Canticle of Cold; Weight Dilemma

(In which Ela sets off at 6.30 to drive to Anchorage for a psych appointment)

Canticle of Cold
Thirty miles into my 220 mile drive, I accepted that the Warthog's heater wasn't working. Fan on highest setting, temperature up on maximum; my feet were numb; and I could feel just a little warmth if I held my hands to the vents.Sunrise isn't until after 8am right now, and I had to get over the mountains before there was a chance of getting out of the shade to be warmed. I think I wove as I drove, trying to give each hand a turn at clenching inside the glove to de-numb, trying to stomp my feet a bit (hard when you're on the gas)!

When I stopped in Soldotna, 72 miles in, for gas and to put another quart of oil in the 'hog, outside temperatures were 0 degrees Fahrenheit. And it was almost sunrise, so must have been even colder. Did I mention it was a cold morning? But fortunately, this is Alaska, so the car is stocked with blankets, down clothes, sleeping bags, in case of getting caught out. 

I used the rest room and stomped some feeling back into my feet, then wrapped up in blankets and drove on, recognizing I would be cold most of the way. I had some hot tea, a race between drinking it avidly and saving some to warm my hands with the steam. 

When it's so frigid and there's too little snow on the ground to insulate, it's deeper cold; crisp and dry, inviting the water of your own being to sublime into air. As the dawn twilight lost its pinkish glow and I could see the road clearly, I noticed the deciduous trees, completely leafless now, so stiff and dignified. Still some very brown and ragged leaves blowing around, reminding: alder, cottonwood, aspen, birch.

My toes were still numb; otherwise, things were better. Turning the heat off for as long as I could bear it and turning it back on again seemed to warm things above tepid, but it was probably my imagination. There were bands of fog, some of them filmy and pervasive, some hanging like bridges above the road, and after I passed through one small band, I could see nothing through the windshield. Freezing fog. A great time to have a faulty heat system! 

I survived the cold. I survived the even greater cold of the mountains, and drove Turnagain Arm with sunglasses on, grateful for the car windows absorbing all the warmth of this winter sun that shines at such an acute angle, it's always right in your eyes or windows. Once in town, I tried out Phil's best ideas on fixing, had a friend in town look the Warthog over, and ended up having the radiator flushed. I'm hoping for a warmer ride home tomorrow, but I'll keep the blankets up front in any case!

Edited to add: The most miraculous thing in this gelid adventure, mundane though it might seem...Evidently, when I stopped in Soldotna to add gas, oil, and blankets, I was so addlepated and chilled, and probably overdue for breakfast, I managed to leave the cap off the oil and the gas intakes. I didn't discover this until town, 150 miles further. The gas cap was still on the roof of the car. The oil cap was still under the hood. They can be expensive to replace, and this had been a journey not devoid of headwinds or bumps like to dislodge such objects. Small graces, minor providences...what was the purpose of this trip? =>

Weight Dilemma
I feel sick to my stomach even typing this, but I've been very open lately, and want to continue to share. 
I saw my psych today.
I've lost weight since I saw her last month. 
She was already unhappy about my weight, but was willing to work with it so long as it was stable.
"Steady downward trend" does not equal "stable."
If my weight isn't stable, she doesn't feel safe prescribing me lithium, although she strongly believes I need it.
Lithium is a salt, so it's implicated in electrolytes; the lower a person's weight goes below what's considered the safe range, the more likely there are to be electrolyte imbalances. These can kill a person just by themselves; they could also cause lithium levels to become toxic.
So, if I haven't gained x amount of weight by my next appointment with her, she will have to take me off lithium because in her professional opinion it's too risky. 

What a mess, eh? How would you handle being told you have to drastically change your behaviors or else be deprived of something that has been making a significant and positive difference in your life and the lives of people around you?

My options are: 
I could gain this significant amount of weight, on my own, on purpose.
Or: I could find another psychiatrist who doesn't share that anxiety about lithium/electrolytes
Or: I could take a different medication, (but why would I do that when this one works so well)?
Or: I could just go back to my earlier anti-medications philosophy and not take any

I'm thinking many people who know me well would be horrified at option 4, concerned about option 3, lukewarm on option 2 (this is Alaska; we have lots of cold weather, but we don't have a lot of very good psychiatrists like this one), and inclined toward option 1. Is that true?

There are probably some things I can do differently food-wise. I'm not going to list what I have been doing, to avoid triggering. Just one little feature: I have some extremely bitter white stevia powder: a brand I wouldn't buy again. Before I left for treatment, I was practically addicted to it. When I got out of treatment, I could barely stand the taste of it. Lately, I am putting it in everything again.

I like the sounds of "Canticle" and "Dilemma" -- I like the sensation of being warm.
And you?