First week over

Well my first week being off work and in therapy is over. I have gained insight into living with BiPolar. Organizing the house will help reduce my level of stress which should alleviate some of the symptoms. Hulda and I are working hard towards being competition ready and having a lot of fun with that.

Therapy is helping to pinpoint other stressors and ways to counter them. My husband and family have been wonderful throughout this. One problem that I have is seeing when stress is causing me to behave differently. I am actively working on managing my stress better through medication and increasing my understanding of how the disorder affects me. It is easier for Tom to see the beginning changes than it is for me. I have asked him to help me by pointing it out to me. The problem with that is that I tend to get very defensive about it. So what ends up happening is that he tries to help and I get mad at him. This is pretty unfair to him. A topic covered in therapy was giving permission to a few close and trusted people. Since verbal permission has backfired on Tom I think I am going to try written permission. I think written permission has the potential for being less overtly confrontational. It would give me a chance to collect myself and really hear what he's trying to say to me. I have a wonderful SIL who is always very willing to be helpful. She said she would be happy to address behavioral changes. I know that I am asking a lot of these two. I am very lucky to have such supportive people in my life. There are other changes that I need to make. My style of communication needs help. I'm still working on that. The other is creating healthy boundaries. I'm working on that too. That one is harder. I run between extremes either keeping people from affecting me at all or letting them push me around. My job is a great example of that.

Despite being anxious about going back to work in 3 weeks I'm starting to feel genuinely happy. I haven't felt like I could accomplish something in months and months. Maybe even years. My self image tends to be pretty crappy but organizing the pantry, training Hulda and socializing more is helping. I have this really huge fear that at the end of this month I'll actually be organized and feeling great then go back to work and watch it all fall apart. This scares me a lot. I get really tense and then depressed. Somehow I've got to over come this feeling of desperation.

Training Hulda has been really great. In addition to the class we take on Monday and Tuesday nights I've started taking a heeling class on Saturdays. This class focuses heeling in the obedience ring. This involves getting my footwork right, heeling next to the ring enclosures and making sure I'm not giving Hulda the wrong body cues. All in all its going really well and I'm looking forward to showing.

Saturday night I went to the birthday party of SIL's friend. My adorable neice was there. She was full of fun and mischief. This may sound really awful but I LOVE watching her pull the adults puppet strings, myself included. She's cute, really smart and really loves things to go her way. A triple threat. Naturally she has us in the palm of her hand. She's not really in control but she thinks she is. Ah, youth!

Ownership

I have begun therapy and am working things through. I am beginning with some basics.

I have 2 problems that affect daily life for me. The first is that I am completely disorganized, to the point where I am truly dysfunctional. This disorganization exacerbates the BiPolar symptoms. The other is that I am overweight, obese actually. My kitchen is rarely cooking friendly and when I say kitchen I mean the whole thing; pantry, refrigerator and then of course the kitchen itself. Food is bought and then never eaten. Money is wasted at the grocery store and then again at the fast food joint or restaurant. So this afternoon it is the pantry.

As an aside, there is a genuine flaw in the construction of our pantry. It is so deep that it is really easy to loose track of what's in there. My SIL has the perfect pantry in my opinion. It's large enough for a person to step into but the shelves are shallow enough to keep track of things. My shelves are 2 feet deep easy. That's just crazy making. I'm so jealous of her!

The next step will be the refrigerator and cleaning the kitchen!

Hulda and I went to training tonight and are preparing for our first practice match on Thursday night!

Habit of Depression

Generally speaking since I began the much dreaded and feared Geodon I have felt pleasant and happy, even productive. I am not experiencing the side affects I was so worried about. I am sleeping like a baby with the use of sleeping meds and sleep hygiene. I am successfully combatting the manic issues I deal with so frequently. I rarely notice the depressive symptoms inherent with manic depression. I have one major symptom of depression that I really didn't recognize or deal with. I couldn't explain in any logical way why I seem to need to isolate myself in my little home cocoon but it is a big problem for me. Given the choice to go and do something really exciting and fun or stay home I will most often choose, sometimes even fight to stay at home. I have tried to explain this away in a number of waya but the truth is I have never been able to explain this well. I saw my shrink today because in addition to a huge crying spell preceded by a case of the 'my whole world sucks' I knew I was in the middle of a downswing. The manic issues are currently well managed but not the depressive issues. I manage my bipolar through my med shrink and my head shrink. My med shrink upped one of my mood stabilizers and suggested I discuss my isolation with my head shrink. She said that people can deal with their depression issues for so long that it almost becomes a habit. Does that mean I have been isolating for so long that med support alone won't get me out of the house? Do I need to kick the habit? There are things I love to do that I haven't done since February of 2005. Isolation has played a major role in my life since that time. Because I believe family is so important I fight the desire to stay at home. Once I'm there I have a great time. I literally love training my dog but haven't gone to classes since August of 2004. Doesn't make any sense does it? Tom and I have plans to go to class together, he is gonna train Monkey. I was really looking forward to competing with Hulda. I'm really tired of this nothing and hope that this is the answer I've been looking for.

The Up and the Down

I have Bipolar. I was diagnosed about 2 years ago. I am doing pretty well at the moment. It is in these moments that I forget why I was diagnosed to begin with. I saw my drug rep (psychiatrist) (she happens to be a very good doctor) today with a laundry list of things to discuss. On that list was 'why do we think I have bipolar?'. We went over a list of problems we had tackled together. Oh, yeah...I remember. I was hoping for a quick discussion about how I'm truly OK and just have ADHD. I was first diagnosed with ADHD at a young age and that same diagnosis has been made several times over the years. I'm comfortable with ADHD; I recognize when I'm having difficulty and I have lots of coping strategies. Bipolar is still new and scary to me. To be honest it is only in the last 6 months that I realized we were confronting the bipolar separate from the ADHD. My symptoms are mild compared to most for which I am thankful.

Still, I have symptoms which is why I go visit the drug rep. I have been doing really well recently and this is because I finally agreed to take the amount of lithium she thought we would be beneficial. I am at a 'therapeutic' level.The thing that sucks is that being on this amount of lithium brings side affects into clearer focus. I have a dear friend at work who had a bad experience with lithium as a child. In her mind lithium is evil, she's a little dramatic but genuinely worried. Doing a web search on side affects of lithium would be a way to either validate or relieve her concern. Here is what I found out:

1.) There is a fine line between therapeutic and toxic levels of lithium. Wow! That was an eye opener. I didn't do much research on lithium, it has been around forever. It is very effective and usually well tolerated.

2.) The following is a list of symptoms I attributed to other causes: HAND TREMOR: DRY CRACKING SKIN ON HANDS: HIGH BLOOD PRESSURE: LETHARGY: WEAKNESS: EDEMA IN CALVES, ANKLES AND FEET: CONSTANT THIRST: CRAZY FREQUENT URINATION: SLURRED SPEECH: NAUSEA: DIMINISHED SEX DRIVE: FATIGUE

3.) This is the only side affect I knew came from lithium: DIARRHEA

Now before you get upset with my drug rep these symptoms are not typical. Some of them have been going on for over a year, some within the last 3 months. Until today, the only symptom I brought to her attention was the diarrhea. It never occurred to me that dry hands or edema could be the work of lithium. I was convinced the hand tremor was due to anemia or the iron pills I take to counter it. So, we had a lot to discuss. Prescribing medication has never been something she does 'to' me. Before changing we look at a list of drugs, discuss pros and cons. For right now she has reduced my dosage. We're going to take it slow because my blood pressure is in play. Depending on how my symptoms are in one week, I may or may not try out a new med. I may be able to simply lower my lithium dosage. I like that option. Lithium has worked really well. The only other medicine for mania we've tried was Depakote. I puked and puked and puked. I love what lithium has afforded me. Relations between myself and my family have never been better. My mother and I are closer than ever. I worry throwing lithium away is throwing that away. Cross your fingers for me.

Zzzzz

I am really struggling to keep to a schedule. I have decided that I need a keeper. A Patti Keeper. Kinda like a zoo keeper without the zoo. I think that a taser will be crucial to my success. I like the idea of a midget. So, if you know of a midget zoo keeper armed with a taser who is willing to work for no pay please, send them my way.

I have resolved my insomnia in-so-far as the bipolar is concerned. That was step one. I am no longer staying awake for 24-48 hours at a stretch. A sleep study of me was conducted on 10/28/06. I will be receiving new equipment on 11/07/06. This should resolve my sleep disturbances (SD). What is an SD you ask? Anytime you wake up at night for whatever reason. Typically I wake up to pee. This is related to sleep apnea which will be resolved next week. Sleep apnea causes me to stop breathing in my sleep. A rush of adrenaline forces me into consciousness. The adrenaline also increases the need to urinate. Don't ask me why, I forget. The lithium I take is a diuretic. More pee. So, I wake up go to the bathroom, lay back down and have trouble getting back to sleep. A typical Patti SD. It is recommended not to stay in bed if it takes you more than 30 minutes to fall asleep. I have an SD 2-3 times a night on average. So I get back up, drink some Sleepytime tea (yeah, I know...more pee) and try to bore myself. That is difficult as I am extremely interesting. Fascinating really. Out of the ordinary. Mesmerizing. You see my dilemma.

So here is my plan.

At 5:30am my Patti Keeper will wake me up. Zzzzz.

I will eat breakfast, feed Hulda, Simon and Monkey. Take my meds, get dressed and ready for work.
Around 6:30-7:00 I will wake Tom. No taser. Well, probably no taser.
An hour after my breakfast I will drink orange juice, take my iron and vitamin C. About 7:40 I will leave for work.

If I get off track. Zzzzz.

At noon I will go home, let the dogs out (and back in), feed myself and take more meds. Then around 12:40 I will return to work.

If I get off track. Zzzzz.

When I return home I will let the dogs out and start dinner. While dinner is cooking I will feed the dogs and Simon. I will have eaten dinner by 6:30. Eating early is conducive to sleep.

If I get off track. Zzzzz.

Between 6:30 and 8:30 I will do tiring work around the house. Exercise a few hours before bed is conducive to sleep. I will take more meds. Tom will get home and we'll talk about our day and our plans for world domination. I will play with the dogs. I will probably watch TV and blog.

If I get off track. Zzzzz.

At 8:30 I will light the essential oil diffuser beside my bed. Essential oils are conducive to sleep.

If I get off track. Zzzzz.

Between 8:30 and 9:15 I will take a scalding hot bath scented with lavender essential oil and drink a cup of Sleepytime tea. A hot bath is conducive to sleep.

If I get off track. Zzzzz.

Between 9:15 and 10:00 I will watch TV with Tom and discuss our plans. I will play with the dogs and drink a cup of Sleepytime tea. Sleepytime tea is conducive to sleep.

If I get off track. Zzzzz.

At 10:00 I will put up Monkey, kiss Tom goodnight and go to bed. I will take sleep meds. I will be pleasantly relaxed by the aroma from the diffuser. I will turn on my relaxing Ocean Waves CD. I will read my book on sleep. Relaxation music and tedious reading are conducive to sleep.

If I get off track. Zzzzz.

At 10:30 it is lights out. Darkness is conducive to sleep.

If I get off track. Zzzzz.

Flawless, don't you think? I am sure there are things I must do that I left out but then that is why I have the midget. Zzzzz.

So, just send that little fellow my way and I'll be set.
Much appreciated.

Zzzzz.

Victory Dance!

I don't see cause and effects very well. Especially when it comes to my health. Here is a good example. My manic episodes were getting out of control around late spring into summer. Thoughts were rushing through my head so fast I couldn't sleep. I would go 24-48 hours without sleep. This would happen once sometimes twice a week. None of the meds I take for sleep helped at all. I tried a few meditation techniques but I couldn't quiet my brain. I slept only when I was physically exhausted. I saw my psychiatrist who increased my Lithium. I had concerns about being on so much medication and had resisted her recommendations. This time I listened to her. The increase in Lithium put an end to the 24-48 hour insomnia episodes. Victory!
The Lithium also put an an end to most of my irrational anxiety. I have panic episodes. Panicking while driving had become an issue for me. This started after I was in a serious rollover car accident. I would have anxiety attacks while driving. I would be overcome with fear especially on high bridges and flyovers. I had to concentrate very hard on simply getting myself to safety. Since the increase in Lithium panic has ceased to be an issue. Despite my efforts to avoid flyovers I would find myself on them. This is the attention deficit in attention deficit disorder. I simply paid no attention to what I was doing. Once it's too late I have to move through it. The fear that my car would simply drive itself over the edge is powerful. I found myself on a flyover recently and that fear was gone. In fact I was able to appreciate how cool the experience really is. Panic episodes in general seem to be gone. This was huge for me and definitely felt like a victory!
I have suffered from severe tension headaches for several years. Occasionally they are so bad that I have to get Demerol shots to cope with the pain. My neurologist explained that they were not true migraines despite the pain. A migraine has to do with blood rushing too fast in the brain (I think that's what he said) while mine were related to anxiety. When my psychiatrist first put me on Lithium I experienced a decrease in tension headaches. Since the increase in Lithium I haven't had a single tension headache like that. I meet with him this week (I see him every 4-6 months) and I'm curious what his opinion will be. I like him well enough but I'm hoping he releases me as his patient. I think it will feel like victory!

Getting relief for problems in 3 areas of my life by putting one into balance is wild to me. I knew that Bipolar affected many layers of my life and I probably paid lip service to that affect. Still, it is wild to me that a solution to one problem could be such so far reaching. I am still coping with insomnia but it is not nearly as out of control. Sleep is incredibly important and I'm working very hard to solve the problem. One piece to this puzzle was getting the bipolar under a greater degree of control. Victory!

Schedules Suck

I got a letter from my doctor's office with lab results. It would seem that I am anemic. The fun part is that I have to take iron supplements. I have to take them 2x a day 30 minutes before eating. My #1 struggle is with scheduling my life. I started keeping a log in late September because I mistakenly took the wrong drug. This doubled me up on that drug which caused problems. My life is full of these mistakes plus common sense stuff I can't get a handle on. The older I get the more neccessary a schedule becomes. I don't mean get up, go to work, come home. I mean all the stuff before, in between and directly after. Left to myself I would probably get tons of stuff started but nothing finished. With a few happy exceptions I don't seem to work on anything but the schedule. That can't be right. Right?

Fun with Drugs

Tuesday night I made an error with a medication. For my convenience my doctor had changed the size in milligrams of one of my pills. She told me this but 4 weeks later I had forgotten.(I had put the new script on hold). When I took my nightly meds I took 450mg instead of 300mg. The effect was immediate and rather negative. Thankfully she and I figured this problem out yesterday. This morning I feel much better. The drugs I take are mood stabilizers, they help me to have more appropriate reactions to my environment. These are common and highly effective bipolar meds. Appropriate doses help me avoid overreactions. Too much medicine and I'm likely to simply not give a shit about anything. I woke up this morning realizing that the things I didn't care about yesterday are impacting me today. I think I'm still on a little bit too much but I will have to document the problems over the next month. I keep a detailed log of everything I experience and summarize each week. It is beginning to paint a picture of the effects both good and bad. There is some good news. My insomnia is under much better control. The rush of thoughts through my mind which had been keeping me awake night after night are gone. I am still having trouble being an active participant in my own life. This is why I think I am on a bit too much. My experience with 150mg difference stands out. Once the meds are in the system and working, small shifts make big difference. I hope me and my doctor can find the perfect brew of pills.