Saturday, 26 July 2014

Existing is Exhausting

The clinic where I see my team moved to a new building two weeks ago. Just a couple of blocks down the road from the old building. I've already been there seven times. I don't know if I like it; it's too big and open and new. I've been going to the same clinic since birth, and suddenly, it doesn't feel like a safe place anymore.

Everything's still getting sorted out and moved around, and this week the dietician had a new addition to her office - a set of those old manual sliding bar scales. She wasn't too impressed, nor was I, and she's determined to get the other scales back. Previously, we've always used shiny new digital scales with the display separate from the actual scales (perfect for blind weighing), which seem to've found a new, slightly inconvenient home in the nurse's room on the other side of the building.

I really didn't want to get on a different set of scales. It'd been a hard morning and the last thing I needed was the upset of a false gain. Being me, I asked if she could weigh me on both sets and note the difference, and then we could just use the manual ones next time. On the digital scales, my weight dropped after two weeks of not moving, and the manual scales read 0.5kg off. Good to know.

In the apathy of depression, I've been skipping a lot of meals, losing a lot of structure. There were two nights last week I decided an orange would be the easiest option for dinner, and I only had breakfast twice. She asked if I've been drinking Ensure and I haven't, but I've been trying to have things like smoothies (120), hot Milo (110), iced coffee (55), to keep my blood sugars up if I'm not eating for that meal, but even they're a challenge when I'd rather just skip it. She wants me to focus on keeping the structure of three meals a day, even if it's just a liquid or a small piece of fruit.

I'd gone in with a red puffy face and held back tears as best I could. I nearly didn't get to the appointment because I just didn't want to talk to anyone. I wanted to, still want to, cancel all of my appointments and wallow. But without them there wouldn't be much left to hold on to. Appointments and blogging are really the only things I have left in these empty days.

When she asked how the appointment with my GP went last week, I cracked and started crying. I word-vomited about the anti-depressants and BPD and how everything felt hopeless, then felt horrible for doing so. I kept apologizing, saying I was sorry but everything just felt so hopeless. It's not a chemical imbalance or a situational depression, I am the problem. She said she'll talk to my GP and get an update on how things are going, but I just felt awful for dumping it all on her.

On Thursday night I ended up at the clinic at 6pm and spent an hour getting fourteen stitches in my leg. I'd tried so hard not to cut, but by the end of the day I just lost it. My adventure for the week; mum didn't have her car so we had to catch a taxi the whole three blocks there (thankfully my brother finished work in time to pick us up after). It was nerve-racking. I haven't gotten into a taxi in years.

It was a GP who I saw for a few months before I met my lovely GP, and I was a bit nervous about seeing her again as she's said a barrage of hurtful things in the past, but she was actually quite wonderful this time. I'm finding that some of the GPs I've clashed with in the past, mostly due to them not knowing much about anorexia or mental illness in general, are still kind, caring, competent doctors in other fields. 

I have to go back on Monday to get the dressing changed and check for infection, and then on Friday I have an appointment to get the stitches out and get my GP to check my lungs quickly. The excitement never ends. 

Now I'm just sitting here thinking; what the hell happened? I hadn't cut for years, and in the past few months it's all come back. My life is a cycle of alternative methods and risk minimization. I think the cutting started up again because there was concern building about my recent head hitting. I've gone through nearly every self-harm method in the book over the years, but I genuinely thought cutting's one I'd left behind.

Billy: He's getting older, and for the first time he's really feeling the cold this winter. Last week, mum took him to the pet store and found him a nice warm coat. He's spending most of the day bundled up under blankets with me on my armchair or the couch. If I'm crying, no matter where in the house I am, he comes and finds me and curls up next to me. My little shadow.

Sorry I've not been commenting as much lately, but I'm always reading. I'll try to catch up over the next few days. And thank you to all of you for sticking with me through all this crap. You guys are incredible and keep me going, seriously. 

*sends out rays of love and hugs and unicorn farts*


Friday, 18 July 2014

A Glimmer of Hope

So, yesterday I saw my GP and found out that;
1) I apparently have BPD
2) Antidepressants won't help me because my depression's "too ingrained"

But let's take a step back to Wednesday when I saw the mental health nurse. She gave me a few handouts on mindfulness - how to practice mindfulness, attitudes to bring to mindfulness, that sorta thing. 

But alongside was a handout for mum's benefit (though I found it quite enlightening) - "Understanding Borderline Personality Disorder". She's mentioned it a few times, and at the last appointment she said she thinks DBT would help me when I'm well enough. But no one's ever mentioned BPD to me before recently. Sure, I figured I had some Borderline traits as a part of C-PTSD, but I've never actually discussed it with anyone. Mum had no idea what she was talking about - she'd never heard of it before.

So I had an appointment with my GP the next day, yesterday, and I told her about the handout on BPD, and that I was a little confused because no one's ever mentioned it before the mental health nurse. She said she thinks it's very likely I have BPD. All the symptoms match. I don't remember ever talking to anyone about that sorta stuff though.
Is it that apparent?
How do they know?

The mental health nurse did ask the psychiatrist about antidepressants, but they won't give any advice unless they can actually see me. I know I should, but I can't. She thought the GP might be able to talk to the psych, but the GP was even less help.

The GP said she was happy with my meds, that she thinks she's helped with the anxiety and mania over the last 18 months. I told her I still don't think my antidepressants (mirtazapine) are helping, but she doesn't seem to think anything else will help either. She said it's "too ingrained".

Too sick for antidepressants, not well enough for therapy. They've always said medication isn't meant as a cure, but as a crutch to help you engage in therapy and make real changes. But I can't even have that.

Sorry for being so miserable guys. It all just makes me feel hopeless. The BPD part doesn't really bother me; obviously it's been lurking for a long time, so it's nothing new. But not being allowed to try any new antidepressants? That is fucking devastating. I don't know how much longer I can deal with this depression. I've been holding on until the next appointment, or until my meds can change and maybe something will help and make slightly less unbearable, but now what? I've just gotta wait until one day I'm magically stable enough to do therapy?

Currently, I'm on;
Morning - 200mg seroquel
Midday - 1mg lorazepam
Night - 200mg seroquel + 45mg mirtazpine
+ 1mg lorazepam as needed
On the upside, she's said I can take an extra 200mg seroquel on nights I can't sleep, which is a relief. "As a treat", she said, hah.

I think I might be getting sick again. It's probably just me overreacting so I didn't mention it to the GP yesterday, but I'll keep an eye on it. Two days ago I started getting painful twinges in my back, which was the first symptom with the last infection. Yesterday I started getting pains in my chest when I cough or breathe in, falling into coughing fits whenever I walk and taking forever to catch my breath, using my puffer multiple times a day opposed to never. The last two nights I've had sweats and chills and have woken up coughing every two hours. My temp was 38°c just before and today everything aches. I just feel awful and exhausted and sick and in pain and ugh, sorry I'm just complaining now. I'm hoping it's just a cold, but I'll see how I feel next week and go back to the GP if it gets worse.

Last week I did 60, 90, and 120 minutes on the aerobic step. The two hours killed me for the day. I did half an hour yesterday, but I think I'll be taking it easy for the next few.

The title's a bit misleading, I guess - I don't have any hope. But I have wine (just two small glasses on Tuesday). I bought it for the label. Effective marketing is super effective!


Friday, 11 July 2014

Alone with my Mind

I had my check-up with the Lung Doctor Man this week. 

I forced myself to push a little harder this week so I could tell him I was exercising with a clear(ish) conscience. I didn't exercise at all for seven weeks across May-June because of how sick I was. Since hospital, I'd only been doing 20-30 minutes of step aerobics once or twice a week, but I knew that wouldn't classify as 'exercise' for the Lung Doctor Man (who's previously stated I should be using a treadmill or exercise bike for an hour a day).

So in the week leading up to his appointment, I managed 20 minutes on Wednesday, 30 on Thursday, 90 on Sunday, and 60 mins in a 'last-chance' session that I barely squished in before the appointment (and another 30 minutes afterwards). When he asked me if I was exercising, I just nodded and said "Yep". I was too nervous to say much else. I didn't want to talk about it. I didn't want to tell him my dietician still wants me resting. He didn't push the matter for once, thank god.

Things were going okay, until he decided to weigh me. He doesn't normally weigh me. I was weighed by his assistant at my first appointment, blind, but ever since he's been fine with me saying "It's mostly the same", because it's not like I've gained or lost any hugely significant amount. But not this time. My instant reaction was to run when he tried to weigh me, except for the fact I still needed tests done, so I stuck it out. 

"Okay, but I'm getting on backwards because I don't look at the number."
I don't know if I should've explained more clearly or spoken louder or what, because after I stepped on the scales, he decided to announce the ever-disgusting number.
"Well, gee, thanks for that!" - the most polite thing I could think to say
"You didn't want to know?"
"...why do you think I got on backwards?!
Sigh. Well, I guess he isn't to know these things if he hasn't had ED patients before. Next time I'll be sure not to eat or drink before the appointment. And he'll be sure not to tell me the number. 

My chest is still very congested and irritated, but not as bad as it was, obviously. My spirometery results were 2.4/3.4, which means I have a total lung capacity of 3.4 liters and can exhale 2.4L in the first second. This put me somewhere around 60% of expected capacity (4.1/5.0 - and I should be able to get out more in the first second). Back in November, at my last appointment, I read 3.5/4.0. I dread to think what the tests would say if they were done during the first few days of my admission.

I told him I've been smoking around 30 cigarettes a day (in reality it's slightly more, but it's still the least I've smoked for months), plus several grams of the other stuff. The cigarettes will inevitably increase as the grams decrease. "Still too much", he said. As if I don't know.

I also saw my GP quickly with the clinic nurse on Wednesday. Some of my cuts are infected so I'm back on antibiotics for another week or two (just as I got off the damn things). She wanted me to go back today, but mum's away and my brother's working and I can't leave the house and walk the 450m to get to the safety of the clinic. So next week I see her on Monday to check them, then again for my proper appointment on Thursday (with the dietician and mental health nurse in between). 

I've been home alone the past few days. Mum went away on Wednesday morning, and I quickly found myself in a panic with my mood plummeting. Feeling unsafe, I ended up impulsively downing four lorazepam and spent the day glued to the couch. Over the next two days, I watched The Dead Poets Society, Harry Potter, Starving in Suburbia, Pokemon and Wall-E, even if I couldn't concentrate. Anything to try to distract myself. I want to sew and do things. I just... can't.

I don't mind being home alone for the most part. I savor the lack of structured meals, no pressure, without a care about the time on the clock. Since I'm on antibiotics, I have needed to keep up a rough three 'meals'. I'm still being horrifically lazy and not preparing much real food. My intake's been anywhere between 500-1,000 since I left hospital, though the last two days home alone have been closer to 400, mostly made up of strawberry-yoghurt-milk smoothies, cheese and crackers, apples, popcorn, chicken noodle soup, plain biscuits... I just don't care enough to prepare proper food right now.

Sorry my posts are getting longer and further apart. Everything's just too hard right now.

Selfies after my check-up because it was the first time I did the whole 'real clothes and makeup' thing for a while. I really need to get back to sewing and expand my wardrobe. Apparently I forgot to smile.


Saturday, 5 July 2014

Canned Soup, Flashbacks & The Mental Health Nurse

On Wednesday I had my fourth appointment with the Mental Health Nurse, and for the first time I left with the feeling that something might potentially help.

She said she was worried about my depression. She asked if anything has helped me in the past, if any treatments or medications have helped at all. Nothing. We went over all the meds I've tried over the past 9 years, then she asked the dreaded 'how long's it been since you've seen a psychiatrist?' question. It's over two and a half years since I last saw any psych - a couple of encounters with the Horrible Psychiatrist at the public hospital. It's over three years since I regularly saw a psych - my ED psych, for a few months following inpatient.

She thinks I should be seeing a psychiatrist. Not even on a regular basis, but at least once every couple of years to 'reassess'. I can't do it though. The thought absolutely terrifies meI don't trust psychiatrists (partly because every psych I've encountered since I developed anorexia has tried to make me fat). I went years without seeing anyone, not even a GP, and it's taken me so long to build up the trust with my dietician, GP, the private hospital system, now the mental health nurse... I can't take the next step just yet.

She's going to talk to a psychiatrist she works with about my history, medication etc. and see if they have any suggestions for different meds or something to try. This is some relief, at least. I know antidepressants don't solve everything, but it's a comforting thought to think there might be some medication out there that will make things a little less unbearable, however unlikely it seems. I'm just thankful she's doing this for me, without me actually having to see a psych, because I know it's not how it's normally done. It's the same thing my GP did when she prescribed the most recent tried-and-failed meds (Zyban and Paroxetine). I just hope this leads to something.

When she was asking me the general 'what've you been up to this week?' and following questions, all of which resulted in answers of 'nothing', she asked if I've ever had issues with Chronic Fatigue Syndrome. It caught me off-guard, but she might be on to something. I feel so tired and weak all the time. I've blamed it on depression, anorexia or a combination of the two, but I've been 'like this' for a while and the MH nurse is wondering if there's more to it than that. I'm going to discuss it with my GP when I see her in a couple of weeks. I guess it's a possibility, but honestly, I'm pretty sure I am just that lazy.

I can't remember how it came up, but my agoraphobia was mentioned for the first time. I don't know how it hasn't come up before. I realized it's been about five years now since I was first diagnosed with agoraphobia. As I write this, it's been nearly two months since I've gone out (with the exception of appointments and hospital). Even going for drives in the car is getting harder. My (failed) New Year's Resolution was to go out in public once a month, but now, halfway through the year, I've only gone out four times (Shopping in January, Bushwalking in February, Nipple piercing in March, Cheese factory in May).

Each day is getting harder as my mood continues to drop. My mind races on all the things I could, should be doing, and leaves me too overwhelmed to function at all. 

I've started skipping meals more again. I wrap myself in a blanket on the couch, too cold and tired to move, as my family sit and have dinner, mum asking for the tenth time if I'm sure I can't join in some crumbed chicken and mashed potato (I've never liked crumbed meats, anyway). I just haven't the energy or motivation to prepare a proper meal, especially at the end of the day. I've since obtained a can of chicken noodle soup, which will provide four easy 48-calorie dinners. I honestly don't care about the nutrition, or lack thereof, right now. It's 'easy' or nothing. Ugh, I can't believe I just wrote those last two sentences.

Sunday was the worst. The day consisted of flashbacks, hysterics, tears, self-harm, and mum threatening to call an 'ambulance' for the first time in months because I couldn't calm down, which only makes me freak out more. You see, apart from my standing issues with the public hospital and the Horrible Psychiatrist, they don't even send paramedics on psychiatric calls anymore - they send police with a psychiatrist tagging along, so you can be assessed (for sectioning under the Mental Health Act) before being taken to the hospital. Which is fair enough, it makes sense, but no thanks. So that makes me panic ten times more, which really doesn't help the situation at all, and ugh, it was just a bad, bad day.

So I've been trying to take it easy, staying dosed up on lorazepam and trying to zone out to cartoons. I've spent the last three days in my pajamas watching Pokemon. It's the first thing I've been able to watch for weeks.

I've made another appointment to see the MH nurse in two weeks. This week, I have The Lung Doctor Man on Monday for my post-hospital check-up, the dietician Tuesday and an appointment with a nurse and my GP for self-harm dressings. The week after is my dietician Tuesday, the MH nurse Wednesday and my GP Thursday. Gee, isn't my life exciting?

Billy and Misty have been my shadows lately, more so than usual. They always know when I'm not feeling right. In appreciation, I thought I'd share some recent photos of my two furbabies, since it's been a while. 

My babies

Misty being cheeky in my wardrobe

And while unpacking online shopping

She gets more use out of the porch swing than anyone

Billy, looking smart after his haircut a few weeks ago. He already needs another one soon.

Cats aren't the only ones who like boxes