Month: April 2016

Clozapine (Clozaril) Labs & Registration

Clozapine (Clozaril) Labs & Registration

Friday was the beginning of the Clozaril rechallenge (generic is Clozapine) process. I had my blood work done; there was some difficulty getting the lab to send the results to my doctor and my pharmacy. It was partially my fault, I did give them the wrong fax number for the pharmacy, but it took 4 phone calls to try to fix the mistake. Even when they finally said the problem was resolved, it turns out that it wasn’t; the pharmacy never received the results. Luckily, I ended up talking to one of the nicest and most caring pharmacists since my father and aunt. He was happy to call the lab himself and request my results so that I could get my prescription. Once he got my lab results, he realized that I had to be registered again in the Clozapine Database because I hadn’t taken the medication since this past summer; all patients need to be registered by both their pharmacist and their doctor. My pharmacist told me he would call me once the registration is complete so I can get my prescription filled. There aren’t many pharmacists that are as polite and happy to help as he was.

Sometime tomorrow I should receive a phone call from the pharmacy letting me know I can bring in my prescription. I admit that I am nervous. I’m not nervous that I will end up with some of the horrible side effects of Clozapine such as neutropenia, which is an abnormally low level of white blood cells, making the patient susceptible to infections. This is why there are so many protocols with Clozapine. I feel like I should be nervous about it, but I’m not. What I am nervous about is the fact that I don’t know if this will work or not. I’m trying to remain positive; I keep saying that this time it will work, I won’t get a fever, I won’t have to go to the hospital, and there won’t be any problems. I’ve been so nervous about this rechallenge, my anxiety level has been much higher than normal; I’m anxious even sitting at home in my comfort zone.

Is this weird that I’m more concerned the medication won’t work than I am concerned that the med will cause serious side effects? I think it’s just because I don’t know how much longer I can live like this. I have had suicidal ideations for more than 5 months. My hallucinations keep getting worse making the paranoia intolerable. And in my mind, the worst part of it all is that I won’t do anything about it. I can’t take my own life, no matter how much I think about it. I know that technically that’s a good thing, but if you lived in my mind for even a day, you would understand. Every day I put a smile on my face and do my best to pretend everything is okay, but inside I’m a disaster. I want to live and be happy to be alive. I need this medication to be the answer. I’ve taken pretty much every other medication and I still do ECTs. I currently take 7 other psychiatric medications, 2 additional meds to treat side effects, and 3 other medications for physical conditions. I just need to catch a break, I’m hoping that will happen with this Clozapine rechallenge. We’re all about to find out.

 

Wellness Recovery Action Plans

Wellness Recovery Action Plans

I decided to complete the WRAP (Wellness Recovery Action Plan) paperwork. I did one years ago when I lived with my mother, and it was very helpful. It could probably help out my husband as well. WRAP helps people figure out and integrate wellness tools and healthy strategies into their lives. It helps both those with mental health illnesses and their caregivers. It asks open-ended questions and statements such as how are you when you feel well, what do you do to stay well, what are your triggers, what do you do when your triggers emerge, what are your early warning signs, and what are signs that you’re about to break down. These questions are just the beginning of the documents. It will take a while to complete. I will probably ask my husband and mother to help me complete my WRAP.

I think it can be a vital part to the maintenance and recovery of those with mental illnesses to have this type of information documented. The thing I like the most about the WRAP is that it helps us create a crisis plan; informing our loved ones and caregivers exactly what we do and don’t want, such as meds we do and don’t want to take, what hospitals we do and don’t want to go to, and who we are willing to let take control in a crisis situation. Completing the WRAP documents gives those of us with mental health illnesses a voice; we get to make decisions when we are well about how we want to be treated when we are sick.

The WRAP that I chose is from NAMI (National Alliance on Mental Illness) in Austin, TX. It can be found using the link below. By Googling ‘Wellness Recovery Action Plan’, you can find many different options, and if you choose to do one, simply choose the one that’s right for you. It’s not easy to complete; it takes time in order to be thorough. It has helped me and my mother before, I’m sure it will be helpful again.

Click to access Developing-a-WRAP-Plan.pdf

 

Blood Work Starts Now

Blood Work Starts Now

As my husband left for work this morning, he brought the mail inside. One of the envelopes was from my psychiatrist. It contained a weekly standing order for blood work to monitor the Clozaril along with a prescription that I can give to my pharmacy once I hear back from my doctor about my blood work.

I wasn’t nervous until just now. In fact, I was slightly excited to start Clozaril because I was hoping it would help level me out and particularly get rid of my hallucinations. I was thinking that it could be the solution I’ve been waiting for. However, now that it’s time to start the process, my heart started to pound, chest pains developed, my breathing quickened, I became sweaty, I started rocking back and forth when sitting, and I couldn’t remain still when standing. Basically, it was a minor anxiety attack. I didn’t know where my fears were coming from. I don’t like anything new, but this isn’t new. This is a rechallenge. I tried it for the first time last summer with no success.

I still want to believe that it will work out, but right now, I’m not so sure. I worry that my Ashkenazi genes will cause problems again. My mind is going a million miles an hour, and it’s going to some bad places. I keep thinking that if this doesn’t work, then there’s no hope left for me. Technically, I know that’s not true, but sometimes fear takes over the mind. There are still a few other options, even though I really don’t like them, they are there. And there is always research being done resulting in new medications and treatments that are often very successful. Will I ever be a part of the success when it comes to treating my bipolar disorder? It’s been a long time that I’ve been unstable; it just makes me question a lot of things.

I simply needed to get all of these thoughts out of my head so I don’t continue to obsess over all of it. I think this has helped clear my mind even just a little. At this point, I feel calm enough to drive, and that’s all I needed. I have stopped shaking and I can breathe better. I don’t have to leave for another 40 minutes. I’m going to take that time to continue calming myself.

 

Living With Anxiety

Living With Anxiety

Living with any type of anxiety disorder is one of the hardest things a person with mental illnesses can deal with; at least that’s how it is for me. There are many forms of anxiety disorders including Generalized Anxiety Disorder (GAD), Panic Disorder, Social Anxiety/Phobias, Obsessive Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD). Personally, I live and struggle with PTSD due to an abusive relationship that occurred 13 years ago. No matter how much I try to get past everything, I still have flashbacks, fears of anyone I don’t know (especially men),  I have a hard time relaxing, I frighten very easily, I avoid anything new, I struggle to sleep, when I do sleep I have nightmares, and I have portions of the abusive time that are mostly a blackout. These are only some of the symptoms I deal with; it’s a huge battle that I fight every day. Sometimes I feel absurd because of how much my anxiety runs my life. I do the best that I can to continue to live my life, but it doesn’t feel like it’s enough.

One of my biggest difficulties is that I do not like having anyone behind me. I’m constantly looking over my shoulder to see if I’m ‘safe’, just so I have a moment to breathe. This makes running errands, such as grocery shopping, very strenuous. It doesn’t really matter where I am, as long as I’m outside of my house, this is a major issue. I wish I had eyes in the back of my head. Also, my therapist tells me that I behave certain ways in all types of relationships, such as giving without thinking of myself, because of the past abusive relationship. I even had over a year long period where I could not handle touching others. Now, I can shake hands with someone if necessary without having an anxiety attack, but it still terrifies me. If I know a person well enough, such as family or close friends, I am even able to hug them. This is a huge amount of progress.

Living with anxiety is about knowing your own boundaries; what helps you, and what makes things worse. Since I don’t like people behind me, my husband generally walks behind me in public, this helps me feel safe because I know he wouldn’t let anyone hurt me. Sometimes when we’re in public, he will hold onto my belt loop or vise versa, also helping me feel safe and comfortable. Benzodiazepines, such as Valium, are very useful, but I try to only take them when absolutely necessary. Everything I do, even just getting mail from the mailbox, has potential for an anxiety attack. I can’t just walk outside without thinking of all the possibilities. I look out the window first to see if anyone is coming, when the coast is clear I go as quickly as possible to the mailbox hoping that I can go unseen.

I am always trying to find new ways to help deal with my anxiety. Knowing my triggers and boundaries is a huge part of managing my anxiety. I do the best that I can every day and try not to let my anxiety run my life. That’s easier said than done, however; it’s easier for me because I have so much support from my loved ones. I control what I can and try to prepare myself for the rest. I have thought about getting a therapy dog. One that could sense when I’m having an anxiety or panic attack and help calm me down, or sense my nerves and stand watch to make me feel safer. Therapy dogs can do so much good; it’s something I want to look into for the future as another tool to manage my PTSD.