The Rehab Diaries Week 2 – Christmas On the Closed Ward

itsbeginningtolookalotlikefuckthis

 

Exactly a week before Christmas a note slipped under my door warning me of changes to the ward over the Christmas break, which would start in a few days and last two weeks. I was aware the ward shut downs to half capacity over Christmas, but I had never been in hospital during that time before.

One of the hospital’s two wards would be closed off completely.  This happened to be the one I was admitted to but I didn’t have to move because the wards are separated by a set of doors, and my room is one of three that are on the other side despite being under care of staff of ward 2.

No more patients are supposed to be admitted during this time, although there were about three more admitted over the next few weeks whenever someone discharged themselves prematurely.  Which happens, it’s a voluntary clinic after all.  Many discharges were planned for that Friday before the closing, so in the end the staff were caring for about a third of the usual patients.

Many staff were forced on leave as well by the hospital, including all of the therapists.  That meant no group or private therapy for two weeks.  No one was thrilled about this, least of all me.  Part of the reason I came to hospital was to have some intensive psychotherapy to unpack why I spent the second half of last year in a constant state of mental breakdown.  The timing of this admission is unfortunate.

Also going on leave against his will was my doctor.  After feeling frustrated with his apparent unwillingness to make a decision last week I explained the kind of pressure that I was feeling.  He explained once again that usually the way to treat my anxiety symptoms would be to add an antidepressant but that my bipolar made that a risky move.  He suggested doubling my melatonin pill, which could help my depression and anxiety and fix my broken sleep in a less risky way than a classic antidepressant.  I agreed.

His going on leave was another cause for concern.  This would be yet another doctor to haul out my life story in front of, who would no doubt have a different therapeutic philosophy and I had no way of knowing what kind of changes he might make.  It’s kind of disturbing really how so many staff said they wanted to stay on – especially the therapists.

As it turned out however upping the melatonin was not as risk free as we may have thought.  My mood swung, and it swung high.  And hard.

My thoughts were racing.  I was shaky, ruminative, anxious.  Irritable.  I spent much of the day pacing about my room and feeling murderous toward my fellow patients.  It just so happened that at this time there were several patients who liked to play instruments.  And just hearing them play sent me into the most unreasonable state of irritation.

There was a lady with a flute, a guy with a guitar and a nurse with a ukulele who liked to join them.  They had timetabled daily sing-alongs but guitar boy could be heard strumming away contemplatively at all hours of the day and for some reason my brain equated that with being unreasonable.

I know, irony.

I got so irritated that on closing day I ended up in the nurse unit managers office having a cry about how annoyed I was.  I thought she would laugh me out of her office but she was sympathetic.

“Why do you think I timetabled these music groups?  They annoy me too!  I was hoping they’d get it out of their system in the allotted hour.”

She jokingly assured me that most of them were getting discharged that day.

The ward closed but it wasn’t a happy place.  Christmas is a triggering time for many people.  I’m lucky not to have to deal with the family dramas that a lot of the other patients were trying to cope with and they struggled.  There was many, many meltdowns.  The short staffed nurses did their best to cope but some therapists certainly would have come in handy.

As for me, my mood just kept on climbing.  On Christmas eve I my mum came and picked me up to help prepare the house for Christmas and when I jumped in the car I stunned her by immediately covering ten different topics in two minutes, occasionally stopping to cackle manically.

“Oh my God…take a breath.  You’re acting a bit manic.”

“My thoughts are racing.”  I admitted.

“oooooooooook.  We’re going to working keeping a nice calm environment today.”

I was worried about how I’d handle Christmas Eve mass and dinner – when the mood’s up, anxiety tends to be up as well – but in the company of my family I was able to relax and go with the flow of the evening.

On the day itself my anxiety was intense- event though I was woken up by a nurse leaving a box of chocolates on my bedside table.  I thought getting out of the hospital was going to be hard and I was right.  The nurses were stressed out trying to get meds for ten patients at once as we all had to go out at the same time.  Some of the patients were getting agitated and taking it out on the nurses and that was hard to take.   I made a mental note to bring a box of leftover candies back with me that night.

After my extreme high the day before I was tired for most of Christmas day and spent most of it on the couch pretending to mind my cousin’s children as they wreaked havoc in front of me.  For the most part everyone left me alone and I got a few good presents out of the day, so I can’t complain really.

If you read last week’s entry you may be wondering…did I speak to the nurse my boyfriend unloaded on last week?  Yes I did – eventually.  She wasn’t in for a week after the incident but on her first shift back I asked for her version of events.

The way BF told it, he’d appealed to her for help after I refused to engage him but she remembered differently.  According to her this guy – the boyfriend of a patient, remember – came up to her and gave her a brief history of BF.  It’s not a happy history.  She asked him if he was seeing a psychologist – which he is – and rightfully delegated that conversation onto him.  Then I suppose he asked her what to do about his wilful girlfriend problem.

How bizarre.

He didn’t deny any of this when I told him what she said, and did end up seeing his therapist soon after, saying that he felt better equipped for it.  I wish I understood what it was about my depressive episode that made his whole life flash before his eyes though.

Until next time,

 

Mac

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What I’m Into This Week

Listening to: Blank space

blankspace

When this song first came out my impression was distinctly ‘meh.’

The tune didn’t pull me in, but a few months in I’m listening to it on repeat because I actually listened to the lyrics and realised this song is about me.

Like, here I’ll show you:

Oh my god, look at that face, you look like my next mistake – me

I can make the bad boys good for a weekend – me.

Got a long list of ex-lovers, they’ll tell you I’m insane

‘cos you know I love the players, and you love the game – me.

Cos darling I’m a nightmare dressed like a daydream – much me, much wow.

I’m doing some fairly intense therapy at the moment so I’m loving playing introspective songs on repeat and crying.  Even though Taylor denies the song was intended that way at all – she claims to have written it as a reaction to the person that the media are making her out to be.  Apparently the media are making her out to be me.  I’m so sorry Taylor.  That is awful.

 

Watching: Girls season 3.

girls

Girls is a show I have mixed feelings about.  It was a show that appealed to me because the main character and I have laughably huge amount of things in common, we even look alike.  Most of the things she does and says I can see myself doing and saying, and yes I realise that doesn’t reflect well on me.  Then again the show’s appeal isn’t great on paper.  I kept watching season 3 for continuity’s sake but I put it off for a while.  Yet when I started, I couldn’t stop.

Are the characters supposed to sound that ridiculous, or is the acting just that bad?  Is Lena Dunham confused about the direction this show is taking or actually brilliant?  I believe it’s marketed as a kind of dark comedy but I end up laughing at parts where I’m not sure if you’re supposed to laugh.  Some of the characters are so unappealing that I cringe whenever they’re on screen (ugh, Shoshanna.)

I’m going to go with Dunham being clever about the apparent confusion of the show because the more confused I get the more I’m compelled to watch.  There’s so many much better blogs out there deconstructing Girls, but I’m probably coming back for season four and I’m not even sure why.  Awww hell.

 

Youtubing – DBZ abridged episode 46.

 

 

I’ve mentioned Team Four Star before, the youtubers behind the Dragonball Z abridged series which I believe is a must-watch for fans of the show.  And even if you’re not a fan, if you’ve ever watched an episode you could definitely appreciate why abridging is necessary.  The series is so much more watchable with 20 minutes of ARRRRRRRRRRRRRGGGGGHHHHHH compressed into 20 seconds.

Even you’re not a dedicated watcher of DBZ this is one of the best abridged series out there, tied with LittleKuriboh’s Yu-gi-oh!  Abridged series in my opinion.  (incidentially LittleKuriboh is one of the voice contributors to Team Four Star.)  They’re always funny but the latest episode is the first in a long time that had me laughing out loud all the way through.

 

Obsessed with:  Being angry at everything

Yeah, we already knew that.

The ward has been a tense place over Christmas, with staff being short and all therapists being forced on leave.  While my meds were being messed with my tolerance to life in general went down the toilet and every single human interaction caused me irritation.  Now the wards have opened up and with my anxiolytic drugs being increased I find my tolerance increasing.   Funny that.

 

Reading:  Mockingjay

mockingjay

Ugh, this book is really hard to get through.  Surely it’s not just me?

For a final showdown type instalment not a whole lot happens really.  Maybe it’s because my brain is all over the place at the moment but the story just isn’t engaging me at all.  Katniss’s detachment from her surroundings has been a frustration for me throughout the series but this is taken to the extreme in Mockingjay.  Heck for most of the action she isn’t even there.  The narrative is only partially relayed back to her later.

Like, what happened to Peeta and Johanna when they were being held by the Capitol?  Yes it’s talked about but only over a few cursory paragraphs.  We’re never even told how exactly rescuing them went down except that it was too easy. And while Peeta takes a while to recover, Haymitch, Johanna and Finnick are mentioned to be struggling with PTSD like symptoms then when we see them they’re pretty much as they were in Catching Fire.

So many potentially interesting plot points are just never explored.  I’m going to finish it though, I can’t help myself with books.  I can’t make an exit halfway through no matter how hopeless it looks.

Hopefully the movie will improve this one for me.

 

Mac

The Rehab Diaries Part 3 – Week 1

Finally, we touched ground at the clinic.

The first thing they do, after you fill out the paperwork and pay the gap, is take your vitals and take a picture to put in your file so the staff coming in on the next shift can match names to faces.  I’ve had several pictures taken over the years to account for aging – and my hair being a different colour in each one.

In all my previous pictures I look either depressed or agitated but in this one I was concerned that I look inappropriately cheerful.  There’s a good reason for that though – after I’d had my medical and was awaiting the nurse with my admission package, BF ducked into my bathroom.  The nurse came in while he was doing his business.

She apparently didn’t hear him flush the toilet and wash his hands while she was setting up the camera.  When he threw open the door just as she was pressing the button, she startled so badly that she jumped and we had to take the photo again.  The second one came out but it was obvious that I was trying to supress my amusement.

After BF left, I was to have my admission appointment with a doctor who I hadn’t worked with for five years, as my regular hospital psychiatrist was away.  I was a little nervous about this meeting; I had been a difficult patient to deal with at the time but was having a lot of trouble expressing what was wrong with me, and took a lot of frustration out on my care team.  As a result I was told again and again that they had no idea how to help me.  I harboured a deep distrust of mental health professionals for a few years after.

My communication skills have improved since then and bearing in mind that I didn’t get along with my current psychiatrist when we first met, I was willing to give him a chance.  I figured it was a better option than starting with yet another doctor who I don’t know at all.  I was relieved to find that he was willing to give me another chance too, and after the official admission business he asked me what I hoped to achieve with this admission.

I explained the deal with my current medication.  The mood stabilisers seem to be struggling on their own.  The efficacy of Topamax is unclear.  My anxiety is out of control.  I probably need to be on antipsychotic drugs as well as mood stabilisers – as many bipolar patients do – but we’ve had trouble sticking with one so far because of side effects.

He listened, and conceded that this would be worth a try…and if I left it with him, he would come up with something.  Wait, what?

Turns out I didn’t have a good appreciation for how gung-ho my regular psychiatrist’s approach is.

In our next appointment three days later I found my frustrations from five years ago resurfacing somewhat.  The doctor seemed unwilling to make a solid decision and kept throwing the conversation back to me, asking me if I had other ideas.  Um, why go through three years of psych residency if it were that simple?

I pressed him and he listed off some antidepressants to treat my low mood which was met with an (admittedly ungracious) groan from me.

“Pristiq?  PRISTIQ??? Don’t you remember what I was like when you put me on pristiq before?”

“remind me?”  He quipped innocently

“kinda nasty.”

He suggested Cymbalta, saying that some of his bipolar patients had seen improvements on the drug but I was hesitant, maybe unfairly due to the number of people of mental health forums I’ve been haunting despairing over side effects.  I said I would ask my dad, also a doctor, for a second opinion.

Finally he printed out some information on the natural supplement SAMe, explaining that it could be a cheaper way to regulate my sleep and depression.  Oh great, now we’ve exhausted all our pharmaceutical options I thought glumly as I left.  Clearly he thought he was giving me greater autonomy over my treatment plan but at the time I felt like I had all these decisions on my shoulders that I’m unqualified to make.

I spend a lot of that week in bed.  I was low, in mood and in energy.  BF normally cares for his mother but she had been in respite for a few weeks so he was with me constantly.  Whether I liked it or not.  All BF all the time.  I just didn’t have the energy to entertain him and I was getting more annoyed by his presence because I felt like he was just doing it to ease his own guilt, rather than because he thought he was helping me.

On one such day he said he was coming over.  I told him no, I wasn’t up for company but he turned up anyway.  In the mood I was in I told him that if he must be here fine, but I said I didn’t want to talk so I wouldn’t.  And rolled over and went to sleep.

I napped most of the afternoon while BF lay on the floor playing candy crush, every now and then being woken up by an overdramatic look-at-me sigh from him.  About two hours in when sighing his feelings out got him nowhere he got up and stormed out.  I’m not sure how long he was gone for as I was asleep in between but he came back with my nurse who looked a little perplexed.

“You should get up.” She turned to him “She hasn’t eaten today.”

I pulled the covers over my head. “Too bad.”

He yanked the quilt off my bed. “Nope!  We’re going for a walk.  Even if I have to wheel the bed out the front door.”

After some protests from me – and a threat to roll me off the bed that probably would have been carried out – we did go for a walk to the nearby lake, and ate Thai food in the sun.  My mood improved for about five minutes.

I was hoping to debrief with the nurse over whatever my boyfriend said to her, but she wasn’t in for the rest of the week.  If he wants to be around and harass me fine, but I don’t want him annoying the staff.

That was a conversation I wasn’t able to have until week two.

So you’ll be hearing about that in the next instalment of the rehab diaries.

Mac

 

The Rehab Diaries Part 2 – The Waiting Game.

Waiting, waiting, waiting.

After stressing out about getting the referral, turns out that was much ado about nothing compared to the limbo that followed.

Usually what happens is the referral gets triaged and paced in line based on need.  The line moves based on discharges, or you may be moved forward if they think your need increases which I’ll provide an example of later.

So when you’re next in line and there’s a discharge planned for the next day, you get a call informing you of there being a room free and could you be there the next day at a certain time?  However, patients do discharge themselves before their program is complete – being a private clinic, we are all supposed to be there of our own free will, after all – and I’ve be called in on the day with two hours’ notice one time.  By then the staff knew me well enough to know that I lived close enough to make it there in that time, and I have people who would take me.

You need lifts because patients are not allowed to drive to and from the hospital.  I would organise that as soon as the referral is sent because you never know when the call is going to come – previously I’ve gotten it the day after, or a week after.  This took two and a half weeks, which is the longest I’ve ever waited.

Turns out, everyone wants to go to rehab over Christmas.  Funny that.  I believe that the clinic was also trying to slow down their intake leading up to the closing of the ward three days before Christmas to reduce the strain on the staff who operate at half strength this time of year.

This doesn’t stop a lot of people looking for a convenient cover to get away from their families – and after some interactions with the residents I can’t help but wonder if some of the families were overly supportive of the idea.  This isn’t speculation, we’ve had whole group therapy sessions on the topic and I couldn’t get a word in edgeways for all the venting.

I’m not looking to get away from family, we certainly don’t have the type of dysfunction that the other patients are dealing with.  I need help.  That’s the long and short of it.

So I waited a week.  A week and a half.  I called the triage nurse (I really didn’t want to do that because we can’t stand each other, but luckily I only ever spoke to her minions) to check the referral had gone through.  It had.  Alrighty then, I’ll wait some more.

I called again two days later, because I was suddenly anxious about the wards closing.  I knew it happened, I just couldn’t remember when and I was convinced it was going to be in like three days before the line got to me.  The nurse assured me that no, it was more like three weeks.  Crisis averted.

Then the next day, the nurse unit manager called me.  And yes, he’d been notified of my calls and was concerned that my need had increased. He had a spare bed for me if I wanted to come in…only problem was, it was a shared room.  I’d had some bad experiences with shared rooms so I knew I had to decline.  He said he thought so but just thought he’d check.  More waiting.

While this was going on I was staying at mum and dads, my hospital bag, doona and pillows perched in a neat pile in the hall way, ready to go.  Mum started asking with concern if they could have forgotten me.  I told her about my calls and assured her that was not the case.  All I could do was wait some more.

And then, two and a half weeks later, it finally came.

There was a room, ready for me.  The time had come.

My boyfriend wanted to be the one that drove me, so we said goodbye to my parents and headed out.

And so began my stay…which you will be hearing more about in the next instalment of the rehab diaries.

Mac