the Exit of the Strattera and Return to Adderall ER

In the century of life since I last wrote in 2016.  A ton has changed in my life.  Marriage is finished, but I guess that is not a surprise. The divorce judge told me I couldn't write my blog if I mentioned him.  So that happened and I obeyed.

My education attempts were squashed by fatigue that didn't resolve itself. I am now 37 years old, a single mom with 3 kids who also has her Mom living in her house.


The kids are well adapted and eat 3 meals a day, wash behind their ears and change their underwear. I think. I have 3 boys, I am doubtful they change the underwear since I never wash many.  The middle one goes commando, I tried taking him shopping for pants unannounced, that did not work out well.  One of us was embarrassed and left the store...

The babysitter lost her mind hit my oldest son. I kicked her out. And managed to keep things running with a little help from my ex and weekly assistance from my Mom. The loss of the babysitter added to the fatigue I was experiencing.

In early 2017 I left my job at Facebook in a desperate attempt to vanquish the fatigue demon. I was told by 2 physicians and a psychologist my fatigue was due to depression. They were wrong. Leaving the highly competitive and stressful call center environment didn't work for long to relieve the "depression".  No doubt, I needed to leave the company that employed us Facebook Sales Reps as sub-contractors.

I found a temporary job that had a lower wage but had a great boss, I liked her a lot and wish I hadn't been in such terrible health and been the employee she deserved. I missed a lot of work! So much work that my own business working on Facebook Digital Ads on the side wasn't enough to keep my savings intact. I spent my savings literally keeping the lights on and feeding the kids. I was missing so much work due to fatigue that I should have been fired. Any non-involved boss would have fired me for missing nearly every other Monday and 1/2 or more of another day each week. But again she was kind and a great human being.

By the middle of 2017, I had gained an extra 15-20lbs.

I can't be exactly certain because I developed a fear of the scale after I saw it hit 252lbs.  I just stopped taking my weight because it didn't matter how hard I exercised or what I ate, the number on the scale just went up. I didn't realize it but I also had developed a reluctance to have my photo taken. It was rather embarrassing to see myself that large. This is a photo of me in the spring of 2017 at my heaviest, about 250 pounds or 18 stones.  I've removed the innocent people from this photo. Yes, I knew I was big. I was tagged in this photo by my cousins. I didn't tell them but it made me cry. How did I turn into one of those before photos that we used to see on Nutrisystem and Jenny Craig when we were kids?

I doubled down on the efforts to control my weight.  I actually quit sugar of any kind.  No soft drinks, no maple syrup in your oatmeal, no added sugar hidden in the pasta sauce, no white bread or rice, actually almost no grains at all. No sugar substitutes of any kind were permitted. Water, seltzer water, and unsweet iced tea were all I drank. Grocery Shopping drove me insane! Try going shopping only to discover there is added sugar in peanut butter and ketchup. I went militaristic Vegan, sugar-free, oil-free, caffeine-free, no eating out, no cheat day, practically only raw fruits and veggies. I went outside and tried walking, but was still too tired to manage more than getting the mail or bringing in the groceries.  The walk from the temporary job office to the parking area was only about 1/4 mile round trip. But it wore me out. I rear ended people twice at stoplights after work.  I couldn't tell you how I went from a full stop with 10+ feet in front of me to rear-ending the car in front of me at low speeds.  Both people forgave me. Unfortunately, I didn't know it was a symptom of what was happening in my body.

I lost 15-20 pounds or about 1 stone in about 6 weeks. So life should have been going in the right direction. It was Halloween night 2017, it could have been April Fools Day and just as many people would believe what was happening was a heart attack.  I handed out the candy to the neighborhood kids. I was exhausted and was ordering the kids not to eat all the candy and go to bed when the most severe pain began in my chest. Within a minute I was nauseous, tried taking antacids that I couldn't swallow after chewing. I spit them out on the floor of the bathroom as I the pain brought me to my knees.  I called for my kids. I asked them to wake up my Mom. My Mom didn't know what was wrong and neither did I.  I was 36 years old.  No one thought heart attack. We went to the ER.

I was given immediate entry to the ER when I walked into registration. The intake rep knew something was seriously wrong. They did what your thinking, took my blood pressure, hooked me up to an EKG and gave me morphine, nitrogen and a few other things like Mylanta.  Took an x-ray and some blood. Told me I was experiencing Heart Burn and sent me home after taking 2 Percocets 7.5mg/325mg.  I spent the night in agony until nearly 6 am when I finally was able to sleep. I missed more work.

I followed up with the primary care physician as instructed, missing more work. I was told maybe it was a gallstone passing and that we should schedule an ultrasound of the gallbladder to verify I didn't need to have it out. It was November 9th, 8 whole days since I had been to the ER for chest pain.  The pain returned. Not as severe, but it was back.  The ultrasound wasn't scheduled until the 10th, and I didn't think waiting till morning was right. This time I threw up on the way to the ER. I wasn't sweaty like the first time. I thought since this is a gallstone I could be patient when it took 2 hours before I was given pain meds. The blood pressure was high but way lower than the 250/110 it was before. Despite the pain, I choose to walk the 1000ft from the ER to the Ultrasound Tech's room. Then I walked back, sat down on the gurney and picked up my book.

As the RN that had escorted me was hooking me back up to all the devices, a very flustered ER Physician burst into my room. "We've called an ambulance to transport you," is what he vomited out. I wasn't quite sure I heard him correctly. My mom was equally confused by this statement. The guy was probably about my age and white as a ghost as he explained that my lab results were back and I had an elevated enzyme that indicated I had suffered a heart attack. I am certain I didn't believe him, the pain was significantly less severe than what happened on Halloween night, so I asked why couldn't we just drive to the other hospital.

I took my first trip in an ambulance,

with the lights on, high on morphine and completely confused as to why they were certain I had a heart attack this time and not heartburn. Because who takes an ambulance for heartburn. I spent the night in the cardiac wing of St. Joesphs in downtown Phoenix. I eavesdropped on the nurse as she became frustrated that the Cardiologist declined to come in that night and said he would see me in the morning before noon since I was so young.  I can attest morphine makes it so you don't give a fuck that something as wrong as age discrimination is happening to you in a true medical emergency. The nurses weren't happy and that should have been enough for me to give a crap, but I went to sleep.

The next day the Cardiologist swaggers in as cock as a TV doctor. "Ah well you're young, it was probably nothing," he tells me.  Still high as a kite, I agree. Probably nothing and the food sucks so...

I was sent to the Cath Lab which is expensive speak for a room where critical heart blockages are broken up and arteries are spread open like a vagina with a speculum in it. I am told the Cardiologist and the techs were surprised to discover an 80% blockage of the Left Anterior Descending Artery which leads to death in 4 out of 5 people who have a blockage there.  It is the type of blockage that you don't want to wait until the next day to deal with, let alone a full 9 days from onset. It's named the 'Widow Maker' because of the high death rates even with modern interventions, it is the deadliest type of heart attack because it supplies blood to the heart itself. Prognosis is a lifetime supply of drugs to keep your blood thin, blood pressure low.  Cholesterol-lowering medications are added as the standard of care in America.  Add a ton of strange looks as you go to the cardiologist office and pick up your meds and you are suddenly ripe for a new reaping of anxiety issues.

I tried returning to work the next week on the advice of the cardiologist. I just couldn't focus.  Good old ADHD had gone nuclear on me. I stopped paying my bills, because what was the point. I stopped answering the phone. I stopped returning text messages or even spending hours per day on Facebook. I became a no call no show and lost my job with the good boss. I failed to complete work as a Facebook Digital Ads Manager. I lost several clients. I checked out of adulting, parenting, and showering. But I was oblivious to it all because it was the holidays and I was walking further than before without the same level of exhaustion. Life was good(ish). Like I never stopped taking morphine.

I kept walking, slow, but far. I checked in with the family physician, the cardiologist and even the psychologist and the nurse that controls the psych meds.  I had so many doctors appointments that I didn't notice my life was in shambles. I had become a hypochondriac as well. Well, I thought that I was being a hypochondriac because I was finally admitting to all the aches and pains that had become my body and visited the ER, Urgent Care Clinic, Doctor, and Obgyn.

Don't ignore pain! It's not all in your head.

My ex claimed I was just a soft pussy that couldn't handle pain while we were married because I would say my back hurts, I am bloated, my leg hurts, my head hurts, my boobs hurt, sex hurt. It wasn't in my head. The hypochondriac learned after months of follow up, ultrasounds, x-rays, ct scans, blood serum, physical exams and countless hours in the car to another appointment I was living with a very real disorder called Polycystic Ovarian Syndrom or POS for short in the second month of 2018.

This diagnosis was my ah-ha moment.  This was the root cause of the heart attack. On the surface POS is just a bunch of painful cysts on the ovaries of women, but underneath it lies a metabolic dysfunction caused by hormone imbalances, high blood pressure, diabetes, high cholesterol, hair loss, adult acne and difficult to lose weight. This was how I arrived in the ER with a heart attack and no family history of heart disease.

So here we were. A heart attack survivor and unknown sufferer of a serious disorder. I read a few blogs, found a few well-known physicians and naturopaths online, read a book and found that I was on the right track with the crazy militaristic version of a vegan diet before the heart attack.  Lose the fat, build the muscle and lose the weight are the overall best practices for living with this broken body. Oh and stop the birth control, it is half the problem.

But then in the follow up with the Psychologist, I let it slip that my focus was horrible and that the Cardiologist said it had nothing to do with all the meds I had been given despite what I read on the internet from actual users of these drugs. The psychologist told me I shouldn't be on Strattera at all. Apparently, it causes an increase in blood pressure over long periods of time and is now associated with an increased risk of cardiac death.  So the rainbow of pills I am taking needed to be changed. He told me to go cold turkey on the Strattera and handed me a new script for an old friend Adderall ER.

What is weirder is that I called the cardiologist office to run this past them and they agreed that I should take Adderall ER, an amphetamine! WTF?! I stopped taking Adderall ER because I couldn't remember to take the damn thing in the first place and it was still disappearing. I still believe to this day my ex was up to something with that Adderall. On top of that, I had just disposed of some really old Adderall ER I found in my sock drawer. I hid it there to try and stop it from disappearing when I was married and forgot about it.  So obviously I was never addicted to it.

Which brings me to today. The first day I have had Adderall in years. Wow! Now some people get the jitters, I remember I had that the very first time I used Adderall. Many non-Adhders claim it makes them super productive and helps them get shit done. But I don't recall this from before and it didn't happen today. I went from having all the thoughts on all the subjects all at once and being interrupted by the next random thought to being able to have a single complete thought smoothly followed by the next thought in a linear fashion. It was weird. I don't recall that before, but my kids were little and I was at home alone with 2 kids under age 5, one with autism at the time. If this happens every time I take Adderall ER, I'll keep it. If this is a one-time deal, I am glad to have had the experience of a calm mind for an afternoon.

Well Duh!

News of the Duh. http://www.msnbc.msn.com/id/42787858/

 I must say that I already knew this, trying to convince a doctor something is wrong at age One is just simply impossible, ask my Aunt!  Doctors seem to think that disorders like Autism is something that occurs after age 3, but it is not.  I know not because my Aunt told me she just knew Baby Gaby was different, but because I saw it when I ran a Home Based Daycare center.

Children with Autism or other disorders like ADHD show up early, very early, like a few weeks or months old.  My child Nicky showed signs that he was different at about 2 weeks.  While I wait for a formal diagnosis, and I have been waiting for over a year, getting help while poor is very, very difficult.  I am certain that Nicky is ADHD.  He was colic as a early as a week, you could not get him to take a nap unless he was in your arms, if by chance you got him down to his crib while asleep, hope that the door didn't creak!  The child literally drove us all nuts.  By the time he was 6 months old he decided that breastfeeding was not fast enough-just a bit impulsive at that point too!  He switched early to bottles and bit big wholes in the nipples, I have never had to replace so many bottle nipples!  He was always needing to change things, he didn't have enough toys and we did not have enough safety things.  By Nine months he was trying to put things in electrical sockets and throwing things at the mirrored wall.  We took the mirrored wall down as a safety precaution because we feared he would pound the mirror to the point of it breaking!  He could not be still for diaper changes, his older brother was often needed to sit on him so he could be changed!

Anyway it was obvious he was impulsive, by the time he was 18 months old I was certain that he would loose his virginity first.  Nicky is going to be trouble, but my biggest concern is that if I do nothing, like the school district wants to until he is in the second grade he will find himself needing to change baby diapers before he graduates.  So I say, Duh parents know something is off early!  The signs are there.

And as a child care provider of other peoples kids, you can tell when something is different.  It gets really easy to see that something is off if there is more then 2 kids the same age.  As that happened when I ran a home based child care, and his behavior or lack of it was just a red haring!  I told his parents that he seemed different then the other children and that I was concerned, but was ignored.  He is nearly 5 now and is severely autistic, something I knew when he was about 15 months old.  And yes his parents, an RN and School Teacher, were very offended and pulled him from my care, but years later apologized for doing so.  They regretted not seeking treatment earlier too.

New Nurse Practitioner, New Dose...

So yesterday I visited a new office to get my meds refilled.  I think this office will be better for me.

The climate in the office was different, it seemed a bit calmer and a lot less judgmental.  The lobby was bigger, about 4 times the size.  The office personal was further away too.  Their receptionist area was larger, maybe that made for a calmer office.  I know that when I worked at UOP and we were all on top of each other we were not happy.  When you work in close quarters it is difficult to take a breath, let alone mumble your frustration away.

I remember one of the clinicians coming out of the back to see his patient out, he was rather jolly.  He saw one of his other patients and he came out to him, sat down next to him, and shot the breeze for a few seconds, shook hands and returned to his office.  He seemed nice, I was not assigned to him though.

WHen it was my turn to meet the new Nurse Practitioner, she came out, called me a few times before I realized she was looking for me, and tried to shake my hand, except my hands were full of candy from the vending machine and mail from the P.O. Box I had just picked up.  I guess that is what ADD looks like when you get down too it.  Hands too full of random things, brain too busy to acknowledge they are being spoken too, a hand bag overflowing with planners, things that still need to be done and it looks rather messy from a distance.  That is how I met my new Practitioner.

It appears to me she is very experienced, she reminded me of an old co-worker, Stephanie.  Stephanie was overly organized, not borderline crazy, downright anal-retantive.  With Stephanie everything had to be done just right and in the right order, she knew if I missed a step and always came out to tell me in person.  That is what the nurse reminds me of.

She was annoyed to find that the other office did not send over my paper file, especially since it had been 2 weeks since they made the appointment for me.  When she opened the electronic file she was equally annoyed and disappointed.  Things that should be there were not.  Things like an actual diagnosis check sheet, patient questionnaires, blood work, and special notes justifying the use of a schedule one drug to the DEA, all missing.  Nice to know that if the DEA audited my file I probably would have lost access to treatment, probably for months as it was sorted out!

Her office was significantly larger then the offices at the other location.  It had more furniture, and if there had been a massage table instead of a desk it would not have seemed out of place.

She typed in all the things that were missing from my file.  She suggested that I try an antidepressant that one takes three times a day.  All I could think is if I forget to take the adderall at least once a week, how would I remember to take an antidepressant 3 times a day?   So she said she would keep it in her notes and see how I did with a higher dose of Adderall XR.  Odd,  I did not ask for a higher dose.  Yes, I was seeing a slight improvement in my ability to finish basic chores, and I had been able to keep a blog.  You should know this is not my first attempt at a web journal, it is probably my 5th or 6th, I usually end up not adding any post after the second or third week.

So an end to this is she gave me a written prescription for 20mg Adderall XR, a requirement to see the lab about blood work and a diagnosis in ICD-9 format of V314.01.   I had to look that up, but it is Attention-deficit disorder, with mention of hyperactivity.  I don't recall being hyper.  Unable to sit still, I fidget a lot. That is just normal for me.  Can't sit through a meeting at work without tapping a foot, snapping gum, or messing with a pen somehow.  But I guess that is how the describe hyperactive. Started new dose this about 2 hours ago.

Nextcare fiasco

So like I said yesterday my kid Nicky is sick.  He was a whole lot of fun and then he spiked a high fever of 103.6F, so I decided I would take him to see the doctor.  Bummer was my doctor was booked and Nicky was very irritable.  So I decided I would take him to NextCare Urgent Care Clinic on Northern and 101 Freeway.  I have been there before and always forget to use their Wahoo service.  Wahoo is you sign in online and wait your turn at home or office.  Sounds great!  Hooray me, I actually remembered to do something that is productive, right?

First I signed in at 3:30 in the afternoon and waited.  I did not make dinner, in part because 2 out of 3 kids were sick and because I knew if I started dinner they would call and I would either ruin dinner or miss the appointment.  So at 5:15 we went to go get McDonald's, I took the time to forward all calls to the cell phone.  I even remembered to put the phone in my bag.  Just as we were about to pull in to the drive-thru, they called. Okay. Good.

We arrive at 5:30pm, we are supposed to sign in and go right to the doctor's office.  It did not turn out quite like that.  At 6:10pm we are still waiting.  My kids are now hungry, cranky and board, they don't like watching the news that is on in the lobby or not having any toys or company.  I get up and ask, "how much longer?"  "Oh just a few more minutes there is one person ahead of you."  I take a big angry breath in and go back to my seat.

Waiting. Waiting. Waiting.  Oh, yeah we finally are taken to triage at 6:20pm.  The nurse is polite.  Only a few more minutes now.  Back in the same room I was in on Monday with my oldest AJ who is also sick.  No magazines, no toys, no eta on when the doctor will be in.  We watch Nick Toons for a half hour.  I peak my head out the door, "Could you tell me how much longer?"  The nurse asks the doctor, oh yeah you guys are next.  Back in I go.  So hungry, trying to keep 3 kids quiet and from completely distroying the room.

Danny climbs on the counter and starts taking out giant Q-tips and tounge depressors.  Nicky is now tearing up the paper liner on the cot.  AJ is spinning around in the doctor's stool.  Trying to be calm and remain in control.  We have now watched 2 episodes of The Last Air Bender and are starting something I can't pay attention to.

Now I am tired, hungry, fustrated, and suffering from low blood sugar.  Back out the door I go, demanding to know how much longer!  "I just need to start and finish this proceedure," the doctor tells the ever patient nurse.  Poor Nurse!  I admit to being frustrated, and complaining about the long ridiculous wait.  She is compassionate and apologizes.  She returns with orange juice and saltines for me and the kids after hearing we are all hungry.   She is the only person who apologizes.

We wait more.  Ah, now I know what is on it is Fairy God Parents and we are now about to start a second episode.  The doctor comes in finally!  She tells me the Quick Strep came back negative and then takes down all the same info that the triage nurse, not the nice one, took down.  Checks he lungs,  checks  his ears.  His ears have a build of disgusting wax.  She leaves the room and returns with an ear thingy to pull the wax chunk out.  Very Gross!  "It looks like he has a budding ear infection in his ear."  She writes this down in the computer.  Says she will be giving him a prescription for Amoxicillin.  All in all she was in the room less then 10 minutes.

Back to the waiting room.  Now we are waiting for the computerized records and prescription to print.  We wait.  The kids have lost their minds and are playing with the water fountain and pushing all the buttons on the soda machine, screaming and running circles around the waiting room.  Too tired to do anything about it, I wait.  I talk very loudly and obnoxiously to another mother that has been waiting just as long after also signing in with Wahoo.  A guy in the lobby is amused.  His wife asks the receptionist to turn off Doctor Oz.  Receptionist searches for the remote.  We are still waiting for our papers.  No idea what time it is when we finally leave, but we leave without our instructions because the receptionist can not get them to print.

Kids Sick again.

What is it with this years cold and flu season?  Is is me or are your kids getting sick again and again?  It seems like it at my house.  3 kids and 2 are definitely sick.  One a mild flu?  The other stomach flu or is it turning into Strep Throat?  The school sent home another letter warning us that a kid has contracted strep.

Nicky and Danny cuddle while sick

Disappointed that I just deep cleaned the kids bedroom carpet.  I think Nicky is destined to throw up on the carpet and not in the bathroom.  Hey, he is 4.  Also disappointed about cleaning the couch.  I go weeks without having anything spilled on the couch and decide to have it steamed, 24 hours later, kids yogurt hits the seat.    

On the brighter side I finally finished catching up the checkbook.  I now know how much money I can't spend because it is not there.  Disappointing.  Now I  can do all the paper chores, like paying for the Cooking Club subscription and I am not sure, shredding stuff?  Still waiting for husbands third W-2 so we can file.

Adderall

Started Adderall yesterday.  

It has been a very long road getting to ADD treatment.  It may seem weird to someone from the outside that a nearly 30 year old woman was just diagnosed as ADD.  You may ask why was this not caught while she was in school or mentioned by a manager once she grew up.  If I had to guess I would say it is because she is a girl.  For some reason ADD is considered a boys disorder, and the facts are that girls have many of the same symptoms, in fact nearly all the same symptoms, but seem to lack the hyperactivity that is stereotyped by teachers and drug manufacturers.  

Did I have trouble staying focused when I was a kid?  Well yes, but I was a "good student".  I daydreamed an awful lot while in class, went to the bathroom more then most, wandered the halls often, and was always the center of attention with my friends.  I could not answer questions from the teacher when called upon and often had trouble "hearing" what was said.  I still have that problem.  You can be talking right in front of me, I can be looking at you and then I am just not hearing what you are saying.  

For the last 10 years I have been searching for an answer about why I was like that.  No one had an answer.  No medical doctor(3), OBGYN(4), counselor(5), psychiatrist(2), lots of lab tests to rule out metabolism issues, diabetes, cancer, thyroid and many mental illness evaluations.  I have tried 4 or 5 anti-depressants, 2 maybe 3 anxiety disorder medications, diet changes, job changes, vitamins and read lots of self help books, (that might be an overstatement, it was more like read a few pages before I got bored).

I took one yesterday, 10 mg Extended release.  At first it made me feel like I had heartburn, then I felt a quiet calmness.  Weird for a drug that makes normal people freak out, I mean it is the same active drug that is in Methamphetamine, and those druggies are weird, twitchy, and can't sit still.  

I took one today and no heartburn, just the quiet calmness.  So here I am