Saw the psychiatrist today—got the referral from my brother (now I’m outing him, too; I’m so getting sued)—and was happy to learn that not only does the guy have the letters FAPA after his MD but the following text on the following lines as well:
Diplomate - American Board of Psychiatry & Neurology
Added Qualifications - Addiction Psychiatry
Diplomate - American Board of Forensic Medicine

A fairly well qualified chap, especially for the questions I had. I asked him if I needed to stay on Prozac and if he thought I had ADD or ADHD or whatever it’s called these days.

I have long held a theory that I might have some mild version of the latter. Not like my brother does—his is severe—but at the core of this hunch lie the facts that coke and crack—bonafide stimulants, anyone will tell you—in many ways have a calming effect on me, perhaps the way I imagine Ritalin—St. Joseph’s Children’s Upper—chills hyper kids. This past year I have overwhelmingly used coke and crack while concentrating on work for long stretches, one time for over 24 hours non-stop. Sometimes I have gotten one or the other in order to focus on my work. Straight, my knee begins to bounce within five minutes, and I have to break my work up into small chunks, no matter how much enthusiasm or determination I have for it. I feel overwhelmed.

Doc B informed me that ADD and ADHD are the same thing and that I did “exhibit” their symptoms. I feel like The Met.

He didn’t want to prescribe a stimulant, however, because my head needed to right itself first, get back into the groove of secreting the right chemicals and firing at the right times and quantities in the right places for the right reasons. Current production is low and needs to be kicked up, ramped up, dialed and locked in.

So, no Coke Light for me, but the anti-depressant Wellbutrin is sometimes used to treat ADHD and it does something different than does my current course of Prozac, which Doc B decreed needed at least a 90-day trial.

I have twice before given Wellbutrin a whirl. Once, in a very experimental way, I went to see a psychiatrist in New York. This was while my ex-wife was out of town. I wasn’t sure I needed anything at all, but was curious. Felt something, I think. Some dumpy uncertainty, maybe. Or, did I just feel the same way everybody feels?

The messy Brownstone doctor slouched in a riveted leather chair and asked me if I used drugs. At the time there was a good deal of low-grade coke in my life and I told him so. I bought cheap bags at the Puerto Rican bar almost nightly…or was it every other…?

In any case, that had to go and Wellbutrin had to come, he said; it being the perfect fit as it was used for depression, curbing coke cravings, and nicotine withdrawal!

Three birds!

Three of my most Hitchcockian buzzards!

I wanted to hit them all with those little purple stones, but I failed to adequately (in terms of degree and duration) make the lifestyle changes required, and, in a frustrated act of futility, the remaindered poppers got pourn in the toilet.

In Nicaragua a year and a half later, higher grade and still cheaper coke was the near nightly (and often morning) ritual and I knew I needed to stop. I prepared to make a river trip to the end of civilization and other remote outposts on the border of Costa Rica, and therein had an opportunity for clean-breaking.

I went to a farmacia in Granada and spelled it out for them on a piece of paper. The girl scrunched her face and asked me what it was for. “The head,” I said, in my best spanish.

With help it was found. And it was expensive. And didn’t last if it ever took in the first place.

So, on top of not being too sure about joining the Prozac nation (it makes me sleepy and thirsty and maybe a little misty mentally), there’s some skepticism regarding the Wellbutrin, though my committment to lasting lifestyle change—as well as my environment—are much more condusive to its success this time. So, I went to Costco and picked me up a $56 brown bottle of the generic, Bupropion - Sustained Release version, which I pop twice daily.

Lab tests have also been ordered, which pleases me despite the inevitable hit to my debt-laden, uninsured wallet:

• 900323 - Comprehensive Metabolic Panel, XS
• 1677 - Lipid Panel, SS
• 3005 - Hemogram (CBC w/o Diff w/Pit), LT
• 9230 - Hemoglobin A1c, LT, and
• 8055 - Thyroid Stimulating Hormone (TSH), SS.

There; farg you, Mr. Frey. Except for the thyroid one, all are your typical blood work, reports my (professional and domestic) nurse-mother. I’m kind of stoked because they say “CBC” all the time on ER, and now it’s really happening in my very own life! But where do they come up with those numbers? I refuse to believe there are over 9,000 tests. My also-mysterious Diagnosis Code, by the way, is 314.01, if I’m reading it right.

10-4.