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 174^th 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