Monday, March 12, 2007

Paxil, The Drug of Champions

Um, no, not really.

You know, when I was young, I not only thought I had the world on a string, but I actually did for a time. When one crosses the snowy pass of middle age and when there are fewer years left than have passed, well, one starts considering one's remaining options very seriously. There isn't enough time to backtrack to a starting point and try again, simply so.

Right now, I'm adrift. My creative energy is at zero. I go to work and watch the clock until I can leave. I go home, now empty except for endlessly needy mammals. And I know it's all in how its perceived, but, God, c'mon already. I think like I'm 28 but it's painfully clear that I'm old enough to be that very kid's father.

What does that have to do with anything? I'm not sure. And that's the trouble.

For most of my life, I never felt unsure about myself, what I was doing, my creative prowess, my intellect or my ability to polish the proverbial turd. Now, it's all gone - the relative fame, the noteriety, the money, the fast times, the big deals, the knowing looks and nodding respect - now gone, all gone.

By the way, I have the uncanny ability to paint the darkest picture possible of any given situation. One of my favorite jokes is this: the pessimist says that things can't get any worse, but the optimaist says, "Oh, yes they can!"

Look, dear reader, I don't want to scare you away. I'm not sure why I feel compelled to write all the stuff I've written here, I really don't. I know that it may seem disjointed, but they're sketches from my stream of thought. I'm actually a pretty regular guy, with pretty regular "challenges" and am not bitingly mad.

I want to share with you. At this point, we're still fairly anonymous, so I don't think you'll find this as scary as you might otherwise. Let me say in advance that I am a very long way to coming to my various points. For whatever reason, I have tried and tried and tried to be more direct and plain-speaking, but it always winds up as at least five hundred words. You should see my resume - six pages! So, it's a characteristic that isn't always pragmatic or palatable.

No, I don't tear the heads of small forest mammals and suck out the contents of their braincases not do I stalk budding celebrities. I don't collect Warcraft paraphenalia and I believe that leather is best employed in the manufacture of shoes and handbags.

So, here's a picture of me sharing: that's my therapist on the left and my physician on the right. I started taking the Wellbutrin for two reasons. My therapist - and this is not a physical therapist,
so fill in the blanks, please - suggested that it would be best for me to start taking Paxil to help open up, mash down obsessional thinking and make my (mild) depression go away. And that was in the first session. I thought that it sounded swell and would fast track me with the talking therapy stuff. The day before going to my doctor to get sized up for this substance, I did some research on the Web (should that be in caps now?)

I'm wiriting this at this point, with more to tell in a minute, hoping you might see it tonight. I like to think I actually talking to someone. Here goes . . .

So, here I am. Emotions raw, but understood. Libido intact, thank G-d (forgot to do that earlier - sorry, Lord.) Not that I plan to use it anytime soon, but it's good to know it's there.

On the serious side, since I'm sharing, I've found this experience highly frightening. I am spelunking without a net or whatever it is that spelunkers use when they're spelunking. At three AM, no one can hear you scream, so to speak. What's frightening in the realest, no-joking-I'm-serious-yo sense is that I'm utterly alone and didn't realize it. I mean, I knew it, I guess, but I didn't feel it. This concept hit me like a ton of bricks and I thought of Kirk saying something like, "I knew I wasn't going to die just then because when it happens, I will die alone." Okay, where's the damn History channel?

So, like I was sayin' . . . this Paxil stuff sounds great on the outside but read the black box warnings. Okay, what is this black box warning of which I speak? The FDA mandates a variety of rules surround what's called a PI, or Prescribing Information, commonly included with
the drug's packaging. These are very strict rules and must be followed exactly. The black box highlights the most dangerous aspects of the drug in question. Paxil's black box says this, basically and paraphrasing, and forgive the implied crudeness and the end: you may
have a worsening of depression, including the inducement of suicidal ideation, activation of mania, tremors, seizuires, abnormal bleeding, tinnitus, heart valve disturbance elimination of libido and finally, your member will fall off. Huh? Okay, that doens't sound too good to
me. I remember 'ludes in college, and well, I would call them aphrodisiacs, either, but the total suppresion of the one thing a 48 year old dude who still thinks he's sort of twenty-eight-ish, has to hold on to? So to speak, that is. Nah, brotha, that ain't no thing. Okay, okay - but the doctor said that it will help, so, let's look at anecdotal evidence from the years of prescribed patients. Oh, goody! In about 30% of case, the worsening depression caused by Paxil remains with the patient - permanently. So does the libido sublimation, Nice. Uh, no, thank you, sir. I will not have another.

So I went to good ol' Dr. Guy and said this, "Listen here, y'all, I ain't losing my private dancer, if y'all know what I mean, just to treat a minor depression. And, after all, I have reasonable reasons for feeling sad on ocassion." Hmm, says the doctor, how's about Wellbutrin, and you can kick the smoking habit, too, while you're at it. Zealots: gotta love 'em. So, okay, with Wellbutrin, will my dick fall off? No, no, it seems to do a bit of the opposite. Yay! says I, lay it on me!

With some trepidation, I start at the recommended 150mg dose. Hmm. Don't feel any different. The doctor did say it would take about two weeks to get up to full speed with this stuff. Day two, feeling oddly agressive, in fact, highly agressive. Day three, more of the same with
concommitant anxiety. What the hay? Let's check those side e-ffects again. Yup: both on the list. Okay, let's move on. Day Three thorugh Five, no big deal, but, don't feel different, either. Day Six, starting a bit of a dark slide. Oh, well, might have happen anyway - who doesn't have blue days once in a while. Day Seven - holy crap, I feel as if someone is searing my solar plexus, the anxiety is so intense. Day Eight - a special day since the dosage doubled - more of Day Seven but with a so-special treat. The worst sadness, I won't say depression, I have ever, ever felt in my entire life. Like someone put a gun to the head of my favoritist puppy and pulled the trigger, only much worse.

Now, intellectually, I know this is the chemical working its magic. But, when you feel something, it's real, because you feel it. Without getting into R.D. Laing for the moment, let's just say that the sensation is most directly engaging. Good thing there were no firearms present is all I can say. Day Nine - more of Day Seven multiplied by Day Eight PLUS the cries of Dante's lost souls. By the way, added bonus is that you get to watch every episode of Law and Order ever
produced because sleep is out of the question, save for two scattered hours a night.

Day Ten, back to Daktari for a Well QuadraGenerian checkup. Unfortunately, one of their nurses DIED and they had to keep me on ice for roughly two hours before talking to me. I felt so bad, I cried.

Let's talk about crying for a minute. Before taking this drug, the last time I cried was when my first ex (oh, god, that makes me sound like SUCH a loser) told me what she told me and that it was time for me to split. Left field, upside the head, okay, you coke snortin' ho, whatev, seeya. Eight minutes in my Chevy Impala with the Seafoam Green Mettalic paintjob with tears a flowin' Now, if the kid on the left in the diaper commericial is more wet than the one on the right -
waaaaaaa! I caught Field of Dreams on Lifetime - waaaaaa! Dr. Phil - waaaaaaaaaaaa!

So, I said to the doctor, who was highly distracted by a death that, frankly, had nothing to do with my needs, this doesn't seem to be working for me. I didn't say the magic words - suicidal ideation - so, he suggested that I get off it or ride it out. Well, duh! What was the alternative. I could try the dick-falling-off medicine if I chose to. Naw, that's alright, let's ride it out.

Let's just say that it's been a shitfest of emotions that I didn't even know I had. Y'see, I talked to the therapist and she said, as cogently as usual, that those emotions are all coming from within.
Hmmmm. They weren't coming from anywhere external and that the drug may be reducing inhibitions that have suppressed those emotions. Uh oh. She rolled out some techniques for dealing with these "issues" and, well, they kind of work, a little.

So, what's the deal? This is about sixteen days in and I've slpt 32 hours. The Rozerem that the doctor gave me, which works on mellatonin, supposedly, did squat. All of a sudden, I'm rethinking the 1,000,000 wrong and unfair things I've done to the ones I loved over the course
of nearly a half-century and, you know what, I'm really tired. I think I'd prefer daily life with a dash of stress and a pinch of depression, thanks.

So, that's my experience with mind-chemical-altering drugs. Except, when I was in med school (long story) we used to take a mood elevator during crunch times, whose name escapes me now (I recall it was Elavil now -ed). My god, cramming took on a whole new meaning. Addictive? Hell, yeah! Good thing there was no internet back then, I can tell you that.

So, here I sit. Typing like an idiot. Because when I write this blog I feel as if I'm really saying something even when it's nothing at all. If we do wind up meeting, I expect to be a total bore. Maybe I'd bring my laptop as insurance.

Let me reiterate that I'm not nutzo, bonkers, wacky, well, maybe a little wacky, although I understand that wackiness is actually agressive behaviour. What does one have prescribed to treat excessive wackiness, anyway? Seltzer bottles?

Okay - so, let's look at the Reader's Mailbag and answer a question. oh, here's one from little Pammy Knight asking whether I'm Canadian. Okay, Pam, I just hope you don't work for the INS! Just kidding, just kidding! I was Born In The USA, in a place called Brooklyn, NY. A tree grew there at one time. My parents then decided it might be good to go live in the frozen Great White North with my father's gigantic family, in Edmonton, Alberta. Those were the salad days but. alas, fortune drove my parents eastward once again, to resettle in New York, to build an empire out of meat and meat byproducts. So, at age twenty, I would have been a little more than half-Canadian. That's my polite side, the Canadian side. Yo, eh!

That's my story, sad but true and in words here I've entombed it for you. Read now and read again for in these words, you'll find a friend. The graphs are long and not well quoted but the prose is clever if slightly bloated. Alas, I'm not a writer by trade - that's just you, a friend I've made.

Keep making the magic happen.

Yours, in situ,


originally published in BigTexasRadio, January 2007 (c) 2007 - All Rights Reserved.