About 2 weeks ago I noticed something was off. I’m getting amazingly good at holding in problems and oddities until I see C for therapy every Wednesday, and by the time I got to her 10 days ago I was bursting with something being…wrong.
I assumed it meant my meds were working. Since my hospitalization in February, I have been on the most regimented treatment I’ve ever experienced – heavy load of regular therapeutic and psychiatric intervention at every possible turn. After my volatile but short lived relationship with Seroquel, a bout of Abilify that spiked my Lithium to dangerously toxic levels, and an oh-so-patient tryst with the long term upwards titration of Lamictal, I threw my hands up and begged for something, anything, that would work as a mood stabilizer NOW. Dr W put me on Latuda, a drug so new that there are actually still commercials for it regularly on broadcast TV, which I knew nothing about – but I seemed to level out a bit and was fairly stable given the situation in general.
By the time I got to my one-on-one session with C 10 days ago, what I had suspected was confirmed. I felt like (and much of this may sound trite or overly poetic but I’m still grasping for accurate descriptors) that I was manic, but not really. That I was energized, but not really. That I was easily depressed, but not really. But as opposed to previous episodes that left me feeling like I was bouncing all over the earth and easily self destructible, it felt oddly contained. Like I was bouncing around in a box instead. Or rolling all over but confined to a hamster wheel. It felt like there was literally an entity inside of myself trying to break free (a la “Alien”) but there were a thousand hands all over me holding whatever it was in. I thought it meant the meds were working – that although I was obviously going through something that the meds and DBT practices were keeping me somewhat sane. At least not hospitalized. To me, this was a huge improvement. The only outward symptoms seemed to be extremely erratic hypertension and tachycardia. Hence why I figured mania – its fairly difficult to be both depressive and maintain a resting heart rate around 120.
In my sessions with C we’ve really been working on acceptance – you see, my biggest fear and anxiety trigger is the thought of going crazy with no warning/reason and ruining the shreds of my life still barely intact. One day, while I was bawling my eyes out with fear, she leaned in, looked me right in the eye, and said “Its probably going to happen. There’s no use spending your life in paralyzing fear and anxiety over something you can’t control.” That was a pivotal moment for me. Realizing that there was no cure to work for or discover – that I could do all I could, so could C, so could Dr W, so could my family, but this was an unstable, incurable chronic condition and there was nothing on Gods green earth that could stop me from ever “losing it” again.
But last week in her office, C seemed concerned and suggested I call Dr W about my symptoms. “Oh fuck. I thought these were good signs/feelings?” Why would I need medical intervention? Wasn’t this how I was supposed to feel now? Didn’t this mean I was getting better? She asked me if I had ever heard of a “mixed episode”. Not except for the fact it was on my Axis Diagnosis paperwork from BrookLane when I was in intensive outpatient there. I had always described myself as rapid-cycling, in that I could swing from minute to hour to day as opposed to months at a time in either extreme state. Turns out, it is actually possible to feel everything at once. How lucky am I?
It took me a few days to digest the possibility that my oddly different symptoms were perhaps a sign of a problem as opposed to progress. I made it until Friday during my lunch break until I called and left a message for Dr W – long and rambling with a “so I just need to know if this is how I’m supposed to be feeling, if this is the meds working, or what is this?”
She returned my call before I made it back to the office. Working in the medical field, I know that a quick personal call from a physician means there’s something up. “No. The answer is no. You absolutely should not have to feel like this.” I burst into tears in my office parking lot. I was surviving thinking this was progress, not something to cause alarm and warrant pharmaceutical intervention. She doubled my dose of Latuda and told me it should take 3-4 days for the mania to begin to subside if that treatment course was working. I was told to monitor my BP and pulse and get in touch with someone if it was still elevated and erratic after 5 days or so.
So over the weekend I went on a boat trip with my family across the Chesapeake Bay.
It was beautiful. I stood at the bow of the boat and soaked in every second – but something was still wrong. I was edgy and irritable and bouncing all over the place. I got stuck rather symbolically in a torrential downpour and seriously considered sleeping at the dock rather than face the 4 hour trip home on a crowded bus, a trip I had no control over and quite honestly was panicking a bit over.
Still waiting for that extra Latuda to kick in.
On Monday afternoon after checking my own vitals throughout the day, I decided to call my PCP about my BP/pulse. It had been high and erratic for over 5 days. I didn’t want to jump the gun, you see, as I ended up in the ER once before over a similar issue and ended up feeling ridiculous after being given the full “chest pain” protocol – EKG, cardiac enzymes, chest x-ray, CT – for them to say “well, you’re not having a heart attack, but this is weird, so keep an eye on that.” Since then I met with my PCP who I know well and trust completely regarding the issue, and he was resolute in his diagnosis that it wasn’t “pure” hypertension, it was 100% secondary to anxiety or manic episodes, and there was no justification for medical intervention – plus, as he put it “Do you seriously want “hypertension” in your medical records for the rest of your life anyways?” So that was that.
But when this was my resting BP/pulse Monday afternoon at work (normal for me is 120/75, p85), I asked if I could sneak away for a moment to try to get in touch with my PCP. After all, I knew after my previous bout of possible cardiac nonsense that it was likely nothing serious, but just the same I’d rather not feel like I was swallowing my own heartbeats or get winded walking back the hall. So I started at the very bottom of the medical food chain – my family doctor.
Again, I know how a medical office works. When I get one sentence out to their receptionist and she’s transferring me directly to a nurse, my stomach sank. I really didn’t want to make a fuss – but at the same time I felt 10 kinds of nutty bananas. I’m sure my coworkers overheard my end of the conversation which included “The ER? I just wanted to check with my PCP – seriously? Now? I’m supposed to bypass your office altogether?” because by the time I put down the phone my saint of a boss was already positioned at my desk ready to take over. Off to the ER I went.
Hilariously, though the waiting room was empty, the department was full, and I was put in the only room they had left – psych holding. Are you fucking kidding me? Now go ahead and figure out whats wrong with my pulse and pressures. I had an extremely competent team, including a new Dr whom I have dubbed “McDreamy” who came to the same conclusion as everyone else – its secondary to the mania. Safest thing is actually to wait it out, as putting me on BP meds would only mean I would actually crash once I normalized. Mom & I grabbed dinner, I felt like an idiot.
I woke up in the middle of the night that night feeling congested. “Fucking headcold.” Ran to the pharmacy to pick up new Latuda dosage, they reminded me about Flu shots – “I should get ahead of that this year, maybe I’ll do that Thursday…the last thing I need is to actually end up physically sick.”
By the end of Tuesday it felt like my sinuses were on fire. “Fucking allergies.” Poor mom had to come over and try to convince me I wasn’t dying.
Wednesday I woke up with razorblades in my chest. I went in to work, trying to soldier through, and made it til about 9 before I totally lost my voice and by 10:30, despite chaos all around me on our busiest shift of the week, I walked into my saint of a boss’s office, announced “I can’t talk and I can’t breathe, I need to go” and off I went – straight to momma’s. See. I already had my ER followup with my PCP that afternoon but have never not been able to breathe through my chest. I was terrified. I was crying.
I was still mixed/manic, in horrific pain, unable to breathe, and terrified. At that point, fuck my blood pressure. I was convinced I had pneumonia.
FUCKING INFLUENZA. ARE YOU KIDDING ME? Good old school flu. Nothing you can do, totally screwed, suffer through it flu. His best quess? Not JUST the fucking flu, but either para-influenza, H1N1 (how retro?) or influenza B. The serious hardcore stuff. My immediate aloud reaction? “My boss is going to kill me.” My Dr wrote me a note for 6 days off – pending not having a fever. “My boss is going to kill me.” My Dr offered to call my office personally and explain that if I stayed at work the whole staff would drop like flies. Grrrrrrrrrrrrreat. I went back to my office with the joyous news and before I was back out the door the place was being what we affectionately call “Lysol bombed.”
So Ive spent the last 5 days off work, mostly restricted to bed, hacking up lung after lung, totally conquered by this stupid illness, and still partially manic on top of all of it. Im a jumbled up mess. Im sure having an “actual” illness on top of a mental episode doesn’t help speedy recovery from either, and Im too exhausted to make “use” of any of this time off Ive had, despite my rapid thought process and the “oh I havent coughed for the last 3 minutes maybe its time to redecorate…oh wait no thats the dumbest idea youve ever had.”
And thats about all I have to say about that.
Except that Im due back to work in the morning and seem to have just spiked a fever.