I saw my pdoc today. She is still trying to get Rexulti samples but it has been an uphill and so far thankless job. But she heard from a new person today so there's a small possibility.

I do not want to go through coming off Seroquel and going onto clozaril during the holidays. They are going to be tough enough this year without my being unwell or in the hospital. So we're trying one last thing: a micro-dose of lithium. I have had 3 toxicities and the last one I was on a tiny dose and had had low blood levels for years so I'm wary of this but I'm on an even smaller dose and she hopes I get just a little boost. Lithium works well for me, it just turns into toxicities easily and causes diabetes insipidus (which is just another med I might have to add), so there is some hope with this. I don't know if this dose will be enough (225 mg I think without having looked yet) and if I can tolerate it at all. But we do know that my bipolar is much, much worse without lithium. I've had much more psychosis without it (and I haven't told them about the last round--I don't do well talking about it, it scares me like it will come back and be worse or "get me" or something if I put it into words) and have been even more untreatable than usual so maybe this will kickstart Seroquel into working like it used to.

I go back the 21st of Dec. and that's my deadline. I told her I don't want to do Clozaril but I cannot do this much longer. So if I'm still not well by then I will start reducing Seroquel after Christmas with an aim of hospitalization after the first of the year.

I am so glad she let me have this one more month. I need to be there for my family with this particularly set of holidays and I need to be well enough to participate. She said the hospital will get me off Seroquel and start the clozaril but I won't be near therapeutic yet when I come home so as I expected I'll have some bad times at home for a bit. And I imagine coming off Seroquel will screw with me anyway; I've been on it for about 8 years I think.

But there's a definite plan. I have to make it 5 more weeks if I can and if the lithium doesn't help. I don't feel very positive about the lithium because it is such a tiny amount. But I've been surprised by lithium before.

So tired. I had to stop at the fabric store on the way home so overall it was an 11 hour day between therapy, driving, the pdoc, the store and the pharmacy. Hard to believe I used to routinely have 11-12 hour days with commute plus work. Now it is just exhausting.