Thursday, October 31, 2013

My mood is dropping

My mood hasn't been very good this past week. No yoga because of my back hasn't helped. And it hasn't helped that we are so light at work that I feel bored and useless, and feel brain dead at the end of the day from spending the day doing mostly paperwork. And the seasons changing is always huge for me. Plus, I decreased my antidepressant a few weeks ago. Plus I am trying to diet- not very successfully. I am so incredibly hungry. And it is not like I am eating 1200 calories- I am eating a lot. Just not as much as my body is asking for. It is really frustrating. I don't want to think about food all the time- but the only way to do that is to eat. Otherwise I can't stop thinking about food.

Anyway, after a rough morning I was really crashing, and realized that I had been on a slow crash for a while. I fled to my car at lunch. I felt like I was shutting down, I couldn't think or focus- no energy. I wanted to curl up into a ball. No, I didn't cry. But I did pull out my spare meds (I keep an extra day's meds in my purse), and take an Effexor pill. I'm going up on the effexor again, I had to do something. I couldn't let things keep going like this. But as it turns out, at the huge dose that I take effexors, it really has a little bit of a kick to it with all it's norepinephrine and dopamine effect from the higher dose. So, I didn't have to wait the 3 weeks it takes me with antidepressants usually to get an effects- I had a little bit of almost instantaneous brightening. Enough to get me though the day.

Hopefully that kick won't fade too quickly. I'm going to need it in the coming days, I think. 

Maybe tomorrow will be better. It is at least a Friday. Although I did decide to skip Friday' yoga class. I'll go on Monday, I hope I will be healed enough to go then. But I do have good things planned for the weekend. I am getting a massage, a pedicure, and going to a drumming circle. I haven't had a pedicure in 2 years. I want to get one before it gets too cold. I want to get a really cool color polish, too.

Wednesday, October 30, 2013

Confronting my mortality

I had my yearly mammography today, and my every 6 month ultrasound of my left breast. My left breast has cysts which seem to be benign, but they want to keep an eye on them. The radiologist said "Cysts are not cancer and do not become cancer, but some types of cancer look like cysts."

I really wasn't worried. In fact, during the mammography, as I was twisting my body with my arm held out to the side and holding my breath as I was instructed, it occurred to me that this was a little bit like yoga. Only topless and with x-rays.

But when the ultrasound tech told me that she had to talk to the radiologist- and then took a very long time to return with the radiologist- I started to worry. I really wasn't so much worried about dying- as having cancer and having to treat it. The surgery, the chemo, the radiation, etc. Even if I lived- I have enough trouble with just the bipolar. Would I want to go through all that?

This is why I used to NOT get mammograms. But my primary care doctor kept getting on my case about it, so finally I did last year.

The radiologist came in and it turns out she just wanted to look at a couple of sites that the tech couldn't get very well. Everything is okay. I just have to come back in 6 months again for another ultrasound.

I am very worried about false positive findings, getting screened this regularly. I can't help thinking they are going to find something, eventually. I hope I am wrong.

Monday, October 28, 2013

Exercise is over-rated- Or at least, not without risks

Every now and then I have low back pain that is very bad. The last time I had it was after a very rigorous workout with a personal trainer. This time it was after a yoga class. To much forward bending- I think I have a herniated disk.

I felt it after one move during the yoga session, but it wasn't too extreme. It wasn't until a couple of hours later when I was putting groceries away, and I leaned down to pick something off the floor- then it really hit. I thought I couldn't get up. I was in agony.

I've been taking lots of naproxen, even though I really shouldn't with the lithium- but desperate times require desperate measures! I somehow got myself to bed last night, and kept my phone within an arm's reach, in case I couldn't get out of bed to go to work. But it was a little better in the morning. And I work with physical therapists who have been telling me what to do. I'm doing back extensions, and it really seems to be helping.

Work was hard, but I managed. I do outpatient, I am not transferring patients. If I was, I couldn't have done my job. I would have been in too much pain.

I'm going to do some more press-ups before bed. I never realized when I had this before what it was- disk herniation- and it has never gotten this much better this quickly. I never did back extension exercises before, like I am doing now.

What I don't know is how soon I can go back to yoga. I don't think I am going to that class again. It was a harder class than my normal one. I think too hard for me, or at least too hard for my back. I hate to admit defeat. And I also liked the time of the class- there is nothing else Sunday evening that I can take.

I didn't go to yoga today. Maybe by Friday.

Friday, October 25, 2013

What constitutes an Occupational Therapy Emergency?

Sometimes getting someone occupational therapy services is urgent. I have stayed late to make a splint for a patient who has had a fracture. Or to start ROM exercises with a patient who just got out of surgery before scar tissue sets in. Or to teach a a patient who has had a hip replacement who is going home and straight to outpatient physical therapy how to dress with adaptive equipment and to order anything needed.

But sometimes there are paperwork emergencies. Today a patient needed an OT evaluation to go to a rehab hospital. The OT evaluation was just a formality, it all comes down to PT: can the patient walk? That is what the insurance company cares about. But they do require an OT eval.

And it was a Friday, and the inpatient therapist called out sick and so I had to go cover and do that evaluation just to get that done so he can go tomorrow. So that was the OT emergency that kept me late at work today.

Generally, it was a stressful day. I got some negative feedback at work. It was not unjustified, but it was also a freak event and I don't know how I could have handled the situation differently. It is not something likely to happen again.

Still, it hurt. But not as much as it might have. I am very sensitive to criticism. I think on the lower Zyprexa dose, I would have been more devastated. Instead, it just hurt, it stung, but I didn't get stuck in it.

I know that is what the meds do. And at times I complain that they make me numb- but the also give me freedom to live that I don't have when I am trapped in my negative emotions that arise from every day events. I think I am less inhibited on meds, which is generally a good thing.

Thursday, October 24, 2013

I'm becoming more high maintanence

It seems I have nothing but medical appointments recently. Yesterday the dentist- where I was told that I am grinding my teeth- to the point that a couple of them are loose. You actually have ligaments that help to hold them in place- I did not know this. So I need to have a mouth guard made. I am going back in two weeks for it. Fortunately, it is a covered benefit through my dental insurance, as it is pretty expensive.

Then next week I have my mammograms, and possibly an ultrasound of my left breast again. I have nodular tissue in my left breast that they are keeping an eye on- they keep taking great pains in the letters they send me to tell me that the tissue is abnormal but not necessarily in a bad way. So I have this again.

Three Wednesday afternoons in a row I am taking off for medical/dental. Thankfully we are very light at work.

In my really bad years, I never went to doctors or dentists (other than psychiatrists). I was young enough not to need any chronic medication- now I take high blood pressure meds. And when you don't know if you want to live, why would you do anything preventative? I wasn't together enough to think about medical appointments, anyway.

I had years I didn't get a mammogram because I was too depressed. Too depressed to go, and too depressed to know what I would do with the information if there was something suspicious. I didn't know if I wanted to live. I started going again last year- and then they told me about my left breast, and that I had to come every 6 months and get ultrasounds. I wasn't prepared for that. I thought I was just checking this off my list, doing what my primary care doctor wanted me to do.

During one of my worst depressions I became convinced I was dying of cancer. I took a very long time for that fear to subside. But just the memory of that conviction makes it a little more unnerving to get a mammogram.

Sunday, October 20, 2013

I hibernated this weekend

I stayed in all weekend, which wasn't a good thing. Yesterday I just wanted to stay home, and didn't feel like going on an 8 mile hike I had signed up for. Today I had plans to go out- but I had a really bad sinus headache that even naproxen couldn't get rid of, and I can't take decongestants with all my meds. So I stayed home. 

It felt good to stay home at first, and I even got two loads of laundry done and did some reading for my sci fi book club. But now, Sunday evening, when I really have nothing else to show for myself- I am feeling bad. 

Next week will be different. There is a new Sunday evening yoga class starting up at my studio, so I will start going to that. Right now the only Sunday evening yoga class is a hot yoga class- I think I would hate that, but with the lithium, I think I shouldn't do it anyway. It is nice to have an excuse not to do it!

I'm still logging my food. I will have one more glass of milk today to take my night time meds- which will put me over my calories slightly. It will just have to be okay. It is better than what I would have eaten if I wasn't counting.

Saturday, October 19, 2013

More Antioxidents, less food

It's my making peace with Zyprexa program.

I went on Pub Med today, and was looking at studies about how to prevent tardive dyskinesia (other than the obvious- don't take meds or be female or get old). It turns out that if you are a rat, there are some anti-oxidents that seem to be protective. Some of them I am taking, a couple I am not- or at least not very much- so I just ordered some from vitacost.

There aren't a lot of prospective studies with people. What they seem to do is give these supplements to people who already have TD and then see if they get better- which it may be too late by then. But the one that has been shown to work is gingo. I already take that one. Good.

I already take a lot of supplements- but now I am adding a little. I take more supplements than meds right now. But many of the supplements that I take are to counteract bad effects of the meds- I don't think I'd be taking all of these supplements if I weren't on so many meds.

I also stepped on the scale this morning, and it was more than I wanted it to be. And more than it was last week. It has been going up and up- just in tiny bits, a half a pound at a time, but it is going up. My weight had been stable- and now with the med increase and maybe the change in seasons on top of that- it is increasing.

So this morning I signed up for an online food tracking site. I think I might have to go to bed soon because I don't have anymore calories left to eat and I am hungry! But so far I stayed within my calories- but not easily. And I didn't weigh or measure, so I may have underestimated.

I am hopeful that I can do this. I have to do something.

Friday, October 18, 2013

TGIF, and a good yoga class

I do not have the body for yoga. You really need to have a flat stomach to do forward folds- my stomach just gets in the way. But I love it anyway. And it was a good class. Unfortunately, I lost my yoga glow afterwards when I couldn't find my car keys. It turns out they were in my purse all along, but it took me many worried minutes to find them.

I have been missing too many yoga classes due to my moods, and then vacation. And my body can tell. It doesn't want to bend as much, and my arms aren't as happy during the planks and downward dogs. But the hardest arm work today that we did was just doing Triangle and Warrior and holding, and holding, with the arms stretched out. It is amazing how heavy our arms can be!

I didn't have to force myself to go to yoga today. It wasn't the battle that it has been in recent weeks (and not always a successful battle). I just went. Amazing. OK- not entirely true- I did have a few thoughts of, wouldn't it be nice to just go home, etc. But these thoughts just came and I said no, I'm going, and that was the end of it.

There is a new moon out tonight, just beautiful. Recently I have felt like I have been worse during the full moon, but this time I feel like me mood is really good.

I don't know the mechanism, but when a full moon is low on the horizon, it looks bigger. Driving home it looked huge. I wanted to reach out and touch it.

Thursday, October 17, 2013

A good day

I just felt very blissful today. I was in a good mood, and feeling grateful for all that I have in my life. Plus I made a cool splint today. That always puts me in a good mood.

Work might be getting more interesting. I might be getting involved with a new pain management program. Or maybe not, it isn't certain. It is an interest of mine. A strange interest- but I think maybe physical pain is close enough to depression that it is compelling to me.

I always say, if I were a wedding planner, I would probably have killed myself by now. But in my line of work, it is pretty hard to feel sorry for yourself (although occasionally I still manage it), and that is a good thing.

We;;, the federal government is open again. And we didn't default. What drama. This congress makes me ashamed to call myself an American- we are the country that can't govern ourselves. We create our own crises.

Wednesday, October 16, 2013

Interesting thought

"Just Me" commented on my last post that maybe I might need the higher dose of zyprexa on my bad days, even if I don't need it on my good days, or every day. And that constantly playing catch up with med adjustments based on mood shifts doesn't work very well. And that is very possible.

I think my biggest fear, however, is that whatever I take my brain just eventually adjusts to- and so eventually the doses always seem to go up. And I don't want to keep going up on Zyprexa. I don't even want to be on it, but I had finally come to terms with the 5mg. And so I am just worried- if I start to get manic on 7.5mg, will it now get raised to 10mg, etc. 

Plus I feel a little spacey on the higher dose, and I really don't like that feeling. 

But for now, I am back to 7.5mg, after talking to my psychiatrist. What did I think he would advise me? What psychiatrist has ever advised me to go down on meds? Except for klonopin. That is the only drug I have had a doctor want me to decrease or go off of. 

But I do like him. He checked me for lithium tremors (none), and did a screen for involuntary movements for tardive dyskinesia (none). Most psychiatrists don't do that. Or at least the ones that I have had. But I really think that if you are prescribing antipsychotics, you should be doing regular involuntary movement screens on those patients. 

Monday, October 14, 2013

The Zyprexa issue is still not resolved

I was feeling very bad yesterday- after a string of bad days, and I realize that I had been making a lot of excuses for feeling bad. Really good excuses, but still. I was feeling bad. And I thought that yesterday I would take a little extra Zyprexa just to get me through the day. And then go back down to the lesser dose. And I felt so much better. Plus, I started to get things done- something I had given up on being able to do until Monday came.

So then last night I took the higher dose. I don't know. I do feel a little out of it at times- but not that much. And I was able to go grocery shopping, something I have not been able to do in the longest time. And I filled my prescriptions too. I got all my notes done at work- although I had a lot of time do do it (a light day).

I see my psychiatrist tomorrow. Do I want him to give me a script for 7.5mg? 5mg? Both? I don't know. I guess I go with the 7.5mg- and I can always cut them. Or I'll take both if he will give me scripts for both. But I really don't want both. I want this to be settled. I want to know what I need.

I went down to 5mg because I felt depressed again on 7.5mg for a couple of weeks. But really, that may have been triggered by going out of town and forgetting to bring some of my meds. Maybe I would have been doing fine otherwise. And it wasn't the Zyprexa that let me down. Obviously I'd like to be on less- if for no other reason than the risk of tardive dyskinesia. But I have been functional at the higher dose- but then, I think I am also sometimes a little spacy on it too.

I guess that is what my psychiatrist is for, to talk about these things. And see if he has any answers. But unfortunately, psychiatry is more art than science. And everything about these meds is a quality of life issue- which ultimately can only be determined only by the person taking them.

Sunday, October 13, 2013

The Walking Dead, again

After watching a number of episodes of the Walking Dead today, it occurred to me that the title did not apply to the Zombies, but to those still living. But I am probably not the first to think this.

If I'm going to watch a Walking Dead marathon, I'm going to need klonopin to sleep

I had never watched the walking dead. But there was this marathon of last season's episodes on today, all for the roll out of the new season premiere. I thought maybe it was a series that might interest me- I had a lot of busy work to do anyway. But it was too much- I need drugs if I am going to sleep tonight!

Maybe just seeing an hour a week would be okay. But several hours (while trying to clean, sort papers, etc), was too much. It was as depressing as reading "The Road," but with more gore and suspense, which has my stress level up too high. So now I am depressed and stressed.

I don't get the Zombie thing. I think that there are enough things to be afraid of that are real. We could have environmental,economic, and societal collapse without zombies. We could have killer viruses that don't turn people into Zombies. We could have a few more atomic disasters. I don't get Zombies, they don't make sense to me.

Won't the zombies die of starvation as all the humans and animals die off? Can they eat plants? Can they eat each other? Do they age and get infirm and die? These are questions I want the answers to.

Saturday, October 12, 2013

Knowing this has absolutely nothing to do with meds

I've stayed home the past two days. I've done some cleaning, which is good, but mostly done nothing. I've isolated. I'm lonely. I can't get going.

I came home early from backpacking, so I had no structure to the rest of my vacation- and I can't get myself together. All that will change Monday morning, when life gets back to normal, but until then I am off.

I have plans for tomorrow- but I didn't keep my plans for today. I don't know if it makes sense to even have them. Will I get myself going?

I need a certain amount of structure, I know that. And I am also disappointed in my trip. And now disappointed in myself, my life. I'm not good left to my own devices for too long. I do need my down time, my alone time, but there has to be a limit to it. And I have passed that limit.

I am diligently doing my light therapy, so hopefully I have the seasons thing under control, as much as it ever is.

I just have to get myself to overcome this inertia. I need to get out of my apartment tomorrow. Walk or hike. Go to church. Visit my dad. Go grocery shopping. Those are all good plans. All doable. I just have to do it, and get out of bed.

Maybe we are stronger than they know

I just read a blog post about how barbie dolls can make girls feel bad about their bodies.

I played with barbie dolls. I didn't want a barbie doll's body- they looked so strange to me. And barbie's feet were permanently deformed, so she could fit into high heeled shoes. This always bothered me. Her neck was too long. She was just a doll.

I also had a Ken doll- and he was so stiff that I couldn't move any of his limbs. I couldn't even rotate his neck. So I decided he was paralyzed. I had a paraplegic Ken.

Of course I didn't play with dolls like most girls. I would play with my barbie dolls and my brother's micronauts and we had space adventures.  And my paraplegic Ken had telepathic powers and could steer the space ship (which was a shoe box), with his mind.

No doll ever made me feel bad about my body. It took actual people to do that.

I no longer feel bad about my body. (I really think good sex cured me of that- but that is another story). I would like to lose weight for various reasons- if for no other reason than to put less weight on my knees when I backpack- but I don't hate my body.

Friday, October 11, 2013

Stayed home today

I didn't leave my apartment today except to take out the garbage. It was raining anyway. But I skipped yoga. I just needed to veg out, have a nothing day. Thru hikers talk about taking "zero days," in which there is no mileage accomplished (usually a stop over at a town). I really need a zero day every week or so or my mood starts to go. But too many zero's, and my mood is pretty bad too. So this means I have to get my act together for tomorrow. I plan on hiking and then going to a meetup group for a hay ride and corn maze in the evening.

I read and watched TV, I cleaned a little and did a lot of unpacking. I am living on backpacking food, because I haven't made it to the grocery store. What I really want right now are fresh veggies. That is what I miss the most when I backpack.

I spent the morning looking at gear on line, and thinking about how I could further cut my pack weight. I know I could get my pack weight down at least another 5 pounds if I get a couple of new new pieces of gear and get rid of a couple of things. I'm not planning another long trip until the spring, so I don't have to buy anything now. I'm just looking. And maybe by then I won't be so broke.

I found myself thinking about meds again. I have sucessfully decreased my Zyprexa and Effexor this past month- and I'm almost weaned off of the klonopin I needed to lower the Zyprexa. Should I try for lower?

Of course I have yet to tell my psychiatrist I am on these lower doses. This is not a function of me trying to hide it- rather the fact that I see him every couple of months. But I don't think he will want me to go any lower on the Zyprexa- not that this would stop me- I don't know what he thinks about the Effexor. I am interested to hear what he thinks.

If I thought I could take all of these meds and never have another serious depression again in my life, I'd take the deal. I really would. But thoose bad couple of weeks I had even on the increased zyprexa made me realize, there is no deal to be had. Our brain is plastic, it adapts to whatever we throw at it. Higher is not always better, it is just higher. Maybe it takes a little longer for the brain to catch up, but it does. It I could feel that bad on 7.5mg of Zyprexa, there was no need to be on that high a dose. Lower doses have been shown to be useful as antidepressant augmenters, and that is really want I think I'm going for.

Thursday, October 10, 2013

Back home, earlier than planned

My backpacking trip was only 2 days. Between the federal government park shut down and an out of date guide book, and last minute change of plans, looking for a place that no longer existed, then not knowing where I could leave my car overnight- I did leave it for 1 night in a state forest, not knowing what they would do. It was a good trip, but I was worried about my car.

I have the backpacking bug again. Maybe I can get in another trip this year- even if it is just another overnight. I know one thing though- I am never, ever scheduling a backpacking trip again for the October- when the fiscal year turns over- because I never want this to happen again. I suspect that these government shut downs are going to become a lot more common.

Well, by spring the parks should all be open I hope! I am going to do a big trip then.

My ankle held up surprisingly well- I used that ankle support. My right hip also isn't bothering me much- I think the yoga has really been helping it. I think what bothered me the most was my right knee as I was driving home! When I drive too much, it hurts. It is all the right side that is messed up.

Back home, back to normal life. I have errands to do tomorrow. And yoga in the evening. And I have to unpack. And do laundry and clean. It is supposed to rain. But hopefully it will clear up for the weekend and I can get in another hike.

Tuesday, October 8, 2013

Frustration, thanks to the US Congress

I am all packed. My pack weight is 27 pounds, without water. Not too bad. I am starting to get excited. Then I go on to a backpacking forum for some inspiration. And I read that the AT over many National Parks is closed. Why had I forgotten this? I thought that I heard someone say that primitive hiking on the AT was OK. I must have heard wrong. I wasn't sure if where I was going was federal or not- I looked it up. It is federal, and it is closed. And my plans are in trouble.

So I spent the afternoon trying to find a part of the Appalachian Trail where I can drive to, leave my car over night, and don't pass over federal lands. I think I finally did- but not before a certain amount of panicking, and almost tears. A part of me considered giving up, staying home. But, I was all packed. If I wasn't all packed, I might have stayed home.

So thank you US congress for almost ruining my vacation. I know that other people are having a lot of bigger problems with the shut down, but this is my experience with it.

I fell for an infomercial- but who can resist Montel Williams?

I have postponed my backpacking trip until tomorrow, because I am having such a hard time getting organized and packed. It is overwhelming.

One of the things I am bringing- well, wearing as opposed to packing, is a Jimmie Copper ankle support. I saw a Jimmie Copper infomercial a couple of weeks ago, and decided to give it a try.

I have always had weak ankles. And then in high school I had a very serious right ankle sprain playing tennis. Back then they didn't do much for you if there was no fracture, just gave you crutches and told you to stay off of it for a few weeks. I have had trouble with it ever since.

And whenever i walk more than a couple of miles it hurts, swells up, and my foot starts to turn in. I'm sure there are ligaments that were torn, and when the muscles get too tired to compensate, the ligaments can't hold things in alignment.

When I walked the 10K this summer, I could hardly walk the next day, was limping for 3 days afterwards, and felt it for a good week. The only thing that saves me with backpacking is that I am wearing boots that go up to the ankle, and I use hiking poles. Still, it is not good.

I tried out the ankle sleeve this weekend on a 4 hour hike. It is not as supportive as I thought it would be- but a lot more comfortable. I wore it driving to the hike, during the hike, and then the rest of the day until I went to bed (I didn't think I could sleep with it on). I have to say, my ankle felt pretty good. I did have a little pain, but no swelling. And while I felt like my foot wanted to turn in a tiny bit, it really wasn't visibly doing this. I would say, a success.

Or maybe it is all placebo effect. I do want to believe this is going to work.

What I really need to do is to see a physical therapist to get a good home programs of ankle strengthening exercises. One of the PT's where I work said she would give me some exercises but she didn't. So I should break down and make a PT appointment.

But would't it be nice if my ankle sleeve were enough?

Sunday, October 6, 2013

Not a good day

I am feeling depressed and lonely. I'm really feeling bad. I hate this. I hate the not knowing. Is this temporary. Is this a sign that lowering my meds  recently was a bad idea. Is this just a bad day, what. I hate having to analyze my moods. I just want to be.

I used to have the 3 day rule, and I should try to stick to it. It has be be 3 bad days before I worry, before I examine meds, change light therapy, etc. I have 3 days to just deal with it and hope it goes away on its own. Sometimes I've had to act a little faster with a mania, but with a depression I can usually wait 3 days before things get too out of hand. So I wait.

I am in bed- I keep thinking I want to nap, but then I can't. I just want to lie here.

Ice cream would be nice. But I only have healthy food around. Damn. What is the connection between ice cream and depression? I don't know. That is what I want to eat when I am depressed. Otherwise I hardly ever let myself eat it. And when I am depressed, I am usually too depressed to go to the store to get it anyway.

The blackness is spreading

No, not the blackness in my soul. The blackness on my cracked computer screen. Which is strange, because for a few days it was stable. And now it is branching out into two other directions that I didn't even know were cracked. I need a new computer. That sucks, this one is less than 3 years old- I can't remember how old it is, only that I bought it after I moved here a little over 3 years ago.

I'm trying to figure out what to buy. Do I want a touch screen feature? Not really, I have my phone for that- but maybe I will in the future. Do I buy a computer for what I want today, or for one that will stand the test of time and new innovations- that will undoubtedly include more touch screen features. And do I want a big one like I have now? or a smaller screen? I don't know. I'll go to staples and look. But after my trip.

I started packing today for my backpacking trip. It is both tedious and exciting. I made some very yummy if expensive trail mix: almonds, dried blueberries, and dark chocolate M&M's. I also has some jerkey, protien bars, and dinners made with dehydrated ingredients. I'm still trying to find some Starbucks Via iced coffee. I had to heat anything up in the morning, I just eat a cold breakfast. Iced coffee and a protein bar or some GORP.

I felt really blah this morning, very hard to get going. I slept badly. I had cut down on the klonopin I am taking at night- something that I had added on when I cut down on the Zyprexa. I am down to 3/8 of a milligram at night. It was a small decrease last night, but my body felt the difference. I tossed and turned, and had a lot of racing thoughts- and some really strange thoughts.

But then this morning I got up at 4am, only to go back at 8am to nap. Now I have had a second coffee, and I'm feeling some better.

I do have some unpleasantness today, however. I have to go into work to do notes, and get things ready for the person covering for me. I will try to reframe it, however. I will have time to get things done when I am alone and can be really productive and blast music and get things behind me that I really need to get done.

Saturday, October 5, 2013

Reminding me why I live out here

I went hiking today. And it made me appreciate living out where I live now- away from the city. There is a lot that I miss, but in the city I missed nature. Unfortunately, as soon as I moved out here I went in to a severe years long depression so didn't do much hiking at first. But now that is changing, and I am taking advantage of where I am.

It was also a good opportunity to try out my new hiking boots, that I bought enough years ago to not even remember buying them. I thought I still had the old ones. I guess not. But these feel like they might be a tiny bit tight on the left toes- I can't decide. I hate it when boots are too loose, I think that is what was wrong with the last pair.

I leave for my backpacking trip on Tuesday. I really don't want to buy new boots. I haven't decided. Maybe I can buy thinner socks.

Meanwhile the crack in my laptop screen has expanded, although the black patch has not. I am crossing my fingers. A new computer is not something I want to buy either. And I am telling myself I will wait until the iphone 6 comes out!

Friday, October 4, 2013

It was good to go to yoga again

I think it is three weeks since I had been to yoga. First I had that dip in my mood when I stopped going. Then I had a tooth pulled. Then this Monday I felt like I was coming down with something. This was my first day back.

I was hoping for an easy class. It wasn't. There was a substitute teacher, and it was hard. I was really sweating. But it was also good. We did some "flow yoga," which I have been wanting to try, but which doesn't fit into my schedule. All and all, a good class, even if it was not what I had wanted. It worked for me.

My mood was a little shaky today. I actually broke down and took a quarter of a milligram of klonopin. Maybe that is just okay, and I have to accept it. It lets me take less of other meds.

Tomorrow I am going on a group hike. The location was changed because of the government shut down. It was supposed to be on a federal wildlife preserve, but now we are going to a different location that is not on federal lands. This is so stupid.

I think Boehner is a coward. What is the point of having power if you won't use it? All he cares about is getting re-elected, the best argument for term limits I have seen. He has the votes to pass a continuing funding resolution for the government. He just won't bring it to the floor. Just do it. Do the right thing. Be a leader.

But I shouldn't be thinking about politics. There goes my post-yoga glow.

Thursday, October 3, 2013

Still on less Zyprexa, still doing well

It seems that the transition from 7.5mg to 5mg of Zyprexa has been sucessful. And I feel better: more alive, more connected, my mind sharper.

But, there is a cost. There was a reason I stayed on the 7.5mg so long. On the higher dose, I just felt this sense of relief. I wasn't scared of my emotions anymore. I wasn't afraid of the next thing to hit. I felt at peace. I wasn't waiting for the next shoe to drop, as they say. And I started doing more, getting more things done, because I think a part of me felt freer because of this. But I was also number.

So on the lower dose, I have a little of the apprehension again- not so much of anything happening, but of my emotional response to things. It isn't bad, it is just there in the background. I know if something bad does happen, or if the bad feelings do come, I can use DBT skill to work on it. But that is not the same as never having to experience them first.

Perhaps is was good for me to be on the higher dose, just for a little while, just to start to jump start some things in my life. But long term, I think that the numbness would hold me back. And I think it was starting to hold me back. I know that the higher dose is always there for me, if I ever need it for a few days because I start to get manic, etc. But I also know that it is not a dose that I ever want to take again for any prolonged period of time.

The question remains, do I want to try to go lower on the Zyprexa. And I don't know. I have tried so many times and failed- but I have been trying while I was working, so I couldn't tolerate a few really bad days. Maybe if I did it over a week's vacation, while taking a lot of klonopin, I could. I really don't know. But not now. Not in 2013, I think. Maybe 2014.

Wednesday, October 2, 2013

I want my mother to be happy

I saw my therapist yesterday, and was expressing my frustration with things with my mother. She is getting more and more overwhelmed by caring for her mother- and she is not dealing with it well. And then there are the usual problems she has with other family members, and her own history of illness.

She lives in a far away state. I can only listen and give advice. It is getting harder and harder to listen, and my advice is never followed. I think I see solutions, but they are my solutions. Not hers. I want her to be happy. I can't make her be happy. I hate seeing her unhappy, and to be unable to do anything about it.

Anyway, I felt like I had to defend myself to my therapist- why do I want my mom to be happy, why do I want to fix the situation, why do I want to make it better. She wanted to know, what is my need, my angle. Why should I have do defend myself on this? I just do.

But the truth is, a part of my wonders if she wants to be "happy." And if the chaos of being needed and in the midst of things has actually held her together in recent years, and that is why she hasn't been as bad as she was in the past. And maybe if things were "better," she'd fall apart. That is what I fear.

But my days of giving advice may be starting to come to an end. Her hearing loss is really getting more noticeable on the phone. She can't hear well on cell phones, and I don't have a land line any more. She wants me to get a land line, I want her to get a hearing aide. The problem isn't her, it is my phone. And my brother's phone- who also only has a cell phone. This last conversation I had with her she didn't hear a lot of what I said.

I stopped trying to talk to my grandmother on the phone years ago, because of her hearing loss. Now it may happen to my mother. These stubborn women don't believe in hearing aides. I swear, I will not be like that. When the time comes, I will get one- and the best one I can afford.

But mostly, my mother doesn't seem to understand that my grandmother is very old, and probably doesn't have too many more years. If she does, okay. If not- it is not her fault. And taking all these blood sugars, blood pressures, and generally trying to make the home a hospital is going to wear her out. At some point, she is going to have to let go. And let grandma let go.

I don't know if my mom is going to be able to leave grandma at all before the end. Because my aunt won't do as much for her- and they won't hire anyone. So mom can't go visit her grandchild. Or her daughter for that matter.

I am not going to visit any time soon. I was just there in July. It was overwhelming then- and I would handle things so differently. I just can't deal with it. I know my limits. But next July I'll be back for the 10K Peach Tree Roach Race (assuming I get in). I'll see them then.

Tuesday, October 1, 2013

Should you be forced to get the flu shot?

At my hospital, this year the flu shot has become mandatory. I got mine today, as did most of us at my office, when one of the nurses from occ health came around to give them. Two people have declined. What is going to happen to them, we don't know. They have to the end of the year to officially decline. Then- I don't know what will happen.

It is coming down from the government. It is something easy to monitor. It is medical. It makes money for vaccine makers. In theory, it could mean fewer flu infections from provider to patient- although the vaccines are far from perfect, and most staff people will never get the flu anyway. But I think that there are a lot of other things they could do which would keep our patients healthier. Like giving us sick days that are not of our PTO, and encouraging us to use those days, when we are sick.

I think we need some germs. We are not designed to live in a sterile environment. But I'm not sure that means we have to expose ourselves and our patients to the flu. I have more of a problem with the chicken pox vaccine- which is rarely deadly or disabling (although shingles can be). We need some germs, or our immune system will go haywire, and cause all sorts of trouble.

I take the flu vaccine because I think it might protect my patients. And I really don't want to get the flu- I think it would be miserable. But I don't know if we should force every one to get it. I can't decide. If it stops there, maybe. If this is the beginning of a slippery slope, then we are in big trouble.

What a difference a day makes

I had a long night's sleep last night, and I am feeling so much better today.

It is the day I go in late, and I am doing a load of laundry. And planning my backpacking trip for next week. I don't know why I bother to look at accuweather's 15 day weather forcast (I have the iphone app). The forcast for that week has been changing ever day. And it is getting worse- they are now forecasting rain for most of those days. But it doesn't sound too bad.

I didn't get my act together in time to order some things I need unless I want to pay for priority mail- which I don't. So I am hoping I can find what I need at the closest EMS store- about a half an hour from here.

I'm only going to go for 4 days- I'm doing a round trip so I can leave my car. But I'm not in great shape, so I'm not going to try for more. Next year, yes. I am going to go for longer.

I did splurge for a new sleeping bag. My one co-worker who also backpacks convinced me that the one I had is not warm enough for this time of year. However, looking at the forecasts suggests otherwise. It might have been okay. Or maybe not. The forecast could change again.

I think I may need to buy a new computer. I cracked the top of the screen, apparently. I can't feel the crack, but I can see blotches of black, and it looks like there are three cracks (I can't feel them though). I must have moved my computer rather roughly yesterday. I can use it the way it is, it isn't a big deal- I just don't know if it is likely to stay this way, or if it might get worse or is likely to break down. I don't want that. Just when I thought my next purchase would be the new iphone...

I want a better camera than the iphone4. Otherwise, I could care less about upgrading my phone. But if I wind up getting a computer, that is going to have to wait a while.

It is so easy to spend money. That is the only good thing about being depressed. I don't spend money. I guess I am not depressed.