Okay, okay, I take it back. Er...alright I don't take it ALL back. But I did have a nice visit with my prescriber this week. I mention this in the wake of my last slightly aggro post about he and I parting ways but I should clarify a couple of things:
1) He's really actually a pretty cool guy.
2) I can see why, as a psychiatric services provider, he doesn't just jump to alter a course of treatment every time a patient comes in with some new-fangled idea.
3) We generally come around to mostly agreeing, eventually, even if I may be impatient. (But it IS hard to be patient when you are the one whose brain chemicals are inadvertently getting jacked around.)
I probably will be changing over to "maintenance" mode soon with my GP since we both agree that everything seems to be working fine for me...I just need to check in with him in about 6 weeks to make sure everything's really for real coolio. Oookey dookey.
IT IS HARD TO BE PATIENT regarding treatment. And I have had an exceptional amount of issues with medications. So...my previous post was accurate to my feelings at the time...and many of those feelings are still true. But I bother to write this "just short of a retraction" post, to illustrate that it IS important for we with the ADHD to acknowledge that we may be patience challenged at times. Having been me for a loooong time, I have learned that when I have BIG feelings about something or feel reactive about it, I simply need to mechanically put it on the backburner for at least a few minutes (or a few hours...or a few days) so that I can be sure that my reaction is based on reality, not on my momentary reaction.
It takes practice, but luckily there's a lot of ways to do this. You can say clever things like "I'll get back to you on that." or "Very interesting...let me think about that.". You can simply walk away if there's a polite way to do so (though sometimes you really just have to turn and walk even if it might seem a little rude to walk away...if it's the lesser of rude options and you feel something really sparky about to come out of your mouth). The electronic version of this is to begin an email in reply and then hit SAVE AS DRAFT instead of sending...then go back later and possibly revise before sending.
Regarding treatment...you should make sure to communicate with your therapist/prescriber/other. Ask them how long they think something will take, what you can reasonably expect to happen. And don't let people not answer your questions. And if you don't like their answers, then you can actually indulge your impatience just a little and get a second opinion. I find that I am able to mobilize patience more easily when I know the parameters...when I have at least a rough idea of what to expect.
So blahblahblah.
Saturday, October 23, 2010
Monday, October 18, 2010
Chapter 2347: Impairment
My new life is making it hard for me to be productive during the times of day that I tend to be most naturally productive.
That's all I've got today.
That's all I've got today.
Friday, October 15, 2010
There's "nothing" wrong with me...
...so...my prescriber is trying to get rid of me.
Let me just...okay first, I don't think he's a terrible prescriber (it's about to sound like I think that, so consider the record pre-emptively cleared).
That said...it's pretty frustrating to see your prescriber once every 4-6 weeks...have awkward to bad reactions to most of the meds you try...have your prescriber argue with you about what you need (Ex: he thinks I need a long acting med for ADHD...I prefer shorter spurts because I simply can't be that focused all the time with the way my life operates...he kept prescribing the long acting ones...)...and then...after a billion trials of different meds and combos...have him say things like "I'm not convinced you have an anxiety disorder. I think you would have been fine without any treatment at all. I think we're just chasing a dragon here. You would have been fine if you'd never walked into this office. You cope just fine.".
Uhhh....what?!
Way to minimize my difficulty, dude. Way to make it sound like "coping" is a great way to live. You seem like a nice guy and you seem smart. But my appointments are 20 minutes long...every 4-6 weeks. We don't really get into a lot of substance. And luckily for YOU, I'm able to be really articulate about my mental health experiences, for the most part. I also spent 33 years coping my ass off to learn ways to "do" life and get things done and it was stressful to the point that it probably shortened my life span, and certainly affected my health (let us all recall the bizarre migraine incident).
I think he's mistaken my articulation and ability to "pass" for lack of impairment. Aw...that's cute. Wait...not, it's not.
I know I'm not the most impaired person around...but is it "normal" for it to take a person with exceptional reading ability 12 hours to get through an article that should take an hour to read? That trivial little impairment made grad school AWESOME times, like 1000.
I'm feeling shy about some of my other impairments right now so I'm not going there.
But...you get the idea. It felt pretty crappy to be told that he thought I was normal...HAHA...which sounds all wrong. I assure you, I'm very interested in improvement, and in mental healthiness. My therapist certainly agrees.
But what the hell was he thinking?! He seems to be thinking that I'm a waste of his time. And so, we are in agreement...I will likely be switching my prescription care over to my GP after my next appt. We are in agreement on this switch, but for totally different reasons.
He acts like I'm a waste of his time...in a polite way...but really, I wonder if he isn't just frustrated with how difficult it has been to find meds that work for me. Incidentally, we finally seem to have hit on a good combo and it happily treats my migraine issue as well. But...I think sometimes that maybe he's taking this all a little personally. I might represent failure to him in a way that he may not even notice in the front of his mind. Maybe that's a strange thing to think...but I've learned over the years that I'm generally more perceptive about people than I think I am.
For me...the switch will be less precarious than it would be for many people getting psych meds from a GP...because I have busted ass to educate myself about what all the meds are and what they do and what their side-effects are. Unfortunately I also learned a lot of it the hard way, through first-hand experience. I've also learned a lot about what DOES NOT work for me and I know what questions to ask...so I'll be pretty well equipped to shoot down insane suggestions from my GP if I'm not feeling okay about them. And I can request a referral if I need one...
So...the switch might be good. I like him as a person, in the short spurts we've spent together, but he might not be the best fit for me as a provider.
I shouldn't have had to fight for a year to simply be prescribed 5 mg of Ritalin to use at my discretion depending on my activities. For the record, it seems that for me, 25 mg of nortriptyline a day and 5 mg of Ritalin for days when I'm desk-bound are about all I need. Seems like not a lot, but my med sensitivity means that for me...these tiny doses make a huge difference. (For some reason, now that I take the nortriptyline at a higher dose, the Concerta is just too much, even at 18mg...though in general, in my experience, I think it's a GREAT, and subtle drug.... The nortriptyline itself makes me feel a little calmer and more focused...so that the Ritalin booster is just the right amount to put me in a subtly quiet and focused mood. I officially cannot even believe that at one point I was taking 70mg of Vyvanse...what the frigoriffico!? I'll own that though...I just knew something wasn't right...so I thought I needed more...not less...one of us should have figured it out...!)
Change...I have complained a lot about it this year (on and offline) but I feel like this change will be good. What do I say on this occasion..."Thanks for finding me annoying because I'm not a quick-fix patient?" or "Thanks for minimizing my relative difficulties because I'm not actually mentally ill?".
I think I'll just go with "Thanks..." and "...later!".
Let me just...okay first, I don't think he's a terrible prescriber (it's about to sound like I think that, so consider the record pre-emptively cleared).
That said...it's pretty frustrating to see your prescriber once every 4-6 weeks...have awkward to bad reactions to most of the meds you try...have your prescriber argue with you about what you need (Ex: he thinks I need a long acting med for ADHD...I prefer shorter spurts because I simply can't be that focused all the time with the way my life operates...he kept prescribing the long acting ones...)...and then...after a billion trials of different meds and combos...have him say things like "I'm not convinced you have an anxiety disorder. I think you would have been fine without any treatment at all. I think we're just chasing a dragon here. You would have been fine if you'd never walked into this office. You cope just fine.".
Uhhh....what?!
Way to minimize my difficulty, dude. Way to make it sound like "coping" is a great way to live. You seem like a nice guy and you seem smart. But my appointments are 20 minutes long...every 4-6 weeks. We don't really get into a lot of substance. And luckily for YOU, I'm able to be really articulate about my mental health experiences, for the most part. I also spent 33 years coping my ass off to learn ways to "do" life and get things done and it was stressful to the point that it probably shortened my life span, and certainly affected my health (let us all recall the bizarre migraine incident).
I think he's mistaken my articulation and ability to "pass" for lack of impairment. Aw...that's cute. Wait...not, it's not.
I know I'm not the most impaired person around...but is it "normal" for it to take a person with exceptional reading ability 12 hours to get through an article that should take an hour to read? That trivial little impairment made grad school AWESOME times, like 1000.
I'm feeling shy about some of my other impairments right now so I'm not going there.
But...you get the idea. It felt pretty crappy to be told that he thought I was normal...HAHA...which sounds all wrong. I assure you, I'm very interested in improvement, and in mental healthiness. My therapist certainly agrees.
But what the hell was he thinking?! He seems to be thinking that I'm a waste of his time. And so, we are in agreement...I will likely be switching my prescription care over to my GP after my next appt. We are in agreement on this switch, but for totally different reasons.
He acts like I'm a waste of his time...in a polite way...but really, I wonder if he isn't just frustrated with how difficult it has been to find meds that work for me. Incidentally, we finally seem to have hit on a good combo and it happily treats my migraine issue as well. But...I think sometimes that maybe he's taking this all a little personally. I might represent failure to him in a way that he may not even notice in the front of his mind. Maybe that's a strange thing to think...but I've learned over the years that I'm generally more perceptive about people than I think I am.
For me...the switch will be less precarious than it would be for many people getting psych meds from a GP...because I have busted ass to educate myself about what all the meds are and what they do and what their side-effects are. Unfortunately I also learned a lot of it the hard way, through first-hand experience. I've also learned a lot about what DOES NOT work for me and I know what questions to ask...so I'll be pretty well equipped to shoot down insane suggestions from my GP if I'm not feeling okay about them. And I can request a referral if I need one...
So...the switch might be good. I like him as a person, in the short spurts we've spent together, but he might not be the best fit for me as a provider.
I shouldn't have had to fight for a year to simply be prescribed 5 mg of Ritalin to use at my discretion depending on my activities. For the record, it seems that for me, 25 mg of nortriptyline a day and 5 mg of Ritalin for days when I'm desk-bound are about all I need. Seems like not a lot, but my med sensitivity means that for me...these tiny doses make a huge difference. (For some reason, now that I take the nortriptyline at a higher dose, the Concerta is just too much, even at 18mg...though in general, in my experience, I think it's a GREAT, and subtle drug.... The nortriptyline itself makes me feel a little calmer and more focused...so that the Ritalin booster is just the right amount to put me in a subtly quiet and focused mood. I officially cannot even believe that at one point I was taking 70mg of Vyvanse...what the frigoriffico!? I'll own that though...I just knew something wasn't right...so I thought I needed more...not less...one of us should have figured it out...!)
Change...I have complained a lot about it this year (on and offline) but I feel like this change will be good. What do I say on this occasion..."Thanks for finding me annoying because I'm not a quick-fix patient?" or "Thanks for minimizing my relative difficulties because I'm not actually mentally ill?".
I think I'll just go with "Thanks..." and "...later!".
I've been a little quiet...
...and it's basically because life is REALLY objectively stressful right now. It's easy to lose sight of the many good things when a handful seem to be coming apart at the seams or burning to the ground, but I've been practicing EXTRA HARD.
I make lists of things that make me happy lately, when it all feels like too much (and lately that is a frequent feeling).
I've had three panic attacks in two weeks and I honestly haven't really and truly had one for about 9 years...this says something about how stressful things have been. But...I am soooo much better at managing them that I used to be. The best first step is acknowledging what's going on.
My therapist also gave me a tool that is AMAZING. She says that when I feel anxious I should talk to the anxiety. Yeah...it sounds like typical therapist googoogaga but it works...when I feel my anxiety level rising, I start to talk to the anxiety. I ask it questions. And as I do so, something awesome happens...the anxiety takes on its own borders...it starts to evolve as a being separate from myself. This process encapsulates the anxiety into a tangible form that no longer seems threatening and no longer feels attached to me. I don't know if this works this way for everyone, but for me, it's the best new magic tool in my toolbox.
So...I guess I've needed more of my energy for me, and less for blogging...learning to ration my energy when necessary? Well then I guess this is all progress...wrapped in a funny, awkward little package.
I'm a soldier armed for battle...and battle seems less scary (and less like a battle) when you're prepared to face it.
I make lists of things that make me happy lately, when it all feels like too much (and lately that is a frequent feeling).
I've had three panic attacks in two weeks and I honestly haven't really and truly had one for about 9 years...this says something about how stressful things have been. But...I am soooo much better at managing them that I used to be. The best first step is acknowledging what's going on.
My therapist also gave me a tool that is AMAZING. She says that when I feel anxious I should talk to the anxiety. Yeah...it sounds like typical therapist googoogaga but it works...when I feel my anxiety level rising, I start to talk to the anxiety. I ask it questions. And as I do so, something awesome happens...the anxiety takes on its own borders...it starts to evolve as a being separate from myself. This process encapsulates the anxiety into a tangible form that no longer seems threatening and no longer feels attached to me. I don't know if this works this way for everyone, but for me, it's the best new magic tool in my toolbox.
So...I guess I've needed more of my energy for me, and less for blogging...learning to ration my energy when necessary? Well then I guess this is all progress...wrapped in a funny, awkward little package.
I'm a soldier armed for battle...and battle seems less scary (and less like a battle) when you're prepared to face it.
Wednesday, October 6, 2010
I may have ADHD...
...but dammit, my cholesterol is BRILLIANTLY LOW! 126 anyone? If my doctors had any idea what I really eat on a regular basis, they would declare me a medical miracle. My triglycerides are low, my good cholesterol is high and my bad cholesterol is low. Hot-diggity!
I'm looking at it this way: ADHD makes certain aspects of life inconvenient. High cholesterol WILL KILL YOU.
Clearly I have way better things to do than worry about ADHD. I've got some celebrating to do here! My arteries are doing a little dance already! I think it's a cha-cha...
ADHD means not knowing
It means not knowing the exact source of the problem you're having, but becoming accustomed to blaming yourself. So much so, that when you are told otherwise, you are surprised and you don't quite believe it. You worry that the messenger may be wrong.
I made an appointment sometime last week (I don't remember when) for what I thought was sometime this week. I then misplaced my iPhone (my lifeline) for several days. During that time I got a little overwhelmed with a variety of sticky notes that I was writing appointments on, because I could not get rid of them, because I couldn't put them into my calendar. This sticky note I'd written the appointment on was one of them.
Yes, I could have entered my appointment and commitments via my computer, but I know you ADHDers out there know how it is when your hard-earned routine gets thrown off...it's not just a matter of adjusting immediately, it takes time for the adjustment to stick. And should you start a new routine when you know that your missing phone is probably just in your home or car somewhere? I would then have to undo another routine and re-ignite the old one...no thanks. This is one of those issues that defines the term "impairment".
Today, I called the office at which I'd made the appointment, thinking I'd missed it a couple of days ago and expecting to have to apologize and beg for a second appointment. To my surprise, the lady on the phone said "no, you're early...it's not until next week...he's out of the office until next week". I didn't quite believe her because I was so convinced of my fault, so convinced that I had missed the appointment. I repeated what she'd said back to her. She laughed and said "yes, that's correct".
So I guess I AM the source of the confusion here...but I hadn't done anything wrong yet. My self-blame was pre-emptive this time. I prefer this to having to apologize later and really, I consider this an ideal outcome, despite my self-flagellation. But the past four days of phoneless/calendarless confusion were stressful...as well as a perfect example of what day to day life is like with ADHD as an adult. I know myself well enough to know that I should worry when my calendar is not nearby. Taking charge of the situation by making the call to double check was the right thing to do, clearly. Making the call was a means of being responsible to myself AND to that nice person I'm supposed to be meeting with next week, NOT this week.
I did find my phone this morning, so life can go back to normal...just as soon as I dig out the rest of the sticky notes from my bag and enter them into my calendar...argggh....
I made an appointment sometime last week (I don't remember when) for what I thought was sometime this week. I then misplaced my iPhone (my lifeline) for several days. During that time I got a little overwhelmed with a variety of sticky notes that I was writing appointments on, because I could not get rid of them, because I couldn't put them into my calendar. This sticky note I'd written the appointment on was one of them.
Yes, I could have entered my appointment and commitments via my computer, but I know you ADHDers out there know how it is when your hard-earned routine gets thrown off...it's not just a matter of adjusting immediately, it takes time for the adjustment to stick. And should you start a new routine when you know that your missing phone is probably just in your home or car somewhere? I would then have to undo another routine and re-ignite the old one...no thanks. This is one of those issues that defines the term "impairment".
Today, I called the office at which I'd made the appointment, thinking I'd missed it a couple of days ago and expecting to have to apologize and beg for a second appointment. To my surprise, the lady on the phone said "no, you're early...it's not until next week...he's out of the office until next week". I didn't quite believe her because I was so convinced of my fault, so convinced that I had missed the appointment. I repeated what she'd said back to her. She laughed and said "yes, that's correct".
So I guess I AM the source of the confusion here...but I hadn't done anything wrong yet. My self-blame was pre-emptive this time. I prefer this to having to apologize later and really, I consider this an ideal outcome, despite my self-flagellation. But the past four days of phoneless/calendarless confusion were stressful...as well as a perfect example of what day to day life is like with ADHD as an adult. I know myself well enough to know that I should worry when my calendar is not nearby. Taking charge of the situation by making the call to double check was the right thing to do, clearly. Making the call was a means of being responsible to myself AND to that nice person I'm supposed to be meeting with next week, NOT this week.
I did find my phone this morning, so life can go back to normal...just as soon as I dig out the rest of the sticky notes from my bag and enter them into my calendar...argggh....
Sunday, October 3, 2010
...awkward...
Went to a wedding yesterday. People consider me a pretty social person but I sometimes hit a funny spot where I just can't deal.
This was one of those times. Suddenly all the noise, motion, et cetera, was too much and I started to cry for no reason and had to leave the room. At least I know when enough is enough...found a quiet spot...hung out for 20 minutes...felt MUCH better.
Unfortunately, by the time I'd returned from my respite, my sweet Sonny Rollins had accidentally eaten a shrimp and puked in the bathroom...his belly determined that we were DONE for the evening and the speedy ride home from Cape Cod began...
This was one of those times. Suddenly all the noise, motion, et cetera, was too much and I started to cry for no reason and had to leave the room. At least I know when enough is enough...found a quiet spot...hung out for 20 minutes...felt MUCH better.
Unfortunately, by the time I'd returned from my respite, my sweet Sonny Rollins had accidentally eaten a shrimp and puked in the bathroom...his belly determined that we were DONE for the evening and the speedy ride home from Cape Cod began...
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