0

Lithium

So, there it is. The word I’ve always dreaded.

My psychiatrist went ahead and prescribed it a little more than a week ago. I guess it seems like the Lamictal is not really stabilizing my moods anymore. I am ashamed of how I have become this aggressive beast whom I don’t recognize. I hate the way I lash out. I can’t stand how angry I stay. And then I want to cry…I think. Yet no tears come. I feel numb. And I want to do something (ANYthing) to make myself feel like I have a pulse. I feel like a walking dead person.

And then there are the feelings that are the non-negotiables as far as any psychiatrist worth his salt is concerned. The feelings that “one would be better off dead.” Ugh. Do I have a plan to harm myself or kill myself, well heck no!! It’s just that feeling of wishing I didn’t have to wake up for quite a number of days. Doesn’t anyone understand that??

I function. I go to work daily. I take care of my physical appearance. I still have a decent filter that keeps me from saying all the horrible stuff that comes to my mind. But I admit that I seem to hate people more. Not REAL hate, you know. Just the feeling of being fed up with most human beings. I mostly don’t want to be bothered. I mostly want to go home after work and wrap myself up in a blanket like a fajita or a big, fat burrito and read a book or watch some Netflix. I wouldn’t mind talking on the phone…but my husband does not approve of my best friend, so that’s out. And I no longer need a phone to talk to my sister since, thankfully, our families now live together.

The good news is that I no longer succumb to the insane shopping sprees that I used to years ago when I was first diagnosed. Whew! Or, at least I mostly don’t. Or, even if I splurge, I don’t spend what I can’t somehow recover. Or, like even if I spend 2 or 3 hundred dollars, it’s not like I spend money that is needed for a bill or something.

The other good news is that I don’t have those voices compelling me to do ridiculous stuff. Or at least even if I DO think crazy stuff, I KNOW it’s crazy and I don’t follow through on it. That should count for something. I guess I’m saying that I don’t have any extra diagnoses like paranoid schizophrenia. So, that’s good.

So why am I writing about this? Because even though this lithium stuff is going to help me with the depression and with the panic attacks and all…it’s not helping yet. I know it’s only been a little more than a week and I am still in the building up phase. I haven’t even been prescribed a full dosage, which I’m glad about since even with such a small amount in my system, I’m going around like a walking zombie. It’s crazy how you can still (almost) function normally, just at a very sloooooowwwww pace. I just feel sleepy and agitated that I can’t spend the day sleeping.

So, no it’s not really helping some of the impulsiveness. I know that I just finished saying that I don’t follow through on the crazy stuff. Yet twice on last week I did something unthinkable and I remember the moment in each situation where the “snap” occurred. It was like I knew both times that I had unexpectedly found myself in an enviable (yet integrity-compromising) situation. I was going to do the right thing, I think. Or at least I was telling myself that I w
ould. I want to think that I would have followed through on the right path, if it hadn’t been for that break. That MOMENT, you know. Sometimes you don’t even recognize the split second that it happens. BUT I DID. I specifically remember making a conscious decision to do what I should not.

And I did. I did what should have remained in the land of ugly possibility. And now it cannot be undone. And I don’t feel very confident that I will do better the next time. Not very confident at all.

In what ways will Lithium help me with things like this?

 

 

5

Lamictal…again

I had a truly wonderful visit with the psychologist named Camille Leaver. She was just like what you would expect: she asked probing questions, but never seemed shocked about any answers. She was non-judgmental and she–unlike Jeff Smith–was very affirming of the choices I have made over time. She congratulated me for implementing practices that help me stay fairly level and that help me cope in the event that my mood takes a dive. That was all very refreshing.

Of course I still had to go see the psychiatrist, and he was as wonderful as Camille. Even so, he suggested that I begin (or rather, RESUME after 7 years) taking Lamictal which in his professional opinion is a good proactive and preventative measure for what I might experience after the weight loss surgery. There are no guarantees that I will fall into black depressions after the surgery…but there are also no guarantees that I won’t. So, okay, fine! I got my prescription filled at Wal-mart and started taking it 2 days ago. I feel–THE SAME. Which is exactly what he expects to happen. If all goes well, I’ll just keep right on feeling THE SAME every day, which is the goal.

I’ve made my peace with the whole thing and I no longer feel like a hypocrite. Whomever feels they can judge me is welcome to do so. Like Camillle said, I have  a 7-year record of being off meds and in a year after the surgery if I want to come back off of them again, there should be no reason that I can’t. They started me off on the lowest possible dosage, and hopefully we will stay right there.lamictal[1]

2

The Irresistible Invitation

I hear your call: the invitation. Your call is insistent, almost irresistible…

and yet I hesitate,

vacillate;

hand10I see your outstretched hand, and I want to…

It’s just that I’m afraid and

hence the air of bravado, the gregariousness

that I despise in others: the stupid sham.

But I put it on anyway, even in layers.

I pretend to believe that it covers me,

covers the bruises left by emotional abuse;

the scars left by rejection.

I smile the smile that has dazzled hundreds, laying it on thick,

surprised and dismayed that it never fails to fool the rest. Aye, the fools!

The heartless fools. But you were never deceived.

I wink the wink that has smitten them in droves,

pucker and pout and raise and eyebrow: make a suggestion

that leaves them thinking they thought of it

and baby somebody’s gonna get hurt, but I’ll make sure it’s not me.

Oh, God! They don’t SEE…

But I know you see. With loving eyes

you penetrate the disguise

removing each layer (OW! Could you be more gentle?!) as I wince in pain

embarrassed and ashamed.

You don’t blanch at the ugliness, the stench of ill-treated sores.

You dress my wounds, bathing them in your tears (of joy?)

It is for this that you have called to me!

And now I recognize you for the Wounded Healer that you are.

I want you for my own!

…But you have others to attend to…

2007. Dedicated to Henry J. Nouwen, author of “The Wounded Healer.”

12

FINALLY, something goes right!

Today’s visit to the surgeon was like being in a dream!

I arrived 15 minutes early as they request that you do, and I took a number from the fancy kiosk. I never made it to my seat in the waiting area before the automated voice said they were now serving MY number at receptionist area 2. Imagine that! The receptionist got me checked in and I thought I’d take a moment to calm myself in the bathroom. I came right out, but the nurse had apparently already been calling my name while I was in the restroom! She was now waiting on me, holding the door open to escort me to the back area. Since when does anyone get this sort of prompt, efficient service in ANY doctor’s office?

She checked my vitals while we chatted. My blood pressure was a bit elevated, but not enough to scare anyone. She weighed me to see if I weighed what I thought I did. That was a no. And she measured my height to see if I’m still as short as I claim to be. I am. She mentioned the Bipolar thing in my record. I told her that I’d already made an appointment to talk with the people at The Mood Treatment Center. She said the Physician’s Assistant would be in to talk with me and then the doctor himself. All this, and it was only 10:03.

The PA checked my breathing and only gave me a quick look above the navel to see if there was anything that looked weird or anything that might pose some sort of obstructive problem to having the surgery itself. All good there. She mentioned the Bipolar thing. I told her that I’ve already made an appointment to talk with the people at The Mood Treatment Center. (Do these people communicate with each other, or not?) She said that the doctor would be in to chat with me shortly. 10:13.

So, in comes the physician, Dr. Adolfo Fernandez. He had a very comforting presence. And he seemed very comfortable in his own skin. We discussed my medical history, previous medical procedures, weight loss efforts. The wonderful thing is that despite my morbid obesity, I have no co-morbidities. This is a blessing. He mentioned–as I knew he would–the Bipolar thing. FOR HEAVEN’S SAKE! I told him that I’ve already made the appointment to talk with the people over at the Mood Treatment Center.

I think he believed that he should make sure that I knew that for my weight loss needs and goals, that I would be better off choosing the more invasive Roux-en-Y Surgery. Yes, I do realize that I could possibly lose another 15-20 pounds more by making that choice. But as far as I can see, I’d also be increasing my risk of death. So, okay, NO. The end. He was satisfied with my responses to everything and my demonstrated knowledge of the various procedures. So, basically, he thinks I’m a good candidate and all he wanted me to do is to sign a vow that says I will not gain even one more pound before my surgery. Okay, okay, I’m being dramatic. It wasn’t called a vow; officially it’s called a Weight Agreement. I feel like an idiot, though. I mean if NOT gaining any weight was as easy as signing a sheet of paper, then I would have signed two thousand papers a year, if necessary! (lol)

Okay, so he wanted to know if I had any more questions for him. Well, heck yeah! How soon can we get this party started? You know, get the show on the road! Well, he knows I’m a teacher and all, so even though it’s rare that patients get to weight loss surgery quicker than about 3 weeks after completing the Nutrition class, HE PUT INTO THE COMPUTER SPECIAL INSTRUCTIONS TO ENSURE THAT I GET MY SURGERY BEFORE THE NEW SCHOOL YEAR STARTS! He goes to the beach the 3rd week every August, so he hopes to get me in and out of surgery during the first week of August! Then I would have a couple of weeks to fully recover before getting back to work! Yippeee! Hurray!! Who will celebrate with me?

When all was said and done, including drawing the four vials of blood they need for testing, collecting my co-pay, and telling me to wait on an appointment call for a mammogram, I was on my way out of the door in UNDER AN HOUR. May all your doctor visits go just like this one went for me!

My weight today:  290.5 lbs

My height since the 6th grade:  5’2″ (well, actually 5 feet, 2 and 1/2 inches)

9

Up and Down (Part 2)

It was difficult to accept the diagnosis of Bipolar from the psychiatrist because of the way I had been raised. We come from a very fundamentalist religious background that pretty much “demonizes” every sort of illness and ESPECIALLY mental illness. I am not pointing fingers at anyone; I’m simply explaining why it was so difficult to accept. What made it worse was the way people would preach a doctrine of physical and spiritual perfection that made those of us who were still struggling in any way do the most hypocritical thing possible: hide our ailments and pretend that everything was okay. Admitting any sort of sickness or disease or disorder or habit after having professed salvation was the same as saying that Christ had died in vain or that despite Christ’s great sacrifice you are lacking in the faith required to receive the benefits. Either way, you’re a loser.

I can’t tell you how many prayer lines I stood in, each time believing that THIS was the night that I would be set free FOREVER. But as the months rolled on, each black pit of depression was blacker than the previous one. I lived in secret misery for years, still proclaiming Jesus as the healing miracle worker who has no respect of persons. I simply attributed my own lack of change to my inability to continually exhibit the faith that was sufficient to move Him. It was like being at the grocery store with .50 cents and the cashier telling you that you need $50. No matter how much you believe in her grace and mercy, and no matter how much you beg and plead, and no matter how much you seek to flatter her with praises you’re not leaving that store until you pay up. That’s the way I saw my own faith deficiency. And with each passing year, I felt more hopeless.

I took the meds. First, Lamictal at the lowest possible dosage. Three months later the psych increase the dosage. Later he added another med and then later increased that dosage as well. At the end of a year, I was on 3 different meds including stuff like Welbutrin and Abilify, all at the highest dosages. Eventually I was not myself in ANY way. I was in a distracted, agitated, sleepy CLOUD which did block out the crazy-impulse voices, but unfortunately also blocked out my own voice. I don’t remember being able to think ANY thoughts or feel any feelings except aggravation and lethargy. I remember wondering what was the point if one way or the other I was still going to feel like a miserable wretch.

Knowing that I had been advised not to ever come off all those meds without doctor approval or supervision, I still did it. My psychiatrist had told me that I would be on medication for the rest of my life, period and that we would just keep switching up and changing things until we found what “worked.” After a year, we had not found that magic combination. So I prayed that God would help me and sustain me when I threw the remaining meds in the trash. I committed to trying to live in a way that would not welcome anymore drama into my life and in return I just wanted Him to help me not to kill myself.

Seven years later, I am still alive. I try to live in a balanced way. I am thankful to have loving, supporting friendships as well as a loving husband. I work a full-time job and am working on a Master’s Degree. Until recently, I had been committed to eating well and getting lots of physical activity; things that I know have an impact on one’s ability to cope with life. Above all, I have embraced a spiritual path of meditation and have been blessed by the teachings of my guru, Paramahansa Yogananda. I give glory to God for having stabilized and sustained me thus far.

THAT’s why I was so upset about the recent Psych Eval in which he said he would not recommend me as a candidate for weight loss surgery unless I got back on medication. It’s like a slap in the face and a total disregard for my growth over these seven years.

1

Up and Down (Part 1)

In 2007 I was diagnosed with Bipolar Disorder. As a child, people called me “spastic,” and “hyper.” In my pre-teen and teenage years I would feel depressed from time to time. As a young adult the depression would be so deep that I felt I could hardly breathe sometimes.

But it was only when I was 36 that I was diagnosed. Did I suspect before then that I had a serious problem. YES. I have kept journals since I was in the 8th grade and I had an English teacher who required that we do so. It’s impossible to journal on a regular basis and not eventually notice a pattern in your moods. And yet, every time the cloud would lift, I had the insane idea that I would never again feel so much like killing myself. Can you believe I thought that EVERY SINGLE TIME?

Then my husband cheated on me. And left me and my four sons to live in the church that he used to pastor. And then I took him back after a year of praying to God to PLEASE send him back. [Yes, in retrospect I do realize just how insane I had to be.] And then I realized I’d made a mistake in taking him back and the depressive phases would last much longer. And then I decided to stay with him until I could finish college and enter the work force so that I could leave his ass. But then, years later while I was working on my Master’s Degree–which is enough to drive anyone batty all by itself–he left me for the second time.

What I’m trying to demonstrate is that I was never sure that it was ME who had the problem. I just thought my LIFE was extremely problematic. I sincerely thought that the trauma of my life (having been molested as a child; experiencing teenage pregnancy, the homesickness of living in Europe for 2 years, the poverty associated with marrying young, having four sons and being uneducated and jobless, having a husband who was a preacher, liar, and adulterer, the stresses associated with maintaining a 4.0 average in college and grad school as an adult and as a sometimes-single-parent) were causing me to be…well, you know, “up and down.”

If it had not been for the fact that I was nominated for the only full-ride scholarship and stipend given annually in the department where I was to do grad studies, I may never have even sought psychiatric evaluation and psychological therapy, much less been able to afford them. Indeed, if I had not forced by the dean to stop breaking down in the bathroom in uncontrollable crying and screaming fits, I guess I would have just continued the silent suffering that had become my life story. I would never have put myself into the category of people who have a “chemical imbalance.”

And the good times were no longer just good; they were AMAZING beyond belief. I began to feel high on life whenever I wasn’t in the black pit. And once my husband had left me I was free to experience all the “life” that I had given up after high school in order to marry him. And even more incredible was the fact that I was taking 5 classes at a time, and learning other languages and producing some the best academic writing I have ever done. I was a freaking GENIUS. All while I was losing my mind.

And then came the meds.

10

I Knew Better than to Be Honest

Damn.

I’m sorry if that word offends anyone. I am soooo not a person who goes around cursing. It’s quite ineffective. But boy, what a stressful day! With all my heart I had been looking forward to the Psych Eval that I was to be given as a first step on my journey to weight loss through bariatric surgery. But now I am so angry and confused that I just want to go to bed and get rid of this day.

I promise to write about the whole damnable experience, but right now suffice it to say that it was a freaking DISASTER. In spite of my original hesitation about doing do, I answered all the questions in the battery of tests and in his personal interview with transparency and full disclosure. End result: He wants me to go back to the same medications that I have not taken in about SEVEN YEARS and get my mood stabilized before he will recommend me for the surgery. He said that I am “obviously” Bipolar and that I manifest all the signs of being in a manic phase RIGHT NOW.

What an ugly and TOTALLY unexpected obstacle. I felt enough shame already for having to ask for help through surgery in the first place. Please imagine how I will feel if I go back to taking the same medications that I have told people ALL OVER THE WORLD that I now live without. Why do I have to be such a freaking sell-out? What a twisted, mean world this is. What I hypocrite I feel like. What I failure I feel like.

This is NOT going at all how I’d planned.