Monday, June 23, 2014

A long, strange list of supplements I can't tolerate

The reality of the new job is starting to sink in. For one thing, our temporary headquarters are fairly makeshift. I hate my chair -- its seat is too big for my thighs and it gives me a backache. I'm trying to navigate a role that's new to me in an agency that's new to me, which is a whole lotta new. I thought I was doing fine until my heart started beating really fast, really often.

At first I thought it was just anxiety. A week ago I was scheduled to visit the residence, which is still being renovated. I was wearing sandals because now that I no longer work for a hospital, I can. Unfortunately, you need to wear closed-toe shoes on a construction site. Since it was late in the day, I ran to Payless with my supervisor, bought a shoddy $25 pair of flats, and went to the site. Walked all over it, up and down stairs.

I woke up the next day in knee agony. Could barely walk. Which was a damn shame, since that evening I was supposed to go to my niece Shira's graduation. I  missed a day of work and the graduation.

Missing a day of work made me nervous, so early on. I'm still on probabation for five more months and four more days. Missing the graduation made me miserable, and having a severe resurgence of the knee pain was terrifying. So the next day, I woke up with a pounding heart. We -- the program director, two of the four case managers I supervise, and I -- were supposed to go to a psychiatric ward and meet with potential residents. I had to appear normal and in control.

We met at another site because they had a van we could use to drive to the psych ward (it's not well served by mass transit). All the way there I was nervous and conscious of my heartbeat. When I got there at about 8:50 a.m., I was greeted by one of the care managers.

"I've been here since 8!" she said. "The email said the meeting was at 8."

Really? I thought. I was almost positive I'd said the meeting was at 8. Had I screwed that up? "I'm so sorry," I told her. "I thought I set it for 9."

"No problem," she said, sitting down at the table in the small conference room near the entrance and busying herself with her cell phone. We sat in silence for more than a few minutes until the other care manager joined us, and then the program manager arrived.

I was kind of surprised she didn't want to talk to me, since I'm her supervisor. Then again, I've never been a supervisor before. I've done clinical supervision, but never had to address someone's behavior or demeanor. Also, I was terrified that they might realize how anxious I was, how confused my thinking. I could barely concentrate. I tried to calm myself down by reminding myself that anxiety is just a feeling and it passes, which didn't really help much.

After we met and reviewed a few things, we set off in the van for the psych ward. I wasn't 100% sure what we were going to discuss with the residents -- my supervisor had left things kind of undefined. When I'm thinking clearly I'm fairly quick on my feet and able to respond appropriately to situations. But I wasn't thinking clearly. I was terrified, and I had no idea what I was going to do or say.

We got to the ward and they put us in the dining hall. Where we waited. I was annoyed because I'd spoken to the housing specialist about this meeting and we'd set a precise time: 10:30 a.m., after they've finished morning rounds. At about 10:50, the housing specialist came in.

"Are you sure we were supposed to meet today?" she asked.

I'm losing it, I thought, but I committed. "Yes, we said today at 10:30," I stated firmly. Did I screw up the date or time? I wondered.

She didn't have anyone for us to meet with that day. So we took the case managers back to the locations where they work, and my supervisor and I were taken back to our temporary offices. I immediately checked my calendar and emails. In black and white, they said that the meeting with the care managers was at 9, and the meeting on the psych ward was at 10:30 on that day. That was a bit of relief.

But it didn't erase my anxiety. Okay, so I wasn't completely losing my mind, but my heart was still pounding. I started wondering if my Cymbalta dose was too high. My psychiatrist, Dr. New, raised it during last winter's deep depression. But now I have a job that I don't hate, a schedule that's not killing me, and it's summer. Could I be hypomanic?

I made an appointment to see Dr. New at the end of the week, just two weeks after my last appointment with her. She didn't think my symptoms supported a diagnosis of hypomania.

"No pressurized speech or racing thoughts, no increased spending, no hypersexual behavior, right?" she said. None of the above. "How are you sleeping?" Quiet well, actually. I wake a few times but fall back asleep.

"It sounds like anxiety, and maybe a little more depression," she said. I couldn't understand why. Nothing bad has happened to me recently except that the guy I met and liked pulled a disappearing act. But that's nothing new. "I wouldn't want to reduce your antidepressants. If anything, I'd maybe want to increase the mood stabilizer, but I'd hate to put you on four medications."

I would hate that too. So we agreed that I would take the Klonopin more often than once every month, which is about how often I usually take it. "Take it every day if you need it," she said. "Half a milligram twice a day." I'll see her in another two weeks.

I put the Vitamin K in my purse and resolved to try that. Then I thought of something else that might be the problem. Something about the pounding heartbeat made me think of calcium. Because I have a shameful little secret: In addition to the calcium supplement I take daily, I've been consuming calcium-based chewable antacids. Since my most recent bout of bronchitis, I've been taking Nexium prescribed by my internist/gastroenterologist, but I've still been feeling the burn at the back of my throat. And those calcium chewable antacids are good. I've been chewing them every night.

I looked up the symptoms of calcium overdose:
  • Abdominal pain
  • Bone pain
  • Coma
  • Confusion
  • Constipation
  • Depression
  • Diarrhea
  • Headache
  • Irregular heartbeat
  • Muscle twitching
  • Nausea
  • Vomiting
Well, clearly I didn't have all the symptoms. But bone pain? Sure -- my knees were killing me. Confusion? Somewhat. Depression? Definitely. Irregular heartbeat? Abs.o.lute.ly.

So I've stopped taking the supplement, and I've given up the chews. And already, I feel better, although not 100%. Add calcium to the long, strange list of supplements I need to be careful of -- turmeric, tea tree oil, ashwagandha, passionflower, oregano oil. So far I don't think Vitamin D, fish oil, and folic acid are hurting me, but I'll definitely check next month during my annual physical.

Tomorrow I'm sending my laptop off for maintenance -- it's developed an annoying pink line across its screen. Don't worry, I'll be fine -- especially since I've laid off the calcium.
Copyright (c) "Ayelet Survivor"

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