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The world's longest suicide note: ONE MILLION words.

I write about life with bipolar disorder (a.k.a. manic depression).

All opinions are my own.

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Life Is Better In Flip Flops

6 min read

This is a story about nerve damage...

Tied on flip flop

As you can see from the picture above, I had a very bad injury to my left leg. What you might not know is that the massive lesion to my leg healed perfectly. Some nerves were severed when a piece of mirror glass guillotined its way through my shin, but the nerves managed to regrow. The severed tendons and muscle was sewn back together and my leg had completely recovered.

Then I got DVT (deep-vein thrombosis).

The first I knew about the DVT was that my ankle looked a bit swollen and my foot went numb. It was the fact I hadn't needed to urinate for several days which prompted me to go to hospital. On the day I decided to go to hospital, my foot, ankle, leg and knee were swelling at an alarming rate. By the time I was examined in Accident & Emergency, my left leg was almost fully twice as large as the right leg.

My weight soared from around 80kg (176 pounds or 12½ stone) to 95kg (209 pounds or 15 stone) which is a heck of a lot of weight gain for 5 or 6 days. It took many many sessions of dialysis to get that fluid out of me, while the hospital anxiously waited for my kidneys to start working again.

Unfortunately, the blood clot/thrombosis and other complications caused nerve damage. Presumably the blood vessels which had been surgically repaired and the nerves which had managed to re-grow and re-attach themselves, were quite fragile versus normal physiology. My foot went numb.

To be more accurate, my foot was left numb after many months of excruciating pain.

I had a nerve condition study and an MRI scan, but there was still a lot of swelling and other damage, making it unclear whether a surgical intervention might ever return the feeling to my foot. My main concern at the time was pain management, because it was too painful to walk any great distance, and pain kept me awake at night very badly. I was taking the maximum dose of tramadol AND codeine, plus supplementing prescribed painkillers with dihyrocodiene and other opiate medications, which I bought on the black market. I was briefly a very heavily dependent opioid painkiller user.

Opiates have weird side-effects. I couldn't tell whether the nausea, itching, constipation, cramps, sweating, diarrhoea, and intense anxiousness about maintaining my supply of opiate painkilllers, was a result of their effects or the effect of withdrawal. All I knew was that I would have periods where I felt incredibly rubbish, and then periods where things were more bearable, despite dosing myself regularly throughout the day.

The thing which made the greatest difference - other than a loving, caring, attentive and wonderful girlfriend - was a topical ointment containing diclofenac, which is a NSAID (non-steroidal anti-inflamatory drug). Because of the earlier complications with my kidneys, many medications were contraindicated. Perhaps I shouldn't have used the diclofenac gel, because it's not very kidney-friendly, but it was the only thing which gave me any reliable relief.

It's possible that most of my pain was related to opiate withdrawal and strange interactions between the tramadol, codeine and dhydrocodeine, which I should not have been combining, but I did so out of desperation for pain relief. It's possible that in my desperation for pain relief, I actually made things worse. Perhaps tramadol alone would have been more effective.

Eventually, I decided that I hated all the effects of the opiates, so I decided to go cold turkey. I had been heavily opiate dependent, for a period of several months, so I was expecting to experience pure hell quitting the opiates. Certainly a lot of noise has been made about the addictiveness of OxyContin, Vicodin and other painkillers which have been implicated in the opiod addiction epidemic sweeping the United States, declared a nationwide public health emergency by President Obama on October 26th 2017.

Back in July 2017, I tried to walk from my apartment to my local Chinese takeaway in flip flops - a distance of about 500 metres. I could not walk more than ten paces without the flip flop coming off my left foot, because it was so numb and my toes were somewhat 'clawed' such that I couldn't hold the flip flop on my foot or tell when it was slipping off.

For almost all of 2017 I was taking a neuropathic painkiller called pregabalin - marketed as Lyrica - which I found to be quite effective. However, it occurred to me that this painkiller might have been preventing the natural nerve re-growth which had successfully healed my severed nerves once before. After 9 months with no improvement to the numbness in my foot, I was becoming quite depressed about the prospect of never regaining any feeling in my foot, and consequently never being able to wear flip-flops again, without tying them onto my foot as pictured above.

I like wearing flip flops. They're an important part of my beach bum seaside-dwelling kitesurfer identity.

I decided to stop taking pregabalin.

If anybody tells you that pregabalin is not addictive, they're just plain wrong.

Pregabalin quite recently became a scheduled drug in the UK, making it illegal to possess without a prescription. Pregabalin affects the GABA system of the brain, just like alcohol, Valium, Xanax and GHB/GBL, which are all considered to have a high abuse potential, so naturally pregabalin is no different.

Of all the drugs I've quit and medications I've withdrawn from, pregabalin is one of the worst. Because of its tranquilising and sedating effects, the rebound when withdrawing creates a state of insomnia, anxiety and induces the general sensation that the world is about to end, which lasts for months.

I quit pregabalin under the supervision of doctors, tapering the dosage down gradually, but it was a pretty aggressive schedule, which was chosen by me. I wanted to quit pregabalin as quickly as possible, because I wanted to find out if it would help my nerves re-grow and allow me to wear flip flops again, or indeed be able to feel a kitesurf board underneath my feet.

Pleasingly, I can report that I put on a pair of newly-purchased flip flops tonight, and I was able to walk around without the left one falling off.

My left foot feels different from the right one, but I do have some sensation restored and I don't have the aches and pains which troubled me during a lot of 2017.

It might seem like a minor point, but it's actually something that has disproportionate imporance in my life: To be able to wear flip flops again is a big deal.

Life is better in flip flops.

 

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The Days are Getting Shorter

2 min read

This is a story about the end of summer...

Hospital ceiling

That blue sky isn't real. They installed those fake roof tiles so that patients receiving dialysis have something slightly nicer to look at than grey ceiling tiles, during the many hours that they're being treated. Both my kidneys had failed very suddenly, so I was having 4 or 5 hours of dialysis every day, desperately trying to get both fluids and toxins out of my system, because I was very sick indeed.

I've waited and waited and waited for better weather. My mood has been persistently depressed. Suicidal thoughts have been with me daily, if not hourly. I've been clinging onto the thought that better weather in May and June would lift my spirits, and improve my mood. I've been desperately hoping that my energy will come back, and I'll feel enthusiastic about life.

Instead, a couple of terrible things happened in May and June, which destroyed my fragile little world.

I'd barely gotten started putting down roots - job, place to live, girlfriend, friends - when everything was smashed to smithereens. Now, the longest day of the year came and went and I didn't even notice. Depression keeps me prisoner in my own home. Some days I don't even open the curtains.

I'm wasting the few short summer months, which is a tragedy, but the timing couldn't have been worse to lose a couple of things that I desperately needed. When I needed good luck, I received bad luck... which I know is so often the case in many people's lives, but it doesn't make it any easier to cope with.

Winter is coming.

All those months and months of hard work I put in over the winter are being undone, and the boost that summer should give me - making life easier and more pleasant - has been sabotaged. Things are harder than ever. I'm heartbroken that my summer is ruined.

So, enjoy your ice creams and your days at the beach, and your family holidays. I barely leave the house. I'm as white as a ghost.

Superstitious people say that bad luck comes in threes, so I'm now just sitting at home waiting for the sky to fall in.

 

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What's Missing from this Picture?

4 min read

This is a story about unnecessary packaging...

Holiday essentials

I've had a stressful morning. I had to package my Macbook carefully so that it could be safely sent away to be repaired. I had to locate the original packaging for my Virgin broadband router and box it up so it could be sent back to them, even though it's defective junk. I then had to find a UPS parcel drop-off point and a Collect+ drop off point to drop off the respective parcels. This required a trip to purchase bubble wrap, a suitable sized box and packing tape, as well as two more trips to two different drop-off places.

While I was out dealing with those chores, I also had to purchase a piece of carry-on luggage and some flip-flops. The flip flops were sold to me in a box. I don't know why flip flops need a box - just a simple cardboard clip to keep the left and the right flip-flop together is more than sufficient.

Anyway, I'm home now. I have located my passport. I have located some leftover Euros I had from the last holiday I took... 22 months ago. I opened the box containing my new flip-flops and lo and behold, there was a discrepancy in the number of flip flops present in the box - 50% of the required number of flip-flops were missing.

Do I drive back into town, park my car, walk to the shop and explain the situation in the hope that they admit their mistake and remedy it without quibble? Do I just purchase a second pair of flip-flops and then open and check inside the box before i leave the store? Do I just abandon the whole ill-fated exercise, and buy a pair at the tiny departure airport, where the shops will probably be closed? Do I take time out from the one single whole day I get to spend with my friend, without either of us having to worry about airport arrivals/departures, hotel check ins/out and all the rest of that crap, just to go looking for some suitable summer footwear?

I don't know why this is making me upset, because I don't even know if the nerve damage to my left foot/ankle is so bad that I can even wear a flip-flop on that foot. The last time I tried, I didn't have enough sensation and motor control to keep a flip-flop on my foot.

Also, my flight's delayed - French air traffic controllers on strike or something. My flight barely enters French airspace, but whatever... everyone should have the right to go on strike for better pay and conditions.

My 'holiday' is really just a day spent with a friend who I hardly ever get to see, then we both fly home on Monday. I have another week to go before my current gig comes to an end, so I need to make sure I take the money while it's there on offer.

"Have you got any holidays planned?" asked a person I spoke to on Friday, which is code for "we want you to work solidly until you drop dead". We'll have to see how badly they want me, because I really need a holiday - a proper holiday.

It seems churlish to complain, but I've had a month of hell. Breakup, losing my local job, getting sick, holiday plans pretty much cancelled, the stress of finding a new gig, the prospect of going back to London, the never-ending pressure to generate vast sums of cash to dig myself out of the hole... the hole I can never quite escape from. FML.

What was supposed to be a romantic beach holiday with my [ex]girlfriend has now turned into a very brief weekend meetup of two old friends. It'd have been far easier for us to meet in London, as he was there yesterday. He's travelled London -> Prague -> Lisbon -> Faro -> Lisbon -> Prague, and I'm travelling Wales -> Bristol -> Faro -> Bristol -> Wales. Our carbon footprint is criminal.

Hopefully I'll be in a better mood when I wake up in Faro tomorrow and I can hang out with my old friend for the whole day, free from commitments and responsibilities... I can put up with sweaty feet.

 

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Suddenly Summer

4 min read

This is a story about the pleasant months of the year...

The park

I was psychologically prepared for a miserable winter. I was psychologically prepared for seasonal affective disorder to lay me low after the clocks went back and the days were short, dark and full of drizzly cold awful weather. I was psychologically prepared to knuckle down and work hard during the unpleasant British winter. I achieved a lot, especially considering how suicidal depression, intolerable anxiety and unbearable stress were constantly with me as I attempted to avoid bankruptcy and tried to get myself back on my feet.

Yesterday I was at the marina looking at a yacht I'm going to be sailing soon. Today I took a walk along the seafront and had a picnic in the park.

Theoretically, I have a source of income that lasts until the end of July.

I have a holiday planned in June.

My life is awesome.

Well... my life looks awesome to an outsider. There's nothing too much to complain about except for my crippling debts, the uncertainty about the future, I'm bored and unchallenged at work, I'm still struggling with depression - desperate to feel hopeful about the future, but knowing that things have been quite unsustainable. I've been getting up too early - because my work colleagues are all early birds - and I've been finishing my work too quickly. I hate being bored, but I hate pacing myself too - I'm not capable of deliberately going slow.

I knew winter was going to be hard, but I imagined summer was going to be easy. Perhaps I mismanaged my own expectations. Perhaps I didn't psychologically prepare myself for the whole long slog to freedom. I'm 6 to 9 months away from getting my life sorted out, and that assumes that nothing goes wrong. I could lose my source of income at the end of July. I could lose my source of income sooner - I have no idea what I'm going to be doing after the end of the month.

I shouldn't complain, of course.

I shouldn't complain.

My life is awesome.

So I keep telling myself.

It certainly makes a difference, the pleasant weather. I'm more motivated to leave the house and enjoy the nice things in the local area where I live. I'm planning on going sailing. I'm planning a holiday.

However, uncertainty looms large. My income is insecure. My mental health is quite dubious - I'm struggling to get to the office and get through the days. My job is a lot better than the last one I did in London but I can't cope with being bored and having nothing to do: I've got to be busy busy busy.

It seems churlish to complain. I'm not really complaining - it's a statement of fact. Summer is here but life's harder than I expected... things are still a struggle, although I guess things are a lot less of a struggle. The problem is that I've struggled for so long and I really need a break to recharge my batteries, so that I can carry on without having a nervous breakdown. I haven't had a proper holiday in 21 consecutive months.

The warning signs are there - I had to take a couple of days off sick last week. I'm having an extra-long weekend, because I'm spent; I'm exhausted. It's taken so much to get to this point and there's so much potential for me to really make some good progress now, and start to get my life sorted out, but it's been a ridiculous journey during the course of the last year. The last year has been hell.

Yes, some really nice great stuff is starting to happen. Yes, my life is really improving loads. Yes, I'm really knackered from all the effort I've put into getting myself to this point. Yes, I'm exhausted and I'm struggling to carry on at the same pace; to work as hard as I worked to get me to this point.

This is a bit of a churlish whinge-fest, but I wanted to write about my divided feelings: so happy that summer weather has finally arrived, but also really worried about how much hard work still lies ahead.

I just feel like I should be further ahead than I am, given the suffering and effort involved, but I guess a lot of people feel like that. At least I'm getting somewhere I suppose... I do feel sorry for people who get nowhere, no matter how hard they try.

 

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