Unshelved by Bill Barnes and Gene Ambaum
comic strip overdue media

Friday, January 07, 2005

I talked to the new psychiatrist yesterday

and even though it was only a first visit, we covered a lot of my medical background, what treatments had worked well, what symptoms I was still experiencing, etc. We also got through a brief overview of my family and marriage history (and as always, the knowledge that I married a gay man brought the question 'Did you know he was gay when you married him?' which is always followed by 'yes, but I was young and stupid'. God, I'm never going to live that one down.

In particular I discussed my concerns about my mood highs and lows and the cognitive and memory issues. She didn't think I met a classic manic profile but didn't dismiss hypo- or atypical forms. I came out of the meeting feeling that she had listened intently, reserved a lot of judgement, and she even mentioned that it would take some time to work out a treatment plan. She reminded me a lot of my former doctor in terms of reassuring professionalism but I also got the impression that she would follow-up more stringently on some of the issues that had been pushed to the side when I was first treated for the OCD/BPD and depression. Those, of course, are under good control now, but there still remains things like, oh, the fact that I haven't been in a partnered relationship in 14 years.

She did believe that I was still having an imbalance in my brain chemistry, which could account for both the mood and difficulty remembering/being able to concentrate/verbalise the right words, etc. To help with the mood variance she upped my Paxil to 60 mg--20 more than I had been on, since it does work well for me and I wasn't on the maximum dose yet. I think I may be now. :) That handles the serotonin. She put me on a very low dose (starting with only 2.5 mg) of a drug I hadn't heard of called Abilify. It's a dopamine partial-agonist, meaning that it's technically considered an atypical antipsychotic and was originally approved to treat schizophrenia. That's a little disturbing, seeing as I'm thankfully not psychotic, but it's being used in other areas now, including bipolar disorder and to specifically address cognitive issues that are secondary to other brain disorders. It's similar to drugs used in Parkinson's as well, although it's apparently unique because in addressing the dopamine receptors it tends to help regulate both a tendency for low or high dopamine and keep it on a more even keel. We're going to try this for a couple of weeks and then I'll go back. Let me know if you notice a difference in my writing.

It's a little scary of a prospect (and while it seems to be a fairly safe drug, it's in a class that do everything from exacerbate or induce diabetes to cause permanent movement disorders, so maybe it's overkill if you're having mild cognitive issues) but I really have reached a point a lot of my ambitions and for that matter everyday interactions are being frustrated by this inability to speak fluidly without struggling for a word or being able to remember what I just heard or even said. So, wish me luck. :)

[I don't know if I'll ever find a job if I keep talking about this sort of thing, but then, a huge number of people out there seem to be on some psychotropic drug, right? And at least I've undergone and am continuing treatment, as opposed to all those people out there who think they're perfectly sane and so need help.]

I also went by the company that gave me my CPAP machine and asked about getting a new mask. Apparently there's no trouble in getting it, although I need to follow-up with my sleep doctor. They gave me a nasal one, much lighter than I'm used to, that's soft gel all over, can go over the head or along the chest down to the tube, and (gasp!) I can wear my glasses and read before sleeping without worrying about falling asleep without it on. They also gave me new filters and a hose, since I'm way overdue for those. Apparently my insurance will pay for them every 6 months (or one month for the filter). Since I had an extra mask somewhere along the way, I hadn't updated for two years. So, that may be a lot of the reason for my sleep, irritability, and memory problems, especially since the mask has pretty much fallen apart the last couple of months. And yes, I know, I should have gone before, but I thought I owed them money and that I couldn't get anything until I paid, but apparently that wasn't the case. So, put the whole thing down to anxiety, I suppose. Here's to better sleep.

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