incompetent.

True to form, the “doctor” ignored the fact that my mother told her (at least, she SAID she told her) that this has been going on for months and months, and possibly over a year; that she has lost weight, and has trouble sleeping because of shortness of breath.  She even has to stop halfway up one flight of stairs to catch her breath.

So she did get an x-ray, results to follow, but was denied the pulmonary function testing that I feel is mandatory under these conditions.  Instead she came home with a prescription for an antibiotic and a course of steroids.

The steroids will make her feel better regardless of the cause of the chest issues, but will not address the underlying pathology.  And it will increase her baseline irritability and labile behavior–not good.

In medicine we have this thing called “differential diagnosis.”  It’s a way of sifting through all the things an illness could possibly be, first casting a wide net and then crossing things off the list as they are ruled out, either by the process of logic or by test results, and hopefully a combination of these, along with a dose of clinical know-how, and the faculty of observation.

So in the years that I have been observing the evolution of this process, I have whittled the possibilities down to two:

1. Cancer

2. Cancer

3. Restrictive lung disease

I’ve ruled out COPD (Chronic Obstructive Pulmonary Disease) because that is always accompanied by cough, usually productive of sputum, which she does not have.

She did smoke in the past, approximately 40 pack-years (the number of years smoking times the number of packs per day), but quit about 40 years ago, so smoking-related lung cancer is unlikely.  However, there are lung cancers that have nothing to do with smoking, or are made more likely by a person having been a smoker in the past.  I know the common wisdom is that after a person has stopped smoking for a certain number of years, their risk of cancer is as if they had never smoked, but I have never believed that, having seen otherwise in clinical practice.

Restrictive lung disease happens when, for some reason, the lungs become stiff and cannot move oxygen into the blood.  The late Ralph Nelson, MD, a brilliant physician who devoted himself to medical illustration, dubbed people with restrictive lung disease “Pink Puffers” because they manage to make up for the stiffness of their lungs by breathing faster: therefore they don’t turn blue the way people with other lung diseases do.  My mother is a classic Pink Puffer.

But restrictive lung disease can result from certain cancers that infiltrate the walls of the lung tissue, making the lungs stiff, necessitating an increase in the respiratory rate, and hugely increasing the work of breathing.

I’m feeling sorry for my mom, even though I don’t love her.  I hate to see anyone, any creature, suffer.  I suspect that the process of definitive diagnosis will be a long and unpleasant one.  Believe me, if I were still in medical practice, she’d have her diagnostic workup done, not yesterday, but a year ago.  And then….what would happen to them?  I can’t even take care of my dad alone, due to my own health issues, let alone the two of them.

Tonight I feel as if I’m looking right down the throat of the monster that takes lucky people with two living parents and makes them suddenly into orphans.