Outpatient Therapy, Day 23/Psychiatrist Appt #9

Today’s session went really well. My therapist said I had made such strides over the last seven weeks that she agreed that I could be discharged on the 18th. Today, in fact, we had some new people and some that have been in the group for a little while that had it rock bottom and the therapist used me as an example how things can really get better. I feel good about myself today—something that I did not foresee being able to say even a couple of weeks ago.

I have built up a small coterie of close friends that know me intimately—the ins and outs of my mental illness. This has become my support group, yet another thing I about which I did not even think about. I was isolating so much and vindictively pushing people away to purposely further isolate me. The ironic thing is that the majority of this small group is made up of people with whom I had gone to church. That is my next major hurdle—reinserting myself back into my church. I am feeling less anxious about it, but something is still holding me back. Perhaps it is because not everyone knows my complete story and I certainly do not want to share that with anyone who has not been along for the ride.

I still do not know what “normal” is, but I feel more content than I have for a long while. I have not had any suicide ideation for a while, but the main concern I have, feeling this good, is that I am not ramping up to swing into the manic dark side. I am carefully looking for signs, and my friends know what to look for, so they may see it before I do.

I am going to try to go grocery shopping by myself, cane aside, this weekend. I will see how I deal with being around a large group of people. This should be a good test for me. It has been the one hurdle I have not passed (aside from returning to church). I have gone shopping with a friend that lessened the anxiety, but it is time I try to do it for myself.

I also saw my psychiatrist this morning before group. He also seems pleased at my bipolar improvement. Now that I am getting about six hours of sleep these last two days he has agreed to start reducing my Zyprexa, yet one less pill to take. He is going to submit an extension of my disability (currently ending on the 16th) to return to work on Jan 4th for two weeks at half-time to gradually get accustomed again with full time beginning on the 18th. I hope they approve this extension, as I am simply not ready to return on the 17th. He is not sure if it will fly since I have made such improvement, but he is certainly going to try. He is going to send in the paperwork on Monday.

Well, folks, that’s my story for today and I am sticking by it!©2009

Yet Another Decision

Today is a day off for me. No appointments with anyone. Yesterday evening I made another decision, diametrically opposed to this one only made here.

I had nothing but time on my hands yesterday after my first encounter with my therapist. I spent much of the time playing catch-up in reading the many blogs that I follow and reading comments made to my posts, along with some personal emails I actually received from truly caring individuals. As the day progressed, I did feel the intensity of my rage lessen somewhat (certainly not from anything purposefully done on my part, I assure you)

I had already made the decision to come back and see the therapist for a second appointment—a commitment that I didn’t think I was capable of making, much less caring about. Early evening it occurred to me that if I am going to make an effort with this therapist, I should at least be responsible enough to go back on my meds (a value judgment?). I went back to my bedroom and lined up all the containers (three of which are for blood pressure since it seems I’m having an issue there as well and swallowed them all (I always feel I have to add the caveat: as prescribed LOL). With my history, making the statement “swallowing them all” takes on a whole other connotation!

Went back to my living room and spent the evening listening to some really fine jazz (John Klemmer, Stanley Clarke, Chick Corea, Miles Davis, Jean-Luc Ponty, Al DiMeola). As the evening rolled onward, I made a concerted effort to also start trying to structure the time I try to go to sleep (an ephemeral experience to say the least). Even though I felt far from tired, I took my bedtime meds, crawled into bed and tried to read a book. I am so frustrated with this last action. I opened up to where I had last read (just the previous day) and I had no memory of what this book is about (I’m only about 12-15% into the beginning). This repeated problem really pisses me off, because, if given the chance to be focused enough to read, at least concentrating on that action temporarily quells all my racing thoughts. *Sigh* I return to the first page and start over.

After a few minutes, I realized that I had made an error with one of my blood pressure medications, a mild diuretic (hydrochlorothiazide HCL, hereafter referred to HCTZ). This one, for obvious reasons, taken once a day, should only be consumed in the morning—certainly not just before going to bed. When I hopped up to hit the head, all of a sudden I did not feel so well. No, I wasn’t dizzy per se, but I felt as if I couldn’t catch my breath and also somewhat disoriented. It occurred to me that perhaps the blood pressure crisis I experienced while incarcerated was indeed situational after all. Was my blood pressure now too low? I walked around for a little bit and found myself having to sit down. Very weird feeling.

So, as potentially stupid as this action could result, I decided to drive up to the nearest CVS and use their BP machine. I had much difficulty driving; it required far more dedicated concentration and focus that what I am used to. When I walked into the store, the lights were too bright and there were too many people milling around. Without asking, I blindly walked to the rear by the pharmacy and found the machine.

Now, mind you, when I was first put on the initial does of medication, my BP had skyrocketed to 228/156. When I was released 11 days later, I immediately saw my primary care physician and my BP was still elevated (165/110). What was eerie in both measurements was the fact that my heart rate was only around 56. My PCP decided to alter the medication I was discharged with from the hospital. He effectively doubled the dose of one (clonidine HCL from 0.1mg to 0.2 mg, but dropped it from, 3x/day to 2x/day), increased to dose of another (lisinopril from 30mg to 40 mg 1x/day) and added the HCTZ at 25mg 1x/day).

I sat in front of the machine and it turned out that my BP had dropped to 137/61, HR 72. The diastolic measurement concerned me as I thought that was a bit too low which might have explained how I was feeling. I drove back home, still trying to catch my breath and thought about calling my PCP in the morning. Went back to bed, read a little and actually experienced the feeling of being sleepy (hooray for me). Perhaps adding the Geodon to my bipolar cocktail might have made the difference. I actually got about five (count ‘em FIVE!!!) hours of uninterrupted sleep. I cannot even remember the last time that happened.

When I woke up, I decided to get my BP measured again before calling my PCP. Weird. It was back up to 150/95 HR 61. (I decided to purchase a BP wrist monitor while at CVS this morning to save on having to drive each time. The first reading, while still at the store, calibrated closely to their BP machine, so I was at least on a level playing field) Knowing it was still slightly elevated, I decided not to call my PCP and took all my meds this morning as prescribed. It has now been one hour. My BP is 112/66 HR 71. Perhaps my BP meds are stronger than they need to be. I’m going to take the rest of the BP meds today and monitor this closely and then possibly call my PCP tomorrow and ask if I should perhaps reduce my dosages.

Speaking of tomorrow, I have my second appt with my shrink. As far as he knows from the phone call he received from my therapist yesterday, I have been off my meds since last my discharge. While I did fill the scripts the shrink gave me on my first visit with him post discharge, I never bothered to take any of them (still in the “I don’t give a damn” mode). I am sure his first response is going to be along the lines of “Why won’t you help me be a better doctor to you?” What can I say? I am now willing to take my meds, continue with this outpatient program for this week and next, and then pick up with my individual therapist the following week.

Is this progress? I don’t know. I still feel resistant. I’m still in my “don’t give a damn” mode. I still face abject loneliness, utter sense of no worth, absolute pain over all the consequences arising from my actions throughout my life, and above all, I have no reason why I should be forced to continue this existence from which I want to be finally relieved. Nevertheless, in reality, what do I have to lose except my life, upon which I still place no value?©2009

Crossing the Bridge

You’ve made a decision, one you thought was correct
And honored it with every thought, word and deed
Although the process was hard, steep and rocky
You stuck to your guns and dug your heels in

At first, once the deed was complete, all seemed fine
You knew in your heart it was the best thing to do
You surrounded yourself with what affirmed your position
Which bought you protection you knew you would need


You dove yourself in your new world with a fervor
With that very same passion from that which you left
You were supported and provided with compulsory tools
For this transformation from the old world to the new

Well, life comes at you hard, the tools must be used
But leaving the life you once only knew
Spelled a series of troubles that came unannounced
And set yourself up to rethink your position

You’ve lost your old life and the new one’s too fresh
With the exception of two, do they know who you are
You’ve lifted your veil and removed the façade
But all of this pales to the life you once had

You’re alone charting waters so foreign and distant
You suddenly realize you want what you had
Those relationships and friends that held you together
And your old haunts are tugging for all your attention

Immediately you struggle back to the top of that path
And are standing so squarely at the fork in the road
You look down that broad side so cleanly and crisp
And teeter so slightly at making that step

It’s oh so inviting this choice to be sure
That will ease up that heartache with nary a thought
Those friends that can surround you and regale you with ease
The very same ones you left in the dust

The anguish you feel at the end of the day
You’re much alone with no one to share
The minutiae that life bring into your being
The void that is created is too much to bear

So which way do you turn at this fork in the road
Do you follow the truth and head down the hard path
Or choose the familiar of that which you knew
Whatever the choice there will be consequences for sure

©2007