AM .5 Ativan, 30 Cymbalta
afternoon .5 Ativan, 60 Cymbalta
PM .5 Ativan, 10 Zyprexa
I was not exactly my best self yesterday. I have been "off" for a long time. I miss my old friend, Lamictal. In Lamital's absence, the sky is greyer, the days drearier, and it is more and more difficult to find reasons to get out of my pajamas. In contrast, my moods are sharper, more erratic, and as fierce as a rattled beehive.
That has become the daily question when I awaken.
Especially yesterday morning - my "not exactly my best self" day.
Before you read, please know I am not proud of my behavior. I am actually very embarrassed. But I am sharing it with you to show you exactly how ugly those bipolar, mixed episode, irrational, emotional outbursts can be. I am embarrassed to share it with you, but I have always promised to give you "a not so gentle look into a bipolar mind," and a lot of it isn't shiny and pretty. And it certainly isn't always gentle.
I had a lengthy phone conversation with my health insurance company in which I used many bad words, I raised my voice, and eventually hung up - but not before screaming, "fuck you." This is what I meant when I said I wasn't exactly my best self yesterday.
And so as the not shiny and pretty story goes...(get ready it's a long, wordy one)
I explained to the Care First Blue Choice phone guy the generic for Zyprexa is available to the general public, yes, but it is not available to me, specifically, because it makes me ill. I asked him if he wanted me to be ill. He said he didn't. I asked him if Care First Blue Choice wanted me to be ill. Again, he said no. So I asked him if he could please explain to me how there is a less expensive option available to me.
He replied that since I can not tolerate generic Zyprexa, I can take a different medication with an available generic formula, and that I can refer to the Care First Blue Choice website for "similar" medications and ask my doctor which one he would recommend for me.
I told him that wouldn't be necessary because my doctor already has recommended a medication for me and it's called Zyprexa.
He said Zyprexa is not a choice, and that I need to try something else.
I told him I have already tried something else. I have tried twenty-four "something else" psychiatric medications over the last fourteen years and Zyprexa is the medication that my doctor and I have determined works best for me. I have been taking Zyprexa for seven and a half years. I have tried many other less expensive drugs throughout those seven and a half years, but Zyprexa is the drug that works best for me.
I told him:
Another drug is not an option.
Generic Zyprexa is not an option.
And paying $3000 for it is not an option.
Care First Blue Choice can recommend another drug.
This is about the time I lost my cool.
This is not me.
I'm not a cartoon character,
and I'm not wearing a newspaper hat,
but this is basicly what happened to me:
I asked him if he went to medical school. He said no. I asked him if he was a pharmacologist. He said no. I asked the same about Care First Blue Choice. Again, his answer was no and no.
I replied that it is very fascinating because my doctor did go to medical school and is a pharmacologist. Fancy that, I told him. I also asked him how long we have known each other because my doctor, who has prescribed me brand Zyprexa, has known me and monitored me closely for seven and a half years. I asked him who he thought would have a better understanding of what drug to recommend for me? Him, or my doctor who has been monitoring me for seven and a half years?
At this point he started getting rude. Can you blame the poor guy? I was being an absolute ass. It's not his fault. It's not up to him. His job is just to talk to crazies on the phone, and I was being a crazy.
To clarify I said,
"You will not cover brand Zyprexa for less than $3000 out of my pocket expense."
And he said,
I flew off the handle.
Remember this guy?
Times his rage by a million:
Guess what? The joke's on you, asshole.
Do you know what's a lot more expensive than Zyprexa? The hospital. Which is where I'll be going because I couldn't take my medication. Because you wouldn't give it to me. Would you like me to be in the hospital?
Would Care First Blue Choice like to pay for me to be in the hospital?
Hey asshole, guess what else is expensive? Suicide attempts. Do you know who attempts suicide? People who don't take their medication. Do you know who doesn't take their medication? People who can't afford it. Guess what else. When Care First Blue Choice is paying for me to be in the hospital because of my suicide attempt, do you know what else they will be paying for? Zyprexa. That's right, asshole, Zyprexa. Because that's the drug they'll be giving me. Because that's the drug that works for me.
I understand you are upset.
Yeah, I am upset. I sound pretty crazy right now, too, don't I?
Do you know why I sound crazy? Because I'm trying to fill my prescription for Zyprexa and I can't. This is what I'm like without Zyprexa. I'm fucking crazy.
No one is saying you don't need Zyprexa. We are simply saying Zyprexa is too expensive.
Now you're putting a price on my life? You want me to live like this? You want me to be fucking crazy?
I'm sorry, Zyprexa is too expensive.
Let's see...I have a couple of ideas for a solution. You can cover the cost of my Zyprexa minus a $30 copay like you did last year, you can give me $3000 to pay for it, because I sure as hell don't have $3000, or I can not take my medication because you are denying it to me at a reasonable cost, and I will remain fucking crazy and probably commit suicide. What would Care First Blue Choice prefer because those seem to be the likely options here. Would Care First Blue Choice like to be a contributor to my suicide? Would you feel good about that?
I'm sorry, Zyprexa is too expensive and you can choose an alternate treatment.
Hey, asshole, Zyprexa is my treatment. Thanks for denying me the treatment that has given me my sanity and my life back. Without Zyprexa, I'm not me anymore. I'm just some crazy bitch. You are robbing me of sanity and a normal life. That's on your hands, asshole. You're hands. Sleep well knowing that. Fuck you.
And then I hung up.
Geeze...that was awful. So awful. It is such a perfect example of when I have explained the phenomenon of having emotions that don't fit the situation.
It does make sense to be upset. It would fit to be angry about being denied coverage of an important part of your treatment plan. Even experiencing fear would be appropriate. What will happen to me if I can't take Zyprexa? I do have that fear.
But that? That display? Blaming him, the poor phone guy, for a potential future suicide attempt? Well, that's just ridiculous. And very cruel.
But bipolar disorder is not always kind, shiny, pretty, or gentle.
The rage of a mixed episode can be really scary. During that conversation, I didn't even recognize myself. And now, when I recount it, I am horrified - absolutely horrified and physically cringing that I am capable of being that person who was on the phone.
But remember that acceptance we've been talking about? This is still part of it - accepting bipolar disorder is accepting, at times, we're not exactly going to be our best selves.
Sometimes the best we can do is take our pills (at least the ones we can afford), take a deep breath...and apologize. What's done is done. I can't take back my words, but I can forgive myself for being an asshole, and apologize to the poor man who was not being asshole but merely doing his job.
We win some, we lose some. I know sometimes, it feels like we lose a lot.
But it's all part of that not so gentle look into our bipolar minds.
Don't be afraid to look, friends. I know it's not always shiny and pretty in there, but it doesn't mean we are ugly. It means we have an illness that can be pretty damn ugly at times; we just have to keep doing the best we can. And apologize. Sometimes we need to do a heck of a lot of apologizing. At least I do today.
Until next time...