30 January 2010

Week in Review 30 January 2010


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


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…


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


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




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