Saturday, October 15, 2016

I think I'll be writing again

I've been on an unsuccessful quest to find a new therapist after a break. I'm trying to find someone who takes my insurance, and that is no easy quest. The last therapist I talked to told me that no good therapist is in-network anymore. She may have a point- I have tried a few in-network therapists and it hasn't worked out. I tried to tell her that she should change her listing on Psychology Today which states she takes Aetna (but it only meant she would send the bill to Aetna if you are lucky enough to have out-of-network benefits, and then balance bill you for the rest). I no longer have out of network benefits, so that doesn't help me at all.

The last person I called never called me back. I think I have another couple of prospects, but again I don't know if I can trust the listings anymore. If it says they take my insurance, does it really mean that they do?

But maybe all of this means I am meant to do without. That therapy is a luxury, and I'd rather spend my money on other things. I could go to my hospital's clinic, but I have never had good luck at clinics. I'd really rather not. And I don't want my therapy records anywhere near my work- with everything electronic.

I am still so mad at my hospital for getting rid of out of network benefits. In almost every field of medicine it is easy to find a provider who takes my insurance- except for mental health. People with mental health issues are the most affected. But we don't matter. 50% of psychiatrists don't take insurance, and I am sure it is much higher in my state- it has one one the highest levels of doctors overall who do not take insurance.

Of course if insurance companies paid more for mental health, more mental health providers would take insurance. My last therapist looked into getting a contract with Aetna, but they would have paid half of what she normally charges.

So that is my vent for the day.

Sunday, July 24, 2016

I'm not a Jedi yet

OK, I have mastered phase 1 of distress tolerance, most of the time. I can get upset and not have to take a klonopin, cry half the day (maybe half an hour)- but I survive. What I haven't figured out how to do is to be upset and to function. And really, that is what it is all about. If you can't live your life, what is the point of tolerating distress?

I am upset because I am hypothesizing, time travelling as my therapist says. Projecting the worst. I am having some kind of heart arrhythmia. It really started a few months ago, when my mother was sick, but I couldn't deal with it then so I just ignored it. And then I got into the habit of ignoring it. Until a couple of weeks ago because it is happening more frequently. And then I decided to lower my Effexor. No difference. Stop my thyroid. No difference. And then Friday I finally got a new blood pressure monitor- my old one broke- and I saw that when I feel my heart pounding it is 138 at rest. Which scared me. No, really scared me.

My mom had A fib at a very young age and had a stroke in her 50's. So it could be that. My dad also has A fib, but he got it when he was older like most people. My half brother also has A fib. But it could also be my meds. Lithium causes arrhythmias. Possibly Provigil. And almost all psych meds cause QT-interval prolongation. Will I have to stop meds? Will I have to stop Provigil? Will I be able to keep working if I stop the Provigil? Will life be so hard that I won't even want to keep working or living if I have to stop it?

So now I am freaked out. Afraid that I have A fib and will have to go on blood thinners (no more backpacking), or that I will have to go off of my Provigil. And also afraid that doctors won't be able to figure it out. I take too many meds!

Monday morning I will call my GP. Probably I will go in and have an EKG and my heart won't be doing it. Most of the time it is not. Then my guess is referral to a cardiologist for a holter monitor.

Meanwhile I have things I need to do. Except that I can't function. I should go into work and do notes. I should do a load of laundry, I can't even do that much. I should go to the gym. The grocery store.

This week I have had a lot to deal with including my car needed repair, a delay in the final stage of my dental implants (it seems like it will never end), and a tremendously busy work week and getting behind on notes. Yikes. And I have been so tired.

I've been thinking about trying to come down on the lithium even before this. It helped with the depression, but not with initiation- and I need a ton of help there. I would have expected anything that helped my depression to help at least a tiny bit with initiation, but I don't think that it did.

Maybe that would be the easy answer- that this is coming from my lithium and I have to come off of it. Except the last time I was taken off of lithium cold turkey I went insane.

Sunday, April 24, 2016

Missing my mom today

Maybe it is the mother's day ads that I am starting to see, and the ones that pile up in my in box. Maybe it is nothing at all. I keep thinking of things that I wanted to do with my mom, things that we never got to do. And now never will. Perhaps I should try to do those things anyway. But I miss her. 

I did finally make it to Costco and got my Provigil. But I think it is too late in the day to take it. It will have to wait until tomorrow. And straighten out my lithium tomorrow too. As well as going in super early to get my paperwork done from last week. Of course. 

Another weekend that has passed and I really didn't do much. It just passed. Or I could think of it this way: another weekend I survived. Sometimes I think that on my birthday: another year I survived, in my endeavor to die of old age and not by suicide. Of course with the things I have been reading recently I might be lucky to die of old age and not a side effect of abrupt climate change. 

This reading has me very depressed, and yet I was prepared for it by my earlier peak oil obsession. But surprisingly it does not make me feel suicidal- at least not for the moment. I want to see how things turn out. Simple curiosity. But if things get bad, I do not think I am very tough. I wouldn't make it in a Mad Max world. 

Saturday, April 23, 2016

Trouble with meds

I am out of Provigil, I have been for a week. My health insurance plan won't pay for it, so I drive 45 minutes away to the nearest Costco to buy it- they have it for an affordable price. But it is a hard drive when I am depressed, and I have been depressed, and so I haven't gone. It is a catch-22 situation. And the two days I wasn't so depressed I started thinking maybe I don't need it, maybe I can get off of this drug, take less meds, and not have this monthly trip and expense, etc. And today I was so depressed and anxious I took meds so that I couldn't drive. I have to go tomorrow.

And then I can't find my lithium. I was doing my meds for the week today and I can't find my bottle of lithium anywhere. I have extras of most of my meds, but not really with lithium. I just had five pills- enough for all of tonight, and two out of three for tomorrow night. Then I'll have to go to the pharmacy and just get a refill and pay for it, because it is too soon for insurance to pay for it. I hope I have a refill left.

Too many meds. And my apartment is too much of a mess. Nothing much has changed in my life.

Which is why I am thinking of quitting therapy (again). I quit therapy and then restarted when my mother got sick. But now I am not sure why I am going- I know what I need to do, I just need to do it- and therapy isn't helping me do things. Plus it costs a lot of money.

I like my therapist but she doesn't take my insurance and I no longer have out of network benefits. I tried 3 therapists in-network but it didn't work out. I don't have it in my to try any more. And with my high deductible plan it would still cost a lot anyway.

My psychiatrist doesn't take insurance either, but I only go every three months most of the time so I am keeping him. To find someone who is okay with all my various meds and I like and who seems good- I'm not going to mess that up. I have had too many bad psychiatrists.

It has been a rough week, I can only guess at how much of it from the lack of Provigil. But by Friday I really didn't want to be alive.

Not wanting to be alive- that is a good thing if you are reading or watching Guy McPherson, the scariest man alive. He predicts "near term extinction" for human beings by 2030. There are a lot of scary arguments he makes, but I am still not sure how he comes up with his date. I am also not sure that I can really accept that ALL human beings will be dead- maybe a few will find places to make it.

The thing about his position that is attractive- is that we no longer have to fight. We no longer have to write letters to the editor or demonstrate or lobby for political change. We can just sit back and watch the collapse. But if he is wrong- then we have given up our power to fight.

I don't see a political solution. I don't see us cutting fossil fuel use significantly in time to prevent catastrophe. I see geo-engineering as the only thing that can save us, or perhaps just buy us more time. Geo-engineering is still a dirty word for most, but I think it is the only thing we might be capable of doing to save ourselves.

Sunday, April 3, 2016

Halfway an orphan

My mother died last week. It was, as much as could be, a "good death." I was holding her hand, her mother and my cousins were there as she took her last breaths, and she was at home. Of course there was a little conflict with my grandmother who said she is not dying and tried to get me away- so we had to be on opposite sides- but it was as good as could be expected. Her sister had stepped out to buy something, and I'm kind of glad she did- I think she might have panicked and wanted to call 911.

The week before was pretty awful as I battled with her family over hospice. They didn't want it, I did. I had medical power of attorney, but she lived with them. It was bad. Finally they agreed to hospice at home and we got her out of the hospital. Her vitals were so unstable I was afraid she wouldn't survive the ambulance ride home. But she did, and two more days at home. I got her pastor to come- and we are Lutherans, so no last rights. But still- she died within an hour of his visit. I'm so glad he could come.

I was with her for a week. It was a very intense, sleep deprived week. I will write more about it later. Then the next week was spent recovering, working with the funeral home, planning the funeral, and working with a probate lawyer. She had no will and hasn't paid any bills since she got sick, apparently. It will be a mess, but I made my brother executor.

This past week I asked for off as well. Work gave it to me as unpaid time, even though I didn't have enough PTO. I'm glad. I feel like I just needed it. And this weekend I went to visit my brother and family. Tomorrow I go back to work.

I'm a little anxious about it, but it is time. What would I do with myself if I didn't go back to work? I think my boss was worried about my stability, she said I could take a medical leave if I needed to. I don't. I have been grieving for my mother for a long time before her death. Even that whole last week, when I would spend the nights in the hospital- she was on the telemetry unit so I could watch her vitals- and I would cry, because I knew that they were so unstable. I didn't see how this could go on. And it couldn't.

Whatever issues I had with my mother, I always knew that she loved me. And now she is gone. And my dad is 10 years older, and really starting to slow down this past year. I need to start taking care of myself. I need to be my own mother.

Tuesday, January 26, 2016

My life is gray

I am not having a lot of "I can't stand another second more" moments these days. I am just having my moments of wondering how much longer I have to put up with going on living. There seems to be nothing that I want. I can't even figure out what to eat for breakfast- there is nothing that I want to eat. But it is my late day at work, I will be starving by lunch (and then eat something bad).

I have a problem with initiation and with keeping going through difficulty and I don't know how much of it is depression, meds, or my underlying personality. But perhaps it doesn't matter. The answer is the same- I have to treat initiation as a muscle and see if I can strengthen it.

There is this catch-22 about depression. If you are depressed, in part because your life is empty and miserable- then the answer, at least in part- is action. But the thought of action seems very unpleasant, and it is all that I can do just to keep going in the basics of my life- how can I do more? And so the thought of doing more makes me more depressed, and yet not doing more makes me more depressed because it does nothing to make my life better.

There are many reasons why I am so devastated by my mother's cancer. But a part of it is that I have so few people in my life. My brother has a wife, kids, even in-laws. I still can't figure out how he turned out so normal! I think his wife has a lot to do with it. Plus he has always made connections with people, wherever he went.

In two and a half weeks I go to see my mother, who is now on oxygen. I'll see if a week is the right amount of time to go for. My plan is to go every month until I use up my PTO, and then to start using family leave. I don't know how much time she has left. A doctor in July told her she had less than a year (and he made it sound like quite a bit less) if she did not do chemo or surgery. But that is just an average, and I don't know if any of the alternative things that she did bought her some time.

Wednesday, January 20, 2016

Faster and faster

My mother was in the hospital again. They called 911 when she felt like she couldn't breath Tuesday night. She just got released. They sent her home on oxygen. This is going to be a big adjustment.

I think the hospice discussion is going to happen soon, but I don't know if I need to be there in person to bring it up. She seemed to frazzled today to talk about it on the phone, I wasn't sure the timing was right. I wish I was going to visit them earlier than I am- I don't know if it can wait a month.

I'm glad that she had a good Thanksgiving with her children and grandchildren. It has been downhill from there. Somehow I didn't think it would be so fast. When they said under a year without chemo, I thought somehow she'd get the full year. And I thought that there would be time during which she would still have some health and not be so focused on finding a cure that we could do something together. But that was my wish, and it is her cancer. She will spend it doing what she wants.

I want her to find acceptance. What else is there at this stage? I want her to have peace. And I want to be able to really talk to her- but maybe that is my fault for treating her like a child and not telling her what I think the truth is more often. And I want to be there. But I don't want to quit my job here.

I want, I want. I need to accept. At least today I am not crying. Amazing what an increase in Effexor can do. That was what stopped the tears. I'd like to say it was radical acceptance or inner strength or something. It was drugs. But drugs that let me do my work. There have been tears, and there will be a time for tears again. But when I am crying at work- that is what is unacceptable- because then I can't do my job.