Friday, July 20, 2007

Welcome To The Real World

We can begin with an incident that happened to me a few days ago. I constantly have to fight to obtain medication, for I am too poor to afford co-pays and must depend upon the charity of the drug companies to obtain the drugs which keep my bipolar moods stable. These are dispensed through my mental health agency, Lexington Counseling [of course that isn't it's real name, no real names will ever appear here except my own]. With the Ohio mental health system strained to the breaking point by Ohio politics, any agency is always in the middle of a comedy of errors with one or another of its patients. It was my turn this time around.

It was about the Prozac, which I take in the evenings because the Wellbutrin XL keeps me awake at night. The details do not matter, but I had been off the Prozac for a week. I had to spend over an hour waiting for a prescription in a frantic, over decorated, "postmodern" grocery store, with three forms of forced entertainment at once: blaring televisions, 1970's hits over the PA, zany fishing boat motifs on the unoccupied walls, and all the blaring labels on the food packages.

Afterward, while waiting for the bus, I noticed intellectually that it was a stunningly beautiful summer day and also that I had absolutely no emotional response to this in the least. All of a sudden, everything around me began to have an emotional aura of deadness and flatness, rather like well-used chewing gum. Then, on the bus, I began to sicken of the Columbus landscape the bus was wading through. Finally, every bright primary color in all the road and business signs became a torment to even look at. This is a common set of symptoms which I share with some other bipolars that I call "too loud, too bright, too much".

I felt absolutely horrible until I reached the streets where I live, which are full of only brown brick apartment buildings, and equally brown burned off summer lawns, with no primary colors to be seen anywhere except for the green of the trees. When I got here, the burning cloud eased off of me.

This is a commonplace of my life, and because of it, though I have almost nothing, there are some days when even this is far too much.

We can then turn to my main job. I work as a Customer Service Representative, about 12 hrs a week, for $9.00 an hour, on a toll-free mental health client and family hotline for the entire state of Ohio. I get to talk to some very interesting people: cons in prison, dual-diagnosis crackheads who also are psychotic; perfectly ordinary but terrified families confronting a relative's mental illness for the first time; citizen whistle-blowers reporting abuse and neglect of patients in mental health hospital wards; and, sadly, extremely exploited and violated recovering clients with no recourse and no advocate in a very hard world.

A good glimpse into my work is the call I once received from a polite gentleman in one of our State Hospitals. He wanted to complain that he was misdiagnosed and stated that all three of his personalities were in agreement about it.

My work is "accomodated" or "sheltered" work specifically for mental health clients and my accomodation is restricted and flexible hours. I am well trusted and am first on call to replace my non-client boss when she has vacation, emergencies, or outside conferences to manage. I seem to have a way with telephone crises and overwrought callers. For some strange reason people naturally calm down when they talk to me. I also have a bag of tricks for defusing callers with overly emotional demands. Later, in another post, I'll reveal some of the tricks of my trade.

I am also well liked. The mental illness has amplified my capacity for comedy considerably and I have been known to preface, straight faced, perfectly serious work requests to my superiors, such as Brandy Latour, with something like this: "Well, speaking as one of the zany supporting characters on the Brandy Latour Show..."

But the manic/depressive symptoms never quite go away. Every day when I get up in the morning I have to deal with the foggy, unsettling, and incoherant feelings of having the minimum amount of medications in my bloodstream. It takes a full hour for my morning dosages and my morning coffee to render me fit for anything but staring into space and being miserable.

As the medications hit, and flood the bloodstream to its maximum, I then have a space of about two hours where I am constantly fighting being distracted, and leaping over the gaps in my short term memory that the drugs induce: don't forget the ID badge for the guards at the front door of your job, don't forget your cane that you need to handle your morning osteoarthritis stiffness and for balancing on the lurching and shuddering old transit busses that you take everywhere, don't forget to turn off the stove burner when you remove the pan of hot oatmeal from it...

There was also a tiny crisis a few weeks back when I had what later proved to be merely a heat rash. Another of my drugs, Lamictal, can throw a rash before provoking a deadly allergic reaction known as anaphalactic shock. Lamitical is also an anti-seizure medication. The psychiatrist who prescribes for me stated over the phone that I had a choice. I could go off the Lamictal cold turkey and run the risk of it inducing an artificial seizure, even though I am not epileptic. Or I could run the risk that the rash was a real drug allergy and suddenly stop breathing.

Some choice, huh?

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