The Tipping Point

Last night, somewhere during my long drive to nowhere and back, I felt like I’ve reached the tipping point in this particular Abyss journey. Since April, I’ve felt like a massive depressive meltdown carrying around a Tom. Now, I feel like I’m Tom, and I’m carrying around a depressive meltdown. The difference is in the semantics, I suppose: I feel like maybe I’m getting my legs under me a little.

My therapist asked me today (well, Thursday) about the Fournier’s adventure. I mentioned one session that I’d had this horrible, potentially lethal bacterial infection in…well, in a most inconvenient place; that I’d been about thisfuckingclose to dying, had two surgeries, and spent five weeks in the hospital.

And that I’d happily choose an encore of Fournier’s Gangrene over my 2012 meltdown ten times out of ten. Without a doubt.

He asked me how I could say that, when I almost died. I told him that I wasn’t at all afraid of dying. I was totally at peace: if they put me under anesthesia, and I never woke up, I’d be perfectly fine with that. The entire thing was out of my hands. As far as why Fournier’s is preferable to a massive depressive breakdown,  I think it’s because there were metrics involved with the Fournier’s. They could test my blood, and see that my kidneys were once again filtering out bad stuff. They could do cultures, and see that the bacterial infestation was waning. They could measure the wound, check for healthy epithelialization and that all the necrotic tissue was gone. They administered my IV antibiotics according to a precise schedule. They noted my performance in physical therapy–how far I could walk, how many reps with the resistance bands. Hell, they kept track of how much urine I produced (I blew their minds, too: I had friends sneak in 12-packs of Diet Mountain Dew. It was Urination Domination in Room 142! 😉 ) Finally, there came a point where the empiric data showed clearly that I could safely come home.

With the Depression, it’s impossible to quantify improvement, simply because the only thing capable of assessing whether I’m being repaired is the thing that’s broken in the first place. Yesterday, I felt like I reached the tipping point, where I’ve crested the hill, or whatever metaphor you want to use. That’s just a feeling, though: how much credence does that really hold? I could be completely cratered tomorrow, so what then?

I think what led me to believe I’d reached the tipping point was that I’ve been waking up reasonably optimistic that I’ll survive the day. The past week or two, I’ve been able to do those “normal” things that have been hit-or-miss the past seven months. I can wake up to my alarm, shower, brush my teeth, and go to work. I take my breaks when I’m scheduled to, go to lunch on time, and do my job well. It’s become the norm, not the exception.

And I think Dr. Borgia was dead right: the more I’m able to do “normal” things, the easier it will be to get back to normal.

The one thing that bothers me is the sheer number of different psychotropic meds I take. I have a little pill compact I carry with me everywhere. I have, oxcarbazapine, Xanax, Adderall, and a couple of lithium, in case I get over-Adderalled. I take those multiple times throughout the day. There’s another med I take when I wake up then at bedtime, and two more that I only take at bedtime.

I’m feeling–to quote Indigo Girls–closer to fine, but how much of that “fine” is my brain healing, and how much of it is straight pharmacology? Am I beginning to emerge from this depression? Or could you take all my meds, toss them out the window, and have one of the oleander bushes downstairs start doing laundry and going to work regularly?

A good friend of mine has had her own bouts with depression, et al. A few times since I’ve known her, she’s just stopped taking her meds. I promptly yell at her until she takes them again. I mean, there’s nothing stupider than quitting all your psych meds, especially all at once. I asked her why she did it, and she said it’s because she didn’t want to keep taking pills: she couldn’t tell how she really felt anymore.

I now understand what she means. I’m doing okay this week, but is it because I’m okay? Or is it that the various handfuls of pills I swallow have propped me up? To what degree have I improved? And am I going to be on these meds forever?

All I can do right now is take them when I’m supposed to, and hope for the best. Yes, it was a bit odd taking a giant dextroamphetamine pill at two o’clock in the morning, but that’s where it was scheduled.

When I had the Fournier’s, I quickly accepted that my doctors knew far better than I how to treat this thing. If they wanted to put me on 15 hours a day of IV antibiotics, then I was fine with that. If they decided it should be 10 or 24 or 3, then I’d have been fine with that, too. If they said I needed debridement? Knock yourself out. If they’d told me to sing George Jones songs at the top of every hour, I’d be wearing out “He Stopped Loving Her Today.”

Mental illness is different. I told my therapist that he could have asked me a question in late April, when I first started seeing him, and ask me the same question today, and he could get two completely different answers. And both of them would have been the absolute truth.

Hell,  if nothing else, I think it’s progress that I’m asking myself these questions. Maybe I’m still healing slowly. Maybe I’m propped up on a kabillion different chemicals. All I know is that I have to be at work in 16.75 hours, and I’ll be there.

By no means am I all shiny and new, but I can see I’ve come a long way since April. I don’t care if I’m on these meds the rest of my life, as long as they work. If the balanced regimen Dr Borgia and I have come up with continues to work, I’ll take it. It’s gotten me to the tipping point, and that is a big step. As long as I can remember how bad it was in April or May, I can appreciate being here. The election is behind us–except for Ohio, which Carl Rove insists the GOP won–and life is reasonably tolerable.

I can work with that.

Happy Friday.



12 Responses to “The Tipping Point”

  1. You said it all. I was going to say “The fact that you can be asking these questions is a sign you are on the mend.” But, you know that. Maybe your doc will eventually tell you that you can cut back on meds here and there, gradually. But, like you said, for now, keep healing.
    You couldn’t have even conceived of a “tipping point” a few weeks/months ago, so this is good!
    I have tried to stop taking my Prozac now and then. And my doc yells at me “Why???”. Well, I want to see if I can “make it on my own.” Apparently I can’t. 20% of people just have to keep taking it the rest of their lives. Ok. I’ll happily do that as long as I have money/insurance to pay for it.

    Oh lordy…I have to go to work, but I can smell that a cat in the next room just took an elephant-sized dump in the litter box. The right thing to do is to go scoop that box before I leave.
    Happy Friday!!!

    • I agree: these are questions I couldn’t ask back in May. I look at it this way: my quality of life is more adversely affected by being completely shattered mentally than by swallowing a dozen or two pills a day, so I’m perfectly fine with taking meds. (Plus, they’re all generic!)

      Sadly, none of the meds prevent massive cat dumps. 😦

  2. I can hear how far you’ve come, and it makes me glad. Don’t forget that “normal” also involves chatting to me from work. 😛

    • Would that I could! I miss our chats. However, there’s a new mandate involving non-work Interwebs use (I think somebody let in a virus), and they’re pretty strict. What a buzzkill. xox

  3. I’m glad you reached a good tipping point! I’m glad Dr. Borgia could get you there and I hope someday you don’t have to take quite as many meds, but in the meantime… Enjoy the normalcy they’ve gifted you with. ❤

    • I’m not quite normal yet–that may take awhile–but Dr Borgia seems to have hit a good recipe. If he told me to take mothballs three times a day, I’d probably do it. (Although, I’ve never understood how they get the moths to hold still during the de-balling process)

  4. I like this post, and reading that you can feel a difference in how things have progressed. Remember that lost of us take meds to help prop up our bodies to make their way in the world. I will never be off daily asthma meds, some people will never be off insulin. Your meds help your body’s chemical processes, just like ours, and there’s no harm in that. Give your system what it needs, and keep on cruising, Tom. We love you.

    • Thanks, Laurie. The only thing I worry about long-term, is that sometimes meds just stop working after a certain period. That happened to me with Lexapro. It worked great for four years, then stopped overnight.

      However, I can’t worry about that now. They’re working today, and that’s all that matters. If they stop, I’m sure Dr Borgia and I can find something else.

  5. I’ve worked in drug discovery for nearly 20 years (which is a sobering thought) and I can tell you from a disease-treatment standpoint I loved working in anti-infective and endocrine diseases and hated working in neuroscience.

    AI and endo have easy and quantitative endpoints to measure: are the bugs dead, yes or no? How much (estrogen, thyroid hormone, glucose, etc) is there in the (blood, urine, tissue…) — easy. Neuroscience is all — on a scale of 1-10 how do you feel? It’s a mess.

    Good luck on your continued recovery my friend.

    • Thank you, sir. It also sucks that a med that works miracles for one person can turn another person into a screaming lunatic. The brain is a screwed up hunk of goo. Perhaps I’d be better having my brain replaced with six pounds of Islets of Langerhans. (That always sounds like a Netherlands resort to me, probably with lots of tulips and stoned American college kids acting like dicks)

  6. This makes me happy. The journey may still take a while, but you’re starting to be you. [This is Good]

    • Thanks, Bexworth. Our late-night FB chats helped. If you’d put sausage gravy & biscuits on the damn breakfast buffet, however, I would have been completely healed by now. 😉

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