I'm better. Starting to settle down.

If I go to the ER my doctor loses the chance to control what happens in treatment. I am going to clarify this tomorrow. But if I go to the ER (which has to be planned since it's 2 hours away and I'm not going to wake my mom to ask her to take me) then they'll send me to the same unit I always go to (good) and whatever dr is on call will determine treatment (bad). If they happen to coordinate with my pdoc that's great but they could also decide I need to try meds that my pdoc is not comfortable with me trying because I have a long history of movement disorders and she feels that I will continue with that on the typicals. I've been on all the atypicals I can possibly afford (I can get 'em free after trying them through patient assistance but need samples to try them and my hospital has an anti-pharmaceutical influence policy. They can get samples for specific cases but we tried for 3-4 months to get samples and nobody answered my pdoc's emails; they don't make enough money to bother dropping them off.) And the only one that really had a shot at working was Rexulti and it's so new it could have been bad too. Anyway, the point was supposed to be the hospital dr doesn't have to listen to me nor contact my pdoc and I could just wind up even worse. I went through a few months of movement disorder this summer and it was bad. The med helped but I needed more and couldn't have more and then had to stop something that probably would have helped greatly with just a bit more but I couldn't have a bit more and I wound up with months of severe depression before this mixed episode started around the holidays.

Going off benzos is on my wish list. Not sure it will succeed; I have a nasty anxiety issue and PTSD (and some OCD) nbeyond the bipolar. So it may just be necessary. I've been off before and needed to go back on. Valium is very PRN just for sleep and I'm sensitive to it so a very tiny dose. Right now it's a good thing because I took it a while ago and will stay calm through Tuesday afternoon which I need. Much less than prescribed in fact. I do take klonopin routinely though. I want to see if we can get me lower or off but first I have to get stabilized on clozaril and then just have some time that I can enjoy feeling good. 13 months of solid illness (I've had 4 moderately good days, 2 2 day spans when my mood was changing and I hit some hypomania since last January) is wearing and my life was not great for a while before this hit. From March 2014 until last really a couple weeks ago there were some extremely stressful things going on--I blew out an ankle that I'd injured in the past and had to have reconstruction surgery which was 6.5 months of my life devoted to that and that alone, my brother was arrested and it has caused a lot of family problems, personal pain, things to deal with; I had to retire my national certification for my career (that was the last straw; things seemed to blow up as soon as I did that), just a lot of hard stuff and then bipolar attacked fiercely. So I need some rest before taking on anything new and my pdoc will probably look for a year of stability before agreeing to cut anything. But yes, eventually I want to try to go off benzos. It's harder b/c the MAOI I'm on restricts some of the drugs I might use otherwise for anxiety and it is stimulating itself. So that is another issue that we'll have to deal with eventually.

Thanks again for middle of the night support. I'm calmer now. I need to write down what I need to say with my message for my pdoc tomorrow and hope that the person who takes the message words it as I do.