Category: Medication Side Effects

Bipolar Diary: Tardive Dyskinesia

Apparently I am really sensitive to medications, especially Psych meds. Over the last 2 years, I have tried 6 meds (not all Psych) that I eventually had to quit because of (what I would consider) intolerable Tardive Dyskinesia. I know that many others have it worse, have to take the meds that cause TD and that, for many, it never goes away. I have been lucky that mine generally went away.

Except the last time.

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My Recalcitrant Tongue

The first time I experienced the TD, it took a couple three weeks to figure it out. My tongue kept burning… then I would wake up with blood in my mouth. I couldn’t figure it out. My teeth? They all felt fine.

So I meditated on it, talked to myself about paying better attention, slowing down the movements so I could figure it out.

I began paying attention as I fell asleep, honing in on my mouth.

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A couple of nights after this new mindfulness thing, I relaxed and let my mouth do its thing. And boy did it ever.

Scraping is the best way to describe it. My tongue, clearly having a life of its own, pushed through my teeth, first pressed upward, then pulled back, my top teeth sliding against my raw tongue. Over and over and over again. Apparently, all. night. long.

Oddly, it didn’t do it as much when I was awake. I realized it did some, but not a lot. It was at night that my teeth assaulted my tongue. And holy fuck did it hurt.

Medication Connection

I Googled “tongue scraping” and TD came up. Medications were the culprit. Sometimes ones a person had taken for many years.

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I’d recently started some medication or another (cannot remember and for whatever crazy reason, I didn’t note it or write it anywhere), so went off and within a week, the TD had disappeared. The doctor tried another one to replace the first. Same thing, but this time I figured it out a lot sooner. Went off, it went away, and tried a third medication. This time it was fine.

Fast forward to this recent Manic Episode when I had to go on Risperdal for the hallucinations, then when I fell a tad too low, increasing the Wellbutrin… a med I have been on for several years. I hadn’t an issue with the Risperdal, but began noticing some light TD symptoms after upping the Wellbutrin. No blood this time, but the scraping had begun.

I lowered the dose of Wellbutrin for a couple of days with no changes, so upped it back to the 300 mg my doc agreed to (after I’d upped it myself). It didn’t get worse, but was still annoying.

Resignation

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artist, Margot Rijven

I seem to be in the place where the TD isn’t going to go away, but it isn’t going to get any worse, either.

It is definitely worse when I am tired or sleeping. I wake up with a very sore tongue and can feel I have been rubbing it against the roof of my mouth. I am happy that I am not waking up with a bloody tongue or enormous sores from the vicious play of teeth and tongue while I am unconscious. I am also quite lucky I do not have the serious symptoms of TD that include protruding tongue or uncontrollable facial tics that are obvious to anyone looking.

Still, my TD is annoying. It gets in the way of my work at times, having to make adjustments to my speech because of my involuntary mouth and tongue actions. But so far, nothing has been irreparable.

So, I shall just keep being Mindful and do my best to stay on top off the Tardive Dyskinesia, maybe lessening it over time.

One can only hope.

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Bipolar Diary: New Meds for Depression

My psychiatrist, whom I adore, was great, totally understanding where I have been. I did tell him about the suicidal thoughts, said the standard line “I do not have a plan to kill myself and promise I will not” to quell any concerns he might have.

I forgot to mention in the last post that all my hallucinations have vanished. ALL of them. I cannot remember a time in 2 decades that I have not had at least one hallucination going on, usually olfactory. My world has quieted… and it is disconcertingly odd.

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Medications

I was prescribed Paxil, 20 mg a day and see the doc again in 2 weeks to see if we up it or not. I also lowered the Cymbalta from 90 mg a day to 60 mg a day for a week, then down to 30 mg after that. Interestingly, I have never taken Paxil in all these decades with Depression and Bipolar Disorder.

Dr. Google revealed that Paxil can bring on hypomania, mania, insomnia, agitation and more. I read those side effects and thought, “Bring it on!”

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It takes 2-3 weeks to really begin working in earnest and then another few weeks to settle into the system. Crossing my fingers things get better fast. I miss writing!

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Bipolar Diary: Depression Deepens

TWMental

Depression

The last 2 weeks have sucked even worse than when I wrote on July 13, 2017. Tears. Tears. Never-ending tears. The suicidal ideation is coming more often and is more vivid than when I started the Paxil. And the damn hallucinations are back.

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Almost all of my time is in bed, either curled in pain (another post), staring at the ceiling or sleeping. I leave I Love Lucy on in the background. Sometimes Friends. I’m listening to Mists of Avalon (a book I love), but when I listen in bed, I fall right to sleep. I’ve replayed Chapter 6 four times already.

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artist: Edvard Munch

An Odd Sorta Depression

When looking for images about depression lying, I came across several pieces like this one below:

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Not sure if I’m just more familiar with my depression than when I was younger or if it has really shifted, but I do not hear the lies the girl in the image does… nothing negative about my body, how alone I am in the world, how fat/ugly/sick I am. I did when I was younger, but not anymore.

I just feel sad. An overwhelming sadness. A pall of melancholia that separates me from the rest of you. I cannot even touch what I am sad about except for the endless distress I have about our country because of 45. But this joylessness is deeper than the fear-for-our-lives kind. I feel like I’m under the thick glass of my Nana’s cake pedestal, so close to others, but unable to penetrate the barrier of dreariness to make a connection.

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Medication Changes

The psych doc upped the Paxil to 30mg after 2 weeks on 20mg. He said he still might have to increase it when I see him in 2 weeks. For fuck’s sake, can’t this stuff take effect already? I hate this waiting part.

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I have weaned off the Cymbalta. Is that the reason for this huge dip? Who knows anymore. He wanted to increase my Risperdal, but I refused; the eating is out of control with more Risperdal… can’t abide by that.

An aside: I despise the new packaging that seems to be taking over the medication world. I am not stupid, can follow directions, but they are incredibly difficult for me to get into. I’ve asked the Pharmacy to open them for me and then I rip the inner blister pack out, throwing the outer box away. If you haven’t see them, let me introduce you.

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“Follow these 3 simple steps,” it says. Push the blister pack all the way in, then press on the “lock release button” on the left . Finally, pull the sliding pack out at the same time as pushing the spot on the left. I wish it was as easy as they make it sound! It’s almost worse that rubbing my head and patting my belly at the same time.

Suicidal Ideation

I’ve had lots of suicidal thoughts. A friend stayed with me one night when they were especially bad, reminding me every few minutes that Depression is a Liar. Hearing that, knowing it for certain, is what kept (keeps) me going. Hearing that so-and-so loves me doesn’t do much for my mindset because I rationalize that away easily. Depression Lies, however, works wonders.

Depression is a lying bastard

The thoughts of suicide are so enticing. They call to me seductively as if they were sirens on the ocean’s rocks.

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I try to block them out listening to various albums I have memorized. The Eagles, Carly Simon, Sting (Living Sea), and, of course, Hamilton: An American Musical.

I also try to find positive recovery-from-depression-and-suicidal-thoughts articles and posts online. This is one I go back to over and over:

Suicide Prevention: How to Help Someone who is Suicidal and Save a Life

“A suicidal person may not ask for help, but that doesn’t mean that help isn’t wanted. People who take their lives don’t want to die—they just want to stop hurting.”

When I had my first serious clinical depression in my late teens, I didn’t understand the “wanting the pain to stop” aspect and teetered really close to the edge of death.

As I got older and had some decent therapy, I was able to verbalize the inner turmoil and excruciating emotional pain that was drawing me towards dying. Understanding that I didn’t really want to die, but just to stop hurting… a pain that went so deep as to injure my soul… I was able to cling to those brief seconds of “medication will help remove the pain… hang on a little bit longer.”

Medication and therapy have not failed me yet.

Working/Not Working

Work has been nearly impossible the way I feel. I can do one call, then need 2 hours off to regroup. The calls are easy, mostly with regulars, but the energy expenditure exhausts me. Even writing this post has taken 4 days so far. Ugh. I need to be able to work!

Okay, I need to get this out to you all. It is not a cry for help, I promise. I will not hurt myself, have no plans to.  It’s just those random thoughts that flow through my mind… sometimes like heavy cinder blocks and others like wafting vapors. As long as they continue moving on the conveyor belt, I think I’m okay and headed towards healing.

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Thanks for listening

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Always reaching for help.

Bipolar Diary: Incremental Shift

TWMental

Loving Nudge

After my Bipolar Diary: Depression Deepens post, I had several people tell me to call my psychiatrist immediately. I thought I could white knuckle it for another week, but others saw what I couldn’t. I trust those closest to me and picked up the phone, getting pushed into a non-existent spot in his schedule the next day. Wednesday, August 2, 2017.

Office Visit

The crying had been keeping me from functioning and did not abate while in his office.

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I told him about the suicidal ideation increasing… then added the obligatory, “But I have no plans to hurt myself, am not stockpiling meds and promise to call 911 if I do find myself getting too close.” He replied, “I understand how frightening they (the thoughts) can be, even when you aren’t consciously creating them.” I breathed a sigh of relief that he seemed to understand.

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artist: Soren Dreier

I’ve had at least 8 different psychiatrists in 30 years and this one is one of the top 2. He listens to me, takes my preferences seriously like refusing the Risperdal increase and is infinitely patient with my continued distress.

I really am so blessed to have such a kind (and gifted) doctor. I know that is rare and how privileged I am to be able to receive quality medical and psychiatric care.

I OWE MY AWESOME CARE TO THE ACA/OBAMACARE INSURANCE I HAVE.

I would not be alive without it.

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Medication Change… Again

I continued crying while he pondered, looking at his computer, typing some, then thinking again.

He found a medication I had not tried before… Latuda… which I’ve since read is used specifically for bipolar depression. Yes, yes… it does come with a laundry list of side effects, but I’m ignoring them, listening to my body instead.

I know it takes at least 2 weeks (in my body) to 6 weeks to feel the full effect of psych meds, but when I got home from the appointment, I took my first pill. Then the next morning, I took the second. (It is taken once a day.)

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Whether placebo or really working that fast, I did not cry until late evening the next day. I didn’t cry the next night, either. And the ideation has slowed, the thoughts feeling more “transparent,” fewer hard imaginings. The images had been like mosquito bites, begging to be scratched. (Not sure I explained that clearly… I’m having a terrible time writing this, pardon spelling and grammar errors, please.)

August 6, 2017

I’m feeling better still. The doc told me that if I was feeling too sedated, to drop the Risperdal, which I did on day 3 after starting the Latuda. I’ve been on Risperdal since 1995, so it is a major thought process to not take it before bed. I do feel less sedated (I described it like someone spiked my drink), but there’s a lot more room for not dropping into a slumber at any given moment.

Let me get this out so those who are following along know how I am doing. Thanks for you care and attention, my dear friends. Thank you for your love.

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artist: Zenos Frudakis

Skin Infections (Ugh)

(Rehashing of some stuff, I know.)

Itch, Itch, Scratch, Scratch

I had an iron infusion on October 11th. I receive Solu-Medrol (a steroid) beforehand, but as it wore off over the next day, I began itching. Now, this was my 6th infusion… my first allergic reaction.

I began scratching. And scratching. I took 50 mg. Benadryl. Then 30 min later, another 50 mg. I kept itching. I was using my sharp nails, digging into my skin. I couldn’t reach my back, so used scissors to get the itchies there. Some of this was in the middle of the night; the part with the scissors, I was awake and sitting up.

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Then I went to lay down again and saw a couple of (big) blobs of blood on the sheet and thought, “I probably should go to the hospital!” So I did.

ER Visit

It had to have been one of the most crowded times I’d ever been at this hospital (where they practically know me by name). They couldn’t even get me into a room for over an hour. I was bleeding all over by that point.

The doc came in quickly (yay!) and they gave me a Bolus of Benadryl, some IV Pepcid (which apparently has an anti-itch property) and a nice bag of Solu-Medrol.

It took about 10 minutes when the itching on my arms, legs, hands, belly and feet stopped feeling like I had bugs crawling out of my skin, but my back and head and face kept up almost unabated.

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I got off the table, IV still in place, and poked around the room looking for something long and sharp to scratch with. Not one damn thing. Fuck. I sat on the bed and rubbed back and forth, back and forth… and clawed at my face and head some more.

When the IV was done, I was detached, given Rx’s for prednisone, Pepcid and told to take lots of Benadryl. I went home and scratched with the scissors until I fell asleep from so much Benadryl.

It took 2 more days for the itching to chill out. I was so thankful when it did.

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Residual Issues

Now we are almost 4 weeks out and many of my scratches are still open, two gaping and not doing well at all. The Endo yesterday didn’t seem surprised considering my BGs have been so crazy with all the prednisone I have taken over the last month.

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The wound on my belly is the worst and she used a silver nitrate stick to help with wound healing, then the nurse dressed it. She did the same on my right upper arm… silver nitrate, then dressed. She said she wants to see it in a week and we will decide on antibiotics… holding off on those because 1) I am getting more and more allergic to medications (which at the moment are: Penicillin, Codeine, Azo, Flagyl and whatever was in the iron infusion) 2) they will give me yeast and fuck with my BGs some more. We will try topical first.

The Endo also said I have to see Podiatry for the Neuropathy in my feet. I have a call in to my Primary Care Provider (PCP) for that. And just have to suck it up with the diarrhea at the moment. I will ask my PCP for help beyond Immodium and Lomotil.

I go to the Hematologist tomorrow… am supposed to have an iron infusion, but we’ll see what the plan is for someone allergic to it.

Argh! I am so tired of being allergic to stuff!

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Diabetic Neuropathy Begins

heavy sigh

Legacy of Diabetes

I’ve had Type 2 Diabetes since I was 34-years old… for 22 years now. My entire Cuban family had diabetes as well; skinny, fat and inbetween. My entire life, I watched my pot-bellied relatives manipulate their insulin so they could eat and drink whatever they wanted. I watched as they lost their eyesight, had heart attacks, then had feet and hands cut off from infections. My grandfather died before I was born from complications of diabetes. My grandmother, aunt, uncle all died from diabetic complications. It seems I am next on the list.

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Added Challenges

My Blood Glucoses (BGs) are almost impossible to control. I have been having to take steroids (SoluMedrol & prednisone) because of several allergic reactions lately. (One reaction was to Azo… the other to the 6th iron infusion I had… that one sent me into the hospital because I was scratching myself bloody and using scissors to scratch my back… also bloody.)

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My diet is comprised of almost all carbs for a variety of medical reasons, including dental. Exercise is impossible. I am destined (doomed?) to using insulin to get my BGs under control.

Doctor Visits

Whenever I see doctors, they ask if my feet are numb, tingling or hurt. I have said no for many years. Now, however, they are beginning to hurt more and I realize the pre-pain feeling I’ve had has been like a tight sock on my right foot. Now, at night, there is distinct pain.

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I’ve never read about Diabetic Neuropathy before today and now I am scared.

Besides the foot pain, I also have what seems to be untreatable diarrhea. Taking 30 Imodium a day does nothing to quell the issue. Lomotil doesn’t do a thing either. The GI Doc said I need to get the Endo to help. I see the Endo on Monday. Hope they are able to give me something else. It is distressing, always having to dash to the toilet… pretty challenging trying to work.

I have some Cymbalta from when I was rx’d it for depression and read that was one good medication for the neuropathy. Hopefully, someone will rx it (or something else) to help with the pain.

One More Medical Problem

I have an ongoing list of medical crap I am dealing with, all because of being fat. My fat life is (quite literally) piling on the complications.

All my fault.

heavy sigh

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