October 31, 2003
Dear Aunt Wanda,
It's now been well over 6 months since Paul and I saw you in Arizona before you shipped your possessions and yourself to Poland. Although I haven't heard anything from you, I do truly hope that you have been well, enjoying your time with friends and family, and that the quieter atmosphere in Poland is still meeting with your pleasure. In regards to the latter, the participation by the Polish government in the activities in Iraq in support of the US, would lead me to think that you do not find this to be at all approvable behavior. More than likely it is only so that certain Polish government officials can curry favor in Washington DC circles - government practices don't change much at all, no matter the language spoken, do they?
I'm writing to you now after a very different month for me - and Paul. We had attended the International Association of Bio-Gerontologists 10th Congress at Cambridge University in the UK from 9/19 till 9/23. It was a very intense mentally stimulating series of presentations on the Strategies for Anti-Aging from Friday afternoon till Monday evening with very little rest. I had a week's worth of poor sleep before our flight - construction next door and a sinus cold - and so was sleep deprived by the time we arrived Friday about 1:00pm after a 4 hour drive from Mary and Graham's in Blackburn, northwest of Manchester into which we'd flown the previous morning. Despite taking a couple hours away for a nap starting on Sunday afternoon, the poor sleep I continued to get during the night at the Conference resulted in me slipping into a state of mania on Monday afternoon. (I think I've described some at least of the previous episodes I've experienced, especially the one in 1990 within days of Dad's funeral in Florida.)
My mind just would not shut off and I spent much of nighttime hours thinking those first couple of days, although trying to physically relax. We partook of the after-Conference relaxation - Punting on the Cam, a long established boating experience that really was a lot of fun. In fact we joined in the longer punting trip upriver over a mile to a country pub, enjoying lunch and conversation, some even a bit heated. (I told a National Institute of Health researcher who dismissed Paul's views on supplement value that he was not just talking to some uneducated layman; I was not at all timid - mania tends to really accentuate that nature of mine.)
Well, despite a large glass of red wine while eating some supper at another pub in Cambridge itself with the remaining attendees and the organizer - who'd been present during my stand-tall announcement above, I did not sleep at all during the 3.5 hour drive return to Mary's very late Tuesday night. It was in fact 2:05am when we arrived back and Mary, who Paul had phoned that we be late, opened the door for us. Paul confirmed that I didn't sleep at all in the 4.5 hours till their alarm-TV woke Mary and Graham upstairs; he said I mostly talked, keeping him from sleeping well himself. I could feel that I was losing control of my thinking processes and wished terribly to be able to sleep. Paul attempted to obtain certain herbs and/or neutraceuticals in the local health food store, but the ones likely to work were not legally available - kava, being the one we have here. (I have a prescription for Dalmane, a well known hypnotic, in AZ, which I've made use of only a couple of times over 4 years ago when sleep was difficult.) Despite loading me up with what non-prescription items he had purchased, I didn't sleep again on Wednesday night and instead spent much of the time between the downstairs bathroom and the darkened dining room where Paul and I had an inflatable mattress, which I'd ordered specifically for our stay. I was reading an Antonik family history put together by my brother Chris many years before as a college project, but which I'd never seen. In my mind I was also solving a problem, part of the Nth Dimensional Puzzle, an ongoing project during all my manias of the past in which I "knew" but sought a "proof" for the numerous inter-relationships between all entities in the universe.
So come Thursday morning 9/25, Paul made the decision that he could not take the chance that I would sleep somehow on my own with what he could assemble there in Blackburn. Instead he arranged for an early return flight - we were scheduled to return the following Tuesday. The only seats available before the next Monday was that very afternoon; so with Mary and Graham's help he packed us up and got me ready - I was considerably puzzled, not understanding the need for our early departure. In fact, I was quite panicky by the time we reached Manchester Airport, thinking that some harm was going to befall us. But I remembered Mary's very pointed assurance to me that I'd be OK and Paul's calm and specific instructions and followed them explicitly. Still come time for the flight take-off and I know I was frightened and probably looked so to the woman who had been sitting next to me but sought a seat elsewhere. This provided me with enough room to lie down and try to stay calm with Paul assuring me as he would a terrified child. Sometime after midway, the flight attendants were able to render assistance by way of a sedative that the airline's resident physician ordered after conferring with a physician passenger who spoke with Paul and me. It provided me with much needed sleep after our arrival in Toronto during the taxi-ride home and for another 4 hours. Paul gave me 4, 100mg capsules of Lithium Carbonate from my stock, the main medication I'd been on for my bipolar disorder (manic-depression) much of the time since diagnosis back in 1990. I'd very gradually weaned myself off of it completely about 9 months previously but still had about 30 capsules for an "emergency". He began using 3 capsules a day to try to at least keep me from getting worse and help reduce the mental stimulation from the overload status it had been in for days.
My sleep for the next few days was sporadic, and my memory of occurrences are vague. It was only on the following Monday that Paul was able to arrange for an office visit to the general practitioner that he occasionally used, and who had seen me the previous year. I remember the visit, including the walk to the office from our parking place. The doctor would not prescribe Dalmane or any sedative; he was insistent that we would have to see a psychiatrist. He actually looked very uncomfortable to me, taking my blood pressure, telling me when I asked what it was (~130/80 as I remember, somewhat high for me). Paul was very annoyed but I thought it better to just agree to the psychiatrist than to get into an argument about either this physician's inadequacy or possibly Canadian psychiatric referral practices.
I'm estimating it was another 2 or 3 days (Paul tells me now it was Thursday 10/2) before we were able to see the psychiatrist who had his office at St. Michael's Hospital in downtown Toronto. I remember being in the hospital, though I don't recall how we got there, or later how we got home. The doctor appeared somewhat agitated to me, and Paul told me later when I brought up this observation, that it was probably because he hadn't seen a patient in such a manic state outside of an in-hospital setting; and Paul was adamant that I not be admitted to a hospital. This doctor too would not prescribe a sedative or hypnotic but instead gave prescriptions for more Lithium carbonate, and 2 additional drugs: olanzapine, an anti-psychotic, and clonazepam, used for treatment of panic disorders and seizures. It was not until well into the following week, after another visit and several rearrangements of the drugs following Paul's considerable Internet reading on bipolar disorder, mania, and the drugs I was prescribed, that I finally started to sleep in any reasonable quantity. I had in the meantime been very difficult to handle, not purposefully aggressive to myself or others, but full of ways to just be "busy" sufficiently to make a disorder of the apartment and even cause Paul distress, for instance by putting up considerable fuss in returning to the apartment; once a concerned passerby thought I was the object of abuse and was trying to call someone on his cell phone despite Paul's assurance. Thankfully, Paul got me into the apartment without the arrival of the police and I only sustained a bit of a scrape.
It all seems like a foggy dream of which my recall is only in fragments. In the past week, I've gone through several days of listlessness after almost 10 days of what seemed like fairly normal behavior though I did feel a bit anxious. Now I'm just somewhat fatigued near the end of the day, but no longer manic, anxious, sleep deprived, or dejected. I do have some concerns when I think back at this episode - the most severe in the psychotic portion of the mania that I recall; it's somewhat disturbing to contemplate that one has experienced a period when one's mind was not under control. I don't like that it happened at all and am even angry to a certain degree that I wasn't given a prescription for Dalmane or equivalent when Paul and I first asked. I should have been able to get to sleep, had I had it, before the end of September, instead of more than a week later. And I wonder how much damage did my brain sustain by this psychotic period; Paul thinks it unlikely that any occurred, but how can either of us know for sure. What we do know is that we will have an emergency medication collection for me should sleep be a problem again; this we will take everywhere with us. I have an appointment for mid-December with my semi-retired psychiatrist in AZ and will get copies of my records, which we will also maintain along with copies from the psychiatrist here. With doctors controlling one's access to medications, all one can do legally is have all his/her medical records in order to minimize difficulty in obtaining services and medications.
Since about October 20, I have been able to be of assistance to Paul with the website and our hard-to-get supplement business. Many people have been very profuse in their well-wishing and I have had plenty of opportunity online to explain what it was like to be manic - a new experience for many I'm sure to hear about first hand. It was a different experience for me too - Paul's excellent care, loving but firm, made all the difference in the world. Instead of being simply taken to the ER and presented as a person out of control and unable to sleep, I was carefully protected from harm and lovingly cuddled while Paul read all he could and used the medications at hand to assist my brain in "righting" itself. He described the night I finally slept soundly as "a fever breaking"; my mind was then somehow unfettered. It was from that point on that I began to get better, despite one more worse night when he gave me the originally larger amounts of medication prescribed by the psychiatrist.
So as I wrote above, everything is so much better - almost like most of October never occurred. Tomorrow morning, November 1, we are off on a long day's drive to the Portland Maine area to see Uncle Kaizu who lives with his daughter JoAnne and her husband. I had the desire to see him, not wanting to hear sometime soon that he'd died, so I obtained her phone number through Mary and called JoAnne. She admitted to somehow not being surprised to hear from me but also to not having any reason to expect a phone call; maybe she's just the real calm unsurprised type. It looks good for seeing both of her brothers, Tom (the artist) and Michael (the merchant mariner) also on Sunday. Both Paul and I are looking forward to the drive and the visits. The weather reports are for mild temperatures - good.
I'm going to make double-use of this letter to you by using it as a Kitty Reflects on MoreLife entry. If you ever get someone to surf to http://morelife.org/personal/kittyreflects/ you'll find it among the latest entries. You can also look at your photo: http://morelife.org/personal/photos2003/photos_26.html.
Love and hugs,
**Kitty & --Paul