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Archive for April 2009

A Bumpy Road…

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An awful cliche, but it sums things up. Not only am I still all bumpy with this damn rash, but I am still struggling.

I don’t really know how I feel because I’m up and down and numb all at once. Right now, my head is fuzzy and I keep feeling very dizzy. It means I can’t really think.

I am now getting moments where I feel okay. Better than okay even. I am thinking about what I could be doing and wondering if I can get on with life. The problem is, ten minutes or two hours later, I am feeling as bad as ever again. I am suicidal and see no future at all. I am trying to control the impulses, but I find myself not wanting to. This constant swinging is frustrating as each mood undermines the other and I find myself wondering what is the point if I am going to keep having these swings. It’s just a reminder of the grim reality of this condition. This has been a problem all weekend, but I found myself just pretending everything was okay, even during the bits that it wasn’t. Damn that automatic mask!

Ward round today and it seems my NHS support is not organised or forthcoming. This scares me as my health insurance funding is being stopped in 10 weeks as I’m now diagnosed with a long term condition. Damn my new diagnosis! Aside from that, ward round was productive and I feel a bit more prepared for tomorrow’s discharge.

A Little Bumpy…

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The side effects continue to show themselves. Last night, a bumpy rash started to appear on my arm and today it has got worse. The ward doctor gave me antihistamine to ease the itching and it has helped but it’s still there. I will have to mention it again tomorrow if it doesn’t go.

Aside from the rash, my back and head have both been achy and I’m quite dizzy. This could be Duloxetine withdrawals, Depakote side effects or just general malaise but I wish I felt better.

Oh well…

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Friday, 24th April 2009 at 10:18 pm

A Little Shaky…

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Just a short post from me today as I’m posting from my mobile.

Yesterday, I had my appointment with Dr N. Afterwards I was left more confused and clueless than beforehand. The NHS are hopefully going to provide community support and work with The Priory but at the moment nothing seems to be organised and neither party knows what the other is doing. I was left panicking that I will be left on my own with no support. There is only one possible outcome if that happens.

Today, things are more positive. I saw Dr G and she reassures me that things are in hand. She wants everyone to work together but is aware that may not be possible or straightforward. If things don’t work out as hoped she is sure something else can be arranged that will give me some support. I just hope she is right.

My past experience of NHS mental health services, or rather my trust have been shaky at best. Dr G assures me that her experiences with them have only been positive so I hope that with her on board then maybe mine will be too. Time will tell.

As for shakiness. The Depakote seems to have given me a tremor. I can’t control my hands and it is making typing this post on my phone harder than normal. I feel a little dodgy in general today. Dr G said that is to be expected as my meds are being tweaked so much, but it still sucks. I’m coming off the Duloxetine now. Still on amitriptaline. Reducing my aripiprazole and adding the Depakote. It’s no wonder is it? No other side effects seem to be a problem so far with the Depakote but it’s early days.

Aside from talking about NHS involvement, we also talked about my diagnosis and it is confirmed as Bipolar II disorder. I am glad to have Dr G agree with Dr P and make things clear for me, but it is still sinking in. I don’t really know how I feel. I need to think about it some more. The clarity is positive though. Maybe it will bring about a better route in terms of treatment. Things have to improve. They can’t continue to be as hopeless as they have been.

Anyway. I should stop rambling. More soon…

Assisted Suicide…

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Yesterday, a conversation with my sister got me thinking. She was telling me about someone she knows whose son fell several stories from a window in a tragic accident and he is now tetraplegic and currently unable to talk. We were talking about how that would leave him with no quality of life and that we’d rather be dead than be left in that situation.

The conversation then moved onto assisted suicide, because he of course is so disabled he would not be in the position to take his own life. It probably comes of no surprise that I agree with assisted suicide and would support it in this case. I think a lot of people would agree with me in this case and for other chronic physical conditions.

However, I wonder how many people will agree with me that assisted suicide is the logical outcome for someone with a severe chronic mental condition too. I feel as if I am teetering on the edge of falling into that category. I feel as if my condition is affecting my quality of life such that life is not worth living and I am potentially facing the fact that I am living with a severe and chronic condition.

I am currently holding on with the hope that my new medication might be able to help, but I have little hope. I’ve tried so many medications I’ve lost count (It’s around 20!). How is this one going to make any difference? I feel as if I wouldn’t be able to hold on if I was given the choice, but I am not.

I am still absorbing my new diagnosis. I saw Dr G today and she said that she was leaning towards the same conclusion of Dr P and is going to follow his recommendations. I am trying to hold onto the hope that this is a positive thing, because it gives me a label to understand and finally means that there will be a change of tactics in terms of treatment, but I am struggling to handle the thoughts that bipolar II means that I will be struggling with this for life. Even if we find a way to manage the condition better than we do right now and if this episode eventually passes, it is still likely that I will go through further periods of depression and will again feel as crap as I have done over the past year.

I am not being discharged for a week now. We were thinking Friday, but with a medication change, next Wednesday seems better. That is when my insurance runs out, so is the logical end for the admission. I cannot afford to self-fund any longer and I have been here so long, a full ten weeks, that I have done most of the therapy on offer here and I’m starting to get bored. It is time to move on, but preparation for discharge is difficult and stressing me out. I am anxious about leaving and entering the real world. There is a lot for me to handle out there and I’m not sure I can manage it. Time will tell.

Feeling Vague…

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I’ve not really been here over the past couple days. I feel very vague and am completely utterly exhausted. I don’t really know what to say. There are things floating around in my head but it’s so foggy and useless at the moment I don’t think I can begin to form sentences and write a proper blog entry. Another day perhaps.

I just feel overwhelmed by everything at the moment. I don’t know why. This week is scaring me. Too many meetings, med changes, doctors to see, phone calls to make, things to do, plans to write… It’s going to be a nightmare. All this preparation for discharge is too much for me.

I can’t comprehend leaving The Priory at the moment. It’s scary. I’ve been here almost 9 weeks now and I don’t know how I can cope with anything else. Normal life exhausts me. I just can’t handle it. I’m so institutionalised and I am safe in my little bubble. The outside world is a whole different ball game and I’m not sure I can do it right now. I can barely do this safe dependant life, let alone my life in the real world. Meep.

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Sunday, 19th April 2009 at 8:51 pm

A label…

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Earlier today, I had my second opinion meeting and review with Dr P. I wasn’t given much notice. The ward doctor, Dr C, just said he will be over in a few minutes and fifteen minutes later I was sat in a room with him and Dr C answering questions. It was a bit like the nth degree. My memory is sketchy and I struggled a little, but I gave him an overview of my moods over the past few years. He was keen to find out if I’d had any ‘up’ periods and although I have, I don’t want to exaggerate any of them so didn’t really know what to say. I just tried to explain how I was at various points in time. He had a little bit of knowledge about my history before he started and seemed keen to get an overall picture of my mood cycles. He asked about my agitiation also. It was a different approach to Dr G, who was more keen to get an idea about how I felt and what I thought. They’re polar opposite doctors, but both good at what they do.

Anyway, Dr P eventually said that based on my lack of response to ECT and anti-depressants he believes I have bipolar II disorder and thinks that ADs are not going to be helpful. I hadn’t realised that my lack of response to ECT could be seen as a test for bipolar. If I had recurrent depressive disorder, I’d likely to have had some positive response to the ECT, but because I haven’t, it probably suggests that anti-depressants are not going to work for me. He talked about how some people with bipolar II do not respond to ADs or traditional treatments for depression such as ECT and that was why he was suggesting that diagnosis.

He wants to start me on an old school mood stabiliser, so is putting me on Depakote. I am a little scared as I’ve heard bad thinks about Depakote, but everyone responds differently to different drugs and anything has to be better than the current situation. He is keen to take me off anti-depressants altogether. I’m glad it’s not lithium anyway.

He asked me what I thought and said that he suspected it didn’t really come as much of a surprise. At the time, I said not. I told him I knew a reasonable amount about the condition as I had friends with it and I had in the past suspected that it fitted. Thinking about it since though, it has been a bit of a shock. I’ve been seeking a diagnosis for so long and not received one, so to finally have one is a bit of a shock. It’s an unpleasant surprise too because I know that it can be an awful condition to have and I’m not sure I really want it, even if it does fit. After all, the last year has not exactly been a barrel of fun.

Dr G doesn’t yet know the outcome of the meeting. She isn’t in work today, but she is coming in tomorrow to see another patient so Dr C has written her a letter telling her about the meeting. I may end up seeing her tomorrow to discuss. I’m a little scared about her response to all this as I’m not sure what to expect. I presume she was aware that this was a possibility, because she wouldn’t have got Dr P involved if it wasn’t. Everyone is aware that Dr P is a specialist in mood disorders, especially Bipolar, and if anyone is going to spot it, it will be him.

Generally, I am still absorbing the information. I have suspected I would eventually end up with this label for a while, but it feels weird to finally have it. Dr G has avoided it so far and I wonder why, yet she obviously had her suspicions or she wouldn’t have got Dr P involved. I just hope she agrees with what has been said and is comfortable with it.

I think this has given me a little bit of hope. Things are changing, which is something positive. Hopefully, the new medication regime will improve the situation. I know it isn’t going to change things overnight, but it might pick things up. There is also the fact that this diagnosis should ensure I get more support. The CMHT referral is going through and they are trying to arrange a CPN before I am discharged from The Priory. The bipolar II diagnosis will give that referral more strength and also mean that the NHS pays more attention when I need support.

Aside from that meeting, I also have my GP coming to see me later today. I am a little nervous as there are a lot of things I have to cover with him, but he is lovely and I need to get over that fear. We shall see anyway.

A Second Opinion…

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I went into my ward round this morning with some notes that I’d prepared in advance. I am fed up of going in to see my consultant and not knowing what to say to her. I am fed up of going in to see my consultant and forgetting everything that I want to share with her. I am fed up of the blankness that descends the second I walk into a room with her. So I was prepared. I have been trying to write the notes for a few days and found it quite difficult, but I did get some of it pulled together and managed to get them printed off when I was home yesterday. I handed her the notes as I went in and she read them quickly. I hate that moment. I want the world to swallow me up so I don’t have to sit there as she reads the inner workings of my useless and faulty mind. We get there in the end though and she finishes reading my notes and then begins to answer some of my questions in her usual evasive manner.

She wants me to see one of the other consultants here for a second opinion. I get the impression she is a little flummoxed by me and does not know where to go now. She wants me to see Dr P, who is a specialist in mood disorders, especially bipolar disorder. She warned me he is not in any way shape or form, touchy feely and I’ve heard from others that he is very medication focussed, so will probably listen to me talk for a little while and then dole out meds, but it might be interesting to see what he has to say. I am a little scared though. I hate seeing doctors for the first time.

Aside from the second opinion, she talked about working on my care plan with her on Thursday. The idea is we will work out a plan for when I am out of hospital. She has already contacted my NHS trust with the hope they can provide me some support when I am out of The Priory, but I do not really trust them to be any help. Maybe with a respected psychiatrist or two on my side rather than just a single GP, I might have a bit more luck. We will see I guess.

Finally, she wants to refer me for some long-term psychodynamic therapy. Probably in group format, but she needs to find something suitable to refer me to. I’m a little scared at the prospect and worry that I will dread it in the same way that Alison does, but I think group therapy would be better than one to ones. I find individual therapy a terrifying prospect. I guess we will see what happens.

So.. Despite the fact I was waiting for hours this morning, it was a useful ward round. I just hope Thursday is helpful. We will see I guess…

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Tuesday, 14th April 2009 at 4:54 pm