Just Lamotrigine

… yeah. I didn’t take the trazodone Wednesday night, nor Thursday, nor last night. And I’m doing better. I feel like I’ve woken up from a bad dream. And speaking of dreams, I’m back to my usual anxiety dreams – which I KNOW are dreams once I wake up. So much better.

My anxiety is kinda overwhelming tho. I’d almost forgotten what it was like to feel like this. I have a thing I need to be not only present at but act in a professional capacity. I think I can deal with it, but I’d wanted to go to a cultural event at my local library – no pressure there, just show up have fun and leave. But I was kinda freaking out about it – especially the leaving and getting to my later commitment on time part – so I guess I’m not gonna go. It’s just easier that way. There will be other opportunities … right?

*sigh*

I’m kinda doubting whether I’ll ever be able to find and maintain gainful employment.

I don’t want to stay on just lamotrigine, and either way I’ve been thinking for a while that it would be good to increase my dose slightly. I’m debating whether I should ask to go back on fluvoxamine or clonazepam. The former was a rocky start, but I got used to it and I think staying on it might’ve been good for me. The latter … I don’t think I ever had any problems with it – I don’t remember any. It helped with my anxiety. It’s not the safest med in the world but you know what, fuck it. I’d rather be functional while I’m alive than live longer.

Something tells me getting my prescriber to agree to this won’t be easy. I’m writing her a letter in hopes that will prevent me from ‘acting irrationally’ at our next appointment.

Quit Playing Games with My Brain

Disclaimer: Anytime I write about medications, I’m sharing my own thoughts and experiences. This is NOT medical advice.

I had a rough time on the fluvoxamine maleate, at least initially. September was a stressful month anyway, though. So, it’s kinda hard to determine whether the problems I faced were a response to stress, a reaction to my meds, or some combination. All I know is I started occasionally mispronouncing words that normally I’d have no problem pronouncing correctly. I had to stop most of my Green Party activity because I was getting too overwhelmed. And I was suicidal.

I visited with Banji the first weekend in October and felt much, much better by the end of it. But I’d already told my prescriber about being unhappy with the fluvoxamine, and she’d already switched me to a new medication. Almost reluctantly, I weaned myself off fluvoxamine this past weekend and started taking trazodone.

The only things I’m happy about on trazodone are that 1) I’ve stopped mispronouncing words, and more importantly 2) I had the good sense to make sure I wouldn’t be driving for 5 hours on a new med!

Since I started taking trazodone Sunday night, I’ve had weird, vivid, disturbing dreams that it’s taken me a while to realize (once awake) were dreams. I’m having a harder time falling asleep, in part because the occasional involuntary muscle movements are becoming more frequent. I feel like I’m having trouble staying asleep, but that could be because my sleep cycle is shifted later than it should be. I feel groggy and tired. I’m anxious and having trouble concentrating and following conversations. On Monday while driving I couldn’t see the sign for the place we were going until we were practically there. When people gave me directions I heard “right” and thought “left” until the last moment. When I speak I’m too aware of my mouth movements and I feel like I’m listening to someone else.

When I told Ron about this stuff, ze said, “If you feel like your brain is broken, the trazodone is doing its job. It’s a hospital med used to shut down the brain of a patient who is psychotic and make them sleep. As an outpatient, if you are not psychotic, you have no business taking those meds.”

Ze urged me to find a new prescriber. I … I can’t. Not like this. And even if I were 100% on top of everything, I’d probably have to make my first appointment at least a couple months in advance. And that’s assuming the places I called even had mental health prescribers available – most are already overwhelmed with too many clients.

IF I remember our conversation correctly, my prescriber said I could try this med for a few days and stop taking it if I didn’t like it. I’m sure I remember her telling me I don’t have to wait a whole month, and I don’t think she said I should call before stopping. But I’ve been thinking for a while that I’d rather take just the lamotrigine if that’s what it takes. Maybe all I need is another slight increase, I’m on a pretty low dose.

Being on clonazepam wasn’t perfect, and I know there can be risks – particularly addiction. I feel like my sleep was more satisfying on the fluvoxamine. But I miss the way my brain worked on clonazepam. I rarely felt anxious – that’s probably the most important thing. I might’ve felt depressed, but I was functional. I knew I could do what I needed or wanted, and when I tried I would usually succeed. Now …

Good Bye Clonazepam

I took my last dose of Clonazepam today. I’d been thinking for a while that it might make more sense to stop taking it than to fill the new prescription and drag out another month of taking these half-doses, which don’t do the job but still run the risk of interactions and side effects. I called my prescriber to make sure that would be okay, and she gave the go-ahead. So starting tomorrow I’ll just be taking Lamotrigine, Fluvoxamine Maleate, and the supplements I’ve found helpful: omega 3, vitamin D, and a vitamin B complex.

So far I haven’t noticed any ill effects from the Fluvaxamine, so I guess that’s a good sign. I don’t really feel like it’s kicked in yet; I hope it does soon because I’ve been … well … I’ve spent the last 3 days inside playing Skyrim all day. Today I kept getting interrupted and feeling too overwhelmed to do anything useful, so more Skyrim. Mostly because of politics, drama, and financial issues that I don’t really feel like getting into right now … though … I dunno, other folks are venting to me, and I don’t know who I can talk to about it so … whatever.

New Prescriber, New Meds

I had my second appointment with my new prescriber last week. At our first appointment, she told me she’s not a fan of one of my medications, Clonazepam, and said she wants to start weaning me off it so I can start taking something else. She wanted to put me on a SSRI (selective serotonin reuptake inhibitor) “to help with both depression and anxiety.” I resisted because I’ve had bad experiences with two different ones. There were no changes to my meds last month.

But this month she reiterated the need to get me off Clonazepam and told me to start cutting the pills in half. She also said there are medications that help with hording and prescribed me one, Fluvoxamine Maleate. It’s a SSRI. I’m torn between not wanting to take it because I’m scared of how it might affect my brain and the rest of my body – and wanting to take it because I can use all the help I can get to deal with this hording.

I talked to Wakana about it and she seemed very concerned about the change in meds, especially since I only just started seeing this prescriber. I’ve been taking half doses of Clonazepam since September 1st; so far I’ve already had two days (Monday and today) when I felt ill enough that it affected my functioning, and almost kept me from following through on important plans. I’ve been feeling down, slightly queasy, less sure of myself, tired, anxious, freezing (as in fight, flight, or freeze), and sometimes twitching – in other words, like crap. I suspected on Monday that I was having withdrawal symptoms; Wakana confirmed it today. I have an important meeting tomorrow at noon, and another Friday evening; I don’t have time to malfunction because of changes to my meds.

I’d say “especially changes that are based on the prescriber’s philosophy rather than the medication’s effects on me,” but it’s a little more complicated than that. Clonazepam can be addictive, it has interactions with a lot of things, and I was questioning how much it’s been helping me. I feel like I need more support vs the depressive symptoms than I’ve been getting from Lamotrigine. (There’s no way I’m going off that, though. It keeps my brain from trying to kill me.) To this prescriber, at least, all signs seem to point to SSRIs. I don’t quite get why she’s so obsessed with them.

I’m starting a new bottle of Lamotrigine tomorrow, so I figure it’s a good time to start taking the Fluvoxamine. But I’m really not sure whether it’s the right choice – especially since Wakana pointed out that I’m already addressing the hording without this med, and we agreed that many of the problems I’m facing can only be addressed by getting Fox to take responsibility as well. What will this stuff do to me?

I don’t know, but Wakana suggested tracking my mood and I think it’s a good idea. I’m not sure exactly how I want to do it though – I’ll probably find an app – and I’m annoyed that I don’t have a way to get a baseline. I’d rather not do one retroactively, I’m already having issues because of one change in meds, and I was having issues before that due to interpersonal drama – in short, there are too many variables to determine whether whatever I’m experiencing has anything to do with a particular medication.

I’m just feeling more and more like I want to be done with everything. That’s not a good sign…

The Epic Quest for a New Prescriber

At my last psychiatric appointment, my prescriber of nearly 3 years (an awesome advanced practice nurse) informed me that she’s retiring – and the community mental health clinic where I’ve been receiving care isn’t hiring a replacement. There wasn’t any offer to help me find a new prescriber or set me up with one. She just gave me a list of numbers to call, and sent me on my way.

I knew I should’ve started the search immediately, but I was stressed out by the idea so I did what I do best: I procrastinated. I got distracted. I focused on just about everything else. To be fair, “the incident” happened soon afterward; I needed time and energy to recover from that. (Things are going well, by the way, update pending.)

Two months have passed.

Somehow my lamotrigine & clonazepam prescription refill cycles got de-synchronized, so I’m in a kind of weird situation. I used the last lamotrigine refill a few days ago; “additional refills require authorization.” I have 26 full doses left, including today’s. There’s still one more refill on the clonazepam.

So it’s crunch time. I need to find some way to refill these medications – preferably before I run out or resort to cutting pills in half. I honestly fear for my life if I have a disruption in access to my meds – if not my physical life, my ability to continue my activism and maintain healthy relationships. Perhaps more importantly, I fear losing the ability to do the things I need to improve my life – such as completing my degree, finding a job that pays a living wage, consistently functioning well in that job, and learning how to keep my home from becoming an unlivable nightmare. Even more importantly, I fear losing the ability to take care of myself, which includes the ironically (read: cruelly) daunting task of accessing and engaging in treatment.

These fears are among the most potent triggers for my worst depressive symptoms.

Oh, and by the way, my state just cut funding to community mental health. Clinics are closing or cutting whatever (whomever) they must to try and stay afloat. My current clinic no longer serves clients with private insurance, and it had to let go of its front desk staff.

jiFfM

Star Trek: Next Generation characters Picard and Riker both facepalming. The text reads: “Double Faceplam. For when one facepalm doesn’t cut it.”

So, yesterday, I began The Search. My counselor (who helps me with behavioral approaches to wellness) had suggested that my primary care doctor could possibly authorize refills, so I called his office. They said he “might” be able to, “depending on [my] situation,” so I made an appointment. I’m hoping he can authorize a one month supply of the lamotrigine, and if necessary I can return to him for a three month supply of both medications. (Clonazepam is a controlled substance, so any ‘new’ prescriptions not filled within 30 days expire and need to be reauthorized – at least in my state.)

Even if my primary care doctor can help me, seeing him for psychiatric consultations is not sustainable. I don’t have, nor do I anticipate developing, the rapport I’d need to literally trust him with my brain. I need a specialist who really knows what they’re doing, especially if and when it becomes necessary to make adjustments to my medications. (Which may be soon, I’m still trying to figure out to what degree my current problems can be addressed through music therapy and changes in behavior, vs meds.)

Ideally I’d like to switch to the other prescriber at my current clinic, whom Fox has been seeing and seems to like. If not her, perhaps someone at another location in the same agency – surely that would provide some consistency of care, right? I called the intake office; the person who answered seemed surprised I hadn’t been referred to another prescriber. “Well, you might want to call the other numbers on your list, because we’re currently scheduling for September.” “September?” “Yes.” I hung up on them.

I started making some additional calls. Bad number. We don’t do that. We’re not accepting new clients. We’re currently at capacity, but may be hiring someone, you can check back.

newprescriber1

My to-do list item on Habitica.com with several steps checked, reflecting the efforts I put in yesterday.

There are several additional numbers on my list, but most of the clinics are in urban areas that may be … inconvenient … to access. Middle class suburban snobbery aside, I anticipate that these locations are even more likely to be “at capacity” or otherwise struggling to serve clients for whom they’re the only choice.

So I’m gonna try calling intake for my current clinic/agency back, see what they can do for me. (I realized later that September is only about a month and a half away.) Hopefully my doctor can set me up through August, maybe September as well; if there’s any interruption in my access to meds it will hopefully be short enough that I’ll be okay. And I’d rather have this set as a backup in case my doctor can’t help me and/or I can’t find a prescriber elsewhere; the longer I wait to make the appointment, the later it will be and the more likely this is to become devastating.

I forgot to refill my prescriptions until I ran out – of course on the day I was running late and had to rush out the door. I tried to put in the refill request for the clonazepam first, but was unsuccessful; somehow my prescriptions got de-synchronized so I was out of refills with that Rx number and I didn’t have the new one to put in. I was in crazy anxiety rush mode, so I didn’t try refilling the lamotrigine – even though it had 2 more refills with that Rx number.

I asked Fox to go to the pharmacy for me and he did, because he’s wonderful. He said (they said) they didn’t have anything in the system for me. I was tabling at a pride event and he had to leave for work and it was Sunday, so there wasn’t really any opportunity to follow through on anything.

On Monday I realized I should’ve tried to refill the lamotrigine, better to have one of my meds than neither, right? That was no problem, but I had to speak to a pharmacy representative to deal with the clonazepam. The person I talked to at the pharmacy had an irritating tone to her voice and was too nonchalant, like there was no problem with them not having the information necessary to make sure I have access to a medication that keeps me alive. She didn’t even try to be polite like saying ‘sorry’ – but she did offer to fax my prescriber. And she explained that the clonazepam prescription had expired because it’s a controlled substance, so it has to be filled within 30 days.

I walked to the pharmacy with my inner voices screaming, an irritable mess, barely holding myself together. By the time I got the lamotrigine my ears were ringing and my eyes were so full of static everything was in a darkened haze and I couldn’t think straight and everything felt completely WRONG. That was after missing one dose – and it’s not even that high a dose. I took the dose – better to at least take one of my meds, right? and everything cleared within minutes. The difference was noticeable to Ron over the phone.

I had to play phone tag with my prescriber for a couple days, but I was able to refill the clonazepam today. I didn’t notice as much as an effect when I took it, except that maybe I’m a bit calmer? And I was rather sleepy, I attributed it to waking early from a bad dream, but the medication is known to make people drowsy. Ron seemed surprised I’m able to function at all taking [my dose] of it every day.

To be honest, between what ze’s been telling me about it and what I’ve read online, I’m a bit wary about staying on the clonazepam. Apparently it’s habit forming and it’s better not to take it for extended periods of time. But my prescriber added it for a reason – I think because even with my mood stabilized I was still struggling with anxiety. And I don’t know if I wrote about this yet, but my prescriber is retiring, so I need to find a new one within the next month or two. I’d rather not change my meds until I’ve developed a good rapport with the new prescriber.

So, yay, I’m back on my meds! I anticipate that going a day without lamotrigine and two days without clonazepam will have thrown my levels off; it might take a while for them to get back to normal. And I’m a bit shaken by how profound my (withdrawal?) symptoms were before I took the lamotrigine. I’d come to accept that I’ll probably be taking these medications for the rest of my life, and I’d rather do so consistently than risk going back to how things were before I started taking them. Still, this was a rough reminder of how dependent I am.

Fus Ro Dah!

Since writing my last post and looking at lists of Lamictal/lamotrigine side effects, I’ve done a 180 and no longer feel safe taking my medication. Part of me believes it is a lot easier than confronting the APN about her decision to have me stop taking the medication. Part of me believes that I’ve been experiencing side effects the whole time and either ignoring them, not attributing them to the medication, or acknowledging them and attributing them to the medication but refusing to admit that maybe this isn’t the right medication.

All of me is angry at the APN, psychopharmacology, and the entire “healthcare” system: all doctors, their administrative staff, and especially managed care… I want to say I know it’s irrational, but is it, really? My blood pressure and heart rate are high and that’s set off some alarms regarding the medication… but maybe it’s due to the stress of trying to access medical care!

There isn’t really anywhere for this anger and the accompanying destructive urges to go. The APN’s office is closed for the federal holiday, so the earliest I might be able to talk to her is tomorrow. I have too much other stuff on my plate to waste time trying to get in touch with someone as flaky and dismissive as her! Verbally abusing anyone else would be mean and probably backfire. Physical acts of aggression, homicide, arson, etc. would take way too much effort. I’d rather play Skyrim. Shouting at people in that game is a lot more satisfying, and if it isn’t enough I can set them on fire with my mind.

So I’m just fed up with the whole thing and the thought of swallowing their b.s. in the form lamotrigine dispersal tablets makes me sick! I checked, online sources state that stopping lamotrigine without slowly reducing the dose first is safe for people who are being treated for bipolar, but not epilepsy. (do NOT take this as medical advice! Always talk to your doctor before stopping a medication.) Given the alternatives, I’d rather say “fuck you!” to medication and harness the energy from my anger to be awesome at my classes than keep taking something that may be making me sick.

There is a quiet voice in the back of my head saying that maybe it’s the therapeutic effects of the medication that have helped me get to this point. But my symptoms haven’t been much better than before I started taking it, and I’m inclined to attribute the ups and downs to the circumstances of my life. I can’t tell if it’s making a difference, so maybe it’s not. “There’s no point in taking it just to take it.” Right?

I’ve been wasting too much time and energy on this. There are about a million better things I could be doing!

Dismissed

I had another appointment with the APN on Friday. She took my blood pressure – which was a bit high, both for me and based on the health guidelines I’m aware of – and said it was “fine.”

Then she asked how I’ve been. I told her about being tired and unmotivated to do anything; sometimes I don’t even feel motivated to play Skyrim. I tried to put it in the context of everything that’s been going on: the stress of the holidays and then everything just stopping. I told her when I’m very depressed there’s less anxiety because I don’t want to do anything so there’s nothing to be anxious about, but when I’m less depressed and starting to want to do things I feel anxious about them. (To be honest I’m not sure that’s entirely true. I experience different kinds of anxiety. But I didn’t express this to her.) I also told her about the ominous voice twisting all the imagery in the guided meditation into things I found threatening. I told her I’m both excited and anxious about my classes starting next week: excited because I’ll have some structure in my life and anxious because of the responsibilities. (Not to mention my social anxiety.)

As I was talking about this stuff, she was making notes on the computer (facing away from me). Then she looked back through her notes from past appointments and the information I’d provided in the intake paperwork before our first meeting. She weighed me and told me I’m a candidate for sleep apnea. She told me to go get blood work done so she could see if there is a problem with my thyroid or something (past blood work has ruled that out, but I haven’t been able to show her the printout to prove it). She also called a sleep center for me and handed me the phone, basically forcing me to make an appointment for a sleep study.

Okay, I’ve been dragging my heels, I can kind of understand her being a bit heavy handed. But the next thing she did utterly terrified me.

She told me to stop taking the Lamictal/lamotrigine. She said I’m “sensitive” to it and it doesn’t seem to be helping. “There’s no point in taking medication just to take it.”

That’s it. No plan for slowly reducing my dose over time to minimize withdrawal symptoms. No concern over what effects suddenly stopping Lamictal might have on me. Granted, I’m only taking 75 mg, but we’ve worked our way up to that dose very slowly. If I’m “sensitive” to it, doesn’t that increase my chances of being “sensitive” to suddenly not taking it?

I honestly don’t know if it’s helping. Maybe it isn’t. Maybe it’s wreaking havoc on my central nervous system and I should stop taking it immediately. She didn’t explain why she thinks I’m sensitive to it, and gave a very simplistic explanation of why I should stop (which suggested she views me as medication-seeking). Her tone sounded dismissive to me, so I didn’t feel comfortable asking questions. I couldn’t think quickly enough to formulate them and felt like she wouldn’t listen anyway.

Maybe it is helping and my depression would be a lot worse without it. I feel like she’s not taking my life circumstances into account. I was doing great up to the wedding, then suddenly all my loved ones had gone back to their own lives, nothing meaningful had changed, and I no longer had something important to work on. I couldn’t sleep for a week or so while Mom was having work done on the roof. Then the holidays were a blur of excitement, socializing, not getting enough sleep, and thinking my godmother was going to die. Then, once more, everyone left and everything stopped – except worrying about my godmother. The floor dropped out from under me – and my pending courses for the Spring semester are looming over me.

The courses are the thing that has me the most concerned about stopping my medication. I’d like to have a bit of stability going into such a big lifestyle change; the last thing I need is unpredictable changes in my body chemistry and mood at the same time I’m going into a frightening and challenging situation. The last time I took these courses I had to drop them because they were triggering self harm and suicidal urges. I don’t feel safe trying to take them again without some kind of safety net. (I should probably talk to my instructors about this.) At least taking medication is something I’ve been able to do with some consistency; I feel like I’m doing something to help myself!

I suppose I could possibly enjoy the same effect from continuing to take my supplements (omega-3, vitamin d, and a vitamin b complex with folic acid and vitamin c), but I really don’t want to give up on the Lamictal just yet. Wakana has been urging me to take medication for so long (since before I started this blog), I hate the idea of finding that yet another one doesn’t work. I don’t want to start from scratch again…

During the meeting with the APN, my mood went from 1) low energy, depressed and a bit anxious, to 2) slightly higher energy and a bit irritable, to 3) more depressed, frustrated, and wanting to cut myself. She ended the appointment after telling me to stop taking the Lamictal; she didn’t even ask if I had any questions or concerns or anything else I wanted to talk about. I feel like she thinks I’m not really depressed or only mildly depressed and that I’m being lazy.

(Much of our conversation was her giving me advice: to make healthier food choices, move around more, make a schedule for myself, and give myself a to-do list with simple tasks that help me feel good. Some of these are lifestyle changes I want to make anyway and think would be helpful, but in general it sounds like stuff laypeople say to people with depression because they don’t understand it.)

I left and made sure I have future appointments pre-booked, but thought about not coming back. In an ideal world I would find a better psychiatrist, but with my insurance that would be a nightmare. And I’d have to start the whole medication dance all over again! When I was halfway across the parking lot I thought about going back to ask about reducing my dose slowly, but decided I wanted to consult with someone before trying to advocate for myself. I had just utterly failed at advocating for myself and was in no state to do so successfully.

I talked to someone I know who works with adult psych patients and has bipolar himself, and with his wife who has a good amount of medical knowledge – including potential effects of different drugs and what various symptoms might indicate. Together they helped me decide to continue taking my current dose of the Lamictal until I’m able to talk to the APN again. They encouraged me to talk to Wakana about it and have her talk to the APN as well. My friend with bipolar also made an important point: my insurance might not approve the sleep study right away, or in time for our next appointment, or ever. I can’t wait, untreated, while they bathe in red tape (as I have been for my tooth – brief update: I have an appointment for a periodontal consultation and another to get a root canal).

At the very least, I want a better understanding of her thought process. I want her to sit down and look me in the eye and answer my questions until I feel confident in whatever course of action she prescribes. Is that so much to ask? If I have to go off Lamictal, I feel much safer reducing my dose slowly with a plan we’ve come up with together. If possible, I intend to have Fox there with me. He’ll be there for my future scheduled appointments, at least!

Side Effect?

I’m having an experience that’s new since I’ve been taking Lamictal/lamotrigine, possibly since my daily dose was increased to 75 mg. It happens when I’m very tired and close my eyes and drift off a bit: if there is a sudden sound, I see an explosion of small white lights. Kind of like fireworks. The sound doesn’t have to startle me, just bring my attention back to the present. The phenomenon isn’t painful, scary, associated with a change in mood, accompanied by physical symptoms/movement, or anything else that would suggest it is a serious concern. It’s just… different. I’m not sure whether I should be concerned about it, but I plan to bring it up the next time I talk to my advanced practice nurse.

Good to See You… but I Wish You Weren’t Here

I just got back from my fourth visit to the APN. I told her the Lamictal seemed to be helping; I’ve been less depressed, my lows haven’t been as low, and my mood is more stable – even with the stress of adjusting to Fox’s new job and wedding planning crunch time and health issues, etc. She decided to increase my dose to 50mg daily and encouraged me to find things to do that would give my day structure and social opportunities.

Someone else was coming in for an appointment as I was making future appointments to see the APN once a month; after a short time I noticed that person was waving to me. It took a few moments for me to recognize her: a former classmate! She started asking how I was and when I was done making my appointments she came over to give me a hug. I was glad to see her but concerned: she seemed stressed and anxious and was clearly going through a rough time – otherwise why would she be at a community mental health center? I wanted to ask questions to show interest in her well-being, but I didn’t want to ask anything that might make her feel uncomfortable. And then she had to go in for her appointment.

On the one hand it was kind of encouraging to know I’m not the only one from my school / program needing to take some time for self-care. It’s kind of normalizing? And I’m glad she’s able to access at least some of the help she needs. I like my APN and I’m pretty sure that’s who she was there to see; I feel fairly confident that she’s in good hands.

On the other hand, I’m kind of shaken. I wasn’t expecting to be in a peer social situation with someone from school. We’d had some opportunities to bond as classmates but I see her more as a “friendly professional acquaintance” than a friend. I’m used to doing everything in my power to hide my mental health issues from friendly professional acquaintances; now one has seen me at a community mental health clinic! I don’t think she’d tell anyone – just like I’m disinclined to tell anyone who might know her – but it’s still awkward!

And my first response is to try and figure out what I can do to help her. What would be appropriate to say to help her feel more comfortable? How can I reach out to her to try and offer some support? I need to be careful how I proceed so I don’t risk outing her. Maybe I shouldn’t even be writing about this!

I guess it’s good that I’m so compassionate. But I need to think about how I feel and what I need. I kind of needed to be in and out of my appointment without unexpected socialization. I also need to socialize with peers other than Fox and the all-too-occasional rendezvous with other friends. I kinda want to reach out to her – “Maybe we can meet at a cafe or diner that’s convenient for both of us? Are you free during the week?” And I kinda want to hide in my shell, try to pretend this didn’t happen.