Sunday, August 29, 2010

Sunday

Wow. It's Sunday and you're already getting a new blog post from me. Amazing, right? Yeah, we'll see if I can keep it up.

Anyway, I promised to write something more on-topic, so this is my medical update. Yes, I know that sounds boring. It might just be that, but if you are bipolar or even depressed, you might be having similar symptoms. You are not alone, which I have to remind myself all the time! I am not on here to provide medical advice. I am not a doctor and I hope I'm not pretending to be. I've learned a lot about my condition over the years that I've been treated, including about some of the medications I take and what they do. I want to be as informed as possible when I talk to my doctor. If I have a good one, they want me to be informed, too. The last doctor I had was not that type.

I don't want to give his real name, but Martinez is a very common name here and be aware that that is not his actual name. I don't give my name or my friends' names, so I'm not going to start now. If I have something good to say, I'll say it straight out, though. Anyway, now that I've explained that, I will say that he did not seem to like it that I wanted to be on certain types of medications or that I was aware of more recent research than he was. Keep in mind that I do not read medical journals and this was published in a book in 2004, so we're not talking cutting-edge. He told me that Lamictal and Seroquel were both anti-psychotics, too. I know that Lamictal is an anti-convulsant from just about every source I've read and the other doctors I've talked to. According to them, it works as a mood stabilizer in bipolar patients, which is not the same as an anti-psychotic. So he did not want to keep me on both medications. I stuck to my guns because that was the treatment that has worked the best, so far, as I'd been on the anti-convulsant alone and it did not correct all of my symptoms, including the hallucinations. I wasn't sure I liked the Seroquel because I'd been gaining weight. However, I wasn't sure if it was my diet (I do eat when I'm depressed), so I was willing to give it another chance. I had to argue and argue, but he gave me the prescription anyway, even though he grumbled about it. I didn't like his attitude (he was very abrupt and was just like every other doctor I'd had with the University Health System, which means I had to repeat myself over and over). I didn't have a choice on the next appointment. They just handed me a sheet of paper and that was it.

The next time I went, I was going to ask for another doctor. I did not like him and I didn't feel comfortable talking to him. My previous doctor, whom I liked a lot on a personal level (he was like a father figure for me in some ways, and we had all kinds of pleasant conversations when I came into his office, like similarities between ancient Rome and the United States, the history of art, our experiences in Paris, and any number of things). We had a lot in common and I could relate to him and he could relate to me as he had children my age that had similar interests. He is also the one that had me reading the research and explaining what my prescriptions did and how they worked, what the side effects were and how they would begin manifesting, and what to do if I had any of them. I guess I was spoiled. I will use his name because I think he is a good doctor and very easy to talk to. His name is Dr. Jacques Baillargeon in San Antonio, TX. He's just awesome, really. He is the one that first thought it might be bipolar disorder instead of post-traumatic stress disorder, which was my first diagnosis (another doctor). He doesn't take insurance anymore (he was tired of dealing with them and I don't blame him), but he is worth the rates he charges, which are reasonable for his profession. He could change his policy in the future, so it's worth it just to talk to him.

I went in to my new appointment and I was waiting quite a long time (always there--another reason I was spoiled as Dr. B. never made me wait) and another woman came out. She told me her name was Dr. Rodriguez (again, not her real name) and I could see her if I wanted to, or I could wait a little longer and see my regular doctor. I told her that I'd only seen him once before and wanted to change doctors. I guess she thought I would want some continuity, and ordinarily, I would. But, in this case, I was ready to switch. She was very nice and was new in the office (only her 3rd day there), which was why she didn't have as many patients assigned to her yet. She also seemed to understand exactly what I was talking about and knew all of the research I'd read and more (yea!). She was happy that I knew as much as I did and was actually pretty surprised about that, too. But she was really sweet and I would like to stay with her, given a choice. So they gave me the choice, and I'll be you know what I said. :) They also gave me a new appointment, and at least now, they let me pick the time. As she gets more patients, this may not always be possible, but it was nice this once.

The new plan is to put me back on Geodon as my anti-psychotic since it helped my symptoms better than the Seroquel (and, yes, it was actually making me gain weight). Indeed, my hallucinations had been worse than ever before, by a long shot, and were much more negative and disturbing, and they were never like that before. My concentration and memory were worse on it, as well. Unlike the doctors at the hospital, she wanted to make that change not quite so suddenly, so I'm on a slightly lower dose of the Geodon, and she will raise it the next time I see her. She did raise the Lamictal to 200mg.

I'm not as depressed as before exactly. I think I always get a little optimistic after I see a doctor. I think, "this is going to work this time." But then, later on, I start feeling that familiar refrain of, "Everyone is better off without me." It's a dangerous thought to have and it scares me quite a bit. Usually, it seems like my symptoms are worse at night. Maybe you've had similar problems. But with me, I guess, I'm just doing things during the day and it isn't until I'm trying to sleep that I have time to think...really think. That's when the crying spells happen most. That's when I ended up in the hospital. But with this disorder, at least in that mood, thinking isn't what you need to be doing because your thoughts are controlled by the disease, not you. But I've fallen victim to them many times and probably will continue to do so for, at least, a little while longer. I can tell, after last night and the night before, that the dosage still needs to be adjusted. I had thought that I was feeling sort-of "in the middle", not really badly depressed, but not really happy, either. But I think that was just because I had a doctor's appointment. Now that some time has passed, I can tell I'm still depressed. I'm better than before, no doubt, or I'd still be in the hospital (although I will admit that my acting got me released, not the alleviation of symptoms). If they'd known I had done some acting and taken acting classes, they probably would have seen through it!

But, I also knew that my family were pissed at me for putting them through that when they knew themselves that I wasn't that depressed (yeah, they know me so well). So, I put on a happy face and tried to go on with my life. I tried to enjoy every minute I was out of that place. At first, it did feel great, but not as great as I would have liked. It was nice to see trees, really. I missed them so much. I didn't think 3 and a half days would be that long, but it was. It was worse because I'd been hiking every day before that. I'd used that as a stress reliever. When I couldn't do that, or paint, or draw, or any of the things I normally did when I felt unwell, that was worse than my symptoms at that time (probably not literally, of course). If I'd had insurance, I would have gone to a different hospital. Other people who were there with me said the others were better. Hell, even if I was on Medicaid, I probably could have gone somewhere else. But I'm not working (and I probably wouldn't be here right now if I were), and so I had no choice. However, I will say that I will probably call the crisis line again if I need to. It's better than the alternative, although it won't feel that way at the time. Hopefully, a little cool-down time is enough to get me through another few days, y'know? But the worst thing was really the boredom. If we'd had counseling and other things to do, it would have helped more, I think. So, if I win my case and still need it, I can call someone else. I hope I won't need it.

That being said, I am hoping that I will be okay and that I will be able to go back to work in the not-too-distant future. I don't know when that will happen. It's like there's a light at the end of a tunnel in that I feel some relief from the worst symptoms, but the light gets farther and farther away the more I travel through the tunnel. I keep thinking that it will not be much longer, but it is taking longer than I expected it to to finally get better. Really, when I saw my first doctor, I believed her when she said she thought I could be back to work in 3 weeks. Seems really naive of me now, but at the time, I really did think that I would be cured by a magic pill and everything would be perfect in no time at all. I know that's unrealistic now, but I had no clue back then. I wish I'd been better informed, and I wish I'd had someone be honest with me. So, I'm telling you. It might take longer than you think, but it's possible. I have a friend who was just diagnosed with clinical depression. She's doing wonderfully right now. It helps to talk to her because she's where I want to be, and I see that it's possible to feel better. I know it. I don't know how long it will take me to get there, but I want to know what that feels like. I do. I want to know what it's like to be truly happy for a change. Happy, without the black cloud over me, you know? To quote one of my favorite bands, a-ha, "Make it soon."

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