Daily Archives: January 18, 2014

Sad Days Ahead

Friday, January 18, 2014, 2 pm.  Walmart.  Maneuvering the shopping cart (or “buggy,” as they call it here in Western North Carolina) around the place packed with people gathering supplies for what was supposed to be a blizzard, luckily turned out to be flurries.  I was picking up a few things to top off my Shabbat preparations: mineral water, blue corn chips, orange-and-red striped tulips, and cheesecake.  My phone rang: my mom.  Her cell phone, which was odd at that time of day.  Alarms go off in my head.

Dad has fallen again–the second time this week.  The many-th of this year.  Falls are increasing in frequency, varying in severity, but always accompanied by a decrease in function afterward.  He has a dementia that is not Alzheimer’s.  He’s had many small strokes.  And he’s got a narrowing of his spinal canal that causes him to have to wear diapers because it’s pressing on the nerves that control his body functions.  And to make things even better, his vertebrae–all of them–have been slowly but progressively disintegrating so that he’s bent over in a “C” shape when he walks–if he is able to walk, which is sometimes, with difficulty, with a cane or pushing his wheelchair, which is where he is parked most of the time.

So far he’s managed by sheer force of will to do his shower by himself.  But this time he fell right over on his back, hitting his head for the millionth time on the hard tiled floor, and my mom was not able to get him up; so she did the right thing and called the ambulance.  As of the time she called me they had still not shown up and Dad was still lying prostrate on the floor naked as a jaybird and twice as wet.

It took them a good twenty minutes to arrive.  Good thing there was nothing life-threatening.  And when they finally got there, they came in such hordes that there was nowhere to park both the First Responders van and the Ambulance, which couldn’t even get into the tiny parking spot at the end of the long dirt road where they built their home 40 years ago.  They couldn’t figure out how they were going to backboard him out, given that my parents built their house into the side of a cliff and there is very limited access.  My mother said it was like the Keystone Cops.

After I got her call I put the cheesecake back in the freezer and just left my cart where it was, and drove the ten minutes to the hospital, thinking surely they must have arrived at the ER by then.  But no.  I waited a good half hour.  My mom arrived in her car, and it took the ambulance another fifteen minutes to get around to unloading poor Dad, who was immobilized on a backboard.

CT scan of head and neck were fine, but he had a new compression fracture of L1, the first vertebra below the thoracic (chest part) spine.  And as I gazed at the cardiac monitor, I noticed a very strange rhythm, or dysrhythmia really.  It looked to me (and it has been a very long time since I read EKGs) that he has a partial or intermittent block in the electrical system that runs the heart.  It happened in “runs:”  the pattern would get normal for a minute or so, and then pop back into the abnormal rhythm.  I observed that his level of consciousness varied with the rhythm.  When it was weird, he would get confused and less conscious; when the rhythm was normal, he was more aware and oriented.  That explains a lot, because he’s been “going in and out” a lot lately.  Surely when his rhythm is weird, his heart is not pumping normally and his brain, already battered, is not getting enough blood.

As if that is not enough, he has a urinary tract infection–probably the same one he had about a month ago that was inadequately treated with the wrong antibiotic and no follow-up culture to see if it had cleared.  I was furious then and I’m furious now.

Thankfully, he was admitted to the inpatient service.  The last many times he has fallen and hit his head, they have sent him home, even when he injured himself badly enough to need stitches.  But this time, with the combination of the fall and the dysrhythmia and the kidney infection and the broken back, for heaven’s sake, they kept him.

Today, Saturday, January 18, my mother, the doctor, and I, unanimously made the decision that he will go to a nursing home for “rehabilitation” after his hospital stay.  This is a very sad state of affairs.  In all my years of doctoring, and in all my mother’s years of being a geriatric social worker, neither of us has ever seen an 89 year old person who is sent to a nursing home for “rehab,” be discharged from there to come home, because by that point the person is really not “rehabilitatable.”   If my dad makes it out of that nursing home I will be very surprised and very elated.  But I don’t think he will.

He’s been through at least four six-week courses of twice weekly physical therapy to try to improve his balance and ambulation.  All that’s accomplished is to cause him great pain and distress, but he’s soldiered on with it because he’s not a quitter.  In fact, the main reason for most of his falls is that he’s trying like hell to be independent.

I’m terrified to think of him in a nursing home with a broken back, because I know what they will do: they will leave him lying in the bed, with the excuse that it’s not safe to get him up in a chair, much less walking with assistance, and neglecting to turn him every two hours like they’re supposed to.  I’m terrified that he will develop bed sores.  Maybe I’m just, just, just overthinking….but this is what I’ve seen.  And if he develops a bed sore, he’s gone, because he’s diabetic and his immune system can’t take it.

So I know where I will be spending most of my time, making sure that he’s properly cared for.  It’s a sad time, a time we’ve all seen coming, and now it’s upon us.


Well…I’m WELL on WELLBUTRIN

Welllll bu trin. Why did it take so long for us to be introduced?!!

I feel so good. I feel like nothing is wrong, was wrong, and will ever be wrong. I feel great every morning and every night, and it’s because of Wellbutrin! I can’t think of anything negative or bad. I want to run in a field of flowers and hug people.

Weird, right?

Weird that a week of taking meds, I feel good. A little too good.. When is the crash and burn? When does the bad feeling come back? Now, I am doing thing that I have been putting off for a long time, and finally getting back to me.

But.. is it the real me?


Mental Health Bloggers Widen Their Support Systems on WordPress.com

Originally posted on WordPress.com News:
When we start a blog instead of simply keeping a private diary, it’s because we want…

Mental Health Bloggers Widen Their Support Systems on WordPress.com

Originally posted on WordPress.com News:
When we start a blog instead of simply keeping a private diary, it’s because we want…

Wham, Bam, and Toucan Sam

I swear, after two weeks of intensive training at work, my brain is crammed so full I think I just heard it burp.

This is not a job for sissies, I can tell you that. And I haven’t even gone out on my first survey yet. There is SO much to know, so much to absorb……now I know why the training period is six to nine months. My trainers keep telling me to pace myself, there’s plenty of time to ask questions and learn the intricacies of the job; but as always, I keep gulping down huge globs of information and then getting frustrated with myself because I can’t retain much of it.

Obviously, I need a new learning style, and pronto. It’s waaaay too important that I get this. I want to do a good job, but I also know the pitfalls of defining myself, and my own self-worth, by what I do for a living. And as I recall, it didn’t work out too well for me the last time I did that. Does the term bipolar meltdown ring a bell?

Seriously, I’m getting too old for this shit. I turn 55 this Sunday, and I’m asking myself when I’m going to learn that moderation in all things is the only way to go. I’m getting it right in some areas—the sleep routine alone is a HUGE thing for me—but once again, I feel that old, familiar itch to have more, do more, be more.

I guess the fact that I’m at least trying to analyze it is evidence that I’m not completely hopeless in this regard. All I have to do is look over at Toucan Sam, who’s still perched on top of my computer, to remind myself that mania is NOT my friend and that being over-involved in work is a red flag for it. (Even though my engagement has to be pretty intense during the week, because that learning curve is steep!)

On the other hand…….how cool is it that I’ve recognized this so early in the game, while I still have time to dial it back a little? Until recently, I was so blind to the warning signals that I’d never have seen it coming, and it would’ve run right over me just like it has so many times in the past. Now I have the chance to correct my course and put my career in its compartment where it belongs, and the rest of my life in the other compartments.

So I left my laptop in its docking station at the building, where it’s safe and warm and I can’t touch it during this upcoming long weekend. I need to practice working with some of its features, but I’ll have plenty of time next week to do that. What’s even more important is learning how to be a marathon runner, rather than a sprinter as I’ve been all my life…..and even THAT is going to take some time. May as well settle in for the long haul, yes?

 


Bipolarly 2014-01-18 04:32:00

“Monsters are real, and ghosts are real too. They live inside us, and sometimes, they win.” -Stephen King

Arlina’s Story

It is with great pleasure I present to you my first interview with an everyday girl living with mental illness. Arlina (or Lina) is a highly functioning young lady currently in nursing school who was diagnosed with bipolar disorder.

How long ago were you diagnosed with bipolar?

A: I was diagnosed at 23 which was about 3 years ago now but started showing severe symptoms from about 17. The doctor was treating me for depression and, when I wasnt getting any better after years and years of drugs and therapy and treatment, I saw a tv commercial – something like a psa for how bipolar often gets misdiagnosed because your doctor doesn’t see you when you are manic. In those few seconds I recognised myself and asked my doctor. He told me my symptoms weren’t severe enough so there was no chance.
I lost all hope. I was suicidal. I thought there was no chance I could ever get well again. Asking for a referral to a psychiatrist for a second opinion was the last thing I was going to do, so I could be sure I had searched every avenue before putting my family through that loss. The day of the appointment I was certain I was going to go, have my GP’s diagnosis of depression confirmed, then come home to end it all because there was no hope.
Instead I walked out with a “classic and unmistakeable” diagnosis of Bipolar, a brand new drug to try and hope that i wasnt beyond help.
Within weeks my life was completely different, I could physically feel my brain changing – all the hard work of managing sleep and diet and lifestyle choices were suddenly actually having an effect. I felt reconnected to the world in a brilliant new way and actually started creating goals and reaching them. On my 24th birthday (in feb thats the beginning of semester 1 here in oz) I started studying for my highschool equivalency, by june I had multiple offers to university degrees, by christmas I had finished the first semester of my nursing degree with distinction.
I often meet people who are so close to giving up and I am living proof that you can never ever tell how or when things are going to change.
what stay-well strategies do you use?
A: I am lucky to have a lot of strategies at my disposal. I am medicated, not everyone with bipolar is but I find taking Lithium works really well for me. I use journalling a lot, i find it can calm my racing manic thoughts or help me get some perspective over depressive thoughts, it has also helped me to track mood and triggers over time to have it all down on paper.
But most important for me is being careful to manage my sleep by keeping to a fairly strict routine – I am not great with routines and I struggle with sleep most of all but putting in the effort does seem to help.
How do you juggle nursing school and staying well?
A: I’ve actually been lucky that being in nursing school has actually helped keep me pretty well, it forces me to keep to a routine and be a little more careful with my health. It has given me a purpose in life and a serious motivation to push through bad days, plus I love it – so it keeps me excited by life and curious to keep learning. Best of all it means that my life is no longer centred around my mental illness, it was all I was for a very long time and I had lost sight of being an actual person who just happens to have a mental illness! My uni has also been really helpful and supportive, I have access to many facilities if I need them and the few tutors and lecturers etc who I have told personally have been really positive about having someone with my life experience entering the nursing profession, and student pool to add some diversity and a different perspective.
Have you ever faced mistreatment based on stigma? How did you handle it?
A: I have to say that despite being really open (most would say too open) about having bipolar and most people knowing I have it, the most overt signs of stigma come from those closest to me who love me most. It comes from a place of love and worrying for me but they often find it hard to remember that I am a capable young woman who occasionally has health issues, not just a walking basket case. There is a very fine line between managing my illness in a way that allows me to live a full life and keeping life small and mediocre in order to manage my illness – keeping my bipolar as stable as possible is only worth it if I still have a life worth living through it. Unfortunately my loved ones would often prefer I just avoid ALL possible triggers, living the safest possible existence. I am lucky to have people who care about me so much so I try not to let it bother me.
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Lina’s positive attitude and determination to help herself are so admirable and I thank her for being so honest with her personal struggle. Every day, millions of people live with mental illness and we’re not scary, dangerous or unworthy of love.
If you have any questions or comments on Arlina’s story, please share!

Filed under: Wellness Warriors Tagged: bipolar, depression, lithium, medication, Mental Health, stigma, wellness