17 January 2011

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You know, I had so much to write the other day that I decided not to put all in one post. What the best thing ( did in 2010? Well, on July 27th I quit smoking cold turkey with none of those nicotine patches or gums. I just made up my mind to do it. The first couple of weeks were hard, but by the third week, the cravings lessened

I miss going to therapy, but each therapist I’ve seen (3) just didn’t seem all that interested in what I had to say. Once actually clock-watch during the whole session. I want to return to therapy, but now I am not sure where to go. I think I am going to call the head therapist I worked with during that intensive three-month outpatient therapy. Maybe I can get her to make the appointment for me in case they it to be a referral requirement.

I’ve been fairly balanced bipolar-wise (BP). And what is interesting, when I am feeling balanced, the Borderline Personality Disorder (BPD) doesn’t seem to be as pronounced. However I feel myself slipping into a manic phase. I’ve had all this energy and haven’t been to sleep in 4 days, but I feel fine. My biggest weakness when I am manic is my need to spend money and collecting things I shouldn’t have. Those items always fall in the “want” category!

Well, my psychiatrist was me to have another neuro workup considering the fact that my short-term memory is sporadic at best and I can’t concentrate or focus on tasks. I’ll start working on ten things at the same time, yet make headway on none. So, I am no going to work on one item at a time from start to finish. Not sure what my productivity will be at work.

Speaking of work, I have been staying on top of my projects and my email. My boss hasn’t had to deal with me for the whole month of January so far. I know I am supposed to be getting my performance appraisal this month. I can hardly wait. I rather doubt that it will be as good as last year.

I have perfected the smoothie! I have a 1200-watt blender that will crush ice. I can make gelatos and ice cream and frozen Margaritas. Well, I look at my poor absorption of vitamins and minerals, but instead of taking all these vitamins and minerals in pill form, I am adding leafy green veggies and such (spinach, kale, broccoli, carrots not peeled). I put the veggies in with the blender and all you can taste is all the fruit I usually add to my regular smoothie along with the protein powder and flax seed meal (the actual flax seeds are hard to digest).. Maybe my blood results will look better this time when I go see my regular doctor.

Back to my dysfunctional family. I decided to send everyone framed pictures of Mom following her 90th birthday, evening including K, the niece from hell. I called her out on it and she claimed she didn’t know what I was talking about. Never mind that for the last 10 years I have been patently ignored when the family gets together for the celebration at K’s house. Well, I sent the framed photos to K and today is Jan 17. I actually was expecting a thank you call or card, but nothing has been forthcoming, so I have now washed my hands of her.

You know what else hurt my feelings? Now that I have a dependable car, I have the ability to drive the four hours to her house. WhenI was visiting her back in November, she told me that staying for four days is just too much for her. Three will suffice. Well, that’s hard on me considering it’s practically a quick turn-around trip. And on top of that, she doesn’t want me down there too often (like once per season). Well, she is 90 and has every right to dictate who can and for how long someone can visit. Ah, yes, family. Just warms the cockles of my heart! ©2011

13 January 2011

One Long Year Later

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For the past year I have wrestled with demons, good times, manic phases…you name it. I have been trying to fly below the radar…keeps things that much easier. I want so much to be anonymous, but in today’s climate, that is virtually impossible. I hate the fact that my fingerprints are in the system (not that I plan on going out and committing a crime, mind you).

This past year was a hard one at my job (let me say this right now…I am blessed with employment!). I was still on a learning curve. But what soon became evident were the issues plaguing me during recovery. I still have short-term memory loss and we don’t know if it will be permanent. Things got so bad that I was put in a sort of probationary 3-month re-evaluation subject to my work performance. I’ve lost four accounts because of the mistakes I have made. However, that period soon passed once they understood it to be the cause of a medical condition.

Ironically, I have had a great month at work so far for January. I’ve shifted my focus. I now get up at the crack of dawn (0400, to log on to the employer’s VPN at 0700). That leaves me with 3 hours before I have to be at work. Now, every morning, I am drinking my hot tea while doing my devotions and Bible reading and praying. I am also starting to record Joyce Meyer so I can pause it here and there while I take notes. I figure that’s about the best way I can start the day.

My beloved little church finally succumbed to lack of attendance, so the Pastor chose to close the church. I have tried a few and I have come across one that I am going to attend a few more times before I commit to anything. This is a much larger church and is not affiliated with a denomination which I like. Their praise & worship is a little different from what I’ve become used to, but that can change in time. What’s nice is that my pastor from the previous church and his wife, one other couple and a single dad have decided that they really like this church as well.

There is so much I want to say and I don’t even know where to start. My mom celebrated her 90th birthday last September and she is feisty as ever. She mall walks everyday, plays bridge twice a week and attends several social butterfly lunches. You’d never know it to see her. I have this picture of my Mom and I with our heads together and we have the same colour hair considering I am 36 years younger than she is. I sure hope I come from her gene pool!

Unfortunately, my niece and all of the “precious” great-grand children came with her. She knows she smells like a rose and can do no harm. That pure bull. While she can smile and laugh with the best of them, she is quite devious underneath. Just remember that she is the one who refuses to invite me to the family holiday festivities. I am the only one not invited. Well, after everyone had eaten their dinner and was just sitting around the table in the restaurant, I pulled K outside to finally end it all and call a truce even though I still don’t know how I ever pissed her off that much (hell, maybe she’s homophobic, I don’t know). I pointedly asked her why had I been excluded all these years and she said, “but I only invite my family.” Heck, I am her Godmother and her Aunt. What part of “her family” does that not fit? So what am I, chopped liver…LOL?

My Mom once told me to rise above the circumstances. So, regardless of what K said, I still decided to send her a 5x7 close-up of Mom already framed and a framed wallet-sized photo of Mom and Santa. I also happened to send it to my nephew (her brother) and my brother (yeah, I know, surprise, surprise). Today is 13 January and I have gotten a thank you from everyone except K. Well, now I can wash my hands of her. The next time I will see her will most likely be at my Mom’s funeral. My intention after my mother dies is to make no overtures towards anyone left in the family. If someone calls me, then that’s a different story. But I am an adult and I don’t have time for such foolishness. The only person I can see having a loose relationship with is my older sister P. We have been on good terms, but she is so much like Dad was. Always offering advice when none is asked, and always reminding me of how I could have done something better. Come to think of it, my brother L has the same rock to stumble over.

And so it begins—a new year filled with possibilities. Last October and the ensuing months were the absolute low point in my life. I don’t wish to be faced with the same set of circumstances that led me to attempt suicide.

I quit seeing the therapist I was first assigned to because her available hours conflicted with my work schedule. So she graciously referred me to another therapist she had good words to say regarding her, but I went to two sessions with her and she was a tad bit over the top. Look, I don’t care what time of day it is, I cannot deal with chirpiness. She was just wa-a-ay to happy a camper. So, I called the office, indicating that the second therapist was not a good fit and could I return to seeing the first therapist. The woman who answered the phone said they would have to check my medical records and have the request referred to the nurse and someone would get back to me. Well, it’s been a month and I haven’t heard anything. Yeah, I know, I should probably call and follow-up; I just haven’t had the energy to accomplish much of anything.

I am still seeing my psychiatrist and now my visits are once every three months—more of a med and status check than anything. Nevertheless, he is quite concerned about my lack of attention, focus and my short-term memory issues that have had a measureable impact on my job. He wants me to go in for neurophysiologic testing to see if we can pinpoint either the cause of the problems or if it’s temporary or not (it’s been over a year now…sounds kinda permanent to me). My psychiatrist is worried that I may have caused some injury to my brain when I attempted suicide (God only knows what flowed through my veins that night). Then, after the results are in (I have no idea what tests they would be performing), I may have to do neurocognitive rehab. I have no idea what that is all about either.

Well, I’ve now had my car for one year and I am still happy with it. But get this, I only have 3900 miles on it. I just don’t have long distances to drive around the city. Almost everything I do except for grocery shopping is within walking distance. That’s my effort of getting off my lazy ass and generating some energy burn. I found out yesterday from my Mom that the Honda Fit made Consumers Reports their best value, and Car and Driver put the Fit in their top ten for five years in a row.

OK, shift in focus. Sunday night it began to snow heavily here (I live in the southeast US). We usually don’t get snow, but ice storms instead. At night, it was so serene and picturesque. It was like looking at a huge Ansell Adams mural. When all was said and done, we ended up with 10 inches of snow. I had so much fun. However, I did learn one lesson…don’t attempt to make a snow angel in 10 inches of snow. When you fall back, it’s a longer way down than it looks, and then, once you’ve landed, all the snow falls in and buries you (my most graceful move yet). 4 days later, only the streets are finally cleared, but all of our yards are still covered with the leftover snow. The fact that the temp hasn’t risen above freezing all this time is making it harder for the snow to dissipate. But it sure was peaceful and beautiful. That, most probably, will be our big storm of the season.

I can tell I am losing some of the ground I gained when I was in that outpatient therapy program for 3 hours a day Mon, Wed, and Fri that lasted for three months. I feel the BPD becoming an issue again. I am isolating again and at the same time having a pity party that I don’t have more friends, then I take solace in my aloneness (I prefer that to loneliness). When I really think about it, I love living alone so much that I don’t even entertain the idea of dating much less having a girlfriend move in. I love my privacy. I love not answering my door (unless I know already that someone is on their way…I make them call me when they get in my driveway). I had fun with the Census Bureau. I did not fill out the form and mail it in. I feel it’s an invasion of privacy despite all their protestations that ALL information will be kept confidential. HA! They started coming by the house, first one, then another for a total of five visits. I ignored them completely. They even went to my neighbours twice (they had already been coached to answer in such a way that it did not reveal gender and number of people living in my house). I just don’t want someone knowing my business. While I applaud the medical community and their HIPAA regulations, we could sure use some of that stringent guideline in the private sector. Face it. Too many people know too much information on everyone. All it takes is this wonderful Ethernet world.

I promise, I promise to get back into my blogging on a regular basis. I guess too many of you are sick of listening to Santana. I left it as my playlist for this past year. Today, when I post this entry, I will change the music (I promise). It sure is nice to be back again.©2011

20 February 2010

Week in Review 20 February 2010

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I apologise for the delay in posting my weekly reviews. I have been so busy at work that time has just flown by. So let me catch you up since my last entry of Week Ending 30 January 2010 (see post below).

Work: My job is slowly piecing itself together. My confidence has risen a little bit and I finally got ahead of my emails. For the past three weeks, I have ended the day with as many as 90-100 unread emails. By Wednesday of this week, I finally tackled them all and now I may only have 6-12 emails I have not gotten to. What an improvement.

I feel as though I am actually accomplishing tasks at work and being able to scratch off items on my to do list. I still have about 20 requests I have not handled—some more complex than others.

My circadian rhythm has settled now. I am going to bed around 1930-2000 each evening because I am awakening on my own around 0345. My job requirements changed while I was out on medical leave. Before, if I was in the middle of something crucial and it went past my eight-hour workday, being salaried but non-exempt, I would be paid overtime. I ended up working 10-hour days frequently, which very easily made me feel burned out. When I came back to work 04 January I was told no more OT would be approved which really lightened my burden. Oh, sure, that always left me with not enough time to get my daily job done, but I was freed from the expectation that I would work the OT if I had to. So, I clock in at 0700 and clock out promptly at 1530. Because I am getting up so early, it gives me a chance to drink my hot tea, eat breakfast and stay on my strict medicine schedule.

Now, here is the bad news. Now they have decided to make us salaried exempt meaning if I have to, I am expected to work additional hours without being paid for it. In my book, I think that is a punch in the gut. That is management trying to cut the bottom line while still expecting superior work effort. Not sure when it goes into effect, but this had the potential to increase my anxiety levels.

My Psychiatrist: I had my appointment back on 03 February. He seems pleased with my progression, but concerned that I am still battling the depression. Overall, since the mood swings have stabilised I can see some improvement. He did not make any changes to the cocktail and now I have graduated to only having to see him once a month for the time being. I am looking forward to reaching the point when I only have to see him once every three months.

We talked about my residual symptoms of incurring Wernicke’s Encephalopathy which is still lingering. I am still having problems with my eyes as I am still experiencing saccadic movement  which slows me down at work. It is very frustrating. Also, I still experience short-term memory loss which is equally as frustrating. I have to take copious notes during integrated phone/data conferences so I do not forget anything. I cannot tell you the number of tablets I go through just collecting facts and action items on my part. My psychiatrist believes that my brain will heal slowly over time.

Individual Therapist: My last appointment with P was 03 February 2010. It was a non-event because I told her I was going to have to switch to a different therapist. P’s last appointment of the day is 1300, right smack in the middle of my workday. I need someone who can meet with me at 1600 or later. She highly recommended one of her peers equally qualified, but when I tried to make an appointment with S for two weeks, she was booked. I now have to wait until 09 March—one month out. I will try her on for size in hopes that we can make a connection. It is going to be a bummer having to start from scratch even though she has P’s notes in my record. I just hope she takes the time to read it before our first appointment.

My Car: Well, I am now the owner of a 2010 Honda Fit Sport. I have had it since 06 January and have only put 78 miles on it! I just do not have any long rides to takes around the city. Almost everything I do is right in my own neighbourhood. There is a small part of me that is excited by the fact that I have a new car. However, what is first and foremost in my mind daily is wondering if I can really afford this car. I did well in negotiating it down from the MSRP, but a car payment is still a car payment. It still has that new car smell. Also, I have made the decision that I will not smoke in this car. Hasn’t been too difficult. I just make sure I do not bring my cigarettes with me.

I will try to be better at really trying to nail down a weekly review on time. It’s hard to remember the small, but important details two and three weeks out.©2009

30 January 2010

Week in Review 30 January 2010

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Not much to report this week. I had no therapist, psychiatrist or GP appointments for a change

Work: This full-time work week hit me like a ton of bricks. It is as if all my clients all knew I was back in the office all on the same day. I simply cannot keep up with the email, nor respond as quickly as I used to with some of my more high-profile clients. I still have emails unread dating back to this past Monday 25 January.

I had one major escalation that was a forefront priority for me that I had to stay on top of from the start. The problem was presented to me last Friday afternoon and it resulted in a client wanting a particular service on a product we offer. I let the client know that I understood the importance of a speedy reply to see if we could accommodate his request. No one on my team could give me a firm answer, so I was directed to Technical Operations.

Well, that group did not respond back as quickly as I hoped, but I dropped the ball by not keeping the client completely in the loop in just continuing to communicate that we were still looking into it, but so far, we had not heard back from Tech Ops. The client decided to escalate the issue above me that did not put me in the fairest of light (sometimes you learn your lessons best the hard way).

When all was said and done and Tech Ops told me that we could not accommodate the client’s request, my main concern was regarding who should be the one to tell him: someone from Tech Ops or me (I figured Tech Ops could explain better the technical details of why we could not provide the requested service).

After getting a few other emails from the account team who was also working with this issue, including my manager, and realized that no one had STILL not communicated anything to the client—now a week later—I decided to be proactive.

I called him and reiterated just how important this issue was for them; I told him I that I was remiss in not keeping the lines of communication more fluid in the intervening time, and offered my apologies for the duration of time it took for me to give him a final answer that we could not technically provide the requested service. He was very understanding. He said that he knew I was working hard behind the scenes. I still took responsibility for my lack of communication, and we parted amicably. He said he would contact me next week about some other information he would be requesting, more notably the specifics of the services offered by the products we were supporting for them.

This whole ordeal probably put a smear in my column in my manager’s eye, but I just have to chalk it up to an experience learned. I have always felt very strongly about providing excellent customer service to my clients; I do not know why I dropped the ball on this.

My other problem, which might have leant itself to the aforementioned issue, was the enormous amounts of email that kept streaming in. At the end of every day, there have been approximately 80-90 emails I still have not read, some stemming back, as I said, from Monday the 25th. I only have eight hours in a day (no overtime allowed) and can only process so much. I quickly scan throughout the day the subject headers to ferret out what might be higher priority items. I catch what I can, but I know there are clients who are still awaiting a response from me. In some cases, the questions I am being asked require me to run reports which take 24 hours to run, so that already puts me behind a day. Then I get emails where I simply do not know how to take care of the problem (my memory is still wreaking havoc). Thankfully I have a 12-member team who I can reach out to, but I fear they will get tired of my questions soon enough. What I fear is that they will not remember that I was only on this new job for two-and-a-half months before being out on a three-month medical leave. Essentially, I am still on my learning curve. There are parts of this job I just have not been exposed to yet which is resulting in me being slow on the uptake.

The bright side of this week was my performance review that my manager held with me on Tuesday. He said he was remarkably pleased at just how far I have come in gaining experience in the position and how fast I was learning everything. He pointed to my desire to provide superior customer service as one of my strengths, and the one thing I needed to develop was my sense of self-confidence in performing my job. If he only knew! I did discover that the company approved raises for everyone and I merited a 3.5% increase. Well, it is better than nothing! I also found out that the company has approved a performance bonus this year payable in early March. I am not sure what mine will be, but I will be happy to receive whatever I get. (business has been good, thankfully).

My Car: Well, ole Betsy (never her real name, just seemed fitting at the moment) has retired. I have been spending the last two weeks searching for another car. I want to stay with a Honda as mine lasted for 16 years with mega-mileage. I looked at several dealerships thinking I would examine their certified used cars that came with a warranty. In each case, all they had were Civics comparable to mine —somewhat new, but with massive mileage. Sure, affordable, but I would be right back where I was in a short time. The other choices were the high-end Accords that were not affordable. I had already examined a new 2010 Honda Fit Sport that, when we got down to negotiating, was a far cry lower than the Accords. At this point, why should I pay more money for a used Accord when I can have a brand new Fit for a few thousand less? Moreover, this one comes with a lifetime power train warranty (the very thing that went out on my old car that never had more that the standard bumper-to-bumper three years or 36,000 miles). I did negotiate a good deal and got rid of the sales person and dealt directly with the manager who ultimately had the final say so. We must have pushed the proverbially piece of paper back and forth about five times. Nuts and bolts, I will be getting the car at $3500 less MSRP plus some of the options I wanted. I have never been afraid to negotiate and walk out the door, and this particular dealership (the last of the three locally, two of which I had already walked out when they didn’t meet my price) started hedging when I said that I was prepared to drive 90 miles or so across the state line to get a better deal. Then they started singing my song. I will be picking up the car next Saturday.


General Info: Aside from the constant anxiety at work, my bipolar appears still to be in balance. In addition, my sleep patterns are almost back to normal. It has been such a long time since I have been able to say that. Currently, I am not depressed or manic. Is this what “normal” is supposed to feel like? I would not know; I have never been here before.


Next week I have my appointment with my therapist and psychiatrist. I did have quite an unexpected expense this week. I had to get my bipolar meds refilled. I already know that I have to stay on them, so I bit the bullet and called my insurance’s 90-day prescription by mail program. I had to fill my Geodon and Provigil (not generic) and my Lamictal. Because I still had $1150 of my $1200 deductible, one or some of those meds were going to have to be a full retail price. I almost fell off my chair when they quoted me the Geodon at roughly $1172 for a 90-day supply. So, that drug alone covered my deductible and I got the other two dugs with the insurance cap. Now, how many people can say that they’ve met their medical insurance deductible by the third week in January…LOL.©2009

23 January 2010

Week in Review 23 January 2010

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There are subjects that I have not caught you up on since returning to work full-time. I am going to use this week in review to address the various issues that actually encompass more than just this past week.

Iron Infusions: The study included receiving 1000mg of IV iron infusions. I received 200mg Mondays and Wednesdays for 5 days. Throughout the process, the clinical specialist drew blood to check my haemoglobin and ferritin levels. This study will go on for a year although no more iron infusions are to be given. All subsequent visits are geared towards monitoring my blood levels to see how I fare over the course of the year. On day 35, after the final infusion, my haemoglobin only rose to 12.1 (normal is around 12.3-16). However, my ferritin level (one of the key indicators in my case) rose from 5 before the study to 96. While I am pleased with the ferritin level, I still have borderline iron deficient anaemia. I am disappointed that my haemoglobin did not rise any higher. I am curious to see how the blood level results will be over the rest of the year. My savings grace is that I have not had to pay for any of this as being part of this clinical trial, and the added bonus is, once I have completed the yearlong study, I will be compensated for my travelling costs.

Vitamin and Mineral Deficiencies: If you recall, I began having symptoms of ataxia on 13 November 2009. It began with being unable to keep my balance then progressing to ocular involvement called nystagmus then to short-term memory loss. I failed certain neurological tests (most notable the Romberg test. The combination of all three symptoms indicated that I had Wernicke’s encephalopathy that does, in effect, eventually causes organic problems with my brain. If left untreated, the transient symptoms will become permanent. It was suspected that mine was caused by a vitamin B1-Thiamine deficiency. As a result, my GP decided to run a huge panel of vitamin and mineral blood work. The results showed that my B1 levels were undetectable as well as my Selenium levels (essential for the proper functioning of the immune system). I was ordered to start taking 100mg of B1 twice a day and 200mg of Selenium once a day. After six weeks, the repeat blood tests showed marked improvement and my balance had almost come full circle, although I still have some ocular involvement and short-term memory loss (my brain is healing slowly). Another level that was far below normal was vitamin D. Instead of taking an OTC version of vitamin D, my GP wrote a prescription that I am to take once a week for eight weeks, then once a month forever. This does not even include the fact that I have to give myself 1000mcg vitamin B12 shots monthly forever. My doctor essentially told me that I would be taking these vitamins and minerals forever, along with a multi-vitamin that I am supposed to start taking. Coupled with all of my bipolar medications and the ones for my continued high blood pressure, I am swallowing a horde of pills a day.

Individual Therapy: Now that I am no longer in group therapy, I have starting seeing an individual therapist. 20 January was actually my third visit with her following the intake assessment and one follow-up appointment a couple of months ago (my group therapy took precedence). This visit I determined that one of the first factors I had to deal with was my borderline personality disorder.  You’ll note further down in the link what the causes are—I meet all of them. In examining the causes, I decided to deal with my disruptive family history first. I have discussed at length in previous entries how I have been treated as a pariah at holiday gatherings these past seven or eight years always celebrated at my niece’s home. She patently exclaimed that I was not welcome the first time she hosted these events. I ended up attending, even though I had not received an individual invitation, as a result of my nephew’s insistence. He said, “Alix, family is family. You belong there.” When I showed up at the front door with my nephew, my niece clearly displayed her anger and let me know I was not welcome, but she could not refuse my entry because other people had already noticed me, so she was stuck. The entire time, even my mother showed her displeasure, I was uncomfortable. Always the queen of protocol, she said I should not have come because I did not receive an invitation. To this day, I have no idea why my niece hates me—my mother will not volunteer any information and my sister even told me not to confront her daughter. So much for my supportive family.

Getting back to my early years, I was sexually abused at age five. Upon my mother and older sister finding out, my mother shook my shoulders and told me I was never to ever speak of this to anyone. This was during a generation when it was not understood nor dealt with. I was made to feel as though it was my fault. The family dynamic changed forever after that. I felt abandoned by everyone because no one would help me with all of the shame and guilt I felt. Years later, those memories were buried during the haze of my years-long addiction to smack and coke (I used to shoot speedballs). I eventually cleaned up and have been clean for 23 years. However, during my detox period, all those memories came flooding back. I worked up the courage to confront my mother about the sexual abuse and at first, she denied it ever happened. Then, with further insistence, she simply said it was in the past and refused to discuss it with me ever.

A few years later, my parents had a huge celebration for their 50th wedding anniversary. I was living out of town, but my mother wanted my son and me to attend. I simply asked if that particular family member who abused me would be there and she replied yes. Then she told me that I was only welcome if I did not create a scene. I promised I would not (always being the dutiful little girl trying to find that ever so elusive but never found approval). However, I was very anxious about seeing this family member (whom I shall refer here as L). I had not seen L since the memories surfaced. I was not sure how I would react. When I saw him I felt a flood of emotions wash over me and I was not sure I would be able to control myself, but I remembered the promise I had made to my mother. He acted as if nothing had ever happened. I kept my limited contact to perfunctory responses and immediately found someone else with whom to interact.

The next two obligatory times I had to be around L was my father’s funeral and my nephew’s first wedding. I could not keep my distance as far as I wanted because these events were small family gatherings, but I was determined never to attend any events where he would be present with the exception of my mother’s eventual funeral.

Or so I thought. My sister called me this week and told me she wanted to do something special for my mother’s 90th birthday in September. She wanted everyone to be there. Not only will I have to deal with my niece (a favoured one as she has produced my mother’s only great grandchildren), but there is an outside chance that L will be there. My sister did mention that L had declined because he had already booked a hike in Italy and that was his priority. To tell you the truth, that pissed me off. Isn’t my mother’s 90th birthday, an occasion that will never come again, something that should take precedence above all else? Tell me that he did not know that the week he booked his hike was during my mother’s birthday and that it was her 90th. How callous can someone be? Of course I already had a very poor opinion of him (to say the very least), but this was the last straw. As oxymoronic as this sounds, I hope he changes his mind, if only for my mother’s sake.

So, getting back to my therapy session…I made it a special point to tell P that this celebration would be coming up in September, one that is creating enormous anxiety for me, even now. I need to process all that has happened since childhood. Since the event is not until September, this will give me quite a while to try to come to terms with everything. I wonder what the process will be concerning trying to deal with everything. I can only afford to see her every two weeks, so I hope we can accomplish a lot.

My Psychiatrist: I am now seeing him every three weeks—a far cry from weekly appointments along with daily phone check-ins. R seems pleased with the state of my bipolar disorder, and so am I. The cocktail he has me on (Lamictal 200mg 2/day, Geodon 80mg in the morning and 240mg at bedtime, Provigil 200mg 2x/day, Lexapro 40mg daily, Ativan 2mg 4x/day, and Ambien 20mg at bedtime) has been very productive. I am being cautious about the Lexapro since it is an anti-depressant. In bipolar patients, while these types of drugs can battle the profound depression I found myself in, I have to be aware if I progress to any mania since these drugs can produce this side effect. I am monitoring this very carefully. I do not want to mess with this cocktail as it is servicing a precious need of keeping everything in balance right now. However, R has discussed getting me down to a maintenance cocktail that would probably result in taking me off some of this medication. I do not think I am ready for this yet. It been too soon since I tried to commit suicide. While I have made great strides, I still feel as though, at times, I am teetering on the edge. Even though my next appointment is not until 04 February, I know I can call him at any time. He always calls me back and spends however much time I need without the cost of an office visit. I am very blessed to have such a wonderful psychiatrist.

My return to work: The days leading up to my first day back to work on 04 January was met with much trepidation. I was full of fear and anxiety as much as I tried to stay in the moment. As part of my medical disability status, R sent a letter to the group managing my FMLA program indicating that I should only work four-hour days the first week and six-hour days the second week. My manager was very supportive about that suggestion. I also asked my manager if I could adjust my schedule to work 0700-1530 opposed to 0800-1630 which he agreed to. This serves a two-fold purpose. First, it frees up the afternoon to make available opportunities to have my continued appointments without missing work. Second, I am finished working while the sun is still shining—something that is important to me. I used to hate waking up in the dark and finishing my day in the dark, especially during the Standard Time Zone in winter.

The first two weeks my manager wanted me to concentrate on taking some mandatory computer-based training that was indicated during my absence. Then he wanted me to cull through the 1000+ emails that had collected during the three months I had been away. Just as an aside, no one from work ever knew why I had been on medical leave. Nevertheless, I had to explain to my manager that one of the side effects of my “treatments” was a vitamin B1 deficiency which resulted in a transient short-term memory loss. He seemed to take that OK. But that factor gives me a lot of anxiety as I don’t remember how to do a lot of my job. I was only in this new job for two-and-a-half months before being gone for three. So, I am still on my learning curve. My team may not appreciate the fact that I still have to ask questions, especially on some things of which I had already displayed knowledge.

After the first two weeks, then all of my clients were informed that I was back to supporting their accounts. Just when I had cleaned up my email box, as of the 19th they started flooding in again, yet another source of anxiety. I made it clear that I was not capable of working any overtime, so I am always left with emails that I have not read by the end of the day only to snowball into the next day. Too many critical projects are all happening at the same time. Meanwhile, my day-to-day responsibilities go on.

I try to stay in the moment each day and that, along with relaxation techniques such as being mindful and deep breathing, are helping somewhat. I have to admit, my Ativan plays a roll here as well. My goal is to do the best I can for my clients during my eight-hour day, and when that is over, to simply walk away from the laptop and let my business line go to voicemail (I work from home). I am giving myself room to acknowledge that I am going to be slow on the uptake for a while, but I have to believe that, at some point, I will be back up to speed.

Overall, I am now in a much better space than three months ago. I am quite surprised at the insight I have discovered about myself along the way. I know I will never “recover” from my bipolar disorder and will be on my meds for the rest of my life. That is a sobering thought (and an expensive one—the Geodon alone costs about $1200 before my $1200 yearly deductible is met). It hurt to pay that much a week ago for my refill, but how many people can say that they have met their deductible during the second week of January! At least now, my coverage for everything is at 90%.

I know this was a long entry, but I had so much to review. It is my intention to do a week in review each Saturday since I am back to work full-time. I have to admit, after being on the computer all day at work, sometimes the last thing I want to do is to get back onto my own computer after work.©2009

11 January 2010

Three Months Since…

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I cannot believe it has been three months since I was involuntarily committed  when I tried to commit suicide. It seems like a lifetime ago (no pun intended). So many of the details have just become a hazy dream.

I still do not remember any of the events that led up to being committed. I guess I never will. At least I have all of the medical records to give me an idea of what and how it transpired—what a rollercoaster ride these 90 days have been.

I can say right now that I am in a much better space than I was on 11 October. It has been several weeks now since I have had any suicide ideation. For a while there, after I was discharged, it was a nightly event. I have done a lot of hard work in my group therapy sessions that ended 30 December. And, it appears that my psychiatrist has come up with a sustainable cocktail that has stabilised my bipolar disorder.

Do I regret what I have gone through? Absolutely not. The end result has been incredible. I am stronger mentally than I can ever remember since being diagnosed in 2000. I had what I thought was a pretty good cocktail all those years having nothing to which to compare. What I did not have before was a strong handle on specific coping skills that made the difference this time. Oh, sure, when I tried to commit suicide in 2005, I was exposed to DBT, but never felt it was for me. Truth be told, I thought it was all a bunch of bullshit. And, I’m not saying that I am totally sold on DBT even now—some of the tools have worked well for me; others have been not so much. This time around, I made a concerted effort to learn these tools even, if at first, I resisted strongly.

Lessons learned? I am not sure I can even address that facet yet. I am still feeling my through this maze. OK, one lesson I did learn hard was to never go off my medication. However, when I made the choice to go off my meds in April of last year, it was because I had just found out I had been laid off and could not justify the enormous expense. Now that my insurance has rolled over to a new calendar year, I still have to meet my $1200 deductible for this year. That means I have to pay 100% of all my meds at retail price until the deductible is met. Even though I have a job now, I am pretty tight financially and I am not sure where I am going to come up with the money. But, if I have to, I will put it on my credit card even though it pains me to have to resort to that possibility. I simply do not have the option to go off my meds.

Another thing I think I have learned is the enormous help therapy has been. Now that I am back at work, I can no longer participate in my group therapy sessions (they were always held for three hours three times a week during the middle of the day). I have hooked up with an individual therapist now and saw her last week (I had already had my intake appointment some time ago and one follow-up, but I had to concentrate on my group therapy then). I am not sure how individual therapy will help me as the dynamic is going to be different from group. When I met with her last week, I actually told her I was not sure where to start. She asked me what issues I had that were most pressing to me. Not wanting to bite off more than I can chew, I told her that I wanted to focus on my stress now that I am back to work after being on short-term disability for 12 weeks.

Now that my BP has stabilised, I am going to have to start to deal with my borderline personality disorder and my anxiety disorder. Now, that is going to open up a whole big can of worms. I think that I am only going to put one foot in front of the other and take everything slowly. I have made some significant process and I do not want to find myself in a spot where I begin to regress. I value where I am today and that is what I am going to hold onto—the here and now. As someone once told me, yesterday was over last night and I have no control over tomorrow.©2009

06 January 2010

My First Day Back to Work

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I woke up yesterday morning about 15 minutes before my alarm had been set. I got six-and-a-half hours of sleep and felt well rested. I woke up earlier than I had to in order to enjoy some time drinking my hot tea and settling my anxiety about this eventful day. I had no idea of what to expect.

I spent my last day on full time disability (Monday) talking to my manager. He assured me that everything would be fine. The disability claims group approved me to go back to work from the 5th to the 11th at fours hours a day and from the 12th through the 18th I’d be working 6 hours a day. I explained to him the downside of my vitamin B1/Thiamine deficiency with regard to my short-term memory loss and he understood that it was going to take some time for my brain to heal.

This first week back all he wanted me to do was to go through my email inbox and blow away the majority of the unread emails as my back-up team members were taking up the work covering my clients while I have been away. For these two weeks, my out-of-office email auto reply and my outgoing voicemail message still shows me being out of the office. My manager does not want me to interact with my clients for these first two weeks. He felt that I needed a gradual immersion back into the fold. I am so grateful to have such a wonderful manager. After talking with him, my anxiety levels were reduced.

Well, the moment I had been dreading was finally upon me—opening up my email account. There were 1000+ unread emails just waiting there for me. I took a deep breath (and an Ativan, I will admit) and sorted by sender. It turns out that there were so many I could just delete. When all was said and done, I ended up keeping 73 emails that I felt I had to read which I did. Many came with important attachments about my specific accounts that I would have the need to use later. I saved and filed all of those in the appropriate folders; the next thing I knew, it was 1100.

Oh yeah, my boss did agree to letting me change my work hours and now I will be working 0700-1500—no more overtime hours allowed. I am so grateful for those two situations. I wake up so early anyway; to have to wait until 0800 would be counter-productive. In addition, the upside is getting off at 1500 while there is still sunlight. This gives me the chance to accommodate any doctors and therapists appointments. I never did like working the normal eight hours where the sun was just coming up when I started work and already set by the time I was finished. I hate Standard Time and the sun setting so early in the Winter.

My day actually went quite smoothly. I was very methodical in how I approached the day; I received excellent support from my boss; what more could I have asked. Since my day started at 0700 I was done at 1100. I had the rest of the day free and I realised that I needed a distraction so I would not dwell on what may or may not occur my second day back. A friend of mine had been sick over the weekend and I called her up telling her I was going grocery shopping and asked her what I could pick up for her.

When I arrived at her house, my heart just went out to her. She looked liked she felt so miserable. We settled in and spent about two-and-a-half hours just talking. It was exactly what I needed to divorce myself from anticipating the worst for the next day.

Overall, it was a good day. I am not going to fret about the upcoming days or pile more on my shoulders (emotionally) by projecting outward on the worst-case scenario. I have hope that my job will be far more manageable now than it ever was before. Staying in the moment—what a marvellous tool!.©2009

04 January 2010

Anxious About Returning to Work

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Well, tomorrow is my first day back to work after almost 12 weeks of short-term medical disability. I had only been working in my new job for approximately two-and-a-half months. I am afraid that I will not remember how to do my job. This is a high-stress work environment and I have a lot of high-profile clients that I serve. I am not sure I am ready for this.

Last week my psychiatrist faxed in a request so that my first two weeks back be half-days only. The disability group is scheduled to review that and decide today. I sure hope they approve this request. I have also left a voicemail with my manager requesting that my work schedule be shifted a tad earlier in the day so that I will be working 0700-1530 (not that I have ever only worked eight-hour days). In reality, this time around I am not planning to work any overtime. Working all those extra hours before set me up for my eventual downfall (aside from the very important fact that I went off my meds). I have not heard back from him yet; I hope he agrees to my request. Being able to be off the clock by 1530 will give me the chance to accommodate any doctors’ appointments I may have.

I am looking over at my corporate laptop which has been turned off for all of this time. I am even anxious about booting it up. Not that the laptop will not boot, but I wonder if all my access passwords into the network have been changed since I have been out all this time. I have to have access in order to be able to work from home so I can VPN into the network. I remember what all my passwords are, but they all have time limits on them. Some are only good for 90 days.

I am not even sure how to begin my workday. I ordinarily receive anywhere from 150-300 emails a day. I cannot even fathom how many unread emails are in my account. That thought alone has my hands shaking. Just as I was starting my disability time off, my department was being reorganised and eventually was slotted to be under a new management chain. My manager is still my manager, but the food chain on up from there changed above his level. I hope I am not in for any nasty surprises when I return (meaning I hope I still have a job). I know that my job has been protected while out on FMLA, but that doesn’t mean they can’t come back to me as soon as I get back and say to me, “Oh yeah, Alix, while you were gone we eliminated your position. Thanks and have a nice day.”

I have left another voicemail this morning for my manager to call me back at some point today. I hope he is in. Chances are, he may have taken a few vacation days before the New Year during the time I left my previous voicemail; I need to talk to him today before I report back tomorrow. That is the downside to working remotely from home. My team is located all over the country. The only communication we have is via phone calls and email.

Well, I have planned out my day today to reorganise my office space back to the way it was before I took all this time off. I am also planning on reviewing all of my training notes to have everything fresh in my mind before tomorrow. I woke up this morning at 0430 and am already feeling tired. This does not bode well for my sleep patterns the rest of the week. I hope I can sleep a more work amenable schedule tonight.©2009

31 December 2009

Outpatient Therapy-Final Session

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Yesterday was the last session of my group therapy program. I began this intensive program 21 October and we have met three hours/day on Mondays, Wednesdays and Fridays. Yesterday marked my 30th session.

Initially, I was very phobic to these sessions. Similar to my attitude when I was involuntarily committed , and knowing I was only obligated to attend for two weeks, my original intention was to skate through those six sessions with no effort on my part. I was still pissed off at the world for how I had been treated to date; I did not want to be in therapy and I certainly did not want to get better.

You just cannot imagine the amount of rage that pulsed through my veins—think Incredible Hulk. However, as the mandatory two weeks came to a close, something was triggered inside of me. Somehow, I came up with the idea that I no longer wanted to go on feeling the way that I did. That level of rage and profound depression was eating away at me and I simply had no more energy left. I voluntarily agreed to stay in the program having no idea that it would take this long.

There was a very detailed daily check-in sheet we each had to fill out. It was basically a way for the therapist to determine and track our progress. The dynamics of the group evolved over time with old patients being discharged and new ones being admitted during my stay. While the overall group was large (in my eyes), averaging around 18-20 folks, once everyone took the 10-15 minutes to fill out the check-in sheet, we always split into two smaller groups. The groups remained split while everyone reviewed their sheets, and we all came back together as one group after the break to start the second half.

I could handle the smaller group in which we each shared what was on our sheets. Based on our input, the therapist would probe further with each of us and ask penetrating questions. The sharing half had a tendency to be somewhat tedious at times. Every so often, there would be patients that liked to hear themselves talk. Repetition is the key word here. They would go on and on about one particular issue and even talk over the therapist as if they had no interest in listening to her feedback. I could see the frustration on the therapist’s face every once and a while. As a result, sometimes the first half of the session would take a long time.

After the break, when we all gathered back together, I had a major problem. I had a rough time being around large groups of people. The noise level would always increase and sometimes everyone would talk at once. That started freaking me out. Therefore, I retreated from the large table in the room (it was actually five conference room-sized tables arranged in a large square) and sat in the chair against the door right by the back emergency exit—it was as far as I could get from the group. The emergency exit was not wired to an alarm, and when it got to be too much for me, I’d walk out the door and take a breather. Being that it was the end of autumn as winter approached, the cool, brisk breezes usually refreshed me.

The second half of the session was psycho-education [I’m sure that Alfred Hitchcock could have had valuable input here :)]. This outpatient therapy program was based on dialectical behaviour therapy (DBT).  When I tried to commit suicide back in 2005, I went through a DBT program after I got out of the hospital. At that time, I thought that DBT was pure bullshit. It all centres on learning tools or coping skills to manage various stressors (depression, anger, rage, anxiety, etc). Being that I had been diagnosed with Bipolar I Disorder (BP) and Borderline Personality Disorder (BPD), everyone thought that this type of therapy would be one from which I would benefit. Back then, I thought all these coping skills were stupid. Sure, it might work for some, but I just could not imagine me taking the time to think through whatever emotion I was feeling at the time and remembering which tool would help me through that situation most effectively.

When I realised that this time around would be centred on DBT, I was quite cynical. However, after about four weeks into it, I discovered some tools that could actually serve me well (see this for a list of tools). Without a doubt, using these skills effectively requires constant practise. You cannot expect to utilise a skill and then have it at your fingertips until you practise it. Once practised, when you face an emotional obstacle, you can more readily adapt effectively.

I also realise that there is a lot of controversy around DBT. Some who have been through the training think that it is bunk as I did. I can say that I do not agree with the entire skill set. I learned what tools I knew I could use and left the others behind (there are some I still think are bullshit). All I can say is that it is up to each individual to determine what works in his or her best interests.

That being said, the first half of my last session was great. Our small group only consisted of seven patients and our small group never had the loud mouths (I am grateful that Mr. Noisy was in the other group!). I knew three of them; the rest were new patients. When I finished sharing my check-in sheet, I received wonderful feedback from the therapist. She basically said that I had done a 180˚ from the time I started the program and was extremely pleased to see the progress I had made. It had taken me all this time to see the huge steps I had made. Don’t get me wrong; I am far from being all fixed up. That is why I am going to continue with an individual therapist. BP and especially BPD can take quite some time to manage. While some professionals banter about the word recovery, I think the best I will be able to muster is to manage my BP and BPD to a tolerable level. Only time will tell.

The second half of my last session was surprisingly smooth. While Mr. Noisy was present and accounted for (as well as the other few loud mouths), the group discussion on the continuing module of assertiveness was quite ordered. It was quite appropriate that my last module would be on this topic. As I have mentioned previously, despite my butch bravado, I really could bolster this skill.

Saying goodbye was harder than I thought. All of the patients who had been around for a while (with the exception of one other patient, I had been there for the longest duration) took their time saying goodbye to me and wishing me luck for my future. As someone laughingly said, “Hope to see you at Wal-Mart should our paths ever cross again.”

Overall, I have to agree with the therapist. I have come a long way since I tried to commit suicide on 10 October. It has been a long road for me, some of it fought tooth and nail against any type of recovery. I know I still have a long way to go, but for now I will just accept the fact that I am in a better space than I was almost 12 weeks ago.©2009

30 December 2009

Outpatient Therapy-Day 29 (28 December)

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Because of the Christmas holidays, the majority of the folks did not attend on Monday. After that last fiasco the previous Wednesday, I was glad the whole group was not present. In fact, with the exception of two other people, everyone else was from the other small group. I was concerned because Mr. Noisy was there, but when it came time for him to share the information from his daily check-in sheet he took a direct approach and did not go on and on about everything for a change (as he usually does when both groups join back up for the second half of the session).

It was odd sharing among this group; only two other people really knew me. My check-in sheet was pretty much straight forward. This was the second-to-last one I would be filling out and what a comparison to the first one I filled out 11 weeks ago. So much had changed over all this time. I knew that this coming Wednesday was going to be my last day. The input I received from the therapist was very positive. She couldn’t be as insightful as our small group’s regular therapist (ours was out for the holidays), but she still remembered the state I was in when I first joined the group. I at least appreciated that. She saw the tremendous difference in my attitude, but mostly how much I had changed in the anger area.

The second half of the session was spent still going over assertiveness. Much like the anger management module, this was a long one as well. Being more assertive is something I need to get under my belt. Much like the self-esteem module, the two seem to go hand-in-hand. The group discussion was far more controlled than last Wednesday and Mr. Noisy was less dominating throughout the discussion. I didn’t really have much input that day; mostly I listened to what the therapist was saying.

There is one tool I have been taught that has served me well. It’s called Using Your ABCs. “A” is awareness: the acknowledgement that an event has occurred—it is what it is and no value judgement is placed. “B” is your belief of what that event is. “C” is the consequential emotion of that belief. A ≠ C, but B = C. The theory is if you can acknowledge what the event is and form a healthy belief about that event, the consequential emotion will be a healthier emotion rather than a destructive emotion. Here is an example. “A” = my family has refused to invite me to family holiday celebrations. “B” initially was that I felt unwanted. “C” resulted in an emotion of anger and hurt that escalated more than the situation warranted which cascaded over the rest of the day and then some. If you can change the “B” to equal a response more like “Well, they are the ones missing out on my joining them,” then “C’s” consequential emotion will be healthier along the lines of perhaps still being hurt and yes, somewhat angry (there are times when anger is a perfectly rational emotion), but the intensity of the emotion will be far more controlled and not spill over into everything else that will ultimately escalate (or for as long as you repeat the same thought process).

These tools are serving me well, but I acknowledge that it is up to me to practice them so they will be available for use when I need them. Going into this program, I initially thought these tools were just a bunch of bullshit, but over time, I learned that they merited some attention on my part and realised their value to my success. I will be discharging from this group therapy this Wednesday, After doing this non-stop three days a week @ 3 hours each day, I have found the experience to be quite beneficial. While I am looking forward to being finally discharged since joining this program 21 October, I imagine there may be some group therapy withdrawal I may have to go through initially. This program has become part and parcel of my life since being committed on 11 October as an inpatient.

I have a follow-up appt with my individual therapist in early January to segue into a continued therapy module rather than just quit. I still have unresolved issues to deal with, most notably the tremendous stress I am feeling about returning to work. Yes, I am going to feel somewhat disconnected when my group therapy sessions come to an end this Wednesday.©2009

26 December 2009

My Christmas Day

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I woke up at 0430 and just listened to the pouring rain. It was coming down hard. I thought of my basement and the sump pump. Sometimes, the pump just about breaks even. I went out on my front porch and saw all of the puddles forming in the dark. Then I noticed all this newspaper scattered on the front steps. I had forgotten to check my mailbox yesterday and realised it was the grocery coupon mailer. I stuck my hand outside the porch door and grabbed what was in the box and left the soggy paper on the steps thinking I’d retrieve it later when the rain stopped.

I rarely get personal mail delivered to my house as I have a PO box. However, I noticed a red envelope and quickly looked at it thinking it was a Christmas card. It was. I almost cried when I read it. It was such a beautiful card from my son. I was so happy that he remembered to send me a card. With everything that has happened in the last couple of months, the only energy I was able to muster was getting a card and a present for my son. I did not send out cards to anyone, but I did receive about ten cards which pleased me.

I rambled around the house for a while and then went out to the living room and cranked my stereo and just sat there and zoned out on the music (it would have been far much more pleasant if I could have rolled a joint). After a while, I decided to check my email and was pleased to see an email from a good friend of mine. He was inviting me to join him, his mother, stepfather and adorable two-year-old daughter for their Christmas dinner later that afternoon. What a special treat for me. I decide to call him and accept the invitation once it got to be a decent hour.

The morning just crept by. I was not in the mood to do any writing and felt a little aimless. It was too early to take my medicine and I did not feel like reading anything. So, I just sat on my couch and closed my eyes and listened to the music. I am so glad I live in a house rather than an apartment. I do have an upstairs neighbour that rents the small attic apartment above, but he was gone for the holidays and enjoyed turning up the stereo louder than usual (he’s hardly ever home, so that doesn’t really affect me)

1000 came around. I called my friend and told him how delighted I was to get his invitation, and I would love to join them later in the afternoon. It was still pouring outside and hoped the weather would clear up before I had to leave. Imagine, my family all celebrated holidays without me (their decision, not mine) and here I was able to join another family to partake in a Christmas dinner. I was really looking forward to this opportunity.

The afternoon finally rolled around and I started to get ready. The rain had finally stopped. When I got to his house, it was great to see everyone. This was the first time I had met his stepfather. My friend’s parents live out of town, but I’ve met his mom before as sometime she comes to town and she attends church with him. His stepfather was a great guy. I really enjoyed talking to him as my friend and his mom got dinner ready (I was instructed to relax!). I felt guilty just sitting there while they worked in the kitchen, but I really enjoyed getting to know his stepfather

While the food was great, what I enjoyed more than anything was sitting around the dinner table and sharing the meal with this family. We spent such a long time lingering over dinner and dessert (my friend actually baked the cherry pie—while I love to cook, baking has never been my thing). The conversation was warm and inviting; I was having a great time. When dessert was over, my plans were to help his mom clean up, but again I was kicked out of the kitchen. The rest of the evening we spent in the living room all sharing stories. What a close family they were. I envied my friend; I had not had this much fun sharing a meal in such a long time.

At 1930 I was bushed. I think the combination of a great meal coupled with the fact that I had been up for 15 hours did me in. This was the best Christmas I had enjoyed since my son visited me.©2009

Outpatient Therapy-Days 27 & 28 (December 21 & 23)

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Monday was supposed to be my last day of group—the insurance company had only authorised sessions through then. I was not prepared for it to end. Despite my attitude at the beginning, I have gotten a lot out of this therapy and I think that I have made significant strides. I asked my therapist what process I had to go through for discharge and she told me she didn’t think I was ready, especially with the Christmas holidays coming up—she knew I would be alone as, once again, my family enjoyed their celebration with no nod to me. I am beginning to get used to the idea of spending the entire holiday season alone. My son came to visit me two years ago, but he lives out West and, for both of us, it can get rather expensive just to fly in either direction. So, the therapist told me to return on Wednesday as she was going to submit a request to see if the insurance would authorise additional days.

The second half was on self-esteem—something I am sorely lacking. Despite my butch bravado, I saw traits from the description of those who have poor self-esteem and I ranked right up there. That actually pissed me off a bit. Nevertheless, in reality, I do not always stand up for myself and usually take a back seat. I am not exactly a doormat, but I am not as assertive as I could be. It’s odd as at work I can take the lead with regard to directing projects (considering I have taken that blasted Six Sigma training), but when I am relating to others on a personal level it is more apparent.

As the session drew to a close, I wondered if today was going to be my last day. I gathered my stuff and flew out the door as I had another iron infusion directly after group.

I came back Wednesday morning and was pleased to find out that the insurance company had authorised three more sessions, including Wednesday, through December 30th. That would take me through the New Year’s weekend leading right up to when I was supposed to return to work. When our “small” group was sharing, I tried to process the difficulty and anxiety I was feeling about returning to my job. I fear that I do not remember how to do what I have painstakingly spent three months trying to learn. I try to stay in the moment as I still have another week to go, but I cannot help worrying about it. I feel stuck and do not know how to reinsert myself into the routine. I got a lot of good feedback from the therapist and others, but it did not necessarily quell my anxiety.

The second half of the session was on assertiveness—something that I am not very good at as I am more than likely to be either aggressive or passive aggressive. The entire group, as usual, gathered for this part and our entire group is getting way too large for me. It is enough that my little group, when we split for the first half, has too many people. I have discovered that there are a couple of noisy “talkers” in the other small group. As the therapist began her discussion on this topic, those talkers always had something to say about everything and would get into their own discussions if they disagreed with each other. The more they spoke, the louder they got and more people started getting into the action.

It was becoming too much for me. I wanted to listen to what the therapist had to say and ask my questions if any came up. After a while I thought, hell this is a topic on assertiveness, I think I will try it on for size. Rather than just jumping into the fray as everyone else had been doing, I raised my hand (OK, that does not exactly project an assertive position). The therapist piped up (she was pretty good about keeping the group on topic) and nodded to me. I waited for everyone to get quiet, looked around, and gave everyone eye contact. Then I explained that it was hard for me to be around large groups of people, especially when it got loud and everyone was interrupting each other. I told them that when they got carried away, I felt anxious and asked everyone if they could respect my position.

At first, everyone just stared back at me and then the therapist chimed in first. She said she was glad I spoke up and voiced my concerns and told me that it was an assertive position I took and was very appropriate (I thought to myself, “So there, hah!”). Then the noisiest of the bunch jumped in and said to the therapist, “Excuse me, but don’t you control our group?” She said it was a group discussion, but everyone had to be aware of each other. Then Mr. Noisy said, “Well, I’ll respect your position.” I looked at him and wanted to say, “What am I, chopped liver?” What I really wanted to say was, “Fuck you” but I did not (so OK, I was not completely assertive). For a while everyone seemed to settle down, but it did not take him long to go back to his diatribes and, once again, everything exploded. There were ten minutes left to go, so I just decided the statement I would make would be just to pack up my stuff and leave the room. I was not that quiet about it (here is where I was being passive aggressive), pushed back my chair and got up and walked out of the room. I though, “Well, we’ll have Friday off for Christmas, so that will give me a breather.” However, I was glad my insurance had authorised two more sessions.

Two more days until Christmas. To tell you the truth, this year it has almost snuck by me. I do not get out much so I have not been too exposed to the shopping traffic. Moreover, I definitely do not go to the mall. I have forgotten that it was going to be Christmas on Friday. For me, it will just be another day.©2009

19 December 2009

Appt With My GP #5 (Friday 18 December PM)

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I have been dreading this appointment all day. My hand is still sore from the IV on Wednesday and they cannot seem to pop either of my brachial veins or the antecubital ones in my arms—fairly decently sized veins. Luckily, for me, the guy from the lab was working today and he has always been successful in starting my IVs when the clinical specialist could not.

Before each infusion, the clinical specialist always draws blood once the IV has been started to measure my haemoglobin. My GP told her that if it was 12.5 or better to wait until this coming Monday to give my arms and hands a rest. Well, the level was 12.3, but they both let it slide until Monday anyway. As usual, I made the appointment to take place directly after group. I still dread going, but I can’t beat the price!©2009

Outpatient Therapy-Day 26 (Friday 18 December AM)

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Today our regular group therapist was out. The person taking her place normally works as the inpatient intake therapist, so I was not sure how group would go. As I mentioned in a previous post, our little group was getting much bigger. When I looked around I noticed that we had three more new admits. I feet as if I no longer have a rapport with my group now that the original members have all been discharged. I have been here the longest—two months. Most people only stick around for four to six weeks.

I no longer feel that the group sharing part is meaningful to me since the other patients have no history of my background and what I have been through leading up to my time just before I joined the group. However, the second half of the session is still meaningful since we discuss the various tools to use to keep our emotions in a healthy balance.

Well, today was a little different. This therapist had a lot more to say for each person as each patient was sharing. I really liked his style. Looking back, I wish he had been the therapist all along. This is not to say that the regular therapist is not as competent—their styles are just different. I am still trying to process the increased depression I have experienced this past week as my financial situation looks so bleak. Most of the patients are on SS Disability full time. I do not see how they can afford it. When it got to my turn to share, one of the other patients suggested that I should file for bankruptcy. Aside from using the “should” word which imparts a value judgement, I cannot fathom filing for Chapter 7. I incurred this debt and I have an obligation to pay it off. He practically bragged about the fact that he filed two separate times. I just cannot imagine someone brushing off his or her obligations like that. Besides, I still have to get another car—how the hell I’m going to afford that one is still up in the air. My car is starting to make telltale noises, so I know it is not going to be around for much longer. I will never get financing if I file for bankruptcy. I have to be practical here. Because this therapist had a lot more to say with each patient, we spent the entire three hours going over our check-in sheets.

I cannot imagine not being apart from this group therapy. Despite the fact that I whined about it so much in the beginning, I have really benefitted from it. I found out yesterday that my medical insurance will only cover 27 sessions making this coming Monday my last day. Oh, yeah, I forgot to mention that the disability group that processes the claims did approve my extension through January 4th. I would like to be able to continue with this therapy for as long as I will be out of work.

Now that I have a fixed date to return to work on January 5th, I have to start planning for it. My FMLA runs out pretty much at the same time, so I no longer have any choice. I will be going back to work so I need to get that in my head and just deal with it. Oh how I wish I could afford to be on permanent disability. It is not as though I am being a gold brick about having to work. It is just that the job I have is very high profile and creates a tremendous amount of stress and long hours. It is going to be a rough transition after being out of work for two whole months. However, I am going to try not to stress out over that. Nevertheless, I cannot ignore it either.

Well, I have another appointment with my GP again today right after group to get another iron infusion. I sure hope that person from the lab is there as he has been far more successful at starting my IVs than the clinical specialist has been. You should see my poor arms and hands.©2009

Appt With Psychiatrist #10 (Thursday 17 December AM)

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Today is going to be the last weekly session I will be attending. From this point forward, I will be seeing my psychiatrist every two weeks for a while, then once a month. I will miss the weekly visits, but he and I both agreed that I have made tremendous strides since I tried to commit suicide. It will also be much easier on my billfold as my insurance does not cover any of his fees (he is out-of-network and that deductible is $5500—it will be quite a stretch to incur that much of a balance any time soon).

He has decided to increase my Lexapro to 40mg/day. We have both been pleased with how effective it has been even though I am currently experiencing a setback in my depression (which is the reason increasing the dosage). It has been the only anti-depressant I have ever taken that has had such a marked difference in my depression without tripping a manic phase.

I learned something new today. I just happened to mention the strange reaction I experienced on Monday after my first iron infusion. He said it sounded like I experienced Cataplexy that would explain the sudden onset of fatigue along with the loss of muscle tone. It is frequently associated with narcolepsy and Provigil just happens to be one of the drugs that combat narcolepsy, which might explain why I did not have that reaction yesterday.

Overall, I am glad that I have made such progress thus far. I have received excellent therapy support from both my group and my psychiatrist. I think I am going to have therapy withdrawal once I go back to work. I have arranged to start seeing an individual therapist once I finish with group. I have already seen her two times and I think we have the chance to build a good rapport.

What was nice about today is that my appointment was at 0700 and I have nothing else scheduled for today. It will be nice to have some down time.©2009

Appt With My GP #4 (Wednesday 16 December PM)

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The clinical trial continues. As soon as I left group I wish I had thought to call ahead of time to see if the office was still open. The weather report was calling for 70% chance of frozen precipitation mostly in the form of ice. When I left group, one of the parents told me that the county had already decided to close the schools at 1230.

As I was driving over to the office it was pouring, but there was no sleet mixed in with the water. Good sign. In most cases, when they predict snow or sleet, it hardly ever happens. I was a little concerned when I pulled into the parking lot as there only a couple of cars. Then I remembered that it was lunchtime. When I signed in, I did find out that the clinical specialist was waiting for me.

As she was prepping all of the materials for the IV, I asked her if she would mind if we just let the guy from the lab stick me instead since he got it on his first attempt on Monday (after she had already tried three times!). Therefore, we waited for him and, sure enough, he got a vein on his first attempt. However, as the specialist was adding the gizmos to the butterfly tubing she moved the needle and the IV infiltrated. I was not a happy camper, but we called the lab again and he was successful this time as well.

I like the fact that the iron can be pushed in only ten minutes. Sure beats the six hours I had to endure three years ago. Once the iron had been administered, I had to wait the customary 30 minutes to see if I was going to have a reaction. On Monday I didn’t have one in the office, but I did have that strange experience an hour after I got home. To be on the safe side I went ahead and took the Provigil just in case I started getting sleepy while I was driving home.

Well, it turned out that I did not have that strange reaction this time. Perhaps that reaction Monday afternoon was just a coincidence. However, I do not like the fact that I was overcome with fatigue and feeling so cold all at once. That has never happened to me before, and maybe it won’t again.©2009

Outpatient Therapy-Day 25 (Wednesday 16 December AM)

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My group therapy session today did not go as well as I had hoped. I am feeling more depressed these last few days, since Saturday, but I did not realize how much until it was my turn to share. As I was going through my daily check-in sheet, when I got down to the section marked “current stressors,” I had written that I was facing huge financial burdens due to all the medical bills coming in and that I still had to find the extra money to support buying another car. As I was talking about this, the tears just started rolling down my face. I hate crying, especially in front of other people, but I could not keep up my façade. I was not even sure what the catalyst was of my recent downturn of my mental status, but as I was sharing this, it became apparent to me that my money issues must have been playing a good part of my increased depression. Of course, there was no real tool to deal with these emotions—anything I tried was fruitless. My bills were not going away and there was nothing I could do about it. The latter concept should have given me a clue as how to handle this situation—to accept it at face value and deal with it. But, how can you deal with knowing you have much more outgo that income?

Just to add to my worry and anxiety, today is the last day of my short-term disability. Both my group therapist and my psychiatrist have submitted extension requests, but when I called the third-party vendor that administers disability claims, I was told that the decision would be rendered tomorrow, my first day back to work. I am definitely not ready to face that stress. I left a voicemail for my manager indicating that, while tomorrow is supposed to be my first day back, I was unable to return and that the claim decision would be made tomorrow. I indicated that if the extension is denied, I would like to take my remaining vacation days through the end of the year (I had 14 days still coming to me, and while I was going to be using up 10 of those days, I would end up losing the other four as my company does not allow someone to carry over any vacation days). Then I sent him an email saying the same thing. If they do deny the extension and my manager does not go along with my vacation request I will risk losing my job according to the FMLA rules—I would no longer be protected by the federal guidelines imposed by FMLA. Why can’t the disability group make their decision by the end of today to give me a heads up as to what I should do about tomorrow in case I do not get a reply from my manager? My psychiatrist submitted his request along with the supporting documents on Monday, two days ago. They have previously decided with paperwork only submitted 24 hours ahead of time. Why did they need 72 hours this time?

I also have to go by my GP’s office right after group to get my third round of those iron infusions. I am not looking forward to that considering how many times they had to stick me Monday just to find a vein. I also had that weird reaction when I got home, but when I reported that to the clinical specialist yesterday, she looked up the reported side effects. While feeling tired was one, feeling that extremely tired along with the muscle fatigue and feeling bone-chilled made me think that something did not add up. I do not want to get the same reaction again this afternoon. I am worried in case these side effects start appearing while I am driving home. To be on the safe side, I put a tablet of Provigil in the pill container that I always carry with me. I just hope they can find a vein much easier today. I still have bruises from Monday’s attempts.©2009

Appt With My GP #3—Iron Infusions (Monday 14 December PM)

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Good news…I found out last week that I have been accepted for the clinical trials for people that have iron deficient anaemia and can now qualify to receive my IV iron infusions for free, and they will pay me travelling expenses. The nice part is that all I have to drive to is my GP’s office. This past Monday I went for my first visit. The clinical specialist drew my blood to get a baseline haemoglobin level, and then she attempted to start the IV. Well, my veins are pretty much shot. She tried three times to find a vein, and then she finally called someone from the lab to see if he could start the IV. Boom, on his first shot he found one. It was a painful one in my wrist, but still the same, he got it started. When I had to have IV iron infusions three years ago, they gave me 25mg over a six-hour period. I had to have three at $1600 a pop. I can no longer afford to go back there.

One of the things they are testing me with is a new solution that will allow them to give me 200mg IV push over a ten-minute period—such an improvement. Once the iron was injected, the clinical specialist had to observe me for 30 minutes for any type of reaction such as anaphylaxis. I did not have a reaction so I went home and turned on my stereo and sat on the couch.

An hour later, I found myself nodding off. However, it was not a case of slowly getting sleepy and just closing my eyes. This hit me like a lead balloon. I almost could not move—all my muscles felt slack. Then I realised I was bone-chilling cold. Now, to save on money, I do keep the house rather cool in the winter, but I already had on thermal underwear, sweat pants, a sweatshirt and my thick terrycloth robe. I was freezing. I tried to get off the couch to snuggle under my covers and barely made it back to my bed. It took 20 minutes before I started to feel warm. As tired as I was, over the next two hours, it seemed that I just clock-watched. However, when I got out of bed (now much warmer) I had vivid freeze-frame images as if I had been dreaming. I was not as tired, so I went to my kitchen to make a pot of hot tea. What a strange experience.

The rest of the day was uneventful so I dismissed the entire episode. I am just glad that I can now get my much-needed iron infusions free. I wonder how many sessions I will have to have to raise my haemoglobin back to normal range (it was 9.0 before the iron and normal is generally around 14-16 for females). According to the protocol for this clinical trial, they can give me up to 1000mg over a two-week period, but stop at any point once my haemoglobin is within normal limits. I hope I do not have to have too many since they had such a hard time starting the IV. You should have seen my arms after this session—I had four nicely forming bruises where each attempt was made!©2009