Friday, April 14, 2006

 

Followup with the Doc.

This post actually just reminded me - I've got to call the Doc for a followup. See you avid readers soon.

Tuesday, April 04, 2006

 

The Shock

Okay, The Shock sucks. I just dropped the phone handset and tried to catch it. I caught it successfully, but not before my whole nervous system lit up from head to toe. Good GOD this can go away any time it wants to.

I woke up this morning from a really good, if somewhat scary dream. I woke up during the scary part (giant rats - wtf? Those are scary? gimme a break.) And my nervous system was on fire. Every hair on my body was standing straight out, and every inch of skin was being run over by cold cheese graters. That's kinda neat to have one time, but not ever again. Especially in reaction to a dream - what am I going to do, wake up in pain at every nightmare?

Gah. Appointment on Friday, I'm down to 200mg only at night, or did I cover that already?

Monday, April 03, 2006

 

Is it Monday yet?

I guess you could call my weekend "foggy." I kept up with all my doses and spent both Saturday and Sunday morning in a drug-induced stupor. Girlfriend and I went walking a few places in order to stay awake, and I can;t for the life of me assign days - Saturday? - to places - Best Buy? What was I doing in Best Buy?

Probably the creepiest thing was around hour 11 on both days, pacing, thoughts flying by at a much more furious pace than they would be ordinarily, and wondering if it was time to take the next pill. I kept wanting to get back in the cell it had for me rather than hang around outside and wait for it to happen.

Slept 14 hours on Friday night, slept 12 hours Saturday night, slept 8 hours last night.

After the waiting, the second creepiest thing is The Shock. Every time I startle myself or something startles me - dropping keys, a loud sounds, bonking my knee on a chair, stopping to let a car pull out in front of me - a giant shock hits me from my spine, radiating outward to my fingers and toes. Like hitting your funny bone with your whole body, a real, physical reaction to something that used to be almost entirely mental.

Not only that, but it takes a long time to fade. My last does was 10pm Sunday, now it's 8pm Monday. I just bonked my knee an hour ago and felt The Shock, nice and strong.

I'm always hungry, even after I eat.

Talked to the doctor today on the phone, doc says to move to 200mg a night, only at night. Thanks, doc. I'll do that, and continue to eat, and continue to get pissy with my girlfriend, and continue to wonder why I just feel shitty rather than better. You've got until Friday, doc.

Friday, March 31, 2006

 

Listening to Seroquel

So remember in the post below where I said I took the 25mg dose as prescribed on Thursday morning?

I went to work soon after.

I noticed the side effects about 50 minutes after taking the dose.

Woozy, dizzy, dead sleepy, and a balloon-like feeling in my arms and legs. I couldn't stay awake, there was a constant downward pressure on my eyelids. After twenty minutes of this, I wrote an email to a friend to come and get me from work. Three lines. It took 30 minutes to get it right.

While waiting for a reply, I looked up this little guy Seroquel and tried to find out more about him.

Well, he's an atypical antipsychotic, used for the treatment of acute mania due to bipolar I and schizophrenia.

Did I describe any acute mania to my doctor? No. But hey, he's the doctor.

Turns out that it's also prescribed as a sleep aid.

By this time I was getting pissed, as well as a little less sleepy. I went in complaining of not enough energy and focus, and I'm prescribed an antipsychotic that knocks me out? For acute mania?

No, no, and no.

So I go home sick at noon and sleep until 4pm. Like the dead. I wake up and get out of bed and feel like I've had the flu for four days. Turns out it grates on your histamine receptors like a garlic press and makes you feel, well, like you've had the flu.

I took my second 25mg dose that evening and slept like a baby for about 9 hours. I skipped the dose this morning and I'll take my evening dose tonight. I need to work, and I can't work while sleeping. If this persists all weekend, I'll have to call the doctor and tell him that I'm not taking the medication again on a weekday.

A lot of you might be asking "Why are you taking it at all?" Because I want to be better, and I have to rely on the judgment of medical professionals in order to get there. Now, if I'm going to change his mind about my treatment, I'd rather have another medical professional argue with him about it than me and my website going toe to toe with him.

We will see. Blogging, hopefully, under the influence tomorrow.

As always, check out reputable sources of information like NIMH for the best information. I'm just some guy on the Web.

 

The Doctor and I

Being nominally healthy, I'm not as terrified about HMOs as I will be when I'm older and less healthy. But hey, having worked in a call center before, I kind of understand the procedure - we've got to make sure you've really got a problem that we can't fix before we send you on to a manager.

I think that's what makes HMOs so repugnant to a lot of people. As Americans, we seem to have been given a right to "Speak to your manager!" about this or that if we so demand it. HMOs violate this by saying "You are not a special and unique snowflake, and having a sprained ankle does not mean you can demand to talk to an orthopedic surgeon and incidentally drop by the oncologist's office and have him look at this little bump right here."

Distracted again.

Anyway. Your MD is the best place to start anyway. If he's done his homework, he's seen a lot of people just like you. If you've done your homework, you can run down all the symptoms and he'll write you a prescription for a Schedule II doozy like Ritalin and hey, there you go.

If he's conscientious, he'll recommend you see a psychiatrist, or a psychologist, and might write you a prescription right there.

My visit went like so:

Go in, get vitals taken, wait in the waiting room. Doctor comes in, we chat:
Dr.: What are you here for today?
Me: I'm here for an ADD screening or referral.
Dr.: Why do you think that?
Me: Well, I have this long list of symptoms that I've found from reputable sources that tend to indicate ADD, but "Only My Doctor Knows For Sure."
Dr. : Hmmm. Any history in your family.
Me: My Dad is one distracted dude.
Dr.: Does this come in cycles?
Me: Not really. Like many of the references say, in some time periods I'm capable of great things. In others, I'm not so much. I test and interview really well, but the work I turn in is worthy of a C student.
Dr.: Any addictions - drugs, alcohol, gambling?
Me: There's one addiction, and it's _____.
Dr.: Hmmmm. What about sleep?
Me: What is it? I don't get a lot of sleep and I don't miss it. I feel rested after six hours, but I can go as low as four hours without feeling bad the next day. I don't cheat and nap or sleep late on the weekends, either.
Dr.: Hmmm. Ever been treated for depression?
Me: Yeah. I was diagnosed by an MD and under the care of a psychologist for about six months, and for that I took Zoloft.
Dr.: Hmmm. And how did that work?
Me: I noticed an immediate effect on day one of the Zoloft - I was focused, alert, had no problems with energy or dealing with distractions. After about 4 weeks, the Zoloft had installed this floor underneath me where I felt like I just wouldn't be that depressed anymore.
Dr. : Hmmm. A reaction on day one?
Me: Yeah.
Dr.: Hmmm. Well, here's what I think. I think you're bipolar.

Me: What?

Dr.: In fact, I think that one day, ADHD will be diagnosed as Bipolar III.
Me.: Okay....
Dr.: What makes me think that are three things you mentioned - not missing the sleep you're not getting, the immediate effect of Zoloft, and the nature of your addiction.

The Doctor then went on to explain that, even though I'd protested that I had never, ever had a manic episode in my life, that I had actually described HYPO-manic episodes. And that a hypomanic episode included symptoms that included my addiction, my sleep patterns and my distraction and/or flight of ideas.

Well then.

He then had me fill out a couple of screening questionnaires, both quite obviously provided by the pharmaceutical manufacturers, and looked at them. He said that while those results were positively inclined toward ADD, that I was also positive towards Bipolar II.

He said it would take about three weeks to see a psychiatrist, but that he could start a medication right now if I felt I was up for it.

See the post where I just want to be better. Of COURSE I would take whatever he gave me right there.

So he brought out the Seroquel. He started in on the side effects first, talking about the possible drowsiness, dizziness and vaguely disconnected feelings. I asked what the primary effects might be and he said that after a while I'd be able to focus, there'd be less noise in my brain, and I'd be better able to deal with distractions.

He also said that I should start it on a Friday, seeing as how I could have a weekend to be drowsy if I needed to be, and that we'd start with two doses of 25 milligrams and move on to the higher doses, maximum being about 800 or so, but most daily doses maintaining at 400 mg or so. Again, I'm not the doctor, he is, and if your doctor says you better be taking 600 or 800 mg of your medication, you follow his recommendation.

Dr. : Call if you need anything, and I'll see you in a week.

Remember, he said start on a Friday so that I'd have the weekend to be drowsy.

Remember, I said I'd do anything to be better.

So I got home, it was still Thursday morning, and I took the first 25mg pill. This is what is known as not following a doctors' suggestion. They weren't orders, but they might as well have been...

More in the next post.

As always, check out reputable sources of information like NIMH for the best information. I'm just some guy on the Web.

 

Seeking Help

This post will deal with the resources I've found and the research I've done to identify what can be done about me but also to ensure that I'm not making any of this up.

I have an intense fear of hypochandria - I don't ever, ever want to be in a position to have a doctor say "Yeah, uh, just get out of my office." Doctors, to their credit, don't actually do that, so you can see how my problem could compound itself a bit.

So.

It starts in December 2005. Maybe I was watching America's Only Health Reference, the Today Show, and something about adult ADD came up. Maybe it was a commercial for Strattera, maybe it was a medical segment about adults who were seeking treatment more and more, but I remember seeing it and thinking, "Huh. Maybe that's about me."

I promptly forgot about it.

Maybe then I saw something about Ritalin and brain usage, but I looked into it more.

And then did nothing.

After my boss at work talked to me a third time about my lack of organization and follow-through, and recognizing that this was the time in two previous jobs where I'd made the make-or-break decision to keep living life as I was and get fired, or do something about it. Each of those previous times I'd been asked to leave. This time, I was determined to do something about it.

So the symptoms. Most adults with ADD have some of the symptoms listed here.

I had about 95% of them. I love to read, but I just can't sit down and read a whole page anymore. I'm a self-identified bad driver - we can get there safe, or we can get there on time, but you can;t have both. I almost never speak up in social situations because I've trained myself not to blurt things out. Somebody else pays all the bills because I can't actually sit myself down to do it. I almost never made the connection between being completely unable to finish a meal or finish a project until I looked through some of these.

At my ten year high school reunion, people noticed that I drifted off before finishing a sentence the same way I did ten years earlier.

This is where the people who think ADD is just an expression of creativity or genius pipe up and say "You're just deep in thought," or "you have a creative mind, always rushing from one thing to the next, always looking over the next horizon, always inspired."

You know what? Shove it, okay?

I'm not an artist or songwriter or author or anything like that. I've never had the energy or focus to pursue one thing to completion. I know a lot about physics, astronomy, art, music, culture, politics, cars, rocketry, the Apollo program, video games, marketing, World War II, the United States Marine Corps and parenting, but I don't know everything about even one thing, I'm not an expert in my field or even an accomplished resource in my hobbies, which drift from minute to minute without any anchor or consistency.

So shove it. I would give anything, ANYTHING, to be rid of this. People often think that treatment or medication for ADD stifles the creative spirit. Even though there's no evidence that this is the case, even if it did stifle creativity, I'd seek treatment. I would give ANYTHING.

If you think being creative and spontaneous and flibbertigibbety all the time is fun and admirable, throw a marriage and a couple of jobs in the toilet in exchange. That's what I did, and I didn't even know I was doing it.

I'd give anything. I just want to be better.

So with all that in mind, and a possible plan in action to contact my HMO and figure out how to go about this, I promptly lost track and moved on to the next thing.

Where were we again?

Oh, yeah. Seeking Help.

Contacted my primary care physician. Made an appointment. Drove to the doctor's office, but missed a turn and spent half an hour getting back on to the freeway to find it was so packed going back the way I had come that there was no way I'd make the appointment.

See, it even fights your ability to get help.

If you recognize any of these symptoms in yourself, check with a doctor. Look around at established resources, especially NIMH and its excellent site here. Avoid the "Internet Brigade," the people who
If you're worried about seeking help, look at it this way: you'd think nothing of a co-worker coming to work in a cast on her leg, right? She broke it, she got help, the doctor took care of her. There's nothing wrong with going to the doctor and getting something to make yourself better, and it's time to remove that stigma from getting help for broken brains.

My adventures with my MD in the next post.

 

What this is all about

This blog is a journal of my experiences with ADD or ADHD or Adult ADD or whatever you'd like to call it. It starts with my decision to seek medical attention.

If you've got a comment, a funny story, a similar story or an "Amen, brother," please leave it in the comments. Comments with links are even cooler. If you want to post about Indigo Children or your herbal ADHD cure or the "fact" that people with ADD just need to stop watching TV or just need to get off our butts or just need to get organized, you're free to post comments, just don't expect anybody to listen. Reply on your own blog - they take about 4 minutes to set up.

Unless of course, you have an Indigo child. Then you're most likely so incapacitated by life that mere bloggery is faint-inducing...

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