Michele: Cocktails and Scales

***This post talks about weight and it is not in a particularly positive fashion.***  Also, a picture that covers more than a bathing suit but less than jeans and a t shirt.

I have often joked that I am going to write a weight loss book.  I had it drafted in my head and everything.  For the first time, I am putting into print.  Are you ready?  Here it goes:

HOW TO LOSE WEIGHT THE EXPERT WAY–What Your Personal Trainer and Doctor and Everyone Else Might Not Have Said to You.

Chapter 1:  Drink more water.

Chapter 2:  Eat less.

Chapter 3:  Exercise more.

Chapter 4:  These are no-nos:  Beer, wine, cocktails and all other alcohol.  Yes, I said wine too.

That’s it.  That’s the entire book.  I considered fleshing it out a bit, putting in the whys and hows (did you know that you BREATHE out fat?  It’s true–look it up) but then realized most people don’t care.  They just want to know what to do.  Follow this and I am at least 85% certain you WILL lose weight.

But what happens when you CAN’T follow this?  I had never really even considered that until November of 2017.

Growing up, I had a good relationship with my weight.  Some might consider me a unicorn–as a gymnast in the ’90s, I never worried about my weight.  Through high school, while my friends complained about their butts and thighs in swimsuits, I was just upset about my flat chest.

In college, I gained some weight in my senior year, thanks to fast food.  When it became a bother, I cut out fast food and it disappeared.  Same thing in law school.  Same thing when I moved to LA and started working.  Eat too much fast food (which is a weakness of mine) and I gained weight.  Stop eating it and I dropped the weight.  Simple formula.  I was strong from spotting gymnasts and moving around beams and other equipment.  I didn’t even “exercise” officially.  (Hey Mom–thanks for the easy genes.). I had a son and then a daughter.  I gained 25 lbs and 35 lbs, respectively.  I lost the weight within a year each time.

(I know, so far I sounds like the person everyone loves to “hate”.  Hang in with me for a little while longer.)

So, as many of you may know, I have bipolar type 1, peripartum onset.  I have anxiety issues that my psychiatrist has lumped together as “anxiety” since they all have similar causes if not the same behavior.  These really manifested after I had children.

I also have “hypersomnolence” which means I sleep way too much and am way too sleepy and have done things like fall asleep while driving–but the doctors have no idea why.  When I say I sleep too much, I mean sleeping like 14-16 hours EVERY DAY, day after day.  When I say I am too sleepy, I mean that it takes me at least an hour every morning to stop vacantly staring at things.  I also mean that I fall asleep at inappropriate times, like sitting in waiting rooms and sitting at red lights.  This has been an ongoing issue since high school.  (I got tested for mono FOUR times in high school because the doctors kept thinking that I had to have mono to feel so tired all the time).

After I moved to LA, my new doctor eventually prescribed Provigil for me and it was GREAT.  And then I changed insurance and it was no longer covered.  At close to $800 a month, I could not afford to keep taking it.  Instead I cycled through so many drugs and eventually landed on Dexedrine.  Dexedrine keeps you awake.  It is an amphetamine.  It doesn’t solve for the sleepy–it just make you not feel it.  I would set my alarm for 4:45 am, take the drug, and go back to sleep while I waited for it to kick in.  It worked.  It wasn’t awesome, but it worked.

I was only on it for a short while before going off to get pregnant and then being pregnant and then nursing and then getting pregnant and being pregnant and then nursing.  After all that, I was ready to go back on.

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This was around 92 pounds, which was not the lowest I went.

So I did.  It wasn’t too long before I realized a long term effect of Dexedrine is weight loss.  I lost A LOT of weight.  I am 5 feet 1/2 inch tall.  My weight eventually slipped to 87 lbs.  It was not healthy.  I fought with my insurance to get Provigil covered.  I wrote to them, my psychiatrist wrote to them, my GP wrote to them, my neurologist wrote to them.  No dice.    I had to see a nutritionalist.  I began to worry because LA is filled with skinny people.  I knew I was too thin and I didn’t want my mind to become used to this weight and to think it was normal and desirable.

 

Then towards the end of 2017 several things happened, all in a row.  I found a cash price for Nuvigil (the successor to Provigil) that was affordable.  I switched from the Dexedrine to Nuvigil.  I quickly gained some weight, both because I was no longer taking the Dexedrine and because it had messed with my metabolism, slowing it down.

Then I began taking Rexulti.  I began to feel a little better but I gained 30 pounds in a month.  I explained that I was frustrated because I knew I was overeating.  I ate candy by the bag fulls.  I knew all I had to do was stop eating so much.  My doctor told me calmly that in some individuals, Rexulti actually takes away the willpower to stop eating.  He told me to stop taking it, then reconsidered and said to half my dose.  If it was working and I stopped overeating, keep on that.  If not, stop taking it and we would try something new.  He then added another antidepressant.

I halved the dose and still felt good.  In fact, with the addition of the new antidepressant, I was feeling almost decent.  So I began to wage war on the weight.  By this time, I had gained 45 pounds in 6 weeks.  Through good planning (making sure none of my irresistible foods were in the house) and doing some unhealthy meal skipping, I lost 10 pounds.

I went back to the doctor.  I was still feeling tired.  He adjusted my sleeping pills, added melatonin and told me to see my GP because at this point, it was clear to him that the tiredness was physical and not related to any mental illnesses.

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Nuvigil, Zoloft, a Valium, two Elavil, Rexulti, melatonin and B12.  If I don’t put them in a case, I forget if I have taken them.

And then, a strange thing happened.  A miraculous thing happened.  If I took every single one of my pills, I felt…better.  I felt…good.  I felt more like myself than I had in 7 years.  I was still tired sometimes but I was able to go places.  I was able to talk on the telephone.  I was able to clean.  I was FUNCTIONAL.  I was STABLE.

 

I was also gaining weight again.

Medicinal cocktails can be super tricky.  The whole is, in my case, definitely greater than the sum of the parts.  If I miss taking any single pill, I feel like crap again.  If I miss my sleeping pill, I don’t just feel tired.  I feel like utter crap.  If I miss the Rexulti, I don’t just feel unstable.  I also feel like crap.  I currently take Nuvigil, Zoloft, Elavil (for sleep), Rexulti, melatonin and B12 (I have an actual deficiency), well as Valium as needed for anxiety.  I take them all every single day. As long as I do, I feel like me again.  If I miss any of them, I feel like crap again.

I weight 130 pounds.  That might not sound like a lot, but it is a total weight gain of over 40 pounds in less than 3 months.  It is not healthy weight.  There is no muscle there.  While I don’t want to go back to the days of 87 pounds, I don’t want to stay here either.  But I don’t want to stop taking the Rexulti.  I like feeling like me.  I am not going to stop taking that cocktail.

Even if I resist the food cravings (I substitute in shaved-ice consistency ice, with no syrup–just plain ice–which hey, is like drinking more water!), I still have to deal with what Rexulti has done to my metabolism.  Rexulti increases blood glucose and that leads to weight gain.  Pair that with the beating my metabolism took after going off an amphetamine and it is little wonder that I am gaining weight.

I don’t have a great ending to this post.  I have no idea what I am going to do.  I am taking in more water.  I am trying as hard as I can to fight the compulsion to eat, though I often fail.  I am starting a twice a week dance class.  But I can not, will not, stop the cocktail.

 

Michele: Lists and how my feelings about them have maybe changed.

In the past, I basically existed on one of two speeds:  Manic, when I could do all the things ever, better than everyone else and probably even save the world if I thought hard enough about it, and depressed, when I sat up only when I got uncomfortable lying down.  When I was depressed, I did NOTHING or next to nothing.  I picked up my kids from school.  If I ran the dishes or washed a load of laundry, that was a gold star day.  When I was manic, I made elaborate plans and then did many things while usually accomplishing nothing.

Those elaborate plans almost always involved long lists.  I LOVED lists.  I would make lists of things to do, I would make lists of routines, I would make lists of things to buy, I would make lists of my lists.  I used fancy pens, special paper and always highlighted done items (crossing them off just seemed too negative for something I DID).  I got pleasure in making the lists and dreaming of grandiose results.

I am now running at a new, normal-for-me-I-hope, speed.  I don’t feel like I can conquer the world every day but I also am able to get dressed, put on makeup, visit friends–even ANSWER THE PHONE.   Every day involves dishes washed and put away, at least one load of laundry, basic cleaning, and playing taxi driver.  While my house is still not up to par, it is getting there, slowly but surely.

IMG_2417This morning, I set about making some to-do lists, which I have not done since reaching stable.  I made a general to-do list.  I made a bedroom makeover project to-do list.  I made a playroom rearrangement to-do list.  I used special to-do paper and a sparkly gel pen.

It was harder than usual to make the lists, but I figured that it was because I had full mind that needed to be dumped onto the paper.  I got the lists done and dialed the DMV so I could renew my car registration.  After hearing the expected hold time (25-31 minutes), I grabbed a load of laundry and put it away while I sat with the phone.

50 minutes later, I huffed at the phone when I got disconnected from the man helping me after I waited for almost 40 minutes on hold.  I did get a complete load of laundry put away, I consoled myself.  I picked up my list and highlighted the “7” after “P/A laundry 1 2 3 4 5 6.”  (I have a lot of clean laundry waiting to be put away.)

I smiled as I capped the highlighter and turned back to the list, waiting for the swoosh offullsizeoutput_1509 satisfaction and anticipation (for what I had just accomplished and for the rest of my plans). Instead, I felt. . .frustration.  Overwhelmed.  Weary.

This is the first time in memory that I have made project lists without the rush of manic energy.  I had never realized how much of my excitement and enjoyment was coming from a manic reaction.  I am staring at these lists, knowing that there is actually a chance that the things on them will all get done and that I will be able to finish the projects and chores that I have before me.  But instead of excitement and thrill, these lists now represent work.  Do-able work, but work nevertheless.

I don’t know that I love lists like I used to.

Bok Bok Bok

Hello out there in anxiety-land! I cannot sleep. I am getting ready to potentially move and I start my new job next week. So I thought I would write an anxiety-ridden diatribe.

Location, location, location. I am going to be paying way more than I want to for an apartment so I can stay in the North End of Boise. My kiddo, who has just developed a social circle a few years after my separation/divorce, needs to maintain said social circle by attending the nearby junior high. She said she could move further away since she would be moving anyway, but having just met her friends, I’m going to say that would only serve to further traumatize her.

So what about food? Thank God mom lives right down the street. We are going to have way less spending money and what we do have is going to clothes and food for the girl. It’ll be good for me to stop drinking entirely and have to eat like a bird anyway, I have about 50 lbs. I could stand to lose. So that will be good in a way.

I am trying to talk myself into this situation whereas anxiety is attempting to talk me out of it. Anxiety says, quite clearly, “don’t.” Don’t you dare try to make it, somewhat on your own. And then there are choices. Am I making the right one? Can I get a cheaper unit anywhere else that’s livable? Do the unusually high deposits I will be paying at the other place negate what I will be saving per month in rent?

Decisions, decisions.

And I haven’t even started my new job and I’m already contemplating getting another one to continue to make ends meet. Some online gig. I have a lead on one that pays $12 an hour but it’s difficult to navigate after so many years out of college. Did I have the grades and the brains to edit college papers? Sure, but time seems to have eroded my capabilities. Maybe I’m just exhausted from not sleeping this week. Maybe it will look better if I take a deep breath and quit putting so much pressure on myself.

One step at a time.

So I’m calling some places at 9am and going to a leasing office at 10am. I will have my financials in hand and whatever else they need, my signature scrawled in my blood in hieroglyphics or whatever it takes to get a 13-month lease these days. I’m doing this for my daughter and a bit for me. Independence is a good thing, right?

Breathe, breathe. Edit your math, you can do this. The numbers don’t lie but you’ll have to budget. It will be alright, you have a bit of a safety net right now and some great friends who are already helping you through this. Oy. Calm down.

I took my meds, I took a melatonin, I cannot for the life of me sleep. And I have to be up at 6 anyway so…yeah.

Anxiety sucks but I’m hoping this will normalize my life and my parenting. Gotta leave the nest. I am a 40-year-old bird afraid of leaving the nest. Overgrown bird. Big Bird, if you will, but without the hue or cheery disposition.

Big chicken.

A riddle for you. Why did Mozart get rid of all of his chickens?

Because when he fed the chickens, they all kept saying, “Bach, Bach, Bach.”

Michele: How I Became Crazy (Maybe)

Blame and causation are slippery bastards and not easy to understand or assign.  I hesitate to even consider the word “blame” here.  I am 100% positive that that new baby girl, Piper, was the product of the induced labor–though she probably would have made an appearance, sooner or later, without the induction part.  I am about 98% certain the the broken tail bone is a direct result of the vaginal birth of that 9 lb, 4 oz baby girl.

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Taken the night of P’s Birth

The broken back–that’s much harder to pinpoint.  Less dramatically, I have a stress fracture in the 5th lumbar vertebrae. It almost certainly happened before the actual birth.  It may have occurred in the preceding nine months.  The gigantic baby bump pulling at my back could have caused it.  But before that was a previous pregnancy and before that were years of gymnastics as a child and then years of coaching as an adult.  Slippage and/or a stress fracture at L5 are not exactly common for gymnasts, but neither are they unheard of.  It could have been a ticking time bomb, waiting for the added stress of that belly to set it off.  For all I know, it was a ticking time bomb that had gone off during my first pregnancy, or even as far back as when I was a teenager.  I just was never made aware of it until after Piper’s birth.

My broken mind is like my broken back.  Again, less dramatically, I have been diagnosed with bipolar disorder, peripartum onset.  Added to that is what my psychiatrist and I refer to as “general anxiety.”  I show symptoms of social anxiety, general anxiety disorder (GAD), panic disorder.  We just group it as “anxiety” since his treatment plan would be the same, no matter how many names or letters we gave to it.  I will save talk about anxiety for another time, along with the sleep issues I have.  There is only so much crazy you can talk about at a time.

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Normal first time mom first birthday crazy or mania?

So that’s the official diagnosis–bipolar, peripartum onset.  Beginning before or after childbirth.  I was diagnosed as having peripartum depression at first, and only after seeing a psychiatrist when I wasn’t getting better was the diagnosis changed.  But when did it begin, really?  I had postpartum depression with my first child, Finn.  Was that actually misdiagnosed bipolar?  I search memories from before I had kids.  I was treated for depression, first in college, then in law school.  Was that actually bipolar?  The rush from all nighters pulled in school, working on projects.  Was that “normal” procrastination or something different?  The euphoria I felt at times, that I could win any speech competition, that I was the ultimate stage manager, that I could do ANYTHING.  Normal excitement or hypomania?  I could spend hours picking apart my previous life, trying to see if there was some indication of any manic states.  I HAVE spent hours, picking apart my previous life, doing just that.

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EVERYONE stays up all night at college debate tournaments, is convinced they are unstoppable and are so all knowing they set up their friends (WHO LATER MARRY!), right?

Of course, it could have be that I legitimately had postpartum depression and that it triggered bipolar disorder later.

I have finally come to the conclusion that it is impossible to know.  And it probably doesn’t matter.

The most important thing for me to remember is that bipolar, peripartum onset differs from postpartum depression in that it isn’t going anywhere.  I have bipolar disorder and barring some miraculous cure being developed, I will have to treat and manage my bipolar for the rest of my life.  That probably means medication, every day, for the rest of my life.  It means seeing my psychiatrist on a regular basis, for the rest of my life.  It means that while I will hopefully reach and maintain “stable,” I will never NOT have to be vigilant about my mental health, for the rest of my life.  It means that no matter how hard I try, my loved ones and those close to me and even those who have the slightest contact with me, will at some time or another, be affected by my mood disorder, for the rest of my life.

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Manic-induced, spur of the moment paint decision.
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It came out pretty well, but even my friends said I was crazy.

I continue to work with my doctors, and it seems that we have finally found the right mood stabilizer.  We are still working on details and right now my life feels like a mess but it also feels like we are looking in the right direction.

I am privileged to have access to doctors and medications and other therapies.  I am privileged to have a family who loves me and supports me and helps me.  I am privileged to be able to not work.  I am so damn lucky.

But I still have to deal with the reality that my mind is broken, every day, for the rest of my life.