Category Archives: Exhaustion

Three Weeks

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And two days, for those of me keeping track.  That’s how long it’s been since I stopped my miracle med I was going to take for the rest of my life.

Since I wrote The Finish Line, things have improved quite a bit with my psychiatrist.  And I was cautiously optimistic about the three drugs we had decided upon to replace the one I had to stop.

Things started off well enough.  I was getting up mornings and doing yoga, then going over to the rec center and using the bag for an hour.  I was feeling motivated and determined to fight with everything against depression, because that had been creeping on for a long time even before the med issue.

After about a week or so, I noticed by the end of my day my head was in a complete fog, and I felt like I had been up for three days in a row, mentally (though I wasn’t requiring any extra sleep).  The only thing this could have been coming from was the medication I was prescribed for the immediate relief of my depression.  I held out until the middle of last week, when I realized that even when I doubled the dose, it would only help my depression for half-an-hour, max.  I then said enough.

Strike one.

The second, more long-term medication that was meant for my depression is one you have to start slowly and raise the dose of incrementally.  The reason is there is a small chance of a potentially deadly rash in reaction to it.  You may know the one to which I am referring, but I would lay down 20 to 1 you don’t know half the fun, detailed, descriptively vivid particulars about the two distinctive rashes you really need to watch out for, the ones that are actually serious.  My former psychiatrist believed education was key, and God bless the man for that.

I did very well on this drug before, no reaction, good response, took it for years.  Earlier this week I raised my dose on schedule, and the next day the tip of my tongue hurt a bit.  I figured I must have burned it, or perhaps I was dehydrated.  When I woke up Friday it was in so much pain that I couldn’t move it around my mouth, all I could do was take little sips of tepid water and hold them on it a bit before swallowing.  I knew I wasn’t dehydrated at that point.  I put in a call to my psychiatrist, and even though it looked completely normal, I had already decided I was taking no chances by the time he called back.  He found it odd, had never actually heard of anything like it, but was in agreement with me.

So I didn’t take any yesterday or today, and my tongue is improved enough for Fugdesicles.  My father got the sugar-free kind by mistake, so that’s a good 80 calories a day right there I’m living off of!

Strike two.

The third medication, which I insisted upon because I had no anti-manic. . .  Well, now I’m off the amphetamine all I’m doing is sleeping.  I increased the dose to treat what I rightly identified as prodromal mania last week.  So the last two nights I quartered the dose I had gotten up to.  Tonight I’ll go down to a half.  And maybe, by Monday — when I next see my psychiatrist — I’ll be able to stay awake for more than an hour-and-a-half at a go.

In which case we’ll call that one a foul tip.

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I added that ‘specially for you, Sailor.

Thank you so much to everyone who has shown me such love, support, understanding, caring, and kindness, and to all of you who continue to do so. It means more to me than I could ever find a way to put into words.

© Ruby Tuesday and I Was Just Thinking. . . 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Premenstrual Dysphoria, Mood Disorder, And All The Joy That Comes Along With It

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It started during the first round of the NHL playoffs, I know that for certain.  Well, that’s the first time I noticed something, anyway.  I remember sitting in my family room, overwrought and having murderous thoughts about my father every time he would flip to another channel during period breaks.  It got me timing them on my phone, 17 minutes to the second, and after that he had better watch out.  I didn’t really think too much on it, after all, hockey is the closest thing I have to an organized religion, and I’ve been pretty intense through playoff seasons in the past.

Except a few days later, it progressed to me watching the games on the television in the basement.  I was very upset and reactive, and not just about hockey.  My father became the target for my anger, and my mother for my not-quite-hysterical crying jags.  I thought it was hypersensitivity and anxiety, and in many ways, it was.  Just not quite the ways that I thought.

Then my head started pounding with migraines.  I became exhausted.  I already knew my emotions were all kinds of erratic.  And I was spacey and generally unfocused.  I would stop in the middle of sentences and just stare off at nothing, losing thoughts – or even the ability to generate them – completely for a minute or so.  I knew by then things were not at all right.

The migraine tied it up into one neat little cluster of symptoms for me.  It was all related to my headaches, a seed my psychiatrist had planted with complete innocence at one of our early visits.  He had discussed my migraines, my mood, and done some very casual speculating about temporal lobe epilepsy.  I brushed it off entirely in the moment.  When I was having psychogenic nonepileptic seizures (PNES) from the post-traumatic stress disorder (PTSD) that manifested due to the electroconvulsive therapy (ECT), I was sent to see a neurologist specializing in seizure disorders, the Man, every doctor in the land knew of him and how good he was (and I had to wait six months for an appointment).  He cleared me absolutely of epilepsy, or any kind of pathological seizure disorder apart from the one induced by the trauma.  And yes, it was fun to stick all of those unpleasant acronyms into one sentence, thank you.

But with my bipolar disorder stabilized, there was this strange cluster of symptoms that I knew beyond a shadow of a doubt were not bipolar-related, and the migraine was seemingly the pivotal item upon which they all rested.  There had to be more to explain it.  Especially because shortly after the migraine episode passed, my symptoms remitted.  After a second episode when I was back home to visit my family in Pittsburgh, I began to poke into information on partial seizures, and even made an appointment with Dr. the Man.  But while, in theory, things were coming together, something about this explanation didn’t feel right to me.  I canceled the appointment and just kind of left things alone to simmer.

Then last month, a light bulb went off.  The light started in my uterus, but quickly made its way to my brain.  I was holed up in my room, I had been for days.  I wanted to smash someone or something, I was gobbling up Xanax and weeping, everything around me was irritating and stupid, I was exhausted and my head hurt. . .  And then I had a cramp.  Just a small one, but it pulled everything together in my mind.  I looked up the symptoms of premenstrual dysphoric disorder (PMDD), and voila!  My mom had it, too, which I knew somewhere in my brain.  They gave her a couple of medications to try back in the day, but apparently the cure was worse than what ailed her, and she just had to ride it out. Cooped up in a house all day.  With two small children.  Good Lord, that woman really is a saint.

So between me, my OB/GYN, and my psychiatrist (except mostly it was me), we’ve got it all set to where I up my mood stabilizers (Carbatrol and gabapentin) at a certain point in my cycle, and I’m a normal (well, my version of normal), mostly functioning human being again.  I’m still a little more anxious, irritable, and weepy, but I have been getting by pretty well on the balance. Especially since I started kickboxing again. Such joy, such release, endorphins, everything that is good.

So since things are going so well, let’s throw something into the mix to fuck things up.  It’s the way things work for me, I think I would be caught more off of my guard if things just went to plan.  And honestly, there is no bitterness in that statement.  I am completely used to it by now.

The IUD.  Oh God, the saga of the IUD!  Everything about it has been great, except the excruciating pain after insertion and the unholy cramping of my last period.  I don’t think I gave quite an exact idea of that, and even if I did, I’m going to again.  Keep in mind, ladies, that this is super-atypical.  There is usually increased cramping during your first couple of periods, but not, not, not anything like this.

Last period, I spent the majority of time basically bed-bound.  I had a heating pad cranked up to very high, I was taking Vicodin, alternating every three hours with mega-doses of ibuprofen, and I added in some old, expired muscle relaxers that belonged to my dad (he was happy to contribute what was left in the bottle as long as I shut up after I said the word “cramps” – and by the way, don’t be stupid and ever try this at home), and I had worked out a technique to keep myself immobile from the chest down by the end of the first day.  It was a simple thing, I moved, I wanted to die.  Pain really is a fantastic learning tool.

And still, and still, all of these measures only made my pain just bearable.  I swear to you that I am not playing up the intensity of this.  It started in my back, wrapped around my abdomen, and actually went shooting all the way down through every nerve in my left leg, out through my foot.  My OB/GYN said that it sounded as bad as labor pain to her.  I have no frame of reference, but I did feel totally legitimized and not like I was being a whiny bitch about things.  So that was nice.

And now I’m counting down to go time again.  I’ve got my shiny new bottles of (doctor prescribed) medication in my nightstand.  I’ve got my heating pad next to my bed.  I am all prepared.  Only I’m stressed as fuck about it, of course.  And ladies, you should know what stress can do.  It can delay your period!  Which for me means a longer time on an increased dose of mood stabilizers.  Which at this point is honestly making me a little dopey.  Time is passing oh-so-incredibly slowly, I’m walking around in a bit of a fog, and I just feel like there is something like a medication buildup clogging my brain.  But I can’t knock my doses down, because even now I’m still edgy.

Of course, there is somewhat of a light.  The good doctor and I agreed that we’ll (we’ll? what, is she going to go through the pain, too?) try two more cycles, and if the pain doesn’t get any better, the IUD comes out.  Which is a bridge I shall cross if and when I can see it in front of me.  Right now it’s a pretty long way off.

© Ruby Tuesday and I Was Just Thinking. . . 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Watch Me

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© Ruby Tuesday and I Was Just Thinking. . . 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Through Pain Comes Growth

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I’ve heard that, you know.  I remember it most specifically from an episode of The Nanny, of all sources.  But I have no idea what has come from my latest pain save meals of hydrocodone and promethazine, and a renewed terror of the Migraine Monster.

I’ve had severe headaches since I was quite young, so young, in fact, that my mother remembers them more vividly than I do.  What I remember is a diagnosis of common migraine (a migraine lacking aura – all the weird, usually visual changes that precede the pain by roughly 20-30 minutes in a complex migraine) more than half a lifetime ago.  There was one emergency room visit with CT scan (normal), injections and prescriptions of every drug developed for migraine ever (please don’t make me reiterate them all), prophylactic meds in failed attempts to prevent them, or at least lessen their frequency, about a half-dozen specialists who all confirmed that my brain wasn’t doing anything underlying to cause this pain, and from all of that we have arrived where we were more than a decade-and-a-half ago.

The only thing for the pain is Vicodin (unless someone wants to hospitalize me and give me a nice shot of Demerol in the butt, makes me throw up every time, but oh! how it obliterates that pain!), and thank God I have a doctor who trusts me and is willing to write me for it. And now I’m drinking promethazine for the nausea, because last November, for the first time in all of my life, the nausea progressed to actual vomiting. It was traumatic, having never happened before, so I now work to avoid it.

All of that being said, this time was entirely different.  Trying to even remember. . .

About two-and-a-half weeks ago, I started getting horribly irritable, reactive, anxious, emotional.  These were no mood symptoms, at the time I had no thought of what could be causing them.

Then, last Tuesday into Wednesday, the dam broke and there was pain.  Oh, was there ever pain.

But there were pain-free periods interspersed, and they were sometimes worse.  Because I experienced in them such confusion, the first night was nearly an emergency room visit because my blood pressure jumped and I felt as though I was dying.  The problem is that after my ER experience for a dystonic reaction, I realized that sometimes that little voice is there for a reason, and that it’s better to err on the side of a little hypochondriasis than to, well, die.

I basically lived through some psychosis that was entirely unrelated to mania or depression.  My mood has been completely stable throughout this.  Really stable.  Almost frighteningly stable, if that can be said.

So the pain alternately remits and returns through this past Monday, with less intensity each time.  But it wasn’t until late afternoon on Monday, when I finally passed out in the middle of a text conversation, and slept for nearly 24 hours that I felt like I was on the mend.  I always need to follow my migraines with a good, long sleep (I’m told this is not uncommon).

I still expect another few days of being “out of it”, convalescing, recovering.  My writing alone should indicate that my brain is not yet back to where I want it to be.  This is decidedly not my best effort, but I don’t know how really to share a migraine with you.  When it’s intense, there is no looking at any light, so I cannot type something up.  During the brief periods of remission, I have been able to type short emails, comment responses, etc., but no long trains of thought.

I guess I want to post this because my brain is still so addled.  It will give you some sense. It is not brilliant work, but it meets Ruby’s standards for valuable because it is honest work.

Incidentally, I have never in all of my days experienced a three-week-long migraine.  I have an inkling of what may have caused it, but if I’m right, well. . .  It’s going to be ugly for a while.

© Ruby Tuesday and I Was Just Thinking. . . 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Of All The Weeks In My Life, This Has Been One Of Them

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And it has been very long.  Very, very long.  So long.  Long.

I think I am the opposite of most people who deal with manic-depression, but I’m not sure. I try to remember from the zillions of books I read on it, but that was so very long ago. . .

What happens with me is that when I am depressed, time rushes by, but when I am manic, it goes so very, very slowly.  Guess what this week turned out to be?

“I blink and half my life is over. . .” ~ Pete Winslow

I have never been a huge poetry-reader, I will confess that now.  Mostly I stuck to prose, especially in my younger years.  But beginning a poem in an anthology that one of my dearest and my oldest friend brought back to me when she visited the City Lights book store in San Francisco years ago. . .  (you know who you are now?  hi!).  That line began a poem and it jumped out and grabbed me and has stuck with me in a way so many and so few things have.

City Lights possibly might not mean a lot – anything – to some of you, but if you’re familiar with the Beats and specifically Lawrence Ferlinghetti, that’s his.  The progression is I spent pretty much all of my teens wildly enamored of Jack Kerouac.  I have made good acquaintance with Ginsberg and Cassidy and Burroughs and Holmes and so many more as well, but Kerouac will always be my true love there.  We are both “crazy mixed-up Catholic Buddhists,” though I only have a name for it because Jack gave name to it.

Thank you, Jack.

This week was, as I described to my psychiatrist Thursday when I saw him, florrid mania.  Psychotic, to boot. But then it had little tiny ultradian cycles woven inside the days and most especially the nights.  I would lay in my bed at night, knowing there would be no sleep, listening to music, Thinking, and hallucinating with four out of five senses.  Time stretches out for me in a very unreal way.  And I lay there and I Thought about so many things.  One of them was how I was having my parents drive me to my doctors’ appointments, because I didn’t feel like it was at all safe for me to be behind the wheel of a car.  A decade ago that would have been the first place I jumped in that state.

I have slowed down.  I have grown older.  I have grown wiser.  I have grown tired.

(For those of you keeping score, 72 hours awake, 4 of blissful sleep, 16 awake, between 30 minutes and 2 hours asleep – little hazy about what happened there – 14 mostly awake with a wee bit of dozy time, which is not real sleep but is closer to it than anything else I found, 4 of sleep, 6 more awake and that is now.  I know.  It’s confusing to me, too.)

By Wednesday afternoon I decided the best only course of action for me was to go silent, which I learned by hard lesson is what to do with myself in that state.  I stay completely off of the internet, and keep all other interaction very minimal, until I feel like I have most of my judgment returned.  If I ever disappear for a long period of time with no notice, that will most likely be why.

Thursday night the mania dissipated (though the insomnia didn’t) in a very nice and novel way.  Just a matter of minutes, it was like inside me some dials and slider switches were moved and I was restored to euthymia.  Euthymia.  Such a pretty word.

I think it was a combination of finding a bit of balance, and some clonazepam (Klonopin) that did it for me.  And yesterday morning my doctor wrote me for my favorite sleepies that didn’t kill me but should have (not a botched attempt there, a drug interaction that no one knew about nor figured out for months, despite me repeatedly blacking out – and I was the one who discovered it – but I’m off the other drug), which gave me my four hours of sleep last evening.  Which I needed, because while I haven’t come down this time into a full depression – yet – things got pretty desperate for me yesterday.

The wherefore of that is a little hard to explain, but it has to do with the lovely way I have of almost dissociating when I am so long with very little or no sleep and nicely manic, and no longer having that, being fully present in the reality of the moment.  And it has to do with how hard I work to insulate my mind, my mental state against anything that might further compromise it, even a little, and coming out of that cocoon-in-a-very-high-tower-with-no-door-and-briars-at-the-bottom.  That’s a good one.  It not only describes perfectly what I build around myself, but doesn’t it sound pretty much like hell to come out of?  It is.  I nailed that, and right off the cuff.  Love it.

Lastly, my desperate state had to do with one of the many moments of clarity I had while Thinking, actually this one deserves the designation of ‘epiphany’, that I found myself in during the whole episode.  I’m saving it for another time.  Maybe.

Moral of the story:  ”I’m a paranoid schizophrenic.  I am my own entourage.” ~ a delightfully misnomered quote, from the always lovable and neurotic John Cusak, in America’s Sweethearts

© Ruby Tuesday and I Was Just Thinking. . . 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Thank Science (And My Doctors) For Prescription Narcotics

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Yes, it’s that time again.  Time for me to disclose to you, my lovelies, more than you ever wanted to know about my biological functions.  Hey, my mind is fair game, so why not my uterus?

It really isn’t that gory or graphic or descriptive, so men, you needn’t tune out now.  I’m just laid up with some serious, do not pass out, do not collect 200 ibuprofen, go straight for the heavy-hitting narcotics cramps right now.  Actually, since the pills have kicked in I’m doing much better.  Trying to write a post before now would have been an exercise in futility.

I am, however, missing homemade lasagna night at my grandfather’s.  But my mom promised to bring me a piece, so I can remain curled up in bed here without feeling too terribly deprived.

So far, so good on the trip.  I’ve seen one of my grandfathers and two of my cousins, which is always really nice.  I’ve managed to stay pretty calm amid the inevitable stress my mother and aunt like to induce in, on, and around themselves, and just take things as they happen.  I am still exhausted and I’m running low-grade fevers, but unless something horrible and unforeseen emerges, all I can do until I’m back and can see my PCP is rest and be very careful not to transmit any germs to anyone else.

I can’t think of much else to tell the world at large right now, I’ve been up probably two hours solid, so it’s about time to doze off again.  And I’m not going to write just for the sake of it, if even I don’t find myself interesting, then it’s definitely time to cut things off.

Moral of the story:  ”Push the button, Frank.” 

© Ruby Tuesday and I Was Just Thinking. . . 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

The Rest Of The Story

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So I didn’t exactly tell all of you lovely readers the entirety of my situation in my last post.  Read on and you’ll find out why.

I’m tired.  I’m so, so unbelievably tired that I can’t do anything and I just got off of the phone with my doctor tossing around possible causes.  All I do is sleep like the dead.  Yesterday afternoon, I had it all set in my mind.  I thought, I’m just going to take a short nap and then I can get my laundry and my packing done.’  Only the puzzle pieces had not yet come together in my head – that happens with me sometimes – so I didn’t set an alarm, and my ‘short nap’ lasted about 14 hours.

I then woke up this morning, thought, ‘Fuck, what am I going to do now?’  posted the entry before this one, talked to my mom for about half an hour, then – you guessed it – I went back to sleep for about three hours.  The only reason I’m awake now is because of the aforementioned phone call from my doctor.

You see, it took a couple of weeks, but it did slowly dawn on me that sleeping upwards of 22 hours a day is not really normal.  I had been having so much trouble sleeping at all, if you remember, so at first I thought my system was just sort of “catching up” and re-regulating itself.  Then, when it persisted, I figured I was letting myself sleep too much, which was making me more tired (one of those stupid but true things that happens).  So I tried restricting my sleep time and doing things to energize me.  Fail.  I would fall asleep while doing things.

This morning it finally dawned on me that, hey, this ain’t normal and it ain’t going away either.  Three possibilities crossed my mind: hypothyroidism, anemia, and the dreaded specter of mononucleosis.

I’ve never been hypothyroid, but my doctor had expressed concern after my last emergency room visit that the thyroid hormone I had been taking to treat depression might have done permanent harm to my thyroid.  It tested normal a few weeks ago, and he doesn’t seem to think that’s causing this.  With this conclusion, I tend to agree.

Anemic is also something I’ve never been, I just know it can make you tired, and thought if I was potentially going in for a blood draw, we ought to check that while we’re at it.  Doctor didn’t think that was the case either.  Okay.

But the mono thing. . .  Let me give you a little background.  Another entry into Ruby’s Medical Incredible.  I have had mononucleosis at least twice, and I actually am pretty convinced I had it a third time and it was just never tested for then – because actually it would have been the first time - so we’ll never know, now will we?

(By the by, remind me, someone – and I mean this seriously, it isn’t like all of my other “Maybe I’ll tell you about that some time” moments – multiple someones, everyone, to write a post about why I have such a certainty about that potential first time with mono.  It’s an interesting idea and I could use some feedback.)

The first time it was medically documented was high school, and it knocked me flat on my back for a few months.  I would quite likely have died from starvation within those first couple of weeks, had it not been for my mother.  She would literally wake me up a couple of times a day, keep me awake long enough for me to drink a vitamin shake, and then I would pass back out.  I was damned near comatose.  I came slowly back to consciousness during those months, but I had to drop an entire semester of classes.  It actually hit me so hard that after a summer spent convalescing, I returned to school – only to have to drop that subsequent semester halfway through.  I was still so easily exhausted that I just couldn’t keep up – or more accurately, awake.

Venture into mono-land number two (or three, maybe), happened about four years later and put me in the hospital.  I was tired, but not in the manner nor to the degree detailed above. I was vividly yellow from jaundice and severely dehydrated.  Initially my bumbling medical team (this would be the time when my regular doc was out of town) thought – nay, they were convinced - that it was gallstones.  The gastroenterologist (God bless him) who was scheduled to operate on me the following morning took one look at me and said, “She doesn’t have gallstones, it looks to me like she has mono.”  Apparently they never tested me for that one, because that was back in the days when they still thought you couldn’t get mono more than once, not unlike chicken pox.  There, now you have a better idea of how old I am.

Sure enough.  The jaundice element was because my liver swelled into hepatitis (my spleen, of course, swelled as well) causing the attractive flavescense in my pallor.  Both my PCP and my infectious disease specialist told me that I was the first documented recurrence of mono (blood work to back it up) that either of them had ever seen.  They’d seen relapses, yes, but that would be sort of what I had during high school.  Four years in between does not a relapse make.

Back to the present, my doctor didn’t think mononucleosis was likely either – and I don’t know that I do, but damn, it does feel an awful lot like it.  The few suggestions he did come up with – well now that I’m fully awake, I wish I had argued my point more forcefully (or at all) because I know myself and they’re wrong.  That’s something else going on with me lately, I’m so worn out that I can’t even be bothered to get upset or fight my own battles.  Which is going to mean so much more to those of you who know me and have for some years.

I’m not depressed, although I have had random bouts of crying here and there for absolutely no reason that are easily suppressed and pass quickly.  And I’m not pregnant, a possibility my doctor raised.  Or if I am, another entry into Ruby’s Medical Incredible.

And in the first thought of, last mentioned case, I know depression in all of its many presentations and manifestations, and this is not one of them.

So what is it, then?  Right now I’m thinking mono and hoping that I’m wrong.  Although that really isn’t such a huge deal, it’s pretty innocuous as illnesses go, just a pain in the ass, and I don’t have a job or classes or responsibilities (as such).  I just have to power through the errands and the packing, I’ve got my mom as my backup, should she come home from work tonight and find me asleep, she is to wake me up, I mean really awake so that I can show her I’m all packed.

Here I go.  May the Starbucks be with me.

Moral of the story:  Time and tide.

© Ruby Tuesday and I Was Just Thinking. . . 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Sleep, And Medication, And My Metabolism, Oh My!

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I’ve been meaning to write this post for some time, it apparently just needed to cook some yet.

I’ll bitch about my psychiatrist for many reasons – okay, mainly because of the ECT debacle – but I cannot in good conscience let him take the blame for something that is not his fault.  It’s something that isn’t anyone’s fault, not really.

Per my sleep issues – well, I guess it’s best to begin at the beginning.

My sleep issues did not develop concurrently with my manic-depression.  My mother remembers, as I do, that when I was a very young child she would put me to bed and it would take me roughly two hours to fall asleep.  She would hear me in my room, talking to myself, talking to all of my stuffed toys, talking to the bedpost, or to the ceiling, for all I know.  I had a very vivid imagination, and I guess back then it didn’t much bother me that I couldn’t sleep, because there weren’t regular instances of me getting out of bed, looking for attention or distraction.

Fast forward to middle school.  I had a very good friend, and both of us had our own private phone lines (teenage girl’s dream come true!).  We would wait for our parents to go to bed, and then spend hours on the phone talking, probably until around one or two in the morning (I may be misremembering, but I think that seems right).  Well, once we got off of the phone, she would doze off and I would get down to the business of doing any homework that was due that day.  There was usually a tediously time-consuming amount.  So let’s ballpark me at three or four for bedtime, can’t remember how long it took for me to fall asleep, but I had to have been up by about seven.  Middle school was also when I pulled my first “all-nighter,” coffee and all, to finish a big project.

This is when things get a bit murky, because by then my mood symptoms had begun to manifest pretty rampantly, though not quite full force gale.  Okay, I take that back.  Eighth grade was my first episode of months’ long hysterical depression, preceded by hypomania, and after that – well, I would say ‘All hell done broke loose.’

Translation:  There would be periods of no sleep, periods of constant sleep, sometimes coinciding with mood swings, but not to the point where anyone ever saw something which needed diagnosing.  Well, one person did, from many miles away, and I flipped shit on him when he suggested I should see someone.  I never did apologize for that, and it bothers me to this day.  But I had a third-party (who knew me well) help me determine a few years ago that it wouldn’t do him any particular good.  But it still nags at me.

In my early 20s, when I had my girls, I could spend a day chasing two kids (ages four and less than a year), get prettied up and go out for the night, get home around two, shower and crawl into bed, then wake up around five in the morning and do it all over again.  By then I had already played around a little with the sleep aids with my primary, and our success was limited, at best.

Now to – well now.  Over the years my shrink and I have tried everything – sleep aids, benzos, sedatives, hypnotics, atypical as well as conventional anti-psychotics, things not even prescribed for sleep.  We have tried them in various combinations, he has written me for the highest dose he feels won’t kill me – literally, that was how he put it with one.  He has thrown out a book on sleeping medications during an appointment.  I found one that worked for a little while, and then we had to continually increase the dose, until I finally hit the ceiling and it wasn’t doing a thing for me.

This is all on top of my regular meds, which both my psychiatrist and PCP swear should take down a 350 pound man.

There was one med that worked for me, and we only had to up the dose once.  I found an interaction that no one had heard of, including a PhD in Pharmacology (that’s pretty much their area of expertise, interactions).  Upon further investigation, and the look on my PCP’s face after he got off of the phone with the Pharm PhD, apparently I am extremely fortunate not to be dead because of it.  Thank you to my insane drug metabolism.

The only thing I have never tried are barbiturates.  And really, I know now that there’s no reason to.  Highly addictive, highly lethal (although probably not for me), long-term side effects that are irreversible and not pretty.

So actually there is no solution here.  I need the magic pill, the one which doesn’t exist.  I need something that would knock me out like a barb would (in theory), but that I can take every night for the rest of my life if I have to.  That’s what started me fighting the tears when I was at the doctor last week.  I finally realized that what I need has not been synthesized or harvested or discovered.  For my intent and purpose, it doesn’t exist.

So what now do I do with this knowledge?

Moral of the story:  A gauze pad won’t take the place of a tourniquet, but if you apply enough of them on top of each other, you may stem the bleeding so that transfusions can be given and clotting agents administered.

© Ruby Tuesday and I Was Just Thinking. . . 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

In 5. . . 4. . . 3. . . 2. . .

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So two days ago (8 September 2011), I had my six month anniversary of when I began this blog with my first post, The ‘Miracle Max’ Moment.  It’s a little different from (but also much the same as) the type of posts I have come to write since.  It’s a bit of a process to get from throwing out a random thought and seeing what happens to it to letting anything and everything fly and not giving a rip who may be reading it and how they may respond.

For the record, I’m proud to have gotten here from there.  And thank you to everyone who reads what I write, and who has been brave enough to subscribe and be inundated with my ramblings on a near-daily basis.  A very special thank you to those who have stuck out my moods and my life, in non-blog interaction (of course), but also specifically among the bloggers I know, and those I ‘kind of’ know.

I am good at times, I comment and reply to comments and give quality feedback on posts on other blogs (I think, anyway).  And then there are the times – recently, for example – that I turn almost completely to myself and my world.  I may read, but I don’t comment.  I may not return emails or reply to comments on this blog for days.  I may struggle to do anything, both online and off.

But this blog has been my lifeline.  Lately, if nothing else I try to make myself post each day.  Sometimes I just fiddle around with the bright work (the behind-the-scenes stuff that usually no one can really pinpoint, but makes the experience better for everyone).  But this thing truly is my baby.

Thanks also to all of the bloggers who have decided to help in painting Canvas with their wonderful Minds.  ;P  Lulu, Always, ManicMuses, Novalee, and Manic Monday - you are all wonderful, and you occupy a special place in my life.  Being the site’s Admin (though not the only one behind the concept, ahem, Lulu) has given me a taste again of something I wasn’t sure if I was ready to handle, and it has done it in such a way as to not overwhelm me, or even really show its true face until I was well past the biggest hurdles (well, we’ll see about the hurdles part).

It has given me a responsibility and accountability to others.  It may not seem like much, and at the moment we’re in a place where there aren’t too many things I need to do in an Admin capacity (except for recruit more bloggers, we really want for you to join your voice to the chorus, everyone).  But there have been other times, with setup and implementing new ideas and contacting bloggers individually and all the various and sundries. . .

In any case, it’s different from writing this here blog in so many ways.  Not just in that I have a responsibility to other people (though I do), but also in that what I contribute there has to be more ‘focused and directed,’ and less ‘rambling whatever’ – the way I write here.  :D  So I am honing my craft as well.

I decided that six months of good, solid work here – I haven’t posted every day, but I averaged it out to 23 posts a month – deserved a reward.  If you are highly observant, you may have already noticed something a little different (and no, not the background color).  If you are a subscriber and are reading this in your inbox, I think you have to actually visit the page for this to work.  It’s alright, we don’t mind waiting for you. . .  Are you here now?  Good.

Now everyone look upward, all the way to the top of your screen, almost. . . look at the search bar. . . look at my address, my URL. . .  Notice anything?  Notice anything missing?

Yep.  I have my own domain, no more .wordpress.com, just .com!

It’s really much more symbolic than anything.  WordPress still hosts my blog, but I feel more now like it is in fact my blog.  It may seem like a baby step, a little tweak at most, and in a way it is.  But in another way it’s a huge leap from where I was.  I inched along in itty bitty bits, but I got so far.

I think the biggest factor involved is the symbolism.  Because doing this was a big, scary thing for me.  It was an acknowledgement that yes, I have done something worthwhile and kept up with it, and it was a sort of vow to myself that I will continue to do what I love and I will grow it and expand it in any way that I can.

Happy girl.  Actually. . .


(This song and video are solely the property of their respective owners and artists. Absolutely no copyright infringement is intended.)

And as it happens, I opened my curtains this morning for the first time in ages, I swear with no conscious motive other than to let in the light.  I thought in the moment it was pure practicality, but it makes me wonder now.

Moral of the story:  I am Ruby.  See me shine.

(And in case you’re confused or concerned, you can still enter in my old address with the .wordpress.com and it will re-direct you here.)

© Ruby Tuesday and I Was Just Thinking. . . 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Waning

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The moon my be waxing and almost full, but the same cannot be said for this blogger.  Sometime in the early morning hours of Wednesday (7 September 2011) I lost my energy, and I still cannot seem to find it.

Of course it didn’t help that I spent the entirety of the day in intense neuro-cognitive testing.  I have two blogs from that experience that I will publish sooner or later (they’re in a notebook, I need to type them up).

It also doesn’t help that I’m “surfing the crimson wave”* a bit early this month.  Not that I don’t delight in getting my period (because on one level, there is always a happy dance involved), but I won’t lie and say it doesn’t make me miserable.

I get tired, everything takes enormous effort, and cramps?  Oh.  My.  God.

I have dealt with migraines that have landed me in the emergency room since I was quite young.  I have endured headaches in the aftermath of ECT – take the most intense, searing, disabling headache imaginable, multiply by a factor of ten thousand, and that’s almost what an post-ECT headache feels like.  And no, I am not exaggerating.  Morphine + high doses of Percocet + high doses of ibuprofen + ice packs + laying in a dark, silent room in a dark, silent house = me holding on by just enough of a thread to not dial 911.  In retrospect, I should have.  But in retrospect, I should have done a great many things then.

Bone marrow biopsy (feeling the hand drill grind into my hip bone), tattoos only make this list because when they get really close to – or, I’m told, on – your spine, it hurts like a motherfucker.  Otherwise they don’t really rate on the pain scale in my adult life.

Sciatica – not as intense a pain, but very, very disabling when you’re trying to pick up and carry around a toddler.  I bake all manner of goodies, so the occasional first, or more often second, degree burn is pretty much inevitable.  I once had an ovarian cyst that made sex excruciating.  Oh, and I when I was hospitalized for mono they were giving me Demerol shots in the butt, along with a host of oral pain meds (inflamed spleen and liver).  That was decidedly no bueno.

These are the worst and/or most incapacitating pains I can remember in my life.  Cramps aren’t much then, right?  I honestly don’t even feel like I get them with terrible severity, and I do have a pretty high pain threshold (for every one instance of pain that made the text above, I can give you dozens that I don’t feel rated, despite the bruising and swelling and bleeding and scarring).  Aside from which, I have had them every single month for more than half of my life.  If nothing else I should have at least learned how to deal with them.  They’re even an event I know when to prep for, for Christ’s sake!

Yeah.  Cramps cause for me to curl up in bed or on the couch, and I will confess that if I have it on hand and they get intense enough, I will throw back Vicodin like no one’s business.  Fortunately, they usually only last for a day or three.

In any case, I’m feeling lackluster, uninspired, and my ability to focus and communicate has been with me only in fits and spurts.  So activities such as blog posts, comment responses, email responses, answering phone calls and texts. . . moving, sitting upright in my bed, keeping my eyes open. . .  These things are sporadic for the moment.  I’ll hit y’all back when I can.

Moral of the story:  A latte and cookie from Starbucks may not cure all that ails me, but I do feel a little comforted by them, at least.

*Cher (Alicia Silverstone), Clueless

© Ruby Tuesday and I Was Just Thinking. . . 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and I Was Just Thinking. . . with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.