Drove to Tampa yesterday to go the main VA hospital in my area. It’s a 2-hour drive each way. I spent most of the drive there fighting traffic and listening to “Hey, That’s My Hummus!” Great podcast from a couple of friends of mine.

And so it seems I do, indeed, have a torn rotator cuff. At least, that’s how it looks. Speaking of procrastination, I injured my shoulder over 18 months ago doing a Birthday Dare. Stupid me on roller skates, for the first time in 20 years. Why did I wait so long? Because I’m an idiot. And at the time, my right hand was the most painful…I hyper-extended my fingers and sprained the hand really badly.

I go in for an MRI in a few weeks and we’ll know for sure then, but the doctor I saw yesterday says he’s pretty sure the rotator cuff is torn. He asked me to hold my arms up this way and that, and it’s clear the range of motion of my right arm is much lesser than that of my left. They took more x-rays. I was in and out of the hospital in 90 minutes, which surprised me. The VA isn’t known for its speed.

If the MRI shows a torn rotator cuff, it’s likely going to require surgery. I haven’t had any surgeries since I was 3 and my tonsils were taken out. I don’t even remember that, even with the free ice cream I got.

Yeah, I’m a bit scared, I admit it. I’m a wuss when it comes to pain, though I’ve been living with this for a while now. I guess I’ll learn to type with one hand. You know, for when my arm is in a sling. And I am a lefty, so at least there’s that. I won’t have to learn to eat with my non-dominant hand.

There are logistical issues, as well, like getting to physical therapy post surgery. I’ll have to get them to authorize something local because there’s no way I can drive to and from Tampa several times a week. Hell, I won’t be able to drive for a while, period.

I haven’t yet Googled “torn rotator cuff.” The results are likely to be overwhelming, but I’ll look it up soon. Maybe I’ll Google “stupid skating injuries,” too.

Also this week, I went to see my new shrink. Because the local Sebring VA clinic is so small, they didn’t have a local shrink for a year and a half. All my shrink appointments were via video-conference. Now they have a live person again and it was my first meeting with her.

Shrink: “So tell me about yourself and what you’re in treatment for.”

I repeat my diagnoses by rote.

Me: “PTSD, anxiety disorder, bipolar, major depression.”

S: “You’ve got a lot going on, don’t you?”

I thought, “No shit, Sherlock,” but instead just replied, “Yes.”

Then we went through my meds and how I’m not all that confident in the Abilify, which I’ve been on for a while now. She’s cutting my dose in half to see if it makes a difference. And there will be an extra Klonopin every day, too. She also mentioned adding an antidepressant to my drug cocktail, but we’ll wait for a month to see how the other changes affect me first. Between my diabetes and cholesterol and all the mental shit, I’m on quite a few different things.

She had me hold up my arms in front of me, then dangle them down to the floor, then hold up one leg at a time. Checking for involuntary movements, twitches, etc. Sure, I move my legs all the time, bouncing them up and down, but that’s more about nervous habits and anxiety. I CAN stop moving them, I just don’t. Yes, I can be frustrating to sit next to on a sofa.

S: “Have you ever attempted suicide?”

Me: “Yes.”

S: “When was that?”

Me: “1995.”

I took a bunch of pills with a glass of wine, then threw them up within two minutes, and promptly went to bed. I couldn’t go through with it, couldn’t do that to my family. It was a momentary lapse in judgment at a point in my life where I was at rock bottom.

S: “You’re not suicidal now? No thoughts of harming yourself?”

Me: “No.”

The truth is, I think about it, but would never act on it. The inner voices (no, not literal voices) tend to lead me down this deluded primrose path that says how lovely it’d be to just…vanish. Be absent of this place and all my maladies. It’s calming to me to imagine myself out of existence. Weird, I know. Morbid, maybe. But no, I’m not suicidal.

Besides, I have to see what happens next on “Fringe.” And “Doctor Who” is on tonight. Plus, tomorrow is MTV’s remake of “Teen Wolf,” which I admit I’m curious about. Then there’s the WWDC on Monday, where I hope Steve Jobs will announce the iPhone 5 (or iPhone 4S, or whatever they’re gonna call it). I need an upgrade to my iPhone 3G.

Yeah, sometimes it’s the little things that get you through the day.

--- Thanks for reading! SecondHand Tryptophan

Just got home from Mom’s follow-up doctor appointment. Y’know, from the Broken Kneecap Debacle of 2010? Today was her last scheduled day of physical therapy. She’s gone from a 65-degree flex on that knee to just over 90 degrees. It’s been just over 3 months since this thing started.

She’s been driving (back roads, since highway driving with the constant acceleration hurts), she even went to the grocery store yesterday…first time since her accident. She’s cooking, too – thank God, because my culinary skills are roughly the same ones owned by 7-year-olds.

Long story short: Six more weeks of physical therapy to increase her flexibility and strength. She can return to work almost immediately. And another doctor visit in two months’ time.

Her going back to work is a good thing. It’s been a long three months and Mom has had more than her share of stir crazy. The BITCH about her going back to work now is that I’m the one that’s gonna have to chauffeur her around to work and back every day. See, she works off the highway, so…I’m kinda screwed, especially since her workday starts around 8am.

Ugh. Can’t wait till she can fully drive again.

Me? Meh. Depression still bares its vampire fangs my way, so much so that getting out of bed is just a couple clicks shy of more than I can do. It’s probably a good thing I have another video-conference with my shrink this afternoon.

The Abilify isn’t cutting it; not at the current dosage, anyway. The prazosin, a blood pressure med which has an off-label use for ridding people of nightmares, may be working. I rarely remember my dreams, but can’t recall any nightmares of late. Typically, with nightmares I’ll wake up in a sweat at 3 or 4 in the morning. Been a while since that happened.

What I have noticed is more energy, to the tune of cutting into “productive” nap time. I wish energy = motivation, but it doesn’t. I need something for mood. Or something that will excise drama from my life. Both, preferably.

I understand how my shrink is approaching my case. We don’t want to start me on multiple things at one time. That’d make it difficult to ascertain what medicines are doing what.

But as I mentioned in my last post, my super powers do not include waiting. I want to feel better…not yesterday, TODAY. Hell, I’d just about prefer a manic phase right now. Relief, any relief, would be welcome.

The trial-and-error shit associated with finding the right Magic Cocktail is not fun, nor fast enough for my liking. I know the universe doesn’t give a fuck, but I’m tired of uttering the mantra: “It has to get better, it has to get better, it has to get better.” Repeat ad nauseum.

It does, though. Right?

--- Thanks for reading! SecondHand Tryptophan

One of my oldest blogging buds, James, and I have a lot of commonalities, particularly our battle with depression (and bipolar disorder). He wrote a post, listing some of the things he’s grateful for. Think I’ll follow suit because the Depression is rearing its ugly head yet again.

Feel like withdrawing from society, ignoring all social media, etc. etc. You’ve heard it all before. You’ll probably hear it again.

Sometimes you need to take stock of the good shit in your life in order to maintain some semblance of sanity.

• Despite the last week-and-a-half, I’m relatively healthy. I’m normally not hocking up half a lung. It’s a good year for me to quit smoking, since I still have my health. (And yes, that will certainly be one of the Resolutions for YOR.)
• I have good friends. I may not touch base with them nearly as much as I should, but I know that they’re there for me should I need them.
• I have a working computer. It’s ancient, it crawls along, but it works. And that’s saying something for a 4-yr-old laptop. I’m currently in the process of what will likely be a 17-hour defrag. I’m praying this is the year for the replacement to come along. (MacBook Pro, anyone?)
• My brain works. Yes, I fight depression, PTSD, bipolar disorder, ADD, social anxiety, and who knows what else. But compared to many who have it far worse? I’m thankful that my mental faculties are pretty much operating at full capacity. Usually.
• My car works pretty damn good, considering it’s 10 years old. I’m not a person who gets hung up on vehicles, since they’re a utilitarian kind of thing as far as I’m concerned. Get me where I need to go (and back) and I don’t really give a shit that there’s a swamp in the back seat or that rust is perhaps the only type of molecule holding the roof together. Well, that and the bubble gum.
• Rumor has it that Apple is developing an iPhone for Verizon. I hope it’s true. Another rumor holds that the 4th generation iPhone will be announced on June 22nd. My upgrade pricing became available in January, so I *could* get myself a 3GS, but why? When the next iPhone is due to be released in a matter of months, I’m not tying myself to a 2-year deal for LAST year’s model. I’ll be good and patient and wait. I’m praying that Apple announces not just the next AT&T iPhone in June, but the Verizon iPhone, as well. Cuz when they do? Hasta lasagna, AT&T.
• I have a place to live. That’s not to be taken for granted. I’m fortunate.
• Food. I have that, too, even if lately everything tastes like cardboard to me.
• Daughters. Despite the troubles I’ve caused in those relationships, I couldn’t be prouder of my girls. I’ve said it before and I’ll say it again: they are my crowning achievement.
• Family. Like most people, I have my share of dysfunctionality in my family. Hell, sometimes I feel like I’m the sane one. But I love my family, and I know that I’m lucky to have them.
• Health care. I’d be screwed if not for the V.A. Thank God I have them for my physical AND mental health. Otherwise I’d be broker than I already am.
• SillyBring is only three weeks away and then Shannon arrives!

There are many other items, I’m sure, but these are the things that spring to mind. I have a lot to be grateful for, even if my miserable curmudgeonly self doesn’t mention them as often as I should. Wish I could throw this one in there, though:

• I get laid three times a day.

--- Thanks for reading! SecondHand Tryptophan

Had my first ever videoconference with a shrink today. First ever videoconference, ever, actually. Went pretty well.

The Matrix Therapist had sent the doc the list of meds I’d brought in for her to look at…the ones I was taking 10 years ago, the ones that actually were doing something. And the shrink actually looked that shit over BEFORE we met.

Pretty cool setup, and I had about 40 minutes of her time, which was also cool. We’re stopping the Geodon, even though I’m only taking a third of the max dosage. Gonna try Abilify again.

It’s important to note that the one and only time I’ve had an adverse reaction to a medication – and I’ve been on a LOT of meds – was with Abilify. I fainted. After ONE dose.

But.

I now suspect that the fainting (and it was years ago, after I was first diagnosed as bipolar) was a low blood-sugar event. So we are gonna try it again, because I’ve heard really good things about Abilify. Plus, it doesn’t have a sedating effect, which Geodon is known to have at higher dosages. I want to be calm and relaxed, but I don’t want to feel sleepy all the time. Fuck that.

First, as I mentioned already, we’re gonna have to ween me off the Geodon. That’ll take only about 10 days or so to do, and I don’t look forward to being without something in my system for that long, even if I don’t think it’s doing anything. Could takes weeks or (God help me) months for Abilify to gain full efficacy. Not looking forward to that, either, especially since it’s hard to maintain hope. So many drugs do nothing for me.

We’re also going to try a new med for the nightmares. She asked me if I’d ever taken anything for them, and I said, “Like what? Name a drug and I’ll tell you if I’ve tried it.” She did, and I hadn’t. No one has EVER suggested a med to specifically target the nightmares. I didn’t even think to ASK for such a thing.

The nightmares, ugh. I won’t even get into detail about them here. Some of them are really horrific. The most common theme is I’m being chased by baddies, sometimes monsters that make “Nightmare Before Christmas” and “Hellboy” monsters look warm and fuzzy, sometimes it’s people. Always within arm’s reach, constantly grabbing at my shirt, just touching the back of my neck. And I’m not a runner, people. Hell, I consider walking to my car exercise. But I run like a mutherfucker in my nightmares. Trust me, you would, too.

I’ve woken myself up falling on the floor on multiple occasions, and it’s always when I’m kicking at the blankets on my feet, thinking they’re monsters trying to grab me. Hit my head on the nightstand more than once falling out of bed. Plus, the sleepwalking…I’ve done that, too. So the suggestion of Ambien today didn’t go over well with me. Never tried it, but I don’t need to be DRIVING in my sleep, and that’s not unheard of on Ambien. I’m not about to start hiding my car keys from my own damn self.

I was told during my very first psychiatrist meeting – back in the mid 90’s – that the average person has one nightmare a year. ONE. That is alarming to me, still. I don’t know if it’s true or not. I just know that it’s nowhere CLOSE to my reality.

I have 2 or 3 a week, minimum. The prospect of meds that can help with that? It’s too much too hope for, honestly. If it doesn’t work, I’m going to be really let down. And I suspect I’m going to be really let down.

So…weening off the Geodon. Starting Abilify after that, which should arrive in the mail with the nightmare vanquishing med. Can’t remember the name of that one right now.

I took notes during our videoconference. I like this doc. She’s good. She listens, she offers advice, she explains things well without being condescending. She’s proactive. She doesn’t think Adderall is a good fit for me, even though I clearly remember it working well. And I’m willing to listen to her, and believe her.

I just don’t know if I have the patience for this go-round of Karl’s Medication Olympic Trials. I say that every time, and I mean it every time, but this time it REALLY feels true. Coming off the tail-end of a strong manic phase only serves to give me sharp contrast between mania and my usual depressive state. And it hurts. A lot.

But I’m a survivor, right?

Speaking of which, a big happy anniversary to Violence Unsilenced. Maggie celebrates a year today, as do the many people that have broken the silence. She is doing great work over there. Go show some love, eh?

--- Thanks for reading! SecondHand Tryptophan

I’m slacking. I feel it. Losing my momentum is not a feeling I like. The mania has subsided. My brain is much calmer (and dumber), though that’s relative. It’s still busier than most people’s, I get that. But compared to the manic shit? It’s like my brain finally said no to steroids or something.

Tomorrow I have my first real session with the new shrink, via videoconference. Amazing the V.A. even knows such technology exists, but I’m not bitching. If it weren’t for the video thing, I’d have to drive 90 minutes to meet up with her.

I’m not slamming the V.A. in any way. I’ve heard horror stories, but to be fair, I’ve not experienced many problems with the care I’ve received. And I’m very thankful for that. I don’t have regular health care. The jobs I’ve had of late are contracting positions. No bennies provided. Sure, once upon a time, when I got $43/hour for my time, I could afford it. But not now.

I’m already impressed with this new shrink of mine. She called me a few weeks ago, unsolicited, just to check on me and my meds. On a Friday. At 5:15 in the afternoon. That speaks volumes to me.

So we’ll be discussing meds, mostly that the current regime isn’t doing shit. We stepped up the Geodon. I’m now taking twice as much as I was a few weeks ago and…nothing. That’s the bitch with being treatment-resistant. Lots of meds don’t touch me, then there are those that require a much higher dose than what others find effective.

The trial-and-error associated with medication is exhausting and nerve-wracking. I’m far from the most patient man on Earth, and adjusting meds (and trying new ones) pretty much requires patience, and lots of it. That’s how it is, particularly with the meds designed to hit your brain instead of just your body. They take WEEKS to build up efficacy in the body. And if they don’t work, many of them take weeks to get OUT of your body, which is sometimes needed before adding something NEW.

For me, I’ve pretty much always required a Magic Cocktail, a mix of different meds. I wish like hell that there was a pill that did it all, but there’s not. My chemistry is different than yours, which is different than everyone else’s. So, yeah, trial-and-error. With all the technology we have today, that’s still the way it works. I long for the days of Star Trek, when they scan you with a Tricorder and have you fixed up with a simple shot.

I read an interesting article last month about a pretty major discovery regarding Post Traumatic Stress Disorder (and yeah, I’ve got that, too). They’ve found a way to definitively diagnose PTSD using pictures of the brain. Remarkable, since the only way to diagnose before was through a series of questionnaires and a laundry list of symptomology.

Unfortunately, this discovery probably won’t lead to helping ME…not for a long time. Not until they can point to a brain scan and say, “Ah, see that squiggle there in Karl’s hippocampus? We need to give him Miracle Drug Alpha for that.” Until they know how to correspond the brain pics with specific forms of treatment? Not gonna do much for me. But it’s hopeful for future PTSD’ers, and I’ll take that.

I started out talking about me losing momentum, and that’s really what I’m feeling right now. A lot of hopelessness, lack of motivation, simply losing my give-a-shit attitude. Depression. An overwhelming sense of, well, being overwhelmed. Yes, I’m still checking my sugar and taking my meds, but I really don’t care about it.

I knew this was going to come, the return to the old me. Trying to find some shrivel of happiness in this mode is daunting, at the very least. I can’t survive in full-blown mania all the time – I’d die from sheer exhaustion, from insanity. But I wish I had a way to harness the motivation, the good attitude, the Happy.

Think I’m treatment-resistant in the attitude department, too.

For now, I’ll just take what little pieces of enjoyment I can get. I like the winter Olympics (tons more than the summer Olympics), even though I’m not a sports guy. I never watch baseball, or football, or basketball, or hockey. None of it. That shit bores me to tears. But the Olympics has something for everyone. Plus, it’s only two weeks long. I’m in, I’m out, I’m done for another 4 years. My fave events, by the way, are figure skating, snowboarding, and the skiing…none of which I’ve ever tried.

I also found some meditation podcasts, thanks to Angel. A friend has offered to help me with meditation – something I’ve never tried before – and I plan to take her up on that offer. But the podcast I listened to yesterday really helped to calm me down. I like that. I say I’ve never tried meditation, but the truth is I’ve probably achieved that “nothingness” mindset on my own many times. I may be wrong, but all the dissociating I’ve done in my life kind of mirrors that calming void sensation in meditation. I suppose there are positives to being a Survivor, after all.

I’m gearing up for 2HT’s redesign, and I am excited about that. Should be happening within the next month or so. My original launch date was going to be April Fool’s Day (seems appropriate), which also happens to be both my Mom’s AND my twin daughters’ birthdays. But it’s going to be sooner than that. Can’t wait to see it all come together.

I’d really like a dog. I think that’d do wonders for me. Mom hasn’t been so keen on getting a pet, though. Her rationale has always been, “If you can’t keep your room clean, how are you going to take care of a dog or a cat?” My rationale has always been, “Those two things aren’t even closely related.”

And yes, I’m 43 and live with my mother. I’m also depressed, anxious as Monk, and unemployed. Put me on “The Bachelor” now, ladies. I’m available. *cough*

Like my brain, this post is all over the board. I’m tired of that, too.

--- Thanks for reading! SecondHand Tryptophan

Tuesday night, Mom and I had our first TNT night out since her accident. The TNT’s, for those that don’t know, are otherwise known as the Dynamite Divas. In my head, I call them the Tuesday Night Supper Club, but it’s basically the Meatsuite mentality…just a couple decades down the line.

Every Tuesday, the TNT’s gather round a dinner table at a different restaurant. There’s laughing and crying and everything in between. I happen to be a member, even though I technically lack a vagina. Don’t mock, I paid my dues (which involved a coconut bra and grass skirt).

Mom did great, walking all the way from the car to the table (using a walker). Everyone was happy to see her out and about. Lots of laughter is a good thing.

At some point, the girls were discussing the obituaries. Half the girls read them daily. I suppose when *I* hit the ripe old age of 36 (the age my mother has claimed to be for decades now), I’ll have to read the obituaries every day, too. Isn’t that what old people are supposed to do? That, and eating dinner at 4:30pm, wearing shades that engulf your entire head, and donning black socks with shorts and sandals.

Seems a morbid thing to me, looking to see who died, but whatever. I’m not here to judge (outside my head, anyway).

The stress levels for me of late are through the roof. I maintain some vestiges of my mania, I think, though it’s getting harder and harder to tell. This Natural Calm shit isn’t making me feel very calm, but I’m still taking it…along with the multivitamins, L-Theanine, and melatonin. And my pharmaceuticals.

There’s this thing I do – a lot of survivors do it, actually – called Trauma Breathing. Essentially, it’s very shallow breathing, interspersed with a lot of breath-holding. I rarely breathe deeply. It’s a physiological manifestation of my PTSD. And from what I understand, it’s not good for me.

Somewhere down the road, and sooner rather than later, I plan to undertake meditation. I may find Meditation for Dummies somewhere cheaper than what I saw at Books A Million over the weekend. As an aside, I think it’s ridiculous that you’re expected to become a BAM “member” by paying $20, just so you can get 10% off all your purchases for a year. That means I need to buy at least $200 worth of books in order to make it worthwhile. And that’s a shitty business practice. Why not just GIVE me 10% off? I can already find everything cheaper online. Again, though, nobody ever consults me on these things.

The Resolution, right. Well, it’s not going well, I admit. But I did post my first work story yesterday, so that’s a good thing. (Please Digg and Stumble it, I’d be most appreciative. The more traffic I get, the better it is for me.)

A while back I started my Bucket List, which looked like this:

KARL’S BUCKET LIST

• Great Fucking Road Trip
• Bungee jump
• Meet Flight of the Conchords and get them on my show
• Go to Australia
• Get my own medical marijuana card
• Fix my smile
• Write my story in a book. Have at least one book signing.
• Do the largest dancing in my boxers video ever with dozens of women at least
• Have some random stranger recognize me on the street in any place other than home
• Meet Jaime Murray
• Do a video with @jennyonthespot
• Karaoke in Tokyo (EDIT: a country song)
• Fall in love and get married
• Party in Vegas
• Get paid to do a talk show on radio

I’m going to keep adding to this and editing as need be. I really liked a post that Adam wrote a while back. He was contemplating all the things he wants to accomplish before he’s 40. Adam and I seem to have a lot going on at the moment in the Change Department.

I’m already past 40, but I think I’m going to create a second list of things I want to accomplish before I’m 50. Some of them may crossover onto my Bucket List, but that’s OK.

Making goals is not something I’m well-versed at. I’m not a future-thinking kinda guy. I can barely think about what I’m having for dinner tonight, let alone goals for the next 7 years. It’s a Survivor thing, I’ve learned. Just focus on getting through THIS MOMENT. Survival IS the goal. But surviving isn’t enough, people. That’s not LIVING, that’s just existing. Maggots do as much.

But still, this is the Year of Resolutions, a time when I’m working hard to make mental shifts. I want to see the positive instead of constantly focusing on the negative. Fuck, I want to be – dare I say it? – happy.

So here are some of the things I’d like to get done before I’m 50.

1. Do stand-up comedy. My friend, Mic (who I still call Mike, but whatever), is doing this now in L.A. As a teenager, I’d walk to and from school with Mike and Rob and my brother, Chris. We’d make each other laugh constantly. And play Dungeons & Dragons. Mike’s been telling me I should do stand-up for a while now, and I’ve always pooh-pooh’d the idea because I’m laden with anxieties and neuroses. But lately, I’ve been feeling more and more like I want to try this.
2. Finish and publish a book. Doesn’t have to be my autobiography, but it probably will be. Haven’t touched that damn manuscript in a decade, but I plan on changing that.
3. Get back to England. I lived there for three years, and loved it, even if that was also the time that led to the end of my marriage. I have friends there still, and now I have NEW friends there, thanks to the InterWebz.
4. Drive all of Route 66. This is something I’ve wanted to do for a long time. Big road trip.
5. Become my own boss. I love writing, and I’m happy that I’ve had the opportunities to make a living at it. Ultimately, though, I want to answer to myself. Sure, I don’t know shit about business or even budgeting, but I can get there. And I’m hoping to get a business venture launched in the near future, something I’ve been mulling over for a while now. (That’ll come after I relaunch SecondHand Tryptophan, which is happening in the next month.) Ultimately, this is about not being poor any more.
6. Move out of Sebring. I never intended to stay here this long. I’ve come to appreciate the town, but it’s not enough for me. I want to be somewhere else. Not sure where, exactly, but it needs to be bigger than Sebring. And it’s probably going to be somewhere relatively warm because I’m so not a snow person.

I think those are enough for now. Again, it’s another list in progress.

I’ll bring these lists with me to my Matrix Therapy session this afternoon. The MT was off last week, and I’m in heavy need of some therapizing. I’m also bringing my old IOP journal, the one that lists my med regimen, including the meds that were WORKING. If I don’t find some fucking relief, and soon, I don’t know that I’ll be in any position to get any of the things on my lists accomplished.

In the meantime, who needs a drink?

--- Thanks for reading! SecondHand Tryptophan

I wish I could tell you that this month’s Resolution has gone off without a hitch, but it hasn’t. There’s a bit of a fly in the ointment, and I can’t yet say what. Suffice it to say that I’m still working on fulfilling at least half of my Resolution. And when I find out what I’m waiting to find out, you’ll hear about it.

Meantime, I have other news to report.

Mom had her follow-up at the doctor today. It’ll be two weeks since her surgery tomorrow. Things are moving along. She hasn’t had a pain pill since the weekend. X-rays look good. The doc took her staples out today, so now she can actually get her knee wet in the shower (instead of sticking her leg in a big black garbage bag and taping it shut).

No more lounging around in bed all the time, either. Doc says I need to crack the whip, so I will. Up and about as much as possible. Her endurance is shit right now, but that’ll change, too. She’s walking back and forth short distances (with a walker, mostly, but still).

She’ll be in the knee immobilizer for another month, when she goes back for more x-rays. Thumb needs to stay in its own immobilizer, too. Yeah, we forgot to ask about the thumb last time because, well, it’s pretty inconsequential when compared to the broken kneecap.

Should everything look good in a month, it’ll be time for physical therapy. And that’ll be another 6-8 weeks.

That’s all good. Aside from me being locked to the house for a while longer, anyway. But I can get out when I need to…just have to ask for a sitter. Mom doesn’t agree that she needs one, but she does agree that if the shoe were on the other foot, she wouldn’t be leaving ME by myself right now. So there’s progress.

My diabetes is coming under control. My sugars the last few days have mostly been well under 200, mostly under 140, even. I’m not including tonight, of course, because I scored a 222 after three slices of pizza. Oops. Still, I’m getting there.

I ordered a number of herbal and natural supplements to help with my depression and the bipolar disorder. Checked the list with both the Matrix Therapist and my new shrink, of course. I’m still being compliant and very honest with them about…everything, really. I keep no secrets from my medical team. That would just be stupid. No therapy this week because the MT thinks she deserves time off or something.

Whatev.

Got the Natural Calm yesterday and I’ve been taking it twice a day. Still waiting on my other shipment, which will include a multivitamin, as well as l-thiamine and melatonin. I love the InterWebz.

In an odd burst of motivation today, I went out to the shed and reclaimed some of my journals from my days in group therapy. Took a while, but I found the one I was really searching for. It lists the meds I was taking at the time, some of which were really working. Found tons of stuff in those journals. This stuff is just some of the doodlings between my scribblings.

Hmm. 10 years later and not much has changed from that particular drawing.

My head? It’s…I don’t really know, actually. I’ve had a lot of shit happening (again. still.) and haven’t been taking note of everything. With the journals I found today, I found a blank book I can use. So I’ll start keeping one with all my symptoms/feelings so I can report out to everyone that needs the info.

What I do know is this: I feel more depressed. I’m still likely to tear up if a hummingbird burps the wrong way. Still oddly calm, yet at the same time freaking out from stress. So I suppose I’m still manic, though it’s not nearly as heightened now as it was a week ago.

That Charlie feeling I described? The reversion to Stupid Karl? I feel like it’s happening. I’m not as sharp. Things are a tad foggier. I’m slipping.

I just hope I can hold on to some semblance of a good attitude.

--- Thanks for reading! SecondHand Tryptophan

It’s the end of Month One of YOR. On January 1st, I started off the YOR with this Resolution:

January: Medical

I resolve this month to take all of my medications as directed (including insulin). I resolve to check my blood sugar every day.

This month (and the year to date) has been very rough on me. Mom broke her kneecap just 10 days into this Resolution. The same week, I had major turmoil with friends and relationships, plus two life-threatening low-sugar events. And I came to discover (after that week) that I was in the manic portion of my manic depression. Then *another* episode of near-fainting. And that’s not even everything.

Whew!

Because of the low-sugar incidents, I could not follow the above Resolution to the letter. I had to cut meds until I could meet with my doctor and adjust them. All my weight loss from the past year required lesser dosages. I haven’t been perfect, as I’ve admitted here during this month. I haven’t taken my meds every single time, whether it be because I’m swamped or stressed or whatever.

Nevertheless, I am labeling this first Resolution a SUCCESS. I have been a very good boy (in terms of taking care of my diabetes). Proactive, compliant, asking for help…actually taking an interest in my health (even in the days I really didn’t give a fuck about my health). My meds have been adjusted, I’m officially off long-acting insulin and several other pills…this is all GOOD.

My sugar tonight was 176 two hours after dinner. But my sugar BEFORE dinner was 124. So I’m in much better shape now than I was 30 days ago. We are still working on the control, getting my numbers where they need to be. It’s a process and, again, I knew going into January that this wouldn’t all be done by month-end.

I’m going to continue on with this new habit, as I prepare to move on to Month Two tomorrow. Brand new month, brand new Resolution.

I’m also going to continue with my Prick Buddy. That shit works, and Shannon is doing amazing with her diabetes, as well. I like that. It makes me smile.

Even when I’m not feeling very smiley.

See you tomorrow.

--- Thanks for reading! SecondHand Tryptophan

Today is January 30. Already. Shit, where the hell has this month gone? How did we already get 1/12 of the way through 2010?

Tomorrow is the last day of the month, which means it’s the last day for this month’s Resolution. Not that I’m tossing my new habit out the window, mind you. I’m not. And that was the point for the Year of Resolutions – starting 12 new HEALTHY habits.

Thursday night, I had ANOTHER low blood-sugar episode. I’m OK. (I say that because I hate when someone throws out some scary news and then takes 10 minutes to walk you through the whole story before saying, “I’m OK.” No, people. When you say something like, “I got in a car accident,” you follow it up IMMEDIATELY with “Don’t worry, I’m OK.” THEN fill in the rest of the story. Idiots.)

My best bud was here with me when it happened. I felt I was going low, recognized it, said aloud, “I need to eat something NOW. I’m low,” and came inside to do just that. The details aren’t important, really. Suffice it to say that I found myself on the floor again, trying hard not to vomit or pass out, but orange juice did the trick. And my friend was very calming and reassuring the whole time.

She got to help me check my sugar, and that’s a good thing. She’d never had to do that before. Hell, for most of the time I’ve known her, I haven’t been very compliant with my meds. She’s never seen me low before this year, mostly because I haven’t BEEN low…or even close.

Here’s what I’m supposed to do when I’m feeling low: check my blood sugar, then remedy the situation. It’s important to know what your sugar is when you feel low. Again, normal glucose readings are between 80 and 120. I know from recent experience that at 71, I’m still not fading out. So I was probably at 60 or lower.

Here’s the problem with doing what I’m supposed to do when I’m feeling low: I don’t give a fuck what my sugar is…I just want to STOP THAT LOW FEELING, AND NOW. It’s awful, I don’t want to feel nauseous and flushed and sweaty and dizzy and terrified. I just want it to stop and, y’know, not smash my face into the tile floor. I probably have a cracked skull from the first incident a couple weeks back. There’s this weird…shifting… when I push on my forehead now.

I’ve been checking my sugar 4 times a day, like I’m supposed to. And I’ve been taking my meds, especially now that they’ve been adjusted. Because I nearly passed out again (that’s three incredibly bad episodes for me in the last couple of weeks), I reported it to my doctor yesterday. And we’ve adjusted the plan again.

“You’re scaring me,” she said when she called me.

“I’m scaring me, too.” And I am.

But here’s what’s new…I’m not pulling an Ostrich. I’m pushing FORWARD. I’m being proactive, I’m receptive to changes, I’m asking for help, I’m being compliant, I’m checking sugars, recording the numbers, reporting out to those that need to know. All of that is ALIEN territory for me. And new stuff? Is very scary to me. Change…brrr, gives me chills.

But I’m doing it, anyway.

And it’s paying off.

I know now that my nighttime snacks are critical. No matter how fine I feel, a nighttime snack HAS to happen…and sooner rather than later. This was what caused me to fall out Thursday night. Stupid. Again with the stupid. But these things are not happening for naught. I’m LEARNING.

What we’re doing now to fine tune my diabetes control is adding a 3:00 AM sugar check. Yes, even if it requires me setting my alarm. The doc wants to know what’s happening while I’m (supposed to be) in bed. Why?

This is the 2nd incident to happen around 1:30am. That means my sugars are crashing at night (if I don’t have a snack). And that’s kind of weird.

My morning and noon sugars yesterday were high…above 250. But my pre-dinner reading was 176. Two hours after dinner, my sugar was 157. That’s still high, but it’s relatively close to normal for a post-meal reading. At least for me.

The doc’s theory is that my sugars are dropping at  night. My body’s defenses then are inflating my sugars so that I don’t go into a diabetic coma. Thus, high readings in the morning.

MY theory is that I don’t take insulin at night. Plus, Thursday night (after the incident) I had orange juice, and a PBJ, and Doritos, and beer. And THAT’S why those high morning readings happened. Who’s right? I don’t know. We’ll see. Pretty sure it’s me, though. I feel like Einstein’s smarter brother right now.

My first 3:00 AM reading this morning showed my sugar at 257. This morning before breakfast, it was 254. These are bad readings, I know. But again, I’d far rather be high than low any day of the week. And we’re still working it, still grasping to get this shit in control.

It’s a work in progress. I knew going into this Resolution that my diabetes wouldn’t be under control by January 31. That was not the point. The POINT was for me to be compliant in my health care, to take a proactive role, to stop being an Ostrich.

And that’s actually happening.

The doc wants to drop another diabetes med. The brand new med that she just prescribed to me at our recent appointment. The med that has still not arrived in the mail.

“Stop taking the glipizide,” she said.

“I’m not taking it,” I said. “I haven’t gotten it yet.”

“Good. When it comes in the mail, don’t take it.”

Far be it from me to bitch about having one less pill to take.

We have a follow-up appointment in a couple of weeks. I will continue emailing the doctor my glucose readings. I will continue calling her to report anything significant. We will continue to tweak my treatment plan. We WILL get this under control.

I’m in a very unique position right now, having this manic phase (and recognizing it while I’m in the midst of it). I am optimistic, and hopeful, and open to new stuff. That’s not going to last, I know it. I’m dreading the inevitable crash, which will come…and probably very soon. It may already be happening.

I’ll be back to my morose, miserable, pessimistic self. It’s not an attitudinal thing, folks, it’s biochemistry. The euphoria associated with mania is brain chemistry gone amok. It’s not the norm.

So I’m taking advantage of the good attitude while I’ve got it, false or not. And don’t go jumping on me for using the word “false” there. It’s a genuine good attitude, yes, but again…it’s a result of my mania. It’s chemical. Yes, it’s false. In a manner of speaking.

That doesn’t mean I’m not going to use it to my advantage. I am, totally. I’m going to start keeping a paper journal again, to take copious notes on how I’m feeling…physically, mentally. I want to be able to tell the doctors everything, so we can closely monitor what changes I’m experiencing, so we can continue fine-tuning my treatment plan, so that I ultimately feel BETTER.

And when I come down from Mania Mountain, and Poser Pollyanna is gone, and I’m the fucking misanthropic Karl again, I want to be able to look at my blog (and the journal) and attempt to regain the positive attitude I have at this moment. I want to be able to see the cause-and-effect thing. I want to read how my proactive stance is actually making a DIFFERENCE.

I feel very much like Charlie in Flowers for Algernon. In the beginning of the story, Charlie is a janitor with a 68 IQ. He receives experimental surgery that kickstarts his brain and ultimately becomes one of the smartest people on the planet.

The book spends a great deal of time showing Charlie’s emotional changes, as well as his increase in smarts. Suddenly, world leaders are contacting him for help with their problems. Charlie is curing diseases. He’s solving impossibly complex equations. He’s fixing things that nobody has been able to fix before. He’s fallen in love with the woman that began as his tutor, but becomes his lover when she sees the amazing new person Charlie has become. Hell, he’s far SMARTER than the woman now.

But here’s the rub: his new-found genius status is temporary. He slowly starts moving back to good ol’ Charlie with the 68 IQ.

And that’s how I feel when I come down off my mania. I’m super smart right now. My brain is operating far above and beyond its usual state. I actually feel like I have the IQ I supposedly have…y’know, if you even buy into Intelligence Quotients.

I’m going to slip back to Stupid Karl very soon. And like Charlie, who had a good long taste of a super-charged mind, it’s almost better to have never experienced my brain the way it is now. Because knowing things can be so good is godawful when I’m beginning the maddening decline to the way I was before. It’s the cruelest bait-and-switch I know of. Contemplating this inevitability brings me to tears.

I feel this crazy need to blurt out everything in my head right now, to get it all onto paper before I lose it. I’m making abstract connections that I can’t normally make. My intuition is so advanced and well-honed right now that I feel almost psychic. I’m coming up with brilliant ideas. I’m creative as fuck.

And it’s all going to slip away.

It’s far easier to survive day-to-day when you’re used to being miserable. The expectations are low, so it’s hard to be disappointed. Knowing that there’s another way to see life – EXPERIENCING that other way – is bittersweet. It feels wonderful now (despite all of the BAD shit associated with mania).

But like most things in life, it’s not going to last.

--- Thanks for reading! SecondHand Tryptophan

So the skinny on my doctor visit Monday, which I mentioned on Twitter and Facebook:

• Check my sugar 4 times a day. Before every meal, and two hours after dinner. This helps provide a good picture of my sugars throughout the day. Which, in turn, helps to know where (and what time of day) we need to adjust meds.
• No long-acting insulin till further notice. We may not even get me back on that at all.
• One of my diabetes meds only, the others are dropped.
• 5 units of regular insulin before every meal. I suppose that’s for coverage.
• My A1C is 9.2. Ideally, these days the American Diabetic Association says your A1C should be below 6.5. For those of you that don’t have to know what the fuck Hemoglobin A1C is, here ya go. It’s the 3-month average of your blood sugar readings. When I prick my finger (4x a day) to check my sugar, that gives me my sugar for that particular moment in time. But just because I get a 294 on the meter (80-120 is normal), doesn’t mean I’m that high all the time. That’s where the A1C reading comes in. It shows a truer picture, because it lets them know what my OVERALL sugar has been over the last 3 months. I could explain how it works and shit, but it’s not important. Hell, all this right here probably wasn’t important. Unless you’re diabetic. And me.
• My cholesterol, remarkably, is 118. I haven’t seen numbers below 200 since my 20’s. So there’s that.
• She wants me to email my numbers to her weekly.
• We have a follow-up appointment in 3 weeks. More adjustments from there, as needed. Unless I need her sooner.

But I don’t think I will. I think I’m getting it. Yes, I’m not perfect. Today, for instance, I took most of my meds, but then went out for dinner (thank God for Tuesday nights). Didn’t check my sugar before leaving the house, or take my dinner meds. But I get back on the horse. I’ll take my bedtime meds and start all over tomorrow.

Lather, rinse, repeat. Ad nauseum.

My body has been in such pain. I ache everywhere. The trouble with only sleeping 3-4 hours a night for a few weeks straight (save a couple nights here or there) is that your body is vertical that much more. That puts a lot more stress on the bones and joints. Heh, I said joints.

So my neck, shoulders, and ESPECIALLY my lower back have been killing me. All this extra activity I’m experiencing in order to take care of Mom exacerbates it. Or maybe it’s the non-sleep that exacerbates the activity. I dunno. The point is, I’ve been miserable physically, as well as mentally.

Today I went and got a 90-minute massage. And it made an enormous difference. I fell asleep twice on the table, and was told that’s the highest compliment you can give a masseuse. She’s good. And I didn’t even get a Happy Ending. Bigger shock? I didn’t even care.

I just wanted relief. I got it. And perhaps the best part? My masseuse’s name is Cher. I so wanted to ask her if she was a Cherokee, but she was even whiter than me, so it’s unlikely. Amazing hands, though. I pretty much melted into that table, let me tell you.

The REAL best part is that my head is quieter. No, not quieter, that’s not right. It’s more unified. There’s still way too much shit going on between my ears, but I feel calmer now. The racing thoughts are not back down to normal level, but they don’t feel like they’re where they were last night at this time.

Which, by the way, was a really bad time for me. It’s like being able to view all the alternate universes at one time. I mull over every single possibility, every single outcome…dozens…hundreds of times. Even the ridiculous possibilities. And even those crazy-ass potential outcomes seem reasonable, which only serves to freak me the hell out even more.

I’m insecure enough, but my manic brain makes me paranoid like you wouldn’t believe. Thank fucking God I have my logic. Somehow I manage to talk myself out of my most ludicrous insecurities. Well, I talk myself out of ACTING on them, at any rate. And that’s enough. Mostly. Still torturous, and the self-restraint manacles are getting mighty frayed, but I’m doing it.

And I’m trying to acknowledge that I’m doing it. Because in my mind, what I hear when someone says, “I’m proud of you Karl, you’re making it happen” is this: “What other option do I have?” Dismissing the positive. That freaking Permeable Teflon skin of mine…damn tough. It’s how I describe myself, Permeable Teflon. The bad goes in, but the good slides off…

I’ve talked about the downside of bipolar disorder. It’s bad, yeah. But that’s not the whole picture. There IS an upside…a lot of upside. I think I’ll save that for next time.

I’m actually tired. And I want to take advantage of that.

Mom’s follow-up appointment (first one post surgery) is in the morning. I need some sleep. A LOT of sleep.

--- Thanks for reading! SecondHand Tryptophan