Storytime Sunday: The Cat's Stuck in the Wall

Note: This is an abridged telling of the story on account of not getting my poop in a group to write the story in a timely manner. This is what you get.

"Mew! Mew!" Almost rhythmic mews, distant and muffled. Edie's missing, and now there's muffled kitten meowing no one can pinpoint. We listen from the basement - she's at the front of the house and somewhere above. We listen in the front room - she's near the front of the house and somewhere below. We can hear her meowing beneath us.

"Mew! Mew!"

Hours of searching have passed to no avail. She's going to die of dehydration in there, we have to get her out! I can hear where she is, under the front door. I tear up the flooring in front of the door only to find hardwood underneath. I grab a claw hammer and maniacally attack the hardwood with it, ripping up chunks.

That goes nowhere, it just spews shredded wood all over the carpet and takes a divot out of the floor. Someone eventually gets the idea to look inside the walls. We only find a couple ways in, through the upstairs balcony. The openings are tight and the roof inside looks cramped. But we can hear the cat clearly inside. Yep, the cat's definitely stuck in the wall.

"Mew! Mew!"

Someone needs to climb in there and look. This looks like a job for Stuporman! (That was my inebriated alter-ego at the time. Stuporman - fighter of sobriety, defender of awesome.) I dive in head first and wriggle through the opening. I climb onto a half inch layer of soft dust and sediment and turn around, coating myself in it. With a flashlight, squeezing my head under the floor, and eventually a mirror, I solidly confirm Edie's location: at the bottom of a shaft.

So here's what we knew: Edie got into the wall through a vent opening. She wandered around exploring until she came to a shaft, like a hollow column. Then she fell down it and got trapped. This didn't get us any closer to getting her out.

I tried lowering a shoebox wrapped in a sheet, tied to another sheet, with food in it down the shaft. It just landed on her, if it even made it all the way down. We looked and looked with mirrors. I started chain smoking inside the wall.

"Mew! Mew!"

Someone gave us the brilliant suggestion to call the fire department. They laughed at us. We called the humane society. They don't do that. Someone posted a frantic message to the all-campus listserv, asking for any help.

Two guys came by to help. They tried various approaches. I continued to lay in the wall, smoking. Dust was sticking to my finger and caking to my lips. Someone passed me a pipe. I hit it and resumed smoking. Still in the wall.

"Mew! Mew!"

I noticed the open space between the upstairs floor and the downstairs ceiling. The notion of rats running through there entered my head. Is there rat shit in here? Wait... oh fuck. Someone pointed out to me: the dust. I was laying in rat shit and probably eating hanta virus as I smoked. I spat gritty bits of dust out of my mouth. Then I shrugged and pulled out another cigarette.

I spent late into the night inside this wall, increasingly tired, high, and, later on, drunk. I eventually crashed and came back the next day to climb inside the wall and chain smoke for a few hours, listening to the cat's mews to make sure she was still alive.

"Mew! Mew!"

Four hours in the wall today got me through a half pack of cigarettes and not much else. Still laying in rat shit, but I don't care, this is my spot! By this point I kinda feel like just lounging inside the wall from now on.

It all just kind of runs together at this point. I spent literally all the time I was at that house inside the wall chain smoking. There was no point to being in the wall, I didn't even pretend to be there for the cat other than to 'listen to make sure it's still alive'. Why did I want to lay there in rat shit regolith and chain smoke without a view of anything or any TV/computer/whatever? I don't know. It seemed like a good idea at the time.

The next day, while I was gone, Clark arrived. With a jigsaw and a bottle of whiskey in hand. "Where's the cat," I imagine he asked with a cackle after kicking open the door. He cut a square out of the balcony floor directly above the shaft. As soon as it was open and the cat could see it was a way out, she climbed out on her own. Just stuck her claws out and parkoured up the sides of the shaft. Stupid cat. 

Storytime Sunday: Goddammit to Me

Have you ever really been far even as decided to use even go want to do look more like? I have. This is the story of when I was.

It was 2003. RSD was my life at this point. It seemed to stretch back forever and it would surely continue forever. Mom had set me up in a little rented back house in a simulacrum of independence at least. The pain had gotten a little better with my spinal cord stimulator implant, and with new medications, but it was still pretty bad.

We'd fired the doctors at Stanford after being frustrated for too long with their inflexibility and purely "do as I say" authoritarian way of doing business. We found a new anesthesiologist/neurosurgeon who had RSD himself and was an all-around cool guy. And we found a pharmacologist who specialized in pain management to handle my medication.

Now, one weird thing that happens with RSD is that your opioid receptors - the ones that hydrocodone, oxycontin, morphine, etc. bind to - stop working right and those drugs are minimally effective for the pain. So you have to try other things. My new pharmacologist switched me from Neurontin to Gabitril (that's its own story), put me on methadone (it partly gets around the receptor problem) and some other things. But you have to be innovative with this. You have to think outside the box.

He had an outside the box option: ketamine. It's an anesthetic that works directly on pathways the RSD acts on (specifically, NMDA). It was a perfect option. And he had an outside the box delivery mechanism for it: a topical cream. I was a little sketched out by ketamine, but I went with it. We ordered the cream from a compounding pharmacy and I soon got it.

One tablespoon applied to the affected area once per day. Easy enough. Well, maybe a heaping tablespoon - my legs are big. Hey, this stuff works great. I want this to cover my whole legs. A couple tablespoons - it's a cream, it can't be dangerous. 

I started to get extremely sleepy. Head bobble all the time sleepy. After I fell from briefly losing consciousness mid-stride, mom took me back to her place. I slept a lot. But damn if my legs weren't feeling good.

"Moouumm..?" I shambled down the hallway to her room. "Moouumm..?" My brother was staring at me, I think. Mom walked to the front of her room and saw me, pupils blown, bruise forming on my head. "Are you okay," she demanded to know. I just continued shambling toward her bathroom. She probably asked again if I was okay, but I don't really know.

I managed to shamble past her into the shit-'n'-shower, as we called it (the closet-like room with a shower and a toilet right up against it). I saw her holding the external power supply to my SCS; it had apparently been dangling from my ass the whole time.

I reached out my hand. "Goddammit to me," I demanded.

"What?"

"Goddammit to me," a little softer this time.

"Goddamn what?"

"Goddammit to me."

She looked down at the power supply in her hand, and back at me. "Give it to you?"

I nodded. "Goddammit to me."

"No."

"Goddammit to me," I pleaded.

"You're gonna drop it in the toilet."

"Goddammit to me," more politely.

"You're gonna drop it in the toilet."

"Goddammit to me," super politely this time.

"Fine, fine." She handed it to me. I immediately dropped it in the toilet. It cost $8,000 to replace.

I don't remember what happened next, but apparently she called 911. She thought I had a head injury, but no, I just fell out of bed.

Next thing I knew, I was nowhere and formless. There was something sudden and awful, disembodied pain. I imploded, my muscles all spasming shut in an instant. My eyes flew open. I saw things, as in I got the raw sensory input, but nothing made sense. Though in hindsight I know what I saw, at the time, I couldn't identify shapes or colors, let alone objects. It was just raw, terrifying sensory overload.

What I didn't realize was that I was on the nice-living-room (not the one we normally used), on the couch, getting an IV stuck in my arm. This disorienting assault on my senses and my beings may very well have been the most terrifying experience of my life. It was like I had just been born and hadn't yet formed a concept or understanding of anything - not even my body or my senses.

I woke up in the hospital hours later to learn that I'd OD'd on ketamine. Apparently the extra I was applying had built up in my system and I was just on K the whole time until it crossed that threshold.

As a bonus, I found out from my pharmacologist that even with my stupidity, that shouldn't have been nearly enough to OD, only to have a bad time. Turned out my NMDA receptors must have been shot - likely excitotoxicity damage from so much continuous pain for so long literally killing the receptors. Joy.

I tried ketamine in another form after that. Pills. It became my only "as needed" pain relief other than pot. I was scared shitless of it, but when I needed it, it was a godsend. When I was really hurting, goddammit to me.

The Nuthouse

Gather 'round, boys and girls, and listen to the story of Rachel's trip to the nuthouse. The loony bin. The insane asylum. Whatever derogatory name you prefer for "psychiatric inpatient." 

It was 2001: not a space odyssey. The previous year, I'd been diagnosed with Reflex Sympathetic Dystrophy (RSD, also known as Complex Regional Pain Syndrome Type I), first in one leg but rapidly spreading to both. It's a shitty disease. Really shitty. The pain - burning, crushing agony - never stops. The nerves get crossed, so normal sensations like a light touch can feel like a red-hot belt sander. I was still in Stage I of the disease, though rapidly on my way to Stage II, so fortunately it wasn't that bad. It was just miserable. The best parts are that the doctors gave me about a 5-10% chance of total remission (you're never "cured" of CRPS), it spreads in more than 90% of cases, and more than a third of patients eventually have symptoms throughout their whole body. So it was utterly hopeless.

I was depressed, naturally. In pain, can't do anything, dreams shattered, no hope, miserable side effects from the medications. But I went through the motions. I let myself be carried along by the currents because I didn't know what else to do. Some parts of the ride were even pleasant - the weekly spinal anesthetic injections I got in the OR felt sooo good. It was also, strangely, a respite from my bouts of intense emotional hurt and rage shortly before. In hindsight I was (hypo)manic for much of high school, and even younger (I first experienced psychosis in elementary school), but at the time I was just "impossible." (That description has a lot of meaning rolled into it that I don't feel like unpacking. I'll just say that if someone calls me "impossible," they will generally trigger either a flashback or an intense fight-or-flight - usually flight - response.) And now that I was depressed, that had settled down.

But my depression needed treatment, the doctors decided. To their credit, they first tried an antidepressant with proven efficacy for alleviating nerve pain. But that made me completely dissociated, so no go on that one. They tried a couple others with minimal effect. Then they tried Paxil.

Now, normally if a story involves putting a 18 year old on Paxil, it's not going to end well. When it's a 18 year old with undiagnosed bipolar disorder and miscoded 5-HT-2A receptors, it ends like this.

My energy started to come back. I was more alert. I also got even more grumpy than usual, but that didn't register until it was too late - I had reason to be grumpy after all. I was snippy and implacable. And I started to realize some things. I started to really grasp how hopeless and miserable things were. I started to realize there really was something I could do about it. I could force them to make me better. They didn't want me to die, but that was my ultimate way out. So I could force them to make me better or watch me die, and I'd win either way.

Now, this wasn't arrived at by any kind of rational thought process, or even coherent chain of thinking. It was more a subconscious emotional realization that came into the conscious when the time was right.

I wanted more Norco (hydrocodone). I'd taken the max dose, but I was in pain and I wanted more. I got very, very angry that mom wouldn't give me more. I don't remember things all too well, but at some point while screaming at her, I picked up a nearby pair of scissors and slashed at my arm with them. I think I was wrestled to the ground, but trying to cut my arm open with the scissors is the last thing I remember.

I don't know how I was transported to Stanford University Hospital, but I was taken there under a 5150 order: "danger to self." Basically, I was involuntarily committed by the State of California.

My memory picks up again inside the psych ward doors. I was assigned a room near the entrance on the lockdown side of the ward. At least one of my parents walked me in, I don't remember who, of if it was maybe both. All I could do was cry and scream. The more I did, the more they disregarded me. I gathered enough control to stop and be silent. They left me alone. This was what I needed.

They clearly weren't going to help me, they just wanted to keep me from escaping my misery. Well, if they weren't going to make things better, I still had a way out.

I pulled the pillowcase off my bed. Making sure they didn't see, I tied it to the doorknob. I tied a slipknot in it and slid my head through. Then I squatted, kicked my legs out, and dangled with my butt off the ground. Things were going dim, but they caught me. I know they got me down and restrained me. Next thing I know they're shoving a pill down my throat. Zyprexa, a powerful antipsychotic.

I passed out and awoke in a dissociated fugue, unable to move. The rage was gone, but all the hurt, both physical and mental, was still there. I couldn't cry. I could barely whisper. Lifting a hand was difficult. They administered my morning medications, plus more Zyprexa.

They dragged me down the hall (not literally - I was stumbling as they held me up) to bathe me. I don't really remember it. I had a visitor whom I won't name. They wanted to give me a massage to make me feel better. The orderlies helped lay me face down on a... something, I don't remember if it was a bed or a gurney or what... in a room with privacy.

It started with my back. I didn't like it. It felt like they were using soap, not lotion. They didn't go far down, though, only about halfway down my back. Then they started on my legs. That outright hurt. Remember the non-painful sensations feeling painful? This is someone who knew about that symptom and inflicted this on me anyway. It hurt. "No," I muttered as loud as I could manage, "stop." They didn't hear me, apparently. "Hurts," I tried again. More massaging my calves, tearing at my flesh. The massaging moved upward. Knees. Lower thighs. Upper thighs. It just hurt before, but this was starting to feel violating. Starting to brush up to my butt and around to the inside of my upper thigh. "No," I tried to scream, but only a mumble emerged. I reached up with all my might to stop them, but my arm barely moved. But they did stop - to shush me and push my arm back down before resuming. I tried to crane my head to make them hear me. "Please, no." More shushing. "It's okay." My neck lost strength and my head fell back down. I quietly whimpered as they massaged my butt and inner thigh.

I passed out from the emotional exhaustion. I woke up in my room and dragged myself to a corner where no one could be behind me. I curled into the fetal position and let my head droop back and forth, sometimes hitting the wall. It wasn't forceful - I couldn't have managed force even if I wanted to.

I was already on a drug called Neurontin for my nerve pain. It dulled the pain, sure. It also dulled my mind, made me lethargic, slowed my metabolism, ballooned my weight, made speaking difficult (I couldn't word good), and wreaked havoc on my ability to form new memories. I was on 1500 mg three times a day when I entered the psych ward. Since it allegedly worked as a mood stabilizer (funny story, it totally doesn't based on all the best research), they increased that, first to 1800 then to 2000 for a total of 6000 mg/day. My pharmacologist would later call this borderline malpractice - it loses efficacy at such high doses and basically all you're doing is adding to side effects. Which may have been the purpose. It helped the Zyprexa with incapacitating me.

There was actually a plausibly legitimate reason for this. They needed to keep me from hurting myself while the Paxil left my system and I stabilized, and incapacitating me was a good way to do that. But it was miserable and it made me easy prey, as you saw.

I didn't really eat those first few days. I had to pick at it a little while they watched - had to be a good little psycho. But I didn't want to. I may have been too out of it for much of the pain to register anymore, but I still wanted nothing more than to die.

The 72 hours on my 5150 order expired and it was renewed with a 5250 order, a 2 week extension.

What finally drew me out of the room was the need for human contact, any human contact. I shambled out there, still weighed down by the Neurontin and Zyprexa (though building some tolerance at least), and I think talked to one of the nurses. It kind of went from there. The nurses were all very nice and respectful, even to a psychotic 18 year old, and I thank them for that.

Social contact got me in a different mode. It distracted me from my misery and made me forget I wanted to kill myself. But only while I was talking. Back in my room, in my thoughts, I still wanted to die. Still, I could be good and behave. It was the only way to get transferred to the normal ward, where they promised me better painkillers and a lidocaine IV.

So I behaved. And so I was rewarded a few days later. They took me out of lockdown and gave me a new, much nicer room in the nicer, bigger non-lockdown side of the ward. They also almost immediately gave me the IV anesthetic, as promised.

The people on the locked ward were all recluses in really bad places, so I didn't really interact with any of them. The unlocked ward had a crazy cast of characters. Old, young, middle-aged; mental illness, dysmorphia, addiction. Addiction was a pretty common thing for people to be there for. 

There was one girl there who still haunts me. She was so anorexic - like horrifying anorexic, Auschwitz-anorexic - she was in a wheelchair with a feeding tube up her nose. She was too weak to speak above a whisper. I'm not sure why, but seeing her like that really got to me. She made me feel sad, and not the kind of sad I was already feeling.

There was a lounge on the ward and access to movies. I distinctly remember watching True Romance with some roadie in there for rehab.

There were the silly arts and crafts activities. I got nothing out of them, naturally. No, less than nothing. They just gave me anxiety about how awful it would be if I drew/whatever anything and vicarious embarrassment when people would explain what they made.

At some point I think they might have told my parents I was bipolar. I don't really remember. They seemed to figure the Neurontin was plenty and there was no need to pursue other treatment. Just keep me off SSRIs, that's all.

I slowly picked back up to "normal" and even a little happy - other people's happiness, and their obvious hopes for me, was infectious.

After another 5250 and close to 3 weeks total involuntarily committed, I was released from the ward into my (IIRC) mother's custody. I did kind of miss it at first - there was no lidocaine IV at home.

Postscript: Being in the psych ward was one of the worst experiences of my life. It's also something I'm glad happened, considering the alternative is that I'd be fucking dead. People can be shitty, doctors can be dumb, others take advantage, but at least I'm still here.

Just Your Friendly Neighborhood Lunatic

That's me. It's apparently Mental Health Awareness Week and a friend inspired me to do something for it. Specifically, this is a coming out of sorts. I've alluded to some mental health problems, but I haven't outright owned this stuff to all that many people.

I'm weird. I know I'm weird. But I think I'm normal-weird, not going-to-shoot-up-a-school weird. People who struggle with what I do often get ignorantly tarred as the latter category. So I guess I'm here to say: Hello, my name is Rachel, and I'm a perfectly mostly harmless lunatic.

There are names for what my damage is. I have bipolar disorder with mixed and psychotic features, rapid cycling and complex post-traumatic stress disorder. They're labels, they make it easier to grasp what I'm dealing with due to its similarities to what afflict other people, but they're just labels. Let's break down what they actually mean.

Bipolar disorder: My moods can vary wildly, and I don't mean the garbage people call a "mood swings." I mean they can vary between weeks-to-months-long suicidal depression; or grandiose, sleepless hyperactivity; or uncontrollable hair-trigger rage; or unquenchable lust with an unstoppable sex drive; or batfuck insanity (it's a technical term); or any combination thereof. Sometimes things can trigger it, like sleep deprivation or emotional trauma or just the change of seasons. Sometimes it just happens because fuck you, that's why. When it does happen, I can see it happening, but that doesn't diminish its power at all. So I know I'm easily angered - great, that doesn't make me any less easily angered. I have to be constantly on guard against my emotions, my sleep patterns, my energy levels, and my libido. If any of them get too high or too low, too much or too little, that's a sign of an episode. And episodes always end poorly sooner or later, one way or another.

Mixed features: This means I have the kind of bipolar where I can get "mixed" episodes - manic and depressed at the same time. These are the most dangerous bipolar episodes, because they combine the suicidal feelings of depression with the manic impulsivity. You have the depression to want to kill yourself and the energy and inclination to actually do it. It can also involve rapid fluctuation in the span of seconds. Laughing and crying at the same time is pretty stereotypical, especially if you combine that with dancing and howling in rage. If you're mixed, you're all over the damn place, and really only get the worst of both the mania and depression, none of the redeeming qualities.

Psychotic features: I hallucinate. I have delusions. I hear music, whispers, muffled voices, chanting - none of them actually there. I see shadow people moving in the edges of my vision, or sneaking around outside my window when I'm not looking directly out of it. They're not really there, not even visually; they're just kind of there, always just at the edges of my ability to discern them. I'm sure my activities are being tracked by someone, my every click and scroll on the computer, the time I spend on what page, by some entity who wants to use it to (successfully) divine my inner thoughts and feelings. Yes click on this, that'll look good; don't click on that, they'll figure you out. Anything feminine or female-oriented used to be in the latter category - I didn't want them to know I wished I was a girl. This kind of thing tends to happen when I'm manic. I'm not schizoaffective (I don't think... there are troubling signs I might be somewhere in the vicinity), but I do get raging psychosis and inward-turning antisocial patterns in some of my manias.

Rapid cycling: Strictly speaking, this means I can have four or more depressive, manic, mixed, or hypomanic episodes in the span of a year. As a practical matter it means that I might be in a euphoric mania and a couple weeks later I crash into crippling depression when it burns out, only to fly into a psychotic, dysphoric mania after a month of stability. When I'm not medicated, I probably average 5-10 episodes of various sorts per year, ranging from a few weeks to a few months, with stability sometimes in between them. A good chunk of my life is spent jumping from episode to episode if I'm not treated.

Complex post-traumatic stress disorder (C-PTSD): A variant of PTSD with some distinct differences. For starters, it doesn't happen from a single traumatic event. Instead, it's from prolonged trauma without hope of escape, or at least the perception of no escape. It's most common in two groups of people: torture survivors / POWs, and domestic abuse survivors. It has a lot in common with PTSD - night terrors, hypervigilence (being hyper-alert to danger and "jumpy"), dissociation, amnesia or hypermnesia (the opposite, where the memories are unnaturally vivid), and flashbacks. The flashbacks tend to be different, however - not always, but usually. "Atypical flashbacks." Sometimes called "emotional flashbacks," instead of hyper-realistically re-living the experience, you re-live the emotions and feelings of the experience, as though experiencing it all over again. It can be completely debilitating when it happens. My cat has had to snap me out of the dissociated sobbing of these flashbacks by nuzzling her cold nose to my face. Another "feature" distinct to C-PTSD is attachment issues. It causes sometimes crippling problems with the ability to form and maintain relationships. All of them are tainted by the relationship with one's captors or abusers. It results in a push-pull not unlike borderline personality disorder, due to a tension between defense mechanisms (push) and a sort of echo of Stockholm syndrome (pull). It can promote dependency and co-dependency. It can cause one to seek a rescuer or savior to liberate them from the pain and isolation. Basically, it can cripple the ability to have healthy relationships.

Your bloghostess has suffered most of these effects. Without medication, I wake up screaming almost every night, sometimes multiple times a night. Some painful memories are hyper-vivid and others are dissociated to the point of being remembered in the third person. Without medication, I practically jump out of my skin if I hear a sudden noise behind me. It took me a long time to be at all okay with human touch; it was panic-inducing and the opposite of comforting. And my ability to form and maintain relationships is something I continue to struggle with; in some regards, my development is stunted at an adolescent level on that front.

I tried to "hack" some of these things for a while, turn them to my advantage as I stupidly thought possible. You know, things like deliberately triggering, prolonging, and exacerbating hypomania to avoid sleep and be extra productive. Makes sense, right? Of course, I'd always crash even harder when it inevitably ended, and I dropped out of school after being reckless and all over the place for years.

I attempted suicide twice in one day when I had a psychotic mixed episode. I tried to slit my wrists, then I hanged myself. It made perfect sense at the time. It was the only way out of my intractable situation of constant chronic pain and a hopeless, meaningless life. The psychosis and mania took me from thinking it might be a good idea to knowing it was the one right thing to do and impulsively acting on it. (It's fortunate I was so out of my mind that I was ineffectual and able to be stopped.)

I almost committed suicide again in another mixed episode. Everything just hurt so bad, life hurt so bad; everything was hopeless and miserable and lonely. So I was going to jump off a ~20 story building. I was fortunate a friend talked me down.

I came close to attempting a fourth time in yet another mixed episode. I was going to take everything in my medicine cabinet and try to overdose. It made complete sense, even though it shouldn't have. My future was looking up for once. I was back in school with a shot at real research. I was finally me - Rachel, not Ryan. I had a loving and supportive girlfriend for the first time in my life. Life was good. But it didn't feel good. It felt absolutely miserable and terrible and hopeless. Life felt so awful I wanted - really wanted - to die. My girlfriend got me to delay my plan - just postpone it. Then she dragged me to my psychologist. 

Suicide, and the constant prospect of feeling suicidal, is a normal part of my life. You'll notice all those were mixed episodes; that's when I have the inclination to do something with those feelings. But when just plain depressed, or my C-PTSD is triggered, the thought is always there. When I'm sane, like now, I know I'd want anyone to beat me into submission if they had to in order to save me from myself. But when I'm feeling it, it's what I "really" want - to die. "Just fucking kill yourself," directed at myself, has spilled out of my mouth unbidden more times than I can count.

That last close call, I was already fairly well medicated - all that was missing from the cocktail was my antipsychotic (see below). It's what's called a "breakthrough episode" - it breaks through the otherwise effective medication. Even stable now, I always have to fear that prospect. And if it happens, I have to fear that it will render one or more of my medications ineffective for me from then on. There are indicators I look for. One is that I have trouble sleeping and staying asleep. Another is that my legs become painful and hypersensitive once again. These are indications of mania. Or maybe everything stops being pleasurable and I can't sleep less than 12 hours. That could indicate depression. 

So that's my damage. I'm a wreck. Or I would be without the lovely friends I have helping me. No, I don't mean therapists and the like (though they are helpful). I mean my medications. They patch me up and hold me together. With them, I have no flashbacks, no night terrors, minimal hypervigilence, no depression, and no mania. I'm on 7 (count 'em), plus 2 I take as needed. Let's go through what it takes to keep a lunatic sane, shall we?

Lamictal: I actually take this for two things. First and foremost, it acts as a mood stabilizer, primarily warding off depression but also combating mania. I also take it to deal with "partial" seizures in my temporal lobes that cause hallucinations and synaesthesia, and may trigger bipolar episodes. 

Lithium: The classic bipolar medication. I take this as a mood stabilizer that primarily works to combat mania, also working less so against depression. 

Viibryd: This is my antidepressant, which also generally reduces anxiety (like the hypervigilence). So for both my bipolar and C-PTSD. My psychologist calls it Prozac+BuSpar. This is a new one still under patent, so it costs an arm and a leg. (All the rest of these are out of patent, mostly long out of patent. Like, generic since the 70s.)

Risperdal: An antipsychotic. Ooh, scary! It wards off my psychosis and helps keep my mania in check. It also probably helps with the C-PTSD related dissociation and flashbacks. 

Prazosin: I take this to get rid of the night terrors (thing super-nightmares) that wake me up. It's a goddamn miracle drug. 

Estradiol and Spironolactone: These actually aren't for insanity - they're to make me hormonally female. The spironolactone eliminates testosterone from my system and the estradiol is metabolized into estrogen. 

Propranolol: I take this as needed for "actute" (short-term/spike in) anxiety. It works like a charm. I was shaking and my voice quivering while practicing before a presentation, then it kicked in and I gave the actual presentation no problem. I also take it if I get a fine motor tremor, which can happen if I don't drink enough water with the lithium. 

Benztropine: One problem with Risperdal is that increasing the dose, especially too quickly, can cause a painful neck spasm. This eliminates that spasm, so I take it whenever I increase my Risperdal dose. 

That's a lot of drugs, but I wouldn't give any of them up. On a day to day basis, I have zero side effects. These drugs are just perfectly compatible with me. It's a pharmacological miracle. 

That wasn't always the case. I've had some terrible experiences with drugs. Neurontin, Elavil, Paxil, Zyprexa, Depakote, Seroquel... It took a lot of trial and error to get things right. And it was hell at times. I gave up on treatment for years when I wasn't given other options, and I'm still not sure there was anything wrong with that decision. Paxil landed me in the psych ward and Depakote robbed me of my ability to feel feelings, think thoughts, or do anything but shamble around like the walking dead.

But being unmedicated was its own kind of hell, and I will never go back to that. While still figuring out what your own special pharmacology is, though, it's really a matter of picking your poison. Want to kill yourself, or be unable to brain? Hallucinate and have paranoid delusions, or be an emotionless zombie? Decisions decisions...

There's also therapy, but that only goes so far. Traditional therapy works great for my gender dysphoria issues, and my C-PTSD has significantly improved with the help of exposure therapy and cognitive behavioral therapy. But a lot of things just aren't amenable to that. There ain't no therapy in the world gonna do shit about my psychosis or episodes. Might help me cope with the mild ones, might help me identify the others, but that's as far as it goes.

Anyway, now you know just how crazy I am. I can stop trying to soft-pedal it or conceal any of it.

This is me. This is who I am. I'm not proud of it, I don't like it, but this is an honest picture of me.

I hope I don't frighten you too much.

Storytime Sunday: The Wrong Kind of Squirter

After starting hormone therapy in February, my libido disappeared almost entirely. This tends to happen when you lose all your testosterone. For months I could still drool (literally drool) over pretty girls, but there was really no inclination to do anything. Like, I might drool thinking of sucking on some titties, but I had no desire to touch myself or feel any sexual stimulation - it was all purely conceptual.

In July, my libido started to come back and it really came back. It was like I was a teenager all over again. (Right... I sometimes forget I'm literally going through puberty.) But there was a problem: I could no longer get erections (no testosterone, remember?) and stimulation didn't feel the same even without, so I had no idea how to satisfy the itch. I knew what to do, though: I'd ask /r/asktransgender. The responses were overwhelming. I was best off getting assistance from a "helper" - a helper named the Hitachi Magic Wand:

For scale, end to end is from my elbow to the middle of my hand

I was so excited when it arrived. I ripped it out of the box and immediately got down to figuring it out. It was pretty easy. So I pulled up some eye candy from my hard drive and checked /r/dykesgonewild for anything new, and got comfortable on my bed. I laid a towel out, applied some lube, and started testing it out using one of the methods I'd been told.

It felt really good. Like, leg spasms good. But after a couple minutes it became seriously overstimulating. I wouldn't have stuck with it if that's how it started, but I felt close to orgasm, so I kept going. Just bite your lip and power through, I told myself. 

That was a mistake.

So close, so close. Just a little more. Suddenly I felt an ecstatic release. It felt like 1/2 an orgasm, and I figured it might just be dulled by the hormones. Something shot out of my penis and I thought it was cum. But it continued to keep coming. It shot into the air in a big, clear, spurting stream. Oh shit!

By the time I realized what was happening and managed to stop the flow, I had pissed all over my belly, my tits, my legs, my arm, my bed, and of course the vibrator. It soaked through the towel, through the sheets, and into the mattress. So instead of an orgasm I got my bed and half my body drenched in piss.

The best part is, I went to the bathroom right before starting to make sure that wouldn't be a problem. Less than 10 minutes from "bladder empty" to "the fucking Nile river."

Of course, the first thing I did after cleaning myself up was post the story to /r/TIFU. Some girl in comments tried to convince me I squirted, not pissed myself. Bless her heart. Lulzy commenters ran with it. Comments like, "Always wanted to be a girl, never knew you'd be a squirter." I replied, "Always wanted to be a squirter, but not that kind!"

Did I ever mention how I realized I was trans?

I know this has occasionally come up so some readers are certainly aware of at least the rough outline. But seeing that it's nowhere on the blog, I figure I should put it here for the posterity and the benefit lulz of others.

May 10^th, 2013, I had the first date of my life. It went well, to say the least. You know the joke "what does a lesbian bring to a second date? A moving truck"? Well, that pretty much happened. And all of a sudden I had a girlfriend.

I can't remember if it came up on my screensaver or if she found it on Facebook (probably the former), but a week or so later she saw a picture of me that caught her attention.

Pre-alpha Rachel prototype

I was horribly embarrassed that she saw that. "Is that you," she incredulously asked. I turned bright red. "Uh... yeah," I stammered. "It was a thing they did, up at my last college," I hastened to add, "Dragfest, everyone dressed in drag and got wasted." Yeah, that justified it.

May 24^th, two weeks after our first date: she's sitting on the couch out front and I'm in the kitchen for some reason. She calls to me. "So, uhm... those pictures of you in drag."

I freeze. "Yeah..."

"Well, you know I'm bi. And... I like having a girlfriend."

'Is she asking for this relationship to be open,' I'm wondering, 'and what does that have to do with those embarrassing pictures?' "Okay..."

"So I was wondering if you might be willing to dress up and be my girlfriend sometimes."

Time stopped. My heart pounded in my ears and my temperature shot up a few degrees. This couldn't be happening, but it was. That's it, now or never. This is my one and only chance. "Can I be your girlfriend all the time?"

My mind was so reeling I don't even remember quite what she said next. But she quickly got to asking me if I was trans. "Yeah... I'm sorry." I couldn't help but apologize.

Her response, in effect? "Well that explains a lot." I was confused by that; I asked what she meant. She told me I kissed and made love like a girl, that it explained my 'issues' with using my hardware in bed, that it explained some of my quirks and anxieties, why she was attracted to me after having written off guys and decided she was a lesbian. Less seriously, she joked about how I and our relationship were conforming to lesbian stereotypes.

She said if I wanted to be her girlfriend all the time, I could be. She loved me as her boyfriend and she'd love me as her girlfriend.

And that's how I realized I was really trans, that it wasn't just idle ideation. I had my chance to make it happen, and I took it. And for giving me that chance (and for helping me start to transition, and teaching me how to be a girl, and helping name me, and...) I am eternally grateful.