Always a Quart Low in the Mood Department

eeyre

Oh, bother!

dys·thy·mi·a: /disˈTHīmēə/ noun: (Psychiatry) Persistent mild depression.

When I was little, I loved Winnie the Pooh. Eeyore was my favorite character; I even had a stuffed Eeyore. Perhaps that was a portent of things to come.

I was diagnosed a couple of years ago as Dysthymic with Major Depressive Episodes, and it seemed pretty correct if you asked me. Now that the Square-Jawed NP believes I’m bipolar, these shrinks have forgotten about how insidious dysthymia is. Like water on a hillside, it seeps into all the nooks and crevices, weakens the landscape, and if not attended to, it can eventually cause a landslide.

After a couple of weeks of feeling somewhat contented, my mood has dipped again — noticeably — and my anxiety level has increased. Around tax time, I became so completely off my nut, I filed an extension rather than complete my short tax form. Yeah, the short one. I just couldn’t bring myself to do it without feeling overcome with jitters. It feels very familiar. Jeez, no wonder I used to pop Vicodin so much!

marshI discussed the situation previously with my other shrink, The Marshmallow, and he suggested I talk to NP about it — perhaps the meds need adjustment or some such thing. I didn’t think NP would change the meds, and I was right.

NP feels the medication is working fine — the problem is me. He says I’m not as committed as I “need” to be within the AA program. He quizzed me on the steps and expressed stunned disappointment that I couldn’t recite them verbatim. NP also hates the fact that I can’t come to terms with a benevolent and caring Higher Power and thinks my deflection, sarcasm, and mockery of the system is proof positive that I’m still as sick as I was before.

nazihappy

Hah, Fraulein, you thought you were getting better? Think again!

My visit to the NP yesterday proved to do nothing but further annoy and irritate me and raise my anxiety level even higher. As a shrink, he sure makes a great Nazi. He asked how I was, and I replied fine… well, except for being mildly depressed, agitated, and generally low energy. [The NP appointment wasn't all bad, really. We talked at some length (believe it or not) about, of all things, espresso. He has a big expensive messy machine that makes espresso at 16 bars of pressure requiring lots of cleanup; I have a medium-size expensive clean machine that makes espresso with 17 bars of pressure requiring no cleanup. I clearly win, though he thinks he wins. Ugh! Pfft.]

Satisfied that I’d accomplished my previous homework task (following up with the NY state re-education program; my appointment is in a couple of weeks), he went on to query me about my sobriety and recovery efforts — which he tells me now, he believes are the cure for my dysthymia and anxiety.

He gave me three new homework assignments which unnerve me even to discuss here (I really hate being pulled out of my comfort zone).

spon21. I have to choose a ‘temporary’ sponsor and work the first three steps with her. LC is no longer acting as my pseudo-sponsor, so NP says I need a new one (she didn’t work out all that well anyway). He says the requirements are that it must be a woman and she must have 5 years of clean time. “Impossible,” I informed him, “Only one or two women have one or two years of clean time, and of those, I would only consider one — maybe — the rest of the crew are newbies and most are crazy-bananas-nutso weirdos.” NP scrunched up his nose and told me I was being mean — I should be grateful that I’m not as crazy as the nutbags I’m surrounded by, not pick on them. I told him “It’s not mean if it’s true.” He glared at me and shook his head.

So now I have to pick that one lady who’s not completely nutso as my temporary sponsor until I can get a real one because my meanness is a sign that I really need AA. Uh, okaaaay. This primary request is causing me deep and abiding anxiety. I just don’t want to be obliged to this extent. I don’t want to open up to ANY more people! But maybe the NP is right… so I’m considering it and may ask her this weekend.

spon32. I have to read the following Acceptance passage once in the morning and once at night from the “Big Book”:

“… And acceptance is the answer to all my problems today. When I am disturbed, it is because I find some person, place, thing, or situation, some fact of my life, unacceptable to me; and I can find no serenity until I accept that person, place, thing, or situation as being exactly the way it is supposed to be at this moment. Nothing, absolutely nothing happens in God’s world by mistake. Until I could accept my alcoholism, I could not stay sober; unless I accept life completely on life’s terms, I cannot be happy. I need to concentrate not so much on what needs to be changed in the world as on what needs to be changed in me and my attitudes.”

I take issue with the idea of “nothing happens in God’s world by mistake.” Sorry, but this is raw, unadulterated bah-low-knee. If you ask me, God does not have a plan. If there’s a plan, then there is no free will — and no matter what I do, it’s all in God’s plan and I can’t change anything anyway, so why try? If I sit here and decide to pop a Vicodin, that’s God’s plan. If I decide to quit my job and live on the street, it’s God’s plan. Or if I’d rather type on my blog about what’s zipping around my bizzy brain, that’s God’s plan too, and I have no say in the matter. What a bunch of crap. But the rest of it…. that I can work with and build on. But the NP says that’s just proof that my self-destructive nature getting in the way of my recovery. So I’ll read it every day like he asked, but I won’t like it.

See? My attitude is the problem.

croc3. I have a sticky that he gave me to keep on the bathroom mirror that says “Keep my head where my feet are.” (And since I wear crocs all the time these days, the view is spectacular… ugh). This phrase is supposed to help me remember to live a day at a time, whatever the flip that means. I told NP that I need to plan ahead, staying in the moment exacerbates my tendency to procrastinate, but he says that means I don’t understand. Since I truly don’t get it, I am reading the sticky. I think this too is baloney, but maybe if I keep looking at it, the meaning will eventually dawn on me.

The Square-Jawed NP is absolutely convinced that increasing medication (or changing it) won’t make as much of a difference as working “The Program” will. Since I realize that science says Dysthymia is one of the hardest sub-types of depression to correct without a lot of intense therapy (and even then it often won’t respond), I can’t deny the opportunity. I owe it to myself to at least try — even if it’s on my own terms.

So why do I think I’m sad, if not because of ignoring “the program”? After all, the weather has improved. There’s sun, the grass is greening up, the shrubs are budding out, and even spring flowers are making their initial appearances.

Life just sucks and it will keep on sucking. I do need a better outlook, but I’m not sure where it’s gonna come from. Those medications are no miracle drugs, that’s for damned sure.

I have to lose weight, but without electricity to keep food cold, or a stove to cook anything, its nearly impossible. At this rate, it won’t be long before I’m 300 lbs and I am NOT happy about that. I feel helpless against my own body. Yeah, there’s a reason to feel sensational, huh?.

Aaaannnnd… Winter was one of my biggest gripes, right? Well, I’m looking toward summer’s arrival. Sort of. Spring, while unpredictable, is lovely. But summer always seems to arrive one day when it’s 20 degrees in the morning and 90 in the afternoon, then it never leaves. That’s what sucks.

sweatsunThe long, hot days and nights of 90-100 degrees with no air conditioning and not even a decent fan to cool me. Sweating and feeling dirty from the dust all the time. Any makeup I wear will melt off. My hair will frizz. I’ll walk everywhere in the oppressive heat, and spend sleepless nights sticking to my sheets. It was miserable last year, it’ll be miserable this year. No realistic chance — even with social services’ help — that it’ll be corrected anytime soon. Like the taxes, my heart races and my skin feels on fire every time I go to fill out the paperwork. Avoidance. That’s my problem here.

Gripe, gripe, gripe. Moan, moan, moan.

My according to my stickie, I need to keep my head where my feet are. Not worry about summer’s heat now because it’ll come soon enough. Yet I awake in the night in a mini-anxiety attack from feeling so hopeless. Huh. Maybe hopelessness is my problem.

And with regard to the NY state program for job help and re-education, I doubt anything will come of that. Truly, I do. I think they’ll help me get a job, but won’t do jack to help me go back to school. I’m too highly functioning now and why give money to someone like me? I have a job, and I’ll have kept it for three years this July. It may be a suck-job at a thrift store, but it’s MY suck-job and I’m good at not getting fired. So I have no history of being unemployable. I’m just sad and avoidant, that’s all. But, I’ll go through the process and see where it leads. Prejudging the situation again I guess — another problem.

Much as I enjoy writing on this blog, there are days when I just can’t bring myself to do it. It’s like not wearing makeup, wearing the same clothes over and over, not doing my hair in anything but a scrubby ponytail, not cleaning my apartment. I’m filled with self-neglect — just like I was feeling leading up to my fall into Vicodinville years ago. It started then because I stopped caring. Could it start again now for the same reason?

Recently, I’ve found myself daydreaming about having a Vicodin to soothe my frayed nerves. Not that I have any money to acquire the pills, and I change the thought process quickly not wishing to indulge such an unhealthy idea. But the thought still snuck in a few times today. I feel so anxious about the stupid sponsor thing… I just want to give up on the whole mess rather than be told what to do. Or worse yet, fail at it.

balbeamIt reminds me of when I took gymnastics as a kid. I loved floor exercise, enjoyed the vault, and was thrilled by spinning on the uneven bars, but the balance beam scared the shit out of me. I was never sure why, but I couldn’t even walk across it let alone do a cartwheel or tumble across. All I could think of was, “I’m gonna fall! I’m gonna fall! I’m gonna fall!” Suddenly finding myself terrified of heights, I would make myself fall off in lieu of accidentally doing it and breaking my neck. No surprise that ultimately I failed the class — the first time I ever that I’d failed at anything — and it was all due to my fear of possibly falling. I made myself fall before it happened outside of my control.

I don’t know if that’s normal, crazy, or just part of the overall negative attitude that dysthymia induces.

Not a healthy attitude.

So I agreed to do what the NP suggested, but not without serious reservations and thinking I never wanted to see him again for fear of what he’ll make me do next. But the thought of starting down that road toward Vicodinville again scares me even more.

So I’ll do it even if I have to do it with a bad attitude.

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“Well, I’ve been afraid of changing
‘Cause I’ve built my life around you
But time makes you bolder
Even children get older
And I’m getting older too

And if you see my reflection in the snow-covered hills
Will the landslide bring you down?”
― Stevie Nicks

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Posted in + recovery, addiction, bipolar, depression, education, loperamide abuse, sobrietyland, weirdness, Who's the bitch? | Tagged , , , , , , , , | Leave a comment

Stupid is as Stupid Does

bunSome people might say, I can be a mean person.

Not all the time, mind you, and I certainly can act pretty stupid myself, but I can be decidedly unforgiving when it comes to others’ repeated acts of utter stupidity.

Being surrounded by lots of other stupid people, I wonder, who am I supposed to model a better life after? That’s why I think it’s important for me to go through this ACCESS-VR program and let them help me get a new job or go back to school (or both). I need a lot less stupid in my life.

I’m coming up on five successful months clean in the AA program for my addiction issues, but I’m finding ongoing frustration with the program. One reason I still don’t have a sponsor is I have yet to find anyone in the program that I can really trust with my ‘big’ secrets. The sponsor should be a trusted advisor, but what if I don’t trust them? I have decided that when it’s time to do that fourth step — taking personal inventory — I’ll confess to a priest instead of one of them. The people are knowledgeable and admirable in their efforts, but I have a tough time finding any one of them I could trust not to be stupid around me. They have their way and I have mine. Rather like functioning on different frequencies.

But some in the program have begun pushing me to attend more meetings and get more involved. They don’t know my situation, but they’re very insistent. Sorry, but that’s just where I’m at with it. I frustrate easily, and if I’m pushed too hard by one of these folks, I’ll bolt from the program and never look back. That would be bad. So instead, I just laugh it off, let it go, and wait.

meanI also get frustrated at the thrift store where I work when customers act stupid. For instance, people who drop things off the rack and just leave them on the floor. Or exit the changing rooms leaving a cartful of clothes crumpled on the floor. Or pee in the toilet and don’t flush. Or poop, clog the commode, and tell no one until the next guy floods the bathroom as the backed-up toilet overflows.

Or when I’m walking down the main aisle with a rack of clothes to be distributed on the floor, I politely say “excuse me” to each customer who’s blocking the aisle so they might move their cart over and allow me to pass. Most people smile, shift their carts happily and let me pass. Others just stare at me — or worse yet, glare at me — as if I’d just asked them to give me money. Still others refuse to move at all and glower at me when I accidentally bang their cart with the unwieldy rack.

Another crazy-making thing that happens at the thrift stores is when customers drop off donations. They walk in and drop their bags directly in front of the door, blocking the entry. Who does this? When did this become okay? Or people who ‘shop’ from the donation piles left outside (also called stealing). Or customers who want tax receipts for their stuff and lie about what they have in the boxes (or try to claim $1000 for a 30-year old console TV). Customers like that are frustratingly stupid. That’s not even to mention the bosses and management types who commit gross acts of stupid every day. That list goes on and on.

At my other job with Mrs H, my main frustration is in getting her to write things down. Granted, for a lady in her early 80′s, she’s extremely sharp. But time takes it’s toll; her memory is slipping (so is mine, as a matter of fact). I have a huge three ring binder of notes that I keep with detailed instructions on various parts of my job so that, if I forget how to do something (her procedure for ordering supplies, for instance), I can just turn to that tab in the binder and go. I take copious notes because I don’t want to screw things up and look like an idiot. Mrs H, on the other hand, has no such qualms. She’ll ask me, for instance, how to add an attachment to an email — for the four-billionth time — and I’ll tell her to write it down, but she doesn’t. So every time I go to work there, the majority of my time is spent instructing her on how to do everything from the simple to the complex instead of doing the tasks I’m assigned. All because stubborn Mrs H won’t write anything down. For someone so smart, that’s pretty damn stupid.

At all of this, my eyes roll. It’s become a impulse — it happens without my control. One of these days, I’m going to get caught by a customer, or worse, my boss and written up over it. I can’t help it. The reaction to massive displays of stupidity is too strong.

bun-1At Aunt and Uncle Crazypants’ house, there’s an endless stream of chronic, bleeding stupid. I like to think that my time spent with them is teaching me massive amounts of patience, but there are days when it’s an exercise in utter futility. These two are the very definitions of codependency and passive-aggressive behavior. Way-super-stupid antics. All the time.

Auntie has been very ill for several years. A lifetime smoker, Auntie was diagnosed with COPD about a decade ago. She also has spots on her lungs, most likely from emphysema. She refused any medication for it. She takes pride in not taking any medication at all. Over the years, her physical condition has deteriorated to a truly pathetic state. She needs medication desperately. She’s barely able to walk or move without gasping for air like a fish.

Physically, Auntie is in very bad shape. In addition to gasping for air like a fish out of water, she can barely walk, she’s dizzy, her memory is shot, she’s thin as a rail, she can’t eat, she’s in pain most of the time, and she falls — often. Now, any reasonable person would go to the doctor, but Auntie is not reasonable. She wouldn’t get as much attention if she were well, so she refuses all offers to get help. I’ve told her that at the very least, she should consent to an oxygen tank — much of her problems are related to her breathing — but she refuses. “I don’t want to bother anyone. I’m just an inconvenience,” she’ll cry, “just toss me out with the trash! I’m no good for nothin’ anymore!”

That’s Uncle’s cue to reassure her that she’s not useless and that he’s happy to help her. But, don’t think he’s a saint. When Auntie screws up his dinner order, he screams at her. Not compassionate at all, though he loves her very much, his reaction to the threat that Auntie is truly sick and refusing treatment is to get angry, scream, and insult.

Auntie no longer smokes, but not willingly. Uncle discovered information a couple of years ago about second-hand smoking and became convinced that Auntie’s smoking was causing him to feel short of breath. Long story short, he cut her off from her cigarette supply, and since she’s in such a weakened state, she was unable to walk anywhere on her own to buy her much-loved cigarettes. Then Auntie started sneaking money out of Uncle’s super-secret money stash and would give it a neighbor to buy her packs of smokes. Uncle, of course, found out, screamed, and hid the money from Auntie and cut her off from any further spending money. She is now a ex-smoker by force, and is totally dependent on Uncle for everything — much like an infant. And that’s how he treats her.

Auntie often refuses to eat her dinner (though she always has room for candy), which prompts Uncle to scream at her to eat more, then she slams her fork into the plate with a huff and a pout, then Uncle negotiates with her to eat  “just two more bites of meat” before she’s rewarded with a piece of chocolate for dessert.

Sick.

All her life, Auntie has been deeply insecure about herself. Somehow, she never developed a proper sense of self, so whenever possible, she’s relied on manipulation and passive-aggressive techniques to get by. She needs a man in her life to make her ‘whole’ — without one, she feels worthless. She met and married Uncle around 1970 and they’ve been together ever since. Much of the manipulation she pulls now is an extension of what she’s done all her life. There are times — I swear to God — I can’t tell if she’s faking or attention-seeking. For instance, this year, she’s taken to moaning and talking to herself. “Oh Dear, oh dear, oh dear!” she’ll mutter in succession, hoping Uncle will turn to her and ask what’s wrong. If he ignores her, she says it louder. Auntie often makes a show of grunting when she stands and walks — but only when someone’s listening — and this makes me absolutely nuts. She wants you to prove you love her by pitying her and saying something comforting. Which begs the question, is she faking, or is it real, or is it both? Some days it’s hard to tell, but I think it’s both.

Like I said, I’m mean.

Still, Auntie refuses all treatment. Death wish? It’s a helluva way to go , and why suffer so much if you don’t have to? Because she doesn’t want to be a ‘burden’? One of these days, she’ll fall again and break a hip — then the suffering will really begin. It breaks my heart. I think that, as a true codependent, what she really wants is for Uncle to go all caveman on her and force her to go to the doctor. That will prove that he loves her — at least in her twisted logic. Until the next crisis when it all starts all over again.

Uncle makes me crazy too though. He’s an incredibly hard headed and stubborn person who will, also, do nothing to help himself. When he was younger, he was an automobile repairman and contractor — very good at what he did — and holds several patents for his inventions. But these days, his comprehension is terrible, and his business sense, which was never good in the first place, is disastrous. Uncle’s current patents have virtually bankrupted them both because he no longer has a modicum of marketing savvy to sell them.

Uncle has a temper problem. Always has, but when he was younger, he used to be able to keep it in check. Now? Not so much. Not only does he scream at Auntie when she forgets things, but his frustration with the process of selling his patents causes him to scream at his investors and sale prospects, sending most of them running for the hills. Not good for business, especially when you’re broke. Uncle won’t accept help nor advice from anyone including me, though he asks often. He just won’t listen to anyone, insisting he knows best. He doesn’t understand the ins and outs of modern marketing techniques (such as the necessity of websites). So all the advice falls on deaf ears.

Speaking of which, Uncle also can’t hear — deaf as a doorknob — but he won’t get a hearing aid because he insists that he can’t be helped by them. That’s based on the fact that he tried one of those over-the-counter sound magnifiers and hated it. He’s never worn a real hearing aid. So he can’t hear his investors on the phone, misunderstands what they say, and starts yelling again.

Uncle has Parkinson’s disease, but he doesn’t seem to understand what it is. So when he feels weak, or his hand starts to shake, or he can’t remember anything — he doesn’t see it as a symptom, just ‘getting old’ — and won’t seek medical help for it.

And that’s when he’s not telling me about his poop. I never want to talk to an old person about poop ever again.

Much of Aunt and Uncle Crazypants’ level of stupid has to do with age. They’re both 87. But the basis for all of it lies in their youth. Auntie has had a lifetime of pretending to be helpless, and Uncle has had a lifetime of getting his way. Now that they’re old, it’s just gotten that much worse.

Committing my own acts of stupid — not getting another job, not finding someone other than Mrs H to work for, getting my own car, and not spending so much time with Aunt and Uncle Crazypants — I have no real room to talk here. My problems don’t have an answer just a phone click away though. That’s my excuse.

And that must be why I’m so mean.

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“Laughter and tears are both responses to frustration and exhaustion. I myself prefer to laugh, since there is less cleaning up to do afterward.” — Kurt Vonnegut

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its happy bunny brief

 

Posted in + recovery, addiction, depression, random crap, sobrietyland, weirdness, Who's the bitch? | Tagged , , , , , , | 4 Comments

Loperamide Abuse/Misuse/Addiction and Cardiac Conduction Disturbances — Article Clearinghouse

loptabMad Margaret’s Loperamide Clearinghouse is here!

Enclosed herein are just some of the medical articles  I’ve researched regarding loperamide. I will add more as I continue to dig through my stack (or discover new ones), so please stop back now and again.

So little scholarly information is easily or readily available to both the public at large and physicians trying to help their patients, I feel it’s incumbent upon me to provide pertinent data insomuch as I am able.

Publicly available web-based information is included with authors, source information, and a link to the original. Copyrights belong to original authors; no copyright by me is implied or claimed. These links and articles are provided for educational and public health purposes only.

Some definitions that will help comprehension for our non-medical personnel readers: QT/QTc, • Ventricular Tachycardia

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loptab3Cardiac Conduction Disturbances Secondary to Chronic Abuse of Loperamide: An Initial Case Report

Audi J,1 Layher J,2 Morgan B.11 Georgia Poison Center and Emory University Department of Emergency Medicine. Atlanta, GA;2 Athens Regional Medical Center. Department of Cardiology. Athens, GA

Journal of Toxicology, CLINICAL TOXICOLOGY, Vol. 42, No. 5, pp. 713–826, 2004

Conclusion: This is the first case report of an adult with cardiac conduction disturbances following chronic high-dose loperamide use. Negative toxicologic screens, cardiac studies and normal electrolytes, and resolution of cardiac abnormalities after loperamide cessation leaves no other plausible explanation for this presentation.”

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loptab3Syncope and Recurrent Polymorphic Ventricular Tachycardia Following Loperamide Misuse

Jeanna M Marraffa, Michael G Holland, Ross W Sullivan, Robert Seabury, Michael J Hodgman; Upstate Medical University, Syracuse NY USA

From “2013 Annual Meeting of the North American Congress of Clinical Toxicology”

Conclusion: Massive loperamide abuse may result in QTc prolongation and subsequent recurrent ventricular arrhythmias.”

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loptab31274: Loperamide: The Unexpected Culprit

Pokhrel, Kiran; Rajbhandary, Arunima; Thapa, Jhapat

 Critical Care Medicine: December 2013 – Volume 41 – Issue 12 doi:10.1097/01.ccm.0000440506.29056.c1
Poster Session: Case Reports

Discussion and Conclusion: Loperamide is not known to cause QTc prolongation but methadone, also an opioid, dose cause QTc prolongation. Loperamide is also structurally similar to Haloperidol which has potential to prolong QTc. To our knowledge there is no known cases of Loperamide induced VT-storm. A case series (n=216) of Loperamide overdose failed to reveal any cardiac toxicity but the maximum ingested dose was 0.94mg/kg which is much less than in our patient. Internet search reveals that Loperamide is popular among substance abusers to prevent opioid withdrawals and to produce euphoric effects. Hence, Loperamide needs to be further evaluated for cardiac toxicity at super high doses.”

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loptab31204: Ventricular Tachycardia Storm – Can It Be A Side Effect From Over the Counter Anti-Diarrheal?

Boppana, V Subbarao; Kahlon, Arundeep; Bhatta, Luna

Critical Care Medicine: December 2012 doi: 10.1097/01.ccm.0000425416.95852.ed
Poster: ABSTRACT Only

“The spectrum of side effects from high doses of loperamide is still unknown. Abrupt resolution of the VT, normalization of QT and lack of the need for an anti-arrhythmic after discontinuation of loperamide in our patient makes us believe a causal relationship, but the pathogenesis remains unclear.”

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loptab31.2 Loperamide Intoxication in the Pursuit of Opioid Effects: Report of Two Fatalities

J. Denton1, A. Youmans 1, V. Arangelovich 2
1 McLean County Coroner’s Office, Bloomington, IL; 2 Will County
Coroners Office, Joliet, IL

National Association of Medical Examiners
Abstracts of the 2013 Annual Meeting
October 12-15, 2013

“We present two deaths from loperamide intoxication from excess ingestion of loperamide pills, likely related to attempts at attaining euphoria. Thorough death investigation, autopsy, and additional toxicology testing studies were required to establish the cause of death.”

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loptab3Systems Pharmacology of Arrhythmias

Seth I. Berger, Avi Ma’ayan, and Ravi Iyengar* Department of Pharmacology and Systems Therapeutics and Systems Biology Center New York, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1215, New York, NY 10029, USA

Science Signaling; 3(118): ra30. doi:10.1126/scisignal.2000723

From P.10: “The identification of such potential signaling pathways provides initial insights. For example, two drugs, dasatinib and loperamide, used to treat different pathophysiologies, cancer and severe diarrhea can have QT prolongation as an adverse event and can be connected to the LQTS disease genes through the LQTS neighborhood (Fig. 5C). The paths can be short; for example, loperamide can be connected to KCNH2 through CALM1 (one step), and dasatinib can be connected to KCNQ1 through PRKACA and SRC (two steps), or more convoluted. Such a tracking exercise provides hypotheses about how these drugs might affect the QT interval and increase TdP risk, which can be used to design experiments in animal models or combined with whole genome information to identify “at-risk” patients.”

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loptab3Tissue distribution of loperamide and N-desmethylloperamide following a fatal overdose.

Sklerov J, Levine B, Moore KA, Allan C, Fowler D., Division of Forensic Toxicology, Office of the Armed Forces Medical Examiner, 1413 Research Blvd., Rockville, Maryland 20850, USA.

Journal of Analytical Toxicology, 2005 Oct;29(7):750-4.

Abstract: We report a case involving a fatal intoxication with loperamide (Imodium).”

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loptab3Loperamide Induced Brugada Syndrome

Sheyman, D.O. | Robert Crake, D.O.; Ohio Valley Medical Center, Wheeling WV; Feb 2014

February 2014 — Poster Presentation

Conclusion: 
Although rare, there have been reported cases of antihistamine, cocaine, and psychotropic drug induced Brugada Syndrome. Loperamide is another agent that could induce this syndrome. At present, there are no reported case studies that involve loperamide and Brugada Syndrome, however, because of the patients lack of family or personal history of cardiac problems we believe this may be the first case of loperamide induced Brugada Syndrome.”

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loptab3A Web-based Study of Extra-medical Use of Loperamide: “I just wanted to tell you that loperamide WILL WORK”:

Raminta Daniulaitytea, Robert Carlsona, Russel Falcka, Delroy Cameronb, Sujan Pererab, Lu Chenb, Amit Shethb; a Center for Interventions, Treatment, and Addictions Research (CITAR), Department of Community Health, Boonshoft School of Medicine, Wright State University, United States; b Ohio Center of Excellence in Knowledge-Enabled Computing (Kno.e.sis), Wright State University, United States1

Drug and Alcohol Dependence: LINK1: Poster session — LINK2: Published Paper
Accepted 3 November 2012. Available online 30 November 2012

Conclusions: This study suggests that loperamide is being used extra-medically to self-treat opioid withdrawal symptoms. There is a growing demand among people who are opioid dependent for drugs to control withdrawal symptoms, and loperamide appears to fit that role. The study also highlights the potential of the Web as a “leading edge” data source in identifying emerging drug use practices.”

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Editing note: I decided, out of respect to the authors, to not include content without permission aside from a notable quote that summarizes the article. But if you follow the links, I assure you, you’ll find what you’re looking for.

 

 

 

Posted in + recovery, addiction, depression, loperamide abuse, sobrietyland | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

In a Holding Pattern

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There hasn’t been much to write because, well,… I haven’t had much impetus to write.

I’m not depressed per se, just really low energy and desperately waiting for some break in the weather that indicates spring is coming. I’ve calculated that this winter has lasted 5 months so far — five months of bitter cold, ice, and snow — and I’m totally over it. I need some 60′s, sun, and dry ground (preferably some green grass). Here in the Northeast, I’m accustomed to a 3- or 4-month winter. That’s normal. But this? This is g-damned ridiculous! I did NOT sign on for this — if I had, I’d live in Alaska or something.

I worked for a short bit on a new header for the site. Expect it to find it refined over the next couple of days if I get the urge to do some adjustments that need to happen.

With regard to AA, I went to my meeting (yay! 4-months since my last dose of loperamide!). Nothing special happened. Regarding the Square-Jawed NP and The Marshmallow, yes I saw them both since the last entry, and no, there’s nothing special to report about either session. I got more meds from SJNP — he increased the Viibryd to the full 40-mg dose. He thinks I’m doing great so I won’t have to go back for a month. We also talked about music for a while. It was pretty dull. And the Marshmallow and I had an uneventful session wherein we talked about the possibility of me going back to school a bit more and discussed some of the weird dreams that the Trazodone seems to be bringing out in me. It seems I’m always dreaming either about getting in trouble at work or about trying to get back into my old house — those can be so exhausting and a little depressing! The house dreams are haunting. In them, I’m always trying to get something back from the new owners — furniture, jewelry, something. Or I’ve snuck into the garden to dig among my flowers and plants. The above photo was shot a few years ago when I was still living there. That is a Stella D’oro Day Lily. I know because I planted them. I miss them. That makes me sad.

The deal on the little shoebox house fell through. They want $550 a month not including utilities or anything else, and right now I just can’t afford that. It was nice to think about though.

I have to attend the information session regarding going back to school on disability; then and only then can I apply for benefits. Not that there are any guarantees of course, but I’ve found myself doubting my ability to succeed at it. I’m going to be 46 this year, and I worry that — not having a car or electricity — I’ll be taking on too much. The nursing programs are notoriously intense. Even with all my medical knowledge going in, they’re not going to make it easy. And how will I study at night without power or heat? All I do these days in my apartment is sleep. Pursuing an advanced degree in design would be a breeze by comparison, but it still won’t get me a job with any immediacy, especially in this depressed area. Hell, I can’t get a job now. At any rate, I definitely won’t know anything until after Tuesday next week, and then, it’ll be a wait until I get any answers on approval.

The little Red Dog is doing okay. I’ve squirreled away one or two doses of his back medicine just in case, but he’s off the meds right now and his pain seems to have healed. Knock wood.

Mrs H and Jon are still bickering, and I’m still working at her company, so I have enough to eat and pay the rent on my hovel apartment which just increased.

I’m applying for food stamps again because I’m so broke and tired of barely getting by financially. If it works, I’m going to apply for Section 8 housing and try to get some help finding an apartment that includes heat and electric for a cheap price and/or assistance paying that damned $1800 Power Bill that’s preventing me from getting the electricity turned on again.

No answers, just waiting on Spring. Please tell me it’s coming… sometime… right? Doesn’t it have to?

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We must let go of the life we have planned, so as to accept the one that is waiting for us. — Joseph Campbell

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Posted in + recovery, addiction, bipolar, depression, education, random crap, red dog, sobrietyland, Squalor Apartment | Tagged , , , , , , , , | Leave a comment

The Crazy on the Bus Goes Round and Round

busthingBeing without a car, I’m stuck choosing between two main modes of transportation: A.) Walk; B.) Ride the Bus. I walk many places, but I ride the bus every day to and from work and occasionally to shops in the outskirts; most things are not within walking distance of the hovel apartment.

I don’t know how many of you have ridden a public bus recently, but here in this small burg, bus isn’t exactly ideal transportation. Oh, it’s available, it works, and it’s cheap (only a buck a ride), but it’s not the most convenient. In most larger cities, the bus will often run every 10 or 15 minutes, but here in Small Town USA, it runs every 45 minutes.

So if I want to go to WalMart (in the outskirts), I have to ride the bus there, shop for 45 minutes, then ride it back home — a process that takes an hour and a half at best, to two hours or more at worst (depending on how many transfers you might need). A trip that might normally take 30 minutes or so (including drive time) if I had a car literally consumes hours via bus.

If I shop at the aforementioned WalMart, I’m stuck carrying all my packages home myself — no dragging it to the car then hauling it into the house when I get home. I carry from the store to my house. To facilitate the trip, I shop small and carry a large, over-the-shoulder shopping bag, often in addition to my purse or backpack, and wind up feeling like a pack mule by the time I get home.

Many people who take the bus are accompanied by what I call the “Old Lady Cart” for shopping. You’ve seen them, I’m sure. Old ladies most often are seen hunched over and dragging them around — it’s a tall aluminum version of a shopping cart with small wheels in front and large ones in back. I’ve actually been tempted to get one myself, but they’re surprisingly expensive ($30-$40) and not much good in the snow/ice anyway.

Other people on the bus choose to shop with their kids; they use both the kids (on foot) and the huge strollers for carrying their mass amounts of groceries. Both of these groups haul their poorly-carried booty onto the bus and block the aisles and seats with all the accompanying flotsam and jetsam. Myself, I learned a long time ago to keep my bags to no more than two or else carrying them home becomes incredibly burdensome. Occasionally, when I have to shop for more or heavier items, I’ll choose to take a taxi home — which is no cheap option either at a minimum charge of $7-9 (plus tip) from WalMart to my doorstep.

But it’s the characters who ride the bus who make the whole trip truly interesting. Many people, like myself, take the bus on a regular schedule back and forth to work. For instance, WalMart is one of the big employers around here, and since it’s mostly poor people who work there, many take the bus. Of course, the working folks aren’t the ones you need to worry about because they generally keep to themselves. They read (like I do), they crochet, listen to their headphones, or just sit quietly preparing for the work day. It’s the others — the bus floaters — those are the ones who’ll make the ride hell.

The weirdest and most vociferous folks ride the bus for fun all day; they have nothing better to do. These are the ones that will try to immerse me into conversation, conspiracy theories, arguments, or other such sucktitude. When I’m on the bus, I want to relax and read; I don’t need to get hit up for money or start arguing if the disappearance of Malaysia Airlines Flight 370 was the act of aliens, a government conspiracy, or that the plane was sucked into a black hole. What is wrong with people? Can’t we all just get along — quietly?

Such brilliant theorists conspire to assault me virtually every time I get on the bus. I sit there politely (WHY?!?) and listen while I pull out my headphones or try to get out of the conversation by appearing otherwise occupied, but these are not people who can take a subtle hint. I need to grow a backbone and start getting downright rude with them or else I’ll get stuck every time!

The following are The Core Bus Crazies:

bal1. Weird Bald Guy. This self-described genius is known for his girth and his shaved bald head. He rides the bus all day from coffee shop to coffee shop because he has nothing better to do. He loves a good conspiracy theory and if I make eye contact with him, he will corner me with a good education on his 9/11 theories or tell me how the gays are disgusting and ruining society. He recently bought a Kindle and now refuses to use it because he believes the government will steal his identity if he gets on the internet. Although I own a Kindle already, he wants to sell me his old one and tries to make me a sweet deal virtually every time I see him. I finally had to be blunt and tell him I was NOT interested. He doesn’t bother me so much anymore.

syr2. Crazy Syracuse Dude. He is the worst of the worst. Highly volatile and unpredictable, he’s fairly young (late 20′s?) and is highly recognizable because he always wears Syracuse sports gear including a hat with the SU logo on it. He also claims conspiracy theories and when he isn’t unsuccessfully attempting to mooch spare change off everyone, he sits next to me to tell me how he currently feels about the thrift store where I work. He hates our prices, our staff (except for me, of course), and our “rude” management. He has been in the store before and always causes trouble with his violent temper. I can’t stand this guy, but I humor him when he sits next to me because I’m deathly afraid he’s likely to plot to kill me.

wack3. The Bible Mumbler. This weird old guy always sits across from me on the bus where he sits, with his eyes closed and hands folded in his lap, and mumbles — audibly — what can best be described as a chant or prayer. I’ve not been able to make much out of what he mumbles, but I overheard “God” and “Jesus” mentioned a few times, so I can only assume it’s some oddball prayer. This guy’s not dangerous, but he’s annoying as hell.

kin4. Other Kindle Lady. (What is it about my Kindle that invites conversation with these people?) This old woman loves to talk to me about how great Kindle is because she has one and I have one — therefore, we must be best friends. She gave me a stylus once, thinking I needed one. Apparently, she buys styluses in bulk. She’s not dangerous either, and it all seems innocent enough until the 5-billionth time it happens. I just want to read and be left alone — I don’t want to get into a discussion about it every time I bring that Kindle out!

lat5. Screaming Spanish Guy. He’s blaringly loud, he’s Latino, and he has a long-suffering girlfriend who accompanies him faithfully everywhere. Does she wear earplugs? Is she deaf? How does she deal with it? Even though he doesn’t address me directly, his earsplitting stream of profanity-laden Spanish interrupts my every thought process. His shrill vocalization rises above all the normal roars and squeals of the average bus ride. So piercing, it’s literally painful.

And that’s just off the top of my head. Lucky for me, most of these folks are floaters on the bus, appearing at odd times and not regularly. So watch out! Like a bad cold, you never know when they’ll appear.

They certainly make me appreciate how nice it was when I had a car.

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Being sober on a bus is, like, totally different than being drunk on a bus. — Ozzy Osbourne

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Posted in sobrietyland, random crap, weirdness, Who's the bitch?, Squalor Apartment | Tagged , , , , , , , | Leave a comment

Hope Floats (though sometimes I think it sinks)

hope.jpg“Abandon hope all ye who enter here”* — that was the original subtitle of this blog. It was reflective of the emotionally deflated situation I’d found myself in when I initially detoxed off Vicodin several years ago. I wrote on the blog every day from work, describing the Hell that I felt I was in. Sobriety, as I saw it, was not a place for woosies. Still isn’t.

This time around, I discontinued that particular subtitle because abandoning hope isn’t what I’m supposed to be about these days. Though hope, unfortunately, is often counted among the collateral damage of my present situation. (Yeah, including weather! Just ask anyone here in the Northeast facing below-zero temps in March!! Hope is a rare commodity even among regular people these days.)

That said, I took one step forward today. I fulfilled my obligation to the Square-Jawed NP today by calling that New York State Educational Rehabilitation Department.

Yes, I managed to put it off successfully for three weeks and dodge every chance I had to do it. And yes, I’m going to probably regret that. Big whoo. The fact is, I’m resistant to the idea because I don’t want to be considered disabled due to my depression/bipolar/whatever. I never wanted that for myself.

But… the more I think about it, the more I wonder if it’s really all that bad. Hell, it might even give me a big advantage (despite having to be labeled, per se).

My lesson learned here: I should not prejudge situations before I try them. I’m sometimes too smart for my own good.

I learned, for instance, within about a minute of having called the Re-education Department, that they don’t just retrain — as in, I don’t necessarily have to go back to school to become a nurse or any such thing. They might be able to help me get a job back in my old career of design — and with the edge of being ‘disabled’. Edge, you say? Yes. It’s an edge. I’ll explain momentarily.

First step is to attend an information session. I can do that, but, that’s at 1pm on every Tuesday, and I WORK until 1pm. With the bus schedule, I don’t get back to downtown until about 2pm. But in the spirit of supporting hope, I can ask my boss if I can have an hour or so off next Tuesday, then make up the time another day.

See, that’s one of the problems with working a crummy suck-ass minimum wage job — every hour is counted. No freebie time off. No vacation time. No sick leave. You don’t show up, you don’t get paid — AND you have that time off counted against you — regardless of the reasoning — when the next evaluation comes up.

Second step is to fill out an application and find out what I’m eligible for. Then, third step is to talk to a counselor.

If I allow the NP to submit an official document stating I’m disabled, then I qualify for classes and help in getting a job — above and beyond the normal NY state-offered help for the regular po’ folk. For instance, in government jobs, if I’m disabled, that gives me a certain points-determined edge above other employees. The Disabled and Veterans are allowed preferential treatment in many jobs — not just government ones. Interesting, no?

It might also mean that I could try to get the little Red Dog certified as a therapy dog. A bit of a stretch, I realize, but it would mean I could legally take him with me wherever I go, whenever I need to — including on the bus — since leaving him home might not always be an option. This would be a tremendous help should I manage to find a better hovel apartment in a more distant part of town.

Regarding housing, my rent just went up. I’m not happy. My work partner at the sucky Thrift Store job wants to help and is asking a friend about a certain cigar-box house that’s for rent near her. She’s going to see if he’d be willing to rent it to me for what I currently pay for my hovel apartment. Only problem is, it’s quite far from where I live now. I would be far from Aunt and Uncle Crazypants and Mrs. H too. That would suck.

Still, I’m really hoping to get it for a decent price because it would be ideal in so many other ways. Though it’s far away from downtown, and it’s super-teeny-tiny, there’d be no more crazy nightmare neighbors banging on my door at 2am to ask if I’m the local drug dealer (hell no!) or wondering if that weird sound is coming from MY apartment (it never is).

Plus, there’s a yard and places to plant things. I soooo miss gardening! It’s probably the one thing I truly do miss about the old House is getting my hands dirty in the garden.

Too perfect to happen, I know. I’m probably going to be stuck where I am, or I’ll have to start hunting for a better place more locally. But — if that house deal miraculously works out (I can dream, can’t I?), then I’m virtually across the street from the local community college. How convenient would that be? If, of course, I can go back to college on my own tax dime.

If I can just allow myself to be considered disabled… maybe there will be a sea change in my situation.

tunn.jpgI find it nearly impossible to be optimistic or dream big anymore. I used to do it all the time, even in the face of failure. It was fun. Like a game. I was the Energizer Bunny of big dreams. But now… it’s different. I guess when you lose everything and find out exactly how difficult (nearly impossible) it is to come back from that, you also lose that part of you that allows for hope. That light at the end of the tunnel most often looks like an oncoming train rather than ultimate liberation.

But this time, maybe. If I can just allow it. The power is in me to at least allow the chance.

That’s another thing I’m learning. From the AA Book of Proverbs: nothing changes if nothing ever changes. I have to learn to permit the opportunity to occur rather than always hiding from it due to fear. More often than not, I’ve made up my mind that failure is inevitable long before failure hits. That really needs to stop.

Could I get lucky this time?

* Note: This is how the quote appeared on my blog, and yes, for all you English Majors out there, I realize this is a common misquote. For the perfectionists, the original from Dante’s Inferno: “Abandon all hope, ye who enter here.”

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Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning. — Albert Einstein

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Posted in + recovery, addiction, bipolar, depression, education, Squalor Apartment, weird neighbors | Tagged , , , , , , | 2 Comments