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

Tuesday, April 27, 2010

One Big step back. Kinda.

Last week I realized that the denials I was getting from my insurance might have something to do with my increase to 2 visits/week with Dr. Mind when the most recent treatment plan submitted said that I was doing fabulous. In fact he was a bit nervous about whether they'd continue visits at all because I was functioning so normally that he couldn't make anything even sound like a big problem. So the whole basis of continuing at that point was to allow me to continue to maintain function and provide support and further coping skills.

Well, things are different now. So we decided he should send in a new one. Today he told me about it. Maybe more than I wanted to know. I just am admitting to myself that there is a lot of depression here; he has known this. I was in the moderate to moderate/severe range for everything, and most telling is that my goals have returned to what they were when I came home from the hospital in November.

There is a scale they use to show how someone is doing called the GAF (Global Assessment of Functioning) Score. Generally the highest score someone has had in the last year is given along with the current score. Just before I went into the hospital he did a score that was so low that he had to pull out the book because he uses scores that low so rarely he couldn't easily remember the criteria. At that time I was at a 32. In the hospital I went more like 20. But a few months ago I was at 82 or somewhere around there. We had a big celebration of that, because that score is NORMAL, further emphasizing my diagnosis at that time of remission, something we'd been waiting to say for years. Well, my score now is 52 and he wrote in the report "and falling".

I knew that I was not well. This tells me nothing I didn't know. I like the quantifiers because it lets me know that I'm not exaggerating in what I think,which is why he tells me. (Remember that I'm currently trying to learn to believe my own assessment of pain and other negative emotions).

But I'm halfway to the worst place ever. And there is a HUGE difference between those 2 things and I'm not going to get that bad and safety nets are in place to help. But I hate so much to know that this is real, that I'm NOT making it up. (There is a certain advantage to being able to deny pain to the extent I learned as a child).

I've been so much worse than this. But I've also been better, and watching my brain try to cope with the messed up chemistry is not pleasant. I have to tell Dr. Mind this still and will Thursday, but over the last couple of days the "this is not worth living this way" thinking has started. While not suicidal if we don't talk about it it will be. (Plus the best way to make him mad is to not admit those thoughts immediately; I really haven't only because they were not all that clear until today).

I feel like a grab bag of stress. Anything that comes out of me seems to be yet another thing I'm stressed about. And the full moon and a lot of time with patients with dementia who were all reacting to this did NOT help that at all. (I had 3 in a row who were teary, angry, sarcastic, impossible to calm, etc). It was weird.

Time to sleep now. It wasn't the easiest day. That's why I hate seeing him on lunch break; more to carry around the rest of the day. On the other hand I need to just be grateful because in a couple more weeks if I see him twice a week it will include a late at night appt. Which is hard too.

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