The Sunday Update

I found out yesterday that my medication taper off of Seroquel will proceed much more quickly then was originally scheduled. The doctor assigned to me for the first month I was here left last week for another job, and my case was transferred to another resident on staff. She intends to start the medication protocol about two or three weeks sooner. Since I have had difficulty sleeping without taking a sedating drug first, the theory in starting a much more robust titration schedule is that if sleep becomes difficult to attain (which it almost certainly will) I won't have to suffer quite as long with sleep deprivation before the med trial starts.

The Ketamine IV infusions were supposed to proceed around third week of January. Now they will begin around the first of the year. If I'm able, I intend to post at some length about the effects of the infusions. However, do be aware that there may be a fairly extensive period where I'll have minimal sleep wherein I likely won't feel anything like posting or be able to leave comments at other peoples' sites. For some reason, I didn't sleep well last night even with medication, which doesn't bode well for the next few weeks.

If I can't tolerate a lack of sleep I'll be placed back on Seroquel and then promptly sent home much sooner than anticipated. This is not what I want since the reason I am up here is to find treatment options not available to me on an outpatient basis in Alabama. Instead of borrowing trouble, however, it's probably wisest to focus on the present and not obsess about what may or may not go wrong at some nebulous point in the future. That's a tall order for me though, as I do worry constantly about the future.

The doctors worry most about a particularly virulent bout of insomnia triggering a manic episode. Since I'm still on Lithium as a mood stabilizer (and excellent anti-manic drug) this is not a huge concern for me. Still, what has been determined conclusively is that for every manic episode a person has throughout the course of their life, the more likely it is that the one which follows it will be worse and will be achieved far easier than the one which came before. Bipolar is an illness of degrees and the window between depression and mania narrows considerably with age. I don't wish to be fifty and hit a period of rapid cycling because I've had so very many manic or hypomanic episodes.
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After meeting, today I visited the open-air market which is held in the immediate block or so outside the Dupont Circle Metro stop. The Q street exit side is home to organic produce, cheese, vegetables, homebaked bread, and just about every food product imaginable. I bought a loaf of white bread and a half gallon of milk produced by grass-fed cattle. Both are delicious.