Not feeling good today

I am really tired and dizzy and wondering if maybe I forgot to take one of my meds this morning. Or maybe I am getting sick. Or maybe my body is still adjusting to less meds. I spent the afternoon at work feeling like I was going to pass out. I skipped out on Monday night yoga- and I haven't been in a while. Instead  I am lying in bed, hoping this will pass. I am sneezing a little, maybe I'm getting a cold. I cannot believe how tired I feel.

I feel really bad that I didn't go to yoga. I gave myself all weekend to stay in after I had my wisdom tooth pulled, and I really didn't do anything physical. I needed to go. But I just feel awful. I think I have a fever.

There is one good thing I have to say about today. While I felt awful physically, and my mood wasn't too great either- I did find that my mind was sharper at work today. I was right, going up on the Zyprexa made me dumber, and going back down has helped. I have to remember this, the next time I am tempted to go back up on it again.

I did graduate school on 5mg. I passed the CHT exam on 5mg. I can function on it. Perhaps I'd do better even lower (or off of it), I don't know if I am brave enough to find out. But 7.5mg is too much for me to feel like my brain is functioning well. So it is back to 5mg for now. Maybe eventually lower. I'd like to be lower. But not now.

A lazy Sunday morning

I think I am adjusting to the Zyprexa decrease and no longer need the whole milligram of klonopin at night. I overslept, and I'm really sleepy this morning. Tonight I'll take less.This is good. I also don't have too much pain this morning from where my tooth was pulled- it is just a little sore- so I don't have to take any naproxen. I'll just take a little tylenol later if I need to. I'm still eating soft foods- I think I would be in a world of pain if anything hard hit that area.

Sunday mornings I watch a lot of the morning news shows- either that, or BookTV on C-SPAN2. I can't watch the news this morning, it gets me too upset. I am having one of those mornings when I think that Lincoln was wrong- that our country is too large and diverse to be governable, and that we might as well splint up.

I don't know how I feel about Obamacare. Ideally, healthcare should have been taken care of at the state level, it seems like a states rights issue. But, with the exception of Massachusetts, it wasn't. And something had to be done- and nothing had been done. Is this better than doing nothing? Perhaps. I don't know. What nobody says: there will be winners and losers with this law. It is not all good or all bad. The other things that people don't say: if you liked the health insurance you had, you probably couldn't have kept it for very long anyway. Costs were getting out of hand, and policies were covering less and less each year. I have patients with 50$ copay's for there occupational therapy visits, who tell me that they can only afford to come once or twice. Insurance isn't what it used to be. Like last year when I spent $3000 for my hospitalization- my in-network out of pocket maximum.

I'm doing laundry, and trying to clean the kitchen. Later I will go for a walk. Tomorrow it is back to work.

So far so good on less Zyprexa.

This year I also managed to cut down on my Effexor. Cutting down on my Zonegran did not work. I'm not even going to try with the lithium- I think I'm at the sweet spot, with a level of 0.6. Just at the very bottom of the therapeutic range. That leaves Provigil- which isn't my biggest priority of things to reduce- except for the cost (as my overseas supplier has become unreliable and the price still hasn't dropped much in America).

We are governed by idiots

I can't believe they are going to do it, they are going to shut down the government. And then, after that, they will probably refuse to raise the debt ceiling. The government doesn't work.

And of course if they default on the debt, there goes our low interest rates on our debt, and then we are really in trouble. I don' t know why I bother to put money into my 401K. Well, what else is there to do? Buy gold, I suppose.

Our biggest issue is climate change. I used to think it is peak oil, but climate change just might hit us first- and peak oil might not hit us in time to save us from severe climate change. But take your pick, these are two issues that rarely get talked about. Let alone funded.

We need geo-engineering. In the long run, we are going to have to do something. I'm not giving up my car- because it wouldn't do any good. Everyone else on this planet would have to as well. If my small sacrifice could save the earth, believe me, I would. But if America were to cut CO2 emissions 50% in 10 years, it would shift the power balance and China would now be economically stronger. It is game theory. That is why small nations can go green easier than big ones- they have others to protect them.

So either we need some environmental world dictator to tell everyone to stop CO2 emissions, or we have to give up on that course of action as the mainstay of preventing global warming. And go to geo-engineering. But that requires money, and that requires that the congress can actually accomplish something other than shutting down the government.

But geo-engineering requires the conservatives to admit the climate change is occurring. And it is something that most liberal environmentalists are against. So I don't know who would be for it.

Taking advantage of an unpleasant situation

I had a wisdom tooth pulled yesterday. It had a cavity - which wasn't that terrible, but the tooth above had been pulled a while ago, so my dentist thought I should just have it pulled. I took Friday off, to give me three days to recover, and had it done first thing in the morning.

I really didn't think it would be that bad, as the upper had not been. But when I told the oral surgeon that, he said this one would be worse, as the tooth was more buried. He had to put stitches in afterwards- which I don't remember him doing last time- and he even gave me a prescription for tylenol with codeine (which I didn't fill).

It has been more painful, but I have been managing with tylenol, naproxen, and ice packs. And I napped a lot yesterday too. Naproxen can raise lithium levels so I try to not to use it too much, by as my level is only 0.6, it could go up a fair amount and I'd still be okay. I just can't use it for prolonged periods of time.

What I decided to do over this 3 day "vacation" is to lower my Zyprexa. I started Thursday night. I cut my 7.5mg pill into quarters, and took 3/4ths of a pill (and I took the larger quarters, so I'm taking a bit over 3/4 of a pill). And I am taking a little bit of klonopin. So far it is day two, and I feel fine.

Right now my goal is just to get back to 5mg, I really haven't decided about anything else. When I had the mixed episode this year and went up on the Zyprexa, I didn't do what I usually do- which is to go back down as soon as it was contained. I think it was the wrong decision. But I just wanted things to be easy for a little while, I just got complacent. I was afraid to go down. I thought I was doing well. But I really felt like my mind hasn't been as sharp since I have gone up, and that never went away. I was hoping it would.

Another blah day, and question about meds

I survived another day, and generally am feeling better. I did start getting that anxious feeling again in the afternoon- and I realized that I had an extra cup of coffee in the morning. It was only half-caf, and normally I can drink a lot more coffee with no anxiety, but perhaps not now. Or, perhaps it had nothing to do with the coffee. I took a quarter milligram of klonopin, and felt a lot better.

I am wondering about lowering my Zyprexa again. When I was doing so well, I thought well, I made my deal with the devil. I am actually functioning and doing things. I'll take the higher dose of this drug I don't want to even be on if it keeps me good. That was in July that I increased the dose. But if this quickly I have felt bad again- maybe the dose increase is no longer working, and there is no point in being on it. Maybe my brain has adapted. Or maybe it was never the Zyprexa- the lithium was raised at the same time.

I hate this trial and error system of psychiatry. There is no one who can tell me what my dose of Zyprexa should be. And whether I should go back down- so that I can increase it again in time of need- or stay on the higher dose to try to prevent future episodes, etc. I certainly don't trust clinical trials sponsored by drug companies to answer these questions.

Winter blues?

Work was fine yesterday, but afterwards I just wanted to run home yesterday and go to bed. Today I am thinking of cancelling a social commitment I have after work that will get me home really late tonight.

I'm not bad like I was. I don't have the anxiety and agitation. I just feel down, and worn down. I feel like I have looked into the abyss one too many times, and I can't forget it. I had naively thought I would have a few good months, at least, before I felt that bad again (I thought I was doing so well!)  I didn't. And now I don't trust anything.

I had a brief spell during which life didn't require such tremendous amounts of effort and willpower. It was nice. I got spoiled. I think it is going to go back to effort and willpower for a while. But fall has never been a good time for me.

Better but not good

Yesterday I inexplicably felt better. And the afternoon  jolt of anxiety did not hit me either- so I didn't feel the need to take a klonopin. Still some depression, but not as bad as the last few days. I don't know why I started feeling worse, and now I'm feeling better. Except that perhaps I am becoming a werewolf- and it was the full moon. I remember a couple of months ago another unexplained mood shift, and it was the full moon- and I said it must be a coincidence. But now it could be a trend.

I did blow off yoga yesterday though. I just had to go home and sleep. I did a lot of sleeping yesterday. Then this morning I had lots of strange dreams- but now I can't remember them too well.

It is one of my late mornings today, when I go in late because I work to the evening. I hate those days. It gives me time to get depressed before I have to go in, which makes it that much harder. I wish I had constant hours- but the only way to get that would be to work evenings every day, and then I couldn't take yoga or do anything after work.

I'm just tired of my life, I guess.

Missing yesterday's yoga was not good. I even drove by- I just couldn't get myself to go in. The past week it has been getting harder and harder to try to get myself to go. And I felt like it should be getting easier over time. It felt so discouraging, for it to be getting so hard- I starting feeling very discouraged and hopeless. Because when it becomes that hard to do things, I'm not sure it is worth doing things. So I just gave up and went home so I wouldn't have to think about the a future filled with things that feel so impossibly hard to do.

There is a DBT skill, opposite to emotion action. But I don't want my whole life to be opposite to emotion action. And when I am depression, I become scared that it will be.

How hard to push myself? I don't know.

I did find my klonopin last night, and took half a milligram- enough to get me to sleep- I slept 10 hours, and awoke sleepy but feeling calm. I decided to stay home, and not do the things I had planned. I napped, I read, I did little things. I really didn't feel too bad until mid afternoon, when the depression started to kick in again, but it was easier to bear than yesterday- because I didn't have to function.I didn't have that added stress.

Did I do the right thing? The wrong thing? I don't know. Maybe I should have made myself do something.

Tomorrow is Monday, and work. I don't know if it is going to make things better or worse.

Depression teaches you that you are not in control. You think you are in control of your life- one minute things are going well- and then the next minute you are in hell. And you don't know how to get out. All you can try to do is to survive.

I'm not having a lot of faith in meds right now. It's just that I've never know what else there is, when things get bad enough. I suppose the alternative is to just accept the feelings, and see the depression through- and hope you don't lose your entire life in the process.

Can you will yourself not to get depressed?

I think I am falling. I was so depressed today, it felt so physical- at times I thought I would collapse. This can't be happening again, not so soon. I don't even know why I am depressed. Shouldn't you be depressed about something?

I made it to my splinting workshop, and struggled to be mindful. At times, just being there felt like agony. At one point, another participant asked if I was okay. I told her I was just tired. I don't know how I made it through the class, and the drive home.

Now I have collapsed into bed. I don't know what to do. I guess increase my light therapy. I am not ready for a med change, it is too soon. I hope it doesn't come to that. And I don't know what else to do to head off the steam roller of depression, I never have. There ought to be something to do when you see is coming, when it is just starting- but if there is, I don't know what it is. Other than meds.

This is the time of year for me to get depressed. Maybe that is all it is, the change of seasons. Maybe I need to move to the equator.

Maybe I should try to get myself to a yoga class tomorrow morning. And then go swimming.  It is a plan. Of course afterwards I have to go into work to do notes- I'm hoping the exercise will energize me and get rid of agitation and not exhaust me before I go in to work.

I don't know if this is a good or a bad thing: I can't take any klonopin right now. I wanted to take just a quarter milligram, to take the edge off things. But I can't find it- and I have two bottles of the stuff. That is how disorganized I am (and how rarely I take it recently). I have no patience to search- I started to, but that made me more agitated, which defeated the purpose of taking the klonopin...

I don't know if I should tell my psychiatrist this: yes, I do need another bottle, because I can't find the other two I have at home.

It was a good course today, and at least I wasn't crying- as I have been at a couple of other courses I've gone to when further into depressions. I was able to focus enough to learn. Maybe not enough to have the patience to make the best splints I have ever made, but enough to learn how to make them.

Somehow dragged myself to yoga

It was quite an accomplishment. I was so tempted to just go home after work, decided several times that I was going to do just that- even though I had already paid for the class and it was too late to cancel. I was just feeling too bad. But in the end, I went.

I am glad I went. I'm not going to say that I was mindfully present for the whole class, or that it was the best class ever. I am not going to say that it pulled me out of a horrible mood and made me feel wonderful. I am just glad that I went, however I feel. I think I would feel worse if I didn't go. And my body needs it. This is something I want to stick with.

I'm still hoping this is a temporary thing from disruptions in my meds and my schedule (going out of town and a couple of days off), etc. I am hoping that soon I will start feeling better. If not, I don't know what I am going to do. I don't feel like I am depressed over anything in particular- my life is actually going pretty well right now.

Tomorrow I have a continuing education workshop. Usually I like these a lot- and it is a splinting workshop, it should be fun. I am actually looking forward to it- which shows I am not too far gone. Although I am not looking forward to having to leave the house at 6am tomorrow morning.

Fall is coming, and my mood is going dowm

For the past two days, all I have wanted to do is curl up on the couch and eat ice cream.

It didn't help that I overslept yesterday, so I didn't do my light therapy, or that I mixed up my meds so that I missed a couple of Effexor doses over the past week. Or that I did a load of laundry this morning, but couldn't get the dryer to take my quarters and start- so I have wet clothes spread out all over my apartment to dry and nothing to wear.

I don't want to go to work, although once I am there it isn't so bad. And truly, this isn't so bad. I just hope it is a mood- and not the beginning of a decline. I really hope. Tomorrow it yoga, that should help. And today I will get out during lunch- I have to go to the post office anyway.

Should your doctor talk to you about your weight?

I got on the scale this morning, and I was very frustrated. I have gained almost 10 pounds in the 3 or so months since my lithium and Zyprexa were raised. And this is despite the fact that in that time I have finally started to exercise again and to eat much healthier (lots of vegetables).

This morning I have an appointment for my physical, and I am worried that I will get lectured about my weight- although this particular doctor has never done that (yet). She did once talk to me about exercise, but I was so depressed at the time that it took every single once of energy I had to make it to work- how could I exercise?

The depression is better now, so the exercise is better. Not because my doctor or my health insurance company wants me to exercise. But the weight is not better. I know that I need to work on that next,

I suppose there are some people who do not know or are in denial that they are fat. Who do not know or are in denial that this has health consequences. And for that reason, perhaps, it is worth a conversation. But I work in healthcare, no one has to tell me these things.

A part of me says, anyone who has not been on Zyprexa for 15 years has no business talking to me about my weight. Which is ridiculous- I treat many injuries or conditions I have never personally experienced. So if someone has something useful to say, I am willing to listen.

The problem is, no doctor has ever had anything useful to tell me about my weight. All they accomplish is making me feel bad, and making me want to go off my meds.

So until they have something useful to say, I hope they will say nothing.

Why I love this country

America is a place for second chances and second acts. My current career is definitely my second act. I had to give up a potential career in research due to my illness. I kept getting sick, was in and out of the hospital, and had to go on disability. I was really, really bad at times. A lot of my hospitalizations were not voluntary. Some of it was the meds- they didn't realize I was bipolar, and then when they did, I was badly medicated for a while.

Once the meds got a little better, and I also started taking a bunch of supplements, I started feeling better enough to want to move on to something else. I learned about occupational therapy after my mother had a stroke, and decided it sounded like a good career for me. I also thought it sounded like a good ladder- if I could do the required volunteer work and take the remaining pre-req's to get admitted to a Master's program, then I could do the coursework. If I could do the coursework, then I could do the internships. If I could do the internships, then I could get a job and work full-time.

I took it all on faith that it would work. I even charged all the pre-req courses that I took at the local community college on my credit card, figuring either someday I'd pay it off- either that, or things would have gotten a lot worse- in which case there was bankruptcy. And I took out the maximum loans to pay all of my graduate school tuition (which I am still paying off).

But it was worth it. I have had a second chance, a second act. Something that hit me today, as my promotion at work went in to effect officially, I am now a senior occupational therapist. I love what I do, I can't imagine not being an occupational therapist. I am very lucky.

Made it to the grocery store

It still isn't easy to go grocery shopping. It is impossible when I am depressed ( I live from convenience stores and drive through then). And for some reason, I am still struggling a little with it. But I went after work, even though it would have been easier to go home.

I wonder if some things will ever be easy. Not that everything in life has to be easy- but it would be nice if the little things could be easier. Then I would have more energy for bigger things.

It has been warm and humid the past couple of days- and my body doesn't like it. I am really tired. I don't want to move. I hope it cools down very soon.

Nothing much to say today. Work was very boring. I did so much paperwork my neck started to hurt from looking down so much. And now the carpal tunnel syndrome on my right is flared up- it has been really good recently. Paperwork is bad. By next year we should be doing our notes online, which I am sure will lead to a different set of ergonomic problems.

I didn't want to go to yoga, but I'm glad I did

I had the day off, and I had a delicious, lazy day. But too much of that, even when it is feeling good initially, will eventually pull me down. And by evening, I really didn't want to go to my yoga class. I made myself go, and I am glad I did. My body feels really good after the class, and I feel better.

Yoga or exercise or so many other things require that you commit to them over and over again. Whenever I manage to clean the kitchen, I somehow think it should stay clean. I keep thinking I shouldn't have to clean it again so soon. I'm not very good at housekeeping- or at least not yet. I am getting better at it, just as I am getting better at getting myself to get to yoga. I really should hire someone- but that would be admitting defeat. (not to mention the expense).

It is never really finished. You are never done, until you are dead and buried. I will always have to push. When the depression is really bad, it can seem impossible (and pointless), to even try. But even when the depression is pretty much at bay, I still have to push. It's just that the pushing is a lot easier. I remember during past past couple of years that I had reach a point at which I didn't think I would kill myself for while- I had just had a new niece born, didn't want that to burden her. But I wished that I was dying. I couldn't wait to get old, for life be done. I wanted to be able to stop trying, I was so tired of trying.

I don't think that very often any more anymore.

Robbing the bees

My dad has bees on some property about 3 hours from here. In recent years, I have started helping him with his bees. I started really just to help out my dad, who is getting older (but never let him here me say that), but recently I have started to like it. I just wish it wasn't so far away.

We really didn't rob the bees this weekend, we were just scoping the premises. It was a very bad winter for the mites in the area, and most of his hives didn't make it. He had to start with new bees. Normally he would have extracted at least once by now, but he hasn't. We were looking to see if anything was ready to be extracted. One hive had a super of capped honey, ready to go. Another hive looked good- in a week or two they will probably have finished capping the frames in the top super.

But the other hives were not doing so well. One has swarmed, late in the year, which is unusual. They have a new queen (we found her), but she is not laying yet. Two other hives are weak. A third looks strong, but for some reason wasn't producing the expected honey. 

So in a couple of weeks we should have 60 pounds of honey, which sounds like a lot but is a lot less that we usually get. 

Willingness vs. Willfulness

One concept of DBT is that of Willingness vs Willfulness. Willfulness is stubbornness, it is cutting off your nose to spite your face. It is doing what doesn't work. Willingness is openness. Willingness it engagement. Willingness is doing what works, even when you would rather be doing something else.

The first time I encountered DBT, I did not have a good experience with it. I think there were really 3 reasons. First, and perhaps most importantly, I was not in the right place for it- I was too deeply depressed, I was too suicidal- I wasn't sure I wanted to live. My questions were existential- did I want to live? And here DBT was trying to teach me how to get through the moment. I didn't know if I wanted to get through the moment.

Secondly, I think the program wasn't very good, and wasn't explained very well to me. The second time around, 12 years later, it was a very good program. These people lived and breathed DBT! And it made a lot more sense to me.

But thirdly, the second time I was willing, and the first time I was willful. I can only say that in hindsight, because I didn't know those terms at the time. But I had a different attitude. My first time with the program, I did the exercises expecting them not to help, almost to prove to myself that they wouldn't help. 

After my latest hospitalization, I was referred to an IOP program that was DBT based. I had very low expectations, because the groups in the hospital were so terrible. I told myself that I would give it a couple of weeks- and if the groups were equally terrible, I would quit. But I would try it. And if they were good, I would stay the whole 6 weeks. And just that willingness to be open, to give it that 2 weeks, and to really work it- that was enough.

I was in a different place that second time. I had decided that, at least for the moment, I wasn't going to kill myself. I had a job to go back to. I was not feeling as desperate. 

DBT was designed for people with borderline personality disorder, although now it is being used for a lot of other things. It is designed for handling mood swings. I think that it can fall short for dealing with severe, prolonged, depression. But maybe I am just not doing it right.

As time passes since I was in the program, I think I am using some of the concrete skills less and less- but some of the big concepts just as much. Mindfulness. Radical Acceptance. Wise Mind. Willingness vs. Willfulness. And appreciating the dialectics in life.

The skill I continue to practice is Opposite to Emotion Action. Part of me says, well, of course. If you have spent much of your life depressed, you have spent much of your life doing opposite to emotion action if you have any kind of life. But the difference is to do it more mindfully, and with an acknowledgement of the emotions that you are experiencing, so that it does not feel like such a denial of self to carry on.

What got me to the yoga mat?

I saw my therapist a couple of nights ago and told her that I wanted to cut down to every other week. She agreed that I was doing much better. And she said that she thought that one of the reasons I was doing so well is that I am doing yoga now.

And I think it is true, it is helping. But what got me to the yoga mat? I have been saying for years that I wanted to do it regularly. And I didn't. Every now and then I would manage to drag myself to a class, never to return. It was only after this latest round of med increases that I was able to get myself there regularly. I think that the meds helped tremendously, and I hate to admit it- because it is the two meds that I really didn't want to be on- lithium and Zyprexa.

I don't think it is only the meds. I think it is also that I have finally studied for and passed a certification exam that was hanging over me for years. It is the DBT skills that I have learned. It is having rewarding work. But I had all that in the months before the med increase, and I was still miserable and paralyzed. And then finally, I was able to get myself there. It was really hard in the beginning to get myself there in the beginning, but I could do it. And I kept going.

So I have to give the meds a little credit. As well as me, for "taking up the slack," and using the space the meds gave me to push a little further into life. Because the meds don't get you there. You still have to push.

If I were a better person, I would like Pilates

I tried yogalates today, as my trial of barre Pilates resulted in knee pain. No knee pain this time- I just didn't like it- in fact I liked it even less than the barre class. It was even less fun.

If I am going to do something hard and uncomfortable- which Pilates is for me- it has to be at least a little bit fun. It just wasn't. It just felt like exercise, and I didn't like it. Yoga doesn't feel like exercise to me. Hiking doesn't feel like exercise to me. If I lift weights, I am at least excited about the amount of weight I am lifting- this was just no fun. No distraction.

So even though I have a weak core, I have decided no Pilates. I need to find exercise that I actually enjoy. Maybe I can just do some planks every day. If I remember... And I will try to get a third yoga class into my week, instead of trying to find a Pilates class.

But I did get one good thing out of the class- which was just to use the ball to sit on- and to pick up one foot, and then to try to pick up the other foot and still balance. And then to try it with eyes closed. I have no balance with eyes closed, I really need to work on that. I liked the ball- I think I just might have to buy one.

Inspiration

Diana Nyad completed her swim from Cuba to the Florida Keys yesterday at the age of 64. It was an amazing feat. She was able to use what she had learned from previous attempts to help her with this swim. She was able to accomplish her dream.

I have accomplished dreams too, although they won't get me on CNN. I became on OT, got off disability, and just this year became a Certified Hand Therapist. What are my next dreams?

I want to meet someone. I have had 2 boyfriends in the past 10 years, but neither worked out very well. I want to meet someone else, I want to fall in love again.

And I have to start swimming again. I swam in college- when I wasn't cutting. I would swim laps, in the evenings, before going home. I would swim so hard that when I got out of the pool I would be sweating. It was good. I want to start swimming again.

But mostly I swam the strokes you can do with your head out of the water. I was never very good at Freestyle. I want to learn how to do that, and to get the breathing down. That is my dream.

And then of course there is the dream to hike the Appalachian Trail. Somehow that one doesn't mix with having a job, so I guess if I am going to do that it will have to be as a section hiker.

My Fall Resolution

Children are going back to school this week. Fall seems a little like a new year. So I have decided to make a resolution.

I am going to eat better. I can't promise I will eat less, but I will try. I have gained 5 pounds on the increased lithium/Zyprexa, and I really can't be gaining weight at where I am. But I will eat better, and hopefully that will make it easier to eat a few less calories, enough to lose those 5 pounds and a little more.

What do I mean by better? No sugar. No gluten. No highly processed foods. Maybe occasionally small amounts of honey- my father is a beekeeper after all. But not very often.

I think gluten is a problem. And I am hoping that if I eliminate it some of my various unexplained symptoms will go away, like the joint pain in my hands.

No, I am not eliminating dairy, which a lot of people advocate. I love dairy too much- and I'm not convinced that it is a problem for me as long as I drink lactaid or eat cheese. Maybe someday.

So what will I eat? Lots of veggies, fruit, beans, meat, cheese, yogurt, nuts, tofu, and non-wheat grains. At least that is the plan. Oh- and baked potatoes and sweet potatoes. Yum. I love potatoes- which is part of my problem. But I think better potatoes than pasta. I will miss pasta.

I was tested for Celiac Disease about 8 years ago, and the blood test was negative. I was diagnosed (after a colonoscopy) with nothing more than irritable bowel disease. But the doctor gave me the best advice in the world- which was to take fiber. Between the probiotics, the citrucil, and the lactaid, it is pretty much under control- and it had been so bad I had accidents. It only flares up now and then when I either drink too much regular (non-lactaid) milk, or eat too many vegetables. Yes, if I eat enormous salads every day, as I occasionally do, I will pay a price.

I think that if I don't have Celiac Disease, I am probably ok with any foods that don't have wheat or gluten as an ingredient. I am not too worried about minute amounts from cross-contamination. But I don't know. I will just try this and see how I feel. And use my symptoms of joint pain and the severity of my carpal tunnel syndrome as a guide to how strict I need to be and if this is even working.

How do you know when you are done with therapy?

I am "lucky" enough to not have an insurance company making this decision for me- but only because I am seeing a therapist who does not take insurance. I am paying out of pocket, until I meet my high out of network deductible, and then will hopefully get reimbursed a little bit.

Last week I went to my therapist appointment- and had this feeling that I wasn't sure I needed to be there. I haven't had that feeling in a long time.

Usually when I quit therapy it is because I move (if it is a good therapist, but that is rare)- usually I quit because it is not helpful, and I don't think my therapist is very good. And usually that has been the case because I have tried to use "in-network" therapists, and it just never has worked out very well. So much of the past 9 years that I have been working I have only been in short periods of therapy, and then quit. I have had some extraordinarily bad ones!

This time I went out of network, and it was worth it. I like her, and she has been helpful. But how much longer? Is it therapy forever?

I think that a part of me is afraid to stop, because I am doing well, for the first time in years. I don't want to rock the boat. If I am not stopping my meds- if meds are forever- why not therapy? But I don't think that therapy is forever, at least for me. Unfortunately I do think that meds are forever for me- but not necessarily for everyone.

Maybe it is time to go down to every other week.