Thursday, July 11, 2013

Slowly feeling better

For the past two or so months, I've been feeling drained and exhausted. I thought it was the stupid 5:40am wakeup time. But I'd get up, go to work, come home, and do nothing. Partly that was because after I take off the lidocaine patches it hurts to do anything but sit.

Within the past few weeks, though, I was feeling much worse. And last week, I felt awful. I thought it was because I stopped the fish oil supplements. My doctor (business partner of Dr. Cool) disagreed, and thought my lithium levels might be too high. She took some blood on July 2. Which, due to holiday closures, I didn't see results on until July 9. Interestingly, my lithium levels were low, and my white blood cell was slightly elevated.

However, before I got the results I analyzed how I was feeling (nauseated, weak, heavy, trouble concentrating) and realized it bore a significant resemblance to lithium toxicity. So I reduced my dose to 600 mg, down from 900. I spoke to Dr. R and then saw him before the lab results were in. He approved of the reduction in dose -- even when the levels came back low. Because between the heat and the lidoderm patches, my dose must have needed adjusting. And after reducing my dose, I felt much better.

But not great. And we couldn't figure out where the infection was. Until I realized that part of the reason I felt so tired all the time was that I was waking up several times a night to urinate. There's been no fever or burning sensation, but the frequency could indicate a UTI, to which I have been prone in the past.

I'd been ignoring this symptom because I've been frantically making a million pre-surgical appointments and a billion phone calls and emails trying to make sure insurance will cover my upcoming knee surgery. Which will now probably have to be postponed, because having an active infection isn't a good way to go under the knife.

I'm feeling slightly overwhelmed juggling all my medical problems and trying to take care of everything before my August 5 surgery date, although my friends have been incredibly supportive. And worried about missing so much work, even though I was updating my supervisor frequently. But this morning I got a slightly frightening email from the clinical director of the program:

You have been out since July 2 (6 days). Please submit the leave of absence papers that you had requested previously.

In addition, I need some communication from you when you are out this long.

Yikes! But I stayed calm and responded:

I apologize. I have been in touch with [my supervisor] throughout my absence. I contacted the leave of absence people before July 2, and they told me I have not yet accrued enough work hours to take another LOA after my leave in February-March 2013. Then I got sick.

I will have to use vacation time (I have more than 96 unused vacation hours that I must use before August 11, my anniversary date) for my absence. I am dealing with an infection as well as a reaction to the heat that necessitated a change in my medication. The initial lab work I had done on July 2 was delayed due to the holiday, so that I did not get the results until Tuesday, and then I had to have follow-up work done yesterday. The surgery I was supposed to have in August will have to be postponed.

I apologize for the inconvenience. I was not expecting to have such a severe reaction to the heat and the medication (lidocaine patches. in addition to other medications I take), on top of an infection that has been difficult to pinpoint. I am trying to get the lab results from the subsequent tests as quickly as possible and hope to be back at work on Monday.

And it worked.

Thank you for getting back to me so quickly. We will use your vac time.

I guess it's a good thing that I've been too immobilized by knee pain to go away or do anything fun in the last 6 months. And it's not such a bad thing that the surgery will be postponed. I don't want to feel rushed or stressed about it, and I certainly was before I got sick.

I'd rather take care of everything at a more measured pace. If that means I need to wear the lidocaine patches for a little longer, then so be it. I have to go for another uterine ultrasound because on top of everything else, my gynocologist says my uterus is bigger. I'm certainly not pregnant, so it must be fibroid growth. Hopefully externtal. I also really need to go to the dentist.

So no more rushing around. Hopefully the urine tox sample I left at my latest doctor's appointment will yield results that require antibiotics as more proof that I'm not malingering. I'll reschedule the surgery. I'll schedule the remaining pre-surgical appointments. I'll schedule appointments for the uterine sonogram and the dentist. And I will relax and think positive.

Of course I'm a little nervous about reducing my lithium dose. I don't want to get hypomanic or depressed. But I'll watch myself carefully. And my friends will as well.
Copyright (c) "Ayelet Survivor"

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