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Just got home from Mom’s follow-up doctor appointment. Y’know, from the Broken Kneecap Debacle of 2010? Today was her last scheduled day of physical therapy. She’s gone from a 65-degree flex on that knee to just over 90 degrees. It’s been just over 3 months since this thing started.

She’s been driving (back roads, since highway driving with the constant acceleration hurts), she even went to the grocery store yesterday…first time since her accident. She’s cooking, too – thank God, because my culinary skills are roughly the same ones owned by 7-year-olds.

Long story short: Six more weeks of physical therapy to increase her flexibility and strength. She can return to work almost immediately. And another doctor visit in two months’ time.

Her going back to work is a good thing. It’s been a long three months and Mom has had more than her share of stir crazy. The BITCH about her going back to work now is that I’m the one that’s gonna have to chauffeur her around to work and back every day. See, she works off the highway, so…I’m kinda screwed, especially since her workday starts around 8am.

Ugh. Can’t wait till she can fully drive again.

Me? Meh. Depression still bares its vampire fangs my way, so much so that getting out of bed is just a couple clicks shy of more than I can do. It’s probably a good thing I have another video-conference with my shrink this afternoon.

The Abilify isn’t cutting it; not at the current dosage, anyway. The prazosin, a blood pressure med which has an off-label use for ridding people of nightmares, may be working. I rarely remember my dreams, but can’t recall any nightmares of late. Typically, with nightmares I’ll wake up in a sweat at 3 or 4 in the morning. Been a while since that happened.

What I have noticed is more energy, to the tune of cutting into “productive” nap time. I wish energy = motivation, but it doesn’t. I need something for mood. Or something that will excise drama from my life. Both, preferably.

I understand how my shrink is approaching my case. We don’t want to start me on multiple things at one time. That’d make it difficult to ascertain what medicines are doing what.

But as I mentioned in my last post, my super powers do not include waiting. I want to feel better…not yesterday, TODAY. Hell, I’d just about prefer a manic phase right now. Relief, any relief, would be welcome.

The trial-and-error shit associated with finding the right Magic Cocktail is not fun, nor fast enough for my liking. I know the universe doesn’t give a fuck, but I’m tired of uttering the mantra: “It has to get better, it has to get better, it has to get better.” Repeat ad nauseum.

It does, though. Right?

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I’m slacking. I feel it. Losing my momentum is not a feeling I like. The mania has subsided. My brain is much calmer (and dumber), though that’s relative. It’s still busier than most people’s, I get that. But compared to the manic shit? It’s like my brain finally said no to steroids or something.

Tomorrow I have my first real session with the new shrink, via videoconference. Amazing the V.A. even knows such technology exists, but I’m not bitching. If it weren’t for the video thing, I’d have to drive 90 minutes to meet up with her.

I’m not slamming the V.A. in any way. I’ve heard horror stories, but to be fair, I’ve not experienced many problems with the care I’ve received. And I’m very thankful for that. I don’t have regular health care. The jobs I’ve had of late are contracting positions. No bennies provided. Sure, once upon a time, when I got $43/hour for my time, I could afford it. But not now.

I’m already impressed with this new shrink of mine. She called me a few weeks ago, unsolicited, just to check on me and my meds. On a Friday. At 5:15 in the afternoon. That speaks volumes to me.

So we’ll be discussing meds, mostly that the current regime isn’t doing shit. We stepped up the Geodon. I’m now taking twice as much as I was a few weeks ago and…nothing. That’s the bitch with being treatment-resistant. Lots of meds don’t touch me, then there are those that require a much higher dose than what others find effective.

The trial-and-error associated with medication is exhausting and nerve-wracking. I’m far from the most patient man on Earth, and adjusting meds (and trying new ones) pretty much requires patience, and lots of it. That’s how it is, particularly with the meds designed to hit your brain instead of just your body. They take WEEKS to build up efficacy in the body. And if they don’t work, many of them take weeks to get OUT of your body, which is sometimes needed before adding something NEW.

For me, I’ve pretty much always required a Magic Cocktail, a mix of different meds. I wish like hell that there was a pill that did it all, but there’s not. My chemistry is different than yours, which is different than everyone else’s. So, yeah, trial-and-error. With all the technology we have today, that’s still the way it works. I long for the days of Star Trek, when they scan you with a Tricorder and have you fixed up with a simple shot.

I read an interesting article last month about a pretty major discovery regarding Post Traumatic Stress Disorder (and yeah, I’ve got that, too). They’ve found a way to definitively diagnose PTSD using pictures of the brain. Remarkable, since the only way to diagnose before was through a series of questionnaires and a laundry list of symptomology.

Unfortunately, this discovery probably won’t lead to helping ME…not for a long time. Not until they can point to a brain scan and say, “Ah, see that squiggle there in Karl’s hippocampus? We need to give him Miracle Drug Alpha for that.” Until they know how to correspond the brain pics with specific forms of treatment? Not gonna do much for me. But it’s hopeful for future PTSD’ers, and I’ll take that.

I started out talking about me losing momentum, and that’s really what I’m feeling right now. A lot of hopelessness, lack of motivation, simply losing my give-a-shit attitude. Depression. An overwhelming sense of, well, being overwhelmed. Yes, I’m still checking my sugar and taking my meds, but I really don’t care about it.

I knew this was going to come, the return to the old me. Trying to find some shrivel of happiness in this mode is daunting, at the very least. I can’t survive in full-blown mania all the time – I’d die from sheer exhaustion, from insanity. But I wish I had a way to harness the motivation, the good attitude, the Happy.

Think I’m treatment-resistant in the attitude department, too.

For now, I’ll just take what little pieces of enjoyment I can get. I like the winter Olympics (tons more than the summer Olympics), even though I’m not a sports guy. I never watch baseball, or football, or basketball, or hockey. None of it. That shit bores me to tears. But the Olympics has something for everyone. Plus, it’s only two weeks long. I’m in, I’m out, I’m done for another 4 years. My fave events, by the way, are figure skating, snowboarding, and the skiing…none of which I’ve ever tried.

I also found some meditation podcasts, thanks to Angel. A friend has offered to help me with meditation – something I’ve never tried before – and I plan to take her up on that offer. But the podcast I listened to yesterday really helped to calm me down. I like that. I say I’ve never tried meditation, but the truth is I’ve probably achieved that “nothingness” mindset on my own many times. I may be wrong, but all the dissociating I’ve done in my life kind of mirrors that calming void sensation in meditation. I suppose there are positives to being a Survivor, after all.

I’m gearing up for 2HT’s redesign, and I am excited about that. Should be happening within the next month or so. My original launch date was going to be April Fool’s Day (seems appropriate), which also happens to be both my Mom’s AND my twin daughters’ birthdays. But it’s going to be sooner than that. Can’t wait to see it all come together.

I’d really like a dog. I think that’d do wonders for me. Mom hasn’t been so keen on getting a pet, though. Her rationale has always been, “If you can’t keep your room clean, how are you going to take care of a dog or a cat?” My rationale has always been, “Those two things aren’t even closely related.”

And yes, I’m 43 and live with my mother. I’m also depressed, anxious as Monk, and unemployed. Put me on “The Bachelor” now, ladies. I’m available. *cough*

Like my brain, this post is all over the board. I’m tired of that, too.

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Today is January 30. Already. Shit, where the hell has this month gone? How did we already get 1/12 of the way through 2010?

Tomorrow is the last day of the month, which means it’s the last day for this month’s Resolution. Not that I’m tossing my new habit out the window, mind you. I’m not. And that was the point for the Year of Resolutions – starting 12 new HEALTHY habits.

Thursday night, I had ANOTHER low blood-sugar episode. I’m OK. (I say that because I hate when someone throws out some scary news and then takes 10 minutes to walk you through the whole story before saying, “I’m OK.” No, people. When you say something like, “I got in a car accident,” you follow it up IMMEDIATELY with “Don’t worry, I’m OK.” THEN fill in the rest of the story. Idiots.)

My best bud was here with me when it happened. I felt I was going low, recognized it, said aloud, “I need to eat something NOW. I’m low,” and came inside to do just that. The details aren’t important, really. Suffice it to say that I found myself on the floor again, trying hard not to vomit or pass out, but orange juice did the trick. And my friend was very calming and reassuring the whole time.

She got to help me check my sugar, and that’s a good thing. She’d never had to do that before. Hell, for most of the time I’ve known her, I haven’t been very compliant with my meds. She’s never seen me low before this year, mostly because I haven’t BEEN low…or even close.

Here’s what I’m supposed to do when I’m feeling low: check my blood sugar, then remedy the situation. It’s important to know what your sugar is when you feel low. Again, normal glucose readings are between 80 and 120. I know from recent experience that at 71, I’m still not fading out. So I was probably at 60 or lower.

Here’s the problem with doing what I’m supposed to do when I’m feeling low: I don’t give a fuck what my sugar is…I just want to STOP THAT LOW FEELING, AND NOW. It’s awful, I don’t want to feel nauseous and flushed and sweaty and dizzy and terrified. I just want it to stop and, y’know, not smash my face into the tile floor. I probably have a cracked skull from the first incident a couple weeks back. There’s this weird…shifting… when I push on my forehead now.

I’ve been checking my sugar 4 times a day, like I’m supposed to. And I’ve been taking my meds, especially now that they’ve been adjusted. Because I nearly passed out again (that’s three incredibly bad episodes for me in the last couple of weeks), I reported it to my doctor yesterday. And we’ve adjusted the plan again.

“You’re scaring me,” she said when she called me.

“I’m scaring me, too.” And I am.

But here’s what’s new…I’m not pulling an Ostrich. I’m pushing FORWARD. I’m being proactive, I’m receptive to changes, I’m asking for help, I’m being compliant, I’m checking sugars, recording the numbers, reporting out to those that need to know. All of that is ALIEN territory for me. And new stuff? Is very scary to me. Change…brrr, gives me chills.

But I’m doing it, anyway.

And it’s paying off.

I know now that my nighttime snacks are critical. No matter how fine I feel, a nighttime snack HAS to happen…and sooner rather than later. This was what caused me to fall out Thursday night. Stupid. Again with the stupid. But these things are not happening for naught. I’m LEARNING.

What we’re doing now to fine tune my diabetes control is adding a 3:00 AM sugar check. Yes, even if it requires me setting my alarm. The doc wants to know what’s happening while I’m (supposed to be) in bed. Why?

This is the 2nd incident to happen around 1:30am. That means my sugars are crashing at night (if I don’t have a snack). And that’s kind of weird.

My morning and noon sugars yesterday were high…above 250. But my pre-dinner reading was 176. Two hours after dinner, my sugar was 157. That’s still high, but it’s relatively close to normal for a post-meal reading. At least for me.

The doc’s theory is that my sugars are dropping at  night. My body’s defenses then are inflating my sugars so that I don’t go into a diabetic coma. Thus, high readings in the morning.

MY theory is that I don’t take insulin at night. Plus, Thursday night (after the incident) I had orange juice, and a PBJ, and Doritos, and beer. And THAT’S why those high morning readings happened. Who’s right? I don’t know. We’ll see. Pretty sure it’s me, though. I feel like Einstein’s smarter brother right now.

My first 3:00 AM reading this morning showed my sugar at 257. This morning before breakfast, it was 254. These are bad readings, I know. But again, I’d far rather be high than low any day of the week. And we’re still working it, still grasping to get this shit in control.

It’s a work in progress. I knew going into this Resolution that my diabetes wouldn’t be under control by January 31. That was not the point. The POINT was for me to be compliant in my health care, to take a proactive role, to stop being an Ostrich.

And that’s actually happening.

The doc wants to drop another diabetes med. The brand new med that she just prescribed to me at our recent appointment. The med that has still not arrived in the mail.

“Stop taking the glipizide,” she said.

“I’m not taking it,” I said. “I haven’t gotten it yet.”

“Good. When it comes in the mail, don’t take it.”

Far be it from me to bitch about having one less pill to take.

We have a follow-up appointment in a couple of weeks. I will continue emailing the doctor my glucose readings. I will continue calling her to report anything significant. We will continue to tweak my treatment plan. We WILL get this under control.

I’m in a very unique position right now, having this manic phase (and recognizing it while I’m in the midst of it). I am optimistic, and hopeful, and open to new stuff. That’s not going to last, I know it. I’m dreading the inevitable crash, which will come…and probably very soon. It may already be happening.

I’ll be back to my morose, miserable, pessimistic self. It’s not an attitudinal thing, folks, it’s biochemistry. The euphoria associated with mania is brain chemistry gone amok. It’s not the norm.

So I’m taking advantage of the good attitude while I’ve got it, false or not. And don’t go jumping on me for using the word “false” there. It’s a genuine good attitude, yes, but again…it’s a result of my mania. It’s chemical. Yes, it’s false. In a manner of speaking.

That doesn’t mean I’m not going to use it to my advantage. I am, totally. I’m going to start keeping a paper journal again, to take copious notes on how I’m feeling…physically, mentally. I want to be able to tell the doctors everything, so we can closely monitor what changes I’m experiencing, so we can continue fine-tuning my treatment plan, so that I ultimately feel BETTER.

And when I come down from Mania Mountain, and Poser Pollyanna is gone, and I’m the fucking misanthropic Karl again, I want to be able to look at my blog (and the journal) and attempt to regain the positive attitude I have at this moment. I want to be able to see the cause-and-effect thing. I want to read how my proactive stance is actually making a DIFFERENCE.

I feel very much like Charlie in Flowers for Algernon. In the beginning of the story, Charlie is a janitor with a 68 IQ. He receives experimental surgery that kickstarts his brain and ultimately becomes one of the smartest people on the planet.

The book spends a great deal of time showing Charlie’s emotional changes, as well as his increase in smarts. Suddenly, world leaders are contacting him for help with their problems. Charlie is curing diseases. He’s solving impossibly complex equations. He’s fixing things that nobody has been able to fix before. He’s fallen in love with the woman that began as his tutor, but becomes his lover when she sees the amazing new person Charlie has become. Hell, he’s far SMARTER than the woman now.

But here’s the rub: his new-found genius status is temporary. He slowly starts moving back to good ol’ Charlie with the 68 IQ.

And that’s how I feel when I come down off my mania. I’m super smart right now. My brain is operating far above and beyond its usual state. I actually feel like I have the IQ I supposedly have…y’know, if you even buy into Intelligence Quotients.

I’m going to slip back to Stupid Karl very soon. And like Charlie, who had a good long taste of a super-charged mind, it’s almost better to have never experienced my brain the way it is now. Because knowing things can be so good is godawful when I’m beginning the maddening decline to the way I was before. It’s the cruelest bait-and-switch I know of. Contemplating this inevitability brings me to tears.

I feel this crazy need to blurt out everything in my head right now, to get it all onto paper before I lose it. I’m making abstract connections that I can’t normally make. My intuition is so advanced and well-honed right now that I feel almost psychic. I’m coming up with brilliant ideas. I’m creative as fuck.

And it’s all going to slip away.

It’s far easier to survive day-to-day when you’re used to being miserable. The expectations are low, so it’s hard to be disappointed. Knowing that there’s another way to see life – EXPERIENCING that other way – is bittersweet. It feels wonderful now (despite all of the BAD shit associated with mania).

But like most things in life, it’s not going to last.

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I do. I’m manic. You KNOW I do.

And I will. Later.

Right now, though, a friend of mine needs your love.

But come back. If you stay too long, Adam might think you’re food.

Shit, that would have been a lot funnier back before all his fucking weight loss. Dammit. I think my March Resolution needs to be my timing.

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