Fatigue

Forgive the infrequent posting.
Crap technology continues alongside busy weeks, jumbled thoughts and a lack of faith that these words mean anything anyway.

I ran out of Seroquel last Friday. There was a box I thought was full, it turned out to only be half full so my supply ran out and I didn't have a prescription. No matter, I had an appointment on Tuesday with my psychiatrist, it would just be a few missed doses. 3 in fact. 3. I took one Friday night so it was just getting through Saturday to Monday.
Predictably it was a bit harder to get off to sleep but I managed alright. I have an audiobook of Alice's Adventures in Wonderland read by a narrator named Peter Yearsley and there's a soporific quality to his voice which when combined with the dreamlike words of Lewis Carroll acts in a manner I find far more effective than Temazepam. So I got through. Although there was this big party on Saturday night so I didn't get a great night of sleep then. But no matter, I was fine and Tuesday came and I got my prescription and my drugs and all was to be righted in the world.

Tuesday night I took my normal dose of Seroquel and went off to bed. I was staying with my parents (another story) and my Mum came in to wake me around half past 9. Dragging myself out of bed felt like dragging myself out of my own skin it was so painful. I spent the morning in a stupor, my body weighed down with the weight of the most overwhelming fatigue. After lunch I couldn't take it anymore and went to lie down for a quick nap. I was woken six hours later.

Wednesday night I dutifully took my Seroquel again, shrugging off the day and thinking to myself that it must have just been a temporary readjustment to my brain chemistry but that Thursday would be better. Thursday I wrenched myself from bed around 10 and came home from my parents house and rather than doing laundry or going to the gym or attending German class I dozed in my bed, occasionally getting up to wander dumbly around the house wondering at what it was I was supposed to be doing.

Friday morning I was due in at work at 8.45am. I knew there was no chance I could risk being in a Seroquel haze so I didn't take it Thursday night. I woke up before my alarm on Friday and made it through the day clear headed. That was until the work Christmas party when my head did get a little cloudy and yes it was a bit of a later night than I had anticipated and when I got home and held the Seroquel tablet in my hand and thought about how I had to be in at work again today it just seemed like too great a risk so I tossed it into my pill box.

This morning, despite the still cloudy head and the late-ish night, I was awake by 8am. I wasn't due in at work until the afternoon so I spent the morning catching up on laundry and puzzling over why I was feeling so fractious and hungry and overwhelmed. Fatigue. Of course. Without the Seroquel and with a social life I don't sleep enough so I am fatigued. With the Seroquel I have the chemically induced paralysing fatigue.

I know eventually my body adjusts to the Seroquel and then even though I still sleep too much and spend my mornings staring into space I somehow accommodate it and muddle through. But right now I'm just so tired. And I'm so aware of how tired I am and I'm also so acutely aware of how rapidly my mental state starts to unravel just because I get tired.

I should have gone to bed already tonight.

So it's 1am now. I have things to do tomorrow so I can't risk another day of dozing or afford a six hour nap. No Seroquel it is.

Busy

This is a very hurried post because it's Friday morning and I should be getting ready for work.
My life has felt quite hurried and full these last few weeks as I've tried to juggle deadlines, socialising, family commitments and care for myself.
So, what's been going on you ask?
Well, firstly I've been madly applying for jobs and university courses. Jobs because I need to leave my current job and university courses because I made a last minute decision that the best thing I could do to nourish my recovering brain is stimulate it with study. I've had to run around town tracking down copies of transcripts from all my previous educational institutions but finally everything has been found, copied, certified and submitted.
I've gone out a fair few times these past weeks but then this week I've also indulged in some theatrical immersion seeing three play readings and one full scale production. I've also this week bought tickets for some interstate productions of Macbeth so I've got at least two mini-holidays in the pipelines this year.
This week has also been a big week due to the very exciting arrival of my brand new baby niece. I was on hand to wrangle the two older children so I got to see the precious thing when she was only minutes old. Such a blessing and such a happy time for our family.
Finally I've been trying to spare a few moments here and there to make sure I'm caring for myself properly. This means going to yoga, resting, eating nourishing food and just trying to find some still moments to check in with myself to see how I'm really going. This has been particularly important since I've had to change my medication regime. I have developed a facial tic which can be an indication that the medication has caused a condition called tardive dyskinesia. This is characterised by pronounced, permanent tics or bodily movements. In the hopes that my tic will go away I'm being weaned off Saphris, the antipsychotic I have been taking. So it's just a matter of seeing how I go without it and then coming up with a strategy if everything is not ok. So far I'm feeling fine, in fact I'm feeling rather positive about the future at present.
And now I really must dash as work beckons and I must go. I'll update you soon on any advancements on the job/study front.

Ups and downs

Well the ups is my Effexor has been upped after a stressful shaky week. It has had the desired effect and I've been once again lifted from that dangerous precipice.

The downs is I got dangerously close to that dangerous precipice again.

A couple of factors were surely at play. Work stresses (ho-hum), a wedding (long story - it was a lovely affair but my issues surrounding how I look all came bubbling to a head and I was also fearful I was going to have a confrontation with another of the guests) and the last thing, my living arrangements.

I feel in some ways I've been unfair to my current household. I was hesitant about moving in here and rather than letting go I've let those hesitations fester into a deep seated dissatisfaction with everything about the place and it's inhabitants. I've been escaping to my parents house on a weekly basis which has further fuelled my anxieties about my actual home as my absence makes me feel disconnected and like I must appear odd to my housemates.

I've had many long thinks, a couple of good cries and one particularly insightful session with my psychiatrist in which I came to the conclusion that I shouldn't be paying good money to live so unhappily.

So where to next? Well steel yourselves folks, it looks like I'm about to take the ultimate plunge into Loserville and move back in with my parents. And just in time for summer too!

Honestly though, it shouldn't be that bad. I get along well with Mum and Dad and the money I save on rent can all be funnelled towards travel plans I have for next year (The States. Again.)  I've got a very good potential living arrangement due to come to fruition in about February next year so it should only be a fairly temporary arrangement. And if I'm finding it too much to bear I can always go through the gruelling process of finding another share house, hopefully one where I can feel more at ease.

So, that wraps up another exciting instalment of my life. Send me good wishes for the next one.

My shitty week

I'm having kind of a shitty week. Let's see, where to start? How about my shoulder? Yeah, my shoulder is in pain for some unknown reason, possibly the result of too much filing which I've been doing at my job, which is another thing that has been kind of shitty. Usually I like my job a lot but this week has just been a whole load of meh with some blah piled on top. I'm working reduced hours, some days only 3 hours, and when the work itself is shitty then getting the energy up to go in for those 3 hours is pretty challenging.

Since I started with a body part perhaps I'll continue and tell you about my jaw, which is also in pain. I was so proud and boastful running around being like, 'look at me, I'm side effect free' and then I've gone and developed a side effect. It's not specifically just my jaw, but all my muscles are tensing up as a side effect to the Saphris. It's most noticeable in my jaw though because it's currently permanently clenched and so it aches and my teeth ache and chewing my food has become an ordeal. Now if only this would noticeably put me off my food I might lose some weight and start feeling better about my body, which is another thing that has made me feel shitty this week. No big changes here, still just lugging around all the lithium weight and feeling like a blimp.

I wonder if I'd lose the weight if I went off my medication? I've been wondering about being off my medication ever since my psychologist asked me what I thought I'd be like off my medication. I've been having a few issues with this psychologist and I don't think this has been helped by such portent questions as this. I think I'm going to stop seeing this psychologist but then I have to go through the hassle of finding a new one or try going it alone for a while, I don't know, it's all just a weight on my mind right now. What I do know is that I don't need to wonder what I'd be like off medication right now because the agreed upon course of action decided upon by myself in consultation with some very well trained health professionals is that I'm going to take my damned medication.

And that is medication that from tomorrow is going to start costing me a pretty penny more as Centrelink have decided since I'm working all of about 15 hours a week now I no longer qualify for Sickness Allowance and they've cut off my health care card. And what really irks me is that I'm really not earning very much money. Certainly not enough to have saved anywhere near enough money to move out on my own despite leading an austere existence at present. And what I'd really like more than anything right now is to have a place of my own. I miss having that haven and I am losing hope that it will ever be mine once again.

So that's a brief summation of the things going on in my shitty life this shitty week. However, I'm not feeling depressed, despite there being numerous things I could feel depressed about. I'm not suicidal, not even a jot, so even if my life is shitty at present I still fully intend to keep living it. And finally, this week will pass. It may be replaced with one much worse but it may be replaced with one much better. (Please be one much better.)

Ill at ease

I had a few bad days and then things righted themselves and I got back to being me and went off and did fun things like watch new episodes of Arrested Development and book flights to Sydney to see Angels in America. But I was still worried about those bad days I'd had. So in consultation with my psychiatrist I decided to up my dose of Abilify from the piddly 10mg I was on to 15mg.

A few days later and without consultation with my psychiatrist and I have dropped it back down to 10 and if I didn't think it was a completely reckless thing to do I would stop taking it altogether.

For the few days I was on the 15mg I have never felt so ill at ease. I couldn't get comfortable. Even in my favourite track pants. Even in bed. I just felt physically uncomfortable and emotionally unsettled. It doesn't sound like much but after 3 days I was so exhausted I wanted to cry. I was desperate to know if what I was experiencing was common or likely to pass and so I did what any sensible person with the internet does and I googled side effects of Abilify.

Holy fuck! The horror stories out there about Abilify are intense. One of them claims that Abilify actually shrinks your brain! I don't know whether these posts are written by people who have now forgone all medication and swear by goji berries to keep their mental health intact or if they are people like me, desperately trying to find a medication regime that works.

All I know is that Abilify is my only anti-depressant and the plan had been that if I became depressed again we'd up my dosage as the first line of defense. Now that I know I wouldn't be able to tolerate that I'm without a lifeboat. This makes me think that I might need to try switching to a different anti-depressant, one that I'll tolerate better, not just at super low doses.

Knowing this has left me feeling, along with the residual pharmacological effects, ill at ease. I hate trialing new medication as there are never any fun side effects to withstand as you let your body adjust. I don't want to go through that wobbly stage again where nothing feels right and I can't work or see my friends. I just want things to be settled. Of course I could stay on the 10mg of Abilify and hope I'm never graced by bad times again but that just seems irresponsible.

So watch this space for news of new medication. I'm really hoping that on a pharmacy shelf somewhere out there is the right drug for me.

Sick on sick on sick

An outside observer may be forgiven for thinking that I love spending time in hospital based on how often I do it.

You see, yesterday morning, after taking my bipolar medication and some Codral and Bisolvin for my killer cold I was suddenly doubled over with stomach pain. Soon after I started vomiting and couldn't stop. As I was lying on the bathroom floor feeling like I was going to die, it occurred to me that perhaps I was having a drug interaction so I called Nurse-on-Call. My nurse suggested I to straight to a GP. I went to a local clinic and saw a GP and she suggested I go straight to the Emergency Department at The Alfred Hospital as she wasn't sure what was wrong with me but couldn't rule out appendicitis. So, on to the ED at The Alfred where I was subjected to lots of prodding and poking and I answered lots of questions and was taken off for ultrasounds and as the day wore on I started to feel better but I was hooked up to an IV so I couldn't just leave and besides, I was hoping that somebody could tell me conclusively what had happened to me. Alas, 'twas not to be. I was discharged nearly 12 hours after arriving with a big, fat question mark over my diagnosis.

Somebody suggested that the reflux I get from taking lithium, combined with the amount of mucous I was swallowing and the codeine in the Codral had just created a bad reaction in my stomach and made me very sick. In case this is the case I'm steering clear of codeine, so if anyone wants some Codral, there's some going free at my house.

So, that's it, that's the mystery vomiting ailment that eclipsed my killer cold that eclipsed my bipolar disorder.

I'm really praying (to whom? Not sure) for a sickness free stretch of time now. I'll see out the end of this cold, but that's it, then I want no more. If the universe could be so good as to comply I would be greatly appreciative.

Ch-ch-ch-ch-changes

The weather changed. The heat wave broke and cool winds brought sweet relief. My medication regime changed and brought with it new side effects, more on that later. And my mood changed. It shifted upwards  enough for me to return to work and see that there is a light, it's just not shining on me yet.

I've also had a change in my student status. Specifically changing from being a student to not being one. It's a decision I probably should have made after last year's debacle with me withdrawing. I told one of my teachers what I was going through and asked for some leniency on deadlines. She told me I needed to hand in three assignments by the next class and do a presentation and when I broke down in tears her response was one of annoyance rather than compassion. Anyway I'm sure I'll return to study one day.

The most notable new side effect from the doubling of my Cymbalta dose is short term memory loss. At various points in the last week I've been unable to recall computer passwords, peoples names, who texted me five minutes ago, even my own phone number. I wandered on to a train platform today and couldn't remember where I was supposed to be going. Hardest of all for me is I find myself pausing to recall words that usually fall off my tongue. I'm having a reaction to my memory problem that oscillates between serious concern and ambivalence. Sometimes I think it's something I really need to get on top of and other times I think it's just one other side effect that I have to get used to. I really don't know how much more can be done in terms of tinkering with my medication. I'm up to maximum levels on some meds and the rest I've yo-yo'd up and down with already trying to find the right balance. I don't know. In case you can't tell I'm in my ambivalent phase right now.

I think I'll probably need to cut my already barely existent social life right back to none until I work out whether this memory thing is here to stay. I get so anxious when I'm out and usually I'm alright if I know I have an escape route but feeling befuddled would just make the whole experience much more distressing. No, I think it's an indoors existence with no surprises for me for now.

Pro re nata

I've had some shaky days. Literally and figuratively.

The monsters that creep and prowl around my head have been fed and are hungry for more. They gobble every setback, doubt, frustration or hostile encounter and grow stronger. My reserves are depleted and when I look through my arsenal there are few things that actually assist. 

I have smoked more cigarettes, eaten more chocolate and wasted more time on the Internet. These things pass moments but don't help overall. I've spoken to my family a lot these past few days and that has helped somewhat. And then there's the thing that really works but I'm loathe to use, Seroquel.

Seroquel is my PRN (pro re nata - Latin for "as the circumstance arises") to take when I am anxious. It leaves me in a zombie-like state but it also takes the edge of my anxiety like nothing else. It completely calms my shakes and makes every thought innocuous. When I take my PRN Seroquel the only thing I'm good at is sitting in one spot and staring into space.

It also leaves me with a Seroquel hangover by which I mean the following day I'm dopey and tired. At least 12 people told me how tired I looked today and I'm not looking forward to in the future discovering careless mistakes I've made today in my semi-stoned state.

I wish I had more resilience so that I didn't need to take medication. I wish there was something I could take that would ease my anxiety without completely stripping my personality. I wish I could live in a zen bubble devoid of all negativity. But what's the saying? If wishes were fishes the sea would be full.

Oh this is so inconvenient

Today started as any normal day; I woke up, ate breakfast, went to work, was inundated by emails, decided I hated my job, had free theatre tickets dropped on my desk, remembered I loved my job, swivelled on my chair a bit and thought about lunch. 

Then the not so normal thing happened. My vision went blurry and I started to shake so badly that I couldn't hold my pen.

I took my glasses off and held on to my desk, trying to focus and stop the tremor. I thought perhaps it was a panic attack so I tried to slow my breath, but I was still breathing at an even pace and my heart wasn't racing. I went to the bathroom, really because I didn't know what else to do. My tremor was so severe that I could see myself shaking in the mirror, even through my double vision. I have been warned that with the amount of medication I take there's the potential for the drug levels to become toxic. 

I went to my bosses office and when she asked what I wanted, I held out my hands and told her I couldn't stop shaking and needed to get to a doctor. She walked me outside as I tried through shaking hands to call my doctor. I got through and when I explained what was wrong with me he told me to come straight in. 

All my obs came back within the range of normal, my pulse rate was up a little and my temperature was higher than usual. I didn't have enough of the symptoms to suggest I have serotonin syndrome, but my doctor couldn't rule out an adverse reaction to lithium or a change to my thyroid or kidney function. I was sent away with the reassurance that I probably wouldn't die and to go to hospital if I developed any other symptoms. 

My tremor has now calmed down to an almost undetectable shake and I'm off to get a full panel of blood tests tomorrow morning. I'm worried that this episode is going to mean a change to my medication regime and that is something I'm really not excited about doing a week and a half before I go overseas. There's always the danger with medication changes that my mood will take a dip and I really don't need that when I'm going through the already stressful experience of changing time zones and going through airports. Of course there's nothing I can do but hope symptoms don't progress and that any medication changes are kind to me.

So it's a very shaky sign-off from me tonight.

Bipolar is expensive and time consuming

I broke with routine this morning and got up early to get to work early so I could leave work early to make my appointment with my psychiatrist. After my $220 appointment I went and spent $66 on medication and it looks like I'll be doing it all over again next week! Oh yeah, because that $66 is for only 2 of my 5 medications and I'm running low on others now. One of them costs $50 a month! 

Yesterday I had an appointment with one of the counsellors from the Outreach program at The Melbourne Clinic. Those are fortunately covered by my private health insurance but she wanted to know when I had another hour free next week. The simple answer is I don't. 
I have work and appointments with my psychologist and my psychiatrist plus I'm trying to minimise running around so that I actually get some time to rest. The counsellor seemed highly unimpressed, like I wasn't prioritising my mental health but I really don't know what to do. 

 I feel like my life is overrun by the logistics of bipolar disorder. I have to carefully plan my time so that I have at least 2 hours plus travel time per week to see various health professionals. I constantly draft up budgets to make sure I have the funds available at the right times when I need to see one of my health professionals or refill prescriptions. It's a job in itself. 

 And now, I have something wonderful and big to look forward to and it's feeling like this trip is going to be really positive but I find myself fretting about how many hours I'm going to need to take off work and how much money that is that I'm losing out on so I can go and spend more money on dealing with bipolar disorder. 

 I'm tempted to put a stop to the Outreach visits. My experience has been that they're not there to build a long-term therapeutic relationship, they're heavily based on CBT and mindfulness which I know enough about and find to be of limited value and quite frankly they're taking up time which I would rather be spending at work or taking a walk or reading my book or just not thinking or talking about bipolar disorder. 

 I think the easiest way for me to become a lifelong victim of bipolar disorder, like some of the people I met in hospital, would be to let it overrun my life and at the moment I feel a bit like that is happening. I might even ease up on blogging about bipolar related shit and instead treat you to lyrical prose about other things, like my memories of and cravings for American hamburgers or my sudden desire to get a dog. I want to be more than just bipolar Katie. Perhaps I should have thought of that before I named my blog.

Nystagmus

I woke up to my alarm, remembered my morning medication, got on the bus and made it in to work on time. Wahey! This going to work business is a breeze!
I had expected I was going to be tired but nothing prepared me for how tired I actually was. When lunch time rolled around I wanted to curl up in a ball. Instead I went to the IGA across the road and bought corn chips and fruit chews for the office. When I'm tired I snack.
The other thing I've found out happens when I'm tired is my nystagmus kicks it up a notch.
Nystagmus is an involuntary movement of the eyes. I noticed that this started happening after my lithium was increased and indeed it is one of the known side effects of taking lithium. It would only happen every few hours and as it's only a quick flickering of the eyes it didn't bother me too much.
Tired and staring at a computer screen for hours and it started happening every few minutes, sometimes more frequently. This was particularly frustrating when I was trying to focus on things like numbers or dates or seating charts or little old lady handwriting or any of the other squillion things that I have to look at in my job.
There wasn't much I could do. In fact I don't think there is much I can do. I'm not going to compromise my mental health by stopping taking the lithium. I guess I'm just going to have to get used to blurry vision and do the best I can around it.
I'm in bed now, eyes darting wildly every minute or so and keen to get off to sleep. I have another big day of work tomorrow and a visit from my lovely but tireless nephews tomorrow evening.
Good night.