Any advice from "more experienced" women appreciated.......
So I seem to be entering the beginning of perimenopause. I thought that was a ways off and when things started to change several months ago I ignored it. Until my mom mentioned out of the blue that it started for her around my age; I think we were discussing fertility and whether my sister would have more kids. She is 32; I'm 35 (more or less for both of us). This last period was so different that I would have wondered regardless. So I'm tracking and will schedule a gynecological visit for a few months from now to see what she thinks. From what I read your mother's age is a good guide and my mom says what I'm experiencing sounds like it is starting. (Perfectly the same periods suddenly are......exciting. And my list for Target includes things I've never thought of needing, like overnight and heavy day pads. I've been that lucky woman who never had more than a moderate one day, so I've never needed such things. I see it is now time for multicolored protection.
The funny this is that I JUST had an argument with Dr. Mind about this. I tried to tell him that women in my family experience this early and that it may be an issue at some point that is worth considering rather than "so far off you shouldn't think about it", as menopause can wreak havoc with bipolar women. It is possible that this has been some of my insane anxiety of late. I'll talk to Dr. Brain about this soon as an "I think" and get lots of information. I kind of just view it as a closure, the last sign that I am right about not having children. And also a sign that if I am right (and that's part of why I'll see my gynecologist) that my sister needs to know because it may affect her plans regarding future children.
Among the many weird changes is that I keep getting heat rash under my underwires around my period. I just took my tank top out of my suitcase the other day and today had to go buy another one. I have to wear them under my bras until the rash heals. Granted, it's insanely hot and I was in a place where I baked today, but the rash started before that. Unfortunately the best treatment is no bra for a few days and that isn't happening for a few more days.
Also, just because I want to complain, I'm in the motel tonight and stuck between loud TV room (often a problem as the TVs are wall mounted and the walls are thin) and loud people. I think I'm going to have to turn the fan on the AC on full-time so I can try to sleep as I'm TIRED. Ugh.
Tomorrow I will have happy news of some kind. Lots of complaining lately it seems. Sorry. this is what heat reduces me to: a whiny, sleepy, sweaty blob. And it has been so hot for so long..........
Wednesday, August 11, 2010
Thinking things through
I don't know how much of this I've written about here, but I need to clarify for myself what I need to tell Dr. Body tomorrow and this is my best thinking place. So, my doctor problem.
I know I've mentioned the basics: we weren't allowed to complain, particularly of pain, and so I learned to never ever complain. What I've not explained is the consequences of this.
As a kid we very rarely were taken to the doctor. Well, my sister was because she had allergies with frequent pneumonia, but I remember going to the doctor sick about 4 times as a child and one of those times was because I had a rash from being allergic to new carpet and was sent home from school until it was evaluated. Another time was scarlet fever. I was taken once soon after my grandfather died because of horrible stomach aches that I had for some time, and once for what was really depression but the doctor did not use that word or treat me for it, although he pretty much said that was what it was to me alone, then he gave my father some load of crap. I was taken to the ER at age 6 after falling and spraining my wrist and moaning much of the night in my sleep, waking my parents up. Otherwise I have several scars from wounds that weren't stitched, an ankle and knee that are destroyed from not being properly treated for injuries (all based upon that stupid ankle fracture), and memories of never, ever being home sick from school because we had to be extremely ill to stay home, generally vomiting. I also have a memory of vomiting all over my phonics workbook, desk, and everything around me in 2nd grade, and even worse vomiting all over the cafeteria as a 6th grader. Horrible.
I have a finger that was broken when my father threw a softball way too hard for my just-learning-to-use-a-glove self and I was not treated nor allowed to complain. It was splinted, again because the school nurse said so, but even then I was told when I complained that if I kept complaining that the doctor would take me to surgery and break it again with a hammer. Didn't complain about that again.
When I was 18 and needed my college physical I didn't want to see the doctor (not a pediatrician where we lived) who I'd always seen because I did not like him. (No wonder given he could have hospitalized me with depression and instead went with what my father wanted to hear, so I lived with depression for years longer). The doctor I picked had "never heard of" a tetanus shot allergy, but since my shot records clearly showed I'd been vaccinated in half doses since my first tetanus injection he went with it. I swelled hugely and when I went back in 2 weeks for the other half they were shocked to see how swollen I still was. I was given the other dose, but made to sit and be monitored for an hour (great fun for the child I was babysitting) because suddenly "this is a serious allergy". I told him.......After that I was told no more tetanus boosters, only give if clearly needed and only in an emergency room. That was probably the first time as a young adult I understated.
In college I got sick my freshman year and ended my 10 year no-antibiotic streak. After that I don't remember getting sick all that often in college, just colds, although I do remember having a stomach flu my junior year that quite literally floored me. I was so sick I fainted in the bathroom in the middle of the night. I never saw a doctor because I was too sick to walk to the health center. At the beginning of my senior year I did go to the dr. with depression after I finally gave up on my lengthy fight to not take antidepressants. I understated things and wound up with xanax to help me sleep. I knew this was wrong and did argue that I'd been referred for antidepressants, but they lied and said they'd check with the psychologist so I took the xanax and wound up knocked totally out. The next time I went to the dr. for antidepressants I had a specific letter from the psychologist about antidepressants. On the other hand, I never called the psychologist to question things for an entire week.
Over the next several years I dealt with doctors regarding antidepressants. Aside from needing pushed to go and complain that one wasn't working (or that it had made me lose 20 lbs in 6 weeks, or that I couldn't sleep AT.ALL or or or) I reached the point where I was almost psychotically fearful of doctors. I dreaded going to them. I worked horribly sick many times. I took my first 2 sick days after about a year of working and that was because of my so-called friend saying I was possessed etc. and I couldn't quit crying and therefore could not work. Any other time I'd been off sick, which I remember only happening once when I was vomiting, and I worked on the weekend to make it up. I had a friend/mentor/voice of reason who would pester me about going to the doctor. Generally after about 2 weeks of incessant "go to the doctor" about 33% of the time I went. When I finally became so clearly out of control that I needed a psychiatrist I did do that without arguing, more or less, but I also didn't argue with her no matter what stupid things she did. When I spent those 2 days crying I had to be pushed and pushed to call her and even then she just started me on ativan over the phone. So many times she could have diagnosed the bipolar and she didn't see me or spent 5 minutes with me and didn't try to get the whole story out. I do not really remember how I managed to find the Guru who finally really diagnosed me (we knew but he was the doctor) and there was a lot of stuff that went into begging to be seen and ultimately I was leapfrogged over a months long waiting list because I really needed to be hospitalized but did not have insurance for psych stays. The clinical trial was ideal for me because I had no choice but to see the doctor every 2 weeks for 6 months. Even then I had to be more or less forced to add a med to control the severe tremors I had on high dose lithium because I didn't want "more meds". By the end of the trial I finally was a bit better about at least talking to doctors about psych needs. Then I started with Dr. Brain and she rapidly won my trust, so that part was actually somewhat easy. I still had to be pushed to call her with problems, but I began to learn, and based on the clinical trial recommendations I didn't start with her until she was able to commit to seeing me for a monthly visit. I've never been stable enough to move away from that. I'm fine at telling her about problems now, but it took a long time to achieve that trust, and if I didn't see her so often I wouldn't be as good. That's also an issue with Dr. Mind; we can't manage cutting back to less than weekly because I don't handle it well. For now it's just not even something we discuss.
Medical doctors lost my trust totally though along the bipolar path. I had a doctor I liked in the city, but he couldn't easily be my doctor after I moved away. He also lost a lot of my respect when he and his secretary were making very inappropriate racist jokes about Muslims following 9/11, and again when he was upset he wasn't consulted when I went to a psychiatrist and also that HE wouldn't have me on an addictive med (ativan). By that point I'd been through the clinical trial and was seeing Dr Brain and was pretty certain that the benzo was quite appropriate for me, and as it turns out I've been on benzos nearly 8 years, have seen and also had my case reviewed by several of the top experts in bipolar in the world, and everyone has agreed I need the benzos and in generally they have readily increased them, even these last months when I've been on at monster dose of klonopin.
For 2 or 3 years after moving to where I live now I floundered. I couldn't find a doctor who would accept me and my psych meds as well as my insurance. I literally was rejected by doctors before they met me on the basis of my psych meds. So I used urgent care as my doctor. Urgent care doesn't like that much.......Eventually I started seeing a doctor where I worked. He was horrid. He was afraid of my psych meds (which were not nearly as scary as now), so he avoided treating nearly everything possible. I had infected cold sores on both sides of my mouth for 6 months. I am extra-susceptible to cold sores because of an accidental exposure that caused me to get herpes on my thumb and he agreed that's what they were and even gave me a 3 day course of valtrex, but when that didn't work he pretty much refused to treat it. After a very long time Dr. Brain got so fed up that she wrote for a month of valtrex and finally I no longer had ugly sores on my face. He refused to believe a healthcare professional could be bipolar, so even when I'd be wearing a name tag with MS OTRL on it he would call me a nursing assistant over and over. And then he wound up making me so mad I complained to the medical board. He said I couldn't take some antibiotic with depakote. Fine. So he gave me something else that had no chance of working against a sinus infection (I know now), and when I was still sick when that ended and called in he didn't see me but prescribed the med he said I couldn't take. I had to call and have another doctor give me something else. This was repeated 2 weeks later. So I reported him and he underwent a year long investigation that ultimately cleared him but certainly stressed him out and I hope made him think twice about that kind of crap. That put me back to urgent care alone, and urgent care doctors are hopeless with my restrictions. I've had to tell more than one to go and look lithium up in the PDR and come back when they had thoroughly read the interactions. I've been accused of drug-seeking because I am allergic to codeine and they won't believe I can't take ibuproferon. It's possible not everyone on lithium has the ibuproferon rule enforced, but it is an interaction and for me it is an issue because first I was on very high levels (my ideal level was just below toxic) and so anything that raised my level was out, and then after that I got toxic easily so raising my levels again was/is bad. I also had multiple fights over things like not being allowed cold meds.
I also had bad experiences with emergency rooms. One of them didn't admit they couldn't run a lithium level so they made me wait 4 hours while they took the blood to the city to run it and then got the results, and in the meantime rather than testing for anything else they needed to all they did was drug test (thoroughly) and do a pregnancy test. They then realized that my lithium level didn't tell them anything since it was 24 hours after I'd had a dose and the level was useless. Another ER was very angry that I requested a lithium level be done, depsite my having symptoms of toxicity and this is standard when any symptoms are present, especially in the summer on someone on a high dose. When we went to that ER I told my mother who went with me to be prepared to see me act not nice because they'd treat me like crap. She was horrified by the end, which culminated in my telling a nurse (an LPN with 1 year of training versus my master's degree) off because he basically told me I was too dumb to know what a part of the kidney he was referring to (loop of Henle) was. I told him "given I have a degree in biology and a master's in a healthcare profession I think I do actually know that". He then was snotty back. I was at that ER with a blood pressure of 200/100, severe headache (duh) and very, very swollen legs and feet. When I wouldn't take lasix (contraindicated with lithium) without speaking to a dr they marked I refused treatment and didn't give it to me until I demanded it 2 hours later, after being snotty about my coming in and then refusing care. I didn't refuse care, I asked to speak to a doctor. They also tried to tell me that my BP and swelling were NORMAL. Again, Dr. Brain wound up having to treat this, but I did agree to find a primary care doctor.
I spent part of a vacation on this and Dr. Body was the result. He agreed to my stipulations that while I know he's a doctor I have many allergies/interactions and therefore all meds must be individually looked up before I will take them, and Dr. Brain is in charge overall and if she says she doesn't want me taking something she wins, and that I expect her to be consulted in any situation regarding psych meds, particularly since she is very aware of my situation and will respond to emergency calls about me quickly. He agreed,months but had no doctor), and then began the process for him of learning to trust me. It took a little bit before he moved past misconceptions, but when he did he bought 100% into my treatment plan and needs. And he has let me learn to trust him far more than any other primary care doctor.
Our problem now is that I have to start trusting him with things I've never needed to trust him with before, and it scares me. He's treated me for years for various things, and he has even managed my psych meds for a month when Dr. Brain was sick after I got out of the hospital last year. He single-handedly caught and then researched and found treatment for me when my diabetes insipidus was new, and that is not usually caught just by looking at someone, as he did. He also worked very hard to coordinate a way for me to stay on lithium, found a doctor willing to work with that, and then after 2 years took over the care himself because the nephrologist was not very useful. Since very few people with DI are allowed to stay on lithium, doing this was pretty impressive, but everyone involved agreed I needed to be on lithium. Until this last year though we've not dealt with pain or any of numerous things I haven't moved beyond. Since he hasn't even challenged me on things like allergies we've not had to deal with disagreements. In fact he has taught about me as an example of a clinically complex patient who is managed atypically by letting me participate in and guide my treatments and that just because someone is bipolar they are not incompetent.
I trust him. I just don't know how to complain well about certain things. I can moan on here because this is a safe thing and if you are mean to me I delete you. If he is mean or doesn't believe me (which he has never done but which I fear every time I mention pain or something that can't be seen) then I am stuck. And that is what this very long thing comes down to: I fear not being believed. I also fear that what I was taught as a child is true and that I would "make something up for attention". I don't know why, I know I wouldn't, but I still don't trust me, so I don't trust him.
And again this has clarified things for me. Thank you.
I know I've mentioned the basics: we weren't allowed to complain, particularly of pain, and so I learned to never ever complain. What I've not explained is the consequences of this.
As a kid we very rarely were taken to the doctor. Well, my sister was because she had allergies with frequent pneumonia, but I remember going to the doctor sick about 4 times as a child and one of those times was because I had a rash from being allergic to new carpet and was sent home from school until it was evaluated. Another time was scarlet fever. I was taken once soon after my grandfather died because of horrible stomach aches that I had for some time, and once for what was really depression but the doctor did not use that word or treat me for it, although he pretty much said that was what it was to me alone, then he gave my father some load of crap. I was taken to the ER at age 6 after falling and spraining my wrist and moaning much of the night in my sleep, waking my parents up. Otherwise I have several scars from wounds that weren't stitched, an ankle and knee that are destroyed from not being properly treated for injuries (all based upon that stupid ankle fracture), and memories of never, ever being home sick from school because we had to be extremely ill to stay home, generally vomiting. I also have a memory of vomiting all over my phonics workbook, desk, and everything around me in 2nd grade, and even worse vomiting all over the cafeteria as a 6th grader. Horrible.
I have a finger that was broken when my father threw a softball way too hard for my just-learning-to-use-a-glove self and I was not treated nor allowed to complain. It was splinted, again because the school nurse said so, but even then I was told when I complained that if I kept complaining that the doctor would take me to surgery and break it again with a hammer. Didn't complain about that again.
When I was 18 and needed my college physical I didn't want to see the doctor (not a pediatrician where we lived) who I'd always seen because I did not like him. (No wonder given he could have hospitalized me with depression and instead went with what my father wanted to hear, so I lived with depression for years longer). The doctor I picked had "never heard of" a tetanus shot allergy, but since my shot records clearly showed I'd been vaccinated in half doses since my first tetanus injection he went with it. I swelled hugely and when I went back in 2 weeks for the other half they were shocked to see how swollen I still was. I was given the other dose, but made to sit and be monitored for an hour (great fun for the child I was babysitting) because suddenly "this is a serious allergy". I told him.......After that I was told no more tetanus boosters, only give if clearly needed and only in an emergency room. That was probably the first time as a young adult I understated.
In college I got sick my freshman year and ended my 10 year no-antibiotic streak. After that I don't remember getting sick all that often in college, just colds, although I do remember having a stomach flu my junior year that quite literally floored me. I was so sick I fainted in the bathroom in the middle of the night. I never saw a doctor because I was too sick to walk to the health center. At the beginning of my senior year I did go to the dr. with depression after I finally gave up on my lengthy fight to not take antidepressants. I understated things and wound up with xanax to help me sleep. I knew this was wrong and did argue that I'd been referred for antidepressants, but they lied and said they'd check with the psychologist so I took the xanax and wound up knocked totally out. The next time I went to the dr. for antidepressants I had a specific letter from the psychologist about antidepressants. On the other hand, I never called the psychologist to question things for an entire week.
Over the next several years I dealt with doctors regarding antidepressants. Aside from needing pushed to go and complain that one wasn't working (or that it had made me lose 20 lbs in 6 weeks, or that I couldn't sleep AT.ALL or or or) I reached the point where I was almost psychotically fearful of doctors. I dreaded going to them. I worked horribly sick many times. I took my first 2 sick days after about a year of working and that was because of my so-called friend saying I was possessed etc. and I couldn't quit crying and therefore could not work. Any other time I'd been off sick, which I remember only happening once when I was vomiting, and I worked on the weekend to make it up. I had a friend/mentor/voice of reason who would pester me about going to the doctor. Generally after about 2 weeks of incessant "go to the doctor" about 33% of the time I went. When I finally became so clearly out of control that I needed a psychiatrist I did do that without arguing, more or less, but I also didn't argue with her no matter what stupid things she did. When I spent those 2 days crying I had to be pushed and pushed to call her and even then she just started me on ativan over the phone. So many times she could have diagnosed the bipolar and she didn't see me or spent 5 minutes with me and didn't try to get the whole story out. I do not really remember how I managed to find the Guru who finally really diagnosed me (we knew but he was the doctor) and there was a lot of stuff that went into begging to be seen and ultimately I was leapfrogged over a months long waiting list because I really needed to be hospitalized but did not have insurance for psych stays. The clinical trial was ideal for me because I had no choice but to see the doctor every 2 weeks for 6 months. Even then I had to be more or less forced to add a med to control the severe tremors I had on high dose lithium because I didn't want "more meds". By the end of the trial I finally was a bit better about at least talking to doctors about psych needs. Then I started with Dr. Brain and she rapidly won my trust, so that part was actually somewhat easy. I still had to be pushed to call her with problems, but I began to learn, and based on the clinical trial recommendations I didn't start with her until she was able to commit to seeing me for a monthly visit. I've never been stable enough to move away from that. I'm fine at telling her about problems now, but it took a long time to achieve that trust, and if I didn't see her so often I wouldn't be as good. That's also an issue with Dr. Mind; we can't manage cutting back to less than weekly because I don't handle it well. For now it's just not even something we discuss.
Medical doctors lost my trust totally though along the bipolar path. I had a doctor I liked in the city, but he couldn't easily be my doctor after I moved away. He also lost a lot of my respect when he and his secretary were making very inappropriate racist jokes about Muslims following 9/11, and again when he was upset he wasn't consulted when I went to a psychiatrist and also that HE wouldn't have me on an addictive med (ativan). By that point I'd been through the clinical trial and was seeing Dr Brain and was pretty certain that the benzo was quite appropriate for me, and as it turns out I've been on benzos nearly 8 years, have seen and also had my case reviewed by several of the top experts in bipolar in the world, and everyone has agreed I need the benzos and in generally they have readily increased them, even these last months when I've been on at monster dose of klonopin.
For 2 or 3 years after moving to where I live now I floundered. I couldn't find a doctor who would accept me and my psych meds as well as my insurance. I literally was rejected by doctors before they met me on the basis of my psych meds. So I used urgent care as my doctor. Urgent care doesn't like that much.......Eventually I started seeing a doctor where I worked. He was horrid. He was afraid of my psych meds (which were not nearly as scary as now), so he avoided treating nearly everything possible. I had infected cold sores on both sides of my mouth for 6 months. I am extra-susceptible to cold sores because of an accidental exposure that caused me to get herpes on my thumb and he agreed that's what they were and even gave me a 3 day course of valtrex, but when that didn't work he pretty much refused to treat it. After a very long time Dr. Brain got so fed up that she wrote for a month of valtrex and finally I no longer had ugly sores on my face. He refused to believe a healthcare professional could be bipolar, so even when I'd be wearing a name tag with MS OTRL on it he would call me a nursing assistant over and over. And then he wound up making me so mad I complained to the medical board. He said I couldn't take some antibiotic with depakote. Fine. So he gave me something else that had no chance of working against a sinus infection (I know now), and when I was still sick when that ended and called in he didn't see me but prescribed the med he said I couldn't take. I had to call and have another doctor give me something else. This was repeated 2 weeks later. So I reported him and he underwent a year long investigation that ultimately cleared him but certainly stressed him out and I hope made him think twice about that kind of crap. That put me back to urgent care alone, and urgent care doctors are hopeless with my restrictions. I've had to tell more than one to go and look lithium up in the PDR and come back when they had thoroughly read the interactions. I've been accused of drug-seeking because I am allergic to codeine and they won't believe I can't take ibuproferon. It's possible not everyone on lithium has the ibuproferon rule enforced, but it is an interaction and for me it is an issue because first I was on very high levels (my ideal level was just below toxic) and so anything that raised my level was out, and then after that I got toxic easily so raising my levels again was/is bad. I also had multiple fights over things like not being allowed cold meds.
I also had bad experiences with emergency rooms. One of them didn't admit they couldn't run a lithium level so they made me wait 4 hours while they took the blood to the city to run it and then got the results, and in the meantime rather than testing for anything else they needed to all they did was drug test (thoroughly) and do a pregnancy test. They then realized that my lithium level didn't tell them anything since it was 24 hours after I'd had a dose and the level was useless. Another ER was very angry that I requested a lithium level be done, depsite my having symptoms of toxicity and this is standard when any symptoms are present, especially in the summer on someone on a high dose. When we went to that ER I told my mother who went with me to be prepared to see me act not nice because they'd treat me like crap. She was horrified by the end, which culminated in my telling a nurse (an LPN with 1 year of training versus my master's degree) off because he basically told me I was too dumb to know what a part of the kidney he was referring to (loop of Henle) was. I told him "given I have a degree in biology and a master's in a healthcare profession I think I do actually know that". He then was snotty back. I was at that ER with a blood pressure of 200/100, severe headache (duh) and very, very swollen legs and feet. When I wouldn't take lasix (contraindicated with lithium) without speaking to a dr they marked I refused treatment and didn't give it to me until I demanded it 2 hours later, after being snotty about my coming in and then refusing care. I didn't refuse care, I asked to speak to a doctor. They also tried to tell me that my BP and swelling were NORMAL. Again, Dr. Brain wound up having to treat this, but I did agree to find a primary care doctor.
I spent part of a vacation on this and Dr. Body was the result. He agreed to my stipulations that while I know he's a doctor I have many allergies/interactions and therefore all meds must be individually looked up before I will take them, and Dr. Brain is in charge overall and if she says she doesn't want me taking something she wins, and that I expect her to be consulted in any situation regarding psych meds, particularly since she is very aware of my situation and will respond to emergency calls about me quickly. He agreed,months but had no doctor), and then began the process for him of learning to trust me. It took a little bit before he moved past misconceptions, but when he did he bought 100% into my treatment plan and needs. And he has let me learn to trust him far more than any other primary care doctor.
Our problem now is that I have to start trusting him with things I've never needed to trust him with before, and it scares me. He's treated me for years for various things, and he has even managed my psych meds for a month when Dr. Brain was sick after I got out of the hospital last year. He single-handedly caught and then researched and found treatment for me when my diabetes insipidus was new, and that is not usually caught just by looking at someone, as he did. He also worked very hard to coordinate a way for me to stay on lithium, found a doctor willing to work with that, and then after 2 years took over the care himself because the nephrologist was not very useful. Since very few people with DI are allowed to stay on lithium, doing this was pretty impressive, but everyone involved agreed I needed to be on lithium. Until this last year though we've not dealt with pain or any of numerous things I haven't moved beyond. Since he hasn't even challenged me on things like allergies we've not had to deal with disagreements. In fact he has taught about me as an example of a clinically complex patient who is managed atypically by letting me participate in and guide my treatments and that just because someone is bipolar they are not incompetent.
I trust him. I just don't know how to complain well about certain things. I can moan on here because this is a safe thing and if you are mean to me I delete you. If he is mean or doesn't believe me (which he has never done but which I fear every time I mention pain or something that can't be seen) then I am stuck. And that is what this very long thing comes down to: I fear not being believed. I also fear that what I was taught as a child is true and that I would "make something up for attention". I don't know why, I know I wouldn't, but I still don't trust me, so I don't trust him.
And again this has clarified things for me. Thank you.
Heat
I've made it through this summer without heat really doing much damage. I think I've passed that point. After sleeping practically all weekend last night I fell asleep as soon as I got home about 6 pm. I didn't mean to, and I fully expected to wake up, but I didn't under the cat started attacking my foot every time I moved until I fed them, and then I still slept until about 5. I can't believe how exhausted I am. Some is because work has been intense and I'm tired from that, but really the last couple days have been nothing and the next few will be awful to make up for that. Yesterday I had a huge drive and then one of the 2 people I went to see would not see me, so I actually was done a bit early. Today I will be working as late as I possibly can.
I finally found my keys on the day I was going to give up. Apparently they were at the motel from last week all along and the person I talked to last Friday didn't look, or didn't know where to look or something. But they will get mailed today and I should have them soon. Hopefully tomorrow soon since I can't check my mail or get into the office after hours until I have them. I really wish that kid had given me the truthful answer last week since I could have had them back by Sunday and would have been saved so much stress. Oh well.
I suppose I should get ready for work. I really don't want to. So tired....I have Monday off but will be seeing the podiatrist,dentist, and Dr. Mind so some day off. I hope that it is extremely hot that day though so I can avoid one hot day this summer.
Tomorrow is tell Dr. Body the truth day. He'll be nice, but I still have looked forward to things more. Like my ankle surgery. I think I'd rather have that than do this. I feel stupid. I realize this is part of getting good healthcare with mental illness when I tell him how the mental illness affects things, but still.....I guess I need to just be grateful that I have Dr. Body who I know will be nice instead of one of the many doctors in my past who either wouldn't agree to have this appointment or who would brush me off or scold me. He'll do none of those things, he'll be kind and supportive and understanding. But I still feel like an idiot. And reciting, not an idiot, just signs of child abuse isn't helping all that much.
Now I really have to go.......
I finally found my keys on the day I was going to give up. Apparently they were at the motel from last week all along and the person I talked to last Friday didn't look, or didn't know where to look or something. But they will get mailed today and I should have them soon. Hopefully tomorrow soon since I can't check my mail or get into the office after hours until I have them. I really wish that kid had given me the truthful answer last week since I could have had them back by Sunday and would have been saved so much stress. Oh well.
I suppose I should get ready for work. I really don't want to. So tired....I have Monday off but will be seeing the podiatrist,dentist, and Dr. Mind so some day off. I hope that it is extremely hot that day though so I can avoid one hot day this summer.
Tomorrow is tell Dr. Body the truth day. He'll be nice, but I still have looked forward to things more. Like my ankle surgery. I think I'd rather have that than do this. I feel stupid. I realize this is part of getting good healthcare with mental illness when I tell him how the mental illness affects things, but still.....I guess I need to just be grateful that I have Dr. Body who I know will be nice instead of one of the many doctors in my past who either wouldn't agree to have this appointment or who would brush me off or scold me. He'll do none of those things, he'll be kind and supportive and understanding. But I still feel like an idiot. And reciting, not an idiot, just signs of child abuse isn't helping all that much.
Now I really have to go.......
Tuesday, August 10, 2010
Monumental
Today marks one year with the same employer. Which doesnt big, except that its been a while since I really hit that mark. In 2006 I changed employers after working for the same one almost 4 years. I think. 11 months later I went on disability for 4 months. I came back and put in my notice. So although timewise it was more than a year, it wasn't. Then I was fired 9 months into the last 2 jobs. So.......This is a big,big deal.
I'm beginning to think I am never not going to be tired. This work pace is murder. Today I have a little free time in the morning but Im still so incredibly tired that I don't want to sew or do anything. The heat is really getting to me this week as well, which is the real problem.
I have a day off next week but have to go to the podiatrist, dentist and Dr. Mind, so big deal. I tried to make my schedule a bit easier on myself but I did not succeed. Things all hang on this one woman who asked last week to move to this week, which is fine, but now they only have a few specific days we can see her and those days aren't good for me.
Anyway, I should do something.
I'm beginning to think I am never not going to be tired. This work pace is murder. Today I have a little free time in the morning but Im still so incredibly tired that I don't want to sew or do anything. The heat is really getting to me this week as well, which is the real problem.
I have a day off next week but have to go to the podiatrist, dentist and Dr. Mind, so big deal. I tried to make my schedule a bit easier on myself but I did not succeed. Things all hang on this one woman who asked last week to move to this week, which is fine, but now they only have a few specific days we can see her and those days aren't good for me.
Anyway, I should do something.
Monday, August 09, 2010
Anxiety
I woke up very, very, very anxious. I do not like this. And there is nothing I can do about it until I can get to work, see my schedule and get organized.
Blah.
Blah.
Sunday, August 08, 2010
My plans for this week
1) Work my butt off.
2) Scary Dr.Body appointment. Complete with another urine culture because I still have UTI symptoms and the last culture was negative but I'd also had several doses of antibiotic. So, this time a culture not involving masking. Unless the symptoms are totally gone by then, of course. Which is possible.
The reason this appointment is scary is that he doesn't know some things he needs to know. Things like I have a really hard time with pain and that I will lie, even mid-exam, if I think something shouldn't hurt that does. When I was there a few weeks ago with the possible kidney stone one of the things he did was push hard into the middle of my back. It hurt, quite a bit, but I thought "that's stupid, there's no way he's really checking anything except whether I'll say anything hurt". And it turns out that my lying then indicated one of the symptoms I did have wasn't there. Genius. Did this ultimately affect anything? Probably not, other than I might have qualified for pain meds or a more serious search into what pain meds I could have if I'd told the truth. But he hasn't dealt with me and pain quite so much and he needs to know that 1) my admitting something hurts badly means that I'm in a LOT of pain and 2) I lie about it. The dentist has made it known that I am not to be trusted as so he does things like if I says a tooth is sore he tests every single tooth around it because once I said a tooth was sore and he did what he typically does, which is test the one behind the sore one to compare the reactions and I about hit the ceiling. That led to the discovery of a deep cavity in the tooth I said hurt and a big crack in the one behind it. The filling of that crack had a 50-50 chance of needing a root canal/crown, and so I left knowing it would ache. I put up with it for several weeks before going back. The exam made me say ouch, but not in such a painful way that he thought it was anything at all. However, given the option of the root canal I'd more than likely need based on the ongoing achiness I went for it and it was so extremely infected that my dentist had to flush it with lidocaine solution to fully numb it and then sort of deep clean it. He said it was about 24 hours from sepsis. That resulted in a few things: 1) My dentist no longer believes me about pain. If I say something is sore he suspects "about to explode". My exams are done very carefully because he doesn't trust me. 2) I was given hefty doses of pain meds and antibiotics are ordered to bed for the day. 3) He confirmed what I had observed a long time ago with an independent observation that anti-psychotics (or the need to be treated with them) seem to dull pain awareness. 4)When combined with my experience with my ankle shredding last winter I finally came to understand how little i understand pain.
When talking to Dr. Mind about this a few weeks ago I said something about knowing that my lack of appropriately admitting pain probably led to some of the damage to my ankle. I hurt my ankle going to see Dr. Mind and so he was the one who was there when I bandaged my skinned knee and then pulled off my sock and shoe and saw the damage: a huge, purple lump surrounded by my whole foot swelling within minutes of the injury. I needed the session so we still talked as much as I could and watched in awe as the swelling got worse. By the end I couldn't put a shoe on, so Dr. Mind carries my shoes, coat and purse down the stairs and got me to the car. I drove to urgent care, hobbled in, accepted an ice pack, and was taken back quickly, meaning I triaged in rapidly. I proceeded to insist on walking and adamantly refused a wheelchair. When I mentioned this to Dr. Mind recently he was horrified. Apparently logic would say if it looks like that DON'T WALK ON IT". Again, I thought I was overreacting, and I think that was precisely what led to my leaving urgent care with no pain meds and then led to nobody really seeing how badly injured it was until I finally saw the podiatrist feeling absolutely stupid but unable to tolerate any more soreness in my other foot from limping. He saw the injury immediately upon having me stand in my bare feet so he could see how I stood on the sore foot. Even then I thought he was making the sprain into a big deal when it wasn't until he showed me xrays with angles drawn to show where my ankle should be and where it was. I feel fairly sure that there was a sequence of events that went like this: I insisted it didn't hurt. But then I refused the simple pain meds (motrin, tylenol 3) that urgent care offered and wanted something stronger (they didn't belive me about allergies and interactions) and so looked like I was drug-seeking. I was then up all night and so Dr. Body gave me pain meds from a fax requesting them since he knows this happens frequently. When I saw Dr. Body I remember him commenting about the severe bruising and that it was pretty bad if it went around my heel as it did, but he didn't have xrays and at most had the urgent care doctor's report and in it would be mainly freatured that I walked in, had no fracture, and refused tetanus shots and had some big huge story about needing emergency care, IVs, and specific meds available if given one. The urgent care doctor thought this was all drama, probably psychiatrically related, but in fact it is what Dr. Brain has said needs done if I have to have a tetansus shot because I am anaphylactically allergic and the meds needed to treat anaphylaxis are contraindicated with the MAOI and can kill me by causing a stroke. Therefore I would need the shot while hooked to an IV so if I had to have epinephrine they then could give meds to control my blood pressure rapidly. Urgent care doctor thought I was trying to avoid the shot. So anyway, Dr. Body was working from those notes and to my knowledge was not even made aware of the xray showing a previous fracture. So he too under-treated and didn't send me to a specialist. I think I fooled the PT as well, although there were weird things involved there so who knows. I know they thought it curious that I complained of pain in a 2nd area that hurt because of how badly things were torn, but they did not realize this.
So, anyway, essentially I have an appointment which I am paying out of pocket for so my insurance doesn't find another way to deny my psych visits in which I have to reveal that first, I am a liar, and second, that I have no idea how to tell when something really hurts or doesn't, that I never trust myself, and that if I am to function I need to know specifically how to know that something is wrong and that I need checked out, because if I am left with the impression that there isn't really anything wrong I will make myself crazy and I may need specific paramters that say "problem" versus "no big deal" I will turn that into echoes of my past.
This is not an easy discussion and I am not looking forward to it. Ugh.
2) Scary Dr.Body appointment. Complete with another urine culture because I still have UTI symptoms and the last culture was negative but I'd also had several doses of antibiotic. So, this time a culture not involving masking. Unless the symptoms are totally gone by then, of course. Which is possible.
The reason this appointment is scary is that he doesn't know some things he needs to know. Things like I have a really hard time with pain and that I will lie, even mid-exam, if I think something shouldn't hurt that does. When I was there a few weeks ago with the possible kidney stone one of the things he did was push hard into the middle of my back. It hurt, quite a bit, but I thought "that's stupid, there's no way he's really checking anything except whether I'll say anything hurt". And it turns out that my lying then indicated one of the symptoms I did have wasn't there. Genius. Did this ultimately affect anything? Probably not, other than I might have qualified for pain meds or a more serious search into what pain meds I could have if I'd told the truth. But he hasn't dealt with me and pain quite so much and he needs to know that 1) my admitting something hurts badly means that I'm in a LOT of pain and 2) I lie about it. The dentist has made it known that I am not to be trusted as so he does things like if I says a tooth is sore he tests every single tooth around it because once I said a tooth was sore and he did what he typically does, which is test the one behind the sore one to compare the reactions and I about hit the ceiling. That led to the discovery of a deep cavity in the tooth I said hurt and a big crack in the one behind it. The filling of that crack had a 50-50 chance of needing a root canal/crown, and so I left knowing it would ache. I put up with it for several weeks before going back. The exam made me say ouch, but not in such a painful way that he thought it was anything at all. However, given the option of the root canal I'd more than likely need based on the ongoing achiness I went for it and it was so extremely infected that my dentist had to flush it with lidocaine solution to fully numb it and then sort of deep clean it. He said it was about 24 hours from sepsis. That resulted in a few things: 1) My dentist no longer believes me about pain. If I say something is sore he suspects "about to explode". My exams are done very carefully because he doesn't trust me. 2) I was given hefty doses of pain meds and antibiotics are ordered to bed for the day. 3) He confirmed what I had observed a long time ago with an independent observation that anti-psychotics (or the need to be treated with them) seem to dull pain awareness. 4)When combined with my experience with my ankle shredding last winter I finally came to understand how little i understand pain.
When talking to Dr. Mind about this a few weeks ago I said something about knowing that my lack of appropriately admitting pain probably led to some of the damage to my ankle. I hurt my ankle going to see Dr. Mind and so he was the one who was there when I bandaged my skinned knee and then pulled off my sock and shoe and saw the damage: a huge, purple lump surrounded by my whole foot swelling within minutes of the injury. I needed the session so we still talked as much as I could and watched in awe as the swelling got worse. By the end I couldn't put a shoe on, so Dr. Mind carries my shoes, coat and purse down the stairs and got me to the car. I drove to urgent care, hobbled in, accepted an ice pack, and was taken back quickly, meaning I triaged in rapidly. I proceeded to insist on walking and adamantly refused a wheelchair. When I mentioned this to Dr. Mind recently he was horrified. Apparently logic would say if it looks like that DON'T WALK ON IT". Again, I thought I was overreacting, and I think that was precisely what led to my leaving urgent care with no pain meds and then led to nobody really seeing how badly injured it was until I finally saw the podiatrist feeling absolutely stupid but unable to tolerate any more soreness in my other foot from limping. He saw the injury immediately upon having me stand in my bare feet so he could see how I stood on the sore foot. Even then I thought he was making the sprain into a big deal when it wasn't until he showed me xrays with angles drawn to show where my ankle should be and where it was. I feel fairly sure that there was a sequence of events that went like this: I insisted it didn't hurt. But then I refused the simple pain meds (motrin, tylenol 3) that urgent care offered and wanted something stronger (they didn't belive me about allergies and interactions) and so looked like I was drug-seeking. I was then up all night and so Dr. Body gave me pain meds from a fax requesting them since he knows this happens frequently. When I saw Dr. Body I remember him commenting about the severe bruising and that it was pretty bad if it went around my heel as it did, but he didn't have xrays and at most had the urgent care doctor's report and in it would be mainly freatured that I walked in, had no fracture, and refused tetanus shots and had some big huge story about needing emergency care, IVs, and specific meds available if given one. The urgent care doctor thought this was all drama, probably psychiatrically related, but in fact it is what Dr. Brain has said needs done if I have to have a tetansus shot because I am anaphylactically allergic and the meds needed to treat anaphylaxis are contraindicated with the MAOI and can kill me by causing a stroke. Therefore I would need the shot while hooked to an IV so if I had to have epinephrine they then could give meds to control my blood pressure rapidly. Urgent care doctor thought I was trying to avoid the shot. So anyway, Dr. Body was working from those notes and to my knowledge was not even made aware of the xray showing a previous fracture. So he too under-treated and didn't send me to a specialist. I think I fooled the PT as well, although there were weird things involved there so who knows. I know they thought it curious that I complained of pain in a 2nd area that hurt because of how badly things were torn, but they did not realize this.
So, anyway, essentially I have an appointment which I am paying out of pocket for so my insurance doesn't find another way to deny my psych visits in which I have to reveal that first, I am a liar, and second, that I have no idea how to tell when something really hurts or doesn't, that I never trust myself, and that if I am to function I need to know specifically how to know that something is wrong and that I need checked out, because if I am left with the impression that there isn't really anything wrong I will make myself crazy and I may need specific paramters that say "problem" versus "no big deal" I will turn that into echoes of my past.
This is not an easy discussion and I am not looking forward to it. Ugh.
Its been forever
Last week was work, work, work, sleep, work. And this week will be about the same, so here's catch-up and I'll write when I surface for air again. I desperately need a COTA.
I worked like 6 or 7 hours of overtime. And I did a lot of paperwork at home so that's most of last week.
I did see my wonderful little niece. She is adorable and is starting to be interested in what she sees. She spent a lot time staring into my glasses and at windows and most of all at a black and white flower on her quilt. She did tummy time and is lifting her head, although she has little control. She's tracking and even turned her head to follow her daddy.
My cat went to the vet and she is just aging. Her thryoid probably is hyper and so when the blood work comes back she will then probably need meds or surgery, which I will opt for. I'm hoping radioactive iodine is an option and affordable. This is not a cat who will take a pill daily and I'm not interesting in trying. I know her well, it will not happen. A permanent procedure is much better. Although I have to find out if she would then be on replacement thyroid because that would be just as bad. It may be no win for me. She also has cataracts, so my cat is essentially going blind. Getting blood was a nightmare; she freaked out halfway through the first draw and bit me and struggled and we had to start over on the other side. I was kind of stupid though; I always ask to be allowed to hold my cats if I can because they aren't used to other people and it is less scary for them. Before we came in the exam room I'd been holding her wrapped in a blanket because she got so scared when she got there that she pooped in her crate because some idiot encouraged their dog to check her out. She was much better snuggled up with me. And she did better with the blood from the blanket. I don't know what I was thinking.
And the painting kid cancelled yesterday morning after I got up at 4 to clean. It wasn't his fault though. So I wound up falling asleep at 1 pm and sleeping until 9 AM. Every so often I have a weekend Dr. Mind orders me to spend in bed. This would have been one of them and he just didn't get the chance because he was away. Thankfully I did get the rest and may survive this week.
I'll write again later if I come up with anything. Just not a lot to say about the last several days. Work has been everything.
I worked like 6 or 7 hours of overtime. And I did a lot of paperwork at home so that's most of last week.
I did see my wonderful little niece. She is adorable and is starting to be interested in what she sees. She spent a lot time staring into my glasses and at windows and most of all at a black and white flower on her quilt. She did tummy time and is lifting her head, although she has little control. She's tracking and even turned her head to follow her daddy.
My cat went to the vet and she is just aging. Her thryoid probably is hyper and so when the blood work comes back she will then probably need meds or surgery, which I will opt for. I'm hoping radioactive iodine is an option and affordable. This is not a cat who will take a pill daily and I'm not interesting in trying. I know her well, it will not happen. A permanent procedure is much better. Although I have to find out if she would then be on replacement thyroid because that would be just as bad. It may be no win for me. She also has cataracts, so my cat is essentially going blind. Getting blood was a nightmare; she freaked out halfway through the first draw and bit me and struggled and we had to start over on the other side. I was kind of stupid though; I always ask to be allowed to hold my cats if I can because they aren't used to other people and it is less scary for them. Before we came in the exam room I'd been holding her wrapped in a blanket because she got so scared when she got there that she pooped in her crate because some idiot encouraged their dog to check her out. She was much better snuggled up with me. And she did better with the blood from the blanket. I don't know what I was thinking.
And the painting kid cancelled yesterday morning after I got up at 4 to clean. It wasn't his fault though. So I wound up falling asleep at 1 pm and sleeping until 9 AM. Every so often I have a weekend Dr. Mind orders me to spend in bed. This would have been one of them and he just didn't get the chance because he was away. Thankfully I did get the rest and may survive this week.
I'll write again later if I come up with anything. Just not a lot to say about the last several days. Work has been everything.
Tuesday, August 03, 2010
My poor kitty
I think I posted a few days ago that my cat has been waking up starving every night between 2-3 AM and that she's going to the vet this weekend for some bloodwork (I assume anyway). I realized last evening that she really has been progressing this way for months and I've just fed her more. I first got lazy about measuring out the crunchies, because after the death of my fat cat in Dec. 2008 nobody seemed to pig out too much. Then I noticed she'd started to lose weight, so I started adding a morning feeding of a small amount of something every day. Her weight went back to where it had been. So I decided last night that if she woke me I'd feed her, going against every gut feeling I own, and when she woke me she was STARVING. So I felt a bit guilty about yelling at her the other nights and as of tonight we instituted a one can for each cat nighttime feeding. And she is curled on my lap content for the first time in weeks and I hadn't noticed the difference (she was still curling up to sleep with me, but not just coming to me for pets.) In fact my other cat is jealous and just moved from his spot on the mattress to one where his butt is against my arm to remind me HE is HERE TOO.
I'm just going to keep feeding her. I don't know what else to do until we see the vet. This can't go on indefinitely or my other cat will be obese (and puking up hairballs) and after losing one cat to what should have be a minor surgical procedure and instead turned into tube feeding, enemas, my baby hiding from me before he feared me pushing food down his throat with a syringe, nasty appetizer plates of atricious smelling crap that cats are supposed to love, and then when he started to seem to rally a bit (yet was still in the horrible stage of waiting to find out if the tube feeding would help him start eating or if it just delayed putting him to sleep), his liver enzymes were so screwed up that on a Tuesday night I stayed with him at my mom's (she could isolate him better than I could) and he was feeling well enough to jump into bed and spent the whole night cuddled with me purring every time I woke up, Wednesday evening I came into the room and he jumped onto the bed to cuddle, and Thursday morning my mother found his body after he bled to death overnight. I think he said good-bye the prior to nights. But that made me fear cat obesity, because obese cats are susceptible to the horrible falling apart he had: a GI blockage from eating plastic (which the vet said defied all odds as it all should have passed because it was small, thin, pieces that should have gone straight through and instead tangled into a knot that then managed to hide on xrays, twice). Then he had surgery. But he had not eaten in a few weeks by then except via syringe and he just never started again, which apparently is a fat cat thing. Then his liver broke down and well, I dont want to repeat the rest. So there will be no fat cats here, and the younger guy is about to find out about low calorie food if Im going to be increasing his volume. So now I'll do healthcare all day and all night and weekends. Yippee........
I'm just going to keep feeding her. I don't know what else to do until we see the vet. This can't go on indefinitely or my other cat will be obese (and puking up hairballs) and after losing one cat to what should have be a minor surgical procedure and instead turned into tube feeding, enemas, my baby hiding from me before he feared me pushing food down his throat with a syringe, nasty appetizer plates of atricious smelling crap that cats are supposed to love, and then when he started to seem to rally a bit (yet was still in the horrible stage of waiting to find out if the tube feeding would help him start eating or if it just delayed putting him to sleep), his liver enzymes were so screwed up that on a Tuesday night I stayed with him at my mom's (she could isolate him better than I could) and he was feeling well enough to jump into bed and spent the whole night cuddled with me purring every time I woke up, Wednesday evening I came into the room and he jumped onto the bed to cuddle, and Thursday morning my mother found his body after he bled to death overnight. I think he said good-bye the prior to nights. But that made me fear cat obesity, because obese cats are susceptible to the horrible falling apart he had: a GI blockage from eating plastic (which the vet said defied all odds as it all should have passed because it was small, thin, pieces that should have gone straight through and instead tangled into a knot that then managed to hide on xrays, twice). Then he had surgery. But he had not eaten in a few weeks by then except via syringe and he just never started again, which apparently is a fat cat thing. Then his liver broke down and well, I dont want to repeat the rest. So there will be no fat cats here, and the younger guy is about to find out about low calorie food if Im going to be increasing his volume. So now I'll do healthcare all day and all night and weekends. Yippee........
You're lucky I did not take pictures
Tonight I walked in the door, stripped, and threw my clothes to the basement. Then I took a shower that involved scrubbing and scrubbing and scrubbing. Why? Well, let's review my day. Now, keep in mind that heat and humidity are hard on me and it was 74 degrees and so humid it was hazy at 7 AM. This is not typical of Ohio...I called my mom to ask if we'd moved overnight.
I left home and pulled out a pen to make a note on the notebook I keep beside me for this purpose. My pen leaked all over my hand. Great start.
(Keep in mind that I don't call the RN unless there is a problem).
Patient 1: I got to her house and checked her vitals. One was too low to allow treatment. This is a home that reeks of cat pee. I try to not sit on the floor, but I wound up needing to either sit on the floor or make my ankle hurt, so I sat on the floor. Where I'm fairly sure I aquired fleas, and this belief was increased when she explained that a stray cat they had been feeding was hiding in their home somewhere. So ewww....But so far from the grossest place I go that it didnt matter. One message to the MD and I was gone. After leaving I called the agency RN.
Between homes I called to set up the rest of my day. One pt. reported not feeling well and having blood sugar that was very low. Another RN call.
Patient 2: I think was getting sick. She was not herself. She hung up on me when i called to say I was coming a bit later than intended due to getting lost. She was cranky and confused. RN called again.
Patient 3: Checked vitals. One was out of boundaries. Re-checked it four times and remained out of bounds. Pt. also acting weird. Called dr. and had to leave message. Called RN.
Patient 4: Sounded really healthy on the phone. He was, except for some really weird pain that was too close to several major organs and too non-specific to figure out what it was. After evaluation I decided the MD needed to be aware. So, another MD call. Then another RN call.
Patient 5: Actually did NOT need a special call to the doctor. Praise God. last time I saw her she was a wreck, hours from admission to the hospital and hallucinating, so this was a good thing.
Patient 6: Did not look well and complained of not feeling well. Was pale. Checked vitals as I knew she had an issue with one of them before. Sure enough, way out of bounds. Called dr. Spent 20 minutes on hold. Hung up, and called back in 10 minutes to be told I was supposed to still be on hold. As if. Pt. sent to ER.
RN called.
Patient 7: Thank God again, no major medical problems. Family was a little odd, so had to leave message for PT about something.
Drove back to the office, arriving there 9 hours after starting work. Typed and typed and wrote fax after fax. Went to the bathroom, looked down, and there was poop on my leg. Grossest part? I have no idea whose or when it got there. And I still had to finish working and drive 75 miles home.
When I got in the shower I discovered I had somehow written all over both inner arms during the day, probably holding a pen in a book while bending over.
I may never recover from today.....and that's not even related to the exhaustion!
I left home and pulled out a pen to make a note on the notebook I keep beside me for this purpose. My pen leaked all over my hand. Great start.
(Keep in mind that I don't call the RN unless there is a problem).
Patient 1: I got to her house and checked her vitals. One was too low to allow treatment. This is a home that reeks of cat pee. I try to not sit on the floor, but I wound up needing to either sit on the floor or make my ankle hurt, so I sat on the floor. Where I'm fairly sure I aquired fleas, and this belief was increased when she explained that a stray cat they had been feeding was hiding in their home somewhere. So ewww....But so far from the grossest place I go that it didnt matter. One message to the MD and I was gone. After leaving I called the agency RN.
Between homes I called to set up the rest of my day. One pt. reported not feeling well and having blood sugar that was very low. Another RN call.
Patient 2: I think was getting sick. She was not herself. She hung up on me when i called to say I was coming a bit later than intended due to getting lost. She was cranky and confused. RN called again.
Patient 3: Checked vitals. One was out of boundaries. Re-checked it four times and remained out of bounds. Pt. also acting weird. Called dr. and had to leave message. Called RN.
Patient 4: Sounded really healthy on the phone. He was, except for some really weird pain that was too close to several major organs and too non-specific to figure out what it was. After evaluation I decided the MD needed to be aware. So, another MD call. Then another RN call.
Patient 5: Actually did NOT need a special call to the doctor. Praise God. last time I saw her she was a wreck, hours from admission to the hospital and hallucinating, so this was a good thing.
Patient 6: Did not look well and complained of not feeling well. Was pale. Checked vitals as I knew she had an issue with one of them before. Sure enough, way out of bounds. Called dr. Spent 20 minutes on hold. Hung up, and called back in 10 minutes to be told I was supposed to still be on hold. As if. Pt. sent to ER.
RN called.
Patient 7: Thank God again, no major medical problems. Family was a little odd, so had to leave message for PT about something.
Drove back to the office, arriving there 9 hours after starting work. Typed and typed and wrote fax after fax. Went to the bathroom, looked down, and there was poop on my leg. Grossest part? I have no idea whose or when it got there. And I still had to finish working and drive 75 miles home.
When I got in the shower I discovered I had somehow written all over both inner arms during the day, probably holding a pen in a book while bending over.
I may never recover from today.....and that's not even related to the exhaustion!
Monday, August 02, 2010
huh.
Posting may be sparse this week as work is officially kicking my butt. As in there is an official posting that nobody is write OT orders that are not dated next week starting today (not that this stopped someone from doing right underneath that), and I've been told several times that we'll be trying to interview assistants in the next week. (Have I mentioned that I get to be part of that? I am so very excited about this, as it has always seemed to make sense that if I am going to have an assistant that I should have some say in who they are and that they practice similarly to me, or at least in line with how I expect my assistants to be. You know, like say NOT lying on their notes, assistants of 2008-2009...). Anyway, I'm going to be seeing 1-3 people more than typical every day, and doing multiple evals each day and that is going to mean officially killing me. Please join me in praying that my handyman can't come paint this weekend as I don't have time nor energy for getting the house ready and yet cannot make myself cancel on him for the 3rd week running. I have to be up Saturday as my cat has to go to the vet. She is 15, and I was told years ago that she had very early hypothyroidism. Well, since she keeps waking me up in the night begging to eat (and not wanting her crunchies, which makes me think she has another broken tooth as this happened once before and THAT was a nightmare involving her being very sick after anesthesia and throwing up blood, the vet wanting me to bring her back ASAP, my running around trying to clean up blood and get her and I ready and slipping and spraining my ankle (THAT ankle). So I'm sure I'll be out $150 or so, but I have got to SLEEP. She gets hungry between 2-3, and I get up at 4, so when she does this it cuts my night way down.
As for the huh, I just realized that while trying to get my digestive tract unglued this weekend I gave up all vitamins and non-urgent psych/health meds, leaving me taking only Seroquel, Lithium (the main culprit in why my belly may explode), and my antibiotic (never thought I'd WISH for diarrhea from one of those things), although with lots of stuff to make my insides work. I took a Klonopin today for work, but I've only had that one since Friday, including at night and I've slept fine. So I may have gone from needing more and more to suddenly being able to wean off, at least maybe down to a more reasonable 2 mg/day than 4.
Let's see, what else? My head is spinning from everything I did today and everything I have to do by Friday. Who knows what is going to pop out?
There's been this rather neat little web of referrals between Dr. Mind, Dr. Brain, and Dr. Body. Dr. Mind was so pleased a while back because he got a referral from Dr. Brain who told me the full story which I got to tell him, which was that she told the patient that he had done incredible things for her one patient (me) and that if he wasn't available to not see anyone else at the center (she knows some of them there as she was the psychiatrist there until she joined Big Hospital; that's how she became my doctor). So that was pretty neat, for me as well as for him, because I love being the success story patient. And because I love that he is getting praise for what he has done for me; it has been rather incredible. (It's the team that has really been the best, but he's the day to day person in it). Now Dr. Body is referring to Dr. Brain and suddenly was very interested when I mentioned where I go for counseling. Turns out that when I innocently mentioned something about him to Dr. Mind that Dr. Mind and Dr. Body's father-in-law are very close friends. How weird is that? I met Dr. Body 5 years ago when he was in his first months in his first practice, a tiny one near my home. I've continued to see him for since he moved north to the city a few years ago. Dr. Mind came into play 4 years ago and knows that I have this incredibly supportive doctor who has gone above and beyond for me but we've never discussed who that is and all along there was a link.
I don't know what else. My work computer is calling "finish something, finish something" and I know I need to be I am just sooooooooooooo tired. But if I don't then I won't get them all done in the morning and then there will be more stress. If I can just get 2 of the 5 or 6 ready to go then life gets much easier.
As for the huh, I just realized that while trying to get my digestive tract unglued this weekend I gave up all vitamins and non-urgent psych/health meds, leaving me taking only Seroquel, Lithium (the main culprit in why my belly may explode), and my antibiotic (never thought I'd WISH for diarrhea from one of those things), although with lots of stuff to make my insides work. I took a Klonopin today for work, but I've only had that one since Friday, including at night and I've slept fine. So I may have gone from needing more and more to suddenly being able to wean off, at least maybe down to a more reasonable 2 mg/day than 4.
Let's see, what else? My head is spinning from everything I did today and everything I have to do by Friday. Who knows what is going to pop out?
There's been this rather neat little web of referrals between Dr. Mind, Dr. Brain, and Dr. Body. Dr. Mind was so pleased a while back because he got a referral from Dr. Brain who told me the full story which I got to tell him, which was that she told the patient that he had done incredible things for her one patient (me) and that if he wasn't available to not see anyone else at the center (she knows some of them there as she was the psychiatrist there until she joined Big Hospital; that's how she became my doctor). So that was pretty neat, for me as well as for him, because I love being the success story patient. And because I love that he is getting praise for what he has done for me; it has been rather incredible. (It's the team that has really been the best, but he's the day to day person in it). Now Dr. Body is referring to Dr. Brain and suddenly was very interested when I mentioned where I go for counseling. Turns out that when I innocently mentioned something about him to Dr. Mind that Dr. Mind and Dr. Body's father-in-law are very close friends. How weird is that? I met Dr. Body 5 years ago when he was in his first months in his first practice, a tiny one near my home. I've continued to see him for since he moved north to the city a few years ago. Dr. Mind came into play 4 years ago and knows that I have this incredibly supportive doctor who has gone above and beyond for me but we've never discussed who that is and all along there was a link.
I don't know what else. My work computer is calling "finish something, finish something" and I know I need to be I am just sooooooooooooo tired. But if I don't then I won't get them all done in the morning and then there will be more stress. If I can just get 2 of the 5 or 6 ready to go then life gets much easier.
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