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days_unfoldingOn Friday, I had a therapist/case worker and med doctor appointment in Santa Clara.
I liked the new therapist. She was very gracious about the fact that I ran late for the 8AM appointment. I felt comfortable with her almost immediately. We went through my patient history in extreme detail. She even tested that I was oriented to person, place, and thing ("Who are you? Who am I? Where are you? Who's the President? Who was the President before that? And who was the President before that?"). I'm happy to announce that I am indeed oriented-;) She also asked me what my concerns were about my treatment, and I said that I wasn't sure that my psychiatrist understood that I need to be able to work and drive, and that I lived alone. Any medication that he prescribes needs to take that into consideration. She wrote that down.
Then she asked me how she could fit into my treatment plan, given that I'd see her only every 3 to 4 weeks. That's where I kind of floundered. I asked for a therapist because my psychiatrist said that a therapist should handle any accommodation or disability issues, not him. I finally said that I was going to turn 40 this year, and I should be at the top of my game, but instead I'm struggling to do things that used to be easy for me. Somehow she got a treatment plan out of that: "I see you needing a lot of support." Probably a good way to put it.
Then I had some time to kill until my 2:30 appointment. The therapist had told me about a new Border's that opened up nearby, but I decided to first eat breakfast and then do some writing in the public library. On my way back, I saw a car with its flashers on stopped right in front of me. I put on my turn signal to get into the next lane, but no one was letting me in. In fact, one person sped up so that I couldn't get in. I said, "Oh come on. You have to get me in; I have no where else to go", and to my surprise, someone let me in. As I drove past the stopped car, I saw a guy on a motorcycle down on the ground in front of the car. The guy wasn't moving at all. That looked really bad. When I stopped the car back at Kaiser (around the corner from the accident), I called 911, but apparently several people had called the accident in already. As I disconnected the call, I heard sirens. Hope that the guy will be okay.
So then I had my appointment with my med doctor. He seems to have good days, in which he listens well and communicates well, and bad days, in which there's a tinge of "I'm the doctor. Take this." Friday was a good day. He did say that I should increase my dosage of Risperdal because I'm still hearing voices. He was trying to convince me to take 1 MG, and I countered with 0.75 MG. (I've been taking 0.5 MG.) He also discussed said that increasing my mood stabilizers might help with the voices, and said that he wants to put me on Tegretol over the long term, but that Tegretol usually has major side effects up front. (Obviously he read the note in the chart about my constraints.) Also over the long term, he also wants me to add in a mood stabilizer that acts as an anti-depressant, or to add an anti-depressant. The net result was that we increased the Risperdal slightly, but otherwise did nothing right now. He's perplexed by the rapid cycling, but wants to leave it alone unless it gets severe.
I'm resigning myself to the fact that I'll have to take a medical leave sometime to straighten out this medication mess.
Then I drove home. As I was on my way home, I found that I wasn't judging distances well, and my coordination was off. It wound up being a very scary ride in which I didn't feel 100 percent in control of the car. However, I made it, and went into work for a few hours.
When I left work, I remembered that I had called in a prescription at the Kaiser site near me, and also had a new prescription to be filled. On my way over there, I saw a cat run over in the road and someone at the side of the road with their flashers on--presumably the person who hit the cat.
At Kaiser, I noticed that I was having major problems reading the numbers that they display when a prescription is ready. Then I knew what the problem was--blurred vision. Over the last few days, I had already noticed that my distance vision seemed to have deteriorated rapidly. I spent a lot of time peering at people across the plaza wondering if that so-and-so-shaped blur was indeed so-and-so. Blurred vision is a sign of early lithium toxicity, and I had a couple of other symptoms of early lithium toxicity.
So I hit the water fountain. When I went out to eat (figured I might as well because I'd have to drive home anyway), I bought more water. I kicked myself for letting myself get dehydrated.
On my way back, I saw some sort of accident on Hwy. 101 or on the on-ramp; it was tough to tell exactly what was going on. Flashing lights.
However, I made it home yet again. I looked up the symptoms of lithium toxicity and Risperdal side effects, and the symptoms could have been either one. Debated asking someone to call me on Saturday just to make sure that I was okay, but decided not to. Decided not to take either lithium or Risperdal that night, but doubled my dose of Depakote to have some mood stabilizer in my system. (And as it turns out, my vision was fine the next day, so one of those drugs, probably Risperdal, was responsible.)
I went to sleep, relieved that I was able to sleep in on Saturday. No construction workers; no alarms.
I liked the new therapist. She was very gracious about the fact that I ran late for the 8AM appointment. I felt comfortable with her almost immediately. We went through my patient history in extreme detail. She even tested that I was oriented to person, place, and thing ("Who are you? Who am I? Where are you? Who's the President? Who was the President before that? And who was the President before that?"). I'm happy to announce that I am indeed oriented-;) She also asked me what my concerns were about my treatment, and I said that I wasn't sure that my psychiatrist understood that I need to be able to work and drive, and that I lived alone. Any medication that he prescribes needs to take that into consideration. She wrote that down.
Then she asked me how she could fit into my treatment plan, given that I'd see her only every 3 to 4 weeks. That's where I kind of floundered. I asked for a therapist because my psychiatrist said that a therapist should handle any accommodation or disability issues, not him. I finally said that I was going to turn 40 this year, and I should be at the top of my game, but instead I'm struggling to do things that used to be easy for me. Somehow she got a treatment plan out of that: "I see you needing a lot of support." Probably a good way to put it.
Then I had some time to kill until my 2:30 appointment. The therapist had told me about a new Border's that opened up nearby, but I decided to first eat breakfast and then do some writing in the public library. On my way back, I saw a car with its flashers on stopped right in front of me. I put on my turn signal to get into the next lane, but no one was letting me in. In fact, one person sped up so that I couldn't get in. I said, "Oh come on. You have to get me in; I have no where else to go", and to my surprise, someone let me in. As I drove past the stopped car, I saw a guy on a motorcycle down on the ground in front of the car. The guy wasn't moving at all. That looked really bad. When I stopped the car back at Kaiser (around the corner from the accident), I called 911, but apparently several people had called the accident in already. As I disconnected the call, I heard sirens. Hope that the guy will be okay.
So then I had my appointment with my med doctor. He seems to have good days, in which he listens well and communicates well, and bad days, in which there's a tinge of "I'm the doctor. Take this." Friday was a good day. He did say that I should increase my dosage of Risperdal because I'm still hearing voices. He was trying to convince me to take 1 MG, and I countered with 0.75 MG. (I've been taking 0.5 MG.) He also discussed said that increasing my mood stabilizers might help with the voices, and said that he wants to put me on Tegretol over the long term, but that Tegretol usually has major side effects up front. (Obviously he read the note in the chart about my constraints.) Also over the long term, he also wants me to add in a mood stabilizer that acts as an anti-depressant, or to add an anti-depressant. The net result was that we increased the Risperdal slightly, but otherwise did nothing right now. He's perplexed by the rapid cycling, but wants to leave it alone unless it gets severe.
I'm resigning myself to the fact that I'll have to take a medical leave sometime to straighten out this medication mess.
Then I drove home. As I was on my way home, I found that I wasn't judging distances well, and my coordination was off. It wound up being a very scary ride in which I didn't feel 100 percent in control of the car. However, I made it, and went into work for a few hours.
When I left work, I remembered that I had called in a prescription at the Kaiser site near me, and also had a new prescription to be filled. On my way over there, I saw a cat run over in the road and someone at the side of the road with their flashers on--presumably the person who hit the cat.
At Kaiser, I noticed that I was having major problems reading the numbers that they display when a prescription is ready. Then I knew what the problem was--blurred vision. Over the last few days, I had already noticed that my distance vision seemed to have deteriorated rapidly. I spent a lot of time peering at people across the plaza wondering if that so-and-so-shaped blur was indeed so-and-so. Blurred vision is a sign of early lithium toxicity, and I had a couple of other symptoms of early lithium toxicity.
So I hit the water fountain. When I went out to eat (figured I might as well because I'd have to drive home anyway), I bought more water. I kicked myself for letting myself get dehydrated.
On my way back, I saw some sort of accident on Hwy. 101 or on the on-ramp; it was tough to tell exactly what was going on. Flashing lights.
However, I made it home yet again. I looked up the symptoms of lithium toxicity and Risperdal side effects, and the symptoms could have been either one. Debated asking someone to call me on Saturday just to make sure that I was okay, but decided not to. Decided not to take either lithium or Risperdal that night, but doubled my dose of Depakote to have some mood stabilizer in my system. (And as it turns out, my vision was fine the next day, so one of those drugs, probably Risperdal, was responsible.)
I went to sleep, relieved that I was able to sleep in on Saturday. No construction workers; no alarms.
