Bipolar check-in #47

@BirdDancer :

"Would a cream or gel with arnica help your back? Voltaren is now also available OTC. It required a prescription, in the US, until just recently. A little of this stuff goes a long way. My husband uses both, often. He has various back pain issues and they help him a lot, especially well the Voltaren."

Great suggestions! I have used lots of both in the past. I am happy to see Voltaren Gel as an OTC option now.
My favorite for a long time now: Penetrex - This is a very potent formulation of arnica with other ingredients. I took this to my favorite compounding pharmacist and he was very impressed, telling me that type of formulation would cost over $200.00 for the same amount as in the usual Penetrex packaging.
I had initially thought Penetrex is expensive, but then I realized I spend the same to purchase straight arnica lotion/oil.

Your trips sound like a lot of fun! I do understand feeling like they may be too much . I have had great difficulty when simply traveling to different time zones here in the States. I hope it will go well for you.

Love, Comfort and Good Health for ALL

I'm pretty agitated this evening, but have managed to hold myself back from outbursts. But I definitely feel something. I can't even describe it.

I work for a really large company. I have for about the last 20 or so years work for one or two very large companies. I've managed to avoid screwing it up despite a demotion or two related to mania. Today, I get called on the old video phone and told that I'm being transferred from the division in which I've worked for 10 years straight and have developed a reputation of hard work, and seriousness to another one reporting across the country on another coast to someone I've never met. I'll have lost the reputation I have. All the knowledge I have, is gone now, and I'm going onto an established team where everyone knows the ropes and routine and I'm expected to already know this from my previous role where I got by through hard work not through real knowledge. I'm scared man. And I'm uncertain of myself. People are going to know I'm a fraud finally. I don't even know what to do.

Had an okay day at PHP.

Learned today my pharmacy can dispense Clozaril, the PHP nurse called in the clozaril script but it can't be filled until lab results get back.

That's usually fast. It does matter how long it takes your provider to approve it and send it on to the pharmacy. Usually mine is about 2 days from when the lab is drawn until the pharmacy either auto-fills it when they get the labs or 4 days until I realize the pharmacy isn't going to auto-fill and I call it in and they fill it that day

My. Sister popped over today. Was nice chatting with her. Beautiful day, hot but windy so not so bad. Waited until the shade came to sit outside. Started a new painting, this one of dandelions. Looks easy enough. Drinking a vodka fizz my daughter gave me with the art supplies. Eh, I wouldn't buy it. I'm not much of a drinker tho, maybe others would like it better. I only took it cause there was no cold water. Got my instructions for the colonoscopy today. Yuck. Milk of mag for three days before and mirilax the day before and day of. No aspirin or alive from now until then. They called wanting to know if I needed an interpreter for the lab. I never do. The only hard part is when they call my name. But there are good about knowing its me and it's never been a problem.

how does autofilling work? I don't think I have to worry about that until I get on a stable dose and get the same pills every week.

The lady at my pharmacy told me 3/4 days unfortunately idk why it's so slow.

I just mean by auto-filling that they get my labs and fill the script without my calling in the refill. I think they just have the routine now that they get the lab and I need the refill. My pharmacy honestly has been a little confused about this from time time time. When I was on weekly labls and biweekly labs they still filled for a month at a time (didn't complain because it saved money) and they've tried to give me a 90 day supply several times and I have to explain why they can't (plus I can't afford it) and then wait for them to fill it again.

Hopefully your pharmacy will be faster. Maybe they have to order it? It's not a common drug. When I was going on it I was IP and the hospital sent me home with a week's supply to get me to my next blood draw. I think they or I called my pharmacy and warned them this would need to be stocked for me going forward so there wasn't a wait when I wouldn't have any. I don't know what going on while using a regular pharmacy and lab is like.

Here is the titration chart they gave me

Thanks for the explanation!

And ah no, the lab results coming back is 3-4 days. With my pharmacy if they have to order it's next day.

I started showing some vague signs of covid last night. One tick above normal temp, sore throat, headache, nasal issues. I got tested today. I’ll get my results in a few days. My mom and my therapist swear I don’t have it because I only left my house to go to work for 5 hours on Monday. But they were pretty bad with the social distancing at work. I just feel very unwell in general and I found out the other day that insurance might not be covering a lot of my medical treatment anymore. I mean, I have credit cards and I’m sure I can do well with a go fund me page. I don’t even know what I’m getting into and I shouldn’t even be worrying yet. But I do worry before things happen.

I just have a lot going on right now.

With my insurance a month and three month supply are the same price. So I save a lot of money getting a 90 day supply. I'd hate to be on a drug the was weekly or by weekly. I hope it works out for you.

Off-hand I'd say that is about how I did it. I was around 300-350 when I went home at just over 2 weeks and I've been on 350 as long as I can remember. I have taken all of mine at night since soon after discharge from the hospital but that's just a personal preference; I tend to forget morning meds and felt tired with the AM dose. But I've almost never taken AM or afternoon doses of anything before because I just forget and my pdoc is just glad I'm honest about it.

I remember one day at maybe 12 days on it when the nurse woke me up apologizing because she was out of time to give me my morning meds. I had slept 12 hours for the first time in many months. I felt so much better that day and started improving a lot then.

oh sorry I misunderstood. One thing that probably really helps get my labs through fast is that I go to a huge hospital with like 50 pdocs so there is always someone to sign off on my labs if my pdoc isn't right there. It may vary with the labs too. I think the lab I'm using while on covid lockdown is slower than the one I usually use. I know my pdoc really watches for clozapine labs to come through and signs off quickly too.

Hi swimmingly. That major change does sound stressful. Will you have to eventually relocate, or just report to others that are across the country?

Maybe that new department needs a person with your skill base and hard work ethic. Perhaps they specifically need a person like you because they're missing someone with your skills, experience and talent. I can understand the anxiety about needing to learn new things, but you can also teach some.

Thanks BirdDancer!

This might be the kick in the rump that I need!

@BeyondtheRainbow

My doc told me some people respond quick like you, but for most people the improvement is gradual so it takes a few months to fully kick in.

The lab I go to is a private outpatient one, which may be why it takes longer to come back with results. I remember in hospital getting blood tests - lithium for example - and that was back within hours. I would get the blood drawn at 5am and then when the doc made their rounds at 8am they had results.

I'm just very anxious about this whole process honestly, gonna take a few weeks to get it figured out.

Swimmingly, you are not a fraud!! You are obviously awesome at your job and you will show this new team teh exact same thing you demonstrated to the old.

I am really happy you are doing this, falcon.

Me too!

I hope your test is negative.

I am sure you will figure out the other...

2MG of the klonapin first and if that doesn’t work, more tenazepam. She said the 200MG of extra seroquel is for the psychosis and may take up to a couple of weeks to work. She said we’ll probably have to stay at 800 MG of seroquel for at least a while. She is watching me closely right now to make sure I’m safe. Today was a waste. My mind was all over the damn place but all the meds have my body slowed down to a sluggish speed. I know that happened one day at the end of last week but didn’t last so I’m hoping for that tomorrow. It sure feels good to get tons of **** done! All of this lack of motivation makes me feel like all of the talent and creativity in my brain is such a waste.

I've only had one manic episode but I had to have a high dose of lithium and haldol (1800mg of lithium and 15 or 20mg of haldol I think) before I started to calm down

I feel good. Back playing Scrabble. Occasionally it's intensely frustrating but mostly it's okay. Had club tonight. Won two out of three. Best play, the incredibly obscure XERIC -- wow eh?

Oddly, I am feeling less agitated and less depressed right now. However, the depression and agitation could definitely get worse. I know from my own experience that my depression and agitation typically start off mild before growing worse and worse as the day drags on.

I just want this feeling to end. It is torturous. This depression is easily one one of the worst depressions I have ever had and I wish I could go to IOP or something... but 20k confirmed cases. That scares me. I wish I lived in Greenland or something. Or the North Pole. Yeah, that would be nice.

Anyway, I have meetings that start at 7:30am. Joy... So now I have less than 30 mins to prepare, and I have lots more following.

I see my pdoc and therapist tomorrow. I hope those appointments bring me some relief, even if the relief is only temporary.

I don’t know about your state and programs but where I am IOP is all virtual. Sign on through zoom into a virtual group room on your computer or phone. I always call in because I don’t like how I look on camera. But it’s worth looking into.