Wednesday, July 06, 2011

Dropped into the shitter

Given my long established history with my pdoc, I'm beginning to think he's finally put a note on my file that says I'm a very serious danger to myself and if I call about anything, action must be taken immediately. When I called him before I went into the hospital for being manic, I didn't have to wait hours for a return call. I didn't even have to wait half an hour. He called me back in less than 10 minutes.

When I called his office yesterday to see if he had anything sooner than the 18th (an appointment I'd made when I had my last regular visit with him on June 9th before I'd landed in the hospital), I was initially told he didn't have anything available. I'd even explained to the receptionist that I'd only been out of the hospital a week, wasn't sleeping again and that my mood was tanking fast, but she still said I'd have to wait until the 18th.

After being put on hold for a few minutes, she comes back and very specifically asks, "is this a medication problem" and when I said yes, suddenly an appointment was available. After I hung up, I was worried that she'd misunderstood me and I'd just been given an appointment to see one of the medication nurses who are only authorized to provide refills should you happen to run out of your meds in between pdoc visits. I had plenty of pills, they just weren't working.

Rather than call back and get clarification, mainly because I was already in the midst of a massive panic attack over having to call his office yet again outside my regular appointment time, I figure I'd just show up and hope for the best. I believe the medication nurses see people on a first come first serve basis and since I was given a specific appointment time, I just kept my fingers crossed that I'd be seeing my pdoc.

My pdoc was concerned that my mood has dropped into the shitter so quickly, but more troubling is that I'm in more of a mixed episode than anything. I told him about wanting to cry or always being angry. Of how my mind won't shut off and I still have a ton of things I want to complete, but the other moods are making it impossible to get anything done. He asked if this has ever happened before and was surprised when I said yes. I never thought it was anything related to being manic. I just figured I was trying to rebel against the depression and get things done, but the depression was winning out. I didn't really know anything about mixed episodes before this past year.

Concern for my own safety made me bring the flurazepam I had leftover for him to dispose of so I don't try to overdose on them. Unfortunately, I never even thought to bring the temazepam since they were in a different spot. The temazepam is probably more deadly because I still have another refill left on those and if I were to break down in a depression and get it filled, I'd have about 50. Maybe next time I see him I could bring those to him too. I've thought of just trying to destroy them myself, but can't bring myself to do so.

My current regimen is now 500 mgs Depakote, 60 mgs Geodon and 1 - 3 mgs of Ativan a day for panic attacks. If I'm not feeling better or getting more sleep within a week, I'm supposed to up the Geodon to 120 mgs once a day and add in 100 mgs of Wellbutrin. Other than the Depakote, the rest is what I was on before I went into the hospital, so I questioned his decision to repeat the process.

Last time I was only on 60 mgs of Geodon, which he said has more of an anti-depressant effect at that level, plus the 100 mgs of Wellbutrin, so it was possible that being on too much anti-depressant medication without anything to offset it might be what triggered the mania. I only took 120 mgs of Geodon twice, which wasn't enough to undo the damage quickly enough and wasn't on a mood stablizer when everything originally boiled over. Hopefully this combination will help. Or at the very least, I'd like to be back in that euphoric state where I was getting stuff done rather than in this mopey, brain hurts from no sleep one.

And to make matters worse, I got my period and the allergies that have suddenly sprung up over the last 5 years are making me even more miserable. I just can't win...ever.


Blogger Walkingborder (Karen) said...

I was on 200mg of Geodon before I got pregnant. I'm not entirely sure I see the point of only 60 (unless you really only need a little help, and uh, that doesn't describe you), but you may not need the 200 I was on. It's a high dose. But, I warrant it. *shrug* Anyway, hopefully the 120 will do something for you. It should be good for the rages, at the very least, since it's an anti-psychotic. Though it has many MANY uses. Geodon can be very good stuff, once you find the right dose. Though I will warn you, once you've been on it long enough, it's a bitch to quit. SERIOUS withdraw. I was sick for a solid week. You don't want to miss a single dose. But, with that said, I'm very much looking forward to going back on it here in a couple of months. If that tells you anything. Also, make sure you take it in the evening since it is suppose to make you drowsy. You'll probably end up immune to that, but it can't hurt.

For whatever it's worth, this was my full regiment for BPD before I was pregnant and what I'll probably go back to ASAP once my body is my own again.

* Cymbalta 90mg 1/day
* Geodon 200mg 1/day
* Lunesta 3mg 1/day
* Trileptal 300mg 1/day, 600mg 1/day

Figuring out meds is a PAIN IN THE ASS though. Wish there was one magic cure all pill.

11:16 PM, July 06, 2011  
Blogger her motherless daughter said...

i know that all of this is trying. i watched my mother go through the same process. for what it is worth, i am so proud of you, and happy to hear that you are fighting this battle so hard. i'm sending you positive, wonderful, hopeful vibes.

1:55 AM, July 07, 2011  

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