Tag Archives: anxiety

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.

My Week

Image: Yorkie with words you just won a free pet portrait from I’ll shoot your pets a $250 value!

I was at a Halloween event at Hala’s Paws pet store in Mission Viejo, CA. I entered raffles and won 2 prizes. A Target gift card and a photo shoot of my dog by I’ll Shoot Your Pets located in Temecula, CA. They came over to my house to take pictures bringing a toy and treats to get his attention. Raider was pretty cooperative, but grew restless by the end. He was laying on the couch so the photographer took pictures of him there. The pictures turned out great. I had the choice of a large canvas photo, 3 8×10 prints or a ceramic mug. I have a large picture my niece made with pastel on wood, so I opted for the 8x10s. Here is the link to the photos.

https://galleries.page.link/Q9XLV

I own a small amount of shares from a company I used to work at in the 1990s. I received a package in the mail of documents that they want to buy the shares back. I want to sell. The only thing is I misplaced the certificate and it is over $100 to replace it. Then I can sell and make a small profit. My friend says it does not sound legitimate. The company is definitely buying the stocks back. He just thinks I should be able to do it all electronically. I have never sold stock or tried to replace a certificate. I have the holdings statement. I am going to look through our files this weekend and try to find the certificate.

The hearing aids are in limbo, my primary dr got them authorized but it is not with the right company, so they are working to get that straightened out. I will have them by the end of the year. I just don’t know when. They can’t order without the insurance authorization so for now I am just waiting.

I am going on a walk for NAMI Orange County, CA tomorrow. I am bringing a friend and will see people I know there. I have a fundraiser on Facebook and the Nami walks website. I have met my goal and will add to my collection of T-shirts.

https://www.facebook.com/donate/326881332539007/?fundraiser_source=external_url

https://www.namiwalks.org/participant/359276

The position I applied to transfer to changed from full time to per diem weekends so I withdrew. I will keep my eyes open. Fortunately, I like what I am doing now. When I told my friend I was anxious just deciding if I should apply he said “ don’t suffer twice”. I wish I knew how to turn off precipitatory anxiety. Now, I can relax.

Have a nice weekend!

TikTok @Schizoaffectivedogmom

I made my first TikTok video https://vm.tiktok.com/ZM8DvPD97/ my username is @schizoaffectivedogmom I wrote a blog post early on about coping skills called Coping with Schizoaffective Disorder https://lorib434.wordpress.com/2017/03/20/coping-with-schizoaffective-disorder/ so I am starting with a series on coping skills. The first one is my dog because he is the best. He is cute and funny and likes walks and being pet.

Image: dog on bed

I will keep blogging. The reason I was drawn to TikTok is that I went to an online NAMI CA conference and someone recommended a few users on TikTok. I liked what I saw and would like to add to that. I am older and not very technologically adept so we shall see how long I last. I did make some periscope videos when those were a thing, but few people came.

I am doing well. I just took my dog, Raider, to a Halloween event at a pet store. They had treats for dogs and people, lots of dogs dressed up, raffles, an artist, a dog rescue with the cutest puppies. Raider gets nervous but he seemed to have a good time meeting the other dogs. I just put a bandana on him. I entered the raffles. One prize is a portrait of your dog which would be awesome. We have one that my niece made that I love.

My health insurance, including behavioral health, changes Jan 1. My psychiatrist takes the new insurance. My therapist doesn’t but can apply for continuation of care and if it is approved the new insurance will cover her. Otherwise, I found someone highly recommended who takes the new insurance but retires in 2023. I was really anxious at first but now I am calm since it should work out.

ETA: hey I won the pet portrait from I’llShoot Your Pets (gotta love the name). So excited! and a Target gift card.

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.

 

 

 

 

Intermittent Fasting (IF) and Stigma in Plasma Donation

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

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.

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.

What did I sign up for?

I volunteered to lead one day in my AA group. It is not very complicated. They have a format and I pick a passage from AA literature to read, talk about 5 minutes and then open for discussion. But, I have social anxiety. It is much better than in the past but I am still nervous. On top of that, I told my friend I would speak on her podcast in January. That I am a bit terrified about.

I picked a chapter from the Big Book, More about Alcoholism, and will talk about doubting we are alcoholics. I think it will be good for me to hear others experiences. I just finished step 1- We admitted we were powerless over alcohol and that our lives had become unmanageable.

In my youth my life truly was unmanageable. I had rules for myself about when and where I could drink, by the time I stopped, to keep my drinking from getting out of hand. It is hard for me to see my life as unmanageable. I made a list and will continue to add to it, about being powerless and my life being unmanageable. I will refer to it when I have doubts.

As far as the podcast, I am going to be talking about myself, my experience with mental illness. I had an older brother who has passed away, who had a psychotic break in the 1970s. I am going to talk about his story, too.

My friend called to discuss the podcast with me. I froze on the first question. She asked me about being a mental health advocate. I think of myself more as my job title, a peer support specialist, or someone with lived experience. I have written letters for certain bills but am not very politically involved. We are going to talk again and hopefully I can relax. She can talk enough for the both of us. I just want it to go well.

Powerless and Unmanageable

I am starting to work on the first step of Alcoholics Anonymous. My sponsor has me writing down how I am powerless over alcohol and that my life has become unmanageable.

It is hard. I like to think that with enough willpower I can do anything, but I have tried quitting on my own and that did not work. I have gotten sick, saying “never again” to go out the next night and drink again. I am endangering my physical and mental health, but I did not stop until very recently.

I considered the bottle to be a friend. It was always there, never let me down. I think I was developing a tolerance. I was having trouble getting a buzz. I was letting daily activities go to the wayside. I am terribly shy and needed a drink to socialize.

I was talking with a friend who is very involved in aa. She started telling me rules. You aren’t supposed to make changes the first year and I should be journaling were a couple. She was scaring me. I wondered what I was getting into. I called my sponsor and she said those things can be good but not required.

The meetings I have been going to are over Zoom. I can’t wait to meet people in person. I have just been going to women’s meetings. The ladies have been nice. I have 25 days sober. I am still a newcomer.

Why I Support NAMI (National Alliance on Mental Illness)

I was first introduced to NAMI when a friend told me about their Peer to peer program. I had heard of family to family, another of their signature programs. I signed up and was assigned to a class when one was starting up.

There were other people like me in the class and the mentors were doing well. That was the first time I had heard of recovery. We learned about relapse prevention, our illness, goal setting, advance directives and much more. We had a mindfulness exercise at the end of each session, I enjoyed it and even though I get really anxious, I signed up to mentor. I moved from that program to In Our Own Voice sharing my story of recovery. I still do those presentations.

I work as a Peer Mentor, but until very recently there was no standardized training. I took a mental health paraprofessional course years ago, have years of volunteer and work experience and recently took the NAMI Peer Support/Family Support Specialist training.

They also have support groups both for consumers and family, a warmline, and other programs.

The OC Warmline is only for Orange County, CA residents

Call or text: (714) 991-6412
Toll Free (877)-910-9276

They have an annual walk to raise money through donations. This year it was a virtual scavenger hunt. Usually it is a 5K walk. I walk to support NAMI because they have so many resources and have been able to help me and others.