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Oct. 16th, 2008 09:31 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
the_rckBest laid plans and all that. I suspect that's going to be my feeling about today.
My original plan was to drop Cordelia at school and then take the bus to Kroger to fill a prescription and to pick up a few things we're out of. None of it is really urgent. I can't start the new medication until Saturday or Sunday (Scott needs to be home), and we can survive a day without margarine. It's just that this morning was the best time to go-- This afternoon runs into both Cordelia being grounded and the cleaning lady's scheduled arrival. Tomorrow morning might be possible, but it would be rushed and anxiety because I need to be at the school two hours after I drop Cordelia off in the morning instead of the normal three (which would limit any groceries to things that don't need refrigeration). Tomorrow afternoon is very possible but eliminates the possibility of a playdate for Cordelia.
I'm not going this morning because I'm sick. The details would be TMI. The main factor is not wanting to spend very long out and about. I'm even having a neighbor walk Cordelia to school so as not to be out for that fifteen minutes. Past experience suggests that I'll be fine in an hour or three. If I wanted to be paranoid or superstitious, I'd say that this is my body reminding me that all of my plans depend on it cooperating.
The new medication is Provigil. I'm trying it for fatigue. The psychiatrist warned me that, because using it for anything but narcolepsy or sleep apnea is off-label, my insurance may not pay for it. I *think* my insurance will, just with a high co-pay, but I don't know yet. I did check, and it needs prior authorization, so I called her office to ask her to call that in to the insurance company.
We're starting at a very low dose-- 25 mg. That's going to require quartering the pills because the smallest pill is 100 mg. Fortunately, I have a pill cutter. The psychiatrist said that 25 mg. is a smaller starting dose than is common but that she wants to start very low because I have such a history of medication reactions and because some people find stimulants anxiety inducing. She's afraid that giving me more energy will just increase my hyper-vigilant state. I'm not so worried about the hyper-vigilance. My impression of my thought processes is that the hyper-vigilance is fed by my perception that I need extra warning of danger because my body doesn't work right and because my responses tend to be delayed (by fatigue and by some other processing issues).
Even if Provigil makes the anxiety worse, that won't permanently take it off the table as an option. It will just mean that we have to try to address the anxiety first and that we'll be waiting another year until Cordelia's in school all day.
The timing on trying the Provigil is good. Scott's on vacation next week, so he can be around to take care of Cordelia if I have a bad reaction and to watch for reactions that I can't perceive from the inside.
My original plan was to drop Cordelia at school and then take the bus to Kroger to fill a prescription and to pick up a few things we're out of. None of it is really urgent. I can't start the new medication until Saturday or Sunday (Scott needs to be home), and we can survive a day without margarine. It's just that this morning was the best time to go-- This afternoon runs into both Cordelia being grounded and the cleaning lady's scheduled arrival. Tomorrow morning might be possible, but it would be rushed and anxiety because I need to be at the school two hours after I drop Cordelia off in the morning instead of the normal three (which would limit any groceries to things that don't need refrigeration). Tomorrow afternoon is very possible but eliminates the possibility of a playdate for Cordelia.
I'm not going this morning because I'm sick. The details would be TMI. The main factor is not wanting to spend very long out and about. I'm even having a neighbor walk Cordelia to school so as not to be out for that fifteen minutes. Past experience suggests that I'll be fine in an hour or three. If I wanted to be paranoid or superstitious, I'd say that this is my body reminding me that all of my plans depend on it cooperating.
The new medication is Provigil. I'm trying it for fatigue. The psychiatrist warned me that, because using it for anything but narcolepsy or sleep apnea is off-label, my insurance may not pay for it. I *think* my insurance will, just with a high co-pay, but I don't know yet. I did check, and it needs prior authorization, so I called her office to ask her to call that in to the insurance company.
We're starting at a very low dose-- 25 mg. That's going to require quartering the pills because the smallest pill is 100 mg. Fortunately, I have a pill cutter. The psychiatrist said that 25 mg. is a smaller starting dose than is common but that she wants to start very low because I have such a history of medication reactions and because some people find stimulants anxiety inducing. She's afraid that giving me more energy will just increase my hyper-vigilant state. I'm not so worried about the hyper-vigilance. My impression of my thought processes is that the hyper-vigilance is fed by my perception that I need extra warning of danger because my body doesn't work right and because my responses tend to be delayed (by fatigue and by some other processing issues).
Even if Provigil makes the anxiety worse, that won't permanently take it off the table as an option. It will just mean that we have to try to address the anxiety first and that we'll be waiting another year until Cordelia's in school all day.
The timing on trying the Provigil is good. Scott's on vacation next week, so he can be around to take care of Cordelia if I have a bad reaction and to watch for reactions that I can't perceive from the inside.
