Friday, February 9, 2007

Holding pattern

I write this from bed while watching bad daytime t.v. at 1:30 in the afternoon. Right now it is just background noise. I am trying another meds adjustment for the next few days, to see if it can get me over this patch. Usually increasing from my usual 5mg a day to 10mg a day for a week or so works. But this time I started on 10mg a day back on January 10, and it is now almost a month later and I'm no better off. I've been on 15mg a day before and not had even a hint of mania, only sleep disturbances. I hope that an increase will lift me out of this, because if it doesn't, hospitalization is the only option left. Even I see that.

I ran out of medication mid-week even though I called in a refill last week. But the pharmacy couldn't get a hold of my doctor to get a refill authorized. Finally my husband called the doctor's office and they said they never got the request. My doctor authorized 15 pills (10mg each) but wants to see me for a physical before she authorizes more. I can't get in to see her in the next week because she has no appointments available, and if I'm taking 15-20mg a day for a week, I will run out of medication again. I only got this far because the pharmacy gave my husband two pills to tide me over until the refill could be approved.

I don't have a psychiatrist. I used to, but the last one I had didn't want to listen to me and my experience and what worked and didn't work for me. She wanted me to wean my baby at four months old and take a powerful anti-psychotic drug that would leave me an emotional zombie. I refused to wean my baby to take a medication I didn't want when there were other viable alternatives available. The antidepressant was working well but she wouldn't accept that. When I refused, she flagged my file at the clinic as a troublemaker and no other psychiatrist at the clinic would see me. My insurance wouldn't cover any other clinic that was accepting new patients. I am on my own.

I have different insurance now but I don't want a psychiatrist who thinks he or she knows me better than I know myself. I have lived with this illness for most of my life. I am intelligent and introspective. I know my warning signs. I am honest with my caregivers and my husband. I should have a say in my treatment. I am the one who has to live with myself.

Yesterday my rabbi e-mailed that he had some time today to talk. I wrote back minutes later and said whatever worked for him was okay and could my husband join us. I don't know what happened, but I haven't heard from him since and Shabbos begins in three hours so I don't think we are meeting today after all. Tomorrow he is teaching after shul. It's hard not to be disappointed, to wonder what happened, to think about what I need from my rabbi. It's hard not to take it personally, that I'm not important after all.

Now I feel like my meds are being held hostage, or that I'll run out again before I can get in for a physical. Or that medical beaurocracy will drive me to the hospital just for medication management. I feel like the universe is conspiring against me.

Still I trust that things will work out. I trust that G-d knows what is best for me. I trust that what is meant to happen will happen.

I took a single Tylenol PM last night to help me sleep. This morning when I looked at myself in the mirror, my eyes were sunken, deep dark circles all the way around my eyes. My skin looked grayish and pasty, my mouth in a relaxed frown that hurt to smile. I went back to bed, which is where I remain, resting, watching bad daytime t.v. and just holding on.

Update: still no word from the rabbi. However my doctor's office called and said they had a cancellation for next Wednesday morning, so I will see her then. My counselor called today and said she blocked off an hour on Monday and I could see her again then. I know it's her lunch hour.

She is also working to get me an appointment with a physician's assistant who is supervised by a psychiatrist. She has really good things to say about this PA, and I could schedule counseling and med checks in consecutive appointments in the same building.

One of my friends that I e-mailed sent a card that I received in yesterday's mail, and another one today. She's also been sending me daily e-mail. Another of the four friends I e-mailed is coordinating with my husband to help as she can.

I wish my Jewish community were here for me, but I am very appreciative for the support I am feeling now from others.

2 comments:

Ezer K'negdo said...

Rivka, find a psychiatrist to trust again. They can help you in ways other doctors can't. It is really hard to trust that someone is going to see you for who you are, and hear you and your needs, but see if people you know have recommendations. It will be worth it if you find the right person. Which you will. Hang in there!
Shabbat Shalom

tab said...

I'm glad you are insisting on having a voice in your care. A good psychiatrist will take you seriously. My psych is in a large teaching hospital and when I need a med change, he usually gives me several options - including doing nothing (even when doing nothing is obviously not recommended). This may make you gain weight, this may not but may make your skin fall off... in two months...etc. etc.

Hang in there. You're in my thoughts and prayers...