But I digress.
So guess what happened in therapy a couple of weeks ago? Yep. ANOTHER RELEASE!
It was another completely unexpected, out-of-the-blue moment for me that Dr. Oz identified as ripe for releasin'.
Or so I assume.
Here's what happened: the day after I wrote my last post, in which I told you that I hadn't experienced any negative side effects from my drop from 50mg to 40mg of Effexor, I experienced some negative side effects. I had a day of extreme drowsiness and disconnectedness, which is disturbing and difficult to deal with for both me and my husband.
Ugh. So much for that theory.
After that day though, things seemed to improve pretty quickly. It just sucks because it's unexpected and difficult to predict and terribly hard to combat and all the things that I can't really afford to have happen when I'm trying to care for two small children.
This is not what I want. This is what a gradual ramp-down is supposed to help me avoid.
So... back to the drawing board. New plan. They're all just shots in the dark, really. Throw a dart at the wall, hope it lands somewhere cool, and go with it. I want to be as aggressive and as quick as possible about this without losing the smooth ride. That's what I want. How I get it is anybody's guess (and I do mean anybody's, and I do mean guess, because there is no such thing as a "known known" when it comes to how to do this properly, other than to listen to your body, trust your gut, and take your time. DO NOT LET ANYONE CONVINCE YOU OTHERWISE, NO MATTER HOW MANY DEGREES THEY HAVE), and since I'm the one who feels 100% of the impact and the effects, I'm declaring myself the sole authority on What To Try Next.
I decided to back off a little. I found myself feeling a bit more cautious, once again, about making a move. It's just too scary to mess with this stuff.
So instead of jumping right into a new dosage, I decided to wait. Let my body settle at 40mg. Take my time. As much as I am anxious to be done with this stuff, taking my time has never let me down as a tactic. It really is better to give myself time between steps down.
So I waited another week and a half. Then, two weeks ago, I sat down to make some new pills, and I was planning to shift down from 40mg to 35mg.
Just a shade over the recommended 10% reduction. I'm going to try reducing in increments of 5 instead of 10 for the next 3-4 times to see how that goes. It will become a larger percentage of the whole as I go, but my overall dose will be so much smaller that I'm hoping the impact will be less noticeable.
Anyway, I sat down, got out all my weighing and measuring and pill-packaging stuff, and got to work.
I dumped most of a capsule out into the little cup on my scale, removed tiny little packed-powder beads one at a time until I'd reached the desired weight for my dosage (0.115mg, according to my scale, which is not the easy-to-understand-and-verify 40mg that I'd expected, because why should any of this be easy or intuitive and make sense? I mean, COME ON! It is, however, the typical weight of 40 of the tiny little beads inside a capsule, so... I guess wishes do come true. Ha ha. :| ).
When I hit the magic number on the scale, I poured the beads into one of the 2000 large, clear empty capsules I bought (they only come in massive quantities like this. So. Um. Capsules. I have them), zeroed out my scale, and started over.
The next time around, something strange was going on.
I poured a bunch of beads on, and the pile seemed a bit bigger than usual to get up to my magic number, looking at my digital read-out, of 1.15.
And wait... I thought it was 0.115? Hmmm. Well, the decimal point is definitely where it belongs, because going from the amount in my weighing cup all the way down to 0.115 would be completely wrong. So I must have been mistaken.
So I got to 1.15, then poured the beads into a capsule.
Huh. That capsule seemed much more full than the previous one. That can't be true. They weighed the same!
I held the two (blessedly transparent) capsules side-by-side to compare them.
WHAT. THE. FUCK.
The second capsule was about TWICE as full as the first. I had just weighed them both, seen the same number on the read-out, but one was twice as full as the other.
This, my friends, made no sense.
I poured the first capsule back out into the cup, and the scale informed me that it weighed 0.60.
I lifted the cup up and down a few times, shook it around, put it back: 0.60.
I poured it back into the capsule and dumped out the second capsule: 1.15.
At this point, it would probably occur to you to go and get a pill from the batch I'd made the previous week and compare the two, to see what I was dealing with. Something was wrong, but one of these capsules had a good chance of being similar to the ones I'd been taking, right? So I could find my baseline and correct whatever wrong had been done from there.
Yes, good idea. This idea occurred to me too.
The problem, however, with this good idea, was that I had taken the last pill from that batch that morning, and thus had nothing to compare these pills to.
Oh. Oh no. Oh shit. What the fuck have I done?
I'm not gonna lie. I was panicking.
Because this was a huge mistake I was looking at. The first pill had looked correct. And I'd weighed it, and it had been correct. And now it was completely wrong.
I dumped each pill out again, in turn, and meticulously counted the contents. The first one had the right number (40), but the second one had the correct weight, and that was what I'd been going by for the last few weeks.
Had I been that egregiously wrong the first time, and been dosing myself much higher than I thought all this time?
So if I went with the 40-bead pill, would I be inviting withdrawal symptoms?
Should I still lower my dosage, now, then? And if so, from where? Drop to 35 beads, or drop to 1.10 mg? Which was correct?
Although the number of beads was what I wanted to go with, I knew the weight was what I should go with, since this was what I'd been using as my measurement for all my pills for the last several weeks. I only thought the two correlated, apparently.
Oh my god.
I sat there for 30 minutes or more, panicked, going back and forth and back and forth in my head. What do I do? What have I done? How did I make such a horrible miscalculation, and when?!
And then: inspiration!
I remembered that the week before, I'd taken a picture of my bead-counting setup, with the scale and the beads and a few capsules and stuff, for this very blog. I hadn't posted it yet, but I'd taken it, and it was on my phone.
Maybe... just maybe... there would be something in the picture I could reference.
So I looked it up. And found this:
|Salvation lies in this photograph. Tell me when you see it.|
I was relieved to note that it appeared that I had a complete pill in the measuring cup when I took the pic, as evidenced by the weight on the read-out. And the photo was clear enough that I could count every bead, which I did. There were 40.
So: what the fuck was going on?
OH. HOLD THE PHONE.
Is that a "0.115" I see? Why, yes! Yes it is! Not 1.15, as my scale is telling me now, but 0.115, like I thought in the first place.
So what gives?
Well, as you may have suspected, and as I, owner of this bloody scale, should have remembered but did not, it is possible, at the touch of a button, to switch between units of measurement on this device.
For example: if you accidentally touch the button between making pills, your units of measurement will switch from grams to carats, and what once read as 0.115mg will now read as 0.60c, but you won't notice the c because you will be too busy
HAVING A FUCKING HEART ATTACK.
Oh. My. God.
It was at this point that the real panic set in. My quads and arms started off-gassing like crazy, even though I don't get that feeling as strongly as I used to. It was as powerful as it gets these days, like being riddled with a low current of electricity, and it didn't stop for about two hours.
I kept realizing that I'd been about to dose myself with 100 carat pills-- or something close to twice what I'd been taking, maybe more-- and I probably wouldn't have noticed it on the way up, but I definitely would have noticed it if I corrected my mistake at the next step-down and had major withdrawal symptoms all over again.
Although I wouldn't have understood why.
I could not stop freaking out.
At the same time, I felt SUCH! UTTER! RELIEF! that I hadn't been so completely reckless and oblivious to such a major error. Hoooooly crap, I'd really been doubting my judgment for a while, there.
When in fact, what I should have been doubting was my ability to read a scale monitor. O_o
In my defense: I'd forgotten that was an option. And making those pills is close, intense work.
So anyway. That happened. And the next night, I was in Dr. Oz's* office, telling her about it.
What struck me most profoundly about the whole affair was the powerful, visceral reaction I had to it, especially after the crisis was over. I mean, I well and truly panicked, and my body was surging with adrenaline. It seemed... surprisingly strong.
"Well," said Dr. Oz, "you've been pretty traumatized by this medication. You've really been knocked around by this ramp-down. So it's not surprising that your body is responding to it like a threat."
Well, yes. In case I haven't made it clear in this blog, I really have been knocked around by this ramp-down. I don't always tell you all the details, especially when they sound like, "Felt like shit today. Yesterday too. Tomorrow will probably suck." But there's been some of that, except worse, because those days have come when I was expecting to feel better.
Oh, Big Pharma. You are a cruel, cruel master.
Anyway. I told Dr. Oz about the last vestiges of my cold fire, and how relatively powerfully I had felt it the night before.
"Do you want to do another grounding exercise, and see if we can release what's left?" she asked.
OH GOD NO UGH PLEASE NO NO NO- "Sure."
We did it just like last time: Start at the toes, connect with the tension, don't try to act on it, just notice it, observe it, report it.
I was able to relax much more quickly this time, almost like dropping into a hypnotic state (I noted at the time, then noted that I was noting, noting as well that this likely meant I was not in a hypnotic state, then noting additionally that all the noting I was doing was not what I was supposed to be doing and FOCUS PLEASE.)
Yeah, this is why I hate this stuff.
But I did it, I relaxed, I listened, I observed, I reported. My heels had risen off the floor again, body tensing, but my arms felt no urge to rise up in front of me. Instead, I had my palms on the couch beside my thighs, and they rose off the surface while my fingertips stayed in contact, making little stiff tarantulas with my hands.
Not sure what that was about, but I wasn't questioning just then, I was observing.
"Is there a movement that goes with this?" Dr. Oz asked. "Does your body want to move at all?"
"No." It didn't. I was disappointed, thinking it just wasn't going to happen like last time, but I kept talking.
"My abdomen is tense across, like there's a band going from one side to the other. My forearms feel really tight. I-- wait..."
As I spoke, my head had begun to tip forward, and there was something different about this motion. I don't know how to describe it... it just... it wasn't me doing it.
"My coming forward," I said, and for a moment I tried to help it, move it consciously, and I had the strangest sense of having jumped the track; as if my head had been being led by a string and had been pulling slightly against it to feel the tension, and by moving it myself, I'd just created some slack in the line and lost the direction.
So I relaxed back into it again, not trying to consciously move, and whoa, there it was, that line-tension again, and my head continued to move of its own volition.
It knew where it was going, and it didn't need my conscious brain to get it there.
"Okay, now my body is curling forward too..." I felt myself leaning forward in my seat, slowly, slowly, following an invisible trajectory, head forward, chin to chest, shoulders and upper body curling toward my knees.
And then... forward motion was over, and my body began to move backwards from the waist, spine uncurling upwards and backwards until I was back against the couch again, releasing tension as it went from my toes up through my legs and beyond, and my head tipped backward and came to rest on the backrest.
I opened my eyes and looked at the ceiling. The sense of contrast between before and after wasn't nearly as profound as it had been the first time around, because the tension itself hadn't been nearly as high, but it had been just as surreal. It really felt as though my lizard brain had just taken over and gotten some long-overdue work done.
And what's more, if you put the two release episodes together, you'd have seen, in slow motion, my body flinch backwards, try to pull up my legs and hold up my hands to protect myself, and then get thrown forward and back in a classic whiplash movement.
Like you might see if you observed, in slow motion, a person involved in a car accident.
There is more to talk about. These episodes have changed the landscape quite a bit, but there's still plenty more to be done and to report to you as it happens. But the sense of having accomplished something enormous sits with me.
It seems like it had to have been the hardest part of all of this, and at times I've thought it would be, but it wasn't: it was the surgery. The surgery is difficult and risky and beyond your immediate control, ultimately, but it's only one aspect of the recovery.
The rest-- the greater portion-- is the work: the therapy, the preparation, the rehabilitation, the prevention, the maintenance.
I've done that. I'm doing that. I will continue to do it for as long as-- and in whatever form-- it takes.