Kimberly (kimberly_a) wrote,

  • Mood:

Mostly Coughing, but Also Mental Health


I saw the pulmonologist today and was quite disappointed, as she didn't have a lot of useful stuff to offer. Her main advice was this: "Keep doing what you're doing, and eventually the coughing will stop, though it may take months." Yay? She also urged me to continue to minimize my physical activity, because anything that makes me breathe more deeply/heavily will certainly exacerbate the coughing (soon afterward if not immediately), which only continues the feedback loop of more coughing irritating my throat, thereby causing more coughing, which in turn irritates my throat further, thereby causing more coughing, etc., etc., etc. ad ininitem.

The pulmonologist also ordered some tests, just to make sure the cough isn't being caused/exacerbated by anything like a sinus infection. So when the authorizations come through from my insurance, I'll get to go have some CAT scans ... possibly one of the medical procedures I've never had. I've had MRIs, EEGs, EKGs, and who knows what else, but I don't remember any CAT scans.

After the pulmonologist appointment (and my discussion of it with Shannon), I took off my beloved new Fitbit, because it has been encouraging me to exercise too much. Normally, being encouraged to be more active would be a good thing, but right now I need to be less active, not more, especially given the fact that I've been hypomanic (more about this in a moment) and so don't have the best judgment about relaxing & have taken to pacing restlessly whenever I'm waiting for something because I know it will add more steps to my Fitbit tracking for the day. So I'm only going to use the Fitbit to track my sleep until the coughing stops. *pout* I hate setting aside my new toy. *pout*


So I've been hypomanic for a week or two, probably triggered by the constant sleep deprivation caused by coughing for the past 2 months:
  • I've been having racing thoughts.
  • I've spent a fair amount of money on stuff I don't really need.
  • I've been having trouble controlling my "pressured speech" (need to talk constantly, because I have infinite interesting things to say & can't hold back without great, constant effort).
  • I've been getting ideas for lots of art and craft projects.
  • I've been volunteering to organize/manage events like my friend Crystal's birthday party (and making an ambitious birthday present for her that is requiring hours—nay, days—nay, weeks of work).
  • I've been getting songs excessively stuck in my head, and frequently making up silly little spontaneous songs about things I'm doing at the moment.
  • I've been feeling compelled to clean obsessively and do housework that is probably too strenuous for my current physical state.
  • I've been pacing in doctors' waiting rooms (as mentioned above).
  • And I've just generally been showing most of my usual, classic symptoms of hypomania.

So I phoned the Meds Doc on June 5th & he gave me some recommendations, which I followed. Nearly a week later, the hypomania has not abated, so I phoned him again today & he gave me further recs. Note: By way of explanation, I'll point out that Zoloft is an anti-depressant, which can drive hypomania, and we therefore would want to reduce it; and Seroquel is a mood stabilizer, which can help control hypomania, and we therefore would want to add/increase it (Seroquel can also promote sleep, which is an added benefit for me right now, since the coughing wakes me up so often, causing the aforementioned sleep deprivation that can accompany/trigger/promote hypomania).

Here's the medication plan thus far & moving forward:
  1. I lowered my daily Zoloft dosage from my usual 37.5 mg to 25 mg (6/6/15-6/11/15)
  2. I added Seroquel 50 mg at night (6/5/15-6/10/15)
  3. I'm further lowering the Zoloft dosage to 12.5 mg (starting tomorrow morning, 6/12/15)
  4. I'm increasing Seroquel to 75 mg at night to help with sleep & mood stability (starting tonight, 6/11/15)
The increased Seroquel will most likely make me groggy all day, as I've already been seeing some of this effect at the 50 mg dosage, so I expect it will increase tomorrow. I hate feeling groggy when I have things to do, and feeling groggy while simultaneously feeling the pressured energy of hypomania feels just plain weird. But maybe the grogginess (is that a word?) will help me stay put & rest.

The Plan

So I'm going to TRY to REST and stop pacing around and finding reasons to walk up and down the stairs to increase my Fitbit count (and this effort will be assisted considerably by my not wearing the Fitbit).

Simultaneously, I'm going to prioritize getting to/from CWC and going to groups there as the place to expend most of my limited energy, because my therapist is on vacation for the next 3 weeks & hypomania is unhealthy for a variety of reasons, not the least of which is its tendency to segue suddenly into severe depression (of the possible hospitalization type). I figure if I have limited energy, therapy/support groups are the wisest way to use it. Fun stuff will come second. Actually, housework will come second, and fun stuff will come third. So I probably won't get too do too much fun stuff for a while. But fun stuff is necessary for mental health, too, so I'll have to make sure to get some of it.

Shotgun Players

In a totally unrelated sphere, Shannon and I saw a play last night at the Shotgun Players: Marisela Treviño Orta's Heart-Shaped Nebula, which I adored. It was a play basically written for me, combining death/loss/stars (my dad is the one who taught me to love the stars, and we even watched a lunar eclipse together once, sitting on a hay bale outside his barn one summer in Wyoming) with the use of art as a way of dealing with trauma. It made me cry and cry and cry, both during and afterward.

Shannon pointed out that some of the love story was heavy-handed, but the love story was sort of vague background for me: I was more focused on the stars, and living with trauma, and using art as a way of coping.

It won't speak to most people the way it spoke to me, but—for me—it was incredibly moving.
Tags: art, bipolar disorder, coughing, cwc, dad, depression, eclipse, exercise, fitbit, hypomania, meds doc, meds-seroquel, meds-sertraline, meds-zoloft, ptsd, pulmonologist, shotgun players, sleep, support groups, the starry sky, theater, therapy, trauma

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