Into the system…

blogging, work, mental health, therapy, disability, benefits and more…

Posts Tagged ‘inpatient

Discharged…

with 13 comments

So I was discharged on Friday.

I think my reason for discharge was more down to the fact they don’t know how to help me, than me being any better. The current bed shortage probably had something to do with it too. They are struggling for beds and suddenly they are trying to send us all home.

My consultant suggested that staying any longer would not be good for me. The longer I stay on the ward, the harder it will be for me to leave. You get used to the routine, doing nothing all day. You really can’t help but become institutionalised, living in the safe bubble of the ward. The real world gets stranger and scarier by the day. I was getting more and more scared about leaving. It was an easier life in there and I could just about cope with existing. Being home has been a shock to the system and I realise now how much I’d settled into inpatient life.

It feels pretty risky to discharge me. I know I can’t stay in there forever, but I don’t feel particularly safe. I felt safer on the ward, although in reality I probably wasn’t. I wasn’t on escort during my last week and I could have gone out and done something, but of course it’s the evenings and nights I find most difficult and I was always kept safe then. My consultant didn’t seem to be taking the risk very seriously. She seems pretty convinced I don’t mean it when I say I still want to kill myself.

I nearly didn’t get to come home last week. It was agreed that we would meet with my new care co-ordinator on Thursday, so they could work on a care plan before I was discharged. Unfortunately she wasn’t in work for some reason and my consultant was reluctant to let me go without a CPA. By this point I’d accepted I was leaving on Friday and I didn’t want things to change at the last minute, so I managed to convince her to let me go anyway. We agreed that I would be placed under the crisis team until my care co-ordinator sees me this week. They’re not visiting me, but I’m on the list so if I call they can respond quicker. The likelihood of me making the call, even if things are bad, would be slim, but it was enough to satisfy my consultant.

Then on Friday they closed the ward due to an infection outbreak. Probably Norovirus, a stomach bug had broken out. Patients and staff we dropping like flies and the decision was made to close the ward. No one in, no one out. There were doubts over whether or not I’d be able to leave, but permission was sought and I was allowed to go. I felt fated to never leave.

I also had chest/upper abdomen pain, which was pretty bad on Friday morning. At first I just assumed indigestion, but when it still hadn’t gone away by the second day I was starting to worry. I knew I should bring it up with the ward doctor, but with the stomach bug running wild, I knew I wouldn’t be able to leave if I showed any sign of being ill. I decided to keep quiet, but as the pain got worse on Saturday I was starting to regret it. Managed to get through until today and saw Dr N. He said it could be related to the Reboxetine and has given me some meds that should help. We shall see.

At first, it was a nice novelty to be home though. Not getting woken up at 7am, by a noisy nurse shouting “Good Morning”. Food that isn’t lumpy and grey. A doggy to give cuddles. Internet access and my normal phone. Being able to go out without planning it. It all made a nice change. I even got breakfast in bed delivered to me for valentines day (aww).

Sadly though, the novelty is wearing off and reality setting in. I feel pretty awful at the moment. Nothing has changed. I’m grumpy and anxious. The smallest thing is making me snap. I went to Creative Remedies and instead of making me feel better, I felt worse. I just wish everything would go away.

Anyway I have to stop writing. I want to try and write about my time on the ward, but not sure I’ll get much chance. I wrote a lot in my diaries, so I hope I can use some of it for a few entries.

Hope everyone is okay. Let me know your news! xx

Written by intothesystem

Tuesday, 16th February 2010 at 12:56 pm

Bombshell…

with 16 comments

On Wednesday night Dr M dropped a bombshell and then ran away whilst it detonated.

Contrary to what was said in ward round on Tuesday, “yes, it does sound like a mood disorder. We shall discuss your notes and call you in later to discuss medication”, they are now questioning my diagnosis, saying my picture doesn’t fit with their understanding of Bipolar Disorder. Now, considering this is based on a half hour conversation with me and a couple days of uncharacteristically fast (for me) mood swings, I am concerned.

They said they want me assessed by the clinical psychologist, which may take “many weeks” before they make any decisions. She isn’t sure where I should wait, here or at home, but is concerned about my safety (which to be honest she needs to be! Being in here doesn’t exactly do anything to convince you life is worth it, when you have already given up).

She said she doesn’t want to change my medication as it might influence the assessment. No mention of taking me off my current meds, which could be doing the same!

Then the meeting was over and I was left to handle the fallout alone.

I am a little shocked. They haven’t seen my Priory notes as the CMHT has lost them. I was under the care of The Priory for many months and I think they had enough time to assess me. Not make assumptions based on a short conversation and observations over a couple of days, which have obviously been influenced by an overdose and stress!

I am concerned that the change of tack seems to have come after J spoke to them. What on earth did she say, especially as she didn’t exactly know me or get the full picture as I didn’t trust her?

I can also sense what is coming. A borderline diagnosis is ahead on the tracks and coming at me fast (or slowly as it’s the NHS). I wouldn’t mind if this seemed to fit, but I am fairly familiar with the criteria and nature of the condition. It doesn’t ring true with my experience. I have no fears of abandonment – I am fiercely independent and quite happy to accept someone won’t be in my life any more, e.g. when therapy has ended. I may miss the person or thing, but not object to losing it and will not try to stop them. I do not have stormy and unreliable relationships – I have been with my partner 7 years. We argue like man and wife and our relationship is strained by this episode of illness, but I don’t love him one minute and hate him the next. My mood swings are not generally reactive and *usually* slower than those suggested for BPD. I don’t suddenly want to kill myself after bad news. Yes, I can express frustration or be upset, but not out to a level that is out of the norm or to extremes. I do not act impulsively without considering the consequences. My major suicide attempts have both been a result of a huge amount of thought and planning. In fact, aside from my mood swings I don’t think I am generally a person of extremes. I also have no past trauma, which is often involved with the condition. I could probably half meet maybe 3 or 4 criteria, but never the 5 needed by the DSM or the descriptions given in the ICD. I’m aware I am having to simplify things through lack of space or time – my thumbs will fall off if I write everything I want to, but I think you get the idea.

Also worth noting that borderline PD is one of Dr G’s specialisms and she never mentioned it to me. She tends to be pretty straight with people, so if she thought it was that then surely she would have been able to say so? She also wouldn’t have referred me to Dr P, him being the mood disorder specialist.

I can’t help but feel this is all part and parcel of the way this label can be misused. Don’t fit classic diagnosis, don’t respond to first line medication, female, suicidal and have mood swings. Oh BPD will do. Lets try and put the square peg in the round hole.

Maybe they aren’t thinking Borderline PD, but the mention of psychologists and lack of anything else even remotely close, suggests they are.

I am also frustrated at the lack of desire to do anything whilst waiting for the psychology/therapy assessment. Even if it was BPD, medication can be helpful with treatment and is often following the same kind of strategy as Bipolar II. She may in a couple months time go back to my current diagnosis, make the same changes and in the meantime I have wasted months of my life stuck on this ward. There never seems to be much desire to get you out, unless they suddenly need a bed then you can be out on your ear, recovered or not.

There are a lot of questions and no one has given any answers yet. I wrote a list of the key practical ones and handed it to my nurse to pass on yesterday, but no mention yet. I suspect I will be waiting until ward round next week.

After all this, my bloke went to see Dr N yesterday for his opinion. I thought this would help but it has made me more confused. Apparently Dr N is quite pleased I am being reassessed as he was never convinced by my diagnosis and he even suggested Dr G wasn’t. I had suspected this myself, but when I questioned Dr G on it, she said she agreed with Dr P. My bloke and Dr N apparently discussed borderline PD for a bit too. My bloke also expressed his concerns about rumination (he seems to think if I stop overthinking and forget about my illness I will be okay) and my blog came up. Apparently Dr N didn’t know I was still doing it! Surprised by this as everyone else, including the CMHT knew. I kinda feel left out of my own care again, so am wishing I had been there yesterday, although I know it is not practical.

Since then I have spent a lot of the last day or so pondering all this. I had a visit from Em in the afternoon which was lovely of her and a short break from everything.

My bloke came in the evening. It was his birthday but he wasn’t exactly full of birthday cheer. Em had got me a cake to give him, which we shared some of, but then we spent the rest of the time talking about all this. He has been doing a lot of research, trying to fix everything and find solutions (typical man).

He has been going over the rumination thing and my lack of positive thinking. I know I overthink. I even overthink good things. The problem is I always have and it feels like part of me. Questioning that feels like a direct attack. It may be an exacerbating factor, but it isn’t the only problem and I also don’t know how I could really change this. I can tell myself to stop and distract myself, but the running commentary just carries on and questions me further. I will almost overthink, overthinking. Distraction works to a point, but when I stop I just go into thinking overdrive instead and I can’t distract forever.

He has all these suggestions of how I can get better and things I need to do. Thinking and therapy techniques, supplements, the usuals of exercise etc. Many of these I do try to employ already and it is all well and good to suggest them, but at the end of the day I am: a) unwell and that can make it hard to do anything, especially when I’m in crisis and all logic goes out of the window, b) stuck in here so many of the suggestions are impractical and c) they may help to some degree but none of these things are going to fix things.

It still feels like he basically wants me to buck my ideas up. I was getting frustrated by this. I know he means well and is trying to help, but I wish he was perhaps more sensitive in his approach. He has gone from acting caring and supportively over the last couple days to criticising me again. I do wish things were all as simple as a bit of CBT, some positive thoughts, routine, eating and exercising well and some distraction. Sadly they are not.

Edit: Maybe this is unfair. The conversation was frustrating and I did feel attacked at times, but I am glad he is trying to help. Some of his suggestions were helpful. There are good bits within the bad. I do just find it hard to see them and I don’t know how much I can do right now.

Today looks pretty bleak and pointless. More waiting and the thought of another long weekend ahead is tiresome. I asked about having Nikki, coming to visit so we could have a walk around the grounds, utilities the nurse said I need to get it sanctioned by the doctor. Considering I am not on a section and would be escorted by my partner this seems unfair. I wish I could just walk out and although in theory I can, they are unlikely to let me. A section would probably beckon, if only an assessment one.

I am tempted to ask for some haloperidol! It is the only thing to ever sedate me and although it turns me into a zombie, I’d quite like to sleep away a few days in an antipsychotic-fueled daze right now. It is not practical in the real world, but in here it doesn’t matter. I don’t have any PRN written up as nothing really works.

Anyway this is pretty long and I’m scared it won’t post! I better go. Xx

So it works…

with 3 comments

I thought it formatted weirdly when I looked at in my nokia browser, but apparently it is fine. Checked on skyfire and all good. No idea how I tag posts though. Can do that later I guess. (Edit: finally got around to tagging).

So today has been up and down. getting increasingly high all morning, down a bit mid afternoon and going up again now. This daily pattern often happens when I’m hypomanic. Always worst in the evening as night and supposedly sleep approaches. I’m not sure I’m going to need much again tonight. Been trying to stay off the stimulants although I had some haribo.

Spoke to my grandma. Had to consciously try to slow down my speech and I talked and talked and talked. She couldn’t get me off the phone. Oops.

Played some more solo scrabble this afternoon. It is sad that I end up playing myself, but nothing else to do and no one else really up to playing with me.

Filled in my WRAP form. Makes sense, but I know that when crisis comes I am likely to ignore what it says, even though I know I shouldn’t. It is not like I don’t know what I should be doing. It is just that when it comes to doing it I find it so bloody hard to ask for help, or even if I do manage to ask for it, I can’t then accept it. I don’t know. I don’t really remember being well so filling that part in was hard. It was useful to write what recovery means to me though and my early warning sides for both depression and hypomania. I remembered reading Dee Dee’s account of her WRAP plan as I was doing it and had some of the same thoughts (note – must edit to add link when on computer – Edit: Here we go!).

Crap. I just had bad news. Was meant to be seeing the psychiatrist tomorrow, but I’ve just been told it will be Thursday now. I can’t wait that long for change. I need someone to do something. I need a plan so I have some hope. What is the point in me being stuck in here for days without seeing a doctor? That will be almost a week I will have been here without seeing a psychiatrist. Isn’t the point of being here to have constant care from a psychiatrist and to make a plan to get better? The nurse didn’t explain why. Just told me they will explain tomorrow and a mistake has been made. I feel like I’ve been stabbed. I was counting down the hours until tomorrow afternoon and now there are a lot more hours for me to wait. I don’t know what to do. I started to cry, but I can’t even do that properly. Stopped as soon as I started. Froze up like the weather. I just wish I knew what was happening. I wish I didn’t feel so powerless.

I don’t know how long I can take this. I am meant to be here to get better but I just feel cooped up with no support. I don’t see the point. Wonder if I’d be better at home, but even though I’m here voluntarily I suspect they would change that if I tried to leave. I don’t know. I don’t know. I don’t know.

Any ideas?

Written by intothesystem

Monday, 11th January 2010 at 7:07 pm

Testing Email Blogging…

with 7 comments

I have no idea if this will work from my mobile email address and not my intothesystem one, but it is worth a try. I am not going to blog much as I guess I should be using my time here to try and get better. At least that is what everyone keeps telling me, but then again I am bored and it helps me to order my thoughts and write. All I have done is write. About 80 sides in my A5 paperchase notebook in 3 days. I am going to run out of space in a few days at this rate. Already using vast quantities of ink!

I think I am a little hypomanic at the moment. My mood has got increasingly speedy over the past 24 hours. It was horribly mixed last night. Desperately suicidal and wanting to self harm, yet bouncy and hyper. This morning I am just hyper and giddy. The bad thoughts aren’t as strong and are being replaced by a constant need to talk and write. I’ve been trying to calm down to avoid the chemical cosh. Avoiding the urge to dance around and sing!

Apparently I will see the psychiatrist tomorrow. I was hoping it would be today. Spoke to one of my named nurses for a bit just now though so they should know what my mood is like. I just about talked her silly I think. I seem to have got lucky with my nurses. They seem to be the two nicest staff here but they are both new, young and not disillusioned yet.

I just want people to be straight with me and tell me what is going on though. There doesn’t seem to be much involvement with the patients. We just get ordered to dinner and to collect our meds and that is about it.

Actually just after moaning my named nurse came back with a WRAP form saying that I should get involved with my CPA as I am clearly capable and enjoy writing. I guess I’m not being treated as a complete imbecile then! I am trying to make it clear I want to be involved and not just bossed about.

I shall sign off now. Don’t want to write a missive and it not work, but if all goes to plan I may write a little bit now and then.

Thanks so much to everyone for their kind messages of support. Especially to those who have texted or tweeted. You are helping to keep me sane! I say sane of course when I’m in a loony bin, but you know what I mean. Take care Xx

Written by intothesystem

Monday, 11th January 2010 at 10:46 am

So Back Here Again…

with 3 comments

So I’m back as an inpatient. Not the outcome I’d hoped for. I won’t go into the details of how I ended up here now as I’m on my mobile and it’s nearly lunchtime but I wanted to let you know. I know some of you already do.

Take care everyone, going to try and tweet a bit as it’s quick and easier than blogging and there really is nothing else for me to do here except stare at the ceiling. Kinda hiding from the rest of the place at the moment.

Xx

Written by intothesystem

Saturday, 9th January 2010 at 11:37 am

Assisted Suicide…

with 5 comments

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.

No Veins…

with 3 comments

I had to have my blood taken today, but we can safely say I have really crap veins. It took multiple attempts to get the tiniest amount of blood. I’m having the tests to check my platelet count has improved and also to check my thyroid. It seems my last test showed slight hypothyroidism and Dr G wants to check again before she gets the thyroxine out. I’m not sure how I feel about it. I know it may affect my weight and mood, but I’m not sure if it’s just a bit of an excuse. I guess we will see.

Aside from that it seems Dr G has been talking to the ward doctor, Dr C about me and they’ve decided I need extra support when I leave the ward. They want to work with the NHS and refer me to the CHMT. Dr G says I need regular support. She says in the past the NHS trust I come under has been good when she’s had to work with them, so fingers crossed. Also, she wants to refer me for some long term psychodynamic therapy which could be interesting. It’s assuring that she is thinking about what I need after the ward this time.

I had some upsetting news today. Someone that was in when I was here the first time died last week of alcohol poisoning. She just couldn’t stay off the drink even with the help here. It’s sad. I hate that I’m jealous of her, which feels disrespectful, but I can’t help it. I still wish I was dead. I wish it was me, not her. I hate this world. It’s too unfair.

Written by intothesystem

Thursday, 9th April 2009 at 9:57 pm