It's always about Zyprexa

I have had to take extra Zyprexa recently. And because I was breaking down and taking it during the day- the hunger was incredible. I thought I would pass out from hunger at work. I wanted to eat everything I could get my hands on- my lunch, food that patients had brought in, all of the chocolate covered almonds in my purse and an energy bar.

So last night I just took more at night. I hope that will avert taking it during the day. And hopefully the hunger won't be so bad taking it all at night.

My psychiatrist raised my thyroid hormone slightly. I don't know if that is doing to do the job. The one thing I wonder about is switching from Zyprexa to Seroquel XR. I was on Seroquel at one time, but the short half-life was an issue. I wonder if the XR version will be too sedating during the day. Or, alternately- because it has a shorter half-life than Zyprexa, if it will wear out by the end of the day. I don't know which is better for depression, Zyprexa or Seroquel, although that probably depends upon the individual.

This depression has to go.

It never ends...

Just when I had decided- just today- that I was going to spring for a plane ticket to go visit my dad in Florida... I come home to find I have a bill from the state for $600 in taxes ($100 of which is interest). Only I am pretty sure they are wrong. They don't even list my state withholding correctly, and they state that I have already received a refund. Which I haven't. I am started to wonder about identity theft, and if someone else filled for my refund. I was due almost $500.

So I have to take a day or at least a half day off of work and go to one of the state taxation offices and hope that they can help me out. I really don't know how to fix this and what the procedure is.

Someone doesn't want me to have money.

Why do I watch it?

I was binge-watching "Helix" on the SyFi channel today. And I wondered why. There is enough violence and bad things in the world- it even comes straight to my phone through AP alerts. So why watch more bad things on TV? Why not happy things?

But I like Helix, even if the second season isn't anywhere near as good as the first season was. That was mind-blowing good. This is just passable. But still, I watched three episodes today- and interestingly I saw a study today that said people who binge watch 3 or more hours of TV shows are lonelier than people who don't, so binge-watching TV cannot be seen as harmless. Well, that is funny, maybe lonely people just have the time to binge-watch TV. Who does these studies? And who funds them? Why can't we give that money to people trying to make better battery technology or alternative energy sources or geo-engineering?

So I thought I'd try some light reading- instead of my normal dystopian sci-fi or global warming stuff. No wonder I am depressed! And I decided upon "Fifty Shades of Gray." And I really wanted to like it. I just didn't- or at least what I have read of it. But maybe that is okay. It was a distraction. A sexy distraction. Just a bad story.

The first few pages were so badly written I almost couldn't keep reading, they were really bad. The whole story doesn't make much sense to me. How is it that by the age of 21 she has never even been interested in another man or had a sexual impulse- and then it is full throttle? And why does he like her so much? I don't get it.

I'm still in the middle. But where I am, I keep hoping she will just say no to him. Sex is good, even kinky sex- but I don't get this domination thing. Why would you even let another person punish you physically? We don't even do that to children anymore. And then I want her to say no because I am a dreamer and want to believe that the rich and powerful man isn't the alpha male who will always get the girl and the rest of us have value too. That Cinderella doesn't need a Prince Charming.

So it is kind of a Cinderella story in a way- only with a really messed up Prince Charming. I know that this came from Twilight fan fiction- so there was a limit as to what they could do with the plot- but I would have liked the story better if it started with her saving his life from some accident or health event- something to put them more on an equal footing. Even if not sexually. And that might have better explained his attraction to her. Her heroism- dragging him out of a burning car, etc.

I guess I will have to write my own book!

I will have to get back in the dating world. But after my dental surgery. I am waiting until after that and it may be a while if I have a temporary denture before the permanent one while the implant studs are healing. If I have to use something that I can't eat with - I am guessing that I can't kiss with them either (they are my lower front teeth). So no dates for a while. The surgery isn't even scheduled.

I found myself wondering today if, to get a date, I would have to color my hair. The gray at my temples is pretty significant. I don't wear my hair back because of it, unless I am exercising or hiking. I had beeing this vain. But not ready to make the commitment to color. Is there a way to just color your temples?

A new life!

There is a new life in this world- I have a new niece. She is healthy and fine. So is her mom. I can't wait to meet her. I don't know when that will be as currently the grandparents are visiting so they have the guest room. I'd love to see my how my "older" niece reacts to her new sister.

Otherwise- just having a lazy Saturday, doing laundry and reading and napping. I woke up with a really bad headache that kind of threw off my plans for the morning. I took some naproxen and went back to bed- and slept quite a bit. I was supposed to go and get blood work done- but I think I can still go Tuesday and it will be enough time before I see my psychiatrist the following week.

I've been thinking, with my appointment coming up, do I want to change anything? Going off of the klonopin has gone pretty well. Do I want to try to lower something I take? And then I can't even pick- there are reasons to want to lower just about everything I take. And then of course reasons not to want to change a thing, especially so soon after stopping the klonopin. And going into the spring- which makes it a really bad time to try going down on the Zyprexa.

What will I do if I get springtime hypomania? I've used klonopin in the past, along with increasing my Zyprexa for a couple days if needed. I'd like to think I'm not taking klonopin ever again, but I don't want to necessarily close doors to things that have helped me to function during trying times.

Last night I had a lot of trouble sleeping- probably that's why the headache. I thought briefly about taking klonopin- and then vetoed the idea. I wondered at what point you are an addict vs. someone using a drug? And really, I have been unable to get myself off of Zyprexa after all of these years. Even though it has taken a toll on my health with severe weight gain. Maybe I do belong on a dual diagnosis unit. Of course the one time I was briefly off of Zyprexa (after an overdose) I was put back on it under duress in the hospital. I wonder how my life would have been different if that hadn't happened.

FOOSH

A FOOSH is a fall on an outstretched hand to hand surgeons.

Today I stepped out of my apartment and fell. It wasn't really a classical FOOSH- I really hit my knee first. I don't know how I managed it, but I went down on my knee and then my leg bent and slid under me, kind of like a yoga pose, and then my upper body fell forward and I fell forward onto my hands. Thankfully, just a sore knee, no serious injuries.

But the adventure did not stop there. The world outside my door was covered in ice. My car was covered in ice. So was the driveway. Somehow I made it across the parking lot, chipped the ice off of my windshield, and started down the long driveway- only to find that I couldn't brake as I was entering the road- and there were cars coming. I had to veer off into a snow bank to stop. Fortunately I was able to back up from the snow bank, inch out onto the driveway, and turn onto the road- which was ice-free.

We had a lot of cancelled patients this morning because of the ice. I don't blame them.

I was a little more productive today- for a Saturday

I had my monthly massage today. It was heaven- except when it wasn't, when she was getting in where I was really tight- but it then the next minute it was heaven again. If I was rich they would be weekly...

Normally I go home and nap. Today I went to work and finished up notes from last week. I went to the grocery store. I came home and did a load of laundry. And then I got into bed for a bit- but no napping. I am tired, but not sleepy.

I have to do my medicines for the week. Every week I do this, and every week it makes me think- do I want to change some supplement, change some medication dosage? I think I will try to stay the same this week.  Too soon to do anything else. I don't want to jeopardize getting off of the klonopin. That is the most important thing. Plus, I don't know where my pill splitter is right now... so I can't do much anyway!

I haven't heard back from the dentist regarding the surgery- which probably means that their office is fighting with my insurance company to get it approved and any of it covered (and it will be less than half anyway because I have a cap on benefits). Right now I don't mind them taking their time. I'm getting used to the idea, but in no hurry.

It will wipe out my savings plus health savings account and most of my tax refund. I had planned on moving in the spring- I was putting away money for that. I guess that will have to wait. But it is sort of okay- it is okay that I am using money for something important, and I feel good that I have it.

Still adjusting to life without klonopin

I have been totally off of klonopin for the past few days. The amazing thing is that I am not sleepy during the day anymore. I was so sure I had sleep apnea- and perhaps I do and perhaps klonopin made it worse- it is a muscle relaxant. But I now wake up refreshed and don't struggle to stay awake all day- it is amazing. Although I am still taking Provigil.

At first I had terrible tension headaches- I could feel the muscles in my neck and scalp were so tight. Yesterday was awful. But today, so far so good. I hope it is over. I expected that I would be more anxious than I have been, but really I haven't been that anxious, or at least not too much more than normal. But today I am- and I think it is because I had too much caffeine. I bought the large, unsweetened iced tea (with lemon) that I often buy at lunch- but apparently this is too much caffeine for me off of klonopin.

So I found myself tempted to take klonopin because I was anxious from the caffeine and didn't know how to stop feeling like my heart is racing. And then I thought- it is not worth it. Being awake-that is what is worth it. And klonopin has too long a half-life to use prn (for me).

I hope I have this resolve come springtime, when I am always more anxious. For some reason I haven't been feeling really anxious recently- more alternating between depressed and stoic. I also wonder if my lithium level is higher because I cut down on my caffeine. I actually wonder if I am taking too much lithium, if I am a little bit numb. But now is not the time to change things- it has been less than a week off of the klonopin. I want to see what my next level is.

I told my step-mother I am off of klonopin. She used to be one of my biggest supports, but now she has turned a little anti-med. She asked me what the next meds is, what I will come off of next. And she used to be so pro-med.

I don't want her to have any opinions on what meds I should or shouldn't be on. I don't want her to be pro or anti med. Maybe there will be another med I eventually get off of, maybe there won't be. But what could she know about what meds I need? She is the one who told me to take more klonopin, that I was taking such a low dose, etc. She didn't understand how sedating it was- I would tell her, and all she would tell me is that I am on a low dose.

There is a part of me that wants to ask my doctor for Xanax to use prn. I've never taken it- but it has a much shorter half-life, so it might not have as much of an effect the next day. Then again, it might have rebound effects- you can't win. I know if I keep klonopin around as a prn I will use it very sparingly because of the long half-life. But I also know that I will probably someday take it again prn, hopefully not very much. But not today.

The worst thing you will ever have to do as a hand therapist

Yesterday I had to do the worst thing you will ever do as a hand therapist- which is to call the hand surgeon and tell him that his patient's tendon repair has ruptured. It wasn't the first time, and it probably won't be the last time, but it is awful. Thankfully, it didn't happen in therapy- or it would have been an even worse phone call. I'm not sure why it happened this time. In the past, it has alway involved patients doing something that they were clearly not supposed to be doing (like taking off their splint). This time it is a mystery- it seems to have happened during sleep.

Other than that, my mood is doing a little better. I am back on track with my light therapy. I am also off the last bit of my klonopin- I haven't taken any in 2 days, I was able to sleep with Ambien alone. And when I woke up this morning, I felt so awake! I couldn't believe it. I was sure I had sleep apnea, but just couldn't bear the thought of sleeping with a mask on. But today I haven't been sleepy at all. 

I am still feeling somewhat grumpy- that's the best way to put it. But it is improved. I am trying to find gratitude in good moments- even if I am also having bad moments. And trying to feel grateful for having a job with a job salary (and dental insurance) during my bad paperwork moments.

My paperwork is getting better. The talking to I had from my boss really sunk in. But I think it also helped that I lowered the Zyprexa and got off of the klonopin. That is making it easier to focus. So it is a lot of things.

I will have a new niece very soon. My sister-in-law is due within a week. That is exciting.

I never realized I wanted to be rich

I just want to take medicine that my insurance won't cover. I want to see a therapist and psychiatrist that my insurance won't pay for. I want expensive dental surgery. And now I want to be rich for another reason- today I thought about quitting my job, without having another job to go to.

Maybe it was just a bad day. I was just feeling truly burned out- as I do on those days in which the focus is not on patient care. My boss kept telling me things I should be doing better, that our department should be doing better, we could be doing better... mostly having to do with documentation, answering the phones, etc. And every time she would say something, something in me shut down, and I didn't know why I was there.

My mood was really bad today- I couldn't emotionally defend myself against anything except by shutting down. Actually, what I really wanted to do was to cut- it has been so long since I have done so, but every now and then I have really bad urges, even now.

What I want to do now is to sleep, but it is too early- it never works if I go to bed too early. I have been sleeping so badly recently.

Venting

I was very tired and sleepy today- but every time I lay down to try to nap I would be wide awake. So I finally gave in and went into work to do a couple of hours of notes- but had to take some home. My brain stopped working! I have a deadline to get all of my charts up to date by tomorrow.

I am under pressure because of my paperwork. I am trying to come to grips with needed the major dental surgery- and feeling really bad about not taking better care of my teeth. Although- the fact that they are front teeth- I have a dry mouth anyway from my meds and I am a mouth breather when I sleep- that probably didn't help. And now my income tax filing has been rejected, possibly due to a Turbotax glitch.

I did my taxes yesterday because I got my W2 and health savings account forms. I use Turbotax. It was a little dramatic- they giving you a running estimate of your tax refund- and at one point they were saying my state refund was $3400 something, and I knew that this couldn't be true- maybe my W2 was wrong was all I could think and would they catch me if I submitted it... and then the next moment I owed $5500 something, and I really freaked out. How am I going to pay for that? I needed my refund for the dentist? But finally it settled down to $520, which is just about what it was last year. And my federal was $1900. Well, I know how I am spending it.

I e-filed my federal and state. But today I got messages that my returns had been rejected- with a specific error message that actually isn't very specific. It turns out that this is happening to a lot of Turbotax filings this year- something about the way they are formatting their W2's I think. They say that there is a fix- but I had already re-submitted my returns, which is what Turbotax had first told me to do.  I think that I am going to get rejected again. And I needed that money ASAP.

I did learn something interesting from Turbotax while doing my state return. I always wondered why my state wages were so much higher than my federal wages. My state only lets you deduct contributions to a 401K, no other types of retirement accounts qualify. I work for a non-profit, so I have a 403B. So I don't qualify and that income is taxed by the state. Because I work for a non-profit I pay more taxes. How is that fair?

I should probably write to my state representative. Not that my state has the financial means to be increasing tax deductions for anyone, fair or unfair.