Tuesday, August 09, 2005

inside

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Last week I went to my first appointment with the nurse practitioner at the counseling center. They’re like a full-service gas station, meaning that they provide counseling as well as medical services, including writing prescriptions. I hadn’t wanted to spend the time rehashing the last couple of years, but she hadn’t had a chance to read over my file, so that’s what we did.

She was also incredibly thorough. She asked questions that no one had asked before – “Do you count things in your head, like steps as you're walking? Do you ever get a song stuck in your head, a bit of meaningless melody?” Well, yes, all the time. It may have something to do with being a musician, but it’s also a trait of an obsessive personality. I’m not exactly surprised.

We talked about everything – episodes I had experienced years ago, the problems I had with nursing, current relationships, sleep cycles, eating habits, the problems I’m having now, work, boredom, suicide, side effects I was concerned about, on and on. The questions were very focused – she was trying to figure out what chemicals were working in my brain and what chemicals weren’t.

Once she had the information she wanted, she did something very strange. She sat with her clipboard, thumbed through the pages, and it looked like she was actually thinking. She took her time. We sat in silence for a few minutes while she evaluated the information.

Very aware of time constraints and the need to get RB’s car back to her, I said, “You know, we don’t have to decide this now.”

Without looking up from her clipboard, still deep in thought, she said, “Oh, yeah, I think we do.”

OK. Fair enough.

In the end, she didn’t think I was a true bipolar. She said my manic cycles were just manic enough to qualify, but nothing like what other manic-depressives go through – just under the radar, is how she put it.

What she eventually decided was an odd mix of psychological diagnoses that was actually kind of cool. She didn’t feel the need to classify me as One Thing or Another – simple depression didn’t really cut it, but neither did any of the types of bipolar disorder. I was impressed that she was comfortable enough not to have to shove me in a single category and be done with it. (I’m sure this is how good psychiatrists actually work, but I hadn’t ever seen the diagnostic process in action before.)

She prescribed a low dose of an antidepressant (yes, I’m now in the Lexapro club) and a mood stabilizer. I’ll titrate up to the full dose of the mood stabilizer (Lamictal) – for now I’m on a low dose, which is fine. These medications, she said, would help alleviate the worst of the depression, mood swings, and their accompanying behaviors without “dumbing me down”, which I appreciated. I don’t want to feel stoned all the time if I can help it.

I took the first doses on Thursday night, with a full glass of water and no small feeling of trepidation. (My last experience with prescription medication was, to say the least, disastrous, so I might be forgiven for being anxious about these.)

I had expected to be a little groggy, but when Duckie woke up that night, I was able to function well enough. The next day was weird. I felt like I was tripping – slightly nauseous and shaky and generally pretty ‘out there’ mentally. God only knows what kind of nutty stuff I was posting on other people’s blogs.

By the afternoon, though, that feeling had worn off. Since then, the trippy feeling has been relegated to the background, unless I’m up in the middle of the night. There’s a slight grogginess in the morning, but nothing that can’t be dispelled by a good strong cup of coffee.

Oh and did I mention – I think this stuff might actually work.

I don’t want to get too excited. I am, as I told my husband, “tentatively optimistic.” Part of me still hates the idea of being medicated – the idea that I can’t fix myself on my own or with therapy. The other part is incredibly relieved to see symptoms that I have lived with for two years finally start to lose their stranglehold on my life and my relationships.

For a long time now, there has been no light at the end of the tunnel. I have been trying to function in the darkness of the tunnel, telling myself that this is just how life is for me now, get over it, deal with it. I had about resigned myself to spending the rest of my life in a struggle with outbursts of nearly uncontrollable, completely excessive rage. I had just about given up on being the person I want to be, and settled for being alive, and not hospitalized.

There’s a light now. (No, it’s not an oncoming train – at least I hope it’s not.) It’s a wee little pinpoint for now. I’m not running towards it because, let’s face it, it’s still pretty dark in thisyere tunnel. And I’m scared that if I go too quickly the light will get farther away. Yeah, I know, it’s silly, but that’s how it is in my head.

But for the first time in over two years, I think I might, eventually, get out of this tunnel after all.

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I had a good visit with my Dad and Judy over the weekend. Family illnesses are all of a sudden taking center stage, which took me by surprise. I’ve always thought of Dad’s side of the family as more or less stable – and to be honest, I think I was kidding myself.

Dad’s going in for surgery at the end of August. It’s a bit more complicated than I had originally thought, but I’m glad to have a better idea of what he has ahead of him. I think about it every day – not in a scared, worried sense, but hoping that the doctors keep their hands steady and don’t get shithoused the night before. Judy, his wife and my stepmother, is an amazing woman, and I couldn’t ask for anyone better to be by his side during the recovery.

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We got a nice surprise last night – a visit from Stewart, who had to drop off files to be printed at our local paper – his presses are down and he’s lacking the manpower to fix them. His work situation frankly sucks – but I was glad for the opportunity to see him. Duckie was pleased, too – since she started walking, she and Stewart have started to develop a special friendship. She doesn’t always remember people from one meeting to the next, unless she sees them every day, but she remembered Stewart for sure.

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Lately there have been intimations on the blogosphere and even in the mainstream media about elevated terror alerts, terror threats, ominously significant dates, and the possibility of another attack in the United States or elsewhere.

I have a choice. I can spend my days counting down to the next attack, or I can maintain some hope that the people whose job it is to protect us from this are on the ball, and know it’s coming, too.

I can live in fear, or I can live in the knowledge that even if I face death today or tomorrow, I have given and received love without measure, and that I have been incredibly blessed in this life.

For those of you looking out for warning signs, this isn’t one of them. I’m not “tying up loose ends” and I don’t have a plan for killing myself. I’m actually feeling pretty good. And I will be damned if I’m going to let fear take that away.



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5 comments:

James said...

I'm doing the lamictal and lexapro combo too (along with my other meds). I just started the lamictal as well but I think I can already feel something. I feel more happy and balanced. Let's hope this works out. God knows I too have had my problems with meds.

I hope that your father's surgery goes well. I'll keep him in my thoughts.

andi said...

*fingers crossed for you, James*

oldwhitelady said...

This post is quite interesting. It sounds as though this doctor is one who actually wants to get you feeling the best you can, not just having you shove pills down your throat so she can get a kickback. I'm glad. I hope it works as well as it sounds. I, like James above, hope the best with your dad's surgery.

SB Gypsy said...

Andi,

My sister's experience with her depressions started after the birth of her (now)6 yr old. I'm glad your husband has stuck with you thru this, Mi little sis' cut her loose.
Keep closely in touch with the nurse, those meds can make you looney as well as making you well. Sis ended up in the hospital several times before she got her meds balanced, and the hospital was just adding more & more on top of each other.

Good luck to your dad, hope he does well with the operation.

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