Thursday, October 22, 2009

letter to a doctor

Today, I was just so desperate.
Got a message from my G.P, that my shrink said he wanted to take my meds down by a huge chunk. I can feel the difference between 10-20mg, but 150 made me so nervous i cracked.

All the ooze just came spilling out.
It had to come out. I was rotting inside.

make of it what he will, but you know, this month being "mental health awareness month", it might be a good thing that this gets out.




Dear Dr. C
just got an email from my g.p who informed me that you advised I decrease my Welbutrin to 150mg from 300mg (i kept on forgetting to take the extra 50 mg because i had to manually split the pill, and by the time i did remember, i had started to get manic) and no Starnoc or Xanax.


I can honestly tell you that is going to be a big problem...


Since you are not at the office right now, i have reluctantly resorted to email because i think this needs to be sorted out very quickly. and apologize profusely for bothering you, but since we can't speak on the phone tonight in detail about this matter, i don't know what to do or who to turn to because I am so completely desperate, and if my mood gets worse, might have to make a trip to the emergency tonight.


I'm a) worried about going down to 150mg of Welbutrin. From 300 that is a HUGE jump for my system. And if the current 300mg is keeping me barely afloat on good days (in terms of depression), I don't even want to think what 150 will do to me. Those lows terrify me. I have tried to commit suicide in the past, and with those thoughts lurking close to the surface these past two months, would a huge decrease like that be a wise thing to do during this time?


and b) without Starnoc (with was the only thing that helped me sleep in the past, and i believe had been taking it while on Welbutrin approximately 3 years ago, and had taken it 6 months ago, and again on the night before my wedding because i had "an emergency stash) i don't see why it would be a problem now since i am still on Welbutrin, unless there is some policy about doctors giving prescriptions for getting medications over the border, or via the internet that nobody wants to tell me about directly, because up to now, i have not had any solid comprehensive answers as to why i can't take it now.


I find it beyond frustrating and infuriating that I should have to be penalized for not being able to get a medication that is readily available in the U.S but not here in Canada because somebody didn't do their job marketing it properly at the corporate level. I will call Servier Canada again this week, as well as the people at Wyeth (who are holding on to the patents but not giving information to if or when they will put Starnoc back on the market), but this time i will get all the names of people i speak to as well as everything i was told in writing (which was) "Starnoc was taken off the market - purely for marketing reasons", because when i explain my story, it seems to me that every doctor i tell thinks I'm full of it. I'm not a liar, just desperate to be able to get the drugs that help me get the sleep that i so desperately need.


as you know, Ativan and i do not have a good history. I skipped a dose one night and thought i was honestly going to die. And nobody bothered to tell me that going off "cold turkey" was equal to somebody detoxing cold turkey from alcohol or harder drugs. I had to find out the hard way.


It was beyond any word that terrifying can describe, and i never want to feel that way again. I don't want to have to take it (Ativan) on a regular basis because i don't want to be dependent on a sleeping pill, but the catch 22 is, if i need it, i will take it, but if i do take it for more than one night in a row I will have to keep on taking it because cold turkey or skipping a dose one night is not an option - so the only way to do so is to taper off. I want to take something only when i need it, and not worry about going "cold turkey" when i don't.


I hope that you understand my predicament.


And i'm not sure if I shared this with you, but, when i was on Ativan in the past, I had gone up to 2.5 mg (about 6-8 months ago ?) because the 0.5 mg initially prescribed stopped being effective. Right now, i'm up to almost 1mg. The pattern is sure to repeat itself, which once again, as stated above, the eventual outcome is not an option.


Immovane makes me physically ill, because the nausea from the metallic taste in my mouth last for 24 hours. And unless i take large doses of Trazadone (which recently, I have taken up to 2 pills a night), I feel as if i am completely stoned, clumsy, disoriented BUT not sleepy.


Sleep plays a big part in the regulation of my bipolar, and perhaps because i have not been able to sleep, has made me in turn, more manic. At this point, i am so completely desperate, I don't know what to do, and I'm sure it's not easy for all the physicians treating me, but I am so very terribly distraught right now, and with my mom's scan at the end of November, it's imperative that I remain calm, focused and be able to sleep, which will in turn, will allow me to be able to be calm, focused etc. If and when the cancer comes back, i can't afford for my sake, but mostly for hers, to be the one who needs an incredible amount of emotional support and/or physical care because i have had another meltdown.


And yes, I have tried yoga, acupuncture, meditation, hypnosis, Valerian root, Nytol, Tynenol PM, Benadryl , holistic/natural sleep medication, warm milk, bananas, turkey, Melatonin (which my pharmacist advised me against because of my thyroid problem), and have also asked her about SAM-E, but she also advised against it because i am on the Welbutrin and Lamictal, but aside from knocking myself unconscious, I don't know what else to do.


I will as of tomorrow, try to scramble to find somebody who will see me through the system for free because after consulting with my husband tonight about our finances, we simply can't afford to pay anybody through private practice. I had maxed out this year's limit with other "therapy/councelling/life coaching sessions" (at 175$ hour, and my yearly limit being $500) and since i am not working, or in any real shape to do so, unemployment has run out and welfare not really an option since we are "supposed to be making enough income" to survive, life seems at best, bleak. Over the years, I have been through the system many times. I know that after my first nervous breakdown some 21 years ago, the average waiting time back then was 3-6 months at best to see a doctor through the hospital. Honesty, I don't think that i will be able to last that long, (if not longer now) and that scares me, well, to death.


Once again, I apologize profusely for sending you this email, but i want you to know what is happening since you are following my case and do know me and my sorted history, but also because in my current state, am manic so can type quickly, and i can still type and weep at the same time, unlike talking on the phone - this needed to be told and don't know if i will be as coherent or in any shape to talk about this tomorrow.


If you would like, you can call me at home tonight.
I will take another ativan to try to stay calm, but 1mg will be tonight's limit, and i really hope that will be enough. If anything, my husband is at the ready to take me to the hospital if need be.


And tomorrow, I will be on a photo assignment from 10 to 1pm, and then away from 5-11pm, and Friday morning might be the best time to call me at home, but because i am (trying to) working with an organization that needs photos quickly, my computer is always on.


I'm attaching my mood charts so you can see what has been going on. In all actuality, October has been quite an uneventful month, and normally, that would have in turn, stabilized my mood. When things around me in my life get out of control, i tend to swing, but with a calm environment, my swings came out of the blue and have taken me completely by surprise and have terrified me.


Dr. C, thank you once again for your compassion and understanding of my difficult and complex situation, and once again, sincerely and deeply apologize for troubling you.


Sincerely,
HpK

2 comments:

Auvery Eva said...

it is hard sometimes to explain to doctors how drugs are affecting you...either that you don't want to take any more - yes it's a small dose but my body reacts strongly to it; or when you know you can't cut down. We are all individual with different chemical makeup.
Sometimes it's hard to speak out to doctor or pharmasist. recently I've discovered that a particular brand of the anti depressant I take just doesn't work, my sleep is disturbed and it is as if I have either taken too much or missed a tablet. But the pharmacy seems to just get in what is cheapest that week. finally the doctor has said - you have the right to say that you won't take that one and the pharmasist has said yes people do report such reactions to different brands.
Must be frustrating when there is a drug that will work but you can't have it.

hellophotokitty said...

That is pretty crappy that your pharmacy opts to give you the cheapest drug of the week - and you have every right to refuse and ask for the one your doctor prescribed! All of this is so confusing - kinda like Russian roulette sometimes, and I don't think that's a good thing to feel with anti-depressants!

And fyi - my psychiatrist never replied to my email, which disturbed me greatly because he was always so quick and compassionate to reply to my previous emails....

oh well...