Hormones got me like…

a cure for what ails you, bipolar disorder, endometriosis, medication, rapid-cycle bipolar disorder, Uncategorized

I had laparoscopic excision surgery earlier this month for endometriosis. It was loooong overdue and my surgeon was excellent, which means no more pain! Seriously, I haven’t had a single day without some form of pelvic pain or muscle tension in years, so this is incredible.

Anyway, he popped the hood and did a bunch of stuff. In addition to removing sheets of scar tissue that had formed after my last (unsuccessful) surgery seven years ago, he placed a Mirena IUD. I was always scared of having one placed because I’d heard it was so painful, but he assured me that he could do it while I was 100% out. And readers, I feel great and am so glad I did it!

I’d been on a pretty heavy dose of Megace for about a year and a half. Megace is a heavy hitter and is one of the strongest progesterone medications out there. It’s not really meant to be taken long-term, but the gynecologist who prescribed it back in the day didn’t tell me that. She also failed to mention that it wouldn’t actually treat my endometriosis–it just stopped my periods. I mean, that’s great and all, but I was under the illusion that I was actually treating it. Instead, I was just building up some heckin’ heavy uterine lining that my surgeon had to scrape out. Ew.

I stopped the Megace cold-turkey a few days before my surgery, with the blessing of my endocrinologist. (I have a lot of health stuff going on in addition to the bipolar disorder.) He ran a fasting cortisol panel to make sure the Megace wasn’t destroying my adrenal glands. Everything came back totally normal, so boom, no more Megace. And hello, Mirena!

But, as we all know, hormonal shifts can have huge implications for people with mood disorders. My bipolar disorder has been amazingly stable for years–you all may recall way back in the day when I was first diagnosed (2013!). I’d been on more or less the exact same doses of medication since then, with minor adjustments to my lithium and a change in the type of antidepressant (from SSRI to SNRI) when I first started taking meds. It’s pretty rare for a patient to not have adjustments within a five-year period, but I was one of the lucky ones.

I saw my psychiatrist yesterday and mentioned a few things I’ve noticed–tiny bits of hypomania peeking through and depression where it shouldn’t be. Fortunately, I’ve been very tuned-in to my body and my moods for years because I have to be in order to stay healthy and sane. Being in the mental health field has also helped, because I now have more precise language to describe what’s going on with my moods. My psychiatrist, who I initially had doubts about, has been pretty awesome the last few times and worked with me to determine what meds to adjust and how much. She seems to get that she has the medical knowledge and I have the experiential knowledge, so together, we’re a treatment powerhouse.

I’ve been sleeping a lot more than usual lately and my appetite has been really weird–up one day, then down for a couple days, and so on. I slept thirteen hours the other night and eleven-and-a-half last night. I would have slept later today, but the cats were staring at me when I woke up from my third alarm and I needed to get up and feed them. Groan.

Here are my current meds, for anyone who’s interested. Please bear in mind that these are my doses and that your needs may be different (either a little or a lot!). As always, work with your doctors and make sure everyone’s in the know, especially if you see a few different specialists regularly like I do. They’re part of your wellness team, so make sure they’re up to date!

I’ve dropped the 60mg of Megace and also my 5mcg of liothyronine (a T3 thyroid medication) so far this year! My current regimen sounds like a lot, but it’s actually the smallest amount of meds I’ve taken in years. Here we go!

  • 400mg lamotrigine/Lamictal
  • 88mcg levothyroxine (T4 thyroid medication)
  • 600mg lithium
  • 112.5mg venlafaxine/Effexor

And that’s it! No more birth control pills because Mirena’s got my back. Now that I’ve more or less adjusted (a few aches and pains similar to what I remember PMS being like) to it, I’m feeling pretty good. I still have some residual pelvic achiness from time to time, but my surgery was less than a month ago and things are still healing internally.

How are your meds going, readers? Or are some of you fighting the good fight without them? Summer can be rough for a lot of us mood-wise–hypomania and mania tend to spike, so we have to be extra vigilant. Let me know how you’re doing in the comments!

 

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This week has an been a wild ride!

a cure for what ails you, medication, ptsd, rapid-cycle bipolar disorder, three hopeful thoughts

This story actually starts at the beginning of July, about a week after we moved to Baltimore. I applied for Medicaid through the healthcare marketplace, as did my fella. Since we listed each other on our applications (not knowing any better) and he filed after me, his app bumped mine out. I was never informed (oops), so I sat around for over a month wondering why I couldn’t get coverage and going through the frustration of weekly phone calls to check on my application, to no avail.

So that brings us to this week, when I finally ran out of my carefully-rationed venlafaxine. I’m supposed to take 75 mg a day, and had been taking 32.5 every other day to make sure I could stretch it because I had no other options. I took my last dose on Monday, and it took about a day and a half for the symptoms to start up. And man, did they come back with a vengeance.

I had two nearly-sleepless nights because of the brain zaps and headaches. My application had been received, Medicaid promised on Tuesday, but I had to give them more time to get me an ID number. Meanwhile, the depressive symptoms, combined with the stress of the whole unfortunate situation, snowballed into something truly awful.

The little sleep I did get this week was plagued by night terrors, involuntary twitching, and (so I’ve been told) a lot of whimpering in my sleep, some of which woke me up. I finally got my scripts filled today, after a bit of a fight regarding the dates on the prescriptions, then came home and promptly collapsed after taking one of my newly-procured venlafaxine.

Moral of the story: Withdrawal is exhausting. It’s hard on the patient, and it’s hard on the patient’s loved ones. Fortunately, my brain immediately grabbed that medication and held onto it ferociously, and I woke up feeling much better (perhaps because I slept like the dead for two hours).

This week was a test of my will to fight and my mindfulness skills. I didn’t cope as well as I had hoped–little things sent me into tears, and I was generally irritable the entire time. I didn’t like being around myself. I was plagued by guilt. I felt, for the first time in years, trapped in my body and helpless to fight my invisible tormentor–the bipolar disorder that had, once again, taken hold despite my best efforts to fix the situation.

The good news is that I’m on the mend. I now have insurance, so I can start shopping for a good psychiatrist/therapist/every other kind of doctor I have to see because my body’s kind of a wreck and I have a bunch of chronic illnesses that tend to require a lot of maintenance.

Have any of you had to detox against your will? I hope not, but from what I’ve been reading, it’s frighteningly common. Stay safe, readers. Hang in there–it’s finally the weekend, and I hope all have a lovely one. 🙂

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A brief update.

authoress in motion, major depression, medication, rapid-cycle bipolar disorder, three hopeful thoughts

This is just a brief update on my current meds, treatment plan, and moods. If you’re into videos and want to see the authoress in motion, check it out. 🙂

Breaking up is hard to do.

medication, ptsd

I’m considering “breaking up” with my current psychiatrist, and it’s a tougher decision to make than I’d anticipated.

I like her as a person, but I feel as though we’re not meshing that well on the doctor-patient front. My depression has been particularly difficult to get a handle on, and treatments that previously worked (like Cymbalta) have suddenly stopped helping for no apparent reason. Yesterday, I called and left a message for her with my third request for an increase in my Effexor dose.

The first time, I was told to be patient and give it more time. When I met with her the week after I went to the ER for my panic attack and pleaded my case (since missing a dose and having a dose that was probably too low to begin with kicked off that whole mess), she added risperidone and told me she didn’t want to increase the Effexor until we’d given the other drug a chance to work.

It’s been a few weeks and the only thing the antipsychotic has done is make me even more drowsy than usual–I’m like the goddamn Dormouse to begin with, and the only change is that now I’m really sleepy on top of being really depressed. And in my desperation, I’ve found myself turning to some pretty unhealthy methods of coping with the low-mood-negative-thoughts-constantly-wanting-to-cry thing.

I called the office again today to see if my message had gotten through; after I gave the doctor filling in a quick (probably 30 second) summary of what’s been going on, she agreed to call in a small increase to see if it helps. It might not; I might need to try another drug. But at least I felt like my concerns were being heard.

I feel like my regular doctor and I have had this disconnect for a while now, and I plan to address it at our next appointment. She’s not a bad doctor by any stretch of the imagination, though there’s a pretty clear class divide between us (she suggested Weight Watchers, which is too expensive to even contemplate, when I expressed concern/anxiety over my weight, and has recommended name-brand drugs and alternative medicine that I can’t afford multiple times, despite me repeatedly telling her that our budget’s tight as it is–therapy is expensive) and I think that’s causing some issues.

I tend to avoid conflict at all costs, so it’s going to be tough for me to broach the subject. But I feel like she really knows her stuff, so I don’t want to just “dump” her. I want to make sure we’re on the same wavelength and see if things improve from there first. On the other hand, I’ve been stuck with doctors who aren’t willing to listen to my concerns and give me what I need, and I don’t want to fall into that trap again (ask me about the thyroid debacle that went down last year).

Are you avoidant? Have you ever had to break up with a doctor? Tell me about it in the comments!