The Case of the M&M Interactions

I had a psychiatrist once tell me that the psych meds were all “M&M’s a different color”.  Doctorspeak for, “Same thing, different packaging.”  How refreshing.  At least she was honest about it and didn’t make it seem like one thing was going to be the miracle cure.  That’s now how I refer to my cornucopia of medications.  M&M’s of a different color.  I’ve got my big white ones, little white ones, my shelled white ones, the big bulky blue breathey one, and the mac-daddy of suppliments I take to keep everything else under control.

I’ll take you through a quick run-through of the normal of chronic ailments and then medications.

Bipolar II
Mood Stabilizer:
Lamictal (lamotragine) – 100 mg twice daily = 200 mg

Antidepressant:
Wellbutrin XL (bupropion) – 150 mg once daily

Sleep Aid: (insomnia)
L-Glutithoine (nutraceutical)
L-Theanine (nutraceutical)

Generalized Anxiety Disorder
Anti-anxiety (benzodiazepine):
Ativan (lorazepam): 1 mg, three times daily = 3 mg

Asthma:
Ventolin (no generic)- 2 puffs every 4 to 6 hours or as needed

Migraines:
Maxalt (no generic)- 5 mg when you feel a migraine coming on

Tendonitis of the Knee and Genu valgum (Knock Knee):
Ibuprofin – 200 mg every 4 to 6 hours or as needed

High Cholesterol:
Garlic (nutraceutical)
Omega3 Fish Oil with DHA and EPA (nutraceutical)
L-carnatine (nutraceutical)

Regular Suppliments
Vitamin C
Vitamin E
Vitamin B-12 with Folic acid
Pantothenic Acid
Bioflaviniod Complex
Bromeline 3000
Ubiqinol (I highly recommend this one for fatigue but it’s pretty expensive)
And probably like 10 others I’m not thinking of right now.

And of course, I am a woman of childbearing age, so throw in an oral, hormonal contraceptive.

Throw in 60 mg of prednizone, and a Z-pak and you’ve got a medicine soup.

Think about all of the doctors we have. Pdoc, PCP, OB/Gyn, Neurologist, Orthapedic, etc. Now, consider that despite the hundreds of times I relay the medications from one doc to another, it probably widens the margin of error.

I’m finishing this on my phone so I have to put the full link on.
http://reference.medscape.com/drug-interactionchecker. This is a comprehensive multi-drug interaction checker. Slap ’em all in there and it’ll tell you. Of course with a little doctorspeak.

Turns out azithromycin (z-pak) doesn’t play well with hormonal bc. Pregnancy risk. Hormonal bc doesn’t play well with lamictal and prednizone by increasing the metabolism rate and having higher concentrations in the blood.

Who knew?

Somatopsychic

Definition of PSYCHOSOMATIC

  1. 1: of, relating to, concerned with, or involving both mind and body <the psychosomatic nature of man — Herbert Ratner>
  2. 2: of, relating to, involving, or concerned with bodily symptoms caused by mental or emotional disturbance <psychosomatic symptoms> <psychosomatic medicine>

We hear it so often, especially when relating to depressive symptoms.  Depression hurts.  Ever heard that expression?  Probably.  That is, after years and years of being called a hypochondriac, lazy, dodging responsibilities, neglectful, irresponsible, neurotic, uncaring, inattentive, a complainer, and a flat out liar.  You might still be getting flack for that, right?  I sure am.

We’ve touched upon the issue of bipolar depression and it’s limitations at Dailystrength.org’s Bipolar Support Group and again in Blogging Beepers throughout various posts.  Bipolar depression literally destroys us both mentally and physically.  It’s a proven fact that bipolar depression and hypochondria  have nothing to do with one another.  The aches and pains are real.  The exhaustion and fatigue are too real for words.  The headaches are blinding and are just as real to us as they are to you “norms’.  Depression causes a variety of symptoms that aren’t just made up in our heads.  And they sure as hell aren’t made up because we’re too apathetic toward our own lives.

I’m a control freak, much like Mwam who writes “I Was Just Thinking…”.  I cannot stand the idea of someone else having to take the reigns of my life.  It is my body; it is my mind – I can do, say, think, whatever the hell I want.  Except when I cannot physically or mentally do the things that I think and want.  I don’t put the responsibility on anyone else.  I don’t throw my kid at the nearest person because I’m having a breakdown.  I don’t let the bills go unpaid and I don’t let my house get to the point where it would likely be condemned.  I wear my stylish clothes, dash on that makeup, and I don the smile that you trolls love so much.  I keep on moving at MY pace, where the “norms” like it, or not.

Which brings me to Monday.  I noticed that I had been losing pace unusually fast, and my physical health had turned for the very worst.  Unusually so.  I had made a recent, but passing mention of a physical illness in, “When it Rains, It Bleeping Hurricanes”.  And since “To See If I Still Feel”, I’ve been making multiple mentions of a lingering depressive episode.

I bring you a surprising answer.

Definition of SOMATOPSYCHIC
: of or relating to the body and the mind; especially : of, relating to, or concerned with mental symptoms caused by bodily illness >

Shortly after the accident, I contracted what I thought to be influenza.  It happens biannually.  This year, it was the stomach flu at Christmas, and the body flu in the summer.  The year before it was H1N1 (or Swine Flu) over Halloween and “viral syndrome” (AKA summer flu in doctor-speak because, they don’t seem to think anyone can catch the flu outside of flu season).  I hate it, but that seems to be the rhythm of circulating illness.

Anyhow, during this June influenza, I developed laryngitis, and as a music teacher, this is bad, bad, bad news.  As a wife of a man who has diagnosed hearing loss but is too vain for hearing aids, it was the most aggravating thing to ever happen to me.  99.9% of As the Pendulum Swings readers have never met me, seen my face, or heard my voice.  I am very careful to preserve anonymity.  (Yeah, come find me among the 1,223,348 people that live in Allegheny County, PA!)  I’ll tell you this.  I am a 5 foot 1 inch powerhouse of sound.  If I were a stereo, my speakers would be larger than I stand.  I don’t need a microphone in assembly halls, cafeterias, stages, or theaters.  Literally.  So having the mother of all sore throats that preventing me from speaking at all was a challenge.

But this continued for over a month.  I didn’t want to see a doctor because I knew I would get all fired up when they told me it was something stupid like allergies, asthma, cold, etc that could not account for these symptoms.  But they would.  Because I’m a big flippin’ hypochondriac.  And I would’ve been a whining drama-queen who blew my symptoms out of proportion just so I could go on being lazy.  Over the last week, though, I noticed that I started to lose a lot of traction.  My throat felt like there was glass in it, I had a half an octave surrounding my speaking voice, I was intermittently running a low grade fever, and I had a super sensitivity to changes in temperature.  I noticed my behavior changing.  I started letting go.  I let my kids in my classes have free periods.  I couldn’t go three hours with the dire need to sleep.  I let my kid destroy the house and hardly said a word to him.  I couldn’t.  My throat hurt so bad that I would only talk when it was absolutely necessary.  But when the shortness of breath came, I knew that wasn’t anxiety or any other psychosomatic symptom.  I literally wasn’t getting enough oxygen into my body.  And I started to feel it – HARD.

My husband pretty much reluctantly took me to the local urgent care after he got home from work yesterday.  He kept saying, “It’s up to you, it’s up to you.”  Manslation – I will take me if you tell me that I have to.  It turns out, I have (drum roll please!):

Walking Pneumonia!

Walking pneumonia with acute bronchitis complicated by history of asthma, as a secondary infection to influenza.  And do you know who invited this illness into my ecosystem?  It wasn’t the children.  It was the dirtiest, nastiest, smelliest, most abominable creature I have ever encountered – Rs (we’ll call him).  Rs is my husband’s estranged best friend who recently made reconciliation.  When this guy comes around, it never fails that someone becomes deathly ill.  One year, we thought he gave C.S. SARS because they both had respiratory infections so badly.  (Neither confirmed, nor denied.  No one had health insurance).  C.S. was almost too sick for our first Valentine’s Day.  The only person in my family Rs hasn’t gotten sick yet is T.D.  And if T.D. ends up in the hospital because of that misogynistic germ breeder, there will be hell to pay.

As my doctor is giving me this information, the light bulb goes off in C.S.’s head.  “Oh yeah, Rs had that about a month ago!”  Smooth operator there, Einstein.  You could’ve killed your wife who seemed like the only person susceptible to this illness!  And speaking of, how was I the only one who got any of these illnesses in the first place?  Oh yeah, because I don’t have an air conditioned bedroom, I sleep next to the fan, I spend at least two hours a day in the elements in my commute, I don’t sit at a desk all day to do my job, and I chase after a hyperactive toddler all day.

“This bleeper is going to get an eyeful when I get my phone back.”  Yes, I was sick enough to leave my Blackberry, which is normally an electronic appendage, at home on the desk.  The text message conversation looked a little like this:

So it turns out that for all of this time, this entire month, I have not been having an episode.  My psych meds were ineffective because they aren’t made to treat somatopsychic illnesses, like pneumonia caught by a music teacher who just so happens to have bipolar disorder.  Only the Z-pak, 60mg of prednizone, and sucking an albuterol four times a day is going to cure that.

I will never let anyone call me a hypochondriac again.  Eff you “norms”.

When It Rains, It Bleeping Hurricanes

I swear to {insert deity here}, it’s hurricane season in my life.

The Car Accident(s) and the Untimely Death of “Sebastian”

I had saved my pennies and nickles for over a year to outright buy my first car, my dream car.  It was a 2000 Volkswagen Jetta Sport Edition.  Ultimately, he cost about $10,000 after sale price, tax, title, and a few minor repairs.  I named him “Sebastian” because it was a tough sounding German name, just like my beautiful German car.

Friday, May 13th, 2011 – the one year anniversary of a drunk driver plowing into the front of my house, which was one of the biggest fears I had.  That day, Sebastian took his first hit in a gas station parking lot when a lady who was relying on her backup sensor hit the car twice.  It was mostly cosmetic damage, but the wheel well was pretty messed up and the bumper was pretty much falling off.

Three weeks later, it was June 1st.  My husband was on his way home from work.  He had me on speaker phone and the phone went dead.  I tried to call but it went straight to voicemail.  A few minutes later, my husband called back and the first words out of his mouth were, “I was in a car accident.”  I freaked.

Are you OK?

I don’t know.  Man-speak for “No”.

Where are you?

I think you need to call an ambulance.

I don’t think I can.  I don’t know where you are.  I don’t know how you’re hurt.  I don’t know what’s going on.  Where are you?  I need a location.  I’m coming.

I arrived on the scene and it was encircled by police cars and an ambulance.  I approached it, and caught sight of Sebastian.  My breath was taken right out of me.  The entire drivers side was crushed in.  I didn’t see my husband.  I panicked.  The officers and paramedics looked at me curiously, and all I could do was shout his full name.  He was there, sitting on the traffic island.  His glasses were missing.  He had a cut over his eyebrow.  His knee was swollen and cut.  But he was alive.  And lucky to be so.  He suffered a concussion and whiplash.

He was far from OK.  I stayed up all night to watch him sleep.  He yelled at me to stop coddling him.  I missed work to care for him.  He was not himself.  My husband, usually stoic and stable, was having mood swings.  His personality shifted noticeably.  He insisted on going back to work on Monday.  So, we ended up back at the hospital on Tuesday.  He had post-concussive syndrome, and there was no determining when he would return to normal.

(At this point, I’m thinking he maybe never did.)

The Blame Game

The police report came out on Tuesday, implicating my husband as having run the light and therefore causing the accident.  I know him.  He has been driving for many years and all of them without an accident.  He has never violated any traffic laws; not at least when I was in the car.  There is no way in hell that he would’ve missed a red light, and attempted to cross four lanes of traffic.  The police didn’t even take a statement from him.  It was biased and one-sided because no one else was harmed.

Neither insurance company could determine fault.  Neither paid out.  Sebastian now resides on my in-laws family property, demolished.  But thankfully, we have a loaner car from my in-laws.

Not Needy Enough

As I had mentioned, I was laid off for two weeks between the school year and the summer program.  During which time we had to fork out $392 for an electricity bill.  Why?  Because the local energy assistance program put a cap on their spending and our local electricity company placed us on our their “budget” program while neglecting to notify us.  Their solution?  Reduce your usage.  Supposedly, my bill would drop.

It was a lie.  Two weeks later, we received a bill for $400!  I called our local electricity company to report the error.  We cut our usage down by 3/4th of what it was.  I did the math.  They miscalculated my bill by any excuse they gave me.  It’s based on an average of the last 12 months.  Bull.  That would mean we would be paying about $300 or so.  It’s based on your usage and a percentage of your balance.  Bull.  That would mean they were charging us three times what our usage was.  They even swindled us on the cost of our usage.  We called the PUC.  Their answer?  They can charge you whatever they want when you’re on the budget plan.

I called every local charity service in the area.  No one would help because we just weren’t needy enough.  We were forced to fork over the money or get shut off.

All while my husband was flipping out and blaming me for all of the things I did to cause this situation.  Getting laid off.  Not being able to get charity help.  Not applying for public assistance.

Category 5

I had a bit of good fortune this week and was asked to work twice as long as usual on Wednesday of this week.  It didn’t come without some hefty costs.

I was invited to join a field trip to the zoo.  My task was to push a wheelchair for one of my students who had a broken foot.  Most of you have not been to the Pittsburgh Zoo, so I’ll break it down for you.  It is a very hilly and large place.  I was asked to perform this task because I am one of the younger staffers and likely the most physically fit.  I did so in 90 degree heat for four hours.  I welcomed it though.  I needed physical release and the extra hours were a bonus.  I felt good because I could allow one of my students to participate in the event.  It came with a physical toll of extreme exhaustion.  For the first time in a long time, I was glad to be home.  All I wanted to do was lay down in my bed for awhile.

When I arrived in my bedroom after wrangling my son, I discovered that the work crew had left blow-in insulation all over my room – six inches deep in some places.  I wanted to sit on the floor and cry.  Everything was covered in thick layers of it.  It took me the rest of the night to clean it all up.

I wasn’t in bed until midnight.

I was up again, bright and early with extreme sleep deprivation.  I had to keep my appointment with my psychiatrist.  I was out of medicine and starting to feel the real effects of it.  Then, I would have to rush home to have speech therapy for my son.  After that, I was off to work again.  Except, that didn’t happen.

Because of the holiday, my husband’s pay was delayed.  We had $8 dollars to our name.  And he made my life a living nightmare.  I didn’t get to my appointment.  I didn’t get my medicine.  I just laid on the sofa and cried.  There was nothing to drink in my house.  Nothing to eat.  No money to get to work for either of us.

Due to the generosity of family, we made ends meet.  But not without a hard, long struggle.

Overlooked Medical Problems

My medicine needs adjusted.  I’m not well, and I haven’t been well for a long time now.  (As I’m sure you’ve noticed by now).  My throat has hurt for over a month now and I still have laryngitis.  I’m pretty sure I have tonsillitis.  And I may have damaged my vocal cords permanently as a result.

I will never be the same if I did.  My career will be ruined.  But if I don’t get some medicine soon, I may end up losing control and ruining my life.

Distractionary Tactics

My son had Occupational Therapy today.  I attended.

It’s so difficult to look these professionals in the face and tell them all about my son’s accomplishments for the week.  I wonder if they can look at me and know.  Sometimes they ask how I’m doing, I guess to bait me.  And I hide under the guise that I’ve recently been ill.  That’s not a complete lie.  I had the flu last week and continue to have laryngitis into this week.  Do they still know?

My interactions with my family members have been strained.

My husband discovered my wounds.  There was much silence surrounding the issue.  I wish he could understand.  I wish that for a moment, just one moment, he could feel what I feel.  I want him to be able to connect with me, instead of ignoring my illness when it manifests itself physically.  I feel very alone.

My son is too young to understand what is going on.  I have been difficult with him, just as much as he’s been difficult with me.  Dealing with him in the terrible two’s when he has limited speech is exhausting and frustrating.  I wish every day that he would just wake up and speak to me.

I expect too much.

I dressed, covered my wounds, and went to work.

I was called back to teaching music in the summer program.  I’m glad for it.  I get stir-crazy when I’m home all day.  I can’t seem to find enough things to fill the day with.  I need the distraction.  I cannot be alone with myself for too long.  Except, I spent all weekend trying to find ways to get out of it.  I didn’t think I could do it.  I was in no shape to go teach elementary school children.  What if they could see the deep, dark sadness on my face?  I can’t explain that to kids.  And telling them that I’m sick won’t suffice.

I saw their little faces.  Some ran to hug me.  We smiled.  I was so happy to be back, despite the heaviness of my heart.  It was enough to pull me out of it.  For three hours, at least.

Rinse and repeat.  Until I’m once again alone with myself on Friday.