Category Archives: Medication

Where have I been?

alcohol, chronic illness, depression, diabetes, earwax, hearing, hearing aids, insurance, Medication, mental health, mental illness, MeRT, peer support, psychiatrist, schizoaffective, schizophrenia, Stress Reduction, Therapy, TMS, , , , , , , , , , , , , , , , , ,
Image: cartoon of several people sitting in chairs. Group therapy.

I have several chronic conditions: mental health, type 2 diabetes, sleep apnea, hypothyroidism, hypertension. I am on 9 medications. I was wondering if there is any type of holistic treatment that could help, and searched different terms in my insurance directory. I came upon a mental health facility that is holistic and integrative. They have a nutritionist on staff. It wasn’t exactly what I was thinking but it looked helpful.

I saw the psychiatrist and he is a bit different but I like him. He changed my diagnosis from schizoaffective to major depressive disorder and anxiety. He seems sure I was misdiagnosed. He decreased my antipsychotic, I am on a baby dose that is more of an adjunct for depression, so far, so good. I

Image: Stethoscope with words Transcranial Magnetic Stimulation

They do a type of Transcranial Magnetic Stimulation called MeRT. It took a couple of months but my insurance finally approved it. I had an EEG yesterday. They use the EEG to determine how to apply magnetic therapy. I may start as soon as tomorrow morning.

The therapy helps bring your brain waves to calm, alert alpha waves. You can get there through coping tools like mindfulness and meditation but this works much faster. I have had anxiety Al, of my life and it impacts me daily. I am really hoping this will help. I use a lot of stress reduction techniques and have been trying to expose myself to things I fear.

I spent 5 weeks in Partial hospitalization all day M-F. Now I am in intensive outpatient 8:15-11:45 M-F. The next step down is 3 days/week, then I am done but will come in for MeRT. I think the routine and structure help. I am learning a lot. You can’t drink alcohol while during MeRT. It is M-F daily and 36 sessions total.

You come up with a daily schedule but I have trouble sticking with it once I get home. I was supposed to come up with a meal plan but I don’t know how. I eat, mostly low carb, but I don’t really plan my meals. I keep snacks on hand and my husband usually makes dinner.

My fasting glucose does not match my A1C. My A1C is normal. I am trying a continuous glucose monitor. I like it but it show high readings, too. My dr thinks donating blood gives me a false low A1C so I am having another blood test in a few months and not donating. I am thinking of volunteering for the Red Cross at the donor center, but I am having trouble hearing. I am getting the wax cleaned out of my ears soon and try to get on a schedule so my hearing aids can work.

Projects

anxiety, caffeine, Calories, diabetes, gratitude, internal family systems, keto, Medication, mental health, motivation, projects, psychiatrist, psychosis, schizoaffective, schizophrenia, sleep, Therapy, Weight loss, writing, , , , , , , , , , , , , , ,
Image: gratitude journal.
https://linktr.ee/matthiasjbarker?fbclid=PAAabOSCj2THoNkFK8nkKoP0OquO5P7L8HeLBBjQkatc1YYQb1W-ott8E8IfQ

I have a number of projects that I have trouble completing.

I am interested in internal family systems therapy. I have a book and workbook to use on your own but I have trouble getting started. I have an appointment with a new therapist in Jan and hope she can help.

I am in the process of reading Brain Energy about how mental illnesses are metabolic disorders. I skimmed through looking for explicit directions for how to deal with anxiety and schizoaffective disorder. He talks a lot about keto but I like to have targets for macros and he does not get specific or I missed it.

I got an activity journal that looks fun but I have only glanced at it.

My cousin, @AnnSloan, wrote a book called Suffer, that I have on kindle waiting to be read

I have a gratitude journal by @matthiasjbarker (pictured) that I just started today. It has prompts for everyday for 6 weeks. He also has a motivational zoom I signed up for. Maybe I can get some sense of priority with these projects and a timeline.

I started keto last month. I slipped a little eating some more carbs than I should. I have type 2 diabetes and keto really helps me with glucose control. My sugars went higher than normal and I am having trouble getting to a level I would like. I have not lost weight but I lose slowly usually.

I had a scare where my blood pressure was high at a Dr , not PCP. I tested at home and it was high on several days. I contacted PCP and she said to decrease salt and exercise more. Still high. I went for office visit and she read bp manually. It was normal. She thinks for some reason the automatic readers don’t pick it up right on me. I can go for manual checks if I need. I am a little confused about sodium. Usually you increase it with keto but my Dr wants me to stay to below around 2 g. I had been drinking bullion but I stopped. Grateful my BP is normal.

My sleep had not been well. It is improving. I can get 6-7 hours straight, the problem is it is shifted. I don’t fall asleep until about 3 am and am tired during the day. I cut back on caffeine and my psychiatrist reduced my medication. It is easier to stay asleep with the cooler weather.

Covid update

covid, Medication, mental health, mental illness, , ,
Image Covid test kit

17 days since symptoms of Covid started. I now have post viral bronchitis. My dr prescribed an inhaler and cough suppressant. I have been out of work 3 weeks. I can’t go anywhere with this cough. I have not tested lately, I will tomorrow. I have not had to use the inhaler. I think I had rebound after paxlovid, where you get better and then when you stop taking it your symptoms come back,

I had a neurological symptom where I had manic energy.couldn’t sleep, couldn’t focus. I did not know if it was a mental health issue or part of Covid, My dr prescribed klonopin which worked.

I am bored so I ordered a cameo from a comedian I like, Darren Carter to cheer me up.

Update

CBT, Coping skills, depression, distorted thinking, feelings, insurance, job, Medication, mental health, peer support, psychiatrist, psychosis, Therapy, work, , , , , , , , , ,
Image: Yellow smiley face

My therapist was able to fit me in with a phone appointment on my lunch break Monday. He validated my feelings which helped a lot. Then, he gave me cognitive behavioral therapy homework to find evidence about being worthless, a failure, etc. There is no deadline. I don’t have a scheduled appointment. I will let him know if I need an appointment. He is going to retire soon.

Then, I talked to the assistant to my boss, I don’t know her title, and told her how I have been feeling. She said she has had no complaints from anyone about me. That helped, too. I made sure to document my encounters this week and this month already looks better.

I have a LinkedIn friend, I don’t know if we have met ever, who volunteers in my field. She mentioned she was looking for work. I told her we had an opening, part time and how to apply. She jumped on it and got the job. I think today is her first day. I hope it goes well for her.

I saw my new psychiatrist. He works in the same office as my last one, but he is covered by my insurance. I don’t know what to think of him. He barely spoke to me, just checked boxes while I talked which was off putting. He took a personal call. I am maxed out on the meds I take and he thinks my antipsychotic is too high, so he decreased it and told me how to taper down. No one has wanted to change my meds because they are working. He does not want to see me for 3 months.

I am a little worried I will destabilize in that time. When I made the appointment for August, I asked if they can switch me back to the other doctor when they get the insurance worked out. They put me on a list.

New Year, New Docs and Parenting Woes

coronavirus, covid, isolation, mandala, Medication, mental health, mental illness, motherhood, parenting, psychiatrist, schizoaffective, schizophrenia, stay at home, support groups, Therapy, ukraine, , , , , , , , , , ,
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.

In Sickness and In Health

Dog, Medication, mental health, mental illness, moderation, schizoaffective, schizophrenia, sobriety, , , , , , , , , ,
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.

 

 

 

 

Making coconut milk yogurt

Calories, coconut milk yogurt, diabetes, Fitbit, intermittent fasting, lactose intolerance, Medication, Myfitnesspal, Uncategorized, , , , ,
Image. Coconut Milk Yogurt, luvele.com

I recently discovered I am lactose intolerant. I just bought a yogurt maker and was making yogurt with half and half, which was a simple recipe, but now I am trying to switch to coconut milk. So far, I have had little success. I have made gelatin, which tasted okay but was definitely not yogurt. I had a batch that did not set and one that turned out sour. I used them in smoothies. They are fine to eat, but not what I am looking for.

I am using this recipe https://www.luvele.com/blogs/recipe-blog/best-dairy-free-gut-loving-coconut-yogurt-recipe. It does not seem too complicated but I am having trouble. I have a new batch going now. Fingers crossed it works. They have a different recipe that uses coconut cream that I will try next if this fails.

I probably would give up and just buy non dairy yogurt, but I want to use the maker. I don’t know what else it could be used for.

I have been making green smoothies, too. I drink them most mornings now. Our blender died after 20 years so we got one that makes smoothies and is durable. I put in ice, soy or coconut milk, spinach, cucumber, coconut milk yogurt, ginger, chia seeds, plant protein powder and blend. It is pretty filling.

Image coffee mug with coffee and coconut milk, green smoothie

My weight has been stalled since I had a medication change in June, but my glucose is good and I am in ketosis (on ketogenic diet). I had been logging my food on Cronometer but I think it was overestimating my energy expenditure so I switched to myfitnesspal. You enter your foods and it calculates the calories, carbs, fats, protein etc. I am not perfect at logging but it gives me an idea of where I am at. I have it linked to my Fitbit and scale.

I am still doing 14 hour fasts. It is not too difficult for me. I have not noticed any changes with fasting. I do feel a lot better now that I am not having much dairy.

Intermittent Fasting (IF) and Stigma in Plasma Donation

anxiety, Calories, depression, diabetes, Donation, intermittent fasting, keto, life lessons, Marrow, Medication, mental health, mental illness, schizoaffective, schizophrenia, stigma, Weight loss, , , , , , , , , , , ,
Image of insulin and glucagon levels over time source Digbi Health

I saw the image above of how insulin drops between meals and while fasting. While insulin is low, glucagon can burn body fat. I was intrigued. I am 10 lbs away from a healthy BMI, but still have abdominal fat. I am type 2 diabetic and asked my doctor if fasting would be safe. My glucose is pretty well controlled and I don’t have hypoglycemic episodes. She said it is fine, but recommended 12-14 hour fasts. Which is mainly cutting out the nighttime snacking and eating breakfast later.

So far, no change. My weight has been stalled for awhile. My diabetes medication was reduced in June and my biometrics went south. Glucose up, ketones down, weight up. Thankfully, that stabilized but I can’t get my weight to go down. I log my food on an app (Cronometer) but sometimes I estimate weights. I am going to have to get better at calorie counting to start losing again.

So I am gung ho on intermittent fasting. Watching Dr Fung YouTube videos. Then, I saw this study. https://pubmed.ncbi.nlm.nih.gov/34135111/
A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults

All I can see is the abstract and I heard a review but this is what I got out of it. There were 3 groups. One calorie restricted, one calorie restricted (same as group 1) but alternate day Fasting and a third group with no calorie restriction. The calorie restricted groups both lost the same amount of weight but the non fasting group lost more fat.

It was a short study 4 weeks, I think, and these were lean adults. Also, they were doing longer fasts than I am. But, I don’t know what to make of it. I would have expected the fat loss to either be similar or more for the fasting group since they have lowered insulin during the fasting period. if anyone has any insights let me know in the comments. I will stay with 12-14 hr fasts and keto diet for now.

I tried donating plasma at a donation center. I tried calling ahead to ask about restrictions but they do not give that information over the phone. And, they don’t take appointments for first time donors so I had to walk in and wait. For what it was it was not too bad. First someone checked my veins, which are fine. Then I had to fill out a bunch of paperwork. Then, I watched a video on plasma donation and read through a manual for first time donors.

Then, a woman, I don’t know her title, took me to an office to go over my paperwork. She got to the medications and asked what each was for and looked them up in a huge book. I take 7 medications for various conditions. After she goes through the medications she goes over them with me.

Most were fine. I take antidepressants but as long as anxiety and depression are under control it is fine. But, I take metformin for diabetes. She said that is a temporary deferral. If I was off it for a year I could come back. I don’t know what the likelihood of me maintaining my diabetes by diet alone is, my husband is able to, so possibly. Then she got to abilify which is an antipsychotic although it is sometimes used along with an antidepressant for depression. But, I told her I take it for schizoaffective disorder. That is a permanent deferral.

Bone marrow donation has the same policy. It is not the safety of the product. They consider me a safety hazard. I have been stable for 15 years but still people are afraid of me because of a diagnosis. They should have a sign out front: schizophrenics need not apply. So, I would not have had to waste my time.

The Keto Roller Coaster

anxiety, Co-occurring, job, keto, Medication, mental health, mental illness, peer support, psychosis, schizophrenia, support, Weight gain, Weight loss, , , , , , , , , ,
Image of roller coaster

I have been on a ketogenic diet for about 5 months to help treat type 2 diabetes. I was taking 2 medications. Metformin and Januvia. I am monitored through a program called Virta. I have a coach and a physician through Virta, it is all done virtually. There is also an online community for people on the program. It is covered by my insurance.

At the beginning of this month I had labs that my endocrinologist had ordered. The results were really good. A1C of 4.8 and fasting glucose 98. Everything else was normal, too. For some reason my endocrinologist office cancelled my appointment so I had to reschedule for August. The Virta dr said that I could try going off Januvia since my labs are so good.

So, I go off Januvia and everything goes screwy. I get ravenous at night and have to eat after dinner. I had been slowly losing, now I am gaining weight. My fasting glucose is higher than before I started keto. I test my ketones and they are low. I chatted with people in the community and they tell me to stick it out, that my body will adapt. I am not so sure. I put in a message to the Virta dr to ask for his opinion but I won’t hear until at least Monday. I did not even know if the Januvia was doing anything but I now notice a difference without it.

I rarely talk about work, but here I go. My opinions do not represent my employer.

I work in peer support in a 20 bed mental health crisis stabilization unit (CSU). I have worked in peer support at an activity center for people with mental health issues and in a residential program. The people we see are much more symptomatic than I had worked with in the past. I am available to talk and offer groups but I don’t get much interaction because people want to sleep, are too symptomatic, want to be left alone etc.

It is a new facility and peer support is a new position for my employer. I have been there about 5 months and still have not found my footing. My boss is aware of the issues of people not wanting to interact and told me to keep being available and offering groups. She is going to give me some additional duties once they are approved.

It also can be anxiety provoking when patients are loud or aggressive. I am not involved with dealing with those situations but I feel tense. I help out where I can. I like the place and what we do.

Advice From a Dietician on Brain Health

Brain, keto, Medication, mental health, mental illness, schizoaffective, schizophrenia, , , , , , , ,
Image of highlighted brain

I zoomed with a dietician this week.  We talked about ketogenic diet and brain health, specifically schizoaffective disorder.  She gave me goals for macros and ketones.  I am having trouble just staying in the requirements of Virta, the company that is monitoring my diabetes, so she suggested following that and then make changes.

The suggestions she made was: going from 30g carb a day to 22g. And, cutback on artificial sweeteners.  Keep my protein the same, and increase fat.  She also suggested, for my particular issue, that I should have 2-3 mmol/l ketones in blood.  When I started keto, I was getting numbers in that range, but now it runs around 1.0 so she suggested adding mct oil.  She also suggested balancing the unsaturated fat I use with some monounsaturated fats.

I am trying to hit the macro targets now, but will really start in earnest in May.

I had asked my psychiatrist if he would talk with the Virta doctor and he agreed, but I don’t think he has called. I have been stable a long time, and am wary of making any medication changes. The dietician told me to work with my psychiatrist about any changes, which I would do anyhow.

I really can’t believe I have stuck with this as long as I have. I want to make it a lifestyle change but it is hard. I feel good and am thinking clearly. My main issue is that something does not agree with my gut. My fasting glucose has dropped 20 pts. Still not low enough to change my diabetes meds, but it is an improvement. I have lost about 1 lb/week, it’s not melting off, but I think it is reasonable.

I am in a medically monitored nutritional ketosis program and working with a psychiatrist for my mental illness. Please don’t try this alone.