01/24/2008:

It is so odd that my last entry, almost four months ago ended with "I think I'll slip in my James Bond 1964 Goldfinger DVD." Because I just pulled the very same DVD out of my player after having watched a bit of it prior to the arrival of my regular rental shipment's arrival from Blockbuster.

Today's entry comes two days after the quite successful actor, Heath Ledger was discovered dead in his apartment stocked with Valium, Zoloft, and Ambien. Valium^® was specifically for anxiety, the Zoloft^® was an SSRI which helps alleviate symptoms of depression (as does my own Wellbutrin-XL) and the AmbienTM, the most dangerous of the three drugs, was for a more or less advertised sleep of at least seven hours and, in this case at least, eternity.

A few weeks ago I was so anxious to reveal to my emotionally hurting readers of my discovery that my spending of ten to thirteen hours in bed was not a result of depression, but was an unconscious attempt by my corporeal body to accumulate more than ninety minutes of consistent sleep. The over 90 minutes of sleep was never accomplished, because I awoke every hour and one-half having to drain my lizard. Hence I spent almost all my free-time in the half-empty Malamud bed, with my body knowing it was not getting true sleep and my emotional-mind being crushed by depressive & suicidal thoughts actually generated by lack of sleep while my intellectual-mind realizing, I was spending almost 100% of my non-working hours in bed, wondered if I would become like the 'grandpa Joe' in the 1971 movie, Willie Wonka and The Chocolate Factory.

It got so desperate that I visited Dr. Abimelech at his new Bell Road location and scored three prescriptions, one being Wellbutrin-XL. The other two, Prevacid^® (dispensed as free doctor's samples) to prevent the heartburn that fat-asses suffer after gaining so much weight the organ of their stomach is pushed up and too close to their esophagus, and the generic terazosin which relaxes the muscles at the neck of the bladder so one can sleep until the bladder is actually filled, rather than waking up every ninety minutes to go dribble out two shot-glasses full of urine. It's like my dear departed mother used to tell me, "It's no fun getting old Hammurabi. It sucks!"

Now with the claim that SSRI-based anti-depressants may not work as advertised (for me they do) and with my understanding that I was not depressed because of emotional depression, but depressed due to lack of sleep, since now, using the terazosin I score six and seven hour periods of shuteye and feel like life may be worth living again. Another benefit of actually being asleep is that my wonderful, weird, whacky and wild dream life has returned.

I read where Mr. Ledger was terribly depressed over his split up with his fiance Michelle Williams and I can fully understand that. It's sad that he apparently searched for solace in quite powerful legal and illegal drugs. And he sought comfort in the silent, cold, and deadly womb of aloneness and separateness we depressives often wish we could live the remainder of our lives in.

Being a Bible-believing (and worst example of a Christian myself), I wish that someone had dared to expose Heath to the forgiveness and purpose Jesus Christ pours out to so many of us. As many of you know I came very close to dying over the overwhelming and seemingly never-ending grief over Hanna-Marie's divorce decision. With the result being that I began these pages in the hopes that something I wrote may help someone else hang on just another day. Would these pages have made a difference in Mr. Ledger's life? I hope so. I hope so.

02/20/2008:

It's gotten so bad financially that Dr. Malamud has had to switch my meds from my good old know-everyone Albertson's, actual grocery store, with the little guy pushing around the propane floor polisher, to one of those mega-marts. A place as large as a university gymnasium sporting legions of phony-faced employees and more turnover than Hillary Clinton's campaign staff. Oh yes, and generic drugs for four dollars.

Using the internet, I found the building that Super WalTarCos*Mart had refurbished was an old coat factory location, which had taken over the bankrupted Montgomery Wards building where, years ago, after checking with Consumer Reports, I purchased my current vacuum cleaner. A vacuum cleaner I might mention is still like new.

This history is necessary because it turned out this Super WalTarCos*Mart was walking distance from the home, and the life, I shared for 26 years with the ex-Mrs.Dr.Malamud, Hanna-Marie.

Confused at the Circle-K-sized pharmacy inside the WalTarCos*Mart, I approached the wrong counter but was politely directed to the correct one. While I fondled the totally empty pill bottles in my pants pocket, I checked the three-page list printed on yellow paper, of four dollar generic prescriptions. I found Terazosin, but not my anti-depressant SSRI Wellbutrin-XL. So on my BPH medicine, I stood to save $16 a month, or $192 per year, or $192,000 over the next 1,000 years, should I live that long. Which I will have to, in order to collect the social security withholding I've paid in during the last forty-two years.

After entering my Social Security Number, address, phone numbers, place of employment, health insurance card, Dr. Abimelech's data and my Super Bowl picks for 2009, the chunky clerk caught me off guard when she then looked up and said,

"It usually takes twenty-four hours to transfer prescriptions. When would you like to pick them up?"

Thinking of the recent Northern Illinois University shootings, rumored to be caused by the gunman abruptly halting his  SSRI prescription, I replied, "Well, I had heard that it's very bad to stop taking SSRIs. And I've already missed two days. And I've taken my guns out of storage and for some reason have been sitting around and obsessively cleaning them all day. You don't know if 'they' carry Pendleton Royal Rangoon gun cleaning oil here, do you?"

Quickly holding up her index finger to stop my pleading commentary, she said, "I'll talk to the pharmacist." And then, for a heavy lady, she virtually sprinted off towards the pharmacy section.

As I waited, I saw visions of my twenty-one year old, Mainio, with the heavy chains I formerly utilized to hold down my race car down to its trailer, and instead using them to chain my bedroom door shut as if I were some kind of Lon Chaney Jr. werewolf exposed to the horrors of the new moon.

Within a minute she was again behind her counter, and seemed relieved when she announced, "The pharmacist is going to perform a miracle and you will have your prescriptions in about one-half hour."

I responded with, "Thanks a lot!" And wandered off in search of the gun counter to while away my thirty minutes.

03/08/2008:

Work is so awful. After seeing my pay cut by $8.12 an hour, now they want me to be a janitor too. The assholes. They've mistaken me for the poor losers they normally hire who they can get to do an absurd amount of work for pennies. That's why so many "Arizona Chamber of Commerce" members, i.e., business-owners of both political parties, favor the employment of 'undocumented workers' who they can treat as virtual deaf-mute slaves. But that rant is for a separate column.

I'm living like a pig. Well, I shower, occasionally. Since in the mild Phoenix winters I can get away without carefully stepping into my bathtub shower slippery son-of-a-bitch combo, but every three or so days. Since I live alone, who cares? I wear the same clothes for many days in a row. And I do mean "the same clothes". Since I see very few people during the day, with the majority I see while at work being drunk or too stressed from their own workday hardships to notice Dr.Malamud, an often crumpled, unshaven, and (probably) smelly senior citizen.

I haven't vacuumed the apartment since I moved in last September, but then I'm my only foot traffic. However I do keep everything else cleaned up, the bathroom, the sinks, the kitchen, the dishes, even the toilet with its light blue water lapping at the ivory shores.

Although I do have several weeks of dirty clothes to haul off to the communal laundry room, it's not like the story my friend, Phil Mandinga, told me years ago of his brother and his wife, who, severely addicted to drugs, but having no income problems (isn't that the gawdamned way it always is?) would simply toss their soiled clothes into an unused bedroom. A bedroom, that after many months of this, whose door eventually opened to reveal a tightly compacted and impenetrable, multi-colored, floor-to-ceiling mountain of shirts, blouses, pants, skirts and socks.

I don't think the Wellbutrin-XL is doing anything for me. I think I am finished with, possibly for the remainder of my life, the deadly and severe depression created by my reaction to the departure of Hanna-Marie half a decade ago. I think the only action this $40-a-month-copay SSRI is accomplishing now is to vastly multiply the effects of the yellow or brown tequilas I sip, and twisting my brain within my skull. Which, most likely isn't good for long term mental health.

Readers, do not try this at home. I have an extremely high tolerance (carefully built-up during the past decades) to alcohol and prescription drugs. And that, 'my friends' (as Senator John McCain would say) is nothing to brag about.

So, about the time you were awaking this morning, I was typing on my web pages. I finished off four shots of tequilas (both the dark and the yellow Cuervo's) re-heated in the oven, my Safeway fried chicken bought the other day, popped in Steven Seagal's Under Siege dvd and sat down to eat and enjoy. I went to bed at 10am, and awoke at 5:36pm, my first over seven hour sleep in three or four weeks.

And what I need, like Keith Ledger, is not more pharmaceuticals, but more sleep. More sleep.

03/24/2008:

Well, I'm off the Wellbutrin-XL and off the alcohol. For now. At the moment, I am facing life naked, unclothed by the nerve-numbing prescription SSRI or the self-prescribed golden agave juice of the gods, tequila.

For 'those' who insist that SSRI's (selective seratonin re-uptake inhibitors) do nothing, my reactions demonstrate, for me, that they do do something. When I was carefully withdrawing from my Wellbutrin-XL, by spacing my doses further and further apart I noticed several physical symptoms like a racing heart and the feeling of a single insect somewhere under my skin. I had only a lone critter, so it wasn't that bad, but I was reminded of stories of withdrawal from opiates where the person complains of hundreds of bugs under his skin.

Another symptom was a racing heart for no reason. I wasn't even thinking of Laura San Giacomo but yet my heart would hammer my breast bone like she was standing before me, arms up, slipping her always too tight tee shirt over her blessed breasts. If I was a pussy, I probably would have termed this occurrence a 'panic attack' and called my shrink.

But the reason I'm making this entry today is that I had read the onion-skinned paper, six hundred and thirty-two pages of warnings that came taped to the side of the bottle (the Wellbutrin bottle, not the tequila) and one of the facts I discovered was that this particular SSRI inhibits the histamine receptors in the brain.

The histamine receptors control the release of, yes, histamines, which cause the sneezing, the wheezing and the wet eyes of those with allergies. In any case, shortly after the Wellbutrin cleared my system (it can take weeks) I began having the same sneezing attacks I had as a grade school kid growing up on Solar Drive in Phoenix, Arizona. Yes, 'Solar Drive', how cool is that name?

After months of no allergy symptoms, all of a sudden I was suffering allergies that flooded my eyes as if I were gratefully weeping at the sight of the above Laura San Giacomo, sans tee shirt, sneezing fits that awoke the neighbors of my 700 square foot compartment, scared their cats and children and asthma related wheezing that had me searching for my blue plastic emergency inhaler.

Then I realized that the Wellbutrin-XL, while I think only helps emotions, if you are seriously depressed, had been suppressing my histamine receptors and letting me live a normal life even though I was still seriously allergic to such common things as hops in beer, cats, oleanders and air.

(to be continued, maybe ...)

06/05/2008:

Had my second appointment at the psychologist yesterday. Actually this one was with the doctor office's 'psychiatric-mental health nurse practitioner'. What a mouthful, eh? In my latest wellness scheme, her assignment is to prescribe and monitor the correct anti-depressant medicine for me. Her hour-long interview (to be continued by one-half more hour on our next visit) was many times longer than my general practitioner for the past two decades, Dr. Abimelech, could have ever given me.

The Psychiatric-Mental Health Nurse Practitioner asked more pertinent questions about my mental health than did the psychologist five days earlier. Although the psychologist probably knew many of the answers without even asking me.

She wants me to get a complete physical, fasting glucose (to test for diabetes), thyroid, all the usual tests. Thank gawd they are all covered on my health plan I shell out forty-seven dollars a week for. She also wants me to begin taking a "good" multivitamin. She stated "good" because, 1) At her office she sells a 'good' brand and 2) Because (and having sold multi-vitamins myself) most multi-vitamins are trash, with many times more dollars spent on advertising, labeling and positioning than in the laboratory.

This is because that, other than prescription vitamins, there is no national, certified regulatory agency that assays the ingredients of all vitamins, to confirm as to precisely what is in them lines up with what the label claims is in them. So, like the baldness, prostate, E.D. and cancer cures we hear endlessly advertised on talk-radio, vitamins are also simply a massive, money-making gimmick.

Plus, we now have several emerging studies indicating that vitamins may actually cause problems along the lines of human growth hormone, which not only makes muscles grow and tendons stronger, but also causes not-so-nice tumors and cancers to blossom.

She told me she wasn't going to force me to do anything. (I was hoping she would, and then when I disobeyed, she would spank me, because I'd been a bad boy.) I'm torn whether to tell her a lie or simply tell her, "I ain't takin' no damned vitamins". Especially at thirty-plus dollars a month. Hell, a 1.75 liter jug of Jose Cuervo runs only twenty-seven dollars and it has again and again proven to do wonders for me...by letting me visit the depths of depression that would cause even Harry Chapin to scream out. God rest his soul.

Even I after I claimed the tears running down my cheeks were from allergies, regardless, she said she could easily tell how sad I continued to remain over my divorce. Dammit, us 'actor-types' have a hell of a hard time hiding our true feelings. We have to act, to put on an act, to hide our true feelings.

She told me I'd have to come back for her decision as to the proper anti-depressant to use because she wanted to consult with the other PMHNP in her office. That's fine. After a forty-five dollar co-pay, I'll probably end up on Wellbutrin-XL anyway.

She did give me a two-week sample of a prescription drug that is designed to enable me to sleep longer than my current maximum of three continuous hours. That is because, often the cause of abnormal and prolonged depression is due to the fact the person simply isn't getting six to nine hours of unbroken sleep time. And she also stated that it seemed to her that I was using the alcohol to self-treat my depression. Which obviously is not good, since alcohol simply aggravates depression.

The drug she gave me is Rozerem and I'm pretty sure it was one of Heath Ledger's favorites. No, I don't think it was. In any case the instructions were to swallow the TicTac sized concoction forty-five minutes prior to bedtime. Which poses a challenge, since on my day's off, bedtime is night-time and during my work-week, bedtime is two hours after sunrise.

I did as she said (negating my chance for a pants-down spanking) and I do believe I am, over ten hours later, still groggy from from my single spit-ball-sized ramelteon tablet.

Sure enough, about forty-minutes after gulping down the white pill, I was having a hard time keeping my head up while I typed on my laptop, which was actually on a desk top. I wrapped things up and headed to my lonely bed, picking up the paperback attached to the booklight, I flopped on the bed, turned out the table lamp and lay with the bestseller positioned on my chest. Unread.

Soon I was seeing HD-style, crystal clear, colorful scenes. I guess you could call them dreams. The odd thing was that I could move my real-world arm and hand, and feel the rough, non-600-thread count bedsheet, beneath my fingers. I was dreaming, but I was surely not asleep. Cool. Reminded me of the greatest movie ever, Until the End of the World where Max Von Sydow's character invents a pair of goggles that allows the wearer to view their previously recorded dreams.

I tossed and turned all night, had some wild dreams (which I enjoy) and I did stay in bed about ninety minutes longer than I normally do. She said to give it two weeks.

06/06/2008:

Rozerem Day 2--Thursday night, I took my second dose of Rozerem. Once again I felt incredibly tired, but since I've been able to work through those feelings while on the job, I simply kept editing on my unread and unnoticed web pages for another hour.

Went to bed, I don't believe I read anything before falling asleep. But then later, I tossed and turned. I could not sleep, but I could not wake up.

Finally I managed to awaken and went out to watch my Blockbuster Online DVD. After becoming tired once more, I went back to bed, read some in my awful Tom Robbin's novel (how did this piece of crap get published?) and fell asleep, only to wake up remembering tossing and turning again. And once again unable to fall asleep, or wake up.

When I did awaken, I felt hungover and discovered a headache dinging around in a part of my forehead where headaches never reside. I had previously read the onion skin document that came with the sample pills and know that an increase in insomnia and headaches are one thing they study and document when developing medicine. And that there is a 33% higher of occurrence of headaches while on Rozerem versus a placebo. (2% vs. 3% equals a 33% increase in headaches.)

Not until ten hours later, and five additional hours of non-Rozerem-inhabited sleep, did the hungover-ness and headache exit my tortured body. (Sounds dramatic, eh?) Doesn't look like Rozerem, Dr. Malamud, President Lincoln and the Beaver are a good fit. Which, in a way, sounds comforting.

06/13/2008:

I visited with my Psychiatric-Mental Health Nurse Practitioner on Wednesday and related to her the challenges I had with her prescribed Rozerem sleep aid. She responded that it didn't seem like Rozerem was a good fit for me. And then she came out with the phrase I've heard my times, "Dr. Malamud, you are quite unusual." You see educated people term me unusual. A less educated person would have said that "You are so odd. You seem more like a gameshow host than a doctor."

She prescribed instead, the generic-$4-per-bottle Trazodone.  Which was discovered almost forty years ago when Dr.Malamud was a senior in High School, and was a very early serotonin re-uptake inhibitor (SSRI). However, it is also able to be prescribed as a sleep aid.

She also advised me, being that I'm a drunk, that she thought Wellbutrin-XL would be the best thing for my depression.

The biggest drawback to Trazodone was having to venture to Wal*Mart to purchase it.

Arriving there prior to their 2:00pm opening time, I had to wait until the pharmacist came back. When the rude bastard did return, I was told "20 minutes". Not done in twenty minutes (how hard is it to count out 30 pills?), I returned to the Pharmacy Pick-Up line in thirty-five minutes. I found myself behind an immense slab of a female who appeared to be floating in space and occasionally moving back and forth. It took me awhile to discover the groaning Rascal Power Chair hid beneath her blankets of blubber. And of course she was majorly upset because her discount card couldn't be read, as it had probably been damaged by saliva.

Vowing to get a decent job, so I wouldn't have to visit Wal*Marts anymore for anything I walked out into the 100F degree summer to the mighty Peugeot, slid into the driver's seat and laid my hands on the steering wheel, which felt as though it had just come out of an oven previously warmed to 350 degrees. Ouch.

Home again, on my days-off, I began the Wellbutrin-XL, and since it was bedtime, I tried one Trazodone pill for sleep. The single tablet did nothing to change my 'normal' wake-up-every-three-hours sleep pattern, and every time I awoke, I noticed I was suffering from priapism, which actually wouldn't be a bad thing if I had a female who demanded satisfaction. Don't they all?

Twelve or fifteen hours later it was time again for bed. Those of you who can't sleep or have your sleep disturbed multiple times each night, know that when that happens you do not get the normal benefits from your sleeping and the dream of actually sleeping begins to crowd out all other thoughts, except those about food and sex.

Being pretty much a 'druggie', who delights in the miasma pharmaceuticals can throw the mind into, I decided that this time I'd take one and one-half times my previous dosage. "Lucky I have my handy-dandy pill cutter" I thought as I deftly sliced along the scribe in the Trazodone pill.

I swallowed my increased dosage and went off to work on the Internet. When I could no longer hold my head up, I went off and flopped on my bed. I awoke ten hours later. Hallelujah! As I told my twenty-two year old son, Mainio, later that day, it had been the first time I'd slept without awakening for over six hours this year. Okay, fine, it took two anti-depressants to do it, but at least I slept.

And the best thing was that after I fought through the more or less normal fifty-five years of mind fog to become fully awake, I was indeed fully functional and awake without a trace of drug hangover.

06/15/2008:

On this very lonely Father's Day, which I slept through, I thought I'd write more about sleep.

With five trips on my prescribed Trazadone, as I've mentioned prior, I've been actually waking up fully during my 6pm to 9am non-sleeping period. Three of my Trazodone trips resulted in delightful slumber and not waking up during the six plus hours of repose. Being an old fart, I've just got to keep an eye on my Diet Coke consumption within ninety-minutes of bedtime to avoid the sleep-busting walk to the toilet.

No longer do I take one or two naps during the day. I've begun to wonder how long my waking up every ninety minutes has been going on? Years? Decades? My entire life? I know I have a huge diary of dreams, and the only way you can remember dreams is to wake up during them. And that dreams happen in an earlier part of shallow sleep.

Prior to the Trazodone, every time at work, when my eyelids would begin to droop, they would without fail, slam shut for a quick half-second nap. Now, out of habit I guess, they 'want' to close, but I'm not tired so they do not close. It's a pretty strange feeling, that is, experiencing a wakefulness that is probably normal, but very rare, for me.

My Rozerem prescription messed with my melatonin receptors in my massive brain and changed my dreams, gave me headaches in places where I never had headaches before and would never let me come fully awake. While the Trazodone manipulates my serotonin receptors, and somehow (even the chemists don't know how) puts me to sleep, and then releases its hold on my waking up. Amazing. Of course I'll probably get cancer of the gall bladder. But at least I can sleep.

And those of you who have read this far without leaving to visit your myspace page, your e-mail inbox or such and are depressed you need to consider this. Do you wake up every 90 minutes? Do you never get decent uninterrupted sleep of six hours or more? Do you have a huge 'Dream Diary'?

If any of the above sounds like you, and you are depressed, hopeless, hapless, unhappy, and even angry most days, you need to do a little research and locate a state-licensed medical professional (like my Psychiatric-Mental Health Nurse Practitioner--which requires two more years after earning a Master's degree) so together you can discover if your depression is due, in large part, to your not getting multiple hours of uninterrupted sleep.

Professionals like Psychiatric-Mental Health Nurse Practitioners, can sit down with you and go over your situation for an hour. For 60 minutes. Your primary-care doctor simply doesn't have the time to do that. Plus what he knows about any specific drug, generally came from the most recent visit to his office from the usually female lips of a lying sack of shit drug-rep. (Note: 92% of sales people are "lying sacks of shit".)

I can't relate to you how much better I feel after my Trazodone-powered sleep (your results may vary). The main thing is, I am no longer, 100% of my waking hours, looking forward to a nap, scheduling time for a nap or long term sleep or looking forward to something that will put me to sleep, like Blue Bunny ice cream drenched in Jose Cuervo syrup.

And I'm no longer on edge, that is, little things that I can do nothing about, no longer set off a tirade. It's like an impenetrable soft plastic bubble has been placed between me to gently and lovingly shield me from all the troubles of the world.

While you won't see me on 'Dancing with the Stars', it's one hell of a lot more likely you will see me on the Big Screen, or on direct to DVD movies, or see my books on the shelves of your local Barnes & Noble.

06/19/2008:

Just wanted to keep up to date on my sleep patterns. I've really got to watch how much water I drink before a sleep period, because either that is causing me to wake during my slumber, or my apartment's refrigeration unit, that comes on with a noise similar to an 855 cubic inch Coates diesel engine starting on a zero-degree morning outside my bedroom door, that is causing me to wake.

However, using the Trazodone before I hit the sack, allows me to get back to sleep and stay asleep longer than I thought. That hasn't happened for years.

I wake up a little groggy and then my head starts to clear and I cannot return to sleep, if I've already been in bed six or more hours. When fully awake, I am finally fully awake, and not busy planning my two daily naps. It's pretty neat.

I'm starting to feel like participating in life again. Today, in the 111F degree heat, I stopped at the QT station to fill up on $4.13 gasoline, then I drove eight miles in heavy traffic to an eye-doctor I hadn't seen in years.

Why not simply call? Because with me standing in front of the receptionist and cleaning my .40 S&W automatic pistol on her counter while I'm waiting, almost guarantees me an appointment. But I'm still not certain where my S&W pistol even is, so I couldn't do that. Don't worry. It's in a combo equipped gun safe. A small gun safe. The size of a family Bible.

Then I drove fourteen miles to my favorite LensCrafters^® and had yet another gay guy adjust my glasses (now they have two) so that they no longer felt like a pair of vice-grips attached to my nose.

Then I went by the Albertson's, found out they will meet anyone's price on generics (Hallelujah! No more Wal*Mart abuse from the mean-faced, clipped hair, hippo-clerks) and placed my new Wellbutrin-XL prescription.

Of course, wanting to save me money, the Pharmacist advised me of a generic replacement.
I asked, "Is it from the Israeli company Teva?"
He stepped back to the shelf bent down and looked and then said, "Yes it is from Teva". He asked, "How did you know about it? It just came out."
I said, "I read that the generic Wellbutrin-XL (XL = 24 hour) dissolves faster than the brand name." And I added, "When you're nuts you read everything about the drugs you're using."
Chuckling, he said, "I've never heard that about its dissolve rate."
I said, "Neither had the Psychiatric-Mental Health Nurse Practitioner who prescribed it. I brought in to her office copies of the articles."

Now to a 'normal' person, what I did today wouldn't amount to jack. But for someone normally totally depressed, from long term sleep deprivation, it was a lot. And I may not be done yet.

06/26/2008:

Hope it's the drugs:

Been seriously, okay, somewhat seriously, concerned with the loss of my memory.

The other morning, after I fueled my vehicle, and while I was overcoming the shock of paying $47.00 for less than 12 gallons of gasoline, I could not find the keys to my car.

I searched on the passenger-side seat, the glove compartment, the floor, front and back, the ignition switch, every pocket of my pants. Twice. Throwing my face towards the heavens, I caught a glimpse of a shiny something. It was my keys, right where I had laid them, on the roof of the car, so that I could find them easily.

At work the other night, I was talking to Little Joe Pesci about Leatherface, only I was trying to only utter the lady's given name, not 'Leatherface'.

When Little Joe Pesci said "Mary", I didn't get that normal  Oh yeah!  feeling.

I asked him again, "Mary"? And he repeated, "Mary, that's the only woman who works here."

Although I still didn't feel sure that was her name, I replied, "Okay".

Then yesterday, at my dentist (for the past 25 years), Dr. Perpetual Pain, I could not remember my cell phone number. And I heard the old excuse that "Well, you never call yourself."

The only problem is that I've had the same phone number for about six years, and have been using it on numerous internet forms, doctor's forms, et cetera, because it is my only phone number, that amid my many office moves, and apartment relocations, remains unchanged.

07/3/2008:

Trust No One:

Today I visited my Psychiatric-Mental-Health Nurse Practitioner. Previously she had hooked me up with my Trazodone prescription (for sleep) and my Wellbutrin-XL to fight my depression.

I cannot repeat enough how much better I feel now that I'm getting four to six hours of uninterrupted sleep. The world has a whole different face. A smiling face. It's still kicking my fat ass, but lately it's been doing it with a grin. So, on the depression front, we need to be absolutely sure we are sleeping in four to eight hours segments, not ninety minute to two hour slices. Very important.

However, profits still drives the world, and that is not bad, it's only harmful when someone tries to profit by stretching the truth, in order to sell me something.

In this case, the aforementioned PMH Nurse Practitioner attempted to sell me a "non-prescription" product, that fought "amyloid tangles" (Beta amyloid protein) in the brain.

This miracle cure went by the name of CogniSureTM made by Metagenics® and each 'statement of fact' was followed by an asterisk that led to:

Now, being my father died on May 5th, 1991 of complications due to Alzheimer's disease, I know quite a bit about the horrible affliction.

And I know that nothing truly fights, and/or, rids the brain of amyloid tangles. Certainly nothing purchased over-the-counter for $49.95.

Later, as I was filling my prescriptions at my Albertson's, (where, unlike WalMart, many of the employees seem to understand that the customers pay their salary & they let their faces show it), I queried my Pharmacist, and he replied that nothing stops amyloid tangles, although there are a few drugs (very powerful drugs) that seem to slow it down.

He also threw in, "If someone had something that worked, Everyone Would Know About It."

07/27/2008:

The Way the World Works:

I don't even feel like writing this entry because of the very special headache I've had for the last four days. It's tucked away in a special part of my cranium which signals to me either, "too much drug" (usually recreational), or "drug withdrawal" (always prescription).

Now I know why I slept and slept today. Because when a person is asleep no pain is felt. I was escaping the pain. But the dreams, the dreams were not good.

You might be thinking, "Why not take a painkiller?" And, minutes ago, I did finally take two generic aspirin and the pain seems to be sliding down the right side my face, melding into the dull ache of a single throbbing tooth.

Being on so many prescription drugs, I feel it is not safe to keep adding to the list. My ancient friend Grimaldi is on fifteen prescription pills a day. That's simply ridiculous. But that's what can happen if we don't keep an eye on what chemicals we're purposely slipping into our bloodstream.

And we must keep an eye on our prescriptions, for sadly, no one else really cares. No one else actually knows how the drugs affect us. That's why it's imperative you find a friendly pharmacist (that leaves out all CVS's and WalMarts), so that you can discuss your various prescriptions with him or her.

And this is the way the world works kiddies, the very prescription that finally allowed me to savor how sweet uninterrupted slumber is, is the same drug that is fueling the painful butter-knife-like stabs into a part of my skull that, in response screams, "More. More. More. Please don't stop!" For my last dose of Trazodone, was indeed just over four days ago.

Now the pain could be coming from one or two of the five dental fillings I received the other day from my dentist, Dr. Brutalizer Maximus. But I believe the tooth pain would be closer to the jaw, not drilling down into the top of my right eye socket.

So I will be forced to retire the Trazodone that once empowered my sleep, to the back of my medicine cabinet while I turn to natural extended sleep inducers--whatever they may be.

But now, thanks to Trazodone, I know what I should  feel like, awakening after six hours or more hours in bed asleep.

08/07/2008:

Why Wellbutrin?

I've been getting great amounts of sleep lately, even managing to stay in bed for six to ten hours at a whack. I'm not depressed, not really even tired. I simply go to bed, begin reading, and fall asleep.

My life is so boring that, similar to the awesome movie Until the End of the World, I think I enjoy my other-dimensional dreams more than my three dimensional life.

In any case, I've been thinking about going off the Wellbutrin-XL. But now that I'm on the generic variety that runs only $20 at the Osco, and I think it simply kills my desire for alcohol, it may be cheaper to stay on it, than it is to risk drinking myself blind again.

Although, now, since I'm sleeping regular, I may not use alcohol at all, certainly not to get to sleep like I used to.

09/19/2008:

Weird Weather, Wicked and Webbed Feet

I keep telling myself I won't end it all cause it's just plain stupid. And then I add, "So get on with your life!"

Had two leisurely beers last night (discovering only hours later that I had missed my daily dose of the alcohol-mutating generic Wellbutrin-XL) and found the brew ends up with me feeling like I got my naked brain trampled on by a herd of ducks wearing weight belts.

The other early morning I suffered a headache caused by a crick in my neck that hurt so bad that I was dry-wretching in the toilet. Sitting around feeling sorry for myself, I think things can't get any worse and then God lets Satan touch my body and I quickly discover things can be worse.

Last night the two teeth that need root canals were hurting so badly that I thought I'd have to sell my precious sperm to finance their fixing. Or my plasma. That's a thought.

Knees creaking, I made it out the door of my Cave Creek compartment this wonderful Fall afternoon at about 2:00PM. The neighbor's Alice-in-Wonderland-sized black-striped gray cat, who I hadn't seen all summer, was again basking on the concrete steps leading to her apartment above mine. (It is the God's honest truth I talk more with the animals here than my Island-of-Dr.-Mourea-like neighbors.)

The temperature sign at the rumbling with traffic road's edge near the apartment parking lot read 106F degrees, which was probably high by 6 to 10 of those degrees. Inhaling deep the Arizona air that finally no longer scorched my nose hairs, I smelled the scent of the summers of my youth and I couldn't help but feel grateful to be alive.

Reading an e-mailed news story that I normally do not read, I see an accomplished writer who apparently had it all at age 46, had also hung himself. That's what I want to do. The 'accomplished writer' part that is, for I am already hung (and not gay).

I always feel that God is guiding my life, showing me the way, hacking the path clear like Michael Douglas did for Kathleen Turner in 'Romancing the Stone'. And even if I never amount to anything in 'the world' He will still love me ... but then sentence me to ten thousand years in heaven of pumping out the J-Jon of Mother Theresa. Yes, they have porta-potties in Heaven. You didn't know that?

10/01/2008:

Sleeping my life away

As I barely exist in my apartment, which I can barely afford to cool to 84F degrees, financially it's all coming to a head. And in response, all I do is sleep. Even when I occasionally get the needed sleep of an uninterrupted four or more hours, I still want to go back to bed and sleep. Not because I'm physically tired, but because my soul is tired.

I envision a black and white picture of my soul, an old 1950s model Chevrolet, with the rear tires stuck in the mud, spinning and spinning and getting nowhere. Not moving. Turning and whirling and making whizzing noises while throwing up a steam-like black cloud of vaporized tire rubber.

And like tires have only so rubber to burn off, so also does the soul.

What will be the tow-truck to pull me out of this muck?

Once, out of bed and moving around, I don't feel so helpless. So hopeless. I wish there were someone to take care of me, but I'm now my own parent. And I'm all alone. And you might say, "Join the real world." Yes, join the real world.

I've got three simple things to do today: transfer my photos to a dvd at the camera shop, drop off some shirts at the Chinaman-owned drycleaners, and wash a couple of batches of colors here at the laundry room of the hovel-hotel I live at. Actually, it's apartments, but 'hovel-hotel' sounds so much better.

The Budeprion-XL, which I thought was stopping me from drinking, is not. I keep myself  from drinking and over the past week or so, I've finished off around six beers. I'm a little surprised that two beers are good enough to do what they're supposed to do--which I'm not sure what they're supposed to do--but that's good anyway. And if I can get sufficient shuteye after my swilling, there are little after-effects.

But still, it's strongly advised not to consume alcohol when taking SSRI's like Budeprion-XL. But I really don't care that much, because my life is crap and I'm pretty much starting to enjoy the shit-smell of my pitiful self-sorrowing.

In between moments of dead sleep this morning, I had the never-to-be-answered question of 'How do we know we're not dead right now?' begin to waft through my brain. I had some delightful answers. I remember I had some extremely interesting visions--something with a whole bunch of the everyday things we're surrounded by: automobiles, pavestones, people, streets, et cetera, all covered in very tight and very clear plastic wrap. This was somehow an answer, maybe a clue, as to whether a person is alive or not. Or not.

I've often had incredible, and many times weird and Salvador Dali-like visions, immediately before I actually slip from semi-consciousness into the sleep of the dead. If only I could awake myself to record them. They are so other-worldly. They might echo what the dolts who experimented with LSD saw on their acid-trips.

Like I mentioned before, I asked a young co-worker (who has since moved onto a decent job, and a career, with another fall-back profession stuck in his back pocket) if he could remember the same moment-before-sleep visions and he looked at me like I was a retard as he told me he did not.

Well, another way to squirm a little way out of the cocoon of depression is to simply get out of bed and begin moving around. For me, it's to sit down and start writing or typing. For someone else it may be cleaning or playing an instrument, or everyday chatter with people, or doing something with tools or reading.

I'm going to try to keep that in mind. But I'll be damned if I do any cleaning.

11/01/2008:

Suicidal Depression

I've again halted my intake of the Budeprion-XL, the 'generic' version of the $20 more per bottle Wellbutrin-XL. I've switched back to my original drug of choice, beer.

With beer I can dose myself depending on my mood, from one to four bottles then flop into bed and snag some uninterrupted sleep, to later wake wondering why I had one to four bottles of beer eight hours earlier and who parked the stuffed and stinky sanitation truck on my face and why every damn thing had to be so loud.

If you've been reading my other Dr.Malamud pages (and who the hell in this entire universe isn't?) you recently noted a couple instances of Job-like depression. For you heathens, that is not "ja ah bah" as in employment, but "joe bah" as in the tormented biblical character named Job.

While my life isn't perfect, and I'm faced with many challenges, such as whether to wear the same socks for an entire week or wash my clothes, keep bug-spraying the roaches in my kitchen individually or call management, or fix the left turn blinker on my Peugeot that the kangaroo rats ate the wiring to four years ago, there was nothing I could pin the cause of the blinding bouts of the deepest and darkest gun-metal gray depression I had ever felt.

The depression demons from the depths of Hell did not spring from my halting of the Budeprion-XL, for at that time, I was still meticulously dosing myself every 24 hours. And writing it down. Checking it twice and seeing who was naughty or nice.

Then I got to thinking that, no longer did two or more beers knock me for a delicious (and later crippling) loop as they did when I was injesting the Wellbutrin-XL.

I've about convinced myself, especially since news articles have appeared citing the apparently erratic release of the active ingredient in Budeprion-XL over its 24 hour life, that the generic was indeed not identical to the brand-name drug and probably caused my put-a-gun-barrel-in-my-mouth bouts of depression.

I also thought that, as what happened with Lexapro, my first SSRI, after so many weeks of taking it, and getting used to its extreme calming effect and literal mind-controlling effect, that I had mentally recovered to point where it no longer did any good and was even holding me back from experiencing life. So maybe the Budeprion-XL has done its job, leveled out my moods to where they would be naturally, and is no longer needed.

I do fear for fellow depressives who are using the generic Wellbutrin-XL, Budeprion if indeed it is the lack of quality control at TEVA Pharmaceutical Industries that tossed me into my two near-suicidal, without any real-world reason suicidal moods.

11/07/2008:

Budeprion, "Bad SSRI, Bad SSRI"

Here it is just seven days after I halted my Wellbutrin-XL/Budeprion and I'm once again sniffling and sneezing. As I discovered earlier, their ingredients shut down certain receptors in the brain associated with mood and also a few tied into allergic response. The fact the drug shut down my allergies was as helpful to lifting my mood as was the mostly un-quantifiable actions it performed elsewhere in my rotting brain.

But, since I suspect, the generic Budeprion version of Wellbutrin-XL, of causing my huge not-based-on-facts swings into suicidal depression, I can no longer use it even for allergy relief.

Now I know, or think I know, why they say you should slowly wean yourself off of SSRI's, and that is probably because of the possible suicidal yearnings when you stop taking the drug. The only thing is, that I haven't read anywhere exactly why  you shouldn't go cold-turkey off the medicine.

And of course they wouldn't put that in the literature for all kinds of reasons. Some for legal reasons, some for the fact that in maybe reading the withdrawal symptoms many depressives would not take the SSRI-based drugs to begin with. Which would probably be a good idea, the generic ones anyway.

As I gingerly tugged my full white plastic bag out of my kitchen garbage can I heard the rattling of my current anti-depressive medicines. The very many empty beer bottles.

While I wouldn't advise anyone to "try this at home" (like the 'Myth-Buster' guys say...even the gay one), I don't believe that alcohol consumed in beer-doses (versus the much quicker shot-glass-doses) fuels my depression. I think it simply releases the vice that is clamped around my psyche, my soul, my whatever, and lets me relax a little. Lets me unfocus from the troubles of the world a little.

Unfortunately, (as I later examine the e-mails I sent while drinking my beer-medicine) it also releases other inhibitions that should probably be kept in the grip of that same vice. Always.

And then, too often the next morning's physical reaction to the night's before beer-sumption is not something I enjoy. It would be best if I could survive without either the alcohol or the pills.

11/10/2008:

Regulate your beer intake

Like I've mentioned before, with beer, legally dispensed in handy 12oz. (355ml) bottles on virtually every corner (and best consumed cold, here in the Colonies) it is quite easy to regulate your intake.

Whereas, with a physician-prescribed medication, that you've never taken before, sold only at certain outlets, during certain hours of the day, you get one size fits all. I'm a 250 pound stack of spring steel. How can a pill for me work the same for some dainty little thing that steps on the scale weighing 92 pounds?

And another thing, how come a person can be legally loaded on, say an SSRI, and be almost as screwed up as a good old alcoholic drunk, and then drive. Legally?

In any case, I had only two doses (two beers) last night and I woke up this morning feeling pretty good. As a matter of fact, once at work I was getting a little too happy, a little too loud, enjoying being alive a little too much.

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