Visit with the Med Clinic Today

I went to my med clinic appointment today – finally after missing it twice now. As usual they weighed me. I weighed in at 155 pounds today. That’s 3 pounds less than last week. My dad insisted that I weighed myself again here when I got back to be sure. Yes it’s 3 pounds less. I’m still losing weight. I know many people would say this is a good thing but given my past history with struggling to gain weight before my children were born, this is very concerning for me. Yes I’m happy I’m losing the weight I gained from Abilify but I’m rapidly approaching the pre-med weight and it doesn’t look like I’m slowing down. This is what Topamax is famous for and since my boys were born my appetite has gone to shit which doesn’t help to slow down the weight loss. What the hell am I going to do when I have never been one to force myself to eat?

Don’t get me wrong, I love food. I can’t have a social function of any kind without food present. And dining out is always my favorite thing to do. Food is entrenched in culture and ritual and well… life itself. It should be an act of gratitude. I despise the “fuel up and go” mentality so many people have about food around me in this country now. In order for us to eat something has to die… why can’t we appreciate that, even if only for a moment?

Anyway, I digress. My point is I eat when I’m hungry and only until I’m no longer feeling hungry, not until I feel full. The problem is between the anxiety and the Topamax I don’t feel hungry very much at all so I don’t think to eat, even when I feed the kids. And now when I do sit down to eat it seems like it doesn’t take much to stop feeling hungry.

This is why I spent the entire appointment with them discussing my concerns about the elevated cholesterol levels and whether or not it was related to the Topamax. We discussed the research we found and they reassured me that it’s the Abilify that is better known for causing this – especially if it causes weight gain for you. And since I’m dropping that weight suddenly now it’s flooding my system. After all when you lose weight that fat doesn’t just disappear. It gets broken down and is released into the blood stream so the body can do something with it – either for building or to be flushed out.

So there will be no changes in my meds for now and since my blood work is over 3 months old at this point they are calling for new labs to be done. This time they are also adding in fasting glucose as well just in case my cholesterol is still high. The labs will be sent to both the med clinic and to my regular doctor for discussion. I’d like to see a registered dietician about my diet in regards to slowing down the weight loss. If my cholesterol is still high I want to discuss my options there too. Thus the need for the glucose test. If I’m still pre-diabetic then I’m not sure if a statin is a good option.

Overall my dad seemed relieved to hear that they weren’t changing my meds at this time and warned me that I will likely need the statin anyway due to genetics. I’m aware of that but I would like to avoid it if I can. I’m already dealing with enough shit. I really don’t want to add diabetes and heart disease to the list too. However, it’s in the genes and I’m not getting any younger. I may not have any choice in the matter. At least my blood pressure is still awesome – right smack in the middle of the normal ranges – for whatever freak reason. How I’ve managed that with all my stress plus being a smoker with my genetics I will never know. But hey, I’ll run with it.

She asked me about my mood too. This is where I wished I had thought to bring in my mood trackers in. Why else would I be keeping these? In any case I gave her the briefest run down I could of what’s been happening and then tried to explain how I’ve noticed my episodes seem to have an aura to them like migraines so. Sadly she has migraines too so she understood what I was trying to explain. Like just before the hypomania hits I get this kind of buzz feeling where you just know it’s coming. And for the depression it’s kind of like an impending sense of doom. But now with the Topamax, that’s all that happens. It never goes any further than that. It’s like being on a roller coaster that never goes up or down. You’re just waiting for that shoe to drop but it never does. So it’s a new coping skill I need to work on and develop.

At least now I think I’m starting to understand why some people claim that their meds make them feel nothing. The only time I felt like that was when the other clinic had me on Lamictal, Citalopram, and Abilify which made me feel like a zombie. People use that phrase a lot. I used it, but honestly it to me it felt more like being stoned or over medicated. Kind of like back in the days when I used a lot of pain killers for my migraines. There were points when I used too many and you would just feel out there. Sometimes the pain would still be there and that would be the only thing you felt. That’s the part that sucked the most. This is the biggest reason why I gave up on the painkillers. If they didn’t knock me out, they often just stoned me out and the pain would still be there. What is the point in that? None. Fuck that shit.

And I say the same thing about these mood stabilizing meds too. This is why I am grateful these people are listening to me. They didn’t scoff at me for my concerns about the cholesterol. They didn’t blow off my findings of the research that’s been investigating the relationship between Topamax and lipid levels. They agreed with me. It is exceptionally rare. What I didn’t know and didn’t think to look into was the relationship Abilify had. The fill in doctor on the other hand just dismissed it as my age and genetics. Yes that plays a role, but if your cholesterol has been good for years one birthday isn’t going to suddenly change that out of the blue. Your body doesn’t work that way.

Sadly the clinic doesn’t have the labs from the old clinic for comparison so we don’t know if this is a drastic change to point to the med or if this is a gradual change to point to genetics. I honestly can’t remember when that old clinic did my labs last. All we can do is go from here and track my levels and see if they will go down on their own. If they do then it was definitely the med and from the weight loss. Otherwise my genetics, and possibly my diet, are playing a role in this.

I still feel that Topamax is the right med and at the right dose for me. Yes, I still feel strong emotions. That’s who I am. I’ll be damned if anyone or anything is going to change that. But, I’m not sliding into the depths of despair for no reason nor am I zipping across the ceiling proclaiming genius either. I think this is a solid middle.

Now if only my dad would just stop giving me his “you just need to get your drive back and make yourself do things” speeches. Basically his “pull yourself up by the bootstrap” speeches in disguise. Seriously you claim this is what you do all the time but if you had no drive you wouldn’t be able to make yourself do anything in the first place. Making yourself do something you don’t want to do is not the same thing as having no drive for the things you want to do. It’s just not. Throw in a touch of avoidance behavior along with the freeze response and not much gets done when your drive and pro-activity seems to be exclusive to hypomania. I don’t know which is worse: the fact that I suspect/know this is what’s going on with me or the fact that this is something he will never understand. All the lectures in the world will not change this. Shaming me will not change this.

There is no way to explain to someone that has never experienced hypomania in the first place what it’s like to be in that state for 7 years straight in a fairly productive, mostly functional way only to suddenly lose it. And not just lose it but lose it to a postpartum psychosis. It didn’t just drift away to baseline. It wasn’t a crash into depression. I fucking broke. And in some ways I’m still putting the pieces back together.You can’t shatter a crystal vase, glue it back together, and expect it to be flawless. Won’t happen. I wasn’t flawless to begin with. You always made sure I knew that.

Sometimes I think he expects me to go back to the way I was as a single mom in college without the understanding that it was UNHEALTHY for me to be that way. That was the anxiety ridden hypomanic mind. Has he forgotten the panic attacks I used to have back then? Hell I used to have them just before my first son was born. He would be the one to call 911 back then convinced I was having a heart attack. I’m not going back to that. No fucking way. Yea, you might want that drive in me but you can’t have that without the price it comes with. And that’s the part you are failing to understand. It’s a chemical shit storm that burns the brain. It wrecks the body too. As time goes on, left unchecked, it just gets worse. If I have any say in it, I will never be that person again. Mourn her loss if you need to. I know I do at times, but I can’t go back to being her anymore.

I’m sorry that the new me doesn’t have enough drive for you. I’m sorry that I don’t get enough done for your liking. I’m sorry I don’t do things your way on your timeline. The reality is, this is who I am now. This is what my life is now. So stop with the lectures. Stop with the guilt tripping. Quit with the fucking advice I didn’t ask for. Either ask me if you can take over on whatever it is you want to do or back the fuck off. If I say yes, then get it done. If I say no, then shut up and back the fuck off. I’m tired of not being the person you asked me to be. I just can’t do it anymore.

And I really just want to say “This isn’t my circus!” flip the table, and run the fuck away. Somehow though I get the feeling it won’t help.

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