Fuck to the yes!!

I haven’t gotten a chance to post about my doctors appointment on Monday. It went fucking fantastic. When I was at my neurologist for Botox, I asked him about trying a different opioid. Not necessarily more, but something different. I’ve been on Percocet for 20 years, and I really don’t think it’s doing much in the painkilling department anymore. He said he didn’t really have any objection, but he’s never prescribed anything other than Percocet so he wasn’t really comfortable. He suggested I go to my family doc, and if my family doctor turned me down, to come back and he would do some research. Which is totally fair.

So I call my family doctor, to find out that he’s out of town on vacation and he has a locum covering for him. So I explain the situation to the receptionist, who’s known me for 15 years, and she suggested I go ahead and come in. So Monday afternoon, I went in. It took like 40 minutes before the actual appointment because they just moved to a new clinic space, and so they were taking everybody’s height and weight which was less than I thought, so that’s good, and entering everybody’s drugs into the computer. I didn’t know the dosage of most of the drugs I was on, and I offered to call the pharmacy and find out, but the nurse or nurses aide or whoever said it was fine and they would just reconcile it later.

Anyway, the locum was a young woman and I just explained exactly what I was hoping for. She offered me a stronger dose of OxyContin without the acetaminophen, and I said that I’d taken more Percocet than you are technically supposed to in the past, and I was interested in trying something new. Toradol does nothing for me, and Advil works really well, and they’re both NSAIDS. So it seems reasonable to me that a different drug in the same class might work better for me.

She said that I clearly had a long and refractory history and much as they like to not give opioids out, it seemed appropriate in my case. Then she offered me a referral to a pain clinic I’ve never heard of, where she did her residency, where I guess they do lidocaine and trigger point injections. So I left with a prescription for a summer’s worth of Dilaudid, and a pending referral.

I had a horrible migraine the next day, tied to the weather, so had a chance to try it and it’s amazing. The only problem is that it knocks me right out. Which is OK, I don’t really want to be conscious during a migraine, but it doesn’t mean that I won’t be able to work if I take it.

So I won’t have to buy sketchy drugs off the darknet after all, ha ha.

Some progress.

I saw my neurologist today and got my Botox injections (finally). I asked him what he thought about the steroids and he thought 50 mg was enough to use one time to knock a migraine out, that they didn’t have to be “stepped down” at 60/40/20 over a few days like I’d read. So he prescribed me some more prednisone. That’s fine.

Then I asked about a different opioid. He said Percocet was the strongest he prescribed and I said “not stronger necessarily, different” and he said that he actually never prescribed anything other than Percocet so he had no problem with my having Dilaudid (I mentioned they came in 1 mg which would be less than a single Percocet) but could I ask my family doctor for it, and if he (GP) said no he would do a little research.

So I called my GP’s clinic and found that my GP is actually away and there’s a “really good” doc covering for him. I told the receptionist, who has known me for 15 years now, that I needed a prescription that my neurologist had no problem with me having but wasn’t used to prescribing himself, and she didn’t think it would be a problem. So I’m going there tomorrow for that.

In the meanwhile once I got back to work I started having a truly massive headache and realized that I didn’t have ANY triptans with me or in my desk – not a Frova or a Zomig to be found anywhere – so took some CBD extract, an Advil, a Tylenol-3 and a needle full of Gravol. I could technically work from home but I’m afraid I’ll only sleep because my head hurts so much. Wish me luck.

Summer is coming

And I don’t know if I can stand another one like last year. Today’s pretty much the first day I’ve been migraine free in about a week and a half. I was flat out on the weekend, and I remember thinking on Sunday that I should get up and do some laundry or something because I didn’t exactly have a headache anymore, but I sure as hell had a headache hangover. I was trying to remember what I did last night, and of course I worked on my taxes all evening. How fucked up that I couldn’t even remember what I did 24 hours ago. Anyway, today I went to work, went to see my psychiatrist and cried talking to him the whole time, and he gave me a new drug to try, I don’t remember the name of it but it’s an antipsychotic that’s also approved as an add on for major depression and adults.

Then I went back to work, and started feeling overwhelmed and having difficulty concentrating. And so I basically was just sitting there looking at the screen for about an hour, and then I had my appointment with the counsellor and I cried really hard at him. I was talking about how I don’t get the point of being all anal about opioid addiction’s, because I don’t give a shit if I might get addicted to opioids in a couple of years, if I’m gonna fucking kill myself right now because I can’t stand the thought of being in pain for more than 15 days in the month.

Has my head ever not hurt?

My mood is better than January. That’s pretty indisputable. I don’t feel like I have anything to live for, but I’m totally not in a headspace where I could commit suicide right now. So I’ll just stumble on, because I’m sure the depression will overtake me again in a year or two or three..

In the meantime,  i’ll just enjoy my head hurting every single fucking day. I got the pharmacy to fax my neurologist to ask for a refill on steroids, but he wouldn’t give it to me. I see him in two weeks, so hopefully I can talk him in to more. Otherwise I’ll just order them off the Internet. I really don’t give a fuck. They’re harmful for long-term use?  I super don’t give a fuck about that. My head hurts now. My migraines are affecting my quality-of-life now. So I can’t really be invested in something that’s not supposed to matter until years from now.

I need something to live for.

I’m lonely as fuck. I’m straight up scared that no one will ever love me again. It’s been three years, and I haven’t gotten as much as a second date.  We did an exercise in group a few days ago about how balanced our lives were, and I got all teary because it asked about whether we get hugs or physical affection, and no, I don’t. No.  I could certainly go and pay the professional cuddler to hug me, but…

I don’t understand why when there are people less attractive than me and less healthy than me and they’ve got themselves relationships… why do people tell me that I should be happy being all by myself first and only then do I get a crack at another person? If you had to be perfect by yourself first, I think a lot of the people in relationships would have to be single.

and it’s just loneliness on a really basic simple level that I can’t seem to get across to healthcare providers. It’s chatting about like what looks like it might be good and what looks like marketing bullshit in the grocery store. It’s having someone to text to say that you’re leaving work and on your way home. It’s having someone to give you an ice pack when you have a migraine.   It’s not necessarily the sex with fireworks and the dramatic stuff that you might think of about relationships.

My job isn’t important enouvh, and it doesn’t pay enough, for it to be a reason to live.

So starting tomorrow I’m going to microdose on mushrooms. We’ll see how that goes.

 

 

Modafinil and I don’t get along.

So despite feeling like I had worked a 12-hour day when I had only put in 6 hours, I am still awake now, well past my bedtime, because my heart is pounding. It’s going at like 105 beats per minute (I have a cardiogram app) and I haven’t had caffeine for hours. Since I didn’t feel drastically energized anyway, there’s no use in taking it tomorrow and so there goes 40 bucks on a useless prescription.

Pharmacists can be your best resource… or not.

So I’m sitting here at the pharmacy, having gotten here for 10:00, and I’m “helped” by this gal I have dealt with before. She refused to change my Zomig prescription to the oral dissolving formulation once even though another pharmacist had done it for me before.

I put my prescription on the counter and said “I need to wait for this, please,” and she said “When would you like to pick this up?” like she hadn’t heard a word I’d said. Then she snapped “It’ll be a half an hour,” as if that would deter me. Bitch, if I leave I may not pick this up for days, that is why I need to wait. Maybe if you connected the long list of psych meds I have had filled here to my asking to get these now, you could actually be helpful!

I actually dropped a glove on the way to the car but I thought if I went back to retrieve it I’d go back to bed for the day, so I left it. Luckily it was a dollar store glove. I’m poorly dressed in a short sleeved T-shirt and wool coat, and wet hair from the shower I managed to have, so I’m really killing it today so far. Yuck.

Not sure of my feelings (expanded.)

I had my appointment this morning. It went well. I really don’t know how I feel now, because I didn’t cry during the appointment, and I didn’t cry on the way to work, so does that mean I feel better? Or not? In a way I am going to be pissed if I feel better – I feel I’d promised myself that I wouldn’t go through this again, and I was at the perfect intersection of mood and energy back in December, but didn’t do it because I wanted to give my family a good Christmas. And that’s fine and dandy but all I can think about is that there hasn’t been much that’s happened in the last 3 years to make life worth living, so will I be looking back from the future with regret that I stayed?

I apologized to the psychiatrist for being pissy before Christmas and he said it was okay, and that he’d been worried about me.

He asked if I’d been able to continue taking the lithium and I said I’d stopped two days ago because of the meth-head skin breakout, the shaky hands and the nausea and he said “Okay. So you weren’t tolerating it. Let’s discontinue that then.” I was relieved  – I feared he might argue about how I should’ve kept taking it until I saw him, or that I should stay on it to see if the side effects subside. He is easy to talk to and reasonable, so I am going to try not to freak out as much before appointments. It just seems like such high stakes – 20 minutes to guide the next few days or weeks of my life.

He said he thought MAOI’s might be a good choice for me, but I would have to stop taking my existing antidepressant for two weeks. He gives a complete rundown of his logic, like he explained how his patients have responded to it, what the tyramine restrictions were, etc. I said that two weeks of nothing seemed like a terrible idea, as I thought the imipramine was keeping me going enough to stop me from crying in bed all day every day. He said possibly we could do the ketamine during the initial 2 withdrawal weeks but I would have to be an inpatient. He explained that there just wasn’t a protocol in place to do the ketamine on an outpatient basis, although they sometimes got around that by giving generous “passes.” Also the ketamine maintenance can be done as an outpatient – 45 minutes for an infusion. 

Anyway, he wants to try me on a different stimulant – modafinil – that has great reviews on drugs.com as an antidepressant helper, and I’ve an appointment for a week from now.  He said I should feel the effects of the stimulant right away, like he same day, as it doesn’t take weeks to build up levels in the blood or amything, and I feel good about that. I think he gets that I am running out of patience and couldn’t handle a wait of weeks. I will definitely know if it is working by next week, too, and then I think I am coming around to the idea of ketamine. Now would be a good time to take the time off work, and then maybe all I’d need were the MAOI’s… and if not I’d be set already for ketamine maintenance. I just want to get it under control one way or another!

After only 3 hours of work today I left early as I was fried and getting a migraine, so I didn’t fill the prescription, I will have to do that tomorrow morning.

 

 

 

Damned damned needles.

I am so nauseous (apparently a side effect of lithium.). I had to call the pharmacy three times before I actually got to speak to a pharmacist, who’s going to fax my psychiatrist to see if he will write a prescription for a lower dose. In the meantime, she said I could take Gravol, and I had one injectable dose here with me (pre-filled needles, for migraine) so I went to the washroom here at work and the fucking needle fell apart when I was trying to get the air bubbles out. So I found some chlorpromazine in my bag and fell asleep for 5 or 6 hours, then I woke up (a nightmare I think caused it) and here we are.

Anyway I am not gonna take the antidepressants or lithium tonight and try to remember to pack more Gravol in my purse tomorrow morning. Good times.

Ketamine.

In November I started to feel Capital-D Depressed. Psychiatrist advised Getting Out More and Doing Fun Things. He spent 45 minutes with me and I left all motivated and  actually did a bang-ass job of arranging a ton of things to do and followed through with all of them, but didn’t enjoy them.

That was kind of a scary feeling, like the pit of your stomach dropping, or when your mouth gets hollow and watery before you throw up… in the summer I’d been able to think that things would get better as soon as my migraines settled down.  September and part of October were lovely; I got the house put back to rights and felt really good about it and knowing that I had the desire and the energy to keep  things up, and that it really was my migraines that had been the reason things got behind.

Then in November, after my appointment, I thought it was reasonable that I was bummed as I hadn’t done anything but work lately, and that I would feel better once I got out and was more active.  When I was out, and didn’t feel enjoyment, it was strangely alarming in a way; as if I was looking down at a bone I’d broken without feeling pain…like I know I’m supposed to be feeling something, and it’s just missing. I’m doing The Right Things, and nothing is happening!

I reported back to my psychiatrist and cried during the entire appointment. He wrote me three weeks, no refills, of a new prescription, for a new not-covered $100/month antidepressant (that I’ve now been on a week and a half.)

“Suicidal thoughts?” he asked. Yes, of course I’m having suicidal thoughts, if good things feel like nothing and regular things hurt and bad things feel awful I think it’s probably normal to… so I replied “Uh… 6 out of 10?” between sob-hiccups.

So then he talked about going into the hospital for two weeks of ketamine as a possible next step. “Have you heard of ketamine?” he asked me. “Ketamine?! Like, the street drug??” I said. “Yeah, they call it Special K,” he replied, and explained that apparently it works super fast, like within a couple of hours, and has had good results for bad depression. I had never heard of it having a legit use, but I guess it is popular as a recreational drug (helloooo blog readers who got here that way.) It is dissociative, which frightens me because I’ve had bad acid trips and don’t care to have one again, thank you… and wouldn’t a hospital be a perfect setup for a bad trip?! I also wonder if that is why I’ve read of shrooms for depression… maybe there’s something about psychoactive drugs that makes the brain really happy.

Anyway, I think this new antidepressant is helping a little, in that at least I’m not crying in public, and am getting to work for minimum hours – – there’s a lot going on in my head but I’m too tired (me, the original night owl) to write about it now.