Revolt

*WARNING (and spoiler alert): contains self-induced vomiting*

12th April, 2017

From one drama to the next! Honestly! Did I learn nothing from yesterday? The whole phone thing? Nothing about being careful and deliberate in my actions?

See, I have this system. Yeah right! A system is useless unless you stick to the system. Which I mostly do, but mostly isn’t really enough when there’s a system involved. You stick to the system, or you don’t.

This system involves my medications. I’ve probably been over this but I have a nice purple medicine box with 4 rows. One row for my morning tablets, one empty row, one row of 3 valproate tablets for each night still in their original foil because they go smooshy when exposed to air, and the final row for the rest of my night tablets. The valproate for the evening doesn’t fit with the other tablets, hence its own row, but the morning single valproate tablet fits it, hence the empty row. I have carefully marked the morning tablets, and the night tablets so that I can’t get confused. Plus there’s the fact that I unwrap one valproate tablet in the morning and three valproate tablets in the evening. The morning row has red and pink capsules of venlafaxine and 3 little white tablets; the evening row has a dark red iron tablet, a little pink cholesterol reducing tablet, and three chunky quetiapine tablets, apart from the lithium that is in both morning and evening. They are different, the morning and the night tablets; clearly distinguishable. They are not the same. If you take the time to notice, which I periodically don’t! Theoretically, I check all the tablets lying in my palm, to make sure every one is present and accounted for before swallowing them down. I have a list written on the back of the box telling me exactly what should and shouldn’t be there, for reference. But I’ve been on this same combination of tablets for well over 6 months now, and I’m very careful when I pack the box, supposed to be anyway, so sometimes I just pop the tablets and scull them down, get it over with!

Like yesterday. Before I knew what I was doing I had opened 3 valproate tablets, shaken out the dark red and pink tablets, noticed subconsciously the big chunky tablets, and sculled the lot! Even though it should have been obvious that I was taking the wrong tablets: wrong compartment, wrong colours, wrong amount. It took about 20 seconds to get that same shot through the gut as I had yesterday when I realised that I’d lost my phone. I knew then, consciously, that I’d really stuffed this one up!! It has happened before, once I think, but seriously! What was I thinking? And here’s the thing, I wasn’t. I was on auto pilot, distracted and that’s how it all blows up in your face. What’s the big deal? Those 3 valproate tablets, plus the 3 quetiapine tablets, they’s the big deal. They are basically my sleeping tablets, and here I’ve taken them 10 o’clock in the morning! They aren’t actually prescribed for sleeping, they are mood stabilisers but this is their major side effect. Any other day I’d just resign myself to going back to bed and sleeping them off, but not today.

Because there’s something else that I haven’t told you. I’ve got a job!!

I was going to save the excitement for my official start date on 29th April, however this happened, and on the first day that I’m going in to do the official orientation and get all of my paperwork sorted! I have a 4 hour shift starting in an hour and I’ve just taken my sleeping pills by accident/carelessness!! You can see the problem here. First impressions and all that, I don’t want to call in sick for my very first shift; I’m determined to be there and on time and get this job off to a good start. I don’t want to have to go home sick part way through the shift because I can’t keep my eyes open. I definitely don’t want anyone to think I’m under the influence, or unfit for work! That would be extremely unfortunate! Not just for this job, but for my career; the pharmacy board frowns heavily on pharmacists using any substance while on duty, oddly enough. So, what to do? I think you can see where we’re going now.

The ONLY way to try to prevent the sleepy pills doing what sleepy pills do is to get them out of my stomach before they are released from my stomach to my intestines, and absorbed into my bloodstream, making their insidious way to my poor brain. The only way to get them out of my stomach is to induce vomiting!! Honestly, I cannot think of a more revolting, horrifying task to have on ones hands than this. I don’t think I have ever made myself vomit before. I recognise now how compelling a disease bulimia is to convince you that this is a way to live. To me it is extremely repugnant. But what are my options here? It took a lot of psyching myself up for it, and a couple of false starts, don’t ask me how, but we got going. Here’s the killer: I ended up throwing up my entire breakfast which I’d had an hour and a half ago, yet there wasn’t a sign of the tablets and orange juice from 10 minutes ago. Here is the cleverness of your stomach. It knows that its job is to break down food into smaller pieces so that your intestines can do their job. But there’s nothing to break down in fluids, so your stomach lets them right past. In that 10 minute period, my stomach had already released all the fluid/orange juice, and the tablets with it, and they were gone. That whole disgusting, humiliating, distressing episode, for nothing!!

What next? Well, its time to go to work. Fingers crossed that I can handle this and get through what I need to get through.

Here’s the odd things about my sleepy pills. When I first started taking them I would be dead to the world within 30 minutes, or less. Honestly, I would take them and immediately get upstairs to bed because within 10 minutes all of the muscles in my legs would be jelly and I couldn’t step up a stair if I was being chased by an axe wielding madman! My arms would be equally useless. A couple of times I got into bed and then needed to go to the toilet. I would bounce off the wall, my bed, the dresser, my bed, the wardrobe, the bedroom door, the bathroom door and back again! I’m sure it looked completely hilarious from my husband’s point of view but I couldn’t even see straight, let alone have control of my legs. My eyes would go evil vampire red because of how much the medicine dried them out. Basically I was gone for the night. And I got the best sleep! I was drugged out really. And of course as my dose went up the effect continued.

But over time, as the dose has steadied out, I’ve become more tolerant. I don’t get that drugged out feeling now, and I can stay up sometimes for a couple of hours after taking my night tablets. On occasion it does make me drowsy enough to start blinking heavily, struggling a bit to keep my eyes open, but if I really want to I can keep them open; it doesn’t overpower me like it did before. It still helps to give me a good nights sleep, and without it I sleep pretty lightly and spasmodically. As I experienced last night, because after taking my night dose in the morning, I had to take my morning dose of valproate at night to keep the balance, and one tablet isn’t enough to sedate me; plus I had no quetiapine in my system.

So, I took the wrong dose, and didn’t manage to catch it before it got into my system. And now I have to go to work. Well this should be fun! Here’s hoping I can fight the effects for more than a couple of hours.

Okay, next strategy: a large Coke, no ice from Maccas. Hopefully the caffeine will do something!! I drove all the way to work (I was questioning whether that was a great plan, but I felt fine at this stage) feeling okay, until the last 5 minutes when that warm, fuzzy, about to go to bed for the night feeling settled in. I got a little lightheaded on standing, slightly dizzy if I turned my head quickly, and just plain drowsy. My eyes wanted to shut and go to sleep, my thoughts got a bit thicker, I was trying not to speak slower. I hope to goodness I managed to pull off looking as enthusiastic and committed as I wanted to. But there was a big challenge waiting for me. Most of the 4 hour shift involved sitting at a bench reading policies and procedures and signing off on them, and doing orientation quizzes on the computer!! I mean, seriously! Of all the days in the world, I really needed a stimulating day today, and I got reading of less than riveting material!! I think I pulled it off, I mean I got it all done, but I have no way of knowing whether I was doing it way slower than usual, a bit slower than usual, or how many micro sleeps I had sitting there at that bench! Luckily the chair was very uncomfortable so that keep a bit of an edge on my alertness, and after 2 hours when my supervisor went for lunch, I went out and got an iced coffee with plenty of sugar! I think that did help a bit to keep me going for another couple of hours! Plus the fresh air was good.

Yikes!! What a day! But I did survive, somehow, by some miracle, and I’m going back on Tuesday after the Easter break. To be continued.

Did I come home and go straight to bed? Yep, you betcha! A couple of hours sleep did wonders. Usually I can go straight back to sleep at night after an afternoon sleep because of my night tablets so I did struggle a bit getting to, and staying asleep without them. But I didn’t struggle catastrophically. I think I actually had a pretty good night’s sleep in the end, although I was awake from 5am on the dot this morning, Thursday 13th April.

I can’t double up once I’ve taken the tablets, even if they were the wrong tablets. So what’s the plan to get back on track from here? Most of my tablets can only be take once in 24 hours meaning I can’t take night tablets again today. So I’ll take my morning ones tonight, then my morning ones in the morning (the morning doses are smaller so it won’t be such a big deal taking them back to back) and my night ones tomorrow night; then I’ll be back on track. Until then I’m sniffing my head off because of the longer gap in between doses of quetiapine, from morning one day to evening the next. It usually dries me out so sniffing is unusual and annoying! Apart from that, and the obvious drowsiness there shouldn’t be any consequences from stuffing this up, luckily. When you take the same medication all the time, a one off dose mix up doesn’t tend to affect your overall medication levels enough for issues to arise.

And here it is 7am and I’ve written this blog and I’m ready for breakfast, bright and early. I could possibly be very productive without those night tablets, but it wouldn’t be worth it for my mood. Ah the catch 22’s in mental health treatment! 

So, have I learnt my lesson in being more careful? I’d like to hope so, but I find the lesson only lasts as long as my memory of it, and that’s a whole other story!

Sunday Summary

Dear friends,

It has been a busy week! For me, I mean; probably not what you would call a busy week. I didn’t work at all, I didn’t get many chores done, and the most I did daily was get out of the house for an hour or two. That’s busy, for me.

I’m so happy that it worked out to be that way!

When I finished work three and a half weeks ago I was worried that the naturally “depressed state I was in about finishing work, together with my ongoing lethargy and tiredness, would result in me becoming a bed bound vegetable again.

Well again isn’t fair; I’ve never ever not gotten up at one point or another during the day. But with no definite reason to get up in the morning, my lack of motivation to get up unless there’s someone waiting on me, and the general listlessness of having no set purpose, I thought that there was a fair chance of me lounging around all day.

And it turned out to be that way for a few days. With nothing planned, with accumulated tiredness from keeping up with my shifts at work for six weeks when they consumed about the last ounce of my energy, and no reason why not to get up, I had some pretty massive sleep ins.

Until I missed my tablets one Sunday night! This happened in spite of the careful routine that I have built into my days after I had previous missed doses to prevent the same thing from happening again. Obviously there’s still a loop hole somewhere that I haven’t found but I’m working on it.

My routine is to weekly make up a medicine box with all the medications that I need to take both in the morning and at night. My pharmacist brain cross-checks the directions on the bottles and boxes with the number of tablets I put into each slot and then double check that I haven’t missed anything by comparing what I’ve packed with my complete list of medicines printed on the bottom of the box. My triple check is when I take each group of tablets and I count again to make sure I have it right.

I set this medicine box right next to my bed on my bedside table so that I should see it when I get up and when I go to bed; this should give me a visual prompt to take my tablets. But I don’t trust this system so I have set a morning and evening medication alarm in my phone. This can only be snoozed three times so I also have a medicines app that generates a reminder at 7am and 9pm for me to take my tablets. This can be snoozed to infinity I think, but the fact that I missed a dose makes me wonder if it actually does have a limit to being snoozed. I’m looking into this.

So the missed dose. You wouldn’t think it would make that much difference; it’s only one dose right? But it does make a difference, at least for me at this point while we’re still fine tuning the medications. Most times when I miss my tablets I end up getting upset over some little thing or teary for not much reason or get in a fight with my hubby! Poor hubby, he has to bear the brunt of everything! I think this reaction has been when I’ve missed my morning dose, which means I miss my antidepressant and my morning lithium dose.

This time I missed my evening dose. That means my evening lithium and my other sedating mood stabiliser. I’ve only ever done this once before. It’s never fun, because it means there’s nothing putting me to sleep! This time was terrible! I’m sure I had a maximum of 4 hours sleep but who knows. When you’re tossing and turning and can’t sleep and want to sleep, time loses all meaning! Poor hubby again, every time I tossed or turned he turned! But I physically couldn’t bear the sensation of lying still! It was awful! I just had to move and move and move and move!! I woke at 5am and tried to exist as quietly as possible til hubby was ready to get up. Then, so out of my recent character that it was laughable, I jumped out of bed fresh as a daisy at just after 7am and left the house before hubby! I was in my runners and leggings and I was off!

Compared to my recent sluggish, only-move-if-I-have-to, and even then moving snail’s pace, I was striding off to the park like I haven’t since I don’t know when, and paced out two laps! It was ridiculous to me even as I was doing it! But it was a fabulous feeling! I could move as fast as I physically wanted to for a change, instead of how fast I physically could through mud bearing heavy weights!!

Incredible! And so friends, this is mania. Or a sub form of it. You won’t see me like it often, unfortunately or fortunately, but you’ll know it when you see it. I’ll be smiling at all and sundry, grinning, laughing, putting out a decent amount of physical effort, having a great day! I’ll be chatting flat out, possibly jumping topics or getting distracted. I’ll be super effective and get many tasks done. I’ll be physically active and able to do a lot more activity than usual.

It’s a feeling that is addictive actually, I never want it to end…to start with! By the end of the day I was pretty sick of it actually because I could hardly sit still or rest, and was just feeling irritable, agitated and like I couldn’t possible tolerate having another night like that. By then the frustration tears were pretty close to the surface, but let me tell you I achieved a great days work! All three loads of washing done, some of it off the line and folded! The kitchen was sparkling clean; I’d cleaned the grout and the stubborn grease on the splash back. Lots of jobs attended to, a family visit where I chatted away like a…like a crazy person! Chat chat chat chat chat chat chat!

But I was glad to put it away. Not glad to go back to lethargy and anergy (absence of energy), but after all it’s a balance. You can’t have everything, so you have to decide on the most important things. Which is not being a whirling dervish, but a calm reasonable person not prone to snap decisions and excess!

My short point at the end of that long explanation was that it broke my bed rest habit and got me out into the sunshine, and the outside world. I watched the ducks paddle, saw the swallows come out to swoop and feed, found a magpie nest without getting swooped and in fact saw the magpie partner watching from on high at a distance. And remembered that I liked the outside and wanted to be out there, not inside all day.

Add to this a pep talk from my psychiatrist AND my GP in the same week about just getting outside, no agenda, no pressure, no panic about how I was feeling, just enjoyment…and the message was clear! Just enjoy it.

So I have enjoyed it! What a glorious week it has been!

Monday started slowly, but a late afternoon trip to Blackburn Lake Sanctuary yielded a fabulous hour of the new Musk Lorikeets ( see earlier post) plus an added hour of delightful favourites. Then a sleepover with our great friends and delightful bubba!

I just love love love this gorgeous Galah eating wattle photo!

I just love love love this gorgeous Galah eating wattle photo!

This is the cutest Noisy Miner sequence I've ever had - mother catches moth, baby screams for it, baby gets moth, mother leaves :) eucalypt

This is the cutest Noisy Miner sequence I’ve ever had – mother catches moth, baby screams for it, baby gets moth, mother leaves 🙂

Tuesday didn’t work out how I had thought it would, but a picnic on the banks of the Yarra river in delightful Warburton with several girlfriends and their cute kids is a pretty fine day if you ask me! In addition I got to see two lots of adorable ducklings and a fun Kookaburra.

Cute cute cute! Discovering the innocent joys of crawling up and down stairs, green grass

Cute cute cute! Discovering the innocent joys of crawling up and down stairs

More cute! Fluffy Wood Duck ducklings huddling on a rock in the Yarra River at Warburton

More cute! Fluffy Wood Duck ducklings huddling on a rock in the Yarra River at Warburton

Wednesday morning was a return to Blackburn Lake Sanctuary, the top end this time for some variety of bushland and birds. What a day it ended up with a Kookabura flinging a metre long snake around and many cute tiny birds that were hard to capture.

The fabulous post and rail fence that completely encircles my favourite Blackburn Lake Sanctuary

The fabulous post and rail fence that completely encircles my favourite Blackburn Lake Sanctuary

I spotted this Laughing Kookaburra and stopped for photos, didn't realise it was in the process of killing a snake!

I spotted this Laughing Kookaburra and stopped for photos, didn’t realise it was in the process of killing a snake!

I just love being in the Sanctuary - so pretty and lovely

I just love being in the Sanctuary – so pretty and lovely

Thursday, oh Thursday! This was a bucket list day with a girlfriend and it was amazing! Glorious day, two brand new birds that I’d never seen before, loads of flowers, a couple of moths and some damsel flies! Some amazing scenery, the awesome Kuranga native nursery, Birdsland reserve and a flash trip through the Dandenongs (see previous post).

Friday was appointment day and catch up with my old work mates day and getting my favourite bacon and egg sandwich and eating it in the gorgeous Fawkner Park. A picnic above Yarra Boulevard with my fabulous hubby and some new photo ops over the city as the sun set…wow! Can you beat that for a way to see out the work week?

The great outline of Melbourne city backlit by a cloud sunset, blue sky,

The great outline of Melbourne city backlit by a cloud sunset

The brilliant sunshine, the silhouette of a pretty tree and Melbourne - I love you

The brilliant sunshine, the silhouette of a pretty tree and Melbourne – I love you

Saturday was another girlfriend catch up and was great fun finding plover babies and getting swooped relentlessly by their parents! Then we went on a Loch Ness Monster hunt all around the Blackburn Lake and still aren’t sure exactly what was doing so much flashing and splashing and swimming…tbc, duln duln duulllln! We got a fabulous shot of a Spotted Pardalote by the path and had a great lunch at Gourmet Girl – what an awesome catch up! Over tea cooked by sensational hubby we heard and saw two Striated Thornbills in our minimal garden! I think they’re building a nest! Excitement!!

Mummy Masked Lapwing with tiny weeny baby - these must be very new because the plovers have been docile until this week; now they are savage!

Mummy Masked Lapwing with tiny weeny baby – these must be very new because the plovers have been docile until this week; now they are savage!

Not a clear shot but the beautiful front of a Spotted Pardalote

Not a clear shot but the beautiful front of a Spotted Pardalote

Sunday is rest day and I’m glad for that, but boy I am so glad for every bit of excitement and interest that has sprinkled my week and made it actually fun! And thanks to all my wonderful people who are there every day giving me a hand along, and making my life more amazing!

Funny side story. After looking back at the week in the detail above, it made me remember all the good things and I mentioned to hubby that I’d had an amazing week. His response was fascinating: “Really? Maybe the last couple of days have been okay but I thought you had a bad week.”

To which I, in the mood of putting all the good bits together and seeing them in clear focus and forgetting the rest, replied: “Really? But I’ve done all these amazing things.” So we had a chat and here’s another perspective moment – what’s in focus is really clear and the rest in lost in fog.

My hubby was remembering coming home to me still lost in my afternoon nap, to me not able to get my thoughts together enough for our weeknight Bible study, to him making dinner from scratch every single night of the week, to me as a blob instead of an enthusiastic lover, to me struggling to get enthusiastic about any physical activity; basically to him carrying the load of the relationship, the housework, being the bread winner and the carer for this weighty gal.

So yes, if you look at all the cool bits it was a great week. If you look at all the failures it would bring you to tears. If you see all that hubby did to get us both through the week, you like me would have overwhelming admiration for this great fella without whom I don’t know what awful state I would be in!

So my motivation for this new week is trying to even out the load for my good man, and continuing to have great days!