Follow up

So, about a week after the debacle I went for a follow up appointment with my PCP to check in and update charts and all that stuff. We chatted about a lot of things, she gave me an ointment to put on the allergic-reaction rash I developed to whatever it was they swabbed me down with to insert the IV and do the blood draw at urgent care, the basics. We discussed my upcoming assessment appointment at behavioral health.

“Do you think you’re going to be able to stay sober until then?”

“Oh yeah. Gone through the withdrawals and the sedatives, starting to feel human again, I can and will definitely stay sober another week. Probably much longer. But in reality, until we get my pain and anxiety/depression under control, I’m just going to keep going back eventually.”

I had a really good run this spring, after the first try and the seizure and all. Three months or more, and I was even the kind of drinker I would LIKE to be—the kind that can go out and grab a beer with friends every once in awhile then go straight back to not drinking. And even this last time I lasted almost a month. And both of those stretches of time, it wasn’t even hard, really. Not in the way I always imagined it being hard, anyways. A few days of (granted, extreme) physical withdrawal, an occasional thought of “Huh. I could really go for a drink right now.”, but no problem pushing those thoughts away. I went and sang sober karaoke, soda water and lime on the table beside me. I had no problems going to my favorite bar and drinking an unadulterated ginger beer while I wrote. I could easily sit with friends who were drinking and have a coke. I drove a friend around to breweries, having a sip of each so we could discuss flavor notes, but not wanting more than that taste.

But it’s all part of the cycle, and the simplest explanation of my specific cycle is chronic pain and fatigue to depression and anxiety to alcohol. Because though I am continuing to wend my way down this unnecessarily convoluted medical path, NSAIDs haven’t touched this specific pain and booze has always been an awesome and almost immediate (if temporary) solution for both pain and anxiety for me. It certainly doesn’t help the fatigue, and seems more or less ineffective for the depression either way (though I know it’s a depressant), but for pain and anxiety….

When I was in urgent care last week, a nurse came in, woke me (sweetly. Every time this particular nurse woke me up she did it with this specific affectionate chuckle that made me feel like probably one of her kids used to sleep like I do, ridiculously contorted with impressive bed head. Or maybe I’m just that freaking awkwardly adorable when I sleep.), took my vitals and for the first time that evening asked the question, “What’s your pain level?”

“Five.” And then quickly, “But that’s my normal.” Actually, I realized, that was low normal. This might even be a 4. How long had it been since I’d had a non-alcohol-related 4? Maybe after six weeks the Lupus meds were starting to kick in. (Maybe it was just those pills they kept bringing me for the shakes.). My normal for the past few years has been hanging out in the 6-7 zone, with peaks up to 9.

It’s about that third day at an 8-9 that the devil I know starts to look awfully kind.

And autoimmune and mental health are both things that when it comes to medication, at least, it seems like everybody’s just kind of flying by the seat of their pants.

Lupus meds: “Well, we have no idea why this anti-malarial works for people with Lupus/RA, but it does for a lot of them and we’ve been using it for forty + years, so why don’t you try this and we’ll see what happens? It’ll probably take three months to even start working, though. And it has some unpleasant side effects like splitting headaches, but those usually get better after a few weeks so don’t give up. Oh, and it has a tendency to cause macular degeneration so make sure to get those eyes checked, yeah? It’ll probably also kill your already non-existent appetite. Now take two of these every day for the rest of your life. Come back in three months and we’ll see what’s next.” (One of my friends recently looked it up, and they HAVE finally figured out why Plaquenil works—“It just shuts off inflammation on a cellular level.”. OK, well what does THAT mean, exactly? Isn’t some inflammation important? I feel the same way about immunosuppressants. So my choices are chronic pain and fatigue or more regular infections? I mean, I know the goal is to find some kind of balance where your body can still fight other stuff but stops fighting itself, but how do you figure that out?) Plus the last time I was on it for any extended period of time, they put me on something ELSE in conjunction that was terrible, and then we were starting to talk about the third addition when my insurance situation changed and I had to make some new calls.

Antidepressant/anxietals: “Well, there are these three we use most of the time. We’ll just pick one, you can try it for six weeks, and if it doesn’t help we’ll move on to the next.”

“Are any of them better or worse for pain as well?” (I’d asked about pain meds and the response I got was basically, “If the NSAIDs aren’t working, our next step is usually opiates, and with you recovering from alcohol addiction, I really don’t want to put you on anything potentially habit forming.” “That’s fine. I don’t like the way opiates make me feel anyway, and I DEFINITELY wouldn’t want to be on them long term.”).

“Yeah, but that’s a different one we use for fibromyalgia sometimes, and it’s one we can only prescribe if we’re sure these don’t work.”

“OK then, if we’re just drawing names out of a hat here let’s go A or C. I have family that’s allergic to B.”

“A it is! Take half of one of these every day for a week then a full one, and we’ll meet back up in 6 weeks and see how it’s going. And make sure to tell the people around you you’re starting it, in case you have any negative mood changes.” And if A doesn’t work it’ll be C for six weeks, and if C doesn’t work it’ll be B for six weeks, and if finally at the end of all that it’s still not going anywhere we can move on to other options, maybe even one that will help with pain.

 

There’s no end in sight. And there’s this treacherous little voice in the back of my head that says, “Look, baby, there’s a grocery store two blocks away. I could have two shots of whiskey in my belly in fewer than ten minutes. Pain diminished, anxiety relieved, presto.”.

There’s even part of me that feels like it’s a valid argument, and that ethanol would be a fine solution IF I could stop once I started. IF two shots was ever enough. IF alcohol didn’t mess with the effects of most actual prescribed medications. IF I didn’t happen to be the convergence of two long genetic lines of alcoholics. And IF I could quit/take a break when I realized it was time without either four days on heavy sedatives or full DTs. If, if, if.

 

On the next installment: Something fun. I dunno what it’s gonna be, but it’s gonna be something fun, dammit.

Hearts,

Kat!

 

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