Good Morning Sunshine

This is more of a note for myself than a blog entry, but anyway…

Talked to Dr. L yesterday afternoon. He’s concerned about my sleep - haven’t been sleeping - can’t fall asleep, can’t stay asleep, then can’t wake up in the morning once I finally do get to sleep good. Falling asleep at my desk. Said that we need to get the sleep stuff straightened out so we can see what the Luvox is and isn’t doing as far as mood is concerned.

He recommended taking hydroxyzine for sleep and Focalin (stimulant) to help me be alert/wake up in the daytime. He said he doesn’t like doing “uppers and downers” but that we need to re-regulate my sleep-wake cycle as best we can right now.

Took 25mgs of hydroxyzine last night, then another 25mgs after an hour when I was still awake. Slept fairly soundly for about 8 hours, but could barely pull myself out of bed this morning. Took Focalin once I got to work, and it’s been 1.5 hours and I’m falling asleep. Seriously. I keep nodding off and typing the wrong things when I do.

So, wondering if I need another sleep study. Something is not right. They (not Dr. L, but my other docs) thought I had sleep apnea a few years back, but I didn’t, nor did I have restless limbs. The docs said I had a large percentage of alpha-delta sleep, which they described as not getting enough deep (REM) sleep - my deep sleep cycles are very much interrupted, so my body isn’t resting adequately. They recommended Ambien, or warm milk (I kid you not).

Just heard back from Dr. L. He’s going to send me for a sleep study at a place in Durham.

You know - it would be easier if I did have sleep apnea. At least they know what to do about it. And what I’ve heard from others who have it and start using a CPAP machine - they talk about how amazing it is to finally feel rested.

That certainly would be nice.

no strep. Viral, is what the doc thinks. Which I expected. So, probably been taking antibiotics for nothing at all. Joy joy. And my ear and throat still hurt. Lots of fluids, they said. Tylenol or ibuprofen for pain. It will just take time.

I have so much of that.

I didn’t sleep much last night. Was SO tired, so I went to bed early (for me - about 8:30!), and went to sleep pretty quick, but started waking up at around midnight. Then, at 1:30 a.m. or so, I woke up, went to the bathroom, and couldn’t go back to sleep. At all.

I tried all the things that I knew to try. Finally, at around 3:45 a.m., I took a shower and went and laid back down, and finally went back to sleep. Up at 6, then back to sleep for a bit longer. But when my alarm went off at 7:30 or whatever time I had set it for, I could not pull myself out of bed.

I’m at work. Half asleep. Ear hurts. Only two more days of antibiotics, so not sure when this is supposed to go away. Feel like I’m in a daze. Soooo tired. Can’t think. Have tons of work to do, and just hoping I can stay awake today.

I’m also clammy feeling. I don’t know what the problem is anymore.

Waiting for my psychiatrist to call me back. Will page him again soon. The meds are not working, and I think the increase in fluvoxamine *may* be making me more agitated. I’m not seeing much of the silver linings right now.

I’m going to look at a place on Friday that is *very* convenient and in a decent area. It’s not perfect, but it would be better than any of the other options that I’ve considered thus far.

Was going to see a place tomorrow (Thursday) afternoon, but forgot that I have to take pictures at a lecture one of the professors here is doing. No big deal anyway, as I had already decided that I didn’t want to live there. Scary…

Today is May 14. I now have 2 weeks and 3 days left to find a new home. I am continually amazed at how ridiculously expensive Chapel Hill and Carrboro are, and how much these towns cater to student renters. If you are not a student and don’t want to live like a student, well, you’d better make a lot of money because otherwise, your options are severely limited. You could (a) find a roommate and rent somewhere more expensive, (b) live in a bad part of town for cheap, (c) move out of Chapel Hill/Carrboro.

I’m also amazed at how crappy almost all of the apartment complexes around here are. They are all old. They are all tenderboxes. Many of them are in bad neighborhoods (i.e. higher crime rates). Most of them will cost you $$$ in utilities, which defeats the purpose of offering cheaper rents. You’re gonna pay more anyway. Most of the apartment managers around here get thumbs-down approval ratings too. It’s ridiculous, but they can get away with it because it’s a college town, I suppose.

Finally, I’m amazed at how few places are truly “pet friendly.” This town is pretty big into pets, at least from the looks of the numbers of vets in the area and the numbers of people you see out walking dogs. But there are *a lot* of places that don’t allow pets, and pretty much nowhere allows more than 2 animals, with limits like “60 lbs. combined weight maximum (full grown)” and various breed restrictions (no Akitas, German Shepherds, Great Danes, Rottweilers, Dobermans, Pit/Pit mixes, etc.).

I hate breed restrictions. I wish there were more responsible pet owners so that those breeds didn’t have such a bad reputation. It’s a shame, really.

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I wish gas wasn’t nearing $4/gallon so that it wouldn’t be as painful to commute. I wish there were more “okay” places and fewer scary looking places near campus. I wish there were better options in apartment complexes. I wish I made enough money that finding a place to live would be easy. I wish I didn’t have to lie about my pets and could claim them all instead of just the dogs. Not that I’m getting rid of the cat. What the fuck ever.

Not chemistry class. Not chemistry.com. Brain chemistry.

It is 3:42 a.m., and I am blogging. On a Tuesday morning.

Ah, the wondrous world of depression.

A big indicator of something being “off” with my brain chemistry is insomnia. Particularly episodes of early morning wakening. I’m wide awake right now. Was sound asleep just a short while ago.

I’m also starving. My stomach is growling. My appetite has picked up a bit, which is not a good thing, and which is almost certainly due to the increase in fluvoxamine (Luvox).  Which sucks.

Did I mention I gained ~70 lbs when I first started fluvoxamine? At the time, it was a matter of fluvox being the only drug that helped alleviate my depression. The weight gain sucked, but it finally tapered off, and my doc and I decided that the side effect was outweighed (ha) by the benefits. Other than the initial weight gain, it’s been a good med for me. Doesn’t make me woozy on the occasion that I forget to take it. Didn’t cause withdrawal when I went off of it for a while after being emotionally stable for a good period and deciding to take a chance. (Not a chance I will take again anytime soon, let me tell you.)

I didn’t expect the hunger from the increase, but I can already tell, and it’s only been about a week in. Not sure what to do about it, except try to battle the hunger and not give in, or lower the fluvox and add something else (Geodon?). As the depression is not so severe right now, perhaps it would be worth trying something other than increasing the fluvox. Note to self: page Dr. L tomorrow…

Fluvoxamine does not list weight gain as a typical side effect, or at least it didn’t last time I checked. But, anecdotally, it’s common. So, I don’t think I’m imagining it.

Oddly, I’m feeling fairly optimistic here in the wee hours of the morning. Which is another common symptom of my mood disorder. Once I am able (hopefully) to go back to sleep and wake up at a normal hour, I likely won’t be so optimistic.

Hmmm…wondering if the fluvox is spurring a slight hypomania. Wouldn’t be the first time I’d experienced that. If only I could be so focused and awake during the day.

Okay. I think I’m getting a bit sleepy again. Going to try to get a few more hours before I have to get up and go to work. Eek. Already feeling not so optimistic. :-/

Feel free to skip this whiny post.

Throat still hurts. Doctor appointment this afternoon at 3. I like my doc - I hate her office. You have to jump through too many hoops to get an appointment. You have to call and leave a message for the nurse, wait for the nurse to call, explain your problem to the nurse, wait for the nurse to talk to the doc and call you back. And then (so far) the appointments are in the afternoon. So, if you’re sick, like I am, you still have to wait all day to go to the doctor.

Anyway, my right ear is aching too. I hope I don’t have strep, or maybe I hope that I do, because at least then there’s something she can do.

Started coughing last night. Can breathe fine, unlike last time I was sick, but my trachea hurts. The cough is not very “productive” and very hacking/barking. Not the worst I’ve ever had, but with my throat already being sore, it seems worse.

Worked all day yesterday for commencement. Tried to stay out of everyone’s faces! Had to be there to take pictures - I’m afraid they didn’t come out as good as I wished. Haven’t looked at them up close yet, though. I think the lens that I was using is messed up - I don’t think the autofocus is working very well. Hopefully, they’ll be okay as long as they’re not blown up. The flash gave a glare, so I was using a high ISO setting, which makes the pics grainy too, but at least the color was better. It’s a trade-off, really. My favorite (work) lens doesn’t zoom - it’s a 50mm - but it has a really fast shutter speed, so works well in low light. I needed a wider angle lens for the commencement pictures, though, but switched to the 50mm for the reception. Commencement was short this year, and not too many grads. Hopefully that will change in the future.

Still don’t know where I’m going to live come June. Have an appointment on Thursday to see an apartment in Chapel Hill. Sounds like a good deal, and the landlord sounds pretty thorough. Was upfront about the three pets (so many places are maximum of two pets…), and apparently he doesn’t have an issue with it. Of course, I’ll have to pay pet fees, again. Wonder how long it’ll take me to get my deposit back for where I’m living now. It shouldn’t be a problem, but, well, we’ll see.

Penny had her teeth cleaned on Friday. The vet said she had no evidence of periodontal disease, despite her age, amount of tartar, and being a small dog (small dogs are more prone to teeth problems). The vet that did her cleaning was not my normal vet, but I do love them. They are very thorough - x-rays, before and after pictures, lots of monitoring, etc. The vet techs are all certified (which is not required of vet techs), and they are soooo nice. When I went to pick Penny up, she was behind the front desk with the receptionist, just hanging out. They even trimmed her nails for me, and didn’t charge me for it. I just wish they weren’t all the way in Durham.

Once I file my taxes (hopefully soon!!!!!), I’ll schedule Pud for her cleaning. I chose Penny first because (a) she’s older and I was worried about the anesthesia, and (b) I thought perhaps Pud’s would be more expensive and I wasn’t sure I could afford it right now. I need to go ahead and file my taxes.

Sick. Again. Sore throat. Slight fever. Bit congested. Mild Cough. Mainly, sore throat.

Commencement is tomorrow. It is now 6:14 p.m. on the day before Commencement, and I have so much to do. Was going to do much today, but slept all day. Why? Oh yeah, because I’m sick.

Was a bit of a wreck on the phone with my grandmother last night. Ended up taking something to help me sleep, which is usually a mistake. It was. Then we had a nice thunderstorm around midnight with some good-sized hail. I haven’t seen hail in years and years. It was wild. Went to bed. Got up this morning at 7 a.m. Took the dogs out. Went back to bed. Got up, ate breakfast, took ibuprofen, went back to bed. Didn’t wake up until nearly 6 p.m.

Still feel drugged. Amazed that my fingers are working to type, frankly, because I can barely walk in a straight line right now without feeling like I’m going to fall over. Took dogs out again. Have to go take a shower, get something to eat. Wake up. Need to be able to get some work done. No fever right now, I don’t think. Throat still hurts. Day three of that…

Shaking. Hands shake if I don’t keep them resting on the keyboard.

Got to make it to the office for a bit today if at all possible. Feeling very unappreciated at work right now. Very little motivation. Was going to take Monday off, but can’t because things need to get done. Frustrated. No energy.

Feeling weak. Tired and drained and just weak. Need to call Dr. L again because the meds aren’t working. Not feeling very together right now. Don’t know where I’m going to live at the end of the month, and it makes me want to cry.

Hoping I can stand up long enough to take a shower. Maybe I should eat something first…

Went to the new psychiatrist today, Dr. C. She’s nice, but she’s definitely NOT a med person. Yes, she has a medical degree. Yes, she’s a physician specializing in psychiatry. She’d probably be a better therapist than psychiatrist. I think that’s what she really likes anyway, based on some of the things she told me today. She said she’d wondered why she didn’t just become a physician’s assistant instead of going to med school and then having to do a residency.

Okay…

We were talking about my desire to go to medical school and to become a psychiatrist. She was saying that there are other ways I can do therapy. That’s what she normally does - therapy supplemented by medication.

I have a therapist. A therapist I’m very fond of, actually. I need someone who does medication management. Not that a psychiatrist doesn’t need to know her patients, but she needs to take a more scientific, medical approach to treating mental illness - that’s kind of the point. Yes, psychiatrists can do therapy (though they’re not necessarily taught *how* in medical school), but they are MDs so they can prescribe medication. If they’re not interested in medication management, they should’ve gotten PhDs or MSWs and chosen a career as a therapist, not a psychiatrist. Psychiatrists who aren’t good at medication management (most of them) are doing a disservice to patients who rely on them for mental health treatment.

I told Dr. C that I like psychiatry because I *like* the medication aspect of it. It is fascinating to me. I know for a fact that psych medication works, and I’m amazed that it works as well as it does considering how little science knows about the brain. I want to know more. I want to learn more. I want to be able to help people with mental illness through medicine, not just psychotherapy.

So, I’ve been reminded of why I don’t like most psychiatrists. Most psychiatrists, it seems, aren’t much more up-to-date on the latest in psychotropic medications than most general practitioners. It’s very frustrating.

Anyway, I decided to page my former/current/long-time psychiatrist, Dr. L. He called me and, um, did exactly what I thought he would do - he bumped my fluvoxamine (Luvox) dose a bit. I’ve been on a pretty low dose for a while, but fluvox has been a good drug for me (minus the initial weight gain), and bumping the dose back up a bit makes sense. I had thought about just doing it myself, but figured I’d better check with the good doctor first. As much as I hate the fact that Dr. L moved his entire practice to Charlotte, the fact is he’s brilliant at medication management. He knows the drugs and the brain inside and out. And he knows me and my history.

Dr. C wrote me a script for clonazepam (Klonopin), a benzodiazepine. I’ve only ever taken one benzo - Ativan - that did me no good at all. I told Dr. L what Dr. C had prescribed, and, as I suspected he would, he said he’s not a fan of clonazepam, that it’s one of his least-favorite drugs. It’s one of Dr. C’s most favorite drugs. Hmmm…

Anyway - for the time being, I’m going to keep letting Dr. L manage my meds while I look for someone else local who knows something (please!!!!!!!) about psychopharmacology, particularly for patients with complicated medication histories and treatment-resistant mental illness. Like me. I don’t have much confidence that I’ll find someone who is actually on my insurance, but hopefully I can find someone. Someone competent.

Someone who knows that bupropion ER is the generic for Wellbutrin SR, which Dr. C wasn’t aware of, apparently. Jeesh.

Reminds me of the psychiatrist who treated me the time I was hospitalized, Dr. N. He tried to tell me that one of my meds, Lamictal, wasn’t yet approved for treating mood disorders, nor was it a good first choice for a mood stabilizer.

It had been approved for treating bipolar about 2 weeks before I went into the hospital. The day I was released, when I met with Dr. N for the last time, he told me that he had just gotten the letter saying it was now approved for treating bipolar. I said, “Yeah, two weeks ago.” At least he admitted that I was right.

I voted this morning. I’m keeping *who* I voted for to myself. I think I felt prouder of doing my civic duty today than I ever have, because this is the first time that I think my vote really mattered. I wish North Carolina’s primaries were this important in every major election year.

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Got a flat tire on the way home last night. Went to my therapy session and was going to run errands, but had a call from my apartment management folks saying they wanted to come over at 7 p.m. or so to measure stuff in the kitchen. Um…okay….

So, I went home, but some guy waved at me to let me know that my driver’s side front tire was flat. By the time I found somewhere to stop, it was really really flat. Really really. So I called AAA and they came out and put my spare on. Came home and the people came shortly thereafter. I just stood outside. They gave me all of an hour and a half notice. Joy.

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Ended up getting a new tire today because my tire was damaged from riding on the rim. I just bought those tires, but had to get a new one. That sucked.

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Random people in my apartment right now. When I got home tonight, the owner of my triplex building knocked on the door and said, “I’m the owner. Did so-and-so tell you that we’d be stopping by to measure things tonight?” I said, “No….” He said, “Oh, I’m sorry. Well, the contractor is meeting me here and we need to measure things in your kitchen.”

I was on the phone with my old psychiatrist at the time.

I put the dogs and the cat up, and he and three other men are finally leaving now, after looking in my kitchen and bathroom. I hope I flushed the toilet. Not that I really care. My bathroom is a mess.

I have to find a new place to live by the end of the month. My lease is up at the end of May, which I knew, but when I signed the lease, they said the owner was planning to sell these places. Then, they said he’d changed his mind and I could stay. I got lackadaisical about looking for a new place. But, guess what? He’s still selling. He’s just going to renovate first, turn them into “condos” and sell each unit individually. I can’t afford to buy, and probably wouldn’t buy a unit in a triplex even if I could afford to buy.

So, got to find a new place to live. And move. Before June 1.