Monthly Archives: May 2011

Why I am sorta anti-drug

Well, that was just for the sake of a catchy title; I should more accurately say: “Why I am pro reducing (not eliminating) some prescription medications where possible”. Partly because I am British and we fear many drugs (except birth control which we apparently hand out like tic tacs) and their effects. We have a (possibly overblown) fear about medicated personalities and tolerance and addiction and about, quite frankly, not manning up and dealing with the fact that sometimes life is tough and it is not always going to be a level playing field.

This is the scenario that has lead to my latest blog outburst:

So, my sleep schedule has been a little messed up. It started last Saturday after a slightly emotionally-charged (but fully resolved) day. I got up from bed at midnight and listened to some podcasts online, watched a trashy chick flick and fell asleep somewhere between 3 and 4, getting up ~8 am for church. I was a little tired, but it didn’t stop me doing everything I needed to do that day, pretty cheerfully, and having guests over the evening to sample the champagne for the wedding. And sample we, or at least, I, did. Amazingly I slept very well that night 😉

Monday – no sleep. Nothing was bothering me, nor making me anxious. I just felt excited and spent the night watching trashy movies, catching up with friends in England, snuggling my cats and yes, looking at the odd wedding website. I fell asleep at about 6.30 and had to get up at 8.30 / 9.00 for work. There were no serious effects… apart from skipping my workout (heavy lifting on no sleep? Nay!) there was nothing other than a little tiredness. Here is my email about the day:

“I am shattered! All achey and tired, but OK really 🙂  Little difficult to concentrate but AM doing a very boring grant review. Meeting with Donna in 40 mins, I am going to ask for some help with my job apps and if I can apply for a new grant – I need to be faculty for it, and Donna may well agree to that (without the accompanying salary hike) for a year. Exciting!

Hopefully I will sleep like a baby tonight :)”

I don’t think this sounds like someone at the end of their tether. We had guests over that night, I worked after until about midnight, then fell asleep at 3 am (after, yes, more trashy movies. I am the master of these mwah ha ha).

Next, again, about  a 3 am sleep, maybe 4, but I just didn’t feel tired. I mentioned it to people in the UK and as long as I was still at work (I was), not unhappy (I wasn’t), not unduly tired (I wasn’t) and not missing out on anything in life (heck I was still zumba-ing and doing my weekly HIIT sprints with no problem) they found it funny and cute, and were surprised I had not expected it before.

“You’re getting MARRIED in 2 weeks, we’d be worried if you were blase”.

Have wine and a hot bath / don’t work or talk to anyone after 10 / watch the wedding scene in 16 candles with cocoa were the pieces of advice I received; until I  mentioned it to my PCP. I sorta wanted her to smile and giggle and perhaps have some lifestyle-advice gem I had missed (try a cooler room, don’t be hungry, stablize blood sugar with a light snack… anything). As I clearly wasn’t bothered by it, (in fact, I secretly liked the fact that it made me feel ‘bridal’) I was shocked when she prescribed a benzodiazepine.

I took it that night, fell asleep in 30 mins, slept through my alarm, was groggy the next day and dissolved both  asleep, and into tears, at my desk. Ick! I told my fiance – he said I needed Ambien, a different type of pill. Many of my friends (US friends) had warned me about this, and advised against it. I said that I didn’t think I did – I didn’t think I needed pills at all. He said, I just needed to take it earlier in the evening.

Anyway, I didn’t take it the next night, but my not sleeping sorta bothered my finace and even though he went to sleep ~2 am at 3 am I took 1/2 a dose and dozed off, because I was worried if I didn’t sleep and he found out I hadn’t taken it, he would get frustrated. The next day, I said that I didn’t think I needed anything, but he was fairly insistent I did, and that I needed Ambien and I was scared about an argument / lecture if I didn’t sleep again so I took the tablet at 9, as he suggested, fell asleep at 9.30 and then apparently had the weirdest 1 & 1/2 hours of my life – which I don’t remember. Falling asleep on the floor 1/2 undressed; sleeping sitting up, sleep walking, drinking frikkin’ coca-cola (full fat, this has upset me most), standing in front of doors asleep, crying in my sleep. I woke up then and watched Grey’s Anatomy (NOT my choice 🙂 ) and Michael McIntyre (absolutely my choice) quite happily for a while and fell asleep.

I. Don’t. Want. To. Take. Drugs. That. Affect. My. Personality.

Wait for it. See? My personality is to get hyper and excited about things, and then I crash out when it all gets too much. It may not be ‘ideal’ but it doesn’t affect my life, and anyone who has CHOSEN to be in my life has CHOSEN to put up with that. I always say when I am dating someone “the door is open. I am not doing to force / persuade / emotionally blackmail you into going out with me. If I try and change it will end up being temporary and it won’t be ME. I am who I am, and you don’t have to sign up to that”. Most do; I remember only 1 who didn’t. But sleeplessness nights and being excited and running on a lot of energy has been a feature of my life, periodically: when I first went to Cambridge; when I wrote my PhD thesis in 10 days; when I first moved to Alabama. It is who I am and it doesn’t bother me.

So, I mentioned on facebook that I had a benzodiazepine. A lot of my friends wrote back and said “don’t take it girl! It’s not that bad yet” (one who is a surgeon said that she had even been tempted in her time when she was working on frequent boats of 3 hours of sleep, but had never succumbed)” and an American commented “I am annoyed your friends have that attitude. They don’t know you, and they don’t know the detriment to your life of not sleeping for a few nights”.

Thing is, they do. They know both of those. They know me, they know I am excitable and they love it about me. They celebrate differences in people and support them through and downsides. They know, in my life, I have skipped sleep for a while and been just fine. They have sometimes supported me through it with girlie nights and trashy magazines. They know that I do just fine (heck, I write a thesis that doesn’t need corrections… go figure). They know that if I am not unhappy about it, then all I need is a ‘dear dear’ and an encouragement that this is justification to break the diet and have some cheesecake.

The American who said that, my GP, my fiance – these are the people who do not know me, and do not know how I personally cope with not sleeping for a few nights. These are the people who have not sat down and honestly talked me through whether I have anxiety (I don’t, except now about my last post). That have not asked how my work is doing (quite well thanks, had some good meetings and wrote up a paper). That have not asked if I am too tired to do some healthful exercise (nope, I kicked ass in kickboxing!). These are the people who, in my mind, want to stop me being me.

A while ago I was diagnosed with an infected wisdom tooth just before I was flying. It was a misdiagnosis – it was actually inflamed from slight impaction, but that is what you get with free medical care I guess. Oh no, wait, I paid for it here. My mistake. They have me Percoset for the pain – and it certainly killed the pain. But (shhhhh) so did aspirin and paracetamol. Why shhhh? Because I took the Percoset. It made life so good! It reduced my everyday little worries, it made me calmer, more focused, more attentive, easier to be around. I thought it was great, until my bottle ran out. I asked my (then) boyfriend if I should go and get beta blockers, or anti depressants, or a mild anti anxiety drug to mimic the effects of Percoset in every day life. I knew I wanted to marry him when he looked at me, in the car, at the intersection of Highlands and Clairmont and said  “No baby. You go up and down, but that is you. Your friends and I love you, you don’t need a drug to change that”. He captured exactly how I felt deep down and what I wanted to hear. It breaks my heart that that it not the sentiment I feel anymore, and that I feel my personality is a ‘problem’ to be ‘solved’, without a real discussion of if I am happy with that, and without trying alternatives to manage, rather than change me.

I cling on to my friend David’s words. When I was still settling in to UAB, and wondering if I needed to be more ‘Southern’ in my dress, attitude and so on I asked his opinion. He said “You’re wonderful. Don’t ever change. Be you – but be it knowingly”. It was about a year ago, but these words still help me sleep at night (except this week it would seem 😉 ).

I really love my life. I used to smoke marijuana (in the UK only) until (1) it made me feel queezy and (2) it made me paranoid. But, I was always against it being smoked as part of everyday life. Sure, add it to your occasional party arsenal if you so like. But, if I needed or wanted it every day I would think there was something wrong with my life, and rather than change my mental response to what is my daily life, I’d rather improve the actual life. If my job is boring, I don’t want weed to make it tolerable – I want to change it so that it is and I am LUCKY to be in a position of privilege to be able to do this (which is why I don’t judge others). If I think life it better through a slightly stoned haze, I’d rather change things to recreate that level of enjoyment myself. If I need it in the evenings, because I am bored – I’d rather get a new hobby (maybe that’s why I grow orchids, play video games, write books, weight lift etc etc 🙂 ). If it is because I am stressed at work, I’d rather sort that out differently.

I don’t want to be divorced from my life. I don’t want to miss out on this final 2 weeks of excitement. It’s a once in a lifetime thing. As Daddy said today “If you get tired, the adrenaline will see you though the wedding day and you’ll sleep like a baby for the next week. It’s just two weeks Lek”. I don’t want to be put to sleep ‘like a good little girl’ (unless my life is feeling some detriment from insomnia) while my fiance can keep whatever sleep schedule he likes (he frequently goes to bed at 2 am and naps during the day). I don’t want people to give me something that changes my behaviour without sitting down and talking to me, and deciding if it is the best thing for me, and if I am happy for that. From the bottom of my heart – thanks to Mum, Dad, Stella and Ryan for doing so.

Questions:

My experience (subjective) is that I am in a state where 40% of the men I interact with are medicated / offered medication for ADD / ADHD (although this is definitely a sampling bias), and would like to offer me ADD medication. If this number is on the increase, in 11% time, will we soon medicate the non-ADD people as abnormal? And when will we stop telling people they are ‘not OK’ for who they are? And that they have the power to change who they are, of they want? And that they are capable of adapting their  lifestyle without a pill, sometimes?

I am not against medication per se, not even psychological medication – I have even advised people to take it. This is just a bad experience, and reveals some underlying attitudes that I would like people to consider and challenge in the light of their potential consequences.

Thank you for listening. You did better than my PCP 🙂

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Budget Candy Table – red and white

Ahhh… the dollar store. How I love thee. Each of these glass containers was $1. The twizzlers were $1. The rest of the candy was $40 on the internet (do a little searching) and scoops for the adorably named scoop-scoop.com for about $1.25 each. We just need to add one bowl of my fellow blogger and handy office mate’s very awesome red ‘n’ white M&Ms with our names printed on them. Snacks for the dancin’, and one less thing on the ‘To Do’ list.

Cnady Buffet, a Southern Classic

Get with the program Jefferson County

So, I am just about at my wits’ end. Here is my situation: I am getting married in 2 1/2 weeks. Therefore I need to sort out contraception.

Yes, I said it, out aloud. I am from a culture that talks about these things since we are about 10. Admittedly, school tries to keep things very serious and biological and then we usually giggle and throw prophylactics at each other screaming “you’ve got cooties now! Gross” and behave in other age-appropriate manners. Well… maybe that was just me, but we do at least talk about it.

Now, while it is not a topic of general conversation “Hi, my name is Sarah, and I have a diagphram – do you know where the brown sugar is?” it is not a ‘problem’ topic. Because, see, contraception is everywhere. A slightly tongue-in-cheek and light hearted history of the British Attitude to contraception goes:

Britain: “Gasp! The rest of Europe is so open sexually. They are so immoral! Look at all these naked people on TV / CD covers etc! We disapprove! Now shush about the topic, lest its sordid implications corrupt our beautiful pure youth”.

Rest of Europe: “Your beautiful pure youth have horrendously high rates of unplanned pregnancy and STDs”

Brtain: “Hmmm. This is true. But what can we do?!?”

Rest of Europe: “Well… you could educate them about sex and contraception and the physical and emotional health issues that go along with it. And try… you know… to be a little more open about it”

Britain: “Interesting suggestion. But… but if we do that – people might start having sex! And we don’t want that! We are a terribly prudish and stand-offish race! And we will stay this way to keep a chaste youth.”

Rest of Europe: “Right. But… uh… as you have an 11-year old mother, and a cute 13-year old, who looks about 8, but claims to have fathered a child with a 15-year old girl, that two other children (but which we mean under 16 years) claim to have fathered too, perhaps your approach isn’t working?”

Britain:”It is not! We agree, but if we start being open about sex, and teaching kids about it, and giving them access to contraception, they will start doing IT. We are repeatedly telling them how to say no, and how not to have sex.”.

Rest of Europe: “You have one of the highest teen pregnancy rates in Europe. I think they already are”.

So, I believe I have witnessed a bit of an about turn wrt contraception in the UK, in my lifetime. From ‘don’t do’ to ‘don’t ask, don’t tell’ to ‘you don’t have to do, but here’s what to do if you do’.  As my friend (American) put it: “Britain gives contraceptives out like tic tacs”. It’s sorta true. I has heinously bad period pains from the age of 12  onwards. Think: vomiting so hard I pulled my tummy muscles and then passing out into my own vomit. Lovely. Think: when I was snowboarding with a broken arm I refused to believe it was broken as it wasn’t as bad as period pains. Even when I was pushing my whole body weight with said arm. Nice. So, my PCP put me on the contraceptive pill at about 14. I went with my Dad. It was OK. 22% awkward, but OK.

Eventually,  I used to get my refills at my local walk-in clinic as it was closer to the bus stop. I would toddle along, they would take my blood pressure, ask a few questions, then hand me 6-months worth of free pills. And charge me nothing for the pleasure. Then they would offer me condoms, and I would say ‘thank you very much, but I am not having sex. Really’. It was an anonymous service so I didn’t have to lie, but they would always say “hey – take some anyway. You never know”. And I would say “I do know!” and they would give them to me anyway, in a nice unmarked brown paper bag (because brown bags never look suspicious and remind people of hidden porn / alcohol) and throw in a load of femidoms, dental dams, information leaflets and so on. “Have them anyway… Give them to your friends” was the advice.  Frequently I would arrive home with my bounty and my Ma would eye it suspiciously and say “Do we need to talk?”. Which we didn’t, but to be fair it did open the door for me to be able to talk (however awkwardly / angrily / sullenly) with her about this through those difficult teenage years.

At some point I went on a health kick (an unempirical health kick) and decided the pill wasn’t good for me. And a vane-kick when I decided it made me fat. I was coming off this darn thing dammit. I went to my doctor. She talked me through about 20 other options both for contraception and for the period pains. She fitted me with an IUS (a super expensive intra-uterine device) within 2 weeks (I had to wait for some tests to come back first, which were done that day). For free. She gave me a load of free counseling. She gave me a load of condoms. Nice expensive ones as I am allergic to latex. I think I sold them 🙂

When it came time to have the IUS out I was in the UK. I was there for a period of 2 weeks and decided to remember this about 2 days before I left. Now in the UK there are walk-in clinics in every county and every county has both weekend and evening ones. If you cannot make any of those, GPs are obliged to see you. So, I call a walk-in clinic and explain the problem – they tell me they are full for 2 days, but give the numbers of others – all within easy distance. The others are full, or the times don’t suit me (why? Honestly? Because I am catching up with friends). So my local GP has to see me. They do. They next day. They whip it out for free, and offer me a new one. I decline, and they say “are you sure? The pain might come back”. I tell them I will sort it out in the US and they say they don’t think they is a good idea. This shocked me, and I ignored it. They offered me 6 months of the pill. I turned it down as I was not having sex (we’re British, no sex please. Oh, apart from all those pregnant teenagers). She really wanted to know if I was *sure* and then let me go with a promise to come back and see her when I was next back from the US.

Fast forward to my return to Alabama. Boyfriend proposes. I gaily accept. Hoorah. I plan a wedding. Double hoorah.  3 weeks before the wedding I think I should sort out contraception. I call my GP here and am told she is not accepting new patients. I tell them I not a new patient and they don’t care and I get a random GP. That’s cool, I don’t really care who does this. I go see her the next day. I am impressed – she is on time (rare in the NHS, and certainly better than the 2-4 hour wait at walk in clinics in England) and I pay a slightly annoying, but affordable $20. I tell her the situation and that I would like to avoid hormones.  I don’t want to use condoms. She says “OK, you need a diaphram. You need an OB/GYN. You can see one in 6 weeks”. I point out this might be shutting the stable door after the horse has bolted. She says there is nothing she can do. So I say “OK, how about I use hormones for a short while?”. “Not a good idea” she says, and has no other suggestions. I am floored. I glare at her. She says that there isn’t time for me to use hormones. This is actually incorrect. They (depending on the method) can be used from Day 1 – Day 5 of your cycle. She has my cycle dates and Day 1 is next week. I start to throw a shit-fit. She has no other suggestions (lower , localized hormones? Femidom? Even frikkin’ fertility tracking? Anyone?). She takes my blood pressure and says that because it is elevated, I can’t have hormones as it is dangerous. Again, this is factually incorrect. Raised bp is one long-term risk factor; I am not overweight, I don’t smoke, there is no history of thrombosis and I have a successful history of taking the pill. And bp fluctuates. And she was STRESSING me out. And I hadn’t slept much, if at all, for 3 out of the last 4 nights [because, duh, I am excited to GET MARRIED and planning a wedding and submitting a grant and seeing my very best friend in just 12 days]. Really? She says. And 2 nanoseconds later I am leaving her office, slightly dazed and confused, with a prescription for a benzodiazepine, and a refill, and no follow-up.

THAT is giving things away like tic-tacs.

I could have an IUD – not recommended given my medical history, but an option. In 6 weeks. And it’ll cost around $500 all- in- all. Because I really have that when I am postdoc, my fiance is a student and we’re planning a wedding (did I mention the wedding? Might have done. Little bit excited). No, it is not covered by insurance (but, if you were wondering… Viagra is. Yes, you did read that correctly. Wonder what the gender is of the people who make that decision? Perhaps the women are all off having babies). But anyway, it is OK, because if I can’t afford an IUD an abortion can be as low as $400.

Problem solved.

So, I return to my office, very upset. My office mate gives me the planned parenthood number and I call them the next day. “Yes, the Alabama clinics don’t prescribe contraception”. Oh. Really? That’s good planning there. My office mate suggests the student health centre, which for $30 are seeing me tomorrow, which is pretty impressive, and I hope it is a good score for UAB (who have been universally wonderful to me so far) and I hope it works out.

The thing is: contraception is so free and widely available in the UK not just because it is a health issue, but because it is an equality issue too. For two reasons:

(1) The UK believes women have the right to regulate their fertility as much as men. That is, they have the right to go out and have meaningless one night stands without consequences (it can be consequence free for men who abscond into the night).

(2) The burden of contraception usually falls on the woman – although it does not have to, it usually does. We want to help balance this out by givign her the ability not to pay (when she is already paying for feminine products) and not to have to take time out of work.

I have already lost $20 and a few hours from work. I will now have to lose more time and more money. My fiance’s response? He wants to be supportive. He volunteered: “If I’m not at work, I’ll come with you”. Because work is optional for me. I don’t blame him at all, but I see no reason not to see that statement as indicative of underlying attitudes. If I get pregnant, well, no one is going to force him off work… (that is not his attitude, just a statement).

And my honest thoughts? “Fuck it (pardon the pun). I don’t see my fiance really busting a gut to sort this out. Why should I? I want kids in the next year (he doesn’t for a couple of years, we agreed to compromise and try in a years time when we are financially better off, settled into marriage, knowledgeable about where my career will take us… all good reasons)… But perhaps I will tap out and see what happens, ‘coz quite frankly my grant not going in, not having a dress to wear, not getting these papers in, missing collecting my friends from the airport – well none of them are as important to me as not having a child when I’m married, that I want”. I am not going to do it. If possible, I would like to bring a child into the world with planning. But, it’s tempting.

Sort it out Jefferson. Educate your medical practitioners on more methods. Free up medical practitioners to give people contraception. Get evening clinics. Get anonymous clinics. Try to talk people reluctant to use the best methods of contraception for them (like me) into doing so. Push alternatives. And don’t just whack them out on anti-anxiety drugs.

Just a thought. (A frustrated one – I think the drugs must have worn off. Perhaps my GP can give me something else to keep me quiet).