Posts Tagged ‘notes’
A Second Opinion…
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…
Bad to Worse…
Last week was tough. I went from bad to worse and the end of the week included a visit to my consultant and a review with my key worker. Both events were guaranteed to increase my anxiety and make things worse.
I saw Dr G on Thursday lunchtime. I’d written some notes beforehand as I am fed up the anxiety that ruins every appointment. I arrive at her office and anxiety grabs me around the throat and renders me speechless. My chest is pummelled by fear and I find myself gasping for breath and flailing hopelessly. She speed-read my notes, punctuated with sharp intakes of breath every few sentences. I hate that waiting whilst she is reading my words, reading my mind. I glance around her consulting rooms looking for things to distract myself with. Reading the titles on her bookshelves. Staring out of the window. Avoiding her eyes.
When she’d finished, she turned to me. As always, she took medication first. She upped my Topiramate. 50mg in the morning and 25mg at night now. No surprises there. I had expected my Venlafaxine to finally get the increase she has been promising since November, but still she holds off.
She suggested that suicidal ideation for me has become an almost habitual response to my depression. She suggested that I use it as a coping mechanism, like a pressure valve, that if things are getting too much I begin to think of ways to release it and suicidal thinking gives me that. I don’t know how I feel about her suggestion. To a certain degree she may be right, but I feel she almost trivialises it. I found myself almost wanting to prove to her that I was more serious than that. I know how screwed up that sounds, but I know I’m not exactly thinking straight at the moment anyway. I do wonder when the pressure will push the valve though. One day it might just give.
We talked about work. It seems Dr G thinks I should take a slow approach to returning. Just dip my toe in, by getting in touch with some work colleagues and finding out what’s going on from those on the ground. I guess we’ll see about that. I’m not sure who I’d see. My closest work friends have transferred office or been made voluntarily redundant. I don’t know.
Other than that I can’t remember much. Dr G seemed pretty keen for my one-to-ones to start. She seems to pinning all hopes of recovery on them and thinks they may fill the gaps in my treatment.
After groups on Thursday I saw my keyworker for my review. She had some beck inventories for me to fill in. Both anxiety and depression. I think the anxiety was okay, but my depression scores must have been through the roof. I had no idea what to put on my review form. It asked if you felt worse or better than you did 4 weeks ago. I feel so much worse I cannot describe it. I can’t even remember what it felt like 4 weeks ago. I just know it was better than this.
Friday was more of the same. Therapists seemed concerned about me. They kept asking me if there was anything that had triggered the relapse. If there was anything that had made my mood drop. I don’t know. I don’t really know why I am here again. I just know it isn’t fun. I am frustrated of course. I am always frustrated.
This weekend has been okay though. I have just tried to forget the bad week and try to be normal whilst my bloke is around. It’s not been too bad, although last night I thought my head was going to run away, my thoughts were racing so much. I kept wanting to bash my head against my pillow because it was just driving me so mad. It often happens like that at night. My head feels like it is racing away and I cannot get a hold of it. I lose all concept of size and shape and it just feels so strange.
Tomorrow is another week. A week until I am 23. I cannot believe it is almost my birthday and I am not yet back at work. That is another reason that I feel I have failed. I expected to be back by now. The last thing I expected was to be in this place again. I hate it.
I have to try and see my GP tomorrow. More medication. All I ever do is collect prescriptions and pills. I’m fed up of it.
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.
Into the system... 
