Please help your healthcare workers help you-don't LIE

So today a nurse who works with a patient I've been having difficulty with for some time came over to ask if I knew the patient had taken herself off her blood pressure medication.  I did not.  Apparently only the social worker knew, and she called the dr. but didn't let the clinicians know.  And I'm pretty annoyed by this because this pt. has had some odd new symptoms develop, symptoms that caused us to get a consult with a specialist, and all the time I'm sitting there trying to figure out what was going on she was smugly congratulating herself.  Not to mention I make this woman work hard and since I had no idea her blood pressure was a bit higher because of being off meds rather than just a little fluctuation she kept explaining away by being active before I came I went ahead with pushing her and she could easily have stroked out on me.  So the next visit isn't going to be so pleasant because we have to talk about honesty and how if she's not honest with me I could accidentally KILL her.  Apparently she thinks (per what she told the nurse) that I'm responsible for people reacting to this.  I didn't even know, I just knew she had new symptoms that could be serious and she couldn't exactly hide them from me.

I'm so frustrated.  Everything is a game with this patient and I'm tired of being a pawn.  I'm almost done being a pawn as she's going to meet her goals relatively soon, but I am very, very patient and she is pushing me to the edge.  I'm thinking we're doing great and she's thinking "haha, I feel good because I know something you don't know".

I did complain about the social worker not letting us know.  I have no desire to kill my patients and if they take themselves off meds that I need to monitor something I want to know.  Hope this lady like having her blood pressure taken as if she's going to be off meds I'm checking it as frequently as I desire until I know for sure how it is reacting.  Even worse, imagine if this had happened and my holiday coverage had not known and she'd stroked on them.

Public service announcement over.

Welcome to OT stress time

I know I had a comment or two that my accidental posting of a title that probably seemed ominous and then silence was a little disturbing.  Just so everyone knows, I'll try to keep posting at my usual rate.  However, this time of year things tend to be very, very hectic.   Coping with holidays is tough.  More than tough.  It's extremely hard.  I also have SAD and while I have a light and it helps I always struggle for a while to integrate that into my mornings.  SAD makes me sleepier than usual as well.  And then it is THE time of year.  I don't know for home health yet but I'm sure it's the same, Nov. through February tends to be hopping, generally with Dec. the worst.  A lot of people choose Dec. for elective procedures, plus it's when people get sick.  And to ice the cake this year next week is my last week as a contracter.  The following week I'll be away at isolate Jen from stressors camp, and then I start training for the job I've been doing.  (Obviously different training than I've had, but a week of computerized stuff that I'll struggle with because I have the attention span of a gnat when it comes to that kind of thing).  Then it is Thanksgiving, and that is a holiday, which means Jen takes lots of sedatives.

So don't worry if I'm quieter.  Today, for example, I left home at 7 and got home at 8:45.  I had lunch at 5 pm.  It was an atypical day and just didn't work right, but still, not fun at all.  I've done paperwork until my meds kicked in and I'll have more to do in the morning.

I'm more likely to write if I'm not fine if that helps.  I just am very focused on getting through Wednesday morning and getting my paperwork done, etc and that leaves a lot less time for things like blogging, sewing, packing to be away for a few days dogsitting for my mom, eating, getting labs done, etc. You name it and I'm behind on it right now.

But soon I'll be back, and maybe even tomorrow will be better.  My caseload seems lighter this week but is still keeping me very busy so I'm not sure what that means.

Probably Friday I've have 3 patients......

One thing done

As long as nothing weird happens like the interest rates skyrocket or something I have just bought a car!

I have to give them a deposit today because they're trading for the one I want and then holding it until next week, and I'm waiting for the bank to come through, but pretty much on the 13th I'll pick up my brand new sage green Subaru Forester.  I'm so excited.  I've never had a car with more that bottom line options, and while I didn't get many options because of the one options I did want coming on the 2nd tier of the car (adjustable lumbar support; joy to my poor back) I am getting some things I've never even considered like a moon roof.  Which I suspect will have it's good moments as I get kind of smelly in some homes, plus it can keep air moving in the car while I'm in and out all day.  I also got a remote start so I don't have to drag my battered ankle outside to start the car before time to go.  And it's pretty......and has all wheel drive for the mountains.  No getting stuck for me...Plus I got a good deal and that feels good too.  I worked hard to get that deal.  Not to mention I've worked hard to get to the pretty good credit score I'm now enjoying.  Even 8 months ago my score was in the poor range I believe and at one point it was so low I had to pay additonal auto and car premiums.  No more of that.

Anyway, I need to try to do something before time to leave springs itself on me.  I also need  a lidoderm patch for my ankle.  It must be rainy today. I haven't checked by have one very achy leg.

Week of Silence

This last week has felt like I just needed to be quiet with my thoughts.  I think I was needing in a way to spend some time being quiet and honoring what I went through one year ago.  I also have tried to celebrate my successes in the last year because I know that they stem from the huge benefits of the MAOI that I went into the hospital to start.    I've felt so quiet I've even spent time driving in silence, something I typically can't stand to do because the noises of the engine, wind hitting the car funny, etc. drive me nuts.  So generally in the car there is a a book on CD running at all times.

What the hospitalization felt like and how I experienced it all is still a big deal in my life.  The biggest reason for this is that during the last 2 weeks of October and first 3-4 weeks of November 2009 I was brought to my knees with pain I didn't know was possible.  I thought I'd experienced the worst bipolar could hand me.  Learning I hadn't was a huge shock.  I learned a lot though.  During the last 2 months I've had to increase my Seroquel dose 100 mgs, bringing me into the higher than usually recommended dose.  Which is not a big deal, I've been on high doses of most things.  But it was a big deal to accept this and do it, knowing I'd have side effects and that I might be more tired than I'm used to being.  At first I was and so I tried to go back to the normal dose.  But when it failed I managed to do what I'm supposed to do and immediately get back to the higher dose before anything happened.  I realize now that I'm stuck at this dose of for some time, probably through the winter as usually I'm not allowed to wean much from now until spring.  But there's a big difference; this year I was well enough to make the right decisions. Last year, one of the things that was bad in the hospital was that I was very reluctant to alter my base meds.  Because of when Dr. Brain got sick herself she didn't answer a lot of my questions and I did not go into this knowing that Emsam might make me more agitated and that it was ok to need more seroquel.  Instead I went in with the idea that messing with what had worked for so long was not a good idea since I was only there for the antidepressant change.  I never understood until this how intricately my meds work together.  I remember finally agreeing at some point to try more seroquel and then begging for increases until I had doubled my dose.  In the past I'd been on 600 mg and it had totally knocked me out; now I needed 600 mg to feel ok.  I was so sure that it would become too much that I asked Dr. Body for a script for 300 mg as well as a way to make 400 and 500 mg when I went in for follow-up,sure I'd be weaning off soon.  Instead it's been a year and I'm on more.

On the other hand there's a little voice that worries, and as I've had to take time to remember last year I've had to think about this as any major med change will require hospitalization now, and that little voice wants to know what happens if my need for Seroquel increases.  There's no much room to go up now.  That frightens me.  I can try to not worry, but it's hard to not do so a bit when I realize how fast my needs increased in the last few months.  After months of starting to discuss how meds can be decreased after a year of solid stability we've now increased my lithium by 50% and Seroquel to nearly as much as humanely be taken.

But we're not there.  We're not anywhere bad, just not in the best place ever.  I strongly suspect that after I have my week off in 2 weeks I'll feel much better because I'll have rested.  After all, unless you count the hospital, I've had no vacation in nearly 2 years.  I had a few days off but inevitably they were full of medical appointments. This time is all about peacefulness and healing from stress.  I have no idea how I'll survive without all of you and this outlet, but I'll probably keep writing and then will post later.

And this post was supposed to go up 2 days ago and I apparently fell asleep and posted a title instead.  So now on to today's post....

Never had that happen before

I just got in from the emergency room. No big deal, just a bruise that had to be checked because it was work related and because it could be germy.  I got out of my car and my pt's dog got really aggressive so I stood still and did all the calming the dog things. It saw it's owner and ran over and bit my foot.  Thankfully my foot was up so most of the bite hit the very thick thanks to my orthopedic shoes sole and most top teeth hit the leather edging.  So only one tooth hit skin.

Regardless, annoying way to end the week.  And embarrassing since I could hear the nurses complaining about why I was there at all.  Work made me, would be why......I'm complaining to the hospital.  That's more than once I've been there (out of the 4 times I've ever been in an ER and listened to them talk about me).

One nurse even thought it appropriate to suggest I shouldn't have reported it.  Um, my co-workers go there too. Should I let someone else get bitten because I didn't want to have someone see my bruise?

On the really other hand I just made an offer on a car........Holding breath......

The worst day of my life plus 365

I don't remember a lot from the hospital.  I remember the 28th.  The 28th was the day that I overheard one of the least sick people in the group say he was feeling better.  He was admitted because he needed faster titration of his antidepressant dose than could be done outpatient and then he went home.  He was the person I liked the most there, and I was happy he was feeling better.  But all I could think was that I had just that day finally started my new med after being there 2 full days and nights, meaning I was going to be there for what seemed like forever.  I felt worse, not better, and I was so very tired of feeling worse.  I started crying and did not stop until after the 2nd time I tried to find a nurse to help me I finally found someone, got the words "I.......can't.........stop" out, and then had to wait first for the doctor to order more meds and then for the pharmacy to bring them.  By that point I'd been sobbing with my whole body for hours and the nurse had me calm enough to be laying down. The med put me out and I slept most of the rest of the day.  But during those hours when nobody was helping me and I was too scared to leave my room in that shape I was so serious about wanting to kill myself that any barrier that had ever mattered no longer did.  I cared only about not hurting like that.  Nothing was a deterrent, not knowing I'd get moved to general psych if I hurt myself, that there was no way to successfully hurt yourself using an ink pen rapidly enough to not be noticed on hourly checks or that I had no way to kill myself.  That was the main source of the tears, I wanted a way to kill myself and instead had locked myself up in the safest place on earth.

I am so much better now.  A lot of sense of trauma still exists from that day.  (although not enough to keepme awake apparently). But it's so hard to not remember some of that horrible feeling.  It's why I wasthere, but it was still the scariest thing I have ever felt.

Quiet

I'm going through this kind of weird thing this week.  This was when I was hospitalized last year and the reminders of how bad it was sometimes keep creeping back.  It's much nicer to be free.  I hate that I'm fighting with my illness, but it's so much better.

Last night I had no power.  It came  on at 3:30, so guess when I got up?

Also, work is crazy.  A full day is considering 4 evals or 4-6 treatments depending on driving.  Today I did 4 evals plus 3 treatments, one of which was a discharge (extra paperwork) and I drove 70 miles just between pts. and not including my commute at all.  Needless to say a lot of paperwork came home with me.  I'm finishing this one and leaving the last for morning.  But I had a LONG day and see no end to being ultra-busy.  The OT chart reviewer person sent me a huge packet to read and I just laughed.  I know she's going to want it ready by next chat with her Monday and I seriously doubt it.  I'm not spending a ton of time reading that on my own time and I don't have any extra time this week at all.

As you can probably tell I'm stressed.  It's partly hard because I keep trying to convince myself it's ok to feel sad and stressed and symtpomatic this year even if it's not as bad as it was a year ago.  If I weren't tired I'd follow that logic, but I am tired and so it's hard to keep myself straight.

So more from Jen's world soon, but it may be Saturday before I can be coherent.  But now back to getting this eval finished.

One year ago today

365 days ago I was sitting on this bed.  My bags were packed.  I had flushed harmful meds down the sink a day or two before because I was so suicidal.  I'd removed the plastic bag I'd automatically packed toiletries in.  I had no idea if I was a direct admit or if I had to go through the ER.  I wouldn't know until after 8 AM.  I knew I'd be admitted as the statement "I would kill myself if I had the energy or ability to formulate a plan" was very true and I knew that all it would take was one short burst of mania and I'd be entering very risky waters.  I also knew that soon I would be totally unable to function at all.  Somehow I was managing hygiene, if barely.  But I was also barely functional with anything else.  I'd gone from only eating a little to basically not eating and was living on water.  There was not one thing that was not an effort.  I could not longer be nice or polite.

I can't describe how it felt.  I kind of remember, although mostly my memory stops when I realized I had to go inpatient NOW and picks up when the hospital became unbearable thanks to Cynthia the nurse I hope retires before I ever go back there again.  I know that I knew I was doing the right thing and that after years of resisting hospitalization it was definitely time to go, and without delay.  I think that was my greatest fear, that they would send me home.  I remember telling a friend several days before that I would like if I had to go through assessment before admission and say I was actively suicidal.  I also remember admitting a few days later that I was in fact not going to have to lie about that.

The depths of my desire to end my life still haunts me.  I was safe enough or Dr. Mind would have put me in the hospital days before.  There is no doubt about this.  If I hadn't been scheduled for admission that Monday he would have had me admitted against my will if needed, I have no doubt about that.  But a few days before I was "at risk" but had no plan or real concept of what I wanted.  But by the time I got to the hospital I wasn't organized enough to have a plan (something they are really cautious about) but I was ready to do anything impulsive I could to harm myself.  I simply could not imagine living another minute like I felt and I did not feel strong enough to take on everything I was about to take on--groups, monitoring, being kept safe from myself, almost no privacy ever, and a new med that had less than 50% chance of working, for me probably way less. And then by the end of the first day I knew that it was going to be harder than I thought as I waited and waited to see a doctor (it took almost 30 hours and then it was not my doctor so he was thumbing through my chart scanning while talking to me rather than having had an intense discussion with Dr. Brain about me, and that doctor started pushing a med I've had a severe allergic reaction to that he said I could avoid, requiring an email to Dr. Brain to have her tell him NO.  I wasn't about to take it, but her support helped.

What I remember most about 365 days ago?  My male cat doesn't like to be held.  He does like attention and spends much of his time lying beside me, and when I lay on my side or back and turn out the light he comes and lays on me for a while.  Well, that night I didn't expect to sleep well.  Noah however knew what I needed.  He not only lay on my side as per usual, he figured out how to rest his cheek on mine and he stayed that way and purred for about an hour.  He's never repeated this for even 30 seconds since; all I can guess is that he knew how scared I was and knew how much I'd cried about leaving my kitties.

One thing about reaching this week of looking back, it makes me realize that my episode now is frustrating and long and feels like it's been forever when it's really only been several months and that I had a really good period for a week or so, and that I feel much, much better right now than I did a week ago and 700 mgs of Seroquel is having no adverse effects.  Which is a miracle.  This recent period had been so hard, but it is nothing like choosing to be locked up to prevent me from killing myself.  Admitting that and making that decision were so incredibly hard, I hope to never get that sick again without realizing it is time to go.  With the MAOI I'll likely wind up inpatient again since there are so many interactions and so many difficulties if I need to change drugs, especially if I have to come off the MAOI.  But it will never be as hard as this night one year ago.

And now that 700 mg of seroquel is making me unble to type, so goodnight.

Plotting

Long before I negotiated for my new job I did a lot of research, wrote out a lot of my arguments in advance, and was READY.  And I got what I wanted.

With the car the same thing is trying to happen.  I'm actually having fun with this process.  I already have a good deal on the table and am working to lower it. I have plans, i have offers and counteroffers in my head, and I'm playing dealers against one another.  The internet makes this totally different.

The other 2 times I bought cars I didn't do a lot of this.  The first car I bought my brother kind of pressured me into, and  then did not help me bargain much.  So I wound up with an awful car that I finally sold at 46000 miles because it was broken 50% of the time.  That meant the next car was bought rapidly, although there wasn't a ton of bargaining with 0% financing already in place.

This time I have power.  I don't need the car for a while, I have done lots of research and know what it should cost and what I'm willing to pay.  I also know a lot about how to shop for cars now.  And I know that I can afford the cost of this even if I don't get anything else out of them and get a higher interest rate.

It's almost fun....

Please explain this one

I feel totally paranoid with any explanation I come up with, yet this makes NO SENSE.

Last year for Christmas my mother gave me this little 6 pack of tiny cactus plants.  Cacti grow slowly, so they are all still in the same little pots they came in, waiting to be big enough to transfer together.

Today I realized I hadn't watered them for a while and went to do so.  This is when I discovered one cacti does not have a pot. I truly have no idea when this changed as it's not something I'd necessarily focus on while running around, yet I have watered the plants monthly or so, which is what you're supposed to do.

They are sitting on a table by my sliding door.  Therefor one explanation  could be the window installers dropped and broke the pot (which would be weird since it's plastic) and put the plant back.  However, the soil is pretty intact for that, although with cacti root systems I suppose it could just be held together well.

The only other things I can think of are things like the neighbor kids came in the slider if I left it unlocked at some point (likely) and took it.

How does a tiny planter walk away, leaving an intact plant and 5 other intact plants IN pots beside it?

(ETA;  There is dirt scattered across the little table but it was cleverly concealed by rearranging everything on the table.  Leaning strongly towards window installation team).