Posts Tagged ‘doctor’
A Little Bumpy…
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…
A label…
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.
Slipping Back…
I realise now that a month ago, I was better than I thought I was. I thought there was no progress and I wasn’t getting any better, but now I realise it wasn’t as bad as I had thought. I was still low and the agitation was a problem, but I was coping then. The improvement on previous months was subtle, but it was there. I just didn’t really know how to see it. When you are depressed it is hard to see the positive amongst all the dark fog.
Now though, I can see. I am worse now. The juxtaposition between now and then makes it clearer. The upheaval of Christmas and New Year has done nothing for my mood. The endless charade of being okay and happy during the festivities is wearing and I’m tired. I find the blackness working its way through my mind and mood. The negative thoughts are relentless. There is a whole army of ants crawling around in there. I don’t have any ant powder. I have been existing for the sake of it for months now and I don’t know why I am still holding on. I keep trying to, but it is getting harder again. I do it for everyone else, not for myself. It is all just wearing. I am still wearing the mask.
I saw my consultant today. That was wearing in itself. I told her this. I told her that I was doing better than I realised, but now I am doing worse. I told her that I can feel myself slipping back and not having the energy to fight. She just said that this will leave me stuck in depression. She didn’t tell me how to stop myself or give me a hand to pull me back up. She just said that dips happen and I just have to keep fighting. I felt like she hadn’t listened and I found that hard. She has done nothing and said nothing today and I don’t know why I bothered to try and tell her how I feel. I am to stick on the same meds and she will review before I go away on holiday. I felt annoyed by her and maybe even let down. I don’t really know.
I am frustrated with myself that I have slipped back. I wonder if it is my fault. My fault for not realising things were improving. My fault for not making the most of that little improvement. My fault for not having faith. My fault for being this way. I doubt myself all the time and I’m punitive. I will wear myself down and beat myself up. I worry over everything. I question everything.
I think Dr G made a mistake today in the way she said that I may be trapping myself in my depression. I don’t know if she meant well or not, but it has upset me and annoyed me. It has not done anything to help me, only make me question myself more. I do not know why I have slipped back. I did not intend to slip back. It has just happened and I need a help out of it, not a knock down back into it. I hope things improve. At the moment it feels as if she is not supporting me or helping me. It almost feels as if she has lost the respect she used to hold for me. It feels unbalanced now. I am scared of her and uncomfortable about seeing her.
I don’t know what is next. I am always looking for answers. I don’t have any and don’t know where I can find them. I want to know when I will get better. I want to know when things will pick up. I want to know that they will pick up. I am looking for questions too. It is hard to find answers when you don’t have the questions. I don’t know what I should be asking of myself. I don’t know what I should be asking of my doctors. I don’t know anything any more. I find it frustrating.
Dr G wants to review before my holiday this month. Then she said we need to think about the future and planning beyond that. I am scared of the future. I am not sure I want a future. I am just trying not to think about it at the moment.
October 7th: Into the hospital…
When I saw Dr G, I had been told I would probably have to wait about a week for a bed to come available, so I was shocked on Tuesday 7th when I received a phone call from admissions at about 9.30am. They asked me if I could come in for 11am as a bed had become available. I told them that there was no way I could get ready for then, so we agreed on 2pm. I then realised I had a mad rush to get ready.
I had to go shopping. I had no clean clothes and I needed underwear, nightclothes and slippers. My partner came home from work and we made a mad dash to pack and get the things I needed. We got ready and drove to the hospital ready for my admission. I was shown into one of the consulting rooms and asked to wait for the doctor. When they came, my other half left me to it and I went through the admissions process. The doctor on duty was terrifying. I didn’t like him and so rushed through the questions as fast as I could, leaving out loads of information. I hadn’t realised that the questions would be forming the basis of my initial notes and that they didn’t have access to the history I’d already given Dr G or I’d have made more of an attempt to be open and honest. I really didn’t like him. After the questions I was shown to my room and then came a short physical examination, which proceeded to make me feel very uncomfortable. He poked and prodded me and then handed over to the nurse. I was left for a while and then the nurse came back and asked me a few more questions, got me to sign a few forms and explained that he would become my “named nurse”. I was then left to settle in. I didn’t know what to do with myself. Slowly I unpacked my things and found my way around the room.
I was on 1 in 30 observations, so a nurse popped their head around the door every thirty minutes. Most of them introduced themselves the first time, but there was no way I’d remember any names. I was far too anxious and uncomfortable. Later someone asked me if I wanted to go to dinner or to order something to my room. I decided I had to brave the restaurant sooner rather than later, so agreed to go and get something. I was on escort, so that meant a nurse had to walk me between the different buildings, including the short walk to the restaurant at meal times. This was a status that was to remain the whole time I was an inpatient. Usually people were only on escort for a couple of days whilst they settle in, but they were anxious that I would do something stupid and insisted on keeping a regular eye on me. It was weird though being followed by a shadow all of the time.
On my first night I was met by a very manic patient, A, who decided she would introduce me to everyone. This was terrifying, but I was glad of it. She dragged me into the lounge and announced me to the fellow patients. I stayed for a while and talked to people, but I was pretty nervous and really wanted to run and hide in my room.
The next day was awful. I spent most of it alone in my room feeling terrible, occasionally interrupted for blood tests, a therapy assessment and other admissions rituals. The nurses would pop their heads around the door regularly and every time I was asked if I was okay, I would say yes, no matter how bad I felt. I began to look for ways to self harm and this became a focus. I didn’t know what else to do.
Thursday brought my first ward round, but I can remember very little of what happened. I can’t even remember if it was multi-disciplinary or one-on-one. I think it was MD, but Thursday ward rounds were usually 1:1 so I can’t be sure. It did bring about a change in medication. The Citalopram was to be phased out and Venlafaxine was to be phased in.
I also got to start therapy, which was a relief. It gave me something to fill my days with and stopped me staring at the wall, thinking about ways to hurt myself. This coincided with a fairly dramatic lift in my mood. I went from being suicidally depressed to hypomanic in a matter of hours and by Thursday evening I was running around the ward with A, both of us as high as a kite. I was agitated and couldn’t keep still, my mind racing at a million miles an hour. I retired to my room when I realised I was probably driving everyone else mad and then proceeded to draw all over my legs and entertain myself by listening to The Ting Tings on repeat. I don’t know what time I got to sleep. It was late. Friday was a continuation of this mood, but things started to darken on Friday evening. The weekend was spent on the ward and my sister visited, bringing cakes and presents.
The rest of my admission is all a bit of a blur. It was a great big melting pot of therapy, medication, mood swings, anxiety, depression, suicidal thoughts, lots of self harm, which was getting increasingly out of hand, ward rounds, nurses, visitors, CBT, art, agitation, friendship, talking, TV and jigsaws.
September: Caffeine Crisis…
September 16th: Caffeine Overdose
A week on from the bridge I was a mess. I had spent the week trying to stop myself from hurting myself and I knew that I couldn’t withhold it much longer. The day before, I’d bought a packet of caffeine tablets. I don’t know why. Overnight I had gone over and over the urge to overdose and by morning I couldn’t stand it any longer. I took all of the caffeine tablets, 32 in all. I was surprised at how easy it was. I just swilled them down with a can of Diet Coke. I didn’t care what it did to me. I just wanted to shut up the noise in my head. I guess I knew that it wouldn’t kill me, but I wanted to make myself ill. I wanted to hurt myself. I wonder now if I took the caffeine to stop myself taking the paracetamol or fluoxetine or whatever else I could find. I wonder if I did it to stop myself from going to the bridge. I don’t know if there was some form of self-preservation happening.
The caffeine made me incredibly agitated. Shortly after swallowing the pills I was shaking and couldn’t keep still so I decided to go for a walk, hoping it would use some of my excess energy. I walked towards the village not knowing where I was going or what I was doing. My head was spinning. I felt drunk, dizzy and full of energy. When I arrived at the village I thought about seeing Dr N, but when I got the surgery I was too scared to go in and ask to see him. Instead, I kept walking. I sat down on a bench and texted a friend, then walked back to the surgery, but Dr N had left for his rounds. I gave up and walked home. By the time I got home I was feeling awful. I had terrible stomach cramps, was shaking and my head was pounding. In the end I just lay down in bed and stayed there. When my partner came home I just told him I was feeling poorly.
The night was long and painful. I was awake all night, the nausea unbearable. I kept heaving, but nothing was coming up. My head was spinning and pounding. My heart was pounding. I thought I was dying.
September 17th: A&E
In the morning I was still feeling terrible. My partner was concerned; of course, he did not know that I had brought the pain upon myself. I rang the surgery and made an appointment with Dr N. I was agitated beyond belief, feeling terribly sick and barely able to talk as I walked into his office. I was shaking terribly. I didn’t know how to tell him. I was so ashamed and embarrassed. In the end I managed to spit it out and explained what had happened. He was concerned and didn’t know how to react. He checked my blood pressure and kept asking me if I was going to be safe if he sent me home. I didn’t know how to answer. He decided to send me to A&E, gave them a call and wrote me a referral letter to take with me. He wanted me to call my partner and get him to take me, but I was too scared. I opted for a taxi.
I arrived at the hospital and handed the receptionist the letter. They took it from me and handed it to one of the nurses and then it was handed back. The letter was now open and I could read it. I was shocked to see what it said. Dr N’s differential included not just depression, but “? Personality Disorder”, which one would assume referred to the possibility that I had Borderline PD. I was quite angry. I hadn’t expected that, as it had not been mentioned before, but I also kinda knew that by self-harming in this way I had opened myself up to it. I sat in the corner and banged my head against the wall in frustration. Eventually I was called through, but a mix up meant I was left to sit in the cubicle on my own waiting for a nurse. One nurse saw my letter and said “oh you’re that one” and then ignored me. Eventually a nurse came and asked me some questions. She then found another nurse to take me through to majors.
I was shocked by what happened next. I was led to a cubicle and she instructed me to change into the gown and to get onto the bed when I was ready. I remember her asking me why I did it, but I didn’t know how to respond. She noticed my engagement ring and told me “see, that’s something to live for”. I thought she was an idiot. She obviously has no idea what it’s like. She attached me to the monitor and took my blood pressure and temperature, then left me. I proceeded to spend the next couple of hours feeling terrible, trying to work out what they were going to do with me. I was terrified. Everyone that came over and saw my notes seemed to flinch and wander away. I sneaked a peak at them myself and saw “DSH” in big letters at the top. I wondered if that was the reason why I was ignored. Eventually a doctor came and took some blood from me and asked me further questions. I was scared of him and didn’t know how to answer. He smelled too. Eventually he finished his interrogation and left me again. More waiting and being ignored followed. After what felt like forever, a nice nurse came and explained what was going to happen. I was to be moved to the CDU ward within A&E, to wait for the blood test results and a psychiatrist.
Shortly after I had been moved, my partner arrived. I was shocked to see him, as I hadn’t told him where I was. I found out that he’d been worried that he hadn’t heard from me and at lunchtime he had began a search. In the end the doctor’s surgery had told him I’d gone to A&E. When he arrived he was angry at me for not telling him the truth. He told me I was silly and kept asking me questions about what I had done and why. I just wanted to be left alone. I didn’t know how to respond. He kept asking me questions, in between hugging me and telling me things would be okay. I didn’t know what to say. I was starting to feel a little better by mid-afternoon. The nurse in CDU was lovely and the only one to really treat me like a human being. I was brought food, but it was inedible.
Eventually, I was deemed medically fit and the psych team were able to assess me. This was horrible. I was uncomfortable with the MHP. She asked me plenty of questions, but didn’t seem to want to listen to my answers. My answers didn’t seem to be what she wanted to hear. She didn’t seem to understand why I was there and I got the impression she just thought I was silly and pathetic. She was confused as I didn’t seem to fit her boxes. I think she just wanted to send me home, but realised I wasn’t happy about that. In the end she called the on-duty psychiatrist and he came. He didn’t ask me any questions about what had happened and just asked me what I wanted to happen next. He gave me the choice of going home and pretending nothing had happened, going home and having the crisis team visit or being admitted. I was scared of hospital, so I chose the crisis team. I was discharged after some frantic form filling.
September 18th: Crisis Team
The crisis team were hopeless. They turned up late and then proceeded to perform some bizarre good-cop-bad-cop routine, whilst they tried to find out what had happened prior to me tipping up in A&E. They asked me various questions but I didn’t know what to say to them. I made light of everything as I didn’t know how else to approach the situation. In the end I was deemed sane enough not to warrant their attention. They wanted me to wait for the mental health team assessment that I had been on the waiting list for forever. They seemed frustrated that they couldn’t just stick me in a suitable box and in the end they just discharged me back to my GP.
August/September: New GP, New Meds…
Late August: New GP & Citalopram
After weeks of frustration with my previous GP, Dr L, I finally plucked up the courage to see a new doctor at the practice. Thankfully, Dr L went on holiday so I had a perfect excuse to try someone else. I booked an appointment with one of the two new doctors, Dr N. He was fantastic and it was so good to see someone who actually listened, didn’t patronise me in any way and didn’t try to rush me out of his room the second I arrived. More importantly, he agreed that the Fluoxetine had been doing me no favours. He took me off the Fluoxetine and then started me on Citalopram 20mg. The Citalopram eased the nausea situation and didn’t seem to have any awkward side effects, although it didn’t appear to be doing much, if anything to ease my mood.
Late August/Early September:
Things pretty much continued as before with me spending time at home, feeling terrible. I was becoming increasingly suicidal, struggling with self harm and unable to see any hope for change. The Citalopram did not seem to be helping to lift my mood at all. My partner tried to get me to keep busy, setting me lists of chores and I also spent a lot of time baking and swimming to try and distract myself, but it wasn’t helping. I was doing all the right things: exercising, trying to think positive, seeing Dr N regularly, taking the pills etc.,etc., but my mood continued to plunge, which made me feel more and more frustrated and upset.
August – November: Up to now…
I know I’ve been pretty quiet since I returned to the blogosphere, but I’ve generally been pretty busy with day care and when I haven’t been, I’ve been too ill to write or busy working on therapy homework. Or at least pretending to be busy working on therapy homework.
One of my therapy groups is something called Life Maps. For this session we have to create a “map” of our lives to date, highlighting key dates, events and people from our life story. We can do this however we wish, such as a big timeline, bubble charts or just written as prose, as long as we can use it to explain our story. During the sessions we look at an area of our map and by talking though our story, we can look at the key events that have shaped us and also keep an eye out for repeated behaviour and issues which may or may not have contributed to the development of our illnesses.
Simple right? Haha!! It is hard work. I have barely started to go through things and everything I’ve covered so far seems pointless and unrelated, except the info from the last couple of months. I feel guilty for my lack of progress. I need to look at my teenage years, but I am struggling. My concentration is shot to pieces due to medication and illness and my memory is terrible, so trying to recall events of the past 22 years is not easy. Problem is, I know I can’t use that as an excuse. Everyone else is in the same boat. My perfectionism also haunts me and makes it difficult for me to put things to paper, for fear of it not being right, but I know I need to fight this. I hate that I am not making the most of the therapy offered to me, but I am just not well enough. I know the therapy coordinator was worried I wouldn’t be up to it, but I want to prove him wrong. Problem is, I’m failing so far.
Anyway, I explained how Life Maps works because I decided to try and kill two birds with one stone and type up a potted history of events since I left the blogosphere, covering my path to hospital and beyond.
It has been a crazy few months. This doesn’t really begin to cover half of it, despite the amount of detail I’ve included. I just couldn’t explain how it’s felt to go through all this. It’s been a whirlwind. The future is still hazy. I am still unwell and still waiting for answers. I hate that despite all this, things really haven’t changed all that much since August, when I was last blogging. I just hope that things start to change soon, as I don’t know how much more I can go through before I break.
I’ve decided to do this as a series of posts as it is really long and unwieldy. Below, you can see a number of titles linked to the other posts. I hope this works out okay.
EDIT:– Why are trackbacks so unreliable? If you make a post with lots of links they don’t all ping at the same time. Usually only the first link pings. You then have to keep editing and saving the post until they all work. Stupid thing!
August/September: New GP, New Meds…
September/October: Meet the Shrink…
October 4th: Tell the parents…