The Rehab Diaries Redux – Admission

So, I’m in hospital again.

What went wrong?

Well, I was actually doing really well but then I was faced with some major life changes and instead of dealing with it in a healthy way like say, hashing it out on this blog, I started to drink.

Alcohol has never been a problem for me. I used to joke that I had a relationship with alcohol that I wish I had with food – it could sit in my fridge for weeks or months waiting for a special occasion.  But no more.

I’ve only been drinking heavily for a couple of months but it’s taken its toll on my health and I’ve had a couple of incidents that gave me pause for thought. One day I passed out in the toilet and bit a chunk of flesh off the inside of my lip, then the next day I nailed myself while my boyfriend was over and passed out.  He had to hunt for my key to let himself out of my place.

I woke up the next morning covered in vomit.  Have you ever woken up covered in vomit?  It’s a low moment.  As scrubbed the remnants of last nights spaghetti out of the carpet, trying not to hurl again from the combined scent of vomit and omo, I realised that I needed intervention.  I could still keep going.

It just so happened that I had an appointment with my psychiatrist that day. As soon as I sat down I told her “I think I need to go to hospital…” and explained what had been going on.  She cancelled my ritalin because apparently it promotes addictive behaviours and agreed to write the referral.

The referral process took the longest this time than it ever has before, including times when my referral hasn’t actually gone through and I’ve needed to get another one. It was two weeks between getting the referral and getting the call to come in to hospital when before it’s been an average of one.  It may have something to do with the time of year; for some reason I usually go to hospital in the summer.  To be there in June is a first for me.

I was admitted yesterday and there are a few changes to my care plan because I’ve never been here for a drinking problem before. I have to do an AWS questionnaire every six hours – I think that stands for alcohol withdrawal symptoms – which scores you according to what withdrawal symptoms you are experiencing such as anxiety, tremors, agitation etc.  If you score highly they’ll give you valium.  So far I’ve done it twice and scored zero but I’m told it sets in after three or four days.  Also one of the rules of admission is no alcohol and as a problem drinker I will be subjected to random breathalysing.

I saw my inpatient psychiatrist and she said she wouldn’t change up my meds as yet. She asked me if I was looking to reduce my alcohol intake or stop it altogether.  If I wanted to stop she would put me on antabuse, that drug that makes you violently ill if you have any alcohol.  I said realistically I was looking to cut down.  She said she would wait to see if I started craving alcohol and if I did, she would prescribe me naltrexone.

I saw the ward CMO who went through my medication and ordered the standard blood work. I thought everything was fine until I went to get my medication that night.  They tried to give me half of what I normally take.

The problem was, I take 160mg of zeldox, 400mg of lamictal and 50 mg of Topamax in a day. That’s how doctors read it out when they’re talking about my meds and that’s how she read it out to me so I agreed with her.  It actually is 200mg of lamictal and 25mg of Topamax in the morning and 200mg of lamictal, 25mg of Topamax and 160mg of zeldox at night.  She wrote down 50mg of Topamax, 80mg of zeldox and 200mg of lamictal in the morning and 200mg of lamictal and 80mg of zeldox at night.  When they called her to get her to fix it she wouldn’t change it.

I was livid. These aren’t freaking skittles I’m taking, these are strong drugs with many systemic effects.  Without the right amount of zeldox I don’t sleep.  The staff saw how worked up I was and broke protocol to call my psychiatrist at home and have her change it.  I took the right meds last night but it isn’t fixed properly, my chart is still wrong.  I have to see another doctor today to sort it out.

I don’t know how this admission is going to go because I’m not nearly as unwell as I was during my last one, apart from the problematic drinking. I’m expecting to be here for about two weeks, I don’t expect it will become as long as my last stay (because I was climbing the walls by the time I left.)

I will be doing a rehab diaries though so stay tuned.

Mac

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A New Diagnosis?

Hey, hello, hi. Happy Thursday.

So I’ve been to see my psychiatrist and as a result I may have to amend the banner of this blog.

I went into the appointment wanting to address my disorganisation and agitation with her. I’ve been struggling a bit trying to get college done, I have trouble sitting through my three hour classes and I find myself zoning out to the point where I end up sitting there staring at the computer screen for fifteen minutes at a time.  Sometimes I’ve ended up walking out early because I just couldn’t settle down.

It’s affecting work too. I work mostly from home, but I have a lot of trouble sitting still and getting stuck in.  The other day it took me about two hours to do half an hours worth of work because I kept getting up and pacing.  When I’m working in the office I have people checking in and prompting me to keep at it but I still find myself zoning out.

As well as the concentration issues I have been really disorganised.  My room is a mess, I’m turning up at college without my books or notes and forgetting appointments.  I decide to do something, then I procrastinate, sitting on facebook for hours to build myself up to do something as simple as making a phone call.

I was nervous about bring these issues with my doctor because I was worried she would change up my meds. Despite the extreme weight loss on Zeldox (which, if I’m being honest I wasn’t entirely unhappy about) this current regime has given me the least amount of trouble than any of the number of meds I’ve been on.

I brought it up anyway, and she asked if I had always been like this. I said yes I had – my mother used to despair over my disorganisation at school, and frankly I have no idea how I managed to complete my university degree because I was buzzing and zoned out all of the time.

When I was at school and university my bipolar wasn’t being treated so that didn’t help. I was officially diagnosed with depression and Asperger syndrome so my disorganisation and concentration difficulties were treated by my doctors as symptoms of those.  However while I still may be autistic, my depression and mania are well controlled by medication these days.  I know I’m not depressed and my mum hasn’t been accusing me of being manic.  Yet these behaviours endure.

The psychiatrist agreed that these behaviours seem to be separate to my mental illness and so she put forward a new diagnosis – attention deficit disorder, or ADD. And she looked at me as if she expected me to fall out of my chair.

I remained seated. I’ve suspected I’ve had this for years, although I didn’t go into this appointment expecting to come out with this diagnosis.  It’s not official yet though, she wants to trail me on Ritalin.  Basically if the Ritalin works, I have it.

I’m going to start on the lowest dose, 10mg. She warned me that because it’s a stimulant, if I don’t have ADD it will, well, stimulate me.  She said if I find myself getting more agitated, or developing manic symptoms, I should call her and presumably she will tell me to stop immediately.  I was also given a pathology form for an ECG and warned not to binge drink as the drug will interact with the alcohol.

It just goes to show that you should always keep your doctor in the loop with your concerns even if you’re scared of what they will say or do. Because if this Ritalin works, and my concentration improves, it will make a huge difference for me.

I’ll update again in about a week on how the Ritalin goes

Mac