Yours Truly asks a pointed question on A Canvas Of The Minds. Canvas is a very special collective of very special Mental Health Bloggers. My answer to this question will be posted either here or there soon….stay tuned…..
All posts for the month May, 2014
Posted by Laura P. Schulman, MD, MA on May 22, 2014
Posted by Laura P. Schulman, MD, MA on May 20, 2014
Why does it always happen the night before I have an appointment? Not even an anxiety-inducing appointment, just a regular one that I simply need to get myself to and show up for.
Last night I took my bedtime meds at the usual time, did my whole pre-bedtime ritual: take meds, brush teeth, give Noga the Wonder Dog her brief nightly training session and resultant treats; get into bed with a book.
In general, by the time I make it into bed, I’m crashing, and sometimes don’t even make it through the “putting on pajamas” stage, but wake up in the morning to find myself half naked and freezing. The nights here are still chilly and I might not have got to far along as to pull up the covers.
The important part out of all of this is sleep. I have never been good at sleeping. Even as a child I spent many nights wide awake reading by flashlight under the covers. At about dawn when the birds were waking up and sleepily cheeping, I might fall asleep for the two or three hours before it was time to get up for school.
Last night there were warning signs. An hour after my bedtime cocktail of 50 mg. Seroquel, 1 mg Clonazepam, 1 mg Lorazepam, 10 mg Ambien, plus 300 mg Lithium, I was not remotely sleepy. Not good. I waited another hour. No dice. The book I was reading became hilariously funny, and I convulsed with laughter. My Psychiatric Service Dog, Noga, alerted, and left her spot at the foot of the bed. She peered into my face, assessing my condition. She parked herself nearby, keeping an eye on me.
I started my prescribed protocol for incipient mania. First try to knock it down with benzos: a couple more milligrams of Lorazepam, another milligram of Clonazapam. Wait another hour. Nothing. I’m starting to look for a wall to climb.
Time to pull out bigger guns. Another 50 mg of Seroquel. Wait another hour. Nothing. Another 50 mg. Nope. Another 50 mg.
All this while, I am feeling like I have bugs under my skin. Antsy, fearful that this is going to go into full-blown mania with hallucinations and everything.
It has started to pour down the rain, buckets. By morning my rain gauge would measure two inches, and the river below my dwelling raging out of its banks.
My whole-body arthritis, aggravated by the weather, is making it hard to play solitaire on the iPad. That’s my usual ticket to boredom leading to sleep, but after a couple hours of painfully tapping cards, I give up and take a pain pill–a very mild one, ten mg. codeine and 500 mg. acetaminophen. Not enough to dangerously interact with the piles of pills I have already ingested, but by this time the only thing that concerned me was what would happen to my dog if I died.
Meanwhile, Noga the Wonder Dog has glued herself to my side and won’t budge, even when I jockey for more room in the bed. I move her over and slide over myself so I won’t fall out when the drugs finally (hopefully) hit. She immediately sticks herself back in position against my body, licking whatever parts of me are exposed. We snuggle and smooch for what seems hours. She loves snuggles and smooches. She is my Angel Doggie!
I send my morning appointment an email apologizing for canceling. Of course I lie, saying that I was sick due to something I ate. I turn my alarm off.
It’s three o’clock and I’m finally slowing down and getting sleepy. Noga is cuddled up by my head.
I wake up around noon. Fine, except that I really do have to go into town today (town is an hour away) to get some things for Friday night dinner. I struggle out of bed, make a strong cup of coffee, get into my recliner under my “happy light.” I’ll go as soon as I’m safe to drive, when the muzzy druggy feeling wears off.
Noga starts vomiting. Why do they always have to throw up on the carpet when there is a perfectly good expanse of bare floor available? I catch her before it comes up and place her on the floor, petting her while she pukes. Lhasa Apsos routinely vomit when their stomachs are empty for a long time. She’s been watching over me for 14 hours now, setting her own needs aside in favor of taking care of me.
After she gets done puking I call her over to the “treat station” and put a few yummy things into her tummy. Her food is in her dish, but she ignores it until her dog treat hors d’oeuvre piques her appetite. She gobbles down her breakfast and hops up to her usual place on the left arm of my recliner, where she is now firmly established.
She literally stuck with me all night, watching over me and caring for me as if I was a sick puppy (I was). And now she’s back on the job, after a bit of breakfast and a drink.
Through depression, through mania, she is my Psychiatric Service Dog, always on the job. She takes her job seriously. I would love her anyway, even if she weren’t my Service Dog Angel, but the psychic connection between us is so strong that she’s like an extension of me.
I wish everyone could be so blessed.
Posted by Laura P. Schulman, MD, MA on May 15, 2014