Should I go to the hospital?

Yesterday the nurse that does my injections said I was manic (I disagree) and suggested calling the crisis line or going to the ER, but taht's not really why I'm thinking of going. I have PRNs to chill out when it gets too much.

My pnurse ****ed up my scripts so I missed 5 doses of lithium recently, and yesterday the concerned injection nurse called my pnurse to see if she wanted a higher dose injection or maybe the injection is causing the mania or what. Pnurse said to just keep everything the same. Well, I restarted the lithium (at 600mg twice a day, the original dose) yesterday and now an hour after I take it I throw up and get diarrhea (this did not happen when I was previously on Li). It's making me not want to take it. But today the side effects weren't as bad so I really want to just stick it out, but I figure if I go to the hospital they can decrease the dose and check my levels (which my pnurse hasn't done despite my previous pnurse saying the new one would, and of course the new pnurse didn't want me to talk on our phone appointment... it was 6 minutes long...of yes or no questions and then she hung up). I'm just worried because I've had tegretol toxicity because my team didn't check my levels (I didn't even know you had to check levels for tegretol). I don't want that happening with a med that actually works for me when I get the chance to take it.

Thoughts?

Hi Sapien. If the Lithium is causing you to vomit and have bad diarrhea, you really should have a Lithium level blood test. Can you call her to let her know you've vomited? I'd think she could submit a blood test request same day.

I took Lithium a couple times in the past. I remember the second time having stomach issues for a while. I did have Lithium levels done, but in my case they were in range. I did eventually get past the stomach issues. Time helped with adjustment. However, I did have the levels done. My psychiatrist was always quite good at ordering them done frequently. I was so well known at my local phlebotomist outfit that they all remembered me.

I hope the Lithium works for you in the end.

As for going inpatient, does someone you live with feel that may be necessary? If so, you might consider it. If not, perhaps a little time will prevent the need.

I agree with Soupe. You should have your levels tested. Never mind if she doesn't WANT you to talk to her on the phone! Tell her that you're supposed to have your levels tested right away! Also, the initial side effect could have been just that - a side effect, especially if the problems haven't persisted.

i agree with the other wise and wonderful posters! Try to have your blood checked out at least to see if there is something wrong. As for the hospital, if going to inpatient prove necessary then perhaps it'd be better to go otherwise i think it is ok to wait at least a few more days to see how you feel. Sending many safe, warm hugs to BOTH you, @Sapien, your Family, your Friends and ALL of your Loved Ones! Keep fighting and keep rocking NO MATTER WHAT HAPPENS, OK?!

Okay so I called yesterday and left a message. She should get back to me today but probably not until like 6pm after the med providers leave. I stopped thinking about the possibility of lithium toxicity. Tuesday was the worst, Wednesday was a little better (though I did get dehydrated and lightheaded), and today no vomiting (but yes to nausea), just diarrhea. I'm gonna suggest switching to extended release or taking 400mg 3x a day instead of 600mg 2x a day.
I'm mostly alone these days. I live with my mom primarily and we spend maybe an hour together a day and she just knows I have a lot of energy and is annoyed with me moving furniture around and screaming. I wasn't really thinking of psych IP, just going to the ER to get fluids and make sure I'm not toxic the quick way. I probably won't be able to get any blood test until Monday because nurse will call late evening, tomorrow she'll spend the day trying to get in touch with my pnurse who will wait until the last minute to send it over, so maybe Monday I do the blood work (closed on weekends), get the results by Wednesday? That's like almost a ****ing week. I have a friend at the other clinic for our area and he says they're just as bad. He's on clozapine and it takes like 4 days for them to go from blood work to "okay, you can pick up your meds" so he does what I try to do and stock pile meds for when he runs out.

I don't know if your providers will do this but I avoid the clozapine running out because of slow communication by having my scripts written for 350-400 mg. I take 400 mg for a few days if I get manic so there is some slight need for that but it's usually only once or twice a year. But that gives me extra in case there is an issue.

I don't know if going now for labs is going to show lithium toxicity unless you've had lithium (I may have misunderstood that you've not). But if that happens again you should go get checked at the ER. I loved lithium but it loved to make me toxic and I tended to not get checked until my levels had lowered themselves from being sick. The one time it made me hallucinate and I was sent to the ER and had a test before I started vomiting/diarrhea my level was very high and I needed to be admitted to medical for fluids and monitoring electrolytes.

Hope you feel better soon.

Hi Sapien, how're you doing?

I honestly don't know how to answer that, ahaha. I just ate something so I'm feeling better than before because I went 30 hours no food (had a cup of milk though). Also kindda feel like I took a low dose of acid, but I've felt like that since Monday. Physically at this moment I've no complaints.
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Rainbow, thanks for the tip! And yes, I've been on lithium for about a month with a three day break over the weekend (not by choice).
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No call from the nurse today. I ****ing hate how it's impossible to get a hold of anyone even when I call the right number (and why are there like three numbers for the same center? and why do we NOT call the med line for meds?) I really don't feel like I need to talk to her anymore, but she might call tomorrow, seems everyone's on a delay over there. She was really concerned when I saw her for some reason. Probably playing tricks on me. Everyone's always trying to **** with me but I can see through it.

I'm glad you're feeling some improvement. They're probably not trying to **** with you, they're most likely just all backed up and disorganized like many medical places are. It's crazy how patients can get shuffled around.

Thanks, Beth. I don't know why every time something happens I immediately go to "they're playing games with you" or something. I'm trying to ingrain Hanlon's razor in my head.

She didn't call today either, which I was kinda looking forward to because I have other stuff going on today and I'm not 100% on my safety, but I guess I'll have to wait until Monday now.

Irresponsible that she didn't call.