Saturday, September 7, 2013


Well, THAT was a bit of a fiasco.

I went to the Northern California Headache Clinic last week and met with Dr. Kenneth Peters, who, I learned, was on the team that developed the first triptan medication, Imitrex, back in the '80s. 

This is significant because Imitrex was the first game-changer in the treatment of migraines and triptans remain the most effective migraine medications to this day, so that is no small thing.

Anyway, we crammed a lot of information into a single conversation, so it's always hard to know exactly how much is landing on both sides. But he did hear that I was uncertain about my current course of antidepressants and that my migraine meds were unreliable and that I'd never tried a preventative med before.

"Really?" he said to me, looking down at the file in front of him. "Sixteen years of chronic migraines, you're up to 20 or 25 days a month now, and no one has given you a preventative?" He leaned forward. coming up on the desk on his elbows. "REALLY?!"

I gave him a grim smile. "Nope," I said. "And that is why I'm here."

He offered to take over both my migraine and antidepressant prescriptions, and I let him. He agreed to bump up my Wellbutrin to 450mg, but warned me that Wellbutrin can cause anxiety and if I was already concerned about anxiety, I should watch out for it. He wanted to give that a try, and if it wasn't right, try another type before looking at "the addictive drugs." 

Meaning: the benzos. The anti-anxiety meds. Xanax, Ativan, Klonopin, etc.

Which is fine. I have no desire to form any sort of habit. Lord knows I've got enough to do.

So I took the prescription for the increased Wellbutrin. Check.

Next, he prescribed me a preventative med called Topiramate, a form of Topomax, which I'd heard called "Dope-o-max" on the migraine forums because it supposedly makes you slow and stupid and fuzzy.

Which, hello, is JUST WHAT I NEED RIGHT NOW. :/

When he saw my eyebrows shoot to my hairline, Dr. Peters said, "You've probably heard this drug referred to as "Dope-o-max. Let me tell you about that. We'll spend the next several weeks ramping you up slowly to a full therapeutic dose. During that ramp-up time you may find yourself feeling a bit cognitively impaired. I call them 'senior moments.' You might find yourself having a few more "senior moments' than you're used to having."

Being used to having quite a lot of "senior moments," especially when my depression and anxiety are on the rise and my medication is inadequate for the task, this caused me a bit of concern. How many more senior moments can I take before I become a danger to myself and others?

I told him that. He said, "Really, it shouldn't be that bad. And it should only be for the next month or so. After that, things should even out and go back to normal. For most people, it does. And if it doesn't, we'll try something else."

I figured it was worth a few weeks of discomfort if the end result was fewer migraines. And the real end goal of this clinic's work is to have me off drugs all together, or at least as much as possible, and as soon as possible, once I learn the bio-feedback techniques and identify triggers and make the lifestyle changes that will prevent migraines even better than medications can.

Worth it, in the long run. At this point, I'll try anything.

At least, that was my thinking last Monday.

So I started off with my increased dosage of Wellbutrin and my Topiramate. I take the Topiramate at bedtime, which is good, because even the tiny, 1/4 dose I'm taking now makes me markedly sleepy. It might help me to sleep better, which might ease up one of the triggers for migraines, depression, and PTSD all at once, so that seems like a win, right?

The Wellbutrin was a harder thing to gauge, anti-depressants having a cumulative rather than an immediate effect, but I did notice, that first morning, a bit of a zip in my step when it hit my system, mid-morning. As I can always use a zip in my step, I counted that as a win, too.

Skip ahead to Saturday.

I flew down to LA Saturday morning to attend two major events over the weekend: my youngest sister's bridal shower and my dear cousin's wedding. I was feeling a little antsy and exhausted, but as this is not too far from my normal state, I wasn't alarmed.

I went straight from the airport to the shower, already in progress, and walked into a room full of people. Not my favorite thing, but as the people in the room were most of my favorite people, it was best-case scenario in that regard. I was feeling a bit shaky and off, but chalked it up to my usual self-consciousness and to the New Orleans-like LA weather (90+ degrees, 90%+ humidity?! WTF, global warming?! DO YOU NOT REALIZE THIS IS A DESERT?!).

And then, right in the middle of the shower, a strange feeling descended over me. I can't describe it. A sort of raw-skinned, fogged-out, paranoid ickiness. I was freaking out. I couldn't wait for the room to clear. I don't remember being that uncomfortable before. I didn't know what to call it, what I was feeling, but I felt incapable of tracking conversations and didn't trust myself to communicate clearly. I attached myself to my best friend of 33 years, who was there (thank god), and who kept me entertained the whole time, and I think I managed to get through the event without anyone noticing much was off about me.

After everyone was gone, I was able to tell my sisters about the new meds and that something had kicked in and was making me uncomfortable, but at that point I didn't know what to call it and didn't know what to do. Over the course of the day, it slowly wore off, and by evening I was feeling exhausted but a lot better.

The next day, the same thing happened, but with fewer people around to exacerbate the weird part. We drove up to Hollywood to check into a hotel near my cousin's house to get ready for the wedding, and it became clear then that the uncomfortable part seemed to happen when the Wellbutrin hit my system. That was when it struck me that what I was feeling was anxiety.

It's funny to me to think that it was so hard to figure out what it was that I was feeling. And even funnier (ha ha. Ha. No really. Ha. :/) when I realized I'd been feeling a very low form of that feeling for a very, very, verrrry long time. But anyway, it struck me like a lightning bolt that what was happening to me was just what the doctor said might happen: the Wellbutrin was triggering a high state of anxiety.

What happened next was one of the few truly awesome moments of kismet that has happened to me throughout this whole sordid drug mishap. I said, out loud, "I don't think I'm going to be very much fun at this wedding. I am freaking out. I think my medication is causing me major anxiety and I don't know if I'm going to be able to handle this."

And the two people I said this to turned to me and said, in perfect unison, "Do you want a Lorazepam?"

And that, ladies and gentlemen, is Hollywood.

At first, I declined. I had so much on board at the moment that was messing with me that I didn't want to add anything new and unknown to the mix, especially since I was about to be in a crowd of people I didn't know at an event that I desperately wanted to be present for.

Then I realized that Lorazepam was Ativan, which I had once in the hospital after I had my babies, to fantastic effect, and that the doctor had already said that class of drugs was on the table to add to my current load if necessary, and that I was already in about as bad a shape as I could be in, so I said, what the hell.

And I took half a pill. Half a miligram. A teeeeeeny dose.

A while later, I felt quite a bit better, and it was clear that no ugly side effects were forthcoming, so I took the other half.

And friends, I felt FANTASTIC. Not high, not altered, not floaty or mellow or even relaxed. I felt like myself. My REAL self. More like myself, in fact, than I have in years.

That pill took the edge right off. ALL OF IT.

And that gives me some information to discuss with my doctor. For starters: my anxiety is fucking REAL and it's been dismissed for YEARS and I've even dismissed it myself and have thought that wanting to jump out of my skin for the past year and a half has just been the result of the intense therapy I've been doing and not the result of a medication that's been driving me even crazier.

I didn't know that's what anxiety felt like. I didn't know what to look for. 

I do now.

So when I came back from LA, I called the doc and told him what had happened. He told me to drop back to 300mg of Wellbutrin and we'd get me off of it right away.

I'll be switching to Cymbalta on Monday, which targets anxiety, depression, and also body pain, all of which are major factors for me, and I'll see if this is a better fit. I'm going to talk to him extensively about my PTSD and make sure he's including that in his decision about what drugs to prescribe. But I need to get all of this back under control so I can move forward, and I can see now that the last year and a half has been something other than what I thought. I've been in the grips of anxiety, not being pushed out of my comfort zone by therapy. 

I'm sure that's happened too, but I don't know who much the second was clouded by the first.

After a couple of days back on the old dosage, I was still freaking out and the anxiety was running rampant, so I called back and asked him to prescribe me something to help me get it under control until I can get this stuff out of my system. He gave me some Klonopin. It has been nothing like the 100% normal feeling of Ativan, alas, but it's been slightly better than nothing. I feel a bit sedated, which I guess is the goal for this med. It's just not my goal

Despite all the medications I've taken over the years for migraines and depression  and stuff, I have never had an adverse reaction like this, and never felt "heavily medicated" like this before. Right now, with all of this going on, I feel more anxious about all the meds I'm taking than anything else. I'd just like to feel calm and peaceful.

I would totally take a pill for that, right now. I am not averse to that. Not now, I'm not. I mean, I'm doing the goddamn work to learn how to get myself there drug-free, and I haven't forgotten that this is the goal, but man, it sure would be nice to take the easy way for once and find the pill-pushing doctor and seek the short cut.

Why do I always have to be the responsible one? Why do I always have to choose the long-term solution over the short-term relief?

I mean, I totally get the value of the permanent fix, the safe choice, the holistic method. For god's sake, I think I've more than proven that.

But man, that Ativan allowed me to experience one of the most glorious weddings I've ever been to-- my cousin marrying his long-time partner in a newly-legalized ceremony that they-- and we-- fought long and hard to win the right to have-- and it was truly one of the great pleasures of my life to have been there to share the night with them and see how much it meant to them to take part in this thing they never dared to dream they'd be able to have...

And if a little shortcut now and then to get to have a memory like THAT is wrong, then god damn it, I don't want to be right.

I don't want to toy with dangerous, habit-forming drugs. I just want to feel like myself again. Not my new self. My old self. My pre-all-this-bullshit-self. My enjoyed-her-fucking-life-self. My didn't-walk-the-medication-tightrope-self. 

Realizing that something I thought was helping, wasn't, was a real blow to my confidence. And it just feels like more time, wasted. I am tired of wasting time.


I am tired of being at the mercy of chemistry, within my body and without. I am tired of forces beyond my control having WAY TOO MUCH OF A SAY over how I feel and how I act and what I am able to accomplish in a day.

I want my life back. I want it back. I thought I was getting closer to getting it back, and now I really don't think I am. I feel back to square one. My system has been poisoned. I now have yet another thing to recover from before I can back to the business of recovery. This is not acceptable to me.

Project Monkey Off My Back 2.0: Remove the extra fucking monkey that jumped on when I wasn't looking. WHAT THE FUCK, MONKEYS?!

Hey, that could be the title of my book, when it comes out. Or the subtitle: 

"The Girl Who Lived, or What the Fuck, Monkeys?!"

Or maybe a band name: Kate and the Fucking Monkeys.

Okay, maybe I should stop now. Did I mention the Klonopin?

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