Outpatient Fail

All of our therapy is outpatient. We see our therapist in their office every two weeks. We talk. They push us to talk about the things we’re obviously avoiding. Mostly it works. Until it doesn’t.

That was this week. This week therapy turned to shit. Shit. Complete and utter shit.

I’ve written about our excellent ability to zone out before. It doesn’t tend to end well.

Often it happens during therapy sessions. We’ll be discussing something and become emotionally overwhelmed. Often I feel incredibly anxious, sometimes sad or scared, but whatever the emotion – very overwhelmed.

By this point the conversation will stall. My responses become slower, my voice quieter, and I say ‘I don’t know’ repeatedly. I’ve already stepped back from my body without actually choosing to. At this point there’s nothing anyone can do to help me become more responsive.

Usually I’ll be asked to move by whoever I’m with (psychologist, psychiatrist, nurse) and be unable to. My body is frozen, and although I can hear and feel (and see if my eyes are open) I can’t move. Eventually my head tips to the side, the weight of it seeming to drag it towards my shoulder. From there my body can slowly slide sideways, and if I’m in a chair, out of the chair and on to the floor.

This time wasn’t that different. It’s just that this time was the first time this therapist had to manage it outpatient. They’ve dealt with it repeatedly in an inpatient setting. That’s much less dramatic. They let the nursing staff know what’s going on so I can be monitored, but generally leave me alone to come out of that state at my own pace.

Outpatient though? It’s a downright disaster. I couldn’t be moved. My therapist had other clients to see, but had to reschedule at least two of them. Eventually they had no choice but to call an ambulance to take me to the local hospital emergency department.

That’s when it got worse. I was unfortunate enough to get two male paramedics. Ordinarily that wouldn’t bother me. In such a dissociated state they were terrifying. They were men. Men are bad. Men are not safe.

To make it worse they repeatedly inflicted pain to check my level of consciousness. They did this four times with minimal response from me. Meanwhile I could feel all the pain, but wasn’t able to properly respond. The most they got was a mild grimace, yet they continued. Being conscious, but unable to move or talk is not fun. Throw in pain being repeatedly inflicted and it’s terrifying.

After being released from the emergency department I went home, crawled into bed, and slept. The following day was time to face the music. One super brief phone call from my therapist later, and we’ve planned a hospital admission for August.

August. The month where I had multiple medical appointments. The month where I was finally going to get my pesky wisdom tooth (last one!) removed. Everything has to be rescheduled.

It feels like defeat. Complete and utter defeat.

I can’t safely manage outpatient therapy. I have two more appointments booked with my therapist, but I’m not sure if I’ll go. I’m scared after this week. Scared that I’ll zone out again.

I did have a few thing against me this week. I’d overdosed (wishful suicide attempt) the day before and had a huge hangover from the medication I’d taken. I was rejected for the NDIS for my physical health issues. An outreach worker told me they’d be moving on, and someone else would be taking over my care. Then throw in a trauma anniversary, and the unrelenting depression that’s been haunting me for a year. All of that, even on a good day, is a bad combination.

Trying to stay present with all of that going on is next to impossible. Add in an emotional conversation with my therapist, and I don’t think I had any chance.

Anyhow, hospital it is. Hospital because outpatient therapy is a fail. Again.

Advertisements

Sick and Tired

I needed a break from healthcare appointments. I cancelled all of my appointments. I was just so tired of talking about my health, my feelings, my thoughts.

The break lasted about one and half weeks. I got a letter in the mail form my optometrist. A reminder for my annual check up. No biggie. I made the appointment for the following day just to get it over with.

Then it turned to shit. The appointment wasn’t actually for a regular eye test. It was for new photos of my badly bulging optic nerves, and a peripheral vision test to check for vision loss.

This isn’t new to me. A couple of years ago they discovered the problem with my optic nerves. It was thoroughly investigated, and specialists eventually concluded that I had pseudopapilledema (sue-doe-pap-ill-ed-eema). They said, due to lack of symptoms, that it was nothing to be concerned about, but to get my eyes tested annually.

Jump forward to now. Two years after that diagnosis. My optic nerves are bulging more than they ever have. I’m to follow up with my GP who can do referrals for relevant tests, scans, and outpatient referrals.

I dread this. I suspect I know how this goes.

I see my lovely GP who has a little panic. Then it goes one of two ways. The first way she keeps her cool, and sends me off for any relevant blood tests or scans, and an outpatient referral to a specialist. The second way she completely panics, and sends me straight to the Eye & Ear hospital where I spend the rest of the day in their emergency department.

When I eventually see a specialist (whether inpatient or outpatient) they’re likely to explore the possibility of Idiopathic Intracranial Hypertension. Basically, increased pressure in my brain that pushes the optic nerve forward into my eye. That was the potential a couple of years ago, but they ruled it out due to lack of symptoms.

If I see a specialist about the pseudopapilledema they’re likely to tell me that I need to lose weight. I know I do. I’m 40kg above my healthy BMI. Yes, I know BMI isn’t a particularly accurate way to judge health, but it’s what the majority of doctors rely on. If it’s IIH, even if it’s not, they’re likely to recommend weight loss.

That’s fine. I understand how weight loss would help this, as well as all my other chronic conditions. It’s just that I also have an eating disorder, and every single weight loss attempt has ended in a severe relapse.

I’ve only just gotten back to eating a bit more, and a bit more regularly. Now though? Gone. Obliterated. No food for me because I’m causing, or worsening, my health issues, and it’s all my fault. That’s where my head has gone.

So weight loss to improve my health? Necessary, yes. Possible? I don’t now how. Physical health issues mean I can’t do anything even resembling exercise. Throw in all the mental health issues, especially the eating disorder, and I don’t know how I can lose weight, remain sane, and maintain the health I do have at the moment.

I’m sick and tired of being so sick and tired.

Cancelled

I’m free. No healthcare appointment for three weeks. By chance my next appointment with my psychiatrist is in three weeks, not the usual two. I cancelled the appointment I had with my GP today, and I’ve seen all my other specialists recently.

I’m just done. I’m so emotionally exhausted from talking about symptoms, treatments, response to treatments, managing medication side effects and withdrawals. Mostly the talking though.

I’m mostly housebound. I manage to leave the house for appointments, and that’s about it. I see family when there’s time for me to spend the night there and properly rest. I see friends most when they can visit me. Just getting to and from medical appointments all over Melbourne exhausts me.

I don’t drive because a) I don’t have a license b) I can’t afford to buy, or run a car and c) I wouldn’t be safe to drive a  car the majority of the time. That means relying on public transport. It’s pretty good in Melbourne. I can get to most places without too much trouble, but it does take a lot of energy. I’ve applied for funding for either a mobility scooter or power chair, but whether or not that happens is another matter.

I just need a break. Physically I need to rest and regain some energy. Emotionally I need a break from the near constant health talk. All of the healthcare appointments have meant talking to, and seeing friends even less. So the majority of the interactions I’ve had with people have been with healthcare providers about different aspects of my health.

I’m done. Just done. 100% done.

Waiting

Waiting for a phone call that hopefully won’t come.

Waiting for the next appointment with my GP (Monday).

Waiting to see my psychiatrist (Monday).

Waiting, and quietly wishing, that my electrolytes will end up out of whack, I’ll have a heart attack, and that I’ll just drop dead. Over. Gone.

My GP was blunt. Kind, caring, and supportive, but blunt. The ED is entirely out of control. Obs, blind weighing, bloods, and ECG to be done every week until I can increase my food and fluid intake.

I’d be falling over and fainting if I weren’t already on meds to increase my blood pressure. The call that hopefully won’t come is from my GP. An after hours call telling me that my blood work is badly off and I need to go to the local hospital emergency department. It’s happened once before, and hopefully never again.

I’m to use Recovery Record and log every single item I consume. I dread it. I don’t want a list of everything I’ve eaten and drunk in front of me. My GP is insistent. I think she’ll be woefully disappointed.

I don’t even feel like trying. I just want to curl up, fall asleep, and not wake up again. That’d be lucky though. My body, thus far, has been incredibly resilient, and I’m still alive despite nearly two decades of abuse in the form of eating disorder behaviours, self-harm, and overdoses.

 

Promises

I promised my GP that I wouldn’t cancel my appointment this week. That I’d come even if I were feeling terrible.

The promise was made as a safety plan of sorts. A couple of weeks ago I overdosed the night before my appointment with her, then used the app to cancel my appointment. I told her. I was honest.

So now I’m to show up this week without fail. There’s also the silent, un-discussed expectation that I won’t self-harm in any way. No cutting, no overdosing or misusing medication.

I’m holding on. Barely.

The eating disorder is screaming at me. ‘Don’t eat, don’t drink, don’t think, don’t feel’. The same negative mantra it’s screamed for half my life. It is getting the better of me. The eating disorder plans feel safe and familiar. I’m falling into the trap of thinking that if I just follow the rules well enough that everything will be okay.

I know following any kind of ED rules is the quickest way to end up in the local emergency department. Dehydration in combination with my medical conditions is a recipe for disaster.

I don’t see a way out right now though. Going with the eating disorder seems safe and comforting. At least it doesn’t involve binge eating and piling on even more weight. That’s what I’ve been doing for the last nine months. Binge eating so often that I’ve depleted all of my savings. I’m broke from this damn eating disorder. At least restricting is cheap. Plus I’ll lose weight. Winning all round, right?

I know I’m making poor choices. It sounds utterly ridiculous, even writing it all out. This is where I’m at though. Completely emotionally exhausted, overwhelmed, struggling, losing any remaining hope.