Tag Archives: medication

Nov 11 2011

More on Pdoc

So I mentioned that I saw pdoc yesterday. Not one of our best sessions, but I was grouchy. I told her that I wanted to go off of the wellbutrin and she had a strong negative reaction to that. She practically begged me not to stop it.

I told her that I am having some side effects that are annoying, sometimes to the point of serious frustration. First of all I get songs stuck in my head, sometimes for hours. I will wake up in the night with the song in my head, and wake up in the morning with the same song. I know that doesn’t sound like a big deal, but sometimes it makes me feel crazy.

And wellbutrin has always made my hands shake, but in the last couple of months it has gotten much worse. I have a touch screen phone and it is actually hard to use because I can’t get my fingers under control enough to touch the right buttons. I was using my boss’s computer today and he has a weird mouse that requires one to left click using the thumb. I was having a lot of trouble double clicking with my thumb and it was getting me extremely frustrated. Then I was trying to get some papers out of the filing cabinet and my hands were shaking so much I couldn’t get the papers out.

Last weekend even my husband commented on it, he asked me why I was shaking.

Pdoc didn’t seem to care about these issues, I have found that doctors don’t really care about medication side effects. I do feel that the wellbutrin has helped me this year, so I just don’t know. Another problem is that January 1st my deductible begins again, which means that my insurance doesn’t pay for the wellbutrin (well, they pay for the generic version, but I take the brand name version). Last year I ordered it from a pharmacy in Canada, but I had a lot of difficulty dealing with that place, and weeks of delay in getting them to ship the medication to me. My mother told me about another Canadian pharmacy that she has used, and maybe they will be better. It is just such a hassle. Wellbutrin is very expensive at my local pharmacy – $400 a month, or something ridiculous like that. I only pay $50 a month now that I have made my deductible.

I don’t know. I hate having to take medication for my mental issues. Other medications don’t bother me – like the ones I take for acid reflux or rapid heartbeat. But they don’t have side effects and I can take the generic version of those, so they are cheap.

Another thing pdoc said yesterday was that she thought I seemed better when I was dealing with the cancer. She said I seemed more upbeat, and I was doing research and being efficient and dealing with all of the medical stuff, etc etc. Hey, maybe I should get cancer more often.

She said that frequently after a scare or trauma, a person hasn’t dealt with the emotional part of it, and then that happens weeks or months afterwards. Whatever.

She also seemed to blame a lot of things on my B12 deficiency. That certainly comes in handy when she wants it to.

I asked her if I could just take klonopin during the day, and she said that wouldn’t work, that it is a depressant.

Anyway, sorry to rant on and on. I’m sure we’ve all had meds issues, and there is no good solution.

Jan 18 2011

The Cost of Meds

I went to the pharmacy to pick up my Wellbutrin prescription yesterday. I started taking this (for the third time) the first week in December, so I haven’t been on it very long.

Due to the fact that my deductible starts on January 1, the cost for the prescription is $250 (normally $30 after I make my deductible). I decided not to get it. Now what, I thought. I have to go off of the medication. Fine, I have a lot of klonopin (I’m up to 120 1mg tablets in my stash). I can use klonopin to get by, it works better anyway with fewer side effects (and only about $15 per month). And I won’t even have to see my pdoc for a while, since I don’t need any prescriptions and that is the only reason I see her.

But then I decided to look online and it seems that I can get Wellbutrin from a Canadian pharmacy at a cost of $125 (including shipping) for a three month supply. I don’t know how this is possible if it is, indeed, the same medication. There is a website that checks out these pharmacies, and they have to pay a fee to be included, but who knows if that website is reputable.

Another damn thing I have to make a decision about. It’s one thing if the medication is just a sugar pill, but what if it has something dangerous in it? How do I know if this place is really bona fide, and why is it so much cheaper?

Dec 1 2010

Pdoc Recap 12/1/10

Met with pdoc today. Nothing earthshattering to report. We chatted – I told her about my anxiety last week before Thanksgiving, with the crowds and the traffic. She got into some depth about my anxiety with crowds, how long have I had it, how does it feel, etc. I don’t really think it’s a big deal, I just avoid crowds, but if it will get me more klonopin, hey I’ll talk about it all she wants. I asked her if it is a form of claustrophobia, which I don’t have in general, and she said it is actually agoraphobia. Who knew? Another diagnosis to add to my resume. We also talked about how my sensitivity could be a cause for my dislike of crowds. She asked if there were any positive aspects to being sensitive and I mentioned a couple, but said I don’t think the positive aspects outweigh the negative.

We talked about my writing class and she said I should bring in my stories to read.

We talked about my marriage, she loves to talk about that. And even the sexual part of my marriage. My t has never asked me about that! It’s easy to talk to pdoc though, so it was fine.

She wanted to cut my klonopin down to .75mg per day and I stood up for myself and said, “NO!” I want my 1mg per day (even though I only take .25mg per day). I’m working on building up the stash. So she gave me an rx for 30 1mg klonopin, with a refill! I guess she thinks I’ll refill it in a month, yeah, I doubt she’ll give me another rx if I come back in a month and mine are all gone. That might send up a red flag for her. You have to walk a thin line with pdocs and their meds. It’s a balancing act.

I didn’t talk about therapy with pdoc, except she asked me if I am still going. J had made a comment the other day, and I can’t remember it exactly, but my perception of his words and his tone made me feel like he isn’t crazy about me talking about therapy with pdoc. But I could be totally wrong about that, and imagining things. I probably am. But I didn’t mention therapy with her at all.

I appreciate everyone’s comments and insights on my post about therapy on Tuesday. I’m conflicted about the whole session. I still feel that if J says he will do something that he should either do it or tell me why we are not doing it. I know that is expecting a lot, but it is very hard for me to change my expectations.

I also was reading the Psych Central Forums (I am obsessed with the psychotherapy forum, and I am really thinking I should stop reading it, it’s not good for me) and someone mentioned how hurt she was when she realized that therapy needs to be about her life, and not about what happens in therapy. I guess that is what J thinks about me, I am too focused on therapy and not enough about my life. Someone commented that I am running away from my life by focusing on the therapy part of therapy. I don’t know if I necessarily agree with that – I did want to talk about my husband and mother. But I guess the rest of the things on my list were therapy related – the slips of paper and why J didn’t read them, the voice mail he left me, and how it makes me feel when he talks about his family. So I guess I need to take a new approach in my sessions and actually talk about what is going on in my life. I am really, really feel terrified about doing that. First of all I don’t feel very safe with J right now, like I can’t trust him enough. And talking so much about my life makes me feel very vulnerable, and yes, someone commented on my blog that I am supposed to make myself vulnerable in therapy, and yes, I do know that. But I don’t like it and it makes me extremely anxious. If that makes me a ridiculous person, I guess that is what I am. Yeah, imagine someone going to therapy and not wanting to talk about their life. Have you ever heard of anything more stupid in your life?

Nov 8 2010

Feeling Frustrated With The Medical Community

Situation #1

I was running low on my migraine medication, so I ordered a new prescription to be called in to the pharmacy by my primary care physician. This medication comes in blister packs – 9 tablets to a pack. When I went to the pharmacy to pick it up yesterday they told me that my insurance company has a limit of 4 per month. OK, no problem. I paid my $10 co-pay.

When I got home I opened the bag and saw a bottle rather than packs of tablets. I opened the bottle and there were 4 tablets in the bottle. That’s it – 4. I called the pharmacy, thinking there was some kind of mistake, but they assured me that my insurance company only allows me to have 4 tablets.

This morning I called the insurance company and was told that is true, I am only allowed four. I asked “Four per what?” She didn’t know. She put me on hold. When she came back she said I am allowed 4 per month. I asked what gave the insurance the right to determine how many I am allowed per month? She said that I can buy however many I want, but they will only pay for 4. This is a generic medication, by the way.

I knew there was nothing she could do for me, so I said goodbye. She responded the way these customer service people always do, by asking, “Is there anything else I can do for you?” I replied, “Well, you haven’t done anything for me yet, so I doubt it.” (I was nice to her up until that point, because I know nothing is her fault, she is just the messenger. She did tell me I could write a letter and appeal this decision. Hopefully I won’t get a migraine before I hear back from them.”

Then I called the company that handles the insurance for my husband’s firm. I don’t know what you call them, consultants or brokers, or something. They are pretty smart. I told the woman the story and she said she would check. She did call me back after a few hours and told me that my insurance company is the most strict in regard to this medication. Apparently it has been proven that this medication is not useful for people who get more than four migraines per month, so they won’t pay for more than four tablets. I told her that I only get one migraine per month, if that, but it takes more than one tablet to make it go away. I take them every 6 – 8 hours for a day or two. She said my old insurance company is the most lenient, allowing 3 blister packs (27 tablets) per month. For the same $10 of course. She said she will check to see if there is a way around this, other than me buying the medication myself.

I also called my primary care physician to see if there is anything he can do. That was at 9:00am, and he never called me back.

It’s not the money that is making me frustrated, it’s the principle. We spend about $20,000.00 per year on our health insurance policy, plus our $2500.00 deductible and our co-pays. And they won’t give me 27 tablets per month?

Situation #2

My son had an appointment with the pdoc today at 5:00PM. This is/was my pdoc, until I switched two months ago to my new/old pdoc. This pdoc always runs late. I once had the first appointment of the day – 7:30AM. I got there and the door was locked. He showed up 15 minutes late.

Today he kept us waiting 55 minutes. I had to go outside to put more money in the meter. I was getting angry. But the final straw was that my son was in his office with him for 8 minutes. And I am not exaggerating – I am a stickler for details. Eight minutes. The doctor was with someone when we arrived at 5:00, then he saw a mother with two kids, each kid separately, then the mother separately, and then a teenager, alone and with the mother. So that was four patients in 55 minutes, an average of 13.75 minutes per patient. My son got 8 minutes.

I was angry that he kept us waiting, but hurt that he only spent 8 minutes with my son. My son came out and said, “Couldn’t we have done that on the phone?” Exactly. And he asked my son how he was feeling, my son said, “Good”, and the doctor said, “Let’s increase your dose to 75mg.” I asked my son why he wants to raise the dose if my son said he feels good. “I don’t know.”

And to the person who found my blog by googling “this filthy hell of emptiness and despair”, all I can say is “I’m sorry.”

Nov 2 2010

Therapy Recap 11/2/10

Today I noticed that J and I follow a very predictable pattern in our sessions. It goes like this (and the time estimates are completely and totally my perception, not reality at all.)

1. J says, “What are we talking about today?” (2 seconds)
2. I fidget, squirm, look around, try to speak, say stupid things like, “What do you want to talk about?” (2 minutes)
3. I finally speak about whatever it is I plan to talk about, or give a list of various items. (5 minutes)
4. Question and answer session, where J tries to get more information about what I am talking about, to tries to delve into the issues. (15 minutes)
5. J talks and talks and talks. He gives his insights, his metaphors (lions anyone?), his interpretations, his personal disclosures. (23 minutes minus 2 seconds)
6. He says it is time to finish up, walks to his desk, still talking, I get up, say “Thank you” and leave. Sometimes he is still talking.

It’s nice having a routine.

So we began as usual. J said, “What are we talking about today?” And I squirmed, and fidgeted and looked out the window, and around the room, and said, “What do you want to talk about?” and finally I said, “I had an appointment with my psychiatrist and it was really great.” So he asked what was great about it. Then I pulled out the notes I had made. Kind of silly to do all of the squirming, when I had everything written down. I had written down all of the things my pdoc and I had talked about last week – it took up the fronts and backs of two index cards. The problem was when I was writing it I was wearing my reading glasses, and when I was trying to read it to J I didn’t have my glasses. All I bring in with me is my car key. Oops.

So I read through the whole list. Interrupting myself periodically to say, “It would help if I could read this,” or “This is in no particular order.” My voice was shaking and I was really anxious, and I was trying to just tear through the list. I think I was talking very quickly. I peeked at J every once in a while, and he was really good. He only interrupted a couple of times, I think he knew if I stopped I wouldn’t be able to restart. I made it through the whole list.

His responses were:

He agrees with 75-80% of what the pdoc said (I asked him what he disagreed with and he said, “I wasn’t keeping track.” Hmph.)

He was glad that she said all of those things to me, because if he had said them I would not have been as positive (absolutely true, and I told him so.)

He wanted to know why I thought it was great, and I said it was because I felt heard.

He wanted to know how her responses made me feel about my therapy with him, and I told him that I thought I felt better about our therapy.

He asked me why I was seeing a pdoc if I don’t want to take meds, and I said because I do want my klonopin, I just don’t want anti-depressants. I told him that I lied to her and told her that I take 1mg of klonopin per day, when I actually take .25mg per day. He wanted to know why I was saving it up, and what stash level I am comfortable with. I told him that I like to have 75 to 100 klonopins at any given time. He didn’t understand that. I told him about last December when I really needed some klonopin, but I wouldn’t dip into my stash and I waited two days for old pdoc to call me back and get the rx filled. He said that seemed strange to him. I told him that Advil is available in bottles of 1000 – and who needs 1000 Advil? He said those are usually meant for families. I said that even if every person in the family has a headache every day, it would take a long time to go through that bottle of Advil. He asked if I had 600 Advil, and I had a headache, would I take some out of the Advil stash, or would I go to the drugstore to buy some more Advil? I said that he couldn’t compare Advil to klonopin, because klonopin is a lot harder to get. He asked if I was planning to commit suicide with klonopin and I said no, definitely not. He asked why not and I said it is too unreliable, and I don’t want to end up a vegetable or have my stomach pumped. That would be way too embarrassing. If I am going to kill myself I am going to do it completely, and not make some halfhearted attempt to draw attention to myself.

Then out of the blue, J asked about the cutting. We haven’t talked about this in a long time. I don’t bring it up, and he never asks. I don’t know why he never asks and I don’t know why asked today. He mentioned the “flowchart” collage that I created a long time ago to explain the self injury cycle and he asked me when the last time I cut was, and what stage I am in now. I told him that I remember the last time I cut, but I can’t remember when it was. I know I was at work, and I used my boss’s knife. He keeps his knives very sharp, which I noticed because I frequently make my breakfast or lunch at his house, or cut up fruit for a snack. He rarely cooks, but he sharpens his knives. I never sharpen mine, and they would not cut me very easily.

I told J that I did feel the urge to cut after our “running” self-disclosure episode, but I wouldn’t do it because I didn’t want J to be the reason why I cut. He thought that perhaps I used quitting the hotline as a substitute for cutting, and did I feel that same sense of relief after quitting that I do after cutting? I told him that I don’t think I did, because the running issue has not yet been resolved, there is no closure. He asked me what closure looks like, and I said either I reach a point where I feel that the other person understands my feelings, or we agree to disagree. But right now I feel that we are still in limbo regarding this issue. He said that in a “normal” relationship if there is a conflict a person can leave to go for a walk, or go to the store, but in a 45 minute therapy relationship you have to stay to work it out. I think that in a normal relationship you can work things out as they come up, but in therapy you can only work on them during the 45 minutes you get, and lots of things stay unresolved.

Then he brought up how I take the responsibility and blame for every relationship conflict, or every mistake that anyone makes. Yes, I know this. I think he is really trying different ways to get me to stop doing this, and I appreciate the difficulty and frustration he must feel. Because I feel it too. He thinks if I could stop the “cycle” before I get to the self-hating phase it would be helpful. I do too. But I think my feelings of self-loathing and not being good enough are so deep, so ingrained in the core of my being, that anything I do will not be able to reverse this. I told him that I don’t want to be one of those people who never take responsibility for anything they do wrong, who always blame everything on everyone else. He said, “So you are erring on the side of caution and taking everything on yourself to ensure that you don’t become one of those people?” I know it seems black and white, doesn’t it? There has to be an area in the middle that is more, well, in the middle.

Then J told me that he was late for an appointment last week. He had to go somewhere at a time of day when he doesn’t normally travel, and it would take 30 minutes if it wasn’t a busy time of day, so he allotted 40 minutes, but it actually took 48 minutes. He called when he was on his way to say he would be late. He said he felt that he did the best he could, and that he wasn’t giving an excuse. He told me that his appointment was at 7:30am. When he got there he saw other people arriving late as well, and he thought that maybe they gave out the 7:30 appointments freely, knowing people would be late.

I told him that if it was me, I would be anxious that the office staff would think I was making up excuses as to why I was late, and that they would have a negative opinion of me after that. He said that crossed his mind, but he knew that once he showed up and that he was nice, they would realize that he was just caught in traffic and it was one of those things that couldn’t be helped, that it didn’t reflect badly on him.

He could have stopped the discussion there, but he had to go on to tell me that this was a medical appointment. I don’t know why he told me that, but at that point the thought that went through my head was, “Good! Maybe he got hurt in that 5K race he did and had to go to the doctor.” Ugh. Whatever was the point of his disclosure was totally lost on me then.

Sigh. One of the things we talked about earlier was that my pdoc said that therapy is talking about the little things over and over again, and how I feel that so many things J and I have discussed are still unresolved. So something I thought of is to put each of those unresolved issues on a slip of paper to put in my box that is in his office. We have only taken something out of the box once since we came up with the idea, but I have lots of ideas to put into the box. These things fall into the following categories:

Things that I haven’t had time to bring up (ie; J’s email from last week, the lion metaphor, etc)
Things that I feel we have discussed before and I feel like he doesn’t want to hear them anymore (the January email summarizing my whole year, that he dismissed after one session)
Things that I am too uncomfortable to bring up (when he searched for “sex” on my blog)

Yeah, I hold a grudge. It might feel good to get these things out, at least on paper and in his office. I wonder if he will check the slips of paper when I’m not there. Hmm….

Oct 28 2010

Pdoc Update 10/28/10

I saw new/old pdoc today. She isn’t the kind of pdoc that does 15 minute med checks every three months. She gives a full session and wants to see me once a month. When I went today I thought I might talk to her about my therapy, and that is what I did. I told her that sometimes I have problems with therapy and my therapist, and I’m thinking of quitting. She asked me to tell her what type of problems I am having. I told her that I have to work so hard to get my t to understand me and sometimes we have issues. I told her the story about my session with J two weeks ago and how he told me about his race.

She didn’t take sides for or against him, or me, which I thought was very respectful. She asked me if I told him how I felt and I told her how I went in the next week and was very ashamed, but managed to tell him a few things and then he guessed what I was upset about. She said that was great that I was able to go back and tell him how I felt. I explained to her about how I got jealous, and how I felt set up. I told her that he did apologize and he said he felt badly after I left thinking he might have messed up. But when we talked about it again this week, he didn’t seem to understand why it is different that he runs faster than me from anyone else running faster than me. And that I can’t verbalize why. I told her that I am not good at verbalizing my feelings and I am not a good communicator. She told me that I seem to be a fine communicator.

She wanted to know if I plan to bring it up with him again, and I said that every session is its own little self-contained thing, that nothing carries over from week to week. I said it is a lose-lose situation for my t, because I hate when I walk in and he says, “What do you want to talk about today?” but if he suggested a topic and I didn’t really want to talk about that topic I wouldn’t change the subject. She asked me why I wouldn’t do that, and I told her that I always try to please my t, and be the good patient, and if he wants to talk about something then I won’t stop him.

She asked me if he and I have ever discussed this, that it seems like something we should talk about in therapy. I told her that most of my problems, in real life and in therapy, are from my low self-esteem and my feeling that I am never good enough. That I take the blame and responsibility for anything that goes wrong in a relationship. I told her that he and I have talked about this a lot. She said that real life relationships often get repeated in therapy. I asked her what am I doing to make J respond to me like the other people in my life do? She asked me if I feel invalidated by him sometimes, and I do, and she said that I shouldn’t necessarily take the blame for this. But it is something to be discussed in therapy.

Then I told her that after the session where J told me about the race, I quit my volunteer jobs. She wanted to know why and I told her that I was feeling badly about myself and that I didn’t do a good job and I was sure they could find someone better. I told her that J said I was punishing myself. She asked if I thought maybe I was punishing him too? That maybe this was passive aggressive. She said I was angry at him, so I quit the hotline. I told her that I wasn’t angry at him, that I was angry at myself, and I didn’t see how quitting would punish him. But she said that maybe it was subconscious. I told her how J thought maybe there was a competition between him and me, and that is why I quit.

She wanted to know if I always felt badly after I left therapy, and I told her that I didn’t always. That before the “running” session I thought things had been going pretty well. I gave her my theory that maybe J thought I was doing too well in therapy and tried to make me feel bad, for fear that he would lose a good patient if I got too much better. She asked me if I told him this, and I said that I didn’t think I could tell him, that he rarely talks about his motivations for things. She thought that it is also possible that I was the one afraid of getting well, and I got hurt and angry at him, because I am afraid of ending therapy too. That is possible. I said I have another theory, and that is I am afraid of getting too attached to my t, like I did with my son’s therapist, and so I am always finding fault with my t. She wanted to know why I felt so attached to my son’s t. I explained to her what he did for my son and for me, and how everything fell apart due to his loose boundaries. But she had a great insight, she said that maybe the reason I felt so attached to him was because he took an interest in my son, and helped him, and helped me to help him, which is what I always wanted my husband to do, but he never would. I had never thought about that, but it makes a lot of sense.

I told pdoc that I am hesitant to keep bringing up the same things in therapy, that I am always making such a big deal out of everything. She told me that is what therapy is, talking about these little things over and over. And it isn’t my job to entertain my t, to always be coming up with new things to tell him, and it’s ok to just say whatever is on my mind during therapy, to not worry about how my t will feel. I told her that he says feelings aren’t right or wrong, but currently I am feeling like my feelings are wrong, because he doesn’t understand why I am upset that he runs faster than me, which isn’t even the issue at all.

She said it sounds like there is a lot of work that needs to be done, that we haven’t finished processing the running issue. I said that he just doesn’t understand and I don’t know how to make him understand. She said I don’t need to make him understand, I just need to talk about my feelings. I told her that I have hard time with feelings, I often don’t know what I am feeling. I’m good with bad, sad, glad and mad, and that’s about it. She said that is ok, to just say what I feel and he and I should work on figuring out what the feelings are.

She told me that I seem to have changed a lot since I stopped seeing her three years ago. She said back then I was very closed off, there was a lot I didn’t want to talk about, and now I seem more open. That was interesting to me. I told her how I feel so much worse in my life since I started therapy and she said that is probably because I am feeling things, and delving into things. She, of course, wants me to take medication for my depression. I told her that I am not depressed and she smiled. I said, “All of you pdocs think I am depressed.” I told her that I have a great life and have nothing to be depressed about. She said that I have stress with my son and my marriage. I told her that I do have stress, but that isn’t depression. I also said I won’t take wellbutrin anymore because I think it caused a lot of intrusive thoughts. She asked me what kind of intrusive thoughts, and I wouldn’t say. She guessed at a few things and I wouldn’t really say and she said, “You don’t want to talk about this?” I told her that I didn’t. I already told J about my problems with intrusive thoughts, I don’t ever plan to tell anyone else about them.

I did tell her that I have some poor coping skills – isolating myself, eating and exercise issues, drinking. She asked about my drinking and I didn’t tell the complete truth. She said I should be careful with the drinking. I didn’t tell her about self-injury, another thing I will never tell anyone else about.

I felt like we had been talking for a long time. She doesn’t have a clock in the office, but when I got out to the waiting room I saw that I had been in there for a full 60 minutes. I felt like a weight had been lifted off of my shoulders. I felt like I had been truly heard, and that she really understood me. I didn’t have to spell everything out, I just talked and she got it. It was such a relief. I told her I was still taking the trazadone, so she gave me another prescription for it, and another prescription for the 1mg klonopin, even though I only take .25mg each night. Those were white lies. And I go back in a month.

I think I might be able to handle therapy with J if I can see new/old pdoc once a month to sort everything out with her. I’m so happy that I decided to look for a new pdoc and checked my insurance company’s list and saw her name. I always liked her before, but kind of dreaded seeing her, because I had to sit there for 50 minutes and tell her about my life, when all I wanted was my prescription for whatever anti-depressant I was on at the time. I was a walking zombie, so I had no feelings to speak of, there wasn’t much to talk about back then. But today I felt so good in her office. She is very gentle, and has a subtle accent and a soft voice, and she is so nice. She is older than me, and told me that at my age there are biological and hormonal changes that can affect me emotionally, and I’m in the stage of my life when my kids leave and it can cause emotional upheaval. J would never say those things! I even cried once and had to use one of her tissues.

She just validated everything I said and felt, without negating anything J is doing or saying. I’m not sure how she did that. She didn’t make me feel bad about anything he is doing or anything I am doing, but gave me support in how I can relate to him and what to do to make my therapy more effective.

It felt good.

Oct 18 2010

Darn Pdoc

I have been taking the trazadone for four weeks now. I have to admit that I am sleeping well. I was taking 25mg until last week when I started having trouble sleeping again, so now I am taking 50mg, these were the instructions given to me by the pdoc. For the last few weeks I noticed my mouth is very dry – I had this side effect from wellbutrin, and it was very bothersome. I haven’t been able to figure out what was causing it. And I have been having a problem with weight gain as well, I just can’t seem to lose weight unless I starve myself and the weight is coming on way too easily.

So I checked out the side effects for trazadone:

dry mouth
weight gain
decreased sex drive

Great. No more trazadone for me. I don’t understand why doctors don’t inform patients of the side effects of medications so that we can make informed decisions. We have to rely on google and wikipedia for information.

I also discovered that trazadone can cause tachycardia, palpitations and heart arrhythmias. Considering I am already taking meds to slow down my heart, and I have an arrhythmia, perhaps it would have been wise for my doctor to ask about this?

The trazadone is going in the trash. I’d rather have insomnia than gain any more weight.

Sep 22 2010

Pdoc Update

After I left t, I went directly to pdoc. She was my old pdoc, and I stopped seeing her in March 2007, only due to financial reasons. Her charge at the time was $180 per session (45 or 50 minutes, not sure) and that was every 3 months. (Now it is $200 per session, but I only have to pay 25%). I only went for med checks, but she liked a long session. Then I found a pdoc in my insurance plan and I saw him every 3 months for 10 minutes and paid $20. But he has been stingy with the meds lately, and I was checking my insurance company’s website for different pdocs and saw my old pdoc listed.

So I went in and we caught up. First she said I looked a lot different, which I do. I’ve lost 30 to 35 pounds, depending on the day, I’m three years older. I told her that I am a lot healthier physically since discontinuing the anti-depressants – no more high blood pressure, high cholesterol, etc. And I’m running, and I have an almost full time job between my paying job and my volunteer work. A lot has changed.

She says she does therapy now, she doesn’t do med checks anymore, but she made an exception for me because I am an old patient. We talked about what has been happening in my life, and I got emotional. I used a tissue, yes I was crying. It’s so weird, I cry everywhere but J’s office. Not sure what that means. She said I seem different, that she doesn’t remember me talking about things the way I did yesterday. But we did have the insight that I was on Zoloft or Lexapro the whole time, and I had no feelings really. She said when she saw me in the old days I was much more surfacey.

She senses some depression, but I adamantly refuse to start taking any anti-depressants. I told her about the intrusive thoughts, and she said I had never mentioned that in the three years I saw her. I know I kept that a secret for so long, and J was the first person I told about it.

I think it was easier to talk to her because of my 2 years of practice with J. I’ve been thinking it will be so hard if I ever want to start fresh with a new t, because it will be so difficult to tell my story all over again, but I think I now realize that it will actually be easier because I’ve told it once. That was an eye-opener.

So I told her about my anxiety, and my difficulties with sleep. And I lied to her. I’m sorry. I know it is wrong, I blatantly lied. I told her that I take 1mg of klonopin every night, because that is what I wanted her to prescribe. And I told her I take one or two klonopin every week or two during the day when I am feeling very anxious. So she prescribed me 30 1mg klonopin.

But actually my current pdoc prescribes me 15 .5mg klonopin per month, or every three weeks if I can sneak in a refill. And I split those in half every day. So I am really taking .25mg every night. It’s really not enough, because I have such trouble sleeping, which I told her, and when I need a klonopin during the day I have to dip into my stash. And my stash is getting smaller and I want to get it back to what it should be. I didn’t tell her that though.

So I am sorry I lied.

As for the sleep, her reason was “menopause.” I swear, being a middle aged woman has its problems when seeing doctors. Everything is blamed on menopause. But as far as I know there is no cure for menopause, so can’t she give me something to help me sleep? What did she prescribe? Trazodone. I used to take that and it did nothing to help me sleep. She may as well have prescribed Skittles. At least they taste good.

And she was concerned that I am still seeing my other pdoc and am I doubling up on my prescriptions? Which is a valid concern, because I may do that. Then I thought, maybe I should see her for therapy. We discussed my therapy with J. I told her that my current pdoc said that I need cognitive behavioral therapy, and J said that it ignores the complexity of human behavior. She says she agrees. She is a lovely woman, her voice is very soothing, I actually feel emotion in her office. My concern is what if I don’t like her as a pdoc, then what do I do if she is my therapist? I think it is best to keep the two separate.

And last night I took my .25mg of klonopin at 10:30PM, was tossing and turning until around 12:30AM, fell asleep, then got up at 4:30AM and tossed and turned, and I guess I fell asleep again at around 6:00AM, but my alarm vibrates at 6:30AM. The sleeping problem is really starting to get to me, and I don’t think anyone can really help. Why can’t I get something to really help me sleep, is it that difficult? Well, at least now, with the 1mg klonopin, I can split them in half and I’ll be doubling my dose every night, and have some to spare. And she wants me back in a month.

And of course I am still processing my t session. I think my insight for the week is that I will never feel good about myself as long as the two most influential people in my life – my husband and my mother – don’t feel good about me. One doesn’t care if I live or die and nothing I do is good enough for the other. The feelings of wanting to be dead are rearing their hideous heads again, and it is too soon. Usually I have been on a 3 month cycle with these feelings, but the last time I felt this bad was sometime during the summer. I don’t know, maybe it was June, and that would be 3 months. I was having a lot of suicidal ideation at the beach, and I think I went in June. It just feels too soon.

It feels like the only way I can feel better is to be dead. I know that doesn’t make any sense. But I am stuck with my husband and my mother, and I love them both, but I can’t do anything to make my husband care about me and I can’t do anything to make my mother think highly enough of me. Being dead seems like the best and easiest solution. I’ll never feel better about myself, never.

Sep 2 2010

Discovering Xanax

My son’s second day of his return to college. He was waitlisted for 2 out of the 3 classes that he wanted, and unfortunately a space did not open up in either of them. He did wait until the last minute to register.

And since he doesn’t drive, he is taking the bus to school, which involves a walk of 6/10 of a mile to the bus and two different busses with a wait in between. It takes about an hour; to drive would take 10 minutes. He feels it is not worth the travel effort to take one class, despite the fact that he does nothing else all day. So he wants to wait until next semester to start.

I am not happy.

But this afternoon I got an IM from him asking where the Xanax is because he doesn’t feel well. The only other time he has taken Xanax is when he had his blood test a couple of weeks ago. So I told him where the Xanax was.

A little while later I came home and my husband was just getting home with dinner for him and my son. Son comes downstairs and I ask, “What did you get?” He replies, “lkuw3roin;>fjvn98u38ufdskj.” I said, “What?” He laughs and says, “Quesadillas.” I said, “Did that medicine make you crazy?” He laughed and said, “Yeah.”

So later we are IMing each other and I said maybe next time he should take half a pill, since it seems to have worked too much. He said it worked pretty quickly and worked well. Oh, and by the way, “I took three of them.” I said, “Did I say to take 3?” He said, “Well, for the blood test I took 2 and I felt worse today so I took 3.” They are only .5mg each, but still! He did seem pretty happy though.

I asked if he would like to go to the doctor and get his very own Xanax and he said he would. So we will go to the pdoc, who normally pushes the AD’s. I wonder what he will give my son. I already told him to be prepared and that he can’t take this every day. He said he doesn’t need it every day, only when he is having a panic attack. I said, “Did you have a panic attack today?” And he said he was close.

I am glad he is opening up to me about this. But I also feel so badly for him. Everything is difficult, and I know part of it is his anxiety/dysthymia, etc. Part is learned behavior as well, and I would like him to unlearn this before it gets too ingrained.

But we had a nice discussion about AD’s vs benzos and I was frank with him about my experience with both. He has a good friend in Alberta (he visited her once) and she is very knowledgeable about these meds as well, since she has been on a number of them and also doesn’t seem to do anything all day so she has a lot of time to research things on wikipedia. I think she is advising him. She probably told him today to ask me for the Xanax.

So my son has discovered the joy of psychiatric medications. Let’s hope he doesn’t need too many of them. Just enough to function in the world?

Aug 6 2010

A Safe Way

Last night I watched the Wrestler, and took 4 klonopin. Don’t worry, they are each only .5mg, so that’s still within the therapeutic dose. It is just 8 times more than I usually take. I slept pretty well.

Yesterday someone made a comment on my blog that I have been thinking about. He said: I hope you can find safe ways to express the anger and the fear and other feelings.

I don’t normally express anger, fear and other feelings. I keep everything in. I don’t think I would know how to express these feelings, well, except for anger. I do sometimes explode in a rage, and that makes me feel very ashamed. I supposed that is not a safe way to express feelings.

I’m assuming drinking, doing drugs, and cutting are not safe methods. They can lead to illness or injury, however I am careful not to let that happen. But technically, not safe.

What would be a safe way? When I was growing up I remember my feelings being minimized and invalidated. I wonder if they really were, or if that is how I remember it? I think it is probably true, because my mother continues to do that now, and she is 73 years old. So it wasn’t really “safe” to talk about feelings. I would not get physically hurt, there was no abuse in my life thank goodness. But the response would usually be “You’re fine.” So I just never talked about my feelings. Keeping them in was the safe thing to do.

I wonder how well adjusted people express feelings in a safe way. Exercise, art, music, hobbies, meeting with friends? Actually talking about how they feel? That seems very dangerous, not safe at all. I wonder how I can address this in therapy? And should I even try? Any ideas?