12.24.2004

Christmas Eve

Okay, we're off to spend Christmas Eve with K's family. I got a bit teary-eyed at breakfast as I remembered the challenges of last Christmas. K was starting to recover from her episode with bipolar, but she remained very ill. My mom was visiting and I was killing myself trying to make sure that everyone had the perfect Christmas. I remember only breaking down into tears as the exhaustion and stress took over.

This year is very different. Admittedly, we were shopping this morning, but it was the fun type of shopping where you know exactly what you need to buy and you get to go into cool stores and buy it. We're functioning better in the cold. Today is a balmy 5 degrees above zero, that would be on the Fahrenheit scale, not Celsius. Wind-chill makes it about -15 according to www.weather.com. Thankfully, our car is curled up in a nice warm underground parking garage at the hotel.

K's illness continues to demand accommodation as I mentioned yesterday. Before we go out in the evenings, we try to get back to the hotel for her to rest a couple of hours, so she won't be too exhausted. It seems to work. She's even been drinking. The last couple of nights, she's been having a Bloody Mary, her drink of choice. When we met up with her ex-husband for dinner, she took part in a bottle of wine that he had been saving for her. Given that until recently it looked like K would never drink again, it was a bit surprising that he hung on to a bottle of wine waiting for her to return. Also, it's the first time in two years that she's seen him. K's always careful about drinking and concern for her medications and alcohol interactions has made her even more careful than before the bipolar diagnoses. I'm surprised she feels well enough to risk it, but there have been no problems.

Yes, we saw her ex-husband. She divorced him after we got together, but I was not the one who lured her away from her proper heterosexual marriage. Rather, the luring had been done years before we ever met. The ex seems to like me and has made comments to K that I should date him if K and I ever broke up. Not bloody likely as far as I'm concerned. K's been irritated with him for years. He never moved on after the divorce. Five years after she moved out of the house, her things like a bottle of Tums, soaps in the bathroom, were never moved. A disturbing thought isn't it, that artifacts of a person are abandoned even with someone living around them.

He did share his good news with us that he's selling the house they lived in together and is moving to another community about 30 miles away. It's time and maybe he will even move on with his life.

Back to Christmas Eve, we'll be off in a few minutes for K's family. We need to stop by her sister's to see her baby turtles, five cats, and dog. Then on to her parents for the traditional Polish Christmas Eve meal, consisting primarily of foods I dislike, Polish sausage (yuck), sauerkraut (yuck), Polish mushroom soup (yuck), and pierogies (YUM!). I'm not as ungrateful as a I sound, but it's not the meal I anticipate all year, as is done in K's family.

Tomorrow we return to my mother’s house to celebrate Christmas Day. Our Christmas is fairly quiet, but my gift is being about to enjoy it without fear of K’s illness. That’s enough.

Merry Christmas!

12.23.2004

Christmas time and freezing cold

As I said the other day, we're on the road. We decided for a number of reasons to road trip rather than fly, not the least being that we have to go back and forth between two cities several times over the 12 days that we are out here. Part of our travels consisted going further north than where we live. My god is it cold out here. The first two days I shivered every time I came next to the windows. Let me also say, the weather was in the 30's where we live.

We've both layered on the wool and the high tech fleece to keep from freezing to death. My mother's house is exceptionally drafter, especially when she doesn't put down the storm windows. So K's been being a good daughter-in-law and putting my mom's house in better condition for the winter.

We're slowly learning, as we do more traveling, that K needs at least one day to sleep about 16-18 hours after arriving at a destination. However we get there, be it by car, plane, etc., it seems to take a lot out of her. I don't know if this is part of the bipolar, but if she doesn't get the relaxation time, it can cause rage to flare up. I try to be accommodating, but there are times that I want her with me, participating in life rather than sleeping it away. (Right now, she's quietly sleeping across the room from me in the hotel, so I don't pressure her all of the time.) As we create our travel schedules, we are trying to accommodate her need for rest upon arrival and build in an extra day at the end of the trip, so we don't immediately go to work the day after arriving home. If these accommodations for her schedule forstall any instability, they are well worth the time and trouble they take.

This week, we've been spending some time with K's family, who have come far in accepting our relationship. For many years, their interactions were strained and awkward. They still don't always know how to deal with one another, but the tension is gone and the second guessing of every statement has disappeared. The trust between the family has been regained. As a result, we are trying to spend more time with them, than we did previously.

One example, as we rode with K's parents to dinner last night, an hour's drive, I said something slightly negative about my mother needing lots of attention as she just bought a new computer. K's mother promptly said that there would be no mother bashing in the car and suggested the creation of the group MUAC. MUAC stands for Mothers United Against Children and their charter would not allow any mother bashing within their hearing. Another mother who may be interested in joining a group like MUAC is Ayelet Waldman http://www.bad-mother.blogspot.com/. Very entertaining and non-saccharine view of raising four children.

K and I are starting to relax. My optimistic, happy, bouncy nature is reasserting itself past the house traumas that we had before we left town. If our house has blown up with the new boiler, no one has told us about it yet. The work continues in the basement without us and unfortunately, will continue once we return, but they are making progress down there. I'm starting to feel as if I'll be able to enjoy Christmas.

12.17.2004

Rising Chaos, Lowering Tolerance

The chaos level in the house is rising once again. K woke me up at 5:45 am the other morning to point out that the boiler was no longer functioning and we didn't have any heat in the house. The temperature was a balmy 30 degrees or so. The short version is that as I type, there are two men busily installing a new boiler at the cost of $3900 a week before Christmas.

To complicate matters, we had planned on leaving town tomorrow morning to go visit our families for the holidays. Now we are struggling with the decision as to whether we leave after having the boiler installed less than 24 hours or we delay our trip a day or two. We're planning to be gone for 12 days, so it wouldn't cut into our time too much, but I did pay for a room over Priceline already, and I hate to lose the money. We're planning to make the decision based on how the installatiion goes.

Between the need for a new boiler and the continued work in the basement, things feel somewhat crazy. It's taking a toll. I hate having these guys constantly knocking at the back door, discovering that they've screwed up something, having them ruin or take our stuff. For example, our wheelbarrow is missing. It's been replaced by a wheelbarrow, which isn't ours. The front door to the basement no longer closes and a pane of glass has been broken. We caught one team of workers trying to grind lead paint off the brick. Right now, the floor is shaking and the dog is freaking out due to the noise of them cutting out the old boiler in the basement. Our home has become a burden rather than a sancutary.

K continues to handle the chaos well, but we're both on edge. The good thing is that I believe her reaction is a perfectly normal reaction and not one fueled by bipolar rage or depression. She was in a class a couple days this week, and she was supposed to go to the office this morning. Instead she remains upstairs asleep due to the exhaustion from the class. Her exhaustion has eased, but it is one of the last lingering symptoms of her illness.

I'm edgy and trying to maintain my usual pollyana attitude towards things getting done. But it becomes difficult with the work in the basement. I hope to regain my usual happy, bouncy nature soon.

12.15.2004

Pills, Prescriptions, and Doctors

Dr. Zuger wrote a good essay for the NY Times today discussing a doctor's tendencies to rely on particular medications and not always listen to the patient. She discusses her biases and struggle to balance statistically proven outcomes versus the needs of individual patients.

Given the importance of medications in the treatment of bipolar disorder, the dilemma between percentage outcomes and individual needs remains a constant tension. The additional challenge is finding a doctor, who is willing to work with a patient to work through that tension to develop a medication regime, which is tolerable and effective.

I believe strongly in having an advocate at the doctor's visits to make sure that the patient explains his/her concerns to the doctor clearly and to take notes of the doctor's response. Also, the advocate may speak to elucidate individual points or to query the doctor more closely.

Every since K's heart attack and subsequent depression (prior to the bipolar diagnoses), I've attend the psychiatric visits with her. I was able to listen more clearly and not get hung up on a single statement. K found it valuable to have me there to offer Dr. X feedback as to her moods, ask questions, and to rehash the visit afterwards. If we were to ask him, I believe that he finds my presence valuable in treating K.

An advocate becomes particularly important in discussions of medications to support the patient if the doctor has trouble hearing, listening, or believing the patient. The last role an advocate can play is aiding a patient, who may not want to challenge the doctor. A doctor isn't infallible, and the patient needs to question and challenge, as appropriate.

12.13.2004

Productive, but tired

K is finally feeling better after her bout of illness over the past two weeks. What we are continuing to fight now is the chaos in our household, but progress is being made!

I've been painting the dining room as quickly as possible, so it will be finished before we leave for Christmas this upcoming Saturday. I/We finished yesterday afternoon. K felt up to helping me finish off the trim, which was great. She was able to complete the room, while I attended a reception. I like how we are able to work together to get things done, when she's up for it.

The dining room is completed and we gave away the dining room table yesterday. We are like normal people again with a single dining room table. This table is the one that was being refinished in the living room for way too long. What were we thinking to allow someone to refinish furniture in the middle of our living room? Not a good idea. It looks great, but never again will we agree to let someone work on a piece in our own house.

The chaos on the first floor is beginning to subside, but the basement remains chaotic. We've made jokes about the workers possibly living down there. The frightening thing is that I believe one of them may have slept there Saturday night. I glimpsed him leaving around 10 am with a large heavy coat, in addition to the one he had on.

The even stranger part is that I wasn't particularly bothered by it, other than to point out to K that we need to have all the locks changed when the workers complete the basement. It isn't possible for anyone in the basement to get upstairs and when we are gone for Christmas, it will mean someone will be around to keep an eye on the house. I'm not trying to encourage it, but I'm not going to do anything to find out if he actually is living in our basement. This may not be a "normal" attitude, but I don't feel like stressing.

Bipolar disorder has not raised its ugly head of late. Another PMS cycle has been successfully beaten back by the use of Paxil. That solution has worked wonders on K's mood for the week when I have PMS.

We remain in constant awe of her diagnosis of full remission. It's an almost immeasurable distance from where we were for last year's holiday season.

Busy week ahead getting ready to go out of town again, but it will be good to see the families. Also a relief to know that K is up to the trip and able to handle the emotions of spending time with her family without it sending her spinning. That's the best holiday gift.

12.08.2004

Intenstinal Aliens from Mexico

K and I went to see her internist yesterday afternoon, even though K was starting to feel better. As usual, we had a lengthy visit with the resident before the internist came to see her. K's internist is a wonderful woman with an amazing bedside manner. She's makes you feel that you are the only thing on her mind.

During three of K's four hospitalizations (2 for heart disease and 2 for bipolar disorder), this woman came daily to check on K and acted as K's advocate when necessary. She didn't come during the fourth hospitalization, as I didn't notify her that K was hospitalized. I received a talking to in addition to her direct office number after she learned what had happened. I'll stop fawning over K's internist.

The ultimate diagnoses was they believe K picked up some bacteria, possibly when she had a diet coke in the airport. The ice may not have been made from filtered water. Now, they'll check it out. The good news is that the dizziness and inability to read is likely due to K's minimal food intake for the past week. K's only eaten one or two ladle-fulls of soup each day. Last night though, K went out and devoured a giant roast beef and blue cheese sandwich with no ill effects.

The internist and the resident both were very excited by K's report that Dr. X has put her bipolar disorder down as full remission. It made me realize what a significant milestone that is and how it is the perfect holiday gift.

K's doing better physically and mentally. She's back on the Paxil again to attempt to forestall the effects of PMS. We also have been battling with contractors over the basement, a battle, which is drawing to a close to everyone's mutual satisfaction. I'm not sure we won, but we're reached an agreement that will be more expensive, but less stressful.

Last note, I found another excellent diversion blog, Symbiotic Fishes. If you enjoy Dooce, check out this guy.

Good Site

I was doing a bit of surfing this morning and stumbled across this site, My Mental Trampoline. Tatty has done an excellent job of compiling very practical information, actions, and guidelines to take for bipolar patients as well as for spouses/partners of patients with bipolar disorder. I will add the spouse link to my links at the right.

I encourage you to take a look. She also appears to have a message board and a weekly chat. I have no idea if they are useful resources, but I would assume they are worth checking out.

Blondzila, a point of interest for you, she's another Canadian.

12.06.2004

Pressure

It isn't either bipolar disorder or contractors causing stress in our lives for the moment. It is this unknown physical illness that K contracted somewhere during our travels. She's been ill for almost a week, unable to easily keep food down, stomach pains, unable to focus her eyes, and dizzy. My dining room painting spree over the weekend didn't help with her nausea either.

K doesn't want to or doesn't know how to deal with it. Finally, I got irritated with her unwillingness to call the doctor and made an appointment for urgent care tomorrow afternoon. But now I have to take off work again (I was off on Thursday, because she was concerned about passing out and being home alone.) to take her to the doctor's.

I'm irritated. What would happen if I didn't have a job where I could not easily take time off? I guess I'm also irritated by her being so sick and unwilling to take a taxi or have someone else drive her to the doctor. Even if she did have the car at home, she wouldn't be up for actually driving given her condition, but she could make it to the doctor some other way.

Throughout the week, the painting of the dining room, dealing with contractors, and errands all fell to me as she was too ill to do anything. I don't doubt that she's sick, but I am tired of being the one having to do it all.

What mostly gets to me is the pressure to have to leave work and deal with things for K. I wish she were more willing to do it herself. When I pointed out that I would have to skip a meeting to go with her to the doctor, she got angry with me.

Sorry for the rant. I feel slightly better, but still REALLY irritated.

12.04.2004

Full Remission

Yesterday was the visit to the psychiatrist, Dr. X. K has been physically ill for several days now. She argues that it is Montezuma's Revenge, while I think she picked up a bug somewhere. Whatever the cause, she's been barely able to eat, since Tuesday. Despite her physical discomfort, her mood has remained positive and stable.

As Dr. X signed off on her insurance form (because the psychiatrist department no longer processes the forms themselves. We pay upfront and have to request reimbursement.) He mentioned that he was checking the "Full Remission" diagnoses box. The first time in two years!!! It is a Christmas gift for us. Unfortunately, K remains to ill to go out and celebrate.

My immediate question, as we left the office, was "Does this mean we no longer have to clear every trip through him?" We'll probably check-in if we are going more than three time zones away. The other good news is that K's next appointment with him isn't until March. Additionally, starting in January, she goes from weekly to bi-weekly therapy appointments. Yes!!! These are great signs of her improvement, but also a good forecast for improving our financial condition. The debts for her illness were on the low side, given the circumstances, but we still need to spend some time in 2005 digging ourselves out.

K has excellent insurance, but despite regulations requiring parity between mental health treatments and physical ailment treatments, the insurers have managed to get around it. The type of insurance we have requires the parity. So, her therapy visits were covered about 60% for six months. This year the psychiatrist seems, oddly, to have been covered all year, but only at about 50% of what we pay. Regardless of how you look at it, things are good.

One interesting thing Dr. X had to say was in response to a question from K. She asked if there was a chance that the lithium would stop working. He said it varies, but in her case it was unlikely. Her bipolar disorder cycled out of control after a heart attack, entering menopause, and months of depression. He said that in K's case, the bipolar episode was brought on by extreme outside events. Unless something of that magnitude occurs again, he believed that the lithium would keep her moods stabilized. He said that if someone experiences an episode without an apparent outside stimulus, then they may be more likely to have repeat episodes, as their episodes were spontaneous. (I feel as if this paragraph is convoluted.)

My entire day has been spent painting the dining room and there remains much work to be done tomorrow. K remains ill, though starting to eat more food and not immediately rid herself of it. I'll write about Mexico another day.

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