Sandman Keeps Calling

“Now this makes sense…” was the subject line of a recent email from my psychiatrist. How rarely am I greeted by that phrase in general, much less by the Goddess of Good Health? I was positively giddy as I clicked on the message.

This email was a reply to a long back and forth Dr. T. and I had been having over the causes/solutions to my problem of excessive fatigue. I had developed a habit of looking forward to 8:00 p.m. so that I could go to bed, and then I would wake up at 8:00 a.m., reluctant to go to work because I was so exhausted. Yes, I was clocking in 12 hours of sleep at night, not counting any naps I might sneak in during the day. And yet I dragged. And snoozed, and snoozed, and snoozed.

I have to give myself credit. For the most part, I did not interpret my excessive somnolence as a sign that 1) I was a horrible human being or that 2) I was doomed to a life within the confines of my bed. I knew—sort of—that there was something “wrong.”

I say I give myself credit. It was actually just dumb luck that I didn’t experience a hard core depression in conjunction with the fatigue. Thankfully, I didn’t interpret or experience my life as being horrible; I knew it wasn’t. I knew that T. loved me and that I had friends that loved me, and I loved them back. My family was supportive. My house was a home. I knew that my job, although not always the source of great excitement, was rewarding and dignified. I wasn’t fat. I hadn’t started smoking again. Things seemed to be going well.

Except for the fact that I spent 50% of my days asleep.

What is the use of having a good life if you’re sleeping through it? As I said, though, I was on the ball enough to know that something was “wrong.” When I went to see my psychiatrist, Dr. T., I explained my predicament to her, and she was sympathetic, yet somewhat stumped. She was reluctant to boost my anti-depressant, as I have a propensity for experiencing manic episodes. Instead, she just tweaked my secondary mood stabilizer and asked me to keep her posted. She gave me a slip to get my blood drawn.

I can truly say I didn’t procrastinate on the blood draw. I had minimal free time—I was so infrequently awake--so I had to wait until a Friday, my day off, to get it done. Now, my doctor’s office is not the nicest in the world, but like every other health-related establishment in my life, they know me. The receptionist, J., greeted me cheerfully, and I sat down to wait.

The wait was severe, and my impatience grew to mammoth proportions. I eavesdropped on the guy-across-from-me’s conversation with his mother, where he talked about his globetrotting lifestyle, very different from my traveling-angst lifestyle. I was only sort of happy for him; the other part of me was envious that he was going to Barcelona on vacation. I wondered what he was “in for” at the doctor’s office. Probably a routine physical. He certainly didn’t have a mental illness…poisonous thoughts poisonous thoughts poinsonous thoughts…

“Wendy?” They called my name, just in time, too, as the grass in his yard had turned emerald green and was about to go neon, while my crab grass was withering away.

The gal that led me into the room was the one performing the blood draw, which didn’t enthuse me because I didn’t recognize her. I have spent many years being at the mercy of sub-standard phlebotomists, and the prospect of breaking in another one didn’t thrill me.

My instincts were correct: she flubbed the first stick. She told me that if she didn’t get it the next time that she was going to send me to the lab. I balked. The last thing I wanted to do was traverse Hillcrest in search of someone who could successfully take my blood when I had taken great pains to get here. Moreover, I had had to endure the cheery chit chat of World Traveler Dude. No, it was not to be borne.

I told the nurse that she could stick me as many times as she wanted, as long as she got it done. This seemed to help her relax because her next attempt was a go. Sighing with relief, I held my finger down on the cotton ball as she administered the bandaid. All done.

And all the pain (mainly the pain of waiting) was worth it because now, according to Dr. T, “it made sense.”

I read her email.

It turns out that one of my mood stabilizers had become toxic, and as a result, my thyroid wasn’t functioning. Both factors cause—that’s right—fatigue. Big time. I glanced through the email again. It was that simple. Subtract a pinch of this and add a pinch of that and voila! A recipe for success.

There was a lot of other medical gobbledygook in the message that I ignored. I was so happy that the problem was just going to go away.

Until I was at Borders the next day. I got a phone call—on a Saturday morning, mind you—from my primary care doctor’s office. There were some abnormalities with my blood work, and according to J., the receptionist, the doctor wanted to see me. In order to communicate with J., I had to blurt the word “psychiatrist” out in the middle of the graphic novels section, which was thoroughly embarrassing, I might add, but my stomach started to turn cold. When the primary calls on a Saturday afternoon, something is definitely afoot. The word “kidneys” came up in the conversation.

Kidneys? I have a mental illness. I’m not supposed to have problems with, you know, other stuff. The other stuff is supposed to be working just fine.

When I got home, I revisited Dr. T.’s email. Indeed, there was reference to “renal” somethingorother, and the request for tests. Tests. Apparently, the lithium I’ve been taking for 20 years affects more than just my brain. So when the Sandman came calling, this is what he leaves on my doorstep. Another date with the doctor’s office.

Maintaining mental health is a lifestyle, one that requires attention to diet, exercise, the right amount of sleep, attention to routine, practice of positive thinking, use of support, cultivation of friends, good therapy, medicine, and more. When I’m doing the drill, it’s hard not to be resentful when the medicines that are supposed to help begin to harm. Simply, it’s hard not to cry.

Of course, I’m jumping to conclusions. No one will really know what’s going on until I submit to the next round of tests, extremely annoying tests. Consequently, T. counseled me to cry after I knew for sure there was something wrong, but not before.

I don’t know. I might get some practice in before the real pity party, just to see how it goes.

Now, that makes sense to me.

CVS: Where Everybody Knows My Name

Although the line at CVS pharmacy is situated in order to protect patient confidentiality, there is still a degree of exposure for those picking up their medications.

As I stood waiting yesterday, I had nothing else to do but indulge in my idle curiosity. I checked out the guy in front of me, who I determined to be a "newbie." He seemed awkward and confused by the process and wanted additional information on his prescription. I think he was taking something like antibiotics. He had to be instructed to sign the yellow page in the binder with the medication's name, to verify that he received it.

Oh, how I envied this man!

After all, in the course of treatment of bipolar disorder, I, like all those in my shoes, have taken thousands of pills. In order to accomplish this feat, I have made hundreds of trips to the pharmacy. As my meds are not synchronized to be filled at the same time, I have to go in three or four times a month to keep myself stocked.

As a result, the staff at my pharmacy, CVS, know me by name. As I approached the counter, D., my favorite gal at CVS, immediately started rummaging through the medication area to pull out my meds. There was a medication omitted (another story), but she rectified the problem in less than five minutes. Then we did the beep of the bar codes, the swish of the card, the whoosh of the signatures, the click of the stapler, and the quicky review of the receipt. Debbie smiled, and I was out of there.

So if my transaction was so effortless and pleasant, why do I dread it so much?

It is because when I pick up prescriptions for psych meds, there is nowhere to hide. My disability is obvious.

If there is one place I shouldn't mind my disability being obvious, it should be at the pharmacy. Moreover, I know that I should be grateful that the medications work for me, after so much trial and error, and I know intellectually that without them, I would have no life to speak of. I am one of the lucky ones, and lucky a million times over.

But there is still ambivalence whenever I go to CVS, and I think it has to do with my resentment of the illness. Even at this late stage in the game, there is something inside me that wishes that it weren't true, that I wouldn't be the girl standing in line for mood stabilizers, that I could be that guy waiting for some penicillin instead.

I don't think these feelings are juvenile or immature. I think it's just one more reminder that acceptance is a daily struggle, but there are people in life, even the ones at the pharmacy, that do their level best to help me through with just a little bit more dignity.

After all, they know me by first and last name.