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.
Monday, September 30, 2013
Sunday, September 29, 2013
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 $3000 for my hospitalization- my in-network out of pocket maximum.
I'm doing laundry, and trying to clean the kitchen. Later I will go for a walk. Tomorrow it is back to work.
So far so good on less Zyprexa.
This year I also managed to cut down on my Effexor. Cutting down on my Zonegran did not work. I'm not even going to try with the lithium- I think I'm at the sweet spot, with a level of 0.6. Just at the very bottom of the therapeutic range. That leaves Provigil- which isn't my biggest priority of things to reduce- except for the cost (as my overseas supplier has become unreliable and the price still hasn't dropped much in America).
Sunday mornings I watch a lot of the morning news shows- either that, or BookTV on C-SPAN2. I can't watch the news this morning, it gets me too upset. I am having one of those mornings when I think that Lincoln was wrong- that our country is too large and diverse to be governable, and that we might as well splint up.
I don't know how I feel about Obamacare. Ideally, healthcare should have been taken care of at the state level, it seems like a states rights issue. But, with the exception of Massachusetts, it wasn't. And something had to be done- and nothing had been done. Is this better than doing nothing? Perhaps. I don't know. What nobody says: there will be winners and losers with this law. It is not all good or all bad. The other things that people don't say: if you liked the health insurance you had, you probably couldn't have kept it for very long anyway. Costs were getting out of hand, and policies were covering less and less each year. I have patients with 50$ 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).
Saturday, September 28, 2013
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.
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.
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.
Wednesday, September 25, 2013
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.
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.
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.
Tuesday, September 24, 2013
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.
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.
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