April 9, 2009

My visit to the emergency room

I had a visit to the hospital last night. I was taking antibiotics, the second set, for an abcess in my jaw. But man did my body decide it'd revolt. The most awful red rash started yesterday morning. By dinner time when Tim got home I was in agony, scratching like crazy. Throat really started to hurt badly too. And I thought I'm puffing and wheezing. Let's just get myself to the hospital right quick. And man, I didn't have time to park my butt on a waiting room chair for more than 5 mins. Long enough to hear a lady say how long she'd been waiting, and oh geez they're already seeing you, that's not fair. Yeah, well when you're having trouble breathing lady, that's a bit of a priority I'd say.

Got a couple of shots in the arm of antihistamine stuff (epinephrine?), and a Benydral pill and a nice mask with lovely gas stuff that made it easier to breathe. The doctor was very glad I'd come, obviously. Spent the next 8 hours in an observation bed, to make sure my breathing was back to normal, and that the rash was subsiding. They kicked me out at midnight, with a puffer and a prescription and I got home okay.

While I was there, I was reading one of the Bipolar books that I had around for the last 2 years, and never really "read". It's called "Bipolar Disorder, a guide for Patients and Family" by Francis Mark Mondimore, M.D. My mind often has trouble concentrating for long on actually reading throughly. I tend to glance over the words and read quickly, and have to pause myself. I go back to the top of the page and mentally have to say "read each word, and understand it". Tell myself "try to get the full meaning of the paragraph". Well, what I've learned from that read, from a John Hopkins Press book, by a PhD of psychology, was that there are really a huge spectrum of "Bipolar affective disorder" categories. Wiki entry

There is the classic Type 1 cases > High mania, deep depressions, and sometime rapid cycling of it, and the Type 2 cases, and then the nebulous, yet existing "Type 3" that's not yet given its own "special" category in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition). And beyond those are more types of bipolar or rather manic to depressive behaviours that aren't yet classified. But they know, (the researchers) that they exist through careful studies of patients. They don't seem to yet fit in with the classic "types" but rather are a subset of them.

Medscape article Across the Bipolar Spectrum from Practice to Research

Interesting article here on why there is no "Uni-polar Mania" category in the DSM-IV. Well thought out discussion that "mania" in society is considered to be generally normal, if it drives you to success, brilliance and other "good for society" ideals. But, yes, there is a very much more darker side to mania, as I myself know.

From the above article

In the early stages of a manic episode, a person may seem to be more social, active, talkative, self-confident, insightful and creative than usual. But as the episode unfolds, common symptoms include extreme irritability, overreaction to stimuli, difficulty understanding what is going on, poor judgment, blaming others for things that go wrong, and loss of touch with reality, in some cases including hallucinations and delusions (2). One bipolar sufferer described the state of mania in the following way:

"The fast ideas become too fast and there are far too many...overwhelming confusion replaces clarity...you stop keeping up with it -- memory goes, infectious humor ceases to amuse. Your friends become frightened...everything is now against the grain...you are irritable, angry, frightened." (9).

(2) http://www.psychiatry.ubc.ca/mood/md_bad.html
(9) http://www.nimh.nih.gov/publicat/bipolar.cfm


The drugs I'm on at the moment are both well established over the course of a decade or more of use. But, and here's the kicker, you really must take the medication, but not feel that is enough. No, as the writer stated, the manic depression spectrum is like a moving target. A set of drugs may work for a while, but then there may a seismic shift. More mania may require an adjusting of the medication, or perhaps a change in it. So, really, a constant medical over-view of your condition is really rather necessary.

I'm glad I took the time to thoroughly read good information like that. I can't be complacent that 4 pills per day = I am sane and good, for life.

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