I might be heading toward a pretty big meltdown soon. You know how we are suppose to identify triggers. Well, several have been happening over the last few months and more are expected to come. I'll try to avoid all the details, but the highlights are:

• Over last 4 months, pdoc removed 5 meds that weren't working - had fun weaning off clonzepam, trazadone, gabapentin, seroquel, vistaril
• Injured my knee in September while rehabbing a back injury. Just had surgery last week to repair my knee and clean up some arthritis crap.
• While getting my knee MRI done, the test revealed bone death in my long bones, so I've had heart tests and blood tests galore. Found out that I have borderline diastolic dysfunction, which could lead to heart failure
• My chronic headaches have gotten worse, but now my doctor thinks it is due to chronic sinuitis, so I'm having a CT scan done and being evaluated for surgery to alleviate the pressure in my face and behind my eyes.
• When I woke up from knee surgery, the anesthesiologist was literally in my face telling me over and over again that I needed to see so and so because my thyroid was enlarged and obstructing my airway. I have an appointment with that surgeon in two weeks.
• My regular doctor really wants me to quit smoking, which I had planned on at the end of the year.
• My brother and his family are visiting next week and while I love seeing my nieces, it is very stressful spending time with him. His wife is nice.
• I'll be spending Christmas day with my parents and that is fine. Just the three of us...dad is fixing a rib roast. Not sure what we are doing for the day, but we'll figure it out.

Anyway. Family and medical are my big triggers. My brother really doesn't understand my mental illness challenges, let alone that I have physical issues compounding things right now. It isn't that I want sympathy from him, or at least I don't think that is what I want. I guess I don't really know what I want from him. He pretty much is a putz. Besides, my mom just had an angioplasty done to see if she had a heart valve blockage (she didn't) and so I'm sure that we will all be talking about her experience and how she now has a new lease on life. Forget about how I was schlepping around 36 hours after surgery, going to the hospital with her and dad, not being able to take any pain medication because I needed to drive, all because she couldn't wait an extra week to schedule her appointment and figured that my knee surgery wasn't that big of a deal and I wouldn't mind. Gee, why would I mind. Taking a backseat to everyone is what I excel at.

So...I've been in a mania phase for a month or so. It might we waning a little bit, which would be fine with me. This is the first time in years where I've had my sexual appetite set to voracious. It is nice at first, but gets a little tiresome. I'm wondering if being in a lot of pain over the last few months has aided in that drive since the pain and pleasure sensors are the same.

If you know you are heading into a potential mess, what do you do to avoid it? I can't avoid seeing my family and I really do need to take care of my medical issues. Would love some thoughts. When you need to spend time with family, do you have anything fun or specific that you think of instead of them? Do you play games in your mind? I'm just trying to avoid crashing and burning.