Throat muscle spasms Wednesday and hoarse and sore throat yesterday.

Scares me because of two rounds of strep A sepsis.

But I had sniffles yesterday too. And it is my vocal cords and above, not the trachea below. So I think this is just a cold, a virus.

I might be able to survive the strep A again, but maybe not. And last time I was out for ten months, so if I get it again, I think the clinic would close.

And I have had 8 patients with it in the last two months. I am going to be like Howard Hughes and lock myself in my house and only touch people wearing gloves.... but no, I am still doing clinic. I wear a mask and switch rooms after I see someone who I suspect has it. Though yesterday I forgot and kept using the room.

In my plague dream, the patient frothing and bubbling at the mouth: droplet spread. I wash my hands. I wear a mask so that I am less likely to get droplets when I look in their mouth and they cough... Aren't dreams curious, that it told me so clearly?

No zika in town yet.....

Last night I met up with some of my friends from school to study at Starbucks. I really like one of the women I met there, the other has some issues that make me nervous. I don't know if any other locations do this, but our Starbucks will let you take home used coffee grounds for your compost pile or garden. I hefted my bag into the front seat and moved it to the trunk after I got back from the grocery store. It was cold and dark when I got home last night. This morning my entire garage smelled like coffee grounds and so did my clothes.

This morning I met with my physician's assistant to discuss me going off of my meds. She went back through her notes (it's really hard to believe that I spent five and a half days at a mental hospital) as we discussed my moods and emotional stability. Sometimes medication can be doing things for people that they don't realize. She felt like my statement about the lamotrigine not really helping was fairly accurate. I gave it a fair shot, didn't have the light switch difference that indicates that the medication is effective, so it makes sense to try something different. I haven't taken my anxiety medication in a couple of days, I'm really proud of myself for that, it feels like a huge victory to be able to type that here.

Her concern is that without meds I may end back up at Rogers again. She thinks that the medication may have been partially responsible for keeping some depression at bay and worries that the suicidal thoughts may return. It's legitimate and I trust her to have my best interests at heart. We're going to monitor the situation through charting. I have two charts, I haven't put these together yet, but I have the things laid out on my table, one of the charts tracks mania while the other focuses on anxiety and depression. Normal people are approximately 3-4 on the mania scale with 0 being no mania and 10 being full blown run away to Mexico with some guy I just met because why not?

The anxiety and depression chart has regular people about a one or a two. She suggested using different colors for each week which I thought was smart. At the end of the session she told me I was smart and intuitive and I needed to give myself more credit. I felt really good about how the appointment went and how the changes I've made in many areas have impacted my life. We talked about learning new skills, habits, and changing old behaviors. In the past I've wondered if going to therapy and some of the other things I've been doing have really made much of a difference, today I can say that they have and it's a great feeling to recognize and realize that.

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