My last couple of psych appointments have been very brief if not abruptly ended. I don't think it's because she's tired of me or has given up. It's most likely a realization that she's just going to have to throw darts in the dark until the miracle drug combination bullseye is hit. Other alternatives have proven to be futile. She has an endless grab bag of medications to either substitute for or add on to the ones I'm currently taking. Pure trial and error. That's why it's called a practice I suppose. Sometimes she seems a bit flustered with the situation but I tell myself it's probably because I see her monthly on her once a week late night appointments so she's just tired at the end of the day. Or maybe she's fed up with her career decision. One can only speculate. Wait, who's the patient here?

I tentatively decided to forego ECT for now and reluctantly revealed that decision during my most recent visit. She asked why and I unconvincingly attempted to explain how I have been reading about and researching both the pros and cons of ECT. The cons have me persuaded right now either because I haven't really hit bottom yet or I'm simply too chicken to dive head-first into it. Each time I explain why I won't do it she sings the same tune about how safe and effective it is and doesn't understand why in the world I wouldn't consider it. Somehow I feel foolish with my decision but my gut feeling tells me it would be the mistake of my life to say, yes please, hook me up.

Maybe 7 minutes into the appointment she asks if I've ever taken (insert drug name here) before. Sometimes it's yes, sometimes no. This time it's 'Saphris.' An antipsychotic for schizophrenia and bipolar disorder — neither of which I have. She's using it as an adjunct (add-on) to the two antidepressants I'm currently on. Another doctor she talked to spoke of some success he had seen with this experiment. I asked about side effects and she listed the usual suspects. Before I could say "never heard of it," she was off to the sample closet and emerged with a small, brown paper bag of a month's supply. She said it's best to take it at night and I'll see you in a month. Out I went with my brown paper bag feeling like a homeless alcoholic clutching his concealed bottle of malt liquor. I believe it's the shortest appointment yet.

This stuff is different. It's quick dissolving and has a texture similar to smooth styrofoam. Each one is individually seated in tiny bowl-shaped trays, and as an added treat, they're "black cherry flavored." Before bed, I put one under my tongue and let it quickly absorb into my system. Black cherry? I only tasted salt. Twenty or so minutes later it starts to kick in much like the feeling of alcohol. A bit disoriented, sleepy. My mouth gets dry so I grab a water bottle knowing I'll be needing it through the night. With knowledge that at least one side effect is drowsiness, I fall into bed craving a long night's sleep. Minutes later my left leg flinches awakening me. Not again. I've been here before. Many of these meds I've taken somehow have this strange neurological effect on the legs that causes an extremely unpleasant sensation that only a quick jerk of the leg can temporarily remedy. You could set your watch by its cadence. Sleep is completely impossible. I can't stay in bed with my wife as I fling my limbs every 60 seconds or she'll kill me so it's off to the back bedroom again.

God, what a miserable night. Our back room is cold. The drug makes me groggy. I just want sleep. My left leg consistently flinches waking me each time. The neurological feeling that leads up to each jerk is so uncomfortable and disturbing. Now the left arm joins in. I'm parched. Between reaching for the water bottle, stumbling to the restroom and flopping about like a fish I'm exhausted, upset and defeated. This goes on until around 3 AM. Another medication that promises depression relief has yet again pummeled me into abject exasperation. Maybe a shock to the cranium would have been the better decision, dammit.

The next day I awoke with a headache. A really severe headache. I suppose it could be considered a migraine. My wife suffers from them regularly. It progressed through the morning to the point where my vision was affected. I could barely function. I put in a call to my regular GP to see if they could squeeze me in. They managed to set an appointment in the next couple of hours.

I don't know why, but I decided not to tell the doctor about the cause of the headache. I just wanted relief. He prescribed Imitrex which is the go-to med for migraines. I know mixing to powerful drugs like this was foolish and dangerous but I simply didn't care. I proceeded to the pharmacy and waited what seemed an eternity to get the script filled. Finally, I went home and laid in bed hoping to awake to a clear head. After a short nap, the pain persisted. I was told I could take two after a certain amount of time if the first didn't help. Finally, after taking two doses, relief slowly set in.

What a terrific experience this Saphris was. Made everything so much better. That was the last dose of that crap I would ever take.

Sleep, Interrupted

I've just been diagnosed with sleep apnea. I've heard the term but never knew what it was. For quite a while my family has brought my sleep habits to my attention but I thought nothing of it. I'm apparently snoring louder these days and stop breathing repeatedly throughout the night. There's been a few times where I've gasped for air and awoke myself. So I went to my doctor who referred me to a sleep specialist. The sleep specialist suggested I do an overnight sleep study. This consists of staying in a hotel-type room overnight and being wired to computers via many electrodes and wires. The results confirmed "mild" sleep apnea. I stopped breathing an average of 23 times per hour in a 7-hour period. These moments can be as little as a 3 seconds on up to 12 seconds in duration. They are accompanied by the brain detecting the problem and sending a signal to the body to work harder to breathe. This results in the brain and body awaking even for just a couple of seconds. Most of these awakenings aren't detected whatsoever but the accumulative waking time results in sleep deprivation. When I stop breathing the body and brain are deprived of oxygen. It can all add up to many health hazards such as high blood pressure, coronary problems, fatigue, loss of concentration, and depression. Yes, depression. This new revelation is not the cause of my depression but it might certainly exacerbate it.

The treatment options are a "CPAP" machine which is a mask attached to a programmed box that sends a constant stream of air through the nose while you sleep. Another treatment is a custom made dental appliance you wear at night that juts out the lower jaw and allows more airflow. Another option is surgery where your jaw bone is dislocated and pushed forward with braces. It includes a 4 to 6 week wiring shut of the mouth and a liquid diet. Not a chance. Yet another is puncturing a hole through the trachea. Again, not a chance.

I'm not sure what to do at the moment. I'm the worst decision maker. I need to research cost and insurance coverage. None of this is welcome news by any stretch and I haven't the energy to deal with it.

As I've written in earlier posts, sleep is my only escape. Now it's become a possible accomplice to my depression. In rare cases, if gone untreated sleep apnea can cause death. It's not a likely result for me but the thought of going to sleep and never waking up is appealing in a macabre way. Isn't that how we all want to go?