Stop This Train

Let me just be frank. I love my Xanax. As I’ve stated before, it is insta-calm and living in a city, I am stressed out anyway. Add to that the fact that I am of European descent and do not have the greatest “home” situation in that there is a lot of fighting and tensions and well, the Xanax are my savior in many instances. Pop a few and life is good. Pop more than a few and you wind up having to talk to people you don’t want to talk to.

After I finished the last script, I was given, as promised, a reduced refill of 120 pills which were to last for 30 days. (Insert laughter) Now, I had explained I take up to 12 a day so I literally did laugh when I picked this refill up at the pharmacy because a part of me was quite sure my doctor was just kidding around. However, apparently she was not and I took the 120 and went on my merry way. Needless to say, those went poof rather quickly. 11 days to be precise.

Now, I sincerely tried to hold out in an attempt not to have to call my doctor because I knew she would not be happy to say the least. However, by the 72nd hour, the withdrawals were intolerable. It became a weighted situation. Suffer and possibly have a seizure and for the first time, I truly felt like that was a viable possibility, or call her, admit I fubard the month and hope she had mercy? With my head on my desk, friends telling me to call and my hands covering my ears in a futile attempt to block out the incessant ringing, I broke down and called.

I got her secretary. I simply asked for my doctor to call me and the woman said she wouldn’t get the message until Thursday (it was Tuesday) because she had left for a conference. Would that be ok???? Considering my state, I am amazed in hindsight that I was even able to utter the words, “Uhh, errrr, I dunno…is anyone covering for her?”

The secretary asked what was wrong and not really giving a damn at this point, I explained I was in withdrawals, bad withdrawals and needed to talk to her or someone else with prescribing rights. She told me she would have someone get back to me as soon as she could. Because my doctor’s office is the bomb, my doctor’s PA called me back within half an hour asking if I was ok. I explained that I had seen better days but this was not the first time I was in withdrawals and it was just a slightly more severe case of your typical benzo withdraw. I proceeded to ask, “So, is someone going to get me more Xanax?” 

The PA said she had spoken with my primary and that her response was, “She is supposed to be on a tapering program. She knows she is on a tapering program. I just refilled that not too long ago. I want to talk to her.”  I said “OK, but did you get the impression she is going to give me some more? Do you think she will?” To my dismay, the PA said that my doctor and I can “hash” that out (appropriate term lol) but that she personally didn’t think so based on her reaction. Oh good. On a brighter (sarcasm) note, the PA was calling because my doctor wanted her to call me to #1, make sure I wasn’t having seizures and #2, to get my cell phone number because while she didn’t know when she would be able to call, she was going to call me at some point that evening. I gave her my number and shut off my phone.

The next day I woke up, turned on my phone and had a message from her. At work, my voice mail light was flashing. I picked it up and it was her saying she has been trying to get in contact with me and would try again shortly.

My doctor is very dedicated which I appreciate, but she is also intimidating. As my friend puts it, “You don’t like talking to her because you know you can’t push her around or manipulate her into doing what you want.” In evaluating that sentence, I’d have to say, “Fair enough.” Anyway, I was dreading the conversation and still feeling like total shit but since the woman wasn’t in the office yet still taking the time to make multiple attempts to contact me,  I hesitantly sat at my seat waiting for the phone to ring. It didn’t take long. It was ringing within 15 minutes and it was her. After she asked me if I was ok she proceeded to remind me of the date on which she filled this script pointing out it was 15 days ago and if I am having this degree of withdrawal, I’ve been out for a few days so basically, what the hell? 120 in 11 or 12 days when I am supposed to be on 4 a day? She proceeded to ask me if I was just back to taking these “Whenever I want, however I want?”

Understand, if you’ve never been in benzo withdrawals, you probably don’t quite understand but this woman, who I deeply respect, was really sounding like Linus’ mother from the “Peanuts” at this point. Coming through my overactive, oversensitive, ringing fishbowl head, her attempt at questioning and lecturing very much sounded like “wah wah wah wah wahhhh.” Hence, I had not much to say and just shut up letting her go on about the dangers and what was I doing? She asked if I had taken the fluoxetine and I lied. I said “Actually, I forgot to refill it.” Her tone became slightly more accepting as she said “Ahhhhh, ok well that’s probably why you had such trouble this month.”

Feeling bad and really wanting out of this conversation as I just lied to a doctor reaching a new low in an attempt to get my Xanax, I simply said, “So, can you give me some more? I know I took too many but I am really rough over here.” She asked again how I was taking them and I told her and she said “Well, I will give you some to get by, maybe 5 a day…”

I interrupted her saying that I honestly need 3 to get up, at least 2 during the day and 3 sometimes 4 to sleep. She bent a little and very reluctantly made it 6 a day but she was only writing it for the remainder of the month and wanted me to call her 2-3 days before the next refill date cause she wanted some time to figure out what to do with me the following month.

While that didn’t sound exactly promising, I agreed and said, “So, you need the pharmacy number?” and proceeded to rattle it off. She told me to slow down, she didn’t even have a pen.

But, I had my Xanax…………..

Elvis Has Left the Building

I began therapy at the counseling center that my PCP recommended.

I am not a therapy person. I don’t like talking about the past. I am programmed and was trained never to talk about family issues. While therapy is a help to many I’m sure, it is generally a very unproductive avenue for me. This was no different.

I went for probably 10 or 12 sessions. The initial intake was with the addiction specialist who seemed to use one criteria in deciding to take you on or pass you off. “Have you gone to the internet to buy your drugs illegally or have you been arrested as a result of useage?” Since it was a no on both accounts, he passed me off to a female psychologist who was perhaps 3 or 4 years older than myself.

Note: I really do not respond well to women and I definitely do not respond well to women my age. I never have. If you aren’t considerably older with more education or you can’t prove to me within minutes that you are smarter than me, I check out mentally and couldn’t care less what you have to say. Unfortunately, this was the case with this woman I was assigned to. Within minutes, I sensed weakness and pounced. I lied about several aspects of my life just because I wanted to confuse her and see if she could see that I was lying. I was an irritant in other ways as well mainly to see how she would respond. For example, I refused to sign the forms that would give her permission to speak with my primary care doctor and then proceeded to tell her I have never taken the secondary drug my primary prescribed to help ween me off of Xanax. HA. Drove her crazyyyyyyyyy not to be able to talk to my primary and I even asked her, “Well, what would you tell her?” She said she would tell her I have never taken the fluoxetine and…………….yeah, I stopped her right there informing her that “Noooooooooooo, see, you two?? These worlds can not meet.”

Why you ask?

Because my PCP is significantly older and smarter than I am and I do not associate the word weak with her. In fact, all she has to do is look at me and I shrink. I was not about to have this woman calling her telling her I had lied to her about taking the fluoxetine. No way in Hell. I could smell the summons letters in the air at the very thought. I figured out within 5 minutes of meeting my PCP that she is not one to mess with. I totally respect that and it keeps me in line for a lack of a better term.

So, I stuck around this psychologist for a few months just for the fuck of ita nd because I was under the impression my PCP wanted me to. I found ways to amuse myself and pass the time and generally enjoyed driving her nuts by refusing to sign the consent forms she was so OCD’sh about. I guess a part of me wanted her to be like my PCP and shut me down intellectually but alas that was not to be. However, I did try a couple of her suggestions just to try them. One of these was NA.

Ever been to NA? Let me tell you, it was exactly as I told her it would be and I did not belong there. In fact, a heroin addict sitting next to me laughed at me when I told her I was there for Xanax and she proceeded to tell me if I like Xanax, plfff, I should give heroin a go!

Indeed.

So, this psychologist and I just basically bantered back and forth about my signing the forms. Besides the fact I simply could not have this woman calling my PCP telling her I’d been lying, she also had adopted a “Go to detox” attitude. I laughed. I didn’t know if my PCP would laugh with me because this woman was so adament about my going to detox that I aptly nicknamed her Dr LockHerup.

The final straw between this psychologist and myself came when I went in one day and she was in a foul mood. She threatened to break doctor/patient confidentiality and call my primary without my authorization. The woman was obsessed with speaking with my PCP which I also found annoying. Was this some kind of deep rooted need for validation? To be able to call as a PHD and speak with an MD? Is she really some kind of wanna be psychiatrist who had to settle for a PHD because she couldn’t pass the boards to get into med school or what? I laughed at her asking on what grounds she thought she had the right to do that on. She said, “Self harm.” I basically said “Righto” and advised her against doing any such thing and stormed out after a very awkward 45 minutes of basically a visual standoff.

I appeared for one last time prior to Christmas, one week after the threat to call my primary and I only did so because she said she was going to take time to research inpatient detox centers for me and while I had no use for her at this point, I though it only polite to take the info she spent time gathering. At this appointment I was drug free America having gone through the remainder of the last script rather quickly.

When I am “DFA” I am a very different person. So much so, my psychologist felt the need to point out the excessive chatter, the bouncing legs, the non-stop knee shaking and finger tapping to which I responded, “Yup. This is  a much preferable state to being Xanax calm isn’t it?” She went on to say I speak much differently about Xanax when I am off it rather than on it. She described it as deep seeded “ambivalence” and we spent the last 45 minutes together doing diaphragmatic breathing and progressive muscle relaxation exercises. WHATEVER. I’m sorry but I was dying laughing at her explaining I have a professional job and can not be looking like Mr Miyagi doing the Crane on the beach in “The Karate Kid” in public with these “techniques.” I also laughed asking if she had any concept of how much easier it is to simply pop a Xanax and be done with all of this in 10 minutes?

With that, I left the building and never looked back. 

A Reduction

After going in for the appointment and being, albeit politely, read the riot act, I was sent on my way to finish the script I had and with instructions to start visiting a counseling center to again, help me with the reintroduction to reality and the imminent, ongoing, persistent feelings of anxiety. My PCP felt like she was a little out of her league in so far as the intricacies of anxiety go and wanted me to see a psychopharmacologist who specialized in alternative non-benzo, anxiety treatments.

Off I went.

Month Uno.

While the prescription was for 5 a day, the fact of the matter is 8 was/is my minimum and 10+ was not unusual. I got through the month doing what I had grown accustomed to doing—rationing. I would have 8 one day, 2 the next, then 10, maybe a day here and there without any or only one. We do what we must to get by.

When the 30th day mercifully approached, I called in the refill thinking nothing of it. I left a message. Two hours later, I answer my phone at work and it is my doctor. Not the secretary. Not the PA. Not a nurse. My doctor. I have never had a doctor call me before, especially not for something as simple as a refill. MY doctor wanted to talk about how I was doing.

She started off by saying I made it through the month and that is good. If there is one thing I am horrific at, it is lying. I sheepily said, “Yeah…” This woman is perceptive to a Spidey Sense level and pushed that response to which I explained what I was doing via the rationing. She wanted to know where exactly I was and how many I was taking. I honestly told her that I couldn’t say because it varied each day. Pushing for an answer, she wanted to know how many I took that day. “None.” She asked about the day before. “None.” The day before that??? “None.” She asked how I was feeling and I honestly told her I felt like my head was going to implode, I was dizzy, congested, had amplified senses, felt like ym head was in a fishbowl by the Liberty Bell and generally just out of it. She proceeded to state the obvious which was that I was in withdrawals. Furthermore, because of the length of time I had been on them and the amount I was taking, seizure was a very real possibility. Armed with the info I countered with, “That only happens to 1-3% of people on this.”  Her response? “Oh? And do we want to find out if we are in the 1-3%????”

She proceeded to ask me how many I had taken 4 days ago. I said, “12.” With feigned disbelief resounding in her voice she reiterated, “12?”  I said “Yes, 12.” She said, “1-2, 12?” I said “Yeah. Is that a lot?” Note, at this point, 8-10 is generally tic tac territory so I needed about 12 to float. 8-10 would work physiologically but the 12 got me that extra calm. Needless to say, she didn’t even answer my stupid question. Instead she said she needed me to come in as soon as I could because she wants to see me in person and have another chat. She asked when I could come in. Completely uninterested in coming in, I asked if I could call her back to which she said, “Call me back.” I assured her I would with no intention of ever doing so. She said she expected to hear from me by the following afternoon.  

I got to work around 11:15am the following day and just as I was settling in, my phone rang. It was her office calling stating that my doctor had spoken with me yesterday and was expecting my call this morning. The secretary said the doctor had just come by to see if I called and when she told her I hadn’t, the doctor told her to call me and get me an appointment. (I mean really……..) It was Friday and she wanted to know if I could come in first thing Monday morning. Why is it that when you’re dying and want an appointment, it is next to impossible to get one but when they want to see you, they make time??? Anyway, I don’t like doing things on other people’s orders so I said no and made an appointment for a week or so out.

I was so looking forward to that, let me tell you……………..

We’re Not in Kansas Anymore…..

Upon meeting my new PCP, we went over the medications I was currently taking. Standard procedure. When I said “Xanax,” this doctor did a sort of swivel and said “Uh hmm. How long have you been taking Xanax?” I told her about five years. You would think I had told her the sky was falling on her head. Appalled by this news citing FDA prescribing guidelines of 8 weeks maximum with physician supervision, she declared it was time I came off of “these Xanax.” That’s when the fun really began……..

My doctor proceeded to inform me, or some may say, “Go off,” about the hazards of being on this drug for so long. I just nodded in “whatever” agreement as she began laying out her plan for my “tapering.”

She decided my current method of taking them was “haphazardly” and she gave me a prescription for 150 for one month explaining that from now on, accessibility is going to be limited and basically, the party’s over. (Was I at a party???? Where are the chips??) Anyhoo–she went on to inform me that all refill requests will be going directly through her. Not her secretary. Not her PA.  Not the refill line. Her. If I wanted a refill, I had to call and wait for her callback. I would no longer be getting any without speaking directly with her every single blessed month. (Oh joy!)

At this point in the conversation, she invited me over to her computer where she showed me how this hospital is intra-connected. Each doctor has access to the notes and comments of every other doctor a patient has seen. In other words, “Don’t bother trying to go to another doctor in this hospital because I’m red flagging you and no matter who you go to, they will now know your history with Xanax and my opinion which is, you are addicted.”

I took exception to this term stating I have never had a problem whatsoever with Xanax to which she responded, “And you’ve never tried to come off have you? So let’s see what happens when you have to be under some kind of control and can’t take as many as you want, ok? Humor me.” 

I said “Fine” because really, what else could I say? Let the tapering commence! However, I did have one parting question. “And what if I can’t come off of these?” 

Her response was, “Well, eventually I will just stop prescribing them so I suggestttttttt, you take them exactly as I direct because this is not going to be easy for you. In fact, I want to give you some fluoxetine to help you cope with any negative side effects you may experience.”

With that lovely thought hanging over my head, I left with the echo of “Make a follow up for three months from now!!’ following my wake. I didn’t. Two weeks later I came home to a letter from her stating that since I didn’t make the follow up, she took it upon herself to schedule an apppointment for me. 

Did I mention? We’re not in Kansas anymore. 

Beginning the Journey

It all started while innocently watching television one day. At age 27, I was healthy and carefree. However, as I sat down one night, I felt a piercing pain in the left side of my chest that can only be likened to what one imagines a lightning bolt strike to feel like. As the pain pierced, my heart was off and running. I managed to get to a family member who was at the home but we couldn’t get my pulse rate because it was going so fast. My aunt was called because she has experience with this and lives very close by. She brought her blood pressure and pulse cuff with her and my pulse was 178. We decided I should go to the ER.The ER. What a lovely experience it always is! I did however discover the secret to immediate service in ERs. Complain of chest pain. I went to the front desk, explained I was having an out of control heart rate not too long ago and a nurse took me straight to triage where I was asked several questions including but not limited to, “Have you taken cocaine? Any speed? Are you sure? No coke? No speed? Nothing at all? Has anyone hurt you or thrown you down a flight of stairs this evening? (I am still perplexed by that one) Following the intake questions, next came the vitals. I explained that I felt perfectly fine at this point and the nurse said, “Hon, you’re pulse is 150 and you feel fine? Guess what? You just won a room at the ER inn.” And with that, I was checked in. After numerous tests and questions, the doctors were sure it was a mixture of excessive caffeine, smoking and lack of sleep. They gave me Tylenol and eventually sent me home. But that would not be my last trip to the ER. Several more followed with similiar circumstances and results.

Eventually, I was summoned to my primary care’s office. He referred me to a cardiologist. I had every test known to man. Between the cardiologist and the ER trips, I have had 12 EKGs. I have also worn a Holter monitor for 24 hours, had a treadmill stress test and an echocardiogram. All negative. I was told this was all stress and anxiety related and referred back to my PCP.

Upon returning to my PCP, I was prescribed Xanax.
Oh sweet potatoes!
Xanaxxxxxxxxxxx. Ahhhhhhhhhhhhhhhhhhhhhhhh.
What a wonderful, beautiful drug!
It is insta-calm and worked miracles. All anxiety and stress seemed to flow from my very pores.

My PCP had a very interesting policy for refills. You simply called, got a voice mail, left your request and magically, it would appear at CVS hours later. VOILA!! For five years, I never saw the man, spoke to the man or was questioned by anyone regarding my Xanax useage even though I was going through them faster and faster as time passed even asking for higher milligrams on the voice mails explaining the old doseage wasn’t working. No response. I would eventually run out early, try to pick up a refill at CVS only to be denied. The pharmacist and I developed an interesting relationship to say the least.

In MAy of 2006, I had scheduled a appointment with a specialist at a major univeristy teaching hospital in
Boston for a vascular issue. In order to see him, and he is rated among the best in the country, I had to have a new primary at his hospital.

Enter my new PCP…………………………