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

Monday, April 26, 2010

Powerful (Lost notes from the hospital recovery period)

I found a notebook today that I'd forgotten about. According to the angry first paragraph, apparently when I got home from the hospital and was so anxious (and it's no wonder I've been feeling scared that the anxiety now is the same; it is similar) Dr. Mind made me starting writing. I had to do it by hand, and in just a few days I filled most of a notebook. I kind of remember that now, mainly I remember writing about 15 pages in 2 days and then giving it to him to read saying "you asked for this". At first it was an outlet for the anger of my hospitalization and various things that happened. Eventually it became just another place to "talk". (If you weren't around and haven't read about my hospitalization check late October through December; late Oct. through Nov. is written from the hospital or pieced together by the wonderful Julia from hospital emails, and the next weeks are analyzing what happened there.)

One of the things in there is a list titled "I expected". I imagine this was written per Dr. Mind's instructions, because one of the things I had to deal with was that very few of my expectations were met. Here is some of what that list includes (and lest some of this seems unrealistic, please note that there were never more than 6 patients and there were usually 2 nurses, a tech, various support staff, a social worker, art therapists, and random other people running around. They were NOT overburdened):

-To see a doctor on the day of admission
-To have a med change before day 3
-To be called by the name I use (I use Jen. They insisted on Jennifer. Even my primary nurses day after day after day, despite corrections, insisted on Jennifer. It did not make me feel at home)
-To sleep if given a hefty sedative, or at least to be asked if I wanted the sedative knowing I had to stay awake
-For people to read my chart enough to know I did not stop my meds
-To not have my diet drastically changed without my knowledge
-To receive explanations of said changes
-To be told why tests were done and what tests were being done
-To be told test results
-To have some med to help calm me readily available in an emergency
-To have treatment individualized to my needs, beyond med management
-To have staff educate me on how to apply the patch, what to do to care for my skin, the dietary restrictions, and the other restrictions that go with an MAOI
-To have someone to talk to for more than my quick MD visits about how I was feeling
-For groups to be more interactive than 4th grade
-For groups to vary, especially if they were labeled something like activities, from the same old read to us/lecture us/semi-discuss maybe format. There was not one time anyone addressed simple leisure skills, something I really needed by the time I got home.
-For more groups to be applicable, to have at least 3 groups in 9 days that were not things I had extensively covered in therapy before
-To not be treated as another depression patient when I am NOT a depression patient
-I had written elsewhere about how frustrating it was that "the only time I heard that word [bipolar] it was from me, and it didn't make things more applicable. Being told "don't focus on how you feel" for a depressed patient is very different than "Monitor your moods" which I need to do as a bipolar patient. I was actually told NOT to do what is most important for my staying well, because I wasn't recognized as having a different disease.
-For paraprofessional staff to be trained to get help instead of offering to tell a very suicidal, sobbing, shaking, unable to move because they are crying so hard patient a joke. Not only did he not respond, he did not even check on me for another hour. Finally I wandered around until I found a nurse and sobbed "I...can't....stop....crying!!!!!!!!!", and then later was (gently, this was a good nurse) told to seek help sooner next time. I had and couldn't find anyone, and that was after I'd assumed the tech was going to mention to someone that I was having a total meltdown.
-That when I left the hospital without a doctor a contingency plan should have been in place. Thank God my doctor was able to handle what came up until the day before Dr. Brain was back, but if I had gotten sick and developed a rash a week sooner I could have wound up back in the hospital because he was not comfortable re-starting the patch under those circumstances.
-Rather than reading aloud 101 stress reduction strategies to us, trying some. (One was "build a paper airplane." So have us do that.)
-From the unit brochure "we work together with each patient to develop an individualized plan that serves a motivator and advocate in this journey"
-My apparent plan, which I did not participate in: "Change meds. Offer sedation. Go to groups, relevant or not. Take away the only foods I could eat without explanation. Force participation after giving PM meds 2 hours early. Ignore patient when she says she feels you punished her for doing what she was taught to do by her treatment team."
-Stupid sentimental poems and sayings are just more depressing.
-Huge handouts that are read to you and "discussed" (ie lectured on) for 60+ minutes at bedtime are a form of torture.

Seen from a distance I really was making sense......


Jean Grey said...

Unfortunately, I'd say your expectations were a little naive. The groups are mostly useless, especially if you have a brain and have had any previous therapy. Many of the techs are pretty useless too. You really have to ask for help- unless you are really acting out, it usually isn't going to be offered to you. And in the hospital, you loose a lot of power if you don't fight for it- which can be hard to do when you there for depression. I'm there to be safe and to get medicated, basic survival. But then, I tend to be very "non-compliant" in the hospital in terms of going to groups- unless I get really bored! Or if the OT makes me feel really sorry for her...

Just Me said...

If I had been on a regular unit I would agree with you. But I did not walk into this naively. I was on a specialized unit you have to qualify for, and my doctor (who works on that unit) had described what typically is going on. Unfortunately I happened to be there with a mix of people that meant it was one of the lower run times; apparently typically it is more useful but it can just depend on who is there with you. I was there with 6 people. 4 of us, including me, were incredibly sick. The other 2 were not terribly sick. However, I believe I was the only one who had things in place like a therapist and I was by far the veteran of mental health services. That's just how it worked out. Next time hopefully it will be different.