W, I totally get the dysphoria aspect of this disorder. It has been, by far, the most dangerous and bothersome symptom for me. I admire you for all you have done to keep your stability without meds and I think you have a better chance of continuing that way if you are open and honest with your care team. Tll them that you don't want to be overmedicated or treatment and you want them to try a treatment plan of meds that will not trigger your BP.

I have to be very careful when taking med for other conditions as they can trigger me easily. I don't know if there is much more you can do than you already have except to be honest with the team and trust them. xo

I idon't see how it helps to withhold information. I'd make sure that everyone treating you has the total picture of what's going on, otherwise you're only cheating yourself.

PS: Cross posted on the Hep C Support Group

Good luck. Peace to you.

Maybe just be zombie while your save your life?

((((BIG HUG)))))

Hi Wiccan~~

I'd be straight up with the care team, emphasizing your position on over-medication. Once you and the team have come up with a treatment plan, take your time and diligently research the proposal.

Then I'd pull the trigger and go after that Hep C. Just make for certain your voice is heard ..... and most times that works best without yelling. :)

Best wishes for you Wiccan!!

The first time I started treatment for Hep C, I was on 900mg Lithium and 400 mg Lamictal. An though that combination held the side effects of Hep C treatment in check, the side effects of the lithium and/or Lamictal caused severe complications with equilibrium, balance and cognition(made me stupid).

Not a great trade off.

I stopped the Hep C treatment because I became homeless and had no way of refrigerating the medication and stopped psych meds shortly after returning myself back to some semblance of intelligence. LOL

First of all, I am not writing you as a zombie. LOLOL. I have never submitted to being "zombified" and hopefully, never will, unless medicated against my will. And by taking some meds, I hope that my committal can be prevented.

I can understand your reluctance to tell the Hep C doc about your MI history, because I hate to disclose MI myself. Doctors never look at you the same, at least most of them...and you never know where prejudice will appear. I think it is highly in your favor, that you have managed to use many tools to stay med free successfully. Let the doctor's know that.

You are in a minefield of dilemmas.. One is not to take the Hep C meds-- the virus could progressively destroy your liver and take your life. However, the risk is that the Hep C meds will cause mania that you can not manage and you could become involuntarily committed...and zombified.

I always prefer to pick my poison, because I would like to pretend I have some sort of control over my health. I would disclose just what you need to without lying. That is the honest truth. See a p-doc if you need to. Not all are zombie makers.



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more thoughts---

ask your doc about Trileptal (generic Oxcarbanzapine) instead of Lamictal and Lithium? Why? Lamictal made me very stupid. It took over a year, but my mental processing was pretty bad by the end of it. It also was not a great mood stabilizer for me.

Lithium is known for problems w/coordination and balance. Kay Jameson Redfield wrote about this in "An Unquiet Mind", so you weren't alone.

Trileptal is easily titrated and you can start slowly and slowly get up to a comfortable spot. It comes in 150mg, 300mg and 600mg tablets that are scored. I am currently on 750mg a day. 600mg is considered a therapeutic dose. I like it a lot. Of course it may totally blow for you.

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I wish you all the best. ((hugs))

I'm sorry you're going through such a rough time wiccan..
I would be completely straight with the treatment team for hep C for sure!!
They will keep the meds to a minimum.. Due to Hep C and liver illness it's important that your doc's work together on this for your well being.. I know they won't want to put you on more meds then they have to and they'll try and put you on meds that won't do further liver damage..
Big hug of comfort for you.. You're in my thoughts and prayers..xo

The proverbial Rock And A Hard Spot.

Just my opinion

I think you need to give full disclosure to your Medical team, about your bipolar, and how you have managed it so far.

But now things are different . You might be forced to be on BP meds, just to keep your sanity.

As for the Hep C treatments, you know you have to keep on them, or face a horribly painful death....and I for one , would hate to see you go through that.

I have an AUnt who died of Hep C complications...it was horrific for the whole family, and she endured much pain and suffering for many months , before she passed .

Good luck wiccan

Can you confidentially speak with your psychiatrist to get an expert opinion on how to manage this? this sounds really tricky, and plus you want make sure not to have any counteractions (?word?). I think also maybe being a bit zombified for a short while during a health crisis would be preferable to being totally off the rails or feeling any scary feelings.

I think you should really get the right doc to weigh in on this; I think your healtcare team might be over their head with this.

ps there are great short term acting anxiety drugs, benzos, that can help with agitation and all that without doping you up for weeks. Personally, I like Klonapin, but it can be addictive. But I think a short term use wouldn't necessarily make one an addict.

Will, I have always admired your strength and ability to stay stable without medication. I know that I will always be on medication and use alternative medicine, mind/body work as an adjunct to reduce the dosages that I take. Your Hep C treatment will not last forever. It is a necessary treatment and you know it. You have to be up front with your medical team or they will not be able to help you to the best of their abilities. It's like withholding information from a trial lawyer and expecting him to know the information through osmosis. It just doesn't work that way. So you may have to take some medications. You of all people know how to say NO to the drugs that you are uncomfortable with. And you know how to use your skills and talents to stay in the moment when the nasty anxiety monster comes our way. Meds just help the symptoms nothing more. It won't be forever. But consider it. Think about what it will mean for the other people in your life too. The Hep C treatment is bad enough. Why add to that with symptoms that could be controlled medically? Just my thoughts. As always, feel free to PM me.

Here's the thing, I have already begun to take Clonazepan to help to deal with the anxiety, but am not sure if that is going to be enough, which is why I am considering taking with my GP about adding a mood stablizer such as Trileptal as Suferchic suggested.

My concern with doing so however is: that I have been on several of theses meds before including Lithium, Lamictal, and Depakote as well as on a number of AP's such as Zyprexa, Seroquel, and Abilify. I find that these medications turn out to be more mood null-ifiers than mood stablizers.

What I looking for is something that I can use to help aide me in my ability to control the side effects not in leaving me feeling nothing.

My other concern at this point is that my GP my not feel competent in dealing with this and my defer to a psychiatrist, which I'm trying to avoid at all cost.

I do not get along with Pdoc's very well as I find they have a tenancy to talk down to people and I do NOT handle not being treated as an equal very well. Just because I don't come from a privileged background and my mommy and daddy didn't pay my way through medical school doesn't mean they are smarter than I am and that I'm some moron off the street. What these Jackasses have learned reading in books, I've spent a life time living.

Besides I have never held much stock in modern Western medicine, when I have found that Eastern medicine and that of my Ancient ancestors have served my fairly well.

Well OK, don't know where that rant came from LOL

I think Will that it's important for your doc's to work together whether you see a pdoc or GP...
It's important that both your mood stays stable and at the same time working with meds that are easiest on your liver..
If the GP wants to refer you to a pdoc I would just let him/her know that your only interest is being on the best choice of med while you're going through Hep C treatment...xo