Here, I want to give you an update on the medication change that took place in April, a year to the day Dr. Altman instituted the cross-titer from the Stelazine to the Geodon. As you may remember, I had increasing anxiety and he felt it was time for a switch. For five months now, I've been solely on the Geodon. This isn't a recommendation for a particular drug. The Stelazine worked fine for 20 years. And some people don't do well on the Geodon, for various reasons. My intent is to show you that there is hope if you stay in treatment, and tweak your options as necessary. You shouldn't have to live with disabling symptoms if you don't have to. Ideally, you will find the doctor who executes your drug doses with a sure hand. He or she will be well-versed in the latest routines, and you will be self-aware and able to talk honestly with him or her about your symptoms and how the schizophrenia plays out in your own life.
In the last blog entry I wrote, I suggested that patience is the number-one trait to develop as you begin or continue to work on goals, and make changes in your recovery. I'll review now how this has paid off in my own life. Within three days of Dr. Altman's cross-titer, I noticed a positive effect. Yet from April 2007 - when he began to lower the Stelazine and raise the Geodon - until April 2008, I had to live with a side effect: the knockout punch of the two drugs combined caused me to fall asleep at work every day after lunch. My head dipped in front of me as I sat on the leatherette couch in the kitchen, suddenly dead at one o'clock in the afternoon.
The only solution was to let things be until I was solely on the Geodon. I don't believe in switching meds every time you feel like results aren't happening fast enough. Robin Cunningham last year suggested that once I had stopped the Stelazine and only took the Geodon, I would continue to see improvements long after starting the new drug. He was right.
It's been five months since April and ever since then I've seen a shift in my perceptions. I told Dr. Altman on Thursday at our last meeting that the things that used to upset me no longer do. This good fortune I hinted at in my blog, "Measuring Recovery Gains." When Jasmine, the library science student I mentored gave me the coffee mug, I knew I was a good person and she didn't think I was hateful.
Even as I write this entry, I can tell you without a doubt that it continues to get better three weeks later. Last week I had to go to a LOFT store to return a blouse that didn't fit, and because I wanted to head straight to the food market after that, I purposely left my goals binder at home. So I had nothing to read on the train and nothing to distract me from the worry that had crept up whenever I traveled on the subway. Something happened: I did okay. My thoughts were dim and I paid no attention to them; they had no power to affect what I thought of myself. I knew that I was just a stranger on the train, and the other passengers barely noticed me because they were lost in their own world.
It was a good day: sunny, warm and so I bought a fruit-and-cheese platter from Starbuck's to take to the Promenade, where I sat on a bench looking out at the harbor. When the person on my left got up, I turned to see a guy on the other side of the bench, who then moved farther away. A year ago I would've though I caused him to do that. Now I just continued to eat my lunch, soaking up the sun. In my newly-lucid thinking, I realized that my old belief that I could influence someone's behavior or control what he thought of me was symptomatic of the illness, a minor delusional thing.
Not that it's always going to be calm seas. This Friday I arrived early to Fort Greene, so I dipped into Tillie's before meeting Maya to drive to Queens for the writing workshop. Maybe because I was bored, and had nothing to do, leafing through the Onion wasn't enough to distract me from the worry. I took out the scene I was going to present for a critique and marked it up. Even that wasn't enough to drown out the unease. As best I could, I exited gracefully to meet Maya, who drove up in her car and we headed off.
A week ago when I met with Dr. Altman, I asked him to clarify what he meant by "total symptom relief" as the only acceptable treatment outcome. He said that it would be not having any symptoms. I think about this now. I'm reminded of the concept of dialectic thinking, where things aren't "either/or," but "and," such as "I am tired and awake." Or, in this case, "I have schizophrenia and I am well."
In April, 1992 my first psychiatrist instituted a drug holiday. By that July, I had relapsed and had to be re-hospitalized to get stabilized on the Stelazine again. Now you know: if it could take me only three months to decompensate, and I had what seemed like everything going for me, imagine how it could be for someone else. It's like playing Russian Roulette with your recovery, and the more psychotic episodes you have, the harder it is to bounce back. If you think this is just a statement I'm parroting that isn't true, I'll tell you that I used to be friends with a woman who told me that indeed, it was harder for her to return to her prior level after having numerous setbacks.
Not all drugs relieve all symptoms at all times.
I'm going to push for peace of mind, anyway.
Update to Geodon News: Today [Sunday] I took the train home from the shopping center, and did fine.
Published On: August 26, 2008