Grief, Depressive Disorder, and Me

Grief is depression in proportion toWe finally closed on the condo in Indianapolis this week. It was on the market for over 14 months and was a major source of stress for me, both in terms of finances and logistics. No one wants to be stuck with two house payments. But the physical toll of repairing, cleaning, and painting 2,000 square feet of unoccupied space in another state has compounded my weariness lately.

***

On Tuesday, we arrived at the condo ahead of the closing to do one last walk-through. Dan and I sat on the stairs for a few quiet moments. Though I had been complaining for months that I hated the stupid place and wished I could burn it down, I was a little sad. Not teary, but nostalgic. Letting go was like tearing apart two pieces of heavy-duty Velcro. Possible, yes, but not effortless.

“I used to grab a cup of coffee and lumber down these steps after you went to work,” Dan reminisced. “And then a few minutes later I’d hear Taub clodding down the steps, his nails clicking when he hit the landing. He’d hop in his chair and we’d chill together.”

I smiled—laughed even—at the memory of Taubensee’s butt swishing from side to side as he made his way downstairs. In his old age he was a little less graceful on the steps, but no less adorable. I could see him jump into his overstuffed chair, lay his head on the arm, sigh, and melt into one of his day-long naps.

Bittersweet, that moment. Sad to be moving further away from it, but joyed to have known it.

That’s right, I said “joyed.” JOYED!

And that’s the exact moment I knew the Cymbalta was working.

Some people describe a sort of emotional flatness on anti-depressants, and I was concerned that could happen to me when my doctor prescribed it. But having experienced the inner stalemate of two equally matched yet opposing emotions several times before, I recognized it as a marked improvement.

***

When Taubensee died on August 4, 2013, I was an emotional wreck. I got trapped in an early stage of grief for well over a year. I was drowning in loss. Hell, up until I started the Cymbalta, I was still crying a few nights a week because he was gone and I missed him.

Remembering happy times with him didn’t help heal the wounds either, it opened them afresh. Thoughts of him that started as a picture of an ecstatic puppy frolicking in his favorite open field always ended with me wailing and sobbing in a cold, sterile room while Dan hugged me and the vet said, “You two take all the time you need.”

Happy memories of Taub were like watching a video, I could recall them but I couldn’t feel them. The grief, though, that was so much more. I was stuck reliving that shit, and I couldn’t shut off the sad. I could push it to the back to get through the day if I needed, but I couldn’t move beyond it. If being that perpetually sad took a physical toll on my body (and I’m sure it did), trying to suppress it depleted me entirely.

No wonder I’m physically broken.

Whether my depression lead to fibromyalgia, my fibromyalgia lead to depression, or my head injury contributed to both (post-concussion syndrome can be associated with fatigue and depression) doesn’t really matter. What matters is that I was unable to fix the problem on my own, and I needed help to have any hope of walking a mile without stopping to rest, sleeping through a night, or feeling anything like my old self again.

***

I am thankful that Cymbalta (duloxetine) exists, despite the horrible side effects I endured last week—the migraines and the restlessness and the nausea and the dizziness and the dry mouth. I’d suffer that god-awful week all over again for this small but important improvement in my health.

“A part of me really hopes the depression is the primary factor here, that my fibromyalgia…my physical symptoms are all secondary to that,” I told Dan as he drove me to work this morning. “If that were true, I think the Cymbalta could make my brain better and my brain could get my body to follow suit.”

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Cymbalta (duloxetine) for Fibromyalgia: The First Week

migraine aura
What I see with migraine aura.

Friday morning after taking a shower, I was my usual exhausted self—struggling to put my pants on, using the walls to keep myself upright. But I was also willing away the nausea and vertigo after three days on Cymbalta. So, I asked Dan if he would drive me to work—even though it’s only a block away.

“Sure,” he said cheerily, “just let me get dressed.” I watched as he tucked his red T-shirt into his blue underpants and then he picked up my heated throw and tied it around his neck like a cape.

“What are…”

But before I could finish, his arms were up and he was running around the apartment. You know, doing the superhero thing.

***

My doctor prescribed 30 mg capsules to be taken with supper to treat my fibromyalgia. One pill for the first week, then two pills thereafter. So all of the experiences I’m about to recount are from the training-wheel dose.

Tuesday night, my first night taking duloxetine, I slept fitfully (nothing new there) and woke up in the middle of the night with a raging headache. I sat up in bed and said out loud, “My God, this is intolerable.” My skin felt like it was on fire from head to toe, like my nerves had turned into hot, pointy, triangles. There was some tingling and aching across the back of my head. Then, in what seemed like 5 minutes (but was probably closer to 30 seconds) it was all over. I broke into a sweat and felt surprisingly calm and relaxed. I went back to sleep until it was time to get ready for work.

Now, I’m no stranger to migraines, so although this experience freaked me out a little bit, it wasn’t terrifying. I’ve had migraines in the past that cause holes in my vision, lead to me seeing squiggly lines (auras), and end with tingling and numbness in an arm (sometimes it’s my left arm, sometimes it’s my right) followed by a severe headache that can last hours or days.

So while the fiery triangle sensation was new and slightly disconcerting, it wasn’t panic-inducing. For someone less familiar with migraine symptoms? I imagine an experience like mine could lead to a full-on panic attack.

***

By Thursday, I had noticed a couple of good things. My legs were feeling better—that extreme burning sensation was almost gone. One of my scars from my gallbladder surgery was no longer itchy, red, and inflamed. (All the others had healed quite nicely.) And a nerve in my left ear had finally calmed down. (When touched it would make my left leg and toes spasm and curl. Kind of like when you scratch behind a dog’s ear and they can’t help but do the motorcycle leg.) I feel like my nerves aren’t hypersensitive, and this is huge.

There have been some psychological benefits too, but that will have to wait for another post. I have to limit my screen time.

***

Despite starting off with a huge guffaw Friday morning (the superhero episode with Dan), Friday was one of the worst days of my life. Still suffering from nausea and vertigo, I ended up with a migraine that was completely debilitating. In addition, all the muscles in my shoulders, neck, and face had pretty much locked up. The TMJ was so horrible I could hardly move my jaw, and the cracking and popping in my ears was equally unbearable.

I went into work in the morning, but I didn’t make it back to work after lunch. Dan put the apartment in migraine mode for me, shutting the blinds. I suffered for hours with quite literally the worst headache I’ve ever had. Ever.

I decided late in the evening to have some hot lemon ginger tea with honey and milk. It works nicely to calm my stomach. However, after finishing the tea, my migraine went from a 10 on the pain scale to an 8, and something occurred to me: I was dehydrated. I remembered that it seemed like the Cymbalta was making me pee a lot, so I decided to try Gatorade. I downed 20 ounces in as many minutes and was down to a 4 on the pain scale. Halle-freakin’-lujah.

***

I slept most of the weekend, relying on my favorite podcast and ZzzQuil Friday and Saturday night. I still have headaches, and I don’t know yet how the duloxetine is going to work in the long-term. I do feel, however, that it’s worth giving more time. Most people say the side-effects subside after the first week or two, and the small improvements I’ve noticed seem promising.

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My Prescription Was (Sort Of) Filled!

Duloxetine_chemical_structureHealth Alliance finally approved my duloxetine prescription, and I’m so thankful I don’t have to wait any longer. (Kudos to the Walgreens pharmacist that sent me home with 5 pills at no charge, because he didn’t have enough to fill the whole order and didn’t think I should go without.)

It’s 53°F and rainy here today, and I’m working on day four of a migraine in addition to my usual list of fibromyalgia complaints. I put in my PTO request this morning, which was swiftly and graciously approved by my boss, and now I’m in my pajamas taking care of me.

While I have a bajillion post ideas swirling around in my head right now, I don’t really have the energy to write them out. So I’m just going to put these links right here and walk away slowly. What you do with them is your business, of course.

Pills
Your Health, Your Advocacy: What I’ve Learned About Communicating With Doctors
Pain Depletes…My Bank Account
Lithium Nausea; Curbed By Tater Tots?

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Fibrade™: A Fibromyalgia-Induced Tirade

spoon theory and fibromyalgiaBeing diagnosed with fibromyalgia has been overwhelming. That’s mostly my own fault because I can’t half-ass research anything. For example, I found myself surfing Pinterest last night for “fibromyalgia humor” and ended up abandoning my computer to go cry on the bed for a while.

Dan came back to check on me. “You doing okay?”

“I don’t want to be a Spoonie!” I buried my face in the memory foam.

The Spoon Theory, if you haven’t heard of it, was written to help “normal” people understand what day-to-day life is like for someone with fibromylagia (or lupus or MS or CFS or RA or PA or blah, blah, blah).  I get it, and I empathize. But sweet mother of god, it’s fucking depressing as hell! I got three motherfucking spoons yesterday and spent them washing my hair, walking six-tenths of a mile, and vacuuming hair off the bathroom floor.

(Now might be a good time to plug this article from Scientific American: Why the #$%! Do We Swear? For Pain Relief)

Did you hear me? Washing my hair costs a goddamn spoon!

“Washing my hair”—like “cleaning out my dog’s ears”—used to be one of the hysterically absurd prior engagements I made up when begging off going to the movies with someone boring. Now it’s a legitimate excuse for me to back out of shit I actually want to do.

The following is not a non sequitur for someone with fibromyalgia:

“Hey, Em, want to get fajitas and margaritas tonight?”

“Sorry, can’t! I washed my hair this morning! Love you though!”

I should point out that I am still not on Cymbalta (duloxetine) yet, and my frustration is only multiplying while I wait for my health insurance provider to stop dicking around. Piss or get off the pot, assholes!

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The Things I’ve Tried to Get Some Sleep

sleep with me podcast

I don’t sleep well, and even before I was diagnosed with fibromyalgia I was looking for ways to solve this problem. I tried shutting myself in a quiet room every evening to meditate. When I couldn’t get my brain to shut off on my own for even a few minutes, I turned to guided meditation experts. Good gawd! Those podcasts aren’t relaxing. They’re nauseating.

(No offense if guided meditation is your vocation or it works for you. I just find the awkward speaking cadences and saccharine voices of most mediation leaders to be insincere and off-putting. Blargh.)

I tried drinking caffeine-free tea.

I tried listening to soothing music, including Eva Cassidy’s Songbird and just about everything ever recorded by the Innocence Mission.

I tried boring myself to sleep by counting backwards from 100 in my head. Then 200. Then 400.

My biggest obstacle to sleep is that when I lie down at night, I cannot relax from the shoulders up. My neck and jaw tighten and the back of my skull aches from ear to ear. My shoulders draw up to my chin. I wake up each morning to a stiff jaw and a disturbing clicking sound in my left ear when I open my mouth. (More on TMJ disorders and fibromyalgia planned for another post, in case you’re interested.) Attempts to force relaxation usually just lead to failure, frustration, and even more tension.

But then last night I was searching podcasts for “sleep” and stumbled across Sleep with Me — “the podcast that puts you to sleep.” The host, Dearest Scooter doesn’t take anything too seriously, which I find very reassuring. In fact, I even laughed a little when he encouraged me to package up my brain bundle and kick it off the bed. “It’ll be there on the floor for you in the morning,” he promised.

The podcast’s author credits two things with helping him overcome his own sleeplessness: listening to Doctor Demento and telling his brother boring bedtime stories. These things inspired him to create a podcast that quite literally bores listeners to sleep.

And for me, it works. I got the best sleep I’ve had in months last night!

I went to bed before my husband did and fell asleep shortly after I started playing the first podcast. When Dan came to bed, I woke up and had to start a second podcast. It worked again! I honestly can’t tell you anything about either of the boring bedtime stories, they were that soothingly dull.

If you have trouble sleeping for any reason, you might want to give it a try.

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