Wednesday, October 8, 2008

Take a pill

I've never "taken a pill".

Like most family histories, there's some psychiatric disease in mine. Nothing real exciting, but some depression, some alcoholism. I've never had a tendency toward either.

When Henry got sick, my husband and I made a pact that if either of us thought the other needed "a pill" we would agree without arguing. We figured we needed to be able to lean on each other as much as possible.

I never got there. I guess I sort of hit battle mode; there was a job to do and I was going to do it. The job could have been staying up all night with Henry, taking care of the girls, fitting in some work time, trying to keep the house running, making it until Henry was back out of the hospital. Life was chopped up into small tasks. I actually think medical school and residency helped me with it in that I learned then that you can do anything for a period of time. Keep working hard and soon it will be over.

I knew then that I'd have more trouble in remission. I was right. I'm not doing great. I mean, I'm holding it together, working, doing my home stuff, my kid stuff. I'm even doing some "me" stuff, and being able to enjoy it. But I gotta tell you, this is tough.

I keep wondering if a pill would help. I don't meet any of the criteria for a depressive or anxiety disorder. I think that what I'm experiencing is probably normal, expected. I feel good a lot of the time, but I'm very labile. If he cries a certain way, I'm tossed back into things that happened in the hospital. When he refuses to eat, I sit and silently spin on whether that means it's back. When he says he's got a headache, it's not good. When I think about our next MRI, it's not good.

But just how good can I expect to feel? Wouldn't anyone do this? Is it possible that I am coping optimally, it just can't get any better under this circumstance?

Ugh. Bummer post. Lest you all worry, I am seeing a counselor next week to discuss this very question. Best not to try to be your own doctor.


Eric, AKA The Pragmatic Caregiver said...

Caring for a seriously ill someone-you-love is extremely stressful, and being on tenterhooks after the acute phase is over has pretty much always been part of my life.

I cry at the drop of a hat, when I hang out with friends I tend to party like an undergrad and when I'm not at mom's place, I tend to sleep a little too much or at strange hours.

All that said, I would start to worry when my angst and general worry started to affect my ability to enjoy the good days - and there will surely be good days.

If you won't tell anyone I have a half an Ativan *and* a highball on the plane home from mom's as a reward for "services rendered", I promise not to think you're less of an amazing mother and physician for having some anxiety and blues through such a terrifying time.

And if all else fails, don't put the vodka in the pie crust, put it in the baker. ;0)


Lynn said...

I've been reading for a little while, but I wanted to comment on this post. My 6-year-old was diagnosed with a grapefruit-sized arachnoid cyst when he was two and had about a dozen brain surgeries (cyst fenestrations and shunt revisions) over the next three years. I always found that I coped really well at the times leading up to surgeries and throughout the hospitalizations, but then tanked when we were home and everyone else thought we were "back to normal."

At a time when I thought things were going well with Paul and I was coping great, my internist suggested Zoloft. (He did not seem convinced by my explanation of how great things were, probably because I had burst into tears while trying to convince him.) "Obviously you have a lot of difficult stuff to deal with, and if dealing can be easier with meds, why not? Why should it be harder?" For me, it made a world of difference--and remember, I thought I'd been doing well before. It was just so much easier to relax. I hadn't realized how incredibly tense I was all the time. L

Rob said...

Thanks for the candor. It would surprise me (and perhaps worry me) if this did not happen. When you have something to focus on, you tend to ignore the pain. But pain is pain and it is real.

The best advice I have heard is that there is no right way to act in these circumstances. What is best for one person is not necessarily best for another. This means that you should not compare yourself to others in how you are reacting. You are who you are.

And many of us are glad you are.

Suzanne said...

In my case, my daughters remission has been the hardest part of the journey. I never thought HOPE could be so frightening. Like you and Lynn above, I coped fairly well during the diagnosis and treatment phase, I was not prepared for the heavy emotions of remission. I thought after what we had been through, nothing could bring me down. Unfortunately in my case, I think I buried my feelings, trying to help her just survive. Those out of control feelings just seem to bubble up every so often. Always at the oddest time, driving to pick her up from a school activity, making dinner.
I also used Zoloft and It made a huge difference for me, as well as a good therapist who helped me out quite a bit by telling me that "Duh your whole world was rattled, You sat on ledge for months never knowing when you would fall. I would be more worried about you if you were not admitting to struggling a little"

That was magic to me. I am normal, it is OK to break down and deal with the stuffed away feelings, I will be OK, I will be better prepared to parent my child no matter what her future holds.

I wish you the best.

Anonymous said...

Dr. S., you have wonderful readers and I thank them on your behalf for their input. I'm proud of you for sharing and for your insight and for seeing a counselor to talk more. Remember, you don't have only one chance to decide what's right, you get to decide all along. If you feel like counseling is right at one point, try it. If you feel like it's not, don't. If you want to steal the pie crust's moisture, go ahead, but not too often. And if you feel like a daily pill like Zoloft might be worth trying, you can--and just because you might try it doesn't mean you're deciding to take it forever. You can make up your mind about whether to keep taking it every single time you're due for the next dose. It's always up to you.

Laura said...

I am so sorry you feel this way. But it sounds to me that it is very normal and expected. Maybe even more so in your profession. I think that if I had a sick child I would feel the same way. But I hope that you are able to find some peace soon. And I'm glad to hear that you're going to a counselor. Who among us couldn't use that? Good luck, and I wish you peace.

Anonymous said...

Dr. Smak, We all do what is right for us. During my daughter's illness, I saw both a counselor and took a wonderful drug. It made a huge difference, and I have advocated mental health since. I promised myself that I never wanted to feel that way again.
I don't take any meds now, but would not hesitate to get a prescription again.
take care

Anonymous said...

I believe you are in a grieving mode. Suffering over the loss of cancer. It was so personal and so intimate, and even though it was your mortal enemy, it was a formidable adversary. It was a tough battle but you won and Henry lives. Is it any wonder you are sad, most of us couldn't even fight the fight.

THAT GIRL said...

From the sounds of your previous comments, looks like you are not alone in this. My sister-in-law's son was dx with post-tramatic stress months after her son recovered from ADEM (almost passed away from it at three years old). Even now, that he's surving symptom free in kindergarten, every time he gets sick, or has a pain... she crumples.

Sometimes all we can do is just surive... and the normal every day living is the hard part.

thecountrydocreport said...

If you could step outside yourself and see yourself with the same perspective you have with your patients I think you'll have your answer. I feel like I can almost see the serotonin be depleted with each blog post. Remember this is a marathon and not a sprint. Pace yourself. Take care of yourself.

JeanMac said...

Sending love and a hug your way.I wonder if the remission is almost an emotional "let down" - waiting for the next news?
So far in our journey with Alzheimer's, I haven't used meds but am about ready for some help in that dept. as he slowly fades.No comparison to what you are living with - I've been amazed at your courage and strength - for both of you.

webhill said...

Sounds like normal to me, but I'm no expert there. I wonder if knitting more would help. I noticed today, as I was sitting outside the mammography center (I arrived early) knitting in my car, the woman in the car next to me was fondling some rosary beads. We both had similar hand-activity. We were both trying to calm down, I'm sure.

Anyway. Hang in there.

rlbates said...

Just checking in to let you know you remain in my thoughts and prayers. Take care.

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