One Step Forward, Two Steps Back

I swear I can’t win.  I started on the Cymbalta almost a week ago.  The good news, it is starting to help with the pain.  The bad news, it killed my appetite.  I’m lucky if I get 1000 calories a day.  I’ve lost 5 pounds since I started.  While that’s a welcome loss, it isn’t healthy nor sustainable.  My anxiety has also gone into overdrive.  My blood sugar is running low because of the not eating thing and that tends to trigger anxiety.  Despite telling the doctor this, she doesn’t want me to go down on the dosage (I told her 30 mg had worked fine for me in the past but she insisted on putting me on 60 mg even though I’m incredibly sensitive to medication).  She also doesn’t want me to take a daytime dosage of Klonopin.  She essentially wants me to ride it out.  I’ve got enough Klonopin to take it twice a day before I see her again, so I might use it as a crisis kind of thing.  Oh and she isn’t worried about the not eating thing either.

I’m debating whether to try a different psychiatrist (see previous entry about the psychosis thing) or see if she works out.  I don’t like doctor hopping and it’s my general rule not to do it unless the person is truly an ass or incompetent.  But she doesn’t seem to really give a damn.

*sigh*

One step forward, two steps back.  That’s the story of my life, or so it seems.

A Very Long Day

I’m so mentally, emotionally and physically exhausted.  I started the day with the psychiatrist.  Initial sessions are always long.  Having to go through my history is beyond demanding.  Fighting back tears (and failing miserably) left me drained after the first 30 minutes.  Then she drops the little bomb shell that she thinks I’m psychotics.  I basically told her I respectfully disagree.  Hearing the voice of one of my abusers is more likely a PTSD symptom (PDF) rather than a psychosis symptom.  She wanted to put me on one of the newer antipsychotics.  I told her no.  I absolutely and positively wouldn’t go down that route again.  I gained so much weight on them and they sent my cholesterol sky high.  I don’t need that crap again.  She didn’t seem pleased with my refusal, but it’s my body.  Honestly, it’s not causing me that much distress that I think it needs to be medicated.  I’m quite aware the voice isn’t real and what the origin of it is.  I’m not putting those drugs in my body unless I’m going crazy.  I think they’re overused for things like bipolar, PTSD, ADHD (!) and Autism (!!!).  So, in the end, she upped one of my meds and put me back on Cymbalta for the depression and chronic pain.  Once I’m doing somewhat better, she wants me to get back into therapy.  I’m not against that.  I just need to find someone the energy to find someone.

Then it was to the hospital side to register for blood work and an EKG.  I’m still not 100% certain why she feels she needs the EKG, but whatever.  The nice man filling in from another department was trying to register me into the ER, which is why he couldn’t find the doctors name.  Once that was fixed, I got to the lab where the paperwork was screwed up because my age ended up getting entered as 103.  I don’t even know how that happened.  I got stabbed in the hand, leaving me with a nice little lump and a big old bruise.

Then the fun really began.  Gynecologist time.  I kid you not…  when the nurse took my BP, I almost had a stroke right there given how high it was (190/130) after it being normal (120/80) earlier in the day.  She was pretty alarmed until I told her I was basically sitting there having a panic attack.  The doctor was really nice.  She tried to be as gentle as she could.  It isn’t that easy since my body is a bit weird and I was, well, freaking out.  At least I don’t have to go back for a year, and then only for a quick check, not the full thing.

I’m about to take my meds and go to bed.  I’ve finally gotten myself mostly calmed down.  But I’m exhausted.

Weather Changes

I think weather changes are the worst for me.  Even though I find it difficult to tolerate the cold, this swing upward in temperature along with the rain is, once again, doing a number on my pain levels.

On a slightly positive note, the rebound muscles spasms I was having after waking up (my doc put me on a muscle relaxer at night) seem to have calmed down.  I’ve been trying to do some self massage using the molding around the doors.  It hurts like hell while doing it, but it does seems to give some modest short term relief.

I wish I could get a proper massage.  When I was doing PT in Korea for my back and shoulders, they started each session with about 20 minutes of massage.  And I went three times a week.  Strangely enough, my Korean doctors seemed to be more aggressive about pain control than my US doctor.  But that could be because she’s a GP, not a specialist.

I need to follow up on my Medicaid application.  I think if I could get into see a rheumatologist (I won’t even say a good one), I could do a bit better in the pain management department.  I also need to call my GP.  I’m on an NSAID for whatever sort of arthritis I have in my hands, elbows, shoulders and now feet.  However, I’ve been getting heartburn so bad lately, I could light up the city skyline.  I really hate to stop it because it does help a little bit with the pain and stiffness.  Unfortunately, there aren’t many options in those types of meds.  I tried Celebrex, and while it worked, I’d be reliant on my GP for samples.  At least with the Mobic, it’s only 4 bucks at a local pharmacy.

I guess that’s enough whining for one day.  I’m going to fill out a job application I got out of the blue in the mail.  I think if I’d stop feeling like such a failure for not being able to find a job, I’d be less depressed.

All That Jazz

Or maybe just some of it.  OK, probably none of it.

My brain is utterly fried.  I don’t know what to blame it on…  constant stress, depression, anxiety, fibro.  All of the above, maybe?

I guess if you want to look on the plus side, my PTSD symptoms are pretty much nonexistent aside from anxiety and a wicked startle response.  But I’m bone tired.  Like stay in bed all day bone tired.  And my bones hurt from the cold.  Spring can’t come soon enough for me.

My doc started me on a muscle relaxant at night.  While that’s a good thing (I think since I’m not waking up with spasms in my back and legs) my muscles seem to clamp down even harder during the day.  I could barely straiten my back yesterday.

I’ve applied for my state’s medicaid program.  I’m trying to figure out what the next step with them is.  The website isn’t exactly clear.  I guess I need to go in person.  Luckily for me, there’s an office in the city I live in.  It’s just a depressing place to go.  I’ve already found out that my current PCP doesn’t take medicaid.  Bad because I hate getting established with a new doctor.  Good because, well, to be honest, I didn’t really like my PCP to begin with.  On the other hand, who knows.  The new one could be worse.  And all this is stressing me out too.

I think the only thing keeping me sane is my kitties.  I’m house/cat sitting for someone this week.  Their kitty loves me.  He always wants to be on top of me, kneading me.  And damn it.  It hurts.  I can only put him down so many times before he gets more insistent.  Oh well.  It’s only for a few more days and then I’ll be back with my mostly non cuddly kitties.

Med Changes

Whee.  Back on the med-go-round.  With the amount of benzos Dr. P had decided to prescribe, why the hell am I have panic attacks multiple times a day.  Needless to say, I’m going to see him tomorrow.  Again.

The rheumatologist cut my dose of Gabapentin.  We’ll talk about that on Wednesday.  He also d/c the Tramadol.  Maybe all this crap is from going off the Tramadol, but I’ve never had problems before.  On Tuesday I had blood work done for possible RA.  I see him again on Wednesday.  This is going to be short and sweet because my fingers just don’t work right at the moment.

I am thankful for the two of them.  I even got a hug from Dr. P when I saw him on Tuesday.

Thank You Dr. P

Dear Dr. P

Thank you so much for treating me with respect today. I was afraid when I came in because of the pain you would think I was just drug seeking. But you didn’t. You acknowledged the pain I was in. And you tried to find ways to minimize it. Knowing that someone believes me means the world to me. I don’t know if the new combination will help but at least I have some hope now. Even when I was crying you didn’t belittle me.

So here are the changes. I am to increase the Cymbalta to 60 mg. She also added Mobic. It’s an NSAID. She also increased the Trazodone to 100 mg to try to get my sleep regulated. Her opinion is that the nausea and pain is related to the fibro but wants to hear the gastrointestinal doc’s opinion.  She also said that the Gabapentin might not have had enough time to fully kick in.

Yes I still hurt. Yes I’m still anxious and depressed. But at least someone is trying to help. I’m just glad she didn’t want to do a hands on exam. I don’t think I could have dealt with the pain.

 

I Don’t Know

I just don’t know.  I think I’m going through some PTSD regression stuff.  I’m having shower and bed issues.  I’ve been sleeping on the couch downstairs.  I say it’s because it’s too hot in my room, but really, I don’t want anything to do with my room.

I’m having trouble staying med compliant.  I rarely take my sleep meds.  I still sleep, but with so much REM it’s not refreshing.  Pain meds…  not the best at taking them either.  I feel like I deserve to be in pain.

It’s not easy to sit here and write this.  I can’t put things into words right now.  I can’t concentrate on anything, in fact I’ve lost interest in my Fortran course and learning the ins and outs of XCode (I’m back on a Mac).

I wish I could throw up.  It would make me feel better I think.  My stomach is all churned up again, probably because I’m not taking those meds like I should be.  I’m not sure how long I’m going to last in the states.  It’s been a month and I feel like I’m losing my marbles.

Cymbalta

This is the first time I’ve been on Cymbalta.   I’ve been on it a month.  It’s definitely made a difference in my depression, but I think it’s helping the pain too.  I finally came out of that flare.  God it felt like it lasted forever.  The pain is almost totally in remission.  The fatigue not so much.  But I think I’ve been pushing my body a  bit hard.  If I want out of the house, I have to go where the car  goes.

But…  I got permission to take the car to the park tomorrow.  I’m going to take some pictures.  I miss doing that.  I can shoot on my good camera until the battery dies.  I’ll have to get a new charger for it as it’s 220 not 110 like the States. My old camera takes regular batteries so I’ll grab some of those and just relax.  m I can do some easy hiking and get some exercise.

Bugger

I’m leaving my job after my contract ends.  Ordinarily I’d stay.  But my boss has cut our winter break from 5 to 3 days.  You don’t know how much I need those five days.  The franchise fed her some cock and bull story that hogwons don’t give five days in the summer and the winter.  That’s crap.  I’ve worked at two other and talked to other people.  You get 5/5.  I can’t believe my boss bought it.  AND she broke my contract.  If I were a vindictive bitch, I’d take her to the labor board.  I’m not.  I saw next year’s schedule.  I have even fewer hours.  I’m not working for half of what she put in my contract.  I should have insisted she put the original amount.  I let her put what I’m getting now.  So I’m going to try to get a job at the same school as some friends.  I like the franchise books, but once you’re out of their ESL course, they frankly suck.  They have some sort of online things for teachers.  There are twelve units in the book.  I’ve yet figured out how to get past unit 8 on the web site.  I managed to find the answer key for one of the workbooks and printed the chapter I needed.  There was like 90% overlap between the two.  Book used word A, key used synonym B.  There are more than the average number of mistakes in the books.  I can’t spell.  God knows I be up shits creek without a spell checker.  But one of the authors on the series is a native English speaker.  How you do miss dong for doing, two pages in a row.

Yes, I’m venting.  Before this shit hit the fan, I had to deal with doctor turf wars.  The rheumy gave in and took out the Prozac (which I was going to ask him to do anyway) and the sleep med he prescribed.  I had two blissful weeks of sleep.  Now I’m back to sleeping but not sleeping.  Psych has me on amitriptyline, probably enough to put a normal horse to sleep.  It’s not helping me sleep.  He has me on tiny amounts of Valium and Klonopin at night.  He said that whatever sleep med the rheumy prescribed had the highest abuse potential of any sleep aide.  Have I ever shown him addictive potential in nearly two years?  No.  And the man hands out Valium like it’s candy. I’m going to give it the weekend.  I’ve already spent the days sleeping because I don’t want to deal with the pain (and I wad tired as hell).  Yes, I have pain killers, but I’m afraid of tolerance (different than addiction, thank you very much).  I need to ask a doc about that.  It’s Tramadol + acetaminophen.  I don’t like the acetaminophen one bit.  But apparently it’s supposed to give the Tramadol a boost.

OK, I think that’s enough for one day.

Yay Me?

Did the cardio workout.  I had to let my Achilles tendon heal after a small tear.  I also managed to do the abs part of the workout.  Holy cow.  Talk about intense.  I did them flat on my bed (no I didn’t cheat and use it like a springboard) because I wasn’t sure I’d be able to get up off the floor.

I have the whole pink pajama story.  I’m a little afraid to put it into words.  I know that sounds stupid.  But it feels like that would make it too real.  And there’s nobody here I trust enough to tell the story to.

In other news I have this rash thing spreading across my face.  They look like bright red zits.  The dermatologist I saw said they’re inflamed hair something or others.  And the redness was from the capillaries bleeding around them.  Now I’m seeing them on my arms.  I’m fairly certain they’re not from my meds.  They all list rash in the allergic reaction section.  This isn’t an allergic rash.  I’ve had those.  And no wonder I have on appetite.  Every single friggin’ drug I’m on lists appetite suppression as a common side effect.