Archive for the ‘Lamictal’ Tag

THE BIPOLAR PERSPECTIVE: BEARING THE BAGGIE OF BURDENS   Leave a comment

PISSED

The other day I finally went to the urologist.  I wanted to find out why at fifty years of age I started wetting the bed three nights a week.  As I walked into my sparse HMO Plan’s Doctor’s Office, I was prepared for news of a cancerous growth in my manhood, a renegade testicle or an untreated progressive tropical sexual disease I picked up eating Cuban Food in San Francisco’s Mission District.  But I got even worse news… There was nothing physically wrong with me.  The emotionless managed care physician even managed to look at my prostate, which apparently gave him the “OK” sign as well.  I wonder if it was a “thumbs up” or it just “winked”at him like a Cheshire cat?

RESTRICTED FLOW

 If my member is not sick, that means my night-time urinary incontinence must be in my head.  Or at least that was my first conclusion.  After all these years in therapy trying to keep my Bipolar mind afloat, now I had sprung a leak down below.  And, the treatment was as vague as the apparent cause.  So the vanilla urologist gave the tasteless advice not to drink fluids three hours before bedtime and see what happens.  He also emphasized no alcohol.  I knew this was implausible. My Bipolar medications make my mouth extremely dry.  I have to keep drinking liquids or suffer from such bad cotton mouth my lips stick together when I speak, causing annoying suction sounds.  Plus, the thought of restricting the flow of alcohol prematurely during an evening on the town is out of the question.  I prefer to drink with wanton abandon.  Why should I once again have to add another limitation to my already restricted existence?

HI-HO!

And then it hit me… This was just one more annoying annotation to my treatment schedule I will have to endure due to my Bipolar Disorder.  Just like the cadre of pills I have to take twice a day, now I must regulate my liquid intake.  Another hurdle to clear, inconvenience to negotiate and regiment to be saddled with in order to remain ready for prime time.  I feel like I am in an 1800’s horse-drawn wagon, piled high with pills and their side-effects, barely inching across the baron plains of the old west.  Hi-Ho Effexor, Lamictal and Topamax! Git!

MANAGED MEDICAL INCONTINENCE

However the thing the Managed Healthcare Professional said that bothered me most is he felt the assortment of Bipolar medications I take are probably the cause of my night-time incontinence.  I’m well aware they cause dry mouth, nausea, severe constipation and weight gain, among other things.   But because my nightly dose of the anti-depressant Seroquel makes me sleep quite deeply, I may not be waking up when I have the urge to urinate.  Consequently, I go in my sleep.  And, the doctor made it clear he did not think I should discontinue any of my medications.  So in essence, he was saying it was best to continue wetting my bed.  That way “at least I have my sanity.”  I call this Managed Medical Incontinence.

BEARING THE BAGGIE OF BURDEN

One time a friend who I met in a Bipolar Chat Room came to visit me in San Francisco. When I helped her get settled in her hotel room, she pulled out an identical Zip Lock Baggie to mine filled with pill bottles containing her personal mixture of Bipolar elixirs and poultices.  I suddenly felt a strong commonality with her. I realized all Bipolar sufferers carry their own “baggie” full of unique prescriptions and medication induced limitations like mine, everywhere they go in life. I take a handful of assorted pills twice a day. Some people take theirs three times daily. Some have to take meds with food. Mine make me too nauseous to eat right away.  A number of people can drink alcohol with them, but others get violently sick or depressed and can not combine the two.  Each baggie contains a mixed bag of burdens specially formulated for that individual.  But we all bear the same baggie of burden.

MY BAGGIE IS BIGGER THAN YOUR BAGGIE

Wetting the bed is a pretty heavy burden for a baggie to bear.  You can learn to keep your shaky hands in your pockets, and take your midday dose of medication out of sight from your co-workers.  But if you are ever going to have an intimate relationship, you can’t hide the fact that you are irrigating the bed.  Or, you can wear a diaper to sleep at night and call it an “undergarment,” so it sounds more like Mormon underwear. However I’ve come to the realization that everyone’s baggie seems equally big in their own eyes.  Different people with Bipolar Illness have different medication regiments.  It’s not as simple as just popping a Prozac.  And consequently, we all have our own set of annoying side-effects. Moreover, if they are your annoying side-effects, they are bigger than anyone else’s.  When I first started taking a once daily dose of the anti-depressant Elavil in the mid-1980’s to treat my Bipolar, I didn’t even need a baggie. Conversely,  I thought taking that single pill at night would be a massive intrusion on the rest of my life.  Now I carry a heavy duty Zip Lock Baggie, and yearn for the days of simplicity that came with only needing one pill bottle.  These were the days when my side-effects could be counted on one hand, not amplified to a roar and punctuated by constantly having to change my bed sheets.

THE CAT IS OUT OF THE BAGGIE

Now that the cat is out of the baggie, do I accept my predicament or search for a solution? If you suffer from Bipolar Disorder, you are forever trying to do one thing to compensate for another.   Am I willing to discontinue the Seroquel, become sleepless, depressed and dehydrated, so I can awaken dry just in time for another miserable day of suicidal ideations? Personally I am not ready to accept the Meaningless Managed Medical Memorandum on my nocturnal incontinence. So I will go forth seeking solutions that may or may not materialize.  Will I end up adding to my baggie or shrinking it?  I don’t know. But I do know I am not alone. Because Bipolar babies all have baggies.  No matter how big or small, they are enormous to the bearer.  And all of us in the Bipolar Community anticipate with bated breath a cure for their individual intolerable side-effects just around the corner.  Side-effects are the price we pay for being alive and sane.  However they can also drive you insane.

HALF IN THE BAGGIE

I thought the only way I could write about this was if I were “half in the baggie.”  It’s an embarrassing thing to do sober.  And nobody except the person “sleeping on my bottom bunk” really has to know.  But so rarely can you showcase a Bipolar medication related side-effect that makes the non-afflicted truly realize how gruesome this business can be.  There is no free ride.  Moreover, in most cases Bipolar medication only works to a point.  It does not completely wipe out deep depression, anxiety or mania.  Just enough to get by.  But the side-effects are full strength and show no mercy.

 

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What’s Your Bag?   Leave a comment

First I take the Baggie, the same one I’ve used for at least six years, out of its hiding place in my sock drawer, and put it on my dresser.  Filled to the brim with plastic prescription bottles, they’ve punched wholes through the material greatly limiting its days of functionality.

Like Pigpen’s blanket, the thought of getting rid of it upsets me. That Zip Lock and I have come such a long way together.  The end of a marriage.  A divorce.  A year being single.  An engagement.  Now a broken engagement and I’m alone again.  Maybe the Baggie is actually bad luck?  No.  It couldn’t be.  Not my Baggie.

Next I count out all the pills I need from the various bottles.  I used to use one of those daily dose containers like the elderly, but I was too lazy to keep refilling them at the end of the week.  Then I count the pills to make sure I have the right amount.  Nine in the morning, seven at night.  I also make sure they are in the right denominations.  Two 250mg Effexor, One 100mg Lamictal and so on.

Finally I put them in my cupped hand, go to the bathroom sink, get a mouth full of water and gulp them down.  Then I inspect my hand and the surrounding area to make sure none of them went astray, slipped from my fingers or shot out a nostril.  Now I’m finally free to spend the rest of the day or evening ruminating over whether I took my pills or not and if so were they in the right quantities?

This has been the ritual for the past twenty-four years of my life.  And if I miss a “feeding” I definitely feel it.  Light headedness, trouble focusing, nausea, anxiety…

If you’re Bipolar medication can be a touchy subject.  For me it’s the only thing that stands between a life of relative normalcy and being curled up in a ball on the floor begging to be put to sleep like an animal.  I just can’t stand the depression.   The fragility of my life at times can be very unnerving.  I can’t go anywhere or do anything without my beat up Baggie of psychotropic libations designed to manipulate my dopamine and norfenefrine for the best possible reception.

Some people with Bipolar Disorder have chosen not to go the medication route for a number of reasons.  People don’t want to give up the manic highs.  Others don’t want to gain ten or twenty pounds.  There are even some who feel taking medication is an official confirmation of mental illness and they’d prefer not to wear the blue ribbon.  And in this day and age of only eating raw foods and free range massaged jicama, others do not want to introduce anything man-made into their bodies.  This includes medication that may make them less annoying individuals around mealtime.

I think all reasons for or not taking medication for Bipolar Disorder are justified.  Even if someone is very unstable, as long as they are not hurting themselves or anyone else, they should decide what to put in their bodies.  Especially when it alters their moods.

What does bother me are those with Bipolar Disorder forever searching for their capsule in a pill bottle of bright and shining armor.  They want the ultimate drug that never lets them feel sad and always exist in a perpetual state of “I can’t wipe this grin off my face.”   Maybe they had taken a drug at some point in their lives that briefly made the feel that way.  Or, they once mistook a manic cycle for a drug’s efficacy.  Whatever they felt that one time, they want it back and believe the right drug or combination thereof is out there.  They refuse to stop experimenting until they reclaim the crown of perpetual happiness which is rightfully theirs and inexplicably escaped them.    And, they snuff-out psychiatrists like spent cigarette butts until they find one willing to indulge their personal quest to find the matzoh.

We all know you can never go back home.  And people still looking for the old hood are never going to find the same satisfaction.  But as a fellow Bipolar in complete disorder, I can definitely understand the chase and why some of us can’t stop.   It’s like settling for a Casio when you once wore a Rolex.  They both tell time, but the Rolex made you feel like you weren’t really a prep cook at McDonald’s.

One time a friend came to visit me in San Francisco.  She is Bipolar as well.  I was in her hotel room as she unpacked and pulled out a similar beat up Zip Lock Baggie as I had tucked away in my sock drawer, only filled with her pills.  It made me feel really good and warm inside.  Not because we were both stuck in the same Bipolar boat.  But, because I thought about how many of us must be out there with our beaten up Zip Lock Baggies taking our psychotropic medications day in and day out each with our own little rituals.

We all may not know each other.  If we did we would probably never think to talk about it.  However it’s like coming from the same ancestral heritage.  You know as individuals with Bipolar Disorder we have certain traditions.  Jews wear Yamakas.  Hindus wear Turbans.  And Bipolars have a special bag for their pills.

Anti-Depressants Get You Stoned? Tweet This   Leave a comment

Thanks to my medication, I am better able to control my hypomania.  I have been diagnosed Bipolar II with rapid cycling.  This means I can go from loving life to wanting to discontinue my membership all within a half hour.   My mental state can flip back and forth all day long like a freshly caught trout lying on the deck of a fishing boat struggling in vain to get back in the water.  Eventually the depression would always win out and I’d be back to planning my demise..

But thanks to the advances in psychiatric diagnosis and medications, my lifelong struggle with Bipolar II hypomania has been reduced to a level I can control and I have not recently been scraping the red hot floor of the pit of depression.  In fact, I have amazed myself on how stable I have become in the face of some very serious adversity.  I thank modern science for saving my life.  And I can tell you at least fifty stories similar to mine.

I was looking at Twitter yesterday to make sure my book Buzzkill was not tweeted about again (why break the silence), and I see there is a tweeter professing that anti-depressants and other psychiatric drugs in that genre actually make you high, as in inebriated.  He goes on to purport a person on psychotropics can not make decisions because of their altered mental state.  I am paraphrasing.

Natasha Tracy did a great job calling out this shlomo and addressing his comments in her blog yesterday.  However, this uneducated moronic rhetoric from a self-appointed protector of society makes me crazier than I already am. It’s my bipolar duty to fully skewer this “Mr. Twitter” as Tracy has dubbed him.  And, this is for anybody else who is on the “bipolar doesn’t exist and anti-depressants are evil train” which is now probably winding through birther country looking to blow the cover off something else they know nothing about.

First of all,  psychotropic drugs can not possibly be “fun drugs.”  They don’t contain any kind of narcotic or agents to alter your senses.   If they did people would be chopping up Effexor and snorting it like Oxycontin.   Furthermore, each person requires a specific dose of anti-depressant medication based on their body chemistry, and the same drugs do not work on everyone.  Ineffectiveness means not only don’t they work, but they probably make you feel more depressed.  Worst of all, if a drug or combination thereof does work, you will probably have delightful side effects which may include sexual dysfunction, weight gain, dry mouth, shaky hands and short term memory loss, to name a few.  This is why anti-depressants have no street value either.

So please Mr. Twitter, explain to me what is fun about anti-depressants and alike?  I don’t see kids at Rave’s dropping Lamictals.  I don’t see kids stealing their dad’s Cymbaltas to catch a buzz.  Have you ever heard of a doctor over-prescribing Risperdal at 200-300 a month like some doctors do with Soma, Valium and Oxycontin?  And who would take a drug that may make you feel worse or feel better but ruin your sex life?  Believe me, you have to be extremely depressed to go down the medication route and it’s anything but fun.

Secondly, these drugs are based in science.  They work to regulate the levels of dopamine and norepinephrine in your brain.  When not in balance they create depression and or mania.   Some guy running a garage meth lab in Newark New Jersey didn’t accidentally figure this out trying to make a pound of smack.  Nor did some brainiac at Harvard School of Medicine accidentally mix two chemicals together and have a hunch they may be good for depression.  And when they were formulating Geodon, a little cocaine didn’t fall off the shelf and accidentally get mixed in with it so now everyone is under the misconception it helps with depression.

Third, anti-depressants do work.  Personally, they enabled me to have a reasonably normal life.  I wrote about my experiences in Buzzkill, “My Disorderly Struggle with Bipolar Disorder.”  And there are at least a hundred other books out there with bipolar people telling their amazing stories.  Moreover, one in five people in the general population are dealing with some sort of mental illness.  This makes for an overwhelming cadre of individuals who have been helped by these drugs.  Since Mr. Twitter has never experienced Bipolar Disease, who is he to comment on how the medications make you feel and their efficacy?

If Mr. Twitt tries to hide behind “everybody has a right to an opinion,” I’ll be the first to say “no they don’t.”  Stupid people do not have a right to an opinion.  Only people who have real knowledge on a subject have a right to an opinion.  Otherwise they are just babbling fools.  And I’m pretty sure this guy is the latter.

Finally, how can this social moron possibly make a statement like “people on anti-depressants should not be able to make decisions?”  Is it better that we make them in the throes of suicide?  Do the pills make us so deliriously happy that we might start dry-humping our neighbors?  I’ve yet to see a bipolar person on medication so impaired they make the life-threatening decision of accidentally ordering a regular Coke when they meant to order a Diet Coke with their lunch.    These medications are designed to restore your mental state to one of normalcy.  Does this mean when a person takes an aspirin they should not be able to make decisions?  Because, an aspirin will make you about as loaded as an anti-depressant.  Nothing this person says makes any sense.

I ask you, why does Mr. Twitt, and others like him, have such a vendetta against people with Bipolar Disease?  Why is it an area of such major concern to him? Did a person with Bipolar Disease, wasted out of his mind on Elavil, rob their local Seven-Eleven armed with a pill cutter and steal all of the Gatorade because he had such intense dry mouth?  And now Mr. Twitt is out to keep the world safe by ridding society of these psychotropic drugs?  Is the suicide rate not high enough for him?  Have not enough people suffered from Bipolar Disease alone and depressed?  Am I missing some sort of satisfaction that comes from making people that already have severe depression feel worse?

The problem with social forums is that naysayers can jump on and make unsubstantiated comments remaining anonymous and unaccountable.   And although I understand the nature of the technology and should be well past letting things like this stick in my crawl,  every once in a while a dingleberry like Mr. Twitter breaks through and ignites me.

But please ignore me.  I’m stoned out of my mind on Effexor, Lamictal and Topamax.  What do I know?

Statistics: The Thing Standing Between Bipolar Treatment and The Truth   7 comments

People were so gullible back in the 1950’s and 1960’s.  “9 out of 10 doctors recommend Pall Mall Cigarettes because they are less harsh on your throat. ”  “In a side by side comparison, Lincoln is better than Cadillac.”  “More people trust Goodyear than any other tire.”  I’m paraphrasing, but you get the gist.  And people believed this stuff.  Nobody was calling out for Google Analytics, or even for Pall Mall to simply show how they conducted their survey.  All you had to do is make the claim and everyone assumed it was fact.

Before you start musing at people’s low level of bullshit detection back then, we are still eating up the same statistical nonsense in 2012.  It’s just packaged differently.  Take the Bipolar Disorder drug Lamictal.  According to Wikipedia, between 5% to 10% of patients taking Lamictal will develop a rash, but only 1 in 1,000 patients will develop a serious rash. Plus only 1 in 50,000 patients die from the rash.  This is an un-cited claim according to Wikipedia.  The information powerhouse aggregator went on to say that 9 out of 10 doctors smoke Marlboro Cigarettes because the brand gives them steadier hands in the operating room.  Personally, I’d like my doctor to smoke Marlboros while he’s actually operating on me to insure the very best outcome.

Most people reading this aren’t looking for citations.  Wikipedia has credibility because it says so.  And if 1 in 50,000 actually die from Stevens-Johnson Syndrome (the killer rash), those are pretty good odds.  They are willing to take the gamble if they are suffering from bipolar symptoms and Lamictal is their greatest hope.

Wikipedia downplays the killer-rash statistic, as does its manufacturer GlaxoSmithklein.  But just getting the rash must be scary.  The patient doesn’t know if it’s “the big one.”  And 5% to 10% of patients will get it.   That’s at best 1 in 20 people.  Maybe 1 in 10.  I see these very same statistics influencing people not to try Lamictal,  So you see, we really have not evolved from the 1950’s and 1960’s vulnerability to marketing mind melding.  Any statistics can be made to lean in any direction you favor.  It’s the interpretation you chose to believe that makes up your mind.  However,  I don’t think anyone can argue the Lincoln is a better car than the Cadillac.  Everyone says it has a better ride.  Everyone.

Personally, I chose to flirt with death and take Lamictal for my bipolar symptoms.  Fortunately, I did not get the rash.  I also didn’t know any of the rash statistics.  I just trusted my doctor when he said getting Stevens-Johnson Syndrome was very remote.  And the minute a rash developed he’d stop the medication.   Notice how I used the phrase “I trusted my doctor.”  I think when the drug manufacturers and web sites are whipping statistics at you for their own less than altruistic reasons, you need a doctor or knowledgable advisor you can trust.  Someone from the real world who can talk from experience, not an Excel Spreadsheet.

Years ago when I was just out of college and had started my first job, I had a crippling attack of depression hosted by my bipolar illness.  It was a Friday night and I was rolling around on the living room floor shaking, unable to keep still and telling my then girlfriend that I wanted to die.  I couldn’t get through to my usual psychiatrist and I needed something to help me sleep and keep me from killing myself over the weekend.  One of my Dad’s friends had a brother who was a psychiatrist who I called at home and he said he’d see me first thing Monday.  But to get through the weekend he wanted me to have a glass of wine and a couple of Benedryl whenever I needed it to calm down.  He hadn’t met me yet and did not want to start pumping drugs into me site unseen.  From 30 years of practicing, he knew this was unorthodox but safe and effective.

I didn’t do it.  I was so depressed I ended up overdosing on sleeping pills and was taken to the hospital.  But I admired the doctor’s practical grass roots approach to getting me through the weekend.   He had excellent credentials, 30 years experience and a solution, albiet a little off beat one.   I trusted him more than a statistic.  I’m sure there are many statistics telling you not to mix even Sweet Tarts with alcohol.  However, we all do it now and then usually to no ill effect.  The doctor knew this.  He was being practical and compassionate toward my deteriorating condition.  He also definitely agreed more people trust Goodyear than any other tire.

For these reasons, I am not a big fan of the statistic, especially when it is not cited or the fine print is a disclaimer for it probably being inaccurate.  I also detest when people just make a claim citing everyone as their source.  My grandfather, a Philadelphia native and its biggest cheerleader, used to tell me things like “Philadelphia has become the restaurant capital of the world.”  I’d say “Pop, where the hell did you hear that?”  And he’d say, “Hear it?  Everyone knows it!”  He also smoked Lucky Strikes because LSMFT.  (Lucky Strikes Means Fine Tobacco).   How could you argue with that kind of logic?

So when negotiating the bipolar landscape of doctors, medications and therapy, do your research.  But don’t believe everything you read, even the statistics.  Find people you trust and talk with them.  Statistics are not real.  They are man made.  Experience is real.  And someone you trust to help you evaluate it is invaluable.  Just please always remember, Michelob is the right beer when you’re having more than one.  At least that’s what they say.