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

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

The Rehab Diaries: Getting the Referral

I had an appointment on a Wednesday.   The sole purpose of this appointment was to get me a referral to this private rehabilitation clinic which I’ve been umming and ahhing over whether I should go to for a few months.

It occurred to me that if I’d been thinking consistently for months with no signs of stopping, it was time to cut my losses and go.  My depression was intense for that whole time it felt like, and then I’d gone the other way and was a mess of raw nerves.  The mood stabilisers clearly weren’t doing their jobs.

So I had my appointment.  Then on Tuesday afternoon, the receptionist called me to say that my doctor had cancelled all her appointments, and would it be ok if she scheduled me with someone else?

Well, FUCK.

Continue reading

Mark Latham: Mentally Ill and In Denial

Wow. I go away for a week and come back to just about ten things I personally feel the need to address, but anyway.

I don’t know a whole lot about this guy except that he tried to be prime minister that one time when I was a kid and it didn’t work out so well, which he blames – repeatedly, even ten years later – on everyone else in politics. Apparently he’s fallen into the role of a stay at home parent since then, and has been writing the odd column on the side.

So I guess that means Mark Latham is a mummy blogger now. And it seems that he’s discovered the click bait staple of those mummy bloggers that give the genre a bad name – establishing superiority over other mummies. Especially those who work, what up Lisa Pryor?  His titillatingly titled column for the Australian Financial Review “Why feminists don’t like children” has caused outrage due to his character assassination of the poor woman over her admission to taking anti depressants.

Well I’m not a mummy blogger but I can point fingers and cast shade with the best of them. You want to give out unsolicited parenting and medical advice, Marky-boy? You see nothing wrong with that? Great! Let’s see if you can take what you give.

Mark Latham, you are overwhelmed. You are depressed. You are grieving your lack of relevance and lack the distress tolerance needed to process that grief. You clearly hold sexist views so being a man taking on a stereotypically female role must make you feel inadequate. You want us to believe you are unemployed by choice but are you really? Who will give Mark Latham, best known for a spectacularly failed political career, a job? Getting Mrs Latham a job was probably easier.

You are not well and you NEED TO GET HELP. For the sake of those children who you apparently take such delight in. Will you ‘cop out,’ give up the ghost and sort yourself out to be the best parent you can be for those precious boys? Because people like you, people with issues who refuse to get help for reasons of ego tend to produce some fantastically fucked up children. A lot of people I’ve been in hospital with have fathers who talk like you do.

How do you think the boys will feel when they grow up, Mark? That they weren’t worth you getting over your misguided sense of pride and getting help so they could have had an emotionally stable father? Surely that’s worse than finding out that your mum relied on antidepressants so she could be that loving, present parent that you remember so fondly.

I suppose I should explain what led me to draw this conclusion.

Like most privileged humans you not only have trouble admitting that you aren’t bulletproof, you also feel the need to demonise those that do and maddeningly seem to win at life doing it. Unfortunately unlike most privileged humans, you an available platform to spew misinformed hate to the masses.

Let’s talk about Lisa Pryor. Respected journalist turned doctor? The woman is an achievement machine. And while I’m not familiar with what Mrs Latham does, I think most Australians are familiar with the works of Pryor’s husband Julian Morrow. Despite being having such a busy partner the baby maker has the cheek to pursue not one career, but two!

And you?  You’re unemployed. A house husband. A stay at home parent. For someone who is apparently so content and proud of your position in life, you were oddly vague in describing exactly what that position specifically entails.

Haven’t we been calling you crazy for years? Forgive the ableism, that isn’t the word I would use. But as a fellow ‘crazy’ I’ve noticed there are certain…behaviours that you have in common with the average left feminist behavioural therapy patient.

You were left angry with everyone after your exit from politics, even with the discipline itself.  Intensely so, years later. To the point where you allow your personal agendas get in the way of your career, when you might have had one. Does the word devaluation mean anything to you, Mark? How about dysphoria?

But let’s face it, escaping federal politics with your sanity intact seems to involve interpersonal skills that you don’t have.   For example: something you seem to struggle with a lot? Distress tolerance.

A lot.

Yeah. A lot.

That’s not normal, Mark.

And let’s talk about where you tried to create some precarious argument as to why Pryor’s depression is proof of a feminist conspiracy theory to destroy the family unit…um, that’s called paranoid delusion. Characteristic of a manic or mildly psychotic episode. Don’t worry Mark, we can fix that. Maybe you’ll find mood stabilisers more acceptable than anti-depressants?

I didn’t want to make this a feminist issue, Mark. I know you find such debate tiresome and it’s obvious that on an academic level you are out of your depth there. Let’s face it, that word was only thrown in so that you could do this:

He can’t stop, no he won’t stop

And hey, it worked. You’re bigger than Superbowl! But at what cost? Do you really belong in the public eye while your personality disorder is running out of control? Boundaries, Mark. They matter.

You can feel better, if you choose to. If you choose, your anger will disappear. You could stop feeling like everyone is out to get you. If you choose.

And no, by choosing I don’t mean just ‘getting over it’ or changing your attitude. I’m asking about committing yourself long term to questioning everything you’ve accepted as appropriate and necessary interpersonally. If that means picking up a diagnosis of clinical depression or a cluster B personality disorder along the way, so be it. Anything to be the best father you can be, right?

Ok, that was far too politically correct for your liking. Let me put that in a way that you can understand, Mark.

WON’T SOMEBODY THINK OF THE CHILDREN?!??!?!?!?!1Eleventy!

 

Mac