New Year, New Docs and Parenting Woes

Image man lying down on therapist couch

My health insurance changed in January. My primary care is the same, but I had to get a new therapist in January. I was approved continuation of care with my psychiatrist, but that fell throug, so I had to find a new psychiatrist, too.

I saw the new psychiatrist on Thursday. Fortunately, he did not want to change my medications. I have been on this combo for years. A friend had recommended a different doctor in the practice but he was booked up so they assigned me to this one. I googled and found him but did not get much information. He seems nice. He ordered refills. Our next appointment is over the phone next month.

I like my new therapist. He makes me think. I asked him what he meant by that article on brain hemispheres and he said just that you can change your thinking at any age.

My daughter is 23 and lives with us. She graduated college last year and plans to get her teaching credential. But, she has not applied, yet. She is afraid to learn to drive and is afraid of Covid. She has a job at the library. We drive her back and forth, which is okay. She just goes to work and home and spends a lot of time in her room.

My therapist suggested we are enabling her to avoid self awareness, and how satisfying is her life if she is isolating? Another thing that is making me wonder. I don’t go out much myself and I feel content. It is not out of fear, I am just fine at home. I mentioned her at a support group and they said we are enabling by driving her and that she may stay home until in her 30s. I don’t know what to think. She seems fine, rarely complains. We did not get along for years and we are in an okay place now.

I don’t know what we should be doing, if anything.

I have joined an art journaling group. It meets once a month. The teacher is a therapist, but it is not therapy. She just charges a donation. She brings up a subject for inspiration. This week she wanted us to bring light to Ukraine. We worked with mandalas which is a circle. I like the way mine turned out. I am not artistic but it is still enjoyable.

Image: blue and yellow circles with yellow heart and sunflower in center. Words: hope, support, power of love

I also joined an online journaling group. It disappeared and I thought they weren’t going to have it anymore, but it is back at a different time. It is enjoyable, too.

Brain Hemispheres and the Rest of My Week

Image Brain: colored hemispheres , right pink, left blue

My therapist emailed me this link on a man who learned late in life, through therapy,  how to use his right hemisphere and feel.  I asked why he sent it to me and he said he was sharing the importance of working with the right hemisphere. I am still confused.  Does he think I don’t use half my brain, that I am unfeeling? I see him Wednesday.  I am not sure if I should ask more or just let it go.

https://www.psychotherapynetworker.org/blog/details/1245/its-never-too-late

I have a cold. I took a test and thankfully it is not Covid. I left work early the other day and have been taking it easy. I will be fine before Monday.

I was contacted on LinkedIn to write something on anxiety for choosingtherapy.com.  I wrote a bit about coping skills.  I hope it is what they are looking for.  If anyone is interested in submitting a story,  this is the submission link https://www.choosingtherapy.com/share-your-story/

I don’t know if I have a psychiatrist. I have new insurance and mine is not on the provider list, but I filed for continuation of care which was approved. So, they agreed to cover him. Now, they are asking him to file more paperwork than he is comfortable with. They denied 2 claims. He is only charging me copays. He called my insurance provider , I called, but I have not heard anything yet. I am supposed to have an appointment this week but he will cancel if it is not covered. I did get the name of a psychiatrist on my insurance who is taking new patients but I don’t know much about him, except that he charges a lot if you don’t cancel 24 hours in advance.

My friend turned me on to a hair product. The company is Olaplex. My hair frizzes and it helps tame the curl. I am 57 and finally learning to manage my hair. My daughter has beautiful spiral curls. I just have waves but at least it is not frizzed. I don’t have any stock in the company and I am sure there are other similar products, I am just happy I found something that works for me. And, it goes with my showering habits. I wash my hair 1 x / week and shower without dealing with my hair in between.

They run support groups where I work. I asked about starting a harm reduction or moderation group or SMART Recovery, but they said they are full and they seemed to equate 12 steps with recovery with no other options. They said they will get back to me.

 

 

What is one thing you have always wanted to do?

Image palm trees and water

I saw my therapist today telehealth. One thing he asked me was what do I do for fun or to relax. My knee jerk reaction was that I don’t know how, but I corrected myself. I am a couch potato but I enjoy computer games. I am happy on my couch with my dog typing right now. He asked what is one thing I have always wanted to do, for example, travel, and would I be disappointed if I never do it. I rarely travel, and would like to, but I don’t have a dream destination that I would be upset about not going. I can vacation in my backyard. We go on short overnight trips about an hour away that I enjoy.

It did get me thinking, though, I want to visit my sister in Boston when the weather is nicer. She suggested summer or fall, I have been there once when she first moved but it was a different house. She has a lake she likes to go to that I want to see. I can start planning that trip. My nephew is getting married out of the country but I don’t think I will go. I would like to but it won’t upset me not to be there. Just the coat is too much.

I have new health insurance and took a survey and the result said I am depressed but I feel fine. I am going to ignore that result.

I joined this zoom journaling group through the Mighty. I know everyone has a health condition, not sure if it is all mental health. They list prompts, give 10 minutes to write, share and then repeat. It goes for 3 hours but I leave early because I have another zoom, DBSA later. I feel like my writing is rainbows and puppy dogs and other people go deep. They are nice to me, I can’t go this week but I think I will continue. I know I have other emotions they just aren’t being prompted.

i zoomed with endocrinologist after therapist.My labs were good. I told her I stopped keto in dec and don’t want to go back to where I started but I don’t like logging food and counting carbs. She said I can visually see if my meals are less than 1/4 starchy carbs. I fill myself up with veggies. Beans are my main starchy food. I can do that.

I got a call from an old co worker. we worked at an activity center for adults with mental health issues. we have both moved on. he is now working at a new peer advocacy non profit, I don’t know if it is the grass looking greener. I am content where I am but get antsy when I am not busy I have a lot of down time that should change once I can get trained on some more tasks.

Sensory Coping Skills

Image: essential oil inhaler, sock, modeling clay, lemon heads and phone with image of bedroom with dog

My health insurance changed, so I have a new therapist. I have seen him twice, so far. I am doing well, so we may move to monthly appointments.

He went over some sensory and other coping skills and assigned me to get items. I have a post “Coping With Schizoaffective Disorder” https://lorib434.wordpress.com/2017/03/20/coping-with-schizoaffective-disorder/ These are additional tools

The first is a calming essential oil, like lavender. I don’t like that so I got chamomile and an inhaler. I was skeptical but I enjoy the scent.

The next was a photo of a safe scene.it could be a place in nature, whatever you feel is safe. I took a picture of my bedroom with my dog. That is my safe place.

Music. Something relaxing like rainfall or ocean waves. I found some nature sounds on YouTube.

Fabric, an item that is soft to hold. I bought a fuzzy sock at the dollar store.

Lemon drops or sour candy

Some other things he recommended:

Box breathing (inhale for 4 seconds, hold for 4 seconds, exhale fir 4 seconds).

Exercise

Watch a funny show

Take a shower

Throwing something safe, like modeling clay

I told him I did not think I would do the throwing, but he encouraged me to try them all.  I bought clay but have not tried throwing it yet.

 

When I told him I have trouble getting in the shower. I don’t like to get cold. He asked if anything had happened in a bathroom or shower. I did not go into details but told him yes, when I was 8 years old. He told me to have all the coping tools and journal from the perspective of an 8 year old. I don’t know how to do that, so I journaled what I remember. I think the tools helped me stay calm. I don’t believe that has to do with me having trouble with showers, though.

Insurance Woes

Image: Skeleton with phone, on hold

My health insurance changed at the beginning of this year. I have been dealing with the insurance company. Monday it was impossible to get through. Tuesday I was able to chat and call and get most questions answered, I thought. My primary care physician is the same and she can refer me to any specialists. I see an endocrinologist, a sleep disorder pulmonologist, and a specialist dentist who monitors an oral appliance I wear for sleep apnea. But, I need a new psychiatrist and therapist.

I filled out a form for continuation of care with my current psychiatrist hoping I could at least get my meds refilled before I switch. Up until Monday, I thought he was covered, but he isn’t in my IPA, whatever that is, I thought it was a beer. I found a psychologist and had an appointment on Wednesday. He suggested calling my insurance to ask about a psychiatrist and to double check, he, the psychologist, is covered.

The problem is, this insurance covers medical and behavioral health, but they are different departments and don’t seem to communicate. The first person I called said anyone I see has to be in the medical group, which limits me to 4 psychiatrists to choose from and does not include the psychologist. Then, I contacted behavioral health who said the psychologist is covered, it says in network. I was getting conflicting info so I texted and it took all day but I got confirmation that behavioral health is not required to be in the medical group and does not need referrals but medical care does. I screen shot the text in case there are problems.

So, I looked at the list of psychiatrists and called one who seems to have a lot of experience. I found out she is the medical director and I will be treated by a psychiatric nurse practitioner. I am a little uneasy since I have a complex disorder ( schizoaffective disorder). I am stable now and just need medication management. I made an appointment but checked out some of the other psychiatrists. I found another that sounds good that I will call Monday. I am not sure if it will be the same.

Also, I have been taking a medication called modafinil for excessive daytime sleepiness due to sleep apnea even with the appliance. The insurance rejected the order. my dr is trying to get it for me. I am completely out and so so sleepy.

The therapy appointment went well. I told him I feel shame about past mistakes and have trouble forgiving myself. He asked if I would forgive someone else and I said yes. Why the different standard? I first said “I don’t know “ which I learned he does not accept as an answer, so I reflected on it and decided I should be able to forgive myself, but I still don’t know how. Baby steps?

Then I told him I get uneasy sometimes at work when there is a lot of noise and commotion even though I am not directly effected. Or if my husband raises his voice at home. He told me to journal when I feel uneasy. I have not had to deal with loud noises lately, but dealing with all of this insurance stuff gets me worked up. I want to drink to calm down, but I also want to stay sober. So far, sobriety is winning. I have a blood test in February and I am hoping for good results. We agreed to monthly appointments since I am stable.

Did I mention I got my hearing aids.? They work well. A little bit of trouble getting tangled in my mask. They have blue tooth capability and I have them connected to my phone. I am slowly learning how to disconnect if I want to use my phone or I hear nothing. And, I get notifications through the hearing aids. I go back to the audiologist for follow up soon. Sometimes it seems like only one is working and I don’t know if I am doing something.

Will it be too stressful?

Image: STRESS spelled out in scrabble

I have been stable for 15 years, but I have really decreased stress in my life. I find that when stress increases my symptoms can increase. I did not work for a few years after diagnosis. Then, I volunteered part time for years. I have been working part time for 6 years and I am doing well.

I found out about an open position at my work. It is higher pay, but more responsibility and full time. I put in a request to transfer and am waiting for an interview. I have no offer yet, but I am starting to worry if I am doing the right thing. (My opinion does not represent my employer). I want to ask my psychiatrist his opinion on taking on more, but he is out of town.. I emailed therapist but I don’t know if she will get back to me.

I have a delay with the hearing aids. The audiologist contacted my insurance and they said I have no coverage. That did not sound right, so I called. I have a $1000 allowance but it needs authorization from my medical group. I asked my primary care and she said she is not the one to ask, I had been referred to an ENT when they sent me to the audiologist so I don’t know if the ENT is supposed to get authorization. I am hoping I get them before the end of the year.

I am still doing TikTok videos on coping with schizoaffective disorder. Username Schizoaffective Dog Mom. I used to do live Periscopes. Few people came, but it was fun. TikTok has a live feature, but you need to have 1000 followers (I have 50). I guess it does not make sense to go live with no audience, but I am a little bummed I can’t use that feature. I have enjoyed viewing live videos.

In Sickness and In Health

Image dog on bed

I have had sinus congestion and headaches off and on for a couple of weeks.  It is finally starting to clear up.  I swear I have a barometer in my head and get headaches when it is about to rain.  We had a storm with thunder and lightening and then my head started to clear.

 

My husband and I went to San Diego for a couple of days to celebrate 25 years of marriage.  Mental health issues can be hard on relationships and I am glad we have been able to get through all of these years.  My daughter stayed home with the dog.  I don’t think she missed us but the dog did. We mostly relaxed and ate.  Everything was walking distance from where we stayed.

 

The first night we went to a restaurant, Rockin’ Baja Lobster.  We were there at happy hour.  I went way off my keto diet  and even had a few drinks.  The next day we had lunch at a Brazilian steakhouse, Fogo de Chao.  It was fancy but we just had the salad bar. It was pretty filling.  That night we went to a dueling piano bar, The Shout House.  That was a lot of fun.  They called people up on stage which would have embarrassed me.

 

Now we are home and getting back into our routine.  My mother in law is taking us out tonight and then I go back on keto.  I plan on going alcohol free until April.  I belong to some Facebook groups for moderate alcohol drinking.  I asked about any live groups and was told about one over zoom.  I went, but when I told them I drink twice a year the host was surprised and I felt like I did not belong.  My issue was, I am not sure if I want to expand on that, but I think I figured out what I want to do on my own.  I am keeping alcohol out of the house, but if we go to an event where I am not driving I am giving myself the option to drink.  With Covid there have not been many social occasions.

 

I have health insurance through my husband’s work.  They decided to change insurance companies coming in January.  Our PCPs are in network but behavioral health is different.  As far as psychiatrists, I have been on the same regimen for years so I mainly just need someone to refill my prescriptions.  But, I have so much trouble finding a therapist I click with.  I like the one I have now, but she does not take the new insurance.  I have been searching but I don’t know how to look.  I found one therapist who is great, but is retiring in 2023.  I am not sure if I want to start all over then.

 

 

 

 

Empathy Postcards, CGM, and my week

Image Cover of Empathy Postcards

As part of a gift in a gift exchange I was given Empathy Postcards by Emily McDowell. It reminded me of a time I was hospitalized for my mental health . In art class I made a card to myself. No one brings cards when you are you in the behavioral health unit. I think they just don’t know what to say. These empathy Postcards are perfect for times like that. I think I will use them for friends when they are having a rough time.

Image if this is God’s plan, God is a terrible planner (No offense if you’re reading this God. You did a really good job with other stuff, like waterfalls and pandas.)

I also was given some keto friendly snacks, a little stuffed poodle that looks like my dog, dog treats and a nice note.

As far as keto, things are going well. My labs were good last month, so.my Dr took me off of one med, Januvia. Everything went wacky for a few weeks. My weight was going up, glucose went higher than when I started keto and I was out of ketosis. My Dr gave me the option to give it a couple of weeks more or to go back on Januvia. I decided to see how it goes in a week. It started improving. My weight started dropping and fasting glucose lowered. I am back in ketosis

I asked my coach from the program I am in, for type 2 diabetes, Virta, about a CGM, continuous glucose monitor. The Virta Dr called in a prescription for Freestyle Libre 14 day sensor. I got a voucher from the freestyle libre US website to bring to the pharmacy. It is a free trial. My insurance won’t cover more sensors but I am getting a lot of data. My glucose drops in the early morning and then rises. The sensor does not always agree with the fingerstick. It reads interstitial fluid. The range is set at 70-140 mg/dl and I am in range. I am going to lower it to 126 to see if I can tell the difference. It has a graph but it is hard to read. It is small. So far the biggest rise in glucose is just from waking up and not from my food. The app lets you write notes to go with the readings.

I have sleep apnea and wear a dental appliance. After my dentist adjusts it, he orders a home sleep study. I have done about 4 so far. I did one this week and have seen the results. I wore a t-shirt with tennis balls that is supposed to keep me in my side but the device read as if I was on my back most of the night. I still have mild apnea with the appliance so he will most likely adjust it more. It is not painful but it gets uncomfortable the more he moves my jaw forward and it takes time to get it back in position in the morning.

I talked with my therapist this week. She asked how much time I spend online. I don’t know so I told her that, but it is a lot. She said she spends an hour. She wants me to keep track. I don’t have to change but she says I should know. I like her but don’t like her assignments

What I Have Been Up To Lately

I had therapy last week. I started seeing this therapist after the pandemic, so all my sessions have been virtual. I forget what she asked but I mentioned I remember mistakes from the past, 20, 30 years ago or more and they torment me. She wanted me to share but I am not comfortable with that. I feel such shame and they were mistakes that I feel are unforgivable. If I did not feel shame there would be something wrong. But, I don’t want to delve into them.

My father did not believe in mental health treatment even though schizophrenia, schizoaffective disorder and bipolar run in our family. When I started therapy he discouraged it saying talking about the past just makes everyone sad. I did not understand what he meant until now.

My therapist wants me to work on forgiving myself.  I have to explain to her that some of these things are best kept hidden.

 

 

I have been able to stay alcohol free after my planned intoxication in April.  My plan is sobriety until our wedding anniversary in October.  It was pretty easy to get back to it.

 

 

I posted a link to an In Our Own Voice presentation I did for NAMI, National Alliance on Mental Illness, in a different post. I have not been speaking much lately. I saw a different program by NAMI called VOICES. It is geared towards first responders. I signed up to be a speaker, but am having trouble figuring out where to start. My initial interaction with mental healthcare and police was not until I was 39, but since mental illness runs in my family that was not foreign.

My brother had a psychotic break in college at 20 (I was 15). He refused treatment and would get picked up by the police for 72 hour observational holds in the late 70s. His is a sad story. He was severely symptomatic for 6 years when he finally was placed on a different medication that he responded well to. But, he started becoming symptomatic again, paranoid, edgy, and probably needed his medication adjusted. He went to Yosemite while symptomatic and fell at a waterfall. I don’t know if it was accidental or not, but he died from the fall.

This is supposed to be a story of hope, but it is part of my story.  If I had not seen him so ill for so long I may not have accepted treatment, but I did not want to be stuck in psychosis like he was.  I think it is okay for first responders, but not sure if it will scare the general public who may be worrying about their own children.

My story is much different.  I did go in and out of psychosis for 3 years, but I have been stable since 2006.  I have not been hospitalized for 16 years.  I am married, have healthy grown children, work part time.  I still have some doubts about what was real from the past, but I can function.

 

Medical ketosis for psychiatric illness

Image of highlighted brain

I have been on a ketogenic diet to treat type 2 diabetes, through a company called Virta for about 3 months. I have lost about 1 lb/week, my fasting glucose has dropped 20 pts, and I feel good.

My friend was pushing me to try the diet and now he has been pressuring me to find out information on medical ketosis for psychiatry. He says it has greatly helped his depression. My provider from Virta agreed to talk with my psychiatrist about how a keto diet can affect mental health. But, I started wondering what am I doing. I have schizoaffective disorder controlled with medication and also take medication and use coping skills for anxiety. I don’t know that I want to change anything.

My therapist coached me on how to tell my friend thanks, but I feel pressured. I am not great at setting boundaries. I took her advice and he was cool. He said it is not his business what I decide to do and he is just making suggestions.

Then, I read a post on Reddit where someone is working with a dietician from the Charlie Foundation on a keto diet for schizophrenia. They work on keto for epilepsy in children and have expanded. I emailed and they gave me info on a dietician and I made an appointment for a zoom call on Wed.

The diet I am on now is 30 g total carbs, 13 oz protein containing food and fat to satiate. I am sure the dietician will have something more precise with macro g or percentages. Right now I weigh some but estimate amounts, where I will be measuring more.

My therapist gives me homework. The last thing she gave me was to give examples on where I could be more assertive, like with my friend. And to think of things I am grateful for and proud of. I am grateful for many things. The people in my life, especially my husband and even my pushy friend. My car, dog, food, home… i could go on, but proud of had me stumped.

I work and take care of my family but there is nothing I can identify as I am really proud about. I thought some more. I am proud I have been alcohol free for 6 months and have a plan for moderation. I am proud I have been able to stick with keto 3 months and with the results.