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.

Today Is Self Injury Awareness Day

Apolgies for not getting this up sooner--busy day.

Thanks to Deb for posting about this earlier in the week as I knew it was in March but had forgotten the exact date. I do this often. My memory is abysmal.

I know it's hard as there are so many "days" commemorating and promoting this and that. Sometimes with the proliferation of these things it tends to take away the meaning. But I think I will take the time to blog about this one and give it a bit of show.

Now although this day is not formally recognized and is still more of a "grass roots" effort, I found through this site that two states in the US have actually proclaimed it an "official" day: Connecticut and New Mexico. The site offers some form letters if you feel like advocating to your local legislature. Granted, it's all done up for MPs in the UK but it will give you a template. It also offers some literature about self injury that is written by LifeSIGNS, the UK charity that well, basically seems to be managing the site.

Now on a more personal note, if you do not already know this, I am a self injurer. I have been and am a cutter. Please see the link entitled Cutting on the right for previous posts if you are interested. I have also engaged in punching walls, head banging. I have done these as a child and an adult--except the cutting, that came later.

I have been debating about disclosing this for a while but since today seems to be all about awareness, then I suppose it seems an appropriate time. I engaged in a cutting about three weeks ago. It has been about two and a half years since I last cut myself. I'm not even sure why I did it. There were no obvious triggers that day. I'm still not sure.

I do know that my last year has been fraught with tremendous difficulty and it is very surprising that I haven't completely fallen over the edge in dealing with some of the things that have hit me. Perhaps some extremely minor trigger that didn't even register just tipped the balance? Again, I am not sure. I don't know if I ever will be.

Perhaps I just need to have a big Bipolar flip out ever two and a half years!

I mentioned this to my therapist and she (rather glibly in my mind) said, "Well, you can flip out here!" But that is not the point. When you reach that level of crisis, that critical mass in your brain, you can't wait for a therapy session. Especially if you don't even see the oncoming onslaught. I was dissociated. Absolutely. The last thing on my mind was calling up someone, anyone and talking. The only thing I wanted to do was hide away from my partner, use the knife and then quickly try and repair the damage I'd done and hide it all (which was impossible--I'd cut too deeply.) However, not enough to require medical attention as in the past.

So on goes the battle, I suppose. But just remember--be kind and gentle and patient with the self injurers you encounter out there. Don't be scared even if sometimes what we do can seem a little difficult to handle. Believe me, it's difficult for us too.

My Psych Hospitalizations: The Good, The Bad...And The Slightly Out Of Control? - Part I

When I had a psych consult earlier this week, one of the questions posed to me was, have my previous hospitalizations been helpful to me. On balance, I would say yes. I do advocate hospitalization whenever you are in crisis, absolute dire straits, suicidal or in danger of hurting yourself or anyone else.

I've been thinking of how to write about my hospitalization experiences for a long time now. I've had five, in total. I've thought over and over how to make it all cohesive and coherent but I'm not sure if I can. That might be okay as when you're inpatient, you may not be all that cohesive and coherent yourself.

So I think I'll just give it a go. Be forewarned, this will be long and will contain some rather...how can I describe it...intimate, graphic, ludicrous detail? However, this blog being what it is it should not surprise you.

Hospitalization #5: Cutting - Medically Helpful Yes, Psychiatrically Helpful No

I had self harmed for the second time and required stitches. I knew that this would result in me needing to be admitted to the psychiatric ward but there was no way around it. The cut was bad. And really, I was in pretty rough shape. In retrospect, I think I had been cycling all over the place and had pretty much reached a peak. I knew the drill since this was number five. I packed a bag with all of my essentials, called a cab and off I went.

Now I had not been hospitalized in several years. My how things had changed! I was stitched up in the ER by a decent enough doctor who was certainly not unsympathetic. She wasn't overly kind but at least she didn't treat me in any negative way. I was seen by the Head of Psychiatry early in the morning and he actually remembered me from previous stays. This was kind of impressive but I really didn't care. I just wanted to get out of the ER.

So there began my stay. I wasn't sure how long I would stay but it quickly became evident that it would be the minimum 72 hours. The nurses were locked behind some kind of fishbowl and were completely inattentive or rude. And I don't say this with any ill-tempered patient judgment. I love nurses! I wanted to be one! It is just plain fact. No one could get any sort of help if they needed it. You couldn't even ask a simple question. You were routinely ignored. This was not the psych wards of days gone past!

So I actually took it upon myself to assist patients in need. Oh it was sad. One poor soul couldn't even cut her food she was so distraught! She asked me to and I thought, well shit, half the time everyone's so damn depressed they don't want to eat, the least I can do is help the poor woman out!

I met a young-ish (slightly younger than me) man with Schizophrenia and we seemed to get along. He was terribly awkward and shy but he was somehow drawn to me and eventually we began to dialogue a bit. So one evening, we went and talked in my room (after I had stolen a bunch of scientific-type magazines to try and read from "the lounge.") We were promptly interruped by a nurse who told us that men and women weren't allowed in each others' rooms! What the...? We were just talking. What on earth did they think we were going to start doing? We departed to the "the lounge" where they told us we had to go but with everyone else congregating there and banging and clattering, he withdrew and no longer wanted to talk. Very helpful.

They did try to "stimulate" us with crafts and some type of art therapy. I was so bored out of my skull I thought I'd give it a try. And I was curious. I'd never done this while hospitalized as it was simply never offered. Well the crafts were a bloody joke. Something about making things called "happy boxes" or something with ridiculous cartoon quotes inside. I turned mine into something that looked like an acid trip/horror movie prop. I don't think the group leader was amused.

The art therapy was kind of interesting, however. We were asked to draw "how we felt at that moment." Then, if we could we were to try and explain the drawing to the class. Oh dear. I'm the sort of person that can't really draw a straight line with a ruler. Most people drew stick figures representing themselves. Not me. I came up with something that was actually kind of impressive. In a freakish sort of way. Rather abstract and morbid. I don't know if I impressed everyone or shocked them or a bit of both.

Anyway, after running around doing a whole lot of nothing, I decided to leave. My psychiatrist there was not willing to discuss any treatment options other than what he had already decided in his mind so I was out of there as soon as I could discharge myself.

Postscript: In reviewing this, I've decided that I will post each hospitalization separately as otherwise, this entire piece is going to be way too long for everyone to read.

My Psych Hospitalizations: The Good, The Bad And The Slightly Out Of Control? - Part IV

Hospitalization #2 Cutting - Medically Helpful Absolutely, Psychiatrically Helpful Toss Up

This cutting was very bad. It required surgery as I severed 3/4 or my median nerve in my wrist. All of the doctors were amazed that I did not hit any major arteries or veins. As a result, I was placed on a surgical ward and not on a psych ward. I did have a volunteer "minder" to watch me. I guess I must have been placed on some sort of "suicide watch?" I don't really know as I was so completely out of my mind on either Morphine, Demerol or both I didn't care. I do recall once that I did get up to use the bathroom and he started to follow me.

"Do you mind?"

"I'm supposed to keep an eye on you?"

"I have to go to the bathroom. Are you required to watch that too?"

Minder returned to his seat and awaited my return from the bathroom. Which was forthcoming and since I am still here he did a fine job of keeping me from killing myself.

This was a strange stay. I don't even recall speaking to a psychiatrist and I was never moved to a psych floor after the surgery was done and I had a few days of recovery time. Again, I was simply given the option to go home. Maybe a psychiatrist came to speak to me when I was all pumped up on the pain meds and I don't remember! HA! If so, I wonder what on earth I said! I do remember trying to talk on them and oh...I was making absolutely no sense at all. They just kept shooting me up and then gave me a self-administered unit... I don't even know if I needed that much medication but I wasn't going to say no to it. Not in that state of mind.

Probably the best part of that stay? The nurses! The nurses on that surgical floor were just the best. So kind and thoughtful. Always checking in on me and actually talking to me. They really made the stay so much better.

Thinking About Cutting

I've been thinking about cutting recently. Not really ruminating about it but it's been on my mind. I'll drift off, find myself staring into space and thoughts will meander to fantasies of reaching for some sharp implement--my preferences are for knives. Not at all good when someone in the house is a trained chef? We have far too many and one night, PA got a little out of hand and ripped the drawer right off the the cupboard grabbing at all of them.

Anyway, don't reach for the panic button or start calling Emergency Services. I'm okay. I just wanted to talk a bit about how this now seems to be(coming?) a more fundamental part of my Bipolar identity whereas before, I felt that suicidal ideation seemed to be more of the component that I might need to do battle with on a semi-regular basis.

When I first posted about cutting I questioned my status as a "reformed" cutter since I had only cut twice in my life. I have spoken with other cutters who self-harmed on regular bases and at times, since I did not, I felt like I didn't know what to say. I couldn't quite grasp the concept as I had not practised self-harm in the same way. I did not think that I was being biased within my own community, that is not me at all! Perhaps because I felt that I never would be able to be capable of cutting outside of my previous patterns, I couldn't identify with these other souls. I now feel differently. I now feel that I am capable.

Prior to this, suicide attempts and suicidal ideation were "my worst enemies." Once after a 72 hour hold in a psych ward I was asked if I wanted to go home after a suicide attempt--my worst. I did. The psychiatrist asked me if I was still suicidal. I told him that, yes, in fact I was but with a caveat. I explained to him that I would be suicidal all of my life. It was just something that I would have to learn how to deal with. I wasn't diagnosed Bipolar at the time or erudite enough (at that moment as I was still extremely depressed) to explain the complexities of dealing with the throes, the ups and downs, but I think he understood. Since I seemed to pose no danger to myself and they really couldn't keep me there any longer, I was free to go.

I don't know what keeps me from not cutting or trying to kill myself. Good supports, meds? Remembering some very key elements and conversations from the past and what I've been through? But the battle still ensues at times. Even though I would by relative, psychiatric terms be deemed "stable."

I know that there are very few things that you can control in life. One, your words and two, your actions? Not always can you control your thoughts. But that's okay. Sometimes you need to think about things to try and gain some clarity, even if they are not always so pleasant or are sometimes painful.

Cutting: When The Pain Just Can't Get Out

I was thinking about whether or not to put a trigger alert at the beginning of this post as it might be touchy but I could put a trigger alert on this entire blog. So, for what it's worth since some of this might be a bit alarming:

TRIGGER ALERT!

I am a cutter. Or a was a cutter. Have been a cutter. I am a reformed cutter? Once a cutter, always a cutter? Someone early on commented that I am a "label whore" because of all of my diagnoses and that made me laugh. So I guess, I'll simply add to that and say that yes, I am a cutter. I also say this because since I've done it in the past, I know that I am capable of doing it in the future. I think that will always make me a cutter.

Every cutter has a story, as I have learned. I can not speak for everyone so I will simply talk about my own experiences. Some people cut habitually, I on the other hand have only cut impulsively while in the throes of uncontrolled mixed state cycling.

Why? I guess during those moments, the utter pain, despair, frustration and hopelessness was so intense that words could not express what I felt. In a mixed state, you are simultaneously depressed but experiencing manic symptoms so you have the capability to act out violently. While the depression makes you feel so absolutely dead inside, the mania demands that you do something to make yourself feel alive. You cry out to the world to show your pain, to feel it so you reach for a knife and you damn well make it known.

The first time I cut myself I became an amatuer surgeon (albeit, a very bad one.) I severed three-quarters of the left median nerve in my wrist. All the doctors were amazed that I didn't hit any major arteries or veins. I was sent for surgery the next morning and they repaired it but not completely. I still have some numbness in my hand and fingers that will never return.

The second time, I more wrecklessly slashed my forearm deep into several layers of subcutaneous fatty tissue. No serious damage was done and I was stitched up in the ER.

Cutting is serious business. I absolutely loathe the taboo that surrounds it. Most frequently, it is attributed to people with Borderline Personality Disorder but believe me, people with BPD haven't cornered the market on self-injurious behaviour. I am living proof of that. And it works both ways--not all people with BPD harm themselves either.

Not long after the first cutting I spoke to my cousin who is an ER doc. She didn't know about it, just that I was hospitalized for psych reasons (even though I was kept on a surgical floor.) She immediately launched into a tirade about "cutters" and how she couldn't stand them as they were all a bunch of attention seekers, how they just wouldn't stay on their meds and how they never listened and on and on. I was deeply disturbed. I then told her casually the reason for my admission. Oh, she backpedalled hard but she couldn't redeem herself. I had always idolized her but now she really dropped from my esteem. We have since spoken and she seems a bit more sensitive to mentally ill patients. Perhaps she's had some training or grown up a little bit?

I won't argue that it can be difficult to help or treat someone who is a cutter (or who participates in other self-injurious behaviours.) It can be downright disturbing and painful in it's own right to witness it, perhaps even more so if it's habitual. But it doesn't mean that the person deserves less than adequate and/or sensitive care. For someone to get to that point, they are really, really hurting. I know. I never thought I'd find myself there but I did.