I was hospitalized at Stanford on March 8th. I am currently on the waiting list to be readmitted on the psychiatric unit. I am currently experiencing an increase in psychotic symptoms, including paranoia and auditory hallucinations. It took a while, but I convinced my psychiatrist (at Stanford) to put me back in the hospital. My mother agreed with that decision.
My paranoia is confined to being about just strange men, not my family or friends or doctors. Sometimes I feel like these men are going to hurt me.
It was decided by my outpatient psychiatrist that I go back to taking clozapine, replacing the Seroquel.
Thursday, March 22, 2018
Monday, March 19, 2018
Evolution of Desire
Perhaps I read the book, Evolution of Desire, looking for answers. Why did the email conversation go from "how do I contact you" to I never want to hear from you again in less than an hour? Why did he tell me about those other women he was seeing? Why is it that he didn't choose me to be his official girlfriend? Why was I never chosen? What exactly was wrong with me?
Probably no single book is going to explain Morpheus' behavior, and even an entire library might failed.
Evolution of Desire is the academic, literature version of Someone Like You (in fact, even the "new cow" study was talked about in both).
No matter your feelings on evolutionary psychology, you can't help but notice the overriding sexism guiding this book; however, that doesn't mean it doesn't have anything to offer in way of insight.
What are the general principles explained in the book? Men care most about physical attractiveness in finding a romantic partner for marriage, and this is a cross-cultural phenomenon. People have "mate value," which for women is based on their appearance, and this "value" determines what kind of man they can obtain and latch onto. Most of us date around with people whom are close in "mate value." In other words, if you're a six on the ten attractiveness scale as a woman, you will find yourself dating other sixes. Women, what do we value? Material success and financial stability in a mate. The book goes into the evolutionary reasons behind all of this, which I will skip.
What do men avoid in a female companion? They have a particular aversion to promiscuity in women (of which I qualify), and even today, they like women who are modest, and will not sleep around on them after they're married. The percentage of men who cheat on their spouse? About 40%, which isn't comforting if you're in a long term relationship with someone. For women, it's slightly lower, but still significant.
Falling in love is not a modern phenomenon, and it is not a Western invention. Most cultures around the world have some version of it. For women, I have to wonder, why get married at all, if your spouse is likely to cheat, if you no longer need his financial resources because you have a rewarding career? Maybe because we fall in love, maybe because society expects us to marry, maybe because we want to raise children with two parents, maybe because loneliness sets in, and we can't escape the romantic ideals of our time.
We get trapped into a bad bargain that supposedly lasts for life.
Evolution of Desire talks about certain behaviors that keep our spouse from cheating on us or leaving us for a better mate. One of those behaviors was vigilance, the impulse to check emails of our partner, look through TXT-messages on his phone, etc. Sexual jealousy, and on and on. I find these behaviors, especially in a marriage, to be disturbing and controlling. But, I'm not an evolutionary psychologist.
Probably no single book is going to explain Morpheus' behavior, and even an entire library might failed.
Evolution of Desire is the academic, literature version of Someone Like You (in fact, even the "new cow" study was talked about in both).
No matter your feelings on evolutionary psychology, you can't help but notice the overriding sexism guiding this book; however, that doesn't mean it doesn't have anything to offer in way of insight.
What are the general principles explained in the book? Men care most about physical attractiveness in finding a romantic partner for marriage, and this is a cross-cultural phenomenon. People have "mate value," which for women is based on their appearance, and this "value" determines what kind of man they can obtain and latch onto. Most of us date around with people whom are close in "mate value." In other words, if you're a six on the ten attractiveness scale as a woman, you will find yourself dating other sixes. Women, what do we value? Material success and financial stability in a mate. The book goes into the evolutionary reasons behind all of this, which I will skip.
What do men avoid in a female companion? They have a particular aversion to promiscuity in women (of which I qualify), and even today, they like women who are modest, and will not sleep around on them after they're married. The percentage of men who cheat on their spouse? About 40%, which isn't comforting if you're in a long term relationship with someone. For women, it's slightly lower, but still significant.
Falling in love is not a modern phenomenon, and it is not a Western invention. Most cultures around the world have some version of it. For women, I have to wonder, why get married at all, if your spouse is likely to cheat, if you no longer need his financial resources because you have a rewarding career? Maybe because we fall in love, maybe because society expects us to marry, maybe because we want to raise children with two parents, maybe because loneliness sets in, and we can't escape the romantic ideals of our time.
We get trapped into a bad bargain that supposedly lasts for life.
Evolution of Desire talks about certain behaviors that keep our spouse from cheating on us or leaving us for a better mate. One of those behaviors was vigilance, the impulse to check emails of our partner, look through TXT-messages on his phone, etc. Sexual jealousy, and on and on. I find these behaviors, especially in a marriage, to be disturbing and controlling. But, I'm not an evolutionary psychologist.
Sunday, March 18, 2018
But Not Yet
On March 6, I was at the local ER, in the waiting room, and I was crying. I had just left a pain management clinic, and was told that there were no therapies to help me, besides the ones I was already taking (namely, the Cymbalta and the gabapentin). I asked the pain management specialist how I could handle my pain now, when it was enough to keep me from attending class. The woman, a PA, just stared at me, unsympathetically like I was one more bother in her day. I mean, cancer patients are lining up outside, the elderly with severe arthritis, but who can look at a thirty-four-year old woman complaining of moderate-to-severe pain? I'm just not sick enough.
In the ER, I was put in the hallway, and the nurse came to me, and asked why I was there. I explained that I was having a flare up of fibromyalgia, and I need some relief. She asked what had worked in the past, and I replied honestly that morphine helped. She was ready to give me the shot when the ER physician vetoed it. She and another nurse asked again, and again, the ER doctor told them no.
Doctors and staff alike keep telling me that nothing serious is going on, my MRI show some degenerative changes, but then again, most people's do. As the ER doctor put it, my back pain was not "life threatening."
The bouncing around from doctor to doctor, and even ending up in the ER due to pain is not an unusual experience for women. And there is a gender difference in how doctors treat pain. I've read the suffering of women, especially with endometriosis, a pain that honestly, male doctors cannot relate to nor do most of them have a firm grasp just how horrible it is. We're just expected to deal with it. It's not uncommon for women to say that menstrual cramps put them in bed for a few days every single month.
I've been told (and read) a great many things about fibromyalgia, and every single doctor whom I met with at Stanford Pain Management Clinic asked me what I thought causes fibromyalgia, like I was being tested at a medical school oral exam. To answer, I simply summarized what I had heard Dr. Sean Mackey, MD, PhD say about it. One doctor recited a rather old theory, that fibromyalgia is a muscular and ligament condition, in which normal activity produces micro-tears in the tissue. We know (or at least Dr. Mackey knows) that fibromyalgia affects the central nervous system because people with the disorder experience brain atrophy over time, a condition of the disorder that I'm not looking forward to.
This morning, the pain woke me up. It was a solid seven out of ten on the scale. I took some Norco, and then attempted to go back to sleep, but something about being in bed made the pain worse. So, I made coffee and wandered around the house, waiting for the pills to take effect.
I'm asked to lose weight, go to the gym five days a week, go to yoga class, maintain A's in my academic classes, go to Stanford a couple times a month (missing school), and on top of it, manage two chronic conditions. At times, it seems all a bit too much. I'm a self-improvement project. Someone who will get there someday. But not yet.
In the ER, I was put in the hallway, and the nurse came to me, and asked why I was there. I explained that I was having a flare up of fibromyalgia, and I need some relief. She asked what had worked in the past, and I replied honestly that morphine helped. She was ready to give me the shot when the ER physician vetoed it. She and another nurse asked again, and again, the ER doctor told them no.
Doctors and staff alike keep telling me that nothing serious is going on, my MRI show some degenerative changes, but then again, most people's do. As the ER doctor put it, my back pain was not "life threatening."
The bouncing around from doctor to doctor, and even ending up in the ER due to pain is not an unusual experience for women. And there is a gender difference in how doctors treat pain. I've read the suffering of women, especially with endometriosis, a pain that honestly, male doctors cannot relate to nor do most of them have a firm grasp just how horrible it is. We're just expected to deal with it. It's not uncommon for women to say that menstrual cramps put them in bed for a few days every single month.
I've been told (and read) a great many things about fibromyalgia, and every single doctor whom I met with at Stanford Pain Management Clinic asked me what I thought causes fibromyalgia, like I was being tested at a medical school oral exam. To answer, I simply summarized what I had heard Dr. Sean Mackey, MD, PhD say about it. One doctor recited a rather old theory, that fibromyalgia is a muscular and ligament condition, in which normal activity produces micro-tears in the tissue. We know (or at least Dr. Mackey knows) that fibromyalgia affects the central nervous system because people with the disorder experience brain atrophy over time, a condition of the disorder that I'm not looking forward to.
This morning, the pain woke me up. It was a solid seven out of ten on the scale. I took some Norco, and then attempted to go back to sleep, but something about being in bed made the pain worse. So, I made coffee and wandered around the house, waiting for the pills to take effect.
I'm asked to lose weight, go to the gym five days a week, go to yoga class, maintain A's in my academic classes, go to Stanford a couple times a month (missing school), and on top of it, manage two chronic conditions. At times, it seems all a bit too much. I'm a self-improvement project. Someone who will get there someday. But not yet.
Saturday, March 17, 2018
Baby Heroin
Apparently, opioid overdose killed about 42,000 people in 2016. That's a town of people.
If you go to Stanford Pain Management clinic, in one of their small, examining rooms, there is a letter on the wall, signed by the Surgeon General (a copy of course), asking the staff to help fight the "opioid crisis." There's another piece of paper on the wall, explaining that even patients with legitimate pain can become addicted to opioids (I read recently that 1 in 6 pain patients will become addicted), contrary to popular belief (although I never believed that).
"I don't think opioids are good, especially for chronic pain," the doctor tells me within the first few minutes of us meeting.
When he asked my history of pain medications, I mentioned that I was on MS Contin for a while.
"You got off of it by yourself?"
I nod.
"That's really good. That's a dangerous medication."
Morphine is one of the best medications we have. It eases suffering around the world.
I explain to multiple doctors that the pain has interfered with my studying, and my ability to attend lectures (most days, I only stop studying because the pain is too much for me to sit anymore, not because I'm sick of studying). I've missed a lot of class, due to the fact that I was hospitalized recently (for psychotic symptoms), and some mornings (and afternoons, for that matter), the pain becomes so great that I can't even walk across campus with my bag. Does the staff at Stanford Pain Management care? Maybe. The lead doctor (I can't tell if he's a resident or not) explains that the room was full of people in evaluating my case, including several researchers/professors.
"You're a complicated person," he continues, referring to the fact that I have schizoaffective disorder-bipolar type, and any medication that treats my pain will affect my emotional and mood state. He suggested one medication, a low-dose of naloxone (you cannot take that and opioids at the same time), but later realized after the conference, that it would possibly increase my auditory hallucinations (and also my nightmares). So, that idea was nixed. But he didn't have any other solutions, reassuring me that Cymbalta and gabapentin were the best at treating fibromyalgia, even though I haven't received much benefit from the Cymbalta.
He seemed rather confident that physical therapy would help (it will, and I'm not against the practice, as I told my mother over the phone, I would go to physical therapy once a week for the rest of my life, if it was required). Exercise is the one treatment that all doctors who see patients with fibromyalgia agree actually works. The doctor at Stanford Pain Management Clinic told me to consider myself an "athlete in training" and to exercise as such (from what I've read, your average athlete exercises 2 to 3 hours per day). He also, when pressed by my questioning, believes that losing weight will help my condition.
He was against the use of opioids, and said that the Norco should be used "sparingly." I believe that two pills per day qualifies, but he had a differing opinion on that.
While hospitalized at Stanford's G2P, I was able to get by on two Norco's per day because I had the ability to recline in bed with a large, hot water heating pad that was connected to a small motor. I could prop myself up, and then do my Microbiology homework. One particular day, the pain was steadily increasing, even though I had taken my two allotted pills, and the resident in charge of my case allowed me to take a Norco #10 in addition, which solved the problem.
I asked the doctor at the Stanford Pain Management Clinic if he felt the same about methadone as he did about Norco. He seemed a bit surprised and then horrified by the suggestion, telling me that methadone was more potent, and was even more addicting than Norco because it acted on additional, different types of pain receptors than Norco. Which, of course, made me want to try it more.
I find it interesting that detached doctors who are not experiencing pain can look at a person who is in pain, and tell them to needlessly suffer. We all know the risks of addiction, but the medicine has value in taking care of health. Seroquel has terrible side effects, most remarkably "metabolic syndrome" which includes high cholesterol and diabetes, but--and yet--we still use it in an alarming amount of patients, including in the elderly even though it increases their risk of "sudden death."
It wouldn't be so bad, but the issue of prescribing opioids has now turned political (medicine should be immune to politics), and doctors are influenced by the media, which highlights terrible cases of overdose and addiction, but rarely bothers to include that morphine and other strong opioids make a huge, positive difference in peoples' lives. If you learn a little history about morphine, you will find that backlash has happened before against this drug.
The controversy surrounding OxyContin and the misleading advertising campaign really fucked everything up for chronic pain patients.
(By the way, you can chop Seroquel up and snort it, and apparently, it puts you gently to sleep, and they call it "baby heroin")
If you go to Stanford Pain Management clinic, in one of their small, examining rooms, there is a letter on the wall, signed by the Surgeon General (a copy of course), asking the staff to help fight the "opioid crisis." There's another piece of paper on the wall, explaining that even patients with legitimate pain can become addicted to opioids (I read recently that 1 in 6 pain patients will become addicted), contrary to popular belief (although I never believed that).
"I don't think opioids are good, especially for chronic pain," the doctor tells me within the first few minutes of us meeting.
When he asked my history of pain medications, I mentioned that I was on MS Contin for a while.
"You got off of it by yourself?"
I nod.
"That's really good. That's a dangerous medication."
Morphine is one of the best medications we have. It eases suffering around the world.
I explain to multiple doctors that the pain has interfered with my studying, and my ability to attend lectures (most days, I only stop studying because the pain is too much for me to sit anymore, not because I'm sick of studying). I've missed a lot of class, due to the fact that I was hospitalized recently (for psychotic symptoms), and some mornings (and afternoons, for that matter), the pain becomes so great that I can't even walk across campus with my bag. Does the staff at Stanford Pain Management care? Maybe. The lead doctor (I can't tell if he's a resident or not) explains that the room was full of people in evaluating my case, including several researchers/professors.
"You're a complicated person," he continues, referring to the fact that I have schizoaffective disorder-bipolar type, and any medication that treats my pain will affect my emotional and mood state. He suggested one medication, a low-dose of naloxone (you cannot take that and opioids at the same time), but later realized after the conference, that it would possibly increase my auditory hallucinations (and also my nightmares). So, that idea was nixed. But he didn't have any other solutions, reassuring me that Cymbalta and gabapentin were the best at treating fibromyalgia, even though I haven't received much benefit from the Cymbalta.
He seemed rather confident that physical therapy would help (it will, and I'm not against the practice, as I told my mother over the phone, I would go to physical therapy once a week for the rest of my life, if it was required). Exercise is the one treatment that all doctors who see patients with fibromyalgia agree actually works. The doctor at Stanford Pain Management Clinic told me to consider myself an "athlete in training" and to exercise as such (from what I've read, your average athlete exercises 2 to 3 hours per day). He also, when pressed by my questioning, believes that losing weight will help my condition.
He was against the use of opioids, and said that the Norco should be used "sparingly." I believe that two pills per day qualifies, but he had a differing opinion on that.
While hospitalized at Stanford's G2P, I was able to get by on two Norco's per day because I had the ability to recline in bed with a large, hot water heating pad that was connected to a small motor. I could prop myself up, and then do my Microbiology homework. One particular day, the pain was steadily increasing, even though I had taken my two allotted pills, and the resident in charge of my case allowed me to take a Norco #10 in addition, which solved the problem.
I asked the doctor at the Stanford Pain Management Clinic if he felt the same about methadone as he did about Norco. He seemed a bit surprised and then horrified by the suggestion, telling me that methadone was more potent, and was even more addicting than Norco because it acted on additional, different types of pain receptors than Norco. Which, of course, made me want to try it more.
I find it interesting that detached doctors who are not experiencing pain can look at a person who is in pain, and tell them to needlessly suffer. We all know the risks of addiction, but the medicine has value in taking care of health. Seroquel has terrible side effects, most remarkably "metabolic syndrome" which includes high cholesterol and diabetes, but--and yet--we still use it in an alarming amount of patients, including in the elderly even though it increases their risk of "sudden death."
It wouldn't be so bad, but the issue of prescribing opioids has now turned political (medicine should be immune to politics), and doctors are influenced by the media, which highlights terrible cases of overdose and addiction, but rarely bothers to include that morphine and other strong opioids make a huge, positive difference in peoples' lives. If you learn a little history about morphine, you will find that backlash has happened before against this drug.
The controversy surrounding OxyContin and the misleading advertising campaign really fucked everything up for chronic pain patients.
(By the way, you can chop Seroquel up and snort it, and apparently, it puts you gently to sleep, and they call it "baby heroin")
Saturday, March 3, 2018
"Knowing What Makes Us Happy"
"One study examined the expected impact of breaking up with a romantic partner and compared it to its actual impact...Students who had not experienced a romantic breakup, called 'luckies,' reported on their own overall happiness and then predicted how unhappy they would be 2 months after a breakup. The researchers compared this estimate with the happiness of people who had recently broken up, labeled 'leftovers.'...Leftovers were just as happy as luckies, but luckies predicted they would be much less happy 2 months after a breakup than leftovers actually were...
Although some breakups are indeed devastating, and divorce has many costs, people tend to overestimate how much a romantic break would diminish their life satisfaction [emphasis is my own, not the author's]."
--Social Psychology, pg. 220, by Gilovich, Keltner, Chen, and Nisbett
Although some breakups are indeed devastating, and divorce has many costs, people tend to overestimate how much a romantic break would diminish their life satisfaction [emphasis is my own, not the author's]."
--Social Psychology, pg. 220, by Gilovich, Keltner, Chen, and Nisbett
Thursday, March 1, 2018
Grandmother's Death
"Your grandmother did die by suicide, she just didn't do it with poison," my mother says to me after I tell her about a nightmare I had.
In the nightmare, my mother comes up to me about news from the coroner, who said that grandmother's death was ruled a suicide by intentional poisoning. In the dream, I was hysterical, and turned violent. I trashed the bar I was in, and got arrested. I kept saying that it was my fault because I didn't go visit her often enough.
In the nightmare, my mother comes up to me about news from the coroner, who said that grandmother's death was ruled a suicide by intentional poisoning. In the dream, I was hysterical, and turned violent. I trashed the bar I was in, and got arrested. I kept saying that it was my fault because I didn't go visit her often enough.
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