Wednesday 30 November 2016

From Inpatient to ICU

I was discharged from the Clinic last week. In less than 6 hours, I went from being discharged from the Clinic to the back of an ambulance en route to the Intensive Care Unit.

Things were okay for a very short while, but in the end, that night was nothing short of a disaster. I spent hours crying “I just want to go back, I just want to go back, I shouldn't have come home”. I asked mum to call the Clinic to see if there was any chance of readmission, of undoing the discharge. After they spoke to the psychiatrist, they called back and said no. I was clutching my meds, which had piled up as deliveries continued even though I was in hospital. Mum told them I was wanting to overdose. They said that they'd see what they could do in the morning, but if I took the meds, there'd be no chance of taking me back.

  “They won't let me go back anyway. The psychiatrist wanted me gone as soon as he could. He won't take me back.”

I took nearly two week's worth of meds.

I told mum not to call the ambulance. That her lack of care over the past year had absolved any right she had to suddenly be concerned and call for help.

I took the phones from mum, but there was one handset left. When I heard her call 000, I unplugged the landline from the wall. Obviously that wasn't a smart move, and 000 calls that are suddenly cut off cause concern, but I didn't think of that at the time. As I've had a ridiculous amount of 000 calls this year, they called mum back on her mobile.

I barricaded myself in the lounge room, armchair up against the doors. It wasn't long before I saw the bright lights of the ambulance glaring through the curtains as they pulled up outside. I knew then that I'd messed up. Bad. One of the paramedics remembered me from previous trips, which was dreadfully embarrassing.

I spent the next day unconscious. It was about 24 hours between my last memory of getting into the ambulance and regaining conciousness in the Intensive Care Unit. I don't remember arriving at the hospital. I don't remember being changed into a hospital gain, or the blood tests, or being fitted with a cannula and catheter.

When I came to, they asked the routine questions.
  “Do you know where you are?”
I looked at my surroundings. I was obviously in hospital. But was the public or private hospital? Was I in A&E or the ICU? My speech was slow and slurred whenever I tried to speak.
  “No... not really.”

The last time I was in public hospital's ICU, my wristband read an age of 12 years, 11 months, after the worst overdose I've ever taken. Now, at nearly twice the age, I found myself there again.

After being unconscious for so long, I spent most of the night awake. I drifted in and out for a few hours between 3-6am, but that was it. In the morning, I was nervous. Nervous about what my BSL would read. Nervous about breakfast. Nervous about the psychiatric assessment. Nervous about the potential of having to go home.

My blood sugar levels were just 4.1 just after midnight, and the nurse brought me puréed peaches. Around 2am, my BSL had dropped further to 3.5. They brought me a mini feast of sandwiches, jelly, and orange juice. They pushed me to have the OJ, but I just had part of the sandwich and the jelly. Usually I only eat sugar-free jelly, but I knew even sugary jelly was still relatively low in calories, and felt safer than the juice.

Even though my blood sugars were low, they'd already given me at least one bag (probably more while unconscious) of 4% glucose, 0.18% sodium. By my calculations, 4 grams of glucose per 100ml equalled 40 grams of glucose in the 1 litre bag, which equated to an extra 160 calories of pure sugar.

In the morning, the medical doctor came to see me first, and he was okay with how I was doing. But when the psychiatrist came around (thankfully the Horrible Psychiatrist is no where to be found), it was hopeless. I'd held some hope that I could go back to the Clinic, but no. He wouldn't even let me go to the medical ward, despite that having been the plan. Prior to this, the ICU nurse told me several times they'd be transferring me to a medical ward that day, but I went home later in the afternoon.
  “Blah blah blah, DBT, groups, blah blah blah, medication...”


Prior to discharge from the Clinic, things weren't going much better. In my last post, I mentioned my first lot of leave to go home. The next day, I went home for a few more hours. I made the mistake of asking a couple of questions about if my family was dealing with/getting any help regarding the childhood abuse, and was met with a resounding 'no'. Everything was being swept under the carpet again.

I took a few oxazepam and cried hysterical on the couch. I just kept repeating – I have nothing left, there is no hope for me, nothing will ever get better. Mum told me I'd be late getting back to the Clinic, and I told her I didn't care. It was my last hope, and it was gone. She got angry and told me to get in the car now or I'd be catching a taxi. She told me to call the Clinic, which I obviously couldn't do. I told her she was the one who signed me out on leave, and it was her responsibility to call if something went wrong. She refused.

Then, maybe 10 minutes after the time I'd said I'd be back, the Clinic called mum. I was hysterical on the couch. He told mum to just try to calm me down and bring me back. I later found out they'd contacted my psychiatrist that night, despite being the weekend, and he didn't want me going home for a couple of days.

Seeing the psychiatrist on Monday, after the disaster weekend, did not turn out the way I thought it would. I thought it would be some sort of breakthrough, but he had other plans.

Since I made the mistake of telling him that I felt like I'd made no progress and was worse than I came in, he said there's nothing hospital can offer me apart from being around people, going to groups etc. (apparently keeping me safe is not important). I thought it'd be an indication I needed to stay longer, but obviously I was wrong. He told me I'd be getting discharged. This was on Monday afternoon, and he said we'd plan for a discharge the next morning if I felt able, or if I felt I needed a few more days away from my family, then Wednesday, but absolutely no later than Thursday morning.

The only follow-up I was offered, apart from starting to work with my current team, was art therapy and other socialising-based outpatient groups. None of it seems worth it. Talking doesn't seem worth it. The fear greatly exceeds my motivation.

Being in hospital was keeping me safe during an extremely difficult time. I don't need tools to self-harm – I am a self-harm tool – but the only time I'd self-harmed or misused my medication in three weeks was when I went home on leave, and it happened both times. Now, I've got nothing to keep me safe.

My head was screaming at me to pack my bags and get out the next morning and stop wasting a valuable bed and resources.

When I saw the psychologist on Wednesday, I took several of my bags home and dropped them in the garage on the way, so I wouldn't have so much to take the next morning. I wanted to stay until I'd at least seen her.

The appointment was stressful. I talked about a lot, what's been going on in the past few weeks, although obviously it's too soon to make any progress. It was my first proper appointment, apart from the 'meet and greet' that my GP took me to, back in July, I think.

After the appointment, I was extremely distressed. I just wanted to go home. My head was running, and I didn't want to spend the next 12-18 hours at the Clinic just waiting to go home. I wanted a drink. I wanted to talk to the nurses, but what good would it do? On the drive back to the Clinic, I told mum I'd ask if they could discharge me that afternoon.

Usually discharges happen of a morning, but I asked the nurse, who asked the psychiatrist, and he was more than happy to get me out of there ASAP. So I packed my last couple of bags, filled out the paperwork, and waited for mum to come pick me up.

With much regret, I have to say it was a very poor decision.




As a side note, during my last few days at the Clinic, I was walking like mad. I was painfully aware that I only had 48 hours left, at the most. I knew walking at home would be more difficult, unless I wanted to pace up and down the hallway, which is much less practical than walking laps.

On Tuesday, I set a new record – not only for my time at the Clinic, but probably the most walking I've ever done in a day, at least for many years (27,541 steps in total). Since my ED started, I've longed to be able to walk, even just laps around the block, but due to the ever-increasing agoraphobia, I've never been able to.

Just before 11pm, toward the end of my 174th lap for the day and my fourth hour of walking laps (a little over 5 hours total for the day), after walking for an hour straight, a nurse who wasn't even on my ward got angry and said:
  “Look, you're obviously tired sweetie. Enough is enough. Go to bed.”
  “I can't, I just have to do one more lap.”
  “No, go to bed.”

I kept walking and did my last lap, unable to finish on such an uneasy number. The worst part is that I wanted to do another 25 laps to make it an even 200 for the day. After, I went out for a smoke, tears leaking out because I didn't mean to make anyone angry at me. I got locked out in the courtyard, as it's locked between 11pm-6am, and the nurse didn't see me when she locked the doors.

Another nurse pulled me over just a few hours earlier, toward the end of a 50 lap/one hour session, asking if I was nearly done.
And earlier the same nurse stopped me and asked me to slow down because I was walking so quickly. If I'm anxious, I go fast. If I'm depressed, I go slow.


It's been an intense week, which is why I've fallen so behind on both my journal and blog. It's taken my days to even write in my journal, and I think it'll be another few days before I get around to updating my blog. I know my lasts few posts have been long, but I'm hoping things in life will be a little quieter for now.

I'm tired of everyone just wanting me gone.


In ICU, I had no notebooks, no journal, and no phone. I had only the clothes on my back, the empty medication packets mum had given the paramedics, and a phone with just 2% battery. I used the little time I had left on my phone to quickly check in with MyFitnessPal, terrified of losing my 2,100+ day streak.

Desperate to keep notes, I asked the nurse if I could please have a piece of paper and a pen. I rested it on my phone for a flat surface, shuffling the scrap of paper around, before he kindly handed me a clipboard. I kept frantic notes, so I'd be able to fill in the gaps when I got around to journaling.

My shelf of backup safe foods at the Clinic
(low fat crispbread, oat bars, sugar-free Werther's Original, peppermint tea, 
chewing gum, hot chocolate sachets, and of course, Coke Zero)

The shelf where I kept the gifts that the lovely Sam sent me


xxBella

Monday 21 November 2016

Are you looking down upon me? Are you proud of who I am?

On Friday, I went out to go to the cemetery with my mum. It would've been my Dad's 70th, but he passed away from a brain tumour at the age of 49, a month before my third birthday.

We picked up some flowers on the way. The cemetery is just down the road from my house, and I should really go more often than I do.

Most of my family is there. The only living family I have left are my mum, my brother, and my Great Aunt. I do have aunts and uncles and cousins, but I've never really known them. I could walk past my mum's brother and not know him from a perfect stranger.

We visited Dad's grave first. Mum wiped the dirt and dust from the headstone and plucked a few weeds peeking out. My earliest memory is throwing sand into the grave at his funeral.

Then we walked over a few rows to where my Grandma and Pa are buried. She died not long before my Dad, and my Pa joined her 8 years ago this Christmas. Christmas was always made special because of Pa, and losing him the day after Christmas changed the holiday forever. I hadn't been back to the cemetery since his funeral.

My Great Uncle, who has always been more like a grandfather to me and a father to my mum as she lost both parents before reaching adulthood, passed away in March of this year. I was quite sick with pneumonia at the time, and put off the inevitable hospital admission in hopes of attending his funeral. That morning, however, I was simply in too much pain to even move, and spent the day alone in the same hospital my Great Uncle had only just left.

His grave is on the other side of a very large cemetery, and I was planning to walk. But already in tears, and knowing it would only get worse, I took up mum's offer to drive around instead.

Usually I have trouble spotting the headstones until I'm right in front of them, but Uncle's jumped out at me from several rows away.

I started bawling and gasping for air. Missing the funeral left a sort of hole in the grieving process for me, and this made it all come rushing in. Mum placed her hand on my back, but I jumped away.

I feel a sort of hatred with regards to my Dad's untimely death. Not toward him, but toward the tides of fate. It was the start of an unfortunate series of events that have led to me being the wreck I am now. Mainly, I believe that if he hadn't died, I wouldn't have been abused as a child. He would've been there to protect me. If I wasn't abused as a child, I wouldn't have let it happen again as a teenager. I wouldn't have had to go through a lot of things, and I wouldn't have developed the mental health issues I have now. 


Not long after getting back to the Clinic, I saw my psychiatrist, which was just a blur. I wanted to go home for a little while to get an idea of how I'd cope with discharge, and we decided I'd go on leave for a few hours at 5pm and come home later in the night.

Billy was so happy to see me. He ran around and jumped up and kept bringing me socks from around the house. He loves socks. He'll pull them from your feet if you give him the chance.

Misty took a while longer, as she was out lurking in the yard. When she first saw me from across the kitchen, her back arched and her eyes widened, but she still let me pick her up for cuddles and we had a good 'meow' chat.

After that, it all went down hill. As soon as I'd said hello to them, I cracked a bottle of wine, which technically I'm not allowed to do, but I didn't really care if they found out and discharged me.

I took five oxazepam at once, breaking another rule. I hit my head against the wall and drove a cigarette into my arm while I had the chance. So far no one's noticed the lumps or blisters.

I got back to the Clinic right on 10pm, the latest I could stay out. I'd had nearly a bottle and a half of wine and too many oxazepam. I stumbled once in my heels, just a tiny bit, after the nurse let me in He commented, asking if I was feeling a bit unsteady, but I just brushed it off. I was in tears from the emotionally exhausting day, so they didn't push it.

I barely slept that night. My head was a mess and my stomach was in knots. I spent most of the night up between vomiting and slugging down Coke Zero. I don't know how no one noticed I'd been drinking. Considering they know I drink a few times a week at home, I thought my stumbling and vomiting would've made them break out the breathalyzer.

It was hard being back home. It'll be no different when I go home than it was before my admission, if not worse. Home does not feel like home. I feel like a stranger, and not a particularly welcome one at that.

I went on leave the next day to go home again, which was even more of a disaster, but I still haven't processed it, so for now I'll leave it here. 





“There's nothing I wouldn't do
To have just one more chance
To look into your eyes and see you looking back”


xxBella

Thursday 17 November 2016

Why am I here?

The first few days here were okay. I think I was running on adrenaline. After that, it's just been a downward spiral to the point that I'm worse than I started. Today is Day 15, and I can't help but feel like I'm not in the right place, that we're working towards different goals.

All the hope I had was hanging on this admission. Now, I just want to give up. Nothing's ever going to get better. And I don't want to keep fighting for life if that's the case.

Yesterday was the worst day I've had so far. At 7:30am, I got a text from mum, informing me that she will no longer be driving me anywhere. She said I need to learn to cope with people. It's not like I have enough to deal with at the moment. It's not like I'm trying to take enough steps as it is. And everyone keeps throwing more crap on top of the pile.

As most of you know, I don't go out except for appointments. That's the only place she drives me. Now, I'm losing that. Can you see the problem here?

I don't know why I'm still here. Why start working on the trauma when I'll lose it when I go home?

For so many years, up until only in the past year or two, getting help revolved around the fact that I had to because mum wanted me to. Increasingly, she just doesn't care anymore. And now, without appointments, without my dietician and GP, I've got no motivation or reason to keep going at life in general. I don't know why I still bother.

Forcing and bullying me into being around people and making me feel like worthless when I can't is not a solution. It will not change anything, and when I go home, I'll be back to where I started. It's just a band-aid. Both with mum and the staff here, they're all trying to fix a symptom without dealing with what's actually wrong. And until I get help with the abuse and all the other reasons that stop me from wanting to be around people, that will never change.

I'm going to kindly ask mum to keep her mouth shut until I'm through here and have been discharged for at least a week before dropping anymore bombshells.


The psychiatrist was okay on Monday, and I'll be seeing him again tomorrow.

The plan for a two week admission has now grown to three or four weeks, dependant on when I can get an appointment with my psychologist to start the trauma work, which was the whole reason I came. Her earliest appointment was the 23rd (the end of week three) but I'm just hoping there's a cancellation earlier, because otherwise I'm looking at four weeks to get two appointments in. I don't know if I'll even be able to find my voice to talk about it.

He just expects that I get out of my room, go to groups, and be around people, but I'm making no progress. There are three groups a day, and I only got to one last week (art), and two this week (relaxation, and yoga). I've barely been leaving my room. I'm not even coping with hearing people have conversations. He said if I'm going to isolate myself, I can do that at home.

He said he'd talk to the nurses and organise for them to walk me to the groups and talk to the facilitators about not asking me questions and just letting me observe, although it's still not been enough to get me to groups most days.

I can't say I care much about their goals to get me around people more. There are too many people. Too much noise. It won't continue once I'm home, anyway. I can't pull people out of thin air to bring into my life.

There are a few outpatient groups he wants me to consider, but I'm not too keen. I'm better off with one-on-one and don't function well in group situations, and I at least need time to go home, settle back in, and think about it before I sign up to anything.

As a long-term goal, he wants me to work with my GP to cut back on the benzos. Between the lorazepam and oxazepam, he said I'm on the equivalent of 60-80mg valium a day, and that's since cutting back when I was admitted.


Yesterday, after mum's announcement, I stayed in bed all day, and didn't even try to get to groups. I skipped breakfast, the first meal I've completely skipped since being here. I couldn't even face the safe yoghurt mum brought in for me. Instead, I walked 50 laps. What's the point of trying to eat? I'm making no progress here. I've lost my appointments. I don't know why I should even try anymore.

The nurse came up to me and asked if I'd be here for lunch and dinner, as they do daily.
  “Umm... no.”
  “Are you going out? Where are you going?”
  “I don't know.”

I think she could tell I was bullshitting, because the kitchen still sent both meals. They brought in lunch. I didn't touch it. Toward the end of the day, I asked the nurse she could ask the kitchen to just send some toast, as I hadn't eaten yet and didn't feel up to a full meal. She said she would, but dinner still arrived. I nibbled at the potato wedges, ignoring the fish and everything else, and had a few crackers after, 24 hours since my last intake.

I tried talking to my nurse after I got the text, but she doesn't understand. None of them do. She thinks I just need to change myself, and will be able to take public transport and magically won't be isolate when I go home. Like I said before, forcing it doesn't work. It just pushes me further into retreat. Everyone's trying to fix the superficial issues without addressing the real ones.

So I'm not talking anymore. Yesterday, my nurse pulled me aside during my walk, asking the routine “are you safe?” question. I said “I don't know”, and when she said she needed an answer, I just snapped “Yes” and kept walking.

It's the same thing every day.
  “Are you feeling safe?”
  “Yes.”
  “No thoughts of wanting to harm yourself, or end your life?”
  “No.”

I answer flatly, the same every time, no matter how I really feel. Sometimes I say “no more than usual” or “nothing I can't manage”, but that seems to cause concern and prompt them to ask for 'more details.' If I tell the truth, they won't let me stay because I can't guarantee my safety. All I can guarantee is that I'll hide it.


I got another text from mum that night, saying that at one of her appointments, she'd run into my GP, who asked how well I was doing. Obviously not even mum knows how I'm really doing, because my GP is apparently 'impressed'. I wish I could call her and tell her I'm worse than when I came in.

Mum has come in a few times. She brings me cans of Coke Zero, sometimes some safe crispbread of muesli bars, and any mail I might get (including the adorable parcel pictured below from Sam Percy).

Over the weekend, we drove down the coast to Torquay, which was one of the goals, to go more than a few kilometres away from home. I didn't get out of the car though – that's the next goal – but it was stressful enough as it is. It was a lot to take in, noticing all the changes since we used to drive down there on a regular basis, and there were people everywhere.


I'm still walking pretty much every day, for up to two hours. I'll have time to fill in, and my head says Walk! Walk while you have the chance.”, and so I throw on my nearest shoes and go, even if I'm in my pajamas. I just walk around and around in circles, numb.

You know how some people say they walk to think? I don't do that. I walk to not think, just counting laps and running numbers through my head.

Every now and then, a nurse will pull me aside.
  “You must be exhausted.”
  “I just have to do five more laps.”
  “I'll come find you for a chat when you're done.”

Sandwiches are still making up the bulk of my meals, dismantling and reassembling them to weigh the components and adjust it to my specifications. If there are no sandwiches, I'll have chicken or fish with potato and veggies. There have been one or two exceptions, but they are few and far between.


One curious addition. If you've been reading for a while, you've probably heard me talk about the Horrible Psychiatrist at the public hospital, most notably how he sectioned me, let it lapse without the 72 hour review, and held me for a week more while he figured out the legalities of if he could keep me against my will or not. The registrar who used to work with him, his Right Hand Man, now works here. I've seen her around the corridors quite often, and even seeing her is enough to strike fear into my heart.


CLINIC GOALS

1. Go for a drive more than a few kilometres away from home (achieved)

2. Go out in public somewhere quiet for a coffee, walk, etc. (potentially a visit to the cemetery, or a piercing if I can get into town)

3. Go to more groups

4. See my psychologist at least once, ideally twice, to start talking about the trauma




A cherry cigar one of the patients gave me
xxBella

Thursday 10 November 2016

"Crying helps me slow down and obsess over the weight of life's problems."

I'm starting to doubt if I'm going to achieve anything by being here. I've been inpatient for a week now. The first couple of days were okay, and I felt like I was making progress, but now, I feel worse than I did before the admission. Right now, I'm seriously considering giving up and going home. I'm just wasting a bed. It's not even a matter of wanting to go home, but feeling like I should.


I saw the psychiatrist again on Monday, and am seeing him again tomorrow. He was happy with the steps I've made – staying here for more than one night for the first time ever, leaving my room to smoke in the courtyard, even though I hadn't been to a group yet. His goal for for is to break the isolation and just be around human beings.

When mum's back, apart from seeing the psychologist, he wants me to try going out for a coffee or a walk somewhere quiet. I'm thinking of maybe just going for a drive down the coast. I don't think I can get out of the car. But even going more than a couple of kilometers away from home is more than I've done in months, and scary to think of now, even though I used to feel safe as long as I was in the car.

I don't know. I feel like I'm not achieving what's expected of me. The last few days, I've been even more isolated. I'm scared of all the people. I'm scared of the noise. I've barely moved from bed. I'm wondering why I'm even here and if I really want the help or not.

As soon as I go home, I'll be just as isolated again. I still won't be able to leave the house. I still won't have friends real life. It feels like I'm physically losing my voice. It can't get past my throat, and when it does, it's barely more than a whisper.

Yesterday during morning OBs I broke down into breathless tears when the nurse said it'd be good for me to go to groups. The psychiatrist is happy with me just being around people. Why isn't that enough? They tell me to focus on the achievements I've made, not the ones I haven't, but not everyone seems to agree.

I still say I'm fine, even when I'm so anxious and low I can't move, even when I'm in tears. I don't know why. I just can't say how I'm feeling.

Every day, I can't wait for my night meds to get here and for the day to be over.

I've been to a grand total of one group, art therapy on Monday. I'd asked a nurse if she could come get me and walk me to the group to make sure I got there.

We made stress balls out of balloons filled with flour and rice, which was ironically very frustrating. I'd get flustered when the balloons would pop, and people looked at me and laughed, which didn't help. Thankfully, I'd had an oxazepam before the group, and now have a purple and black striped stress ball.

I was going to go to yoga this morning, but woke up with a headache again, so am just taking it easy for now. I've been planning to get to one group a day this week, but haven't been able to do it.

I've still not had a conversation with any of the patients. They say hello in passing, and sometimes comment on my clothes, but that's about it. After a week, I don't think it's going to happen, and I'm too afraid to talk to them. Several new patients were admitted yesterday, and it's just made leaving my room harder. I'm scared of all the unfamiliar faces.

I haven't even been able to open my curtains the last few days, just enough to peek out into the courtyard and see how many people are out there before I venture forth. I hate hearing people talk and laugh. I hate hearing phones ring. I hate seeing them having visitors. It just reminds me how alone, isolated, and unloved I am compared to them.


I got a text from mum yesterday, after five days of radio silence. I've had no leave, no visitors, and no social contact outside of blogger. She's getting back later today, but I don't know if she's visiting or not. I sent her a list of a few things I need brought in, and told her to just leave them at reception if she doesn't want to visit. I'm not going to ask her to unless she actually wants to. If she wanted to know how I'm doing, she would've made contact, but she didn't.


I've also been walking a lot these past few days, just doing laps around the corridors. The other night, I couldn't sleep, and kept getting more and more distressed even after my night meds. So I threw on my ugg boots and walked for an hour. It's easier late at night when there's no one around.

I walk until my feet are blistered, my muscles and joints ache, my lungs burning. I asked for band-aids, and they had to check them first. I told the nurse I tried to tire myself out before asking for more meds, and she said I'm better to ask for meds first.
  “It's also your eating disorder driving that too though” she said, poking my shoulder as she spoke
As soon as I had the band-aids, I was walking laps again. It seems that for every person who says I should exercise, for one reason or another, there are two saying I shouldn't.

It doesn't make me feel better because of 'endorphins' or any of that crap. It makes me feel better because I'm burning calories. When I don't exercise, the thoughts eat away at me until I do. That's the only relief it gives me. It's all just a numbers game.

It's just so novel to actually be able to walk and not just do step aerobics in the lounge room. That's one thing I'll miss, one thing I've always wished I could do but have never been able to – just walk! While I have the opportunity, I feel like I have to do it, because it's not something I can usually do. I have to walk for at least an hour. I have to reach at least 10,000 steps a day. 

Earlier this week, they gave me the wrong breakfast. I smelt it as soon as they brought the tray in. I ordered wholemeal, as always, but they gave me fruit toast. Thanks to ED 'logic', it started a chain of negative thoughts. Breakfast here is my only safe meal, the only one I know I'll be able to eat.

I didn't say anything because I didn't want them to offer to bring me more food. It felt greedy. I took my coffee and went outside to have a smoke and cry, and eventually came back and ate the yoghurt.

There's a mobile cafe van that comes in the morning, so I've been able to get one proper coffee (admittedly with 4 shots) most days.

They also finally refilled the vending machine on Monday, after three days of no diet soda. Over the day, I guzzled down three overpriced cans of Coke Zero. I'm already dreading when it runs out again.

They had a fruit platter out after my disaster breakfast. I was late to the party though, and there was only one tiny piece of watermelon left, plus some oranges and grapes. I miss watermelon so much. Recently, I'd been getting through a melon a week at home as the bulk of my diet.




xxBella

Sunday 6 November 2016

So Far, So Good (?)

Where do I start... I was admitted to the Clinic on Thursday. I'm currently on Day Four, which is longer than I've ever managed to stay here before.


I had my interview on Tuesday afternoon, which went much better than the phone calls. I spoke, quietly and hesitantly, but I spoke. I answered all her questions, and tried to stay as calm and objective as I could. We spoke about why I was there, what I want to achieve. I told her I want to start talking about the childhood abuse in a safe environment.

As always, she mentioned the AN, and said that if I wanted help with that I'd need to be referred specifically to the ED ward. I told her that I really don't, that I'm working with a dietician, that whole spiel.

She asked if I self-medicate through alcohol, and I said no. Yes, I drink a couple of times a week of late, and yes, I might drink if it's been a bad day, but I wouldn't go so far as to call it self-medicating or excessive. I told her about the smoking, and that I quit synthetics a little over four months ago, although I've had a few short 'blips' with the natural stuff.

She said the psychiatrist was willing to offer me a two week admission to deal with the current crisis. She wanted to be sure I wouldn't pull the plug at 24 hours, as I've done so several times before. I told her I'd spoken to my GP about it. I told my GP I knew that nothing would change at home if I didn't see it through, and she pointed out that, more importantly, nothing would change for me. My backup plan was to see my her or my dietician for an appointment and talk it through with them first if I felt like I was going to discharge.

I had to guarantee that I won't try to commit suicide while inpatient, and told her that my thoughts of death are mostly passive, not usually 'having a plan to take action' type thoughts. She asked if I have any protective mechanisms, like “Oh, I couldn't do it to my family”. Honestly, I don't really think about the effect on others. This will sound horrible, but I don't think I really care. This world, and most of the people in it, have never treated me well, and I owe them nothing. The other thing stopping me? I just don't want to die fat.

She said she'd speak with the psychiatrist and try to call back before the end of the day. Half an hour after we got home, she called and said I'd be admitted at 10:30am on Thursday.

I spent the next day and a half packing and just trying to get everything in order. Making lists and double, triple checking my master “What to Pack for Hospital” list that I've built over the past several years.


On Thursday, I was up early, despite having had a few drinks the night before as a bit of a 'last hurrah', as I sure wouldn't be able to access substances for the next two weeks.

When we got to the Clinic, I didn't have to do the regular pre-admisson interview. I guess that was covered on the Tuesday. I just signed the paperwork. I can see why treatment can add up, particularly in places like the US. I yet again got my money's worth from my health insurance. Their fee comes to over $1,000 a day, all of which is covered by my insurance. For 14 days, that's... roughly two and a half years of what I pay in insurance.

They did an extremely thorough bag check, pulling everything out to a heap on the bed. They shortened every cable, bundling them up and fastening them with cable ties. Nothing longer than 30cm, with the exception of head phones. And they confiscated more than I imagined they would.

Starting with the obvious, I'd accidentally left a razor blade in my wallet, still wrapped and unused. I tend to stash them in random places so there's always one close by if I need it. I don't think I'll be getting that back upon discharge. They also took my shaving razor, pencil sharpeners, and hair straightener. On the less obvious end of the spectrum, they took my blunt, rounded tapestry needles, my nail file, and my tweezers.

Worst of all, they took my hot water bottle! You can burn yourself with them, you know. That thing is usually clutched to me 24/7, so they gave me a few heat packs. Thankfully, it's so warm in my room that I haven't needed them. They also initially confiscated my Fibersure, but got it back later in the day once the doctor gave me the all-clear.

They asked for a brief overview of my life history, starting with my dad dying when I was 3 years old (my very first memory is throwing sand into his grave at the funeral), all the way up to the mess I am now. Then the nurse gave me the grand tour, as it's been a while since I was here, and didn't remember where everything was.


On Day 2, I saw my psychiatrist for the first time. It was mostly a 'get to know you' session. It's been over six years since I last saw him, on my first admission here, where he diagnosed me with C-PTSD. We talked about the childhood trauma issues, how it ties in with everything else, diagnoses and medication.

His aim for this admission is crisis intervention, and to get the ball rolling on the trauma counselling. He wanted me to try to set up counselling with a specific abuse counselling service, but then said that maybe the new psychologist I met a few months back might be able to do it instead, and asked me to try to get an appointment or two while I'm still here. If I get leave to see here and come back to the Clinic – not home – that still achieves my goal of starting to talk about it in a safe environment.

They're not going to be changing my meds while I'm here, as it takes longer than two weeks to see the effects. I was really relieved to hear this, although it was one of the things my GP was looking forward to about this admission – finally having my medication properly assessed by a psychiatrist after years of her being in charge of chopping and changing them all.

I asked him about TMS (transcranial magnetic stimulation, similar but different to electro-convulsive therapy), as I'm wanting to look at more options instead of just talking and medication after 12 years of it not helping. He said that even if it didn't help, there'd be no harm done, as there's no side effects like medication can have. He also agrees there's not much point in trying more antidepressants, as they obviously haven't helped me.

They gave me some information on TMS. Ultimately, I decided not to do it, not on this admission anyway. You see, it's only covered by insurance while you're in hospital, which would extend my stay to 5 or more weeks. I don't think I can do that. I might look into it at some point in the future, but for now, I just can't.


I kept up a facade for the first day. Saying that I'm okay and forcing a smile. But on day two it cracked. The nurses walk in to do checks and instantly say I look anxious.

I found out the day before I was admitted that mum was planning to go away to visit her friends for a few days, leaving the day after I was admitted to the Clinic.

When I called her on Friday to fill her in, she told me she'd be staying for a week. I can't get to see my dietician on Tuesday, and she'd apparently completely forgotten about my appointment with my GP on Thursday (which was specifically booked for then so I'd be able to see her while I'm inpatient), let alone be able to get to see my my psychologist.

No family support, no visitors. Just a scary place full of strangers by myself. Just being dropped off and abandoned, and more of her sweeping it under the rug, because obviously it's just my issue to
deal with alone. She hasn't so much as texted since.

That triggered the first breakdown, the first tears, of the admission. I buzzed a nurse and talked to her. She gave me a PRN, and asked if I'm eating enough, as she saw the AN mentioned in my notes. I told her probably not as much as I should, and she said she'd talk to my psychiatrist and see if he wants to put me on Ensure while I'm here

I was planning to text the dietician to let her know, and ask if she and/or my GP could pleasepleaseplease come visit because I can't do this alone. I wrote the text, but couldn't send it. I don't want to bother her or guilt them into visiting.


Leaving my room is still scary, but I go out for a coffee and a smoke fairly often. My room looks on to the courtyard, where I can check that it's not too busy before venturing out to my little isolated table for a smoke break.

Most of the tables sit 4-8 people, but there was a tiny round table to the side, just by my window, so I pulled a chair over and have been sitting there most of the time.

I really don't want to talk to anyone. I barely even speak to my family these days, and I feel like I'm losing my voice.

A few people have said 'hello' in passing, but I'm yet to actually have a conversation with any of them. They're all very social though. They all sit together in the courtyard and smoke and talk to each other, and I'm just this silent loner sitting at a tiny table by myself. The men scare me the most. I think this is going to be the biggest hurdle of the admission – actually talking and being social with the other patients.

The thought of groups starting tomorrow is scary. They didn't push for the first couple of days, but tomorrow is the day. I underestimated for difficult it'd be. I'm not at all used to being around people, let alone so many. I'm going to ask for a nurse to come get me and walk me to the groups, as otherwise I'll just get frozen with fear like I did on Friday.

Thankfully, the psychiatrist said he's happy for me to start with just getting out in the courtyard and being around people. When I start groups, he said it's okay to just be a wallflower and not talk, but it's still scary.


The last two days, I've woken up feeling very low. It's the weekend, and I'm alone. No visitors, no one to take me on leave.

I miss Billy. I miss Misty too, but I don't have to worry about her like I do with Bill. He must be so lonely with neither mum or I there. He's probably sitting on the couch or by the front door, whimpering and howling the house down. I guess my brother will be there for the weekend, but what about during the week? I'm worried about him. Whenever I'm away from him, I get so scared that something will happen while I'm not there. It's actually a big part of the reason I've decided not to do TMS. I can't bar to be away from Billy for 5+ weeks. One or two weeks is heartbreaking enough as it is.


I'm trying to keep a daily routine of hygiene, getting dressed, tidying my room, taking my meds notes, journaling, coffee, that whole thing. I've been waking up around 5am, unable to get back to sleep. It takes a while for the fear to pass, not that I have much reason to leave my room so early as they lock the courtyard and kitchen overnight, and I can't get a coffee until 6am.

I keep bumping into my old ED psych, which I hate.

I need to really focus on not self-harming at the moment. Even if I hit my head, I'm gonna need to be quiet about it and keep it to myself. The psychiatrist said that if I self-harm at all, I'll be asked (kindly) to leave, as I need to be able to keep myself safe while I'm here. I'm seeing him again tomorrow.

My pulse has usually been 120-130, and my O2 sats lower than usual. I'm keeping an eye on it, as a few days before admission my oxygen got down to 83%.


There's no wifi here, and with the steep prices for extra data on my phone plan, I'm going to be limited in what I can do and how often I can post, but I'm trying to keep up with at least reading everyone's posts with my morning coffee.


My little isolation table


I take my pocket scales and liquid stevia into the kitchen. I know black coffee is supposedly low in calories, but when you drink as much coffee as I do, it adds up, especially compared to my beloved espresso.
  
One of the safer, nicer meals I've had, although I never eat more than one egg

My favourite safe meal - Vegemite toast and strawberry yoghurt
Although I only ever eat one slice, and the yoghurt is higher in calories than my usual


xxBella

Tuesday 1 November 2016

Progress

The past few days have been... turbulent, to say the least.

On Sunday, disaster struck, and everything came crashing down.

The Clinic finally called, but they said they couldn't consider admitting me. Why? Because I just cannot bring myself to speak on the phone.

Mum had it on speakerphone so I could hear. They wanted to know why I want to go, what I want to achieve, what's changed since my last admission. I sat with my head in my hands. As they kept asking and pushing for me to talk, I got more and more distressed. I started sweating and shaking and hitting my head because I just couldn't do it.

Mum told them that my GP would be calling the next day to speak to the psychiatrist personally about what's going on and why I need to go there, but they said that wouldn't be enough to admit me on unless I speak to them on the phone. I've never been able to talk to the phone to anyone except mum. I can't even talk to my GP or dietician. I can't even explain why.

The call ended with the admission worker saying she'd tell the doctor about the unsuccessful phone call, and it felt like the end of the world. This was my only hope, and it as gone. Everything was revolving around this admission, all the hope I had was hanging on it, and now it was gone.

I started screaming and crying at the top of my lungs. Devastated. They wouldn't even consider me going in to talk to the doctor in person, just because I can't talk on the phone.

I couldn't even contact my GP, being a Sunday. I was in total crisis, and she always knows what to do, but I was losing hope that even she could fix this. So I took nearly every pill I had, leaving just enough to get through the next day until the new week's meds would be delivered. I just wanted to sleep. If I can't go to the Clinic, there is no hope of things getting better. There's no where else to go and no other way of getting help.

As a funny (well, not really) side - that night I fell asleep with my favourite knife on the couch. I hadn't yet used it, but sometimes I hold it just for a kind of comfort, knowing it's right there if I need it. I guess I passed out before I could put it away, because I woke up in the middle of the night, having rolled over onto it and stabbing myself in my *ahem* gluteus maximus. I now have a gaping stab wound from unintentional self-harm.


Yesterday, I woke up feeling lost, alone, and hopeless. Later in the morning, they left another voicemail while mum was out. I thought it'd be "Your GP called us, and yes you can come in/no we won't admit you", and either way, that'd be the end of it.

When mum got home from her appointment, she called them back, and it was the same routine as the day before, wanting me to talk to them on the phone. Thankfully, they didn't push as hard, and mum just told them I couldn't do it.

Straight after, we called my GP, and told her about the phone calls. She said she'd try to get in touch with the psychiatrist, plus speak to the admissions people who kept calling me, that she'd sort it out. I didn't think it was going to change anything. She said not to worry, but they'd made it painfully clear the day before that it wouldn't be enough, and unless I get on the phone, they wouldn't admit me.

I still didn't get my hopes up. After Sunday's call and the subsequent breakdown, I couldn't afford to keep thinking it would all be fine, just to crash again.

Then, just before 5pm, they called again. She said my GP had called earlier, but they hadn't been able to get in touch with her, and obviously the psychiatrist wasn't available when she called, so they decided to call for a third time and bully me more.

She said quite clearly, that if I couldn't get on the phone and say "My name is Isabella Rayne and I want to be admitted to the Clinic.", that they couldn't take me, as they can't confirm I'm a voluntary admission, and they don't take involuntary patients.


This morning, I caught my GP for a few minutes after I finished with the dietician. She said she was working on it, and I told her they'd called again in the afternoon.

She pulled me aside, and said she'd called yesterday and spoken to someone, and reinforced the fact I can't talk on the phone. I dug through my purse for the piece of paper mum had jotted a name and a phone number down on from the last call, and lo and behold, it was the same person. I told her that they'd said they hadn't spoken to her, that she'd been unavailable, and she looked as surprised as I was. She confirmed that she had in fact spoken to them.

I told my dietician that I thought they were just going to keep calling and calling, trying to get me to talk on the phone, until they gave up and threw out my referral. My GP wouldn't say I wanted to be admitted if I didn't. I wouldn't get in the car and go into the Clinic for the admissions interview if I didn't want to go. Why was that so hard for them?


Later this morning, there was a fourth phone call. But this time, she said she'd just gotten off the phone with my GP, and was asking me to come in to speak to them face-to-face and answer their questions instead of talking to them on the phone.

Straight after, my GP called to check that everything went through okay. She is seriously amazing. She told me the lady who'd called is nicer and less pushy than the others, and will really work with me to assess everything.

So, at the end of all the drama, I'm going in to talk to them in a couple of hours, at 2pm. As a bonus, mum's surgeon gave her permission to drive again as of yesterday, so after three months, I no longer need to catch Ubers and taxis everywhere.

With any luck (and god, do I need it), I'll have some good news by tomorrow...


xxBella