Thursday, August 21, 2014

A More Proactive and Thoughtful Thomas

A somewhat perplexing thing happened at Thomas' meds appointment on Thursday. When it was my turn to come in, I talked about how good Thomas has been doing since the clozaril increase. All of the delusional thinking and work-related depression had just about disappeared. But in the car on the way up to Dr. N.'s I asked Thomas again (we had discussed this a lot lately) if he wanted to take another antidepressant. He readily agreed that he did and we went back to listening to music.

When the session was wrapping up, I was asked if I had anything else to say and since Thomas forgets things, I brought up a couple of things including the anti-depressant. Dr. N. asked Thomas if he wanted to try out a new one and Thomas said yes. So, Dr. N. rattled off a couple of names of meds one of which I didn't recognize. The option both Thomas and I recognized was Cymbalta and Dr. N. was choosing it because it had energizing properties. We sat in that room and batted around thoughts about deciding to go on another anti-depressant (Thomas is already on Wellbutrin). Here are the issues.

-Adding more Wellbutrin is known to cause more paranoia so that's probably not an option

-Adding Cymbalta seems like a good plan but the "energizing properties" worried me a bit because Thomas is finally getting decent sleep for the first time since his clozaril was lowered a few weeks ago and I was concerned that it would interrupt his sleep.

--If we're going to add Cymbalta then do we take the Wellbutrin away immediately or do we get the Cymbalta rolling pretty good and then remove the Wellbutrin?

--If we add the Cymbalta and try to remove the Wellbutrin and Thomas gets more depressed then do we keep both of them in the mix?

--If we do decide to keep them in the mix then that means that Thomas will be on 5 medications and we all agree that seems like a lot of meds to be on. Then again, if it takes 5 meds to keep Thomas stable then perhaps 5 meds are what we should stick with.

There were so many thoughts and questions and finally Dr. N. dumped it in Thomas' lap. He asked Thomas what he thought and he seemed really unsure. I think all of our debating scared him. So, Dr. N. asked him if he wanted to wait to try them and read about the Cymbalta first and shock of all shocks, because this has NEVER happened before, Thomas said that he did, indeed, want to read about it first and then make his decision.

Huh.

Okay.....

It's not that I don't think he should do exactly what he's choosing to do, it's just that he's actually choosing to be so proactive. To me, this is a good sign.

I think.

Well, I'm going to choose to see it that way.

It's funny how as a caregiver of someone living with this illness your brain gets used to taking something seemingly small and running with it in 20 different directions. One of my thoughts was, is he wanting to read about it first to make sure it doesn't poison him? I know, I'm sounding like a crazy person because what normal person would go to that place (or the many others that I went to) but this is what I'm talking about. Thomas' mind is a labyrinth and each turn of a corner in it, from the outside looking in, is a strange journey and after a while my mind gets used to that and proceeds to concoct all sorts of scenarios.

At any rate, when all is said and done, if things are exactly what they appear to be, then I am thrilled that Thomas is being so proactive about choosing and reading about his meds. In the past I have handed him the information that the pharmacy gives with each of his pills and he has refused to read them so this turn of events is a good thing in my opinion. I wonder what he'll end up choosing. Personally I'm not entirely sure he needs another anti-depressant but that's not my decision to make. I am proud, though, that it appears that Thomas really cares about his body and his mental health.

This is a good sign.

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