Monday, April 27

The state of things

I realized that I haven't posted much of an update since my rather dark, dire post a couple of weeks ago . So I wanted to give you all an update to let you know how things are going.

At last check, I had been searching for a psychiatrist to help me handle my meds outpatient. So I looked up some on the Medicare website who were relatively close. I left 5 messages. I got zero calls back. (And in the messages, I asked them to give me a call back, even to let me know if they simply weren't taking on new clients.) It just seems like psychiatry is a strange profession if you're not timely with calls. Most people only start seeing a psychiatrist when they truly need help.

So I decided to look for a psychiatric nurse. I couldn't tell from the Medicare website how to distinguish between regular nurses and psychiatric nurses. Instead, I worked backwards. (Generally a good tactic with bureaucracy, since that's generally how you feel you're moving anyway.) I googled "psychiatric nurse seattle" and found a whole association. I then found one half a mile from me, and looked her up on the Medicare webpage. Voila!

I lucked out, actually. April is very nice and really listens. She asks a lot of questions, too. I saw her today for the second time. I told her that, overall, my functionality is getting better. I don't feel as reluctant to leave the house; I can accomplish tasks without feeling overwhelmed. The sadness feels more transitory, too. It doesn't feel endless or all-consuming.

But on the other side of the equation, my mood swings are still terrible. They might even have gotten worse. It's hard to tell, since they're not something Tim and I catalog. Usually, I'm grumpy and easily irritable. But these days it's practically a flash-flood of emotion. I'm fine, right up until I'm not. The angry mood swings almost feel like PMS: everything drives you insane and makes you want to hurt someone, even as part of you knows that it shouldn't be such a big deal.

The flash depression is almost scarier. On Saturday, I was a little antsy all day; but Tim came back from a Magic event around 9 p.m. and I was happy to have him and our friend Seth there. Then Seth needed to go home, and Tim walked him out. In the 10-15 minutes they chatted, I became forlorn. There's really no other word for it. By the time he got back, I was knee-deep in malaise. I was sad and distracted, but couldn't (as I usually can) pinpoint why. I couldn't talk through it and come to a reason, either. I simply felt sad and lost and low.

Listening to all this, April decided we should try a mood stabilizer called Lamictal. There is a very, very small chance of a serious side effect, so if I get a rash I need to see a doctor immediately. Otherwise, she's going to slowly raise the dosage every two weeks until we find a level that works. If it helps me get to a more even keel, I'll be thrilled. It's terrifying to be a spectator in your own emotional outbursts.

I also had a blood draw so that April could check my thyroid and my Vitamin D levels. Let's hope that tells us something, though my thyroid has always checked out in the past.

After that appointment, I went to see my regular GP down the street. I had wanted to talk to him about weight gain. I constantly want to eat. And willpower doesn't seem to be kicking in at all. I'm up to 210 lbs, which is alarming for me. It's the heaviest I've been in several years and close to the heaviest I've been ever. (I should point that I've been told 175 would be a good, healthy weight, given my overall stature: big hips, big bust, thick bones. And Tim has threatened to sleep-feed me if I ever get close to my 1500-calories-a-day-and-jogging-most-mornings, skinniest weight of 155-160.)

I had considered trying Alli, but was taken aback by the cost ($60 for the starter pack). I read up on it and discovered it is actually just a half-strength version of Xenical (Oleostat) which helps block fat absorption. I reasoned that it would be cheaper to get a prescription than pay for the over-the-counter thing.

I wanted it, not only for the extra help in losing weight, but also because taking that stuff guarantees that unhealthy eating has an immediate consequence. I figured it was what I needed. If I knew that I would undergo severe "intestinal distress" (to put it politely), I would be unlikely to indulge in sweets and fatty foods.

Unfortunately, it appears that I'm overreacting. Which is to say: I need to eat better and lose some weight, but the gain hasn't been as drastic as I thought. Apparently, I've only gained about 3 pounds in the last two or three months. And back in September, I weighed in around 207, too. So this seems to be a case of my not acknowledging reality.

At any rate, my doctor said, given these facts, he wouldn't recommend Xenical. Too many side effects -- which was why I wanted it, of course. Still, based on the facts he was looking at, I probably wouldn't have written a prescription either. (Assuming, of course, that I could write legit prescriptions.)

Still, I got pretty upset, tearing up. I guess just because I hate to feel so out of control. Which, when you get right down to it, is a strange turn of phrase. I'm not sure we're ever really "in control" of ourselves. It makes me think of taming and training, that there are right and wrong emotions. I guess that mindset isn't really a very healthy one either.

At any rate, I feel unable to effect change, which isn't giving myself enough credit.

  • I found a psychiatric nurse and even go willingly to her appointments. (I am prone to find reasons to cancel or skip medical stuff.)

  • I'm taking walks relatively regularly: 3-4 times a week for the past three weeks. I have to say that making it more of an adventure/challenge (find cans to pick up and recycle) definitely makes it easier to get out of the house.

  • I took out some yoga DVDs from the library. Nothing intensive. I finally tried the first one yesterday. I did the "Stress relief" part, which was mostly gentle stretching and loosening. The most intensive pose was downward-facing dog. Next, I want to try the "Stress prevention" chapter. If I like the DVD enough, I may try to find it cheaply on Amazon.

So I am able to affect change. Just not as quickly or effectively as I might like. But that's a Type-A personality for you. It's a reminder to accept what I can and can't do. (I've decided the word "limitations" is too negative for the moment.) To accept myself as whole and not in need of fixing. But that's a major flip from my usual mindset. So it will take time.

Did I mention I'm not a patient person?

In other news, Tim -- Mr. "2-liters-of-Mountain-Dew-a-day" -- is now off soda completely. The citric acid in that much Mt Dew would flush the Adderall out of his system. So he had to quit, cold turky. But he started chugging water like it was, well, Mt Dew. He refills his 62-oz water bottle about 4 or 5 times a day. It's insane. But he managed to avoid any headache the first day, getting one at bedtime the second day and a slight one on the third day. So, as long as he avoids water poisoning, I'm happy.

Now we just have to figure out how to return the Mt Dew stockpile we have without a receipt. There's always a new adventure in our household...



Blogger Meg said...

Wow, that's a lot of water! I would seriously be worried about him dangerously throwing off his electrolytes! Is there a reason why he's such a compulsive "drinker"? Does he have diabetes or another ailment that makes one thirsty?

Glad to hear, though, that you're both still hanging in there.

April 27, 2009 at 4:39 PM

Blogger Petunia said...

I'm really sorry to hear that you have been struggling with mood swings and depression.

I sincerely hope that April will be able to get your meds right where you need them to be, so you can feel like yourself again.

I know they aren't tangible, but I am sending some good thoughts your way.

April 27, 2009 at 7:10 PM

Blogger Abby said...


That's actually not a bad point. Next time he goes into the doctor, we should probably ask about that.

The only real reason, as far as I can tell, is that he feels like he has eternal cotton mouth. And when his teeth were going bad, he couldn't chew gum (still hard with dentures). Hard candies tend to stick to the dentures, as well. So he uses liquids to keep hydrated. Or just to make my life more interesting. I haven't decided which yet.


Thanks for the positive thoughts! They may not be tangible, but they certainly couldn't hurt!

April 27, 2009 at 9:14 PM

Blogger Shtinkykat said...

You're definitely a fighter, Abby. It seems like you're pulling through and you're making great progress. Heck, you're doing much better than I in the exercise department! Keep up the good work.

April 28, 2009 at 4:31 AM

Blogger Alane said...

Thanks for the update I have been concerned. It is possible that part off Tim's water drinking is withdrawal from the mountain dew. Have him drink powerade or gatorade diluted almost 50/50 for a few days and see if that helps. Mountain Dew is one of the worst sodas on the market. In Appalachia(sp) they have actually diagnosed a condition they call Mountain Dew Mouth to the soda. You can probaly find some articles on it.
Glad to hear you are getting outside. I know with my depression things that help me is getting outside and getting involved. I know with GB this is tough but you might want to look for a support group or something else that gets you out and socialing with other people. Right now the two of you are quite isolated. This isn't healthy or fun. You need to rant and rave with girlfriends. Maybe just having phone dates. I know money is tight but maybe a few friends could call you on a regular basis. I had something like this going with an old friend who lived out of state. We called it our date night. We would take turns calling each other but that was our time. No one interfered, we would drink to much beer and giggle and gab for hours.

April 28, 2009 at 5:55 PM

Anonymous Anonymous said...

I've been worried too, hon. I was so glad to read this. You are doing all the right things and I only wish I was as self-aware as you are!

Talk to me ANYTIME. I've been there. I might have even saved a map.

April 29, 2009 at 10:38 AM


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