Wednesday, November 9, 2011

Partially Compensated Metabolic Acidosis

The human body is amazing....for more reasons than I can count, but one of which is its ability to physically compensate. Whether you know it or not, there are all kinds of autonomic functions (the kind you don't have to think about, like your heart beat) that are constantly changing to accommodate everything you throw at it. One such "situation" is called partially compensated metabolic acidosis.
For my non-medically oriented audience, stick with me. Under specific conditions of duress your body can develop something called acidosis, the cliff notes on the subject are that the pH in your blood drops too low. If it drops too low it's incompatible with life, in in reality, the tolerated range is really quiet small. Nature was kind in our evolution and created autonomic functions that try their very best to "right" things before we crash and burn. In fact, you can go on for a fair amount of time before your ability to compensate is worn out...or the problem that caused the acidosis in the first place overwhelms the ability to compensate. Still with me? Any idea where I am going with this?
My current state of being is the cerebral equivalent of partially compensated metabolic acidosis. My brain has, for years, recognized the scattered disordered thoughts, the inattentiveness, the restlessness and has created ways to compensate, to accommodate it all. I makes lists down to the minutest detail so that I don't miss anything (but then usually lose the list or don't fully follow it). I use having to pee as a socially-acceptable excuse to get up and move (whether is is leaving a class, on a plane, a movie--makes no difference). I think in black and white because it gets things done--I don't know what to do with grey (it actually overwhelms me). There are set places in the house that a few select things go so I CAN'T lose them (like my wedding rings). This is, apparently, how I have compensated. There are things I have actively done to organize my life (not knowing why, mind you, other than the fact that is decreased my anxiety) and there are things that I have just done but seems to make a helluva lot more sense in hindsight. Now, this all works fine and dandy until something tips the scales and suddenly I can't compensate anymore. The expression of the loss of the ability to compensate has been panic attacks and shut down. I flap, as in my hands. And wring them too, and pull on the hair on my arms and really, everything just goes haywire--in fact, I look something akin to a schizophrenic poodle (yes, I realize its not proper English to start a sentence with a conjunction--bite me). Complete meltdown = feeling broken. I feel guilty for having lost it, incompetent for not having been able to prevent it, berate myself--then I try to pick up the pieces. Rinse and repeat--over and over again. Its exhausting--and until now, there has never been an explainable "cause." Cue entrance from stage left: ADHD!
Its hard to explain to someone who has never experienced severe anxiety what it is really like. I have tried to tell my husband that its like that moment of shock you have after a near car accident - except it lasts for hours, days, or even weeks. Its not something that you can "just stop" or choose to not have happen--its a symptom! Problem is--if you don't know what is causing the symptom, you are screwed! By now it must make sense to someone why this whole ADHD diagnosis is such a revelation??
In partially compensated metabolic diagnosis you do a number of things: figure out what the cause is, take over the role of compensating or assist the body in doing so, treat the root cause. When applied to my brain and life...well, it starts to make sense! It might have taken 20+ years to figure out the root cause (there were a lot of red herrings in there!!) but finally there is a diagnosis that actually makes sense and accounts for all the random bits and pieces: ADHD. Check. In terms of assisting my brain - treatment of ADHD should be multifacted--it's not something that magically goes away--you have to learn a way to accomodate and live with it. I started vyvanse this past Saturday--a little baby dose that will inch up slowly if I need it to (really, its a trial and error thing). I go to therapy once weekly to talk through things (there is alot of sorting through the past and unlearning some bad thoughts about myself) and for cognitive behavioral therapy. I do homework at home. For the record, those who believe that you simply fix ADHD with medication you are crazy--its something that helps you manage life but it doesn't fix anything permanently--just like tylenol doesn't permanently fix a fever. Excuse me as I clamber off my soapbox (I'll probably trip and fall anyway--I'm clumsy like that).
Don't know if this was more to try and explain things to the world or rationalize it to myself in a language I trust. In any case, its undeniable progress in the march of acceptance.
Sarah

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