C(K)eeping Up With The Concertas

I saw my new shrink last week.  She was nice, friendly, positive, and generally affirmative (affirmational? She affirmed what I said) but, as she pointed out before we even sat down, it was a bit of a mismatch.  She deals with palliative care patients, and not at all with ADD.  She was only handed my file* because they needed people to take over for my regular shrink, who is now on maternity leave.

8_YouCompleteMe.gif
Not My Shrink.                         …ok now tear your eyes away and go back to the blog post…

I was a bit disappointed because I had been imagining this new doctor-patient relationship as the one that would complete me, mental health-wise.  Alas.  I need a Tinder for psychiatrists.

She asked me, at one point, probably because I was rambling at high speed and holding a Grande Pike Place, whether I was self-medicating with coffee. I am not, and I told her as much. I usually have one coffee in the morning and one, if I am desperate to stay awake, around the kid’s bedtime.

She also told me, as my last shrink told me, and probably everyone in the medical profession will tell me, that I need to get on the meds and just stay on them if I want to have a good idea of whether or not they’re having any effect. As you may recall, this is one of the great questions that surround my decision to medicate.

Since taking them intermittently, as I have been doing (sometimes intentionally and sometimes unintentionally)  for more than a year, is not a viable option for me at this point, I have a problem.  Even if I ‘set an alarm on my phone’  (which everyone thinks is the answer to everything ADD), taking them on a regular basis has proven to be much more difficult  than it would seem.  It’s not that I don’t remember to take them. It’s that if I remember, and I am not seated at my desk (where I keep the bottle) or in a position to get the ‘travel pack’ out of my purse immediately, then the task will get put on an indefinite ‘snooze.’

WhatsApp Image 2017-05-15 at 1.44.52 PM
The Elusive Travel Pack              Writing About it made me remember to refill it!

At the behest of Dr. Affirmational, I decided to try once again. She asked if I could commit to two weeks straight and I told her, without much confidence, that I would surely try.  My appointment was on a Thursday, and I decided that the following Monday would be my first day. I took a pill on Monday. I took one on Tuesday. I took one on Wednesday. I forgot them on Thursday and Friday and then didn’t bother over the weekend.

Correction: I did not forget them on Thursday and Friday, Rather, I remembered on Thursday but I was in the car, driving. And I remembered on Friday but I was in the supermarket, and I  was in a rush to get out.

Today is Monday, the start of a fresh new week.  I took one this morning. It made me jittery after an hour. I calmed down. I am finishing my blog post that I’ve been meaning to write for 11 days.  Thanks to the shakes, I know it’s having an effect on me, but I don’t know if it’s actually fulfilling the intended purpose.  Hopefully, if I can keep up with the Concertas,  I’ll be able to tell you in two weeks. Wish me luck.

 

*Interestingly, she was actually NOT handed my file.  So most of my visit consisted of me recounting all the things I do and the things I don’t get around to doing and how I feel about it all. What else would we have talked about, really?

Medication Today: Taking Account

So I took my medicine like a good girl this morning.

I have not been terribly productive.

I did have some distractions. Also got thrown a curveball.

I did reorganize my to-do list a bit.

I kind of lost my appetite but still ate— just, healthier foods.

I was a bit shaky after I had a coffee in the afternoon– actually a Starbucks latte drink mix which prob. had a lot of sugar as well  as caffeine.

I felt better after that.

I did spend an awful lot of time on distractions and also recovering from distractions.

 

 

 

 

update-clipart-canstock19412148

I saw my Shrink again last week, and here’s what I had to report:

When I first got this new round of prescription after our last appointment and  I started taking the medication,  it was the week before winter break.  I took it the first day and the second day, but on the third day I felt all cloudy and disoriented.  I think I skipped that day– or the next.  I had started a list so that I could keep track and maybe chart the effects of the medication on my productivity– because, ultimately, increased productivity is my goal.  At least, I think I started a list. I have one attached to my pill bottle with an elastic band but it has some very random dates on it. Seems I haven’t been keeping track very well.

Strike one against the effectiveness of medication, I guess.

I wasn’t sure if the cloudiness was due to some side effect of the medication or a withdrawal from it.  All I knew is that I was barely functional. I could hardly prepare school lunches– something that is usually rote for me and doesn’t require a whole lot of thinking (though I still hate doing it and it sill takes me waaay too in the morning.)

On the other hand, i also had a cold, and this could have led to the cloudy feeling as well. Coffee helped. Napping too, though how much of an opportunity do I really get for that?

For me, the problem with being in a fog goes even deeper than zombie-like, purposeless wandering.  It reinforces a deep fear of mine, which is that I will become dependent on meds in the way that people are dependent on glasses, or that they will permanently dull that region of my brain because I’m not using the muscle behind it.

I decided at some point that week–  I believe I’d had 3 out of 5 of the intended doses, to postpone the big experiment until after winter break.  I still had work to do in the intervening weeks– I was preparing for a new business initiative I’m hoping to get off the ground, not to mention all of my regular duties.  But I didn’t want to do this medication thing haphazardly– because then what would be the point? I want to know if the stuff is working and if it’s worth all the soul searching and departure from my long-standing resistance to medication. As I had discussed with the shrink at or last encounter, I need to stick it it consistently for long enough to figure out whether it’s worth sticking with at all.

I started taking the medication regularly – Concerta– when the kids went back to school after winter break when my routine, theoretically resumed.

As I mentioned above, I am working on a new program that I hope I can develop in to a business.  I am hesitant to mention it here or even tell people around me about it because it seems that every few months I embark on a new project with great enthusiasm, and sometimes at great expense or personal investment, only to abandon it a little while later — always with a different excuse ultimately forming a pattern of failure associated with ADHD. I guess it’s important that I keep trying to find success– but the process can be disheartening.

In this case, however, I gave myself a deadline. I set up a date to present my project to a local organization, and that date was last week.  Even though I so far have only that date and two subsequent ones (it’s a series) booked at the same venue, I put a ton of work into it, hoping that the investment will pay off with further bookings and that, by the end, I’d have a program I could market more broadly.

As it happened, my weekly ‘protected time’– the one day each  that I arranged with my husband would be my own time to work on my own projects without interruption when he’s responsible for picking up the kids and being with them late into the evenings–  got compromised the first week after winter break because of a job-related commitment that there was no way for him to get out of. I tried to put in time that day anyway, but then my DS called home sick from school , so that day got cut short.

On the second week’s protected time, DH was desperate for me to help him out with a few projects that he regularly relies on me for, and they also really couldn’t wait. So last week I also lost a good half day from my protected time. I did manage to get a lot done in the late afternoon and evening, however, so it wasn’t a total loss.

Throughout the past two weeks I have been taking my meds pretty faithfully. One exception was last Thursday when I did my presentation. I find that the medication can make me shaky, depending on what other elements are happening (whether I’ve eaten, slept well, etc) and just today I noticed that they actually make me a little emotional the way that Adderol did– not to the point of being crazy, but enough to cry over some sad and/or heartwarming articles I read during my brain-warm up this morning (aka acceptable procrastination time– but that’s another blog post for another time.)

I guess that the pattern I’ve found so far with these meds is that the benifit– the drive– that is (most likely) supplied by the meds, is accompanied by a degree of stress. With this med it is to a lesser degree than the last, though I don’t remember feeling it at all before last week. I wonder if it has to do with the fact that they say it can take several weeks to start working.  Is it going to get worse now? Or is this as bad as it gets, because I can handle it at this level.

There was also another day the week before that I forgot or neglected to take the meds.  Let’s say I took them for 8 our of the 10 intended days.  I was supposed to only take a break from them on Saturdays but I haven’t been taking on Sundays either.

For me,  a deadline is the best motivation to get working, and I really pushed myself to get all everything done on time, and done well. It’s hard to say whether the pills were working or not, but I felt very motivated, and I spent a lot less time ‘getting into’ the work, and a lot more time actually working on it.  When I got distracted, it was a lot easier for me to get back on track, whereas sometimes it can take me half an hour or more to ease back  in.

Also, this is work that I really love to do, and I know that I’m good at it because I have done it for years, though not lately. So again– hard to say if it’s because of the drugs.

My program went well, though I only got through about half of the materials we’d prepared. I thought the participants really enjoyed it and that it got their wheels spinning. I’ll find out when I get back the evaluations.

After telling the doctor all this, I was surprised to hear her say that she was concerned about the fact that I was feeling cloudy.  The meds are supposed to make you more functional, not less, she said.  With regards to that, and also to my fears of long-term damage, though, she didn’t tell me to stop.  She just said again that I need to do a risk/benefit analysis.  Are the meds helping me meet my goals, overall? If so, are the risks and/or side effects tolerable?

The idea behind the medication, she reminded me, is not to provide a cure, but to provide a higher level of function.

Also, we discussed how I’m effectively doing three jobs at once if I take on this new venture.  Mothering, working the equivalent of part-time for DH, and now this.  Honestly, I don’t mind putting the work in to see if I can get this started, even if it means a couple more late nights.  Granted, it also means I’m pushing off some of the mothering stuff (nothing significant) and also some of the paperwork I’d otherwise be doing, which means it’s building up faster than usual.  I guess I’m ok with that too.

 

 

 

Badge: Fears

I think I’m getting better at these badges.

I took all the fears from my last post and put them all into one marble. Is that fair?  I listed at least five different fears.

It’s amazing how not trying to write about things really brings them to the forefront of your mind. I wasn’t thinking of fears at all in that post… until I was….

 

In Psych I… uh… Trust

It had been five months since the last visit with my shrink.  To be specific, my shrink is a psychIATRIST– a medical doctor who is licensed to prescribe medication, as opposed to a psychOLOGIST who is a person who studies human behavior and the human mind. Both may or may not practice psychoTHERAPY, a method for remedying  what ails the  psyche.

I’m not sure what kind of doctor BeetleJuice’s waiting room buddy there was waiting to see…  Is there such a thing as a head un-shrinker?  (Better call in Rick Moranis. Now THERE’s a movie mashup just waiting to be made. rick_moranis

The reason I make the trist/gist distinction is that the function of  my psychiatrist, as I see it, is mainly oversee my rotation through a series of ADD meds until we find the right one which will, in combination with my own efforts and personal growth and strategic planning, release me from the perils of  distraction and impulsivity that my brain, unaided,  keeps leading me towards. As a result I will, in theory, begin– or resume — my climb on the ladder of success, self-fulfillment, and fortune.   For this purpose alone has Dr. C. spent a decade in medical training. In contrast, a psychologist might try to work with me on strategies and techniques… I think.  I have never actually heard of one who deals with ADD.

My shrink laughed at me last week. I told her that I’d only called her after such a long spell because I’d run out of the prescription she’d given me in June — a 28 day prescription. It’s now the middle of December.  I told her that I was trying to take it as needed, but since I hardly had any time between July and November to sit down and do any work, I hardly took them. Also, when I did  sit down to work in that period, I neglected to or forgot to take them. I admitted that, shortly after I called her, I found another stash of about four doses in my purse where I knew I’d have them with me in case I forgot to take them in the morning.   That was the part that got her laughing.

“That’s so ADD!”

An astute, and timely observation.  I laughed along. It was a good moment; We bonded a bit, I think.

I told her about how I was not really sure about the effect of this round of medication. I am pretty sure it led to a crash on at least one occasion. I was in the supermarket on the day  after I’d taken it.  I hadn’t had a dose that day. I started to feel really over-caffeinated and jittery, and acutely aware of all the chaos around me…. which had never felt like chaos before. The supermarket is always a busy place but I don’t usually feel like I am at the centre of some storm. It was odd and unpleasant. I felt weak as well, and would have liked to sit down, but since there was no opportunity to do so, I just pushed on.

Honestly, I am not sure it was a crash or that it was at all connected to the meds, though I did notice a coming-down at other times on other meds.  This is one of the things I was afraid of.

The Doc told me that the meds certainly may have played a role in my odd experience at the grocery store, and that if I’d been taking them every day as prescribed, it might have not happened. She says I misunderstood about taking it as needed and that until I figure out what meds, if any, work for me, I should take them consistently for a few weeks.

I am always afraid that I’ll become dependent on medication. I am afraid I won’t be able to ‘get back’ to where I was before– back to my  brain baseline.  I am afraid that the medication will cause permanent changes– if not damage– to my brain. I’m afraid I will lose my ability to be creative. I am afraid I won’t see inspiration all around me.

She said I could take a medication break on Saturdays.

I dutifully took one dose the first Monday after my visit. I don’t know that it did anything.

Actually, I know it  did something because I was ravenous in the evening, which meant I hadn’t eaten enough in the day, which is not the worst side effect, in my case.

Let’s see how the rest of this stash goes.  If I really like them, I have four extras in my purse…

The Last Word on Drugs (For Now)

I don’t think I mentioned this at any point yet but a number one reason I don’t want to take meds is that I worry that it will affect the way I think, in that it will suppress my creativity and… all the other fun and wonderful and sometimes quirky things that make me ‘me’.

More on Drugs

(In my last post, I wrote about my feelings on drugs and medications in general. To summarize: I have always been really hesitant to use medication, even when I really need it…..  but I am very grateful for their existence when they help me feel how I need to feel and be who I need to be. )

I would like to share one of life’s little ironies with you.

I spent last Sunday doing some very heavy yard maintenance which involved relocating a pile of lumber. It was hard work, and I was tired at the end of it, but I was otherwise OK. I woke up a little bit stiff on Monday, which is to be expected after having engaged in hard labour– nothing I couldn’t deal with — and then I spent all day sitting in a hard chair  working on my computer, writing about how I almost never medicate, and hardly ever need to.  That evening, however, I was in total and utter agony.  My lower back hurt so much I could barely move. I had too many pillows, and then not enough.  I could not find a comfortable position. I was worried that I’d wake up stiff as a board, because my reaction to pain is to tense up my muscles, especially around the core.  Am I alone in this?  Is this what everyone does? I was afraid that the tension would make my stiffness and pain worse, so I administered myself a hot water bottle and shot of whiskey.

Now, I know that I spent all of the last blog post going on and on about how I barely drink, and I don’t do drugs, but this was an exception. My DH was horrified. For some reason he thought that my one finger of liquor was a precursor to full-blown alcoholism, even though I have no genetic or historical predisposition to it.   I guess we’re really a puritanical kind of family– except that we have a fully stocked liquor cabinet. Go figure.

I did have some pain the following morning, but it was tolerable.  I still felt some pain on Wednesday but I was definitely on the mend. By Thursday I was pretty much over it and I resumed all of the heavy lifting that I normally do in the course of a day– grocery shopping, loading and unloading the dishwasher; carrying kids around– the usual.  I even began reassembling a non-functional IKEA bookshelf that has been accumulating junk in my bedroom while waiting abut six months (ADD Alert!) for some TLC.

On Friday morning, I went fishing in my deep freezer to catch some cod for dinner.  To my dismay, I found that the entire unit was completely defrosted.  The freezer is in my basement, and it was completely packed with food that I’d just bought on my monthly Costco stock-up trip.  I carried basket after stinky basket and bag after putrid bag up the stairs and out the door to my garbage shed. In fact, the bags were so heavy that I could barely lift them over the top edge of the bin.  My back was protesting, but I guess not loudly enough.

I was hosting a dinner  for 16 people that evening and I had a lot of prep and cooking to do.  I was peeling, chopping, processing, and frying on my feet for four hours. Normally, this kind of work has no effect on me, but that day, at about hour 3, I noticed that my back felt like it was on fire.  I couldn’t stop, though. Dinner wasn’t ready. I got a stool from the bathroom to keep one foot up and distribute the weight, but it was too late. I couldn’t find relief in any position.  I had no choice but to keep going. I finished frying the last piece of battered fish, and went upstairs to shower without even pretending to clean up the huge mess I’d left in the kitchen.  In the shower, I could barely lift my arms to wash my hair. I tried lying down just to give my poor back a rest, but I couldn’t find any position that offered relief.

When the guests started showing up I forced myself out of bed, put on some comfortable and stretchy clothes, and did my best to brush my extremely knotty hair. All this time, my core was tensed up to keep me upright.  The meal was a success, and even though I tried to recruit guests to carry ‘heavy’ things like platters of food around, I still ended up having to do a fair bit of weight bearing, which was making the pain worse all along.

To make a long story short (this was supposed to be an aside), I found myself later in the evening wearing a waist support belt (which I use to improve my posture when sitting at my desk) after a couple of shots of lemoncello, two advil, a menthol patch, and Voltaren cream, which is a topical pain reliever.  I somehow got through the evening but then woke up from pain halfway through the night and slept fitfully. DH, finding me zombie-like in the morning, convinced me to take some more Advil.  And so began my day, made possible by analgesics.

I must admit, on the rare occasions that I do try pain relievers, I am always amazed at how well they work. I mean, they take the pain away. How crazy is that?  They make me really functional.  What more can you ask for?  I am so grateful to live in a world where a simple, sugar coated pill can make you feel so much better so quickly.

That being said, I still prefer to do everything I can to function as the person I want to be without medication. For pain I wait it out, or do targeted breathing. I use a hot water bottle or ice, or sometimes a band aid will do the trick, even though I’m over seven years old.  As I mentioned in my last post, I also managed to manage my life before ADD meds– for better or for worse, and that is where this blog post was intended to begin.

I was going to use this post to write about my journey from med virgin to drug-dependent desperado, but  I guess that will have to wait until next post because this one is getting too long. So much for my aside.

Header image from https://openclipart.org/search/?query=drugs