Alternative title: “I’ve heard people say their bodies start to fall apart in their 40s, but this is a special level of ridiculousness only I could achieve.”
I am mentally trying to batten down the hatches for the next month or two. Here’s what’s up:
1. Depression meds 💊
I was long long ago diagnosed with depression and anxiety and have been taking various antidepressants for, wow, about 21 years I think. I have a great psychiatrist, and over time we have established an effective pairing of meds: Effexor and Cymbalta. Each works for about 2 years then calls it quits abruptly and stops working. Lord only knows why they do that but it’s not uncommon. My first red flag is skyrocketing anxiety and when that happens I know it’s time to switch to the other med. Its a pattern I just live with, and I’m grateful I have two meds that work for me and that I can switch off between them.
Well, 3 weeks ago I hit the 2 year mark on Effexor and like damn clockwork my anxiety levels shot through the roof this week for no good reason. It’s time to switch again. Antidepressants often cause withdrawal symptoms if you stop taking them (increased anxiety, dizziness, flu-like symptoms are mine) so we titrate off one med and onto the other to minimize withdrawal symptoms.
So, the changeover from one med to another is not fun. We usually do a 4 week changeover process until I’m on the full dose of Cymbalta, and the Effexor will stop working completely before the Cymbalta kicks in, plus I will have some minor withdrawal symptoms from the Effexor dose going down. Great timing for my Effexor to stop working (see below).
But honestly, I love my meds. I’m so grateful for them. Anyone who feels the need to post a “nature, life’s antidepressant” meme as a comment should refrain. I suffered from anxiety and depression through my entire childhood, and having drugs that work and can give me a normal good life is a miracle. Thank you Pharma.
2. Ankle surgery 🔪
I’ve mentioned before that I have ankle surgery coming up. It’s on April 5th. I tore a tendon in my ankle nearly entirely through, and because of that it’s causing me a great deal of pain. The surgeon will take a tendon from the top of my foot where there are two tendons that do duplicative work, move it to my ankle, and break my heel bone and screw it back into place a little further over to support the new tendon better. Ick.
I’ll be on crutches for 3 weeks (at least) and then in a boot for 6 more weeks (at least). It’s estimated to be a full 6 month recovery period. I’ll get lots of PT in that time as well. In the end though, I should be able to walk distances again, and without a limp, and I can hardly wait for that time.
3. Ear tubes
I’m 46 years old last time I counted. And a couple of years ago my left ear started filling with fluid to the point where I can barely hear out of it. My right ear has fluid in it too but not to the same extent.
This is, apparently, something that’s pretty rare. Each MD I’ve talked to has said something like “Wow. Adults often tell me they feel like they have fluid in their ears but they seldom actually do. But you do. You have A LOT of fluid in there.” Heh, lucky me?
Thankfully it’s an easy fix. I need tubes in my ears like I were 6 years old and not 46. They make special “permanent” tubes for adults that have to be installed under anesthesia because apparently it hurts like the dickens. I’m having it done April 21st.
My timing? It could be better.
I first started pursuing the ear issues by requesting an ENT referral about 8 months ago. The first ENT I saw told me the following: a) I have fluid in my ears because I’m fat and I should lose weight to fix the problem, b) the only thing he could do is install tubes but they fall out and create scar tissue so he doesn’t recommend them for adults (he apparently doesn’t know about the type of tubes that is used on adults???) and c) he could do a procedure that involves inserting a balloon in my Eustachian tube and inflating it so the tube gets enlarged and drains better and he’s willing to try it on me but he’s never done it before.
I skedaddled out of his office, made a new appointment with my amazeballs GP, and requested a new referral to someone competent. He sent me to someone excellent, who was flabbergasted at everything the other ENT had said, set me up for a hearing test and a surgery date ASAP. It just happens that all the waiting for appointments has put my ear surgery in the same month as my ankle surgery. But meh, may as well get it all over with at once is my feeling!
4. Psoriatic Arthritis and Immunosuppressants 💉
I saw my beloved rheumatology NP on Tuesday and talked through my pain levels and intestinal issues and we decided sulfasalazine isn’t cutting it for me, and we need to switch to a biological to control my psoriatic arthritis. She recommended Humira and I’m totally here for it. I’m so glad she listens and believes me. My blood work (which involved umpteen vials and enough blood to feed a vampire family for a week) backed up what I told her too, though she didn’t have the results till a day after the appointment: my inflammation levels are creeping up and up, despite being on sulfasalazine.
But because of my surgeries I have to be off all immunosuppressants for a month. I’ve already quit sulfasalazine and am already feeling the effects. I don’t start Humira injections until toward the end of April once my surgeries are done. Joint pain, and gut pain, and intestinal uproar shall be at max levels by the time Humira kicks in, which will be a while after I first start it. It can take up to 3 months to reach max efficacy. This shall be a fun little pain and poop ride.
Incidentally, I can’t take any of my usual NSAID drugs while surgery is coming up either. No Meloxicam, and not even Advil. So Tylenol is my only friend at the moment. It’s efficacy is… limited.
5. It’s foster care
Sprout’s new case worker visits next week and Sprout has a permanency hearing at the end of April. Between those two things we should be getting a feel for whether adoption track is still the plan, or whether there will be a change. There’s some family stuff going on in her family that I can’t write about here because it’s confidential to say the least, but it’s stressful. It’s foster care. It’s what I expect.
What a list! When I put it all together like above, no wonder I feel overwhelmed lately! People keep asking me when I’m going back to work and the only answer I can give is: not until my ankle is better and Humira kicks in. It’s the only answer I’ve got right now. After that, we shall see.
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