Tuesday, February 10, 2015

Mental meandering

Inside my knee
I haven't written much here lately ... well, I haven't posted much.  I seem to start writing and hit a wall or lose my train of thought.  I've not had much to say ... possibly nothing to say, but it is still frustrating to not be able to finish my thoughts.

Pam has been going nuts trying to work ... or more like fight with our pharmacy, our insurance and our doctor.

Our doctor is the truly helpful party in this mess, but always winds up getting dragged into the mess because both the insurance and pharmacy say "we've contacted your doctor many times and they refuse to respond."

Our Ambien always seems to be the biggest issue.  It is a controlled substance so we can only request a refill a few days before we run out ... unfortunately the pharmacy chooses to do nothing until the day we run out and then point the finger at the doctor.

This month Pam had to deal with my Wellbutrin.  My doctor has me on 150 mg three times daily.  It is a very high dose, but we worked up to that amount over several months.  First the pharmacist said that they couldn't fill it because it would interact with another medicine I take ...

Ummmm ... I've been taking the same things for a year or more.  Why is it now that you worry about an interaction?  Or why was it never brought up before?

The pharmacist then changed his story and said we needed prior authorization from the insurance to take this medication at this dose.  Both the doctor and the insurance say this is not true ... that the prescription should just be refilled.

Finally the jackass pharmacist says that my doctor is not using proper protocol with my medication or treatment.

Random pills
Random prescriptions
I really do not want to sound like I am blaming one person for all this, so I will refrain from stating this is a male pharmacist who works days at the Walgreens on Ventura Rd in Oxnard.

He says he has nearly 10 years experience in the field, but he does not know me nor my history at all ... he did not see my mental state a year ago ... so why would I trust him over a doctor that has been treating me for over 10 years, works very closely with me and is really the only doctor I've ever gone to that truly understands and cares about the big picture with both me and Pam.

According to the pharmacist Wellbutrin should never be prescribed at 450 mg per day.  The protocol is increase the patient to 300 mg and if that doesn't work change the patient to 300 mg slow release.

This math makes no sense ... if 300 is not working try using 300 ... ??? ...

The only upside to this is I have been in a very good place mentally for a while and I was going to ask my doctor if I could try to go back down to 300 mg daily anyway.

And also, while I was in the pharmacy to pick up the prescriptions and talk to the boneheads face to face they kept advising me to tell Tim that medications are the same but from a different manufacturer and that's why they look different.  They didn't want him to be concerned or confused.

I did laugh a bit at that.

While we were at the doctor I was given the result from the chest x-ray I had a couple weeks ago.  This is still all part of a followup from the surgery just over two years ago.

I've been curious, bordering on a little concerned about what they might find.  I do get what feels like muscle cramps or spasms at the lower region of my chest cavity when I sneeze or cough a lot.  It can be pretty painful, but it usually subsides pretty quickly.

The x-ray showed nothing out of the ordinary.
O2 meter
The boredom of pre-op
at it's best

My doctor figures the cramping muscles are normal due to the surgery.  This is a bit of a relief ... maybe more than a bit.  The fewer things I worry about going wrong or being an issue the less stressed I feel.

So Friday I go to the hospital to have another meniscus surgery on my left knee.  Despite having this same procedure before I felt a little uptight.  I'm sure I wasn't near a panic attack, but I wanted to calm myself a little.

Luckily my friend Lyndsay  was on Facebook ... but calling her a friend is truly an understatement.  She is much more like a sister ... a confidant, a counselor, a mentor and a motivator all in one.

I am actually blessed to have several friends who fall into this same category ... Lyndsay was the one helping me that day.  And she did help ... I did relax.

The pre-op parade was a little depressing as every single person had to ask my name ... my legal name.  Pretty much all of them called me Tiffanie, but having to say that name I want to disappear a dozen times was a bit of a downer.

Time seemed to drag as the surgery time got delayed.  Eventually Dr. Mazurek popped into my  cubical.  "Hi Tiff.  Just want you to make sure we're operating on the correct knee."

"I think I'll be asleep at the time."  I smiled.

"That's why I ask you now and autograph you."  He scribbled his initials on my left leg and left the area.

After that the anesthesiologist came in and talked for a bit.  I'm not sure he knew how to refer to me, but he was not rude ... just seemed uncomfortable.  After a brief discussion he gave the go ahead for me to get my dose of verced.

The nurse who had been so wonderful to me from the time I got there came in with the syringe.  "You'll feel this almost right away."

Outside my knee
The drug was in and I was being rolled through the halls toward the operating room.  The further down the hall I went the more the drug blurred my thoughts.

The room was set up differently than other surgeries.  I didn't get to see the buffet table of interesting tools and instruments, just a bunch of electronic screens, 2 light fixtures which were not turned on and a small crowd gathering around me.

As they secured my arms and legs I wiggled a little to understand where the straps were.  I truly hate being restrained, but I knew it had to be done so I kept practicing my relaxation.

"I'm giving you something that will make you sleep."  The anesthesiologist was hovering over me.  By this time he was holding a mask in his hand.  "This is just oxygen.  Breathe deep."  He placed the mask on my face.

When it comes to surgery and anesthesia I am a little strange.  I seem to be aware of everything right up to going all the way under ... and after I go under I am aware of the passage of time.  I've been told everything from this is unusual to this cannot be true.

Maybe it is just my imagination.

This time as the drugs dragged me away from my conscious brain I was aware ... aware of time ... aware of sounds  ... aware of movements.  I did not feel pain nor was I aware of any feeling of trauma.  I just felt like I was in a grey place with dark and distorted shadows.  The sounds were muffled and distant, but I did hear voices and noises.  When the staff began to revive me I figured something was wrong because I had not been under very long.

It turns out that  the opposite was true.  The tear in the meniscus was small and very easy to take care of.

From that point on it was so wonderful.  The post-op staff did not ask my legal name ... I was Tiffanie ... I was treated as a female ... it was incredible.  The nurse encouraged me to respond with sentences like, "Come on girl, a couple deep breaths."  I pulled down my blanket and she said, "Oh girl, you're all sweaty.  Let me dry you off."  When she called Pam to tell her I was almost ready every reference to me used female pronouns.

After leaving the hospital I did something I haven't done in many years ... I threw up.


There was nothing to throw up but a little bile ... and it hit really fast.  I'm not sure why it happened, but I'm willing to wait another dozen years or more to do it again.

Pam's bacon
swiss & steak
I slept after I got home.  The medications did a real number on me ... I was loopy and out of it for a few hours, but felt great when I woke up.

Saturday Pam and I went to Quiznos.  Here I was with my messy hair, no makeup and, earrings and looking like something the cat may have dragged in.

The clerk took Pam's order ... Bacon swiss and steak with no mayo.

After the clerk tried to talk her into every dressing in the store he finally looked at me.  "And you ma'am?"

Ma'am??  Really???  At my worst, feeling nearly naked with no makeup, in a top that might be a little feminine, wearing crocs and slouching so I don't put weight on my knee and he calls me ma'am?


I ordered a chipotle steak and cheddar and we ordered my mom a turkey club.

Between the reaction at the lab a while back, the pharmacy and now the sandwich shop I think I'm gaining confidence.  I think people perceive me as female, and the only doubts that are left are in my head.

My chipotle
steak & cheddar
I never expected to reach this point in my journey.  Now that I am here I can look to other things I never thought I could accomplish.

I don't think this journey has an ending point ... no specific accomplishment where I say, "That's it.  That's all I can do."  I just need to keep moving forward and see how far this life takes me.