One Night of Missed Pills Equals Two Lost Days, So Far...

It doesn't take much to topple this bipolar person from her delicate balance.  I've worked very hard to achieve "normal."  Normal is for me a very hard-won balancing act.  I teeter here, on the balance beam of sanity, a bit wobbly but still standing. One missed dose of antidepressant and the two mood stabilizers made me stay up all night and spend yesterday watching old movies and lying in bed trying to stay out of trouble.  I tried to tweet a bit, write a place holder post, and clean up my dresser, but I couldn't type.  Words tumbled out like letter salad.  I now think I know what it must feel like to be truly dyslexic, the brain moving like lightning, too fast for the fingers to keep up.  My one little cleaning project expanded as I moved the mess on top of my dresser from one surface to another, expanding chaos rather than taming it.

Today I thought I'd be back to "normal," but I'm slow and disinclined to do anything but stay out of trouble.  Monday is a day I usually grocery shop, but I'm not inclined to trust myself to stay out of trouble in a store of any kind.  Shopping is potentially dangerous.  And I'm not in desperate need of anything yet.  I can feed myself today.  I have plenty of dog food.  Nobody needs a treat, so sending myself off to the treat store is just flirting with disaster.  If I really want to see what shopping is all about for me, I'll clean the cupboard and fridge.  I could probably feed a family of four for a month on what I have stashed away.  I'll thaw something for dinner.  I know from a cursory glance that I have ham steak, pork chops, rib eye steak, pot roast, ground lamb and more.  In my pantry I have rice, potatoes,  grits, cereal, two back-up jars of mayonnaise; what the hell do I need?  I have greens for salad, cabbage for slaw.  I have honey yogurt and blueberries.  I will not starve.

I'd love to work outside, but the temperature is climbing toward the high 90s so I'm going to spend another day just chillin'.  If my brain were in good functioning order I'd read all day, but a page of words is like trying to read word-salad.  Typing is easier today, but still not as natural as it should be.  I could retweet all day on twitter, but I'd have nothing original to add to the conversation, so I'll give it a break for one more day.  The world won't wobble off it's axis without me.

It's All In My Head

I'm Bipolar.  I'm crazy too. And to make matters worse, my pedophile dad was a psychologist.  So, even though it was important to the family that I keep my piehole shut about what my daddy had been doing to me, my daddy was always telling me that my seething fury and the self inflicted wounds of careless "accidents" was all in my head.  And it was, in the sense that I might open my mouth and spill my guts to a sympathetic stranger, and what would come out might just put my whole family in jail and me in the looney bin for life.  My mother would scream, "Snap out of it!"  My father would say, "It's all in your head."  It never helped, and though it was all in my head, I could not snap out of it.

My dad's dad was a famous surgeon here in Salt Lake City.  He was Chief of Staff of a couple of Salt Lake's finest hospitals and a high up muckymuck in the Shriners.  He too was a pedophile.  I found this out when he died and his elderly only daughter (another crazy woman) got all Doc's films and photos.  As she and her children were watching the first of Docs carefully numbered films they were surprised to see two kids, ages ten and seven, having clumsy sex with one another.  The little boy was the seven year old and he grew up to become my daddy.  The little girl was the old woman watching home movies with her children.  It was a little awkward.  The man with the movie camera was Doc and the director was his wife, my Grandmother.  And so begins the problem that would disguise my bipolar disorder with all the symptoms of an adult victim of child sexual abuse.  Turns out that's not uncommon in children with bipolar disorder.  Pedophiles either create their own victims or find them.  But the kids with underlying bipolar disorder are often also the victims of child sexual abuse precisely because they're vulnerable.

It is rare for the bipolar child to be unscathed by other victimization.  We are bullied, we are withdrawn, we are moody and sometimes full of a rage so fierce it can only be safely turned within and we are often the teens who cut ourselves or have frequent "accidents."  It is also rare for the bipolar adult to be without substance abuse.  We are mostly self-medicating, trying desperately to find a place within that feels "normal." If I'm describing your childhood here and you have been diagnosed as "depressed," that may just be your predominant pole in the bipolar swing.  It was mine.  I spent years so depressed I couldn't get out of bed.  And depression almost always begins with symptoms that seem like a serious sickness.  You ache all over; you feel so tired movement seems like walking through molasses; you might have a low grade fever, a headache that won't go away; you lose your apatite; you go to your doctor certain there will be a diagnosis and a pill to fix it.  And eventually, after a series of expensive tests that find nothing, you'll get put on an antidepressant. And there are pills to fix your symptoms.

There are so many drugs to treat depression and the mood swings that go along with it, like the occasional psychosis.  But first everything else has to be ruled out.  My thyroid was almost always suspected since my eyes are prominent, or were before the upper lid began to droop.  But, if after a month or so on a new drug, my symptoms aren't getting less debilitation, I probably need to try another drug.  There is one that will help.  And it needs to be a psychiatrist who works through that process of finding the right drug, so I can live in a place of emotional balance.  It's a process of trial and error.  The errors can feel like a full blown psychosis or a lobotomy.  And most bipolar drugs are not weight neutral as it is so genteelly described in the inserts that come with a new drug.  I gain up to forty pounds on certain antidepressants, and no amount of dieting will get rid of it.  This is one of the reasons so many women won't stay on their antidepressant.  Would you rather sleep for a couple of years or live your life with a bit more weight?

At the depth of a depression is a coma-like sleep that is dreamless and very difficult to come out of to eat, bathe, and then make it back to bed.  Eating, bathing and walking across the room all take enormous energy when in the depths.  Sorrow resides there as well as oblivion.  Regret is sorrows twin.  And it doesn't help to have a family member shout "Snap out of it! I don't believe in depression!"  That's probably just a family member who is in the hypomanic phase of bipolar disorder and hasn't been diagnosed yet.

I'm Having An Upside Down Day

This morning while talking on the phone to Z, half asleep at 11:30, I took my pills. I always wake up, get coffee, pee, take the dogs outside and then open my weekly pill minder, take the day of the week container out and slam that handful of pills back with a swig of coffee. There are two doses: the one for morning contains the mood stabilizer Neuronton, the blood pressure drug Lisinopril, the blood thinner Warfarin, Estradiol, the drugs that keep my heart in normal rhythm, Diltiazem and Flecainide, and one tiny aspirin; and then there are the night time drugs that include a dose of Lisinopril, a Flecainide, two of the Neurontin, a whopping 80mgs of Simvastatin, and my antidepressant Doxepin. For the first time ever I opened the pill minder upside down and took my night time dose by accident. I didn't realize it until I got off the phone. Then I looked at the pill minder in my hand and realized my mistake. I had to take the morning drugs that I don't take at night, like the Warfarin, and the Diltiazem. It's a fuck-up, but not disastrous. The worst that will happen is a minor doziness today since my antidepressant is slightly sedating.

I called my therapist Fred, the minute I realized what I'd done. I left him a message. He'll check with my psychiatrist to confirm my decision skip my usual evening dose since I took it this morningish. I'm going to try to avoid double dosing if possible. The worst that will happen if I take another Doxepin will be a mild hypomania. And like most normal people I kind of like a little hypomania. It sure won't kill me and I just might finally get my house clean. I was going to grocery shop today, but now I don't think driving is wise, so I'm going to stay close to my bed as I may be flopping down and sleeping as if this day were night.

Medicare Explained By One Who Knows

You may not realize this but fashion models are considered contract labor. We have agents to promote us and manage our bookings for a hefty 15% of our earnings. But all the rest is up to us. And in order to get the best possible tax help a model needs a tax accountant who specializes in Entertainment Industry tax rules. Then we have to provide for our own insurance.

While I was healthy and working I bought my medical insurance from United Healthcare, the only large insurance company providing coverage for individuals in Utah at the time. In the beginning my monthly premium was $325 a month. I thought that was pretty high, but it was the only option. Then I started getting hefty premium raises every six months or so. It was not that I was sick, it was just "a little adjustment for the rate of inflation" according to the billings person at United Health Care.

I ran into a rough patch. In a six months check-up with my internist, where urinalysis and blood work were done, I seemed to be having a "sugar spill" in my urine. This required further tests and a visit with an endocrinologist. More tests were done. And in the end, it turned out to be one of the many strange permutations of stress and depression. Then I got a notice that my insurance had gone up to $500 a month. But the drugs for depression were very expensive, so I kept the insurance. But I also kept getting more and more depressed. I was referred to a good psychiatrist who diagnosed me with bipolar disorder and put me on a good mood stabilizer (another very expensive drug) which made it possible for me to keep working so I could afford my insurance. I was chasing my tail.

Within a month of getting that Bipolar diagnosis Untied Health Care doubled my monthly premium. At $1,000 a month for just me, I had to drop private coverage. Then I couldn't afford to pay for my therapist, get my drugs filled, or pay for follow-up care. No psychiatrist will prescribe without follow-up care.

As I grew more stressed by the depression and the rising bills, I was able to work less and less. Finally I was bankrupt. Fortunately I filed before the rules were changed for individuals filing for bankruptcy. So medical bills and the cost of private health insurance ruined me economically. Not having insurance made it impossible for me to pay for my drugs and this led to a lengthy hospitalization for psychosis. Which was the result of untreated bipolar disorder.

I was advised to apply for disability. I applied with all the documentation they required and they turned me down after a three month wait while they decided my fate. A friend of mine who's a social worker told me that all first-time applications for disability are turned down, no matter what. Proforma. I reapplied and was turned down again. After further conversation with my friend I discovered that there were attorneys whose specialty was disability law. So I got a disability attorney. They assess your case and if they're pretty sure they can prevail they take your case for a percentage of the lump sum award. If you finally get on disability they reimburse you for the time from your first rejection to a successful outcome. This whole process took over two years, so even though my monthly disability stipend is the minimum possible, three years worth is a tidy sum. The payout is based on your earnings at the time of your award and for the three previous years. These are the lowest earning years for most people who end up on disability. So I got roughly $700 a month to live on and Medicare. It is Medicare that saved my life. And that is not hyperbole. Once I was on Social Security Disability and Medicare parts A, B, and D (the only good thing G W Bush did in his entire presidency) have saved my life. Once on Medicare I was eligible for the fabulous care by Valley Mental Health and the Master's Program for bipolar patients over 50. They saved my life, and that is not hyperbole.

Medicare is far better coverage than my $1,000 a month private insurance. Every referral from my internist had to be okayed by some bean counter at United Health Care. Under Medicare I have never had to wait while a bureaucrat has weighed whether or not my well being was worth the cost. And if I needed help finding the part D private piece of the pie that Bush gave the private sector, a "bureaucrat" at Medicare patiently helped me find the one that would cover all my drugs at the lowest cost. In my case that's Etna. Since my income is so low, I get extra help with drug costs, so there is no "doughnut hole" for me. If the public sector were picking up the cost of the part D coverage it would be simpler and therefore less expensive for taxpayers. It was giving part D to the private sector including the drug companies, that has made part D a problem for so many. It is the drug companies and the private insurance companies who lobbied so hard for their hand out from the Bush Administration that has driven up the cost of that program and made it a bureaucratic nightmare for so many senior citizens and their families to negotiate.

I have the experience of both options--private and public. I'll take the simplicity of the public option over the bean counters in the private sector any day.

Scrambled Brains For Breakfast, Anyone?

This is one of them many things about bipolar disorder that I really, really hate. You're going along thinking you're doing just fine, and then, like a good little patient, you keep your scheduled appointment with your shrink. Not all bipolar patients are as compliant as I, but than most bipolar patients don't live this long. So, there I am bringing her up to date on my situation, and it turns out that the old school anti-depressant I've been doing so very well on is implicated in "cardiac events." It's also implicated in fat, but aren't most of them? Anyway, now I'm doing the Alice in Wonderland bit, where she takes a bite of this, and it makes her really fat, and she take a bite of that, and it makes her disappear. Did you even notice that I disappeared yesterday? Thanks Randal and Beach, at least now I know who my real friends are.

So now my brains are so scrambled I can't read, write, or stay awake long enough to do much of anything. Just as I was going down for the count today, shortly after waking up, I had the foresight to call the one friend I thought might call, and tell her I was taking a "nap," so if she had anything to say to me, say it quick, and then don't wake me up with a phone call, please. I thought of calling my other friend--yeah, I am that popular--but got too sleepy to pull it off. And who doesn't like a good nap, anyway. Well, three or six hours into mine, the phone goes off like a bomb, right next to my head. I come out of my sleep and croak, softly, so as not to hurt myself, "Hello???" When what I really wanted to do was scream, "Who the fuck is this!!!" Well, of course it was my other friend, the one I didn't call to tell I was taking a nap. "She says, "You sound strange, are you alright?" To which I answer, "I'm taking a nap, you woke me up." The second half of that was perfectly obvious, but somehow needed to be said. Then she said, "Well, I'm worried about you, you don't sound like yourself." I just should have said, "I'm not myself. You have the wrong number," but she'd have never fallen for that one. So I said, "I'm not exactly myself, I'm seesawing between two competing drugs, and my brains are scrambled." To which she replied, "Well, you missed Olbermann." The TV was on and sure enough, there was Dan Abrams talking to that annoying twit, Contessa Brewer. Then my friend said, something that sounded like bla, bla, bla. It was all very well intentioned and for my own good I'm sure, but god, how I wanted to sleep on and on into the night. Fortunately, Olbermann gets a second hour following Dan, so the day wasn't wasted after all, but my nap sure was.

If you're thinking I sound like I'm slipping into depression, this is what it feels like, but it probably won't last very long. In the early days of real antidepressant therapy, they just slammed you on a full dose and that was that. Now they treat us like the delicate flowers that we must be, and ease us off one drug as they ease us on another. Me, I prefer the old way. Get it over with quick. But I'm a good little patient, and I follow my doctors instructions.

In the meantime, you will not know who you're going to get, Dr. Jekyll or Mr. Hyde. Good luck, it's bound to be a bumpy ride.