Trying To Hold It Together

[Chava]

My therapist is gone for a few weeks, which I don't think should be a problem, but I'm entering a squirmy muscle and panic phase. It's partly related to hormones and different pills I'm on, but it's like the combination injects my body with unhelpful adrenaline. Last month I ended up in the ER for another EKG just to double check a really uncomfortable arrhythmia.

So that, and I went to refill my painkillers, tramadol, (upper back pain) and found out my prescription was useless. I have on my bottle that I had 5 refills before October (ridiculous, but points to how moderately I use them...at most 2 a day, with prescription being for up to 8 pills a day). But today I was informed that tramadol was recently changed to a schedule C (IV) medication. I wish someone at the clinic had notified me because I waited until the last minute, so was down to one pill. I don't take many but my back hasn't been very good the last couple days, and tends to get worse with this adrenaline madness. Also, if I just STOP, even from taking 2 a day, I will have major ER-worthy mood problems with my combined hormone sh#t, pain, and zero sleep. The good news is the walk-in clinic doctor gave me a mini prescription until I can call my doctor on Tuesday. But I might have to go in to get it re-ordered?? And it's the busiest week of the year.

I'm trying not to think about stuff. I went biking and walking this evening and that seemed helpful. I don't plan well outside of work. There is no "crisis" plan and maybe I would have felt better if I had something in place. But I did get some guidelines from the ER last time. If my heart feels screwed up again, I should go in if my pulse remains above 120 or if the arrhythmia lasts beyond 20 minutes (it always does...?). Smoking does NOT help, but trying to quit this week is making it all feel like too much. So I'm just trying to distract myself so I don't chain smoke. Now I have this fear that my doctor won't want to re-order tramadol because of the schedule change. I don't know what she'll do. I need to get off that sh*t but I've done well keeping to small doses and it's all that helps for back pain and my bad cramps (hormone pills should help, but the pms makes me want to die). So I'm afraid of pain, i'm afraid of having to force my system to adjust with no support, and I'm afraid of going 5 years backwards. Probably none of this will happen and my doctor will be supportive. But when I cut down to just 1/2 of one pill per day, it seemed to snowball with the hormones and my back locked up...my whole upper body was "freezing" and I became unbearably sad. So, this is sort of a "medication" post but really I have a load of fear, no therapist (no e-mail or anything), and no back-up plan.

If any of you have had helpful "back-up" plans for crisis, please share ideas that have helped. Right now I just know there's the ER, but I'd like to keep my panic in check so I don't go there. I think the busy week will rescue me from any massive mood drop into sadness, but the mild panic is sustaining and building. I feel like I've been punched in the face (plus moments of over-heating and wanting to barf).

Thanks for reading (part of expressing this might just help me talk to my doctor on Tuesday). I'm going back to moving, muscle exertion, and trying to unload some of this adrenaline safely.

p.s. I didn't want to post here again, so just heads up if anyone wants to tell me to pull myself up by my bootstraps or anything to that effect, or how stupid I am for taking any tramadol, please think it and don't share.

 

[joeylittle]

If any of you have had helpful "back-up" plans for crisis, please share ideas that have helped.

I need to keep lists, short lists of things that I will do when I'm sliding downwards. They have to be simple, physical (when possible), and really just hook my mind into being in the moment instead of in the rising fears, or the overwhelming feelings, etc, etc. So, going for a brisk walk and needing to see all the letters of the alphabet in order on license plates before I can come home. Cleaning my apartment (including dusting, vacuuming, actually putting things away). Clipping my cats' nails and grooming them and giving them a good hard play session. Turning on music and dancing and lip synching (this one is probably the hardest, because it also forces a mood shift. I don't try this all the time).

Those are the things on my list right now. I'm pretty good at believing in rules, so it's just a personal rule that I need to first go to the list. About two-thirds of the time it works. The rest of the time it will either keep things at bay but not get me out of the bad zone, and then I take an ativan and try one more thing, or I'll just not be able to keep it together and I'll call my therapist. I know I'm lucky that I can include him in my plan. Before I had him, it was calling one of the 2 people in the world who know about all this stuff with me, and telling them I needed to talk. I hated doing that, because it felt like expecting friends to be clinicians. But it worked.

I think it's really good and commendable that you are able to know what's going on with yourself even while it's happening, and I agree with you that it's going to serve you well when you see your doc to be able to talk about this stuff specifically.

 

[Chava]

Lists also overwhelm me right now because there is so much to do, but I'm making a list and thinking of it NOT as "to-do" but options or things to run through if I feel like I'm spiraling downward. Keeping it physical and present is helpful. I'm going to zone out on a painting. My artwork sucks, but I feel like I need to grab onto something so I don't blow into pieces. Sensory, physical, absorbing..

Last time I saw my therapist I sort of wondered what I should do if in crisis, but didn't even want to ask and assume it would be a problem. You know? So now I just feel unprepared. On my way out of my appointment I at least asked if I could e-mail if needed and my therapist told me she probably wouldn't have a good connection. So I just never thought about this. It feels like a "test" to see how I manage and I want to think I can figure it out. I've gotten pretty used to being able to e-mail my therapist in a crisis. She usually gave me little reminders, but mostly it helped that she responded and I didn't feel trapped all alone in my panic or mega sadness. But no response for three weeks...? I can't think about it.

 

[joeylittle]

Yeah, don't think about it. Zoning out on artwork sounds great - that's kind of like what I did when I couldn't move because of injury, I would cope by knitting. Not as engaging as painting, but still helpful. Anyway, I think painting is really smart.

And try and ask your therapist next time. Even if she gives you a clear "no, I want you to do this instead", that would I'm sure be helpful. I fall into that trap of assuming I know what mine will say, when of course I don't (I get an A+ in mind-reading). Or I don't want to hear the answer. But it's always more progress to ask - I won't even say "better", just more progress.

I did try calling crisis lines for awhile, but got really bad workers, and it just made me worse. I put in another thread somewhere that theres a crisis chat line in the US, and that worked better for me. My problems with chat lines was I think a big part of why my therapist was readily available for me early on.

Tell me to step back if I'm wrong about this, but I feel like I've read that you have been through AA. Are you still in touch with your sponsor? Can they be a kind of support phone call when you need it, even just for certain periods when you know it's gonna be rough for you (like now?)

 

[Chava]

My sponsor moved several years ago and we lost touch. I don't have a sponsor now. Sponsorship is sort of weak where we're at. There's one woman I admire but she's sponsoring too many people. But I could probably call her. I also have a good friend for times like this but she is going through a lot of physical health issues herself and I don't want to add my need for support to her list of things she can't keep up with right now.

I did find a document I created last month after ER...all kinds of things I was noting that helped with this hormone-adrenaline surge (even things like wrapping my torso tight in a scarf). Did I think of this list earlier today? NO. I was only thinking about what if I die this week and my mom has to clean out my basement. I have to clean the basement!! That sort of irrational fatalism. Anyway, I put the document in a visible spot on my computer...I should actually set up my printer so I can print it out. It also has the instructions from ER, so I did good work on that last month, but funny how my brain doesn't work when I need it. I was really stressing about the junk in the basement and being forced into tramadol withdrawal and having the earth suck me under.

Soothing things normally do not fit on my panic list. But it does help to snuggle with my dog and cat. For the most part I need to be absorbed in something physical or sensory. I did a lot of stuff with resistance bands tonight. I hope I don't regret that in the morning. But it helped for now. Just feels like a gush of adrenaline I need to release in bits without hurting myself. I can't worry about my therapist. I do have a friend who will let me stay in her basement if I'm in bad panic and feel ill and like I want to be closer to ER (I like out of town). I've stayed there a couple times and never had to go to ER because just being closer, and having someone to stay with, helped me settle a bit. She's having a busy week too, but if I'm in a crisis, I bet she'd let me camp out in her basement.

Thanks @joeylittle

 

[joeylittle]

Hey, you're welcome. I'm really glad of the thread actually - it's helped me reconnect with this stuff, and inspired me to write out the list and post it again. I think calling the sponsor in your area that you admire is a great idea, too. Worst she can say is "no".

Anyway, you got this. I'll be thinking of you and the tramadol situation. I really hope that works out ok.

 

[darrenS]

Just hang in there Chava , i can certainly relate to the fear of pain and running out of pills, its a daily thing here also

 

[JEKBreatheandBelieve]

I just wanted to let you know that I read your post and I am thinking of you. I don't have any back-up plans, but that is a good thing to think about. My therapist is going on vacation in October and it's freaking me out so I probably should think about that.

You work in education, right? I start teaching this week, too. I am freaking out about that, too, even though I am usually fine in the classroom. It's just the leading up to it all that gets me. And then I worry, what if I can't make it through the day?

I hope you can talk to your doctor and that you are able to get your prescription filled. Maybe if you can, you can talk to your doctor about your fears. Anyway, I really just wanted to let you know that even though I don't have much in the way of suggestions, I read your post and am rooting for you.

 

[Chava]

Thank you @JEKBreatheandBelieve. Yes, I wish I we would have talked about back-up plans. I know I avoided asking because I wanted to feel like this would be no big deal and I'd be fine if my therapist is MIA for a while. Partly that is a helpful way to look at it, but I wish maybe a couple weeks ago we would have talked about it a little, and what I could do if I couldn't e-mail.

The beginning of the school year is crazy, for sure. I feel ready for my stuff, and not too stressed, but more bothered about hopes of communicating with the clinic (I can't talk to my doctor without an appointment, all communication goes through a nurse if I call, and parts are always lost...I REALLY hope I don't have to leave class within the first week to meet with my doctor and straighten out any of this crap...hopefully they are helpful since nobody told me my prescription was just going to become obsolete).

It feels like by body has been injected by an epi pen and I just woke up. Lots of squirmy muscle stuff I have to manage without pulling any muscles, etc. Helps to move a lot or work with resistance (pushing, resistance bands...) burn off some of the adrenaline. Trying to let it "out" versus hold in the tension and create a ball of pain and panic.

Hope you have a good week, JEK...always feels good to get those first couple days behind us...thanks for your note.

 

[Jane.l]

When I can't email my T and feel I need to - sometimes I write the email and then save it rather than send it - and it does help , it straightens out my thinking a little - I think about what he would say or do about what I have written and also I have it there to pick bits out when he is back that I think might be important. I know it's only a little thing but sometimes the small stuff makes a difference .

My T is away too soon - really dreading it !

 

[Chava]

Thanks @Jane.l ...I'll try something like that. I've written e-mails before, meaning to not send, and then just send sort of impulsively. I seem to have messed up permanency-constancy issues sometimes. I live alone and it's like nobody else even exists. I'm not "part" of any relationship or connected to anyone unless I'm actually in the same room as them. So, aside from all of my panic, I'm worried my therapist will "disappear" in my head. I don't get anxious about this...I just approach people I know almost like they are strangers again and I don't feel like "starting over" in a few weeks because of this brain damage I seem to have. It's some sort of strong natural barrier to forming connections and it sucks, but I'm trying to understand it. I'll keep notes, my panic list, but maybe also include my therapist in loving-kindness meditation (if I can actually manage to slow down enough to do that in any form) to remember she is still "there" and she's still my therapist, she's just not available for a while.

 

[Chava]

Pulled through panic, no arrhythmia or ER trip and feeling like a dumbsh*t. Movement and exercise helps, if I manage it the right way (not over-doing anything and waking up with more pain...tricky balance but I'm getting better at it). I feel less anxious about trying to get a message through to my doctor at a huge clinic tomorrow...like I just need to make the phone call and not feel so pre-devastated by the communication chain. If I need to make an appointment, they're usually able to squeeze me in within a week, which is pretty good.

As for my therapist being away I also found another forum that can help through more of my more specific "crisis" symptoms (panic and physical pain). The other cptsd symptoms are challenging, but I can manage on my own a little better. It's still hard to call people and reach out directly, but I'll go to my AA meeting this week too, and that group always puts me in a positive head space. Thanks again for the boost of support over the weekend.