Tag: Concerta

The Drugs Don’t Work

Now the drugs don’t work
They just make you worse
But I know I’ll see your face again
The Verve, The Drugs Don’t Work

Dear Internet,
Ritalin, Concerta (32mg and 54mg), Adderall, and Focalin.
To give you a brief idea of the foray into my brain has been like, in the last five months, I’ve cycled through the above and received well documented and undocumented side effects for my efforts. Focalin, the latest drug, pushed me to the edges of paranoia, anti-socialism, and rapid/cyclic impulse thoughts.
I would not classify myself as being an introvert or extrovert, I seem to be fluid between the two, but on Focalin in social situations, I was always scamming to get a way out. I would wall myself up internally so that even the most banal small talk would be difficult. I would come off as standoffish, an asshole, or just plain weird.
People in my space made me nervous. People taking up time I had allocated for another task, irritated me. Music, I realized today, was not listened to because of depression, but because it moved the focus to something I didn’t deem as being important instead of allowing me to work on the task at hand.
I was sharp around the edges.
We could have the most innocent of conversations and I would take great umbrage at any perceived slight I felt thrown in my direction. Then I became hyper-sensitive to this behavior and had to monitor all written and verbal conversations to make sure I didn’t fuck shit up.
All of this defense and protection is exhausting.
Being crazy is exhausting.
Tonight I told my medicating therapist I took myself off of Focalin, and as of the Tuesday, I’ve been free of legal meth for 5 days. I’m still on lithium and will remain on lithium for as long as I live, but for now I need a break from the ADHD drugs. At least not take them on a regular basis.
He agreed.
The medicating doctor thinks this is all rapid signs of over stimulation. I am not going crazy, well not at least yet. The doses I was on for all of the drugs were of the lowest dose available. Ritalin works, but on occasion and for a few hours, and any attempt to prolong the drug doesn’t work. Good when I need to work at home or want to sit down and write, but I don’t think, at this time, I want to be on an ADHD drug permanently.
Since I’ve built my own coping skills on managing ADHD all these years, although haphazardly, I’m going to research for resources of tried techniques to help compensate so that the Ritalin will be last case use, not first in hand. I’ve also started my meditation in the morning to calm my mind.
In the last five days, the amplified symptoms have calmed and started to leave. Now I hope to find only peace.
x0x0,
Lisa

Collectioun of Cunnynge Curioustes: April 6, 2013

Johann Georg Hainz's Cabinet of Curiosities, circa 1666. Courtesy of Wikimedia Commons
Johann Georg Hainz’s Cabinet of Curiosities, circa 1666. Courtesy of Wikimedia Commons

During the Renaissance, cabinet of curiosities came into fashion as a collection of objects that would often defy classification. As a precursor to the modern museum, the cabinet referred to room(s), not actual furniture, of things that piqued the owners interest and would be collected and displayed in an aesthetically pleasing manner. Collectioun of Cunnynge Curioustes is my 21st century interpretation of that idea.
Dear Internet,
I’m going to stop saying this week was, $insertdramaticadjective here, every week and just accept the farce of my life. But at some point, I think I would settle for just a week where everything is stable in some capacity or form.
This week, I am trying a new ADHD drug called Focalin, which isn’t too bad actually. It’s way more potent than Concerta, which is awesome, and it’s not filled with crazy producing side effects like Adderall, which is even better. My mood has been pretty stable so emotionally I’m feeling pretty good.
Outside of that scope, however, things have been slightly, “Jesus fucking christ!” producing. My Macbook Air, Bawdy Wench, died last weekend and after two trips to the Genius Bar, hours spent attempting to fix it by TheHusband and myself, a host of unicorn blood spilled – nothing worked. I specifically name what type of laptop not because I’m being a pretentious douche (well – you got me.) but for those who are tech centric will know that the diagnosis is either the hard drive (which is a SSD) or the logic board. But it is not clear if it is one or the other. If you buy a replacement logic board for $300 or so bucks — which are only available used or refurbed — and that doesn’t fix it, then you spend another $300 or so bucks getting a new drive and hope that fixes if it. If you’ve bought both and it’s not fixed, not only are you out of about $750, but you have a dead Mac still and by  that point, you might as well have sucked it up and bought a new Mac.
All of this happens a month after the warranty had expired and as such, I could not buy AppleCare to get it covered. So we had two choices: We can spend a flat rate $280 and send it to the Apple Depot where they would fix whatever was broken (so if it’s the logic board AND the drive, both would get fixed for $280) OR I can buy a new Mac. We went with the $280 fix.
TheHusband and I talked about selling the dead Air and the held together by string Macbook Pro that I use for my desktop to Gazelle and using the cash to fund a new, better machine but we opted against it. Medical bills from all my surgeries hit us harder than anticipated and I’m just thankful we had the $280 to fix my laptop.
Since the discussion of Macs brings out STRONG FEELINGS in people, you can at least acknowledge TimeMachine is a most glorious invention. My drive was backed up to the minute before it died and everything is safe.
The lack of laptop hit harder than anticipated – namely that in the early evenings, I usually start needing to elevate my foot and the only way to do that in some form comfortably is in bed, with my laptop on my lap. No laptop means that a lot of the work I was planning on doing this week didn’t get done. I have an iPad, with a Bluetooth keyboard, but that does not have the same power or options as my Air.  Less browsing and working on writing projects, more TV watching. I’ve been spending the nights mainlining Veronica Mars and attempting to keep a Zen attitude about everything (it mostly working).
You may notice I’ve started appending “This day in Lisa-Universe in:” at the end of posts with dates (sometimes) after it – as I start adding the back content, I’m now linking to that content in current posts. That has been entertaining to read.

Writing

The Lisa Chronicles

Watching

  • Doctor Who
    Second half of season 7 has started. Fantastic!
  • Game of Thrones
    Season 3 has begun.
  • Veronica Mars
    Recently I mentioned there was a Veronica Mars movie Kickstarter in progress that I think I may have hyperventilated when the goal was reached in a scant 11 hours after launch. Since that day, I’ve been humming the theme song in my head almost non-stop, which moved me to discover Netflix no longer had the show available on streaming, NOR was it available on Hulu or Amazon streaming services. So I did what anyone else in their right mind would do: I bought the DVDs. Now you may say to yourself, “But Lisa! You said you were not going to spend extra money this year!” I’ve been 86% keeping that promise – except for red lipsticks and Veronica Mars.

Weekly watching: Formula 1, Vikings, The Vampire Diaries, House of Lies, Elementary, Spartacus, The Americans, Archer, and Project Runway.

Links

What have you read/watched/listened to this week?
x0x0,
Lisa

This day in Lisa-Universe in:

Wolf who fills himself with all who die and will swallow the heavenly bodies

Dear Internet,
Sometimes there are no words to express what is going on in my head, so I’ve made the executive decision to use animated gifs instead.
David Tennant Crying in the Rain
The last few weeks have been a shit hole of catastrophe in my brain.
When I started back to work after my lay up, Dr. H. was of the mind that since Concerta only seemed to work some time, I needed to try something else to find something that worked all the time. The following Monday, I went up to two Adderall XR in the morning, with no effect. Spoke with Dr. H. that evening and he moved me back to Concerta 36mg. Tuesday was fine. Wednesday, I was an idiot and accidentally took double my Concerta dosage in the morning, so instead of 36mg, I was high as a kite on 72mg. I immediately dosed myself with Klonopin to keep me more even and brought the bottle with me to work.
By mid-day Wednesday, I was quietly having a meltdown in my office. I was reading something about something and got so intensely frustrated, I wanted to start punching holes in the brick walls. I kept myself together by duct tape and string. Thursday, my dosage was normal but I was so tired, I broke my no-caffeine rule and drank a Coke that evening to just get over the hump. Friday was much the same as Thursday. Saturday, I was heading to MSU as a panelist at the MSU Comics Forum.
Even after taking my regular dosage and my lithium early on Saturday morning, I could not function. I had to drink a Coke to keep awake to drive to Lansing and by the time our panel came up, I was manic in my head. Kristin and I were supposed to head to Gizzard City for dinner but I felt so whacked out, I didn’t know if I could make the 1/2 hour drive to the restaurant  eat, and then drive home. So I bailed and drove home on a wing and a prayer.
Sunday was glorious. I felt like my body had finally been reset. Monday, I spoke to Dr. H. and he was concerned about Concerta’s effects during the week so we’re going to try Adderall XR again except this time, we’re going to split the dose: half in early morning, second half later part of the morning. Makes sense. I’m on spring break, let’s give it a try.
Didn’t work.
Not only did the Adderall XR do nothing for me, but it turned me into this moody, depressed, state of an animal. I didn’t want to leave the house, I didn’t want to hang out with friends, I didn’t want to do things with my husband. I just wanted to wallow in bed and watch terrible TV.  So the long ago set plans to do something on spring break week were all mostly broken. When I was feeling up to doing something, it was mostly writing and working on my cadre of websites. Except, there were massive problems on my host providers end and my website couldn’t stabilized all fucking week. 504 and 502 errors all over the place. Which wasn’t super helpful when this happened:
amandapalmerRT
TheHusband wanted me to stop taking the Adderall XR and I refused. I had to see if I could finally metabolize the drug AND I had a phone appointment with Dr. H. on Friday (yesterday). I’ll be fine.
Except, I wasn’t.
During my phone consult on Friday evening, I was nearly hysterical. Dr. H. had no idea why this was happening because chemically, Adderall XR isn’t supposed to effect serotonin levels. But obviously something was happening because it was fucking mess in my brain.
Here is how it is supposed to work:
I take Lithium (1200 mg, half in the morning, half at night) as a mood stabilizer.  With my mood stabilized (and I get blood drawn to check my Lithium levels every couple of weeks), the ADHD drugs work better. If I feel too amped up or I can’t sleep, I take Klonopin as needed. When the ADHD drugs don’t feel like they are working, then we ramp up the Lithium. Except now I’m at the therapeutic levels of Lithium (known via the blood tests) so I can’t amp that up, so we have to work on the ADHD drugs.
Or go on anti-depressants for more stabilization to make the ADHD drugs work better.
Which I’m rejecting.
A decade or so ago, I was seeing a medicating therapist when I lived in DC area, who decided to cycle me through almost all known (to her) permutations of various SSRIs/Anti-$whatevers in her drug book. So if X combination did not work, then, we’ll try something else! Then try something else! Then try something else!
The hitch in this giddy up is I metabolize drugs fairly quickly. For SSRIs, if it takes 14-21 days before the drug stabilizes  on me, it could take as little as 7. Rather than up/down the dosage, she just changed me to something else. I was cycled through so much, over the course of six months, my life fell apart. Granted, the relationship I was in then was already on the rocks, but everything else that may have been okay such as job, professional and personal relationships were all hit hard by this. It was fucking terrible and a fucking nightmare
The other hitch is I’m one of the rare cases of people who get suicidal thoughts on anti-depressants.  I’ve been on varying doses of:

  • Wellabutrin
  • Effexor
  • Celexa
  • Prozac
  • Paxil
  • Zoloft

XR or not, doesn’t matter. On or off Lithium, doesn’t matter. I start taking an anti-depressant, I want to kill myself.
When I went off the drugs a decade ago, I swore I would do whatever was necessary to stay OFF the drugs. Change diet, living, jobs, whatever, I’d do it. But DBT and yoga  can only do so much; I recognized I needed to be more proactive in my mental health. But this last few weeks has shown me glimpses of what that life was like a decade ago, and it is NOT one I want to repeat. I have too much at stake to lose all of it due to my fucking terrible brain chemistry.
There was no fucking way I was going back on an anti-depressant.
So there I am, nearly hysterical on the phone with Dr. H, very emphatically without a goddamned moving an inch to my voice, that I will not get on anti-depressants. We agreed to keep me on the 1200mg of  Lithium and go back to the Concerta 36mg, since I can tolerate that and it works somewhat. The rest is up for discussion when I see him in a few weeks.
My hysteria got worse when I got off the phone and was talking to TheHusband about the whole phone call ordeal, then my mood shifted in to self-protective mode where I did not want to be touched, stroked, talked to, or anything. I remember wrapping my arms around myself while TheHusband tried to sooth me during this depressive spike. I cried. A lot.
After I made the decision in October to start seeing Dr. P. again, he collated in later sessions the depression I was experiencing was more than likely stemming from the untreated ADHD which was creating a vicious circle of frustration and all the life changes that had happened in the last few years and were not dealt with. So, more normal life stuff rather than chemical.
This is how I knew what happened this week was different, even despite the chemical incredulousness of it, the mood shift down this week was caused by Adderall XR. This WAS chemical, and it was crippling, and it was debilitating.  How fast I shifted during the day, before the phone, while on the phone, and then after the call was huge.
Today, I started the morning with half of my Lithium dose (the remaining dose will be later) and Concerta. I’m still feeling prickly, my eyes ache as if I had been crying for hours (though I haven’t), and I am still in my pajamas. But for the first time in a few weeks, that I feel okay.
And this is how I absolutely do know, it will be sunny one day.
x0x0,
lisa

Better living through chemistry, round two: Saturday

Dear Internet,
It was a little over two months ago I started taking my ADD/ADHD medications or  as my friend Liz calls them, legal meth.  I live blogged the first weekend diligently, and the experience convinced Dr. H. Ritalin was not the drug for me. Additionally, I needed medicinal help with my bipolar so the legal meth of any flavor could work properly. I was then started on to lithium and switched over to Concerta.
Ritalin is short acting and could be taken over the course of the day to keep the strength up. Concerta 36mg, on the other hand, is longer lasting but it needs to be taken before 9AM  in order to allow me to sleep at night. On the weekends, if I woke up too late, I would take one 5mg of Ritalin  instead of Concerta to get me over the hump I needed to get tasks done in a timely manner.
In the beginning of the Lithium/Concerta combo, it was fucking glorious. I was productive, I was focused, the quirks about my personality I always attributed as just my personality, turned out were actual symptoms of both diseases and were tempered with the drugs. That small period from end of December to early January was a golden age. Sure, there were some kinks in the process like no caffeine as it made me feel like I snorted 10 lines of speed  even if I had caffeine in small doses and my anxiety would sometimes get out of control, but who cares? I was feeling really fucking good and I was productive.
Work started  back up on January 9 and things were hopping. I could complete tasks, organize myself better, I wasn’t short with co-workers,  and if a difficult situation arose, I could handle it with aplomb. Everything was awesome.
During the initial period of Lithium/Concerta, I was super productive with my writing because it was all done during the day when the Concerta was peaking, ergo it makes sense I was super productive at work because the Concerta would be peaking during those same prime hours.
Then, the downside.
When I came home from work, however, I didn’t want to do shit. No matter what time I got home, once the pants came off, at most I could handle was reading on the Interent or watching TV. Anything other than that was either too taxing, too long, or required absolute concentration from me which I couldn’t give. This also allowed
I kept up the Collectioun of Cunnynge Curioustes because that was an easy thing to do. Open a post, format, set the post date, and save the draft. Anytime I found something that fell into a CCC post, I just had to open up that week’s post and add it. Friday nights, I would verify everything was in order before it posted on Saturday and be done with it. Very little work was involved on my part.
I returned to work on January 9th. January 16 was my monthly follow up with my orthopedic doctor, who decided I needed to have surgery two weeks hence to explore the still open wound to find out why it was not closing after seven months. During that two week period, I was a frenzy of productivity at work but at some point the Concerta stopped working as effectively, so lithium was upped. The general idea is the more my mood stabilizes, the better the legal meth works.
Other signs started to illuminate the drug wasn’t working such as I was getting easily irritable and short with people again. My productivity at at work was beginning to slow down considerably and my former bad habits started to appear. I was staying later and later in the belief I had to do the work NOW and not that it could wait until the following day. This obviously effected my home life.
Dr. H. and I were in contact either via phone or appointment during all of this. If I was metabolizing the 36mg to the point of non-effectiveness, then it was time to up the dosage to 54mg and see what happens. The catch is with the 54mg dose, I’d need to take it at 6-7AM. He thought my recovery period would be good time to experiment with the 54mg to see how I do.
A week before my surgery, all extraneous medications were stripped from my regime except for Concerta and Lithium. On the day of my surgery, January 29th, I did not take my morning doses of either drug and when I came home that evening (it was outpatient surgery), I only took my evening dose of lithium. I stayed off of Concerta for the rest of the week because I didn’t want to interfere with my antibiotics and my pain meds (sweet, sweet Vicodin). I decided the second week to stay off the legal meth as well and gloried about in the ability to drink caffeine. I spoke with Dr. H. via phone on February 8 and he upped my lithium to 1200mg and I was to start back on the Concerta the following the week.
During that week, Concerta and anxiety wrecked my sleeping. Some days I would get up early enough to take 36mg, and others it was a Ritalin kind of day. Every day was always in flux.
I went back to work on February 20th and started the morning with 36mg of Concerta, my morning lithium dose, and half a Klonopin. While this combination worked well mood wise, not so much for the focusing and concentration part. At least, not as well as I had hoped. I had still not taken the Concerta 54mg because I was afraid if I did, I’d never get to sleep.
After  a month of  all over the place mentally  and being laid up physically, I finally got to see Dr. H on Friday to go over my therapies and talk more about what was going on. The ramped up anxiety, the heightened ability to not sleep even when sleeping aids were produced,  were driving me crazy. I knew as I was on/off drugs for the better part of the last month had much to do with the problems since there was no consistency, but even attempting at consistency became problematic.
So we try another experiment, this time starting with the Concerta 54mg.
I woke up on Saturday at 6:30A to take Concerta 54mg, and then napped for a bit. At 8AM I became wide eyed and bushy tailed and started writing this post. I had a hair appointment at 10AM that would end up lasting five hours. I spoke with Dr. H. in the afternoon and he suggested I try Adderall on Sunday depending how the rest of the day went.
TheHusband and I rearranged some afternoon plans to get my Adderall script filled. Dinner was had. Shopping was done. We were home by 19:00.
The way I explained it to Dr. H. earlier was Concerta 54mg was giving me alertness for several hours, then it ebbed for a few hours, then picked up again, so when I spoke to him at about 15:30, I felt pretty together. But by 18:00, I was crashing pretty hard and falling asleep at the dinner table. I was not expecting the crashing or how hard I would much so that I needed to drink a can of Coke just to keep going for a few hours before falling asleep around midnight.
I started this post early Saturday morning and finishing it late Sunday night. Perfectly illustrating even a simple task can become highly complex when the drugs don’t work.
x0x0,
Lisa

Collectioun of Cunnynge Curioustes: February 16, 2013

Johann Georg Hainz's Cabinet of Curiosities, circa 1666. Courtesy of Wikimedia Commons
Johann Georg Hainz’s Cabinet of Curiosities, circa 1666. Courtesy of Wikimedia Commons

During the Renaissance, cabinet of curiosities came into fashion as a collection of objects that would often defy classification. As a precursor to the modern museum, the cabinet referred to room(s), not actual furniture, of things that piqued the owners interest and would be collected and displayed in an aesthetically pleasing manner. Collectioun of Cunnynge Curioustes is my 21st century interpretation of that idea.
Dear Internet,
Another week of lots of television watching, and less of doing much else. Dr. H. pulled me off of Concerta last week, upped my lithium and thus a week of drug experimentation went by. Of course, as I was temporarily off the legal meth, I took that as invitation to drink as much caffeine as humanly possible. Which gave me all the speed of the legal meth but none of the focus and concentration. When I look back at my browser later in the day, I would have no idea what the devil I was doing to get me there. Porn? No, but close. My mind is all over the place, and when I did one thing, I would have to do something else at the same time.
No reading, no writing, no letter writing, nothing was done this week.
I worked from home for a bit this week, but like personal work projects, I was all over the place and unable to really complete anything.
For the follow-up call a week later, Dr. H. said I should go back on Concerta gain, so today we start at on 36mg dose. Hopefully this means less sounding like I snorted massive amounts of drugs when I’m writing these posts.

Listening

Reading

Watching

Also weekly watching: Mr. Selfridge, Banshee, Portlandia, Top Gear UK, House of Lies, Elementary, Spartacus, The Americans, Archer, and Project Runway

Links

What have you read/watched/listened to this week?
x0x0,
Lisa

Crab Canapes and Christmas Pudding

Dear Internet,
Tomorrow I go back to work as my holiday break is now over, thus things may slow down around here after my mania output for the last few weeks. It’s now eight days into the new year and I thought it would be a good idea to give up an update as to how  my proposed changes are coming along.
(I’m still tap dancing around the notes that need to be finished for body and health pieces, but I’m just not there yet.)

  • Buy Nothing in 2013
    I promise I will not tell a lie: I have spent money on non-essentials this year, totaling $90.26, but it was for very good causes. Two of the items, a yearly subscription to Duotrope and the fall issue of Jane Austen Knits, were items I planned to buy in December but forgot until after January 1. I know I’ll probably end up purchasing a license for Licorize sometime later this week, but that’s a one time cost. Removing myself from temptation has been huge. I also am ignoring anything Margaret posts because I almost always end up buying what she suggests.  Anything I have found has gotten pinned or added to my wish list. Side bonus: Removing myself from vendor catalogs has slowed amount of junk mail in our mailbox.
  • 2013 will be the year of creativity (even if it kills me)
    I’ve only really worked on the cooking and knitting stuff, which have been slow going as one meal a day is a green smoothie of some sort, lunch is usually a salad, and dinner is something we come up together. Our timing is going to change once I go back to work tomorrow, so not too much to report.  In the knitting area, I’ve almost finished my brother’s hat and will be working on fingerless gloves for me next.
  • Year of the written word
    The goal was to write at EPbaB five times a week, at about 250 words per piece, and 10 hours a week writing fiction. In the last 8 days, I’ve published something here everyday except for one and in space of 7 published days, the pieces here totaled 4992 words. In fiction writing, the goal was to write a short story a month and get something published by my birthday. I’ve finished one story a few days ago and I’m starting on a second. I have two additional stories in draft form that also need to be finished.  So far, these goals are being met. But again, with work starting back up for me tomorrow, this output is more than likely slow down. The second bit of this challenge was to read everything I’ve had on hand – which I’ve not really done, but I am still shooting for finishing a book a week.
  • teh interwebs
    This was by far the best thing I’ve done as my inbox is so quiet right now, it’s kind of frightening. I did go so far as to unsubscribe from several of my favorite retailers emails, in addition to paring down other vendor emails to once a week or month. I’ve stuck with following vendors in one format instead of all of the ones they offer, which has also helped considerably. I almost did purchase a domain, one I was eyeing on in late November but didn’t follow through at the time, but refrained from doing so. I spent several days paring and cleaning up my RSS feeds, but that may end up just being a lost cause for the moment. I’ve not started putting together a workflow for the archives.

I’ve struggling as to how to articulate how I’m feeling today, and lately, finding it is much harder than I had hoped. The 900mg of Lithium has definitely leveled me out as far as moods go. I fake raged to TheHusband, while feebly pounding against his chest, if this was what being happy was like, then I’m not sure I could deal with it. Most of the side effects of lithium have dissipated, and I’m feeling pretty much, overall, okay. I’m still freezing all the time (and we’re on track for January to be our warmest month on record), but I have no evidence to say this is because of Lithium or not. But I’m far enough away from being without lithium to know the difference between when I’m on it and when I’m not. I’ve not gained weight and I am drinking a lot of water, so I do not feel dehydrated as one would think for taking a salt.
Concerta on the other hand is tricky – very tricky. I need to take it no later than 9AM, for if I do, I’m apt to be up all night. If I go a day without it, I can still sit and work without being all over the place. If I go two days without it, then it’s like I was before and like nothing has changed. I get small bouts of mania, but these seem further afield than before and seem to be random, meaning there is no trigger. My headaches are mostly gone.
In the before, I was very passionate about some things and mildly interested in others. In the during, I had zero interest in anything, and to some extent, to anyone. I could not feel or love what it was to feel or love. I did things because I knew how to already do them and I knew that they needed to be done.  Robotic. I could muster energy to feel something about tiny things, but larger things were passed over. I did not think of myself as being depressed until much later for I did not act like those I knew to be depressed acted. I did not see myself as being manic because I did not act like those I knew to be manic acted. Something was wrong, but to what extent that wrongness and/or what was needed to fix it si still remain to be seen. Well. We know, but whether this snake oil is actually working remains to be seen.
There you are. Here I am.
x0x0,
Lisa

Chef's Special

Dear Internet,
It’s early Sunday evening and Downton Abbey is starting soon here on the eastcoast.  I’m still debating on whether or not I’m going to watch it live since I’ve already seen this season that is about to be shown in the US. I also know what happens at the Christmas episode too, and really, if you watch DA long enough, you begin to realise Julian Fellowes has a pattern and that pattern must be kept to. The English must keep to their schedules after all.
On Friday I called Dr. H to discuss the status of my drugs. We have phone appointments set for every Friday from now until my next appointment with him at the end of the month. Presumably the idea is I see him once a month, but phone every week, and see my therapist Dr. P every week. Dr. H. has decided to up my lithium to 900mg (300mg in the morning, 600mg at night). Apparently the average therapeutic dose is 1800mg. I’m to stay on Concerta at the current dose. I’m to continue to keep track of my feelings and moods and report back to him next week during our next phone appointment.
Except.
After we hung up, I proceeded to have a minor panic attack because I’m having an atypical side effect, extreme feeling of cold, and I don’t know what to do. As I had forgotten to mention this during our initial phone call, I opted to read Doctor Google about the side effects of Lithium which sent me into a tail spin of AMG I AM DYING.
Obviously, I’m not dead.
Or having cardiovascular collapse, which happens in very rare cases due to lithium toxicity. But the side effets listed on the page don’t mention it’s not a singular side effect but it’s a combination of all of those things that will put you into physical distress. I called Dr. H. back; he explained; I felt better. Problem solved.
But fuck Doctor Google.
I was overly productive in the last couple of days in writing, getting up a few short stories up to my Beta Readers and working on a few more. I plowed through my files looking for more snippets or starts I could expand on, so I could start working on those pieces. Instead, I ended up reading a lot of things I wrote a decade or two ago, and instead of finding myself depressed or lost for time gone, it ended up energizing me.
I was hesitant about visiting those pieces, sure that seeing that much raw power would depress me because the output of the years hasn’t been the same since that period. But I knew then, what I know now: That a few particular pieces were glorious and while some may come close to that power, and maybe one or two would surpass it, its rhythm and depth could never be exactly matched. It takes youth to have that kind of raw vitality, and while I’m still youthful (and vain enough to think I can produce more like that), there is something gorgeous about the pure consciousness of your early 20s.
Twenty three year old Lisa was wondrous in all of her faults, desperation, and earnestness. She was never afraid to rip back all the layers of pretention and love fiercely, love wholly, and live completely. The pureness of her energy, and of her innocence, is almost breathtaking to witness, even in written form.
I love her, and it really doesn’t get any more real than that.
x0x0,
Lisa

Macdubhsith

Dear Internet,
For the last couple of days I’ve been on a big digital cleaning kick, partially because I needed something fairly mindless to do as to not think about a few future Kalendae Januariae posts I had started writing. One is on attaining a healthy body and the other on obtaining a healthy soul. I struggle with how much I want to discuss, how much I want to reveal, and how much even just thinking these things is giving me false fear and shame for things I have yet to publish. While I shouldn’t give any fucks about what the world cares about weight or body image, it does and therefore I end up feeling cagey about discussing it. The same goes for anything spiritual, for if you talk openly about how you truly feel, a lot of dynamics shift in relationships because of the splintering of beliefs.
Also, people tend to be assholes.
In a couple of small digital communities I’ve helped build in the last year, one of the main themes I strongly advocated was for safe space. This had to be a place you can dump out your soul and you will not be judged, blamed, or threatened for how you feel. Trying to maintain that kind of safety in an open space, such this blog, is much, much harder. And it’s funny for I have no problems discussing ANYTHING except when it comes to body image and spirit. Sometimes the wounds of abuse are much shallower than I lead you to believe for it takes but the wrong slight word to bruise me these days.
So instead I wander aimlessly around the internwebs, reading about my Scottish forefathers and mothers.
A problem with this mindlessness it doesn’t really push the fear away to a safer distance, it instead bottles it in another place to be accessed at another time when I’m least suspecting it. Fear and shame are so integral to our lives, on so many levels, I sometimes want to punch the bubble that seems to be keeping me trapped here in this place. Write everything, write nothing, look like this, don’t look like this, be this kind of professional, don’t be this kind of professional: the conflicting messages are driving me insane!  Sometimes even the Zen minimalists piss me off for they are like here, have a few easy steps to let everything go, and then you will be free. And oh, have a cookie (if it’s whole food, gluten, dairy, sugar, and egg free).
Friday I call Dr. H. to give him my update on how lithium and Concerta have been working and see if he needs to adjust my meds. Tonight, over dinner, I grilled TheHusband on how I was with this new combination. “Insufferable as always,” he says. On further reflection, he said I was significantly less moody. I have also seen that in myself as well, I’m not getting all riled up as easily anymore when people irritate the fuck out of me. Rather, I remove myself from the situation in some fashion, whether it is unfollowing, unfriending, or just choosing to not respond when a comment is directed at me.
Lithium has a tendency to make people feel warm. Lucky me: I’m still freezing all the time. My hands are so cold, I’m knitting a pair of fingerless mittens in the next few days. I layer like the dickens, and started wearing long pants and socks to bed. My right hand feels like ice is flowing through it even though when TheHusband touches me he feels warmth.
The Concerta/lithium is supposed to do two things: Stabilize my mood and then get me focused. As I’ve been off caffeine for nearly three weeks now (?!?!), in theory since lithium acts as a downer, I should be falling asleep earlier. This is not happening. One day last week, I made the mistake of  Concerta after 11AM, did not go to bed until nearly 5AM and woke up at nearly noon the next day. I skipped that day’s dose and righted my body, somewhat, but I still cannot seem to get to sleep before midnight. Even now, TheHusband and I have been getting up at 6AM and working out, and I’ve been taking my Concerta when I wake up so in theory, I still shouldn’t feel like I’m on fire and yet I do.
My sexual libido is also still lacking.
Sometimes I feel like this huge disconnect in my life is because I see the world as it is being perceived and when I hold it up to my own, as it doesn’t match that image, my life than is not enough. Or it’s a sham. Or it’s falling apart. If my husband and I are not out hob nobbing it every night, does that mean we’re not living life? If I’m not out donating everything I own to every worthy cause, does that mean I’m incredibly selfish? If I’m not consoling everyone who comes to me with a sob story, or is in pain, or hurt, does that mean I’m a terrible person? Where and when does it end?
The question I then need to ask is: Is it me or is it the drugs?
x0x0,
Lisa

Lithos

Dear Internet,

I’m so happy ’cause today
I found my friends,
They’re in my head
Lithium by Nirvana

Friday I had my follow up with Dr. H., my medicating doc, and I was hoping he’d say, “Yep, Concerta isn’t working, let’s put you on X and try that instead” and let me go on my merry little way. Didn’t happen. Of course, because that would be far too easy. So, now, then what do we do?
I spent the better part of an hour going over every drug that has entered my system or that I had left in the last couple of months (OTC or prescribed), and went through my entire 1.5 weeks on Ritalin + Concerta experience. Noting to him every little new “thing” triggered by either drug or was put to rest by either drug. I’m thankful that I wrote as much as I did while tracking my mania/The Sads, but I didn’t write enough because he asked me a lot of questions I could not easily answer nor were there any hints in my blog when I checked while at his office. I think it’s important to be a public voice for this drug experience, but sometimes it’s hard to keep track of what I’m doing and how I’m doing or do it in a matter that is more coherent. Maybe it doesn’t have to be?
TheHusband pointed out maybe if I wrote more stream of consciousness (which I did a lot of when I was in my ’20s), it would be easier. I think he has a point. While I plan on keeping up with writing about this publicly, I need to be more diligent on my note taking privately. I bought DayOne for my Mac, iPad, and iPhone ages ago and used it pretty heavily after for the first month or so and then tapered off. It was interesting how much came out when I was writing only for me – though to be fair, when I write here, I also am writing just for me. But writing in a matter that is more private, I suppose, frees up a lot of internal censorship that I unconsciously use on myself. The only glitch I had using DayOne was when I was on computer (like work) that is not MacOS variant based. My solution to that was either bring in my Air (which I’ve been doing more of) or use Evernote and create a folder tag for DayOne writings to transpose later.
So, more writing about this experience. Duly noted.
As I said a few weeks ago, the accepted diagnosis is ADHD with Bipolar with bits of Borderline Personality Disorder thrown in for good measure, which coincides with the diagnosis back in 2005. When I was living in Northern Virginia (NoVa) from 1999-2002, I was seeing a therapist there who cycled me through a lot of drugs: anti-depressants, anti-anxiety, anti-psychotics (alternative for the anti-anxiety) for Bipolar and definitely anxiety. I was on, then off, then on, and then off so many drugs that I felt like my brain would just explode. I swore then no matter what the fuck happened, I was NOT putting myself on any of that medicinal merry-go-round again. I’d learn to live, cope, and exist with my current brain chemistry as it is because I could not take that kind of mental anguish again.
So when Dr. H. said he was putting me on lithium today, I burst into tears in his office.
With the exception of Klonopin in the last ten years, I’ve been mainly drug free. I was hell bent on going holistic on the vapors of my brain, but that apparently hasn’t been working and so, where we are.
This where the helplessness started to become so overwhelming that I nearly bolted from his office. I came to him, as a recommendation from Dr. P. to get the drugs for ADHD and monitor them, and now he’s putting me on this medicinal go around for the bipolar, which is apparently triggered by the ADHD? The way Dr. H explains it is that if Ritalin AND Concerta are triggering mania, depression, and other traits of the bipolar, those need to be addressed first before Concerta (or any related drug) can really be effective for me. I’m unlucky in that not only do I tend to metabolize drugs more quickly than other humans, and I also tend to pick up the rare side effects from the drugs. They can’t plaster me with a catch-all drug to cure X because that triggers these other things that have now sprung up.
Dr. H. gets my hesitancy about this, but he feels pretty confident we can find that sweet spot where everything plays nicely and I can feel some sense of normalcy. But it will be tricky, which means I have to be more diligent on keeping track of my moods and everything else in between.
This isn’t the first time I was on lithium, as I was on it during the first chemical-go-around when I was living on NoVa and I remember that sweet spot for like 3 days when I was on lithium and something else where everything was fucking awesome. The world seemed brighter, the colors were deeper, food tasted sublime, and I did not feel like a scatterbrained idiot. Here’s to hoping that we can get there again.
ProTip: Don’t ever read forums, regardless of the reliability of the website, about drugs, drug interactions, or their side effects. Because you’re going to end up self-diagnosing yourself with consumption or the vapors, and never want to leave your house again.
TheHusband, who rejects “white man medicine”1 for most everything gets that in order to make his Pookie Bear better, she’s got to swallow the poison. We’ve been big supporters of whole foods lifestyle for a long time, and while we tend to fall off the wagon here or there, for the most part, for fat people, we are pretty fucking healthy fat people. But we know we can do a lot better, so before this drug shenanigans came into play, we planned to kickstart our healthy eating and exercise again. To be more whole, mentally AND physically just reinforces the idea that we really need to get behind this and stick with it. The goal is that with a better balanced diet, more exercise (as I am more mobile now), and seeing Dr. P. every week and Dr. H. monthly, things will (hopefully) start to get better.
Kale smoothies, here we come. Rah. Rah. Rah.
But darkly, in the shadows lurking, I also know, as it is with any kind of drug that is taken for the brain, there is almost always a dark side before the dawn. That is the risk you have to take.
My regime is 600mg of Lithium (1 300mg tablet taken twice daily), 36mg of Concerta, and my usual assortment of multivitamins and supplements. Because of the Concerta, I’m off caffeine (and have been for 11 days as of this writing). because of Lithium, I cannot take NSAIDs (aspirin, ibuprofen, etc) and I should watch my salt intake. Dr. H. also wants me to refrain from alcohol while I’m on lithium, which means I can’t dip into the Absinthe my brother got me for Christmas.
I’m also allergic to dairy, so there is also that to add into the do not haves.
It’s a good thing I like water.
x0x0,
Lisa

1. He’s Native American.

The Mysterious Case of the Attack of the Sads

Dear Internet,
Morning, December 25th.
Everywhere on the Internet, everyone  is filled with holiday cheer, about presents that were given, love that was received, and cheer for the entire world. My initial instinct was to respond to all those cheer filled posts with messages of hate and meanness. Instead, I closed out of Twitter/Facebook and started sobbing.
I feel like my world is crashing around me and I know this isn’t me, this is the Concerta speaking. If the trade off of focus and getting shit done is this mess of helplessness, crying, and thoughts that are beginning to border on the extreme, then I need to get off the drug.
TheHusband attempted to console me as my lower lip quivered and tears were streaming down my face. He wants me to vocalize, what we’ve come to call “The Sads,” but sometimes there is no reason for being sad, it just is. This past Saturday, I woke up with a plan to get shit done ™ and spent the day in my jim jams, in our dining room, cleaning out my multitude of an  inbox (And for the record, I’m not even finished). The idea of seeing, talking, and interacting with anyone, even my husband, filled me with dread. By late afternoon, he coaxed me to play video games and eat a mediocre take-out we had delivered from a local Chinese restaurant.  On Sunday, I did a 180 degree turn and felt mostly fine, as I did on Monday. On those days, showers were taken and long movies were seen. Now The Sads are back and there is nothing I can do but let it ride this out this time.
I never made it a secret that the holidays are terrible time of year for me, but since TheHusband and I got together four years ago, we’ve been trying hard to start new traditions by making ourselves happy and fuck convention. This year, beginning long before I started the drug experiment for my ADHD, I was giving no fucks about the holidays. I did not do a poll to solicit cards / send cards as I do every year, I did not bake cookies until the very last minute, and we didn’t get the tree up until the 23rd.  Presents were bought at the very lasts of minutes and shipped as expensively as possible. Whether or not we celebrated seemed immaterial to me – it was just another goddamned day.
The three days of Ritalin, I was manic, but I was focused and I got shit done. As the mania started to subside, I felt something I had not felt in a very long time and that was hope. On the week I’ve been on Concerta, I’ve been up and down like a yo-yo, I don’t feel as laser in focus as I did on Ritalin (but there is much better focus), and I’ve broken down into uncontrollable sobs more than once. I found myself being way more surly than even remotely necessary to people, and everyone is a goddamned asshole – even the dog. When I sleep, I sleep for 8-10 hours (with or without Klonopin, doesn’t seem to matter).
The headaches have been a near constant all week, and they travel around my face. Sometimes I feel like my face is a mask about to be ripped off from the pressure behind it and other times, it’s concentrated in a temple or above the bridge of my nose. I’m cold all the time, even when sitting in the warmest room of the house, thermostat at 70, my hands are like ice and I am shivering. My appetite has diminished. I haven’t had caffeine for a week.
Concerta seems to amplify all the worst of what I was feeling without giving me a trade off in return.
Afternoon, December 25th.
TheHusband and I winged it on presents for the holidays this year. It’s hard to shop for someone when that person either doesn’t wants small things (TheHusband) or buys it themselves (me).  As time was running short, I kept flip-flopping on how to celebrate. We want for nothing, and then, we want everything. My brother was slightly easier, he wanted gifts from the heart. So the cookies were made and a hat was knitted. A bottle of Hennessy  and a few choice gift cards to round out his gift. He presented us with gift cards to a DIY place for TheHusband and a Coach bag for me. I feel like everyone wins in this scenario.
We flipped off tradition and TheHusband made Mexican, all from scratch. The only thing he didn’t do was take the cow, kill it, and process it. The cooking took all day, and we were finally able to eat in the early evening hours. My brother joined us, as did his girlfriend. Margaritas made the rounds (2 ounces Triple Sec, 6 ounces Tequila, can of limeade, and a few fistfuls of  frozen ice. Blend until frothy), and we got good and tipsy. Or in TheHusband’s case, his teeth got tingly.
My mood stabilized a lot by the evening when presents were exchanged and alcohol had been drunk, but I was still feeling emotionally overwrought.  Once the kitchen got a first pass through on cleaning, the dog had been walked, we were in bed early and I was asleep before midnight.
Morning, December 26th.
I was up early to take Jeeves in for his yearly oil change and detail, and home by 7:45AM.  I’ve switched to decaf coffee because I can only apparently take so much herbal tea, and  discovering I craved the coffee taste, not necessarily the buzz. I met up with Karen who was home for holidays at Wolfgang’s before heading back to the house. I was yawning through our mid-morning breakfast date, but I haven’t been feeling tired, just drained emotionally.
The rest of the day became a blur.
Early evening, December 26th.
The rest of our presents to the other showed up today and we were both most pleased. I have not left the house since coming home from breakfast this morning, TheHusband has not left at all. The impossible task of sorting out my digital life over took most of my day, as I continue to unsubscribe and delete accounts no longer used across the Internets. I feel like I’m always doing this housekeeping and it never seems to get any easier or lighter. It becomes one of those tasks that needs to be done, but I choose to do this instead of something else that has pressing value.
TheHusband commented I seemed more stable today, and I agreed, except for the lingering headache that I try to forget and find I cannot. No crying jags, no yo-yo, but whatever focus this drug is supposed to give me is not here. I find myself all over the place today as I sort and clean and sort some more. Zero focus. Zero concentration. I have been known to metabolize drugs too fast for the effect to take over, so this is what may be happening, but I really do not know. Against TheHusband’s request, I’ll continue taking the drug until I see the medicating doctor on Friday so that I can come off the drug safely or ramp up to another dose or switch to something else.  I do not see my therapist for another few weeks (holidays), and that seems so far and yet I know it’s not.
When I made the decision to document this experience, it was to provide an outlet for my own voice that often feels strangled, to give voice to those who cannot speak, and to have some tangible proof of what goes on inside my brain (drugged or not). I have very clear goals of things I want to do in the upcoming months, years, and I keep looking at crazed brain syndrome as hindering me in obtaining those goals. I honestly do not know how I made it this far without having some sort of breakdown. The prescribing doc talks about Concerta, Ritalin and like drugs like their snake oil, and I am still desperate to believe him. I need to believe him.
This is where the frustration comes in, knowing that I can have the ability to do certain things, find that that ability to be stunted in some way, and then as I reach out for relief, find that it is almost always out of grasp.
And that, perhaps, is what breaks my heart most of all.
x0x0,
Lisa