Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Saturday, November 21, 2009

Locked Up, Day Seven

Day Seven started rudely. I fell asleep somewhere around 9:30 or 10:00 Saturday night. I was still holding a book and sitting up and the light was on, but all that medication really hit and I fell very sound asleep. It was unpleasant then when at midnight I was awakened and told that I couldn't have anything to eat or drink until blood was drawn in the morning. I have no idea why nobody would have told me that at say, 9:00 med pass. That night was the time change, and so instead of waking at my usual 5 (not that I start every day then, but I do start or completely wake up then), I was awake at 4, trying to force myself to sleep so I wouldn't think of how much I wanted water. Finally the nurse brought my thyroid med in and told me I could have water. I was pretty frustrated. First, drinking is really important with lithium and the kidney problem I have. Second, I'm thirsty ALL the time from meds. Third, it was the first time anyone told me what a test was or why it was done. I'm an adult, a competent adult, whether I'm on a psych unit or not, and I think the staff was disrespectful when they drew blood and did EKGs and on and on without telling us anything.

Eventually (and of course later than any other day blood was taken), the plebotomist (thankfully not the one who made a crazy joke on the psych unit) came and took my blood. Unfortunately she didn't put the pressure dressing on correctly and well, there was a messy incident.

I then went through a mess with meds that was ridiculous. I take a med called Nuvigil. It boosts my antidepressant and helps me wake up. It's a new version of an old med called Provigil. When I talked to admitting before I went to the hospital they said to bring med bottles so they could verify that things were written as I said. What they didn't tell me was that they'd also use my meds if they needed to. And with Nuvigil knowing that turned into a $450 loss on my part. What happened was that I only had about 5 when I went in. I didn't worry about calling Dr. Brain to be sure she'd gotten my insurance approval for me because I knew I'd see her within a few days of getting out and I'd be fine on those 5 until then. So I ran out, the hospital had none, and they seemed to have no clue what to do. Finally I gave them a script I had from Provigil that I still had in my purse and hours later I got a dose of that, which I think caused the hypomania we'll talk about tomorrow. (The reason this cost me $450 is that after discharge I had to get something and without prior authorization I had to pay. The hospital sent home a Provigil script which I also didn't have prior auth. for so I paid $136 for 10 pills, just so I had something. Some of the $450 I may be able to get back. A lot, probably not.)

Sunday was mostly a repeat of Saturday. Same awful group. I'm a Christian and I am a big advocate for Christian therapy and the role of faith in healing, but I was pretty upset about this group because she made it far too faith based. I felt that the psych unit, a place where people are so easily influenced, is not a place to talk about your specific beliefs. (Hers and mine weren't the same, but even if they were I wouldn't have thought it appropriate. Religious thoughts can be very distressing to some mentally ill people, and very confusing. Plus, that's a time you need to believe what you believe and be left to it.) Partly I feel like this because I know that I felt so confused and odd during some of that time that if someone had tried to teach me to follow the tenets of the Mayan faith (random example) I might have, despite that not being my belief system when well. I still have to talk to Dr. Mind about this part; we're approaching it but it's hard for me to say.

I again made a collage all afternoon, wearing my sound blockers. Being out was so exhausting. I wrote quite a bit that day about how I was so unsure I would be able to handle my noisy job in only 2 weeks.

I wound up napping that afternoon and a nurse had to wake me to eat. I shouldn't have bothered. Despite my doctor's attempts to help the diet, I was given 2 grilled cheese sandwiches that day, one for lunch and one for dinner. And I most certainly did not order two of them. I had been given a choice of broccoli, which is not on the MAOI diet but was listed as a thing I couldn't have on my card. I really wanted that broccoli. And they didn't give it to me. Nor did I get another food item. So I had an applesauce from the snacks, and spent another bit of my life very upset about this. Now that I'm home I'm still having a hard time figuring out what I can/want to eat. I still have a pretty limited number of things I'll eat, I just have figured out what I can eat that will supplement the calories a little on a day I'm not hungry, like today. I've also figured out some combinations that help, like egg beaters with a little breakfast sausage (can't have other sausage) and some safe cheese. I eat that a lot and it's got plenty of protein at least. Dr. Mind told me today that this symptom may hang on for a while. If it does I truly blame it on the hospital. I was ready for the diet. I was not ready to have a random set of restrictions even my doctor said I didn't need enforced. I was not ready to have every food that I might eat taken away from me immediately after being scolded for not eating. And I'm even more angry that I didn't get a dietary consult about the diet after requesting it, because now it's going to cost me $.

So dinner made me cry. Sunday was a harder day for me. A lot of people thought they might be going home Monday and I wasn't going to be going until Wed. or Thursday. I was a bit afraid of being alone, or being there alone with this one patient who....I don't want to say much about other patients......let's just say the high functioning unit was a stretch for her and if you want to know why I had a hard time look up "learned helplessness" and then consider she wouldn't sit near me at meals because with my special diet she couldn't copy my choices. Or the time I took a shower after her and had to spend 10 minutes cleaning up her dirty washclothes, dirty towels, the bottle of soap she'd spilled all over the clean linens, and her slowing spilling tipped shampoo bottle. That was not when I exactly felt like taking care of other people........

I was really surprised still at that point by how emotional I was. The crying about dinner (again) wasn't like me. The inability to accept that my diet was really screwed up and that what I was trying to fix that was ineffective was too much for me to accept. I also cried when I found a hair from my cat on my pants.

I worked more that day on being ready to leave. I called Walgreens and asked them to have patches available and was reassured they would. I asked the nurse for the tiny amount of guidance of what to do if a patch fell off. That answer was all the training I got in patch care and it's what I blame for my experimenting in treatments for broken out areas. (I know I'm obsessing about this, but the thing is that if an area breaks out I obviously can't patch it again until it heals. But what I learned last week is that I also need to avoid the area around that red area. And that gets tricky. On the other hand, I mixed up something that I think might actually be helping the hives even, and if it's better in the morning I'll mix up a good size batch and maybe that will help).

I had a lot of anxiety about when I was leaving. I'd been told anywhere from Tuesday to Friday. At that point Tuesday had been mentioned as hopeful. But I felt that it would be better to return to a support system, which meant either being scheduled for Dr. Brain the day after discharge, which wasn't ideal since it's a 2 hour drive each way, or going home Wed. to see Dr. Mind on Thursday. I was very worried about the fact that 2 days before I'd felt impulsive enough about hurting myself that I had to get rid of the one thing in my possession that might hurt me (paperclip).

This was also the first day my notes really complain about being there. I will discuss this a lot as time goes on (and may have some already), but I needed to be there. There is no doubt about that, and I got there just in time. They did what I was there for and I'm better and I was kept safe and mostly they were kind. It was certainly a better place for me than a general psych unit. However, for a unit set up for bipolar and depressed patients only, it wasn't all that appropriate for me. I was the only bipolar patient, and aside from my meds being different, nobody treated me differently. Nobody considered that my issues might differ a bit and if I tried to express that usually I was discounted. I also did not need to learn huge amounts about depression. For one thing, after as many years of therapy as I've had (ignoring my degrees and profession) I've been through this. For another depression is not the worst part of my illness and nobody ever talked about that part. This is where I am very bitter that I did not have anyone to talk to individually. I felt that a lot of it was very boring (partly it was because it was done in a way that did not help 6 severely depressed patients focus on the topic so nothing was ever connected nor was it enough sharing that we could help/learn from one another). I also felt a lot of groups were condescending, like "ok, this thing I downloaded from the internet says you all feel ______ and this is how you fix that". We might have been hospitalized but I think most of us could verbalize about how we felt about some topic all by ourselves. Generally I didn't feel anything like they said I should. Which was infuriating by the end. My final annoyance about groups was because the nurse I disliked, who was responsbile for the worst, internet based groups, felt that she could compare her frustration about having to go outside to smoke in the rain because of the law to our feelings about being trapped in various situations. You simply don't complain to a bunch of people who are locked up, missing the last week of fall weather and pretty leaves, about not enjoying your time outside. Thanks to the way the windows had heavy mesh on them, then blinds that nobody could control, we couldn't even see outside much of the time.

I had a long talk in the evening with another patient, the one I liked the most and who I was most upset about leaving on Monday. He was new to all this, so he had a lot of questions for me about my experiences, etc. He also told me how much better I looked that day, so much less haunted. That was such a good word for how I had looked. I literally was afraid to see myself for the first 4 days because the look in my eyes was bad. If Dr. Mind had seen me look that way he would have had me inpatient without hearing one word. I was so glad to find out that a lot of my frustrations weren't just me, including this nurse I really disliked (more on her eventually too).

That was a lot of writing. I think that shows how much better I felt; I could analyze the day and how I felt. Finally. I also was conversing by then, which was a big deal. I still don't feel like I can have any conversation I might want to because saying things isn't always easy. But that's just the thing where this takes more than 3 days.

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