Happily Ever After

So...  what did YOU do last weekend? :)

Here's what we did:

Here comes the bride! Seriously, does she not stun? And Dad looks great, too!

That's me on the mic, with the permanent head-tilt. Preternaturally calm. Got some laughs, brought some tears, even got a "YEAH!" at one point and  enthusiastic applause at the end. I am pleased to say I rocked it, people! I did my sister proud!

And away they go! Look at those smiles! Those are two happy newly-weds. It was a perfect, perfect day, and they were surrounded by wonderful friends and family and infused with the love and hope of everyone present.

Yep, I can safely say that officiating my sister's wedding was one of the all-time most amazing things I have ever done. Maybe THE most amazing, as far as personal achievements go. Writing that article that went viral never came close to this, because so much of that was accidental. This was very much a deliberate thing; something I made with a purpose and for a specific desired effect, and it accomplished exactly what I hoped it would.

It was just straight-up amazing.

It definitely ranks on the list along with marrying my husband, having my children, and graduating from college (all three times). 

Those are the top awesome things. The I'd-never-do-differently things. The Highlight Reel. Those are the ones. 

Maybe seeing the Eiffel Tower for the first time, from a hillside in the distance, would be on there, too. Although not an accomplishment, that sure was cool. 

The week was fantastic; spent, as expected, with the family in an enormous house in Lake Tahoe. They found a house big enough to hold us all for the week and to host the wedding in the back yard-- a trick cribbed from my own wedding up at the Russian River several years ago.

Such a great idea, if I do say so myself!

The kids ran around with their cousins, the guys cooked like mad geniuses for the Friday night bash, the women made centerpieces and hung Christmas lights in the yard for the big event (that's the way we do it in our family), and I helped everyone with their written pieces because, miracle of miracles, I was the only one finished.

Oh, and my sister Miranda baked the most outrageously delicious cupcakes and cake pops ever to grace the Earth. She should be illegal. 

Or she should live in my kitchen. One or the other.

_____

The crazy thing that happened, after it was all over, is that I felt... good.  

I felt... great. 

All the way home, late the next afternoon, I kept catching my brain searching, searching, searching for the thing that went wrong. Surely there had to be something to be embarrassed about. I hadn't said the right things, or I'd said too much, or I'd done something embarrassing or revealed something I hadn't meant to show.

Nope.

I had said exactly what I'd wanted to say, and just how I'd wanted to say it, and I'd elicited the response I'd hoped to elicit, and I saw the joy on my sister's face that I'd hoped to see, and I heard her friends talking about her wedding as if it would be memorable in exactly the way I'd hoped they would. 

I had wanted to make the day special not only for her and her husband, but for everyone who came to share it with them, and I felt like what I'd tried to do to engage them all and bring them into the moment with us had worked very well.

I couldn't find anything to feel bad about. I felt like an unqualified success.

More than that, my shame centers were blessedly clear. It was... weird. Disconcerting. 

Exhilarating.

You guys, I don't remember the last time that happened. And when I say that, I mean this:

I don't know if that has ever happened before.

Like, ever.

I don't know if there has ever not been a voice that has snuck in, after the fact, and whispered, "You didn't really do that, not really, you cheated, you skated by, it was too easy for you, you didn't really work for it, you didn't do enough, you didn't do your best, you didn't do it right, it wasn't perfect, it wasn't enough, it was too much, you were showing off, you were being selfish, you were being lazy, you're a fraud, they'll all find out...."

This time, not only did that voice not come, but it took me three days to notice that this  was what was really missing. It wasn't just that I couldn't find the thing that had gone wrong. 

It was that I didn't feel any shame, either.

For three whole days, I felt nothing but a quiet, golden, contented hum. Powerful. Accomplished. Capable. Free.

My regular readers will know what a big deal this is. It is a Very Big Deal. In fact-- and I am not saying this lightly, my friends- it might be The Biggest Deal Since I Began This Therapy.

As you may recall, there is evidence to suggest that PTSR is, in essence, a shame disorder. I have written about that in this blog, and I agree with this theory (although not to the exclusion of others). Shame has certainly been my own constant companion, not just throughout these past 22 years, but even before the accident. It's what made me prone to such a powerful PTSR response in the first place.

So in light of my shame-free response to this extremely shame-prone, emotionally-heavy situation last weekend, I am thinking something pretty damn incredible has happened. Something so incredible that now that it has occurred to me, I don't even know what to do about it. But I'm going to tell you about it, and I'm going to think about it, and I'm going to do my best to make it happen again.

Here's what I'm thinking:

During and after that wedding, when I was doing what I meant to do (and what I was meant to do) and then trying and failing to feel any shame about it, I was NOT having an I WANT TO LIVE moment.

I WAS LIVING.

I. WAS. LIVING!

And if THAT'S what it feels like, then hot damn! I'm going to try to do as much of that as possible. 

A girl could get used to THAT.

_____

Me & the Mrs.

Time For An I Want To Live Moment!

But first, a quick update: Cymbalta and I may be friends after all. It appears that I was premature in my accusation of menstrual hijinks. All systems are still go. I'm still not on the med combo I should be on, but I haven't taken the step backward I thought I'd taken. So that's good.

I told you last week that a friend has recommended a psychopharmacologist, and that sounds like the best way to get the best information about the right drugs to be taking, given my particular combination of monkeys and monsters.

Also, in biofeedback this week, I dropped into deep relaxation for about 10 minutes and slowed my breathing to 6 breaths per minute, and raised the temperature of my fingers from 78 degrees to 89 degrees! Holy moly! Just like that! No conscious direction required, just relax, focus on the breath, and boom, open your eyes, look at the monitor, and you're 11 degrees warmer!

If I'd had a migraine at the time, that baby would have been TOAST!

_____

So. I Want To Live. 

It's been a while since I've talked about much besides migraines and medication, so I thought I'd take a moment to talk about something else that's been going on in my life lately, and a pretty big thing I've learned from it. 

You've had something to do with this learning, after all, so I should let you in on it.

A week from today, I will be officiating at my youngest sister's wedding. I'm the oldest of four sisters. We share a pretty special relationship, the four of us. We are very close. They are all fantastic, smart, funny, kind, wonderful women, and I love them dearly.

Here, this is us at our cousin's wedding that I told you about recently:

That's Liz, the bride-to-be, on the left, then Miranda, Karin, and me. In birth order, 4, 2, 3 and 1, respectively.  Karin is actually the tallest of us all but she's crouching down because she was wearing magnificent heels and didn't want to dwarf me  (the shortest). Extroverts on the left, introverts on the right. Ha ha.

And here's another one of us from a few years ago, at my daughters' first Christmas, because then I get to show off my sisters and my daughters in one amazing photo:

I love this one of all of us. It's also one of the few pictures that makes me go, "Oh. Right. My daughters really ARE identical!"

Anyway, next week. Officiating the wedding. I get to spend the next week with these wonderful people and their wonderful families and my sister's wonderful friends, putting together this amazing event. It's going to be so much fun, and such a special time for all of us.

My sister and her fiance asked me to officiate last Christmas, and after thinking about what I'd say in my speech for a long time, and then having sort of a busy and then sort of a rough several months, I finally got started on it in August and really got focused on it in September after my cousin's gorgeous wedding, and I finished it up this week and really feel like I said what I wanted to say.

I went ahead and wrote the rest of the ceremony as well, so the whole thing, except for three or four borrowed-and-doctored sentences, will be my original work, and I'm very proud of it. I feel like I'm offering my sister and brother-in-law something from my heart for their big day, and that's such a lovely thing to be able to give them.

And here's my I Want To Live moment: I've realized, through the process of writing this wedding ceremony and finding myself not only comfortable with writing it, but surprisingly comfortable with the idea of delivering it in front of a crowd (not, in the past, my forte), that these past couple of years of writing and working through my PTSR have given me a level of confidence that I didn't know I'd gained.

I feel... like I know what I'm doing. 

I feel... like I have something to say, and like I know I can say it in a compelling way.

I feel... like an authority on my own perspective, and like my perspective is valid enough to present without disclaimer.

I feel... sort of like a boss.

In the past, before I started all of this work and before I started the blog, I knew, sort of, that I could write, but I didn't really feel like I had the right to it. I didn't feel like I could presume to speak for anything or anyone. 

Even myself. 

I thought that in order to claim any ground to stand on, you had to have credentials. You couldn't just call yourself an expert in something without the PhD to prove it! You had to have the research publications and documented evidence and vetted references and all the rest.

After writing this wedding ceremony and realizing that my lack of dread and  terror over performing it comes from the fact that I believe in it, and I am proud of it, therefore, I feel confident in claiming the authority to present it as my point of view, I understand that somehow, somewhere along the way, I've discovered something I remember thinking I'd never find. In fact, I wrote about it extensively last year, in this post, when I realized what I'd really lost in the accident: a sense of personal boundary and identity; the Fortress of the Self.

I understand now, with startling ease, that any ground I choose to stand on is mine. That I am an authority on my own thoughts and beliefs, and that I am able to present them in a compelling enough way that others want to listen.

I find myself standing here, suddenly, with the knowledge that I do, indeed, have something to say, and that you are out there, interested in hearing it. 

And here's the kicker: that doesn't scare me anymore!

It crept up on me without my notice, and now it feels as natural as breathing. That's part of the trick of it, I think, and also part of the power. It's instinctive now, not artifice, and finally, finally, occupying the place it should always have been in my mind and body. 

I've got a lot of work to do to make it real outside of myself, but inside of myself, maybe for the first time in my life, I think something that should always have been true is finally, actually, really-for-reals true.

I am a writer.

Me. A writer. On the inside. It's not what I do. It's who I am.

For the first time ever, I can say that out loud without feeling like a fraud. 

I've chosen my ground, and I'm standing on it, and by god, this here ground is MINE!


Ladies and gentlemen of the jury, behold: I WANT TO LIVE! 

Biofeedback

This week, I started the psychological portion of my migraine therapy at the Northern California Headache Clinic.

I am learning biofeedback.

I'm pretty excited about this. Biofeedback is something I've been interested in learning since I was a kid. My mother always wanted me to learn it, in part because she thought I was a hypochondriac and thought it would give me a way to work through my anxiety or whatever was causing my symptoms.

Turns out, she may have been partly right-- biofeedback has been shown to be particularly effective in treating migraines. As it happens, it's also effective in treating anxiety, depression, and PTSD, so I'm thinking this will be a really great skill for me.

So far, all I've done is get three fingers hooked up to a computer, and slow my breaths to match a chart of my breathing to a metered chart on the screen.

I will go back for 6-8 sessions to learn the whole technique, and then I should be able to use it at home to do things like raise the internal temperature of my fingers (which, if I raise it by 3 degrees, has been proven to ward off migraines-- for realz! One of the symptoms of migraine is that your fingers get cold because the blood rushes to your head, so if you can force the blood back to your fingers, you can stop the migraine before it starts. Who knew?!).

Dr. Oz has also recommended Neurofeedback, which is biofeedback for the brain, as a particularly effective tool for anxiety. I plan to begin a course for that as soon as I finish regular biofeedback. I'm going to learn both techniques-- I figure I'll arm myself with the most effective non-medicinal tools while I'm doing all these medical tweaks. The sooner I can become independent of these meds, the happier I'll be.

_____

Speaking of the meds, Cymbalta and I are not friends.

It's messing with my period. That seems unbelievably inappropriate to me, and has me completely freaked out. I would like to maintain the illusion that I am not poisoning my entire system with this shit, thank you. So when unrelated functions start freaking out, so do I. Not cool, Cymbalta. Not cool.

However, it sure is making my back feel better.

Then again, I just feel... sick. All the time. This stuff makes me feel sick. It sucks. Except for the part where it makes my back feel batter than it has in years-- if not decades-- it sucks. 

So it's back to the drawing board, to tweak and sample and keep on trying to find the right fit. Ugh.

I HATE THIS WHOLE PROCESS SO MUCH I CAN'T STAND IT!

I need to find a new cocktail. Don't know what or how, but I need to. A friend of mine has recommended a psychopharmacologist, which seems like a really great idea, so I may try that instead of an MD or psychiatrist for my meds going forward.

I just want to get back to normal and be off meds for good.

Anyway, that's what's going on. Good implications for migraines, depression, anxiety, and PTSD with the bio- and neuro-feedback. I'll keep you posted. These two things together may spell the real end of the medical drama for me, eventually. 

In the meantime, I'm still med-shopping and suffering the consequences of an incorrect combo.

Working on it. Always working on it.

Wish me luck. I'll let you know how it goes.

Frailty, Anxiety... Clarity

I think I've figured something out, and I think it's important. And I think it bodes well for me.

Very well. Perhaps immeasurably so, if I'm right.

But yes, I'm going to make you wait a minute for it. Because that's how I roll: MEAN!

_____

First, a bit of an update.

Did I tell you I had an MRI a few weeks ago? I don't think I did. Well, I did. I've had a few over the years-- pretty standard procedure for we of the history-of-massive-head-injury-and-chronic-migraine set, as one might presume.

They always tell me that there is no significant increase in risk of stroke or cancer or tumors or anything like that with a massive head injury (although they know now that there is an increased risk of stroke in the months after a TBI, which I almost certainly had back then, before such things were diagnosed that way. Glad to have dodged that bullet.). Same with migraines. They give us these tests to rule out other causes for the symptoms that we are experiencing, not to find complications of the conditions we know we have. 

But it's always a little weird and scary anyway. One's inner hypochondriac tends to speak up rather forcefully when one's head is locked in a cage inside a giant, rattling, clacking, clanging, beeping, screeching tube. 

(And seriously: what's with those MRIs, anyway?! Have any of you had one recently? The noises! What purpose could they possibly serve? It's like a sound check for every single weapon and/or emergency alarm effect ever used in any sci-fi movie or TV show ever made. Over and over. Paired with rumbling and shaking and clicking and clacking and banging and clanging and dancing and prancing and all the other reindeer.)

Way primitive for such a high-tech procedure.

Crazy.

Also, did I mention: FACE LOCKED IN A CAGE AND THEN STUFFED INTO A TUBE?

I did okay, though. It was funny, they kept asking me if I was claustrophobic-- my doctor, when he told me I needed to get the test; the nurse who called me to schedule it; the receptionist who checked me in. Everyone. And every time, I answered, "Yes, I am extremely claustrophobic."

Was I willing to do this test?

"Yes."

And that was it. End of subject. I kept hoping they'd offer me something soothing to ease my way-- they usually give you a valium or something, sheesh-- but nope, nothing, nada. Pssh.

Which was fine, as I couldn't have taken it anyway. I had to drive myself there and then home again immediately afterward to pick up my kids at a friend's house. But it's the principle of the thing.

So there was little claustrophobic ol' me, head locked up like Hannibal Lecter, rolled into the tube about as far as my waist. My hands were folded over my abdomen, and if I steepled my fingers, they touched the ceiling, so it was about 4" above my nose. 

Close quarters.

I was in there for about 20 minutes. Loud noises, as I said. And I did fine. No big deal. They check in with you frequently, in between 2-3 minute bursts of noise, and they keep lots of cool, fresh, moving air in the room so you don't feel stifled.

So anyway, I did the test, and had a couple of weeks before my next appointment with the doc, during which I might have let myself get a little nervous about the findings if it weren't for my finely-honed dissociative abilities, so instead I immediately forgot all about it.

PTSR, you are so good to me sometimes. ;>

I went and saw the doc on Tuesday, and he told me that he'd gotten the results (it took me a minute to remember what the hell he was talking about, so thoroughly had I deleted the information), and that there was nothing of concern in the findings: no tumors, nothing that needed another look. There was, however, a good deal of scarring on the brain and evidence of the injury. He could see where all of that had taken place.

I wonder what, if any, implications scarring on the brain will or could have. I'm going to ask him next time. I never think of good questions in the moment-- I need to process things for a while first. This is a really irritating quality in a person. When that person is me. 

I also wonder if I can get copies of those brain scans. I want to see them. I see the doc again in November, and I'll ask. If I can, I'll post them here. Cool, right? 

You can see my braaaaaaaains!

_____

Another week on Cymbalta and Topomax, and I'm feeling a bit less muddled, but I suspect I haven't found the right med balance yet. I'm still out of sorts and not quite right. Since I haven't been on the full dosage for a month yet, the doctor and I agreed to wait until my next appointment before we change the levels, but I have a feeling I'll be increasing my dose.

I am experiencing two contradictory things: I think I'm sleeping better at night (I haven't been wearing my Fitbit lately to measure my sleep effectiveness. Gotta get that thing back on so I can see!), and I have still been ridiculously, overwhelmingly tired during the day.

I told the doctor this the other day, and he thought it was odd-- that neither drug should make me sleep better, and neither should make me tired, beyond the initial ramp-up-period sluggishness. 

I didn't really have a response to that. I know how I feel, and that's how I feel.

But then, yesterday, I thought of something that makes a lot of sense.

This is the thing I figured out:

We now know that the Wellbutrin was causing me constant, low- to mid-grade anxiety for about a year and a half, and that element has now been removed. 

What if it was that constant agitation that was keeping me from getting better sleep? What if it was the Wellbutrin that was causing my poor sleep, and also my agitation during the day that kept me from feeling the overwhelming exhaustion that I'm feeling now?

So now that it's gone, my body is really feeling that vast sleep deficit?

AND, my body is actually finally able to start making up for it?

I have taken NAPS lately, people! NAPS! ME! Like, THREE OF THEM!

I am not a napper. But lately, I just can't help myself, I can't keep my eyes open, and it has been helping. I've been going to bed a little bit earlier and actually falling asleep, and I've been staying asleep, and the Cymbalta has been helping my back pain which has made sleeping more comfortable, and I've been a teeny bit more refreshed in the morning.

What if removing the Wellbutrin solves the sleep problem?

And if it does, here's a better question, and one I can't wait to experience the answers to:

What problems will solving the sleep problem solve???

Imbalance

Well, the last time we spoke, I'd just made a big med switch and wasn't feeling well.

That was due to a few things, not least of which was that I was in the beginning stages of a pretty epic case of the flu.

Ugh!

Or whatever the hell that was. I wasn't very congested, actually. Extremely light, which is weird for me, but super, super achy and exhausted for days, and the worst migraine I've had in a while that just wouldn't let up. So that sucked.

That, paired with all the new meds, made for a pretty awful week.

But then I rallied as much as I could and went to Park City, Utah for the weekend to celebrate with my sisters and a few friends in honor of my youngest sister's upcoming wedding, and that was wonderful.

Everyone was really mellow and lovely and well-matched-- there were eight of us, and we basically spent the entire weekend in one giant conversation, all together. We were all on the same wavelength. What a fantastic group of people. I love every one of them!

So now I'm back, and I'm continuing with these meds, and they continue to make me tired and slow, but at the same time, I notice little bursts of... something different.

It's hard to explain. I still feel a bit lighter than I did on the Wellbutrin, and I think it was the right choice to move away from that. But I do think I still have a lot of anxiety, and I am aware of it now-- I think it's of the free-form variety, not the drug-induced variety at this point-- and now that I know what it feels like I'm attuned to its presence in my body and it's bothering me.

I am becoming aware of precisely where the imbalances are. This doesn't sit well with me at all.

But anyway, back to the meds. Since I started both at once (Cymbalta and Topomax), it's hard to know what is causing what. I mean, obviously these drugs have different effects, but many of the side effects overlap and I can't tell which ones come from where.

I am up to the full dose now on both drugs. 100mg of Topomax and 60mg of Cymbalta. The migraines have leveled out to the point of disappearing in their typical form, which sounds amazing, but I do have some kind of annoying headache/nausea something most days, it's just at a very, very low level. A very low, nagging ache.

It's not quite classifiable as migraine pain. It's different/ I haven't really had anything like it before. It's clearly part of this whole thing, and it's still annoying, but it's miles better than what was happening before, so I'm just observing it and seeing what it does next.

Before I move on, I'm just going to reiterate what I said a few sentences ago: my migraines have all but disappeared. 

Like, I got a new prescription of migraine meds a week and a half ago and I haven't even opened it yet.

Sure, there's an asterisk (or seven), but this is progress, people! We're figuring this out. And figuring it out without a migraine is a LOT more fun than figuring it out with one, I will tell you that for sure!

Something else I've noticed is that my back feels better. Like, a LOT better. Cymbalta is supposed to help with that, and by god, it DOES. Who knew?!

Another thing: I lose my balance occasionally (that culprit I know: Topomax). Nothing major. Mostly I just over-balance when I bend over or try to stand on one foot or something. There was one memorable one-footed sideways shimmy in the Salt Lake City International Airport that I'm pretty sure made me look like a drunk in front of a room full of disgruntled passengers waiting on delayed flights, but they were feeling bitter and judgmental anyway so there wasn't much I could do about that.

There are some other things going on, too. I think I'll switch to bullet points now, rather than explain everything individually.

So, in the pro column:

• NO MIGRAINES!
• Back feeling better!
• Feeling lighter!
• Less anxiety!
• Better sleep!
• Lighter appetite!
• Losing weight (4 lbs so far)!
• Feeling more motivated!

And in the con column:

• Incredibly tired!
• Cottonmouth!
• Terrible diarrhea (sorry, but it had to be said. This is real life, people)!
• Carbonated drinks taste gross (an incredibly bizarre side effect of Topomax)!
• Sometimes shaky!
• Lose my balance (which is a little bit funny but still)!
• Still with the mild headaches!
• Still with the anxiety!
• Still not motivated enough!
• Still not enough energy!

Overall, I'd say I'm riding at a C+. Those pros are really good. But the cons are nothing to sneeze at, either. I've only just reached full dosage, and I'll give it 3 months total (unless my doc recommends longer) before I make a decision to try something else or not.

_____

Another plan I had was to see the psychologist at the Northern California Headache Clinic to learn the  bio-feedback technique (it takes 5-7 sessions to learn it), and then I can be a free agent as far as the medical side, and try to find a doctor closer to me with whom I have better chemistry, and who I feel takes my whole situation more into account when prescribing my medication.

The doc at this clinic was  very good, don't get me wrong, it's just really, really far away and I don't have the freedom to get to know him really well, and I want someone who is more on the cutting edge of PTSD science as well if I'm going to be working with them. There are so many great doctors in my area, there's got to be someone who's working with both PTSD patients and migraine patients. 

I will find that doctor.

I'm realizing that anxiety is playing a MUCH bigger role here than I'd realized, and I need to address that more  directly than I have. And I've been so dissociated from my body that I'm only now learning what all of these things feel like. Who knows what else I'll discover?

So, that's what's happening. I have to admit, it's terrifying to be doing this while trying to raise two small children. I don't like feeling medicated. Even though I've taken anti-depressants before, I've never felt medicated before, like I do now. I feel it all the  time, and it's disheartening and exhausting and frustrating. Sometimes I just want to sleep until this phase has passed, and wake up healthy and alert and ready to bounce into the next one.

I'm too tired to be this tired!

But I am unbelievably fortunate to be able to do it now-- I don't forget for a moment that I have unthinkably amazing resources and support and time to do this work at this point in my life, and as hard as it is, it's also most important to do it now. 

Those girls and my dear, heroic husband are the reason.

So I will keep going. And I'll figure it out. And if I'm a little muddled and sleepy and stumbly in the meantime, well.

In the long run, is that such a bad price to pay?

Cloudy

All right, I've made the switch.

Dropped the Wellbutrin (which I discovered quite unpleasantly has been causing me anxiety at a low and constant rate for the past year and messing with everything), have started the ramp-up with Cymbalta, and am continuing the ramp-up with Topomax (my first-ever preventative migraine med).

Update, 9/14 2:30pm: In migraine news, since I began the Topomax 2 weeks and 5 days ago, I have had 7 migraines, one of which lasted 10 hours, the rest of which lasted 2-5 hours, and only one of which "broke through" with full-fledged migraine pain. As ridiculous as what I am about to say may sound now that I've written all that down, this, my friends, is HUGE PROGRESS! 

I'm not even up the the full therapeutic dose yet and I've already dropped from an average of 75% migraine days over the past few months to 36% migraine days in the past 19 days. (!!)

Anyway, back to Cymbalta and Topomax:

Both of these are expected to make me excessively tired during the ramp-up phase.

BOY, IS THAT EVER TRUE.

I feel like I've been hit by a bus. A really, really tired bus. After I had collapsed from exhaustion in the middle of the road.

This level of tired is seriously uncool. I've already been operating at a ridiculous level of sleep deprivation with this over-active amygdala of mine-- according to the sleep sensor bracelet I wear, I never have more than 4.5 hours of non-consecutive sleep in a night, no matter how long I'm in bed. So I'm sort of stumbling around trying not to fall asleep in my soup.

But believe it or not, I already feel... better. Lighter. Easier. Just... a bit... better.

The biggest difference, and the most welcome one: I am enjoying my children more.

I have more patience with them. I am not constantly just trying to get a moment of peace and physical distance from them. I am able to look into their shining little faces and enjoy moments with them without reservation.

It's been a while. I shudder to think how much longer it might have been.

That anxiety, that agitation, had wormed its way into my personality and was really starting to make its mark. My husband keeps beaming at me and saying, "It's so nice to have you back!"

I guess I'm back. :)

Or at least, I'm on my way.

I didn't know I was so far gone, which is ABSOLUTELY TERRIFYING JESUS CHRIST. But I'm on my way back now, and I'm grateful for that. I don't know if what i'm doing will be enough, or if it will be the right combination of chemical magic, and let me just say that I am more than a little horrified by this whole chemical clusterfuck, yes I am indeed, but today, I feel remarkably better than I did last week, more than I believed possible.

So that is something. No small something.

I want to get out of this state of chemical dependency as soon as bloody possible-- I've never had an experience like I had with that Wellbutrin a couple of weeks ago, and realizing what it's been doing to me for the past year is terrifying and frustrating and confusing and infuriating.

How could I not know?

I knew I was uncomfortable, but I figured it was just the price of playing poker, you know? I thought I was just pushing myself to uncomfortable places. But I think also that I just have a really, really high bar for what I'm willing to put up with. In fact, I think there's probably an incredibly high threshold before I'll even notice the discomfort in the first place, so dissociated have I been all these years, and so used to dealing with chronic pain.

I've been told that before, that people with migraines have ridiculously high pain thresholds, and I've seen that in myself. So I think that's played a part in my lack of awareness. I know that when I cash it in-- when I reach a breaking point and have to go lay down or stay home or whatever-- it's because I am BEYOND jacked up. Discomfort is de rigeur for me, so it takes something fairly catastrophic to take me out.

Thanks, Wellbutrin. You jerk.

Anyway, I'm not feeling great today, although I did get a bit of a nap yesterday and might get to bed early tonight, too, in my ongoing efforts to mitigate this hit-by-a-bus feeling. So I will leave you with this song by Simon and Garfunkel, which seems quite apropos.

Enjoy. And Happy Fall. I hope the leaves are beginning to change where you are. To me, that always feels like the real New Year season, when the slates get cleaned and the world gears up for a fresh start.

I'm ready. Are you?

Cloudy
The sky is gray and white and cloudy,
Sometimes I think it's hanging down on me.
And it's a hitchhike a hundred miles.
I'm a rag-a-muffin child.
Pointed finger-painted smile.
I left my shadow waiting down the road for me a while.

Cloudy
My thoughts are scattered and they're cloudy,
They have no borders, no boundaries.
They echo and they swell
From Tolstoy to Tinker Bell.
Down from Berkeley to Carmel.
Got some pictures in my pocket and a lot of time to kill.

Hey sunshine
I haven't seen you in a long time.
Why don't you show your face and bend my mind?
These clouds stick to the sky
Like floating questions, why?
And they linger there to die.
They don't know where they are going, and, my friend, neither do I.

Cloudy,
Cloudy.

STRIKE ONE

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 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?