Medicate Me

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Just like yesterday was a big day in therapy, today was a big day in medication management. I met my new psychiatrist today. We had a good session, I talked both about how I got to the point that I’m at and also my more recent successes over my anxiety. He pointed out that my anxiety seems to be more social, with the exception of driving, and that makes sense. It’s not the laundry room that causes panic, it’s the thought that I might be in there with a stranger who’ll judge me. It’s not the store itself that I have a hard time with, it’s the people that fill it. With the exception of my issue with driving, almost every one of my anxieties can be traced back to being in a social situation. So we’re going with a diagnosis of social anxiety rather than generalized anxiety disorder.

He also took me off the medication that I was taking for anxiety, at least, on a regular basis. He explained that the effects of the medication in question only last about four hours, so it’s not designed to be used as a preventative. He likened it to taking Tylenol to keep you from getting a headache. He also mentioned that long-term use of that medication seems to have a tie to dementia, something that runs in my family and that I would prefer to avoid if at all possible. So I’m now only taking that medication when I actively feel anxious.

In its place, he put me on a new-to-me antidepressant that’s indicated for anxiety maintenance. As is typical with antidepressants, I’m starting with half the target dose for a week and then ramping up to the full dose after that. I hope that it’s going to help with the anxiety. Because of how I was taking it, I never really felt anything from my current anxiety medication, and I hope that this changes once the medication has been in my system for about a month.

I’m due back in his office in five weeks – four weeks after the full dose has started. We’ll take it from there and see where we go.

And I’d like to close by pointing out that seeing a male psychiatrist is a huge step for me because of my PTSD. I got a bad case of dry mouth because of the anxiety of being in his office and my blood pressure reflected my nervousness. I hope that gets easier as time goes on.

Quarterly Report

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Went to go see my psychiatric medication manager this morning.

She had an intern sitting in with her, which I was fine with, and she wanted to know about the fatigue that I’d been experiencing during my last visit with her. I told her that I think there’s a combination of my prescriptions that’s conspiring to make me drowsy in the morning, and we discussed the potential of adding Provigil to my medication regimen to offset that. I’ve been on Provigil before so I know that I’m not allergic or anything, although I don’t know about contraindications with current medication. She referred that question to my sleep specialist in April, and we moved on.

She was pleased to hear about my recent socialization and my very gradual tendency to be more comfortable in social settings, although I have to admit I’m still a little nervous in them, especially if there are people that I don’t know. I neglected to tell her that since my last visit with her I’ve socialized twice with people I hadn’t met in person before and that I’ve been to multiple SCA events and didn’t even have a panic attack before the most recent one, but I did let her know that I’m getting out of the house more often and that Pokémon Go is a help with that.

She’s especially pleased to hear that I’m going back to school in the fall, and she believes that the additional structure that will accompany that will be beneficial to me, and especially with regard to this rut that I seem to feel I’m in lately.

She also noted that two sessions ago I could barely keep my eyes open, and she’s overjoyed to see that I was alert and much more participatory in my session today. I confessed that her front office had a lot to do with that – one more cancelled or late appointment is likely going to end my relationship with the practice, so I tend to get there very early now, and today I got there almost an hour ahead of schedule, so there was a little bit of a nap in the car before I came up for my appointment.

She thinks I’m making good progress, although I think it’s slow going. But slow progress is better than none at all, or worse, regression, so I’ll take it. New appointment at the beginning of May has been set and I made plans to work out an issue with my account.

Improvement, But At A Price

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On Tuesday, I went to the doctor’s for my annual physical and quarterly bloodwork. I can’t report much to you, since the test results were given to me while I was driving (look at me getting behind the wheel!) and I was paying more attention to the road than numerical values. I do remember my A1C is at 6.1, which is not quite where we want it, but it’s still very tolerable. My triglycerides are still high, despite the prescription strength fish oil that I’m taking, but at least they’re down significantly. They’re less than twice what they should be for the first time in years, so I’ll take it. My blood pressure was a little high, though, high enough that they retook it before letting me leave the office, and the prescribed me another medication to get it under control.

And what a job it’s doing. I’m used to my blood pressure hovering around 145/95ish, which is still pretty high. This morning it was 120/81, almost perfectly textbook. Other readings have been slightly higher, but still in the 120s/80s – much better than I had been recording. I’m very pleased with the results.

However, there is an unpleasant side effect to this medication. Everything that I take in by mouth – all food and drink – has a metallic aftertaste. In foods with strong flavors, it’s not really noticeable. (Thankfully, one of those foods is coffee.) But with water, since it really has no taste, the aftertaste lingers for a while, and it’s very strong – to the point that I initially thought the water filter had had something go wrong with it. And generally speaking, the only things I drink during a typical day are a glass of milk to get my morning meds down, coffee, and unflavored water – with the majority of what I drink water.

So I’m going to have to get used to this metallic taste, or find another medication that’s going to work. I hope I can get used to it – I really like the results I’m getting from my medication regimen these days.

July 7, 2015: Three Good Things

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1. I went to go get bloodwork done this morning. I asked a question about how I should be taking one of my medications and was assured that I was taking it correctly. (Wish it were working better, however. It’s one of my blood pressure medications and it’s still really high.)

2. I tried a new recipe for dinner tonight. It didn’t work out well, but it’s the first time I’ve cooked from a recipe in a couple weeks.

3. When the recipe went south, I managed to head off a bout of irrationality on my own, without any outside assistance. This is a big deal.