Zoloft

The increase in anxiety after dropping the Mirtazapine quickly became intolerable. I have grown weary of the daily struggle to go about my life. It feels like every moment of the day when I am outside my home is a battle. It’s not quite that bad in reality, but anxiety attacks were become a daily occurrence, and after a while the fight simply wears you down. It was becoming obvious that things were getting worse, and the rate of decline was accelerating. It was time to put the brakes on. This is where I was when I called the doctor last Tuesday to ask for a Zoloft prescription.

The Mirtazapine Experiment Concludes

When last I found time in the chaos to write in this space I had just been handed a prescription from Mirtazapine and was preparing to embark on yet another pharmacological experiment with this chemistry set I call my body. I was hopeful that it would be the last piece of the puzzle, but I am sorry to report that yet again the downside outweighed the benefit and that three weeks later I am no further ahead for having endured the mind numbing fog of these damn pills. I suppose to say I am not further ahead is not completely accurate, I have succeeded in eliminating one more drug from the list of viable options.

Wandering Through The Haze

The last couple weeks have been a confusing time for me. I have found myself in somewhat unfamiliar territory emotionally and physically. About three weeks ago I made a casual observation that my mind had become somewhat muddied. My cognitive processes seemed much slower and my memory had gone to pot. I was having a great deal of trouble recalling names from the previous chapters of my life, and I couldn’t seem to remember to do anything. Theses memory problems were most troublesome because I work as a salesman and forgetfulness is bad for business, but as time passed they worried me a little more.

Along with the mental cloudiness my temper was getting much shorter and as time passed my wife and I barely spoke without ending up making some sort of short, frustrated, and angry comment toward each other. About a week ago I began to notice I was doing things that made no sense, like forgetting steps of repetitive tasks I have completed thousands of times, and was becoming distrustful of myself which in turn was causing a marked increase in my anxiety levels. I had just come to the realization that I was beginning to slide downhill quickly when this weekend the tension with my wife exploded into a real open argument. She basically asked me what the hell was going on that I was repeatedly doing things that made no sense, or failing to do things that were obvious. It seems the greatest source of frustration on her part was that I had turned into a complete idiot.

Wellbutrin Doubts Answered

I took Wellbutrin for years. It was originally prescribed to try and mitigate the unfortunate personal side effects of the SSRI medications I was taking and it just never really went away. In the back of my head I was never really sure it was doing much of anything. A couple times over the years I would get fed up with the side effects of the SSRI and stop it. This always led to a slow decline in the stability of my mood. The first indicator that something was wrong would be chronic stomach upset. Before my actual mood deteriorated I would get tired of feeling sick all the time and end up back on the SSRI.

A little over a year ago I stopped the SSRI medications again and until recently my mood and stomach have behaved nicely. Over the winter I survived benzodiazepine withdrawals without the help of and SSRI and actually felt really good for awhile on the Wellbutrin alone. I suppose in hindsight I should have left well enough alone, but I had this nagging doubt that the Wellbutrin was doing anything and was excited by the prospect of a drug free existence. I worked my way off the Wellbutrin and by the end of May I was living with no chemical safety net. Within a month things started to decline. I was flirting with the idea of calling the doc when the recent insomnia hit and I had little choice but to do something.

About the same time the insomnia popped up I was beginning to lose myself in my own head. The anxiety was dripping off me. I worried about everything and just generally began to feel fearful. I was worried about the big questions in life. What are we doing here? What happens when we die? Big stuff with no real answers, but that caused me to spend way too much time in my head. I tried to stop myself from having these internal conversations, but my brain just went there on its own.  About a week after I started the Wellbutrin I noted a slight let up in the overriding sense of unease, but I still couldn’t get out of my own head. When I last saw the doc we increased the Wellbutrin dosage from 150mg to 300mg. About a week in I finally found some relief from these dangerous internal though patterns.

I guess the question is answered. The Wellbutrin is doing something. The question now is if it will be enough. I travel around and work with the public. Twice in the last week or so I have had a customer point out that I look unhappy. I don’t feel particularly unhappy. I am tired. Sleep has been better, but not perfect, and even when I get a good night’s sleep I feel tired in the morning. I know that is not a good sign, but there have been improvements in my sleep over the past week so I remain hopeful that the fatigue will pass. I have also experienced some of the milder side effects of the Wellbutrin restart which include occasional dizziness and feeling cognitively slower. Some of these symptoms are letting up, and I wonder if the fatigue may be part of that as well. In the past when I have taken SSRI medications I have felt pretty good. At this point on the Wellbutrin I wouldn’t say I feel good I would just say I don’t feel bad. I am most certainly not on solid ground

A Familiar Theme Reoccurs

A common theme throughout this blog has been the seemingly endless parade of shitty decisions that land at my feet. These are the kinds of things that have to be decided on for life to move forward, but which have no clear cut right and wrong choice, or if there is a right choice it comes with consequences that make it difficult to bear.  The past couple weeks have seen a reoccurrence of this theme in ways that I had hoped I would not deal with again.

When I last wrote on this blog I was struggling with a professional decision. I had been offered the opportunity to work on the water again, but I would have been gone a great deal and missed some important family events. Of course this sacrifice was going to be rewarded with a salary the likes of which I had never seen before, which would have solved a lot of our day to day struggles around here. The very moment I was made aware of this opportunity I shook my head and mumbled something about “timing”, another theme I seem to see a lot of, and wished to myself that this had a popped up two or three years ago. At the end of the day taking the job was going to involve giving over a little more of myself than I was willing too at this time. I have mixed emotions about turning down the opportunity. I have never in my life been presented with an opportunity that I was so uniquely qualified for. It was bizarre how the job requirements matched up with my experience and qualifications, and I think I would have liked the job. Even my wife couldn’t honestly say we had made the right call as she watched the prospect for that kind of income vanish.

One of the reasons for turning down the job that I didn’t talk a lot about, but was always there under the surface, was my health circumstances. I have already seen what happens when I am put in situations I am not comfortable with when my head isn’t quite right. I had real concerns that making a change of this magnitude where a significant amount of the control I have over my schedule, and therefore what I must do when I am not feeling well,  would be turned over to a relative stranger may not work out well. I have been struggling with my medication free existence and am looking to get things on an even keel not turn them upside down. At this point as long as I don’t lose my curret employment I think the decision was right for now, and I even managed to turn it down while keeping the door cracked for any future possibilities.

My mental health has been anything but predictable over the last few weeks. I introduced my readership to my not so good friend Freddie some time ago, and as always he has remained steadily in the background, while occasionally stepping into the forefront trying to steal the show. Other than off and on feelings of general unease, and one horrible timed night of insomnia (I doubt very much the timing was coincidental), much of the flat out feelings of anxiety have been reasonably controlled. Of course “reasonably controlled” is a far cry from where I was just prior to stopping Wellbutrin and I was certainly hopeful that things would be better than that.

The last several days has brought with it a change that has proven to be the proverbial straw that broke camel’s back. I have seen a return of the gastro intestinal symptoms that have always been the weather gauge of my mental state. Long time followers of this blog my recall that when depression and anxiety first appeared in my life in a debilitating sort of way the first symptom was actually stomach upset for which I was subject to countless horrible tests to determine that nothing was wrong with me. It was an awful time I hope to never repeat. I am now on at least four consecutive days of stomach pain and gas with significant diarrhea for the past two days. It has reached the point where I have begun to worry about leaving the house or going on the boat with my father, which means it has reached the point where I am no longer going to deal with it. I made the decision this morning to make the phone call, and I have spoken with my shrink’s nurse. I requested a prescription for 150MG of Wellbutrin XL. I am not happy about this and am not terribly confident that it will even work. In the past when the stomach upset really gets going the only solution has been the SSRI type drugs, which come with their own problems that I will magnify other ongoing challenges I am dealing with making them less than ideal. It is my hope the Wellbutrin combined with my improved diet (down 30 pounds now) will settle things down some, of course the probably means a semi permanent goodbye to my new friend the mocha latte.

I am still waiting for the call back from the doc saying that the RX has been called in, but I don’t anticipate there will be a problem. It will be hard to swallow that first pill. I wrote here when I stopped taking the medication that the doc pissed me off a little by preparing me for the possibility of going back on them. I knew it was a possibility and while he was trying to be helpful his words are doing nothing make this easier. The decision has always been mine not his, and sometimes making the right decision is the hardest thing to do. There really should be no down side to this. I should feel better with minimal side effects, but there is something about having been completely chem free and having to go back that really sticks in my throat.

Adjustments

I am officially spooked. Waiting for the other shoe to drop would be the appropriate cliché. About three weeks ago I posted the news that I was going to make an official stab at living my life free of psychotropic medications. The very day that I wrote that I spoke to my doctor, his nurse actually, and asked what the best way to proceeded would be. I had dropped my daily dose of Wellbutrin from 450mg to 300mg and under their direction I dropped from 300mg to 150mg.

Wellbutrin XL (Photo credit: Wikipedia)

I was told to do that for a month and monitor my mood closely. I had already scheduled an appointment with him for May 2^nd so the timing was about right to be ending the pills when I see him next. I had a bunch of 150mg pills already, so I made the dosage drop immediately. Today is the twenty first day and I only have two pills left. I am not going to refill the prescription so by the start of next week I will be done. So what’s the problem? I feel really good. Not perfect by any means, but well. Sure when I stop my body will still have to process the remaining drug in my system before I will be really free of it, but I am doing ok. It just doesn’t seem possible that from December to now I could remove all these regulating forces from my life, and not have it turn into a disaster.

I actually started this blog in an attempt to avoid returning to SSRI’s. I had been off them for several months when I started writing here, but was having a hard time keeping myself out of the darkness. I needed a place to process my thoughts and I was desperate to avoid returning to that particular type of drug so with a little encouragement from the blogosphere I began to share my experience. I was only a month into it when I was faced with the challenge of not only staying off the SSRI, but dropping my ultimate crutch; the Klonopin. That experience was chronicled in a number of posts starting here. At the time I simply hoped to survive it. I never dreamed it could be the start of something much bigger. For years my shrink had been telling me that the Klonopin was a mood depressor and that I would do well to get off it, but he never really pushed the issue. As I began the withdrawals it became clear why he never really forced the idea. If you don’t come to the conclusion that you want off that drug on your own, if you’re not committed fully, I am not sure anyone would stick it out. It took awhile to feel normal again, but it appears he was right.

There have been definite changes as my body has adjusted to less and less medication. Most notably I have moods again. I get sad, happy, and angry. I used to just be mellow. I am cautiously excited by this new development. Of course feeling happy is a wonderful new experience, but anger is not as wonderful, and sadness I am all too familiar with. I am fearful of both these emotions. Sadness is natural, but when you have suffered from depression each time you feel it you wonder if this is the beginning of the end. Will I have to go back on the pills? With anger I just worry about managing it. I haven’t had too for so long that I fear I have forgotten how. It sounds strange to say, but I want to be angry. It is a natural emotion and it is healthy. On the other hand unchecked it can be very destructive. In the past I have become irritated, but rarely did I give voice to my angst. I didn’t want to fight with my wife, and I swallowed it down and carried on. Recently I have been more than irritated and my anger has boiled over and caused arguments. I am not comfortable with it yet, but after a short, but fiery exchange with the Mrs. last night I felt no more hostility when it ended. In the past after I would swallow it down I would be pissed for hours. Related to these arguments I have noted that my verbal filter seems to have bigger holes in it. In my teens I never lacked for an opinion. “Painfully honest” was the term once used to describe me. If I thought it I said it. I wasn’t entirely tactless, but I wasn’t afraid to speak my mind either. I never really noted the change, but as an adult I have been less that way. I chalked it up to maturity, but in the last couple weeks some of that directness has returned. Maybe this is related to the drugs and maybe not, but since I am still under their influence it will be interesting to see how that particular characteristic develops over the next several weeks.

The other emotion or feeling that I learning to live with again is anxiousness. I am not going through my days scared of nothing, which is an improvement over those days before the Klonopin, and the more recent withdrawal experience. That said when I was on the Klonopin I was rarely anxious about anything, and I never really worried about mild sensations of fear because the drug kept a lid on it. Now I no longer have the chemical buffer, and the only thing that keeps a lid on it is my own cognitive efforts. Before the need for the Klonopin arose I didn’t often feel scared. I was a pretty typical late teen early twenty male. I didn’t take as many chances as most, but nobody would have accused me of being a pussy either. Prior to taking the drug feelings of fear and panic consumed me, and now that I am off the drug, I find myself somewhere in the middle. I am certainly not feeling bullet proof, but I am not scared of living either. I suppose I should not expect to feel the same. While under the Klonopin umbrella I have matured from a 23 year old college student to a 35 year old father and husband.

I so hope that this experiment is successful. I have been off and on SSRI’s multiple time, but I was always on the Klonopin when I was trying to quit the SSRI. I don’t know for sure, but it has been about a year now without the SSRI’s which is without a doubt the longest stretch ever. I hope this works, and I hope my wife and I will both like the new me.

Going To Try Chem Free Living

Forgive me blogosphere for it has been thirty two days since my last entry. It has been an amazing month, and with the notable exception of my employment circumstances things are looking up around here. The truth is my urge to write peters out when I am feeling good. When I have no real angst I have no inspiration.

A regular theme throughout the life of this blog has been my experience with the medications used to treat depression and anxiety. Anybody who has done much reading here knows I hate these drugs with some passion, but have also relied on them to get through the last twelve or thirteen years of my life. In that time I have never been completely drug free. For over a decade I have gone through each and every day of my life under the influence of at least one and most often two or more drugs designed to effect my mood. I hardly remember what it feels like to function without these pills.

Over the winter I went through the long ordeal of withdrawing from over ten years of daily Klonopin use. The last pill was taken December 30^th and it was probably the third week in February before I began to feel in anyway normal again. At the end of February I had an appointment with the shrink and I asked about the possibility of getting off the Buspar and Wellbutrin. He told me I could drop the Buspar anytime and drop my Wellbutrin dose by a third from 450mg daily to 300mg if I felt up to it. I had been taking the Buspar twice a day prior to this appointment, but beginning to next day I only took it at night. After a week of the “only at night” dosage I quit altogether. Other than a mild hiccup in my sleep, which was probably all in my head, I didn’t even notice the drug was missing.

I was feeling very encouraged by the successful drop of Buspar. For many years I had used the Klonopin as my crutch. I never forgot the way the panic and anxiety felt, and I was fearful of returning to those days. During the withdrawal I was reminded of why I was scared as the experience was highlighted by two months of increased anxiety with several days spread out over the period that were nearly intolerable. With the Buspar gone I was living clear of any drug whose sole purpose was to control my anxiety, and I was functioning fine. For some time now I have been nagged by a vague awareness that the Wellbutrin isn’t really doing anything for me. With the Buspar gone it was time for the next hurdle so I cut the Wellbutrin dose as I had been directed. It has been about three weeks since I dropped the dose. I don’t remember the exact date/day, which I honestly consider a good sigh unto itself, if I can’t remember exactly when than I must not have been obsessing over it too badly. I am feeling very good, better than I remember feeling in a very very long time. Truthfully I feel better than I ever remember feeling. I left a message with the shrink this afternoon asking how to make the next drop. I am scheduled to see him May 2^nd and I would like to have made the next drop a few weeks before then so if things do start to get weird I will have the checkup already on the calendar.

My wife and I committed to another change a couple months ago as well. Somewhere on this blog I once listed my weight at 250 pounds. I was lying. You know you are self conscious when you put the things in print I have put on this blog, and you can’t tell the truth about your weight. My weight maxed out at 266.6 pounds on my 5’11” frame. I remember the weight because the last three numbers struck me. I am not a terribly religious person, but I knew I was too heavy and the 666 stuck in my head as a bad sign. I had settled to 263ish when my wife decided she needed to drop some weight. I watched her get started and she was doing well. She bemoaned my cooking constantly as she struggled to lose, but lose she did. A couple weeks after she started I followed. I didn’t make a lot of noise about, and didn’t even tell her. My motivation was twofold. First my son is 2 ½. If I am going to be able to play and participate in his life I better get some of this weight off. The second is probably the greatest motivator for all men. Sex. My wife and I have always had mismatched sex drives, and one of the effects of dropping the Klonopin was a sharp increase in my drive which was already way ahead of hers. I had heard complaints from her that my weight made sex uncomfortable, but for some reason it took the light bulb a while to go off in my head. I finally decided if I wanted more sex I needed to take responsibility for making myself more appealing, and the act for comfortable for her. By the time I last posted a month ago I was down to the 250 number I had claimed to be. I wanted to brag, but how do you brag about being at the weight you told people you were already at? This morning marked two consecutive days at 238 pounds making my total weight loss from the start weight 25 pounds, and from my max weight almost thirty pounds. My pants used to fall down my ass like they do on all fat guys. They are still falling down my ass, but now it is because they don’t fit.

Weight loss is a real chore for me. I don’t want to get into all the details here so maybe I will put together another entry talking about that, but I can say the work is paying off. When I hit 245 my wife commented that the sex was better, and she was right. She has dropped about 17 pounds and the combination has made for a noticeable improvement. With the Buspar gone and Weight and Wellbutrin lower the biggest change I can see other than my general mood is my sex drive is off the charts. The mismatched desire has always been a problem in our marriage, but recently she has made more effort to participate and I tried to do some little things to keep her interested.  We talked about it last weekend and I told her that in a perfect world I would be looking for sex four times a week. She was a little taken aback by this. Last year we averaged every 10 -14 days with several instances where we approached 30 days between sexual encounters. This year has been once every 7 -10 days, and lately I am noticing we are pretty steady on a once on the weekend pace with the occasional extra thrown in. This is an amazing improvement over where we have been, but I think she was shocked to discover that I am only getting about 25% of the sex I actually want. Will this foster more understanding of where I am coming from? The drug free me is finding the urge stronger than ever so I certainly hope so. I am hopeful that this rapid change in my desire wont cause us any problems.

The past month has seen many more changes as well that I simply don’t have time for here, but maybe they will give me an excuse to write here a little more often. As a parting word I would ask for forgiveness for any typos you may find in this entry. I really want to get something posted, and I am rapidly running out of time so my editing will be quick and sloppy.

Tests and Choices

In my last entry I defended the idea that those that suffer from depression and anxiety are actually much stronger than they feel, and are certainly stronger than the general public gives them credit for. Last week I was challenged to believe all that about myself. It was a long bad week that left little time to do anything but get through it let alone do any writing.

Back in November I took a spill on the walk outside my house landing hard on my right elbow. It hurt like hell at the time and has continued to be painful as the weeks have passed. I finally saw a Doctor about it who thought I should see an orthopedic surgeon. When that appointment came around it was determined that I should have an MRI of the elbow. I wasn’t all that worried about it until I was asked during the registration if I was claustrophobic. I have had a couple encounters with actually being trapped in relatively small spaces that have stuck with me, but I have never considered myself claustrophobic. I am actually quite sure that anybody would have been scared in those previous circumstances. Of course if you ask a guy with an anxiety problem if he is claustrophobic you are going to get their brain moving and that is never a good thing.

I have had a creeping feeling that last couple weeks that I am slipping. I don’t want to face it head on because I have come to believe in self fulfilling prophecies. In my experience if I get worried about how I am going to deal with something the worst case scenario of those worries often ends up being the case. It is probably stupid and maybe even reckless, but I feel that if I admit I am slipping I will fall, and if I ignore it and try to keep on trudging it will go away. To be clear I am talking about anxiety here not depression.  

Back to the MRI story… In the days leading up to the appointment I was feeling generally uneasy about it but I kept telling myself it that it cant be that bad. I figured I would tell the technician about my background and play it by ear. I was sitting in the waiting room when the tech came to get me, and I pulled a typical guy stunt. The tech was young, female, and attractive. Why should this matter? It shouldn’t. I am happily married and well off the market, but I am a guy and pride or ego or whatever stepped in and I suddenly wasn’t so sure about confessing my insecurities. Stupid. Very stupid. She did eventually ask the claustrophobia question, and I muttered something about generalized anxiety.

When we got in the room with the machine I was stunned at the size of it. Turns out upper extremities are about the most

Image via Wikipedia

difficult part of the body to scan. She lays me on my stomach with my arm out in front of me, and gets me all propped up on pillows. I am laying on the little gurney thing look at the hole thinking that the whole center of the machine is going to slide out as the gurney slides in. I mean it has too right? There is no fucking way my fat ass is going to fit in that little god damned hole. Imagine my surprise when  I was wrong. She tried three times to stuff me in there and it just wasn’t going to work. Now I am overweight, but were not talking obscene. I am 5’11” and weigh in at 250 pounds. I have wide shoulders probably from ten years of competitive swimming. I am big, but I am not out of control. There are plenty of folks fatter, and plenty of guys with bigger shoulders than me, but I was not going to fit head first. Her next attempt was to put me on my back. Of course that puts the bad arm at my waist meaning my waist is going to be in the center of the machine and I will be ALL THE WAY in. I get situated and she says I have to roll up on my side a little and raise my left are over my head.  When I asked why she said it was the only way she could get my shoulders in the machine. At this point I am still playing along, but the anxiety is at a very high level and the associated stomach upset is building. I get my arm over my head and she places a grid over my bad arm and ties it to me, which effectively ties me to the gurney. When it comes to me and small spaces I am fine if I feel like I can get out. It is not so much the tiny space as the feeling of being trapped that bothers me, but here I am getting ready to be wedged back in that tiny hole with one armed up over my head, and the other tied down. She begins to run me in slowly getting my up on my side a little more to squeeze me in. My shoulders are folding up and my head is sliding down the side of the tube. My nose is an inch from the top of the tube, and as I go in it is getting darker as my body mass closes the hole.  I have a sudden image of myself puking in the tube unable to move and I am done. Get me out of this thing!!

I was embarrassed and felt like shit. Many of my troubles mirror those of my mother. She cant even get in an elevator. She has had a couple MRIs but they always involved valium. When I was on my way home and told my wife what had happened her response was “you are your mother’s son” which wasn’t exactly the hug I was looking for. The remainder of the week I suffered through the anxiety hangover. When something like that happens it is not over when it is over. Once those chemicals get flowing in my brain they don’t just stop. I was low, easily angered, my stomach was a mess, and I was always on edge. Other events transpired over the week to reinforce all those feelings. I have been dealing with gradually decreasing levels of anxiety for the last seven or eight days. They are not decreasing fast enough.

The new plan is for me to go check out one of the larger bore MRI machines and see if I can hack being in that one before I make an appointment. Having just been through, and maybe still going through, the Klonopin withdrawal the last thing I want is to be drugged up for this test. It will probably be the end of this week before I can make that happen. I am trying not to schedule it and just do it when time allows to prevent any build up of anxiety.

I am not sure what I am going to do with this increased state of anxiety. I have written before that I feel like I am flying with no net, and that sensation is still strong. The Klonopin was my filter, and to a large extent my safety blanket, but it is gone. With my Coast Guard documents still in limbo I am in a tough spot. I see a few choices but they all blow. The first and most likely course is to hold steady and see what happens. I could always try a little talk therapy to see if it takes the edge of. Another option is to go back to the shrink and say I cant hack it, which will make me feel like a failure, and will likely lead to the loss of my documents. An alternative to this would be to get the medication from a different doctor and keep my mouth shut. The last option would be to go back to the SSRIs and all their associated side effects. The effects of this on my sex life and marriage make it the least likely course even if it is the one that would probably make me feel the best. I have written before about a life filled with unpleasant choices, and if that list doesn’t prove my point I don’t know what does.

I am at least back to believing that if I can go about my day to day life with all the above shit going on that I am actually stronger than people think.

Klonopin Free

It was a week ago tonight that I took the last Klonopin that I will hopefully ever have. With the previous reductions in dosage I didn’t feel any effects right away. I would drop the dose Friday night and start feeling a little off by Monday. Those feelings would generally last into Wednesday, but I was better by Wednesday afternoon and ready for the next drop Friday. This time I got hammered the very next day. I am sure that a lot of it was in my head, but Saturday was the worst day I have experienced in the last four or five years. It was terrible and included an unfortunate little display in front of my wife and child. The aftershocks of the day carried over into Sunday, and I was still pretty edgy on Monday. Tuesday was back to work after the long holiday week and after a rough start I was feeling pretty good in the afternoon. Things have improved at a fairly steady rate since.

Image via Wikipedia

I saw the shrink for a follow up appointment on Wednesday and he seemed pleased with the progress. He told me that if you consider the body and just a physical vessel the withdrawal symptoms from the Klonopin shold be gone in 5 -7 days. Apparently this is what they have observed in laboratory animals. Of course I have a brain that is guilty of over thinking makes the situation much more complex and he said  I could be feeling a little off for the next six months. Knowing that there is actually no physical effect from the drug left has been helpful to me in coping with what has been going on. I at least know that I am more in control of what is happening in my brain than it may feel like.

Through the past week I have been struggling some in two broad areas; sleep, and stomach upset. I wrote a couple weeks back about a horrid night of insomnia. I don’t kick an experience like that easily and predictably it has stuck with me. I haven’t been through anything as bad, but in the nights following I would take two are three hours to get to sleep each night. That carried into this first part of the week when about Wednesday night it only took about an hour. Last night I only recall tossing around a little and looking at the clock one time. I may have been to sleep in as little as twenty or thirty minutes, but staying asleep was an altogether different story. I was up every couple hours through the night. The other sleep oddity that popped up earlier in the week was the appearance of regular and strange dreams. On Klonopin dreams would occasionally happen, but they were rare and it was even rarer for me to remember any detail. Over the last few days I have had vivid and strange dreams every night. I still don’t recall a lot of detail as I write this, but I do remember having clear memories of some of the more bizarre dreams first thing in the morning. This isn’t really a problem, but some of the stranger scenes can be a little unsettling when you are already questioning how your brain is working. It will take some getting used to if it continues.

The stomach upset is at least as big a problem as the sleeping. When I was a teenager everybody quaintly referred to my nearly constant mild stomach upset as a “nervous stomach”. Sure. Apparently as an adult life makes me nervous as I have a stomach ache in the form of gas, cramping and diarrhea nearly everyday. The closest thing to a cure I have found is the SSRI type anti-depressant. Of course anybody who has been following this blog knows how much I hate those pills and why. Since the Klonopin has been gone my body has doubled down on the quantity and intensity of these stomach problems. When it really gets rolling I may have significant stomach pain eight or ten times throughout the day leading to five urgent trips to the bathroom. That number would be higher if I worked in a place that actually provided regular access to a restroom. There is nothing like driving down the road trying not to shit your pants multiple times a day. I discovered a product called Imodium AD Multi Symptom that treats both diarrhea and gas. I have taken it twice in the past two weeks, and it seems to bottle me up with little or no cramping for a couple days (no regular bathroom visits either) before the symptoms start to return. I don’t know what the long term effect would be of taking this shit (or anti shit?) a couple times a week would be, but I have a feeling I am going to find out.

So that is where it stands at this point. I don’t feel a lot different than I did on the medication other than the problems described above, and none of those problems are new. This Withdrawal has been unpleasant, but the serotonin withdrawal syndrome I experienced the last time I stopped the lexapro may have been worse overall. As far as the Coast Guard is concerned when I have been off the klonopin “four to six weeks” I provide them a letter from the doctor and records from the pharmacist, and they will reevaluate my application. Lets hope for a good month.

Incompatible With Maritime Safety

So there are not going to be any profound observations or statements in this post. Mostly this is an update for anybody reading this that read my blog about my experiences with medication and about feelings of loss. I went to the mail Saturday morning and found a letter from the Coast Guard with a delivery notification notice attached. I knew before I opened the envelop, but the chore had to be done. They waited until the second paragraph where they  stated that I have been found to have a Major Depressive Disorder that requires chronic treatment with Klonopin. “This finding is incompatible with maritime safety”. That’s the complete sentence that is the USCG’s fancy way of rejecting my application for merchant mariner credentials.

I am not surprised the medications were a problem. I knew they were going to want to talk about it, and I expected to have to fight some for parts of my credentials. Here is what does surprise me though; I applied for a mates license that isn’t the biggest available, but it is large and allows service as mate on about anything except the larger ships. I applied for a license to be the mate of tug boats. I applied to be the captain of smaller vessels, and I applied to be an AB on any and all size vessels. An AB is a fancy way of saying deckhand, or they guy the chips rust, paints the boat, handles the lines, and other supervised duties. All these credentials I already held. Everything listed above is a renewal and everything was originally issued when I was taking more medication than I am now. So not only have they decided I am not safe enough to stand a watch as a mate or be the captain of some smaller boats, they have decided that I am not safe enough to chip rust off the side of a boat under supervision. I can’t stand on the bridge next to a mate and look out the window for other boats or take steering commands from the mate. Are you fucking kidding me!?!

The idea that I am “incompatible with maritime safety” really pisses me off. I quit a $70K a year job that was months away from becoming a $90K/yr job because the company I worked for put me in a situation that was dangerous, and wouldn’t change the circumstances even after I twice asked. How many people have the judgement and moral fortitude to do that? My experience has been not enough. I have seen things in the maritime industry that are incompatible with maritime safety and the mostly have to do with the egos of men drunk on the power they hold in their little worlds, a completely fucked up moral code that existed in that particular companies culture, and the use of under qualified, barely trained individuals as crew due to manpower shortages.

Some may remember the summer before this past there was an accident in the Delaware River off Penn’s Landing in Philadelphia. A tugboat pushing a sludge barge hit a tour boat in the river and killed two Hungarian kids here on a church trip. I remember when this accident happened, but I was long off the boats and paid little attention until few weeks back when the incident was back in the news because the mate running the tug got sentenced to 366 days in prison for his actions that day. According to news reports the mate of that tug received a call from his wife while on watch. She was distraught because there had been a complication while one of their kids had been undergoing a routine medical procedure, and they believed the child had been deprived of oxygen for several minutes. He was powerless to do anything at the time, and she never should have called him, but he became distracted by his family situation and moved himself from a steering station that allowed him the best visibility over the tall barge to a station the offered much less visibility, but that had a computer station where he started doing internet searches on his child’s condition. He made or received 22 phone calls in the hour leading up to the accident, and turned down the marine radios so he could hear these calls better. The captain of the tour boat was making radio calls that went unheard aboard the tug boat as the mate was distracted, and couldn’t hear the radios. This all happened early in the afternoon. The off watch captain may have been asleep, but it was a rare captain who took more than a catnap during their midday off watch. Regardless of what the captain was doing the mate should have woken him to take control of the tug and barge while he sorted out his family situation. He was too distracted to be running that unit anywhere, let alone on a summer day in that part of the Delaware River. He lacked the judgement to recognize this or lacked the moral courage to get the captain, or both.

The point of this story is to demonstrate one way in which accidents can happen in this industry. I worked with the man at the controls of that tugboat, and he had more than demonstrated he lacked the judgement to be there, but had been protected by a captain that took a liking to him. The source of this accident can be traced to ego and lack of judgement. It had nothing to do with anybodies reaction times being slowed by fractions of a second. In spending most of my life on the water I cant come up with a circumstance were an hundredth of a second was the difference between an accident and not. In the transportation business we study the accident chain. This is the idea that in a complex environment accidents are generally the result of a chain of events set in motion long before the actual incident. In the above case it would have started when the captain’s skewed sense of morality kept this guy working despite warning signs he wasn’t up to the task, events that occurred years before the accident.

Today I spoke with the Coast Guard and confirmed that I am not eligible for any merchant mariner credentials. The Coast Guard treats these medications the same whether you are an AB, licensed to take six people for a cruise on the bay, or licensed to be the captain of a super tanker. I was told that mariners on drugs like klonopin where responsible for numerous maritime accidents. I told him that I doubted that to be the case, and would like to see accident reports supporting that claim, which predictably pissed him off. I was told that my only recourse was cessation of the medication. Decisions… Decisions…