Dear Friends, (& Mari, especially),

Yes, the question I posted back in April about the interaction of psychoactive meds and surgery was in aid of my girlfriend. She took many, many meds for Bipolar Disorder, and narcotics for back pain. But since, for the first time in her life, she was feeling "normal"; not subject to irrational impulses to "do" stuff, (in her case, usually, buy things), nor suffering from bouts of profound depression and shame from her manic acts, she didn't want to take any chances of regressing by d.c.'ing her psych meds for surgery.

The program was supposed to be to ease her back pain via surgery and reduce her need for narcotic meds, and then delete the psych meds selectively until she was taking only what was needed. The latter couldn't be done, however, until the interaction of the narcotic on the psych meds was reduced or eliminated.

We found that none of the meds needed to be d.c.'d other than on the day of the operation. In fact, it was important that some be resumed a.s.a.p. after surgery, (like Neurontin, for instance), because of serious reaction to their sudden withdrawal.

The "Why" of her death is still a mystery to me. It is as if her body simply lacked the energy to recover from the surgical trauma even though her will was strong. The attending physicians proposed multiple heart attacks and strokes as causal but they diagnosed those symptomatically. I don't think that they know either.

Her lungs were in much worse shape than she let on because of a lifetime of smoking, and I think that that was one of the fundamental causes of her death. However, I never remember her being out of breath or "winded" during our relationship. She would pause when walking, frequently, to ease her back, but not, (or, at least, so she said), for reasons of fatigue.

I still think of this event as a tragedy of theatrical proportions. After Sisyphean effort, we get to the top of the mountain, only to fall off the cliff.

Fondly,