The drug you can never quit

My dear friend D read about my nausea when I ran out of Effexor, and sent me this helpful link to Crazy Meds. CM lists: Effexor's Cons: For many people Effexor XR has the absolute worst discontinuation syndrome of an antidepressant. Effexor (venlafaxine hydrochloride) is a medication people utterly loathe to have taken. It is not uncommon for someone to fire doctors during or immediately after they quit taking Effexor XR(venlafaxine hydrochloride).


I'm trying to remember why I switched from Cymbalta. Oh, well helpful Crazy Meds is reassuring on this point: It appears as if the discontinuation syndrome for Cymbalta (duloxetine hydrochloride) is just as harsh as that of Effexor (venlafaxine) for many people. In case you're wondering what Cymbalta is for, Crazy Meds tells you that, too, in technical language: Major Depressive Disorder (i.e. feeling depressed.as.fuck or like Whale Shit at the Bottom of the Ocean) - approved 4 August, 2004.
Diabetic Peripheral Neuropathic Pain - approved 7 September 2004.

And if you happen to type the URL incorrectly, you get this very technical notice: The file you were looking for is just an illusion created by the devil.

As are most things.

Son of Meltdown

One thing about cancer is if 10 days after surgery you are weepy and feeling sorry for yourself, everyone says, Yes, of course, you just had a mastectomy; you're having a meltdown, it's only natural. And if you feel that way when you're going through treatment, people say, Oh yes, of course, you're going through treatment. But if you have a few days of terrible headaches and crying, more than weepy but less than jags, and feel ever so sorry for yourself, you can't say to people, I'm having a meltdown, of course, because I had breast cancer, OK, chemo ended in July 2007, and I do have cancer still, that darn polycythemia vera, blood cancer. Because the timing is wrong. Really, haven't you gotten over cancer yet?

And so when your personal trainer (Personal trainer! What privilege!) is sarcastic; when she is once again incredulous that you can't line up your toes by looking in the mirror and have to look down at your feet; when you can't remember which way to move after that squat in which you must keep your head up, you must keep your back straight, your hips back and what is the purpose of this anyway; isn't there something less complicated you can do in order to stretch whatever muscle you're supposed to be stretching because no muscle is aching yet as it should be becuase you aren't angling the squat right and because even though a second grader would have learned this by now--large side step, squat up, squeeze, step to the other side--it all stymies you. You can't let the trainer see you cry. She's upset herself because the lock in her apartment malfunctioned and she had to wait for the repair guy. It does not do to be an adult in this world and cry in the gym for no reason.

But there is never no reason. There are many reasons: You did not sleep enough, you returned to sea level from the mile-high city--why not blame it on altitude, why not on the stars instead of ourselves, Brutus?--where you had headaches and hay fever and terrible heartburn and had to throw up just a little bit. B thought it was because of your oral chemo, throwing up was normal, but that wasn't it. It had to have been the dark chocolate you bought to lure buyers to your table where you were signing books, or would have been signing books had they not sold out. You took orders then.

But that was all the day before yesterday and closer in time, Y has written imperious emails and during the squats and leg movements (not jerky, smooth, squeeze at the end) you think of retorts: You must be so unhappy. You must really feel powerless or else you wouldn't try to control me. Why don't you at least pretend that you believe everyone is equal? But you must not engage. And haven't you been imperious with Y? But yeah, he started it, really Mom really.


You think if, if only you had a brain tumor there would be a reason for this--this head pain, this heart pain. Horrified. You don't want brain cancer but you want a reason--a socially-acceptable reason--and yeah, it could be medically related: you are sick, you are disordered, you have general anxiety disorder, a basket overlarge diagnosis, everyone's got it.

You were weepy and you were running out of potion, red-capsuled Effexor, in that mile-high city. You took half a dose yesterday, your last pill and none this morning. You were out, flat out.
***
And then you get more Effexor and you sleep eleven hours and the next day you are Good As New. You are yourself again. Though anyone could argue that the unmedicated you is the unmediated you, the real you. Without chemical additives.

{Effexor, hero of the day}
To read about Meltdown I, click here.

Toys R on Us & the Bad Oncologist

Monday I met with my friend C from the Bay Area, in town to give a lecture and to celebrate his father's 80th birthday. After being an adjunct lecturer and a freelance editor for many years, he's finally gotten a job as chair of liberal studies in a university. He is an inspiration to us all. He's considered full time but just has to work 30 hours a week. That is truly inspirational. All this is an answer to the question: What can you do with a Ph.D. in English?


We had coffee and then he went with me to Tom Thumb Hobby & Crafts in Evanston, because I wanted to look at outdoor furniture to put on my head. I'm working on a proposal for an art installation called Chemo/Lawn and part of it will be made up of pictures of such things on my lawn-like head. I bought two miniature trees, a swing set, slide, see-saw and picket fence. I don't know how I'll get the fence and trees to stay up. I sort of jokingly/seriously said I'd use chewing gum. The sales clerk said that it doesn't come off. I said, Peanut butter is supposed to work. And he said, On the Simpsons, they tried peanut butter and oil and nothing worked. I said, That's a cartoon!


How can people get household hints from cartoons? I mean, it's one thing to get political news from the Daily Show, but at least Jon Stewart is a real person. Though Jon Stewart isn't his real name.


Now on to the Bad Oncologist. As a scientist deciding what potions to give me, he was probably good. Or excellent. Let's say he was excellent. But as a person, not so good. My psychiatrist, the Effusive Shrink, had told me early on that some of my anti-despair medicines would mix badly with Tamoxifen. I mentioned this to the first oncologist while I was in the middle of chemo and he waved me off, saying there was plenty of time yet. The Effusive Shrink had to call him twice before he called her back. Flash forward to the Girl Oncologist, who made me wait while she looked up drug interactions. She found one, with Cymbalta. She said she'd talk to the Effusive Shrink about substituting Effexor. I met with the Effusive Shrink today who said that another anti-nihilism drug that I take, Wellbutrin, also mixes badly with Tamoxifen. Our plan is to taper off the Cymbalta and start slowly on the Effexor. Then we'll substitute something else for the Wellbutrin. In the meantime, I don't want to start Tamoxifen because then I won't know whether any side effects I have are from the Effexor or the Tamoxifen. But see, if the Bad Oncologist hadn't waved me off, we could have started this back in May. Though we were also waiting for the results of my genetic testing. Or rather, I was thinking about genetic testing then, though my surgeon had said it wasn't necessary, and I finally got the testing in July. If I had the BRCA gene mutation, I'd probably get my remaining ovary removed, and then I'd definitely be in menopause and I probably wouldn't be taking Tamoxifen. So I guess the oncologist was right to wait.

How disappointing to realize that there's no one to blame.