Starting Up Again

It’s been many years since I’ve written here. I decided earlier this week to get back into writing on this blog specifically.

So what has been going on the last 3.5 years? A whole lot. I had a second bariatric procedure and I lost more weight. My highest weight was 440 pounds. I’m now 177. I was down to 164 but pandemic…….

I’m still working with infants in early childhood education. I’m still at the same place, though I’m brushing up my resume. I’m still coloring, though on my own. The meetup group doesn’t meet anymore because, well, *gestures wildly around*. I’m still baking and I’m part of an online baking “club”. “Club” because it’s only two of us. We are still trying to get people to join us.

A while ago, I quit therapy with Dr. D. I’m back working with her again. Dr. W (who I still see) encouraged me to start therapy again. I’m glad I did. The thing that made me walk away was her trying to dive into (what I recognize now as) my social anxiety. I wasn’t ready to tackle it and I was doing well in other ways. The break was good for me.

In terms of meds, I’ve been able to taper off the Haldol, Effexor and Celexa. In a few months, I’m hoping to start getting off either the Zoloft or Wellbutrin.

Last summer, one of the baby girls in my class at work had some possible vaginal bleeding. The way it was handled by my boss plus just the idea that maybe someone was hurting that little girl really messed with my head. At that point, I was seeing Dr. D. I ended up taking a week off to get my head screwed back on. The family left the center and I occasionally wonder what happened to her and hope she’s okay.

A couple months ago, we had a new family join the center. There are an infant boy, a toddler boy and a preschool girl. These children were removed from their mother. The toddler spent many hours just crying “mommy” over and over. The way the building is set up is there is a half door between the infant room and the toddler room. So I could hear every single scream. It broke my heart. It didn’t help that the toddler teacher was getting frustrated and would say “J, please stop crying.”. Let me say, that I totally understand her reaction. She had 6 other kids under 3 and it was overwhelming at times. I’ve been in her shoes. I was told A, the baby in my room, was born to a crack addicted mother. I need to do some reading on what the shorter term ramifications are of that. I’m probably most concerned about B, the preschool girl. She seems totally unaffected. I know she’s older than J, but she’s only 4.

I’ve been dealing with my reactions to those two incidents with Dr. D. After the baby girl, I took a week off to get my head back on the right way. Last week and this week, I’ve been on vacation. There were many reasons, one being the new family. Another is physical exhaustion. I’m still dealing with fibro. Two weeks ago we were so short staffed because of Corona. I ended up working 8-6 with a 2 hour break. It just wasn’t sustainable for me. I’m also the acting administrator for 4-6. Another staff member thinks she’s in charge and was being a general pain in the ass. I told my boss that E can be in charge since it seems that’s what she wants. My boss told me that no, you’re in charge and I deliberately chose you. And then there’s all the BS that needs to be done for Step Up to Quality. I was doing a good deal of other teachers’ work.

It’s definitely been a crazy year.

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Psychiatry Monday

BTW:  I’m writing these as sort of a record of what’s going on.  It helps me keep track of changes and reactions to meds and therapy.

 

Today was a fairly normal visit with the psychiatrist.  I’m feeling a bit better.  It’s getting there a little at a time.  I’m still hearing voices, but they are less frequent and less intense.  Dr. W isn’t as concerned as she was earlier in the month.

A few changes today.  I’m going down again on citalopram.  In need to get off of it because of interactions with the Lupron.  With that change, Dr. W decided to go up again on the Zoloft.  The only other big change is going up on the Haldol.  11 mg at first and then 12.  I’m hoping that will have to be the last dosage adjustment up.

Psychiatry Wednesday

I met with Dr. W today.  A ton of stuff is going on with my cancer treatment and its intersection with my psychiatric treatment.  I had two options.  One was going off the Wellbutrin and going on Tamoxifen.  The other was using Lupron to shut down  my ovaries and using the drug for post-menopausal women.

I was going to start with the Lupron combo because I was having so much trouble coming off the Wellbutrin.  But…  Yes, there’s always a but with me.  Lupron doesn’t play nice with Haldol and Celexa.  I found out after looking up side effects of Lupron.  I came across the drug interactions.  There were big red stoplights next to the two drugs.  Some kind of cardiac problem that I simply don’t understand.  I guess that puts me between a rock and a hard place.

So after some discussion with Dr. W, we decided to go with the Lupron option.  The Wellbutrin was working so well for me.  I’m going to go down on the Celexa along with up on the Wellbutrin and Zoloft.  Together we decided to go up another two milligrams on the Haldol over the next few days.  That seems like a funny decision, but with other things changing (Zoloft up, Celexa down, Wellbutrin up) it’s best not to change too many things at once.  But up on the Haldol because the voices are still a big problem and are quite distressing.

I see Dr. W again in a week and half.  We’ll make some more adjustments then.  I’m not looking forward to this transition, but it’s necessary.

Therapy Thursday

Another week.  Another day of therapy.  And as usual, it didn’t disappoint (just kidding).

Since I’ve been talking about cancer treatment there, I went through what the oncologist said yesterday.  Basically I have two medical options for long term treatment.  I can go with Tamoxifen but it requires getting off the Wellbutrin.  And that doesn’t seem like it’ll happen anytime soon.  So medically, my other option is shutting down the ovaries with Lupron and treating with Arimidex.   That’ll cause menopause.  The other option is removing the ovaries and going with the Arimidex.  At the moment the choice is Lupron and Arimidex.  The long term plan is to go off the Wellbutrin and then switch to Tamoxifen.

We talked about control and losing control of my body.  Losing what makes me a women.  In other words, the ability to reproduce.  Not that I want to reproduce, but the thought of it.  I don’t know why it bothers me so much.  But it does.  Perhaps that’s something to explore next week.  The other small topic on this was going to the dentist next week.  It’s my worst nightmare.  Why?  At least I can answer that one.  Feeling exposed.   Feeling vulnerable.  Having someone (turns out it’s a woman) standing over me.  Yeah.  Nightmare.

On of my usual comments was X is my fault.  In this case letting the depression and voices get so bad without asking for some help.  I got the usual “It’s not your fault”.  Fault and responsibility is something I struggle with everyday.  I don’t even know how this came up.  But it did.

I guess it’s a matter of putting one foot in front of another.  Hopefully the increase in Haldol will help with the voices and the Zoloft will help with the depression.  And now that radiation is finished, hopefully the fatigue will subside.

Psychiatry Tuesday

You know things are bad when the doctor tells the scheduler that you are a priority for scheduling.  My chin almost hit the floor.  I mean, things aren’t good.  And there has been a lot of pain (both physically and emotionally) lately.  But I certainly didn’t think I fit into priority territory.  Priority.  Minimizing.  I do such a good job of it.

I have four appointments scheduled between now and the beginning of July.  She’s going on vacation for 6 weeks starting the middle of July.  She once to see me once again before she leaves.  Unfortunately, that means I’ll have to take what I can get off the cancellation list.  That is if any appointments come up.

I’m trying to get off Wellbutrin because I can’t take the estrogen blocker with it.  Wellbutrin renders the other med useless.  When I tried to go off before, things got dicey.  I see the oncologist tomorrow and have no idea what to tell her other than I tried and it’s going to take longer than anticipated.

So Dr. W started me on Zoloft.  Yippy skippy.  Another med to add into the mix.  She upped the Haldol and wants to be a bit more aggressive with it.  I’m still hearing voices…  almost constantly now.  Depending on how I’m doing, she may start weaning me off the Wellbutrin next week.  Yes.  Next week.  I don’t think I’ve ever seen a psychiatrist that often since I was in the hospital.

It all seems so complicated right now.  Appointments with the medical and radiation oncologists.  Appointments with Dr. W.  Appointments with Dr.D.  Maybe moving up to twice a week with her.

I keep hearing people say that I will feel better once the radiation is finished.  I finished yesterday (yay me).  But it’s not like a switch.  Really recovering will take about as long as the radiation took.  In my case, four weeks.  The only one who gets how I feel is my primary care, Dr. M.  Dr. M went through radiation himself.  He said it’s not uncommon for people to get more depressed right after finishing.  I totally agree with him.  You’re in the middle of treatments and running around.  And it feels like you’re doing something active.  Now I have to wait on the Wellbutrin and see what the oncologist says.  It’s like I’m not doing anything at all.

I have some Haldol and Trazodone in my near future, so I better sign off.  I’m really fighting sleep right now.  Better to give in.

The Day After

So I saw Dr. D yesterday.  It was tough, complete with a panic attack.  She encouraged me to call Dr. W.  Since I seen her earlier this week, I didn’t think it was a good idea.  But Dr. D gently explained that Dr. W would be concerned that I let myself continue to suffer needlessly.  So I called.  I got a call back that evening, which surprised me because she’s on vacation.  She asked what was going on and I told her everything.  Well almost everything.  I didn’t tell her how long things have been going on.  She gave me hydroxyzine, which she has given me before.  Dr. W said she’s hesitant to prescribe a benzo at this point.  Not because she’s worried about addiction.  But rather given the amount of medication I’m on.  I understand her point of view, and I respect it.  What it says to me is that she’s being conservative, but is willing to go with something more powerful if I need it.

Dr. D wants me to come back on Monday.  I don’t really know how I feel about that.  I do have somethings I want to talk about related to the physical abuse.  But I’m not completely confident that I can get through it without losing myself in the flashback loop.  It makes me scared just thinking about it.  I’m going to copy/paste it in here so I can just read it if need be.

It was my grandfather. The summer after kindergarten, my parents made me stay there while they took my grandmother out of town. I don’t remember what I did that was so bad, but I got punished but good. He took off all of my clothes and made me lie on the bed. He put my arms over my head with my hands together and told me to stay that way. If I moved or cried, he hit me with a leather belt.

I don’t know how long I stayed in that position. It was so cold in there. He had the air conditioner on as cold as it would go. It felt like it was forever. I had almost fallen asleep when he came back into the room. I laid there while he felt my whole body, from top to bottom. He was on the bed with me. Then he left and told me not to move or I’d get it with the belt again.

I tried not to cry, but I did. As soon as he heard me, he came back and punished me for disturbing his baseball game. He told me that I better not move again. So I didn’t. I laid there and counted the cracks in the ceiling, over and over, and over again. But I couldn’t help but listen for him. I was terrified he would come into the room again.

After what seemed like forever, he came back into the room. And he got on the bed again. I was so afraid he’d get the belt out again. He wasn’t touching me anymore. He was on top of me. I couldn’t move. I couldn’t breathe. He was so big and heavy. The penetration was extremely painful. I wanted to scream and yell, but I couldn’t. It hurt too bad.

All of a sudden, he jumped off of me and the bed. I put my arms down. He started to scream at me. He told me that he had said not to move. He told me I was an evil child filled with the devil. He was right. He got the belt again and told me to put my hands back up or he’d punish me again. I begged him not to, but that made him really angry. He took me by my shoulders and shook me. He kept yelling how little girls should obey their elders. He put my hands back over my head and made me stay like that.

I laid on that bed for hours. It was so cold in that room. I really had to go to the bathroom, but he told me not to move or say anything. I had to go so bad, I ended up wetting the bed. When he found out I had wet the bed, he beat me again. And then he was on top of me again. It must have gone on like that for hours. I remember watching it go from day to night.

I hurt right now just thinking about it.  I think I’m going to sign off, take some hydroxyzine, and eat.  Toast for breakfast and not eating anything else doesn’t cut it anymore.

Living With Haldol

It’s definitely not an easy drug to live with.  I’m tired all the time.  I’m lucky if I make it 20 minutes on my walk because I just want to climb back in bed.  Therapy is draining enough as it is without adding bone numbing tiredness into the mix.

Unfortunately, based on what I said today in Dr. D’s office, I won’t be coming off it any time soon.  If I try to go down a bit the voices come roaring back.  On the dosage I’m on now, they’re simply a dull roar.

On top of the fatigue, I grind my teeth and clench my jaw.  That’s resulted in some TMJ type stuff going on.  Next Monday I have an appointment at the local dental school to evaluate one tooth for another root canal and the TMJ.  I’m taking Cogentin for this, but it only really works well up to my previous dosage of Haldol.  It doesn’t do so well on this higher one.

Thankfully I see Dr. W about all this on Wednesday.  I don’t know what she’ll change.  I know the one thing I want changed in antidepressants.  I take Cymbalta for pain.  That’s nonnegotiable.  But the Celexa has to go.  It’s doing nothing as far as I can tell.

As usual, the med go round goes round and round and round and…  well, you get the point.

The Med-Go-Round Goes Round and Round

This is what life feels like right now.

I talked to Dr. W yesterday.  The voices are pretty bad right now.  She tried to increase the Haldol once before and that led to such horrible jaw clenching that I had to go down plus start taking Cogentin with it regularly.  Now, given my symptoms, she feels I should go back up and she increased the Cogentin too.

I feel like I’ve been on this ride for so many years.  And I’m going round and round.  I’m actually dizzy when I sit down and look at my med list.  I doesn’t help my list when you factor in the fibromyalgia diagnosis.

I see Dr. W next week.  We’ll see where the med-go-round stops then.

Itty Bitty Baby Steps

After working on it for like a month, I’ve finally called a psychologist.  I tried doing the Psychology Today route.  Too confusing since my insurance is administered by X company, but because it’s Medicaid, people who take X don’t necessarily take my form of X.  Today I worked up the courage to call X company directly and get some names.  I took those names and Googled.  Luckily one of the people specializes in trauma.  I left a message on voice mail.  Thankfully, she’s out of the office until Monday and I can quit stressing over it until then.

Earlier, I saw useless GP.  Remarkably, he wasn’t all that useless today.  I guess it helps if you go in focused and only asking for one med change.  A few weeks ago, I started Couch to 5K.  I messed up my previously messed up ankle.  So after resting for almost a week didn’t do anything I made the appointment.  Now, all of this could have been taken care of last week, but drunk family member fell down in her driveway and I had to take her to the ER and wait around while they scanned her head.  I barely know this person, but nobody else who could do it was around.  I swear, I think I’m going to start using the phrase “Not my monkey.  Not my circus.” around my family.

So I see GP.  He orders an x-ray basically to cover his butt should the 6 weeks of PT he prescribed not work and he wants an MRI.  I guess having a GP who also does sports medicine is handy.  He says I can continue walking, but no more than a half mile or so and no C25K period.

He also gave me a referral to a different rheumatologist to evaluate for seronegative arthritis.  Despite lab results and symptoms and joint pain responding to steroids, current rheumatologist doesn’t think there’s anything else going on aside from fibromyalgia.

Oh, and I get to increase the Vitamin D I’ve been taking because I’m still deficient despite taking a standard 2000 IU a day.

Only other thing is I had a sleep study done.  I wish they’d hurry up and send the results.  I had a split study, where they monitored the first part and then put me on a CPAP machine the second part.  I’m guessing the fact they did the CPAP means I had a significant number of apnea events.

Psychiatrist is being a bit pushy, but I don’t expect less.  She’s ready to call up Company X and go off on them because they want to do her job.  She’s the one pushing therapy.  I think things have lifted a bit because as I said above, I’ve been able to deal with looking into it.  She also wants me to go back to the NAMI group I used to attend.  But I haven’t been there for like 10 years.  There’s a meeting tomorrow night.  But I don’t know.  I guess I’m minimizing things again.  I get all “But it isn’t that bad” all the time, despite evidence to the contrary.

And no, dear psychiatrist, my mother’s voice isn’t going away.  It’s been in my head my entire life.  And no, I’m not psychotic.  I think we’ll have to agree to disagree.

Coping Skills

I’m learning to live with the side effects of the Cymbalta.  Yogurt is my new best friend.  It’s easy on my tummy and I found a flavor I like (Yoplait’s Whips in Chocolate).  They’re 100 calories a pop and I can usually get two down.  I’ve been eating those for breakfast and lunch and trying to choke down whatever we’re having for dinner.

I actually started adding Breakfast, Lunch and Dinner in my to-do app.  It’s definitely got a game type vibe to it, and that helps motivate me to actually open it up.

I’ve given myself permission to take a Klonopin during the day if things get really rough.  Yes, I get the doctor’s point that she doesn’t want to change too many variables at once.  But there’s no use in torturing myself.  All that accomplishes is making me want to eat even less, which feeds back into the anxiety.

Thankfully, I seem to be sleeping better.  The increase in the Trazodone has helped on that front.  I was hoping the sleep would help with my pain, but alas, that doesn’t seem to be the case.  In fact, it seems to be worse than before, with a lot more muscle tension and spasms.  I’m going to start back up on the magnesium supplement I was taking since the Cymbalta (or lack of food) is screwing with my lower GI tract.

Finally, I’m taking it one day at a time.  That’s the only way I’m going to get through my life.  I’ve quit looking toward the future because I don’t see it dramatically changing any time soon.