Back From My Physical

So I had to go for my annual physical with my GP this morning. As suspected I have indeed lost more weight. The total should be about 20lbs. now. I am eating. At least something. And supplementing with Ensure. Crap, I had a rather healthy portion of spaghetti last night for dinner! I skipped the salad but that's mostly water anyway, right? I thought I'd just shovel in the carbs and the protein.

My GP was rather concerned. She asked if I am exercising. HA! Nope. For one thing, I'm too lazy and for another I'm too drained and exhausted--both mentally and physically these days. I do walk a little bit on work days for my commute? I don't know how much that counts. I know people say that exercise is good for those of us who are psych/neuro disordered but even when I tried I never seemed to reap any benefit. Cycling mostly. As in riding a bike, not being Bipolar.

Sorry, bad joke.

We will need to follow up soon after the upper endoscopy and colonoscopy next month to find out what on earth is going on. My cluster of symptoms seem to "look" like four things. Two of them start with a "C" and two of them start with an "I." I'm not jumping to any conclusions but I'm not ruling anything out.

But the weight loss is troubling and bizarre.

We also went over my psych evals and she was just about as peeved as I was about the last one. She couldn't understand why psychiatirst #2 refused me ongoing treatment. I also brought up Aspergers and she didn't bat an eyelash. We're going to get the two evals back, review them, I suppose and she is going to try and find yet another psychiatrist for a consult as she really wants me to see someone who will agree to monitor me on a regular basis. I mean, I know I have a complex brain but I'm beginning to feel like a neurological leper. And a social one too.

During my exam, I rambled on and on about how fucked up my life has been and is of late, I told her about my recent cutting...anything else?

She asked me to come back in a month and hopefully she will have the results of *everything* and hopefully a better psychiatrist to help me out. So as far as my head goes, no med changes as of yet. She booked me in for 30 minuntes which are her types of "counselling" appointments. She wants to spend more time talking with me as I guess both my body and my life are rather chaotic.

I think I have been lucky to find a real gem. Even if I have to travel a bit of a distance to see her each time.

I Must Have Order! (Or Not...?)

Alright, I'm tired so excuse me if this post may not be so orderly.

It is born out of a comment I made on someone else's blog about drugs and mismatched socks.

But the drugs don't really have anything to do with it.

I need a lot of order in my life--even to the point of minute things. Like matching socks. I mean, it's an absolute imperative. However, I can also live in organized chaos. It can seem like a bit of a paradox but it's really not. Because it's my chaos. To anyone else, it would look like a F2 Tornado had just gone through the room but chances are, if you give me a minute, I'll be able to get you what you need.

This was a lot easier when I lived alone.

My partner went through a bit of a cleaning sweep (pun intended) over the weekend and moved all of the DVDs from where they were "neatly scattered" by the DVD player in the bedroom. The DVD player had been moved by me to the bedroom from the living room well over a year ago when we had friends with a son who is on the Autistic Spectrum. We let him happily watch a movie later so we could carry on with dinner. I just never bothered to move the damn thing back so there it stayed.

So anyway, I stroll back into the bedroom and immediate panic sets in. WHERE ARE THE DVDS?!?! No, I'm serious. A wave of panic actually came over me--even though it was brief. Before I started asking, I decided to start looking. I did find them. Moved to a shelf. In another room. At least I didn't have to go digging for them like a lot of my other stuff that sometimes gets moved. And sometimes gets lost and never found.

And don't even get me started when my partner decides to rearrange the kitchen.

Confusing the Psychiatrists

Well, I just returned from my second psych evaluation. I never blogged about the first, I don't think? I can't remember. Well if I did (or did not) here's a brief review.

Of course with my "doctor anxiety" I was nervous as hell. Add to the fact that I hadn't had a full consult in about seven or eight years. I had no idea what to expect. It went alright, however. The psychiatrist at this "institution" had a gentle demeanor and a soft voice and we actually ran over the allotted time. I felt okay with it and he allowed me to ask as many questions as I needed.

Alright, I thought, this whole evaluation thing isn't so bad. Granted, it was difficult to pack your entire life's woes and psychological/neurological history into such a brief time span. I didn't cover everything in perhaps as much depth as I wanted with this man. The reason being, this consult was a "one off" and I did not expect any further appointments or follow ups with him. And again, I was nervous, unprepared and it was difficult. However, we went through Medication History, Family History/Trauma, Bipolar Disorder, Self Injurious Behaviour, Hospitalizations, ADD and a little bit about Aspergers.

After it all, he said he would "try and put something cohesive together" for my GP. I had to laugh a bit at that one.

Today was a bit different, however. I was mistaken about a lot of things. First, my appointment duration. I was told an hour, I only received 30 minutes. Also, I was under the impression I would be seeing this psychiatrist on an ongoing basis. Nope. But more on that later. Also, this man was not as...well, he certainly had a different "demeanor" than the first psychiatrist I saw.

It was a good thing I was a bit more prepared for this appointment. 30 minutes! We very briefly touched on all of the above mentioned in the first appointment. He asked some fairly simple and straightforward questions and I answered them. I gave him my prepared "dossier" and he flipped through some of the pages. Basically some self-prepared notes about ADD and Aspergers and some highlighted notes from referenced materials etc...

He asked if he could keep all of it. I told him the copies were his.

He basically told me about a counselling group (i.e group therapy) for women who are trauma survivors and how I could take advantage of that. He also told me that I would not benefit from ongoing psychiatric treatment from a psychiatrist due to my problems with functioning and other issues. I have no idea what this means. I don't know if this is an allusion to the fact that I have Aspergers or not. He said that seeing a psychiatrist would only exacerbate my problems. He said that I already have a therapist, see a neurologist and have a GP so that is good enough. Well, then why offer me group therapy? During all of this I simply stated that people with Aspergers do not usually do well in therapy. He agreed.

I still remain confused.

I did manage to get out of him his med recommendations. He had five. Ooh, decisions, decisions! He also casually mentioned one of them, Risperdal, would be helpful with both Bipolar and Aspergers. I told him that yes, I knew this. I also had to remind him of another med that would probably be helpful. He agreed and wrote it down. I so often wonder what doctors think of me when I stroll into their offices and spout such things.

So at that point, time was pretty much up. I felt unfulfilled. I asked him what he thought of the ADD and Aspergers. He said it was hard to tell due to "other issues" and the trauma I had been through. Alright. I understand all about truama and it does not preclude neurological disorders. I also argued high comorbidity rates (and even had that reference material with me.) I asked him if he planned on reading what I had brought him. He said that yes, he would. As I was putting on my coat, I asked again, "So it wasn't all in vain, then?" He said that no, it wasn't.

Yes, I can be terribly blunt.

Now I understand that clinicians can not provide diagnoses on the spot and I did give him a fair amount of documentation to review but a little more feedback would have been helpful.

Shoot, I can't stream the song I wanted for my new MP3 so you'll just have to go with my second choice. "One In Ten Words" by The Spoons. Canadian Band and the poppy little song is from my youth...it makes me laugh about communication.

"Bound" And Less Determined

I had no idea how to title this and I am still not sure how to write this without it descending into some sort of lurid expose into Patient Anonymous' past experiences and dalliances. That is not what this is about. But I need to put how I made an interesting self-observation into context so that will necessitate some self-revelation. And really, if you've been following this blog at all--nothing should surprise you anymore. We're all adults here. If this shocks you or you find it "titillating," get your head out of your ass.

I have worn one of these. Several times. But not in a psychiatric setting. Many years ago, I did a tour of the BDSM/fetish scene. And yes, the Bipolar was in full swing (undiagnosed, untreated.) This is no "value judgement" on "the scene" or myself if you will, it is simply the point where I was in my life.

I was introduced to all of this by a friend who was involved and asked me to go to a BDSM safe practices session put on by a local advocacy group. I found it rather amusing that she thought I might be "interested." Sure, why not? So I attended with her and her male partner.

Interesting, indeed! Wow, they pulled out all the stops! There was so much to look at! Some items seemed as if pulled out of some kind of medieval torture chamber and others just looked kind of neat and fun! At a certain point, the session leaders asked for volunteers to put on some type of bondage gear and then share their experiences with the group later on. Oh, I was excited! Pick me! The offer for the straightjackets came up and several arms shot up in the air. I was selected. Now the cardinal rule of S&M is "Safe, Sane and Consensual." So if at any time, anyone became uncomfortable, or agitated in their "restraints" they were to notify someone immediately and they would be taken care of.

Oh my. What a strange feeling. I had never had my body placed in such a position. At first, it was incredibly awkward but I realized that if I didn't fight it, if I just relaxed into it... All of the sudden, something rather strange began to happen to me. I felt comforted like I couldn't believe! I sat in that straightjacket for hours! I honestly don't remember how long it was but it was most of the afternoon of the full day session. I didn't want to take it off!

I later met a man who owned two straightjackets (who also coincidentally was diagnosed with MDD and ADD.) We are still friends to this day. He also designed bondage gear. We both found it incredibly calming and soothing and would occasionally get together (outside of the public scene where we did this as well) and basically tie each other up in our homes for comfort! Other elements of sensory deprivation could/would/might be employed.

When things got really, really rough for me and I couldn't sleep, I would occasionally employ self-restraint techniques in order to somehow try and calm myself down. My friend even offered me one of his straightjackets but I never got the knack of getting in/out of one solo (Houdini, I am not.) I managed with some personal and self-styled gear.

Think this all sounds a little bizarre? Temple Grandin (along with my friend) may not agree. If you do not know her, she is Autistic and has done some work (but not limited to) The Calming Effects of Deep Touch Pressure. Now, I am not on the Autistic Spectrum and despite how many similarities I may think I have with my friends' Autistic son, I don't believe I would fit the diagnostic criteria. Asperger's might be the closest I could come and even that would be a stretch. But it is interesting to see the similarities with the ADD children. And I do and always have had some other "sensory" issues. Probably not enough to again, meet the criteria for Sensory Integration Disorder but still, it makes me think!

I've always loved being loaded down with extra blankets on top of the duvet or I'll even throw all my partially worn clothes on my side of the bed, just to have that "added weight." I've always loved the feel of restrictive clothes (tights, leggings, bodysuits etc...--not "nylons" or "pantyhose" though--the fabric needs to be heavier!) I've been like this since I was a kid!

And no, you don't need to go as far as Temple's "Squeeze Machine" if that sort of freaks you out. It does look a little scary. A lot of Occupational Therapists advocate the use of weighted vests or blankets with kids that are Autistic, ADD, PDD or have SID. The affects of these have not really been studied (and neither has Grandin's machine) but I did manage to find this.

Perhaps I've managed to trade some of it in for "chemical" restraints now? And no, I don't want to bring up the whole debate about restraint usage in hospitals/institutions. That's not what this post is about either.

And if any of you out there are giggling away, stop it right now. If anyone actually has any serious questions pertaining to BDSM, contact me privately and I may or may not answer them--depending upon if you cross any boundaries or if you are completely inappropriate.

Edit March 09 2007: Aspergers has now entered the picture in terms of my psychological/neurological profile. I am still awaiting "confirmation" or at least an opinion from two separate psychiatrists.

High Functioning vs. Low Functioning...What's The Scale?

So going back to this post near the end, I questioned just how functional I really was. A lot of times, you hear the terms "High Functioning" or "Low Functioning" when professionals (or even lay people) refer to those with psychiatric or neurological disorders. Most commonly, it is heard in the realm of discussion of "Spectrum Disorders" such as Autism Spectrum Disorder or I would even go further to say "Bipolar Spectrum Disorder" even though it is not commonly referred to as such. But since it has been classified so finely (cough, cough) by the DSM-IV and the ICD into little boxes, I would think that "obviously" shows a spectrum of behaviour. What a lot of professionals need to bear in mind, however is that, due to the nature of these disorders being part of a spectrum, those beholden to them (I don't want to call us "sufferers"...let's not make us look more weak and pitiful, thank you) will invariably end up shifting throughout the very spectrum of the behaviour defined.

Is that clear? I hope so. Put it this way, if you're "labelled" BPI, that doesn't mean that you will never experience a mixed state or an extended period of depression lasting for months on end or that your cycling patterns won't change and you won't end up an ultradian cycler--the type that I ended up being. I was diagnosed BPII which apparently is "incapable" of cycling as fast as ultradian and I still carry the BPII diagnosis/label but guess what? As the years went by, I was cycling so fast that I was manically jibber-jabbering away and running around my apartment like I was on speed for 15 minutes and then suicidally in tears with no energy about 15 minutes later. Supposedly if you're BPII, that can not happen. Well, tell my brain that.

It's the same thing with Autism. So, if a child is diagnosed at the ripe old age of two or three with Autism, they receive therapy and then perhaps the diagnosis changes to PDD-NOS, are they no longer autistic? Well, that might depend on if you're applying for funding to continue therapy for your child (and that's a whole other issue...) And what about Asperger's Syndrome? There are people that are still debating whether or not that's part of the "higher functioning" part of the Spectrum or another separate disorder all it's own.

Okay, so the "functionality" thing. I understand that we all have "to classify things" in order to make sense of our existence and all of that sort of thing. But I find it difficult to apply the high/low functionality label to something that can be constantly in flux. Things can trigger all of us with psych/neuro disorders. I mean, what about "medium functioning?" I've never heard of that. I kind of think we all might be somewhere around there because half the time, no one knows just how they're going to be from one day to the next! And it can't just be based upon IQ, how we get around in the world, ability to hold jobs etc...is it really that simple? Because again, all of those things aren't necessarily static.

Am I over thinking this? Is the label whore getting tired of being labelled?

I would be considered "high functioning." But compared to what? I am gainfully employed. Okay, I get up every day and I go to work. I am intelligent? What else? Beyond that, there are cracks in my exterior. You may not see them but they are there. Luckily, I work in a very lax environment so I have the luxury of showing up in a baseball cap and jeans! That works very well when I don't feel like showering. Which happens frequently. I know, that sounds awful, doesn't it!? Feel free to gasp aloud. So how functional is that? Ooh...personal hygiene is suffering! Look out...that's a sign!

On the weekends, I spend a gross amount of time in bed (or on the couch.) Not sleeping because we all know how that situation is. No, I just need to rest and don't feel like doing much. My job isn't stressful but after a week of working I'm drained. Uh oh...maybe she's not so "high functioning...?"

I'm not really a social person. Well, I *can* be but I need some encouragement. Once I get into the groove I can do it but you generally have to get the cattle prod out (to get me off the couch, remember?) Did all that hypomanic euphoria (and subsequent disappearance thereof) permanently clip my social butterfly wings? I just don't have the energy anymore. Hmmm...the functionality meter is dipping...

What makes me social? Booze! If there's one thing that will give me a taste of the "good ol' days" it's a drink of anything alcoholic. But it's the Sword of Damocles, that's for sure--in a lot of ways. It's not good for my head, it's not good for my relationship...it's just not good at all. Well, it is but it has a price. So I try and keep that at a minimum. I have a long self-medication history so it's a slippery slope. Okay...so functionality's a coin-toss with this one. Just my cross to bear...

So in the end, I still don't know how "functional" I am. But I do know one thing. With Bipolar and pretty much all of the other disorders out there where triggers can make them worse, you can go from functioning quite well to being barely able to take care of yourself at all in no time flat. Been there, lived through it.

And speaking of functionality, I have to go back to work tomorrow. Vacation's over! I may be a bit absent from blogging as I am going to be swamped. But you never know...I might be able to fit it in. Depends how "high functioning" I am...