#WeekendCoffeeShare (February 19, 2022)

Posted on by Astrid

Hi everyone on this gloomy Saturday evening. I’m joining #WeekendCoffeeShare today. I’m right between my dinner and my evening coffee and I cannot offer you a drink other than water right now, as my staff is busy and I don’t want to leave my room. I’ll get to that bit later. So, can I get you a drink of water? Otherwise you’ll have to wait until my staff returns. Anyway, let’s have a chat.

If we were having coffee (or water, in this case), I’d share that we’re quarantining right now, as four or five of my fellow clients are positive for COVID. Four are confirmed and the fifth one can’t be tested but is treated as having COVID too. I took a lateral flow test right after dinner this evening and so far I’m still negative, as are the four other clients supported by the same staff as me outside of my one-on-one hours.

This is the reason the staff are busy, with the staff who care for the COVID-positive clients having to wear PPE and the other staff having to remain out of these clients’ way. It is all rather chaotic.

If we were having coffee, I’d share some of my new clay creations with you too. Like I think I said yesterday, I finally created a cactus on Monday evening.

Polymer Clay Cactus

Then on Wednesday, I created my second-ever polymer clay cane. This one I did using a heart-shaped cutter for the image. I managed to do the reducing all by myself! Then I had my staff cut it into slices, which we then made into beads.

I also created several possible charms to go with these beads. One is a heart which I do kind of like. The other was a unicorn, but I threw that one away. I now only need to make more beads, because, even though I have more than just the four beads shown in the picture above, I don’t have enough for a necklace.

If we were having coffee, I’d share that, this afternoon, I have been experimenting with photo editing and meme making again. I didn’t have any success, of course. I mean, I found a photo editing app called Snapseed, which is relatively accessible with VoiceOver, but the one thing I wanted to do, ie. add text to an image, was not. That is, I couldn’t for the life of me figure out how to enter the text I wanted to add onto the image.

The result of all my experimenting is that now I have eight apps in my Photography folder on my iPhone rather than the four I used to have. And those four already seemed excessive, being that, besides the camera and default photos app, I only use one out of the two image recognition apps I have. Oh well.

If we were having coffee, I’d share about my nurse practitioner’s appointment on Thursday. I am so thankful we were still allowed to leave the home back then, because the appt was really productive. With respect to my new medication, the pregabalin, my nurse practitioner recommended I wait and see another two weeks before concluding it’s ineffective for my anxiety. We discussed my anxiety in a little more depth and also for the first time in a long while went into my diagnosis. He actually said he believes my diagnosis is DID (dissociative identity disorder) or at least some variation of it (ie. other specified dissociative disorder). I quickly talked over it saying it doesn’t really matter, as I know firstly he can’t diagnose me (but then again the psychiatrist can) and secondly I still haven’t had the extensive assessment required for a DID diagnosis in most places here in the Netherlands. That being said, it felt so good to be validated like this! My nurse practitioner also finally will make room for us to discuss my flashbacks at a later appt. He said the reason he didn’t go into it right then was the limited time left in our appt, but he’d definitely like to discuss it with me. That feels kind of weird, but in a good way.

If we were having coffee, lastly I’d share that I’m so glad the storms are finally over. Last Wednesday night, I hardly slept at all due to the high winds. Thankfully, last night and the night before that were better. My husband’s and my house did suffer some damage to the roof though. Hopefully insurance will be able to cover the cost of getting it repaired.

How have you been?

Gratitude List (February 18, 2022) #TToT

Posted on by Astrid

Hi all again. I am feeling in the mood for a gratitude post. It doesn’t mean I’m necessarily feeling upbeat – not too downcast either, thankfully. Oh wait, I hadn’t started my gratitude list yet. I’m just inspired to write one. As usual, I’m joining in with Ten Things of Thankful. Here goes.

1. I am grateful I’m negative for COVID so far. The virus finally reached my care home, as several clients tested positive yesterday. Thankfully though, my lateral flow test was negative yesterday and I’m not having symptoms suggestive of COVID at this point.

2. I am grateful for a great essential oil blend in my diffuser right now. I put lemon, tangerine, orange and spearmint in it and it smells truly delicious.

3. I am grateful for a good nurse practitioner’s appt yesterday. I was still allowed to leave the home yesterday to go to my appointment and it was really productive. My nurse practitioner validated my experience of dissociation and we were able to talk some about my anxiety too. We will discuss my flashbacks separately later.

4. I am grateful to be indoors. It’s storming outside and I’m so happy I don’t have to leave the home. Not that I’m allowed to now that the official positive PCR test results are in for my fellow clients, but oh well.

5. I am grateful for relatively cheap quark. I usually have that with my muesli for breakfast now, but yesterday used up the last few spoonfuls. However, a staff offered to buy new quark at her local supermarket. She got 1kg for €1,28. At the supermarket my care facility order from, they only have the 500g cans for €1,09. Not that I personally have to pay for my quark, but I don’t want the facility to have to pay €1,09 on a can I cannot even get three breakfasts out of.

6. I am grateful to have been able to be very crafty lately. I think I already mentioned creating the polymer clay narwhal last week. This week, I created another couple of things. Can you guess what this is supposed to be? About half my staff guessed it correctly and the others didn’t.

7. I am grateful for bananas, plums and grapes. Somehow, the staff had forgotten to order bananas last week, but thankfully, the care home next to mine was able to give us two on Wednesday. Yum! Then on my way home from my nurse practitioner’s appt yesterday, we stopped by the supermarket for some more fruit. We got plums and grapes. The plums were surprisingly sweet.

8. I am grateful for free audiobooks. Or one free audiobook, at least. I haven’t started listening to it yet, but the first book in one of Blake Pierce’s series is free even as an audiobook. I loved reading the first book in the Riley Paige Mystery series, even though I haven’t read any of his other books. This is the first installment in another series. Free stuff is always great and, now that iOS is giving me a headache working with my Braille display, I’d love to give audiobooks a try.

9. I am grateful for peach yogurt. It is the only type of fruit yogurt I really like and I’m so grateful we’ve been having it all week.

10. I am grateful to be alive. After writing my poem this afternoon, I’d just like to say this.

What are you grateful for?

#WeekendCoffeeShare (February 6, 2022)

Posted on by Astrid

Hi everyone on this rainy, windy Sunday afternoon. I’m really regretting having started the landing page for #Write28Days rather than just having linked up some archive of the tag or something, as today I’m already a day behind and it looks weird to add posts to my landing page again now. Okay, maybe that’s just my autistic brain acting up. Anyway, this afternoon I’m joining #WeekendCoffeeShare. If I feel so inclined, I’m going to add another post on my #Write28Days topic tonight, but again I won’t promise I will.

I’ve just had my afternoon coffee. I’m supposed to have a serving of fruit with that. Since the supermarket delivered 5kg of pears yesterday, the staff badly wanted me to eat a pear. Thing is, I’m not a fan. Besides, it’s not my problem either the supermarket got the order wrong or my staff mistyped it in the system. They should have been five pears, not 5kg. Anyway, I chose a banana, but if you all would like a pear (or two) with your coffee, tea or soft drink, we’ve got loads! Let’s have a drink and let’s catch up.

If we were having coffee, I’d share some more details than I did yesterday about my psychiatrist’s appointment on Tuesday. First, we decided to decrease my topiramate (Topamax) dose again to 25mg morning and 25mg evening, because the other 25mg I was taking in the evening was only giving me side effects and no positive effects. We also discussed my fear of letting go of my sense of control particularly in the evening and at night when getting ready for sleep. This means that traditional anti-anxiety medications or sleeping pills are pretty much out of the question for me, since they’d cause me to get drowsy and hence by definition lose a bit of control. Then, I’d fight the effect of those pills and get even more anxious. The psychiatrist instead prescribed me pregabalin (Lyrica). This, like topiramate, is originally an anticonvulsant, but it also works for anxiety. I would be starting with one 75mg tablet on Saturday early evening (around 5PM, when we have dinner here).

The psychiatrist also recommended that my nurse practitioner talk to the mental health agency’s psychologist to see if she can offer me ideas for coping with the anxiety. My nurse practitioner is also going to discuss this with my care facility’s behavior specialist.

If we were having coffee, I’d tell you that, indeed, I started on my decreased topiramate dosage on Tuesday right away. I slept great my first night and originally thought maybe this was the solution after all. It wasn’t to be though, as the next day I was right back to being sleepless and anxious.

Then yesterday I was anxiously awaiting starting my pregabalin at 5PM only to find out first that the staff thought it was put in the med system for 8PM. Then, once they took a closer look, they found out the pharmacy had put it in there for 8AM and the morning staff had indeed given it to me. I’d apparently taken it without noticing. No side effects so far, but this really is quite stupid, as there’s a reason I should be taking it early in the evening. I E-mailed my nurse practitioner, who will hopefully get back to me tomorrow. By the way, I also noticed I got a capsule rather than a tablet. The dosage is right, thankfully.

If we were having coffee, I would share that, yesterday, I decided to order soft pastels to use with my polymer clay. They should be getting here any moment, as thanks to my Select membership with Bol.com, I can have stuff delivered for free any day of the week.

If we were having coffee, I’d tell you that I asked about sealing my polymer clay creations if I’d used acrylic paint or soft pastels on them. I particularly commented that I don’t want to use resin for this, as it’s rather risky with the UV or fumes of the two-component epoxy. Thankfully, I was reassured that sealing isn’t really necessary and, if it is, I can use other products than resin, such as floorboard protector or liquid clay.

If we were having coffee, lastly I’d share that, due to the high winds, my husband didn’t visit today. He didn’t want to risk driving on the highway in his small Daihatsu Cuore, particularly near Lobith, where they’d issued a weather warning. Better luck next week!

How have you been?

Gratitude List (January 28, 2022) #TToT

Posted on by Astrid

Hi everyone. I have been doing my gratitude posts on Saturday lately, but today I feel in the mood for one and I don’t care that it’s Friday. Since the Ten Things of Thankful (#TToT) linky is live already, I’m joining in with it. Here goes.

1. I am grateful for Chinese takeout on Sunday. It was delicious! Originally, the staff had been planning on cooking noodles herself, but then due to another staff contracting COVID, shifts got moved around. The staff who would be cooking the noodles, had ordered shoarma to go with the noodles, which was a combination neihter me nor the staff who was now going to cook liked. In the end, we decided to put the shoarma in the freezer and get Chinese takeout.

2. I am grateful my husband, who got ill with the flu last week, is better again. He tested negative for COVID, thankfully, and was able to return to work on Tuesday.

3. I am grateful a fellow client, who went into hospital earlier in the week, was able to come home again.

4. I am grateful for fried fish for lunch on Tuesday. Originally, I felt bad about doing something that wasn’t on my food plan twice in one week, but I thoroughly enjoyed it anyway. In addition, thankfully, the dietitian reassured me that this is completely within reason.

5. I am grateful I lost 1kg over the past week and have only 0.2kg to lose to cross the border from obese to overweight. I am also grateful that the dietitian isn’t expecting me to lose weight quickly. Furthermore, once I am in the overweight category, the main goal is to prevent weight gain really.

6. I am grateful for the support of my assigned staff. Last Wednesday night, I hardly slept at all and I sent her an E-mail in the middle of the night. The next morning, even though she hadn’t read my E-mail yet, she woke me up despite actually not being my staff for that morning. We had a very good talk.

7. I am grateful for the support of my nurse practitioner. He doesn’t really know what will help me in the way of medication or whatever yet, now that we’ve more or less concluded that the topiramate isn’t as effective as we’d hoped. However, he’s enlisting the help of the psychiatrist.

8. I am grateful I finished my first handmade polymer clay necklace in time to give it to a fellow client in the care home downstairs from mine for her birthday today. It took me over a month of hard work, but I am so proud of myself for finishing it! I am also grateful she was very happy with it.

9. I am grateful for an extra weighted blanket when I feel very anxious. I always use a blanket filled with sand-like granules when sleeping, but when I feel very anxious, I can add a ball-filled blanket on top of it for extra deep pressure.

10. I am grateful I was able to solve at least one of the problems the most recent iOS update was causing with VoiceOver on my iPhone. Since updating, VoiceOver’s speech prefaced every character I typed by “Underscore”. This turned out to be due to a setting that had been switched by the update or something. Unfortunately, some problems, like Braille display sluggishness, persist.

What have you been grateful for?

Share Four Somethings (January 2022)

Posted on by Astrid

Hi everyone. Can you believe it’s almost the end of January already? I can’t wait for this month to be over with, honestly. February can be depressing too, but not as depressing as January. At least then the weather may start to warm up a little. Let’s hope! Anyway, today I’m joining Share Four Somethings. I think I joined this link-up once before, but am hoping to make it a regular habit now that it’s a new format. Here goes.

Something Loved

Essential oils. Yay, my three new oils arrived today! Though I haven’t tried them out yet, I will certainly be doing so soon. One, lemon, isn’t really new, but I’d had to throw out the old bottle because it’d gone past its shelf life. This really should be a motivator to use my essential oils more often. The other two, spearmint and sweet marjoram, I haven’t used before.

Something Gleaned

Honestly, I had to Google the definition of “glean”, so I could say I gleaned the meaning of the word. I guess my English isn’t as good as I’d like to say it is.

Seriously though, I have been reading the Bible everyday since January 1. While 24 days isn’t my longest streak ever by far, I do find that the more I study God’s Word, the more I learn. My most recent realization came from the story about the Bible passage I mentioned yesterday. The pastor sharing the story about the passage said that “favor” in Psalms 30:5 could also be translated as “grace”. This, until then, I’d always seen as a decidedly New Testamental term. Then again, I now am beginning to see that the Bible isn’t really strictly divided between OT and NT, but it’s all one story leading to Jesus. To those of my readers who’ve been believers for longer than I have been, this may seem obvious. To me, it’s a big eye-opener.

Something Braved

Well, as regular readers of my blog will know, this month was quite hard. I’ve been dealing with a lot of anxiety and PTSD symptoms. Even though one of my medications, topiramate, which specifically works to combat trauma-related symptoms, was upped earlier this month, I’m not yet noticing the change. On the contrary, in fact, it looks like I’m doing a little worse. That is, I might be noticing a slight positive change over the past few days, but it’s so early on that it’s hard to know for sure and I’m not sure whether the change is positive compared to how I did on my old dosage too. I thankfully will have an extra appointment with my nurse practitioner on Thursday to discuss how things are going.

Something Achieved

Two somethings here, is that okay? First, I have been writing more frequently and more widely than I did before. I am really proud of myself for this, as it is actually one of only a few ways in which I’m still staying active lately. Due to my anxiety, after all, I’m struggling to try new things such as crafting or even to go for a walk. However, I do try out new writing techniques and that’s something at least.

The other achievement is my diet. I started on a healthier eating plan with the help of a dietitian early in the month. Not with the aim of losing weight, although it would be great if I could lose the 1.5kg I need to lose to no longer be obese. My main goal is to experience less inner conflict about eating, as I have a history of eating disorder symptoms. So far, I’m sticking to it pretty well. More importantly, the one day when I couldn’t fully stick to the plan, because we had Chinese takeout, I didn’t resort to eating disorder behaviors. That’s quite an accomplishment!

Gratitude List (January 22, 2022) #TToT

Posted on by Astrid

Hi everyone. It’s time for another gratitude post. I’m struggling a little, but, as I’ve said many times before, this makes them all the more important. As usual, I’m joining in wiht Ten Things of Thankful (#TToT). Here goes.

1. I am grateful to have seen my husband on Sunday. We went to the Subway drive-through to get a sandwich. I chose a turkey one, to which my husband asked whether I took it because of my diet or because I was in the mood for turkey. “Both,” I replied.

2. I am grateful my mother-in-law visited me on Wednesday. We went for a drive around the nearby countryside and for a short walk in a nearby village.

3. I am grateful for muesli for breakfast. I am also grateful the dietitian allows me muesli with some nuts or raisins in it and it doesn’t have to be plain grain.

4. I am grateful for blueberries. When in the nearby village with my mother-in-law, we decided to get some groceries for her. I decided to get blueberries too.

5. I am grateful my dental chek-up last Wednesday was uneventful and, other than the fact that I have inflamed gums, everything was fine.

6. I am grateful for a good laugh with one of my staff on Thursday. I originally was anxious about her being my one-on-one that day, because a few weeks prior she’d triggered me with what she thought was encouragement of my independence. I thankfully talked it over with her and we then laughed our butts off at some silly jokes we were cracking.

7. I am grateful I am inspired to write on my blog. I still struggle to find the motivation to go on walks or to craft, but at least I’m writing almost everyday, sometimes twice a day.

8. I am grateful my nurse practitioner keeps trying to help me and takes me seriously despite how complicated I might be. I have been experiencing increased flashbacks to the time I spent in the psych hospital lately, but I try to remind myself my staff and my treatment team at mental health are different.

9. I am grateful it looks like the essential oils I ordered on Thursday, are on their way. I ordered with a company that doesn’t use the bank’s payment processing system, so I had to make my payment manually, then panicked worrying that I’d made a typeo somehow. Apparently not. Let’s hope the company isn’t altogether lying and will actually have shipped my essential oils.

10. I am grateful I’ve found the courage to experiment with essential oil blends that are slightly different from the ones I find online. For example, earlier I used tangerine rather than orange in a blend that otherwise contained cardamom and cinnamon. It smelled delicious!

What are you grateful for?

Most Relaxed When I Am Slightly Distressed?

Posted on by Astrid

I had a meeting with my nurse practitioner today to discuss my topiramate. Like I mentioned last Sunday, the increased dosage isn’t doing what it should. I was experiencing slight tingling in my hands and feet and, more annoyingly, increased drowsiness. Moreover, the medication wasn’t working for my hypervigilance; if anything, it was making it worse. The slight tingling in my hands and feet has decreased to the point of almost disappearing over the past few days. The drowsiness has not. Neither has the hypervigilance.

A theory I came up with recently, in a conversation with the care facility’s behavior specialist, is that my ideal level of alertness is really slight distress. In terms of the care facility’s signaling plan, phase 1 rather than 0 is really when I’m most relaxed. The reason, in fact, is that relaxation scares the crap out of me because it includes a sense of loss of control.

I am reminded in this respect of my last surgery as a child, when I was eight-years-old. I clearly remember going under the anesthesia – I had refused a tranquilizer to calm me beforehand – and I also vividly remember keeping on talking, even when my speech became slurred, up till the moment the anesthetic knocked me out. I was deathly afraid of letting go of my control.

I am also reminded of my fear of going to sleep, which goes back to early childhood. It may in part be related to my trauma-related symptoms, because of course my traumas started as early as infancy. However, I wonder whether this is also somehow related to the fear of losing control.

I once heard that benzodiazepine tranquilizers are no good for people with borderline personality disorder, precisely because the anti-anxiety effect causes aggression in them. I am not sure whether my current diagnosis includes BPD or not, but something similar might be going on with me. I don’t generally become aggressive when I’m under the influence of tranquilizers. However, as my nurse practitioner said, this thing does show that alertness and distress are not some linear thing on a scale from -2 to 3 (on my care facility’s signaling plan) in real life.

The bottom line is that we don’t yet know what to do about my topiramate. We’ve so far decided to wait another week or two to see if, since the drowsiness should decrease with time, this will cause the positive effects to start becoming noticeable. If not, we may go back to my old dosage, but I’m not yet sure what to do about my PRN quetiapine then. After all, we upped my topiramate in hopes that I could do without quetiapine then. Right now, I’ve felt like I would’ve needed a PRN medication quite regularly, but I’m trying to suck it up for now. That’s pretty hard. I’ve had a few almost-sleepless nights over the past week and am pretty anxious most evenings. But yeah, I’m muddling through. Thankfully, my nurse practitioner did give me an extra appointment next week to check in on the meds.

Moaning About My Meds

Posted on by Astrid

It’s 8:30PM and I’m probably going to bed before 10PM tonight. Since upping my topiramate (Topamax) a week ago, I’ve been more sleepy earlier at night and consequently going to bed sometimes by as early as 9PM or even earlier. Unfortunately, the quality of my sleep doesn’t seem to be better.

Last night, I had a horrible dream in which my staff were chattering among themselves and all the while I was trying to get their attention because I was anxious, but to no avail. That’s how I’ve been feeling ever since upping my medication: I am still anxious, but too drowsy to react to it. In fact, I’m not even 100% sure my experience last night was completely in my dreams, because, when I awoke, I couldn’t get to the level of alertness necessary to press the call button.

I don’t really mind the drowsiness as much. Or the tingling in my fingers and toes, which I’ve started to experience since increasing my topiramate dosage too. But the medication does have to work for my hypervigilance. And hypervigilance is not just an outer reactivity, or is it?

My assigned home staff did say yesterday that she judges from the staff’s reporting that I’m calmer, because I come calling out for help less at the times I’m not having my one-on-one. That comment triggered me intensely, because it made me think I’m supposed to take my topiramate so that I don’t ask for help outside of my assigned support hours. I’m reminded of my psychiatrist’s comment about meds as a “chemical nurse” again, something I now don’t see as quite as validating a statement.

This evening, I did E-mail my nurse practitioner my concerns. Of course, the topiramate’s positive effects might still need time to kick in, but if they don’t, I’d rather go back to my old dose. Which, of course, means we will need to find me a different PRN medication or something for when I go into crisis. It also means we’ll need to postpone my aripiprazole (Abilify) taper. Honestly though, I don’t really care about those.

Gratitude List (January 8, 2022) #TToT

Posted on by Astrid

Hi everyone. It’s Saturday again and I’m trying to get into the habit of writing a gratitude list then. At least today I’m doing one. As usual, I’m joining Ten Things of Thankful or #TToT. Here are some things I’m thankful for.

1. A productive appointment with my nurse practitioner on Monday. We are going to discuss my crisis signaling plan together. This is used by the staff to help guide them on how to support me depending on how I’m doing. My assigned staff should have E-mailed it to him by now.

2. Sunshine! I am so grateful that the sun’s shining at least some of the time. It’s near freezing cold, but at least from indoors I can look out the window and see the sunlight.

3. Reading. I am so grateful I feel motivated to read again. I’ve picked up several books again. I’m currently reading the latest Maggie Hartley foster care memoir, but have several other books I want to get into soon.

4. The Word of God. I am so grateful I am still going strong with my Bible reading. I am also grateful I discovered an interesting Biblical podcast yesterday. It’s called Spoken Gospel. Yesterday, I listened to the episode on Jonah 1.

5. Weekend treats. Like I mentioned yesterday, I started on a food plan/healthy diet this week. I am grateful I am allowed to have a cinnamon star cookie in my diet today.

6. Getting my money back from the broken Fitbit charging cable I’d returned. I am so grateful about that, since I was fully expecting Bol.com (which is a site similar to Amazon here) objecting. After all, when trying the thing, my staff had removed some plastic thingy that kept the cable rolled together. Thankfully, I got my money back without any fuss.

7. Phone conversations with my husband. I am grateful to have him. I am also grateful he’s coming for a visit tomorrow, since I haven’t seen him since Christmas.

8. My staff, the one who had COVID, being recovered and back on the job.

9. My still getting up at 8AM consistently to do my Morning Pages. I am grateful I still find something to write about each morning even if it isn’t something related to my creative endeavors.

10. My computer. A few days ago, I thought for some reason that it’d broken down, but it’s still working. I also managed to clean its keyboard (it was very necessary) and, since I don’t have the type of alcohol or whatever you need for that, I wasn’t sure I’d do it properly without causing it damage. I am so grateful everything still works as it should!

This week, it was harder to come up with ten things of thankful than last week. I think I might do a daily gratitude list in the diary app Day One, now that I’ve revived it for my Morning Pages anyway, so that I have something to refer back to when I’m doing this list.

What are you grateful for?

A Productive Appointment With My Psychiatrist

Posted on by Astrid

I had an appointment with my psychiatrist today. Last week, I had already raised some issues relating to my medication with my nurse practitioner and asked to see the psychiatrist about them.

Among other things, I finally dared to ask for them to consider lowering my aripiprazole (Abilify) dose. I have been on this antipsychotic for nearly twelve years and on my current dose of 30mg, which is the max dose, for about five or six of those years. I have had the wish to lower my dosage for years, but was always asked to wait for a while to stabilize. Now that my one-on-one has been approved for the coming two years and I’m relatively stable, I thought further waiting would be senseless.

My psychiatrist today proposed to lower my dosage in steps of 5mg each, while remaining on a new dosage for three months. She claims that the first two weeks, I won’t see any effects of the lowering of my dosage so any change in behavior doesn’t count as a sign that my dose needs to be upped again. When I wrote in a Facebook group about my lowering my aripiprazole, I was met with surprise at the slow taper. Indeed, I’m not sure where my psychiatrist got the idea from that the first two weeks don’t count, since aripiprazole has a half-life of about 72 hours, not two weeks. However, since I don’t suffer with any major side effects, I don’t see why the slow taper would be bad.

My psychiatrist said that we won’t have a goal dosage in mind, so we’ll keep tapering until it’s no longer the right thing. Yes, even if this means I can do without aripiprazole altogether eventually. I was a little shocked when she mentioned the possibility that I might not need my aripiprazole at all at one point. Of course, given the slow taper, this will take like 18 months or so, but I don’t mind.

I won’t start my taper until next month, because first we decided to increase my topiramate (Topamax) by yet another 25mg in the evening. Then I’ll be taking 50mg in the evening and 25mg in the morning. This is still a pretty low dosage even for trauma-related symptoms. It is hoped that, by doing this, we’ll help reduce my night-time anxiety even more and I won’t need my PRN quetiapine (Seroquel) anymore. After all, that wasn’t helping with my anxiety really. I originally got my quetiapine when I was still experiencing a lot of overload-related irritability. Now it’s more anxiety and PTSD that’s causing me to feel strong distress, so topiramate may be a better fit. Of course, topiramate is a daily medication, but if it can prevent me experiencing significant distress, I’m willing to try it.

I do feel a little weird, in that I was always taught that medication isn’t a substitute for coping skills or support and at the same time that it’s either one or the other. I mean, even Dutch care funding regulations at least used to say that if someone was medicated for something, they no longer qualified for support in this particular area. My psychiatrist today called medication a “chemical nurse”, in that a nurse’s role is to help calm you down when in crisis and that’s what meds do too. Now that I have the best human support I can get, I think it’s time to figure out the best medication I can get too.

Lastly, we discussed my getting medication specifically in prep for dental treatment. I explained that, after getting seven cavities filled without anesthetic many years ago, I have pretty bad anxiety but it shows itself in freezing. We decided I could take lorazepam (Ativan) 2.5mg the morning before the procedure and then when leaving (the surgery is about a 45-minute drive away), I could take another 1mg. The psychiatrist said I could skip the 1mg if I was feeling really drowsy, but my staff said the dentist can deal with me even if I am.

Overall, I’m pretty satisfied with the results of this appointment. My nurse practitioner should have sent the prescription for the increased topiramate to the pharmacy and that should be filled next week.